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.  

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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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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BUILDING effective Communicators: Personal Narratives and the one who needs to be interrogated

One of the things that many of my clients struggle with is being able to share a simple story or information about what they have done during their day.   If I ask them what they did or what they ate for lunch, they simply shrug and say, "I don't know."  These same clients struggle when I ask them to tell their caregivers what we JUST did in therapy.  "Um, I don't know" they say as they look down at their feet.  My response to this is always, "Oh no-nothing stuck!  Sorry mom/dad-we are going to have to go back and redo this session."  Usually this gets a giggle out of the child and they are able to  at least come up with a single word answer or something that they did.  

I'm a story teller by nature.  I know that I tell more stories than my friends-and I'm sure sometimes it gets a little annoying.  I fill my blog with silly little stories.  Story telling is how we connect with other people.  It is the basis of communication and conversation.  Take time and think about the conversations you are having with people at your school or clinic.  Are you sharing stories about your weekend, something your pet did or a cute thing your toddler did?  It's how we strengthen our relationships with our friends and acquaintances.  Remember that time when I went out to throw out the trash and got trapped inside the dumpster?  

I find my clients tend to fall into four categories:

• The child who responds with "I don't know" or give single word answers.  
• The child who shares too much information.  Usually I have to cut them off.  
• The child who give me information but it starts in the middle and jumps all over the place.  
• The child who uses non specific vocabulary.  

Today I'm talking about the first type of client: the one who needs to be interrogated.   

This is the client who only gives me little bits and or pieces of information.  If I ask them what they did over the weekend, they probably say, "I don't know."  Or they will tell me one little piece of information.  "Zoo."  or "Played a game."  I am forced to ask a variety of questions to try to figure out what they did.

I know there are many more reasons why these clients are just giving me a little bit of information.  Here are a few things that I look at and some treatment activities that I use:

• Limited Perspective Taking Skills:  Do they understand that I have different thoughts than they do?  Or do they think that I just know what's in their brain?  I want them to understand that I only really know what they tell me.  Barrier games are a great way to help them understand that you only know what they tell you.  When we are looking at our pictures to see if they are the same, I make comments like "Oh I remember you said to put it on the page-I didn't know you wanted me to put at the TOP of the page.  
• Syntax disorders:  Some children struggle to formulate sentences for their thoughts.  Instead they speak primarily in 1-2 word utterances.  I usually start working on noun-verb-object sentences and continue to expand their sentences.  Modeling longer utterances can be helpful.  For readers, I might write out their responses and then see what information we can add to expand the sentence.  
• Poor time conceptualization or memory issues:  Some children have a really hard time remembering what happened yesterday or relating it to a certain time.  They might tell me a story but when I ask the parents about it, it turns out to be an event that happened 4 years ago.  Some kids may not remember what they had for breakfast.  I can't remember what I worked on with my first hour group if I don't write it down right away!  Calendars can be an effective tool for helping the child improve their understanding of time as well as being able to relay information about specific events.  
• Organizational challenges:  What information is important to include?  What do people want to know? Visuals and graphic organizers can be really helpful to provide a structure for what they should include.  I think organizers focusing on the 5 W's (who, what, where, when and why) can be a great start for what information to share.  

What strategies or activities do you use with students who need to be prodded for information?  Share your stories and successes below.  If you liked this post, please consider sharing it with others by pinning or sharing this post on Pinterest or Facebook.  Check back here on Thursday to read about the one who gives a monologue.  

Tuesday Turkey Leftovers: 3 super quick crafts

I love holiday weeks because I can pick 1-2 activities and use them with most of my clients.  It saves on my planning and set up time.

I pick up little activities as I see them in the store.  This year I went a little bit crazy for Thanksgiving.  So instead of saving myself prep time, I'm using more of it to set up all the activities I decided to do.   My turkey leftovers is a bunch of the activities that I decided to use.  I'm using most of these at Thanksgiving dinner too!  

I started the month making some Pom pom turkeys.  Yesterday I made individual batches of stuffing with some of my feeding clients.  It took a little while to figure out the correct measurements for single servings.

Single Serve Stuffing
Ingredients:

• 1 Container of Stove top stuffing.
• Butter
• Water

Add 1/2 cup of stuffing mix to microwave safe bowl.
Add 1/4 cup water to bowl.
Add 1 tablespoon of butter to bowl.
Heat at one minute intervals until done.

Turkey Cookies: 
I had picked up these sugar candies at Michaels when they were 50% off.  We are using them tomorrow in therapy to address sequencing, subject-verb agreement, and summarizing/explaining.

Thanksgiving Trail Mix:  

I used peanuts in the trail mix but I should have replaced it with a cereal like Kix.  Cheaper and safer in this day of peanut allergies.  

We made this with some of my social language kids based on an activity suggested during the Preschool Social Thinking class I took.  I put each ingredient in a separate bowl along with some random ingredients we wouldn't be using (other nuts, raisins, shredded coconut.)  I spread the bowls out on the table and gave each child a plastic bag.  On their turn, they had to watch my eyes to see what to add to the bag to make the mix.  

Thanksgiving trail mix

• Nuts or Cereal like Kix or Cheerios.
• Dried Cranberries
• Butterscotch chips

Put the ingredients in a bag and shake the bag to mix it up.  

