Tactile Speech Cueing
Producing speech is a complex process that involves coordination between the diaphragm, vocal folds, jaw, lips, tongue, and more. Speaking requires motor skills that need to be practiced and learned, like riding a bike or shooting baskets (Marisette, 2016). Some of the most common speech and language disorders in our clients are dysarthria and apraxia. In both disorders, clients know what they want to say, but the quality of their speech can be unclear and difficult to understand, even for close friends and family.
What’s the difference between dysarthria and apraxia? Dysarthria is characterized by impaired movement of the muscles used for speech production, including the diaphragm, lips, tongue, and jaw (Marisette 2016). The brain sends motor plans to the articulators, but they struggle to execute them. In contrast, clients with apraxia have difficulty planning and sequencing movements, including movements required for speech (Marisette, 2016). The brain struggles to send efficient motor plans to the articulators.
Children with dysarthria and apraxia improve speech quality with mass practice (Marisette, 2016). SLPs commonly use auditory and visual cues to help their clients see and hear how sounds are produced (Marisette, 2016). There is a growing body of evidence that suggests tactile cues can also be an effective treatment for dysarthria and apraxia (Grigos, Hayden, and Eigen, 2010).
Tactile cues are becoming widely used by speech-language pathologists, related disciplines, and parents. Tactile cues use a light physical touch on the jaw, tongue, or lips to support and shape correct movement. There is a specialized touch cue protocol called PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets). The PROMPT Institute offers specialized training for SLPs (The Prompt Institute, 2019). However, you don’t need to be a specialized SLP to use touch cues to benefit your client or loved one! Here are three touch cues Laura M. Kunz, M.A., CCC-SLP uses with her clients to produce the bilabial sounds /m/, /b/, and /p/:
/m/ – lips together, hold 3 fingers in front of lips (horizontally), as making ‘mmmmm’ sound slide fingers across the lips.
/b/ – lips together, hold four fingers in front of lips (vertically), as you say the sound move your fingers in a downward motion.
/p/ – lips together, hold index finger in front of lips (vertically), as you say the sound move your finger in a downward motion.
Music therapists can incorporate touch cues when working on articulation of consonant sounds with clients, especially when using NMT techniques DSLM (Developmental Speech and Language Training through Music) or OMREX (Oral Motor and Respiratory Exercises). Try it out and see let us know how it works out!
– Molly, Music Therapy Intern
For more information, see the following articles and videos:
Grigos, M., Hayden, D., and Eigen, J. (2010). Perceptual and Articulatory Changes in Speech
Production Following PROMPT Treatment. Journal of Medical Speech-Language Pathology, 18, 46-53.
Kunz, L. (1983). Touch Cue System [PDF file]. Retrieved from:
www.northroyaltonsd.org/Downloads/TouchCue.pdf
Longwood CSD YouTube Channel. (2016, August 20). Childhood Apraxia of Speech: Tactile
Cues [Video file]. Retrieved from: https://www.youtube.com/watch?v=pfTlTRV-yV8
Marisette, C. (2016). PROMPT: A ‘Hands on” Approach to Improving Speech Clarity [Web
page]. Retrieved from https://1to1therapy.ca/prompt/
The Prompt Institute. (2019). What is PROMPT? [Web page]. Retrieved from:
