Monday, July 18, 2016

Articulation Ideas: Playtime for S-Clusters- Review and Giveaway

I can always count on having children with s-cluster goals in speech therapy.

Preschoolers and kindergarteners are cuddly, cute and very wiggly- they need hands-on activities! So I am ever on the lookout for fresh ideas and activities to keep those little ones engaged.

Articulation Ideas: Playtime for S-Clusters- Review and Giveaway www.speechsproutstherapy.com
Spoon drop s-blend activity

Enter S-Blend Playtime! Activities for S-Clusters, a new resource by Kim from Activity Tailor. What I love about this pack is that it is chock full of great ideas to get kids up, moving, digging, sliding, opening and exploring as they practice those s-blends.

S-Blend Playtime Activities includes creative ways to use stuffed animals, toy planes, miniatures, play dough, shaving cream, blocks, and stickers. You could easily fill up to 8 sessions per blend, which would carry you through at least 2 cycles with little to no planning and prep required! I love that.


Included are ideas for play activities, games, recipes (make some slime!) and tabletop activities for seven blends: SK, ST, SP, SL, SM, SN, and SW.  

For each blend, there is a printable tabletop activity, from coloring ice cream scoops (/sk/) to adding smiles on fun faces (/sm/). There is a listening list for auditory bombardment in therapy, 6 play activities, a movement activity and a send-home parent note with instructions and pacing boards with a list for parents to read, and pictures for children to name.

The play activities use items you probably already have in your therapy room, cutting down on expenses. I don't know about you, but materials usually come out of my own pocket, so that really helps!

I think one of my favorite ideas is making scary/ not scary boxes. 

Most of my preschoolers are fascinated by anything a bit creepy. I happen to have scorpions, snakes. beetles and spiders in my bug collection- perfect! Maybe a skeleton would work also, hmm.

I think I need to make some slime too. Slippery slime slides slowly. Oooh, this will be fun!

Click HERE to see the details in Activity Tailor's store.



These activities would fit right in with my intensive preschool program.

I do centers and hands-on activities for my littles to fill two-hour sessions. Read more about this service delivery model and what's included here:  Intensive Service Delivery Model for Preschool Speech Therapy.

Would You Like to Win a Copy?

Leave a comment with your favorite activity for s-blends, and I will pick a winner at random!
I will pick a winner at 12 am EST on July 25th. The winner will be announced here and on my Facebook page, so check back!

Good luck, I can't wait to see your ideas!

Update 7-25-16, We have a winner!

Thank you to everyone who entered and shared ideas. A winner has been chosen by a random number picker: Lisa Filion! Congratulations Lisa, please email me at speechsproutstherapy@gmail.com  and I will send your copy of S-Blend Playtime! Activities for S-Clusters. A special thank you to Kim from Activity Tailor for providing a free copy.

Monday, July 11, 2016

10 Terrific Storybooks for Speech Therapy and How To Use Them.

What are your favorite storybooks for speech therapy? 


That is what I asked the bloggers at Speech Spotlight, and I am excited to share their favorites with you. Speech Spotlight is my other blogging home, where I collaborate with nine talented SLP blogger friends. Stop by and visit, if you haven't already!

Is your favorite here? 10 Terrific storybooks and how to use them in speech therapy. www.speechsprouts.com
Is your favorite for literature-based speech therapy here?
If you have visited me before at Speech Sprouts, you know I think literature-based therapy is terrific. The cat's meow. Awesome. Outstanding. The bee's knees. Fabulous. (Maybe I like synonyms and idioms a little bit too?)

I will be definitely be headed to the library to check out this list of delightful children's books. 

There are some new ones in here for me. I'll tell you about one of my new favorites too!


1. The Pout-Pout Fish Goes To School by Deborah Diesen


Is your favorite here? 10 Terrific storybooks and how to use them in speech therapy. www.speechsprouts.com
Build vocabulary with
The Pout-Pout Fish Goes to School
Ashley from Sweet Southern Speech posted about her favorites in her post Building Vocabulary With Back to School Books. She writes "The Pout-Pout Fish series of books offer an excellent opportunity to use imagery for vocabulary building. Just look at his face on the cover!" 


