Sunday, February 17, 2019

Diagnosing Childhood Apraxia of Speech: A Review of the DEMSS from the Trenches

 The  Dynamic Evaluation of Motor Speech Skills (DEMSS) is a tool I've been waiting for.

Diagnosing childhood apraxia of speech (CAS) in young children can be tricky- the DEMSS is a new tool to assess for CAS and help SLPs plan speech therapy treatment for childhood apraxia of speech. Read this post to find out why every SLP needs this in their toolkit. #speechsprouts #apraxia #speechtherapy #speechandlanguage
The DEMSS is a criterion-referenced dynamic assessment of childhood apraxia of speech.

 Does this sound familiar? You're evaluating a young child with a severe speech sound disorder. You note a limited consonant and vowel inventory, use of mostly simple word shapes (V, CV, VC or maybe CVC), numerous sound ommissions and really poor intelligibility.

Is it childhood apraxia of speech (CAS) or another speech sound disorder? 

 It may CAS, but we can see these characteristics in children with severe phonological disorders or dysarthria too. Assessing and making a differential diagnosis for childhood apraxia of speech can be really difficult in many cases, even for the most experienced clinicians. You need a tool to help you make a differential diagnosis because that diagnosis will help you shape your treatment plan.

If this is CAS, where do we start?

This is a child who struggles to communicate. You want to design the most effective treatment plan for this child to help him or her increase functional communication and intelligibility as quickly as possible. You have more questions: What initial targets should I choose in therapy? What are the most effective cues and strategies specifically for this child?

If you've read my blog post series on childhood apraxia of speech, you know that I have a particular interest in assessing and treating children with CAS.


 I had the wonderful opportunity to do a deep-dive and learn more about CAS when I attended a small-group, intensive 2-day training with Dr. Edythe Strand of the Mayo Clinic in 2016 and was inspired to "spread the word" about CAS. I wrote a blog series about childhood apraxia of speech for SLPs.  You can read the first post in this series here: Childhood Apraxia of Speech: What SLPs Need to Know.

Dr. Strand and Dr. Rebecca McCauley had been working on developing a dynamic assessment for childhood apraxia of speech for several years. We learned about the DEMSS and got a sneak peek in our training, although it wasn't yet ready for publication.

In the interest of full disclosure, I've been watching for this assessment and am excited it's now published. Why?  Because I would love a standardized tool that uses a dynamic assessment approach to help me make my clinical decisions when I suspect childhood apraxia of speech.

When I learned the DEMSS had been published,  I reached out to Paul H. Brookes Publishing Company and requested a copy so I could share a review with you. I received a copy of the DEMSS at no cost from Brookes Publishing for the purpose of this review. I was not financially compensated for this post. The opinions within are completely my own and based on my experience.

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My review of the Dynamic Evaluation of Motor Speech Skills (DEMSS)

First Impressions

When my copy of the DEMSS arrived, the first thing I noticed was the small, thin box which contained a paperback manual. But where are the protocols? The manual explains that DEMSS response forms, as well as a tutorial, are available online.

You can fill out the response forms online and save them to your computer, or print a copy for hand-coding. A key code is provided to access them.  The response form is also in the back of the manual, but I think it's best to print online rather than try to flatten out the book on a copier.

SLPs are used to speech or language tests contained in large, unwieldy boxes that take up a lot of precious storage space, so the small footprint is a plus.

We're also used to receiving a certain number of protocols with our purchase of the test and then needing to purchase more when those run out.
The ability to print the response forms or complete them online at no extra cost is definitely budget-friendly.

Administering and scoring the DEMSS

The manual provides details about administration and scoring. There are also video tutorials online that provide practice and pointers as you watch an SLP administer the DEMSS.  Dr. Strand states in her introduction that the tutorials are supplemental practice, and clinicians should read the manual for full information about the administration of the DEMSS.

She's right. This is not easy, grab it out of the box and go assessment. You'll need to put in some time to learn the test, especially if you have limited experience with CAS. There's a lot to watch for.

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Online Tutorials

Recognizing vowel distortions and prosody errors can be tricky.

Dr. Strand provides practice for you with her audio and video tutorials for the DEMSS. These tutorials will initially take a couple hours to go through at the minimum but are really helpful. Don't skip these!  The examples include notes on what to watch for, how to score, and examples of correct administration as well as common errors in administration we can hopefully avoid.

Even though I've trained with Dr. Strand, I absolutely benefitted from going through the examples, and will likely listen again if I haven't assessed CAS for a while.  The tutorials definitely provide added value to the DEMSS.

Part 1 of the tutorial is a downloadable file that contains a PowerPoint with audio and video examples of vowel distortions and prosodic errors. The purpose is to help train your ear to recognize these distortions during the administration of the DEMSS. I listened to each example several times

Parts 2 & 3 are video examples of full assessments which give you practice evaluating and scoring responses of two different patients, one with mild CAS and one with more severe CAS.

