Tuesday, July 15, 2014

Not for the weak of heart-More super simple games for the busy SLP.

I'm always looking for quick and motivating activities to use during articulation drill sessions.  I couldn't believe we did the first one but it was really funny for the client with whom I was working.  I kept trying to move on, and they kept asking for more cards.  That's like the best isn't it?  When kids want to keep doing their drill activities-at least when they are accurately saying the sounds.  Do you ever get the client who LOVES to drill but can't say the sound right?  Each time they just keep plugging away saying 20 times incorrectly (Listen to this:  tat, tat, tat, tat, tat.) Inside I just want to scream NOOOOOOOOOO  stop saying it that way.  Instead I use a melodramatic break up routine-"Shhh.." I say gently as I put my finger on their lips.  "No talking."  

Here are four motivating activities to use during the summer-some of which I admit are not for the weak of heart.


1.  Articulation T Ball.  Minnesota is hosting the All Star game this year so we are capitalizing on the excitement with our own version of Arctic T-ball. One of my coworkers had an awesome idea for bringing in a T ball set to play with.   I snagged my son's old T ball set when he wasn't looking and brought it into work.  Most of my materials at work are ones I snagged when he wasn't looking.  I put cards at each base.  We start at the first and they have to say 50 words before they can run to first base.  We continue at each base.  By the time they've scored their "homer" they've practiced their sound 200 times correctly.  Woo hoo!

2.  EET T Ball.  I love Sara Smith's Expanding Expression Tool.  Instead of bases we use the EET steppers.  Before I "pitch" I hold up a picture that they need to describe.  They hit the ball and start defining the words.  I pick 4 that I want to work on.  The student runs to the base and if they are able to give an example using a full sentence they can move on to the next base."  For example, The ball that I am going to pitch is "apple".  You could tape a picture of an apple to the ball but I just hold up the picture.  
The student runs to first base An apple is a fruit.
Second base:  You can peel an apple.
Third base: It is red, and round.  
Home plate:  An apple has seeds and a stem.  

HOME RUN!  

3.  Step on it:  I played this game with a little one.  The child was working on CVCV shapes and I pulled out a few cards to practice with in between some toys.  I had the child step on it and then I made a raspberry noise.  The we both giggled.  My professional term is raspberry noise-the child probably thought it was toots.  And they thought it was hysterical.  So much so that I couldn't go back to any toy activities.  My client just kept requesting "more cards".

4.  Food or not Food:  This is another quick play game.  Just grab an articulation card deck.  I usually play this when I am working on carrier phrases.  I have my client say, "Eat ______."  or "Don't eat ______."  I make sound effects based on what they chose.  For example, if they tell me "Eat cake," I make some eating noises and say "Mmmmm."  If they say "Eat coat," I start to eat it and then make some wretching noises.  For some kids, we work on saying, "I eat _____."  I usually act VERY surprise if they eat non edible items.

What silly games do you use in therapy to address drill types of activities?  I'd love to hear about them below.  If you thought this post was helpful, please consider sharing it with others on Facebook or Twitter by clicking on the buttons below.

Sunday, June 29, 2014

Thrifty Finds {linky party}

I think getting a good deal can be addicting. I'll admit to having bought a thing or two primarily because it was such a good deal rather than because I had a need for it. The only thing better than getting a good deal is sharing with other people.  That may be a Midwest thing, we love to share what we paid for things.  "See this shirt?  Yah, I got it for 5.00 on super clearance over at the TJ Maxx." Or it might just be me.    Anyhow, I was excited to see that Jenna at Speech Room News was hosting a thrifty find linky party.  I love to see what other people have picked up too and am always excited to share what I found.


1.  Toss Across
I was stalking this game for months after I'd read an awesome post from the Activity Tailor on how you could adapt the game to add picture cards on it.  I think it took me about 6 months, but I was finally able to find it at one of the Goodwill locations by my house. 

2.  Snap Circuits












This cost about 80.00 retail and I was able to pick it up for about 5.00.  I use it in social skills groups to provide an activity to focus on while practicing conversational skills.  It's also good to use as a motivator as you can give out pieces throughout the session.  You snap the circuits into place using the diagram and can create a bunch of different reactions including turning on a light, a fan and/or playing music.  I kind of want to take it home and just do it myself. 

