The Best Speech Therapy Exercises: Evidence-Based Strategies for Children and Adults

Key Takeaways

• Speech-language pathologists (SLPs) support communication, cognition, and swallowing through nine recognized areas of practice.
• Each area benefits from targeted, evidence-based exercises customized to pediatric or adult needs.
• This guide highlights the best speech therapy exercises supported by research in each area of practice.
• Using these techniques alongside digital tools like Constant Therapy can enhance outcomes and support home practice between sessions.
  

Speech-language pathology covers a remarkable range of skills—from helping toddlers say their first words to supporting stroke survivors as they relearn to communicate. The American Speech-Language-Hearing Association (ASHA) defines nine key areas of practice for SLPs, often referred to as the “Big 9.”

Each domain requires its own specialized, evidence-based interventions. Whether you’re a clinician refining your treatment toolkit or a caregiver hoping to understand therapy approaches, this guide outlines the best speech therapy exercises for both pediatric and adult/geriatric clients in every area of practice.

1. Speech Sound Production (Articulation, Phonology, Motor Speech)

What It Is

This area focuses on how clearly a person can produce sounds and words. SLPs help children develop correct sound patterns and adults rebuild intelligibility after neurological or motor impairments.

Best Speech Therapy Exercises

For Children:

• Phonological Contrast Therapy (Minimal/Maximal Pairs): By contrasting two words that differ by only one sound (“bat” vs. “pat”), children learn how sound changes alter meaning. Numerous controlled studies show that minimal pair training effectively reduces phonological errors and improves intelligibility.
• Auditory Bombardment + Drill: Children listen to multiple repetitions of target sounds to strengthen sound awareness before active practice. Research by Hodson and Paden supports this as a foundational step in the Cycles Phonological Remediation Approach, improving sound acquisition and generalization across settings.
• PROMPT / Tactile-Kinesthetic Cueing: Using gentle tactile cues to guide jaw, lip, and tongue movement, PROMPT has been shown in multiple case series and RCTs to improve speech motor control and clarity in both children and adults – though particularly in cases of childhood apraxia of speech.

For Adults:

• Integral Stimulation: This multi-sensory technique, where clients watch, listen, and imitate, is backed by strong clinical data showing improved speech initiation and sequencing in apraxia of speech.
• Lee Silverman Voice Treatment (LSVT LOUD®): Originally developed for individuals with Parkinson’s disease, LSVT LOUD® is a high-intensity motor-speech program that strengthens respiratory–phonatory coordination and articulatory precision. Multiple randomized controlled trials confirm that it not only improves vocal loudness, but also enhances speech clarity, prosody, and overall intelligibility across motor speech disorders.
• Contrastive Stress & Prosody Practice: This technique focuses on producing natural speech rhythm, intonation, and emphasis by contrasting stress patterns (e.g., “I didn’t say he stole the money” → stressing different words changes meaning). Research supports its use for individuals with apraxia and dysarthria, improving speech naturalness and communicative intent through prosodic recalibration.

2. Language (Receptive and Expressive Communication)

What It Is

Language therapy targets understanding and producing words, grammar, and complex meaning. It supports literacy, academic success, and conversational skills.

Best Speech Therapy Exercises

For Children:

• Enhanced Milieu Teaching: This naturalistic approach integrates language teaching into play and conversation. Large-scale studies show EMT promotes expressive language growth, particularly in children with developmental delays.
• Focused Stimulation: Clinicians provide high-frequency exposure to target structures (“The dog is running! See the dog running!”). Meta-analyses confirm it boosts vocabulary and grammar skills in toddlers with language delays.
• Narrative-Based Language Intervention: Using stories to teach syntax and vocabulary, NBLI has been linked to improved comprehension and narrative organization in children with language impairments.

