Speech Language Pathologist Harriet Klein on the Misarticulation of ‘R’ Sounds

Harriet Klein is a professor and director of the doctoral program in Steinhardt’s Department of Communicative Sciences and Disorders. She teaches articulation disorders (graduate and undergraduate), language disorders in children, and principles of intervention. Among her honors are professional achievement awards from the New York State Speech Language-Hearing Association and the New York City Speech, Hearing, Language Association for excellence in teaching, research, and clinical activity.

You study what you have called “one of the most challenging phonemes for the developing child” the consonantal ‘r.’ For a speech language pathologist, what makes ‘r’ so special (and so troublesome)?

The consonantal ‘r’ sound which starts a syllable, is closely related to the vowel type ‘r represented by the letters ‘er’, ‘ir’, ‘ur’.   When we refer to the learning of ‘r,’ we refer to both types of sounds. During language acquisition, the vowel type typically precedes the consonant type. The ‘r’ (both types) are challenging to learn because production involves complex movements of the tongue, more complex than most other sounds. This challenging motor behavior may be one of the primary reasons for the ‘r’ being a later developing sound and present as an error sound in the speech of children with articulation problems.

How do you treat a child or an adult who has trouble articulating ‘r’?

Treatment involves paying attention to those factors we have hypothesized to contribute to the problem. We always consider the motor aspect as well as the perceptual aspect; how the child makes the sound as well as how he hears it. Children who misarticulate ‘r’ will eventually learn to accept their productions (if they are understood) and stop listening to the adult ‘r’. To address both factors, we generally begin with getting the individual to identify the correct ‘r’ and discriminate the correct ‘r’ from the error sound. We also ask the child to imitate the clinician’s production of the sound. It typically takes several sessions before the correct sound is achieved. During that period the child is continually learning to compare her own production with the clinician’s and is attempting to make adjustments. When the target has been achieved, even in a syllable, continuous practice is essential.

Is this a hard condition to treat?

‘R’ sounds are difficult to treat and the duration of treatment is often related to the age of the client. A younger child may make more rapid progress than an older child because the habit may be less solidly formed. The correction of ‘r’ may be compared to the effort it takes to changes any well-ingrained habit in favor of another. In the case of ‘r’, the new behavior involves a set of new, challenging, motor movements.

You were recently awarded a Steinhardt IDEA grant with Adam Buchwald for a project titled,Developing ‘r’ in Children with Phonological Disorders: Ultrasound Imaging and Perceptual Judgments. How will ultrasound imaging help you to learn about ‘r’ production/correction?

The new project involves recording children with impaired ‘r’ production as they receive a course of treatment. Monthly recordings are planned. These will be analyzed perceptually (judged by expert listeners) with reference to the quality of ‘r’ production and viewed with ultrasound equipment to describe the position of the tongue with each effort to produce ‘r’ tokens. The purpose of the project is to provide data on the articulatory changes that occur with clinical intervention of /r/ in children. The most significant impact of the proposed project will be to provide baseline date on the development of ‘r’ in children who have speech-sound disorders. To date, there is no published evidence of the lingual changes that take place during the treatment process. As a result, a number of alternative procedures have been described for the correction of ‘r’. Many suggestions have been based on the intuition and experience of clinicians. Children have been shown how to move the tongue to produce ‘r’ which may in some instances interfere rather than facilitate accurate ‘r’ production.

Is a person ever too old to correct an articulation problem?

Most articulation problems can be helped regardless of a person’s age, but the longer the problem is maintained the longer it may take to change. Intervention success also depends on the cause of the problem. If there are physiological concomitants such as hearing loss, structural or neurological impairment, the prognosis is more guarded. Frequency of treatment, motivation, and cognitive level will also affect outcome and duration of treatment.

To learn more about services available, visit Steinhardt’s Speech, Language and Hearing Clinic.