Doxa Therapy

Articulation Disorders

We try to help our clients with articulation disorders by doing a variety of excersizes. Below you find a list of excersizes that we could do with the client, they are always tailored to the client needs. We try to find local solutions for people as its difficult to find the right materials in Uganda. Feel free to ask our therapists what excersizes you can do at home or what materials you need to perform them.

1. Fingers on Lips Technique: Placing fingers on the lips while practicing specific sounds can help clients feel the movement and position of their lips more clearly. Alternative you can give lip massage with the same purpose. This tactile feedback can aid in achieving proper lip articulation. For instance, for the /p/ sound, the individual can feel the lips come together and then release.
2. Tongue Movement with Objects: Using objects like lollipops, chewies, or tongue depressors can help improve tongue movement and coordination. We often use these objects in combination with peanut butter, lemon, or honey depending on the client’s preference. Tongue movement is important to target the /t/ sound, the individual can practice tapping the tongue against the alveolar ridge (the bumpy area behind the upper front teeth) while holding a tongue depressor.
3. Chewies for Jaw Stability: Chewies or chewable items can be used to provide sensory input to the jaw and improve jaw stability. This can be especially helpful if the client exhibits jaw movement during speech that negatively affects articulation. By providing something to bite or chew on, you can encourage a more stable jaw position.
4. Mirror Feedback: Using a mirror alongside tactile cues can enhance visual feedback. The individual can watch themselves in the mirror while practicing speech sounds, allowing them to see the movement of their lips, tongue, and jaw, and compare it to the desired articulation.
5. Modeling and Imitation: Demonstrate the correct articulation and movement for the client using your own mouth, and then have them imitate your actions. This can help them better understand and replicate the precise movements needed for accurate sound production.
   1. Sound Isolation:
      • Have the individual practice producing the target sound in isolation (e.g., “ssss” for /s/).
      • Repeat this sound multiple times to work on accurate production.
   2. Syllable Repetition:
      • Combine the target sound with different vowel sounds to create syllables (e.g., “sa,” “se,” “si,” “so,” “su” for /s/).
      • Encourage the individual to repeat these syllables to reinforce correct sound production.
   3. Word Level:
      • Practice saying words that contain the target sound (e.g., “sun,” “sock,” “snake” for /s/).
      • Emphasize clear and accurate production of the target sound.
   4. Phrase Level:
      • Create short phrases or sentences containing the target sound (e.g., “She sees the sun” for /s/).
      • Work on maintaining correct articulation within longer speech segments.
   5. Minimal Pairs:
      • Practice words that differ only in the target sound and a similar sound (e.g., “sip” vs. “zip” for /s/ vs. /z/).
      • This helps highlight the distinction between the target sound and the incorrect sound.
   6. Sound in Sentences:
      • Incorporate target sounds into longer sentences (e.g., “The silly snake hissed softly in the grass” for /s/).
      • Focus on natural and accurate production within context.
   7. Reading Aloud:
      • Choose reading materials (books, articles) containing a variety of words with the target sound.
      • Have the individual read passages aloud, emphasizing proper articulation.
   8. Structured Tongue Exercises:
      • Use tongue twisters that involve the target sound (e.g., “Sally sells seashells by the seashore”).
      • These exercises challenge the tongue’s movement and coordination.
   9. Visual and Auditory Models:
      • Use mirrors to provide visual feedback on tongue placement and movement.
      • Listen to correct sound production, and compare it with the individual’s speech.
   10. Practice Across Different Contexts:
       • Encourage the individual to practice the target sound during various activities and conversations throughout the day.
6. Blowing exercises: Help strengthen the muscles involved in speech production, improve breath control, and enhance overall oral motor coordination, but can also indirectly impact speech clarity and volume.:
   • Bubbles: Have the individual blow bubbles through a bubble wand. This activity encourages sustained airflow and control, which can improve breath support for speech.
   • Feathers: Place a feather in front of the individual and have them blow gently to keep it floating in the air. This exercise focuses on controlled airflow and can be adjusted to target specific speech sounds.
   • Straws: Using a straw, have the individual blow air to move lightweight objects (e.g., small pieces of paper) across a surface. This activity can help work on different levels of breath control.
   • Blow Painting: Combine art and speech therapy by having the individual blow paint across a paper to create colorful designs. This exercise engages the oral muscles and promotes controlled exhalation.
   • Cotton Ball Blowing: Place a cotton ball on a table and have the individual blow to keep it moving or make it go through an obstacle course. This exercise is fun and encourages focused breath control.
   • Blow Horns or Whistles: Use small blow horns or whistles to produce varying pitches and volumes of sound through controlled blowing. This can help the individual develop greater breath control and oral muscle strength.
   • Blow Out Candles: Light a candle (safely) and have the individual blow out the flame. This exercise requires precise control of airflow and can be adjusted to work on specific speech sounds.

