Articulation Therapy: Inner Voice Recordings
I've had orthodontia for most of my life and still wear a retainer at night. When I was in grade school, I had a palate expander to change the shape of my mouth. A strong wire was connected to the back molars that exerted pressure on the hard palate. This was some time ago, when only an orthodontist could adjust a palate expander. I had periodic visits and the adjustments were substantial, not incremental. After the appointments, I would sit on the floor in my bedroom and cry from the pain.
When the palate expander was first installed, it affected my speech and caused a lisp. At school, other children commented and made less than flattering imitations of my speech. I remember thinking to myself, "This is not okay. This is not how I talk." That afternoon, I made a plan. I had a tongue twister book that my aunt had given to me. I read the different tongue twisters out loud to myself until I could speak the way that I used to speak. I think that I read aloud for over an hour, continually adjusting how I was moving my tongue. It's only now, as an adult, that this vignette seems prescient for my future career.
My experience was rehabilitative - not habilitative. Rehabilitative services address skills that were previously mastered and lost. Habilitative services help children meet developmental milestones. I had already met developmental milestones and was able to produce all sounds correctly in all positions. I knew what my speech sounded like prior to the dental appliance. I understood my targets. I wanted to regain something that I had lost.
For children who have developmental speech sound disorders, they have only ever heard themselves producing approximations of adult targets, possibly using a variety of compensatory strategies. They don't have auditory memories (inner voice recordings) of themselves saying sounds correctly. Sometimes they recognize that their speech is different from their peers, but sometimes they don't. Articulation therapy may involve giving clients a new internal recording that they can use as a target.
We can use actual and imaginary audio to help clients recognize when it is time to retain new inner voice recordings:
- Audio-record the child's optimal productions and closest approximations
- Have the child listen to recordings of the best productions multiple times
- Compare and contrast recordings of optimal and less than optimal productions
- Have the child pretend to turn on an imaginary recording device to capture optimal productions: "You are doing great! Tell your ears to start listening and tell your brain to remember what you hear."
- Praise optimal productions using listening words: "That was amazing. Remember what you just said so you can hear it again in your head."
We have amazing auditory memories. Maybe we can start helping our clients focus their ability "to hear" themselves.