Monday, April 28, 2014

Stepping up to the challenge of Challenging behaviors and surviving to live another day

I would say at least 50% or more of my caseload has exhibited challenging behaviors for the last 16 years that I've been practicing.  Hitting, throwing, spitting, biting, work refusals, crying, refusing to leave etc.  Today I'm going to talk mostly about individual sessions.  At school settings when I have one student who is more difficult, I use different strategies.  When I can, I try to set up individual sessions with them to start and then work them back up to a group.  

When I have a child that is not complying in therapy, I ALWAYS start by looking at their activities.  Is the activity the just right challenge for the child?  Have I used motivating materials to engage them?  Have I explained what the expectations in a way that they understand?  Have I established rapport with them?  I find that taking the time to gain their trust makes a huge difference in how I can manage their behaviors.  I've talked before about therapists who say "THEY need to change-or not everything is fun or THEY need to learn how to do this work because they are in 4th grade."  I don't disagree that they need to learn how to follow the rules to be successful in society.  But I don't know that I've ever seen a case where the therapist has just put their foot down-and the kid has started complying and learning.  Here are a few tips:

We statements:  I encourage my clients to think of us as a "group."  We can work on this today.  We are friends.  Friends like to say nice things to each other.

Use humor:  For some children, I can diffuse a situation much more quickly by using humor than insisting that they make restitution (example, stopping therapy until a child to pick up the materials after they have thrown them.)  Once they are calm, we go back to clean up.  But if they are agitated, it's not a good time to try to get them to comply with anything.  (and it's wasting valuable therapy time.)

Use "You can" vs. "Will you" statements.  I learned this technique in Toomey's SOS feeding course.  It's really hard to remember.  But it's helpful not to ask something that's not a choice.

Offer choices whenever possible.

Utilize schedules and duration maps to give information about what they need to do and how long they need to do it.  (Check back later this week for some more information on schedules and maps!)

Offer empathy.  Instead of setting behavioral expectations when a child is getting aggressive, try giving them the words to express how they feel.  "You feel mad.  Your face is red and your fists are clenched.  You really wanted to win that game.  It is no fun to lose games."  Once the student is calm-probably on a different day, revisit the situation using social role plays or social autopsies.

Be Proactive.  Focus your energy on stopping the behaviors before they start vs. giving consequences to the behaviors.  Have you ever had an eye opening moment in therapy?  I posted this story last year but wanted to share it again because I found it to be so helpful to me.

About a week before my wedding, he bolted out the front door of the clinic in to a busy parking lot.  I ran after him SO worried that he would be injured or hit by a car.  He ended up falling on the sidewalk.  My adrenaline was so high that I couldn't stop.  I JUMPED over him, lost my balance and face planted on the asphalt.  I scraped my face up and one side of my body.  I made that horrible noise when all of the air leaves your body at once.  It was so loud that the front desk staff came running out.  It probably sounded like I had gotten hit by a car.  A woman in a walker was leaving from a physical therapy appointment and said, "Oh my goodness, are you okay?"  My little runner was getting up at this time.  "GET HIM!" I croaked out, lying on the ground.  When you start asking people in walkers to corral your clients, you know you need to start thinking about some new techniques.  The story ended "happily." I was able to get my client, most of the scrapes and bruises had disappeared before my wedding.  And my coworkers were not that upset by my hysterical crying that day.  

I understood the functions of behaviors-or I thought I did.  I made up plans, had consistent consequences, avoided (with the exception of my running leap) excessive attention to the behavior.  I spoke with the family, consulted with occupational therapy and suggested a behavior therapist. There was a 6-12 month wait to see a behavior therapist.  I watched Super nanny episodes.  I made sure that consequences were clear at the beginning of the session so there were no surprises.  I had sticker charts and schedules at the ready.  The behavior didn't change.

Every time we would walk back to a therapy room, he would run to the kitchen to get a snack.  I'd say, "No." and we'd end up in a time out.  I'd have to carry him back to the room kicking, screaming, and pinching.  We didn't get much speech therapy done.

Then one day, as we were walking down the hallway, I stopped right before he usually ran away.  I looked at him and said, "Tell me I want snack."  He did.  We went to the kitchen, got a snack and then went to the therapy room and had a fantastic session.

