The Force is Strong in Speech Therapy…

“Ms. Saus, you really like Star Wars.”

Yes, dear child. Among many things, I do really like Star Wars.  And it’s  apparent when one sets foot inside the therapy room.

Actually, there are pieces of numerous pop culture icons in my therapy room, from Star Wars and Star Trek to Marvel’s Avengers or superheroes, and How to Train Your Dragon.  There’s an assortment of yellow beetles and happy faces, too.  When therapists spend as much time as we do in our therapy rooms, it’s elemental to create a space that works with us and sparks the interest and imagination of the young minds we work with.  Ours, too, right?  It opens the door for rapport, conversation, and connection.

Over the past few years, the love of Star Wars has grown in momentum with the advent of new series, toys, and now  – unless you’ve been living under a meteor rock – a new movie that’s about to drop.  It’s been a great time to be a fan.

And a Rogue.

Wait – what’s a ‘rogue’?

There is, believe it or not, a group of people who actively use Star Wars in their classrooms to creatively teach academic concepts and life lessons to our students.  As members of  StarWarsintheClassroom.com, we earn the moniker: “Rogues –  an elite group of educators who seek to make learning more fun and exciting by integrating the Star Wars Saga into their curriculum”.  It’s an honor to be amongst their ranks and admittedly a whole lot of fun.

It’s also a bit of a challenge.

One asks: “That’s great and all, but just how do you use Star Wars in speech therapy?  And with your age group [of three to five-year olds]?”  After all, the social, political and even mathematical ties worthy of dissection and discussion readily apply to activities for older students, but pre-Kindergarten?

Rest assured, there are more ways to effectively incorporate the fun of a galaxy far, far away than one might think.  Allow me to count [just a few of] them:

Rapport
As mentioned before, the recognition of a favorite iconic figure or item in your room or on your person goes a long way in making a connection with a student – from the unequivocally shy ones to social butterflies, and even with the troubled ones who feel alone and unconnected with the world.

Recall, Storytelling and Play, Answering Questions
Familiar thematic items and figures add something extra to your curriculum, such as using a themed Build-a-Bear to supplement a  literacy-based speech and language unit about teddy bears.  Language use during play and conversational turn-taking require students to recall past experiences, respond to questions, and make additional comments.  Talking about movies, television shows, toys and characters, and things that are really important to them is a great way to target open-ended communication skills.  Initiating a Star Wars conversation might elicit some of your best topic-maintenance trials!

Social Awareness and Perspective-Taking
The Saga’s Jedi Code and practice often speak of mindfulness of surroundings and others.  This awareness of others and the world around us is crucial to building good communication skills.  One must be observant of situations, as well as others’ feelings and attempts to communicate, in order to maintain reciprocity, social conversation, and connection to others.  One of my favorite teachable moments of this concept occurred when two little boys were building Don’t Break the Ice.   Both boys saw a different design in the blocks depending on where they were seated at the table.  The opportunity was golden for quoting Obi-Wan Kenobi:  “You’re going to find that many of the truths we cling to depend greatly on our own point of view.” The guided conversation that ensued, as well as the understanding and reciprocity that dawned between them, was one of those unscripted moments that is inspiring to witness.

Drill/Practice & Rewards
Star Wars figures make great manipulatives.  Use them for practicing position/direction concepts, following spoken directives, sorting, counting, or describing.  Break down crafts (many to be found on Pinterest and Google) into pieces earned during drill and practice tasks, following directions, or to target sequencing.  Add new dimension to your game closet with open-ended SMARTBoard activities, BINGO boards or related store-bought games.  Playdoh or kinetic sand with Star Wars cookie cutters or figurines target vocabulary, any number of language concepts in play, and add a fun sensory component!  Homemade foam lightsabers make great bubble poppers (check out Miracle Bubbles in thematic bottles).

