Speech therapy for 8 year old?

March 13, 2017 3:59 PM

My 8 year old has trouble articulating the "r" sound. Do I have unrealistic expectations about speech therapy?

It seems to be developmental - no other delays or behavior issues or diagnoses. Just difficulty pronouncing "r" (it sounds more like a "w"). We have done speech therapy 1 hour/week with a private speech therapist for seven months, with homework assignments to work on "r" words during the week, and I still don't hear any difference at all. It's not covered by our insurance, and at $200/week, the cost adds up fast. It is normal that there would be no improvement after seven months? How long should I expect it to take? Should we continue, or quit in the hopes it will resolve on its own, or find a new therapist? Our therapist has had no answers when we ask how long it can be expected to take and just said each case is different, so that hasn't been helpful...

posted by Mallenroh to Health & Fitness (16 answers total)

Our son had the same issue and it cleared up with therapy in a few months. The therapist was provided by his public school, BTW—is that an option for you? Perhaps there's a structural component. Has he been seen by an ENT?
posted by Johnny Wallflower at 4:17 PM on March 13, 2017

Have you asked her about a prognosis lately? Ask her point-blank if there's still hope that the sound will develop. R is the worst sound to teach and it can take a while, but she should still be able to tell you whether it's going to come or not.

Also, ask about what progress he's made. Saying a sound in conversational speech is actually the last step in teaching any speech sound, so it could be that he's making progress and you just can't hear it when he's chatting with you. Can he say the r in words? Phrases? Or even the sound all by itself? Has he made any headway at all in the past seven months?
posted by christinetheslp at 4:18 PM on March 13, 2017 [4 favorites]

I received ongoing speech therapy from age 6 to age 14, but mine was a combination of hard-stop stuttering as well as working with the letter 'r'. The latter of the two took me three full school years of weekly two-hour-long therapy sessions to overcome. Mine was, however, covered by my public school(s) per special education needs, so that stood out to me in reading your post.

If I had to think back to it, I remember it was really quite hard to develop awareness of the physiology required to pronounce the sound, somehow, especially at that age. Frankly, that level of verbal self-awareness is not a directly conscious factor - it almost has to be behaviorally trained in. I still soften my 'r's from time to time when I get relaxed into it, but I have a feeling most speech therapy patients do ultimately come around in some form. I never felt pressured around 'fixing it,' personally, otherwise I think I might have developed some shame around it. Thankfully, my growth around it has actually really improved my life.
posted by a good beginning at 4:18 PM on March 13, 2017 [2 favorites]

I had this same speech impediment as a child and went through speech therapy from around 6 years old until my parents gave up, around 9 or 10. Though I am only one person, I will say that when it finally faded away around 16, it wasn't because I was practicing the tongue and throat formations the therapists taught me. I did have to deal with bullies mocking my speech, but I knew even then that they would pick on anything else if I hadn't spoken the way I did.

Maybe there have been enormous developments since the early 90s in speech therapy, but your question lends me to believe there haven't been. If I'm intoxicated, I still slur/"wibble" my r's to w's saying particularly difficult words (like particularly, or rural) but honestly it hasn't ever affected my career as a college instructor or my life overall. Being in speech therapy did affect me somewhat though--I felt like a failure when I didn't "get better" and also felt highly resentful that my speech was seen as aberrant, that my ability to articulate a consonant that honestly never caused any confusion in spoken English was more important than the things I was actually saying.

I'm only one (still grumpy) data point, but if it seems to be a problem for them later on in life your child can choose speech therapy for themselves and, assuming this isn't a physiological issue, it will be just as effective later as imposing it on them now.
posted by zinful at 4:22 PM on March 13, 2017 [4 favorites]

My kids have a similar issue. One is entering his first year of speech therapy and the other his second, they do pull-out sessions twice a week at their school. There have been some noticeable improvements, but this is over a time period of many months.
posted by gnat at 4:57 PM on March 13, 2017 [1 favorite]

Our 5th grade (10-year-old) son has problems with r sounds of many shapes and sizes, and has been in speech therapy at school since 1st grade. We also take him to 30-minutes-per-week sessions with a teacher who does it from her home after school. (As an aside: we pay $30 for a 30-minute session.)

He has made progress, but it has been REALLY slow and he still struggles with it. I had the same problems that he did when I was a kid, and just grew out of it naturally. So I was skeptical of both the efficacy of the therapy and even the need for private lessons. But I have come to understand that (a) they do make a difference and the teachers are really helping, (b) it comes really slowly, and (c) each kid really is different. It might be a process of years rather than weeks or months.

To add to comments above, if your child is in a public school I'd urge you to talk with his teacher and seek an IEP for speech.
posted by AgentRocket at 5:01 PM on March 13, 2017

> Our therapist has had no answers when we ask how long it can be expected to take and just said each case is different

Second opinion is called for, at least. Undoubtedly each case is different, but you should be able to get an answer such as "X% of patients are successfully treated in M months, and Y% are never fully treated," (etc.)

