A Hot Tip for Successful “R” Therapy

If you work with children who have a distorted /r/, the following may be the most valuable and critically important strategy you’ll ever use. 

 

To know where we’re going, let’s take an in-depth look at our destination.  Let’s think about—and feel—the /r/ placement together.

 

Close your eyes, and say /r/ out loud; sustain. Pay careful attention to the bilateral elevation of the back-sides of your tongue. Do you feel your back-tongue “corners” touching the area behind your back, top teeth? It’s the same place you contact for /k/, /g/ and /ng/.

 

This significant mouth-part behind the top, back teeth is called your “retromolar pads.” 

 

These pads are the primary points of destination for the sides of the back-tongue.  This tongue-to-pads contact not only provides the go-to placement for the tongue, but stabilizes the tongue during the entire /r/ production. Do keep in mind,

 

Co-articulated speech requires small oral movements. And

to generate refined small movements, you must stabilize your tongue near the moving part.

 

The /r/ requires a solid stabilized bilateral footing. 

 

The child needs to learn to get there quickly and consistently, during both types of r-contouring (The Back-Up /r/ and The Retroflex /r/), and eventually, across ALL CONTEXTS.

 

So how do you get your r-child to find the tongue-to-pads placement?

 

Answer: With a Dental Floss Holder (DFH); this tool is amazing.  It’s an SLPs best friend when working with /r/.

 

Flossaid Dental Floss Handle

 

(Suggested resource, Amazon.com; the Flossaid Dental Floss Holder (DFH) can be purchased individually, or in packs of 3, 4, or 18. The price ranges from $5 each to around $2 each, depending on how many you buy.)

 

I suggest that each child has his/her own, and is only used during therapy sessions. If it goes home, it rarely comes back. Place each child’s DFH in a baggy along with a sticky note with his/her name on it. Poke a few holes in the baggy for ventilation.

 

Every therapy session, with the tongs of the DFH, palate the back-tongue corners then the retromolar pads and ask the child to MATCH the two, i.e. elevate the back-tongue and touch the sides to the pads. At first, palpate for them. Eventually, each child will be able to palate his/her own tongue-pad placement.

 

Say to the child: “A good /r/ is made with the back of the tongue anchored to the pads behind your top, back teeth; like this.” Show him/her your back-tongue and retromolar pads. 

 

Then palpate the child’s. The DFH tongs point down when palpating the back-tongue corners, and the DFH tongs point up when palpating the top pads.  

 

It can be helpful if the child closes his/her eyes to heighten intra-oral tactile perception.  Encourage them to turn their thoughts intra-orally, “Send a spy down to your tongue and focus, place, and feel your tongue-sides on the top pads.” Looking in a mirror is fine, but can be distracting for some children.

 

You may wish to spray some flavored spray on the tongs to increase sensory awareness and enjoyment. (Amazon.com; “Too Tarts Spray Candy”)

 

If your school district has intra-oral tool regulations, find out what they are and the rationale for them. See if they would allow you to get special parent/caregiver approval.  Oral tools provide oral sensory assists to localize mouth-parts, just as a mirror provides a visual sensory assist. Tools are a helpful part of therapy.

 

Do keep in mind: Pad placement palpation is not “fancy sound-stim.” It’s not touch the pads and voila, a good /r/.  But it sure is helpful. 

 

It’s the most important piece in the formation of the /r/.  In fact, it’s one of three components of the /r/ production (in addition to respiration and phonation):

 

  1. Placement - on the retromolar pads

  2. Lingual Tension – sustained during the production, (/r/ requires the greatest amount of lingual tension of any consonant sound), and

  3. A Resonance Chamber – the formation of either a pharyngeal resonance space (for The Back-up /r/), or, an oral space (for The Retroflex /r/)

 

If you want more on /r/, check out Char's courses:

 

"R" Solutions: From Capability to Carryover

"R" Remediation Therapy

Complete "R" Remediation Therapy

 

Also be sure to check out her website, CharBoshart.com for Part 2 and 3, for info and answers on the importance of and how to generate tongue tension and the resonance chamber for /r/.

 

Have fun!

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