1 The Entire World Presentation Overview of Sibilants™ • Targeted for intermediate level of knowledge. However, encompass entry- level to experienced clinicians. • Review S & Z first, then SH & CH, J, ZH. • Evaluation procedure. Christine Ristuccia, M.S. CCC-SLP • Specific treatment strategies. www.sayitright.org • Case study examples. ©2007 Say It Right ©2007 Say It Right Course Objectives What is a Sibilant • Know how to evaluate and treat the various word positions of the sibilant sounds:[s, z, ch, sh, sh, j, and zh]. A consonant characterized • Know how to use co-articulation to elicit correct tongue positioning. by a hissing sound. • Be able to write measurable and objective IEP goals. • Be able to identify 3 elicitation techniques S, Z,Z, SH, ZH, CH, and J • Identify natural tongue positioning for /t/, /n/, /l/ and /d/. • Know difference between frontal and lateral lisp disorders. ©2007 Say It Right ©2007 Say It Right Facts About /s/ & /z/ Facts About [s] & [z] • Cognates. Have same manner and [s] spellings S as in soup production with the exception of C as in city voicing. Sc as in science X as in box • Airflow restricted or released by tongue causes production and common “hissing” sound. [z] spellings s as in pans x as in xylophone • Different spellings, same production. z as in zoo ©2007 Say It Right ©2007 Say It Right Say It Right™ • 888—811-0759 • [email protected] • www.sayitright.org ©2007 Say It Right™ All rights reserved. 2 Two Types of Lisp Frontal Lisp Disorders • Most common Frontal Lateral • Also called interdental lisp • Trademark sound - /th/ • Cause: Tongue is protruding too far forward. May actually be visible during speech. • Goal: To bring tongue tip back ©2007 Say It Right ©2007 Say It Right Lateral Lisp Possible Causes of a Lisp Disorder • Less visible, more audible problem. • Thumb sucking • Caused by tongue in wrong location (too low) allowing air to escape • Tongue thrust (primarily from sides of the mouth). • Dental (front teeth missing) • Sound produced is often “wet” or spitty. Sometimes called a “slushy S.” • Cleft palate issues • Goal: Focus air stream out front of the mouth. ©2007 Say It Right ©2007 Say It Right EW S & Z Approach to Categories of /s/ & /z/ Lisp Disorders • Evaluation and treatment for • Initial, medial and final /s/ and /z/ frontal and lateral lisps are similar. • Correct production of both frontal • Initial /s/ clusters and lateral lisps disorders in the alveolar ridge region/behind • Final /s/ clusters bottom front teeth. • Use student’s strengths to elicit misproduced phonemes. ©2007 Say It Right ©2007 Say It Right Say It Right™ • 888—811-0759 • [email protected] • www.sayitright.org ©2007 Say It Right™ All rights reserved. 3 Initial /s/ Blends Final /s/ Blend Clusters • sp (spin) • sm (small) • -fs (coughs) •-ks(makes) • shr (shrimp) •sk(skate) • -sts (forests) •-sk(mask) • st (stump) •sw(swing) •-ps(cups) •-sks(asks) • str (string) •sl(slim) • -sps (wasps) •-st(fast) •sn(snail) ©2007 Say It Right ©2007 Say It Right Start With a Comprehensive Evaluation •Evaluate ALL /s/ and /z/’s in ALL positions to attain a comprehensive understanding of student’s ability. • Establish frontal or lateral lisp disorder. • Establish natural tongue positioning for /t/. ©2007 Say It Right ©2007 Say It Right Choosing a Target Why establish natural tongue positioning for /t/? • Check stimulablity for /t/ and /ts/ • Because /t/ and /s/ have the final word productions. exact tongue placement. • Find natural tongue positioning. • You are using the student’s success to elicit incorrect or improper tongue placements. • To practice student’s natural tongue positioning. ©2007 Say It Right ©2007 Say It Right Say It Right™ • 888—811-0759 • [email protected] • www.sayitright.org ©2007 Say It Right™ All rights reserved. 4 Where do you Why not just refer to produce /t/? /s/ as /s/? • Goal: To set student up for • At the Alveolar ridge? success by using phonemes with similar production as /s/ or /z/. • Behind the bottom front teeth? • Student often goes back to “old” sound production. • Want to establish a new sound pattern. ©2007 Say It Right ©2007 Say It Right Tenets for /s/ and /z/ Plan Remediation Approach • Treat frontal and lateral lisp • Base intervention on target selected. disorders in a similar manner. • Focus on one target at a time • Consistently focus only on target until until corrected. corrected. • Use elicitation techniques to • Choose appropriate elicitation establish tongue positioning. strategies matched to target selection. • Choose new target at 80% accuracy at sentence level. • Use phonetically consistent probe lists. ©2007 Say It Right ©2007 Say It Right Why focus on one sound Begin Remediation and word position at a time? Isolation • Enhances motor planning. Single words • Provides consistent practice & repetition. Phrases • Ensures students know their goal. Sentences • Allows productions of other /r/ word combinations not yet targeted to Reading/Structured Conversation begin to generalize. Conversational Speech ©2007 Say It Right ©2007 Say It Right Say It Right™ • 888—811-0759 • [email protected] • www.sayitright.org ©2007 Say It Right™ All rights reserved. 