Language Delay or Disorders:

Here are some language exercises that can be beneficial for kids with language delay or disorders. These exercises aim to enhance various aspects of language development, including vocabulary, sentence structure, comprehension, and communication skill. Practicing with the kid in a playfull way helps to get on the desired level. The exercises should be adapted to the individual’s specific language level and goals. A speech-language pathologist can provide personalized guidance, assessment, and exercises tailored to address the specific language needs of the individual with a language delay or disorder.

1. Vocabulary Building:
   • Word Association: Choose a target word and have the individual generate as many related words as possible within a certain time limit.
   • Categories Game: Name a category (e.g., animals, colors) and take turns naming items that belong to that category.
2. Sentence Formation:
   • Sentence Expansion: Start with a simple sentence and have the individual expand it by adding more details or describing the action further.
   • Sentence Completion: Provide a sentence with a missing word or phrase and have the individual complete it. For example, “I like to eat ___.”
3. Following Directions:
   • Simon Says: Play the classic “Simon Says” game, giving the individual simple instructions to follow.
   • Recipe Following: Provide a simple recipe or set of instructions, and have the individual follow the steps to complete a task.
4. Comprehension:
   • Listening and Responding: Read a short story or passage aloud, and then ask questions to check comprehension.
   • Picture Description: Show a picture and ask the individual to describe what’s happening. This exercise helps with visual comprehension and expressive language.
5. Narrative Skills:
   • Retelling Stories: Have the individual listen to or read a short story, and then ask them to retell the main events in their own words.
   • Story Creation: Provide a story starter or picture and have the individual create their own story based on the prompt.
6. Conversational Skills:
   • Turn-Taking: Engage in a conversation, taking turns to speak and listen. Focus on maintaining eye contact, active listening, and responding appropriately.
   • Asking and Answering Questions: Practice asking open-ended questions and answering them in complete sentences.
7. Pragmatic Skills:
   • Role Play: Engage in role-playing scenarios to practice social interactions and problem-solving skills.
   • Situational Language: Discuss various situations (e.g., asking for help, ordering food) and practice appropriate language for each context.
8. Language Games:
   • Board Games: Play board games that involve reading, following instructions, and engaging in conversations.
   • Word Puzzles: Solve word puzzles like crosswords, word searches, or scrambled words to enhance word recognition.
9. Book Sharing:
   • Read Aloud and Discuss: Choose a book to read together, and afterward, discuss the characters, plot, and feelings expressed in the story.
10. Expressive Language:
    • Descriptive Language: Encourage the individual to use descriptive words (adjectives) to talk about objects, people, or places.

Voice Disorders:

here are some exercises that can be beneficial for individuals with voice disorders. These exercises aim to improve vocal quality, control, and overall vocal health:

1. Vocal Warm-Ups:
   • Start with gentle humming, lip trills, and sirens to warm up the vocal cords.
   • Practice gliding through your vocal range using different vowel sounds.
2. Hydration:
   • Drink plenty of water throughout the day to keep the vocal cords hydrated and maintain optimal vocal fold function.
3. Breathing Exercises:
   • Practice diaphragmatic breathing to support voice production and reduce strain on the vocal cords.
   • Inhale deeply, allowing your abdomen to expand, and then exhale slowly and controlled.
4. Pitch Variation:
   • Practice sliding your pitch up and down, exploring your full vocal range.
   • Aim for smooth transitions between pitches.
5. Resonance Exercises:
   • Explore different resonant qualities by using nasal and oral sounds. For example, alternate between “m” (nasal) and “ah” (oral).
6. Articulation Exercises:
   • Overemphasize articulation of consonant sounds to promote clear speech and prevent vocal strain.
7. Yawn-Sigh:
   • Yawn gently and then exhale on a soft sigh. This exercise relaxes the throat muscles and opens the vocal tract.
8. Straw Phonation:
   • Hold a straw between your lips and hum gently. This exercise can help reduce strain and promote a balanced vocal sound.
9. Semi-Occluded Vocal Tract Exercises:
   • Use exercises like lip trills, tongue trills, or humming to create a partially closed vocal tract, reducing vocal cord tension.
10. Vocal Rest and Avoiding Vocal Abuse:
    • Rest your voice when it’s tired or strained. Avoid shouting, whispering, and excessive throat clearing.
11. Posture Awareness:
    • Maintain good posture to allow for optimal breath support and vocal cord alignment.
12. Voice Monitoring:
    • Record your voice and listen for any signs of strain, hoarseness, or tension. This can help you identify areas that need improvement.
13. Professional Guidance:
    • Work with a speech-language pathologist or voice therapist to receive personalized exercises and strategies tailored to your specific voice disorder.

