This is the last week of school for public schools and there is freedom in the air! I remember the feeling when I worked in the public schools as we wound down, took down the bulletin boards and said goodbye for the summer. There is a natural break for many of the students although some qualify for summer school services.
In private practice we keep chugging along. I personally have started to take several weeks off because I think it is healthy for me as well as my students. Over the years, I find that kids are participating in more structured activities in the summer and it is even harder to schedule therapy in the summer than during the school year! I was faced with several kids going to camp until 5:00 and then I could schedule their therapy. I can’t imagine engaging little guys after a full sweaty day of camp fun:)
When parents asked me if it was “okay” to take a break, I said, “Yes.” I am going to give them several suggestions for practice related to their goals for articulation, language and word-finding to keep skills sharp over the summer.
It’s not often that a picture book is co-written by an author and child but in “Armond Goes to a Party, A Book About Asperger’s and Friendship,” Armond weighs in on what it feels like to be asked to a birthday party and attend, even if it is a good buddy like Felicia. Armond has Asperger’s Syndrome and what is fun for his typical peers can be daunting for him, since “…parties are disorganized,” might have surprise smells, noises like the pop of a balloon, or require you to socialize which is hard. This new book clearly looks at anticipating a birthday party from the perspective of a child with Asperger’s and is a wonderful tool to use as a social story for friends like him as well as his typical peers to see things from Armond’s view. How can he go to the party? It’s not in his normal Saturday routine? What if something stinks? What if I have to think of something to say to the kids? What if a balloon pops? What if no one wants to talk about dinosaurs, my favorite topic? The party was all that and more, so Armond asked Felicia’s mom for a break. She knew just what he needed, a quiet room with favorite toys and books. When he rejoined the party, he gave Felicia her gift and helped organize her gifts. He admitted to Mom that the party was hard but he was proud of himself for going.
Reading the story, I’m proud of Armond too. AND thankful that he told his story to the author so other parents and kids who like “Armonds” and want to invite them for playdates or parties can have a little homework assignment of reading a book like this to to learn how to be a better friend.
With two of my grandchildren discovering the joy of reading in this kindergarten year, I am especially tuned in to fun, new picture books with simple repetitive lines that can reinforce reading over the summer break . Here are a few of my favorites that I grabbed from the “New Books” section of our public library, one of my frequent hangouts.
“Never Ever” by Jo Empson: A cute, pigtailed little girl and her beloved stuffed bunny takes us through this story of the imagination as she begins with the declaration, “Nothing exciting ever happens to me! Never, ever! Humph…” Passing through the apple orchard, grasslands, wheat fields, and river she is oblivious to a flying pig following her, gorilla beneath her feet, lion among the grass, and turtles as her stepping stones. The repetitive phrases “never, ever, ever, ever” provide a wonderful opportunity for kids to repeat and “read” this story with an adult. Roar! Yuck and MMMmmmm…yum add some punch to each encounter with an animal.
“Splat! Starring the Vole Brothers” by Roslyn Schwartz: These loveable rodents set out for their stroll when a pigeon flies overhead and “SPLAT,” drops a white mess on one of the mole’s head. “Tee hee, ha ha, ho ho” ensues as the other brother finds this hilarious. The pigeon’s droppings continue to be slug to others with a “Who-hoo” and a high-five until the two have a mishap with a banana peel but realize it is the best protection from future droppings!
It’s not easy to write a fun, silly, and engaging book with few words but both of these books are on the mark for making summer reading a favorite activity.
“Salty, sugary, good rice with soy sauce!”
Parents are conflicted right now. They are excited for the end of the year and all the deadlines, homework to be completed, projects to oversee and conferences to end. But, if you’re honest, you also worry a little that you should be encouraging reading and writing over the summer so your child doesn’t regress in these important skills.
When my boys were younger I had them keep journals (which lasted only a short time) of activities and outings over the summer. I often get great ideas at homes where I do speech therapy and just last week two kids shared their “journals” with me that I wanted to share.
A first grader wanted to “read” his whole journal to me. It is always so fascinating to see the invented spelling and see a child decipher it so easily when I am still struggling to see what he wrote. This little friend was using “My Journal” by Really Good Stuff which had the top half of the page for an illustration and the bottom half with lines to describe his picture. Really Good Stuff’s website has journals appropriate for kids by grade level, giving them the space for their drawing and the number of lines to write that are typical for their grade.
I’ve shared a PAL Award winner that I think is fantastic for girls 6 years old and up, “My Super Life Journal…By Me” by Pom Tree. Opportunities to write are intermingled with photographs, places to draw and sticker and felt pieces to adorn your book. Parents report that little girls get lost in it for hours as they make their DIY book about how fantastic their life is!
Fun opportunities for language growth through writing can be as simple as setting up a pretend store with a pad of paper where kids have to write down their order to receive it, or add a pad of paper to the pretend doctor’s office where the doctor writes down the diagnosis. I’ve see the latter suggestion at work in free play in a preschool and it was so funny to read the doctor’s orders–and YES the handwriting was hard to read, just like in real life!