2. Aunt Isabel Tells a Good One by Kate Duke


Susan from Kids Learn Language said, "One of my favorite books for therapy (only one???) is Aunt Isabel Tells a Good One, by Kate Duke." It's an engaging story that walks kids through how a story is written - what elements you need to have. 

Aunt Isabel tells her nice and nephew about stories, as she makes up a story from elements they all suggest - and the heroine saves everyone. Her kids have always loved it! Susan has a companion resource for this book in her store. https://www.teacherspayteachers.com/.../Story-Elements...


3. Leaf Man by Lois Ehlert

Ashley also shared this lovely book in her blog post Fall Books and How I Use Them in Speech Therapy. She targets compare and contrast, sequencing, vocabulary and superlatives. It's also a terrific book for incorporating fall art in speech therapy. 

4. A Bad Case of Stripes by David Shannon

Linda from Looks Like Language  loves using A Bad Case of Stripes to help students make inferences and work on social skills. It helps students understand that other people have different perspectives. Linda reads it with her students to work on interpreting facial expressions and talk about how people feel about each other.  

5. Dear Mrs. LaRue: Letters from Obedience School by Mark Teague

Linda also really likes this book for teaching students to look for pictured clues to make inferences, compare and contrast, and for talking about how different people can have different viewpoints in the same situation. 

6. Dear Zoo by Rod Campbell
Is your favorite here? 10 Terrific storybooks and how to use them in speech therapy. www.speechsprouts.com
Teach Describing words with Dear Zoo.

Colette from Alberta Speechie shares this favorite in her blog post on Bringing Children's Lit Into Speech. She says Dear Zoo is not only great for teaching the names of different zoo animals, but it also uses describing words such as jumpy, fierce, grumpy and naughty which might be new to the children. Children love to act out the different descriptions! 

7. The Apple Pie Tree by Zoee Hall

This favorite is from Ashley at  AGB Speech Therapy. She loves to use this book for teaching seasons and sequencing. The book is colorful and engaging, and has a delicious apple pie ending! I can see myself making some mini-pies with my students after reading this one.

8. Press Here by Herve' Tullet

Is your favorite here? 10 Terrific storybooks and how to use them in speech therapy. www.speechsprouts.com
Follow one-step directions
with Press Here 
Jennifer from Speech Therapy Fun says she loves Press Here because it's so different from the average book. It's great for one step directions and the students love seeing what happens when they follow the directions. I definitely agree, Jennifer! It's one of my favorites, and you can read a review of this book HERE at Speech Sprouts.

9. The Little Pea by Amy Krouse Rosenthal

Sarah of Speech is Beautiful picks this adorable book as a favorite of hers. The main character is a little green pea who does not want to eat his candy. (What a fun turnaround to read with any veggie-hating children!) This simple story is perfect for initial /p/ and story retell.

10. Peck, Peck Peck by Lucy Cousins
This story about a young woodpecker and his daddy is one of my newest favorites at Speech Sprouts. You can read the full review  HERE. I am always looking for sound-loaded books, as you may know if you have read about my sound-loaded storybooks for articulation freebie. This book is repeats the word "peck" over and over as the little woodpecker flies off to try out his new skills. Perfect for teaching final /k/. It's also great for where questions, categories and rhyme too. 

There you have it! 


I hope you have discovered a couple new titles for your therapy room.


I know I can't wait to try out some new storybooks with my students. You can always find my reviews of more great children's books by clicking the Storybook category at the top of my blog on my home page. I will be adding new ones to my Best-ever Storybooks series, so check back often, and let me know if you have a favorite you think I would like. 

Now, where's my library card?  I'm going to need it!


Until next time my friends.


Wednesday, June 29, 2016

How to Uncover Emerging Skills with a Dynamic Assessment for CAS


Where do I start in therapy for Childhood Apraxia of Speech? 

Uncover emerging skills with a dynamic assessment approach for CAS and yield some powerful information to kickstart progress in speech therapy!

