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SLP Mommy of Apraxia: August 2014

Tuesday, August 26, 2014

Back to school speech folders.

I'm in a new district, a new school, and with a new bunch of kids this year!  One thing I've always done the first week is have the kids make their own "speech folder."

Kids love decorating their own folder!  I start with a long piece of construction paper that come pretty standard in most schools. 

I then whipped up three template pages the kids can write on and then glue onto their folder.

The first page starts out with them writing their name, and then they glue it on the front cover.


Aside from their name, the second page I consider the most important.  It has the child think about WHY they come to speech.  I think it's important to start the year discussing the child's goals so they can be an active participant in their learning! 

This page also has them tell one fun fact about themselves, which always gets them talking! 


 
 
 
Finally, the last page contains their teacher's name and their favorite subject.  If there is time, I let the kids color and decorate it.
 
I have always found this activity to be a great first session activity, and works for really all age groups.   Hope you all like it too! 
 
I'm only going to offer it free on my TpT store today, so if you are interested.  Snag it now!
 
Happy Back to School!
 

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Friday, August 22, 2014

Last year of Pre-K

Today was Ashlynn's official first day to her last year of preschool.  It was also two years ago today I heard the words, "Laura, this is apraxia."                                                                                                   I'll never forget that.  It was like hearing something for the first time you don't want to believe, but that you instantly know to be true.                                                                                                                   Apraxia.  Apraxia.  No.  Not my baby.  Why apraxia? That one word brought forth all sorts of things in my brain.  Speech will be a struggle.  Learning to talk will be a struggle.  She will have to have a lot of therapy and she will have to work for every sound, every word, and then every sentence.                                                                                    I texted a colleague.                                                                                                                          "She has apraxia and I'm devastated."                                                                                                     I cried. My little social butterfly whose favorite word was "HI" would have to fight to be able to talk.  She would have to earn her right to do the ONE thing that brought her joy: To be social and speak to others.

It was a hard pill to swallow.  I remember I put her in her car seat, and as I leaned over to hug her I cried.  She smiled and asked me, "hi?"  I cried some more.        

Her first week of school though was nothing short of amazing.  She qualified for free preschool in a special needs classroom due to her needs.  You can read about that here. First week of Pre-K

Her second year of preschool brought even more exciting developments.

Today she was sooo excited for school.  When she came home, she wasn't able to really tell me WHAT she did, but it typical Ashlynn style, she could tell me WHO she played. with.  There was Mia and Carly, her teachers Kubra and Donna.  I'm excited, hopeful, and maybe a little nervous.  This IS her year to catch up. I'm doing everything I can as her mom.  She's in private speech and OT, she's still getting private swim lessons since swimming has been amazing for helping with her bilateral coordination, we're doing sensory and OT/PT activities at home, and of course the speech she always gets from me.  

We sure have come along way from that day in the car that I cried, and from that text message that said I was devastated.  Our ENTIRE family is different now, and we're all better for it. 

So bring it on school year 2014/2015!  We're going to give it all we got!

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Friday, August 15, 2014

Initial 'T' tic-tac-toe

One thing I've found, is that as an SLP, finding materials for apraxia can be challenging.  This is mostly due in part to the fact that syllable shape and complexity matter more for apraxia than they do for other speech sound disorders.

For example, if you were working on the 'T' sound and opened a typical articulation workbook, it wouldn't be uncommon to see a variety of single syllable and multi-syllabic words mixed in together.  As an SLP specializing in apraixa, I need materials and FUN worksheets that my kiddos with apraxia can use without having to say, "Let's skip that word" or "Don't worry about that one."

Here is a tic-tac-toe game I made for a kiddo right now who needs a review and extra practice for initial 'T.' You will notice the syllable shapes are simple: CV and CVC.

To get more repetitions in, I also had a basic deck of cards (minus the face cards) sitting by our game.  We had to pick a card and whatever number we picked was how many times we had to say our word!