I found the videos very helpful in training me to listen for subtle vowel distortions and for prosody errors and how to score them. You watch a clinician administer the DEMSS.  Dr. Strand does voice-overs during the video, gives administration tips and points out errors in the child's speech to listen for.

I liked that the scores for each child's response were printed at the bottom of the video so you can compare your judgment of the response in real time with the clinician's scoring.

You also have the opportunity to watch how the clinician cues the child during the assessment to see if production improves. This is the "dynamic" aspect of the DEMSS that is not included in other tests for CAS I've used.

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I've administered the DEMSS to four children as of this post. I've read the manual and watched the videos. I feel semi-confident in my administration of the assessment so far. I think I'll need more practice to feel fully confident that I'm administering and scoring as accurately as possible. I also think it's totally worth it. Keep reading. You'll see why.

Administration Time:

The manual estimates it will take 10-30 minutes to administer the DEMSS depending on the child. It took me a little longer for my first couple of administrations, but with familiarity, it's getting faster.

Stimulus words

The DEMSS begins with simple CV syllable shapes with a variety of consonants and vowels such as me and bye. The stimulus words progress in complexity to bisyllabic and multi-syllabic words such as movie or peekaboo. A total of 60 words can be administered. Children with severe CAS may only be able to complete a portion of the test.

Scoring

Because of the nature of CAS, there are many subtle things to watch and listen for as you test. Articulatory accuracy of consonants, vowel accuracy, and prosody are scored during the test.

On the DEMMS, you cue incorrect attempts providing up to six cued trials and then record accuracy on the next imitation trial.  You're watching for and noting voicing errors, groping, consistency, rate, segmentation, difficult transitions and more.

I like that the response form includes check boxes for these "notes" on each page. The ability to quickly check instead of writing your observations is helpful. The form also breaks down the type of prosodic errors you may hear (for words with more than one syllable) including segmentation, equal or incorrect stress, syllables that are added or deleted.

That's a lot to monitor all at once! Even if you videotape the assessment, you'll need to score while giving it so you'll know when to cue. Be prepared, this will take some practice.

After four administrations, I'm still working on it. In return, you'll gather a ton of specific information about the child's performance that will be golden as you make your diagnosis and treatment plan. That's my "why." Totally worth the effort in my opinion. No more "Where do I start?" You'll know.

Read on for more details about the DEMSS.

Articulatory Accuracy

Initial attempt
Scored from 1 to 4 points.
Scores are based on whether the word is correct on the initial attempt, if it's a consistent developmental substitution error, or if the child self-corrects without a model. 

Cued trials

If the word isn't correct on the first try, the clinician provides cued trials. You record whether the child gets the word correct on the first cued trial, whether it's correct with additional cuing, or no attempts were correct. 

I suggest making notes as you go, noting specific cues which were effective for the child and the level of cuing needed.  Great information for a starting point in treatment. 

Consistency

Each stimulus word is presented for a minimum of two trials, allowing for a consistency score. Consistency is scored as 1 for consistent across trials or 0 for inconsistent across 2 or more trials. 

I really like this feature of the DEMSS. Information about the consistency of productions is so important to differential diagnosis and is not available on "static" tests which score a single production of a stimulus word. 


Vowels and Prosody

Prosody is scored on words with more than one syllable and is either scored 1 for correct for 0 for incorrect.

Vowels are scored on all words, with 2 for correct, 1 for uncertain, and 0 for incorrect. Uncertain? Yes! Sometimes I definitely know I've heard a vowel distortion or the response is accurate, but sometimes it's pretty mild and I'm unsure.

The ability to score as "uncertain" is a unique (and appreciated) feature of scoring vowels on the DEMSS, allowing for that middle ground.

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Interpretation


The DEMSS is intended to be a criterion-referenced measure which is one of several tools used for a complete and thorough evaluation. 

The DEMSS Total Score yields a measure of the likelihood that the diagnosis of childhood apraxia of speech is correct. Total scores of 0-323 are considered significant evidence of CAS, scores of 323-373 yield some evidence for at least mild CAS and scores of 373 to 426 yield little or no evidence of CAS.

This information, along with other characteristics of the child's speech noted during the DEMSS is combined with all other information gathered in the assessment battery to make a diagnosis, an estimate of severity and recommendations for a treatment plan.

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Overall, the DEMSS is a powerful tool to use when a diagnosis of childhood apraxia of speech is suspected. I feel the dynamic assessment approach yields rich information that's not provided when only a "static" assessment is used.

If you'd like to learn more about the difference between static and dynamic assessment click to read my post on How to Uncover Emerging Skills With a Dynamic Assessment or for an in-depth look at CAS  you can start with the first post in the CAS series HERE.

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I hope this review has been helpful.

Diagnosing childhood apraxia of speech (CAS) in young children can be tricky- the DEMSS is a new tool to assess for CAS and help SLPs plan speech therapy treatment for childhood apraxia of speech. Read this post to find out why every SLP needs this in their toolkit. #speechsprouts #apraxia #speechtherapy #speechandlanguage Please comment if you've tried or would like to try the DEMSS. What are your questions and struggles when it comes to assessing childhood apraxia of speech? I would love to know your thoughts.