Is this a case of Rhotacism? That may be a useful search term as you research how treatable it is, but you may not want to apply the label in case it's not, as judged by experts rather than by me, what it is.
posted by Sunburnt at 5:33 PM on March 13, 2017 [1 favorite]

My experience is the same as zinful's. A few years of unhappy speech therapy sessions didn't make a difference (I tried and tried and TRIED to do the stupid homework exercises and never could figure them out); sometimes I'd get teased but mainly not; I grew out of it around middle school; and now (in my 30s) once in a great while I'll come out with a w instead of an r which I'll correct and most people never notice, and it doesn't matter.
posted by frobozz at 6:01 PM on March 13, 2017 [1 favorite]

I had bi-weekly speech therapy for r and sh sounds in public school from about 1st grade until about 4th grade when we decided that it wasn't going to work, and I never found it helpful at all and I didn't show any improvement. For me, at least, focusing on what I'm doing with my mouth messed up how I sounded worse than the problem, and was more noticeable for people who wanted to make fun of it than a mushy mouthed R.

Nthing what zinful said, getting pulled out of class and having a practiced way to pronounce R's made me feel worse and got me more negative attention than the problem ever did, and while it mostly cleared up in middle school (honestly it was playing a brass instrument that did it I think, I don't understand how.), I still flub my R's sometimes and I'm usually the only one to notice.

A couple of other data points, my sister had the same issue and therapy cleared it up in about a school year, and I had two 'partners' in therapy with the same issues, one who was basically in and out in like a month and another who was in about as long as me and never improved.


I'd ask them how they feel about the therapy, if they think it is helping them, if it makes them feel bad about themselves, that sort of thing. If they seem positive on it, I'd guess that maybe it's helping in some way that isn't noticeable yet, or that they just haven't nailed it yet. I do think your therapist is correct, it really differs from person to person.
posted by neonrev at 6:17 PM on March 13, 2017

My son had that problem and since he didn't qualify for help through the school we would just practice at night when we read stories. I don't know if that helped or he just grew out of it but one day he said 'cherry' correctly when he was 9 1/2 and it was like like a switch, he just got it right ever after.
posted by Requiax at 6:41 PM on March 13, 2017

Best answer: Progress with the /r/ sound can be tricky. There are so many different /r/ sounds--beginning /r/ like in "rabbit," but also 6(!) different vowel /r/ sounds-or, er, air, ire, ear, ar. And all the /r/ blends! I work with elementary kids, and most kids get it, but some don't. More than 10 kids of my caseload of 50-some kids are working on the /r/ sound, so it's a common sound for kids to have trouble with. But, especially with 1 on 1 private therapy at an hour a week, I'd expect at least *some* progress by 7 months, especially at the sound or word level.

I would ask these specific questions from his therapist (or observe to find the answer):

-Have you focused on discriminating between w/r sounds? Can my child hear the difference between the two? Has his awareness/discrimination of hearing w/r improved?

-What tactile cues are you using in therapy? You can use a "bite block" tongue depressor held in place on the side of the mouth by the back teeth. This stabalizes the jaw, so that you can really feel and concentrate on the tongue movements. There is also a tool called the "speech buddy" that encourages the tongue to go "up and back" by uncurling a small plastic curl, placed inside the mouth (hard to describe--google it!)

-What visual methods have been helpful in therapy? (You can use modeling (look at me) or even a flashlight and mirror for your child to watch his/her tongue go "up and back."

-ask what his/her strongest /r/ sounds are. (Many kids do initial /r/ best, but some kids do vowel /r/ best (like er/ar/ear, etc.) If after a year his/her therapist doesn't know which /r/ sound is strongest, I'd get a second opinion or try a different speech therapist.
posted by shortyJBot at 6:53 PM on March 13, 2017 [5 favorites]

Nthing zinful's experience (interesting to see so many with the same story). 5 years of in-school speech therapy, still can't really say r's correctly, no one cares.
posted by entropyiswinning at 7:29 PM on March 13, 2017

I am also an elementary SLP and agree with everything shortyJBot said. Definitely seek out a new SLP or try your school district if you are in the US.
posted by scrubbles at 10:15 PM on March 13, 2017 [1 favorite]

I had this same issue and speech therapy wasn't offered to me (perhaps it's a different system in the US - it was assumed here that kids grow out of 'minor' speech problems). I learned to lengthen my vowels to compensate, a conscious process at first and then automatic. It happens still when I have to pronouce words with an R and W together (like 'wainwright') but rarely. Nobody notices. It IS a drawback with foreign languages - I can't pronounce French well at all, I struggled a bit with Spanish oral exams, but day to day, no.
posted by mippy at 5:10 AM on March 14, 2017

Another point for "grew out" of it. I struggled with the r sound as a child enough to be bullied regularly about it. Speech therapy was out of reach for our family. As an adult I still feel a twinge of struggle when saying words like regularly and particularly, but sound fine otherwise. Nobody has ever mentioned it to me.

Maybe take a year or two off of speech therapy but keep up the exercises your child was assigned. Reassess at the end of the year.
posted by eisforcool at 6:53 AM on March 14, 2017

I had public-school therapy for my R's. Remember nothing about it, other than one exercise was to spell words from flash cards then say them. One was a rhinoceros. I'm like wtf I'm 7 years old and you want me to spell that much less say it?

Think I only had a few sessions but my R's are fine today. Still can't spell rhinoceros though.
posted by raider at 8:52 PM on March 15, 2017