Now that the weather has warmed up–we hope–I have started to take my speech therapy outside. Some of my favorite successes in doing therapy have been outside. Little 2 1/2 year-old Ian was apraxic and we had spent many sessions indoors all winter. But when spring arrived we incorporated a walk around a big block, using the vocabulary of the outdoors–dirt, mail, stick, rock, water and so on. We passed the same berry bush, mailbox, little stream and pile of gravel every time and I modeled approximations for him, and gave him the visual, auditory and physical prompts. Finally one day as I lifted him up to hang over the stream and throw rocks in the water which he loved, he blurted out “rock!” His mother and I went into cheers, we were so shocked and excited. that was his first word–and not an easy one at that! Had I had any presence of mind, I would have jumped into the water and retrieved that rock to give to the parents as a memento of all the hard hours of work they had put in along with me to achieve this little success.

I find that often preschoolers who are delayed or apraxic tend to make progress in our therapy sessions but don’t always carry over their skills to other venues like preschool or a walk outside. So, last week I took Benjamin for a stroll with his parents to point out simple vocabulary words beginning with the earliest sounds, /w,b,p,d,t,h/ to reinforce talking outside. We were entertained with plenty of trucks, frogs, geese and sticks, but he pulled me toward a man who was seeding his lawn. I modeled “dirt” (instead of my usual “duh”  CV model for dirt) and to our surprise he said “dirt” with a final /t/! He went on to repeat my model several more times that day. The next outing we spent a good deal of time dropping rocks down the sewer grate on the street into the water below and he repeated my model for “drop.” This was a huge step that Benjamin was starting to use final sounds. I gave the parents a list of words to reinforce: net (neighbor’s soccer net), water, mail, box, hole, bug etc. This list gave them some direction on how to use their walks to reinforce language. I also pointed out that he was now imitating our models and the next step would be for him to spontaneously say the word. So I showed the parents how to pause a few seconds, holding the rock, to see if he would say, “drop” without my model. I always give parents homework:)