It’s important to note that these exercises should be practiced consistently and gently. If you have a diagnosed voice disorder, it’s recommended to work with a qualified speech-language pathologist or voice specialist who can provide individualized exercises and guidance based on your specific needs. Additionally, if you experience persistent hoarseness, vocal pain, or other voice-related issues, consult a medical professional for evaluation and appropriate treatment.

Apraxia of Speech: 

here are some exercises that can be beneficial for individuals with apraxia of speech. Apraxia of speech is a motor speech disorder that affects the ability to plan and coordinate the movements needed for speech production. These exercises focus on improving motor planning and speech coordination:

1. Repetitive Movements:
   • Practice repetitive movements of the articulators (lips, tongue, jaw) to improve motor coordination. For example, have the individual tap their lips, move their tongue side to side, or open and close their jaw.
2. Isolated Sound Practice:
   • Work on producing individual speech sounds in isolation. Use mirrors for visual feedback on articulator movements.
3. Syllable Repetition:
   • Practice producing simple syllables with the target sound (e.g., “ba,” “ka,” “pa”). Gradually increase the complexity by adding different vowels.
4. Phonetic Placement:
   • Use tactile cues (e.g., touching the lips for bilabial sounds) to help the individual place their articulators in the correct positions.
5. Sound Sequencing:
   • Practice putting sounds together to form simple words. Start with consonant-vowel combinations (e.g., “ba,” “ma”) and progress to more complex patterns.
6. Slow and Exaggerated Speech:
   • Encourage the individual to speak slowly and exaggerate the movements of their articulators. This can help improve motor planning and coordination.
7. Gestural Cues:
   • Incorporate gestures or hand movements that correspond to specific sounds. These visual cues can assist in triggering the correct motor patterns.
8. Visual Feedback:
   • Use a mirror or video recording to provide visual feedback on the individual’s speech movements. This helps them monitor and adjust their articulation.
9. Paired Practice:
   • Practice imitating the speech of a partner. This can help the individual coordinate their movements by following a model.
10. Melodic Intonation Therapy:
    • Use a sing-song pattern to practice producing words and phrases. The melodic aspect can help with motor planning and fluency.
11. Functional Phrases:
    • Practice producing functional phrases or sentences that the individual uses frequently. This connects speech practice to daily communication.
12. Pacing Boards:
    • Use pacing boards or rhythm cues to help regulate speech rate and coordination of sounds and syllables.

It’s important to remember that apraxia of speech therapy should be individualized to the person’s specific needs and severity. Working with a speech-language pathologist experienced in apraxia of speech is essential, as they can provide targeted exercises, cues, and strategies tailored to the individual’s challenges and goals. Consistency, patience, and gradual progression are key elements in apraxia therapy.

Dysarthria:

here are some exercises that can be helpful for individuals with dysarthria. Dysarthria is a motor speech disorder caused by muscle weakness or lack of coordination affecting the muscles involved in speech production. These exercises aim to improve speech clarity, strength, and coordination:

1. Respiratory Exercises:
   • Diaphragmatic Breathing: Practice deep breathing to support speech production and enhance breath control.
2. Articulation Exercises:
   • Repetitive Practice: Work on producing individual speech sounds in isolation, then progress to syllables and words.
   • Intensive Articulation Practice: Focus on overemphasizing articulation to enhance clarity.
   • Tongue and Lip Movements: Practice precise and controlled movements of the tongue and lips.
3. Loudness Training:
   • Practice speaking at increased loudness levels to improve overall speech clarity. Use a visual cue, such as a decibel meter, to monitor progress.
4. Pitch Range Exercises:
   • Practice producing speech at various pitch levels to improve prosody and vocal variety.
5. Syllable and Sentence Pacing:
   • Use pacing boards or metronomes to regulate speech rate and provide a rhythmic structure for speaking.
6. Voice Exercises:
   • Pitch Glides: Practice smoothly transitioning between low and high pitches to improve vocal range.
   • Vocalization with Vibrations: Use tools like a vocal vibrator to stimulate vocal fold vibration.
7. Bilateral Movement:
   • Engage in bilateral limb movements (e.g., tapping both knees) while speaking to improve speech coordination.
8. Functional Phrases and Sentences:
   • Practice producing common phrases and sentences that are relevant to the individual’s daily life.
9. Exaggerated Speech:
   • Encourage the individual to exaggerate articulation and vocalization to enhance speech clarity.
10. Visual and Tactile Cues:
    • Use mirrors for visual feedback on articulator movements. Tactile cues can include gently touching the lips or cheeks to prompt muscle activation.
11. Gestural Cues:
    • Incorporate hand gestures or cues that correspond to specific sounds or words to aid in speech initiation.
12. Chewing and Swallowing Exercises:
    • Engaging in chewing exercises can help strengthen the muscles involved in speech production. Swallowing exercises can enhance oral muscle control.
13. Relaxation Techniques:
    • Incorporate relaxation exercises to reduce muscle tension and promote more fluid speech.

It’s important to work with a speech-language pathologist who specializes in dysarthria to create a personalized treatment plan. The exercises should be tailored to the individual’s specific type and severity of dysarthria. Consistency and practice are key, and progress may be gradual. Therapists can also incorporate compensatory strategies to improve communication effectiveness in real-life situations.

Cleft Lip and Palate:

cleft lip and palate can lead to challenges in speech and articulation due to the structural differences in the oral and nasal cavities. Here are some exercises that can be beneficial for individuals with cleft lip and palate:

1. Oral-Motor Exercises:
   • Cheek and Lip Puffing: Practice inflating and deflating the cheeks and lips to improve muscle control and strength.
   • Tongue Movement: Engage in tongue exercises like moving the tongue from side to side and up and down.
   • Tongue-Blade Elevation: Place a tongue depressor on the tongue and practice elevating it to the alveolar ridge (bumpy area behind the upper front teeth).
2. Nasal Airflow Awareness:
   • Encourage the individual to pay attention to airflow through the nose while speaking and to use their fingers to feel the airflow.
3. Bilateral Movement:
   • Practice bilateral limb movements (e.g., tapping both knees) while speaking to improve speech coordination.
4. Resonance Practice:
   • Work on adjusting resonance by practicing oral and nasal sounds, monitoring the vibrations, and achieving a balanced sound.
5. Articulation Exercises:
   • Engage in articulation exercises to target specific speech sounds. Focus on precise articulator movement and placement.
6. Vowel and Diphthong Practice:
   • Work on producing vowels and diphthongs accurately to improve overall speech clarity.
7. Nasal Consonants:
   • Practice producing nasal consonants (/m/, /n/, /ng/) to improve nasal airflow control.
8. Nasal Hygiene:
   • Teach proper nasal hygiene practices to prevent infections and maintain optimal nasal health.
9. Breathing Exercises:
   • Engage in diaphragmatic breathing to support speech and improve breath control.
10. Visual and Tactile Cues:
    • Use mirrors for visual feedback on articulator movements. Tactile cues can include gently touching the lips, cheeks, and palate to encourage muscle activation and awareness.
11. Gestural Cues:
    • Incorporate hand gestures or cues that correspond to specific sounds or words to aid in speech initiation.
12. Functional Communication:
    • Practice using functional phrases and sentences that are relevant to the individual’s daily life and interests.

It’s important to work closely with a speech-language pathologist who specializes in working with individuals with cleft lip and palate. They can provide personalized exercises and strategies that address the specific challenges and needs associated with cleft lip and palate. Consistency, practice, and ongoing guidance are essential for progress in speech and communication.

