Too many R clients get stuck somewhere between the sentence and conversation level, and can’t make the leap to mastery. Helping these clients achieve mastery of R (or any phoneme) involves a philosophy about how to engage a learner in learning. The closer you get to less structured therapy tasks, such as conversation, the fewer worksheets there are, because therapy becomes more about you —the pilot, and the passenger-your client, figuring out the remaining roadblocks to complete mastery of R.

 This episode covers

• Six roadblocks to R generalization
• Specific strategies for each roadblock

Materials to support mastery (because we do need some materials)

— Useful Links —

Impossible R Made Possible Video Course

Tally it Up!

The Tipping Point 

What Got Lost in Translation 

Phonological Awareness Screening Test (PAST) 

Phonological Awareness Tracking Form 

Tracking Phonological Awareness 

I Taught My Cat to Clean My Room

Music: Simple Gifts performed by Ted Yoder, used with permission

Transcript

Denise: Welcome to The Speech Umbrella, the show that explores simple but powerful therapy techniques for optimal outcomes. I’m Denise Stratton, a pediatric speech language pathologist of 30 plus years. I’m closer to the end of my career than the beginning, and along the way I’ve worked long and hard to become a better therapist.

Join me as we explore the many topics that fall under our umbrellas as SLPs. I want to make your journey smoother. I found the best therapy comes from employing simple techniques with a generous helping of mindfulness.

Hi, and welcome to another episode of The Speech Umbrella podcast. This podcast has listeners from many different places, and today I want to give a shout out to the top three countries outside of the US that tune in: Germany, Canada, and Ecuador. Now I’ve been to Germany and Canada, but Ecuador I have yet to visit, so I’m looking forward to that someday. Today, we’re talking about one of my favorite subjects and that’s R therapy.

The title of this episode is It’s Not the Plane, It’s the Pilot. I recently saw Top Gun Maverick, and when I heard Maverick say that, it’s not the plane, it’s the pilot, I thought it was a perfect way to introduce today’s topic. The question I want to answer today is what strategies are effective for clients who have poor self-awareness when using R at the conversation level.

When I set out to create my Impossible R Made Possible program, I wanted to accomplish a couple of really critical things. I aimed to teach how to elicit a perfectly articulated R consistently, but I also wanted to develop tools for clients who are really poor at self-awareness and self-monitoring. These clients get stuck somewhere between the sentence and conversation level, and they can’t make the leap to mastery.

If you’ve been in the field for a while, you know exactly who I’m talking about. You might be wondering what ‘it’s not the plane it’s the pilot’ reference has to do with any of this. You see Impossible R is much more than a vehicle that provides you with warmups and target words and phrases, although it has plenty of those, and it’s more than a vehicle that tells you how to elicit R, although it does that very well, I think, it’s a philosophy about how to engage a learner in learning and the closer you get to less structured therapy, such as conversation, the fewer worksheets there are because therapy becomes more about you, the pilot and the passenger, your client, figuring out the remaining roadblocks to complete mastery of R. In my opinion, most of that can’t be done effectively with pre-written material.

Now that being said, I do have an entire module on self-monitoring and auditory discrimination in the course, but since publishing Impossible R Made Possible, I’ve continued to learn how to support self-awareness and I’m super excited to share what else I’ve learned with you today. Impossible R methodology has everything you need to keep clients moving forward.

Today, you’ll come away with some great strategies for mastering all sounds at the conversation level. And this works for sounds besides R and stay tuned for a special offer at the end of the episode. Here’s a rundown of what we’ll cover today. Roadblocks to mastery, I’ve come up with six of them, specific strategies for each roadblock. Plus, I’m gonna tell you about materials I have to support mastery. There are some pre-written materials, but I have also got videos talking about techniques and other podcasts. I’ve done that I’ve talked about this. So if you’ve already bought the course, check back and see what else I’ve added.

Roadblock number one, make certain all motor issues are resolved. You know, before a pilot takes off, they do a check of all systems. That’s what you’ve gotta do. That client is not gonna fly unless all motor systems are working as they should. And here’s some questions to ask yourself, do they have unnecessary tension, when speaking? Do they have smooth, easy transitions to, and from the R sound, do they sound like their peers at the phrase or sentence level? Is there R spot on? Does it have the acoustical profile of a perfect sounding R? I know, I know you may be thinking, duh, I wouldn’t be working at the multi sentence level or conversation if they didn’t have this perfect R but it really pays to double check and make sure that’s not an issue.

This trips up a whole lot of clients and it trips up some clinicians too. You know, we don’t get training on this. You don’t get someone saying to you, okay, before you graduate, let’s take a little time and talk about what an almost there R sounds like as opposed to a perfect R and let’s see if you can hear the difference.