If you're interested, you can find it on my TpT site here: Letter 'T' tic-tac-toe

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Tuesday, August 12, 2014

The high of summer! The fear of "back to school."

Oh summer, how I love thee. Filled with swimming lessons, play dates; visits to the park and zoo.

During summer, I get to see my children be children. Their carefree smiles light up a room, and the echoes of their laughter can be heard long after they lay down their head. Yes, therapy appointments are a way of life for Ashlynn, but even speech and occupational therapy bring positive updates from the session and we can quickly return to our days of play.

This summer I signed up to a few good facebook pages I found: MamaOT and Inspired Treehouse. I LOVE these pages! Instead of the packet of ideas I would get heaped upon my shoulders during the school year, these pages provide an idea a day to do with your child. Simple, easy, fun! When I just get one idea a day, the load seems MUCH more manageable. I was so inspired, I tried to do the same for speech and language on my SLP Mommy of Apraxia page, since I'm usually doing something related throughout my day with my kids since that at least, comes naturally to me. I really think they helped Ashlynn, and I felt good about incorporating some sort of speech, sensory, or occupational/physical therapy at home.

 My husband and I also saw HUGE improvements this summer in the motor realm. Ashlynn climbed a play structure that she had yet to conquer at our nearby park. Who knew how much core stability, bilateral hand coordination, and crossing midline play a part in climbing a simple play structure! Well, I'll tell you who know.

Parents of children who have dyspraxia!

At the local amusement park, she was riding the tea cups independently. My husband shot a video. During the first two go rounds she was just sitting there, but by the third go round she figured out how to spin the wheel to spin her teacup! You should hear my husband cheer. Who knew how much core strength, bilateral hand coordination, and crossing midline play a part in being able to operate a simple teacup ride.

 Oh yeah, parents of children who have dyspraxia.

 However, now summer is coming to an end. I see facebook posts ripe with updates along the lines of "I'm so happy school is coming up!" Or memes like this one:


Not me. School. Sigh. What can I say? I have a love/hate relationship with school.

 I firmly believe school helps children develop their social skills and gives them important language models, which is especially important for kids with speech and language delays. The first week my daughter went to school shortly after she turned three, she came home singing a tune I actually could decipher, and at that time she was nonverbal! That my friends, is the power of school!

 On the other hand, school brings new fears and new worries. I always thought, once she starts talking, I'll be okay.

 Not true.

Now I'm worried about her phonemic awareness skills, language lag, slow processing speed, and being able to write.

 My God how much do kids need to do and know now just to be ready for Kindergarten???

 I'm not looking forward to the IEP meeting, the parent/teacher conferences, the comparisons I try not to make when I'm visiting her classroom.

 Quite frankly.... It SUCKS. Apraxia STILL sucks!

 So no. I'm not ready for Ashlynn to go back to school. My SLP friend and mother to two young boys with apraxia who has a blog: Landon Journey just posted this song lyric the other day:

If I could make days last forever
If I could make wishes come true
I'd save every day like a treasure and then,
Again, I would spend them with you.

As my brother says though, "Life's not fair. Get used to it."

So farewell summer! I bid you adieu. You have been so kind to us this year. We have made castles in your warm sand, felt the glow of the sun upon our face, cooled off in your waters, and celebrated the milestones and successes at our pace. Though I'm anxious for the coming school year, I have faith you will be waiting on the other side.  Welcoming my children to your sunshine, casting light onto their beauty.


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Friday, August 8, 2014

Speech freebies! Friday FREEbees.

Visit Speechie Freebies!
I'm excited to participate in my first "speech freebies" link up!  Therapy for CAS should always be individualized; however, if you have a child who has mastered or is on their way to mastering CV syllable shapes, I created sheets to practice using a BINGO game format.  I chose this game because CAS requires mass and distributed practice, and this is a fun and easy way to get those two in one session.



I've added the link to my TpT store!  Enjoy!

                                                                      CV BINGO


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Tuesday, August 5, 2014

Articulation Test Center: App review and giveaway!