Imagination and Confidence
In this day and age, we work to tear down gender barriers and minimize social stigmas.  What better way to instill imagination, creativity and the confidence to “just like what you like” and “be yourself” in your learners than by embracing your inner geek and becoming a role model? Whatever your obsessions, show your students it’s OK to be passionate about something, even if others might consider it silly. An added bonus comes from using it as a treatment tool!

Think you have what it takes to be a Rogue?  Be sure to check out Star Wars in the Classroom.  Like these ideas, or want to discuss ways to use the things you are passionate about, but are not sure where to start or how to make the content relevant?  Feel free to contact me by commenting below, through the website, or on Twitter!

May the Force be with you… 

Goals ALL of Our Students Can Target

It’s that time of year again for many of us – in fact, most of us are already past those first few days of a new school year.  Despite how school-based therapy sure does its best to drag some of us down, there is always something hopeful and exciting to the start of a new school year.  I don’t know about the rest of you, but even after seventeen years, I still start each year with the mantra “This is gonna be the  year.  I’m gonna nail it this year.”  (When one of you actually figures it all out and accomplishes that, fill me in, okay?)

Ya Gotta Have a Goal.  Do Ya Have a Goal?

The never-ending loop of change-and-back-again is in full swing, the summer has ended without ceremony, and there’s a new (or continued) list of expectations for the classroom.  “Accountability” and “continuous improvement” are huge buzz words in schools these days, and while some states have specific criteria with which their speech-language pathologists’ skills are evaluated, many tend to throw their school-based SLPs into the teacher bracket and judge their effectiveness to a set of criteria that doesn’t quite jive with their actual scope of practice.  It is a work in progress, I think.

In the district where I work, the continuous improvement adult learning framework and quality tools have become a required aspect of all classrooms (even early childhood and special education), including therapy rooms, and I can attest to the real struggle some of it has been to make it applicable not only to special education, but specifically therapists.  We are doing our best! Again, it is another example of a work in progress.

One of the big requirements of the continuous improvement classroom is the incorporation (and display) of a class-wide, attainable goal, written in SMART format.  (If you don’t have to write goals this way, be glad – I still don’t fully get it – but, for schools, it’s a mnemonic that stands for specific, measurable, achievable, realistic/relevant, time-related).  Now, I know what you might eventually ask – how can a speech therapist write a single caseload-wide goal that all of our kids can target when they have such specific and individualized targets?

I pondered this, too, particuarly being in early childhood special education, where a three-year old cannot realistically (in most cases) be expected to regurgitate, much less understand, their specific speech or language goals.  But, after a bit of consternation, I came up with something that covers most of my students.  (Of course, because of the absolutely individualized nature of what we do, some students need modifications in order to participate, which I’ll get to, later!)

Why Do You Come to Speech?

During my student-teaching days, thanks to my lovely experience in an elementary school (which helped me do a 180 from adult rehab – but that’s another story), I had the realization of just how important it is for kids to know why they come to see me.  If you ask the kiddos on your caseload why they come to speech, chances are, many of them will answer “to play games!”  while you sustain a mild concussion from your beautiful head-to-desk gesture.  Let’s face it, though – they’re not entirely wrong, but we’ve led them to believe that because of the many awesome things that happen in our rooms. (Shh, don’t shatter the illusion – I believe it, too.)  

I also believe that when students know their goals, even a general one like this, they take greater ownership and responsibility for their participation and feel like they are more a part of their sessions.  Call it a “buy-in” mentality.

You Don’t Have to Re-Invent the Wheel!  I’ve Got One You Can Borrow.

Here is what a few of us are using as a SMART-format goal, written for our “class” (or the majority of our caseloads), to fulfill the requirements of our district’s continuous improvement “adult-learning framework” criteria.  If any of you are stuck in a quandary trying to figure out how to make this work for you, I hope the example is helpful:

By the end of the 2015-2016 school year, 100% of Ms. Saus’ identified speech and language students will respond appropriately to the question: “Why do we come to speech class?”

