Hello!

I just returned from a two week vacation in New England and Eastern Canada to see the fall colors and eat lots of seafood.  A beautiful and tasty vacation!  There are three things I want to share with you that are upcoming:

First, I have two SATPAC workshops this month.  The first is in San Jose on Friday October 25^thand the second is in Oakland on Saturday October 26^th (See below for registration information).  I also do presentations for the Bureau of Education & Research (BER) on /r/ and /s/ remediation and will be presenting 4 workshops for them in January (7-Cherry Hills, NJ, 8-White Plains, NY, 9-Chicago, 10-Champaign).

Second, if you are going to the ASHA Convention in Chicago, Peter Flipsen,Jr. and I are presenting a study I did last year on /s/ remediation.  The results are exciting in that this was the second study on /s/ remediation that I’ve done.  The first was done only by me and this study was done by two other SLPs.  The results were very similar in that most kids were completely remediated in less than 3 hours of direct therapy using the SATPAC Program and Approach.

And third, I’m very excited to let you know that SATPAC Speech is sponsoring Pam Marshalla to speak on Carryover in Speech.  The presentations will be February 27^th in Pasadena (Monrovia) and February 28^th in Anaheim.  Pam is a terrific speaker and I’m excited to be the sponsor. I’ve learned more from Pam than any other SLP and I can safely say that I would not be a national presenter if not for all that I learned from her. The cost will be $99 and seating will be limited so be sure to sign up early (both state of California and ASHA CEUs will be available).  Registration information will be on my website www.satpac.com in the next couple of weeks.

Stephen Sacks

SATPAC Speech

To see details about /r/ and /s/ remediation and more information about my approach, I offer free ASHA CEUs on my website www.satpac.com or you are welcome to just watch the presentation.

Workshops- For more details see  https://satpac.com/workshops.  If you would like me to come and speak to your organization or school district, contact me at steve@satpac.comsteve@satpac.com .  For the BER seminars, here is a link to one of my workshops:  http://www.ber.org/seminars/CourseInfo.cfm?seid=XSA4W1-CHH

The SATPAC Speech newsletter continues with helpful tips for remediation of articulation/phonology disorders.  If you missed previous newsletters, they are on my website:  https://satpac.com/newsletter.

This issue of the newsletter will focus on an important element of my approach which involves therapy response rate.  That is, the student makes lots and lots of correct productions.  When I first started experimenting with SATPAC over 20 years ago and using a prototype computer program, I was struck by two things.  First, my students were producing a lot more target sounds per session than I was used to and (I’m sure not coincidently), they progressed at a much faster rate.

I started doing some calculations about making correct productions and figured out that in a typical speech session (once or twice a week in a group of 2-4), it would not be unusual to produce the target sound correctly less than 50 times.   I’ve actually observed sessions where 5 productions of the target sound were produced while doing a fishing game.

Anyway, in a typical week using their target sound incorrectly outside of therapy means that the students are in the upper 90% making incorrect target sounds.  Anything we can do to make transfer to conversation happen more quickly and more efficiently will have a profound effect upon how fast remediation occurs.  Using a very efficient systematic type of therapy like SATPAC leads to the student more quickly moving into generalization/transfer and thus quicker remediation.

When I was an undergraduate, I had a professor who said that in a good articulation session, we should get 500 correct productions!  I told her that was impossible.  (I later found out that she did one-on-one private therapy for an hour).  However the point stuck with me and I’ve found that I’m able to get 400 correct responses in a 25 minute session using a contrastive stress technique using sentences from the SATPAC Generalization/Transfer Phase.  For the /s/ sound, I modelGrace has a soft whisperand the student repeats Grace has a soft whisper. I then ask, Bill has a soft whisper?and the student responds, No, Grace has a soft whisper. So in less than 10 seconds, the student has made 8 correct /s/ productions.

Lots of correct productions lead to quicker remediation!

Stephen Sacks

SATPAC Speech

To see details about /r/ and /s/ remediation and more information about my approach, I offer free ASHA CEUs on my website www.satpac.com or you are welcome to just watch the presentation.