For him, I needed to provide an alternative COMMUNICATION behavior prior to his maladaptive behavior.  The consequences weren't working for me because it wasn't helping him to get his needs

Here are a couple of things I learned that day:
1.  Preventing a behavior rather than providing consequences works really well when you only have 30-60 minutes to work with a child.
2.  Constantly repeating strategies that aren't working is a useless exercises.  The strategies need to change.
3.  As the adult, I'm the one that has to change my behavior in order for the child to adjust theirs.
4.  I'd still refer to a behavior therapist any time I can.  They are the experts in this

Sunday, April 27, 2014

Love It AND list It {Linky party}

Thank you to Jenna from The Speech Room News for hosting another awesome Love It and List It.  This month's topic is behavior management.  What a great topic-especially when students get so squirrely at the end of the year.  I always start by making sure that my activities are fun and motivating.   Because I work with many individuals with multiple impariments, I use a lot of visuals to give information during out sessions.

Here are some of my favorite resources for visuals to work on behavior management:
1.  5 Point Scale: by Kari Dunn Buron and Mitzi Curtis:  I have made up blank templates of these in each of my therapy rooms-so versatile-you can use this for almost anything.  I use this a lot to work with kids on voice volume.
2. The New Social Story Book by Carol Gray.  Do you ever get tired of people asking you to write social stories?  This book has a great introduction which explains how to write social stories.  When I am in the clinic-we talk about the steps and I train the parents on how to write their own Social Stories.  They can personalize and hopefully feel comfortable enough that they can make them up on the fly as needed.
3.  Sandbox Learning:  Customized social stories online.  This is great for busy therapists or busy families.  There is a lot of flexibility with these stories.  You can customize the characters to look like the student with whom you are working.  You can add personal information to tailor the story to them.  Each story costs around 9.00 but you have unlimited access to the story for one year.  So if you have 10 kids who need to work on waiting, it ends up being fairly cost effective.  They offer a free sample story on their website.
4.  Time Timer  I love time timers for giving a visual representation of time to my students.  I try to get the ones that hang on the wall and beep because they are easily destroyed.  They also have an app now which is great too.

5.  Lesson Pix  I joined Lesson Pix this year.  It's an online resource which allows you to create your own visuals.  There are a variety of options for visual schedules, first/then boards and token boards.  Plus the website is inexpensive which makes it easier for therapists on a budget to afford.  I do have Boardmaker at work.  Lesson Pix is very similar but with more options for templates and clearer pictures.  It's convenient for me to use at home if I need to make up a visual for a client while I am watching Game of Thrones.

I'm excited to read everyone's ideas!  To join the linky party OR to just see all of the other awesome resources, head over to OR click on the button below.

Friday, April 25, 2014

Autism: Zeroing in on WHAT to teach.

I've been working with children on the Autism spectrum for the last 16 or so years.   I've noticed more consistently in my state (Minnesota) that these students are not always being serviced by the Speech Language Pathologist.  I've heard some colleagues mention that these students need services from an Autism specialist or that they need ABA services and that speech therapy can do nothing to help them.  Some of this is an issue of caseload sizes-I get it.  It just makes me sad when the answer to caseload sizes is to stop servicing students instead of hiring more speech language pathologists.  That's a complex issue related to funding which would I could probably write about at length-some other day perhaps.  It's probably just because I love working with this population so much that I get concerned.  

Communication is the tool by which we relate as human beings.  I'm a story teller by nature, but if you observe others in conversation-most of it is sharing stories or experiences.  We bond over past experiences (Remember that time when you got locked in a dumpster?  Wasn't that hilarious?)

I want these clients to be able to request but also to be able to stay in a back and forth interaction.  I want them to be able to tell their parents what they did at school and how they felt about it.  I want them to learn how to share a memory with another person.  I want them to be able to tell a joke and giggle with their friends.  I want them to have at least one friend.  I don't always get there but that's my end goal for them.

Here's a secret of mine: I don't really care if these clients learn how to use an embedded clause or communicate using the appropriate verb tense forms.    I want to focus more on pragmatics than on form with them.  Okay, I said it-please don't take away my ASHA card.

Instead I try to work with parents to focus on building up foundational skills such as Joint Attention and turn taking.  This brings me to a produce I purchased from Maria at  Communication Station: Speech Therapy  "Beyond Eye Contact: Connecting with the Young Pre-Verbal Child with ASD."

She has created an extensive, 47 page power point presentation that discusses how you can establish and increase joint attention for children on the autism spectrum through play.   

This is a must read for clinicians who are new to the field who are working with children on the Spectrum.  It is a great refresher for more experienced therapists.  

These types of power points are focused on teaching the person reading the slides (vs. being presentation ready).  Each slide was filled with useful information.  

The presentation is teaches you how to connect with children on the Autism Spectrum using the following steps:  
  • Observation of the Child:  Provides specific information for what to look for as well as what objects and toys to use during your observation.  
  • Accommodating for Sensory Needs:   This section provides basic information related to what sensory needs you should assess during your observation.  Additional power points are available to provide more detailed information related to sensory processing.  
  • Following the Child:  Learn how paying attention and valuing the child's interests can help you connect.
  • Using High Emotions: Discusses the importance of exaggerated emotions as well as some activity ideas. 
  • Bringing the Child Into Your World.  
She also includes information on eye contact, verbal imitation and strategies to use when the above techniques don't work.  I really appreciated getting the charts on play development and ASD observation checklist that were included at the end of the presentation.  

Here's the best part:  She has offered Speech2U readers a discount coupon through this weekend.  Simply head over to her website: Communication Speech and you can purchase Beyond Eye Contact: Connecting with the Young Pre-Verbal child with ASD for 50% off her usual price of 19.99.  Just enter the code: Speech2u50 at checkout.   This offer is valid through 4/27/14.   

Sunday, April 20, 2014

Finding your TPT niche {linky party}

I'm excited to be linking up to Teach Speech 365's "Finding your TPT niche" linky party.   I am a big fan of the origin movies for comic books (sorry-I'm a nerd who married a nerd) and this linky party is an opportunity for us to share our "origin" stories.

I was a TPT and Teacher's Notebook shopper for about 6 months before I opened my own store.  Jenna from Speech Room News had a blog posting about how she made her own therapy materials.  I'm not sure if this is the exact entry I read-but it gives some great information regardless.   Speech Room News custom therapy materials.  Can I just take a minute to talk about how awesome she was to post this tutorial?  First she started by providing awesome free resources for year and then starting selling some of her products.  She didn't have to share how she created them but she did-and I think a lot of the SLP's on TPT saw the same post.   Here's what I thought when I read first her post-"Wow.  That seems pretty cool but I'm not creative enough to come up with my own materials.  But I sure appreciate people who can create their own products."

A lot of my life has been a series of "surprise accidents."  For instance, I only became a Speech Language Pathologist when I misread the code during our aptitude testing.  I HAD wanted to go into speech communications and work in marketing.  But when the college brochures started coming describing Speech Language Pathology programs, I thought that it would be worth checking out.  My brother qualified for speech and language services for most of his schooling and I'd always loved children.  It must have been fate.  Some of the "surprise accidents" I encouraged.  I spent a whole year making dating decisions based on a Magic 8 ball.  (Should I go out on another date?  Signs point to no.) 

Joining TPT was another "surprise accident"-although not really a happy one.  I worked on my first product: Alien's Multiple Meanings when I was in Arizona for my dad's second funeral.

It was about 6 months after he had died-but I couldn't sleep so I decided to try signing up for TPT and making a product.  My first 6 months of products were probably brought on by my insomnia.  This is weird-but it was soothing for me to just sit and create products-focusing on making sure the pictures and words lined up correctly.

I think it took a little longer to find my niche.  One of the things that I love about TPT is that it has made me more creative-and it's opened up doors for me to be a more inventive therapist.  If a client or student isn't making progress, I can come up with a new product to motivate or help teach them in a different way.  Here are a few of my "niche" products.

Interactive Flashcards are products that I made to try to teach skills to children on the Autism Spectrum or other students with developmental disabilities.  I wanted to make things more visual-while giving them an opportunity to physically manipulate the pictures.

WH Question and conversation starters are a fun way to address articulation carryover or to check on generalization of wh-questions using holidays and seasons.

Flip Flap books are a fun way to create a project within a therapy session or to add a little bit of movement to activities.

Finally, I'm really excited about my newest set of products: Nothing Minimal about These Pairs.  I'd been trying to find some good resources for minimal pairs for about a year when I finally realized that I could just try to make something.  I really like the included activities as well as all of the visuals that are included.

I'd love to hear your story too!  You can click on the image below to link up with Teach Speech 365.

Thursday, April 17, 2014

Recycled Guest Posts: Teaching communication Alternatives to Challenging Behaviors in Young Children.

Shari was a 5 year old girl who just started therapy.  She wasn't producing any words, had minimal eye contact and cried during most of each session.  She really enjoyed ball slide types of toys but became upset when she wasn't allowed to control the entire interaction.  When the clinician touched the ball she cried, tried to throw the toys across the room or threw herself on the ground. 

Sometimes children like this will be described as "behavioral" or "having behaviors."  Behavior is Communication.  Everything that we do is a behavior.

If we label a child or student as "behavioral," it seems to indicate that the blame lies with them.  There is little for us to do or try, we can only provide consequences to the behaviors.  However, it is very rare that the child is capable or able to change without the adult changing their behavior first.  We adjust our expectations or how we are interacting with the child in order to affect change in them.

