September 6, 2023 • 14 mins
Tired of feeling perplexed by nasal air emission and phoneme-specific nasal emission? We’ve got you covered in this enlightening episode! We’ll unravel these complex issues that often trip up even the most experienced SLPs, providing you with a wealth of knowledge and practical strategies. Expect to gain a clearer understanding as we dissect hypernasality, nasal air emission, and phoneme-specific nasal emission, shedding light on how to distinguish and treat these conditions effectively. Through engaging case histories, we share our journey to resolution.
Two cases are discussed, along with the considerable it took to correct them: a case where a preschooler produced a pharyngeal fricative for S and Z, and a case of phoneme specific nasal air emission. Tune in to get some tips on solving the puzzle of nasal air emission.
--- Useful Links ---
13K Podcast Download Giveaway!
https://www.instagram.com/dstrattonslp/
https://www.facebook.com/SpeechUmbrella
SpeechPathology.com
Impossible R Made Possible
Top 10 Toys for Speech and Language
PROMPT
Music: Simple Gifts performed by Ted Yoder, used with permission
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
Welcome to the Speech Umbrella, the show that
explores simple but powerfultherapy techniques for optimal
outcomes.
I'm Denise Stratton, apediatric speech-language
pathologist of 30-plus years.
I'm closer to the end of mycareer than the beginning and
along the way I've worked longand hard to become a better
therapist.
Join me as we explore the manytopics that fall under our
umbrellas as SLPs.
(00:27):
I want to make your journeysmoother.
I found the best therapy comesfrom employing simple techniques
with a generous helping ofmindfulness.
Hello and welcome to the SpeechUmbrella podcast.
If you're a school SLP, you'veprobably said goodbye to your
summer break and are getting toknow your new referrals.
If your private practice isanything like mine, your phone
(00:47):
will soon start ringing off thehook because parents have been
alerted to a speech-languageproblem and now they want your
services.
Regardless of where you work,fall is a busy time.
It's a time when small butpersistent articulation issues
can feel like a thorn in yourside.
You might be thinking why can'tI fix this artic issue and just
graduate this child already?
(01:07):
Today I'm going to talk abouttwo issues that pop up in the
speech therapy world Nasal airemission and phoneme-specific
nasal emission.
If you haven't heard of them,don't be too surprised.
I had to research it to findout what it was called when I
first encountered it, and itcertainly can cause SLPs a
headache or two.
A good title for this podcastcould be Another Thing I Didn't
(01:29):
Learn in Grad School.
Seriously, though, this podcastis actually called Case Studies
in Treating Nasal Air Emission,and here's what we'll be
covering what is nasal airemission and what is
phoneme-specific nasal airemission, and I'll be talking
about a case history of eachtype of emission and how they
were successfully resolved.
Speechpathology.
com has a great breakdown of thedifferences between
(01:51):
hypernasality, nasal airemission and phoneme-specific
nasal emission.
I'm paraphrasing what they'vewritten here, so let's talk
about hypernasality.
Hypernasality is most commonlyassociated with velofaryngeal
dysfunction, impaired movement,coronation and timing of the
velofaryngeal valve because ofvelofaryngeal insufficiency or
incompetency.
(02:11):
It indicates an abnormalcoupling of the oral and nasal
cavities during speech.
Hypernasality occurs withphonated sounds, not voiceless
consonants.
Hypernasality is a resonanceissue that occurs both
throughout conversation and withindividual words, and it's very
evident on vowels.
If that's hypernasality, thenwhat is nasal air emission?
Well, nasal air emission refersto the inappropriate release of
(02:33):
air pressure through the nasalcavity during speech.
It only occurs on consonants,especially pressure consonants.
It affects articulation and notresonance.
Nasal air emission can occurbecause of velofaryngeal
insufficiency or incompetence,or it could also be a result of
faulty learning or from afistula.
The easy way to think of it isnasal emission is a type of
(02:54):
speech error where air is forcedthrough the nose while
producing sounds that don'tnormally require nasal air flow.
Finally, what is phoningSpecific nasal emission?
It is the release of airpressure that occurs on certain
phonemes only.
