Treating Speech Sound Delay

“Scientists have recently determined that it takes approximately 400 repetitions to create a new synapse in the brain – unless it is done with play, in which case, it takes between 10 – 20 repetitions”

~ Dr. Kathryn Purvis ~

 You might have seen this quote floating around lately so I’d like to apply it to treating speech sound delay. Children who have delayed speech sound development take up most of my paediatric caseload. I work on delayed phonological processes (this is what children do to simplify speech when they are learning to talk) or articulation errors (how they move their lips, tongue, jar to produce speech sounds) on a daily basis. But how can we determine the best dose, form, frequency, duration and intensity of therapy that results in the best outcomes for our kiddos?

In 2016, a review about the intensity of treatment in speech disorders reported on a range of studies. Here are some of the main points:

  • For individuals with speech and/or language deficits the optimal intensity for treatment is uncertain. This is due to the different rates in which people learn and the different severities of speech and/or language difficulties.

  • Over-learning or under-learning the motor skills can arise when determining the intensity that is ‘just right’.

  • This review reported on studies where intervention 2 – 3 times a week with sessions running 30-60 minutes that includes at least 60 trials resulted in better treatment outcomes.

  • Many variables need to be considered when answering the question “how much therapy is sufficient” and studies such as these can provide valuable information regarding the most effective treatment intensity aiding speech pathologists in making informed clinical decisions for their clients with speech disorders. 

Okay, how can clinicians adapt this to their clinical work? And what have I learnt from working with children with speech sound delay?

  • Practise in PLAY! At SubiSpeech, we love a good theme! Themes can add context, a realistic use of speech sounds and lots of fun whilst doing so.

  • Encourage repetition during play-based activities for quicker learning.

  • Consider shorter but more frequent sessions for some children.

  • Every child is different – trust your clinical judgement in line with a strong evidence base when making decisions about treatment intensity.

speech blog pic.png


Kaipa. R., & Peterson, A. M. (2016). A systematic review of treatment intensity in speech disorders. International Journal of Speech-Language Pathology, 18, 507 – 520.




Comprehension | Receptive Language

The definition of comprehension is the ability to understand information that is heard, read or seen. In order to comprehend, a number of processes need to happen. Beginning the process is early literacy skills or the ability to recognise names of letters, match sounds with letters, break words sounds and blend sounds into words (Suggate, Schaughency, McAnally & Reese, 2018).  A strong link between these skills and later vocabulary development, narrative and reading comprehension has been reported in numerous studies (Suggate et al., 2018).

Keeping in mind that a breakdown at one or more of these steps will hinder comprehension, let’s take a look at the process…

Comprehension Processes.png



Reflections - Let's Communicate

We’ve made it through the first term of the 2019 school year – looking back the weeks have flown by, but not without some valuable learning. I’d like to reflect on what I have taken away from last term before we jump into term 2, so here goes! 

Children need to be heard, to feel like they are able to share their thoughts, feelings and ideas. To feel like they are important and valued, no matter what the topic of discussion is.

To listen – sounds simple, right? However, with so much to balance, responses like “oh, yeah” just roll off the tongue. I encourage you to really listen to what your child has to say. How?

o   Body language and tone is just as important as what you are saying. Make sure you face your child and make eye contact and appropriate facial expressions.

Here’s why…

o   Children need to be taught before they can ‘do’ – if you model how you’d like you child to speak and behave they’ll have an example to follow.

o   Active listening will help you to respond to positive AND negative emotions – anger, embarrassment, sadness and fear, in a sensitive way.

o   Improves your relationship and bond with your child

Children are much more receptive to instructions when they are phrased positively and include the desired behaviour, for example…

o   “Remember, we walk nicely along this path” instead of “stop running!”

Screen Shot 2019-04-28 at 11.39.33 am.png

 As we jump into Term 2, make some time to really listen– you never know what they might come out with!



Reading - Identify, Comprehend, Coordinate, Repeat.

Reading is defined as a multifaceted process that involves recognising words (identify), understanding the meaning of the words and sentences (comprehend) and doing so in a fluent manner (coordinate). The aim is for the reader to extract meaning from print.