I help my kids take ownership in their contribution as well as encouraging them to support and cheer on others by turning it into a motivational bulletin board.  This is not designed as a way to visually “shame” my students.  This is simply a huge visual data chart that makes it easy for the kids to understand our progress and get excited as we get closer to our goal.  (Of course, there’s an incentive of a rockin’ ‘speech party’ celebration once we hit that goal, and the kids are involved in the planning.)

When my school implemented a new, building-wide Positive-Behavior Support Plan with a superhero theme a few years back, I ran with it and decked the speech room out in hero-themed decor.  When a student answered our targeted question, they got to choose a superpower to knock out the bad guys.

This year, it’s back to Star Wars, and the students are helping the Ewoks with a celebration.  When they answer the targeted question, they get to “blow up” their firecracker by hanging up colorful streamers and a setting off a confetti popper (my custodian loves me).

Some therapists choose to have their older students summarize their specific goals, for example: “I’m working on /r/,” or “I’m working on recalling three details from a story.”

Another therapist in my district has her elementary students naming things that make them good and effective communicators (e.g., “eye contact, asking follow-up questions, staying on topic, etc.)

And what if you have a low-functioning/high-needs population?  How the heck are you supposed to target an all-encompassing goal in that case?  With a little creativity.  Perhaps there is a similar goal they are all working on, such as one-step commands or responding to others when greeted/asked a question.  One of my colleagues simply made it a goal that her high-needs friends would simply make progress, and decided on whether it was mastering a certain number of objectives, progressing by a certain percentage, or meeting an overall annual goal.  

These are just some ideas.  And, even if you are not required to have one of these broad goals or post it in your room for all to see, it is definitely food for thought.  Do your speech students know why they are coming to your class, or to your private therapy practice/clinic?  Do your students know the sound(s) they are targeting?  Do they know what makes a good communicator?  These may not define “individualized” goals, but in the end, they should be considered an integral part of our practice!

Have ideas or questions?  Need any help?  Please feel free to contact me!  We’re off to a great start this year!

Helping the Preschool Child Understand and Follow Spoken Directions

I was pleased when asked for a guest-blog submission in conjunction with Citra, developer of a communication tool for iOS and Android tablet users.  The post is full of ideas to share with parents, families, caregivers and early educators.  While the post is no longer available on their site, you can read it below.

The requested action is nothing unusual… a seemingly normal part of your routine; something you do every day… but somewhere, there’s a breakdown.

“It’s time to go!  Put your blanket on the bed and go put on your shoes,” you say.

Your child immediately goes to put on his or her shoes, but that first part, about the blanket?  It is as if you never said it.

“Push your chairs under the table, put your art on the drying rack, and line up at the door,” you say.

That one child always pauses just a moment, and looks around at her classmates in action, then begins doing what she sees them doing.

“Go get the red shirt with the dog on it,” you say.

Your child brings you a shirt, but it’s not red, and it certainly does not have a dog on it.  Or perhaps he just brings you his stuffed dog, but no shirt.

What is happening?  Is that child not paying attention?  So you tell him or her again, with similar results or a complete look of confusion.

Somewhere, the full message is not processed, details are forgotten, or missed.  For the preschool child, there are any number of reasons why the follow-through of a spoken directive is not successful.  Often, it is a simple matter of attention.  He or she may be distracted with a toy or another activity and is not fully listening.  Does the child even hear you?

For very young preschoolers, longer strings of words with descriptors and multiple steps are naturally difficult because of the many components of language and memory involved, and they just have not fully developed an understanding of the concepts or the skill of remembering multiple steps.

Other times, simple adjustments such as verifying attention or understanding developmental norms is not enough.  There are many preschoolers who truly struggle to make sense of verbal language and have difficulty responding appropriately to it.  They may have developmental delays that impede their ability to process language and follow through with directions.  Perhaps they are second-language learners with weaknesses in vocabulary knowledge.

Whatever the reason for the breakdown, there are some useful, “go-to” strategies that aid in holding a preschooler’s attention to, and processing of, verbal directives.  Keeping these strategies in mind and providing opportunities to practice will further develop their skills.

