Evidence Based Practice
Data has recently shown that children may go from eliciting R sounds in words to conversation in less than 12 hours of therapy.
The Retroflex R requires an elevated Tongue body, with protruded lips and jaw almost closed. Retracted R has back lateral edges raised with a groove down the center of the tongue. Marshalla, 2011
There are 21 different tongue positions for the R sound and 3 constrictions, pharynx, lips and anywhere along the palate. (Boyce and Schmidlin, 2008)
Bernhardt & Stemberger, 1998 found that lips needed to be "rounded."
Shriberg, 1980 found that there needs to be a degree of jaw stability
Delattre and Freeman, 1968 reported the need for a high level of toTongue tension.
Marshalla, Pamela; Successful R Therapy, Marshalla Speech and Language, 2011
Boyce, Suzanne, Schmidlin, Sue. Using Ultrasound With Therapy for Resistant /r/, ASHA 2008
Bernhardt, B., & Stemberger, J. (1998). Handbook of phonological development. From the perspective of constraint-based nonlinear phonology. San Diego, CA: Academic Press.
Shuster, L. I. (1998). The perception of correctly and incorrectly produced /r/. Journal of Speech, Language, and Hearing Research, 41, 941–950.
Delattre, P., & Freeman, D. C. (1968). A dialect study of American r’s by x-ray motion picture. Linguistics, 6, 29–68
Freedman, Mass, Caliguiri, Wulf and Robin, 2011 found more accuracy in tongue movements when there was external focus (one other than sound.)
McLeod, found that SLPs have difficulty determining the necessary positioning for the lateral tongue edges.
Freedman, S. E., Maas, E., Caligiuri, M. P., Wulf, G., &Robin, D. A. (2007). Internal versus external: Oral-motor performance as a function of attentional focus. Journal of Speech, Language and Hearing Research, 50, 131-136
McLeod, S (2009, November) Speech Language Pathologists’ knowledge of tongue palate contact for speech sound intervention. Invited seminar presentation in Clinical tools for representing speech productions: Transcriptions and beyond. ASHA, New Orleans, USA.
Solutions to the R Disorder
What Can the Bite-R Do?
The Bite-R provides a stable jaw, rounded or protruded lips, and the positioning of the back lateral tongue edges.
The Bite-R was designed to produce a high degree of tongue tension by lifting and retracting an elastic band with the mid-front of the tongue.
Once the client develops tongue awareness, sound awareness follows creating spontaneous carryover.