Speech Therapy Cues
Speech therapy cues are one of the most important aspects of a successful speech therapy program. It is essential to understand the hierarchy of cueing and how to use cues appropriately and purposefully.
I will review how I cue for articulation therapy here.
How To Use Speech Therapy Cues
For articulation therapy, cueing is one of the most important parts of a successful therapy program!
It is a delicate balance. The speech pathologist must have the child produce a target sound as much as possible in order to teach and solidify the new motor habit. However, the speech pathologist also wants the child to be independent with his/her productions (not depending on the therapist to say the sound).
To achieve this, the speech pathologist must fluidly move through the hierarchy of cues to find which cue provides opportunities where the child says a sound correctly while having the most independence possible. The speech pathologist may move up and down through the hierarchy depending on the child's progress within one activity.
Let's review MY articulation cueing hierarchy from the most help to the least help.
Speech-language pathologist use touch or devices (i.e, tongue depressor, spoon) to teach correct placement of articulators.
I also consider PROMPT a tactile cue and chart it as such.
These cues are helpful in teaching initial production; however, once a child can say a sound at the needed level (isolation, phrase, word, sentence), I fade this cue as quickly as possible while maintain success.
Imitation - Verbal and Visual Cue
Child produces target sound/word/sentence at the same time (copies) as the parent or speech-language pathologist. Production may be exaggerated to allow for processing time and so the child can clearly see what the all the articulators are doing to say each sounds/word.
I may slow down sound production, I NEVER segment individual sounds when imitating words.
I give imitation its own place. It is a glorified version of copying. The child doesn't have to figure out on his/her own how to say the sound which is necessary at first but impedes the child from moving this new motor habit to procedural memory.
Delayed Imitation - Verbal Cue
The speech-language pathologist gives a verbal model of the target and then says another phrase or pauses before expecting the child to repeat the target. For example, the speech-language pathologist says "ball, what do you want?" The child then says "ball."
The slight delay in repeating helps to move the child from copying to saying the target sound with more independence.
The speech-language pathologist or parent provides a visual prompt such as pointing to lips to remind the child to close lips when producing /b/ or a visual card to help the child remember how to say the sound.
The child is now saying the word without a verbal model; however, he/she must look at the therapist or the card for this cue to work.
As part of Speech Therapy Talk's Membership, I have these AWESOME visual cue cards for single sounds and blends that kids love. Seriously, they have been a game changer. They review:
- the letter
- articulator placement
- HOW to say the sound
The speech-language pathologist uses a verbal cue to remind the child how to say a target. For example, the speech-language pathologist might say "tongue back" to cue for a correct production of /k/.
Verbal prompts are more or less a glorified reminder of correct production. However, the child doesn't need a visual on how to say the sound.
I always want to make sure that EVERYONE in a child's life is on the same page when cueing for correct productions. Consistency is KEY!
Once I figure out which least restrictive/least invasive cues work best, I provide all caregivers/teachers with the worksheet below. I highlight which cues to use with the child. This may need to be updated as the child progresses.
These worksheets are available for all sounds and are available at Speech Therapy Talk's Membership site.
The speech-language pathologist or parent will remind the child to use the target sound during the task at the beginning of the task only.
This is the last step before total independence for saying a sound correctly without cues!
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