The first step is to look at our activity choices and consider our own interactive style.  Sometimes our expectations are too high or we may have chosen toys that are less than motivating.  In the case above, I ended up backing off from toys and really focusing on interactive "people" games such as Ring around the Rosy."  When we went back to object play, she was still having a really hard time with any back and forth turn taking.  It seemed like she had learned to use crying/yelling as her "turn" within our interactions.

In general, behavior can be broken up into four different functions:
  • Tangible 
  • Attention 
  • Escape 
  • Sensory
When you are considering trying to replace a behavior with a more socially appropriate communication choice, there are a few things to consider.  We need to make it as easy as possible for them to communicate.  Sign language may not be the best choice as you need to provide hand over hand assistance or the child may have motor delays.  I try to have pictures of the common ones we would teach and then have the child tap it in the earlier stages.  This is a simple motor movement that is easy for the child to complete.  When implementing these programs, it's really important to try to respond as soon as the child touches the picture.  Don't worry, you can work on compliance in a little bit, they only need to get these immediately when they are first learning them.    The Checklist of Communication Functions and Means Assessment is a great way to start looking at different communicative behaviors and how the child is attempting to communicate them.

This refers to behaviors which the child is using in order to try to get an object or do an activity that they want.  We want to teach the child to request the object.  In the example above, the child had learned to request by crying and throwing herself on the floor.  (at a greater frequency than a typical 2 year old.)  We started by breaking the behavior chain.  We started the ball slide activity by just giving her the balls when we played.  Once she understood that she could get the toys, we were able to increase the challenge.  Now, she needed to just touch the toy to get the ball.  Eventually we shaped this into pointing and then holding her hand out to receive the object.  

The function of this behavior is to gain the attention of someone.  Here's what can be tricky-children don't always differentiate between positive vs. negative attention.  When you think the child is trying to gain attention, you can work on teaching them to say things like "Look," "Hey," and calling people (ex. Mom/Dad)   Calling games and hide and seek can be really fun ways to work on gaining attention.  You can hide under a blanket and have the child call out for you.

The function of this behavior is to stop an activity.  I might start by looking at the activities, is it too difficult?  In terms of teaching communication alternatives, we could work on saying "help" or requesting a break.

A big concern of parents and professionals is that if we teach the child to request "all done" or "break" that they will use that all the time and never get any of their work done.  They will try this.  BUT remember, they were already requesting a break.  They were just doing it by throwing or hitting or screaming.  Once the child has had success and understands that they CAN request a break, then we can start to build in tolerance for activities.  For example, "Okay, you can have a break but first we need to finish one more turn.  Eventually you can increase to multiple turns before they can have their break.

Generally if the behavior doesn't fall into the other categories, it can be considered to be meeting some sensory need for the child.  Consultation with an Occupational therapist may be helpful in determining more socially appropriate activities to try to meet the sensory need.

When we know the function of the behavior, we can start to provide more socially acceptable communication alternatives.  Please note, maladaptive behaviors can be complex.  If you attempt a few of these interventions and do not find success, it may be helpful to contact a behavioral analyist to complete formalized assessment in this area.

Tuesday, April 15, 2014

Recycled Guest Posts: Wise Wallet Wednesdays: Don't Throw Away those Packing Materials.

Hi! I'm Kelly from Speech2u.blogspot. I'm really excited to be participating in the dabblingspeechie's Wise Wallet Wednesdays. I know I'm always looking for a way to stretch those budget dollars (when I have a budget, that is.)  If you are lucky enough to get a budget and get materials, I'm going to show you a few ways you can use your packing materials in therapy.

1.  Packing Peanuts:  I simultaneously love and hate packing peanuts.  They are SO much fun to play in and they are SO HARD to clean up.  You could probably design a fantastic common core aligned activity related to static electricity.

If you get a big box, you can throw your little ones in it and work on concepts  like: in, out, up, down and under.  I will take my box of vocabulary or articulation objects and hide them in the box.  We can work on naming while they take the objects out of the box.  Sometimes we work on blowing the styrofoam off of our hands or lay on our backs and see if we can blow the peanuts up in the air.  
If you are a crafty type, there are a ton of craft of Craft Ideas for using packing peanuts on Pinterest.  You can glue them onto a snowman or I love this sheep craft idea from Mommy Doodles:  

2.  Air Pillows:  Air pillows seem to be replacing the packing peanuts.  I think the warning labels say that these are not toys for children-but in the care of a responsible Speech Language Pathologist they can be a lot of fun.  

You can separate them and put them on the floor and have a blowing race from one end of the room to the other.  Adding a "card deck" or "worksheet" station at each end of the room prevents this from becoming a completely pointless activity.  Also, you don't want to do this with kids who spit when they blow.  It's more of them than you would think.  