1. Make sure you have their attention. Say their name, tap them on the arm, move yourself so that you are in their line of sight; but make sure you have their attention before giving the direction.

2. Be brief.  Particularly for younger preschoolers, less is more.  Use short and concise directions.  Use simple sentences and fewer words.  Be aware of how many steps you provide and how many details/descriptors you use.  Some very general guidelines for typical language development with regard to multiple-step directions and the understanding/use of modifiers (descriptive words) include:

Age:	Steps:	Modifiers/Descriptors:
1 Year	Beginning to understand and respond to simple 1-step directions (e.g., Come here, Stop, Put it down)	n/a
2 Years	1-step directions (e.g., Put the crayon on the table, throw the trash away, clap your hands)	minimal, but simple modifiers and descriptors such as size/shape/color are emerging
3 Years	2-step directions (e.g., Find the big ball and give it to me, Get your blue shirt and put it on)	early qualitative descriptors such as size/shape/color
4-5 Years	2-3 step directions (e.g., Finish your snack, throw your empty cup in the trash, and sit on the square rug)	multiple descriptors

3. Give extra time.  Avoid repeating yourself.  Whenever you repeat a direction, the child must re-process all of those words again, essentially “starting over”, before he or she can even begin to take action.  Be sure to allow at least ten seconds (which can seem like a very long time) for them to process and respond to a direction.  Once time has been allowed and you are certain the child does not understand, employ additional strategies.

4. Provide visuals. Use pictures to show the steps the child needs to do in order to complete a task or follow through with directions.  There are multiple ways to do this, including using clip art or photographs of the steps.  Some resources for images include the widely-used Mayer-Johnson’s Boardmaker, a web-based program such as LessonPix, and free online art from websites such as My Cute Graphics or Google Images.  You can also use the Citra App, which uses the Boardmaker and SymbolStyx image libraries.

5. Provide a model.  Live peer models, such as a friend or sibling at home or fellow classmates at school, provide an opportunity for imitating and success when following directions.  Children learn from watching each other.  Have a capable sibling or classmate demonstrate what you are asking of your child, first.  If there are no peers, model the directions or steps to your child yourself.  Narrate the steps or directions you want your child to complete as you or someone else does them.  This provides an excellent model of the language as well as a physical representation of the concepts.

6.  Expose.  There are many opportunities for exposing children to language in order to increase their skills.  When you aren’t expecting children to take immediate action and follow the directions, take the time to both talk about and demonstrate what needs to be done or model a sequence of events.  Every-day routines such as bathtime, getting dressed, preparing snack, or classroom projects provide opportunities to talk about the steps you are going to take.  Narrate the steps as you go through them.  Use modifiers and descriptors appropriate for, or slightly above, their developmental age so that they can hear the language in use and become familiar with the vocabulary.  The combination of providing a model of language, and the experience of doing the steps while they hear the language, offers children a tangible experience to associate with the concepts and makes them more “concrete”.

As with all areas of development, the more children are exposed to specific vocabulary and sequential language that comprises verbal directions, and the more opportunities children have to practice, the better they will become at using these skills.  If, even after providing additional strategies and opportunities, there continues to be a concern, consider making a referral to a speech-language pathologist or developmental specialist for further evaluation and intervention.

 

 

3-D SLP, Jr.’s “Bears on the Loose” – A Product Review

We are big fans of nerdy boxes in this house, having sampled anything from LootCrate™ to NatureBox©, and others.  They are a fun concept, if a little pricey, so we have not kept subscriptions on them over time and have only enjoyed ordering one on occasion.

However, with the drop of 3-D SLP’s professional subscription box, I have been extremely intrigued.  Now, here is a box I wanted to get behind!  Unfortunately, my target population is early childhood – three to five-year old students and families – and the 3-D SLP box is really intended for elementary-aged students, with higher-level language concepts and themes.

Well, darn.

However, the the company pays attention to the customer base and – voila!  With growing success from the original subscription box, 3-D SLP now has launched a “junior” version, just for early interventionists and their students and families.