My friends over at Little Bee Speech are throwing a HUGE sale August 12-14th to get ready for their 30% off back to school sale!

In case you aren't familiar with Little Bee Speech, they are the minds behind the award winning Articulation Station Pro and Articulation Test Center.  I absolutely LOVE both of these apps.  I wasn't paid to endorse either app and I don't get any royalties for writing my review.  In fact, I personally paid for both products and am raffling off the free promo code they gave me to write the review!

Articulation Test Center allows you to choose between a screener or the full test.  



Since the test can be given fairly quickly, I usually choose the full test option.  However, I have had cases where I am just looking at vowels, or just looking at "R" sounds, or just want a quick tally of blends and it's great for that too.




The stimulus items are real-life, colorful images that are aesthetically appealing to children.  As seen below, target sounds are already identified in green, and if they child misses a sound, the clinician can quickly touch the sound and it will turn yellow to indicate an approximation, or you can tough it again and it will turn red to indicate an error.  If the child omitted the sound, you can quickly swipe the letter up and it will indicate a deletion.  If you choose, you can hit the down arrow you see on the right and it will open up a menu for you to indicate sound substitutions and/or phonological processes used.


In my example below, this little girl omitted the /l/ in slide.  I quickly and easily touched the /l/ tile and swiped it upward.  I then touched the arrow to the right and was able to mark which process was used.  This is nice because the app will generate a graph and report where you can easily see any patterns.




The settings feature is great and allows you to turn off or on the voice prompt, written word, or remove the image completely just leaving a written word.  I usually turn off both the voice prompt and stimulus word since I am trying to elicit speech sound production without giving cues; however, there are occasions this would be nice to have.









The test also offers picture scenes to aid you in obtaining a speech sample.  Once again there is a record feature, and I find the pictures to be colorful and appealing to children.










If you touch an object in the picture scene, in this case, the owl; more probing and cueing is provided to get the child talking.









When the test is completed, the app offers some great data summaries.  The picture below shows a section of the sample report that is automatically generated from the data.  As you can see, it lists and explains the phonological processes used by this child, but it also summarizes the errors.  The other tabs provide useful information as well.



I absolutely LOVE this app.  Though it's a qualitative test, it gives a lot of great information in a quick, fun, and easy way.  I love the results summation, and I think it is very user friendly.  I highly recommend this for any practicing SLP.  You won't regret having this app.  

Before the sale starts on August 12th, I'm raffling off a free app to one lucky reader!  All you have to do is like my facebook page, slpmommyofapraxia, or if you already have, you can enter that way!  Otherwise, you can sign up with your email or you can leave a blog post comment!  I'll notify the winner on my fb page and by email.





a Rafflecopter giveaway

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Monday, August 4, 2014

Apraxia Intensive Training Institute 2014

The Apraxia Intensive Training Institute (aka apraxia bootcamp), is an intensive training sponsored by the non-profit organization CASANA of apraxia-kids.org.

WHAT IS SPECIAL ABOUT CASANA?

I love CASANA for SOOO many reasons.  As an SLP but parent first of a child with apraxia, CASANA was literally built on the backs of mothers who had children with apraxia.  Sharon Gretz is the founder and executive director and she attended EVERY session.  This is her baby, next to her two human babies of course.  It was apparent she wanted to make sure that professionals she's endorsing will do right by the kids they see, just like apraxia expert David Hammer did right by her son Luke.  Kathy Hennessy is a mom of not one, but two children who grew up with CAS; and she is the the Education Director for the organization.  She too attended every session.

I get chills thinking about these women, because they are so inspiring to me.  They know the struggle.  They've lived it and they want to ensure that no parent who has a child with apraxia has to feel isolated and alone in their fear of the unknown. More importantly though, they want to ensure that quality therapy is a right that every child with CAS receives.  Our success is their mission, but it's more than professional.  It's personal.  

WHAT WAS THE TRAINING LIKE?

