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/r/ Speech problem….or is he tongue tied?

Sunday, 15 November 2015 / Published in Dental Hygienist, Dentists, Orofacial Myologist, Orthodontist, speech languge pathologist, Therapists

/r/ Speech problem….or is he tongue tied?

Sandra,

I was researching some tools to assist my son with his speech and I discovered your web page.

I hope you do not mind me asking you for some pointers.     I am a strong support for L in any way I can help improve his speech.

However, it is frustrating when he struggles speaking, and people either do not understand or they plainly laugh at him.

L who is 9 years old is having difficulty with the /r/ sound (especially at the end of words). L has been going to speech for approximately 2 years.  My concern is I would like very much some techniques I can use to work with L at home to improve his speech.  Nothing breaks a mother’s heart more then when your child, says, “I just want to talk normal like all the other kids?” 

I am limited on funds and understand if you can not assist me on my request. I am in hopes though, from what I have read about you; that maybe you could guide me with some web pages or insight on what I can do to make this transition easier for my son.

Thank you in advance for your time in reading about us, take care.

Sincerely

P

Dear P, I didn’t answer you right away because I was away.  Once I arrived home, I wanted to be sure to have a clear mind!  Where do you live?  Has L been receiving school therapy or have you been seeing a private therapist?  I’m asking these questions so I can give you a better answer. Let’s eliminate any possible physical reasons for his difficulty.  Often, they exist and are the reason for the problem. Have L open his mouth as widely as he can comfortably open it. With mouth remaining open, have him lift the tip of his tongue to the roof (palate) of the mouth behind his upper front teeth.  Is he able to do this?  Check the attached piece of tissue under his tongue (lingual frenum) to be sure that it is not attached too close to the tip, not embedded deeply into the whole underside of the tongue, and not real short. This is critical. Now look at the roof of his mouth and see if it seems to be unusually high or narrow, or both.  This also affects R speech production. Does he have any language or other learning issues?  Sometimes I find the R problems can be associated with “hearing” the sound as it should be or discriminating one sound from another. How are his L sounds?  I want to eliminate any connections of R and L, which often exist in certain types of speech problems.   Have him try L in various locations and listen and watch how it is produced.  L should be made with the tip of the tongue up behind the upper front teeth. Look, love, lady, last   Pillow, allow, following, relies     Please,  fleas, slips,  black, glass calling,   falling,   really Now, importantly, can he make a pure, continuous ERRRRRRR sound by itself, not in a word?  Therapists should not go beyond this level into words.  The patient/student must be able to produce that pure ERRRRRRR 100% of the time because that is the basic R sound in all contexts.  Do let me know if he can do it. Let me know how he makes the L’s in the above words and how it sounds to you. P, this is a start….get back with me and we’ll take it from here. Sandra Holtzman Hello Sandra, Thank you for responding to my questions…L  goes to speech therapy once a week at school. I did the exercise with L per your request…He opened his mouth as far as he could so I could see his tongue…the tissue looks to me as it is rather close to the tip or shorter than mine or per say my daughter’s La has NO other language or learning issues at all other then the /r/ sound. I also asked L to say the words you listed below and his /l/ sounds clear and well.  The ERRRRRRRR  sound he can not do clearly, eventhough he tries very hard. He wants to master his /r/ sounds so bad. Are there any excercises we can do at home to progress his speech with /r/ ‘s? The teacher gave him a choice of how to lift his tongue..he chose to say the /r/ with his tongue tip up and back. The words he is practicing thus far in his speech notebook are: rat    road    race   rope  rabbit   roses  rock   rocket   ring   Halloween/October  astronaut/costume  skeleton  scary  haunted house   deer season  chili/cold weather food   ghost  Fall Break vacation  The sentences are as follows thus far: the football player made a touchdown. I ate an icecream cone. A spider scared my sister. She is a princess. The note on this page for the exercise says:   Please concentrate on a good /r/ when saying the words and sentences. I appreciate the assistance from your emails. Take care,  I look forward to hearing from you soon. Sincerely, P I’ve been inundated lately and finally am able to address some more of your concerns.  Were you able to see if L’s palate/roof is high or narrow?  Can he suction his tongue flat into the palate and maintain it there? As far as his speech work, my opinion is solidly this:  if he cannot make a clear ERRR consistently 100% of the time, I would certainly not ask him to make it in complex settings (words or phrases).  Once he could make the ERRRR consistently and easily, THEN I would put it at the end of words that terminate with an ER (papER, toppER, hammER, etc.) From what you describe, he might have a short or ankylosed lingual frenum, that strip underneath the tongue that attaches to the floor of the mouth.  If so, it might not be possible for him to produce the ER in any context consistently.  Is there any way you could send a digital photo, perhaps, of the underside of his tongue (with his mouth wide open and tongue lifted up and back as far a possible, showing the “frenum”).  That might give me an idea of whether it is fair to expect him to make the ER without first clipping the frenum. I’ll wait to hear from you, Sandra Holtzman Post: /r/ Speech problem….or is he tongue tied?

Tagged under: ankylosed lingual frenum, difficulty with the /r/ sound, L sounds, lingual frenum

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