3.  Flamingo Bingo and Lotto

I don't know why this was at the Goodwill for 1.99 but it was so I snatched it up.  I sometimes drive miles out of my way to shop at this particular Goodwill.  I've found some cute games but no other SLP games.

4.  Cranium Bumparena











I had this game at my first clinic but had forgotten about it until I saw that Jenna had written about it on her blog.  I remembered how fun it was.  Luckily for me, I found it not too long after that at a garage sale. 

What thrifty finds have you snatched up?  I'd love to hear about it.  Head over to The Speech Room News to link up your favorites!  

Monday, June 16, 2014

Super Simple Articulation Hacks for the Busy SLP

Is anyone else working this summer?  Being in a clinic and schools means that I work year round. Usually I'm super energized by the sun and thoughts of summer activities but this year we had a late Spring (our strawberry fields haven't even come in yet).  I'm coming off a rainy weekend, which makes me feel even more tired.  My to do list is getting longer as I ignore it in favor of my "to couch" list.  
I originally entitled this post as a lazy speech therapy post-but received valuable feedback from some readers.  One of them drew my attention to recent article published online.   Have you read the Wall Street Journal online article which calls our field notoriously sleepy and low tech?  It's frustrating.  While my "lazy speech therapy posts" were written tongue in cheek, I also don't want to contribute to any public misconceptions that we are sleepy or lazy (with the exception of how sleepy we are after completing 200 IEPs our apparently as sleepy as I am this summer).  So I'm retitling this post to read, "Super Simple Articulation Card Hacks for the Busy SLP."  I keep seeing this "hack" thing come up in Social Media posts.  From what I can tell it just means tips.  But I'm probably missing something really important in the shades of meaning of this new term.  Feel free to laugh quietly to yourself about this old Speech language pathologist's attempts to use those words the young kids are saying.  

Here are 2 games that I played this week which allow you to get a large number of repetitions in a short period of time using a very minimal amount of your valuable prep time.  

My Cards/Your Cards:  
This is a great activity to practice phrase level productions.  

1. Grab a deck of articulation cards.
2. Explain rules: "You can tell me who gets which card by saying 'My ______ ' or 'Your _______.'Whoever has the most cards at the end of the deck wins. 
3. Act increasingly outraged as the child continues to say "My ________."

Switcheroo:
The perfect game if your articulation cards are messy and out of order.  

1. Grab a deck of articulation cards.
2. Explain rules: "I'm going to turn over a card and you have to say it.  If the card is facing the wrong way, say '________ is turned around.  Time to switcheroo.' "  
3. Switch chairs with the client.  This game is more fun if you have a different chair then the child.   I like to complain about how small their chair is and how it is giving me back pain. Sometimes I beg them to give me my comfortable chair back.  

What "lazy" games do you use in therapy?  I'd love to hear your suggestions below.  You can also contact me on Twitter @speech2you, #lazyspeechtherapy

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Thursday, June 12, 2014

BUILDING effective communicators: the one who makes you play Mad Libs®

The one who makes you play Mad Libs®:  

This is the client who really struggles with vocabulary.  Their stories are difficult to understand because they are using the wrong vocabulary OR because they are using too many non specific words.  "So then I told him that I wasn't going to be okay with him being like that and stuff and he said he was going to be there and I told him that I don't care if he gets that thing he is not going to be my friend. "  The lack of specific nouns and details makes it difficult to understand and it feels like you are always filling in the blanks.  I feel like these children have difficulty with word retrieval or general vocabulary deficits.

Vocabulary Deficits:
These children benefit from specific vocabulary instruction.  I've mentioned this before, but I really like the suggestions in the book, Bringing Words to Life: Robust Vocabulary Instruction by Isabel Beck, Margaret McKeown, and Linda Kucan.  Jenn at Crazy, Speech World wrote a great post awhile back about this book if you missed it. This would be a really great method to use if you were pushing in to the classroom!

In addition, I will sometimes focus on teaching vocabulary "strategies."  Depending on the age of the client, we will work on synonyms, antonyms, categorization, prefixes/suffixes and multiple meaning words.  Semantic mapping tools such as the Expanding Expression Toolkit (EET) by Sara Smith are very helpful in providing a framework for my clients to think about how to define or talk about vocabulary words.