I like to cut out pictures for articulation practice and then tape them on the bags.  We practice our sounds a certain number of times (like 10) and then they can try to jump or step on the bags to pop them.  You need to hold onto the kids hands when they do this because some of them are tricky to pop-and they are slippery.  No need for anyone to break a leg in speech therapy.  

And yes, I have a high heeled tape dispenser.

3.  Traditional Bubble Wrap.  This stuff can be addicting.  It's fun to just lay a big roll of it on the floor and have Pre-K kids walk across it to hear the "popping noises."  I also use this one with worksheets:  

This is a Super Easy one-Just place the Bubble wrap on top of the worksheet.  Students say a row of words and then pop the bubbles on that row.  

Sometimes I just place larger picture cards under the bubble wrap.  For this activity, we were practicing CV combinations-the client had to say the CV word the same number of times as the bubbles on the card.  This would work great with Super Duper cards as well.  

It's also a fun way to work on multiple choice questions by pinching the correct answer!  For this activity I used Teach Speech's  Who, What, where, and When Questions with Visuals product.

Those are a few of the ways that I have used packing materials in my therapy room.  Do you have other ideas for how to use packing materials?  I'd love to hear from you here: 

Or you can link up your own ideas on how you use packing materials on Instagram:

Monday, April 14, 2014

Recycled Guest Posts: Speech Snacks Feeding

This is a post that I did to celebrate Speech Snack's 2 year blogging anniversary!

About 10% of my caseload is feeding clients.  I don't blog a lot about feeding therapy techniques because I think that these kids really need services from a feeding team and trained professionals.

Suzanne Evans Morris is a FANTASTIC resource for feeding information papers and ideas.  I was lucky enough to go to one of her courses on transitioning children from G-tubes when I was in grad school.  One of my favorite papers of hers is on different food progressions for biting and chewing.

One of the techniques that I do use is grading my food choices based on how "easy" it is for my kiddoes to manage from an oral motor standpoint.  With my feeding clients, I tend to use single textured foods until we are closer to discharge.  For instance, I can alter the food's taste, consistency or size/shape in order to make the food more manageable for my clients.

One of my favorite consistencies to use in therapy is called a "meltable hard solid" This is a term used by Dr. Kay Toomey from the SOS Approach to Feeding.  A meltable hard solid is a dry food that becomes moist and is able to be swallowed with minimal effort.  Puffed corn is an example of a food that is easily managed and almost melts in your mouth.

Once they are able to manage that, I try to find foods that you can put in your mouth and chew 1-2 times but also maintain their shape-so that they don't get scattered all around the mouth (requiring more tongue movements.  Instead they stay on the molars and kind of mush together when you are chewing them.  Mush is probably not the most technical word I could have used.  

One challenge in working with these patients is finding foods that are easy to manage and healthy for children to eat.  Cheri Fraker, OTR uses a Food Chaining Approach which links foods currently in a child's repertoire to more advanced foods.

I will generally try to get my clients to accept more liquids and smoothies as this is a great way to get in some vegetables and protein while discussing small changes in food/taste.  Does the shake taste different if we add in one spinach leaf?  What if I could get them drinking Kale shakes?  The bright green color throws them off though.  I've got to think of some cool names for them: Hulk Juice, Green Lantern Shake, Tree Shakes....

Another food that I try to build up with my clients is popsicles.  The cold can be good for triggering swallowing-and it's another way to add some vegetables in.  In general I work towards having kids accept that the vegetable is in the smoothie/popsicle vs. trying to hide it from them.  It's a trust issue.  

The Zoku Pop Makers are awesome for using in feeding or traditional language therapy.  They freeze a popsicle in about 5 minutes.  I tried Blueberry Kale (I'm on a Kale kick, obviously....) this week at home.  For feeding kids, I work on accepting different fruits as well as temperatures and how to lick foods.  For my language kids, I work on adjectives like cold, verbs like lick, bite, freeze, pour, stir, get and put.  I can take pictures of the activity and work on sequencing.

Here are a few other products I've found really helpful for using in feeding therapy:  


Freeze Dried Fruits are a great way to introduce fruits and vegetables to kids as they are dry and more similar to a chip.  I usually check the consistency before offering to my clients.  For instance, the peach freeze dried fruits require one big chew and then kind of melt and stay in one place.  The pineapple ones require a lot of chewing.  The dried carrots were very difficult to eat and small enough to be a choking hazard.

Once opened, these snacks tend to go stale fairly quickly.  I will use these as snacks in speech or language sessions.  We might take them and talk about foods that are crunchy, more crunchy or the crunchiest.


