The Speech Staircase

For parents, the idea of practicing speech at home may be daunting. Where do I start? What do I do next? What activities would work best? Here is what I often share with parents:

The Speech Staircase

In speech therapy, there is the concept of a "speech staircase" that helps guide where to start and where to go. The information below is most appropriate for children with phonological difficulties. Children who present with motor speech difficulties will often require modifications to this approach. Please consult with your speech therapist before using the strategies below.

The Speech Staircase

As with any skill, you should start small (and at the bottom) and work your way up. Here's what this would look like for speech:

Isolation: This means target the sound on its own. This allows the child to put a label to the target and provides a foundation on which to build longer words and utterances. It also allows you to provide feedback specifically on what the child is doing well or what the child needs to adjust.

Syllable: Once the child can produce the target sound in isolation, add a vowel before or after the target sound. At this stage, the child starts to learn how to transition into and out of the target sound.

Word: Next step is putting the target sound in words. Here is where things start to get a little more complicated as there are a few things to consider.

1. Length and complexity of the word: Start with shorter and simpler words. Work your way up to longer and more complicated words.

2. Location of the target sound in the word: Depending on the length of the word, the target sound may appear at the start (initial position), in the middle (medial position), or at the end (final position). In some cases, the sound may even appear in more than one place in the word. You may choose to:

   1. Master the target sound in all positions before moving up the staircase.

   2. Master the target sound in one position, and move up the staircase. Then come back to the word level in a different word position, and move back up the staircase.

3. Presence of other difficult sounds: When picking target vocabulary, be cognizant of other sounds with which your child may be struggling.

Phrase: After words, we begin with two-word combinations or carrier phrases. Carrier phrases are short phrases that remain the same, while the target word changes. Examples of this are phrases like "I see a ___" or "I want a ___". Begin with a consistent second word, as it requires fewer cognitive resources, and the child can dedicate more of their focus to the target sound/word. Once this is mastered, add some variability in the phrases. For example, the extra word can be a colour or adjective that changes with each target word.

Sentence: As the child masters these phrases, continue adding one or two words and increasing the complexity of the sentence, maintaining the focus on the target sound.

Reading: Of course, this only applies to children who are of reading age, otherwise, you can skip to the next step. Reading allows the child to produce the target sound in a structured context, which has not been rehearsed. Sentences will vary in length and not all sentences will have the target sound. That being said, they will have the visual cue of when to produce the target sound. To facilitate this, the target sound can be highlighted or written in a different colour to make it stand out.

Structured conversation: At this stage, the child is aware that they are going to focus on their sound. A conversation can be structured by building it around a target word, or a retelling of a story/movie.

Unstructured conversation: This is the most difficult step: spontaneous conversation. It is difficult because the child is not actively thinking about their speech. In my next blog (click here to read it), I will discuss strategies to support the generalization of the skill from a structured context to an unstructured one.

As your child moves from one stair to the next, you may find that they go back to making the same mistakes. Don't be discouraged! This is completely normal. Your child may benefit from visual supports and/or pauses to carry their skill up to this new step. This isn't laziness or stubbornness. The child is not ready to make it up to those next steps, and so they will return to their habitual way of saying the word.

An example:

Tina is working on the letter /k/:

Isolation: k

Syllable: kee, koo, ko, ka, ak, eek, ook, uk, ik

Word: car, cap, cop, bike, like, rake

Often, children struggling with /k/ will produce it as a /t/. As such, be mindful of words like "cat", "tack", "tick", etc. that include both the /t/ and the /k/. Save these for later, when the child is more consistently able to produce /k/ at the word level. Let's say Tina also struggles with /f/. When working on words like "fork", "fake", or "carafe", only focus on one sound, in this example, we would focus on the /k/. So if Tina said "pork" for "fork", and said the /k/ properly, we could offer specific praise like "I heard your /k/ sound at the end! Good work!". Asking the child to produce both sounds correctly, while she is still learning them, puts a significant strain on her cognitive resources and Tina is unlikely to be successful.

Phrase: have car, have cap, I see a car, I see a cap

Tina may start saying "have tar". She might benefit from having two blocks in front of her. One block cues for the word "have" the other cues for the word "car". As Tina points to each block as she says the word, it may slow her down enough to give her time to move her tongue into position to produce the sound correctly. She might also benefit from a visual cue to pause between words and/or a touch-cue at the top of her throat to remind her to use the back of her tongue to make the /k/. As Tina gets more proficient at this level, we can shorten the pauses or remove the blocks. They can be reintroduced as needed.

Sentence: The car is going up. The man is wearing a cap. The boy is on a bike.

Reading: Perhaps reading a book like "When you give the mouse a cookie"

Structured conversation: Tina is talking about the book you just read.

Unstructured conversation: Tina is telling you about what she and her friend Katie did at school.

The takeaway:

Start small and work your way up. It's normal to slip back a little as you progress to each new step. Most importantly, work with your speech therapist to make sure that you are targeting the right sounds and that this approach will work for your child. If you suspect your child has speech difficulties, I highly recommend being assessed by a speech-language pathologist in your area.