Workshops-I have 4 workshops scheduled in California in September and October.  For more details see  https://satpac.com/workshops.  If you would like me to come and speak to your organization or school district, contact me at  steve@satpac.comsteve@satpac.com .

Back to School Special! Mention this special in a purchase order when ordering SATPAC for a 33% discount or $100 (normally $150).  To get this price when ordering (not using a purchase order), write to me  steve@satpac.comsteve@satpac.com.

The SATPAC Speech monthly newsletter continues with helpful tips for remediation of articulation/phonology disorders. If you missed previous newsletters, they are on my website: https://satpac.com/newsletter.

This issue of the newsletter will focus on an important element of my approach which is the use of nonwords. The SATPAC Approach is based on the idea that when we as SLPs work to remediate sounds/phonological processes, the therapy should be as close to conversational speech as possible and to include the elements that we use in conversational speech (i.e., coarticulation, normal rate, natural prosody, etc.). It also includes some best practices and the use of nonwords is one of these.
Gierut, Morrisette and Ziemer (2010) demonstrated that nonwords induced greater, more rapid system-wide generalization as a function of treatment than did real words.

SATPAC uses facilitating context nonwords at the beginning to develop a consistent motor pattern with the idea that quickly developing a consistent motor pattern will lead more quickly into successful conversational speech. For /s/, the word beetseet is often used.

There are 3 phases in the program. In the Establishment Phase, the /s/ sound is used in only one context (beetseet) through 7 different steps (e.g. emphasis on the non-target syllable, emphasis on the target syllable, phrases, sentences, etc.). In the Practice Phase, the /s/ sound is used in many contexts but vary systematically. Using the place/manner chart and the vowel circle, nonwords are used which move slightly away from the previous word. List 1 of the Practice Phase goes like this: beetseet, mitseet, weitseet, fetseet, vatseet, tutseet, dotseet, etc. Note how the initial consonants are moving from the front of the mouth toward the back. And you can see how the vowels are moving from front closed to open and eventually to the back. The purpose is to make minimal changes from word to word and to develop this consistent motor pattern using -tseet. Eventually as the students progress through the lists, they will be able to say the /s/ sound in any context. The Generalization/Transfer Phase uses real word phrases, sentences and conversation.

The quickest way to normal conversation is through systemic use of nonwords!

Stephen Sacks
SATPAC Speech

To see details about /r/ and /s/ remediation and more information about my approach, I offer free ASHA CEUs on my website www.satpac.com or you are welcome to just watch the presentation.

To see details about /r/ and /s/ remediation and more information about my approach, I offer free ASHA CEUs on my website or you are welcome to just watch the presentation.

This is the third in a series of semi-regular monthly newsletters suggesting helpful tips for remediation of articulation/phonology disorders. If you missed previous newsletters, they are on my website: https://satpac.com/newsletter.

This issue of the newsletter will focus on another element of my approach which is normal rate. The SATPAC Approach is based on the idea that when we as SLPs work to remediate sounds/phonological processes, the therapy should be as close to conversational speech as possible and to include the elements that we use in conversational speech (i.e., coarticulation, normal rate, natural prosody, etc.).

Early in my career I was practicing the /s/ sound with a student and we were working on sentences. He was saying them at a slow rate: I wash with sssoap. I like to sssing. The bell rang and he said in at a normal rate: Thee you later Mithter Thackth–Itth time for retheth!

Realizing that it is necessary to begin at the level where the student’s skills are, we often have to begin at a slow rate. However, the goal needs to be to practice at the same conversational rate that the student speaks. Having supervised many SLPs through the years, I’ve noticed that consistently SLPs practice too slowly and consequently, transfer doesn’t happen.

With SATPAC, I follow a 3-part approach. First the target sound is established (Establishment Phase) in one context (for /s/ I frequently use the nonword BEETSEET). It is repeated over and over until the student is 95% accurate. Then the second step uses the target sound in many different contexts. In SATPAC, this is known as the Practice Phase. The student builds up to a conversational rate practicing systematic lists (140 beats per minute using a metronome). The third step is the Generalization/Transfer Phase where the student is now using his skill to practice phrases, sentences and conversation–all at a normal conversational rate.

