Practice Sample Video

If a picture says a thousand words then what does this clip tell you. Notice how the child practices so well looking at the display, the child wants to make the computer light up. Great natural motivator for great practice.

Teaching K to a preschooler age 4

Learning back sounds for a child can be hard, but teaching back sounds can be just as hard when you can't see what the tongue is doing back there, The palatometer display will show you and the child exactly where the tongue contact is.

In this first clip, notice that the child's tongue tip is touching the front and not in the back like it should in the word chicken.

In this second clip, the same child is trying to not touch the front part of his mouth but by saying it too far back. Notice there is no display (dots lighting up) contact because the child is saying the /k/ too far back in the glottal area. This is often a common error on the therapist part to keep this incorrect placement going without realizing it because it's so exciting to get a resembling /k/.

In this third clip, you and the child will see the back contact forming, like it should. It's not perfect yet but it's where it needs to be.

in this fourth clip, you and the child will see the contact for both /k/ words, bike and key.

this is a good facilitative technique to pair words when they have same tongue contact in both words but are in different locations in words; e.g. final vs initial position of words.

Newsworthy Item

Hot off the press, CompleteSpeech is hosting a pilot program for PARENTS to get rental palatometer systems to use at home. This will allow parents to see more progress with their children as they will be able to monitor daily home practice.

This shouldn't take the place of seeing a certified speech therapist as they are the only ones qualified to evaluate your child's speech completely and accurately. They will guide you with what needs to be worked on and how to work through the speech issues.

If you are interested in this home program, leave a comment at https://www.completespeech.com/ they will love to hear your thoughts on this.

new video clips from summer therapy

Client A, age 11, with unknown syndrome (to be determined) has articulation, prosody, multiple syllable and formulating complete sentences issues.

She was a hard worker, had good attention, pleasant, and very stimulable for remediation with visual prompts and displays. She made steady progress each week. She will continue with speech therapy with the palatomer technology but with less intensity during the school year.

This is a good reminder that children with more than just a simple articulation issues will require more time with therapy.

Research has shown that with every layer of concern: cognition, attention, motivation, sensory- hearing, oral defensiveness, severity of the problem, and multiple problems will affect their longterm prognosis. It not to say they won't make progress, they will, parents need to be more patient with the curve of their progress.

Informal gathering of data has been showing that articulation therapy with visual display using the palatometer has allowed almost all the clients to make faster progress (better curve) than traditional therapy in a shorter amount of time. (More research needs to be done of course)

Client A was working on her /r/ words in this clip.

Summer Therapy Short notes

The first week of Summer speech therapy started out so smooth this year.

1. Thanks to another certified therapist getting on board and hiring 5 graduate students and 4 senior volunteers. (hint for professional- this is the way to go!)

2. Also, I was able to evaluate the clients early except one this year. That also made a big difference.

3. During the oral motor check make sure and watch out for jaw movement, lip tensing,

coordination problems and kids grinding their teeth. (this may pose problems on the mouthpiece sensors working properly.

The second week

1. More kids have broken sensors this summer than last, watch out for kids that grind their teeth. Add this question on your oral motor check. If this is the case, let the parents know this may be a problem with grinding through sensors on the smartpalate. They should see a dentist to resolve this, or at least therapist need to have the clients take the mouthpiece out more often, after saying several words, so they don't chew on it between words.

2. We also learned to not put too much denture adhesive on the mouthpiece. More isn't better, in this case, less is better, but you need little dots on four areas, front, back, and sides by the molar area. If this doesn't work well, try cutting small pieces of denture grip tape and put on the four spots.

The third week.

1. For better /r/ resonance, have the client look at the display and have them put their tongue near the last molars, keep the tongue there and have them push air over their tongue when they say their /r/ words. This improved resonance and /r/ production. Many clients have been saying /r/s too tight in the back of their throat, sounding like a growl, while others have their contact patterns to forward opposite of the correct contact pattern shape, weak /r/, deroticized. NOT everyone will have the same /r/ contact pattern, but generally the /r/ contact pattern looks most like the sound "ee" "oo" and "y in yeah"'

2. Another thing we learned was that some clients produced words in a harsh choppy fashion, so if we modeled the words in a smooth " sing song" fashion. then they produced the words more smoothly. I reminded them to let their tongue do the work not their head, neck or upper torso.

3. There is a progression of /r/ development. some progress from "re, r, r-blends, gr, kr, to front r blends; fr, br, pr, to complex /r/ blends; str, through all vocalic /r/ words." While others need to learn to adjust their tongue from either too forward, or too far back to the right placement by the second to the last molar, palatal area. Then after they can adjust their tongue, they need to slow their their words as they go from clear vowels to schwar /er/. In most cases clients didn't realize their were two sounds they were transitioning into. they thought it was just a /r/ word, which often was produced in a flat way.

The Fourth Week

1. We learned it's typical for clients to have intermittent high moments and frustrating moments. Everyone should be aware this is a natural process with most therapy, so no different using palatometer system. However, the best thing about using the palatometer visual display is that clients seem to "understand" better why it takes so much practice to accurately "train" new motor movements. They "see" the benefit of how "they" make the small positive changes happen.