How to Uncover Emerging Skills with a  Dynamic Assessment for Childhood Apraxia of Speech www.speechsproutstherapy.com


What is a dynamic assessment?

Dynamic assessment means we are cuing the child, and seeing how they respond to different levels of cuing.

To me, this is a game-changer. I was frustrated with my usual assessment battery. I wondered if I had enough evidence for an accurate diagnosis, and I wanted more direction on where to start in therapy to get the biggest bang for my buck!

 If you haven't been trained in using a dynamic approach to your motor speech exam, I hope you will read on!

This is part 4 in my series for SLPs on Childhood Apraxia of speech: Let's Talk!

If you have been following, you know that I attended an amazing small-group intensive workshop this spring with Dr. Strand, of the Mayo Clinic. With her permission, I am sharing with you.

In my last post, we talked about


Part 3: 4 Essential Steps in Assessing Childhood Apraxia of Speech
Dr. Strand recommends:
1. a spontaneous speech sample
2. a standardized elicited speech test
3. a structural-functional exam
4. a dynamic motor speech exam, using imitation tasks and cuing.

Let's talk more about that last one!


============================================


What are the advantages of a "dynamic assessment" approach?

Dynamic assessment can help us to:

How to Uncover Emerging Skills with a  Dynamic Assessment for Childhood Apraxia of Speech www.speechsproutstherapy.com

1. Make a differential diagnosis

We may see characteristics when the child is asked to say unfamiliar syllables and respond to cuing that may not be evident in conversational speech. These include groping, inconsistency across trials, and segmentation of multi-syllabic words (ex."bi...cy...cle") not evident in conversational speech.

2. Provide a better picture of emerging skills, and beginning therapy targets

A dynamic approach allows us to observe what the child does when attempting specific syllable shapes, versus what she may habitually do in spontaneous speech. The use of cuing may prompt a child to attempt certain movement gestures we may not see otherwise.

3. Determine severity, which is important for prognosis and therapy planning

We can observe the child's response to various levels of cuing. A child that requires intensive cuing would be considered severe, a child who responds with minimal cuing may be considered mild.

4. Identify which cues are more effective for the child.

This can really help get the ball rolling toward making progress.


Is there a published instrument to use for a dynamic motor speech assessment?

There has long been a need for an assessment that could assist with differential diagnosis in young children and those with severe apraxia of speech. Dr. Strand and her colleagues have been developing a standardized assessment, the Dynamic Evaluation of Motor Speech Skill (DEMSS) Strand, McCauley, Wigand, Stockel & Bass, 2103).

You can read more about the DEMSS here: A Motor Speech Assessment for Children With Severe Speech Disorders: Reliability and Validity Evidence.

The DEMSS is nearing commercial publication, according to Dr. Strand. Personally, I can't wait, because I think it will be a really valuable tool. However, it is not yet available. So what to do? Design your own!

============================================


So how to you design a dynamic assessment for CAS?

1. First, choose a hierarchy of syllable shapes, consonants and vowels. Here are some examples:
  • CV- me, two
  • VC: eat, up
  • CVCV (same C): mama, bye-bye
  • CVC1 (same C): bib, mom
  • CVC2 (different C): wipe, done
  • Bisyllabic: baby, movie
  • Multisyllabic: banana, potato

2. Ask the child to repeat the utterance (immediate direct imitation)

3. Vary the length of the pauses between your production and theirs.  (delayed direct imitation) If correct, see if they can still do it when you add a delay or pause between your model and their production. (I'm going to say a word, and I want you to say it when I point to you.") Are they consistent?

4. Use cuing as needed to elicit improved production

Cues To Try:

  • ask the child to watch you as you say the word "Watch me, I'll help you." (If children are more accurate when watching you than not, this is a key sign of CAS)
  • ask the child to say the word simultaneously with you "Let's say it together, ready?"
  • slow your model slightly (but never, never segment within a syllable! Say "Mmmoooomm" rather than M-o-m.)
  • hold the initial articulatory position a little longer when modeling. "mmmop"
  • provide tactile cues

Judging performance:

While eliciting your word list, take note of:
  • Consonant accuracy and how it changes with cuing
  • Consistency in repeated productions
  • Vowel accuracy
  • Prosody in multisyllabic words or in phrases. (We don't judge prosody in monosyllables)
  • Additional characteristics to watch for across all assessment tasks

Remember, there are currently no specific set of markers that are agreed upon as absolutely differentiating childhood apraxia of speech, and some characteristics are stronger indicators of CAS than others. However, these characteristics can provide valuable information, and if a child has a high number of characteristics, CAS is more likely.

Read more about this in my second post: Is It CAS? Navigating Differential Diagnosis.

Watch for these characteristics:

  • Difficulty achieving the first articulatory position (ex: doesn't bring lips together in the beginning of "Mom'
  • Inaccurate movement between articulatory positions during transitions
  • Groping
  • The addition of a schwa
  • Trial and error behavior
  • Even and equal stress, or stress in the wrong place
  • Segmenting or breaking up multisyllabic words
  • Greater difficulty with multisyllabic words
  • Distortions of substitutions (can also be due to dysarthria)
  • Slow rate (can also be due to dysarthria)

Use the characteristics you have observed in your dynamic assessment, along with other evidence you have gathered to make your differential diagnosis and impression of severity in your diagnostic statement. A thorough description of your conclusion and the evidence for it is important for treatment planning. 

============================================

If you haven't viewed Dr. Edythe Strand's videos for parents on YouTube, I highly recommend that SLPs watch them as well. 


You will see clips of children during assessment and treatment and examples of some of the characteristics. You can see all the segments here: Childhood Apraxia of Speech: Information for Parents. or watch them segment by segment.

These particular segments have video examples of children speaking with various characteristics of speech sound disorders, including CAS, which can be helpful to watch. Try watching them and seeing if you can observe the characteristics in our list for practice. 


You may also want to read my earlier posts in my childhood apraxia of speech series:

Part 1: Childhood Apraxia of Speech: What SLPS Need To Know - What CAS is, and important definitions we need to understand

Part 2: Is It CAS? Navigating Differential Diagnosis - The characteristics of CAS, and which ones help us differentiate CAS from dysarthria, ataxia or a phonological disorder

Next time we will talk about planning therapy for a child diagnosed with CAS, and what the principles of motor learning theory have to do with it!

See you then!

References:
Strand, E, McCauley, R, Weigand, S, Stoeckel, R & Baas, B (2013) A Motor Speech Assessment for Children with Severe Speech Disorders: Reliability and Validity Evidence. Journal of Speech Language and Hearing Research, vol 56; 505-520.





Monday, June 13, 2016

Best-Ever Books For Speech Therapy: Peck, Peck, Peck

Summertime means it's time to find some great books to read!


I can head to the library, and I have time to peruse the stacks all I want. For this book-lover, that's a treat! So have I found a great mystery to read? Science fiction maybe? Or perhaps a biography? Well...no.


My first trip to the library yielded an armload of children's stories.

Read about my favorite book for articulation therapy! Love using storybooks to teach speech and language? This adorable book is perfect for final /k/ and rhyme too. www.speechsproutstherapy.com

I don't even have any little ones at home! (I will go back and find that perfect summer read for me, just not yet!) I can't resist trying to discover a few more storybooks to use with my little ones in speech therapy, while I have the time.  If you have read about my free Sound-Loaded Storybooks for Articulation list you know I love using terrific children's literature in therapy.  So now I have some new gems to share with you.


Today's find is Peck, Peck, Peck by Lucy Cousins.

This book is totally sound-loaded with final /k/ and it's adorable too! The story is about a little woodpecker who learns to peck. He is growing up, and it's time to learn new things. The story repeats the word "peck" a bunch, as the little guy ventures out and pecks everything in sight! Perfect for auditory bombardment.


Read about my favorite book for articulation therapy! Love using storybooks to teach speech and language? This adorable book is perfect for final /k/ and rhyme too. www.speechsproutstherapy.com

 One thing I really love about this story is that it is the daddy that teaches the youngster, and tells him how great he is. I think we need more children's books where the daddy is the teacher and nurturer. So many of my children at school do not have a daddy at home every day, and I love having them read about a good fatherly role model!

