Perception training is part of most approaches to treatment sounds (Williams, McLeod, & McCauley, 2010). Discrimination training (helping a child hear the difference between sounds) is the traditional view of perception training. Established by clinical researchers in the 1930s, it remains the dominant perspective today. Another approach, promoting awareness, is on the horizon.
Discrimination training addresses the well-known phenomenon that some children do not appear to hear their own speech errors. Sometimes called “the rabbit kids,” these are children who pronounce rabbit as wabbit, but who, when asked if they say rabbit as wabbit, may reply, “No. I say wabbit as wabbit.” In addition to making a good story, the reply of “the rabbit kids” suggests they do not hear their speech error.
The presumed explanation for failure of children to hear their own errors is that their speech discrimination mechanism has sustained damage. The intervention is to repair the mechanism through discrimination training. The most typical training activity within this approach is identification. To illustrate, the clinician instructs, “I’m going to read a list of words. When you hear our treatment sound, I’d like you to raise your hand.” Of course, instead of a list, the activity could involve a story, pointing to objects, and so forth. After you establish discrimination (that is, once the child can discriminate the treatment sound from other sounds), treatment moves to production practice.
Promoting awareness (promoting a child’s awareness of the difference between sounds) offers a more cognitively oriented perspective on perception training. Promoting awareness begins by noting that it is highly unlikely that “the rabbit kids” fall down the wabbit hole because they have a broken discrimination mechanism. Speech perception, in common with other sensory systems, develops and matures months before an infant’s first birthday (Kuhl, 2010; Pascallis, de Haan, & Nelson, 2002).). Like all parts of the body, damage can affect speech perception. However, because it is a critical foundation for speech learning, the outcome would be catastrophic and not limited to one or several late acquired sounds.
If perception problems are not the result of an immature or broken speech perception system, what is the problem? And, equally importantly, what can we as clinicians do about it? The answer may be that when children speak their attention is on their intention, not the sounds tumbling out of their mouth.
Fast-fading Memories: This attention on intention is true for children with and without speech disorders, and for adults as well. In many ways, our perceptual system makes it difficult to monitor speech sounds. To illustrate, echoic memory lasts only milliseconds and then fades. Short-term memory lasts slightly longer, from 10 to 15 seconds up to a minute.
Just Like Adults: Adults—including highly trained speech-language pathologists—find it difficult to pay attention to small differences in their own speech. To illustrate, even an experienced clinician may not realize that their [r] in ride is voiced and their [r] in pride is voiceless, that [k] in key is made much more forward in the mouth than [k] in cool, and that [p] is aspirated in pie but is unaspirated in spy. In other words, a child with a speech sound disorder does whatever everyone does: not pay attention to the actual sounds coming out of their mouth. The difference between children with and without speech disorders is that we notice the child with the speech disorder because their intended production differs so markedly from their actual production.
Within this perspective, the goal of promoting awareness is to focus a student’s attention on their speech. Promoting awareness also helps to promote generalization of treatment sounds to persons and settings outside the clinic. Almost all children and students need this assistance and so almost all receive ongoing help promoting awareness integrated with speech production practice (Anthony et al., 2011).
A clinician has a wide range of clinical tools to turn into awareness activities. Table 1 lists 9 options.
Table 1. Clinical Options to Promote Awareness
Old Way/New Way
These options are useful with any child whose development is sufficiently advanced to allow them to reflect on their speech, typically late preschoolers and older. The following brief annotated dialogue illustrates promoting awareness with a late preschooler receiving speech work on [s].
Clinician: Do you remember what we call our treatment sound?
Child: The snake sound.
The metaphor reminds the child that [s] is continuant.
Clinician: Do you remember how you used to say [s]?
Child: I said ta.
Clinician: Now you’re a big kid and say [s]. I know. Can you say [s] the big kid way, the little kid way, and then the big kid way again.
Child: ta sa ta.
Old way/new way focuses the child on the difference between [t] and [s] while building self-esteem through demonstration of progress.
Clinician: And now can you say sa three times in a row, listening to yourself, without me saying anything?
Child: sa sa sa.
Clinician: How do you think you did?
Self-correction promotes self-monitoring, which the child needs to do to generalize treatment success.
When a child leaves speech treatment, the world is full of distractions that may push his awareness of speech right out the window. You may find that including some distractions during speech tasks helps maintain hard won speech gains outside the treatment session. Children enjoy—and may find it challenging—to say words with treatment sounds while hopping on one foot, or rolling a ball in miniature bowling, or—for a student—practicing a class speech that contains the treatment sound.
Anthony, J. L., Aghara, R. G., Solari, E. J., Dunkelberger, M. J., Williams, J. M., & Liang, L. (2011). Quantifying phonological representation abilities in Spanish-speaking preschool children. Applied Psycholinguistics, 32(1), 19–49
Kuhl, P. (2010). Brain mechanisms in early language acquisition. Neuron, 67, 713–727.
Pascallis, O., de Haan, M., & Nelson, C. (2002). Is face processing species specific during the first year of life? Science, 296, 1321–1323.
Williams, L., McLeod, S., & McCauley, R. (2010), Interventions for speech sound disorders in children. Baltimore, MD: Brookes Publishing.