It is the result of faultyarticulation due to mislearning,
rather than velofaryngealdysfunction.
Therapy needs to changearticulation placement.
(03:15):
Now, personally, I don't discerna lot of difference between
nasal air emission and phoningspecific nasal emission, except
for the placement issue.
Speechpathologycom says phoningspecific nasal air emission
requires a change in placementwhere nasal emission is using
nasal air flow when it is notrequired.
So of the two, it seems thatphoning specific nasal emission
(03:35):
would be the more severe problemto treat.
If we are only talking aboutmislearning and indeed that's
all we are talking about todaywe are not talking about VPI or
fistulas or anything structural.
Okay, that was some prettyheavy reading there with all of
those words.
You don't know how many times Ihad to say that over again for
you guys to understand.
I don't pretend to be an expertin voice issues, but my
(03:58):
experiences with clients whorecruit too many muscles to the
task at hand has given me ahelpful perspective on treating
faulty nasal emission.
So let me explain what I meanby recruiting too many muscles.
When a child mis-articulates asound, they can either call too
many muscles to the task.
So anytime we want to dosomething, our brain says, hey,
(04:19):
you need to do this.
Well, let's get these musclesin action to do this motor
action, and they just recruittoo many muscles, or they can
recruit too few muscles andmis-articulate the sound and it
can get kind of tricky to figureout what's going on.
A child who doesn't makebilabial contact for M could be
recruiting too few muscles.
However, that would only betrue if their jaw was hanging
(04:42):
open and they appeared all slack.
See, they're not using themuscles to bring their jaw up.
But if they're not makingbilabial contact because their
lips and cheeks are pulled backin extreme retraction like a
huge smile, that error is due torecruiting too many muscles in
one direction.
They don't have balance betweenretraction and rounding of
their muscles and they probablylack a neutral resting posture
(05:04):
too.
Looking at muscle recruitmentis more valuable for me than
looking at placement, because sooften the muscle recruitment
proceeds or is the cause of theplacement issue.
I've learned the supplies tolearn nasal emission in almost
every case.
I can illustrate this best withtwo case histories.
The first case I'm going totalk about I would classify as
phoning specific nasal emission,and that's because this
(05:28):
preschool client was producing apharyngeal fricative for SMZ.
I can't even reproduce thatpharyngeal fricative.
It was like something happeningin the back of your throat that
sounds super weird.
So placement was an issue inaddition to his nasal emission.
It was a very strange soundingsubstitution.
He had already been checked outby an ENT and there were no
structural problems.
So I knew that therapy alonecould correct it.
(05:50):
But it was not an easy fix.
The first thing I noticed washe had extreme tension and
over-retraction of his lips andhis cheeks.
I'm a prompt trained therapistso I'm used to looking at how
the muscles are working tocontrol the jaw and the lips and
the cheeks and the tongue.
And this prompt training stoodme in really good stead because
I understood that he needed toget more balanced muscle
(06:11):
movement through rounding.
So you see he was retracting,he was pulling back his lips and
cheeks and so we need tocounter that movement with
rounded sounds which are O and O.
And we did lots of activitiescombining the vowels O and U
with M, p, b, n, d and T.
I avoided S and Z completelyfor a long time and this was
because he couldn't produce themwith a vowel at all, he just
(06:35):
made the pharyngeal fricative.
He could say S or Z inisolation, but the minute you
tried to move him to a word,that pharyngeal fricative would
come back.
So he couldn't combine S and Zwith a vowel.
And the reason I targeted N, dand T with O and U is that the
alveolar placement is reallyclose to S and Z.
The reason I targeted M, p andB is I wanted to get nice,
(06:56):
relaxed, bilabial placement withrounding.
Remember he overused hismuscles to pull his lips and
cheeks back and that interfereswith a really nice neutral lip
contact.
And we also used H as it's agreat early consonant.
And who and ho, as in Santa saysho, ho are really nice words to
use, are fun target words.
It was also necessary for me tohelp him get the correct jaw
(07:17):
grading for the vowels A and Abecause he was really tight and
really tense with those vowels,but rounding was always part of
every session.
