Using Oral Motor Techniques in Articulation and Phonological Therapy

T063I 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?

 

 

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Talking To Your Premature Babies in the NICU Improves Language Scores

kc and twins in NICUHaving 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.

 

 

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Let’s Teach “She” and “He”

She pronounsMore 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 mermaidout 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 she cookiesfor 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.

Posted in 3-6 year-olds, Language, Preschool, Speech and Language Delay, Strategies to Encourange Language Development | 1 Comment

How Do You Teach Pronouns to a Preschooler?

ninja turtle toyAs 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:

Hello Sherry,

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.
  • imgres-7Use 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.

 

Posted in 3-6 year-olds, Language, Speech and Language Delay, Strategies to Encourange Language Development | Leave a comment

Happy Mothers Day!

Mother's Day watercolorHappy 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!!

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Use a Puzzle with Surprise Flaps to Spark Up Speech Therapy Lessons

Ravensburger shark alarmMy readers know how much I enjoy using a great puzzle in speech therapy. Puzzles can be used at a very basic level of adding a piece after a child takes a turn, repeating their target sound at different levels or a phrase with target language structures. The actual content of the puzzle can also afford an opportunity for a fun lesson too.

Ravensburger’s new  “Finding Nemo Shark Alarm  puzzle” is just that. I introduced it to one of my little clients this week and used it for reinforcement for his /sh/ and /ch/ carryover as well as took advantage of the 9 “surprise flaps” which are on slightly larger puzzle pieces and flip open with fun facts on Squirt, Gill, Bloat, Nemo and others. I used these little personality descriptions to launch a language lesson discussing Squirt’s “fearless and easy-going attitude” “spunky personality” and “expressive eyes.” Many of the character descriptions use some abstract expressions to invite conversation such as what does it mean to “have a temper,” “maintain a sunny disposition,” or “blow things out of proportion?”

For those of us who are itinerant speech therapists, it is helpful to have a therapy tool that can address more than one goal. Although I’ve been asked if I lift weights (no it is just my heavy therapy bags!) I am relieved to lighten my load with multi-purpose materials.

Posted in 3-6 year-olds, 6-8 year-olds, Strategies to Encourange Language Development, Toys | Leave a comment

“Finger Peeps” Puppets Can Build Language in Speech Therapy

Wooky Ent Finger PeepsI have shared several “Artzooka” make-and-play kits by Wooky Entertainment. They are colorful, fun, creative and fairly simple to assemble for pretend play and language learning. Last week I brought their newest kit to a therapy session and my little friend loved constructing his 6 puppets with the punch-out  bodies, arms, heads  and a selection of 60 accessories. The double-sided bodies were a yummy assortment–pictures of jelly beans, watermelon, leaf, and pasta–with two holes to push little fingers through for the legs. The possible characters included a lion, boy, girl, parrot, crocodile, or monster which took on personality according to the accessories a child chose. Add a guitar, skateboard, microphone, cotton candy or flute and your character takes on a theme for the story. We worked on third person singular “He wants_____” or “the lion sings.” But these puppets can be used to further a variety of articulation and language goals. Here is my full review.

Posted in 3-6 year-olds, Articulation, Language, Strategies to Encourange Language Development | Leave a comment

Teaching Northwestern University SLP’s How To Choose Best Toys

Northwestern roundtable 5-14Last Friday I had the privilege of speaking at my alma mater, Northwestern University to their first year masters degree students in speech pathology. It all started when I received a note from one of their assistant professors telling me how much she liked my blog. A phone conversation ensued where we had such fun talking about our profession and how to excite students about therapy, not just courses and books! So I found myself speaking to about 60 bright students about my journey from the university through public school therapy, founding Play on Words, my private practice and then creating the PAL Award. I shared how to choose a good toy, book or game to make a speech therapy session lively, fun and effective and then took questions. I encouraged them to pick up some games and see what the player is asked to do?

