How to Teach Your Child to Speak Clearly - Treating Speech Disorders

All right, in this video, I'm going to tell you the process of getting a speech delayed or disordered child to start using the correct sounds in speech when they're talking, having conversation. So if your child is having pronunciation errors, this video is for you. It doesn't matter if your child has apraxia of speech, dysarthria, whatever, that kind of a speech disorder. This is the logic that goes behind everything. So in the beginning, we need to know the severity of your child's speech disorder. So remember in the previous video, I talked about the difference between speech and language? Today, we're going to zoom in on speech, right? So if you don't know the difference, please go to agents of Speech.com course. There's a free course, it's called introduction course for parents with speech delay. Watch that. Okay. I cannot use, like 20 minutes to go through the basics here, but go there and check it out. It's all free man speech. We're going to drill down onto this. The reason why is that we got. I had a conversation with a parent through an online consultation assessment, that kind. And if you want that, the best way is to join the courses and you will see when we open up slots. Okay. I was telling her about exactly what I'm going to tell you here. The first thing is to know the severity, the degree of how bad or good the speech disorder is. So we start off with something what we call a speech intelligibility. Right? So that's a crazy name for how clear is your child's speech? How much can a random person, a stranger on the street, understand your child's speech? So if they say a sentence or a word, is the person going to pick it up? And we usually do that as a percentage. Okay, meaning like 70%, 80%, 90%. Sometimes it's like 0 to 10%. It's all gibberish. And of course, then we have to do therapy, right? So I think it's a general consensus around like below 70% is already warranted for therapy. So when a child comes into the clinic, whether online or offline, what we're going to do, we're going to do an articulation assessment. So it's called an articulation assessment, but actually what it does is to look at the whole speech disorder as a whole. Right. So why we call that articulation assessment is because there's a word list, a standardized list of words that we ask children to go through, and then we. We listen professionally with our ears that have listened to a lot of Sounds and we determine if what sounds are missing, replace, mispronounced, whatever. We, we call those omissions for, for deleted sounds, right? Which is for instance, if I say the word, let's say home, if I delete the ending M, then a hole and I don't have the M, that's a deletion omission, right? And if I replace like for instance, if I replace the M with a P, then it becomes hope, right? That's a replacement, right? That's substitution as we call it. Professionally, we want to go through these and there are various reasons for these omissions and substitutions and so on, but we go through the whole word list, we listen, we mark down the errors, so to speak, and then we will know what the at around this time we will know the phonetic inventory of this child. And it's not the whole picture just yet because we have to do other tests. So after the articulation test we have a list of errors basically and we have to investigate further. So we'll know what sounds your child has and what your child doesn't have. Right? So the intricacies and the detailedness of the articulation assessment I will not discuss here because there are loads out there even in America that there'd be like, like more than a dozen depending on where you live. So it doesn't matter what you use either. But once you have that preliminary list of like errors and what sounds your child has or has not, then we drill down into the have nots and see if it's stimulable. We do a stimulability test and it sounds like really cool, but basically just means if a child cannot do that like home and then he missed the M at the end, can we get a child to do the M sound first by its own? Right. We stimulate at a phonemic level, meaning like only the sound by isolation. So is by isolation. So once we have that and your and. And the child can do the M sound by isolation, right? And I talk about all these like levels of syllabic structures and all these things inside of. Of a very not sexy course inside of that agents of Speech.com course. The free community with all the stuff is in the course called speech disorders crash course. I don't think a lot of parents have gone through that, but the people who have, they were so happy because then they could start understanding a conversation with their speech therapist. And some of them have even done the speech therapy on their own. But anyways, going back to the stimulability test we go through a bunch of queues to see if the child can do that single phoneme. And usually when we target a phoneme, it's going to be a consonant. So there's a difference between a consonant and a vowel. So vowels are just sounds like ah, e, ooh, e, o. And then maybe you can put them all together and then you can see like a, I, ow. These ones have two vowels, and we call those diphlongs. Anyways, I'm throwing a lot of words at