This post will focus on the act of reading - the ‘identify’ step. So, how can we support children who are learning to read? We can do so by having a basic understadning of the skills that are required…

  1. Phonemic Awareness
    This takes us back to the previous blog post. Can the child break words apart?

  2. Letter - Sound Knowledge
    Can the child match letters to sounds, for example, the letter ’r’ makes a /r/ sound and the letters ‘s’ and ‘h’ can be put together to make the /sh/ sound.

  3. Can the child use letter-sound knowledge to read unfamiliar words. This is the act of sounding out, or decoding.

  4. Sight words
    Can the child store words (sight words) and then identify those words automatically and quickly, such as ‘and’ or ‘the’.

At SubiSpeech we use a number of resources to support literacy goals, here are few of our favourites…

  • Little Learners Love Literacy - “The Little Learner decodable books have delightful stories that children can read using their phonic knowledge; the letters and sounds that they have been explicitly taught using the Little Learners Love Literacy approach.” - Little Learner’s Love Literacy

  • SoundCheck - “SoundCheck is designed to let children experience success in spelling, by teaching the skill of segmenting words, or breaking words into sounds.” - Little Learner’s Love Literacy

  • Reading bookmarks - these are fun to make and are easily accessible. Grab some coloured paper and some Textas and you’re ready to go! They are most effective when they include the main goals that the child is working on with their reading.
    For example, one child might be working on
    sounding ‘in’ when reading, whist another, on acknowledging punctuation.




Letters and Sounds – The Difference and Teaching Tips

Children begin their literacy development with phonological awareness. Phonological awareness is a child’s ability to reflect on the structure of words they hear. According to current research, these skills are a predictor for later literacy acquisition. With strong phonological awareness skills children are able to link their spoken language, written language and understand as well as access and achieve the school curriculum.

So, how do we reflect of the structure of words? Well, let’s begin with some syllable and sound segmenting - this involves what can be phonemes (what can be heard)…

Screen Shot 2019-03-13 at 3.45.29 pm.png

Now, let’s incorporate graphemes and letters. This will involve what the word looks like…


For the word ‘tree’

  • We hear 3 phonemes (or sounds) t|r|ee

  • We use 3 graphemes to represent the three sounds t|r|ee

  • We use 4 letters to spell the word t|r|e|e

Let’s try another! Take the word ‘spoon’

  • We hear 4 phonemes - s|p|oo|n

  • We use 4 graphemes - s|p|oo|n

  • We use 5 letters – s|p|o|o|n


Now that we’ve got an understadning of phonological awareness skills, how might we teach them?

  • Elkonin boxes are a fantastic visual support. See how they are used for the word ‘spoon.’

  • Be very explicit when asking a child to “find a word that starts with…”
    If you are working on sounds, you might say, “find a word that starts with the /s/ sound” (make sure you use the sound - “sssss” and NOT the letter). This could include words like soap and sock.
    If you are working on letters, you might say, “find a word that starts with the letter ‘S’. This could include words like soap and sock but also, show and shoe. 

With a solid foundation of these pre-literacy or phonological awareness skills, children can then begin learning about the wide variety of graphemes and letters used in the English language!

More information:



Gillon, G. T. (2004). Phonological awareness – from research to practice. the guildford press New York.

Schedfer, B., Stackhouse, J., & Wells, B). (2017). Phonological awareness development in children with and without spoken language difficulties: A 12-month long longitudinal study of german-speaking pre-school children. International Journal of Speech-Language Pathology, 19)465-475).



Back to School - Let's Talk Routine!

New year + new term + new teacher = difference expectations and lots of firsts for your kiddos! Back to school time can take its toll on everybody in the family. Waking up early, having breakfast, getting dressed, brushing hair and teeth, making the bed and packing lunches, homework, library books and news. Phew! And that’s all before the school day even starts!

 So, let’s talk routine! Recently, a parent approached me. Her daughter was beginning Kindy and asked, “children work better with routine, right?” I was thrilled that this topic was brought up, ideal for our first blog post of the year!

Effective routines are predictable and help children to know what to expect. It helps to decrease tantrums and meltdowns - who has time in the morning for that? For all children but specifically those with expressive language delays, routines provide the opportunity to model functional vocabulary - words that children will hear and are expected to understand and use during everyday tasks.

What does the research say? Routines help to limit distractions and manage behaviour therefore impacting on children’s emotional, cognitive and social development. Ultimately, routines provide security and more effective use of time.