For Adults:

• Semantic Feature Analysis (SFA): Clients describe words by their features (category, function, color, etc.) to strengthen lexical networks. Multiple studies (Boyle, 2004; Kiran & Thompson, 2003) confirm its effectiveness in improving naming and generalization in aphasia.
• Verb Network Strengthening Treatment (VNeST): By generating sentences around a target verb (“cook: chef–meal”), clients rebuild verb and thematic role connections. Research demonstrates lasting gains in discourse-level language for individuals with aphasia.
• Response Elaboration Training (RET): This approach expands on a client’s spontaneous utterances (“dog…run” → “The brown dog is running fast”) to increase sentence length and content. Empirical studies show RET enhances verbal output without rote memorization.

3. Fluency (Stuttering and Cluttering)

What It Is

Fluency therapy helps clients manage stuttering or cluttering by modifying both speech mechanics and emotional responses to communication.

Best Speech Therapy Exercises

For Children:

• Lidcombe Program: A parent-led behavioral treatment for preschoolers who stutter, the Lidcombe Program has strong evidence from randomized controlled trials showing sustained fluency improvements over time.
• Easy Onset Exercises: This method encourages gentle initiation of airflow and voicing. Clinical evidence supports its use for reducing stuttering tension and increasing speech control.
• Fluency Shaping: Teaching smooth, continuous speech through slowed rate and gentle onset, fluency shaping techniques are well supported in the literature for reducing stuttering frequency.

For Adults:

• Fluency Shaping Techniques: Fluency shaping establishes smooth, forward-flowing speech through systematic control of breathing, phonation, and articulation. Techniques like slow rate, continuous phonation, and gentle onset have decades of empirical support for reducing stuttering frequency and promoting long-term fluency maintenance across age groups.
• Stuttering Modification Strategies: Developed by Charles Van Riper, a pioneer of the field of speech-language pathology, this approach helps individuals manage stuttering moments through desensitization and easy stuttering. Research supports its value in reducing anxiety and improving communication confidence.
• Cognitive-Behavioral Integration: Combining cognitive-behavioral therapy (CBT) principles with speech modification, this approach helps clients identify and reframe negative thoughts about stuttering while practicing fluency skills. Research shows that integrating CBT significantly reduces speech-related anxiety and improves self-efficacy, making it one of the most holistic evidence-based fluency treatments.

4. Voice and Resonance

What It Is

Voice therapy focuses on healthy, efficient voice production and resonance. SLPs work with both children and adults experiencing vocal strain, nodules, or neurologic voice disorders.

Best Speech Therapy Exercises

For Children:

• Vocal Hygiene: Behavioral voice care—hydration, avoiding yelling, and vocal rest—is a cornerstone of pediatric voice therapy, with preventive research confirming reduced recurrence of nodules.
• Resonant Voice Therapy (LMRVT): RVT teaches forward-focused voicing to reduce strain. Evidence from pediatric and adolescent studies shows improved vocal quality and reduced vocal fold impact stress.
• Confidential Voice Therapy: Encouraging soft, breathy phonation helps children recover after vocal injury. Controlled trials show faster healing times and safer vocal habits post-therapy.

For Adults:

• LSVT LOUD®: A high-intensity program originally designed for Parkinson’s disease, LSVT LOUD® has robust randomized trial data confirming increased vocal loudness, clarity, and carryover into daily communication.
• Resonant Voice Therapy: In adults, RVT reduces hyperfunction and improves efficiency. Studies demonstrate measurable acoustic and perceptual gains across dysphonia types.
• Vocal Function Exercises (VFEs): These systematic pitch glides and sustained phonation drills strengthen laryngeal muscles and coordination. Decades of research support VFEs as one of the most evidence-based speech therapy exercises for adult voice disorders.

5. Hearing and Auditory Rehabilitation

What It Is

These interventions improve how individuals process, interpret, and respond to sounds—whether due to hearing loss, auditory processing disorder, or device use (hearing aids, cochlear implants).