2. Another thing that worked well with clients was to rotate through different sound groups.

Even if they have one sound to perfect, i.e. the/r/ sound, move through consonant /r/, vocalic /r/ and r blends. just to give a break from over working one area too long. Also alternate easy target words with difficult words so they can see, feel and hear their success. Success breeds more success.

3. All clients are making steady progress. It's a beautiful thing! Those working on correct /r, er/ are now able to say them in sentences with and without the smartpalate. As they advance, record them talking for 1-2 minutes, then let them pick out target words that they might need to work on as well as target words they did well on. Be sure and work on "natural" sounding phrases with accurate prosody. Many clients will focus so hard on producing accurate sounds that their speech becomes a little robotic if you don't add natural prosody into their practice.

The fifth Week.

Wow, It's hard to believe five weeks went by so quickly.

I got some great comments from my hired graduate students and volunteers. Here are their comments:

They found that the palatometer technology provided great visual displays where they noticed that clients made quicker progress with their speech and most "traditional" therapy techniques.

Client's understood where to put their tongue for correct placement

Client's worked better because they had on-line visual feedback.

Generalizing went will with most clients if they did their homework.

Parents and clients commented that they were impressed with the progress.

but many were worried that they will lose their "correct" speech patterns. Research has shown that even after a year, clients kept their accurate speech.

INTENSIVE SUMMER SPEECH THERAPY HIGHLIGHT CLIPS

STAY TUNED; MORE TO COME

Client H, age 7.6 Third day of summer speech program.

Graduate Clinician helping with his practice.

It's typical to provide more prompts to "look" at

the monitor for young children.

This client has articulation and nasality issues but the visual tools helped him to produce his sounds more forward as he still worked on correcting "R" words. The vowel formant visualizer tool allowed him to see if he moved his vowel to the 'ER" position, while the palatometer tool allowed him to see his tongue contact for the "ER" or "R" position. It may seem confusing at first glance but we would point and look at only one thing at a time. It was nice to have them side by side as I was able to see that both displays confirmed the production accurately. It appeared that the palatometer visual display was easier for the child to understand and control.

Typical R practice using the Palatometer Technology

This is only the fourth session for client M-3, female, age 9.4

Client is reviewing new unpracticed R words

Still the fourth session for client M-3, female, age 9.4

Client is practicing her correct /r/ words with a harder /r/ word

"reach" and "bear" Look how well she tries to get her

/r/ placement/sound on her own.

One Benefit of Learning Correct Swallow

A high school client told me today that he realized that after he learned how to do a correct swallow he was able to swallow "pills" for the first time. He said it was kind of bad, that he could only take liquid form or his mom would crush pills and put it in yogurt. He feels more grown up now that he can actually "swallow" pills the right way. He said he use to choke and gag on pills or they'd come out of his mouth.

Technique to increase self-monitoring skills

Many children with articulation problems have an underdeveloped auditory feedback mechanism thus it makes it hard for them to "hear" the difference in their speech to know correct from incorrect (distortions).

The palatometer provides another modality "the visual" modality to facilitate the underdeveloped self-monitoring process.

Here is a simple technique.

1. Record the child or adult saying a word three times in a row. Save the recording.

2. Play back the recording and have the client listen to each word again and judge each word by putting a mark on a written visual acoustic arrow as to how close to the correct target they were or how far from the correct target sound they were.

3, Then go back find the worst sound display and click through the visual display/target sound to see what went on, do the same clicking process of the display with the correct target sound.

4. Let the child tell you what happened. One mother said "I really don't believe HE can hear the difference" and the child said, " I sound the same as all the other kids not in speech." After going through the visual check of each sound, he said "I didn't get to a correct /s/ placement and it went into a different position which was incorrect placement for 3 msec., while the other good /s was held in the correct placement for 4 msec." He liked to use numbers. Wow, he was totally accurate with the description after visually seeing the difference once. After this process, he self-corrected incorrect /s/ words two times in a row in his connected speech. His mom just smiled big at him and he smiled back. He realized he made the correct adjustment and carryover from what he had just learned.

A video display of this techniques is coming soon.

correct Swallow palatogram video

One of the major goals for correcting tongue thrust is to

establish and maintain correct swallow with liquids and foods.

Here is a new demonstration video of using the palatometer

system to teach tongue placement for correct swallowing pattern.

EVIDENCE-BASED THERAPY

Therapists often want to provide the best evidence based therapy possible, but does it always translate into evidence based-results across all therapists?

There is no doubt that using the palatometer system provides such evidence based-results. Further more, using the palatomater system, could even -out the playing field for most therapists.

I'm kicking myself because I should have taken photos of before and after results of several tongue thrust clients that came in with occlusion gaps, ( even after two years of braces because of their tongue thrust problem.) This is a good lesson to be learned; take the time to snap a before and after client photo with dates.

The results were truly amazing. Only after ten sessions (5 weeks) the client's occlusion was beautifully fixed as well as his tongue thrust and speech. It's hard to put into words the sheer joy that comes over you, when your clients make tremendous progress. It's that kind of progress that all therapists dream of for their clients, but was made into reality with the palatometer technology.