We don’t get to do that. And then we’re expected to teach our clients that. That might be a whole nother podcast, I don’t know. I had to train myself to hear that because earlier in my career, I did reinforce Rs that weren’t spot on and then that client couldn’t move on to mastery. So that’s roadblock number one, make sure all those things are resolved.

Roadblock number two. Here’s another question to ask yourself. Can they say R correctly at conversational speed? And one way to check this since they aren’t saying R well in conversation, it would be hard to measure there, but is with what I call timings. So I have a set of words and I see how many words a client can read in a minute.

And I found that clients who can say 100 target words per minute, make big strides in conversational accuracy. Now, if they’re younger than 10, I multiply their age by 10. So 90 words per minute for a nine year old. And so forth, but when you’re doing timings, you can get insight into the nature of the roadblock.

Is it a motor issue of gradually building their speed or is it lack of self-awareness? if it’s lack of self-awareness, you may need to start with a small set of words because they will keep missing words just randomly. And you’re like, ah, why can’t you get this? Sometimes I’ve had to take as few as six words and just make them really, really focus in on their accuracy.

It’s not a motor issue. They are just not monitoring themselves. And then we just build up from there and we build and we build and we build until we get a nice set of words that they can read for a minute. Here’s another Top Gun analogy, man. I’m finding these all over the place. In the movie, they practiced a little bit slower and then got faster and then got faster as they were going through these canyons, these crazy canyons, the whole object of timings is accuracy with speed. That’s critical, just like with these pilots, you need to insist on both so lower the requirements until they can experience success and then increase. By the way. I should say that when I’ve got a client working on just six words or whatever, I’m not timing them for a whole minute.

We do less time, and then we just gradually gradually increase until they have a number of words that would be reasonable for them to say in a minute, I have one caution about timings. If your client has trouble reading, that can really stymy them and slow them down, and it’s not an issue of conversational speed, it’s the issue of their reading.

And even if I have pictures there, their eyes will go to the word and it just slows them down. So you may need to forego timings. Try it and see if it works. There are some other things you can do, which I’m gonna talk about now, besides timings. Another way to build speed with accuracy is using hand clapping with chants.

I think this is so awesome. Now it’s challenging, but you can do it. So you’ve seen kids, little kids, like first graders, clapping hands with a partner and crossing midline and tapping their knees and clapping their hands together, then clapping their partner’s hands all while they’re saying these crazy long chants.

So I’ve started doing this. You might need to slow it way down at first. Cause they might look like a deer in the headlights. But imagine if your client could say red rover, red rover, send Rachel right over, while they’re doing all sorts of different hand clappy motions, it really, really ingrains it into them.

And one thing I’ve noticed is you got to watch for the stiff elbows. So, you know, when you’re doing these hand clapping chants and your elbows are bent, and then you push them out to meet your partner’s hands. Well, some kids have some kind of motor involvement that their arms are stiff and straight out like a robot and they really can’t clap against you just because I think the cognitive load is kind of high. So it’s another thing to watch. You want them to be able to have that motion from their elbow and actually clap their hands against yours and not be stiff armed like a robot. I mean, after all, that’s what their peers can do.

You don’t need to go lightning speed, just a nice normal, conversational pace. Older clients might think this is kind of silly, but you know, they can clap their own hands together, they can clap against a table, they can cross midline and tap their knees, I think crossing midline is really key. So just adapt it for whatever works for your client.

Roadblock number three. Check their phonological awareness. Check and see if it’s age appropriate. Now for the age we generally start working on R, which is generally third grade and up, we can expect fully developed phonological awareness in a typically developing child. So if they’re behind at all, there’s probably something you need to work on.

I would use a rigorous phonological awareness assessment such as the PAST by Dr. David Kilpatrick. The PAST is rigorous because it takes into account their time to respond. Remember, conversation is fast and the analysis of words, breaking words apart, rather than putting them together, that’s more rigorous.

If you have a phonological awareness assessment that has them just combining words that doesn’t teach them all they need to know. You really need to do analysis, breaking apart of words, combined with speed. Oh, by the way, the PAST is freely available and it’s fast to administer, so that’s great. Poor phonological awareness has been the main reason some of my clients couldn’t self monitor. They couldn’t master R in conversation. So what are you gonna do if their phonological awareness is poor? Personally, I love Equipped for Reading Success, that’s by David Kilpatrick who created the PAST. It’s my go-to. I love it. Although, Equipped for Reading Success is a book you have to buy, it’s based on studies done by the US Department of Education and the materials they used are all out of copyright.