 Read about my favorite book for articulation therapy! Love using storybooks to teach speech and language? This adorable book is perfect for final /k/ and rhyme too. www.speechsproutstherapy.comRead about my favorite book for articulation therapy! Love using storybooks to teach speech and language? This adorable book is perfect for final /k/ and rhyme too. www.speechsproutstherapy.comSo off the little woodpecker goes, out into the world to practice.

He finds a gate to peck and makes a hole right through it. Then  he spots a big blue door. This can't be good!

As the little woodpecker makes holes in everything he sees, the word "peck" is repeated constantly.  

It is also printed on the page next to everything the woodpecker is pecking.

I like to work on print awareness with my preschoolers, so this is great. I can have them point to the word "peck" on each page. We will take note of the "k" on the end of the word, and practice making the sound it spells. Lots of velar practice. Love that.

The text rhymes too.

We can work on listening for rhymes as we point out rhyming pairs. Then we will generate a few new rhymes to go with them. Wait and gate, door and more, hat and mat. Perfect!

It's lots of fun seeing the growing number of holes in the pages.

The little woodpecker works his way through an armchair, a teddy bear and even a book named Jane Eyre. Yup, rhymes make me smile.

Maybe we'll count the holes. For sure we can talk about the words "a few, more and most." Quantity concept time.

My children love characters that do something a bit wrong. 

The little woodpecker heads to the bathroom  and pecks some blue shampoo, and he even pecks the toilet too! Eww!  The kids will love that. It's just the right amount of gross.

As the woodpecker heads through the house, we can talk about each room, what he might find there, and work on a bit of categorization. This is why I love children's books, there are so many, many natural opportunities to teach language concepts.


Finally, there is nothing left to peck.

The little woodpecker is tired out, and he's ready to head home. He tells his daddy about his day. About the many, many holes he's made and how much he loved it.

Daddy tucks him in, tells him he loves him and gives him a kiss. So sweet.

This book will be on the top of my list when we do a final /k/ unit.

 I hope you can find this wonderful storybook in your library too! I know I will be checking out more stories by this author, Lucy Cousins.

If you are looking more more fun books, read my review of  Press Here by Herve' Tullet. Click this link, Best-Ever Books For Speech Therapy: Press Here. It's sure to be a favorite of any child who reads it!


What are your favorite storybooks for speech therapy with preschoolers and kindergarteners?  

I am always looking for more suggestions, so comment if you have one to share!

Happy Reading! 

Hope you have lots of time to enjoy a good book if you are on break, or soon to be. You can find more of my favorites for littles here: Storybooks.  Until next time.

Sunday, May 29, 2016

10 Tips To Get You Organized at The End of The School Year- You'll Thank Yourself Later!

Summer is coming. Get organized now.

 Whether you are an SLP or a teacher, just a few organizational tweaks now can make your life easier in the fall. You might even want to kiss your brain for being so forward thinking!

10 Great Tips for SLPs to Organize at the End of The School Year That Will Make Your Life Easier in The Fall! www.speechsproutstherapy.com


May and June is crunch time for school-based SLPs. 

This is the time of year when school-based speech language pathologists are rushing to complete end of the year tasks. It seems like there are a thousand things to do, IEPS, last minute assessments, reports, COSFs, Medicaid Billing, progress reports and meetings. Oh, the meetings. Many, maaaany meetings.

You may not be thinking about back to school right now. But you should be.

Do a few things now to get organized, and back to school will be easier and smoother for you! Beginning the school year is also a challenging, hectic time. When we get back, it is always a transition to get up and going again. So what can you do to prepare?

I asked some school-based slpeeps for their best ideas, and got some great tips to share with you.