I also encourage you to share and pin my posts on CAS to help "spread the word" to clinicians who are wanting to learn more about CAS. It's so important!

Thank you, my friends. Until next time,



Wednesday, January 2, 2019

14 Preschool Songs and Fingerplays for Winter Speech Therapy

Songs and fingerplays will brighten up your winter preschool speech therapy sessions. 


14 Winter songs and fingerplays which are terrific preschool speech therapy activities to boost speech and language skills. Do you love penguins, bears and snowmen? This post has you covered! #speechsprouts #preschool #kindergarten #speechandlanguage #winter

Winter means snowballs, snowmen, penguins and bears... all of which are fascinating to your little ones and a great starting point for speech and language activities. 

Why not learn about winter in your speech therapy session with songs, fingerplays and movement activities to engage your littles? Bonus- you'll boost their learning in multiple ways.

If you read my post on 14 Songs and Fingerplays for Fall in Preschool Speech Therapy, we talked about those benefits. What a natural language-boosting way to work on skills! 

What speech and language areas can you target with songs and fingerplays?

Oh my goodness, songs and fingerplays are a smorgasbord of language-learning opportunity in speech therapy! Think about all the skills you can practice. Here are a few, I'll bet you can think of even more.

1.  Prosody: We know that simple catchy music gives children practice with the melody of language: pitch, rhythm, and duration. Sounds like the perfect opportunity to work on prosody doesn't it? 

Did we sing that word softly or loud? Fast or slow? High or low? When did we use an excited voice? 

2.  Sentence length and structure: The repetitive lines give children lots of practice with longer more complex sentences that language delayed children may not yet be producing on their own. Great for increasing MLU and children who leave out small words and word endings.

3. Rhyme: Sing the song or recite the fingerplay. Which words rhyme? Where in the sentences are you finding the rhymes, at the beginning or the end? Can you tell me another word that rhymes with it?

4. Vocabulary: Many songs and fingerplays repeat thematic vocabulary words over and over. Studies tell us it takes multiple exposures spaced out over time to learn a new word. This is even more important for our language delayed children. 

Presenting the words in multiple ways through songs, fingerplays and thematic units is powerful! Snowflake, melt, cave, and penguin are just a few of the words you can practice. 

5. Auditory memory: Repeated exposures to the lines help children remember and process the words in the songs and fingerplays. 

6. WH questions: Sing your song, recite and act out your fingerplay. Then ask questions. What did she see? Where were the shadows?

7. Adjectives and describing:  "I'm a little snowman, short and fat." How did the snowman look? Was he tall?

8. Prepositions: On the ground, in my cave, down I'll go! 
 "There once was a bear, who loved to play. (from Dr. Jean's Hibernating Bear). Where did he play? In the woods, every day!

9. Articulation: Did I say snowman? Snowflake? Snowball? Repetition of /sn/ blends and other articulation opportunities abound in repetitive songs and fingerplays. Have fun with your artic sessions.

10.  Narratives: Children can practice sequencing and story-retelling after the songs and rhymes are learned. 

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Tips for using songs and fingerplays for language development

  • Repetition: Look for repetitive songs providing multiple opportunities to practice.  Don't present the song or fingerplay just once. Enjoy the same one multiple times in a session and over several sessions. 
  • Pacing: If you are following along with a video to present the song, be sure to choose a video with a slightly slower pace. Many are too fast for our language-delayed students to keep up. 
  • Pre-teach the words and motions at a slower pace.
  • Visuals: Use pictures, story-telling pieces or other visuals.

Here are my picks: 14 winter songs and fingerplays for preschool speech therapy.

Snowflakes from Teach Preschool

10 Little Snowflakes from the Teaching Mama. I love this song because it repeats snowflakes with lots of s-blend practice (One little, two little three little snowflakes), and each verse ends by saying where the snowflake is: On my tongue, on my hat.... great for where questions too.



Snowflake, Snowflake action song by Intellidance is wonderful! Watch the video demonstration of the song and actions with dance-like moves.

The Snowman from Teach Preschool

Dr. Jean Warren is always a treasure of great songs and fingerplays!

I'm a Little Penguin by Dr. Jean Warren on the Preschool Express. This is sung to the tune of "I'm a Little Teapot" and I love the action words waddle, dive and swim for acting out as you sing!

Hibernating Bear by Dr. Jean Warren on the Preschool Express is sung to "Up on the Housetop". Winter is a great time to teach the position concepts of "inside" and "outside". The bear goes inside his cave. Who goes inside when it's cold? Who is outside?

I See Shadows by Dr. Jean Warren is fun for Groundhog's Day in February. Some are short and scary, some are tall! Perfect segway to a lesson on short and tall.

Lights, camera, music! Videos of Winter Songs


If you have a computer, tablet or whiteboard to show a YouTube video, try Snowflakes, Snowflakes by the Kiboomers.