If you have your students practice at a conversational rate, you will be pleased by how much quicker they transfer their skills into conversation.

Stephen Sacks

SATPAC Speech

To see details about /r/ and /s/ remediation and more information about my approach, I offer free ASHA CEUs on my website or you are welcome to just watch the presentation.

Hello!

This is the second in a series of semi-regular monthly newsletters suggesting helpful tips for remediation of articulation/phonology disorders.  If you missed the first one, it is on my website:  https://satpac.com/newsletter.

This issue of the newsletter will focus on another element of my approach which involves the use of coarticulation.  The SATPAC Approach is based on the idea that when we as SLPs work to remediate sounds/phonological processes, the therapy should be as close to conversational speech as possible and to include the elements that we use in conversational speech (i.e., coarticulation, normal rate, natural prosody, etc.)  I find that there is a disconnect between the way most SLPs do therapy and conversational speech.  That is, we tend to work on sounds with either the sound in the initial or final position. Yet when we speak in conversation, the target sound is usually neither first nor last but somewhere in between. For that reason, the SATPAC Program always has the target sound embedded in the middle of the words.  Here are some examples:

1)    For /s/, I frequently use the nonword BEETSEET.  Notice how the target /s/ sound is imbedded in the word and is in the prevocalic position meaning that it is followed by a vowel.

2)    For /r/, I frequently use the nonword EERGA.  The /r/ is in the postvocalic position in this case.  In practice, it is much easier to stop with the /r/ at the end of the word than to have to transition into other sounds.  Coarticulation from the beginning makes it easier for the student to make that transition. (Note:  In this case, it is actually easier with the GA following EER because it is a facilitating context.  As the SATPAC lists progress, the GA goes away and /r/ is said in various contexts).

3)    If I’m working on s-clusters, I have the student say the word “A” before the cluster so they have to transition from an open mouth position for the “A” to a closed mouth position for the /s/ (e.g., a spoon, a stop, a sketch, etc.).  Again, it is much easier to start with the /s/ in every case but much better practice to be making the transition from the ‘A” to /s/.

To see details about /r/ and /s/ remediation and more information about my approach, I offer free ASHA CEUs on my website at https://satpac.com, or you are welcome to just watch the presentation.

I am Stephen Sacks and this is the first in a series of semi-regular monthly newsletters suggesting helpful tips for remediation of articulation/phonology disorders.

Briefly, my story began 33 years ago when I had my first day of speech therapy at an elementary school and realized I didn’t have a clue how to remediate articulation deficits effectively (particularly the /r/ sound). So my journey took about 15-20 years; learning the skills, the correct principles and developing techniques for effective and efficient remediation.

Along the way, I developed the SATPAC Computer Program and a systematic method for remediation (The SATPAC Approach) which led to being honored in 2011 with the American Speech and Hearing Foundation’s Rolland J. Van Hattum Award for outstanding commitment and contribution in the school setting.

for Speech-Language Pathologists & Audiologists
July 23, 2012 – Vol. 22 – Issue 7 – Page 14
By Stephen Sacks, MA, CCC-SLP

In 1975, I walked into the speech clinic at California State University, Fresno, a 24-year-old with no voice. I had been working as a sound engineer in a recording studio. With the constant noise level, it had become increasingly difficult to talk until I had totally lost my voice.

As I worked with the student clinicians over the next two semesters, a change began to occur. My voice started to come back, and I also became interested in the profession. I began taking classes and pretty soon I was hooked.

My biggest anxiety was not how difficult the classes were but my ongoing speech issues. I was diagnosed with adductor spastic dysphonia with bowed vocal cords which led to lots of breathiness. I also developed significant dysfluency as it was difficult to make the transitions from unvoiced plosives to vowels (e.g., pay). I started avoiding certain words and speaking situations and wondered how I would ever pass the final oral speaking test to become an SLP.

Discouragement & Inspiration

Dr. Robert Brooks, a clinical psychologist and researcher, frequently writes how charismatic adults can change children’s lives.