Word Retrieval Deficits: 
I often see these clients use non specific vocabulary or sometimes they will pull out an incorrect word.  Dianne German has tools to assess what types of word finding deficits students or adults have and specific interventions or strategies to teach students based on their error patterns.  She has several online classes available that I think I am going to try to take this summer.

In therapy, we may work on categorization activities including rapid automatic naming activities.   I may put out 4-5 objects (super heroes are fun) and practice pointing at each one to see if the child can continue to name them at a faster pace.  We use cues like providing same sound cues or visualizing words to help with word recall.  I also work a lot on synonyms and antonyms as a strategy for describing words that they are not able to retrieve.  We spend time learning how to describe words too if they need to talk around a word.  

Teaching self monitoring can be challenging because the speech is intangible.  The child says something and then it disappears.   I can tell them that they were not specific but sometimes they don't believe me.  I use writing a lot with these clients because it provides a concrete visual for us to work with.  Software programs such as Dragon Naturally Speaking or voice memo apps can be motivating to use in therapy and make it easy to visually see what we are saying.

Here's how I use it:
1.  I start by having my client tell me a story or how to do a specific task.   I use the Dragon Speaking app.  This is more difficult to use if you have a student or client who has articulation errors.  I sometimes use that with those students to show them how other people perceive their speech if we are having a hard time monitoring.  
2.  We print the transcript.
3.  I have a four colored pen that we use.  We go through and edit.  I might use red to mark non specific words and green for grammatical errors.  We talk about what would be better choices to make it more understandable.
4.  Once we are both satisfied, we re-record what they wanted to say.  Then I can email the recording or play the recording to the parent at the end of the session.

What strategies do you use to work on word retrieval or vocabulary deficits?  I'd love to hear your thoughts below.  Check back next week for some of my favorite materials and apps to use when you are working on personal narratives.  

Tuesday, June 10, 2014

Research Tuesday: Personal Narratives and Adults with Autism Spectrum Disorders

I'm finally joining up for Research Tuesday.   You can head over to Gray Matter Therapy on Thursday to find out what other speech bloggers have been writing about.  This is a great way to stay up on research based interventions without having to spend your time scouring through a variety of different publications.

Since I have been focusing on personal narratives this month, I was interested to see what research was out there related to personal narratives and Autism Spectrum Disorders.  My experience has been that these skills are very difficult for my clients.  I was excited to find an article that looked at both storybook narrative skills and personal event narrative skills.
You can read the whole article HERE.  

What did they do?
This research study looked at storybook narratives and personal event narratives of 10 high-functioning young adults with ASD.  A trained research assistant elicited three personal event narratives and one storybook narrative.  Sessions were video taped and transcribed at a later date.  The adults most complex personal event narrative was used for scoring purposes.  Each narrative was assessed using the Narrative Scoring Scheme (NSS).  The NSS was chosen to provide information on narrative macrostructure (overall organization of the narrative) and cohesiveness.

What did they find out?  
The adult's storybook narratives were rated higher by the NSS than their personal experience narratives.  These results were statistically significant and thought to be easily noticed by the listener. The authors also noted that the adult's ability to use mental state words were decreased within the personal event narratives.  They noted, "That is many high-functioning adults with ASD had minimal skill in describing how they felt about events in their lives and reaching conclusions about those events, even though they were proficient at these same skills when retelling a fictitious story."

What does it mean?   
I found this study fascinating.  It reinforces my thoughts on the importance of teaching personal narratives to my students and clients.

I think it would be interesting to do a similar study with younger elementary school students to see if the same differences exist.  It would provide some insight into whether these skills are innate or if the student's learn how to retell a story based on their academic instruction.  We focus on literacy, summarizing, predicting and inferencing in our reading instruction programs.  Is that what is making a difference in their success with story retelling?  If that is the case, then we could incorporate similar strategies when teaching personal narrative skills.