If I have clients that LOVE to eat chips-I might try these chips because they have about 4 grams of protein per serving.  The brown bean chips require more chewing but the white bean chips hold their shape in your mouth and only require a few chews before they are ready for swallowing.

Saturday, April 12, 2014

Recycled Guest Posts: Functional language therapy: Making Chips in Therapy

I'm recycling some guest posts I did over the last year while I am on vacation.  I hope you are having a great week!

I really enjoy incorporating hands on activities: crafts, experiments, gross motor games and cooking in my therapy sessions.   I use these activities with early Elementary clients up to Middle school depending on their goals.

In the past, I struggled with keeping my eye on the big picture (therapy goals) vs. getting stuck in the process-(making the activity.)  The activity is secondary to the concepts or lessons I'm trying to teach within the therapy session.  Today I'm going to write about how I would incorporate a chip making activity into a therapy session with a variety of different clients.

I love salty snacks AND cooking gadgets.  So when I found this microwave chip cooker I was intrigued.  The claim was that you slice potatoes, apples, sweet potatoes or beets into thin slices and then cook on the "plate" until they are crispy.  

I do feeding therapy as well as traditional speech therapy so the chip cooker seemed like a great way to expand some of my clients diets using familiar foods.

The first thing I do once I've decided on an activity is decide who will be participating and what goals they are working on.  Then I review the steps of the activity and decide what goals I can incorporate within the activity.

I take pictures of each of the steps and after the activity we work on sequencing the pictures and paraphrasing the directions.  I try to send home a black and white copy of the directions so they can explain what they made in therapy to their parents or siblings.  

Having the sequencing pictures helps me pick out the vocabulary I'm targeting.  For this activity I targeted action verbs:  
Slice, place, sprinkle, put, cook, and eat.  
Because each potato gives a lot of slices we had a lot of practice.  In a group setting I might try setting up a routine where the first student does the first action and then explains what to do to the next student.  Example: 
Student A tells student B:  You need to slice the potato thinly with the mandoline slicer.  In theory, then the student could complete this action-but I didn't let anyone try the mandoline slicer.  
Student B then tells Student C:  You need to slice the potato thinly with the mandoline slicer.  We would continue on in this fashion.  

Basic Concepts/Attributes:  

I decided to focus on thick vs. thin.  We talked about why thick potato slices took longer to cook than thin slices.   You could also focus on attributes: hot/cold, wet/dry, or salty/plain.

I have several clients who use AAC devices to communicate.  I decided to focus on 3 different utterances during this activity:

Get ________.
Put on.

I modeled this several times within the activity and then prompted my clients to request or comment within the activity using the selected vocabulary.  

This activity lends itself well to CH words: chips, chomp, chew, choose, Pinch (of salt), (make a Batch)

Many of my articulation clients can earn these types of activities by returning their homework.  Then I intersperse each step with drill activities.  

Problem Solving/Reasoning:  
I might forget to get salt or certain supplies for my clients to see if they can request the correct materials.  I drop a few chips on the floor to see if they can explain the problem and give me some solutions.  Putting it back on the tray is a solution-but I try to work on what might be the BEST solution to the problem.  I asked questions about why we wouldn't put too much salt on the chips and whether we could put the plastic holder in the oven to cook the potato chips.  

Social language Skills: 
These activities are usually a good time to work on politeness markers as well as general conversation.  

I hope this post gave you some ideas of how you can incorporate activities within your therapy sessions.  Thanks again to Jess for allowing me to guest post on her blog.  

Friday, April 11, 2014

Recycled Guest Posts: Inferencing

I'm recycling some guest posts I did over the last year while I am on vacation.  I hope you are having a great week!

One of my favorite skills to work with older children is inferencing.   So I'm really excited (and a little nervous) about my first guest post for Carrie's first year blog-a-versary.  Today, I'd like to share how I teach inferencing and some of my favorite inferencing resources.

I start by telling my clients that we are going to be working on inferencing.  We define inferencing as the ability to look at the information provided and then make a guess about what we think is going to happen.

  • improves social skills
  • improves reading skills
  • improves language skills 
We talk about HOW LONG a book would be if the author had to write every little thing down.   Usually, we decide we don't want to read a book that is THAT long.

When teaching inferences, I'm less concerned about the correct answer and more interested in the PROCESS that the child used to make the inference.  So usually I will have them guess the inference and then circle or TELL me the clues they used to figure out the inference.
Then I have them explain why it couldn't have been a different choice.  In the above example, it couldn't have been a restaurant because the boy went up to the COUNTER to order.  It couldn't have been a Mexican restaurant because he ordered a HAMBURGER.  

