The 7 Stages of Speech Therapy

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A very common communication difficulty we see here at Child’s Play are speech sound errors. Children who experience difficulty with their speech production have trouble using the correct sounds (e.g. replacing “k” with “t”, like “tat” for “cat”). There are a number of different types of speech delays and disorders, and intervention for each will look slightly different based on their underlying issue. For the most part, however, intervention will follow the same hierarchical approach..

Why this approach?

Unfortunately, just because a child can say a target sound, does not mean they can use in within their everyday conversation. Speech is habitual and mostly automatic, and for this reason it is very difficult for a child to change the sound patterns they use. This is why a gradual approach involving small step-ups in complexity is used. Each stage of speech therapy is slightly more difficult than the last, and this helps your child to build a foundation for their eventual use of the sound in their everyday speech.

1. Isolation

In this stage we work on achieving a correctly produced target sound on its own (e.g. “s”). Before we’re able to work on a sound, a child must first be able to say that sound on it’s own.

2. Syllables

In this stage we work on producing the target sound in simple syllables (e.g. “soo”, “see”, “sah”, etc.). The consonant + vowel form is short and simple and helps children learn how to say the target sound in combination with a vowel. We may also work on vowel + consonant syllables (e.g. “ees”) and consonant + vowel + consonant syllables (e.g.
“oosoo”) if necessary.

3. Words

In this stage we work on producing the target sound in all positions of the word, including word initial, word medial and word final (e.g. sun, listen and grass respectively ). Once we’ve worked on the building blocks of words, in the syllable stage, we begin to target use of the sound in actual words.

4. Sentences

In this stage we work on producing the target sound within sentences (e.g. “The sun went behind the clouds”). In this stage we step up the complexity quite a bit, and are working on a child being able to remember to use their target sound in the midst of lots other words.

5. Stories

In the Stories stage we work on producing the target sound in long stories, usually with multiple words containing the sound (e.g. “one day the sun and moon were listening to music while laying on the grass. While they were laying there they saw a seal hiding behind a house“). By having a child make up stories using their target words, we are working on their ability to both use the sound in a complex context (with lots of other sounds) and to be able to use the sound while their attention is focused on creating the story. This helps to build their ability to use the sound automatically, which is necessary for the next stage.

6. Conversation

In this stage we begin to work on using the target sound correctly while conversing with others in their everyday communication. Mastery of this stage is our ultimate goal. During this stage we’re working on supporting the child’s ability to use the target sound completely automatically, and to be using the sound outside of therapy.

7. Maintenance and Monitoring

Once a child is demonstrating use of the new target sound spontaneously during their day-to-day communication, we begin to phase out therapy and begin parent monitoring of their ongoing use of the sound. Monitoring is an important step, as a few children will experience some regression of their new use of the target sound. Monitoring your child’s speech over a few months will help to identify if this is happening, and can usually be rectified with a few booster therapy sessions with your Speech Pathologist.