The traditional sequence of articulation therapy follows a tried and true hierarchy of levels of speech sound production, starting with isolation and syllable level and advancing all the way up to structured conversation and finally spontaneous speech. A common frustrating occurrence can be when kids have been flying along each level and then can’t quite seem to get those last stages of generalization so that they can finally reach that bittersweet milestone of graduating from therapy.
Take a look at the practice stimuli kids are commonly presented with, and you may find the culprit is a lack of randomized practice opportunities. Articulation therapy sessions are frequently set up to allow for blocked sequences of practice. In a block practice framework, the target sound is typically presented in the same position of every word and the child progresses through a list of these words one after another. Block practice is great when kids are starting out and need that level of predictability to help learn the new motor pattern. Randomized sequencing practice occurs when each new word stimuli in a given session differs with respect to whether the target sound is included, and perhaps which word position it appears in. Some concurrent task sequencing programs mix word and phrase level also. Because the target shows up “at random,” it’s impossible for kids to fall into a pattern of anticipating when the sound will need to be produced correctly. This makes the therapy task more difficult, and allows for better motor learning and habituation of the correct speech skills for that target.
So, when arranging word lists for articulation therapy, consider throwing in some randomized practice as well. Typically, this would fall into the hierarchy following mastery of word level block practice targeting the sound in error. At Verboso, we’ve made it easy for therapists to customize a practice session to incorporate randomized practice by adding multiple sounds and positions to the same session in our speech games. Just add multiple targets and hit the “shuffle” button at the bottom of the screen when selecting practice stimuli and you’ll be able to track how kids’ performance changes with this more complicated task.
Robin, D. A., Maas, E., Sandberg, Y., & Schmidt, R. A. (2007). Motor control and learning in childhood apraxia of speech. In P. Hall, L. Jordan, & D. Robin (Eds.), Developmental apraxia of speech: Theory and clinical practice (2nd ed., pp. 67–86). Austin, TX: Pro-Ed.
Skelton, S. L. (2004). Concurrent task sequencing in single phoneme phonologic treatment and generalization. Journal of Communication Disorders, 37, 131–155.