Persistent Speech Sound Disorders Course

Helping SLPs, SLAs/CDAs, and SLP graduate students build confidence through structured, clinically relevant lessons.

Overview

Speech Restored Inc. has developed seven structured learning modules designed to help Speech-Language Pathologists, Speech-Language Pathology Assistants/Communicative Disorder Assistants, and graduate students enhance their assessment and treatment of persistent speech sound disorders. The course integrates principles of orofacial myofunctional disorders with the clinical application of an evidence-based jaw stability tool (bite block). Originally introduced to speech-language pathology by James Dworkin in 1978, a bite block is used to provide jaw stability, allowing for more independent and precise tongue and lip movements during speech assessment and treatment.

Building upon extensive bite block training with Dr. Megan Hodge at the University of Alberta in 2014, Speech Restored Inc. provides clinicians with practical, hands-on instruction to confidently and effectively incorporate this evidence-informed tool into clinical practice. Dr. Hodge’s specialized training in bite block application provided the foundation for many of the clinical principles integrated throughout this course, which have been further developed through over 25 years of clinical experience supporting individuals with persistent speech sound disorders across healthcare, education, and private practice settings.

These research-informed modules feature extensive visuals, photographs, demonstration videos, and downloadable resources designed to build competence and confidence in assessment, treatment planning, clinical decision-making, referrals, and recommendations for individuals with persistent speech sound disorders.

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Persistent Speech Sound Disorders Course: Preview Videos

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Module 1: Fundamentals & Orofacial Myofunctional Disorders

Gain a foundational understanding of how Orofacial Myofunctional Disorders (OMDs) influence speech, swallowing, and facial development. Explore the four fundamentals of speech sound remediation through research, case examples, and video demonstrations designed to enhance your clinical insight and confidence.

Module: Fundamentals of Speech Sound Remediation and Orofacial Myofunctional Disorders (OMDs)

Orofacial Myofunctional Disorders (OMDs) involve dysfunctions of the muscles and functions of the face and mouth. These disorders can affect facial growth and development, speech production, chewing, swallowing, and oral hygiene. Understanding and addressing OMDs is essential for effective speech sound remediation and the promotion of optimal oral health.

In this module, participants will explore the Four Fundamentals of Speech Sound Remediation, which form the foundation for effective and lasting change in speech production:

Resting Position
An ideal oral resting position includes lips gently together, molars slightly apart, nasal breathing, and a tongue lightly suctioned near the palate. Abnormal resting postures—such as a forward tongue position—can contribute to dental changes like open bites and impact articulation precision.
Stability
Jaw stability provides the foundation for independent, coordinated movements of the lips and tongue. A stable jaw allows for efficient adjustments and precise control during speech production.
Lateral Margins
During speech, the sides of the tongue (lateral margins) should remain in contact with the upper molars for stability. This lateral bracing supports accurate airflow direction and precise tongue placement for clear articulation.
Tension
Appropriate tongue tension enables the quick, flexible movements required for speech. This includes lifting and retracting the tongue, creating the grooves necessary for accurate sound production, and maintaining control without rigidity.

Beyond these fundamentals, this module highlights how Orofacial Myofunctional Disorders relate to key clinical domains:

Mouth Breathing: Contributes to poor jaw growth, malocclusion, and altered facial development, which can affect both speech and overall health.
Speech Disorders: Many children with OMDs demonstrate challenges with articulation and resonance.
Sleep Disorders: OMDs are linked to sleep-disordered breathing, which may be misinterpreted as ADHD or behavioral concerns in children.

Included in This Module

Research articles and evidence summaries
Child case examples illustrating clinical application
Video tutorials and demonstrations to support hands-on learning

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Module 2: Speech Sounds Overview

Discover how speech sounds connect to the four fundamentals of movement and structure — resting position, stability, lateral margins, and tension. This module blends research, video demonstrations, and practical examples to help you understand how consonants and vowels are shaped, supported, and refined through motor-based principles.

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Module 3: Bite Blocks

Learn how to effectively use an evidence-based jaw stability tool called a bite block to promote jaw stability, tongue and lip independence that supports precise articulation. This module combines research, demonstrations, and clinical examples to help you confidently integrate bite blocks into assessment and therapy.

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Module 4: Screening

Learn how to complete a functional speech assessment that uncovers the root causes of persistent speech sound errors. This module combines current research, clinical demonstrations, and hands-on assessment tools to help you evaluate speech with precision, efficiency, and confidence. Participants will also learn to feel confident in recognizing when referrals to other professionals are appropriate, ensuring comprehensive, collaborative care for every client.

Module: Functional Speech Assessment

This module dives deep into completing functional speech assessments that go beyond surface-level testing to uncover why speech sound errors persist. Participants will learn to analyze oral function, structure, and movement patterns through a comprehensive, practical approach to assessment. You will also gain confidence in recognizing when referrals to other professionals are appropriate, ensuring comprehensive and collaborative care for every client.

