Volume 37 Number 1 pp. 69-96 2011 Review Article Horns, whistles, bite blocks, and straws: A review of tools/objects used in articulation therapy by van Riper and other traditional therapists Pam Marshalla (Marshalla Speech and Language) Follow this and additional works at: https://ijom.iaom.com/journal The journal in which this article appears is hosted on Digital Commons, an Elsevier platform. Suggested Citation Marshalla, P. (2011). Horns, whistles, bite blocks, and straws: A review of tools/objects used in articulation therapy by van Riper and other traditional therapists. International Journal of Orofacial Myology, 37(1), 69-96. DOI: https://doi.org/10.52010/ijom.2011.37.1.6 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. The views expressed in this article are those of the authors and do not necessarily reflect the policies or positions of the International Association of Orofacial Myology (IAOM). Identification of specific oducts,pr programs, or equipment does not constitute or imply endorsement by the authors or the IAOM. International Journal of Orofacial Myology 2011, V37 HORNS, WHISTLES, BITE BLOCKS, AND STRAWS: A REVIEW OF TOOLS/OBJECTS USED IN ARTICULATION THERAPY BY VAN RIPER AND OTHER TRADITIONAL THERAPISTS PAM MARSHALLA, MA, CCC-SLP ABSTRACT The use of tools and other objects in articulation therapy has been bundled into new groups of activities called “nonspeech oral motor exercises” (NSOME) and ‘nonspeech oral motor treatments’ (NSOMT) by some authors. The purveyors of these new terms suggest that there is no proof that such objects aid speech learning, and they have cautioned students and professionals about their use. Speech-language pathologists are trying to reconcile these cautions with basic Van Riper type therapy routines. The purpose of this literature review was to summarize the ways in which tools/objects were used by Van Riper and other speech professionals between 1939 and 1968. Fourteen textbooks were selected for review. Van Riper and other developers of traditional articulation therapy regularly used a wide variety of tools/objects in articulation therapy. Tools/objects were used when other auditory, linguistic, and cognitive means failed to stimulate correct phoneme productions. To call these activities “non- speech” methods seems to misrepresent the historic purpose objects have served in articulation therapy. More empirical research is required in this area. Key Words: Articulation therapy, phonetic placement method, oral motor techniques, nonspeech oral motor exercise, nonspeech oral motor treatment, oral sensory-motor techniques, traditional articulation therapy, motokinesthetic method, orofacial myofunctional disorders, oromotor, speech tools, horns, whistles, bite blocks, straws, tongue depressors. BACKGROUND Some speech-language pathologists (SLPs) that employ these types of tools have been have cautioned against the use of objects bundled into categories called nonspeech such as horns, whistles, bite blocks, and oral motor exercises (NSOME; Lof & straws in articulation training (Bowen, 2005; Watson, 2008) and nonspeech oral motor Lof, 2008; Lof & Watson, 2008; Powell, treatments (NSOMT; Lass & Pannbacker, 2008; Forest & Iuzzini, 2008; Muttiah, 2008). Employing the term “nonspeech” Georges, & Brackenbury, 2011). Activities suggests that using an object in articulation This paper is an abridged version of an original paper by Pam Marshalla from “Horns, Whistles, Bite Blocks, And Straws: A Review Of Tools/Objects Used In Articulation Therapy By Van Riper And Other Traditional Therapists ”. The unabridged version will be published on the Oral Motor Institute website: www.omi.com t 69 International Journal of Orofacial Myology 2011, V37 therapy is unrelated to classic processes of main architect of traditional articulation speech correction and therefore should be therapy. The final year,1968, was selected avoided. One writer even stated that it would as the year that the first principal works be a progressive step if these types of about phonological concepts entered the activities were condemned (Bowen, 2005). English literature (Chomsky & Halle, 1968; Some arguments against the use of objects Jacobson, 1968). Phonological theory in speech treatment have been: facilitated a radical shift in the way speech- language pathologists analyze and treat (1) There is insufficient evidence to speech impairment. support the use of objects in articulation therapy. Ten textbooks were selected for review (Appendix A). These books were chosen (2) There has been no demonstrable because they met the following criteria: relationship between so-called (1) They were used to train students “nonspeech” activity and speech. studying the assessment and treatment