No matter what, make it fun and learning happens.
Every year I am more amazed at the elaborate plans parents make for their kids for the summer. I couldn’t wait for summer to come when my three boys were young so we could get away from a schedule and plan one day at a time. Sounds really out-dated doesn’t it?
But, parents of kids with special needs, especially on the autism spectrum, have a harder job in planning the transition from the routine of school to the open-ended time of summer. I just got a newsletter from Esther B. Hess, Ph.D., a developmental psychologist and executive director of a multidisciplinary treatment facility in West Los Angeles, Center for the Developing Mind. I had attended one of her continuing education seminars and was impressed with her knowledge and class so wanted to pass on her tips for planning a summer schedule “of stability and certainty” for kids with special needs which includes checking out what is available from your school district for summer school, looking for camp programs that match your child’s strengths, if you plan to travel, staying in one place for a while, including new therapeutic programs, and scheduling regular play dates with typical peers.
I’ve watched as parents have executed some of these plans, signing up for weeks of sports camps when their child was strong in that area and admired by peers, or taking guitar lessons which didn’t fit into their schedule during the school year. Also, parents have taken advantage of a morning of a specialized intensive therapy program to build language or reading that again couldn’t have fit in their school-year schedule.
Thanks Dr. Hess for the great suggestions!
I have enjoyed reading, learning and sharing practical knowledge to use in speech therapy from Pam Marshalla’s book on Articulation Carryover and am ready to tackle her book on “Oral-Motor Techniques in Articulation and Phonological Therapy” to blog about what I am learning and trying out!
Pam Marshalla is an expert in both areas and I appreciate that she goes deep and is practical in both subjects.
According to Pam, oral-motor therapy is incorporated in 6 treatment areas today of which articulation and phonological therapy is the one emphasized in this book. Practically, that is where I am looking to learn too.The primary goal of OM therapy is to facilitate improved oral (jaw, lip tongue) movements. She makes the point clearly that oral-motor therapy is INCLUDED in a program of articulation and phonological therapy and doesn’t stand alone.
Techniques fall into 3 categories, according to the book–exercises, cues and stimulation techniques:
1. Exercises where a client practices movements that have been taught. I am working with a child who has a strong tongue thrust and trying to teach him the /s/. We have been “exercising” getting to the spot on the alveolar ridge by making a clicking sound and repeated /t/ sounds
- Repeating movements: Again he is asked to practice lifting his tongue to the alveolar ridge 10 times in a row
- Maintaining Postures: He is asked to hold his “spot” and count to 10. It has been rewarding to see progress as kids practice during the week, strengthening their tongue by doing this holding exercise
- Lifting weights: Add weight through resistance in an exercise. I am also working with a child on tongue elevation for /l/ an overall precision. I have used an upside down spoon to provide a bit of resistance to elevation.
- Stretching Muscles: We all stretch to warm up before an athletic endeavor so we need to stretch the oral motor mechanism. This was a good reminder for me to begin with this. I do use “gigglers” to “wake up” the face as I tell my little clients. They love them if they are not overly sensitive to stimulation. I have had kids grab he alligator or elephant and start to press it against other parts of their body. Do you think they crave sensory stimulation?? I have to laugh. I have the alligator and elephant but noticed that now they have basketball players and cheerleaders.
2. Cues are used to teach and remind students of oral-motor movements
- Hands-On OralCues: These are touch cues a therapist uses on the client’s face. I prefer PROMPT and highly recommend taking that course to learn physical prompts. I am continually amazed at how difficult cases come around when I start to use physical prompts.
- Modeled Oral Cues: We can emphasize the intended movement on our own face. The tricky thing here is that many kids I work with have trouble with eye contact (or should I say maintaining eye contact with my mouth). I have a little guy right now who is hyper active and I have to give verbal cues to get his attention but when I do, he is able to imitate my oral cues.
- Cues on the Rest of the Body: Pam suggests that at times cues on the rest of the body are helpful such as “tickle the arm to remind the client to produce prolonged stridency,” etc. It would be fun to share those cues that have been successful. Anyone want to share?
3. Stimulation Techniques are used to cause new movement to arise. They “utilize tactile and proprioception stimulation” to inhibit abnormal movements to facilitate more normal ones.
That’s it for today, I am going to add “stretching” to my OM routine with kids today. I will continue to review this helpful manual over the next few weeks.
What are your favorite go-to manuals for teaching oral-motor techniques?
Having experienced the NICU in a very personal way about a year ago, I was excited to read about a new study published online February 19 in Pediatrics. We were blessed with twin grand babies, born several weeks premature and visited them in the NICU where they stayed for several weeks. It was an unbelievable atmosphere with very able professionals tending to so many tiny babies and parents holding, feeding and talking to their little ones.
