I am a speech language pathologist (SLP) in the Edmonds School District. I work at Spruce Elementary and Maplewood Center.

This blog is intended as a resource for parents and teachers of the students I serve. Take a look around!

It’s here! My 2016 summer speech/language practice calendar. The calendar is in both Spanish and English, and can be used to practice articulation, language, or stuttering strategies from the end of June to the beginning of September.

2016 summer practice calendar preview

Top reasons to practice over the summer:

  • Summer Slide

The “summer slide” is a term educators use to refer to what happens when students leave school for summer break, and don’t practice any of their academic skills until they come back in the fall. June – September is a long time to not practice! Students who do not practice their skills will actually go backwards in their skills, falling further behind their peers, and begin school in the fall at a disadvantage with their peers who have practiced, even only a little.

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The good news is that it doesn’t take much practice to prevent the slide. Even 5 minutes a day, a few times per week, can keep students from losing skills over the break.

  • Make faster progress

Students who practice at home, during the year or over the summer, make faster progress on their skills than students who don’t practice. Research on therapy effectiveness has shown that therapy programs that are more “intense” help students to grow more than therapy that is less intense, and one of the key factors in intensity is how often students work on their target skills. Practice at home is a major way to increase intensity, and boost the effectiveness of what is happening in the therapy room.

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  • Graduate from speech/language therapy!

Having a large-ish caseload in a public school, I have a variety of homework-completion levels amongst my students. Some students practice and bring their homework back every week, some students do it occasionally, and a few students are not able to do it at all. I work just as hard with the students who bring it back as with those who don’t, but I have noticed a definite trend, where students who practice graduate significantly faster than students who don’t. For speech sounds, learning a new motor pattern takes time and practice, just like learning to play a sport or play the piano. The more you practice, the easier it becomes! For language skills, practice talking and listening is working on the muscle of your brain, which also needs exercise in order to grow. The students who practice the most are the students who graduate from speech/language therapy the soonest, and get back to full-time learning in their classrooms.

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This month in Teacher Norma’s classroom our language circle time is focusing on body parts. Knowing body parts is important for students because it impacts self-care (getting dressed, personal hygiene) as well as a student’s ability to tell a caregiver if they are hurt or ill. For students who are not yet using words expressively, it is still important to understand body words when parents, teachers, or doctors use them. “Stick out your tongue”, “Give me your hand”, “Arm in the jacket”, etc. Body part vocabulary is important!

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We have been playing with Potato Head toys during circle time. I have picture symbols (sometimes called PECs) with different body parts, and each student gets to choose which part they will add to the potato. Together we build the whole potato! I let students put the body parts anywhere they want, though they usually put them in the “normal” places.

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Our book this month is “My Nose, Your Nose” by Melanie Walsh. It is a book about how children are similar and different, using both body parts and things they like or don’t like. The book touches on skin tone, hair texture, but also things like loving chocolate cake, or not liking shampoo. It also covers a good chunk of the major body parts, while still feeling like a storybook rather than an “educational” book.:-)

 

And of course, who could talk about body parts without singing the Hokey Pokey? In our class we skip the “left” and “right” and focus instead on the basic body parts – arm, leg, hand, food, head, tongue, ear… Students take turns choosing which body part we will sing next, and we do it all together.

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Answering yes/no questions is a very important skill, especially for children with limited verbal skills. If a child can answer yes/no questions, it expands how much they can tell an adult or caregiver almost exponentially. Yes and No are so powerful!

Yes/No are also ideal target words because they can be expressed simply, with or without verbal words. Children can nod, vocalize, or look happy to express “yes.” They can shake their head, look unhappy, or push away to express “no.” Yes/no questions can apply across many different settings, from snack time (do you want a cracker?) to recess (do you want the ball?) to bedtime (do you want your red pajamas?). They allow parents and caregivers to offer choices, and children to have more control over their lives by expressing opinions. Being able to answer yes/no questions can reduce frustration for both children and parents, especially for children with communication difficulties.