5 Cues to use with /t/ Auditory, Tactile and and /ts/ final words Visual • Sharp not slushy sound. • Incorporate a multi-modality approach to learning. Involve as • Feel difference of tongue many senses as possible. placement. • E.g. snake sound • Slide finger down arm while color or trace a large “s” producing phonemes. use snake cue –wavy motion ©2007 Say It Right ©2007 Say It Right Choices of Elicitation Big /s/ Techniques •Exploded /t/ • /ts/ final words, phrases and Sentences • Straw to demonstrate placement. • Elicitation Techniques • Alveolar target exercises ©2007 Say It Right ©2007 Say It Right /ts/ Final Single Words /ts/ Final Phrases ©2007 Say It Right ©2007 Say It Right Say It Right™ • 888—811-0759 • [email protected] • www.sayitright.org ©2007 Say It Right™ All rights reserved. 6 Final /ts/ Final /ts/ Sentences Sentences Bill wants the kites. Tom Bates bought new pants. Garrett’s new darts are next to the weights. ©2007 Say It Right ©2007 Say It Right /ts/ Final Stories Shaping an /s/ from a Robert’s dad coached the little league team, the phoneme combination Mets. The Mets needed new • Show the student screening equipment. They bought a results to educate student about few bats and nine mitts. The batter tried out the the /s/ & /z/ variations she can new bats and the catcher say. tried out the new mitts. Robert’s dad called out, • Use results of screening to “Now we’re ready.” “Let’s determine appropriate elicitation play ball and get lots of hits!” techniques. ©2007 Say It Right “Let’s go Mets!!” ©2007 Say It Right /t/ Final Sentences + Elicitation Techniques /s/ Initial words • Sibilants are produced at the alveolar ridge region (behind the • Example: Cleo, the cat said meow. lower front teeth) as are other consonants - /l/, /n/, /d/. • Coarticulation used to stimulate medial /s/. • Use the other consonants to facilitate production. • If successful (80%) correct • E.g. Tan silo pens productions, try medial /s/ words (e.g lasso). Feel sad reads ©2007 Say It Right ©2007 Say It Right Say It Right™ • 888—811-0759 • [email protected] • www.sayitright.org ©2007 Say It Right™ All rights reserved. 7 /l/ Final +/s/ Initial = /n/ final + /s/ Initial = /s/ Medial Words /s/ Medial Words Darren will sail today. Tan silo. ©2007 Say It Right ©2007 Say It Right /ls/ Sentence with /s/ When to move onto next Initial in Isolation sound/word Position I feel sad today. Æ sad today • Once a word position for target /s/ is mastered (criterion is 80% for 5 Darren will sail Monday. consecutive sessions at sentence level), Æ sail Monday re-administer screening to assist in choosing the next target. If successful (80%) accurate, try • Re-administer advanced screening to initial /s/ words (e.g. sun). choose next intervention target. ©2007 Say It Right ©2007 Say It Right Case Study: Sally •Sally cannot produce any • Sally Morris is a 7 year-old second /s/’s correctly. grader at Seaford Avenue Elementary School. •The SLP determines • She is referred due to not being able to that she has a pronounce her /s/’s. Frontal Lisp • The sibilants each have voiced cognates. Disorder. Each sound has a twin, with the only difference being one sound is voiced (vocal cords vibrate) while the other is voiceless. ©2007 Say It Right ©2007 Say It Right Say It Right™ • 888—811-0759 • [email protected] • www.sayitright.org ©2007 Say It Right™ All rights reserved. 8 Sally’s Remediation /s/ Blends and Final Strategy: /s/ Clusters • Teach “exploded /t/.” •Initial Blends: /sp/, /str/, /sl/, etc. • Practice /ts/ final words. • Alveolar target exercises– /ns/, /ls/. • Final Clusters: /sk/, /sp/, /sks/,etc. • /s/ in initial, medial, final word positions. • Treat as necessary to correct specific articulation disorders. • Initial blends and final clusters. ©2007 Say It Right ©2007 Say It Right Final /st/ Exercise ©2007 Say It Right ©2007 Say It Right When to move onto /z/ Voiced Consonant Rule When all word positions • In English when and clusters for /s/ are there is a voiced 80% or greater at the consonant preceding the sentence level final “s” the /s/ is pronounced as a /z/. ©2007 Say It Right ©2007 Say It Right Say It Right™ • 888—811-0759 • [email protected] • www.sayitright.org ©2007 Say It Right™ All rights reserved. 9 Voiced Consonant Contextual Pronunciation Rule use use As a diffuse As a verb diffuse noun or device it’s [z]: devise spouse espouse adjective misuse misuse it’s [s]: house house advice advise abuse abuse excuse excuse close close ©2007 Say It Right ©2007 Say It Right Plural Endings Voice Ending Rule Sometimes the /z/ is devoiced after remediating /s/ ©2007 Say It Right ©2007 Say It Right Cognates /s/ and /z/ Tenets of /s/ and /z/ Approach • Focus on one target at a time until it is voiced (bus) corrected.