I was once taking my morning break, sitting on a railway bridge just outside my clinic when someone came up to me. He asked if I was the speech therapist. I said: Yes. He said that his son, Jason, then aged seven, had had some help for a speech problem, and been discharged. An assurance had been given: The remaining problems would sort themselves out in time. But as a father he was still worried.

We went on to talk about his work. I resolved to see Jason as soon as possible.

There were no problems with Jason’s school work, He could say all the sounds of English in various positions in words, with no obvious problem in casual conversation. But I was confident that his father’s concerns were justified. And when I asked Jason to say some longer words, I found that he could say very few words of four syllables or more, words like monopoly and calculator. His speech sounded immature.

But what caused which errors? I took a word Jason couldn’t say, and made it a bit simpler. We continued this process, gradually moving closer to the target, until he could say it correctly. With no consultation and presumably no rehearsal, a week later Jason again said it correctly. Starting from a variation of a given target word that he could manage, I would give him around 100 nonsense words, making no corrections, just praising all of his efforts, but trying to ensure that every trial would be possible for him. My purpose was to define the point(s) at which the breakdown occurred and to find a way of working up to that point that would facilitate success. We continued like this until he could say all the long words I could think of, and Jason and his parents were not aware of any other problems with his speech.

Contact Dr Aubrey Nunes