Today was my last day with little Reagan. I have really enjoyed my sessions with her because she tries so hard, her mom encourages practice, and her little brother pulls up a chair when I come, thinking he is part of the session!
As a goodbye gift I brought “Groovy Scrapbook” by Alex toys. Since Reagan and her family are moving out of state, I thought it would be fun to chronicle her adventure through a scrapbook. Being the little girl that she is, she wanted to start right in on the scrapbook. Her first page was entitled, “Goodbye Sherry.” She loved decorating around the bare spot in the middle of the page, reserved for a picture of us on her last day of therapy. She especially liked the zig zag scissors, sequins, stickers, borders, buttons, 
ribbons and a floppy flower to glue on. The project lent itself to speech therapy, as she practiced her sounds while creating her page.
I was reminded of my old scrap-booking days when I chronicled my activities from middle school through college. It was fun to watch a 5 year-old enjoy the collection of goodies in the box to select for her remembrances.
Goodbye little Reagan. I loved my time with you.
Some kids work harder in a less structured setting, moving and learning as they go. Summer is a great opportunity to take these kids outside to explore and work on speech and language goals on the move.
My friend, Nathan, is such a kid. He is so happy to explore, expecially with Duke, my dog, and will practice his articulation, language structures, answering questions and following directions best in a less restricted environment.
Last week we discovered that when we walked down to the creek to view water bugs and look for frogs, we actually found little tree frogs hopping out of the leaves under our feet. We could only detect them from their movement but managed to catch one in a cup and watch him climb out. Our next outing was the pond. No frogs there but 
we identified cattails, and were visited by a beautiful butterfly who followed us along the edge of the pond. We spotted an elegant egret and family of geese.
When we returned we wrote Mom an e-mail letter, including pictures of our outings. Nathan had to supply the words under each picture to recall what we had done. This is hard for him but with the visual cue, it was made easier.
Honestly, it’s fun for me to get a change of scenery too.
Here is a copy of my newsletter in case you aren’t on the distribution list:
If you want a child you are working with to make progress in his/her articulation goals, you have to inspire them to practice between sessions. Make some fun stationery to list their practice words or sentences on and encourage parents to post it in a prominent place. Have parents and kids post stickers or write stars after each practice so they can “show off” their hard work the next time the therapist sees them. One Mom added “Speech” to her child’s responsibility chart and it became part of her daily routine.
Often I tell parents to keep practice sessions short, fun and frequent. It can be helpful to “warm up” a child’s speech before they head off to school. A reminder of using that /s/ or /r/ sound while talking at the breakfast table helps a child key into their sound. Let them listen to you and point out good and bad productions of their sound. They love to catch adults doing it wrong and it builds their auditory discrimination skills to monitor their own speech.
I realize I have an advantage over a school therapist in that I see parents during or after each speech therapy session AND they are paying for my services so I tell them, “If you want to spend less and finish speech faster, make sure your child practices!” It seems to work. They are anxious to get “new words” for practice after each session and the parents get more invested in the process. If kids are older, let them take responsibility for practice. I have some 7 year-olds who are working on /r/. They are motivated to practice simply by my offering to bring a special game of toy if they comply. One mom was to e-mail me the night before to tell me if her son practiced that week and I would bring the Playmobil Egyptian pyramid. Certain toys are reserved for good speech behavior:)
I get this question a lot. Just yesterday I was at a house and the mom asked me whether she should be concerned about her 3 year-old Eli’s speech. I asked about specific sounds, saying he should be able to say, t,d,p,b,m,n,w, but other sounds aren’t established until he is older, like s,l,r.
Often, parents are expecting too much of a preschooler–that he should be speaking perfectly and understood all of the time. The fact is, he isn’t expected to correctly produce all sounds yet and we shouldn’t correct him or call attention to the mispronunciations or he might feel like he isn’t a good communicator, and even start talking less.
In the case of Eli’s mom, she was noticing that he was mispronouncing sounds that she knew he could say. Mom said, “He says, nilk for milk, and I know he can say “m”. Sure enough, little Eli said he wanted more “nilk.” Sometimes kids hang on to random words that they have mispronounced since they were little and even though they are capable of saying those sounds, the word persists for a while. In this case, continue to affirm him with, “Yes, MMMilk.” Emphasize the mispronounced sound in your own speech. Later when you are brushing teeth or playing around, make some fun sounds and include the “m” with a few “milks” thrown in.
Never draw attention to these sounds that your preschooler can’t make. Maybe they are in a word as a blend which is much harder to say and will take a while for him to learn. If you are still concerned, find a speech language therapist through your school system, ASHA’s website or your pediatrician’s recommendations.
One of the more challenging sounds to correct in a child is a frontal lisp. It is hard to retrain the tongue to be placed accurately behind the teeth rather than protrude forward. Sometimes progress is faster than others.
I have blogged about success using techniques from Pam Marshalla’s excellent seminar on “Practical Therapy Tips for Persistent Articulation Errors: Frontal LIsp, Lateral Lisp and Distorted R.” Sometimes I am pleasantly surprised at how quickly a child picks up on the cues and arrives at a correct production.