  • Ask questions
  • Add on to a story
  • Describe an object
  • Name an associated object

Then I shared some specific games and companies who are intentional about developing products that are fantastically fun but also embedded with potential learning:

Say the Word by Peaceable Kingdom–Cooperative games–social language

What’s In the Cat’s Hat? by WonderForge

Who Am I? by Janod

Rory’s Story Cubes–MAX  (also the app is available) by Creativity Hub

Highlights Buzz Blast by MindWard

Roll ‘n Play by Thinkfun

After I ended the roundtable, several students lingered and started to get excited about starting a blog among the graduate speech pathology students. One student volunteered that she had a graphic design background and others had talents to contribute. I’d love to see them get this going. They realized they should be sharing therapy ideas among themselves too! So, “Wild Chats” I hope you get your blog going. I am looking forward to reading it!

 

 

 

 

 

 

Posted in Games, Language, Strategies to Encourange Language Development | 3 Comments

Best New Toys to Develop Speech and Language

It’s spring–I think! New flowers, new buds, and new toys. I have tested so many new products for the PAL Award in these past few weeks that I want to share some favorites that stand out for having the potential to build language skills. Here we go:

Faber Castell Creativity Can girlThe Big Creativity Can by Faber–Castell. I set this tub of fun in the middle of table and watched 3 sisters aged 6, 7, and 9 go right to their projects after examining the clay, wheels, stickers, styrofoam shapes, wiggly eyes, feathers, bells, pom poms, paper grass, mesh tubing and more. They were busy in their own corner making a hot air balloon and “salsa dancer” (pictured to the left) as well as a bouncy toy. They offered advice, asked for help holding pieces as they stuck them together and showed off their creations. There is plenty in the box to make up a toy, figure or animal or object but you can also offer household items like paper towel rolls, or oatmeal boxes to stretch the imagination. Do it in a group and listen to the language. Here is my full review.

Let’s Make Pom Pals Pom Critter Kit by PomTree. Phew! That is a lot of “poms” but this tub of fun is filled with several sizes and colors of pom poms, wiggle eyes, foam shapes, felt stickers and chenille stems to make your animals. No glue is necessary as little squares of double-sided sticky tape keep your pal together. This make and play craft quickly turned into some wonderful creative scenarios as the pom pals came to life.  Open-ended play that relies on the child as director,  encourages language development as kids make up the format! Here is my full review.

Playful Chef Deluxe Cooking Kit by MindWare.  Kids learn the language of cooking, as they tie on their aprons, follow the color-coded directions for measurements, and learn about cooking gadgets and  fun facts about ingredients. (I learned a thing or two also!) The 14 kid-sized tools are nice quality, especially the flexible star cake pan which was a hit.  This child-parent/adult activity makes it special as kids learn their way around the kitchen. Here is my full review.

 

 

 

Posted in 3-6 year-olds, 6-8 year-olds, 8 years and up, Language, Strategies to Encourange Language Development, Toys | Leave a comment

Spring, Time To Grow Language With New PAL Award Winners

Crocuses popping up, dogwoods blooming and peepers whistling in the neighborhood pond remind me that spring has arrived and the landscape is alive again. As we look at new growth and new beginnings what about checking out some great toys and games, just introduced, that can grow language? Children are invited into play by fantastically fun toys that encourage growth as kids meaningfully add on to a story, make up riddles, complete early reader words, and step into pretend play.

Here are some of my new favorite PAL Award winners:

Say the Word by Peaceable Kingdom

Peaceable kingdom Say the Word“The Repeat-After-Me Silly Story Memory Game!” says it all. In Peaceable Kingdom’s new cooperative game, everyone is the story teller, adding on a zany phrase or sentence using a word card in their hand, recalling what was previously said.  The Story Master monitors the round, chooses a character card (we chose “My Fairy Godmother,” “Quintuplets,” and “The Zombie”), deals 3 word cards to each player (ranges from wiggle, donkey, or bumpy to bunny slippers, tarantula or afro) and the story begins.  What a delightful, funny way to build language skills as players must use a new word to relate to the ongoing story line. Kids learn vocabulary, how to advance a story using a controlled set of words, and strategies to memorize meaningful chunks of language.