10 Things You Can do Now to Make Your Life Easier When You Get Back to School


  1. Inventory- We have to do inventory at the end of each year. Before you sign it and turn it in, make yourself a copy and file it. I also keep a check-out list for materials I share with others. Check items back in when returned. It will make it much easier next year to know what is still in your room, and what others have. 
  2. To Do List- Make a to do list for the first week back to school. You may be surprised what you can forget after a long relaxing summer! I include priority tasks such as IEPs and assessments due soon, who needs accommodations distributed to teachers, parents to contact about scheduling, AT to distribute or set up, consults to complete. Keep this list in the very front of your file cabinet.
  3. Passwords- Make a list of passwords, because if you are like me, you WILL forget these over the summer! Sarah says it may be a tech no-no, but you may need it! Keep your password list in a secure location.
  4. Student folders- Sue keeps a folder for each student to grab for their session. At year's end she stocks these with fresh attendance calendars, logs and an intro letter. Then she is ready to go in the fall.
  5. Students moving- When Lynda knows a student will not be returning, but is still in her district, she puts a post-it note on her working file with next year's school so she knows where to send the file. Those moving out of district go to the "moved" drawer. 
  6. Bulletin Boards- Kathy puts her fall bulletin boards up now, then covers them with paper or trashbags. 
  7. Prep Forms- Jenn preps her beginning of the year release of information forms she will need, so they are ready to go and current. She preps a referrals list too.
  8. Location of Items- Tracy uses Google Keep to record her notes to self about locations of keys, files and tasks. She loves this because she can add to her notes from her phone, no matter where she is, when the thought strikes her!
  9. Computer Cables- At my school, we have to unplug everything, and it can be a jumbled mess in the fall. Joan labels her computer cables because everything gets disassembled. 
  10. Room furniture and equipment- Teachers often get back and are setting up their rooms very early, before I am there, especially new teachers. Sometimes they scout for "spare" equipment and things can go umm... awol. I put away surge protectors, headphones, cables and remotes in a file cabinet.  I label my teacher rolling chairs, table, trashcans, bookcase and anything that is not nailed down with my name. Helps prevent confusion and items growing legs!
10 Great Tips for SLPs to Organize at the End of The School Year That Will Make Your Life Easier in The Fall! www.speechsproutstherapy.com
Graphics by Kinka Art and Creative Clips

Hope you found some helpful tips! If you have a favorite tip to share, leave me a comment. I would love to hear from you.


Happy summer everyone!

Follow my blog with Bloglovin

Sunday, May 15, 2016

4 Essential Steps in Assessing Childhood Apraxia of Speech

You have an evaluation scheduled. This child is highly unintelligible, and you suspect childhood apraxia of speech, or CAS.  But just how do you design your assessment?

4 Essential Steps in Assessing Childhood Apraxia of Speech www.speechsproutstherapy.com

How many phonological assessments have you done? Probably hundreds for me, and I bet you can practically assess for a  phonological disorder in your sleep! But we don't see that many children with childhood apraxia of speech, unless we specialize in that area. So it may be a little less clear as to how to design the most effective assessment and how it may look different from what we usually do for our phonological children.


This is Part 3 in my series on Childhood Apraxia of Speech, Let's Talk! 

To start at the first post, head to Childhood Apraxia of Speech. What SLPs Need to Know.

If you have been following, you know I recently had the wonderful opportunity to learn from Dr. Edythe Strand, a leading expert in CAS. Me? I am not an expert. Dr. Strand generously gave permission and asked us to share what we learned, because she knows that many SLP's have not had the opportunity for in-depth training in CAS, and often feel unsure about how to approach assessment and treatment.

Do you have questions? Grab a cup of coffee, and let's talk!

=================================================

You've gone over the child's history, and made some initial observations. 

You have noted some of the characteristics we talked about in my last post: Is it CAS? Navigating Differential Diagnosis. You suspect CAS. What's next?

Planning Your Assessment

A carefully planned assessment can help you make a differential diagnosis between childhood apraxia of speech, a phonological disorder, dysarthria or ataxic dysarthria. Let's take a look at what Dr. Strand recommends. 

4 Essential Steps in Assessing Childhood Apraxia of Speech www.speechsproutstherapy.com


1. Spontaneous Speech: Take a Language Sample
This is a great place to start, especially if the child is not a talker, or very limited in verbalization. Be sure you include both free play and structured play. 
  • Do you note any differences in communication between the two? 
  • How does the child communicate: verbal, gesture, pointing? 
  • Does he imitate you? 
  • Make some initial observations about his phonemic and phonetic inventories. Does he use sounds meaningfully (in at least two contexts), or is it vocal play?  
  • How would you rate his intelligibility? 
  • Do you see groping or awkward movements of the articulators?

