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 use your cues appropriately and purposefully.
I will review how I cue for articulation therapy here.
For articulation therapy, cueing is the most important part (besides having a good evaluation and goals). How speech pathologists cue will decide how successful a therapy program will be.
It is a delicate balance. The speech pathologist must have the child produce the target sound correctly as much as possible to learn 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 correctly).
To achieve this, the speech pathologist must fluidly move through the heirachy of cues to find the cue in which provides opportunities where the child says a sound correctly and has the most independence possible. The speech pathologist may move up and down through the heirachy within one activity.
Let's review MY articulation cueing heirachy from the most help to least the help.
Tactile Cues: The speech-language pathologist uses touch or devices (i.e, tongue depressor or spoon) to teach correct placement of articulators.
Tactile cues are now all the rage with PROMPT. Tactile cues are helpful in teaching initial production; however, once a child can say a sound correctly at the needed level (isolation, phrase, word, sentence), I fade this cue!
Imitation: Child produces target sound/word/sentence at the same time (copies) as the parent or speech-language pathologist. Production maybe slightly exaggerated to allow for the child to learn correct production.
Personally, 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: The speech-language pathologist gives a verbal model of the target and then says another phrase before expecting the child to repeat the target. For example, the speech-language pathologist says "ball, what do you do want?" The child then says "ball."
The slight delay in repeating helps to move the child from directly copying to saying the target sound with more independence.
Visual Prompt: 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 correctly.
The child is now saying the word without a verbal model; however, he/she must be looking at the therapist or the card for this cue to work.
Verbal Prompt: The speech-language pathologist uses a verbal cue to remind the child how to say a target correctly. For example, the speech-language pathologist might say "tongue back" to cue for a correct production of /k/.
Verbal prompts are basically a glorified reminder of correct production. However, the child doesn't need a visual on how to say the sound.
Initial Reminder: The speech-language pathologist or parent will remind the child to use the target sound correctly during the task at the beginning of the task only.
This is the last step before total independence!
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