He often does workshops with adults where they retell their stories from childhood about how some adult (frequently a school employee) said or did something that permanently changed their lives for the better. There are also painful incidents where an uncaring adult left the individual permanently scarred.

In my case, I had both happen.

One of my professors had assigned the class to watch a movie on stuttering. Because of my situation, I had done a lot of reading on stuttering. I thought this film was pretty superficial, and I told that to my professor. Standing in the speech office with other students around, she proceeded to tell me I shouldn’t even be in the department because I didn’t have the voice of a professional SLP.

In the Communicative Disorders Department at that time was an instructor named Bette Baldis whose classes I really enjoyed. One day after my traumatic experience with the professor I asked Bette whether she thought I should continue to become an SLP. Her response was, “Are you kidding Steve? You are going to be terrific!”

Discovering a Passion

I graduated in 1980 and never did pass the speech test but was allowed to continue. The first job I found was working in the schools. I took it and have been in the schools ever since.

In the mid-80s, I began having more voice difficulties. There were white growths on my vocal cords, and I had a surgery called a vocal cord stripping. This involved removing the top layer of skin from my vocal cords leaving them reduced in mass. After my surgery, I plodded along the best I could and then in 2008 decided to have a bilateral thyroplasty. This involved surgically inserting some plastic triangular-shaped devices which pushed the vocal cords closer together making it easier to phonate. My voice is somewhat better than it used to be, but I still find it difficult to talk in many situations, particularly when it is noisy.

As my 32-year career has progressed, several things have stood out over time.

The first was my initial day as an SLP. I took over a caseload with the usual assortment of speech and language problems. As I was working with some kids with no /r/ sounds, it became very clear to me I did not have the skills I needed to remediate their deficits. That day was instrumental in shaping my future. I vowed I would become an expert remediating speech disorders which resulted in doing lots of reading, attending many workshops and experimenting with different techniques.

I felt I continued to be mediocre until I went to several oral-motor workshops. Two significant concepts in oral-motor principles involve stabilization and differentiation. When I began to apply those principles I began to have consistent success. Rather than just telling a student with a frontal lisp to close his teeth to prevent the tongue from sticking out, I could now instruct him to develop the proper foundation for saying a correct /s/ sound.

The student was now instructed to stabilize the back of the tongue on the back molars and differentiate the movement of the back of the tongue which stayed still from the tip of the tongue which lifted up. I incorporated recommended oral placement exercises and developed others which helped get the articulators in the proper position to move into successful speech.

Articulation Fading Away?

Because my special interest is articulation/phonology, I’ve noticed over time it has become less prominent in our profession. As I present my workshops and talk to SLPs, there seems to be a consensus that as in my case when I graduated 32 years ago, new SLPs don’t have the necessary skills to efficiently and effectively remediate articulation/phonology disorders.

In the schools, it appears students with articulation/phonology disorders are the largest group of students we serve. I continue to see students in middle school and high school who have never made a correct /r/ sound, who have been dismissed from speech for lack of progress, and I will consistently get them to produce a correct /r/ in our first session.

In the future, I hope school SLPs and university professors can better partner to study what works best for students.

There is a belief the Chinese symbols for crisis can also be interpreted as opportunity. Whether or not this belief is true, my crisis turned into an incredible opportunity. I feel so lucky to have stumbled into what has been a terrific and rewarding career that was unimaginable when I walked into the CSU Fresno speech clinic 36 years ago.

Stephen Sacks is program creator at SATPAC Speech, LLC. The American Speech-Language-Hearing Association presented him with the 2011 Rolland J. Van Hattum Award for school-based professionals. He can be contacted at info@satpac.com.

Article on Advance website

Copyright å©2012 Merion Publications 2900 Horizon Drive, King of Prussia, PA 19406. 800-355-5627 Publishers of ADVANCE Newsmagazines

www.advanceweb.com

This article was published by for Speech-Language Pathologists & Audiologists
July 23, 2012 – Page 14

for Speech-Language Pathologists & Audiologists
August 15, 2005 – Vol. 15 – Issue 33 – Page 14
By Stephen Sacks, MA, CCC-SLP

With a nod to Ron Clark, Disney’s American Teacher of the Year in 2001 who wrote The Essential 55, about discovering the successful student in each child,1 I have developed “The Essential 10 for Successful Articulation/Phonology Therapy.”

