Wednesday, February 27, 2013

Guest Posting: Let's Get Physical! Keeping PK kiddos attention during therapy.

Today I am guest posting on [simply speech.]'s Welcome Home series today!  The topic?  Using movement to keep PK students attentive during therapy!

Here's a preview of all the goodies you will find over there...

So here is my biggest secret to success with preschoolers:  Movement!  It is NOT developmental to expect a PK age child to sit and attend to an activity for 30 or 50 minute sessions.  Children are constantly learning, exploring, and problem solving.  They, like us all, need proprioceptive feedback.  I provide that by adding movement to almost ALL of my therapy activities.  When I add movement to any activity, I have learned that my PK students attend longer to one single activity and will participate in more trials during the therapy session than if I would expect them to sit the entire time.  The movement does not have to be big or elaborate.

Want to know my simple tricks of the trade for some of our favorite activities as SLPs? Head on over to [simply speech.] TODAY to find out!

Do you use movement activities in your therapy sessions?  Feel free to share your great ideas below!

Happy Talking

Tuesday, February 26, 2013

Tip Tuesday! Articulation Tip: Teaching Students to Self-Monitor Speech Rate!

This is Part 2 of a previous post focusing on training slow speech rate.  Find Part 1 here.

When working on teaching a slow rate of speech, the 3rd and final step to making slow rate a habit, is for a child to self-monitor his/her own speech rate.  I call this skill "Listening to myself".  I do this by using three basic techniques we as SLPs tend to use when focusing on correct articulation production and/or fluency.

The key is to use the techniques that work for the child across all levels of speech complexity (word, phrase, sentence, reading (if a reader) and conversation level).  This means I may have to use a variety of cues to determine the cuing system (verbal, visual, tactile) that will work for this child.  I remember that I am scaffolding the child to use a skill I have already taught him/her: a slow speech rate.

3 Techniques for Self-Monitoring Slow Speech Rate:

1.  Using verbal cues:  Verbal cues are any words or phrases I have found that successfully cue the child to monitor and/or change his/her speech rate to a slower rate.  In this technique I include:

  • Types of Modeling: (including previously taught techniques in Part 1)

    • Over Exaggeration
    • Rhythm 
    • Tapping
    • Consistent use of slow rate by SLP

  • Verbal Reminders: 

    • Directives: (explain exactly what you want the child to do)  "Slow down", "Make sure you pause when speaking", "Take some breaths".
    • Feigning Misunderstanding: (pretend you can only understand the child when he/she uses a slow rate)  "I'm sorry, what did you say?", or "I can't understand you when you talk so quickly".
    • Descriptive Speech:  "Remember to use your turtle talk" or "Remember to snail sail your messages"
2.  Using Visual Cues:  I create visual cues that can be used independently or go along with the descriptive speech reminders above.  Below are some of the visuals I use to cue use of slow speech or to have the student evaluate his own speech rate and determine which pace he is using.  I like to laminate these and glue to a Popsicle sticks so they can be held up easily.  You can grab your FREE copy of these visual cues here!

3.  Paying Attention to Listener Cues:  The last thing I do is train the student to use visual cues from the listener to see if his/her speech is being understood.  If not, they need to slow their speech rate.  

  • Understand/Aware of "Confusion":  I want my student to know what it looks like when someone is confused by his/her speech production.  To do this I begin by using a number of emotions pictures (the ones I use for my children with ASD) and have the child label the pictures that represent when a listener is confused vs. understanding.  
    • Describe confusion:We discuss how confusion can be visualized at times by "facial muscles are strained-pinched eyebrows or raised eyebrows and enlarged eyes, shoulder shrug, open mouth, and even a long pause after you are finished talking".
    • Describe understanding:  We know someone is understanding us when they are "nodding their head in agreement, looking us in the eye, smiling, facial muscles relaxed, etc.".
  • Label Confusion/Understanding in SLP facial expressions:  Then we practice labeling confusion vs. understanding first in my facial expressions and what to do IF confusion is identified (a.k.a. slow down speech rate!).
  • Label Confusion/Understanding in peer's facial expressions:  Then we spend time labeling confusion vs. understanding in peer's facial expressions and what to do IF confusion is identified.
By the time student's master technique #3 they are beginning to use slow rate more often than not and do not require much more monitoring practice.  Then I move on to focusing on correct speech production.

Word of caution:  These techniques will not be come a habit unless consistently used and targeted until the child no longer needs scaffolding.  So remember, you may spend many weeks on some of these skills depending on the child's development, cognition, and monitoring skills.

Those are my techniques for teaching a child to "listen to him/herself".  What are yours?

Happy Talking!

Friday, February 22, 2013

Freebie Friday: Follow the Artic Rainbows!

I LOVE St. Patrick's Day and I also love using pictures for my articulation kiddos (as most of my kiddos are non-readers).  But to make this activity I really couldn't fit pictures into the small spots above so I wrote words.  I decided to use words from Webber's Jumbo Articulation Drill Book because I'm pretty sure many of us SLPs have access to this resource.  Each page has words that go along with pictures from the book so readers and non-readers can use these handouts.  Also, you have the option to use this activity in therapy or to send home to parents.

As you can see, each page focuses on a different sound with 10 words in the initial, medial and final positions separated by the rainbows strips.

You could use dot markers, stickers, crayons, pom poms, or even bingo chips to color the rainbow strips.

I'm pretty sure I'm going to use skittles so my kids get to "taste" the rainbow while following it! :)  I am planning on placing colored skittles on the words, and after they are produced correctly at the level we are working on (word, phrase, sentence, etc.), they get to eat the skittle and color in the circles (with crayons, dot markers or maybe I'll even use water color paints...that sounds like fun)!

I included a blank page for you to make your own if you want.

Check out the packet and download it here for free!

Enjoy and happy talking!

Tuesday, February 19, 2013

Tip Tuesday! Articulation Tip: Mastering Slow Rate of Speech!

This post is in response to a followers request.  Thanks for your input and suggestions!

One of the very first ways to improve intelligibility is to teach a child to use a slower speech rate.  When children with articulation disorders use a fast speech rate, often times the number of omissions and sound substitutions increase, syllables are reduced and overall intelligibility is significantly affected.  So, I take this part of therapy very seriously.  In fact, there are times I have spent more time focusing on the use of slow rate than I have focusing on correct sound production.  

Parents who are reading this, you can now see that when your child's SLP writes a goal for using a slow rate of speech it is for a very specific purpose.  Please do not underestimate the power of slowing your own speech rate down and encouraging your child to do the same.

The million dollar question is of course, how do we change someone's speech rate?  Below I outline 3 general steps I take to teach a child to use a slow rate of speech.  I'm sure there are many other techniques and ideas you use out there.  Feel free to share with us your techniques in the comments below.