I'm always looking for new ways to teach inferences.   Here are some of my Favorite resources or products:  

1.  Super Duper Cards:  Super Duper has sets of actual inferencing cards which are pretty basic.  They also have some of the available as an App.  

2.  No Glamour Inferences by Linguisystems.  I send these worksheets home for home programming.  My favorite section is the section on Object Inferences.  This book also works on Social inferencing which is helpful for many of my clients.  

3.  David Newmonic Inferencing book.   This is my go to resource for Middle school students.  This ebook does a great job of breaking down inferences into pictures, sentences, paragraph level material and then a full text.  The material is more appropriate to older clients.  

4.  Phil Tulga-Inference Riddles online.  This game is played online.  The clues are given one at a time.  You get 10 chances to guess the term.  These are more abstract concepts such as "day."  You can also buy an expanded version of this for 4.95 on his site.

5.  What's in the Bag game on I like using this online game with younger clients.  Three words are presented and the student needs to guess what's in the bag.  You can present it with just the clues or click continue to get three color choices.  If you haven't been on's website you are missing out. 

Do you guys work on inferencing?  If so I'd love to hear your favorite materials or resources.  

Thanks again Carrie for letting me come over and celebrate!  

Wednesday, April 9, 2014

More "Cheep" Easter ideas and a Freebie!

I'm super excited to be heading out on another trip-this time to Disney World to celebrate my mother in law's 70th birthday.  While I'm gone, I'm going to run some of my guest posts I've done on other fabulous's bloggers sites.  I had a few more fun Easter activities that I did this week that I thought I would share along with a FREEBIE!

Bunny and Me by Adele Greenspan and Joanie Schwartz.  This book is probably out of print.  I love to use it when I am working on bilabials-the sentences are short enough to encourage imitation. (ex. baby gets ball, bunny gets ball.)

The Game:  
Bunny Hop is one of my son's games that I bring in to work around Easter time.  I like that it is pretty quick.  On your turn you roll the dice to determine what color bunny you are going to try.  You push down on one bunny of that color and then press down on the same colored farmer's head.  If your bunny hops up you get to keep it.  The goal is to end up with one bunny of each color.

We worked on expanding sentences: Bunny hop, Bunny did hop, Bunny did not hop.  We also worked on short phrases, my turn, you go, I do, blue bunny etc.  

I saw these carrot targeting toys at the dollar spot.  I was really excited to use them in therapy.  I also got this organizing box on clearance.  The inside dividers are flexible which means you can change the number of compartments.  I used this game during drill types of activities.  I put a number at the bottom of each compartment and then had the students throw their carrots in the container.  Then they had to do the same number of targets as what they landed on.  

Super easy and fun for my students.

And the freebie.  I really, really love barrier game activities.  When I saw this clip art, I thought it would be perfect to address describing skills.  You can pick this up for free by liking me on Facebook or heading over to my Teacher's Pay Teacher's store. 

Hope you liked some of these ideas.  If you thought they were useful, please think about sharing this post with others on Facebook or Pinterest by clicking the buttons below.

Monday, April 7, 2014

Take the TPT Plunge-linky party.

Felice at the Dabbling Speechie is hosting a take the TPT plunge linky party.  It's a post to encourage people who may have picked up a lot of freebies on Teachers Pay Teachers or Teacher's notebook to take the plunge by purchasing a full product.

I started looking at TPT when I was doing virtual therapy-it was so easy to go and pick up some materials to use for my sessions.  I'll admit that it took me a little while to actually purchase a product.  But once I did, I was hooked.  I purchased my first product in April 2012.  Since then, I've purchased 118 more products.

Here's how the linky works.  Each blogger is going to write about 2 products that they've purchased that they use frequently.  Then they will also post about one of their best sellers.  This way, you get a lot of recommendations for tried and true products.

Two of my favorite purchases:

1.   WH Questions with visual choices by Teach Speech 365.  I love this product for introducing WH questions.  I use it with a lot of my clients that benefit from visuals.  I know that some of my colleagues have seen this and ended up purchasing their own copies.

2.  Match It Quick-Vocalic /r/ from PSST!  Let's Talk.  This is a fun activity to pull out and get a lot of practice on vocalic /r/.  Each card contains pictures of vocalic /r/.  You pick another card and have to find the one picture that matches.  There is a fair amount of prep if you want to cut out the circles but it's worth it.  Very fun and motivating for my clients.  

And now for one of my best sellers:  

Don't be a Zombie: Pragmatic/Nonverbal Language:  60 pages of pragmatic language practice.  