you, but what I'm trying to get at is that most of all the speech disorder stuff that happens in the consonants, the vowels. If your child is having problem with vowels, then we treat vowels first. Okay? And usually speaking, if we're treating a vowel first, it means that it's very severe. I'm not going to sugarcoat it. If our targets are vowels, it's going to be very tough. That's a tough case. So I'm going to talk about the consonants, because the vowel parts, I think you need specialized help over there. And we can have a conversation inside of community when you join. All right, so for constants, we go through this, the mobility. We check all the prompts. Can we give them a picture of a closed mouth for m? And they'll know how to do M? Can I just tell them to copy me and do M? Can I put the lips together? And they do M? Right. So we go through the list, and obviously some sounds are much easier to stimulate than others. Right. And after we stimulate at the phonemic, like, isolation level, we go down the syllable structure. So we start with a consonant, and then we do a cv, a consonant plus a vowel. So a lot of times the consonants, if you have a. A vowel behind it, it becomes immediately difficult. So I'm going to give you a, an example that a lot of people can relate to. And that's a trill R. So for instance, this R is used in a lot of European languages and Southeast Asian languages. So this trill, you might be able to do isolated, like this, just a consonant. But then when you add a vowel, sometimes it becomes really difficult. And the reason is because there's something called a vowel context. So vowels, they differ from, if you have to, you know, spread your lips or round your lips or how high the jaw and tongue will be. So, for instance, let me give you an example. So after we try the. The constant level, right? We go down CV and then we add a vowel and become. Right. So as you can hear, I'm not very good over the Trill either. But then you can hear that the was the strongest because I didn't need to move my mouth that much after producing the consonant, the R. So the vowel context helps a lot for us to understand. And this is what we call a deep test. It's like a. How deep can the child go with a particular consonant or a sound or whatever? So it goes from C cv, and then we'll see what vowel contexts work, right? And after that, we will add like a cvv, like a consonant plus two vowels, Right, Two vowels. Or we go cvc. And this is at the deep test level, depending on what language you speak, this is hitting some of the real words. So you can use some real words. So especially in Chinese, that would be very easy because like a syllabic structures, syllable structures are like, it's just CVV or cvc, right? Or CVVC for that matter. And I know I'm gonna speak in a way that. As if you understand, but stick with me a little bit and you'll get it. So once we know these, the deep test for each consonant, we will have a treatment plan already. We'll know that, okay, we're gonna do these sounds, right? And depending on factors, is it. Is this sound going to happen a lot? The language that your child chooses to speak, for example, f and S is quite important in Chinese and in Cantonese that where I'm from in Hong Kong. And then like, I can't speak for other languages, to be honest. And then there's also like a developmental. Like how developmentally sound it should be. Like, there's that school of thought. So for instance, pmb be those ones that are bilabial, meaning two lips. Like the lip sounds, we might be able to target those more. And the reason is because those are much easier to stimulate to make your child say those sounds. So we might want to push those first. And then the last one is. The last consideration is like, for instance, if I do a sound, can it help the child understand the other sounds as well? So some people might go ahead and do the hardest one. They might do a F sound in the hopes that it will help with the S later on because they're similar and that they create a friction in the sound. And it's continuous. So there's a lot of thoughts around this. There's a lot of professionally speaking people are having debates and stuff. You as a parent, you don't need to care. If you're a therapist and you're listening to this, you should know this already. Go away. Like all these Considerations, Right? And you can talk to a professional about this. The main thing then is the treatment goals. Okay? So if your child is a pure articulation case, then you have to start thinking about why they. And this is why in a lot of videos I say, and in the courses I will say, and if you do a consultation, I will say that speech cases, they really require to know exactly why they cannot do the sample. Is it because that they don't know how to put the articulated in a certain way to create the sound? Are they aware that they're doing it wrong? Like, all these considerations we have to think about in order to give them the correct way to treat it, because the cues and prompts we use will be directly directed at exactly how the child is creating the error. So let me give you an example. Let's going back to the M, like, if they cannot go like that, right? So you can see I have this professional inclination to add gestures to everything. When you go, what happens