The Motor Speech Hierarchy
The Motor Speech Hierarchy (MSH) a central element of PROMPT therapy is a 7️⃣-stage guide that helps SLPs analyze speech through the lens of MOVEMENT. (For more about PROMPT visit their web-site at promptinstitute.com )
Why I ❤️ it:
⭐️ The MSH corresponds neatly to developmental progression of speech sounds. In slide 3, I’ve juxtaposed it to the consonant norms outlined in 2018 by McCleod & Crowe (poster from The Speak Boutique store) and vowel norms from Dr. Namasivayam et al’s 2020 paper: Speech Sound Disorders: An AP Perspective. https://www.frontiersin.org/articles/10.3389/fpsyg.2019.02998/full
⭐️ By addressing sounds according to MOVEMENT, S-LPs can address several sounds at once. E.g. when working on lip closure, we can address P, B and M at the same time. When working on back tongue control, we can target K and G together.
⭐️ It is a MYTH that you need to address sound errors in the sequence of the MSH. PROMPT trained SLPs to analyze the subsystems of speech breakdown & prioritize/customize according to the specific child’s abilities and needs. #clinicaljudgement
The MSH in a nutshell:
1️⃣ and 2️⃣:
✅ 💪🏼 tone/posture
✅ basic phonatory control
⭐️ both = related to 💨 BREATH control.
‼️important bc/ speech = shaping of air through the vocal tract 🫁 👄.
✅🦈 JAW movement.
✅ vertical ↕ movement
✅ mostly VOWELS
✅👀ing for central & stable 🦈 mvmt.
✅ LIP 👄 movement
✅horizontal ↔️ movement.
✅ lips stretch: “ee”, or are ⭕️: “o”.
✅lower 👄 to 🦷 contact for F/V
✅ 👀 at if 👄s are closing fully and symmetrically.
✅TONGUE 👅 movement
✅ anterior/posterior ✈️.
✅is 👅 moving independently from jaw.
✅sequenced movement - changes in voicing & 💨 control (valving) and integration of multiple planes of movement.
✅ 💡Compare “mom” (↕️movement/all voiced) vs. “squirrel” which requires variation of voicing, control of jaw, lip and tongue movement. ↕️↔️👅)
✅ Prosody: the melody 🎶 of speech. 💭re: ⏱ time and volume/emphasis.
✅ Stage 7️⃣ is connected to Stage 3️⃣. We consider prosodic elements throughout a child’s intervention.
‼️ very important for kids with CAS.