Auditory Processing Disorders:

auditory processing disorders (APD) affect how the brain processes and interprets auditory information. While therapy for APD should be guided by a licensed audiologist or speech-language pathologist, here are some exercises that can help individuals with APD improve their auditory skills:

1. Auditory Discrimination:
   • Same or Different Sounds: Present pairs of sounds and have the individual determine if they are the same or different. Start with simple sounds and progress to more complex ones.
2. Auditory Memory:
   • Auditory Memory Games: Play games that require remembering sequences of sounds, such as “Simon Says” or “Repeat After Me.”
3. Auditory Closure:
   • Complete the Sentence: Present sentences with missing words and have the individual fill in the missing words based on the context.
4. Temporal Processing:
   • Rhythm Clapping: Clap a rhythm, and have the individual repeat the rhythm back to you. Vary the complexity of the rhythms.
5. Auditory Figure-Ground Discrimination:
   • Listening in Noise: Practice listening to and understanding speech in noisy environments, gradually increasing the noise level.
6. Auditory Sequencing:
   • Sequencing Sounds: Present a sequence of sounds and have the individual arrange them in the correct order.
7. Auditory Localization:
   • Sound Localization: Have the individual identify the direction from which a sound is coming.
8. Auditory Attention:
   • Selective Listening: Practice focusing on one sound source while ignoring competing sounds.
9. Auditory Comprehension:
   • Listening to Instructions: Present a series of instructions and have the individual follow them.
10. Auditory Association:
    • Word Association: Present a word and have the individual quickly provide a related word.
11. Phonemic Awareness:
    • Segmenting and Blending: Practice breaking words into individual sounds (segmenting) and blending sounds to form words.
12. Music Activities:
    • Melodic Patterns: Practice recognizing and reproducing simple melodic patterns.

Remember that exercises should be tailored to the individual’s specific deficits and needs, and they should be conducted under the guidance of a professional. An audiologist or speech-language pathologist experienced in APD can provide a comprehensive assessment and design a treatment plan that includes appropriate exercises to improve auditory processing skills.

Social Communication Disorders/Autism: 

social communication disorders involve challenges in understanding and using verbal and nonverbal communication in social contexts. An example of a social communication disorder is Autism. Here are some exercises to help individuals with social communication disorders improve their social interaction skills:

1. Conversational Turn-Taking:
   • Engage in structured conversations where the individual practices taking turns speaking and listening.
   • Use visual cues like holding a token to indicate whose turn it is to speak.
2. Active Listening Skills:
   • Practice active listening by maintaining eye contact, nodding, and providing verbal and nonverbal feedback to show understanding.
3. Making Eye Contact:
   • Practice making and maintaining appropriate eye contact during conversations.
4. Body Language Awareness:
   • Discuss and practice interpreting body language cues, such as facial expressions, gestures, and posture.
5. Emotion Recognition:
   • Engage in exercises where the individual identifies and labels various emotions based on facial expressions and situations.
6. Emotion Expression:
   • Practice expressing emotions through facial expressions and body language.
7. Context Inference:
   • Engage in conversations with incomplete information, encouraging the individual to infer meaning from context.
8. Topic Maintenance:
   • Practice staying on topic during conversations. Use visual prompts or cues if necessary.
9. Initiating and Ending Conversations:
   • Role-play scenarios where the individual practices starting and ending conversations appropriately.
10. Problem-Solving Scenarios:
    • Discuss hypothetical social scenarios and work together to brainstorm appropriate responses and solutions.
11. Role-Playing:
    • Role-play common social situations, such as greetings, introductions, asking for help, and making requests.
12. Video Modeling:
    • Watch videos of social interactions and discuss the observed behaviors, emotions, and appropriate responses.
13. Group Activities:
    • Engage in group activities that encourage cooperation, teamwork, and social interaction.
14. Journaling:
    • Encourage the individual to write about their thoughts, feelings, and social experiences. This can help them reflect on social interactions.
15. Social Stories:
    • Create or read social stories that address specific social situations and provide guidance on appropriate behaviors and responses.
16. Mindfulness and Perspective-Taking:
    • Engage in mindfulness exercises and activities that encourage understanding others’ perspectives and emotions.

It’s important to create a supportive and understanding environment for practicing these exercises. Working with a speech-language pathologist or social skills therapist can provide personalized guidance and feedback to address the individual’s specific social communication challenges. Progress in social communication skills often requires consistent practice, patience, and ongoing coaching.