Working on speech sounds - a case study.


by Shelley Parkin – Speech and Language Therapist
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Children develop their full range of speech sounds over time - it is normal for very young children to make errors as they develop and organise their speech sound system. Certain speech sounds develop quite early on, such as ‘b’ and ‘m’, while others develop much later, such as ‘r’ and ‘th’. Some errors are what we call ‘typical’, or expected at certain ages, and others can be ‘atypical’ or not what we would expect. Even the typical speech errors can sometimes persist for a bit longer than expected and may need support to resolve. This case study describes working with a child with a ‘phonological delay’, where one or more of those typical errors was taking a bit longer than usual to resolve.

Joshua was in Reception class when I started working with him. His mum and teacher were concerned that he did not produce his ‘k’ or ‘g’ sounds when talking. Mum, in particular, was so used to Joshua’s speech patterns that she understood everything he said. However, less familiar adults and the children in his class didn’t always understand him - this was becoming frustrating for Joshua, who couldn’t understand what their problem was!

Substituting ‘k’ and ‘g’ with other sounds is a typical speech error made by young children as they develop their speech sound system. Speech and Language Therapists refer to this process as ‘Fronting’, as the ‘k’ and ‘g’ sounds which are made towards the back of the mouth, are replaced by ‘t’ and ‘d’, made towards the front of the mouth. Young children typically grow out of this error process by the time they are 3 ½ years old, but for some children, it takes a little bit longer and they may need some support.

I chose to start working on ‘k’ first. I checked whether Joshua could hear the difference between ‘k’ and ‘t’ (Joshua was substituting ‘k’ with ‘t’) both on their own as single sounds, and in words. He could, so we were off to a good start! I also needed to determine whether he could make a ‘k’ sound on its own - this proved to be more tricky. I tried lots of games to try and stimulate sounds made in the back of the throat- growling like tigers was the most popular.

Once Joshua could produce the ‘k’ sound, I used a ‘Minimal Pairs’ therapy approach. This involves using pairs of words that differ only in one sound - the sound you are targeting (‘k’) and the sound the child is substituting (usually ‘t’). Minimal pairs for ‘k’ and ‘t’ include ‘key/tea’, ‘car/tar’, ‘cap/tap’, ‘fort/fork’ etc. During therapy sessions, we played lots of games using these kinds of pairs, e.g. lotto games and pairs games. Joshua soon learned that he needed to distinguish between the pairs of words otherwise the games didn’t work. These activities helped Joshua to separate out and distinguish these sounds in his memory store. Once he became familiar with ‘k’ I introduced ‘g’ as well- Joshua picked this up really quickly as the two sounds are so similar.

It takes time to change a speech process like this- it doesn’t happen overnight. We worked on it step by step, gradually increasing the difficulty from single sounds to words, to sentences and beyond. But with regular practice (disguised as fun) Joshua began producing his ‘k’ and ‘g’ in his everyday speech. His mum and teacher were thrilled, but best of all, Joshua could chat to his friends and be understood first time.