of speech disorders. (3) Articulation improvement cannot be gained if therapists focus on the (2) They were published between 1939 individual parts of phoneme and 1968. productions instead of whole (3) Their titles contained the words phonemes or syllables. speech, speech therapy, speech correction, speech disorders, (4) Speech-language pathologists may articulation, articulation therapy, or be using objects indiscriminately in articulation disorders. articulation therapy. Three other books published before 1939, Despite objections such as these, Lof and and one from 1955, were added to this Watson (2008) also demonstrated that the group because Van Riper consistently use of NSOME seems to be widespread in recommended them as resources for North America. additional methods (Appendix B). Therefore, a total of fourteen textbooks were reviewed. The central questions to be answered in this Altogether fifteen speech professionals paper are: authored these texts. Four of the writers served as Presidents of the American How did Van Riper and other Speech-Language-Hearing Association architects of traditional articulation (ASHA), and six received ASHA’s therapy use objects in articulation prestigious Honors of the Association therapy? (Appendix C). Van Riper wrote four of the books under review. What was their rationale for using Once the review of these fourteen books objects in articulation therapy? was completed, three of Van Riper’s later texts (Van Riper, 1978; Van Riper & What types of objects did they use? Erickson, 1984, 1996) were surveyed for comparison to the earlier volumes used in For what purpose did they use the review. One letter Van Riper wrote in these objects? 1993 also was reviewed for comments he made about his early work in articulation therapy (Secord, et al, 2007, p. viii). METHODS Each text was read, and findings were recorded on worksheets designed especially Textbooks published between 1939 and for this purpose (Appendix D). Each object 1968 were reviewed. 1939 was the year Van named as a tool to teach the movements or Riper published his first textbook (Van Riper, positions of phoneme production was added 1939), and he is widely considered to be the to the list. The page on which the object appeared was noted and its purposes were 70 International Journal of Orofacial Myology 2011, V37 described. Objects also were classified “Fraenum Fork” was designed to teach the according to the following types: Animal tongue to groove for the sibilants. The “S- product (A), Body part (B), Cold object (C), Concentrator” was designed to teach a Eating utensil (E), Food (F), Glass object smaller and tighter groove at the tongue-tip (G), Heated object (H), Liquid (L), Metal (a more “concentrated” groove). The object (M), Musical instrument (MI), Paper “Ruvinator” was designed to push the object (P), Plant-based object (PB), Rubber tongue into a high back position for the object (R), Toy (T), Wooden object (W), lingua-velar phonemes. Van Riper referred Other specified object (OS), and Other non- to all of these objects as “curious wire specified object (ONS). contrivances.” Other unfamiliar items also will be found in RESULTS Appendix E. The “Velar Hook” was a tool made out of “a rubber pen holder” A total of 86 different objects, or types of (Scripture, 1912, pp. 153-155). The object objects, were mentioned in the fourteen was placed in the mouth and hooked onto textbooks reviewed (Appendix E). Careful the back of the velum. The instructor then scrutiny of Appendix E reveals that many of used the tool to exert slight forward pressure these objects were regular household items against the soft palate. The client worked to such as spoons, toothpicks, lollipops, lift his soft palate up and back against this mirrors, tissue paper, and ping-pong balls. resistance to close off the nasal port. Several items were common Froeschels (1948) named three other medical/laboratory items such as nasal unusual objects: “Kerr’s Modeling bulbs, pipettes, and tongue depressors. Compound,” “Stents Wax,” and “Stents Some items appear to be alternate names Plate.” These products are used today for for the same object. For example, the making dental impressions and models, but following terms were found: “applicator,” the purposes for using them in articulation “applicator stick,” “thin applicator,” “wooden therapy were not described in Froeschels’ applicator,” “stick,” “thin stick,” “thick stick,” text. “rounded stick,” and “tongue depressor.” It is possible that all of these were terms for the Appendix E also reveals that the hands and tongue depressor, but the texts did not make fingers were considered “objects” in this that clear so these objects were listed review. Manipulation of oral structures