Using gestures or facial expressions is often how children start expressing their preferences. Sometimes making a face is enough, but sometimes the rejection can be pushing or throwing, which we don’t want! Starting with what we know the child wants to tell us, we can build those preferences into more conventional ways to indicate yes/no. If a child is using a push-away to express rejection, we can pair that with a sign or word to help them learn more socially acceptable ways to get their message across. Adults modeling yes/no in situations that children are currently in is very important for emerging communicators to learn how to use yes/no themselves.

There are different kinds of yes/no questions, also. Yes/no questions that are preference-based (example: Do you want a cookie?) are easier than fact-based yes/no questions (example: Is this a cookie?). Students typically master preference-based yes/no questions before they can answer fact-based yes/no questions.
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Using visual supports is essential for students who have difficulty with yes/no. The graphic above is one I use every day. I have two cards – one with “yes” and one with “no.” When I ask a student a question, I hold up the cards so they can see their options for answering. It helps cue students who may not remember the words independently, but can point to the answer they mean with the visual support. This can reduce the amount of echolalia that students may use (repeating the question instead of answering it). A student can say Yes/No, point to the word they want, or even look at the word that they mean.

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This month we are reading Are You My Mother? by P.D. Eastman during circle time. Each time the baby bird meets a new creature, I ask the question “Is the [cat/dog/cow/boat] his mother?” The board gives visual supports, along with pictures for the “yes” and “no” for modeling and pointing.

Are you my mother

Other books ideal for working on yes/no:

Additional resources:

Lastly, here is a video with a catchy song about yes/no, made by an SLP working on a kickstarter project. There are words that pop on the screen about their project, which is a bit annoying, but the song is pretty fun and could be engaging for a student who doesn’t mind the words, but enjoys music and puppets.

EET stands for Expanding Expression Tool. It is a kit which helps students to use stronger, more descriptive oral and written language. From the EET website: “The Expanding Expression Tool provides students with a hands-on approach to describing and defining. As a mnemonic device, it provides visual and tactile information which facilitates improved language organization. The kit itself is designed to allow you to follow a hierarchical approach taking student’s expression from words to paragraphs to reports. Therefore, it can be used by a variety of ages.”

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Confession: I saw the EET craze a while back, and ignored it. I saw all of the blogs of other SLPs talking about EET, how they were using EET in therapy, how great EET is… and I never looked it up. Then one day I did look it up, and discovered that it costs a lot of money to purchase the EET kit, but that it actually looked very handy. So I did what any self-respecting, thrifty crafter does – I bought materials at the fabric store and made my own describing beads.

EET beads

My describing beads are not the same as the original. It is made with wooden beads, which I painted and then embellished with a sharpie. It is strung differently on the cord than the EET, and has a ring at the top so I can clip it on my carabiner. However, it can work as a visual aid in the same way as the EET, and I can use it with all of the fabulous (and often FREE) Teachers Pay Teachers EET products. There are describing worksheets, graphic organizers, visuals to help remember what each bead stands for, and tons more.

 

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The EET beads are a physical reminder for how to describe something. Each bead stands for a different aspect of describing, as you can see above. When describing something, you start with the green bead, and work through each bead until you get to the end. What group is it? What does it do? What does it look like? What parts does it have? 91rja0ebmol-_sy355_My current go-to for practicing wits describing beads is while playing the game Hedbanz. Each student gets a card, and then use the describing beads to prompt their questions to figure out what they have. The better their questions, the faster they can guess what is on their head.

What could you describe using the EET?

 

Today I am sharing a video I found this week on a stuttering forum on Facebook. It was made by a young woman who stutters, imagining what if the covert stuttering “voice” in her head were a real person, pressuring her to hide her stuttering to avoid negative interactions or feelings.

I am so impressed both by the concepts the filmmaker is exploring, and also by the technical production by someone so young. I sometimes have difficulty taking a photo with my phone, but she can film in split screen, and edit the dialogue between her two selves!

This is a fantastic conversation-starter for older students, who may be grappling with the same issues around hiding their stutter vs. letting people know that they stutter. I am adding it to my growing playlist of stuttering videos on YouTube. I hope you enjoy it as much as I did!