3 Steps to Train the Use of a Slow Speech Rate:

1.  Create Awareness:  The very first thing I have to do is make the child aware that he/she is using a rate of speech and is too fast and explain WHY a slower speech rate is preferred.  To do this first I have to demonstrate then teach the child to monitor my speech rate.
  • Demonstrate:  I usually begin by giving a child directions very very quickly (so fast that the child cannot understand me) and look at them expectantly to perform the direction.  Then I ask them why they aren't doing what I asked.  For PK kiddos, usually they will look at me and just say "What?".  I than ask them (slowly) "What, am I talking too fast?".   Older kiddos can actually tell me I am talking too quickly for them.  I will then restate the directive in a slow rate (slower rate than I typically use) and ask them if they understood me that time. Of course the answer is "yes".  So, I go on to explain to them that because they talk very quickly, this is how they actually sound to others.  The point: I'm trying to make a connection for the child between slow rate and increased understanding.  I am demonstrating to them the rationale behind using slow rate of speech.
  • Monitor my speech rate:  Then I take time (sometimes several sessions if I need to depending on the child's age, cognition level, and monitoring abilities) and have the child learn how to discriminate between a fast and slow rate of speech first in my speech and then (if I have access to using peers) in a peer's speech rate.  This is ALL I will focus on during this time.  THIS is the ONLY goal right now.  I don't care about misarticulations, ALL I care about is training the child's auditory system to recognize a fast vs. slow rate.  How do I do this?  I can use any materials, books or games for this goal:
    • Books:  I read books, and if the students are readers they can take turns reading books, and have the student label (thumbs up/down, using visuals for fast/slow rate, or even using a kids LOVE the use the Taboo buzzer and buzz me every time I'm using a fast rate) fast vs. slow rate of speech.
    • Games: Uno, Go Fish, Crazy 8s, ANY card games or board games will do.  As the games get more exciting, I try to use a faster rate of speech to see if the student notices.  Most times he/she does not at first and I have to show the child that just because we get excited doesn't mean we can increase our rate of speech.
    • In Play:  Especially for younger kiddos, I try to pull out toys (Mr. Potato Head, Farm, doll house), etc. and spend time having them listen and monitor my speech rate in play.
  • Once the child can monitor fast/slow rates of speech in my utterances (and peers if I have them), we move on to step 2!

2.  Practice what we preach: Now its time to have the student practice using a slow rate of speech.  But in order to do this I need to make sure I ALWAYS use a slow rate of speech with this child b/c if I'm not using it and modeling it, why should he?  I use the following to practice slow speech rate:
  • Over exaggeration: I begin by having the child practice slow rate in an over exaggerated manner for 2 reasons.  1) we get used to speaking slowly, 2) by the time we speed up to normal rate of speech it will feel "fast" compared to this over exaggerated slow rate making carryover more likely.
  • Rhythm: Sometimes kids struggle with carryover of slow rate so I move into rhythm exercises.  So we may repeat rhymes or we may speak in a rhythm for entire sessions.  What?  Seems crazy? It's not!  We are retraining the child's neurological process of speech rate so we are involving the left and right sides of the brain for this.
  • Tapping exercises:  Tapping exercises are a nice way for me to transition kiddos from over exaggerated slow rate and using rhythm to speaking slowly but fluently in phrases and sentences.  These exercises are very similar to teaching slow rate of speech for children with fluency disorders.  I have several different kinds of visuals (e.g. road with stop signs, different colored boxes in a strip, etc.) that I use to have the child (and myself) tap out (at a slow rate) carrier phrases and sentences...followed by typical conversation.
  • If my student is doing it, so am I!  This is a rule I follow consistently because I am ALWAYS modeling and cuing.  So it only makes sense that if my student is using over exaggeration, rhythm or tapping...then so am I!

3.  "Listen to myself": The last step is teaching the child to self monitor his own speech rate at word, phrase, sentence, reading (if a reader) than conversation level.  I want to train the student to "listen to myself" where he provides feedback about his own speech rate throughout the session. This includes:
  • Using verbal cues
  • Using visual cues
  • Paying attention to listeners cues
I explore the topic of teaching self monitoring for speech rate more fully in this  post.  Check it out!


Once the child can correct speech rate after my verbal/visual cues to slow down (~70% or greater), I move into focusing on misarticulations.  I keep those visual cues around to sustain use of slow speech rate but I move my main focus on to sound production.

That's it!  3 steps (with a whole lot of mini-steps included) to make a slow speech rate a habit!

Thanks again for the post topic suggestion.  As always...Happy Talking!

Friday, February 15, 2013

FREEBIE Friday: President's Day Game!

What shall I do for President's Day?  I thought of this simple game for one of my older clients who may not know these presidents but it's certainly worth exposing him to.  In this little packet is a game board and 6 Presidential Facts cards.  I tried to pick past presidents that I thought or hoped my client may have heard of, but feel free to make whatever fact cards are appropriate for your students or in accordance to their CCS.

Grab your freebie here!