I'm a little Snowman by Super Simple Songs has a nice slow pace for our little language learners and repeats the simple verse several times. Love that for helping children learn and participate.


Fingerplays, Poems and Chants

Here's a Hill shared by theholidayzone.com is a fun little action rhyme about zooming down a hill on your sled.

The Mitten Chant from the Teaching Mama. This fingerplay includes describing words: snug, fuzzy, warm and colorful. Work on describing and categories after the chant. What else is soft? Fuzzy? Yes no questions: Is a shovel fuzzy? A cat?

The Mitten Chant also has singular mitten and plural mittens. A great jumping off point to talk about plurals. the concept of a pair, winter wear and winter activities. You need two mittens in the winter. What else do you wear two of? (boots, earmuffs, socks, skates, skis)

 Preschool Express has many great songs and fingerplays. Two more favorites:

The Snowman by Dr. Jean Warren shared on the Preschool Express includes the concepts of large, middle-sized and small.  Roll a snowball large, then one of middle size...

A Funny Little Snowman from the Preschool Express This cute little rhyme talks about the snowman and his carrot nose, then along came rabbit...what do you suppose? Fun for prediction and rhyming!

Snowball by Shel Silverstein shared on Goodreads is a funny little poem about a child who made himself a snowball and kept it as a pet! The absurdities are fun to talk about as you answer why questions (Why can't you keep a snowball as a pet? Why was the bed wet?) and predict what will happen!

If you've never read Shel Silverstein, go to the library and take out one of his books right now. Don't wait another minute, his poems are so funny and silly and...awesome!


14 Winter songs and fingerplays which are terrific preschool speech therapy activities to boost speech and language skills. Visuals like this build a snowman activity are perfect accompany the rhymes.  #speechsprouts #preschool #kindergarten #speechandlanguage #winter


What's your favorite winter song, poem or fingerplay?

If you have other favorites, share with us! I'd love to hear them. Be sure to pin this post to your Pinterest Boards so you can find the links again easily when you need them. 

 Stay warm and cozy, and have fun!

Sunday, December 9, 2018

15 Last-Minute Speech Therapy Games and Ideas for a No-Prep Christmas

A cookie cutter christmas tree activity with green play dough and colorful pony beads for ornaments. Just one of the fun last-minute games and ideas for stress-free, no-prep speech therapy sessions this Christmas! #speechsprouts #speechtherapy #Christmas #speechandlanguage
Dough Christmas Tree Activity

No-prep speech therapy Christmas games and ideas that will put a twinkle in your eye!

Christmas is jolly. It's also hectic and exhausting. There are schedule changes, special holiday programs, progress reports, and evaluations to wrap up... you get the picture. So how to stay merry? I say keep it simple and go no-prep. (Or at least low-prep!)

No-prep activities can include printables, but also books, games, simple crafts, digital activities, you-tube videos and more.

Leave me a comment if you try some of these ideas, and tell me your favorite activities too!


Christmas Story Books for Speech Therapy

Head to the library or your bookshelf for your favorite Christmas stories.  If you can't find a copy, search to see if there is a good read-aloud on YouTube. You'll want to preview the YouTube videos because some are great, and well..others are pretty bad!

Find a video where you can see the book. One without camera shake and one where the narrator reads well, but not too fast. Tip: Sometimes I turn off the volume and read them myself.

 Here are a few books that are fun for your PK through elementary students. Read the book, practice articulation words as you find them, talk about the story and characters, answer wh question... you know what to do! Books are a goldmine of opportunities for speech and language practice.

These YouTube links are good as of Christmas 2018. If you find one is not working in the future, do your own search, you're sure to find more. 

Stack-em and Knock-em Down Santa Cups.

Make a Santa cup stacking game. Just one of the fun last-minute games and ideas for stress-free, no-prep speech therapy sessions this Christmas! #speechsprouts #speechtherapy #Christmas #speechandlanguage
Santa Cup Knockdown Game

Okay, I realize that adding the belt and buckle to the cups (The red ones above were painted) is a bit of prep, but it's not required. Your kids will have just as much fun stacking red and green cups in a pattern. Use styrofoam balls to toss or bowl, or even wadded up paper will work. Answer a question, get a cup, when they're all stacked you knock 'em down.

Snowball Toss. Turn the cups open-side up, get out some cotton balls and toss. For more fun, mark the cups with point values. Students earn cotton balls for answers. Or... if you don't mind a bit of noise, use jingle bells to toss instead!

Jingle Bell or (Pom-pom) Tic-Tac-Toe Grab two colors of jingle bells, draw a quick tic tac toe grid and you are set.

Play Bingo Riddles

Solve the rhyming riddles to play this Christmas speech therapy bingo game! Fun inference, vocabulary and listening practice. Just one of the easy no-prep ideas for no-stress last-minute Christmas speech therapy sessions! #speechsprouts #speechtherapy #Christmas #speechandlanguage
Christmas Bingo Riddles

Christmas Bingo Riddles: This is my holiday must-have! Always a hit, children love it because this bingo game is kicked up a notch with rhyming riddles to solve. We target vocabulary, listening, inference and rhyme, plus we practice articulation as the words come up. You can print out and laminate (prep) or simply print the BW version for no-prep play.