Best Speech Therapy Exercises

For Children:

• Auditory Verbal Therapy: Empirically supported for children with cochlear implants, AVT teaches listening as the foundation for speech and language development..
• Ling Six Sound Test: A quick listening check for six key sounds spanning the speech frequency range; validated as a reliable daily assessment tool.
• Speechreading with Auditory Cues: Combines lip-reading and listening to improve comprehension, supported by studies showing faster auditory skill acquisition.

For Adults:

• Auditory Training for Speech-in-Noise: Structured listening tasks improve speech-in-noise understanding; numerous studies demonstrate neuroplastic auditory benefits in hearing aid and CI users.
• Communication Repair Strategy Training: Teaching clarification and repetition requests increases conversational success; supported by rehabilitation research.
• Cognitive-Auditory Integration Tasks: These exercises train listeners to integrate auditory and cognitive processing, such as remembering verbal instructions while filtering background noise. Studies in adult aural rehabilitation demonstrate improvements in speech-in-noise perception, working memory, and listening effort for hearing aid and cochlear implant users.

6. Swallowing and Feeding (Dysphagia)

What It Is

Swallowing therapy helps clients eat and drink safely by improving muscle strength, timing, and coordination.

Best Speech Therapy Exercises

For Children:

• Oral-Motor Stimulation: Gentle tactile and temperature stimulation enhances sensory input and bolus control. Evidence supports its role in neuromotor feeding difficulties..
• Pacing and Volume Control: Structured pacing reduces aspiration risk in infants and children with dysphagia; clinical studies show measurable gains in safe swallow coordination..
• Behavioral Feeding Therapy: Combines shaping and reinforcement to expand diet variety. Empirical data supports strong outcomes in pediatric feeding disorders..

For Adults:

• Swallowing Exercises: Collectively known as rehabilitative swallowing exercises, these maneuvers strengthen the muscles of the oral, pharyngeal, and laryngeal phases of swallowing. High-quality imaging studies (e.g., videofluoroscopy) confirm that consistent practice improves hyolaryngeal elevation, airway closure, and overall swallow efficiency in dysphagia recovery..
• Effortful Swallow: Clients swallow hard to improve tongue base retraction and pharyngeal pressure. Research shows improved bolus clearance and safety post-stroke.
• Expiratory Muscle Strength Training (EMST): Using calibrated resistance devices, EMST strengthens the expiratory and subglottic pressure systems that support voice, cough, and swallow safety. Multiple clinical trials validate its benefits for individuals with Parkinson’s disease, ALS, and post-stroke dysphagia—showing measurable gains in expiratory pressure, vocal intensity, and airway protection.

7. Cognitive Aspects of Communication

What It Is

These exercises address attention, memory, and executive function—the cognitive underpinnings of communication and daily life.

Best Speech Therapy Exercises

For Children:

• Story Retelling with Visual Supports: Promotes sequencing and comprehension. Studies confirm improved recall and language organization in children with cognitive-communication disorders.
• Metacognitive Strategy Instruction: Teaches children to plan, monitor, and evaluate their own learning. Evidence shows gains in problem-solving and self-regulation, especially in TBI and ADHD.
• Working Memory–Embedded Language Tasks: Structured digital or tabletop tasks improve cognitive flexibility and short-term retention, supported by growing neuroplasticity research.

For Adults:

• Errorless Learning and Spaced Retrieval: Teaches memory retention through gradually increasing recall intervals while ensuring a high success rate; widely validated in dementia care research.
• Attention and Working Memory Practice: Structured tasks that require sustained, selective, and alternating attention—often paired with verbal or visual working memory demands—help retrain cognitive networks affected by stroke or brain injury. Controlled studies demonstrate that consistent practice yields measurable gains in attention span, processing speed, and everyday cognitive performance.
• Functional Task Training: This approach focuses on practicing real-world cognitive tasks—such as managing medications, budgeting, or meal prep—within therapy. Evidence from rehabilitation studies shows that contextualized, task-specific training enhances functional independence and generalization better than decontextualized drills alone.