We spent a long time on thisand near the end of his therapy
journey, when he was able tocombine S and Z with a vowel,
his progress just took off.
It just accelerated so quickly.
And then he needed just alittle bit of work on
(07:37):
generalization and he was done.
So if you were to look at thenumber of sessions we actually
worked on S and Z, which werethe problem sounds compared to
the other phonemes, you mighthave a hard time believing that
these fricatives were the soundshe needed to learn.
And in case you're wonderingwhat kinds of words and
activities we used, here are acouple of my favorites for what
I call rounding work.
We use play-doh andcookie-cutters because you've
(07:58):
got dough, you've got who.
I have an owl home for a houseof barn, but I have ho ho.
I have a Santa cookie cutter.
Moo for the cow boo for a ghostwoof, for a dog bone for the
dog.
Two you want to make two.
We want to cut out.
Two.
We want to give it two eyes.
We want to do it.
By the way, I have lots ofideas for activities and games
(08:19):
with the younger crowd.
On episode 91, when I talk moreabout this play-doh stuff and
if you're looking for anactivity for very early rounding
work, like just the O sound,check out my Instagram reel, one
about using Cheerios on a stick, and I also have an Instagram
reel on painting a rainbow.
I talk about how just to usethe word bow, which is great for
early rounding work.
(08:39):
So that's how that situationwas resolved by working on
rounding, rounding, rounding anddecreasing his tension, which
was caused by over recruitmentof muscles.
My second case history concernsa client with what I would
classify as nasal air emission,although it was only on one
phoning.
He had no placement issues, itwas just a quirky way to say
(09:00):
volcalic R.
This client was nine when hecame to me and he came just to
learn to say the R sound and onhis very first day I was able to
elicit a bunched ur and Ithought this is awesome.
He's gonna be done so fast.
But the best laid plans of miceand men go off a stray, as they
say, and this was the case withhim.
He had a boatload of phonemicawareness work to do so that he
(09:22):
can even recognize when he wassaying R correctly at the
conversation or sentence level.
And add to that he was an onedge kiddo kind of nervous and
he was pretty devastated if hedidn't get something right on
his first try.
So it was a case of slowly andcarefully moving him forward
with pre-volcalic R, r-blends,phonemic awareness and then
(09:43):
volcalic R.
And you might think because hewas able to say R right off the
bat on his first day that thevolcalic R was pretty easy to
glide right into.
But it wasn't.
He was really off again, onagain and he varied between
omitting the volcalic R orsaying it with a nasal emission,
so it was slightly distorted.
And one day he would nail it anice pure ur with no distortion,
(10:06):
and the next session it wouldbe gone.
And I couldn't find aconsistent key to get rid of
that nasality.
He even got really good athearing it.
I would record him, he wouldlisten back.
He was like, oh, that camethrough my nose, but he didn't
know how he's doing it.
He didn't know what to do tostop the nasal distortion from
coming through.
I have to say here I've oftenhad our clients who have had the
same issue with volcalic R, butI've always been able to guide
(10:28):
them through it, just teachingthem to relax and doing what I
call relax practice.
And if you want to know moreabout relax practice, I have an
entire podcast on that calledPeaceful Speech.
That's episode 19.
That's one of my most listenedto episodes.
By the way, relax Practice is afoundational piece of my
impossible or may possiblecourse, so check it out at
thespeechumbrella.
com slash R-course.
(10:50):
Okay, let's get back to thisclient.
No amount of relax practiceresulted in consistent change.
One night I was strollingthrough my garden because that's
how I relax pondering on this,and I thought what if I ask him
to whisper volcalic R?
I don't think he can be toonasal if he whispers R.
He already knew the placementfor volcalic R.
(11:12):
He just needed to eliminatethis small distortion.
Well, I'm happy to report thatthat whisper technique worked
like a charm.
He had zero distortion whenwhispering, and so then I just
gradually coached him toincrementally increase his
volume, and anytime that nasaldistortion came back, we dropped
back down to the whisper and wejust kept going up and we were
(11:32):
on our way once more.
And now he still needs to learnto be consistent with the
vocalic R, because then he wasomitting it sometimes.
