Speech Sound disorders (SSD) include disorders of the articulation, in which a child has difficulty physically producing one or more sounds, as well as phonological disorders. (Phonological process disorders), where sound errors of certain patterns are produced by child.
ASHA (2008) defined articulation disorder as problems producing specific age-expected speech-sounds. Articulation errors come in four varieties: substitution, omission, distortion and addition. Substituting a sound for another sound could be an example for articulation error (e.g. Bed for Red), or leave out few sounds (e.g. saying nana for banana where ‘ba’ sound if left). Distortion of ‘S’ sound or lisping can be another type of articulation disorder. Motor movements required to produce accurate sound is the underlying cause of an articulation disorder. but these troubles may be functional or organic (mechanism challenged in some way and/ or neurological damage).
Treatment for articulation disorders is based on a behavioral model. Techniques include rewarding successive approximations toward accurate production, modeling, imitation, and reinforcement. Phonetic placement cues can be additional strategy to establish a new sound (e.g., “Put your tongue tip behind your front teeth” to elicit a /d/ or /t/), mirror work (providing the opportunity for the child to see how the sound is produced), and labeling the sound with its descriptive name (e.g., “making the space sound” for /s/).
The process of dealing with the articulation therapy using traditional approach (Van Riper) which includes isolating the target sound that is difficult for the child to produce. For example, if the kid is having troubles with generating the ‘th’ sound, the SLP will begin with activities that isolate that particular sound. The toddler repeats the /th/, /th/, /th/ sound again and again once more until they meet a positive accuracy degree. Once reached, they’ll be guided to next degree of therapy.
The next level includes practicing a sound in syllable for example, focusing on the ‘s’ sound, adding the vowel would make the sounds ‘sa,’ ‘so,’ ‘si,’ ‘se.’ After this level is attained by the child, move into the word level for example targeting the /t/ sound in the initial position, we could deliver the kid phrases to copy such as ‘top,’ ‘tongue,’ ‘two,’ or ‘toe. The baby will exercise pronouncing the sounds in different phrases beginning, middle or end).
Once this level is mastered move into sentence level using the target sound. Stories and conversation are further steps to practice which can be used outside the therapy setting. This can be elicited by rotating specific topics or showing cards and having a conversation with the child. Generalization is the last step, once the child has mastered the sound(s) at the word to sentence to conversation levels they can move to generalization part. This step is to ensure that the child’s speech is clear and accurate across all areas. Some treatment strategies include; using a mirror for visual feedback of place and movement of articulators, gestural cueing for place or manner of production (e.g., using a long, sweeping hand gesture for fricatives vs. a short, “chopping” gesture for stops)
Provide tactile biological feedback using tools, devices or substances placed in the mouth (e.g., peanut butter, tongue depressants) to provide feedback on correct tongue placement and coordination.