At school you will notice that routines are used when entering the classroom and when transitioning between activities, and in speech therapy session, visual schedules are commonly used to provide children with clear goals and guide them through the session. We spend more time working on speech and language goals, less time discussing what are we doing next and most importantly, reduce anxiety of the unknown.

Why not start by setting a morning routine to help you and your family start off the school day calmer, happier and more productive!


Dodge Chan, C. (2008). Retrieved from http://superpowerspeech.come/2015/07/effective-routines-in-the-speech-room.html

Leinhardt, G., Weidman, C., & Hammond, K. (1987). Introduction and Integration of Classroom Routines by Expert Teachers. Curriculum Inquiry, 17(2), 135-176.

Ostrosky, M. M., Jung, E. Y., Hemmeter, M. L., & Thomas, D. (2003). Retrieved from



Summer is Finally Here!

The festive season is fast approaching and we’re sure our kiddos, families, teachers and therapists are looking forward to a well-deserved summer break! But, with all the family gatherings and long days in the summer sun with friends, it’s easy to put speech practise on the back burner. So, how can you support speech and language development during the summer months?

Screen Shot 2018-12-19 at 10.33.54 am.png
Screen Shot 2018-12-19 at 10.34.42 am.png
Screen Shot 2018-12-19 at 10.34.56 am.png
Screen Shot 2018-12-19 at 10.35.52 am.png



Kindergarten Speech Pathology Screening

So, you’ve received a letter inviting your child to participate in a Kindergarten Speech Pathology screening. At Subi Speech we offer Speech Pathology screenings for Kindergarten aged children – keep on reading to find out it involves!

What is a screening?

A screening is a short assessment that evaluates a range of developmental areas. This is arranged with Primary Schools, and will include the assessment of a child’s…


Prior to the screening

A short presentation at the Kindergarten information evening can be provided. This is where the speech pathologist can be introduced to the parents, the screening process can be explained and consent forms handed out.


The screening session

The screening sessions will be 20 to 30 minutes long.
The Screen of Communication Skills (SOCS) will be used. It assesses: speech, language (semantics, comprehension, grammar and narrative) and phonological awareness. This assessment enables the comparison of children’s scores to norms, based on the score of children within the same age group, in Western Australia.

 Sharing of assessment results

Parents and teachers of children that have been identified to have speech and/or language delays will be provided with…

  • A report that includes: a description of the assessment tasks, the child’s results in comparison to age norms, a summary of areas that are developing well and those that need support and recommendations for therapy and for speech and/or language facilitation at home.
  • A following up meeting with the speech pathologist to discuss screening results and speech intervention.

Parents and teachers of students that do not present with speech and/or language delays with be provided with:

  • A brief overview of the areas that were assessed, and the child’s abilities (below, within or above normal limits).

Teachers will be provided with:

  • A spreadsheet that lists all the scores of the children in their class.

 Speech Pathology Assessment and Intervention

  • If a child has been identified to have speech and/or language delays an in-depth assessment or therapy may be recommended.
  • Individual speech therapy sessions in 5-week blocks are offered. These can be held at the school.



The sound of literacy learning: Practical tips for acquiring pre-literacy skills.


Despite what you might think, learning to read and write is not a naturally developing process. If we were never exposed to texts and print, we would never acquire literacy skills. Children can attain pre-literacy skills throughout childhood with opportunity to explore and play with sounds and print. The foundation of reading and writing is called phonological awareness. It’s our ability to tune into and manipulate sounds in language. Notice that we haven’t mentioned letters yet. We’re talking about a purely oral skill set. As adults, we’re so used to working with extended language and texts that it can be easy to forget what it’s like to be learning to tune into sounds. Pop quiz! Below are some common phonological awareness tasks. See how you go…

How many sounds are in:

o   Flag

o   Thought

o   Shoe


Which words rhyme?

Bluff                        Plot                        Four

Yacht                        Paw                        Tough


How many syllables are in:

o   Elephant

o   Fascinating

o   Inaccessibility


Ahhh, doesn’t that take you back? These are the skills that children learn about in Kindy and consolidate in Pre-Primary and Year 1. However, there are lots of things that parents can do to help children of all ages tune into the sounds in speech.