But that was manageable.
I could do that and so could he.
And don't you love it when yousolve a problem?
I do.
That's why I love ourprofession and this whisper
technique is going into mytoolbox.
This particular kiddo was alsorecruiting too many muscles,
(11:53):
although in a really subtle way.
He did wring his hands a lot,to the point where I sometimes
even gave him theropathy, hopingto make the hand wringing less
of a distraction for him.
And, as I mentioned before, hekind of operated on the edge as
far as nervousness went.
But when I saw the completestillness he experienced when he
whispered volcalicar, it madeit really obvious to me oh yeah,
(12:15):
tension was the problem here,and tension goes hand in hand
with recruiting too many musclesto the task.
To wrap things up, remember totake a look at over recruitment
of muscles.
When you have a client withnasal error mission that has you
scratching your head, rememberthat it can look like
nervousness and tension.
It might just be the source ofthe problem.
And when you master the simplesource of the problem, then the
(12:36):
complex takes care of itself andyou can graduate that kiddo.
If you're in need of a reliableway to be come an R Zen master,
especially as a school yearstarts and the R referrals start
piling up, take a look at myImpossible R Made Possible video
course.
It's two hours of instruction,including client videos showing
how to elicit R and 60 pluspages of worksheets to save you
(12:58):
time and energy.
You'll find that at the speechumbrella dot com slash R dash
course and on TPT.
Thanks for joining me today onthe speech umbrella podcast.
Transcripts and links for thisepisode are located at the
speech umbrella dot com slashblog.
While there be sure to sign upfor the free resource library
where you have access to over 25therapy and clinic resources
(13:18):
for free, those are at thespeech umbrella dot com slash
free.
I'm on social media now.
I look forward to discussingspeech therapy with you.
Find me on Instragram atdstrattonslp, and Facebook and
YouTube at the Speech Umbrella.
Please tell a colleague aboutwhat you learned today on this
podcast and invite them to joinus under the Speech Umbrella.
Bye for now.
Speaker 2 (13:40):
Thanks for listening to the Speech Umbrella.
We invite you to sign up forthe free resource library at
thespeechumbrellacom.
You'll get access to some ofDenise's best tracking tools,
mindfulness activities and othergreat resources to take your
therapy to the next level.
All this is for free atthespeechumbrellacom.
If you've enjoyed this podcast,subscribe and please leave us a
(14:03):
review on Apple Podcasts andother podcast directories.
Welcome to the Speech Umbrella, the show that
explores simple but powerfultherapy techniques for optimal
outcomes.
I'm Denise Stratton, apediatric speech-language
pathologist of 30-plus years.
I'm closer to the end of mycareer than the beginning and
along the way I've worked longand hard to become a better
therapist.
Join me as we explore the manytopics that fall under our
umbrellas as SLPs.
(00:27):
I want to make your journeysmoother.
I found the best therapy comesfrom employing simple techniques
with a generous helping ofmindfulness.
Hello and welcome to the SpeechUmbrella podcast.
If you're a school SLP, you'veprobably said goodbye to your
summer break and are getting toknow your new referrals.
If your private practice isanything like mine, your phone
(00:47):
will soon start ringing off thehook because parents have been
alerted to a speech-languageproblem and now they want your
services.
Regardless of where you work,fall is a busy time.
It's a time when small butpersistent articulation issues
can feel like a thorn in yourside.
You might be thinking why can'tI fix this artic issue and just
graduate this child already?
(01:07):
Today I'm going to talk abouttwo issues that pop up in the
speech therapy world Nasal airemission and phoneme-specific
nasal emission.
If you haven't heard of them,don't be too surprised.
I had to research it to findout what it was called when I
first encountered it, and itcertainly can cause SLPs a
headache or two.
A good title for this podcastcould be Another Thing I Didn't
(01:29):
Learn in Grad School.
Seriously, though, this podcastis actually called Case Studies
in Treating Nasal Air Emission,and here's what we'll be
covering what is nasal airemission and what is
phoneme-specific nasal airemission, and I'll be talking
about a case history of eachtype of emission and how they
were successfully resolved.