8. Social Communication (Pragmatics)

What It Is

Pragmatic language therapy teaches how to use communication appropriately in different social contexts.

Best Speech Therapy Exercises

For Children:

• Video Modeling / Social Scripts: Children watch and imitate modeled social behaviors. Systematic reviews confirm its success in teaching eye contact, conversation, and emotional recognition.
• Peer Mediated Intervention: Involving peers in structured interactions, PMIs are supported by strong evidence for improving pragmatic language and social engagement..
• Social Stories™: Developed by Carol Gray, these personalized narratives teach social norms and transitions. Research supports their effectiveness in children with autism.

For Adults:

• Conversational Coaching with Video Feedback: Teaches adults with TBI or aphasia to use supported conversation techniques while allowing for review through watching video-taped examples; research shows improved participation and reduced frustration.
• Inference and Theory-of-Mind Training: These exercises use videos, short stories, or real-world scenarios to help clients interpret nonliteral language, emotions, and social cues. Evidence supports their effectiveness in improving pragmatic inference and empathy in adults with right-hemisphere damage, TBI, or social communication disorders.
• Supported Group Therapy: Structured small-group sessions allow individuals with aphasia, TBI, or pragmatic disorders to practice real conversation in a safe setting with peer and clinician feedback. Research consistently shows that group therapy enhances communicative confidence, participation, and life satisfaction through social reinforcement and carryover opportunities.

9. Augmentative and Alternative Communication (AAC)

What It Is

AAC supports communication through technology, symbols, or alternative systems for people with little or no verbal speech.

Best Speech Therapy Exercises

For Children:

• Aided Language Stimulation: An AAC intervention where communication partners model language by simultaneously speaking and selecting symbols on the AAC device. Decades of pediatric AAC research demonstrate that aided language input significantly boosts vocabulary growth, symbol comprehension, and spontaneous communication in children with complex communication needs.
• Core Vocabulary Instruction: Rather than targeting fringe or situational words, this approach emphasizes teaching high-frequency “core” words (e.g., go, want, more, stop) that represent the majority of daily communication. Evidence from language development and AAC studies shows that focusing on core vocabulary promotes greater language flexibility and generalization across contexts.
• Partner Training with Communication Temptations: This interactive strategy sets up situations that naturally invite communication (e.g., offering a favorite toy but not activating it). Combined with partner modeling and wait time, research shows it increases spontaneous communication attempts and joint attention in children with developmental language delays or autism.

For Adults:

• Supported Conversation for Adults with Aphasia (SCA): Developed by the Aphasia Institute, SCA™ teaches communication partners to reveal competence through written keywords, gestures, and validation techniques. A robust evidence base demonstrates that SCA™ significantly improves participation, comprehension, and confidence for adults living with aphasia and their partners.
• Scripted AAC Phrase Training: Clients practice short, functional scripts—like “I’d like coffee, please”—to build fluency with AAC devices in daily contexts. Studies show that script training improves automaticity, message formulation, and communication efficiency for both developmental and acquired communication disorders.
• Errorless Learning for Device Navigation: By preventing errors during AAC practice (through immediate prompting and modeling), clients form accurate procedural memories for navigating their devices. Evidence supports this technique as highly effective for individuals with cognitive impairments, yielding faster skill acquisition and greater confidence in AAC use.

Bringing It All Together

Whether your goal is to improve articulation, regain speech after a stroke, or strengthen cognitive communication, evidence-based exercises remain the cornerstone of successful speech therapy. When paired with home programs and digital tools like Constant Therapy, these interventions empower clients to practice independently, reinforce clinical gains, and sustain motivation over time.

The Constant Therapy exercises combine clinical research, functional goals, and consistent practice—meeting each person where they are on their communication journey.