At first, it was so surreal.  Here I was, one of 24 out of a 100 applicants in the country picked for this training.  Beside me were seated fellow SLP's of esteemed caliber and success in treating apraxia.  In front of me stood three top experts in the field, two of them published in the research.  

The training was longer and more intense than ANY conference past, present, or probably future.  We were expected not to be "talked at" but to critically analyze, bounce ideas of of, and problem solve aloud what we knew.  Our mentors only initially acted as guides, mentally exercising our brains, challenging our beliefs, therapy practices, and perceived truths.  We worked from 8:15 to 8 or 9 at night.  We spoke of nothing but CAS.  Eventually, we "local experienced experts" had to let our guard down and problem solve in an environment of mutual respect and learning.  

It was the three E's:

Exhausting: At one point during a differential diagnosis section, Ruth Stoeckel was asking thought provoking questions.  We all had answers, brilliant answers, but she wanted more.  I finally shouted out in exasperation, "Ruth!  Just tell us what you're looking for!!" 

She didn't.

We were forced to think and problem solve some more.  If we are to be true experts in the field, she needed us to come up with it on our own.  Her telling us was simply too easy.

Emotional: There were tears.  Lots of tears.  Tears as experienced, awesome SLP's realized maybe we could have done better with some previous clients.  Not maybe...certainly.  As a professional I loved their passion, but as a mother, it brought me to tears.  I told one SLP, as a mom, I don't care if you're not the best...because your heart, caring, and critical analysis is what will make you my child's "life changing" SLP. 

Exhilarating: A famous quote this bootcamp came from my recently, dear friend Ashley, who was presenting her video case study.  After being constructively criticized, stripped down, and vulnerable she said with poise, "I've found right after the confusion comes the learning."  Brilliant Ashley!! 

I have to admit, wearing two hats at this conference was hard.  The compassion and love these colleagues feel was tangible, and they have to be able to turn it off and let loose or they would never enjoy life.  On Friday night they were all sharing therapy ideas around copious bottles of wine, and I had to slip away.  I felt glad they could escape the pressure they feel to do right by their clients with this challenging disorder, but I also felt jealous they could turn it off...if only for a moment.  

Having a daughter with it leaves no such luxury.  I cried heavy tears that night.

WHAT IS THE BEST TREATMENT APPROACH FOR CHILDHOOD APRAXIA OF SPEECH?

Isn't that the million dollar question?  Usually at professional conferences, the speaker will talk about their treatment approach.  What they do and why it is successful.  You are talked at, occasionally invited to participate, and then sent home with an informational packet.  

This was WAAAAY different.

We had access to all the current treatment approaches: 
PROMPT, KAUFMAN, SpeechEZ, ReST, DTTC.....you name it, we learned it, and if you think I'm blowing smoke, I can tell you that five of the programs agreed to produce an overview CD just for CASANA's bootcamp and also agreed to answer questions gathered from the participants!  I'm telling you, CASANA covered their bases and made sure if they endorse an "expert" you are truly an "expert."

However, we didn't just learn the approaches.  We had to analyze each approach.  I can tell you one thing though.  All these approaches had a common thread of incorporating principles of motor learning theory.  As for the research?  Well, that's still up for debate; however, I can say we read a 2014 review and the method that has the most evidence but is probably the least well known is DTTC. Does that mean the other approaches aren't valid?  No! We concluded a lot of the approaches could be contributed to the fact that the SLP was simply just an amazing SLP, or that there just isn't enough research to prove this or that method has worked with a large population.

WHAT DOES THE RESEARCH SAY?   

Research for speech disorders is incredibly difficult to do, primarily tied into cost.  Sharon Gretz recognized this and that's why CASANA is big on research.  Donations and money through walks help fund research.  This is another reason I have so much respect for CASANA.  Honestly, if we don't have evidence based practice in the treatment of apraxia, how can we be sure this method or that method is sound??  In addition, though one method may work for one child, will the same work for another?  The answer?  We just don't know!  We need research! 

WHAT NOW?

What now?  Another million dollar question.  Sharon Gretz minced no words. 

