Articulation and Phonology Disorders 39circumstances that resulted in correct production discovered. By varying the phonemes that precede
and follow the /r/, Wendy is able to get Geraldo to produce a correct /r/ speech sound in isolation.
Geraldo is able to produce a correct /r/ in the word combination fun– run. Eventually, Geraldo can
consistently produce the /r/ sound in isolation, and Wendy rewards him for each correct production.
As Wendy continues with the production phase, Geraldo is taught to produce the /r/ phoneme
in more complex contexts. First, he produces the speech sound in the initial position of syllables
such as ra, ree, and roo. Then he produces the phoneme in the final position of syllables such as
eer, oor, and ahr. Fi nally, during syllable production, Geraldo learns to produce the /r/ phoneme in
syllable contexts where his phoneme is in the middle.
Now that Geraldo has mastered correct production of the /r/ phoneme in isolation and in syl-
lables, Wendy moves to the next level of articulatory complexity—words. Similar to the production
exercises for syllables, Geraldo first works on producing the /r/ phoneme in the initial position.
Wendy shows him photo cards and word lists, and he is soon able to produce it. Then he works
on the /r/ in the final and medial positions of words. Soon he is producing it correctly in all three
positions of words.
Continuing to increase the articulatory complexity, Wendy has Geraldo create sentences and
phrases using words with the /r/ phoneme. First, she encourages him to attend carefully to the /r/
sound production. As his mastery increases, she gradually creates conversations in which Geraldo
attends less and less to the /r/ sound production. The goal is to gradually help Geraldo learn to
use the /r/ phoneme correctly in off- guard speech. Wendy also enlists the help of his teachers and
parents to cue him to use the phoneme correctly in the classroom and at home. Soon Geraldo has
mastered the correct production of the /r/ phoneme in all contexts and has carried over what he
learned in individual therapy to all aspects of his life.
Case Study 2-5: Group Therapy for
Articulation and Phonology Disorders
Circle is their favorite activity in group therapy. In circle, Nicole, Yonkel, Tara, and James
Robert get to stand together in the small therapy suite, hold hands, and play enjoyable games. As
first graders, they are not certain why they spend time together in circle or why they leave the
regular classroom 3 days a week. All they know is that circle is fun, and as they settle down for
therapy, they coax the speech teacher to begin. On Mondays, Wednesdays, and Fridays, at precisely
10:15 a.m., the teachers and students can hear the chant “Circle, circle, circle” resonate through the
halls of the small elementary school.
Because the clinician believes that two or more brief therapy sessions are more beneficial than
one long session, the children are seen in group therapy for 10 to 15 minutes twice daily. The fre-
quent, short sessions are more impor tant for younger children because their memory and attention
are limited. Consequently, Nicole, Yonkel, Tara, and James Robert have circle in the morning and
after noon three times per week.