The Four Key Components of a Functional Assessment

Intake and Case History
The assessment begins by gathering essential background information, including the client’s main concern, family and language history, and any relevant medical, dental, or developmental factors that may influence speech and language.
Speech Restored Inc. provides guidance on collecting additional details to help clinicians gain deeper insight into the root causes of persistent speech sound errors.
Observation
This stage focuses on evaluating the client’s resting position, connected speech, and overall facial and oral mechanics. Clinicians observe features such as lip closure, jaw alignment, and tongue positioning to understand how these influence speech.
Speech Restored Inc. has developed a hands-on Observation Checklist to help clinicians complete thorough facial observations and identify areas contributing to speech sound disorders.
Oral Mechanism Screening
A detailed examination of the face, jaw, lips, teeth, tongue, and palate is performed to assess their roles in speech production. Tasks such as diadochokinetic rate testing and tongue mobility assessment are included to evaluate coordination and independence of movement.
Speech Restored Inc. offers practical tips for completing oral mechanism screens and demonstrates the use of a Tongue Mobility Screen to identify ongoing areas of difficulty that may contribute to persistent speech sound errors.
Speech Sound Test/Screen
This final component focuses on identifying specific speech sound errors and connecting them to potential underlying causes discovered in the previous steps. This integrative approach allows clinicians to design targeted, functional therapy plans that address root issues rather than surface symptoms.

Included in This Module

Research articles and evidence-based summaries
Video demonstrations and client examples
Functional assessment forms, including the Observation Checklist and Tongue Mobility Screen
Case studies and next-step recommendations for clients showcased within the module

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Module 5: Treatment

Learn how to treat persistent speech sound disorders using principles from orofacial myofunctional therapy and the use of a bite block. This module provides clear, step-by-step strategies, video demonstrations, and practical tools to guide confident, effective treatment.

Module: Treatment Strategies for Persistent Speech Sound Disorders

This module provides a comprehensive framework for the treatment of persistent speech sound disorders, integrating principles from Orofacial Myofunctional Disorders (OMDs) and the use of a bite block to promote jaw stability, tongue independence, and efficient speech production.

Participants will learn both general treatment strategies and specific therapeutic techniques to address the functional contributors to speech sound difficulties. Participants will also learn how to break down therapy goals into manageable and achievable steps for non-stimulable speech sound errors.

General Treatment Strategies

Open Communication: Maintain transparent communication with clients and families. Use trial therapy when possible structural or functional concerns are present to evaluate appropriateness and guide next steps.
Build Confidence: Set achievable goals, gradually increase complexity, and celebrate small successes to promote motivation and confidence.
Gross and Fine Motor Movements: Start with large motor movements to help achieve small, stabilized movements. Incorporate multisensory input to support motor learning and improve overall coordination.
Control Phonemes: Simplify therapy targets, use high repetition, and isolate sound patterns to prevent confusion with similar phonemes.
Introduce Verbal Scripts: Develop short, personalized scripts to enhance recall and reinforce learning through familiar routines.
Co-Articulation Awareness: Teach the importance of smooth sound transitions to improve overall speech fluidity and connectedness.

Specific Techniques

Bite Block Usage: Use bite blocks to facilitate lingual-alveolar valving (LAV) and promote jaw stabilization, particularly for clients with motor coordination challenges.
Tongue and Lip Movements: Implement engaging oral motor movements, such as “puppy tongue” and “pointy tongue,” to improve lingual tension and lateral margins. Use these easy-to-grasp concepts when educating clients on tongue positions for challenging sounds.
Resting Position Practice: Reinforce nasal breathing and proper oral resting posture to support stability and optimal articulatory function.

Included in This Module

Video demonstrations and clinical examples
Access to hundreds of word lists organized by sound and vowel context
An Oral Movement Guide outlining strategies for tongue, lip, and resting position training
Individual Speech Guides providing step-by-step methods to stimulate persistent speech sound errors
Techniques for breaking down complex sounds into achievable therapy steps

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Module 6: Client Example #1

Follow a real clinical case study demonstrating the step-by-step use of bite blocks in remediating the /r/ sound. Observe assessment, treatment progression, and measurable outcomes through video examples, clinical insights, and session reflections.

Module: Case Study – Treating /r/ Production with Bite Block Integration

This video case study follows the speech therapy journey of a client working to overcome persistent challenges with producing the /r/ sound. Despite prior orofacial myofunctional therapy and orthodontic intervention, the client continued to experience difficulties with the /r/ sound.

Therapy was provided bi-weekly, with a structured progression of movements using bite blocks (BB) to improve lingual tension, tongue mobility, and overall jaw stability.

Key Therapy Components and Progress

Initial Assessment and Setup

Conducted conversational and reading assessments, including multiple /r/ screening tasks.
Introduced bite block movements to establish tongue stability and improve lingual tension.

