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Emil Froeschels' Therapy Approaches

Optical-tactile method (articulatory placement) for speech sound production

"It consists in showing the patient the characteristic position of the organs of articulation for every sound and letting him feel the concussion in front of the mouth, or in front of the nose (in the case of voiced sounds) which the air generates in the vicinity of the larynx. He will learn an a, for instance, by imitating the wide, oval, opening of the mouth and the deep position of the tongue. A mirror, especially one with three surfaces, would also aid the patient, inasmuch as he can thus compare the position of his own mouth with that of his teacher" (Froeschels, Dittrich, Wilheim, 1932, p. 47.)

Tactile method for speech sound production (articulatory manipulation)

Froeschels advises that the instructor manipulate the articulators in the mouth of the person with speech sound difficulties, who are not able to produce the sound through auditory imitation (aural) or visual imitation (looking in a mirror). "For this purpose it is advisable to adopt the following position of the hands: With the two middle fingers the nose should be closed by side pressure on the alae nasi. The two thumbs are placed left and right, immediately above the ridge of the the upper lip. In this way a ring has been formed around the lips and they can be moved in all directions (Froeschels, 1933, p. 35)

See Froeschels 1933 for details about how to manipulate articulators for spedific speech sounds (pp. 35-39).

Mirror practice

Use mirror practice and placement of articulators for individual sounds. Might need to "guide the tongue by spatula and stylet" to get patient to produce the sound with his mouth. "From sounds we will proceed to connected sounds, from syllables to words, from words to sentences" (Froeschels, 1933, p. 94)

Guided writing

"…It is often necessary at first to guide the patient's hand. Naturally one will again proceed from the simple to the complex, beginning with strokes or single letters in order to teach syllables and words gradually (Froeschels, 1933, p. 95).

Letter recognition for reading

"Reading exercises are to be undertaken…beginning with individual letters. For this purpose I make use of single small cards, on each of which is a letter written or printed. These small cards are laid together in syllables and words, when the reading exercises have gone beyond individual letters" (Froeschels, 1933, p. 96).

Sentence repetition

"It is part of the disease-pattern of motor aphasia that grammatical forms and sentence building are defective. One must practice, therefore, as in the case of other paragrammatic patients, step by step, beginning with the simplest independent sentences, in order gradually to treat complex sentences, subordinate clauses, questions, etc." (Froeschels, 1933, p. 96).

Auditory training

"Understanding (for sounds and words) can be reawakened through the ear if the words are spoken behind the patient and the corresponding mouth position is shown only when he does not repeat the sound" (Froeschels, Dittrich & Wilhelm, p. 97).

Pointing to named pictures

"The aim of the treatment is to enable the patient to find correct expressions. The best procedure is to place individual pictures in front of the patient and point them out; then when the physician calls the name, the patient must select the correct picture and designate it himself. In this way there will be success in strengthening the patient's memory up to a certain degree" (Froeschels, Dittrich & Wilhelm, p. 97).

Treatment of stuttering in children

(Froeschels, Dittrich, Wilheim, 1932, p. 210).

1. Strengthen child's ability to speak-picture books, one picture a page. Tell stories, using simple sentences about pictures.

2. Talk to child using perfect speech, not baby talk.

3. Have teacher avoid severity and not to require a prompt reply.

4. Prevent others from imitating child.

5. Explain the processes of speech and hearing to person. Ideas: Speaking is exhalation. Teach about larynx and resonance principles using a megaphone-loud exhalation. Have patient exhale through tube (or clinician's hand in tube-like position). Talk about speech sounds as different resonating cavities. (these explanation completed in 3 or 4 sessions, 20 minutes each).

6. A week later, have patient speak meaningless combinations of syllables follwing deep inhalation (5 X eaily, 3 minutes each). (play of breathing).

7. A week later, reading begins-a retelling of what has been read, and after that conversation. Remind patient that words are only a play of breath. "If difficulty with any sound arises, immediately it is pointed out that the difficulty is unfounded, since this sound is not in any way different from the other in principle"(p. 209).

The F method for producing the s sound

A practical method for checking progress during the treatment of sigmatisms. Pract. Otorhi-Laryng. 9, 6, 358-364. (The F method described and recommended for all forms of lisping.) (Froeschels, 1947)

"The patient is asked to give a prolonged F-sound. The therapist using the thumbs and index fingers of both hands quickly places them between the lips and front teeth in order to life the upper lip and lower the lower lip thus making the teeth visible. In the great majority of cases the F changes in this way into a correct s or at least into a sound similar to an s. In the first few sessions this procedure should be used only two or three times. In the moment the patient realizes that the therapist is trying to make him speak s, he may try to cooperate and will inevitably produce his wrong s because he lacks the right idea.

Have member of family do this 20 to 30 times a day, with patient thinking f. After few days, have child remove his lips from his teeth himself. Once patient can do this upon request, have him "join it with a preceding vowel" and later with a following vowel. Use interposed H if trouble (s--hah, s--ha, s--hee). Proceed to words: "only a short step" (Froeschels, 1964, p. 32)

Chewing method for voice

The patient is asked to chew as usual with closed lips, but without anything in the mouth, and to observe his tongue, which moves continually during the chewing. Immediately afterward he is asked to chew "like a savage," that is, by opening the mouth and with extensive movements of the lips and tongue…Then the patient must give voice during chewing. If the chewing is done correctly, that is, with vigorous movements of the lips and the tongue,a great variety of sounds excape the mouth…The patient should chew with voice production at least twenty times a day for a few seconds only…After a few days he whould read several times a day for one or two minutes only (Froeschels, 1964, pp. 153-154 in selected papers).

Chewing method for dysarthria

Teach relaxation before teaching speech (Froeschels, 1952, p. 119).

The patient should "chew his voice." Care must be taken not to produce stereotyped nganganga, mamama, hamhamham, etc, but to really assume the psychical attitude of chewing. The chewing should be performed simultaneously with the opening and closing of the lips. In this way a marked improvement can be achieved. With dysarthric patients who have chewing difficulties, the spasm, as a rule, are more severe in speaking than in chewing (Froeschels, 1952, p. 119). .

References on the chewing method (chronologically)

Other references for above citations (chronological)

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