4 Essential Steps in Assessing Childhood Apraxia of Speech www.speechsproutstherapy.com


2. Elicited Speech: 
If you recall from my last post, breakdown in CAS often occurs in elicited speech more than spontaneous speech. Note if there are differences.
  • Articulation or Phonology Test:  Do a standardized test if the child is capable. He he is non-verbal or very limited, you may not get much here.  
  • Imitation Tasks. 

4 Essential Steps in Assessing Childhood Apraxia of Speech www.speechsproutstherapy.com


3. Structural/ Functional Exam- a good oral motor exam can help you determine or rule out whether dysarthria or oral apraxia is present. You don't always have to do each task because you can often observe informally when function is normal, but if you notice abnormal function, test further. Here's what you are looking for:
  • Signs of dysarthria: Check jaw, lips, tongue and velum for weakness, reduced range of motion, strength, speed, and drooling.
  • Signs of oral apraxia: You will want to rule this out if you suspect weakness or dysarthria.  Have the child blow, pucker, smack lips, cough and do sequential imitation (diadokokinesis tasks).  Can the child do it? Does he grope? Is it uncoordinated? 
  • Signs of ataxic dysarthria:  This can often look similar to CAS with inaccurate/ inconsistent movements. We can also see voicing errors. Watch as the child says one syllable (puh) and compare to 3 syllables (puh-puh-puh).  
    • In severe CAS: the errors are more inconsistent and they will do better with a single syllable than three. 
    • In ataxic dysarthria (which is caused by damage to the cerebellum) errors are more consistent across tasks, there will be uncoordinated movements, regardless of number of syllables, and you may see a wide-based gait or intention tremor. 

NOTE! We often hear "the child has low tone." Tone is how much muscle contraction there is at rest. A child can have low tone, but normal strength in action. Low tone is usually not weakness and is not a problem for speech!

4 Essential Steps in Assessing Childhood Apraxia of Speech www.speechsproutstherapy.com


4. Motor Speech Exam: This type exam has traditionally been used with adults to assess for acquired apraxia of speech, but has not been widely used for CAS.  A motor speech exam allows us observe how a child's speech varies across contexts, and watch for signs of praxis. Start at the level the child is capable of. You can look at:
  • Vowels
  • CV, VC, CVC words
  • one, two and three syllable words
  • phrases
  • sentences of increasing length

Dynamic Assessment

Dr. Strand advocates for a dynamic assessment approach to the motor speech exam. 


What do we mean by "dynamic?" 

We are cuing the child, and watching to see how performance changes with different levels of cuing. This in in contrast to a "static" assessment, which measures a child's performance after a single response with no cuing or assistance. Most standardized tests are "static."  

Why do a dynamic assessment?  It helps us:

1. Determine level of severity. Lots of cuing needed means a more severe presentation of CAS. Less cuing would be mild or moderate. Great information to help us recommend frequency and intensity of services, and level of cuing support needed.
2. Find out which cues are most effective for this child.
3. Reveal emerging skills- very helpful for planning initial therapy targets. We may see movements a child is able to make with cuing that we may not see in a "static" assessment.
4. Helps with differential diagnosis by allowing us to see:
  • groping we may not see in spontaneous speech
  • inconsistency across trials with and without cuing.
  • whether the child is segmenting syllables (ba-na-na). We usually see this with unfamiliar or multisyllabic words. 

================================================

How are you doing? 

Is this coming together for you? I'll tell you, writing these posts is really helping me review and frame my thinking and approach. Re-visit and re-read, it really helps! 

4 Essential Steps in Assessing Childhood Apraxia of Speech www.speechsproutstherapy.com


Dr. Strand has a YouTube series you need to check out.

 These videos were made to help explain CAS to parents, but they have terrific information and excellent video examples for SLPs too. I highly recommend you take a look, and share with parents.