 

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One of my favorite times in Teacher Norma’s classroom is when I lead circle once a week. We have a routine of songs, books, calendar time and listening activities which we do each week. The content changes, but the goals are constant and so important. Circle time is a fantastic time to address social language use, listening skills, answering questions, emerging literacy, and so much more! Today I’m going to focus on the beginning and end of the circle time routine: greeting and leave-taking.

 

What’s so important about hello and goodbye?

There are several important communication skills embedded within a greeting. One of the first is imitation, which is foundational to learning language. During normal development, children begin to imitate waving hi/bye around 9-10 months old. Waving hi/bye has been linked with overall development. When children master this skill, it shows that they are able to recognize that another person is there, and that they can interact with that person. Saying hi and bye is a great way to practice joint attention.

Another purpose of a hi/bye routines is that they signal a transition. We begin every circle with Hello Friends, and end every circle with the Goodbye Song. These routine-based cues help children to anticipate what is happening next.

 

Nonverbal ways to greet

There are more ways than words to say hello and goodbye, which is another reason they are popular early goals for emerging communicators. A child can use words, wave, fist-bump, hi-5, use PECs or AAC pictures, shake hands, or make eye contact and smile – all of these “count” as saying hello! I use hi-5s a lot with younger students, who enjoy the feeling of slapping hands, the motor skill of aiming their hand to match mine, and the excitement of the social routine. Some students are not yet able to hi-5, but they will reach out a hand to be squeezed, like a child-version of a handshake. Nonverbal greetings usually develop before verbal greetings, so these are great steps towards the ultimate goal of a more conventional word, sign, or AAC greeting.

Thanks for reading! Goodbye!raised hands

 

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We have been exploring Pete the Cat books in teacher Norma’s classroom the past few weeks. This month we are reading Old MacDonald Had a Farm, featuring Pete the Cat.

I love this book/song for how versatile it is. Students at many different levels can interact with the book in different ways.

Emerging language: Students in the beginning stages of language can practice using “more” to continue the song, or to turn the page. Some students are working on the sign for “more”, while others are using switches or words. This works well for students who are motivated by music or interaction with adults. Pause the song in the middle or end of a verse, and wait expectantly for the student to request “more.” If they are still learning “more,” they may need you to model using it (“Let’s do MORE”, accompanied by helping with the sign, or pushing the switch with the child) and then continue.

Imitation: The repeating refrain “E-I-E-I-O” is great for imitation of speech sounds. I have a few students who are in the babbling/imitation stage of learning language, and they love to sing along and practice different sounds.

Labeling: Students who are beginning to use words can label the different animals in the song or book. Farm animals are fun to label, especially when paired with their funny sounds. I sing the song, and pause when we get to the animal to let the student fill-in the animal themselves. If the student does not know the word yet, I point to it, label it, and then look at them to see if they will label it with me.

Answering questions: Students who are using longer word combinations can start to answer questions about the pictures in the book. Questions starting with “what,” “where,” or “who” are the easiest ones to start with. Talk about what is on each page, and ask questions starting with wh-words to engage more advanced students.

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Where is the turtle? Where is the pig? Who is in the truck? What does a cat say?

You can find Pete the Cat Old MacDonald Had a Farm at the Sno-Isle library, on BetterWorldBooks.com, or you can read it free on YouTube!

Long-time readers of this blog may remember waaaaaaaay back in 2012 I started a pilot program in my district doing what we called FIT therapy. A group of SLPs in the district wanted to try to implement the new model of short, frequent, intense therapy sessions to see how it would work for our articulation students.

The pilot year went very well, and the following year we kept data on our rate of students graduating from speech therapy. The data was impressive, and I’ve been doing FIT therapy with my articulation students ever since. I have also expanded to use it with students working on vocabulary as well.

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This past October I presented the method, along with our district’s pilot program and data, at the Washington Speech Language Hearing Association’s annual convention in Tacoma. My presentation was well-received, which was a relief to me because I was very nervous about it! Several other SLPs have since asked for my slides, in order to present the method to their colleagues and spread the information further.

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Me, nervously waiting to present!

