The /r/ sound is one of the most difficult sounds for a clinician to target. Where do we start? The R that initiates a syllable is very different from the R that is vowelized, and the R that is stressed within a word is different from the unstressed R at the end of words...or are they? Covered will be seven basic steps that are necessary to move clients onward toward habituation. Participants will learn the secrets of taking the correct steps in the correct order. You will no longer be left in limbo, unsure whether to begin with the initial sound in isolation, or in the final position, or with clusters....or whether to simply pull your hair out in frustration!
Certain structural and functional complications that interfere with the treatment process are described and ruled out. Basic lingual skills necessary for success are introduced early in the treatment program. Participants will progress — much as their clients will — through small, critical steps along a smooth and sensible pathway leading to the final goal of habituation. Offered for 0.15 ASHA CEUs – 1.5 contact hours.
While the content of this online CE course does not focus exclusively on any specific proprietary product or service, the methods in this course are derived from the text, Orofacial Myology: From Basics to Habituation. Course author, Sandra Holtzman, is the author of this text and receives royalties on its sale. Additional financial and non-financial disclosures may be found by clicking on the Presenter & Disclosures tab.
Video PowerPoint presentation with author narration & downloadable handout.
This online CE course is an updated version of a previously offered eCourse - #e54. While some of the content material may be the same, this course is considered a different offering with ASHA.
Sandra R. Holtzman, MS, CCC-SLP, COM, QOM, is an ASHA certified speech-language pathologist who has specialized in orofacial myology for more than 30 years. She is a certified orofacial myologist and a member of the International Association of Orofacial Myology (IAOM). Sandra is presently serving on both the Board of Directors and the Board of Examiners of the IAOM.
Sandra has addressed SLPs, dental professionals, and other specialists across the United States on the connection between orofacial musculature and speech disorders, tongue-tie (ankyloglossia), thumb and digit sucking habits, mouth breathing, and other topics. In 2000, Sandra established Neo-Health Services, Inc., which provides continuing education workshops, therapy for orofacial myofunctional disorders and other speech-language disorders, and supplies oral myofunctional products. She is author of Orofacial Myology: From Basics to Habituation (aka the "Myo Manual").
Financial — Sandra Holtzman is presenter of online CE courses sponsored by Northern Speech Services; receives royalty payments.
Financial — Sandra Holtzman is the author of the text "Orofacial Myology: From Basics to Habituation"; receives royalty payments.
Financial — Sandra Holtzman is the owner of Neo-Health Services, Inc; ownership interests.
Nonfinancial — Sandra Holtzman has no relevant nonfinancial relationships to disclose.
This program is offered for 0.15 ASHA CEUs (Intermediate Level; Professional Area).
ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.
ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:
If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.
Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.
Additional accrediting agencies by which Northern Speech is an approved CE provider:
Course Completion Timeframe: You have unlimited time to complete this online course. You may log off and log on as you wish in order to complete all sections of this course.
Content Access: Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the E-Courses tab, and then viewing your desired course.
Certificate of Completion: On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on the Eastern Standard Time Zone), and number of contact hours (CEUs / CEEs).
ASHA CE Registry Submission: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
Purchase Orders: Purchase orders are NOT accepted when registering for online courses. Payment must be made online in the form of a credit or debit card payment.
More FAQ: Please click here.
What is an Online Course? Our Online Courses include text, audio, or video formats and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any computer, via your Northern Speech account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%) a printable certificate of completion is presented to you.
Receiving CEUs: Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to online CEUs.
Registering for an online course: You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.
Accessing your purchased course or returning to a purchased course: You will be able to access your online course by logging into your Northern Speech account and then clicking the Online Courses tab on your profile screen. Click View next to the course you’d like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.
Course completion timeframes: Nearly all our courses provide for unlimited time to complete your course. You may work at your own pace and start and stop your course as you wish. Any access limitations will be clearly noted on the individual course description page.
Course content expiration: Nearly all our courses provide for continued access to course content and materials, even after completion of the post test. Any access limitations will be clearly noted on the individual course description page.
Testing requirements: Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.
Certificate of completion: A certificate displaying participant name, date of course completion (based on the Eastern Standard Time Zone), and the number of contact hours earned is presented to participants once a score of 80% or greater is earned on the post test. Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.
ASHA CE Registry: Northern Speech will provide CEU information to the ASHA CE Registry for you. At the time of course enrollment if you select that you are taking the course for ASHA Credit and if you provide your ASHA Member Number, Northern Speech will automatically submit your hours to the CE Registry after you successfully complete the post test. Please allow 45-60 days from the date of course completion for your hours to appear on your CE transcript. Note that ASHA will record your CEUs as earned on the last day of the month in which you completed your course. For example, if you completed your course on Nov 7, the CE Registry will reflect course completion as Nov 30.
Number of CEUs offered: We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.
State licensing boards and online CEUs: NSS is an ASHA CE Provider and most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.
Course formats: Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page.
Course handouts: Most of our non-text online courses provide a link to download the accompanying handout.
Purchase orders: Purchase orders are NOT accepted when registering for online courses. Payment must be made online in the form of a credit or debit card payment.