I love that I can gather up large groups to do make-up therapy with Bingo Riddles or do I can do in-class therapy too. (There are 28 boards) And it's just plain fun!

If you love Bingo Riddles and want to check out my other games, you can find all my Bingo Riddles HERE


Christmas Crafts for Speech Therapy


Easy Candy Cane Craft using a pipe cleaner and pony beads: Perfect no-prep Christmas activity in speech therapy #speechsprouts #speechtherapy #Christmas #speechandlanguage


If you want to send home a tree ornament, try this Pony Bead Candy Cane. You'll need a pipe cleaner and red and white beads.  Each response gets a bead or two to add to their pipe cleaner. You can also work on requesting: "I need a red bead, please."

If you've pulled out the pony beads, grab a can of green play dough and a Christmas tree cookie cutter. Now you're ready to make Pony Bead Christmas Trees. Cut out a tree and give your students beads to decorate with after each response... it's just that quick and easy!

How about a two-item craft? Try this Ripped Paper Christmas Tree Craft from Totsfamily.com You just need construction paper and glue. Label each strip with a prompt if you like, or just practice, then add a strip.

Try Paper Onion Christmas Ornaments for your older students. Paper, scissors, a ruler, binder clip and a stapler and you're ready to go. They are so pretty and you can have your students write artic words, irregular verbs or antonyms/synonyms on the paper strips.

Make an Articulation Word Candy Cane with red and white paper. So cute and fun. You could pre-make the word strips to go on the canes, but I say no-prep, please! Just write the word as the student says it, then give the paper strip to the student to glue.




 

Christmas No-Prep Resources

I have many resources in my store that are ready for your no-prep speech therapy sessions. Watch the video above for a quick peek!

Following directions activities for Christmas speech therapy! Interactive, no-print fun for tablet, whiteboard or computer, or you can print it out as cards. Leveled activities with 1-3 elements: size, color and Christmas objects. #speechsprouts #speechtherapy #Christmas #speechandlanguage #followingdirections #sped
No-Print Christmas Following Directions

Christmas Following Directions  This is a great interactive activity for your tablet, computer or interactive whiteboard. You can also print it as cards. Follow directions with color, size, and object to find the Christmas item named. Choose 1, 2, or 3 elements to modify the difficulty as children advance. It also includes a fun motivational trim the tree activity every few slides to keep your students engaged.


This Gingerbread Dot marker activity is just one of 58 No-prep Christmas speech therapy activities perfect for mixed groups. Print and go open-ended fun with puzzles, color by number, mystery squares and more for PK-4th grade. Includes Christmas questions Quick Lists. #speechsprouts #speechtherapy #Christmas #speechandlanguage #whquestions
No-Prep Christmas Speech Therapy Activities

Mixed Group Magic: No-Prep Christmas Speech Therapy Activities  Use any activity (and there are 58 different activities in this pack, for a range of ages!) with any goal, making it perfect for managing your mixed groups. These can be open-ended activities or customize for each student by adding a short list of prompts to the page. No more shuffling cards and pages.

Activities include puzzles, color by number, dot marker,  mystery squares and more plus Christmas themed WH and Yes/No question Quick Lists are included. (additional Quick Lists are also available) Or... just write in your own prompts.


Teach the basic concepts of same and different with these fun Reindeer task cards in speech therapy this Christmas. It's interactive fun as a clothespin task, dot marker activity or hole punch the reindeer's nose! Includes a BW mini-book. #speechsprouts #speechtherapy #Christmas #speechandlanguage #sped #preschool
Same and Different Reindeer Shapes 

Same and Different: Reindeer Shapes
Teach the concepts of same and different. Its print and go with the BW version when you make the mini-book, or print in color and laminate to make cards. There are 3 ways use to use this resource: A clothespin task card, dot markers or use a hole punch for some fun fine fine-motor practice.


Teach the basic size concepts of small, medium and large with these fun Santa task cards in speech therapy this Christmas. Interactive fun as a clothespin task, dot marker activity or hole punch activity. Includes a BW mini-book. #speechsprouts #speechtherapy #Christmas #speechandlanguage #sped #preschool
Santa Shapes: Teach size concepts small-medium and large

Size Concepts: Santa Shapes Clip, dot or punch while learning size concepts of small, medium and large. Like Reindeer shapes, it comes with color cards, a BW mini-book with parent letter and printables too.


Need more ideas? Find all my Christmas activities and freebies available in my store HERE

I hope you have a very merry, no-stress December and Christmas!

If you try any of these activities, please tag me on social media, I would love to see!

Cheers,


A cookie cutter christmas tree activity with green play dough and colorful pony beads for ornaments. Just one of the fun last-minute games and ideas for stress-free, no-prep speech therapy sessions this Christmas! #speechsprouts #speechtherapy #Christmas #speechandlanguage


Tuesday, October 23, 2018

Best-Ever Books for Social Skills: You Get What You Get

Ever have a child that whines if he didn't get to be first?

