Case Study – Articulation

Eliana , an 11-year-old fifth-grade girl, has difficulty producing the “r” and “th” sounds in all positions of words. Eliana’s parents’ first language is Spanish, and both Spanish and English are spoken in the home.  Eliana’s parents notice that she has difficulty producing all types of /r/ in both English and Spanish. Results of a speech-language evaluation reveal sound substitutions /w/ for /r/, /f/ for voiceless /th/, /d/ for voiced /th/ and distortions of /r/ in all positions of words. When given verbal and visual cues, Eliana is stimulable for these sounds; however, she has more difficulty with vocalic /r/ than the others. Although her speech is reportedly about 90% intelligible or better to most listeners, Eliana’s peers are starting to comment on her speech as “baby talk.” Eliana’s teacher says that she is a hard worker and performs average to above average in most subjects. The teacher has noticed that Eliana is reluctant to participate in class and worries about her self-confidence as she approaches the sixth grade.  Eliana currently receives special education services for organization and social skills due to ADHD and qualifies under the primary disability of Other Health Impaired.