Tutorial: Motor-based treatment strategies for /r/ distortions

Jonathan L. Preston, Nina R. Benway, Megan C. Leece, Elaine R. Hitchcock, Tara McAllister

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: This tutorial summarizes current best practices in treating American English /r/ distortions in children with residual speech errors. Method: To enhance the effectiveness of clinicians’ cueing and feedback, the phonetics of /r/ production is reviewed. Principles of acquisition, which can inform how to practice /r/ in the early stages of therapy, are explained. Elements of therapy that lack scientific support are also mentioned. Results: Although there is significant variability in /r/ production, the common articulatory requirements include an oral constriction, a pharyngeal constriction, tongue body lowering, lateral bracing, and slight lip rounding. Examples of phonetic cues and shaping strategies are provided to help clinicians elicit these movements to evoke correct /r/ productions. Principles of acquisition (e.g., blocked practice, frequent knowledge of performance feedback) are reviewed to help clinicians structure the earliest stages of treatment to establish /r/. Examples of approaches that currently lack scientific support include nonspeech oral motor exercises, tactile cues along the mylohyoid muscle, and heterogeneous groupings in group therapy. Conclusion: Treatment strategies informed by phonetic science and motor learning theory can be implemented by all clinicians to enhance acquisition of /r/ for children with residual errors.

Original languageEnglish
Pages (from-to)966-980
Number of pages15
JournalLanguage, speech, and hearing services in schools
Issue number4
StatePublished - Oct 2020


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