Or she pouts when she didn't get the color crayon she wanted or didn't win the game? Yup, you know the one I'm talking about. You need this adorable book by Julie Gassman, You Get What You Get. (and you don't throw a fit).

Best-Ever Books for Speech Therapy! This adorable story is terrific for teaching social skills in speech therapy. Melvin doesn't always deal with disappointment well. Until he learns about this terrible rule... read this blog post to learn more!  #speechsprouts #socialskills #speechtherapy #storybooks

This is one the best-ever books for teaching acceptance that we can't always get exactly what we want.

Melvin is a young squirrel who doesn't deal well with disappointment. If he doesn't get enough chocolate chips in his cookie or loses his turn in a game, watch out! It's full-on meltdown time. 

When Melvin starts school, he finds out he really hates his teacher's favorite rule: You get what you get and you don't throw a fit!

Because of this terrible rule, Melvin can't throw a fit at school if he's last in line, or has to use crayons instead of markers.

But at least his family doesn't know about this awful rule. Until...he accidentally lets it slip!

Much to Melvin's dismay, his astounded family is delighted when they learn about the rule. And there is no going back. 

Now the rule applies at home too. He can't stomp his feet, shout or flail around. Nope. Not even when his sister wants to watch a show he doesn't. Because, well...you know. You get what you get and you don't throw a fit. 

You Get What You Get and You Don't Throw a Fit is the start of a great social skills lesson.

We read the book and I ask my students, have you ever seen someone who acts like that when they didn't get what they wanted? They always nod yes, and tell tales of other students. (Even if they've been known to throw fits themselves!) 

Of course, just like Melvin, some children struggle with handling disappointment more than others.  

The result can be lots of negative consequences and sometimes even social isolation as peers lose patience or become annoyed with crying and whining. 

Talking about Melvin's squirrelly behavior make it non-threatening to discuss, rather than talking about the student's own behavior.

So we dive in a bit deeper. Can everyone be first in line? Win the game? Sit in a certain spot? Play with that favorite toy? No, it's just not possible, is it?

So we make lists.
  1. We list situations where a child might feel disappointed. 
  2. We list inappropriate ways to react. Oh, no! We would never behave that way. Why not? 
  3. We talk about and list social consequences. Teachers get mad when you are interrupting the class and you get in trouble. Maybe you lose a privilege. Friends won't want to play a game with you if they know you'll throw a fit. 
  4. What should we do instead?
A great way to wrap up the lesson is to have the children draw a child (or a squirrel!) throwing a fit over something, then have them draw what they might have done instead. 

I am always looking for great speech therapy books, so leave a comment if you have a favorite!

I hope you get a chance to read You Get What You Get with your students. I think you'll love it.

Until next time my friends, 




Saturday, October 6, 2018

14 Songs and Fingerplays for Fall in Preschool Speech Therapy

Songs and fingerplays are your best friend for teaching language in preschool speech therapy this fall.


A round-up of fabulous fall songs and fingerplays for preschool speech therapy plus where to find the best youtube videos to teach them. Speech and language targets and more autumn speech and language activities are listed for your fall themes. #speechsprouts #speechandlanguage #preschool #fallpreschoolactivities #fingerplays
Five Little Pumpkins storytelling set


Do you sing with your pre-k students? You should! Children really don't care if you sing like a bird or are a little off-key. They just love the experience. Little ones don't judge, so if you're not already singing with your young students in speech therapy, you need to give it a try.

I'm going to share some of my favorite songs and fingerplays for Autumn, and resources you can use to create a whole themed unit around many of them.

Why should you do fingerplays and songs with preschoolers? 

Music, rhythm, and rhyme are all powerful tools for learning and for getting verbal with your littles. Here are just a few of their magical, language-boosting powers:

1. Catchy but simple music gives children the opportunity to hear and practice the rhythm of language.

What a great way to work on prosody! Repeated practice with pitch, rhythm, and tempo are built right in.

2. Songs and fingerplays that feature repetitive lines give children repeated exposure and practice with vocabulary and sentence structure. 

The repetition makes it easier to learn the lines and for children to participate.

I find my minimally verbal students who rarely speak or those who are at the 1-2 word phrase level will often sing a few lines along with their favorite songs. It's a great beginning to practice sentence structure, vocabulary, and turn-taking. I sing the first part "The itsy bitsy spider went...." and my students will fill in the blank with a multi-word phrase!

3.  Songs with motions and fingerplays are a great vehicle to combine fine and gross motor movements with language practice. 

It's multi-modal learning in such a fun and natural way. Who didn't love Head, Shoulders, Knees, and Toes as a child? We sing, we touch and we move- all the while learning to name body parts. Plus, you're burning a little energy and providing movement so the children are ready to attend to the next activity.

4. Practice with rhyme builds phonological awareness. 

Many of our favorite songs and fingerplays rhyme. Rhyme is an important building block for early literacy skills. Sing the song, point out the rhymes, and generate a few more rhymes, all the while having great fun.