1)    Build a sentence: Take turns adding words to a sentence, even if it ends up a bit silly. For example, “The… fuzzy… birdie… flew… onto… a… dog.”

2)    Robot Talk: Pretend you’re a robot and *break-up-ev-e-ry-thing-you-say-in-to-syll-a-bles*

3)    Bounce a rhyme around. Start with a simple rhyming word, like “pot,” and pass play from person to person as quickly as you can. Each person must think of a rhyming word before play passes back to the first person.

4)    Play “I Spy” but use sounds rather than letters. For example: I spy with my little eye, something beginning with /fffff/… (phone)

5)    Say your sounds precisely: It’s tempting to try and make sounds as loud and obvious as possible. However, we have loud sounds (like /mmmmm/) and soft sounds (like /fffff/). Here’s a video that is helpful for saying sounds clearly and precisely: Spelfabet – What are the 44 sounds of English?:

So get talking, and get creative! Encourage your child to have fun experimenting with sounds, and help lay the foundation for literacy.


Answers to quiz:

Sounds in FLAG (4), THOUGHT (3), SHOE (2)

Rhyming pairs: BLUFF & TOUGH, PLOT & YACHT, FOUR & PAW




Love, E. & Reilly, S. (2012). School readiness and early literacy. Retrieved from

Gillon, G. (2008). The Gillon phonological awareness training programme. Christchurch: University of Canterbury.

Reading Rockets. (2018). Classroom strategies: Phonological awareness. Retrieved from


1 Comment

The Language of Learning


In this month’s blog I would like to talk about the amazing changes that occur in children’s language between 3 and 4 years of age.

Up until 3 years of age children will be most comfortable talking about the “here and now”. So they are happiest talking about what is right in front of them, such as “look, truck”. So it’s easy to follow their lead, make comments, and expand on their language such as “ yes, a big yellow truck”.

Screen Shot 2018-07-09 at 3.34.18 pm.png

The magic happens around 4 years of age, the age at which children start to talk about the “there and then”. This coincides conveniently as their lives begin to expand and they start attending Kindy and other outside groups. As their world expands and they want to talk about these new experiences, they need new language structures to support this growth.

To talk about the “there and then” they need an increased word bank. They need a bigger range of verbs and to use past tense both regular and irregular forms. Such as “we wented to the park with Grandma”. So this is a great opportunity to “recast” these new forms in a way that supports what they say but models the correct way such as “yes, you went to the park with Grandma and what did you see?”

They need new connecting words to join up their new experiences in the retelling such as “and, and then, because, so and but”. To be able to link two ideas together shows a huge increase in children’s complexity of language. Such as “and we saw a train and then we got an ice-cream” This linking of ideas is the first step towards “literate style" language which is vital for story telling, telling news and explaining games.

They also need to refer to people with pronouns such as “he, she, us, them, they and it”. These forms can get confusing for the language learning as we need to help these develop such as “we went with she” rather than “we went with her”. Pronoun use is a great window into children’s developing complexity of language.

Screen Shot 2018-07-09 at 6.17.29 pm.png

They also need to follow increasingly demanding instructions and understand a whole range of new commands such as “ firstly, secondly, next, after, before and lastly”

All of these structures and forms of language are exactly what children need to navigate their way through the first years of school. Therefore, their language moves along the oral/literate continuum. At home in the first years their language is “oral” in nature. For example, “put that there” can be understood perfectly when you are face to face and one on one. More “literate” language moves towards the written form of language. For example, “pick up the yellow pencil and draw a circle around the sun”. The language of instruction and description is much more specific. Children need exposure to this type of language before the formal processes of reading and writing begin.

This truly is a magical stage of language development. So get talking and listening for the development of the language of learning!

Information drawn from:

Brown, R. (1973). A first language: The early stages. London: George Allen & Unwin.

Love & Reilly (2012). Love and Reilly: Speech, language and literacy resources.

ABC Reading Eggs (2018). Where children learn to read!



1 Comment


Speech Therapy Techniques


Modelling, recasting, praise, self-talk... You may have heard your child’s speech pathologist use words like this during therapy sessions, or maybe you’ve been asked to incorporate these techniques into home practice.

But what do they mean? How do I use them? And how will they help my child’s speech and/or language development? 

