Learn why it is necessary to control syllable shape in your target words and how.
Why does syllable shape matter when choosing words for speech therapy?
Childhood Apraxia of Speech (CAS) is a neurological speech disorder that disrupts the sequencing, transmission, and execution of the motor-planning commands of speech. For most people, this process is automatic and effortless, but for children with CAS, each sequence must be taught and then practiced over and over again until it becomes automatic.
Think of it this way. Pretend that children with motor-planning problems have a circuit breaker somewhere in their system between their brain and their mouth. If the demands on the circuit are low, the breaker does not trip and the word is produced correctly. If the demands are high, the circuit breaker is overloaded and word production fails.
Words with many sounds are more demanding than words with fewer sounds. Consonants put more stress on the system than vowels. A new sound or sound combination takes more effort (putting more demand on the system) than one that has been practiced many times. As a therapist, you always want to find that balance between stimuli that are demanding enough to teach new skills, but not so demanding that the circuit breaker trips and the student only experiences repeated failure. Controlling syllable shape is one way to create an appropriate list of target words for children with CAS and other children with a motor-planning component to their speech problem.
Children who have no motor-planning problems can learn a new sound like /p/, practice it at the beginning and ends of words, practice it in phrases and sentences, and then use it in conversation. Once taught a /p/, children with a motor-planning component to their speech disorder can say the /p/ in some one-syllable words, but not others. Why? Not all one syllable words are the same.
Understanding Syllable Shape
One-syllable words are words that contain only one vowel. "A" is a one-syllable word. "Springs" is also a one-syllable word. "A" is a one-syllable word comprised of just one vowel sound - /eI/. "Springs" is a one-syllable word comprised of six sounds (five consonants and one vowel) - /s/, /p/, /r/, /I/, /ng/, /z/. One-syllable words are not all created equal. A one-syllable word with 6 sounds has motor-planning requirements that are significantly more demanding than a one-syllable word comprised of only one or two sounds.
One-syllable words can have a variety of syllable shapes. Typically more sounds = more difficult. More consonant blends = more difficult. You can break down the sounds in the words into consonants (C) and vowels (V). There are also R-colored vowels or vocalic R sounds (like in the words car, fur, and air), but we will save discussing those for another time. If there is a vocalic R in your word list and you are working with a child with a severe speech disorder, discard that word for now.
The simplest one-syllable words have a vowel-consonant (VC) or consonant-vowel (CV) shape. Whether you are targeting a consonant or vowel, it is interesting to note that some children may find production easier in a CV context and other children will have an easier time with VC. Experiment to find out which is easier for the child you're working with. Remember that you're working with sounds - not letters. "bee" and "she" are both CV words even though the first is spelled with one consonant and two vowels and the second is spelled with two consonants and one vowel. You are looking for words that are pronounced with only two sounds regardless of how they are spelled.
In terms of complexity of syllable shape, consonant-vowel-consonant (CVC) words are next. To keep things simple, you want to choose CVC words that include two sounds your child can make and only one target sound. For example, if your child has trouble with /k/ and /n/, and you're targeting /k/, do not choose the word "can". Choose "cab" instead. Another thing to remember when creating a CVC word list is word position. Again, the child may find words with the targeted sound at the beginning of the word more difficult or they may find words with the targeted sound at the end of the word more difficult. Adjust your word list accordingly. Remember to keep your focus on sounds. Words like "ship", "with", "cheat", and "those" are all CVC words.
One-syllable words with consonant blends come next in terms of complexity. If you're working with children who have a severe speech delay I would avoid these for now. Consonant blends are two or more consecutive consonants in the same syllable that are produced in a blended fashion. Your one-syllable word could have one or two consonant blends. CCVC, CVCC, CCVCC, CCCVC, CVCCC, CCCVCC, CCVCCC, and CCCVCCC are all potential one-syllable syllable shapes.
Guidelines for Creating Word Lists by Syllable Shape
- Include only one target sound in each word. Make sure all the other sounds in the word are in the child's phonemic inventory. (Alternately, accept approximations of the other sounds in the target word.)
- CV and VC words are the simplest. CVC words are more complex. Work at the highest level of complexity the child can handle to maximize speed of progress and generalization.
- Avoid words with vocalic /r/ and consonant blends.
- Experiment with words that include your target sound in initial position and words that include your target sound in final position. A child may find one position easier than the other giving you a starting point for therapy. As soon as possible, mix the word positions together to increase difficulty and improve generalization.
- Remember to focus on sounds, not letters when searching for words to include in your list. All of your words will be two or three sounds, but may be spelled with more letters.
Moving Beyond CVC Words
If your child has mastered production of your target sound in one-syllable CVC words move to simple two-syllable words or focus on the CVC words in short phrases before trying to work on the sound in consonant blends. The simplest two-syllable syllable shapes are VCV, CVCV, and VCVC.
A useful technique when moving past CVC words is to introduce a simple carrier phrase that is used over and over again with the target words. ("Give me the _____." or "That is my _____.") Another strategy is to find a nursery rhyme, children's song, or children's book that contains some of your target words and use them with the child pausing to let the child fill in the target words at the appropriate times.
Motor-Speech Articulation Method (MSAM)
Controlling syllable shape is one of the fundamental underlying strategies I use when designing the illustrated card sets that are the core of my free and premium speech materials. Other strategies involved in target word selection in the MSAM method include controlling the phonemic complexity of the individual sounds that are the building blocks of the target words and maximizing co-articulation variety.