I have been beside myself waiting for the inaugural box, and am equally excited to share my thoughts on its contents and accessibility with you.

3-D SLP, Jr. arrives in a very nice, heavy-weight box printed with the beautiful company logo.  After receiving a bit of wear during its travels (seems to be an issue with my local post) I am  grateful for the mindful packaging to protect my product.

Upon opening the box, I discern the care with which it has been packed; it is an attractive display, boasting a carefully-selected book with materials and activities that thematically coincide for an approximate month’s worth of therapy sessions (give or take, really, depending on how many sessions you provide).

Allow me to take a closer look at this box, in particular.

 

Inside, is a beautifully illustrated book, The Teddy Bears’ Picnic.  Each page holds a wealth of opportunities for language exploration, including discussion of action words, pretend play, outdoor and summer-themed vocabulary, descriptive concepts, and opportunities for open-ended questions and recall: a fully-loaded treasure for any speech-language pathologist, for sure.  

A sturdy folder contains a pack of very nice quality, custom-designed and color-printed reproducibles and materials.  Each item within the box is listed, along with a brief description and possible therapeutic uses.  There is a sample lesson plan, ideas for fine and gross motor activities, sample poems and songs, and play-doh recipes with a cute bear cutter!  Additionally, there are vocabulary concepts (action words, descriptive words: empty/full) and other suggested language targets.  Also contained in this packet is a parent letter with family carryover strategies and ideas for each “age and stage” of early development.

While initially I did wish for additional and more specific language targets, I think it is especially important to point out what I discovered next:  how very open-ended and flexible this theme-box is.  After taking time to peruse the reproducibles more thoroughly (because, let’s face it, I had become completely distracted by all the other glorious manipulatives and shiny objects contained in the box – which I’ll get to in short order), I began jotting down the additional ideas that came to me:  other bear books and songs and crafts, sequencing and following directions, bring-a-teddy-bear to speech day, sorting food vs. non-food items or healthy vs. unhealthy food choices…the ideas just kept coming.  Which I think is both brilliant and the intent of the box.  

In this bear-themed box is a plastic “honey jar” filled with colorful bear counters of varying color and size.  Immediately, language targets of “empy/full” and “big/little” come to mind, as well as general cognitive concepts of sorting, counting, and color recognition/naming.

Also included is a set for pretend “picnic” play, complete with a checkered picnic napkin to set out the colorful plastic bowls for eating delicious picnic foods with speech friends, pretend friends, or teddy bears!  Clients can work on play skills, sharing with others and making sure everyone has one, and pronouns (e.g., Can I have one?  Give one to her.  He needs a bowl.  Where is my bowl?  Where is your bowl?)

In a cute little burlap bag decorated with the 3D-SLP, Jr. logo and a checkered accent is a handful of colorful pom-poms and plastic tongs, ideal for additional pretend picnic food, counting, and sharing.  The tongs add a delightful and entertaining fine-motor element.  I have added more pom-poms to my bag, to match the bowls in the kit, for sorting.  Adapt the tong and pom-pom activities for articulation practice by having students earn their turn!  For every three to five target sounds/words/phrases/etc., they can choose a pom-pom to add to their bowl for themselves or their teddy bear.

Clever packets of gummy bears and tubes of apple-scented hand sanitizer (to clean those hands before you enjoy your picnic!) and sunscreen (for all the fun in the sun!) wrap it all up in a little thematic “thank you” gift box with a final reminder to take care of ourselves in our hectic world of early intervention.  How neat is that?

Indeed, the premiere 3D-SLP, Jr. box has held up to its name to De-liver, De-light, and De-stress its recipients and promises to start my school year off with lessons at my fingertips.  I am anxious to delve into next month’s box and discover a whole new wealth of lesson opportunities!  

Have you received a 3D-SLP box?  What are your thoughts?