is that, Is it because they have a structural deficit that they cannot put their lips together? And you see some children that actually use their tongue to help that. So you have to think about, is it like jaw weakness? It is very easy to jump to oral motor stuff. And I was talking to one of our coaches about this because we're seeing a lot of parents, especially in Southeast Asia, to jump into a lot of oral motor stuff. And it's also the other side is true. I think nowadays in the western countries, they don't really do a lot of articulation or speech disorder stuff. They would rather use like C to help out. So it's very easy to jump into oral motor. And also the other. The other side is true. It's very easy to not jump into anything for the M. You have to think about, oh, is it because they don't understand, they cannot hear the difference, right? Or is it that they can hear the difference, but they're like, they morally cannot do it? So if that's the case, there's a few cues that we can use. We can put their lips together. We can give them like a lollipop stick for them to. To have a tactile cue so that they can put it together. There's loads of tactics about how you can do this, and it depends on the error that is going on. Okay. All that being said, that's the first part of all speech disorder stuff that we're going to do. If your child is a pure articulation case, right. Then teaching more sounds is going to be your Main focus, after you teach the sounds, right, you want to get the sounds in different language contexts. So we start off with a single word level. After you do the CV cvvc, those kind of stuff, you get the real word, single word level. So if we're doing M at the end, it might be home, it might be poem, it might be some sam. These ones are great. And then after you do like a monosyllabic one syllable word, we do two syllables. So on top of my head I cannot really think of any di. Syllabic 2 syllable M final words. Right. So once you go through these lists of stuff, you start to put it into a sentence and then into a story and then you'll be done. And so that's just a normal articulation case. Obviously that's a very oversimplified thing I'm teaching here. There's other things going on. There might be a phonological aspect, meaning they don't really understand the sound rules and therefore they're substituting it. Or there might be auditory processing where they cannot like under hear difference between a sound and another sound. Right. So we really have to think about. And then I think a lot of parents would be. And this is the part where you might skip to, is about apraxia of speech and other like more severe speech disorder that we might even, we might not even have the confidence to put a label on. That's a lot of speech therapists over there in globally is that when you see a child who has, who's non verbal or having alien language or very inconsistent errors or even consistent errors, sometimes we can't put a finger on why like a lot of therapists will not have the confidence to give any type, shape, form of a diagnosis. And. But then you can follow this framework, right? The first part of what I said just now was all about creating more new sounds and then putting those sounds into the correct, into different language levels so that your child will generalize and learn how to use it in real life. Right. So that's always good and true. And we're always going to have to teach, we're always going to have to teach new sounds and go through this process no matter what diagnosis, speech wise. Okay. The second piece is going to be. I remember when we did the deep test, right? There's like a consonant, the consonant. Vowel, vowels, cones, vowel, vowels, cvv, cvc, whatever the structures are. Some children have difficulty in syllabic structures. So what we do is we only choose one variable, right. When we're teaching new sounds, we're teaching new sounds. But then when we're teaching new syllabic structures, we do not. We do not use the sounds that they're not solid with. So we take the sounds that they know already, okay? And then we shop them together and create new syllabic structures. Okay, let me just give you an example about why and about. Okay, so this is not disordered or pathological in any way. And I need to make this disclaimer first because some professional will pounce at me for using this example. But for instance, if someone has an accent problem, especially Chinese people who I listen to a lot, so when they say home, they say home, right? So it's like canceling speakers. So what happened was like home is actually a cvvc, so H, O, and then the other symbol, so O. So is it ou, right? O, U, M, there's actually two vowels. But then in Cantonese and Chinese, we don't have a CVVC structure, so we simplify it in our brains and we call it home instead of home. That's a syllabic structure problem. Now, I'm not saying this is disorder. It's just this cultural aspect. And I'm not, you know what I'm saying? So similarly, in parallel, children that have a speech disorder, they, when they don't have a particular syllabic structure, understood, practiced, and established, they will reduce that syllabic structure to whatever they know. So that's why when you hear a child who has a speech disorder, they say a longer word, right? They