I am sorry I have not responded sooner! I must have missed your post. It surprises me that your daughter still has so many speech sound errors after 3 years of therapy. Does your SLP target one specific sound at a time? Does she utilize many methods in order to elicit the correct sound in isolation/syllables/single words during therapy sessions? Does she give you specific daily home practice? Do you observe the sessions?

How is your daughter doing in other areas of learning such as reading, spelling, math? How well does she understand language and express herself with language?

I hope you will write back!

Mary Lou

Hi Tammy,

I use the "cycles" approach, too, so I can certainly support that for a child who has multiple sounds to acquire. I share your concern that she should be doing a lot better after 3 years of focused therapy. Most of what you describe fits with a diagnosis of apraxia of speech (difficulty sequencing or blending sounds with others in words, difficulty placing her tongue as needed, having more difficulty in connected speech.) Does she mispronounce words that have multiple syllables such as saying, "busketti" for spaghetti? When you commented on her weak airflow for "sh", it made me wonder if she is having difficulty maintaining oral air pressure. Do a lot of her words sound hypernasal (like she is talking through her nose)? Or, does it ever sound like air is leaking out of her nose when she speaks? If yes, has her SLP ever commented on this? If she is hypernasal and has difficulty with pressure sounds like s, sh, f--are her k and g sounds good?--she could have a submucus cleft of the hard palate (not visible since it would be covered by skin) or have a short or poorly functioning soft palate. She could be retaining her backing productions to try to "close the port" at the back of her mouth to try to keep as much sound in her mouth as possible. This is all speculation, of course, but this would be worth ruling out. I am assuming that your daughter has good hearing. If it hasn't been checked, it should be.

Ask me some questions or fill me in on some more sound error types if you would like. Speech production improvement is my "thing" so I am very interested in your daughter's situation.

How wonderful that your daughter is excelling at school! What she say to you about her speech difficulties?

Mary Lou

Aileen and Mary Lou,

I have an appointment tomorrow with an ENT doctor to check her palate and tissue under her tongue. I will keep you posted.

Mary Lou,

The ENT doctor found no problems with her palates or frenulum. So we need to work harder with the articulation. Do you have any other ideas to help her make these sounds? You asked about her mispronouncing words for ex. for spaghetti she would say s(which is gargled) stop sometimes she can get the p stop and then getti. She will work really hard to get the sound but than will have a stop or break and then finish the word. She has more consistent blends in the end of the words but her s sounds are always gargled. Her SLP has not worked with her at all on the SH sound. We are both getting frustrated, I feel so bad for her because I see how hard she is working and how bad she wants to make those sounds correctly.

Thanks so much for your interest, it means the world to me. Tammy