 "Well, you are nothing." 

We all laughed a nervous laugh. What do you mean we are "nothing?"  

We learned we had to complete a case study that satisfied our instructors. We were told to be prepared to get it back.  They have had two previous cohorts and no one had ever turned in the perfect case study.  We were told they were investing in us.  From now on, we were their colleagues.  If we have a question, they will help us with the answer.  

Say what?

Yep...these busy, in demand apraxia experts are invested in us....and the kids we treat.  They  love kids with apraxia that much; however, we have to prove our worth.  They can't endorse us and not be 100% confident we are doing right by these kids.  That's why we should all expect our case study back again, and again, and again.   

In the back was Sharon and Kathy.  I couldn't ever help but think of them.  They had been burned by too many "experts" saying they would help their child; and here they stood, an advocate for those who are standing in their shoes.  

I was proud and honored to be here.  I'll complete my case study and know I earned it.  I will forever be committed to CAS, and I will never forget my experience at this "bootcamp."




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Friday, August 1, 2014

Boot camp

I am currently at an apraxia intensive institute, aka "bootcamp."  I live in Colorado, and this bootcamp is in Pittsburgh.  I'm a Colorado native and I'll admit, I'm not well traveled and I really don't care.  When my husband asked me to marry him, I told him I hoped he really liked Denver because it would take a lot of get me out of here.  My family is here.  My history is here.  My roots are here.  Plus, I love the state, I love the city, I love the attractions, I love the people, I love what it has to offer.

Many people love a 7-10 day vacation, but for me, I want to come home usually after day 4 or 5. I knew this bootcamp would be hard, because it's four days, almost five, away from home by myself. However, I did it because I know it is for the best.  I know I'm doing it for all the right reasons.  I know it's a once in a lifetime opportunity and I had to seize the day.  I know I was called to apraxia for a reason, and I want to be one of the best damned SLP's for the job.

I've been busy and my mind has been occupied.  I am surrounded by amazing, competent professionals in the field, and that's not to mention I am being trained under top experts in the country.  There are SLP's even from Canada here!  How lucky am I?

I can't wait to blog about the experience; however, tonight is about catharsis.  I write because I am a writer.  I write because writing is a vehicle to express my emotions and as I write, my soul slowly feels healed; if only for the night.

We finally get a break here at bootcamp.  The experts hosted a "wine and cheese" night.  If you know me, I'm not one to turn down a party.  If there was/is a party and I can go, I'm usually at it.  However, downtime only let my mind wander.  What are my kids doing?  How was their day?  What did they discover today and what made them laugh?

My focus is drawn back to loud laughing and witty joke telling.  A room full of SLP's never disappoints to produce loud banter, clever plays on words, jokes only SLP's understand; basically, the stuff I live for.  I smile and actually laugh until I cry, but then I wonder, "Is it bath night?"  Did Ashlynn wonder why I'm not there to read her book?  She always wants me to read a book, and sometimes I'm tired and I don't want to, but I do it anyway, because I know this time is so short.  One day she can read her own book, or she'll have homework, or she'll want to talk on the phone with her friends instead.

More loud laughter erupts.  Why can't I enjoy myself?  I think of Cody.  My party buddy since 2001.  In a room full of people, he commands the attention and he makes me laugh.  He's funny and witty too and he loves a good party.  I married him for a reason, and right now I miss my best friend.
And Jace.  That little boy is just like his daddy.  Such a little troublemaker, but with a heart of gold.  I miss his cute little pucker when he kisses me goodnight, his proud "I did it!!" when he does something new, and his energy that exhausts me after a long day.  What trouble did he find today, I wonder.

More loud banter.

I go outside for some air.  I see a rollie pollie out for a stroll on the sidewalk.  A smile cracks on my face and a tear forms in my eye.  Ashlynn loves rollie pollies.

This experience is awesome, intense, amazing, and life changing.  I wouldn't be here if it were anything but; however, every choice you make has a price.....and the price seems very expensive tonight.


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