5.  Build auditory memory and sequencing skills with cumulative songs and rhymes.

Songs like The Farmer in the Dell or Going on a Lion Hunt require the singer to remember and sequence the previous lines. I love to use pictures, toys or finger puppets as visual aids to help children sequence as they sing.


6. Songs and fingerplays for the preschool crowd often fit in beautifully with theme-based learning. 

Using themes in therapy helps build associations, vocabulary and a rich vocabulary. There are so many great songs and fingerplays that will fit right in.


How do you find those fabulous fall fingerplays and songs?

Many of the classic songs and fingerplays are have been done as music videos and are on Youtube.

Watch the videos to hear the melody and learn the lyrics.  Keep in mind that for children who have speech or language disorders, many available renditions are too fast to allow those who need extra processing time to participate. Look for those that have a slower pace, especially when your students are first learning the rhyme or song.

Check out the numerous websites that have lists of songs and rhymes for preschool.

A quick search will yield tons sites with fingerplay and song collections for the preschool set. 

Here's a great one: Take a peek at the Preschool Express This is a free site owned and operated by the wonderful Dr. Jean Warren. This site has a music and rhyme station plus games, art and themes galore.

Michigan State University Extension also has a Fingerplays and Songs for Childcare Database you can search if you're looking for the words or just something new.

Write down the lyrics of your favorite songs and fingerplays for quick reference when you're ready to use them. 

An index card or page per song will make them easy to organize and find if you alphabetize them.  You might want to keep cards of each season or theme together on a ring for easy reference when you are ready to go during your session.


How to teach the songs and fingerplays to children who have speech and language challenges.

Pre-teach the lyrics and motions at a slower pace.

Learn the song or fingerplay before you watch the video or listen to the music. Your children will have more confidence and success with repeated practice modified for your students. You'll model, cue and scaffold just as you do with sentences and conversational speech.

When learning a new song or fingerplay, sing or recite at a slower pace, and learn the lyrics and motions one step at a time as needed. Once your children learn the fingerplay or song, it's fun to play a slightly faster video and they'll be more ready to follow along.

Use visuals and story-telling pieces

Visuals can include objects, stick puppets, magnet board pieces or the Youtube videos I'll share with you, or all of the above. Visuals help children with sequencing and memory for the lyrics, and re-telling too. 


Favorite fall fingerplays and songs round-up!

 I've gathered some of my favorites for you and I'm including links to many videos and sites where you can learn them and enjoy following along with the videos. 

I love following up the songs and rhymes with themed activities. Take a peek at Speech Sprouts Fall Speech Therapy Activities Pinterest Board for inspiration on activities and crafts.  Save your favorites to your own boards so you can easily find them later.

You may want to save time and have coordinating activities ready to go, so I'll give you a peek at my favorite fall preschool speech and language activity packs too. They always cover a variety of targets so you'll have several sessions full of speech and language activities ready to go for each theme.

Do you see any of your favorites here?


1. Autumn Leaves are Falling Down

This fingerplay teaches fall vocabulary: leaves, falling, rake, pile, jump.

Autumn Leaves by The Kiboomers is a nice slower rendition of the song, good for children with slow processing or apraxia.

Autumn Leaves by The Learning Station The pace is a little faster and has fun harmonies. The cartoon character demonstrates the fingerplay as they sing.

Find more leaf songs and rhymes plus many more themes at Preschool Express

2. The Farmer in the Dell

Fall is harvest time on the farm and Farmer in the Dell is fantastic for sequencing and auditory memory as children recite each animal sound.

The Farmer in the Dell by Mother Goose Club Playhouse is a cartoon video with the traditional lyrics. It has some slight pauses between verses, which I really like.

Another adorable The Farmer in the Dell video is by Super Simple Songs. This version features a cute redheaded girl farmer and has lyrics about farm activities like milking the cow and planting the seeds.

3. Five Little Pumpkins

Enjoy this slightly spooky fingerplay and talk about ordinal vocabulary (first, second, third....) with your students, then follow up with bright orange pumpkin-related activities.

The Five Little Pumpkins by the Kiboomers is a colorful video done at a slightly slow pace which is terrific for teaching the fingerplay.

For a super pack with oodles of speech therapy materials to go with this rhyme, check out my Five Little Pumpkins Speech and Language Activities pack.


Five Little Pumpkins is just one of the fabulous fall songs and fingerplays for preschool speech therapy in this post. Lisette shares links to the best Youtube videos to teach them, speech and language targets and more autumn speech and language activities for your fall themes. #speechsprouts #speechandlanguage #preschool #fallpreschoolactivities #pumpkintheme #fingerplays
Five Little Pumpkins Speech and Language Activities

4. Way Up High in the Apple Tree

Way up High in the Apple Tree by The Learning Station I love this simple rhyme and fingerplay for teaching the concept of "up high." It's sound-loaded like so many of these rhymes and songs making it great for articulation practice of /w/ (way), /h/(high), and /sm/ (smiling).