Progress Through Sessions

Sessions 1–3: Focused on prevocalic /r/, tongue mobility, and Lingual-Alveolar Valving (LAV). Early improvements were observed in lingual tension and /r/ accuracy.
Sessions 4–6: Emphasized blending exercises, sensory feedback, and structured practice for consistency. The client began to self-correct and gained confidence.
Sessions 7–9: Introduced /r/ in sentences and minimal pairs, leading to natural integration of /r/ in connected speech.
Sessions 10–12: Transitioned to bunched /ɚ/ stimulation, refining placement. The client learned to alternate between retroflex and bunched /r/ positions.
Session 13: Targeted /r/ blends, focusing on stability and accuracy, resulting in consistent productions.

Therapeutic Techniques

Use of bite blocks (BB) to enhance jaw stability and lingual control.
Sensory feedback and modeling to guide accurate tongue placement.
Gradual introduction of complex vocalic /r/ forms and connected speech contexts.

Achievements

Marked improvement in /r/ sound production.
Increased lingual tension and stability through bite block use, supporting more precise articulation.
Demonstrated ability to self-monitor and self-correct in spontaneous speech.

Included in This Module

Video examples documenting the client’s progress from initial assessment through treatment.
A 1–5 rating scale to support objective and subjective tracking of progress.
Clinical notes and reflections from each therapy session.
Detailed home practice activities for continued carryover and reinforcement.

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Module 7: Client Example #2

Follow the therapy journey of an 8-year-old client working toward accurate production of the /r/ sound through the use of bite blocks and the Four Fundamentals of Speech Sounds.
This module presents assessment findings, detailed therapy progression, and measurable clinical outcomes—supported by authentic session notes and practical tools you can apply in your own practice.

Module: Case Study – Advancing /r/ Production Through Bite Block Integration with a Posterior Tongue-tie
This module follows the therapy journey of an 8-year-old client whose primary concern was difficulty producing the /r/ sound. The client had previously targeted /l/ and /l/ blends in therapy and presented with no literacy, numeracy, medical, or dental concerns.
Therapy was delivered bi-weekly using a structured progression of exercises that incorporated bite blocks (BB) to improve tongue mobility, increase lingual tension, and reduce cheek tension. Each session built upon the previous one, emphasizing stability, control, and precision in tongue placement and movement patterns.
Key Findings and Interventions
Assessment Results
Initial assessment revealed moderate difficulty with tongue mobility, a restricted tongue tie, and a narrow tongue shape. The client also demonstrated weak posterior stability and a tendency toward thrusted /l/ productions. These findings guided the selection of bite block exercises and tongue positioning techniques used throughout therapy.
Session Highlights
● Session 1: Introduced mid-tongue contraction exercises; home practice included BB and tongue positioning tasks to reinforce awareness and control.

● Session 2: Notable improvement in mid-tongue contraction; introduced retroflex and bunched /r/ techniques, along with new activities targeting tongue bowl formation and cheek relaxation.

● Session 3: Focused on complex word phrases with lip hold; continued precision work through targeted tongue exercises for /r/ accuracy.

● Session 4: Incorporated mixed syllable combinations and “Karla” exercises to refine tongue positioning and improve coordination.

● Session 5: Emphasized the “Luh walk back” technique, facilitating emerging /r/ productions and encouraging a wider tongue shape for clearer articulation.

● Session 6: Reviewed tongue hold techniques and practiced complex sound sequences to enhance consistency and carryover.

● Session 7: Introduced “ar” co-articulation and sentence-level practice, leading to greater accuracy, stability, and generalization of /r/ production across contexts.

Included in This Module
This module provides:
● Documentation of client progress from initial assessment through treatment

● A 1–5 rating scale for tracking both objective and subjective progress

● Clinical notes and reflections from each therapy session

● Detailed home practice activities to promote carryover and continued success

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Group discounts are available. Contact Speech Restored to discuss pricing for your team or organization.

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Module breakdown:

Fundamentals and Orofacial Myofunctional Disorders (0.5 hours)
Speech Sounds Overview (0.5 hours)
Bite Blocks (1 hour)
Screening (2 hours)
Treatment Strategies (1.5 hours)
Case Study #1 (1 hour)
Case Study #2 (0.5 hours)

In addition to the modules, participants receive full access to an extensive downloadable resource library, including (but not limited to) word lists, assessment forms, treatment guides, and clinical supports.

Included with your purchase:

Access to all 7 modules for 1 year from the date of purchase
Full downloadable access to the resource library

Upon successful completion of all seven modules, participants will receive a Certificate of Completion documenting 7 professional development hours. This certificate may be submitted to applicable professional colleges, regulatory bodies, or licensing organizations and are subject to individual jurisdictional requirements.

Persistent Speech Sound Disorders Course

Overview

Persistent Speech Sound Disorders Course: Preview Videos

Module 1: Fundamentals & Orofacial Myofunctional Disorders

Module 2: Speech Sounds Overview

Module 3: Bite Blocks

Module 4: Screening

Module 5: Treatment

Module 6: Client Example #1

Module 7: Client Example #2

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