So I have taken those materials, I’ve prettied them up, if you want to use the Equipped for Reading Success approach, you can download those free materials at thespeechumbrella.com. And I also have a whole podcast episode about using Equipped for Reading Success and reviewing Dr. Kilpatrick’s book, and that’s episode 14, it’s called What Got Lost in Translation.

Now here’s another strategy for building phonological awareness. And this is when you’re working on a specific sound. So it could be R it could be S. But it’s to use sentence repetition. The way I do this is to read them a sentence with more than one R word in it, then ask them to repeat it back to me. And then this is the kicker, after they’ve repeated it back to me, I asked them to tell me which words in a sentence have R in them. And when I first started doing this, I was blown away by how difficult it was for some of my clients. They could repeat the sentence, but then they just got so lost. They could not tell me which words in the sentence had R in them.

Some of my clients asked me to repeat the sentence again and again, so they could catch those R words. And then what I would do is I would build from a sentence with two R words to three R words. I think my max was four R words. If your client has a really delayed phonological awareness to the point where they can’t analyze two syllable words, because that’s how they would start with the Equipped for Reading Success approach, or if they can’t repeat sentences, which is where they start with this approach, then you’re going to need to back up and find out where you really need to start. And for that, I use my phonological awareness tracking form. It’s got some early listening activities, some things you might need to do to prepare them to do actual phonological awareness and you get my phonological awareness tracking form at thespeechumbrella.com in my store or on Teachers Pay Teachers.

Roadblock number four is auditory discrimination. So a question to ask yourself is can they hear their own errors when listening to themselves on a recording? And can they hear their own errors in real time? If not, I use the three P’s: pencils, papers and poems. I go into depth about how to do this with the games and the science and snack videos on episode number five, and that’s called The Tipping Point.

You can really use any kind of phrase or sentence for this, but I love to use poems. Eventually. I may have them memorize it and hey, they’ve already been working on it. So that poem is already partly in their memory. In real time, I have them make tally marks for each target word they say, as they say it, this is really key. They can’t get behind themselves. They can’t get ahead of themselves. In other words, not make the tally marks too late or in anticipation. They need to make the tally mark as they say the R word. And you would be surprised how difficult this is for some clients. Otherwise they aren’t really being mindful.

It’s interesting. I have found that a sequence of two or three R words in a row is what is most challenging. It’s very common for my clients to miss a word out of a sequence that has two or three R words in a row. And we don’t move on until they can say that sequence correctly. So just for example, in the poem, I Taught My Cat to Clean My Room by Ken Nesbitt there is a line that reads to use a bucket, brush, and broom. I cannot tell you how many poor self monitors will have to try again and again to get just those two words correct in sequence. So then when they get one word right, like brush, then they’ll get broom wrong and then they’ll switch. And the pot at the end of the rainbow is getting both of them in that line all together with the other words, I have a video called Tallied Up that shows how to do this. Persistence pays off here. So many parents have told me that they notice a difference at home after clients get past this hurdle. And really sometimes it’s just one or two poems and just getting those words in a sequence that makes a difference.

They say things like he seems to be paying attention to how he speaks. That’s what they’ll tell me after we’ve done some of this tally work. Now Tallied Up can also be used to tell stories. I ask them to tell personal stories rather than pre-written ones, it’s much easier. It’s relevant to them. It’s just so easy to say hey, tell me a story.

And if they’re having trouble coming up with a story, I have a little journal page that’s available in my free resource library, where they can kind of sketch it out or write it out and then tell it and use tally marks recording themselves and listening back works in very much the same way, you can do longer passages with recording.

One thing I would say is sometimes you get indistinct words, I mean, you don’t even know if they’re right. The client doesn’t know if they’re right, just because of the recording quality and we just throw those out, but iffy ones need to be clearly wrong or clearly, right. Because we are making sure they know when they’re right and when they’re wrong, if it sounds iffy, it’s probably not spot on. And so I’ll say to them, well, if you’re not sure, try again, and it’s almost always better when they try again. And so then, you know, oh, well that iffy one, that really wasn’t correct because this one sounds better.

Here’s another technique you can try. And it’s just with playing games. It can be any game like Keplunk, Connect Four, Pick Up Sticks, and what I do is I tell the client you’re gonna make a goal and I want you to write your goal down. And I’m gonna make a goal and I’ll write my goal down. And the goal might be something like I’m going to use an R word every time I take a turn, or the goal might be, Hey, I’m gonna use two R words every time I take a turn.

