When working on changing production of speech sounds, perception is equally as important as production. Particularly for Deaf and Hard-of-hearing students (Hoh), ensure they are able to perceive the difference in their production compared to a target sound. Perception can be trained using visual, tactile, and auditory cues. If students do not have access to one of these senses, lean on other modalities of cueing to support. Access to speech sounds is a case-by-case basis and depends on if they wear hearing technology. Additionally, students with co-existing diagnosis may have limited access to visual or tactile cues (e.g. sensory neuropathy).

One way to make perceptual awareness meaningful for students is to use minimal pairs because it demonstrates how changing a single phoneme can alter a word's meaning. This concept for older students presents logistic and semantic dilemmas that probe them to think more about the true impact of misproductions.

When presenting phonemes, provide appropriate, accessible sensory information that can assist the student in identifying them:

• Auditory: If a student has access to the target speech sound, with or without listening technology, we can use auditory feedback to identify differences in speech sounds to assist students in identifying and discriminating between sound productions
  • Clinician models
  • Recordings of the student's production
• Visual: Visual feedback is especially helpful for many Deaf and Hard-of-hearing students (Hoh). Note any barriers that access to visual information and best practice is to modify the presentation to improve visual access (e.g. improving lighting, size of visual, positioning, considering visual distractions in environment or clothing). Examples of visual cueing may include:
  • Use of spectrograms
  • Highlighting placement of phonemes with gesture
  • Cued speech
  • Use of a mirror or video for visual feedback and review
• Tactile: Tactile feedback can give valuable information about speech sound production. Note any co-existing diagnoses that may impact a student's ability to access tactile information (some neurological disorders which may coexist with hearing related differences can also impact sensation). Examples of tactile cueing might include:
  • Asking student to feel for appropriate tongue placement in mouth (e.g. tongue to bumpy part behind your teeth)
  • Demonstrating how nasal resonance can be felt by placing a finger on the side of the nose
  • Demonstrating how voicing can be felt by placing hand on throat

Focusing on perception of the correct sound promotes student success if they cannot yet produce a sound independently while encouraging self-monitoring of their own productions. Training perception and production simultaneously helps students advance towards independence by learning how to identify and correct errors themselves.