Available on Amazon: Click here

 uKloo Riddle Edition Treasure Hunt Game by uKloo

ukloo_riddle_on_whiteheader-1024x462The uKloo family is growing and they’ve done it again– introduced us to yet another fabulously fun treasure hunt game that promotes reading, thinking and now problem solving! Parents hide several riddle cards and the hunt begins.  “If there is rain or snow or sleet, put these on to protect your feet,” sent them off to peek inside the boots sitting at the front door. Learning extends beyond the game as our friends started making up their own riddles.  The Riddle Writing Tips encourage brainstorming, describing, using adjectives, homonyms, synonyms, and antonyms and using figurative language. Who had a clue that stumping your friends could be such “smart” fun!

Zingo Word Builder by ThinkFun

imgres-4Zingo™ is back! First it taught us matching pictures, then sight words and now spelling and reading. Something about sliding that red device back and forth for “the reveal” captures kids’s attention and they can’t get enough.  My beginning readers took a letter tile and placed it in each empty spot on their word-builder card and slowly sounded out the words. They were thrilled when they said a word that made sense. Kids were doing just what they’d been taught and found great gratification and fun in the process. Learning to be an independent reader opens up worlds of language learning.

Available at Thinkfun: Click here

 My Super Life Journal by PomTree

PomTree_TGC-0042 Scrapbook Journal_HRThis “Awesome, amazing, super, crazy, wonderful, lovely, adventurous, sunny, creative beautiful life journal” (and that’s just what is on the cover!) inspires little girls to celebrate all the little things in life with big splashes of color, stickers, art, words and adornments. The spiral binder holds it all–all about me, what I love, the best, dance and doodle, trips, fashion, places to visit, and favorites. Store your supplies in the vinyl storage zip bag or binder pockets, waiting to record your next adventure. I can’t think of a better way to excite kids about reading and writing as they tell about their amazing life with words and illustrations. This would be a perfect activity book for summer, to keep minds sharp.

Playpark by Plan Toys

imgres-8“Whee!” was the first word out of our little friend’s mouth as she gave one of the wooden family figures a ride down the cable car. “Use the harness for the baby,” I was instructed. Kids rode their bikes, raced down the ramp, climbed the rope ladder and took off on the glider from the launch area. Kids took turns winding the wind turbine to offer rides to their figures. Plenty of pretend play is inspired by open passageways from the ground floor up to the top level. Stories abound as kids get inspired by this toy!

Available at Amazon: Click here

Dinosaur Floor Puzzle by Galt Toys

61cps7AhmPLKids indeed thought this 30 piece dinosaur puzzle was giant and quite grand. With eight of the jigsaw pieces able to stand alone as complete prehistoric animals including some favorite dinosaurs, kids loved building the puzzle around these figures. Lots of conversation ensued as negative spaces began to show signs of a foot, wing or tail to match the creatures. The thick cardboard prehistoric figures with a wipe-off finish served as pretend play characters after the puzzle was completed. Kids couldn’t help but carry on with the story, reinforcing language skills to prepare them for later reading and writing.

Available at Amazon: Click here

Story Box-Safari by Janod
J08542_1I always like to watch kids when the packaging becomes part of the play. Our Safari Park pieces are stowed in a sturdy box shaped and illustrated like home base for the animals and tourists. My little friend set up his elephant, hippo, giraffe, zebra, lion and gazelle while the ostrich roamed free and the crocodile lazed in pretend water. The fence kept things reigned in until he started to match the animals and place them next to their pictures on the box.  Soon the monkey and ostrich were on the roof , watching as the safari train loaded its passengers and went on tour. Later he said, “Up the elevator” and lifted the figures up the side of the box to the top for a better view. This set was wonderful for pretend play and story telling as kids drove the story and used the props to direct the play. Language learning abounds when kids are given the right tools to do their work!

Available at Amazon: Click here

 

 

 

 

 

 

 

 

Posted in 3-6 year-olds, 6-8 year-olds, 8 years and up, Games, Language, Strategies to Encourange Language Development | Leave a comment