 

Bottles, Binkies, and (Very) BAD Things…

The preschool years are the final steps in a packed five-or-so years of development that set the stage for a child’s success through school and early life experiences.  These days, the expectations are increasing. As a teacher, therapist, and a parent, I see what our classrooms are doing and know that children today have to know more, do more, and think more than they used to before they enter Kindergarten.  To be successful and participate to the fullest in their classroom environment, they need to be able to communicate to the best of their ability.

There are any number of things that can impede a child’s ability to develop good oral communication skills, but one of the most fundamental pieces in that development is the need for the muscles and structures of the mouth to develop without anything getting in the way. Yes, I’m talking about those pacifiers. The nighttime bottles. Sippy cups. The thumbs.

While sucking is an absolutely appropriate and necessary step in early development, there is not much need for it to develop further once a child has reached 12 months of age (give or take).  Prolonging the use of bottles, pacifiers, sippies and especially thumbs may avert the initial nightmare of parting with these beloved crutches, but the endgame will result in much worse than temper tantrums and crying.

Over time, your child’s jaw and roof of the mouth will develop around these intrusive objects and the pressure they provide.  Their teeth will become misaligned (and once those permanent teeth come in and they are still sucking on their thumb/fingers, you all know what this means – thousands of dollars in braces down the road).  The misalignment of teeth and malformation of oral structures can result in speech sound errors.  Your child may also develop a tongue thrust, where the tongue protrudes upon swallowing and also while talking, resulting in what is commonly known as a “lisp”.  And constantly having something in their mouth can lead to overall weak speech muscle movements (making speech harder to understand) and delayed language.

Understand that bottles and pacifiers are perfectly appropriate early in a child’s life.  Do not feel concern or guilt because your child of 12 months or younger uses one.  Avoid the use of “sippy” cups or use them only for a short time, as the muscle movements involved in using them are much the same as bottles and pacifiers.  Straw cups and eventually a normal open cup are much better choices as they encourage correct tongue placement and movement.

Having difficulty ditching the pacifier?  Here are some strategies you can try:

• Cold Turkey. Like the proverbial band aid or even like smoking – many proclaim this is the best method.
• Dip the pacifier in something bitter but not harmful, such as coffee, and leave it for them to find
• Cut the pacifier. If they don’t seem to mind and just like having it in their mouth, keep cutting pieces off until it won’t stay in their mouth.
• Choose a big day, such as their birthday. Talk about it, prepare for it, then help them “throw it away”. When they ask for it, remind them that it is done, because they are big now. Provide an alternative, such as a healthy snack or drink to put in their mouth instead of the binky.

What about the thumb? You can’t dip it in coffee or cut it! Try:

• Limit the amount of time for sucking – bedtime, in the bedroom. Not in public.
• Praise the child when they are NOT sucking, but avoid confrontations such as telling them they “can’t suck their thumb anymore”. That just sets off all their stubborn bells and whistles.
• Talk with them about why it is better not to suck their thumb or finger.
• Give it time. Give them alternatives, such as extra hugs when they need the “comfort” thumb-sucking provides, the words and language they can use when they’re upset, and be positive.

Feel like you’ve already exhausted these strategies? Be patient. It won’t happen in one instance, overnight, or sometimes even after a couple of days. This is a habit that has been formed and we all know it takes a good deal of work to break habits and establish a new routine. Yes, tears and tantrums can be expected and they are trying, but it is much easier to take the moments of difficulty now than a few years down the line when speech, dental, and peer-relationship concerns become more likely.

And finally, feel free to speak to one of our wonderful, friendly, neighborhood speech-pathologists here at Gerner Family Early Education Center if you have questions or concerns, or are just plain not sure what to do next.

Good luck!

~Angela “Applesaus”

References:

Shotts, L., McDaniel, D., & Neeley, Richard. (2008). The Impact of Prolonged Pacifier Use on Speech Articulation: A Preliminary Investigation. Contemporary Issues in Communication Sciences and Disorders.

American Academy of Pediatrics. (2000). Thumb sucking and pacifiers. Retrieved July 14, 2003, from http://www.aap.org/healthtopics/stages.cfm#early.