Let’s start with some definitions and examples...

Screen Shot 2018-06-06 at 11.58.24 am.png

Modelling techniques are most effective in good listening conditions. This is because they are aimed at helping the child to focus on ‘rules’ they need to learn.  When using modelling techniques at home, ensure you...

  • Speak slowly and clearly
  • Use short sentences
  • Model the target/s correctly
  • Avoid repeating the child’s error
  • Practise in a quiet environment with limited distractions

Are modelling techniques effective?

Definitely! Research in the area of grammatical acquisition found that children’s grammatical skills improved when they hear the correct grammar used in adult language. Especially when these utterances built upon the child’s. Evidence also states that modelling techniques are effective, as they give the child the opportunity to hear the correct use of language or pronunciation of speech sounds. This enables them to store it correctly and sets them up to master it themselves.

Adults model language and speech to their children naturally in conversation. However, for children with speech and/or language difficulties this is not enough. They need lots (and lots!) of repetition. 

Now you know what we Speechies do all day! (Well, a fraction of it anyway!) During your next at-home practise session, playtime or conversation with your child, give some of these techniques a go!



Hassink, M. J., & Leonard, B. L. (2010). Within-treatment factors as predictors of outcomes following conversational recasting. American Journal of Speech-Language Pathology, 19(3), 213 – 224.

Bishop, D. V. M., & Leonard, L. B. (2000). Speech and language impairments in children: Causes, characteristics, intervention and outcome. Retrieved from

Bowen, C. (2011). Delivering feedback – Modelling and recasting. Retrieved from:



The Real Magic Carpet Ride: Why Book Share Matters


We all remember the struggle of getting through that home reader in the early years of school… Jack has a ball. Sally has a bat. Jack and Sally play all day... As parents and teachers, getting kids excited about reading can be tough. But research shows that book share in early childhood creates opportunity for the kind of interactions that fuel language development. Notice that we didn’t say “reading” there… Looking through a book, talking about what happens in the story, being read to and engaging with the pictures, these are the moments that nourish a child’s language before they acquire literacy skills. A child doesn’t need to be able to read to enjoy books and stories. All they need is time to sit and engage with a caring reader. Through the process of sharing books, children can develop their ability to understand and produce sentences, learn new vocabulary, and figure out how stories are put together. This learning is very important for success at school, laying a foundation for children to engage with their peers and share their experiences, as well as to understand and produce texts as they get older. 

When to begin

You can start sharing books with your child the day they are born. It’s a good idea to have some time set aside each day just for sharing stories. It’s important that you and our child are not feeling rushed or pressured. If your child becomes a bit restless, bring the book share to a gentle end; pure enjoyment of the stories is key for engaging children in more independent reading later on.

Top Tips for Book Share at Home

o   Ask your child what they would like to read… Help them to choose from a library or from some books at home. It’s ok if your child wants to read a book you feel like you’ve read a thousand times before! Children generally enjoy the repetition, and hearing the language in the story again and again helps them to learn it and use it.

o   Find a quiet place where you and your child can sit side by side, so that you can both see the book clearly. Your child might like to hold the book and turn the pages as you read.

o   Before you start, look at the front cover and talk about what you see together. What might the story be about? What might the problem be? Does the title give us any clues?

o   As you turn each page, react to the pictures and wait for your child to respond. A simple gasp and pause before reading can stimulate some great conversation and generate interest in the story.

o   If your child wants to just turn the pages without really listening to the story, it’s absolutely ok to let them do it. It’s important that your child enjoys the process of looking at books with you, and just talking about what you can see and the sequence of events is a great starting point. As your child learns more about stories, they may become more interested in listening to the text.

o   Have fun! Enjoy being a bit theatrical as you read dialogue and cherish the time together.

 For more info…

The following links have some helpful information:






Dickinson, D., Griffith, J., Michnick Golinkoff, R., & Hirsh-Pasek, K. (2012). How reading books fosters language development around the world. Child Development Research, 2012. Retrieved from


Pollard-Durodola, S., Gonzalez, J., Simmons, D., Kwok, O., Taylor, A., Davis, M., Kim, M., & Simmons, L. (2011). The effects of an intensive shared book-reading intervention for preschool children at risk for vocabulary delay. Exceptional Children. 77(2), 161-183.