Based on my 25 years as a school speech-language pathologist, I have found the following to be essential:

• a solid foundation,
• perfect practice,
• mandatory homework,
• repetitions per session,
• systematic therapy,
• hierarchy,
• natural prosody,
• coarticulation,
• conversational rate and
• change occurs over time.

A solid foundation is essential. In order to successfully remediate articulation/phonology disorders, oral-motor issues often have to be addressed before working directly on the sound. For example, if students cannot make the /r/ sound, can they retract the tongue appropriately and grade the jaw to be able to consistently retain the proper position? Can they differentiate the tongue movement from the lips and the jaw when attempting to say the sound?

For the /s/ sound, can students differentiate the front from the back of the tongue so they can stabilize the back part of the tongue and use the tongue tip independently? For the /k/ sound, can they differentiate the tongue movement from the jaw, keeping the mouth open and still while retracting and elevating the back of the tongue? If the answer is no to these questions, direct speech therapy to remediate these sounds will be difficult, if not impossible.

Another essential is perfect practice. As therapists, we need to provide accurate and timely feedback to our students while they are learning to correct their deficits. We need to reinforce correct products and discourage the incorrect ones. Like with a golf swing, we are dealing with motor memory. If a student with an /r/ problem puts his tongue in the incorrect position and makes an incorrect /r/ and does not know the production was incorrect, it becomes more difficult to establish the correct /r/ sound in the future.

If students have group therapy for articulation once a week, they may make 50 to 100 correct productions during a half-hour session, while making hundreds of incorrect productions the rest of the day. Just five to 10 minutes of practice five days a week reinforces the correct productions and leads to eventual success by moving students more quickly into transfer so they are making some correct productions during the part of the day they are not in therapy.

Because students typically make hundreds of incorrect productions outside of therapy in a typical day, there needs to be many correct productions to change that behavior. The number of repetitions per therapy session is another essential element of successful articulation/phonology therapy. One of my professors in college had said there should be 500 correct productions in a therapy session. While that seemed unreasonable at the time, over the years I have worked up to close to that number in a focused 25-minute session.

Systematic therapy also is important. Many times I have seen therapists asking students to make sentences with their target sound when they don’t have the sound clearly established yet. Sounds need to be established in a single context, generalized into every phonetic context, and finally transferred into phrases, sentences and conversation.

Along the same line, there should be a hierarchy in therapy. I recommend bisyllable words followed by phrases. Structured sentences should follow.

For example, if /s/ is the target, structured sentences might be “I want a sock” or “I want a seat.” Follow with varied sentences like “I bought a new sock” or “Can I have your seat?”

To increase the number of correct productions, a contrastive stress strategy works well. Continue with questions that require the student to generate the word for the first time:

Therapist: “Is that a shoe?”

Student: “No, a sock.”

When the student can generate successful target sounds, I recommend conversation and/or reading with discussion as the terminal step in structured therapy.

In conversation we use natural prosody and do not focus on any particular sound. In therapy there is often an unnatural emphasis on the target sound. For quicker transfer to conversation, practice should emulate natural conversation as much as possible. At the bisyllable level and phrase level, stress should vary. A contrastive stress model is suggested at the sentence level to take emphasis away from the target sound.

For example, if the target is /s/ and the sentence is “A boy bought a big sandwich,” ask questions after the student says the sentence. A sample question is “A girl bought a big sandwich?” The student would reply, “No, a boy bought a big sandwich.” The student is then asked, “A boy stole a big sandwich?” The student replies, “No, a boy bought a big sandwich.”

Because we speak in phrases and sentences and not in isolated words, practice is most efficient in the same manner. Target sounds should not be the initial or final sound of the practice word. To effectively target a sound, it should be in a coarticulatory context. A CVCCVC bisyllable with the target in either the third or fourth position is the most efficient.

