Field trip to the Gym...

I've got a couple of reaalllly wiggly kids that are working on articulation.  Today, I took a break from the table and set up stations in a therapy gym.  Each station had a set of 10 articulation cards that the children had to say three times  before completing the station.  Here were my Stations:

1.  Trampoline Basketball:  Jump on the trampoline while saying your word.  If you said the word correctly-you got to throw a ball in the basketball hoop.  This activity was interesting as several of my clients had difficulty jumping and "saying" their target word.  Instead they would jump-and then stop and try to say the word.  Obviously, for successful carryover, you need to be able to say your speech sounds while moving.  It reminded me again of the importance of varying the location or what you are doing when working on articulation or speech sound production.  

2.  Roll Across.  I had my clients say their words a certain number of times and then roll across the mat.    A lot of them misunderstood and did forward rolls which made me a little nervous.  

3.  Trapeze Swing Across:   Say your word and then swing across into a set of pillows or mats.  I've tried this with past tense verbs with some success.  Give the child the verb (walk).  Then have them say, "I will walk" before they are on the swing.  While they are swinging, they work on the present progressive forms "I am walking"  Finally as they drop into the mats, they say the past tense form.  "I walked." 

4.  Spin around:  Say a certain number of words and then the child gets to spin.  Check with your occupational therapist because some children can have adverse reactions to spinning.  I sometimes do a similar activity in my office with my office chair with my little guys.  I have them hop up and then we get to do a couple of spins on the chair in between repetitions.  

5.  Scooter Board   I add a certain number of cards on each side of the room.  The child says the targets and then uses the scooter board to transport them somewhere else in the room.    I like picking up different containers for them to put things in.  After Easter or Halloween is a great time to stock up on Theme baskets like Spiderman or Angry Birds.  It's probably really helpful when I share THAT tidbit in May.  Ned's head is another really fun container.  Work on phrase or sentence level production (in Ned's nose, I put it in Ned's ear.)  

We had a lot of fun and I ended up with more repetitions than I would typically get during a traditional table top therapy session.  Not everyone has access to a gym but I'm curious: Do you incorporate movement into your sessions?  

Praxis: It's not just a test you take after school

A few months ago I went out after dinner with an occupational therapist friend of mine.  We spent the night catching up and geeking out on therapy techniques.  She was describing a class she had taken on Ideational Praxis.  I found an article online called, "A Theoretical Model of Ideation in Praxis" by Theresa May-Benson, M.S., OTR/L.

Praxis refers to motor planning problems.  I have a LOT of motor planning problems and would have benefitted greatly from occupational therapy as a child.  

 For example, I'm pretty sure I was still riding my Big Wheel into grade school because I couldn't ride my bike.  And I once made the mistake of jumping out of a pedal boat to use the lake's facilities.  Only to realize that I couldn't figure out how to climb back into the boat.  My friend and I pulled the boat while swimming and tried to wave down other boaters-but they just waved back.  I think we were swimming for at least 30 minutes before some kids told their parents they thought we were in trouble (I was...) and the parents rescued us.  I made myself practice climbing onto the dock for the rest of the afternoon and was finally able to figure out how to get up onto the pedal boat the next day.  You are probably picturing a cute 10 year old Speech2U.  But really I was 32.  

Anyhow, I find motor planning and praxis interesting.  The article is focused on Ideation which is defined as the ability to know what to do with things.  For example, I can look at a ball and know that I can throw it, kick it, bounce it, roll it, sit on it, put it under my shirt to pretend I'm pregnant, or play catch with it.  Theresa May-Benson is proposing that some children may have problems with Ideation which impairs their ability to interact with new objects in different ways.   This is different from a child with motor planning deficits who knows what they would like to do but can't figure out exactly how to do it.

These children are described as children who often sit out of activities, stand and watch others or refuse to participate in different play activities.  They may be the kids who say, "I don't know" when asked how to play a game OR when asked what they want to do.   It sounds similar to the planning and initiation deficits described in Executive Function disorders.  

What was really interesting to me was the idea that language is an integral part of the ability to initiate motor actions.  So the question becomes, is it that the child doesn't know what to do with the object-or is it that the child lacks the language to help him conceptualize what to do with the it?  May-Benson suggests "Using a conscious language-driven approach to expand and generalize the child's semantic knowledge of possible object-action interactions provides an additional avenue for ideation"  (page 174).  She suggests clinicians can help their clients improve their ideation by mapping in language during gross motor activities "For instance, the clinician might help the child analyze a swing: "Sam this swing is on a stretchy cord.  It goes up and down. What could we do with it?"  (page 174).

So what does this mean for us as Speech Language Pathologists?  First, it gives me some ideas of how I can map in language if I am doing a cotreat with OT.  Second, I think it reiterates the importance of teaching a variety of object functions vs. just one.  Maybe the long term goal for an object function goal is to describe 5 different ways that you can use it.  It also reminds me of the importance of teaching actions and helping my clients describe WHAT they are doing in the most descriptive terms.  Last, I think it reminds me to teach object characteristics.  For example, you could pull out a variety of objects and have them tell you what they THINK it will feel like.  Will it be heavy or light?  If it is heavy how do you need to pick it up?  

What do you think?  Is this information you could use in your sessions?