Have you already taken the plunge?  Head on over to the Dabbling Speechie to link up.  I'd love to hear about your favorite products below.

Friday, April 4, 2014

"Cheep" & Easy Easter Ideas for Speech Therapy

It's hard to believe that Easter is just a few weeks away when you just got 10 inches of snow dumped on your front lawn.  Easter egg hunts aren't very much fun when you risk losing fingers from frost bite.  I've been busy packing to get ready for our family trip to Disney World to celebrate my mother-in-law's 70th birthday.  I spent today pulling out some of the activities I did last year since I only have four more days of work until vacation!

I found these foam egg puzzles last year at Michaels.  They are great for a quick activity.  I made them up for a variety of different activities:  

1.  Defining vocabulary by stating: Category + function + description.  I use this in conjunction with my EET strand.  I also made an definition cue card to show them how to define the word (ex. A _______ is a type of _________ that you can _________.  It is _____________.)  I sent this home with some pictures of Easter objects for home practice.  

2.  Some of my clients with pragmatic language challenges were working on different levels of emotions.  We wrote a small, regular and big emotion on the front of the egg.  On the back of each piece we wrote an example of when we felt that way.  

3.  Articulation Practice.  I sent my articulation clients home with eggs containing their target sounds or sentences containing their target sounds.  

These are some of my favorite things to do.  I don't think I'm breaking any ground by suggesting that you try an Easter egg hunt in therapy.  But these were made for the lazy speech therapist.  I print off a worksheet or articulation pictures, cut them out-put them in the egg and hide them.  If I'm feeling nice I might add some candy to the egg.  I LOVE that they have character eggs now-it makes it easier to do these scavenger hunts year round.  Working on /s/ blends?  I'll grab my Sponge Bob and Spiderman eggs and hide some pictures.  I just picked up some R2D2 and Ninja Turtle ones to use with some of my /r/ kids.  Here are some other ideas for Easter Egg hunts: 

Social Language/Inferencing:  
Now that I have all of these character heads, I thought they could be a fun way to work on the idea that people have different thoughts.  We start by working on object riddles.  I write out the answer and put it in the character's head.  So for example, if the answer is "apple", I put that in a Batman egg.  Then I say something like, "Batman is thinking about a fruit that is red, grows on trees and has seeds."  The child guesses and we look inside Batman's head to see if they guessed it.  I will use pictures for non-readers.  

We expand this to social inferencing to work on theory of mind.  Write the answer and put it in the egg head.  A super simple problem would be: Batman sees Joker making fun of Robin.  What does Batman think about Joker.  

Visual Referencing:  I work on visual scavenger hunts a lot with my students with nonverbal language disorders.  I'm always surprised by how difficult this can be for some of them.  We play this game 2 ways.  First, I hide eggs with treats/candy.  They get ONE chance to try to find the egg that I am thinking of.  If they open the wrong egg, I get to keep the prize.  They need to watch my eyes to see where I am looking.  They also can check in with me, and I will shake my head yes/no to let them know if they are going to pick the correct egg.  

Describing Skills:  For this activity I have the child hide the Eggs while I wait outside the room or close my eyes.  In a group, you could have each child hide 2-3 eggs.  Then they need to give you clues to figure out where they hid their egg.  For older students, I use some "hard-to-find" eggs that include suction cups on the eggs to place them up high.  

What are you doing for Easter?  Check back this week because I've got a few more Easter surprises up my sleeve-including an Easter vocabulary freebie AND a fun new game from the dollar store.  And I'm coming up on a pretty big milestone-I'm thinking a party might be a good way to celebrate it.    

Wednesday, April 2, 2014

World Autism Day: Light it Up Blue

Today is World Autism Day.  I'm lighting it up by changing my font color to blue.  Last year when I wrote this, the prevalence was 1 in 88 children.  This year that prevalence has changed to 1 in 68.   Autism impacts a child's ability to interact with their world and to process the information within that world. 

About 50 percent of my caseload for the past 15 years has been children and young adults on the Autism Spectrum. Because it is a spectrum disorder, abilities range from severe to mild.  I worry that even my children who are "higher" will have difficulty managing as adults.  In general, these are smart children who need help to figure out how to manage within a confusing world.  One of the challenges as professionals is to help prepare them to live successfully within that world. 

Last year, I wrote several posts during Autism awareness month.  Here are some of them: 

Autism and Eye Contact



Kid's Social Skills Books

5 Cool Thought Bubble Ideas and one super lazy one

This month, I will be writing about some of the social skills books I have as well as some newer kids social skills books and how I've been using them in therapy. 

Visit Autism Speaks for more information on Autism and World Autism Day.
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