Monday, October 25, 2010

That nasty /r/ phoneme

Calling all pediatric SLPs!  This post is in regards to the bain of many SLPs' existences.  /R/.

My neighbors/friends asked if I would help them out. Their son is not saying his /r/'s correctly.  As you know, I work in the hospital with adults.  I am wanting to help them, but feeling like I might not be the best person for the job.  They are willing to try me anyway.

Their 12 year old has been in speech therapy for years.  He can produce /r/ correctly in structured tasks some/most of the time.  They do their speech homework. 

My questions to you are:
What are the cues you SLPs use to elicit the /r/?  (I know several of us use different cues.)
Do any of you take private clients at home, just informally?  Do I need to do any official paperwork??

Thanks guys!



  1. I have 2 tricks for /r/:
    1) Push out lips, keep them really stiff. This will work on the w/r error.
    2) Tell the kid about tongue placement--the sides of the tongue need to be pulled up & back by the upper rear molars. This works for the low tongue error for /r/, usually effective b/c it's very tactile.

    @lilmiracles has some fancy way of shaping from "sh" but I couldn't describe it.

    And you're very lucky this kid can say /r/ some of the time! If you're starting from zero, it can take many sessions to get /r/ in isolation!!

    Re private clients, they need a receipt of payment if going to submit, but I recommend it anyway just so there's no awkwardness of did they / didn't they pay. I would also recommend a rudimentary chart:
    -documented consent--either written, or you chart that they consented
    -a brief report, you can just do a 1/2 page w/ history & nonstructured assessment findings & goals.
    -attendance & brief progress note each time (2-3 lines)
    At least, that's the bare minimum in Canada. The US might be different!

  2. Research Pam Marshalla. She has the BEST techniques for /r/ therapy. I have some of her products and they are worth it! I went to a workshop and she is amazing. I have seen good results using her methiods for the hard to fix r, & lateral s. I follow her on twitter too..she is an amazing resource. @pammarshalla on twitter.

  3. Kristin, I would definitely have them sign a contract for services that has a part in it where you cannot be sued for services you did or did not render. We just wrote up our own.

    Also, do a case hx report, get information from current IEP if possible, and then do progress note for each time you do therapy. Even if you are not accepting money for it, you should still do these things to protect yourself. Even if they are your neighbors or family, it doesn't hurt to cover all your bases. Then you only need to report the income on your taxes if if is over like $500 I think. I can't remember the right number for sure.
    I like getting /r/ from /g/ and /k/. Good luck!

  4. Check out Speedy Speech for /r/. Very effective and highly recommended!

    Good Luck!