For instance, if the target sound for a student with a frontal lisp is /s/, a nonsense bisyllable like “beetseek” is recommended. There is an added advantage of using a facilitating context. The /b/ requires no tongue positioning, and the /ee/ moves the tongue back into the lingua-alveolar position, followed by the /t/ also in the lingua-alveolar position. When the duration of /eet/ is lengthened, it turns into the correct /s/ sound, as in /eets/. This is again followed by /ee/, keeping the tongue in the lingua-alveolar position. Finally, the /k/ will have the tongue moving back, making it less likely to protrude into the lingua-dental position.

Practice should simulate real conversation as much as possible. To transfer practice into conversation, the practice has to be at a rate that is comparable to conversation. If practice occurs at the rate of 100 beats per minute (BPM) per syllable using a metronome and slow conversational speech is 140 BPM, transfer will not occur. Practice must be at least at a slow conversational rate.

The final essential element of articulation/phonology therapy is that change occur over time. Keeping this principle in mind means that therapy needs to provide time for growth. Given an option of five therapy sessions in a week vs. five therapy sessions weekly, the latter is preferable.

I have had several successes with a student who had a chronic /r/ or /s/ deficit remediate in six sessions or less. This has happened due to significant changes occurring from one weekly session to the next. The student performs homework diligently and returns the following week looking nothing like the student of the previous week due to significant growth.

References
1. Clark, R. (2003). The Essential 55: An Award-Winning Educator’s Rules for Discovering the Successful Student in Every Child. New York: Hyperion.
Stephen Sacks has been a speech-language pathologist in the schools for 25 years. He can be contacted at steve@satpac.com.

Article on Advance website

Copyright å©2005 Merion Publications 2900 Horizon Drive, King of Prussia, PA 19406 – 800-355-5627 Publishers of ADVANCE Newsmagazines www.advanceweb.com

This article was published by for Speech-Language Pathologists & Audiologists
August 15, 2005 – Page 14

for Speech-Language Pathologists & Audiologists
February 24, 2003 – Page 11
By Stephen Sacks, MA, CCC-SLP

åÊ

I’ve been a speech-language pathologist in the schools for the past 23 years and for the last 8 years have used the SATPAC Computer program to remediate articulation deficits and phonological processes. Using this program, progress is usually quick but the following 3 cases were exceptionally so.

Coaching Little League Baseball for 3rd and 4th graders, I had two boys on my team who did not have the /r/ sound. After listening to them talk all season, I approached their parents to find out if they were receiving speech therapy. Each told me the same story-that their son had received a year of speech therapy without any noticeable change. One student received group therapy and the other individual.

As a service to them, I offered to see them individually over the summer for 30 minutes once a week. The course of therapy for each student was essentially the same and after 6 sessions, they were both using the /r/ sound correctly in conversational speech. Granted, this was not a typical situation. The parents were highly motivated and followed my homework directions explicitly. Their mothers were present during the sessions and could see how I worked with their sons. Nevertheless, these students were able to remediate a chronic problem quickly and efficiently because of the nature of the SATPAC computer program.

Here is how the therapy proceeded. There was some variation between the students but their progress was similar enough that I can give a general description that can be applied to both of them. Before SATPAC, the prerequisite oral-motor skills were developed. Therapy began with the students learning the proper “EE” position of keeping the tongue back and wide and anchoring the sides to the inside of the back molars. I taught them to differentiate their tongue movement from their jaw movement by having them bite on a Popsicle or craft stick positioned between their back molars on one side of their mouth. They held the stick in front of their mouth, keeping the jaw still and sliding the tongue back and forth on the top teeth. Finally, they were ready to say “EER” keeping the mouth in a tight smile being slightly opened and still while sliding the anchored tongue slightly back. They used a mirror and a flashlight so they could visually monitor their tongue movement. For homework, they practiced the “EER” sound 100 times/twice a day. By the second week, they were ready to put the “EER” sound into a facilitating context with coarticulation for quicker transfer to conversation. The CVCCVC nonsense word they used was “GEERKAP”. This context was facilitating because the /g,k/ sounds keep the tongue back and the /p/ requires no tongue positioning.

