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

Speech & Language with puzzles

Sorting is an important foundational skill that sets up the building blocks for logical thinking and organizing.  These skills are necessary for later educational development in math (i.e. order of operations, geometry), reading (identifying main idea and relevant details), and writing (developing a topic sentence and organzing relevant details).

Most parents have simple puzzles like this at home.  When my daughter was two, I held the pieces and gave her two choices.  She would have to make a sound or word approximation (because of the severe apraxia) to request and then I would give her a piece and she would find the appropriate place.

Now that she is 4, I laid out the pieces as you see below, and she sorted them using a sentence: "A cat is a pet."  "A tiger is a zoo animal."

To promote pre-literacy skills (exposure to print, print awareness), I wrote the name of the category on a sticky note and put it above the puzzle.

That's it!  Happy playing!

Skills addressed:

Sorting

Classifying

Expressive language

Early-literacy skills

Speech and Language with Post it Notes

My daughter loves Post it Notes.  LOVES them.  She loves writing some small scribble on them and then proudly sticking them up around the house to put on display.

Today we drew pictures that included her target sounds to work on speech, but we also drew shapes to work on our pre-writing strokes for OT.

Based on the response from my facebook post, my kid's not alone in loving them!  Try it!  Easy and fun way to get speech practice in at home.

Baking with speech and language

Parents are always looking for ways to incorporate speech and language activities at home.  Whether it is to stimulate a typically developing child's vocabulary and language, or to help a speech or language delayed child; baking is great and fun way to work on speech and language.

The first and most important rule before you start, is you have to accept the fact that your toddler will make a mess, and that is just part of the process, or um, fun.

When I do baking or food activities with kids in school, they absolutely love it.  That's the key. When kids have fun they are at their best learning.  Also, baking is a multi-sensory activity, meaning many sensory systems are activated.  When children are using multiple sensory systems, acquisition and retention of skills is more likely.  Baking with your kids inherently promotes:
Vocabulary development
Sequencing
Following directions and comprehension
Pragmatic language - the social piece of language

Let me explain a little bit further.

Vocabulary Development:  For the young child, words are learned best in context.  Certain authors refer to this as "event-based knowledge."  Many of children's first words are usually embedded within scripts that are part of their daily lives.  Examples could be: bottle, cookie, doggie, bath, etc.  These words are said to them frequently throughout the contexts of their daily lives.  Baking provides the same event-based knowledge experience, and exposes them to new vocabulary.

Sequencing:  The ability to understand sequences and to sequence is an important skill.  Sequencing most simply refers to the order of things.  When kids get into school, sequencing is very important to understanding: patterns, math, a story etc.  Following a sequence of steps is inherent in baking and makes it the perfect activity for this skill.

Following directions and Comprehension: These two things fall under receptive language skills; however, they are very important to the development of overall language skills.  Kids who are good at retaining and following directions have less difficulty in school since they are not devoting a lot of their cognitive load on simply understanding and remembering what they are supposed to do.  Baking is a fun and easy way to help your child practice these skills at home.

Pragmatic Language: This is usually referring to the "social" element in language.  This involves the way language is used to communicate with others.

With a little forethought, baking can also be a way to sneak in more direct speech language targets while working with your kid at home.

Muffin Mondays and Waffle Wednesdays

This summer I implemented Muffin Mondays and Waffle Wednesdays. Ashlynn is VERY interested in what day of the week it is, so I did this to also give her a framework of her week.
Ashlynn's current speech/language needs include: syntax (the form or structure of a sentence), and consonant blends (two consonants found together in a word: sp, st, sl, fl, bl, for example).

It's important to know your child's goal, and then structure your baking around the goal.  Get creative, but it's not as hard as it seems.  In Ashlynn's case, I chose  the words: spoon, flour, stir.  For syntax, I had her ask me "Can I do it?" to work on her questions forms.

Then each time we used a spoon I had her repeat "spoon."  While she was mixing the batter, I would ask her what she was doing and cue her as needed to say the "st" blend in "stirring."  Instead of using 1 cup of flour, I broke it up into four parts to give her more practice saying "flour" each time she poured in the flour.  For an extra bonus, she had to put "stir flour" together in a simple phrase.  I would hold the spoon until she said the desired words, and then I would give her the spoon back when she was successful!  She loved it.

If your child isn't yet talking as much as Ashlynn, hum the 'm' sound while you mix the batter or if your child isn't great at imitating yet, just have him/her make any vocalization to request an item.  If they can't yet imitate even a vocalization, imitate any spontaneous sounds they make to provide an opportunity for vocal play. If they aren't really vocalizing yet, don't get discouraged!  Practice turn taking and reciprocal play.  They pour then you pour.  You stir then they stir.

