Phonetic Consistency and /r/  
By Christine Ristuccia, M.S., CCC-SLP

Treating /r/? I bet you have a few choice words to say concerning the subject. Every speech-language pathologist (SLP) has their own stories (and frustrations). Understanding where to start; how to conduct treatment; and, how to determine progress, are the key problems vexing clinicians. It’s not uncommon for students to be enrolled for years in speech services to receive treatment for an /r/ articulation disorder. SLPs consistently rank treating /r/ as one of their most difficult and frustrating tasks. So what’s a better way?

One popular theory for correcting articulation disorders is to isolate sounds and work on correcting the sound in isolation. The basic sound, or phoneme, is selected as a target for treatment. Usually the position of the sound within a word is considered and targeted. That is, does the sound appear in the beginning of the word, middle, or end of the word (initial, medial, or final).

Take for example, correction of an “S” sound (lisp). Most likely, a speech-language pathologist (SLP) would employ exercises to work on “Sssssss.” Starting practice words would most likely consist of “S-initial” words such as “say, sun, soap, sip, sick, said, sail.” According to this protocol, the SLP slowly increases the complexity of tasks (context of pronunciations) as the production of the sound improves. Examples of increased complexity could include saying words in phrases and sentences, saying longer multi-syllabic words, or increasing the tempo of pronunciation. 

Using this methodology, the SLP achieves success with his/her student by targeting a sound in a phonetically consistent manner. Phonetically consistent means that a target sound is isolated at the smallest possible level (phoneme, phone, or allophone) and that the context of production must be consistent. Consistency is critical, because factors such as the position within the word, grouping with other sounds (vowels or consonants), and the complexity all may affect production. 

The repetition of consistent contexts allows the student to align all the necessary processes required to properly produce language; language skills (ability to formulate correct sounds in the brain: What sounds do I need to make?), motor planning (voicing and jaw and tongue movements: How do I produce the sound?), and auditory processing (receptive feedback: Was the sound produced correctly? Do I need to correct?). A student with an articulation disorder has a deficiency in one or more of these areas. To correct the deficiency, adjustments have to be made in one or more of these processes. The process to correct it is more often than not, trial and error. With so many factors, however, isolating the variables (the sound) is really imperative to getting to the end result faster.

Phonetically consistent is essentially practicing the same thing over and over. What is practiced is consistent and does not change. The words might change, but the phoneme and its positioning is the same (say, sip, sill, soap, …). Thus, successful correction (of the disorder) is found in manipulating or changing the other factors involved with speech production (tongue positioning, cerebral processing, etc.). Once a successful result (speech) is achieved, then consistent practice becomes essential to reinforcing correct productions.       

The /r/ Phoneme

The /r/ phoneme is an unusual sound. It’s overwhelmingly categorized and treated like a consonant. However, in the post-vocalic position, when /r/ comes after a vowel (after a, e, i, o, u), it takes on vocalic properties. This phenomena is recognized as a unique subset known as vocalic r, vowel r, or r-controlled vowel.

Interestingly, there is a certain degree of uncertainty, inconsistency and messiness to vocalic r and how it’s been addressed in speech-language pathology through the years. Vocalic r’s uniqueness has been generally recognized, but agreement on what exactly constitutes vocalic r and how it should be classified, evaluated, and treated has not been achieved. Vocalic r is an exception. Exceptions are hard to deal with when organizing protocols, postulating grand theories, or developing products. Where does it fit in? And how? For the most part, /r/ has been treated consonantally, lumped together with b, c, d, and the rest. This is the cause of much of the problem with /r/.     

To really understand /r/, we need to peel away the layers disguising the root cause of an articulation disorder. This is the foundation behind treating /r/ with a phonetically consistent approach. 

Breaking down /r/ into its most basic component or allophone, enables the SLP to address the root sound. Once isolated, the target intervention sound can be determined for treatment unmasked by other conflicting, confusing, or complicating sounds. Can the patient produce the sound? Are there some combinations of sounds (consonant-vowel, vowel-consonant) that the patient has some success or difficulty with?

Looking critically at /r/ shows that there are numerous phonetic variations. At least eight distinct phonemes exist: 

AR  as in car

AIR as in software

EAR as in beer

ER as in butter

IRE as in tire

OR as in seashore

RL as in girl

Prevocalic R as in rain

Taking into account word positions (initial, medial, and final) and combinations (blends) reveals that there are 21 vocalic combinations and as many as 32 different allophonic types of /r/: prevocalic r, er initial, er medial stressed, er medial unstressed, er final, ar initial, ar medial, ar final, air initial, air medial, air final, ear initial, ear medial, ear final, ire initial, ire medial, ire final, or initial, or medial, or final, medial/final rl, br, kr, dr, fr, gr, pr, spr, str, shr, tr, and thr.

Does that mean that a child must master or be taught all these allophones? No. But, understanding that a variety of /r/’s exist provides tremendous insight into both evaluation and treatment. To get a complete picture for /r/, an evaluation must test the full range of potential sounds. This is one of the many causes of frustration with /r/: Most evaluation tools do not address ALL possible combinations of /r/. This creates an incomplete snapshot of a patient’s ability and misleads clinicians on where to begin therapy. To get the best picture, having more distinct sounds to check is obviously more complete than a test that only checks three sounds (initial, medial and final). The more information gathered, the more information the clinician will have to use in determining a personalized treatment strategy. 

The results of a full spectrum /r/ evaluation tell the clinician which phonemic /r/ words the student can produce and those which they cannot produce correctly. Most children deemed to have /r/ problems can, in fact, say several or even many /r/’s correctly. The context of their production is important.

Allophones that are correctly produced provide significant information:

• Is there one (or two) word positions (allophones) within a phonemic variation that are correct (i.e., army {ar initial} and barn {ar medial} are correct, but star {ar final} is not)? This indicates that success may be achieved with the incorrect allophone because the other allophones (word positions) within the phoneme family were correct.  Basically the sounds are similar and thus should more easily transfer. (Thus, in the example, ar final could be selected as the starting intervention treatment target.).
  
  

• Is one word position correct within a phonemic variation? Yes, then the clinician knows he/she can employ a variety of treatment techniques, such as co-articulation and whisper techniques, to “tease” out the other word positions. For example, use a correctly produced cart to get a correct car, simply by whispering and dropping off the “t;” cart, car-t, car—t, car. 
  
  

• Practicing words with correctly produced allophones, improves the confidence of students, thus positively influencing motivation. This is important when students get frustrated and discouraged.
  
  

•   Know which allophones not to practice. If a sound is correct, don’t waste time practicing it; spend the time on the allophones that they need to make progress on.

Incorrectly produced allophones provide the following information: 

•  Know which words to target for intervention. Work on the sounds that need improvement.
  
  

• Know which words to avoid at first. If a complete phoneme is incorrect (e.g., [er] in all word positions). Work on other sounds first. Tackle the easiest obtained sounds first, build success and confidence, allow generalization to occur, and then address the harder, more difficult sounds.

With this detailed information the SLP will have the information to zero in on only one or just a few allophone(s) to start treatment. If several options are present, select only a single allophone to start with (e.g., [or] final). 

A phonetically consistent remediation regimen should focus on consistent practice of only one allophone (i.e., door, store, more, floor, pour, etc.) until success is attained. Once successful, the SLP should then re-evaluate. Generalization of other non-treated allophones will probably occur. Reselect a single interve ntion target and repeat. 

Christine Ristuccia is the founder and president of Say It RightÔ. (www.sayitright.org) and the author of many books including the award winning /r/ remediation program The Entire World of RÔ.