Speechpathology.
com has a great breakdown of thedifferences between
(01:51):
hypernasality, nasal airemission and phoneme-specific
nasal emission.
I'm paraphrasing what they'vewritten here, so let's talk
about hypernasality.
Hypernasality is most commonlyassociated with velofaryngeal
dysfunction, impaired movement,coronation and timing of the
velofaryngeal valve because ofvelofaryngeal insufficiency or
incompetency.
(02:11):
It indicates an abnormalcoupling of the oral and nasal
cavities during speech.
Hypernasality occurs withphonated sounds, not voiceless
consonants.
Hypernasality is a resonanceissue that occurs both
throughout conversation and withindividual words, and it's very
evident on vowels.
If that's hypernasality, thenwhat is nasal air emission?
Well, nasal air emission refersto the inappropriate release of
(02:33):
air pressure through the nasalcavity during speech.
It only occurs on consonants,especially pressure consonants.
It affects articulation and notresonance.
Nasal air emission can occurbecause of velofaryngeal
insufficiency or incompetence,or it could also be a result of
faulty learning or from afistula.
The easy way to think of it isnasal emission is a type of
(02:54):
speech error where air is forcedthrough the nose while
producing sounds that don'tnormally require nasal air flow.
Finally, what is phoningSpecific nasal emission?
It is the release of airpressure that occurs on certain
phonemes only.
It is the result of faultyarticulation due to mislearning,
rather than velofaryngealdysfunction.
Therapy needs to changearticulation placement.
(03:15):
Now, personally, I don't discerna lot of difference between
nasal air emission and phoningspecific nasal emission, except
for the placement issue.
Speechpathologycom says phoningspecific nasal air emission
requires a change in placementwhere nasal emission is using
nasal air flow when it is notrequired.
So of the two, it seems thatphoning specific nasal emission
(03:35):
would be the more severe problemto treat.
If we are only talking aboutmislearning and indeed that's
all we are talking about todaywe are not talking about VPI or
fistulas or anything structural.
Okay, that was some prettyheavy reading there with all of
those words.
You don't know how many times Ihad to say that over again for
you guys to understand.
I don't pretend to be an expertin voice issues, but my
(03:58):
experiences with clients whorecruit too many muscles to the
task at hand has given me ahelpful perspective on treating
faulty nasal emission.
So let me explain what I meanby recruiting too many muscles.
When a child mis-articulates asound, they can either call too
many muscles to the task.
So anytime we want to dosomething, our brain says, hey,
(04:19):
you need to do this.
Well, let's get these musclesin action to do this motor
action, and they just recruittoo many muscles, or they can
recruit too few muscles andmis-articulate the sound and it
can get kind of tricky to figureout what's going on.
A child who doesn't makebilabial contact for M could be
recruiting too few muscles.
However, that would only betrue if their jaw was hanging
(04:42):
open and they appeared all slack.
See, they're not using themuscles to bring their jaw up.
But if they're not makingbilabial contact because their
lips and cheeks are pulled backin extreme retraction like a
huge smile, that error is due torecruiting too many muscles in
one direction.
They don't have balance betweenretraction and rounding of
their muscles and they probablylack a neutral resting posture
(05:04):
too.
Looking at muscle recruitmentis more valuable for me than
looking at placement, because sooften the muscle recruitment
proceeds or is the cause of theplacement issue.
I've learned the supplies tolearn nasal emission in almost
every case.
I can illustrate this best withtwo case histories.
The first case I'm going totalk about I would classify as
phoning specific nasal emission,and that's because this
(05:28):
preschool client was producing apharyngeal fricative for SMZ.
I can't even reproduce thatpharyngeal fricative.
It was like something happeningin the back of your throat that
sounds super weird.
So placement was an issue inaddition to his nasal emission.
It was a very strange soundingsubstitution.
He had already been checked outby an ENT and there were no
structural problems.
So I knew that therapy alonecould correct it.
(05:50):
But it was not an easy fix.
The first thing I noticed washe had extreme tension and
over-retraction of his lips andhis cheeks.
I'm a prompt trained therapistso I'm used to looking at how
the muscles are working tocontrol the jaw and the lips and
the cheeks and the tongue.