With other clients who needed a final stop, I might have chosen the word "dump" and then every
time we pour in an ingredient, we work on the word "dump."

Really, the possibilities are endless!

In addition, you can also tell your SLP that you incorporated some great "distributed" practice throughout your child's day.  In motor learning approaches to therapy, mass practice refers to the production of a large number of repetitions of a single target(what you should be seeing in therapy) and distributed practice refers to hitting targets with a greater amount of time between trials or sessions.  However, distributed practice is very important for stabilization and generalization!  Parents are the greatest asset when it comes to carryover, because you are in a better position to afford the child numerous opportunities for distributed practice!  In addition, you can do it in ways that are fun and multi-sensory in the child's natural environment.

 

January book of the month: The Jacket I Wear in the Snow

Winter is in full swing, and there is no shortage of books that talk about winter, snow, and winter clothing vocabulary. Also, the preschool in my district has winter clothing vocabulary on as part of the curriculum, so it's perfect!

The book is a repetitive, rebus style book that is great for practicing vocabulary, early reading skills, sequencing, and as always speech!





I started with some cutouts from the story I found here:
Winter clothes

Then I printed them out, laminated them, and put velcro on so that the kids could dress the boy.  I used a printout doll from the website you can find here: Paper dolls

This was the final result and it's just so darn cute! All my kids from preschool up to even 4th grade love dressing up the boy.  For my speech kids, I strategically pick a clothing item for a sound they are working on.  There are a lot of good options including 's' blend words that seem to be a constant therapy target for at least one group a year.  For a child with apraxia, there are some good basic CVC words you can use (i.e. cap, boot, sock,), or in my daughter's case since her speech is improving so much, I gave her most of the cards and she had to practice recall while I read the book.  The use of the cutouts provide a visual and tactile aid to help kids learn and recall the vocabulary, so you will see I try to make cutouts to go with books I have whenever I can get my hands on them.  Unfortunately, I'm not very talented in the drawing department, so I have to rely on other sources as you see I did here!

 For my older kids, we did silly things to practice following directions with spatial concepts: on top, under, over, etc to work on receptive language, and then they had to do a retell.  Again, the visuals really help in being able to sequence and retell the story for those kiddos who have weaknesses with language processing.

Speech/language with simple Christmas chains

We're in the Christmas spirit around here and we started with a classic Christmas chain. 

* I first had Ashlynn sort the strips into their respective color piles. Great for developing early sorting and categorizing skills.

* I then instructed her to put glue on the "end" of the strip.  Many kids with language delays have difficulty with positional words and she is no exception.  She kept wanting to glue in the middle, so I had to keep reminding her "no, not the middle, put the glue on the end. (Also great for O/T practice)

* We then put the strip "through" the other strip.  During this, I made sure to emphasize "through" because again, this is another word that kids have difficulty with.

* Once the chain had three links, we repeated, "white, green, red"  and then each time, I would stop and ask her what comes "next" or "after" emphasizing those two concepts. 

*Also, having her identify what comes next is the beginning of early patterning and sequencing skills.

* Finally, at the end of the activity, we counted the links! 

Easy and fun! 

Skills addressed:
Colors
Sorting
Sequencing/Patterns
Concept vocabulary (next to, after, through, end, middle)
Following directions
Counting

Sound Box books idea from: Trust me, I'm a Mom blog

I recently met via the Facebook support group, a mom who has dedicated her blog to ideas parents can do at home for speech carryover. I had never heard of these "Sound Box Books" but they sound great, and apparently, may even be at your local library. Read about here!

Trust Me, I'm a Mom: Let's Talk Tuesday - Sound Box Books, Activity & a...: 'Let's Talk Tuesday' is a bi-weekly post series with ideas on how you can help your child of any ability, but especially tho...

Superhero Brave

For those of you familiar with my blog, I've spoke of "Ben" before. A little boy on my school caseload from a Spanish speaking family who has CAS and is nonverbal. However, IQ testing shows him in the 75th percentile! He's sooo smart. I met him last year in Kindergarten, and we formed an instant bond.

His Kindergarten teacher was frustrated that he wouldn't talk; and I'm not sure if she felt it was a reflection on her, but she really wasn't that supportive of him. 