I am thrilled that others are interested in implementing FIT therapy (also known as QuickDrill, 5-minute therapy, or 5-minute kids) with their clients. I have put my presentation on Google Slides, which is available for viewing for anyone who is interested. The handout is also on Google Drive, free to download (see below).

I would love to know if anyone else uses this service delivery model, or if you are inspired to try it!

This month we have been talking about shapes in Teacher Norma’s classroom! Some students are at the level of exploring physical shapes with their hands, and other students have begun to label shapes verbally. There are many, many ways to play with shapes that can be done at home.

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The book we have been reading together in class is called Shape Capers. You can get it at the library, or on BetterWorldBooks.com. The book introduces shapes – circles, squares, triangles, rectangles, and semi-circles, and then uses the shapes to create fun pictures of different objects (a race car, a rocket, a dinosaur…). The students enjoyed touching each shape, and matching the shape they were holding to the picture in the book.

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I made puffy fabric shapes that velcro onto a display board, which we used as we read the book. Each student got a shape to hold and explore, and when their shape came up in the book, they added their shape to the board. It gave students a chance to learn new words, as well as listen for their shape to be called. And the students enjoyed the texture and squishability of the fabric shapes!

At home, playing with Play-Doh can be one way to learn more about shapes. You can download Play-Doh shape mats here, which you can use while playing with Play-Doh to create and reinforce different shapes.

Flash cards and sorting is another way to learn about shapes. Here is a shape activity with cards of objects that are naturally circles, triangles, squares, etc. Cut them out, and have students label the shapes they see, or sort them into groups based on shape. If your student is not able to label yet, then you can do it with them and model the words as you look at the cards.

Happy Holidays everyone! Stay safe and warm, and I’ll see you in January 2016!

 

 

highway-road

In October I presented at the Washington Speech Language Hearing Association’s annual conference. I spoke about QuickDrill Therapy, and had a great response to my session.

While I was at the convention I had the privilege of hearing Elyse Lambeth from Children’s Hospital in Seattle present about tools for stuttering therapy. One of the tools she shared was the concept of “fluency lanes.” I loved her graphic, and have adapted it into a handout that I use with my students.

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The handout is a drawing of a freeway, with the goal of “say what you want to say” at the top. The goal for every student who stutters is that they are able to say what they want to say, when they want to say it. We work on speech strategies as a way to help students towards that goal, but they have other options also. The real goal is not that a student use X strategy. The goal is that each student will chose whatever option works best for them in each situation, even if that option is stuttering openly. Sometimes saying what you want is more important than using a strategy.

The graphic helps students to visualize their options. The box at the side of the road is a parking space. A student is “parked” if they decide not to talk at all. Will it get them to their goal? No. But it is an option they have the power to chose. In therapy we talk about this option, and the consequences of choosing it. Will people know what you think if you stop talking? How will you let your friends know what you like or what you want to do with them? I rarely have a student chose to park instead of drive, but it is still an important option to point out.

The bumpy shoulder on the side of the road is for when students avoide words to prevent stuttering (circumlocution). If a student continues talking, but is avoiding words to keep themselves from stuttering, it will take them more time to go around the tricky words. They might not say exactly what they want. They are still talking, but it is a slow and bumpy road.

The lanes on the road are for different ways to say what they want. One of the lanes is to continue talking and allow the stuttering to happen. Easy stuttering is always an option for communication, and sometimes it is the fastest option! A student can always feel okay choosing to stutter if that will get them to their goal. Working on stuttering acceptance, easy stuttering, and voluntary stuttering are good ways to practice communication in this lane.

The other two lanes are for changing the way you talk (fluency shaping) or using a strategy to alter a stutter (stuttering modification). I don’t differentiate between these two approaches much with elementary-age students, but the difference may be significant in some situations. A student can chose to use their tools to speak more fluently, which will get them to their goal of saying what they want. A student may chose to travel in these lanes if it is important to them that they not stutter while they talk, such as during a class presentation, or talking with a particular person or in a particular situation.

The freedom to chose how to communicate is a fundamental human right. I love this handout because it helps children who stutter to express themselves however they want!

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