And this prompt training stoodme in really good stead because
I understood that he needed toget more balanced muscle
(06:11):
movement through rounding.
So you see he was retracting,he was pulling back his lips and
cheeks and so we need tocounter that movement with
rounded sounds which are O and O.
And we did lots of activitiescombining the vowels O and U
with M, p, b, n, d and T.
I avoided S and Z completelyfor a long time and this was
because he couldn't produce themwith a vowel at all, he just
(06:35):
made the pharyngeal fricative.
He could say S or Z inisolation, but the minute you
tried to move him to a word,that pharyngeal fricative would
come back.
So he couldn't combine S and Zwith a vowel.
And the reason I targeted N, dand T with O and U is that the
alveolar placement is reallyclose to S and Z.
The reason I targeted M, p andB is I wanted to get nice,
(06:56):
relaxed, bilabial placement withrounding.
Remember he overused hismuscles to pull his lips and
cheeks back and that interfereswith a really nice neutral lip
contact.
And we also used H as it's agreat early consonant.
And who and ho, as in Santa saysho, ho are really nice words to
use, are fun target words.
It was also necessary for me tohelp him get the correct jaw
(07:17):
grading for the vowels A and Abecause he was really tight and
really tense with those vowels,but rounding was always part of
every session.
We spent a long time on thisand near the end of his therapy
journey, when he was able tocombine S and Z with a vowel,
his progress just took off.
It just accelerated so quickly.
And then he needed just alittle bit of work on
(07:37):
generalization and he was done.
So if you were to look at thenumber of sessions we actually
worked on S and Z, which werethe problem sounds compared to
the other phonemes, you mighthave a hard time believing that
these fricatives were the soundshe needed to learn.
And in case you're wonderingwhat kinds of words and
activities we used, here are acouple of my favorites for what
I call rounding work.
We use play-doh andcookie-cutters because you've
(07:58):
got dough, you've got who.
I have an owl home for a houseof barn, but I have ho ho.
I have a Santa cookie cutter.
Moo for the cow boo for a ghostwoof, for a dog bone for the
dog.
Two you want to make two.
We want to cut out.
Two.
We want to give it two eyes.
We want to do it.
By the way, I have lots ofideas for activities and games
(08:19):
with the younger crowd.
On episode 91, when I talk moreabout this play-doh stuff and
if you're looking for anactivity for very early rounding
work, like just the O sound,check out my Instagram reel, one
about using Cheerios on a stick, and I also have an Instagram
reel on painting a rainbow.
I talk about how just to usethe word bow, which is great for
early rounding work.
(08:39):
So that's how that situationwas resolved by working on
rounding, rounding, rounding anddecreasing his tension, which
was caused by over recruitmentof muscles.
My second case history concernsa client with what I would
classify as nasal air emission,although it was only on one
phoning.
He had no placement issues, itwas just a quirky way to say
(09:00):
volcalic R.
This client was nine when hecame to me and he came just to
learn to say the R sound and onhis very first day I was able to
elicit a bunched ur and Ithought this is awesome.
He's gonna be done so fast.
But the best laid plans of miceand men go off a stray, as they
say, and this was the case withhim.
He had a boatload of phonemicawareness work to do so that he
(09:22):
can even recognize when he wassaying R correctly at the
conversation or sentence level.
And add to that he was an onedge kiddo kind of nervous and
he was pretty devastated if hedidn't get something right on
his first try.
So it was a case of slowly andcarefully moving him forward
with pre-volcalic R, r-blends,phonemic awareness and then
(09:43):
volcalic R.
And you might think because hewas able to say R right off the
bat on his first day that thevolcalic R was pretty easy to
glide right into.
But it wasn't.
He was really off again, onagain and he varied between
omitting the volcalic R orsaying it with a nasal emission,
so it was slightly distorted.
And one day he would nail it anice pure ur with no distortion,
(10:06):
and the next session it wouldbe gone.
And I couldn't find aconsistent key to get rid of
that nasality.
He even got really good athearing it.
I would record him, he wouldlisten back.
