For many kids, /p/ is one of the first sounds they learn to use in words. It’s also visually salient, meaning it’s very easy to see how it’s made, so when kids are struggling with this sound, working side by side in a mirror to show them correct placement is often a quick fix to help get improvement.

What do you do for hard to correct errors? Some substitutions patterns, like /m/ substitution or glottal stops, can seem impossible to correct. Here are a few tricks to teach /p/ when the first line of defense, “watch me and do what I do” doesn’t seem to cut it.

Use sound shaping from /h/

Instruct the child to make an /h/ sound. Praise them for the good /h/.

Next, ask them to “trap” the /h/ sound by closing their mouth quickly. After they can do this a few times, ask them to “trap it” and then let some air sneak out. Show them how you make the /h/ sound, then put your lips to together and open back up quickly. This will cause them to produce a /p/ sound in a “hop”-like production. Have them repeat this a few times.

After they’ve got the “hop”-like production down, have them see if they can leave off the /h/ and say “ap.” From there, you can either start to vary the vowel, and you’ve got a great word final /p/ production, or you can see if they can maintain the accuracy while adding a vowel after the /p/, with an “apa” production. I’m a big fan of trying both and seeing which one works better for that child!

Whisper /p/ with placement cues and biofeedback

Another great strategy for teaching /p/ productions when basic imitation isn’t cutting it is to try to see if the child can imitate in a whisper. Lots of feedback about placement, getting the lips to touch, and being very very quiet can help to increase accuracy.

If nasal substitutions are present, or if the child has suspected velopharyngeal insufficiency, adding nostril occlusion is helpful also. Using your two index fingers, cover the child’s nostrils while they try to make the whispered /p/. This way, you can still see their mouth moving, and you are not blocking their eyes from watching you. Holding their own hand in front of their mouth can help them feel the airflow release from the /p/ sound—a great way to get biofeedback that they successfully stopped the air and released it out of the mouth!

If the child is successful with nostril occlusion, try weaning by only covering one nostril. If the child is able to improve their placement for /p/, but still has nasal emission, make sure they are seen by an interdisciplinary cleft palate team to determine whether there is a structural reason for this. You can help families find a team near them at the American Cleft Palate Association website.

If lip closure is incomplete, consider an external aid like a tongue depressor

For kids who are struggling with /p/ because they can’t get their lips together, use a tongue depressor or similar type of object to help them have an external focus to touch their lips to. This can help them get their lips together for improved productions. Hold the tongue depressor lengthwise across the mouth so they have more surface area to aim for and feel. After a few repetitions of /p/ with successful lip closure using the external aid, gradually wean from it by moving the tongue depressor to the side of the mouth as a cue only.

It’s important to note that sometimes glottal stop substitution errors are hard to differentiate from omissions, and can make it seem like a child is not able to achieve lip closure, when in fact the problem is a substitution of a glottal sound for oral placement. In these cases, the two procedures above are more effective, as they address the underlying problem, which is incorrect placement learning, not inability to achieve lip closure.

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