By the third week they were able to successfully use “GEERKAP” in the seven different steps of the Establishment Phase. They began using the CVCCVC Generalization Phase lists that have minimal changes between words. This developed a consistent motor memory pattern for the “EER” sound within these nonsense words. They were required to say the words quickly before proceeding to the next list. As competence occurred in each list, the student was moved farther and farther away from the “GEERKAP” facilitating context until they could say the /r/ sound in any phonetic context. It took an additional week to get through all 9 of the Generalization Phase lists.

By week five, they began transferring the /r/ sound into phrases and sentences provided by the SATPAC program. At this point, transfer into spontaneous speech was beginning to occur. Finally at the sixth week, they were able to converse at a slow conversational rate using their /r/ sounds with over 50% accuracy. It was clear to me that with practice, they would continue to improve and in fact they did. I saw them during baseball season the following year and both kids were totally remediated.

The third exceptional case involved a lateral lisp which was remediated in 3 sessions. Because I worked in a year-round setting, I was able to get an extra pay contract during one of my track vacations. I was assigned to a school where the therapist was out on leave. I saw the students on my caseload once a week for what was to be a six-week period. My student was a 4th grade girl who had been in therapy since second grade. She was able to make a reasonable sounding /s/ at the word level but said her words too slow and there was no carryover into conversation. Therapy began as with the /r/ students with oral-motor therapy and the “EE” sound. She quickly progressed to saying “EET” using only the tongue tip for the /t/ sound and keeping the sides of the tongue anchored and stationary. She used a flashlight and monitored her movements visually with a mirror. This moved into saying “EETS” by having her extend the duration of the /t/ sound. She then said “EETS-EE” with a slight pause between the syllables. The reason for the pause at this point was that if she conceptualized saying “SEE”, her lateral lisp would have returned. Continuing, she said the two syllables faster and faster until they were said without a pause in between. Each one of these steps in therapy involved 30-50 repetitions. Her homework for the week was saying “EETSEE” 100 times a day.

I had an IEP meeting with her father later that week and explained the SATPAC program to him. I told him that I would be sending home lists of nonsense words for them to practice together. He was instructed to model the word for his daughter at a normal speech rate and to correct her if she was too slow or if he heard any lateral /s/ sounds.

In the second week of therapy, she quickly moved through the Establishment Phase and into the CVCCVC nonsense word lists in the Generalization Phase. The facilitating context word was “BEETSEEK”. Again, each list consisted of words that had minimal changes from the previous word and each list moved farther and farther away from the facilitating context until she was able to say the /s/ sound correctly in every phonetic context. This occurred during the third week. When I saw her for the following session, she was using the /s/ sound correctly in conversation with near 100% accuracy. I made a point of checking up on her a year later and she still was using the /s/ with 100% accuracy.

Again, she was not a typical case. I had the father present from the start and was able to show him how to implement a successful homework program for her. She was highly motivated to get out of speech and practiced diligently. However, with all three of these students, the systematic nature of the SATPAC program maximized their ability to progress. Developing a consistently correct motor pattern (perfect practice) in the Establishment Phase and the rapid repetitions of CVCCVC nonsense words in SATPAC’s Generalization Phase of therapy led to the successful motor patterns that these students needed to quickly transfer into conversational speech. My success using the SATPAC program has not been as dramatic with my typical student but it has always been significantly faster than my previous articulation/phonological therapy. In this era of high caseloads, little time for preparation and emphasis on literacy, it behooves us to implement articulation/phonological therapy as efficiently as possible and SATPAC is the tool that has allowed me to do this.

For more information contact Stephen Sacks at info@satpac.com or https://satpac.com/

åÊ

Copyright å©2004 Merion Publications 2900 Horizon Drive, King of Prussia, PA 19406 – 800-355-5627 Publishers of ADVANCE Newsmagazines www.advanceweb.com

This article was published by for Speech-Language Pathologists & Audiologists
February 24, 2003 – Page 11