Updated: Sep 13, 2020
This fall, some of us will be continuing to provide teletherapy, some will be providing teletherapy for the first time, others will be going back to in-person sessions while wearing full PPE, and still others will be attempting a hybrid model. Isn't 2020 great!?
Both teletherapy and masked in-person service delivery models present unique challenges when demonstrating correct placement of speech sounds for our students.
Below are some tips for working with articulation students followed by a list of apps, videos, and websites that can be used to provide video models for speech sound placement.
I have been doing teletherapy full time since mid-March, and when teaching new sounds during teletherapy sessions, I've found that I have to be even more descriptive with verbal cues since my visual model isn't always as clear on camera as my face-to-face visual model. When teaching retroflex /r/, for example, the student can see me open my mouth but can't always see just how far back my tongue is curled, how high up it is, or the fact that it's spread to touch my back molars.
I always make sure that I'm not screen sharing when providing a model so that my face will take up more of the students' screen. You may have to enlist a caregiver's help to make sure that the student has the largest possible camera view selected. I move my mouth close to the camera and shine my cell phone's flashlight into my mouth so they can get a better view-- it looks weird so they are also more likely to watch what I'm doing! ;)
In a few cases, the teletherapy model has led me to change the order of speech sounds targeted. For example, with an older student who needs both the /"th"/ and /"sh"/ sounds, I have opted to start with /"th"/ as productions are significantly easier to see and hear. In this case, I am forthcoming with parents about not wanting to reinforce distorted productions which would require us to backtrack later. I have found that the clarity of fricatives s/z, /"sh"/, /"ch"/, and /"j"/, especially when lateralized, is the most difficult to judge when listening through speakers. If selecting other, age-appropriate sounds to address first is not an option, it may improve clarity to listen to the student through earbuds or headphones.
Using apps or videos that demonstrate proper placement can be really helpful, especially if you are not sure about the clarity of your on-camera model. As an added bonus, they can be recommended to caregivers for practice outside of sessions.
For articulation activities and ideas that can be used during teletherapy sessions, check out the Distance Learning Series: Articulation blog post co-written by me and Lucy Stone over on The Speech Express blog.
In-Person Sessions with PPE
Full disclosure, I have not had to attempt this yet (and trust me, it is absolutely not lost on me how lucky I am!) Some of the tips below have therefore been taken from other SLPs on social media (you guys are superheroes- seriously).
I've heard from multiple sources that administrators are actually suggesting that SLPs remove their PPE to work with articulation students (!?) or that they wear only a clear face shield but not a mask! Various studies have shown that wearing cloth masks significantly reduces the spread of COVID-19. The official recommendation from the CDC is that everyone older than 2 wear a mask in all public settings, especially when social distancing is difficult to maintain.
According to the Cleveland Clinic, face shields can provide further protection to the eyes, nose, and mouth, areas that Coronavirus can enter. However, shields are open at the bottom and therefore provide far less protection. According to MIT Medical, face shields are also more likely to spread respiratory droplets from an infected person to others since they don't capture droplets as well as masks do.
It is NOT recommended that you wear a face shield without also wearing a cloth mask underneath! Ideally, for the maximum amount of protection, you would wear both a mask and a shield. You should always replace the shield if it winds up getting cracked/damaged, and sanitize both the shield and cloth mask frequently.
In an effort to make their face shield look less intimidating to kids, some SLPs online have been decorating the shield's headband. You can also buy face shields (for adults!) that have princess crowns and various animal ears/faces. You can find some of them on Amazon here as well as on Etsy here.
I hope this goes without saying but it is not recommended that you remove your PPE, which would put yourself and others at greater risk, even when providing articulation therapy. Your health, the health of your family members, and the health of your students should always be the top priority!
Smile masks are masks that have clear windows to allow the wearer's mouth to be visible. In addition to students working on articulation, students who rely more on cues from lips such as those with hearing impairments or cochlear implants may benefit most from the SLP wearing a smile mask. Seeing your mouth can help students to identify facial expressions (e.g., for students working on social skills) and can also put little ones more at ease.
There are a number of sellers on Etsy and Facebook currently selling their own variations of smile masks. You can search just about any of the SLP Facebook groups for "smile mask" or "clear mask" to find product suggestions from SLPs. SLP @mrsmcspeechie has tested and recommended this one by DOMDRICHStudio and this one by DaphneCreationsStore. Keep in mind that the mask still needs to fit securely so that air does not escape around your chin and cheeks. Some masks come in multiple sizes or have adjustible ear loops so they can be tightened. If you have another great recommendation, feel free to drop it in the comments below!
Of note, these masks can be hotter than cloth so you may want to switch back to your standard mask when working with certain students who aren't as in need of visual cues. They also have a tendency to fog up but you can either buy smile masks that are advertised as anti-fog, purchase anti-fog spray, or try rubbing a thin layer of Dove dish detergent or toothpaste on the window with your finger (then let dry before wearing). You will likely need to reapply this anti-fog treatment periodically throughout the day.
In addition to using video models for articulation such as those provided below, with some students you may be able to shift the focus temporarily from individual speech sounds to teaching overall intelligibility strategies. There are multiple resources out there that focus on things like slowing rate, increasing volume, segmenting multi-syllabic words, and repairing communication breakdowns. I highly recommend this one, Intelligibility Strategies, by Lucy Stone of The Speech Express! Also check out her multi-syllabic word rings resource and the multi-syllabic word list on Home Speech Home. When working on intelligibility, I love using apps that allow the student to record themselves and then change the recordings to sound like silly voices.
The following are links to apps, YouTube channels, and other websites that provide video models of speech sound production.
Apps that Provide Video Models of Speech Sounds
Sounds of Speech includes animations, videos, and audio samples for how English speech sounds are produced.
Speech Tutor and Speech Tutor Pro - includes articulation videos that can help with placement as well as phoneme and minimal pair decks.
Speech Sounds Visualized provides x-ray images and 3D animations of how each sound is produced in the mouth.
Speech Sounds on Cue shows how to produce speech sounds and words using full-motion videos.
YouTube Videos that Model Speech Sounds
Peachie Speechie has an entire video series modeling speech sound production. In addition, she has videos focusing on teaching speech-language skills like adjectives, categories, inferencing, and fluency strategies.
Mister Clay has many videos that model production of common sounds including /l/ and /s/. Some videos also include articulation word lists. Also worth checking out are his videos that include core words for AAC users.
Speech Therapist Mom posts videos showing speech sound placement. She also has many videos related to Autism and that provide parent training on topics like teletherapy and teaching joint attention.
Additional Websites that Model Speech Sounds
Seeing Speech allows you to click on IPA symbols in order to listen to each sound. Includes visualizations from ultrasound, MRI, and animations.
Sounds of Speech designed for ESL learners, includes animations, videos, audio samples, and features of consonant and vowels found in American English, Spanish, and German.
Speech Sounds Visualized shows how sounds are formed using x-rays and animations.
Speech World includes animated videos of speech sounds with front or side views and fast/slow speed options.