This video is 52 minutes long, and contains all the segments. But you can also view her videos in shorter segments.

This video shows video examples of children with different severity levels of CAS:

This video shows video examples of children with a phonological disorder, and dysarthria.


Now we have the pieces of a thorough plan. 

You may be saying, "So exactly how do I conduct a dynamic assessment?  We'll talk about that in my next post in the series. You can find it here: How to Uncover Emerging Skills with a Dynamic Assessment for CAS.

If you are enjoying this series, please comment, share, pin and post to help spread the word!


 Until next time, friends!








Monday, May 2, 2016

Best Year-End Picks for SLPs: Speech and Language Activities that Will Help You Sail into Summer!

SLP's and Teachers have worked hard all year.

May and June means progress reports, finishing evaluations, End of year IEPs, COSF reporting, billing and more. I know, because I am there too.


Find the best resources to make your year-end planning a breeze!


Time to treat ourselves!

 The Frenzied SLPs know how hectic the end of the year can be. We know need some extra love and slam-dunk resources to make your year-end therapy planning a breeze.

To say thanks, we are joining Teachers Pay Teachers to show some extra appreciation for all you do with a Speechy & Teachers Appreciation Sale! Teachers Pay Teachers is celebrating their 10 amazing years with this year-end bonanza.

Woo hoo! You will find everything in Speech Sprouts store on sale for 28% off when you use the code: CELEBRATE. 

That's terrific, but...

 There are literally thousands of resources to choose from. Mind-boggling for sure. No worries, the Frenzied SLPs have you covered. We will help you de-frenzy (Is that even a word? OK, I just made it up :)


We have gathered up some of our best picks for you to save you time and make your shopping fun and easy.  

My year-end favorites from Speech Sprouts

Definately my Oceans of Fun Bundle. You get plenty of under-the-sea fun in this two-pack with  Smiley Shark Speech Therapy Book Companion and Diver, Diver Who Can it Be? A Reader Focusing on Where? Questions. Tons of ocean-themed language, phonological and articulation activities- you are sure to cover nearly everyone on your caseload with this one. 

Best Year-End Picks for SLPs:Speech Therapy Oceans of Fun Bundle www.speechsproutstherapy.com

Best Year-End Picks for SLPs: Smiley Shark Book Companion www.speechsproutstherapy.com         Best Year-End Picks for SLPs: Diver Diver Where Can You Be? Reader www.speechsproutstherapy.com



Another favorite for year-end vocabulary fun is Antonym Picnic.


Pack your picnic, make a cootie catcher, make a fun sandwich-shaped mini-book to send home or play one of several included games as you teach those antonyms.


Best Year-End Picks for SLPs: Antonym Picnic www.speechsproutstherapy.com           Best Year-End Picks for SLPs: Antonym Picnic www.speechsproutstherapy.com


Best Year-End Picks for SLPs: Antonym Picnic www.speechsproutstherapy.com              Best Year-End Picks for SLPs: Antonym Picnic www.speechsproutstherapy.com



I'm packing my cart with this resource from Twin Speech Language and Literacy, LLC. This Summer-Themed Articulation Bundle will be perfect for my artic groups or a send-home summer packet.

Best Year-End Picks for SLPs: Speech and Language Activities that Will Help You Sail into Summer!
From Twin Speech Language and Literacy, LLC

This one will make my life easier this fall too, when all those referrals come pouring in! Grab these Speech and Language Checklists from All Y'all Need, and be ready.

Best Year-End Picks for SLPs: Speech and Language Checklists
From All Y'All Need

Hope you enjoy  these easy-breezy resources!

Be sure to hop through the link-up and see what else the frenzied SLPs have in store for you. Go ahead and pop your favorites in your cart ahead of time, and you will be ready with a fast and easy checkout. 

Stop by Speech Sprouts and see what else I have in store for you.

 Everything, including my bundles, will be and extra 28% off with the code CELEBRATE, so don't forget to use that code! (Easy to forget, I speak from experience, drat!)

Here's the Link-up from more of my Frenzied Friends:


Happy Shopping!