Hi Vanessa,

I recently participated in your webinar and I thought you would be a good person to ask a therapy question. I’m a TalkTools Level 2 therapist and I’m treating privately and collaborating with another SLP to help her son with a distorted /r/.

We have finished bite blocks, chewy tubes/grabbers and I feel confident his jaw is stable. We are starting horn #8. He appears good with straw #8 and the straw D. He likes sensory input and we use cool lemon swabs for improved sensing of the back of tongue side spread which we are seeing improvement. Lip and tongue disassociation is our focus.

I was wondering what the correct cue for lips when we attempt /r/ in isolation? His mom prefers to use the “don’t move the lips” or lip retraction without movement when I introduced the “freeze” /ee/ to /r/ technique. In the past that is what I did, but now I feel that slight movement is ok and is needed for him. I’m wondering what position of the lips (protruded or retracted) is best for the mentalis muscle for /r/ production. I’m also wondering the exact role of the mentalis with /r/ production. This is a child again who needs high sensory input. I haven’t been successful with finding the answer online.

I appreciate any suggestions.

Thank you for your blogs, webinars and inspiration!

-L

Hello!

Thanks so much for watching the webinar and your kind words!

I don’t have a black and white answer here (of course!) but these are my thoughts:

•  believe a small amount of lip movement is adequate for the /r/ phoneme. I too used to encourage a tight retracted lip however with my OPT training I realize that that can reinforce poorly dissociated muscle movements in speech. And we know that speech requires fine tuned, dissociated muscle movements for co-articualation.
• Speaking of co-articulation, keep in mind that phonemes (especially vowels) surrounding /r/ in speech will impact the placement of the lips.
• The mentalis muscle aids in jaw stability which we know is essential to dissociated tongue movement. When the jaw is stable, it will allow the tongue better retraction and increased tongue side spread on the molars… 2 of major players in the /r/ phoneme!
• If the mentalis muscle is truly dissociated, you shouldn’t see an upper lip component to an /r/ sound because the mentalis muscle impacts only the lower lip. It has no attachment to the upper lip.

I suggest the following for treatment:

• The button pull program
• Pennies on a tongue depressor
• Check for tethered oral tissues, this can be a big hinderance to /r/ productions.

I hope this helps! Have a great weekend!
Vanessa

Vanessa Anderson Smith, MS, CCC-SLP is a TalkTools presenter and LEVEL 4 ACCOMPLISHED Therapist and owner of Anderson-Smith Speech Therapy in Sioux Falls, South Dakota, where she specializes in oral placement, feeding and speech therapy for pediatric clients. She has also trained in apraxia of speech and is also certified in SOS feeding therapy for problem eaters. Vanessa holds a B.S.from Augustana College and M.S. from University of South Dakota.

Vanessa is hosting 2 live webinars this summer 2018. 

LIVE WEBINAR
Bridging the Gap: Private Practice & School SLPs

As a private practice therapist with a background working in the school and early-intervention education settings, Vanessa will discuss the “how-to’s” of private practice and school based therapist collaboration for carryover of oral placement therapy. Vanessa will detail how she has successfully joined forces with school-based SLPs and OTs to better serve mutual clients.

CEUs: .2
June 20 | 12-2 p.m. EST
Register now

LIVE WEBINAR
Practical Tips & Strategies for Meal Planning & Prep

Vanessa will provide practical strategies for the parent/caregiver-therapist team to structure meal plans for all kiddos, including special needs. Instruction will include identifying typical vs. atypical feeding patterns, and the importance of the parent/therapist partnership in developing a meal plan.

CEUs: 2
July 25 | 12-2 p.m. EST
Register now