Group discounts: Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.
Computer requirements: For our online courses to function best, we recommend that you update your computer to include the newest version of your Internet browser (Safari, Chrome, Internet Explorer, etc) and newest version of Flash Player. Also a high-speed Internet connection is recommended (cable or DSL). Speakers or headphones will be required for many of our courses as many contain audio components.
Course Cancellation Policy: A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded.
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"This is the only /r/ method that has worked for my clients!! I like that the course is direct, to the point. Great how-to seminar. Thanks!!" – D.N. (Apr. 2018)
"I appreciated the steps to follow to draw out /r/, and I really enjoyed the video clips." – K.M. (Apr. 2018)
"The videos of various techniques used to achieve success of "er" in isolation. I liked breaking the interventions down into the 7 stages." – S.M. (Mar. 2018)
"I liked being reminded about what to rule out before the beginning of the program. I love how Sandra actually shared what steps to take in treatment in a very clear manner. I wish more continuing education videos were as thorough about treatment implementation as Sandra's was." – M.M. (Mar. 2018)
"Starting with the purest 'er' and then moving to the "her" as a phrase; I will find this very beneficial. I liked the step by step instructions. Very easy to follow and implement." – M.B. (Feb. 2018)
"It was a great, very detailed and explained well course. I especially enjoyed the videos as it helped to solidify the concept. I appreciated the seven steps broken down. I also really found the various activities (e.g., hot/cold search game, role reversal) to be so helpful and keep it fun!" – K.K. (Jan. 2018)
"The breakdown of the /r/ sound and the emphasis on the need to meet each critical step was very beneficial." – A.L. (Dec. 2017)
"I enjoyed the steps and concrete hierarchy to help with /r/ (with EBP to support it) and learning a new method." – B.P. (Dec. 2017)
"Learning how to move into habituation was especially helpful. I like that the course provided examples I can use in my sessions." – M.S.L. (Nov. 2017)
"Great intro into R therapy! I liked the examples of therapy as well as transitioning from ER and breaking words down." – A.W. (Oct. 2017)
"The entire thing was so helpful and most is the sequence for me! I now realize I was starting in the wrong place and worse, not moving through stimuli in a sequential and thoughtful manner. I liked the resources and examples! The pace was so perfect for maximum absorption. The videos gave me hope for my really awful R kiddos!!!" – K.M. (Oct. 2017)
"It is very practical and easy to implement. I liked the step by step gradual development. I know exactly where to start and how to target the /r/ sound. Thank you very much! This course was extremely beneficial to me." – P.C. (Oct. 2017)
"The /r/ in general is very difficult to teach. I think breaking it up into stages was very helpful." – J.W. (Sept. 2017)
"The detailed sequence of the therapy process for /R/ remediation was very helpful. The visuals in the handout were very clear, and the videos of therapy were informative." – J.D. (Aug. 2017)
"Going over which combinations of /er/ sounds to start with after a child is able to produce the /er/ and how to move along to get into habituation were the most useful discussions. I liked the easy of the steps and examples for each." – D.S. (July 2017)
"All of it was beneficial! Very informative - the best /r/ course I've ever taken!" – L.D. (June 2017)
"The steps are clear and specific to a habitual /er/ sound. I have not received training to correct the /er/ sound that was so concise. I look forward to implementing this program at my school site." – E.B. (June 2017)
"The analysis of the placement of all sound combinations and possibilities (Stage 3 - Additional Sound Families) was extremely helpful. The in-depth treatment information, videos, and specific examples were consistently provided to enhance learning." – L.A. (May 2017)
"The author provided great examples of words, phrases, and sentences to use that all incorporate the target sounds. I enjoyed learning about the hierarchy and how to move through each stage with a client. However, I expected to hear about the different ways a client can produce an /r/ - retro flexed vs bunched." – M.I. (Apr. 2017)
"The course was very informative. Sandra Holtzman did a great job presenting the information and demonstrating the steps needed to achieve success in obtaining production of the /r/ phoneme." – J.O. (Mar. 2017)
"I like how practical this course was. I feel like I can make a positive change with my students' therapy tomorrow!" – A.C. (Mar. 2017)
"It was all well presented and applicable to my daily therapy. I liked its simplicity and to the point delivery." – J.M. (Mar. 2017)
"I thought it was most helpful when she explained why she started with the ER sound. It made me think differently about how to approach therapy with my clients in the future who have difficulty with the R sound. I liked that the course had set steps to follow and provided a way to move through ways to achieve the R sound in therapy. It was individualized but at the same step could be applied to any client you are working with on the R sound." – J.E. (Mar. 2017)
"I appreciated how the hierarchy is organized and easy to follow. I liked the video examples." – I.D.L.R. (Mar. 2017)
"Very applicable to therapeutic practice. The slides and videos make it easy to follow along to. The course gave clear and well-supported guidelines for use and to accomplish outcomes." – M.L. (Feb. 2017)
"This was one of the best CEU courses I have taken in regards to articulation. I can't wait to try using these steps with my students with /r/ errors." – M.L. (Jan. 2017)