Speech therapy indicators
One of the most important elements in speech therapy intervention is supporting the child with cues. It is therefore essential to understand how to use the hierarchy of cues in order to intervene effectively and achieve our objective. The success of the intervention depends on the speech therapist's ability to provide cues and also to know how to gradually fade away these cues so that the child can produce the target without using the cues.
To do this, the speech therapist must determine in their assessment and must constantly adjust during the intervention to find the clues that facilitate the child's productions, gradually decreasing the support they offer over time.
It is also important to mention that a review of oral anatomy, brief or more detailed depending on the child's age, as well as providing details on articulator placement before and during the intervention, is a key element in my speech sound interventions. 3D mouth models can be used, in addition to a tongue depressor, fingers, or any other tool that may be helpful in assisting the child to become aware of articulator placement.
Next, the speech therapist can vary the level of support provided, without necessarily reducing it, depending on the child's performance and their specific needs at that moment. The speech therapist may then move back and forth between different levels of support depending on the child's requirements. Here are the different possible levels of support, from the one offering the most support to the one offering the least:
TOUCH SCREEN: When teaching a new phoneme, it can be helpful to use your fingers, a tongue depressor, or any other tool to physically demonstrate to the child where to place their articulators in their mouth.
IMMEDIATE IMITATION: Immediate imitation is the cue that offers the most support to the student. The adult presents the target and invites the child to reproduce it immediately afterward, like parroting!
DELAYED IMITATION: Delayed imitation involves giving the child a model and then allowing some time to pass before prompting the child to reproduce the target produced by the adult. During this delay, the speech therapist produces another short utterance before asking the child to reproduce the first word that was modeled for them.
VISUAL CLUE: The visual cue can be given by pointing towards the lips, for example, to remind the child to have a good lip seal, or even with images such as the ones I have developed here to give him a reminder of the sound he needs to produce. This involves providing support, without giving a verbal model.
VERBAL INDEX: Here, the speech therapist can give the child a verbal reminder to achieve the correct production, without having to provide a visual model or demonstrate the target. (e.g., Don't forget to raise the tip of your tongue)
INITIAL REMINDER: When we use this index, we have reached the stage of generalization to spontaneous speech, and this consists of simply giving a reminder of the objective, of the expected articulatory placement at the beginning of the activity.
Leave me your comments to tell me how you use the cues in your practice. If you would like to download the speech therapy cue visual, you can do so here:
Download visual sound stimulation →