So you can see how easy this would be. You might say, it’s my turn. Or you might say, it’s my turn. And I’m pulling the red stick out or something like that. It’s really easy. But what is so great about this is as the SLP, you are not correcting them. So how this works is you model it. You say whatever you’re going to say, and you talk about, oh yeah, I said two R words, I did make my goal, I gotta give myself a plus or a tally mark or whatever. Then the client takes their turn. And all you do is you say, did you meet your goal? If they forget to say anything, then they’ll go, oh, shoot, I didn’t. And they’ll say something. And I’ll say, did you mark it down?

Because the game doesn’t proceed until they have made a tally mark. And this works really well because they’re at the point where if they just know they need to say the R word, if they’re thinking about it that much, they’re going to get it correct. It’s the idea of them thinking about it in conversation in a natural, pragmatic activity, like game playing that works really well.

So you hardly have to do anything. All you have to do is if they forget, say, huh, did you meet your goal? Okay. I got one more idea. This is videos. I’m gonna make your client a YouTube star. Although, of course they won’t go on YouTube. So I have them make little videos of science experiments and of fun snacks. And I have a binder that is full of little fun snacks. They can make like spider sandwiches with Ritz crackers. There’s a lot of Rs in that. Science videos that work real fast, like fantastic foamy fountain, where you just make that this explosion of soap bubbles, that is so cool. And what they have to do is they have to describe the equipment you need, and they describe the experiment as they go through it.

If you’re really wanna get into some language stuff along with the R, they explain why the science experiment worked. I go into depth about how to use the games and the science of snack videos on my episode, The Tipping Point and that’s episode number five.

Roadblock number five, sometimes this one sneaks right past me. But you need to find out how fast they speak normally, and not in the therapy room. Some of my clients are so therapised and I come into the therapy room and they know they’re supposed to slow down. And I have no clue that they speak like lightning outside of the therapy room. Some of my clients talk so incredibly fast outside of therapy that they can’t possibly self monitor, and the only way to know this is to ask their parents, or sometimes they get so comfortable with you they’ll forget, and they’ll start using their normal speed and you’re blown away. And you’ll understand why they aren’t generalizing. I tell them they’re breaking the speed limit and that if they want to master R they have to slow down outside of therapy.

This is really a personal choice. You can help them build self awareness that they’re speaking way too fast, but it’s kind of hard if they don’t speak too fast in therapy, to show them that they’re speaking too fast. I had one teenage client, this was her hangup and she devised her own therapy program, and what she decided she would do is that she would record herself while she was walking to school with her friend, cuz they were always chatting and then she would analyze it later and listen to her Rs, and then she told me ‘I had no idea I talk so fast and I had no idea I was making so many R errors’. That was a really effective way for her to work on her Rs.

If they’re younger, you’re gonna have to get the parents involved, and again, I have several good ideas for doing that on that episode, The Tipping Point.

Roadblock number six, last but not least, what we call the hardest R words, co-articulation nightmares for some of our clients, that’s what these hardest R words are. So the strategies I use go from slow to fast, aim for completely natural sounding words. Even if they’re slowing it down, you’ll know that everything is working as it should if they can sound natural. I do timings and with the hardest R words I often have to build them up with their timings. And we’re just not gonna go for a hundred words a minute right off the bat.

We’re gonna build up their skills. I also use word builders. So if you don’t have the Impossible R Made Possible program, let me describe what a word builder is. Once a client gets their perfect first R word, for example, the word like run, I’ll put it with one other word, just like run away. I wanna make sure they can say a run away and then I’ll put it with another word, but I’ll put a word before a run, so like I run and they have to be able to move from the I to the run without any kind of pause, without any kind of losing the quality of the R, I run. And then we go, I run away. So then the word is sandwiched and it sounds completely natural between two other words. So I will do the same thing with these hardest R words until they can get a hard R word completely integrated into their conversation.

So those are my strategies for the hardest R words, and with some clients, they come real easily and with some clients, it just takes time. Can’t go around it. Can’t go above it. Can’t go under it. You have to go through them. Well that about wraps it up for today. I have so many materials, so many podcasts, so many videos, that you can check my show notes to see all the things that I have developed in addition to Impossible R Made Possible to support you in getting your clients to graduate.

Also for the months of August and September in 2022, all of my R products are available for a 10% discount at thespeechumbrella.com. Put in the coupon code elementary to get that discount. Thanks for tuning in. And I’ll talk to you next time.

Thanks for listening to The Speech Umbrella. We invite you to sign up for the free resource library at thespeechumbrella.com. You’ll get access to some of Denise’s best tracking tools, mindfulness activities, and other great resources to take your therapy to the next level. All this is for free at thespeechumbrella.com. If you’ve enjoyed this podcast, subscribe, and please leave us a review on apple podcasts and other podcast directories.