Tuesday, February 12, 2013

Tip Tuesday has moved to Wacky Wednesday and Therapy Thursday this week!!!!

I know today is Tip Tuesday and I promised a tips blog every week.  Well actually Tip Tuesday has turned into Wacky Wednesday and Therapy Thursday this week which means you get TWO tip blogs (and freebies of course)!

My first tip post will be on Hodson's Cycles Approach, what is it, how to implement it, and of course a freebie I made for one of my kiddos on the primary patterns he is struggling with!  You can find this post on Let's Talk Speech-Language Pathology.  But here's a little preview:  

This post is up and running so if you want to learn more about secondary patterns and how to implement the cycles approach click here and let me know what you think!

Ok for the special announcement I promised yesterday....(drum roll please)...

ASHAsphere Guest Blogger...this Thursday will be the 1st installment of my new monthly column in ASHAsphere called Kid Confidential.  Every month we will talk about a new topic focusing on speech, language and child development.  The article is now up and running so head on over to ASHAsphere and check out my new column.  Don't forget to comment!  Never be afraid to share your thoughts, ideas, experiences so we all can become better therapists!

Do you have a topic you want to discuss on ASHAsphere's Kid Confidential?  Let me know!  Comment below or on my ASHAsphere blog and you may just see your topic in an upcoming article.

Thanks for your support and as always...happy talking!!!!

Sunday, February 10, 2013

FREEBIE: Tic-Tac-Love!

I really wanted to use those candy hearts for St. Valentine's Day so I thought, why not make a game of Tic-Tac-Love and use the hearts as my "Xs" and "Os"?  So that is what we are going to do.  Each child will have their own color hearts and I'll have mine.

I think to add some movement for my PK kiddos, I'll be printing out a second copy of one of these pages and use them as my Tic-Tac-Love cards, throw them all over the floor (face down of course), and have my kids take turns throwing bean bags on them to "choose" their picture.  Makes it a bit more exciting to leave winning up to chance.  Don't you think?

There are four different Tic-Tac-Love sheets so you can use them for group therapy sessions as well.  You could pair up 2 kids per card.

It can be used as a vocabulary game or a reinforcement game.

Parents wanting to use this game: practice your child's speech and language homework/pictures, etc. and after a few trials, have you and your child choose a card and place a chip or candy heart on the picture chosen.  OR just play like regular tic-tac-toe. Whomever gets 3 in a row in wins!!!

Teachers you can use this as a whole class activity, pairing kids up or as a center.  Its up to you.

How do you plan on using this game?

Grab your freebie here!

Happy St. Valentine's Day and Happy Talking!


Freebie: Building Syllable Hearts! Targeting /P/ and /B/!

I have another St. Valentine's Day activity for my kiddos who are working on bilabials!  For my readers, this is a perfect articulation and phonological awareness task.  For my non-readers I plan to "write out" the words, letter by letter, as I sound them out after the child labels the picture to show them the connection between sounds (phonemes) and their letters (graphemes).  

Oh and I think I'll be giving out some valentine candy hearts for each word said correctly!!!! YUMMY!

Want your FREE copy?  Grab it here!  

How do you plan to us this activity?  Comment below!

Friday, February 8, 2013

Freebie Friday: Heart Puzzle Word Association Game!

In therapy, we are talking about how two things are similar and different.  So I made this simple word association game and put the pictures on heart puzzle pieces.  As you know by now, whatever I make for my kiddos you get to have as well.   

So grab your FREEBIE here!

In this activity there are two sheets of 9 heart puzzle word associations and one page of blanks so you can make your own!

Just cut laminate and have your students match up the two pictures that "go together" and explain why.  Some of these associations are more complex or out of the ordinary than others just to increase the complexity and to encourage my kiddos to "think outside the box".

I'm excited to use these, I hope you like them too!

