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The remediation of /r/articulation errors in school-age children often poses a challenge for speech-language pathologists. This study was designed to investigate whether an appliance placed in the maxillary arch would facilitate the production of /r/, whether intervention with or without a direct auditory model and with or without the appliance would have significant effect on treatment success, and whether the appliance would be a feasible treatment adjunct for speech-language pathologists who treat school-age children. Thirty-six school-age subjects were randomly assigned to one of four treatment groups. Each subject was seen individually for 15 minutes twice weekly for a period of 6 weeks. Results of the study indicated that the R-appliance was considered to be a useful clinical tool by the speech-language pathologists. Statistically significant differences in favor of the children who used the R-appliance, with either treatment model, were noted at all levels of production—sound, word, and spontaneous speech. In addition, at the level of spontaneous speech, the R-appliance combined with the direct auditory model treatment yielded significantly better results than the R-appliance combined with the non-auditory model.

FOR the speech clinician who is experienced in the evaluation of children with repaired cleft palate it is not difficult to determine that a child's palate is inappropriate in movement and/or length for adequate voice and articulation development. A child evaluated at two, two-and-a-half, and three years of age will generally have given enough speech clues for the clinician to make such a judgement. No x-ray studies need be required to make this determination, only the trained ear of the clinician and his observations.The clinician has only to listen for the early plosives /p, b, t, d, k, g/. They are characteristically either present and strong, present and weak, substituted for by glottal stops, or produced in association with glottal stops. There is no necessity that plosives be used in the proper positions, only that they be present. Even the child with delayed speech may exhibit these sounds in his babbling if palatopharyngeal function is reasonably adequate. Here, it should be made very clear to the reader that current palato-pharyngeal function for speech is being assessed.Future adequacy is not a question at this point. Our interest here is that function

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