Turkey K Cups: 

We got a Keurig machine at my work a few months ago.  As a manager, I try to get small treats or gifts for my staff at Holiday times.  I started looking for K-cup crafts but couldn't find the ones I was looking for so decided to make my own.  I got a sampler packet of K-cups for (kind of) cheap on Amazon.  Then I made the Turkey K cups.  I think this would be a great idea for Place Cards at Thanksgiving if you had a Keurig machine at home.  Just add the name of each individual.  After dinner, they can take their K cup in to brew their own cup of coffee!  

I printed off the turkey feather and cut them out and attached to the top of the K cup using removable double sided sticky tape.  Then I drew some eyes, the waddle and a turkey beak on the bottom of the K cup.

Do you want to make your own: Download the Turkey feather backs by clicking HERE.  

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Light Box Therapy

Last year, there was a plethora of postings about using your own light table during therapy.  I saw postings on Play at home mom, Testy Yet Trying and Speech Room News. 

This was also around the time that I started having some anxiety about the lack of fun sensory experiences I'd given to my then three year old.  Had I used all my fun-ness in speech therapy????  I used to be an awesome mom who had great ideas for behavior management, developmentally appropriate activities, and fun outings for the family.  Then I had my own kids.  As it turns out, sometimes I prefer checking my Facebook status to whipping up a batch of fresh Kool-aid play doh.  I bought a sled this year and have taught my young son various ways to express the idea that it is too cold to go sledding.  Although now I just justify this as teaching him the skill of being bored and good self regulation. 

BUT the light table I could do.  Pretty much any project that could also benefit my speech clients gets a green light.  I used Testy Yet Trying's tutorial and bought some of the materials suggested by Play at Home mom.  My only suggestion if you go this route is to avoid spraying the paint in the garage next to your husband's car.  Spray paint travels pretty far.  Whoops.

The light table was fun for my son and in therapy but I struggled with how to use it effectively to target goals.  I brought it back this year to work on joint attention.   I put some colored sand in the bottom of a clear container and we worked on taking turns drawing in the sand, looking at each other and commenting.

Some of my other clients saw the light table and wanted to play too.  So we ended up with these activities:

I used a sheet of articulation cards from Testy Yet trying and put it on the light box.  (Note this is NOT the lightbox I made.  Shortly after making the light box, a dollar store went out of business and I got this Fiskars craft light table for 5.00)   We started by saying each word.  Then I put my sand tray on top. 

Now they had to uncover each one using a carrier phrase. 

Another way we used the light box was by putting 2 picture cards on the light box.  We would say the targets (in this case it was he/she)  Then I'd cover the pictures with the sand.  Could they remember where the card was located?  Then we practiced the targets again. 



I used some simple three picture sequence cards.  First I put out the cards and had them tell me what the "MAIN idea " was.  (going swimming in a backyard pool)  Then I had them sequence the cards in order.  For this activity we did the order going up and down similar to schedules that they were familiar with.  As they sequenced the cards, I modeled simple sentences.  Then we put the sand on top and the students uncovered each photo and described what was happening in each picture. 

I still have a bunch of clients who are working on temporal directions.  For this activity, I had them draw in the light box.  (Before you draw the circle, draw a square.)  You could also adapt this by having the kids complete a more complex drawing with you giving the steps.  Ed Emberley books have some great simple drawings that you could use in the sandbox. 

I'm thinking it would be fun to work on with emotions too.  You could draw the circle and have them draw in the eyebrows, mouth etc.  Or you could try to "change" people's emotions by drawing over pictures of real people.  I could see this being really motivating: (Let's see what the Math teacher would look like if they were really mad....) 

What other ways have you used a light box in therapy? 

Having your cake and Eating it too

Last week was my birthday (in case you missed it.)  We celebrated by making Cakes in a Cup. 

This activity had more ingredients then I typically like to use.  But I liked the theme and was really curious how Microwave cake tastes.  (very, very, very dense.) 

I got the recipe from Makinglearningfun.com

Here's what we worked on:

Following Eye Gaze:  I have a lot of clients who need to work on eye gaze and following eye gaze during the session.  For them, I hid all of the ingredients around the room.  They had to try to figure out where I was looking in order to find the ingredients.  You could expand this to work on recognizing nonverbal gestures by having them try to figure out the entire recipe without talking aloud. 

Recognizing Facial Expressions/Facial Referencing:   Once we'd found all of the ingredients, we worked on facial referencing and requesting information.  My clients had to ask if a certain ingredient was supposed to go in yet or not.  I stopped speaking, so they needed to check my face and body language to determine if I was telling them yes or no.

Categorization:  For some students we worked on subcategories within the grocery store.  As we pulled out ingredients we tried to decide what aisle we would need to go to find it in a supermarket. 

Reasoning/Problem Solving:  During the activity we practiced some "why" questions.  (e.g. Why do we have to keep milk in the refrigerator.  Why do I want you to spray the mug with cooking spray.  What would happen if we put the cup in the microwave for 2 hours. etc. etc.)

Vocabulary Verbs and objects Needed:  We started by reading through the recipe and highlighting all of the actions: stir, measure, pour etc.  We talked about what kinds of objects would help us pour OR what we need to stir the batter.


We had a lot of fun making our Cakes in a Cup.