That is what happened with 6 year-old Sam last week. (I don’t work on correcting a frontal lisp until a child is 6 or 7 years old.) Using some of the techniques I learned from Pam as well as others I started with a long “E” and progressed from “E” to ”T”, encouraging him to extend the “T” and get extra air flow. He actually started to say an “S” as he prolonged the “T”. Then I modeled “EATS”, adding the “S” to make “TS,” stabilizing the place for accuracy. He was able to repeat final TS words (eats, hits, waits, wants, etc.) so I left him after the first session with a list of final TS words to practice. The next session, built on “EATS” and we added “E” at the end for “EATSEE” still releasing lots of air after the “T”. Eventually he could separate it to “EAT SEE” and he had an initial “S” sound! After that session I gave him a list of initial “S” words to practice and try in sentences if he could. The practice piece is essential because I am asking him to change a habit which is hard. He is re-training his tongue and jaw, to go to a new place for his “S” sound.
It is important to take into account jaw placement when evaluating and treating a frontal lisp. According to Pam Marshalla, a classical frontal lisp is a tongue and jaw placement problem because a child tends to lower his jaw when the tongue is protruded in a lisp. Work on jaw stability is an important part of therapy to correct a lisp.
I am often asked this question. Parents call up concerned about their preschooler who can’t say an “s” or “r” correctly. I often reassure them with norms and tell them to call back if it is still an issue in 2 years. Norms vary but it seems that /r/ and /s/ should be established by about age 6-8 years of age. Some of the norms I have used as reference are:
- Iowa-Nebraska Articulation Norms Project
- Templin, 1957
- Sound Aquisition: Single Word Responses from the Journal of Speech and Hearing Disorders, November 1990
Certain books make it easier to teach language. Give me beautiful, clear illustrations, a simple but engaging story and I can use it to work on many different language goals.
The Very Greedy Bee by Steve Smallman is the story of a not so nice bee who spends his time “gobbling pollen and guzzling nectar!” Landing in a meadow of juicy flowers, he declares them his own, with no intention of sharing. As the day progresses he gets fatter and fatter and fatter until he falls fast asleep. Awakened in the dark, he found it impossible to fly home due his rotund tummy. Two friendly fireflies came to his rescue to lead him home, only to encounter another obstacle where the greedy bee had to rely on helpful friends. This turnaround story ends with a honey party and a not so greedy bee!
I used this story with kids on the autism spectrum as well as typical kids working on their articulation skills. The following language goals can be addressed:
- answering wh-questions-How did the fireflies help with the leaf” “What did the ants do?”
- completing statements– “The bee couldn’t fly because…
- talking about emotions and descriptive adjectives: happy, sad, disappointed, greedy, helpful, sharing
- prediction–”What do you think the lights are? A monster?”
- descriptions–tell what you see happening on a page
- beginning, middle and end–tell what changed as the story progressed
- application–When are you greedy? When do you share? How does that make you feel?
- preliteracy–point out the fun words in bold print that get kids laughing like “Slurp! Slurp! Burp!”
I find books to be a great language enriching carryover activity for articulation.
Recently I was working on /s/ and /sh/ with several students and used the book, Bright Stanley by Matt Buckingham to provide practice and carryover for the sounds. Stanley and his school of friends with their shimmery scales provide lots of practice for the /s/ and /sh/ sounds. I read the book in sentences and phrases, pausing to let the child repeat after me. If they are at the carryover stage, simply read the book and have them re-tell it using the pictures. Provide an /s/ word or two to get them going if they get stuck. Stanley is on the hunt for his friends who have the same bright, shimmery scales so there is plenty of opportunity to practice thinking skills like prediction, association and cause-effect too.
Afterwards, we made our own Stanley, with lots of markers and glitter glue. This Stanley apparently is such a good swimmer he doesn’t need fins!
Okay it is almost Valentine’s Day and I am still finding great free downloads for valentines to use with kids to make speech therapy more fun. They’re great for parents to use too for the “homemade” look for those dozens of valentines that are required for distribution to the class.
I discovered the website, www.bunnycakes.typepad.com, a site for “crafting, sharing and the joys of life.” They offer several designs of valentines that are simple to cut out for kids and fun with an animal theme. My favorite is the zebra (which was real popular with a 5 year-old girl today). Other options are the “Love Big” valentines featuring an elephant, sweetheart candy messages and “Love is all you need” valentines.
Add some scissors, glue and cut outs and you have your valentines, decorations for the take home bag, or mailbox.
Using Valentine’s Day books that have a simple story of making valentines, friendship and distributing them to handmade mailboxes or bags can serve as social stories for children on the autism spectrum or those with language delay or disorder. Books like Little Critter: Happy Valentine’s Day, Little Critter! by Mercer Mayer takes your child through the story of getting ready for Valentine’s Day.
And don’t forget, Happy Valentine’s Day!
