Wednesday, August 19, 2009

Progress from word, phrase, to sentences

Client E: Practicing /S/ sentences

video
Client E, came in three times per week, total 10 sessions
Came in with lisp, and strong tongue thrust
causing a gap between her teeth.
She is practicing /s/ production in sentence
level. She is in her third week and re mediated
all target sounds, established and maintained correct tongue
rest position and swallow with all liquids and foods

ARTICULATION THERAPY WITH THE PALATOMETER SYSTEM

5-minute practice on
word and phrase level

Therapy session in action
with split-screen display.


Sunday, August 16, 2009

Denture Paste Use, and more Aug 2009 lesson

Denture Paste Use

I used denture grip paste to keep smartpalate in place with a child who had nubs for teeth. Don't use too much or too little denture paste, it can cause problems. If it falls out after 10 or 20 seconds, just put it back in the mouth and gently hold for another 10 seconds. Usually it take hold. The client can practice chasing dots with the "Tongue Coordination" game while the paste is setting up.

Children with tongue tied issues, should get it resolved first before working with the palatometer system. For others who have tongue tip weakness, You can also work on tongue tip coordination and strengthening for a week or two. This greatly supports therapy production.

Tongue Thrust
The palatometer system has proven to be helpful to remediate tongue thrust of all kinds within 5 + weeks, if seen minimally 10 sessions. If they have tongue thrust and sound errors, therapy time will vary and most likely take up to 20 sessions or so.

Getting placement of sounds is the easy part with the palatometer, getting it to carry over with clients who have apraxia is another matter. Neuro-typical clients do well with catching on to placement and generalizing new skills from word to phrase to sentence level. It still takes time to generalize to conversation.

Optimal Therapy schedule
The optimal therapy amount for success seems to be meeting three times per week for seven weeks, or 2 times per week for ten weeks.

For next summer intensive therapy session, try holding therapy 4 times per week over 5 weeks, this will be better, providing one more week for progress, than what we did this last summer which was 5 days per 4 weeks. Some clients that had multiple issues needed more time.

Hard of Hearing clients
Hard of hearing clients needed to work on more than just palacement, they have resonance issues, and voice issues.
Still work on placement first, then work on " forward focus" (forward airflow)- maybe using the vowel formant software, then work on oral/nasal resonance with the nasometer and visi- pitch for the prosody.

Voice Issues
One voice client improved his articulation and vocal quality with a variety of voice therapy such as Lee Silverman Voice Treatment for clean vocal fold adduction, Many Stemple voice exercises, breathing techniques, and talking through a straw (Titsa Method), which unloaded tension off their vocal folds, and direct digital manipulation of the voice box to increase relaxation around his throat.