He was like, oh, that camethrough my nose, but he didn't
know how he's doing it.
He didn't know what to do tostop the nasal distortion from
coming through.
I have to say here I've oftenhad our clients who have had the
same issue with volcalic R, butI've always been able to guide
(10:28):
them through it, just teachingthem to relax and doing what I
call relax practice.
And if you want to know moreabout relax practice, I have an
entire podcast on that calledPeaceful Speech.
That's episode 19.
That's one of my most listenedto episodes.
By the way, relax Practice is afoundational piece of my
impossible or may possiblecourse, so check it out at
thespeechumbrella.
com slash R-course.
(10:50):
Okay, let's get back to thisclient.
No amount of relax practiceresulted in consistent change.
One night I was strollingthrough my garden because that's
how I relax pondering on this,and I thought what if I ask him
to whisper volcalic R?
I don't think he can be toonasal if he whispers R.
He already knew the placementfor volcalic R.
(11:12):
He just needed to eliminatethis small distortion.
Well, I'm happy to report thatthat whisper technique worked
like a charm.
He had zero distortion whenwhispering, and so then I just
gradually coached him toincrementally increase his
volume, and anytime that nasaldistortion came back, we dropped
back down to the whisper and wejust kept going up and we were
(11:32):
on our way once more.
And now he still needs to learnto be consistent with the
vocalic R, because then he wasomitting it sometimes.
But that was manageable.
I could do that and so could he.
And don't you love it when yousolve a problem?
I do.
That's why I love ourprofession and this whisper
technique is going into mytoolbox.
This particular kiddo was alsorecruiting too many muscles,
(11:53):
although in a really subtle way.
He did wring his hands a lot,to the point where I sometimes
even gave him theropathy, hopingto make the hand wringing less
of a distraction for him.
And, as I mentioned before, hekind of operated on the edge as
far as nervousness went.
But when I saw the completestillness he experienced when he
whispered volcalicar, it madeit really obvious to me oh yeah,
(12:15):
tension was the problem here,and tension goes hand in hand
with recruiting too many musclesto the task.
To wrap things up, remember totake a look at over recruitment
of muscles.
When you have a client withnasal error mission that has you
scratching your head, rememberthat it can look like
nervousness and tension.
It might just be the source ofthe problem.
And when you master the simplesource of the problem, then the
(12:36):
complex takes care of itself andyou can graduate that kiddo.
If you're in need of a reliableway to be come an R Zen master,
especially as a school yearstarts and the R referrals start
piling up, take a look at myImpossible R Made Possible video
course.
It's two hours of instruction,including client videos showing
how to elicit R and 60 pluspages of worksheets to save you
(12:58):
time and energy.
You'll find that at the speechumbrella dot com slash R dash
course and on TPT.
Thanks for joining me today onthe speech umbrella podcast.
Transcripts and links for thisepisode are located at the
speech umbrella dot com slashblog.
While there be sure to sign upfor the free resource library
where you have access to over 25therapy and clinic resources
(13:18):
for free, those are at thespeech umbrella dot com slash
free.
I'm on social media now.
I look forward to discussingspeech therapy with you.
Find me on Instragram atdstrattonslp, and Facebook and
YouTube at the Speech Umbrella.
Please tell a colleague aboutwhat you learned today on this
podcast and invite them to joinus under the Speech Umbrella.
Bye for now.
Speaker 2 (13:40):
Thanks for listening to the Speech Umbrella.
We invite you to sign up forthe free resource library at
thespeechumbrellacom.
You'll get access to some ofDenise's best tracking tools,
mindfulness activities and othergreat resources to take your
therapy to the next level.
All this is for free atthespeechumbrellacom.
If you've enjoyed this podcast,subscribe and please leave us a
(14:03):
review on Apple Podcasts andother podcast directories.
Popular Podcasts
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Therapy Gecko
An unlicensed lizard psychologist travels the universe talking to strangers about absolutely nothing. TO CALL THE GECKO: follow me on https://www.twitch.tv/lyleforever to get a notification for when I am taking calls. I am usually live Mondays, Wednesdays, and Fridays but lately a lot of other times too. I am a gecko.
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.