Reference:
Pamela Rosenthal Rollins (2014)
Narrative Skills in Young Adults With High-Functioning Autism Spectrum Disorders
Communication Disorders Quarterly

Monday, June 9, 2014

BUILDING effective communicators: the one who requires a flow chart to comprehend:

The one who requires a flow chart to comprehend:  


This client  is able to share different information but doesn't know how to sequence it.  They start in the middle of the story and jump around trying to give me all of the information.  I have to ask more questions to figure out what they are trying to tell me.  If I ask them how their weekend was they may something like, "I spilled the popcorn but it was okay because everything was awesome and Professor business is a super bad guy but then he was okay."

Poor Sequencing abilities:  These students may have difficulty with sequencing the order of events or activities.  I usually start by working on simple 3-4 step crafts or recipes.  We can write each step down and then put the cards in order at the end of the activity.  We also practice sequencing cards of familiar daily activities.  We spend a lot of time working on time concepts such as before/after and first/then.  As they improve, we start to work on story recall.

Poor Time Conceptualization:  I think these clients also struggle with time concepts.  We work on sorting time concepts (ex. which one is longer one day or one month) and identifying time concepts on calendars.   (Which day is yesterday, find a month, where is next month etc.)  We write our therapy activities or big events (school field trips, birthdays) on our shared calendar so we can talk about what has happened and what will happen.

Difficulty Self Monitoring:  This client may not be attending to whether his or her listener is understanding what they are saying.  We work on recording ourselves and listening to see if what we said makes sense.  Did we start at the beginning and continue through until the end?

No Internal map for how to retell a story:  This client benefits from graphic organizers and structured practice on how to retell a story.  We might start with very simple narratives that include where you were, who was there and what you did.  As they become more successful with providing the basic information, we start to expand to include other details or more complex sentence structures.

What activities do you use to work with students with sequencing problems?  I'd love to hear about it below!   Tomorrow I am linking up with Gray Matter Speech Therapy for my first Research Tuesday Post.  On Thursday, I have the last in this series:  the one who makes you play Mad Libs®.

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Thursday, June 5, 2014

BUILDING effective communicators: The one who gives a monologue

The one who gives a monologue:  


This client has the opposite problem of the one who needs to be interrogated.  If I ask anything about their weekend they start at 4 pm on Friday and give me a blow by blow account of every single thing they did.  "I got on the bus and I sat with Tommy and we talked about how I didn't think we should have homework over the weekend and he agreed and we both said homework is stupid and then I got home and I was hungry so I had a snack so I walked up 10 steps to the kitchen and I saw that my sister was there and I told her that she needed to get out so I could have my snack and play mine craft with my online friends because we all love mine craft and......"  If I let them, they would probably keep talking until the end of the session.  These are usually my clients who tend to have very specialized interests (Minecraft, Lego's, Star Wars, Trains, the inside workings of air conditioners...)  They can usually speak at length on their preferred topics.

Here are some of the challenges these clients face and a few activities to address them.

Limited Perspective Taking Skills:  These clients also need to work on perspective taking.  They have a hard time choosing what information needs to be shared and what information can be inferred.  For them, we focus on shared knowledge.  We use visuals to talk about what shared interests or knowledge they have with their peers/teachers.  This can help them start to think about what and how much information they would need to share with different people.

Poor Turn Taking Skills:  We spend a lot of time talking about how we take turns within conversations.  We practice taking turns sharing 1-2 sentences worth of information.  Sometimes I use a balance scale and pom poms to help them visually see how many turns they are taking.  We may work on throwing a ball back and forth as we are talking.  This is another quick way to visually reinforce the idea that conversations are a series of turns.

Poor comprehension of main ideas vs. details: I find that a lot of these clients tend to focus more on the details vs. understanding the main idea of what they are trying to say.  Some of these clients seem to focus on the "irrelevant" details-for instance the client who perseverates on the FBI warning before a movie.  We work on identifying main ideas vs. details and discuss the importance of sharing our "main idea" with our listeners.

Summarizing deficits:  Once we are able to identify main ideas vs. details, we start working on summarizing.  We might have conversational rules that we can share a story or information but we want to start with the main idea and then we can share (only) 2-3 fun facts about our topic/interest area.  It's fun to use movie trailers to address summarizing.  Watch the trailer and have them restate it in 1-2 sentences.  (I think this is an action movie that is about fighting in outer space.)

Do you have great strategies or activities to use with students who share TOO much information? Share your stories and successes below.  Check back next Monday to read about the one who you need to a flow chart to understand.

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