Second freebie below:
I don't think I ever told you this, but my son and I volunteer at a local assisted living on the dementia unit and I make cognitive therapy activities from time to time.  I made the below activity for them.  I know some of you SLPs out there also moonlight with adult patients so I thought I'd add this FREEBIE just for you.  If these types of activities are something you would like to see more of, let me know.  I don't know if this type of activity is something you could us or not so I need your feedback.

This activity is a Famous Couple Heart Puzzle Match Up.  Download, print, cut and have your clients match up which pair of famous people go together!

Grab this freebie here!

Happy Talking!

Tuesday, February 5, 2013

Tip Tuesday: Articulation Tip: Reducing Use of Habitualized Misproductions!

I have recently read some posts about SLPs and parents who are struggling with their children's habitualized the use of misarticulations for various commonly used words.  I thought I'd just share what has worked for me in the past.  I use these techniques for ALL disorders relating to articulation deficits (including but not limited to apraxia, dysarthria, use of phonological processes, articulation disorders of varying severity etc.).  

3 Simple Steps to Reducing Habitualized Use of Misproductions!

1.  Segment, Segment, Segment:  The first thing I do is have the child segment the target sound in syllables or words (depending on child's ability to imitate and segment).  Why segment?  The purpose is to REPLACE the use of ingrained misarticulated sound with CONSCIOUS production of correct sound in order to train the child's brain to sequence the correct sounds together for target words.  Segmenting means to produce the target sound separately from rest of syllable or word.  For example, if I am working on initial /s/ in the word "sock" I will have the child imitate "s" after me first, pause, then imitate "ock" ("s" pause "ock").  I use hand and other placement cues, models and a mirror to achieve successful production.  We would practice this until the child no longer needed my model for EVERY trial (this usually occurs very quickly, within the first 2-3 trials).  Once the child can do this, we move to step 2.

2.  Repeat, Repeat, Repeat:  Once the child can segment words with only one of my models, I quickly begin to have them repeat the segmented production 5-10 times in a row.  I usually begin with 5xs in a row for young children (PK kiddos), and 10xs in a row for older children.  For severely apraxic or dysarthric children, 5 repetitions may be too many...then I reduce to 3 repetitions initially and move up to 10 repetitions for these kiddos.  I explain to ALL children the rationale for repetition.  "We are teaching our brain, how to say this word the right way.  Just like we exercise our muscles we need to exercise our brain over and over so our brain learns how to say these words."  I then send a few words the child can segment and repeat home to parents for practice in front of a mirror.  Once the child can segment these words independently I immediately move to step 3.

3.  Fluent production in words:  It usually takes a week or two of daily home practice for a child to be able to exhibit repeated segmented production of ingrained words successfully without relying on me for additional assistance.  Once this happens I begin to have the child move into fluent word production.  If the child resorts back to ingrained misproductions I (of course continue use of hand and placement cues and mirror as needed) move to simultaneous production of fluent word.  Simultaneous production means I sit side by side with the child both of us looking in the mirror, using our cues, and producing elongated form of target word.  By elongating the sounds in the word and using continuous voicing, the child is not able to add misarticulated sound in target word. We do this with my rules of repetition (5-10xs) then move to child's own fluent production of words.  Once the child can do this at word level, we begin to practice at more complex levels (phrases, sentences, reading, conversation).

That's it...three simple steps to reduce habitualized use of misarticulations.  Happy Talking!

Friday, February 1, 2013

Freebie Friday: Football Frenzy

My first official Freebie Friday is featuring Football Frenzy! A WH ? Activity  from Brea at Let's Talk Speech-Language Pathology!

This freebie was posted around this time last year, but most of us didn't know back then how great the materials are over at Let's Talk Speech-Language Pathology and we missed out.  Well not anymore!

As this Sunday is Super Bowl Sunday, Brea is allowing us all to take advantage of this FREEBIE once again!  And she's made a few changes, so if you have downloaded this in the past, you may want to do so again to get the updated version.  Check out Football Frenzy below!

 Click here to download this freebie!

If you would like one of your freebie's to be featured here on a Freebie Friday, contact me at

Enjoy and happy talking!

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