simplify it for themselves. They make. Make it easier, right? So I have the first piece going back to the intervention goals, right? The first piece is always to get new sounds, all right? Always to get new sounds. Once you get new sounds, move down the ladder of the language levels, right? The second piece is to see if can they do the syllabic structures, single syllable or two syllable syllabic structures that they can do or not, right? And you go down the complexity. All right? You need to work with a speech therapist, man. It's very difficult to tell you what to shoot for. And in the short video, and then the last piece, and this is universally true, is always going to be nice and appropriate for any speech disorder case, albeit you need to know exactly why, as I was saying, and how to queue and prompt and what sounds to target and stuff. So that's why it's a little bit more bespoke. The last goal that we usually shoot for is that we need to see if there's any syllable sequencing problems. So syllable sequencing just means going from one syllable to another. Going from. Like if there are syllable pauses, like a pause between syllables, or when they go between, from a syllable to another, are there going to be more speech errors? So the professional terms to search for, if you really want to, is called co articulation, syllabic sequencing, all these. So what we do is we get the syllable structures that we taught already from the second goals and then we put them in a sequence, right? So depending on what language one speaks, right. Usually speaking, we go to three to five. And all these are in textbooks, man. Like, if you ask me, they're in textbooks. They're in talking to senior speech therapists and, you know, like reading different scientific papers, research papers. And so syllable sequencing is something that we do a lot with children who are apraxic, apraxia of speech. And what we do is, for instance, if we know that a child already has the sounds and remember we're only keeping one variable, right? So if a child knows the M sounds, they can do syllabic structures of cv, then we might do ma, ma, ma, like that. And then there's. I'm quoting some study out there. I don't know which one. I read it a long time ago. My boss told me to read it. I learned it. And it works with, with speech tutorial cases. But what we do is we do the same syllable, mama ma, and then we change. Once they do like this kind of pattern, then the last one, we change it into a different sound. So it might be ma, mi or whatever. So once they do mama mi, they're able to sequence that. The next step is that we change the positions. So we do ma mima. So it's like a, B, a situation. So you can only do it for three syllables. Or you could do five. So if you're into math, there are different combinations and like different combinations that you can do, right? Different permutations, in fact, because there's a sequence, right? Sorry, my cat just sneezed on me. Anyway, anyways, once you go through, like, I will start with three syllables. And it really, again, it depends on your child's performance and ability. I cannot just tell you all it's not here, start there. Use this. It depends on the situation. The sequencing is as such. We started with same syllables, same sounds, and then we change one thing and we move the sound in different, different combinations. And then we treat the flexibility of them using the different speech sounds in different contexts. Right? So I think this is more than enough. There have been people saying, oh my God, you're not Talking Enough info. Is this enough info for you to take some action? It probably is too much info. So we have so many info on the Internet, not even from us. There's so many different speech therapists out there. Like, it doesn't take that much information to take action. If you're watching this, do you know your child's speech intelligibility? Do you know your child's phonetic infantry? Do you know what syllabic structures your child has or has not? Do you know if your child goes from one syllable to another? Are there any errors involved? If you don't know these questions, chances are you don't need to watch another video of ours. Go find a speech therapist. Or it doesn't need to be with us. It doesn't need to be with anything. Go find out, man like you. Start educating yourself. Take action. Teach as much as you can, and then you know, that's that. And if you need more help, need more directed help, go to agents of Speech.com course. Join the free community with 15,000 parents inside. Where I look through the questions there, I wouldn't say daily I go through them and answer questions. There are loads of free courses that we use to sell for money. Like we changed it into a coaching business now Agents of Speech. And we help parents all over the planet. It might sound cool, it might sound excellent. If you like it, then you like it. If you don't, then that's fine as well. But the main objective of this video is to get you educated enough to take action, okay? You must act on your knowledge. All right? All the stuff I've been saying here, I think maybe 10% may apply to you. Okay? That's all for today's video. If you like it, please like it. And if you want to keep watching, watch the next one here. All right? Thank you.