This year is different! He has a new teacher and she sees what I see, what I saw. She's sees a smart, friendly, lovable little boy who wants to talk, but just needs people to believe in him and boost his confidence. Every time I see her she starts a sentence with, "you won't believe this" or "I LOVE him." Yesterday she told me she believes this year is going to be HIS year. Starting from the first day when she was going around having kids do introductions, she frowned upon getting to Ben and having the other children speak up and say, "Oh he doesn't talk." She immediately stuck up for him, telling the other children yes he did talk and that people talk in different ways. Some use Spanish, some English, some use their hands, some use gestures, and some use devices. 

Ben's corners of his mouth got just a little bit wider.

Another day, one of the kids noticed that Ben appeared to be talking to the class frog and remarked, "Look! I think Ben is talking!"

Her reply?

"Of course he's talking! Didn't I tell you Ben talks?"

Ben's chest puffed out just a little bit further.

And then there was today. The icing on the cake.  I picked him up and she calls me over to brag about an assignment he finished first and attempted to share with the class. Picking up on her hint, I praised him loudly in front of the other children. As we leave the too, a little classmate returning from the bathroom enthusiastically called, "Bye Ben!" Now Ben knows how to say bye with perfect clarity. In fact, he says it to me everyday. He pressed his lips together, but the anxiety was too much and the boy left before Ben uttered a sound. I decided to scratch the lesson plan for that day, and instead I asked him if he knew what brave meant.

I had him draw a picture of someone he thought was brave and I told him I would do the same. We sat at different tables, and I told him not to peek.

When he was finished, he drew a picture of Hulk and Captain America. I asked him why they were brave and with a smile he pantomined strength and then pantomined a sword motion. I verified he thought they were brave because they were strong and had swords to which he eagerly nodded his affirmation. I then wrote on the back that Hulk and Captain America are brave because they are strong, have swords, and I added they fight bad guys. He tapped my arm and held up three fingers. I said, "three bad guys?" to which he nodded apparently satisfied. 

He then pointed to my picture. I asked him if he wanted to see mine and he again nodded yes. As he looked at a picture of a little boy with a blue school uniform, he looked at me puzzled. I asked him, "Don't you know who this is?" Ironically, I had also just happened to also draw him holding a sword fighting a word bubble in his head! What luck!

"It's you Ben." 

His eyes lit up and he pointed to himself incredulously. 

"Yes" I said. "You are my superhero because even though talking is so scary, you still try, and that's what makes you brave." 

Now that smile was a full blown grin.

I went onto tell him I needed him to be even more brave than he already was though. I needed him to be superhero brave when it's time to talk. We then stapled the pages and walked back to class.

At the end of the day, the Facebook support group had convinced me to tell his parents about the lesson; and since they only spoke Spanish, I decided to go out with the teacher at dismissal and have her translate. When I walked in the classroom, all the kids were sitting on the carpet with their backpacks on their backs in preparation to go home.  In the middle was Ben, with his backpack on, but our book in his lap. It did mean something to him!  As luck would have it, BOTH parents came to pick him up that day.  As the teacher translated, his mother choked up and gave him a big hug as they left to go home.

Now his chest was puffed out just about as far as it go!  That's what superhero brave is all about!

"I see" with DIY binoculars

If you have a child in speech, or a speech language pathologist yourself, you are probably familiar with the term "carrier phrase." A carrier phrase refers to the initial component of a sentence that stays constant (usually a subject and verb, allowing for a fill in the blank at the end (the predicate). Common examples include:

"I want ______."

"I have ______."

"I see _______."

"I like________." 

This list is not exhaustive, but does give you an idea. In the educational arena, these are frequently referred to as sentence stems. 

Carrier phrases are used in a variety of therapy strategies for a variety of disorders. The predictability allows the child to practice learned skills beyond the word level, moving into the phrase and sentence level.  It decreases the cognitive load needed to form a sentence AND remember the learned skills, because the sentence stem, or initial phrase remains constant. In this way, the child can practice their skills at a higher level of complexity (phrase or sentence level) but doesn't have the increased demand to also generate a new and novel sentence.

To practice her words in a sentence I have a great idea that comes from my fabulous and creative mentor Deborah Comfort, who is currently the private practitioner seeing my daughter. She had Ashlynn pick out some fabric swatches from a book she had at the end of the session last week.  For the next session, she had hot glued the fabric onto two toilet paper rolls and then hot glued the toilet paper rolls together side by side. She poked some holes in the top and threaded some yarn, and Presto, they gave a set of DIY binoculars. Using the carrier phrase "I see_____" they practiced a variety of words with targeted sounds at the sentence level. 

