Trying for blends (/sn/, /bl/, and /pl/)

We've starting working on blends with Ava. She's had a lot of success with both /s/ and /l/. Typically, /s/, /l/, and all blends would not be sounds you'd choose to work on with a two year old child. However, Ava struggles to make herself understood. She has motor planning problems with speech and for whatever reason, /s/ and /l/ are easier for her than other sounds that would typically emerge earlier (like /k/). So, if we take the time to improve the sounds that are more stimulable, we'll improve her intelligibility sooner. Sure enough, /l/ is definitely popping into her conversational speech and it sounds great. To a lesser extent (mostly in initial position), /s/ is popping in as well. So, we decided to try for some /s/ and /l/ blends.

Her /sn/ words are: snow, snap, sneeze, snip, snail, snore, and sniff. She is pretty good with all those final consonants (notice, we aren't doing snake).

We are cueing her on multiple levels. First, we are using semantic/visual cues. For "snow" we use the visual cue for /s/ followed by shaking our head "no". For "snap" we use the visual cue for /s/ followed by tilting our hands on our head to visually cue "nap." For "snail" we use the visual cue for /s/ followed by pretending to hammer a "nail." And so on...

This works well when we keep the /s/ sound completely separate from the second part of the word. As soon as you ask her to imitate the blended word, she loses the second consonant. Snow becomes so. Snap becomes sap. Snail becomes sail.

Using an auditory prolongation cue was also unsuccessful. Ava, say "sssssssssno." Her response was simply "so".

Visual cues were unsuccessful. Semantic cues were unsuccessful. Auditory cues were unsuccessful. I finally tried incorporating some tactile cues. I happened to do this with feet because Ava thought it was funny, but you could do this with hands, fingers, or knees as well. I first grabbed one foot and giving it a light squeeze I asked her to say, "Hi sssssss." She repeated, Hi sssssss." Then I grabbed the other foot and gave it a squeeze and asked her to say, "Hi no." Again, she repeated, "Hi no." Then I squeezed each foot in succession as I said, "Now say ssssssss-no." She had the tactile cues of me squeezing each foot in succession with each part of the blend. She had the auditory cues of the prolonged /s/ sound followed by an emphasis on the /n/. She was also watching my face and mouth at the same time. This time she was successful.

We continued to practice that way about three additional practice sessions and then I was able to fade the cues. First I was able to stop using the tactile cues. Then I was able to minimize the prolonged /s/ sound. Now I can simply show her the card and give her an auditory cue with a just the slightest prolongation of the /s/ and a slight emphasis on the /n/ and get a /sn/ blend production from her. It's like the motor planning finally kicked in and now she has it. We still have a lot of work to do. It is inconsistent and we get no carryover to other s-blends (/st/, /sp/, etc.). At least the variety of cues and prompts managed to help her experience some success with the specific blends we are working on right now.

I used the same strategies for /pl/ and /bl/. Our /pl/ words are plum, play, please and plane. Our /bl/ words are blue, blood and blow.

Quick summary of cues/prompt types you may find useful:

• auditory (slight separation of blend consonants, prolongation of first consonant in blend, emphasis on the second consonant of the consonant blend, clapping or snapping for each section of the blend word, etc.)
• visual (use gestural prompts for specific phonemes, use gestures to represent semantic cues, have child watch your mouth)
• semantic - assign meaning to the second part of a blend word (the "no" of snow, the "nap" of snap, etc.)
• tactile cues - tap or squeeze a hand, finger, or foot to emphasize each part of the blend word you are trying to produce in sequence