Researchers at Women & Infants Hospital of Rhode Island looked at the amount of words spoken to premature babies and how it impacted their language skills at the corrected ages of 7 and 18 months. 36 medically stable premature babies, on average born 13 weeks early and weighing about two pounds at birth were in the NICU where their environment was recorded, so researchers could count the number of words that had been spoken to them by their parents, child vocalizations and “conversation turns” meaning mother’s words or child’s vocalizations within 5 seconds.
As the number of words spoken to the child by his parents increased, so did the babies’ scores, with those exposed to the most parental talk, having the most developed language skills. The mother’s education level was not a factor in the findings.
“The adult word count to which infants are exposed in the NICU at 32 and 36 weeks predicted their language and cognitive scores at 18 months, according to study results….Every increase by 100 adult words per hour during the 32-week recording was associated with a two-point increase in the language score at 18 months.” (ASHA Leader).
Not only does this show the powerful impact parents can have on their premature infant’s language development during their stay in the NICU, I think it also speaks to the need to get this information out to parents when they are in this new, and might I say intense situation, with a premature infant. I know from watching new moms in the NICU, they might not be able to nurse their babies right away, dress them in their own clothes, visit whenever they want or even hold their babies right away, but they CAN talk to them and have a very positive impact on their language development.
More on yesterday’s topic of teaching personal pronouns to preschoolers. I had a session today with my little girl who is also working on he/she and his/her. She loved the Fisher Price Happy Family set which has many girls. I have the canoe, camping tent, campfire and frying pan, plenty of babies (which are a favorite) and chairs and high chairs. We started with lots of “she” models as we freely played with the dolls. “Should she put the baby in her carry pack?” “Yes, she should.” A few minutes into our first session, Caley was easily repeating my models without really knowing it as she loved the play. When the girl got into the canoe to paddle down the “river” we needed an alligator which we made out of playdoh. Caley promptly announced that the alligator was a girl which was convenient for me because I had another female model for the pronoun, she! I didn’t even have to put a pink bow around her neck. Now that the playdoh was out for making the alligator, Caley decided we needed a mermaid and appropriately dressed on of the girls.
I believe it’s important for kids to know what they are working on. In this case I ask Caley, “What is your word?” and she says, “She!” Putting it front and forward, helps her be more attentive to using it. I actually heard one or two spontaneous uses of she during that first session.
You have to gauge your little client as to when to introduce he as the next goal. Some kids need a longer time to establish a pronoun. I do a little bit of the opposite pronoun work for contrast (showing a boy doll and describe what he is doing) but mostly bombard the client with she first.
Finally, we finished up with a party as we made various food for our two female dolls. When I asked, “Who has some pizza?” she would reply, “She does, she does and she does,” as she tapped the different dolls. It helped her to hear her target word repeated over and over.
As you know, I enjoyed speaking to masters students in speech pathology at Northwestern University about a week ago. I really like to share ideas on how to make therapy fun and effective with the best toys. I received the following note from one of the students and thought I would share me response as it might be helpful to others. It did take me back to my days as a student when I was diligently planning for each client, looking through the materials room at what was available and then going into my therapy room with the one way mirror, knowing I might be observed–a little scary:
I am currently a SLP graduate student at NU and heard you come speak to us a couple weeks ago! I am currently trying to teach a 4-9 year old boy how to use the correct pronouns ( he, her, his, hers, she, he, they, them). Instead of saying “she is sleeping” he will say ” her sleeping” or instead of ” they are running” he will say ” them running.” Our last session we tried playing with a mr. and mrs. potato head but he was not having it. Do you have any ideas of what toys I could use for our next session, or any recommendations on how I could help demonstrate this?
I just started working with a little girl who has the same goals so I am right in that space too! Here are a couple of tips that might help.
- Find out what interests your almost 5 year-old boy. Mr. and Mrs. Potato Head are sort of go-to therapy materials for 2 and 3 year olds but my guess is he would much rather talk about ninja turtles or legos Ninjago, Chima or super heroes. I was at a 5 year-old’s house yesterday and he shared his prized ninja turtle toy that holds his weapons under his shell (now you can work on “his” weapons!)
- Make sure the boy and girl figures or drawings are clearly different for contrast in modeling feminine and masculine pronouns. Mr. and Mrs. Potato Head might not be as obvious as a mom and dad doll figure like the Fisher Price “Happy Family” set which has great accessories like beach bags, fire pits, camping tents etc.
- Model one pronoun such as “she” and get it fairly established before introducing the next one, “he.” I’ve found this is less confusing and the child feels mastery over the one you are bombarding her with.
- Use books to model the pronoun you are working on. Read a phrase, emphasize the pronoun, “He is in the batmobile,” and your little client will learn to repeat after you. Over time you will fade your prompts and be able to point to a picture for him to describe it.
- Use playdoh to add props to your scene, maybe a soccer ball “he” could kick or a bat that “he” could swing.
Happy Mothers Day to all the amazing moms whose children I work with. Thanks for welcoming me into your homes and families!
And a special thanks to my special mom who is still one of my greatest fans. She has risen above her circumstances of 62 years living with multiple sclerosis and is my hero!!