Ashlynn loved it of course! It's also more fun than sitting at a table practicing flash cards. As you'll frequently read in my posts, I am a big proponent of multi-sensory learning and this fits the bill. Maybe tomorrow we will take it to the zoo! Great carryover practice and lots of fun!

Speech Stickers App Review

Speech Stickers is the first app that I downloaded for Ashlynn (my daughter with apraxia) when she had first turned three.  I chose it because it was cheap, and said it was developed for children with apraxia.  The app is simple in design with not a lot of bells and whistles; however, my daughter did actually enjoy practicing her speech with this app.

The app is set up for kids in the very early stage of apraxia therapy.  The child can practice sounds in isolation and in CV(consonant-vowel) and VC(vowel-consonant) combos. The app is based around blocked practice with a lot of repetition that is necessary for apraxia therapy.

After you pick your sound or sound combo, you can then decide how many times times the child has to say it before they get a "sticker" or a little animation as a reward.  Then, the child chooses between five characters on the bottom, all of which have a different pitch to their voice.  This is a bonus too, because children with apraxia have difficulty with "prosody" or the rhythm of speech.  The characters' mouths model the correct placement.  The above picture is showing 'm.'  Below the characters are modeling 'mo.' This is also great because it gives the kids a visual cue for the correct mouth posture.

A scoring bar at the top help score and keep track of data. You must press the green check or the red x to move onto the next practice sound.  The app is designed so that the bar can also turn upside down so that the therapist can discreetly score; however, my daughter picked up on this in a heartbeat and would push the buttons haphazardly just so she could move on.  Once you reach the set number you earn a "sticker" or reward.  You can choose from eight stickers seen below:

They are so simple, but my daughter loved them.  I chose the bus just so you can get an idea of the animation.

What I Love: 
- Works on early developing syllable structures
- It really helped us work on final consonants when my daughter wasn't adding them.  Helped us get the final 'n' and final 't'
- Gives a reward in the form of a short animation that is interesting to kids
- Models different pitches and inflections, which is difficult for kids with apraxia

What it's Missing
- I would like the option for the child to record their voice
- As an SLP, I would appreciate the option to email the data
- It doesn't include more complex syllable structures such as CVC and CVCV, so it's only applicable for the early stages of therapy

Impressions:
This app was helpful during the early stages of therapy, when Ashlynn was struggling to sequence basic syllable structures.  She had just turned three, and was motivated to practice speech.  In addition, she loved the sticker rewards.  It did help us get those final consonants that she was struggling with too.
As an SLP, I have also used this app with a five year old, and he enjoyed it too.  For the price, I would recommend this app if you have a kiddo in the early stages of therapy.

December book of the month

December book of the month is The Gingerbread Man.  This classic book has so many repetitive opportunites jam packed in the pages, and the kids absolutely love it!

Tonight, Ashlynn's word was "man" which combines a bilabial sound 'm' with a final consonant 'n.'  On almost every other page the Gingerbread man shouts,

"Run, run, fast as you can.  You can't catch me I'm the Gingerbread man!"  Then, various characters procede to try and catch him while calling "come back, come back!"  It didn't take long before Ashlynn was shouting "come back" along with me.

As usual, depending on your child and their needs, you can have them repeat the word, a phrase, or an entire sentence with the target sounds embedded in it.  For older kids, it's another great sequencing/retell activity to do after you read the book.  My school aged kids really like cutting out felt characters and placing them on a felt board while retelling the story. 

Happy reading!!

I Know an Old Lady Who Swallowed a Pie, book of the month

I Know an Old Lady Who Swallowed a Pie is a knockoff from the classic children's song, "I know an old lady who swallowed a fly." 

This is a great repetitive book I use with the kids to get ready for Thanksgiving.  The book chronicles a lady who goes through and eats certain Thanksgiving items. 

In therapy, I have cutouts of all the various items that the kids hold.  When it's their turn, the visuals may serve as a reminder to help them remember their word.  At the end, my older kids are required to do a summary and may use the visuals to help them complete it.  However, that's further down the line for Ashlynn.

For now, I gave her the word "pie" since this another bilabial she is still mastering.  In addition, it's also one of the speech words used in the Kaufman apraxia card set.  As before, I read the sentence, "She swallowed the cider to moisten the___, the Thanksgiving___ which was really to dry..." pausing and pointing to her visual to remind her to say the word.
By the end of the book, she was doing great and said "pie" in the cutest voice when I would pause for her to complete the sentence.  Her daddy even stopped in the hallway the other night to listen as we were reading it before bed.