For more apple speech and language activities see Apple Apple Reader and Speech Therapy Activities which includes a cute printable cut and paste reader targeting "where?" questions: Apple, Apple where can you be?


Way up High in the Apple Tree is just one of the fabulous fall songs and fingerplays for preschool speech therapy in this post. Lisette shares links to the best Youtube videos to teach them, speech and language targets and more autumn speech and language activities like this apple size sort from Apple Apple Where Can You Be?  #speechsprouts #fingerplays #speechandlanguage #preschool #fallpreschoolactivities #appletheme
Apple, Apple Speech and Language Activities


5. The Owl

I really love The Owl fingerplay from A to Z Kids Stuff. So cute! It has the actions written out for you.

6. The Owl Song

The Owl Song video by The Kiboomers has lots of fun action verbs: open, fly, hop, flap, turn

7. Five Little Turkeys

Five Little Turkeys is the perfect song for your Thanksgiving theme.

The Learning Station's Five Little Turkeys starts out slow and then increases in speed as it repeats.  

My Five Little Turkeys Speech Therapy Activities includes this interactive flipbook so your children can make those turkeys "waddle off" as they count down. This pack has activities for the concepts of same and different, matching, prepositions, associations and Where? questions too.

8. I'm a Little Acorn

I'm a Little Acorn This is a lovely video by DanceandBeatsLab that combines the music and motions into gentle dancing movements.

9. Grey Squirrel

Grey Squirrel Sung by the Learning Station will have your little ones swishing their bushy tail as they repeat the song with mama squirrel, daddy squirrel, baby squirrel, grandpa squirrel, and grandma squirrel. Great for the /sw/ blend and "sh" practice (swish, bushy).

10. We're Going on a Bear Hunt

One of my all-time favorites, Bear Hunt has plenty of fun actions, works on sequencing memory and yep- prepositions too. The hunters go through, over around and more. Plus its got a dark cave with a scary bear! 

Try this fun video by The Kiboomers We're Going on a Bear Hunt

11. Itsy Bitsy Spider

No list is complete without the Itsy Bitsy Spider. Or Eensie Weencie Spider if you prefer. Target sequencing and the prepositions up and down in this gentle little song about a not-so-scary spider.

Itsy Bitsy Spider by Twinkle Little Songs is a pretty rendition of the rhyme. It has a just-right slightly slow pace too.

The Itsy Bitsy Spider by Patty Shukla is a bit faster. It combines the rhyme with body parts vocabulary as that little spider wanders off!

You'll find plenty of spidery speech and language activities to go with the song in this pack: Itsy Bitsy Spider Speech and Language Therapy Unit.


The Itsy Bitsy Spider is just one of the fabulous fall songs and fingerplays for preschool speech therapy in this post. Lisette shares links to the best Youtube videos to teach them, speech and language targets and more autumn speech and language activities for your fall themes. #speechsprouts #fingerplays #speechandlanguage #preschool #fallpreschoolactivities #spidertheme #theitsybitsyspider #nurseryrhymes
Itsy Bitsy Spider Speech and Language Activities


12. Scarecrow, Scarecrow


Scarecrow, Scarecrow by the Learning Station  Turn around, reach up high, bend down low...this is another version that increases in speed each time the verse is repeated.

This fun little build a scarecrow activity can be found in my SK Articulation and Language Activities Pack:


Scarecrow, Scarecrow is just one of the fabulous fall songs and fingerplays for preschool speech therapy in this post. Lisette shares links to the best Youtube videos to teach them, speech and language targets and more autumn speech and language activities like this build a scarecrow game. #speechsprouts #fingerplays #speechandlanguage #preschool #fallpreschoolactivities #spidertheme #scarecrow #nurseryrhymes
Articulation and Language Activities for SK


13. Two Little Blackbirds

This cute little fingerplay targets fast and slow.
Watch Dr. Jean demonstrate Two Little Blackbirds in a video sponsored by ESC Region 13.

 14. The Wheels on the Bus

This classic song and fingerplay targets part-whole by talking about the parts of the bus, repeats "wheels" and "go" for /w/ and /g/ articulation practice and opposites (up and down, open and shut).

Wheels on the Bus by Cocomelon (ABCkidTV) I like the slower pace of this video and love that the bus is a school bus filled with a family and animals too. The cute realistic characters demonstrate the fingerplay motions for you as they go for a bouncy ride.

The Wheels on the Bus by DanceandBeatsLab is a faster and more energetic rendition of the popular fingerplay sure to get those wiggles out for children who can follow the faster pace. It combines the song with fun dance moves your children will love.


I have two resources for you full of speech and language activities for Wheels on the Bus.

Wheels on the Bus Speech and Language Activities includes printables plus an interactive no-print story for your tablet or interactive whiteboard.


Wheels on the Bus is just one of the fabulous fall songs and fingerplays for preschool speech therapy in this post. Lisette shares links to the best Youtube videos to teach them, speech and language targets and more autumn speech and language activities like this bus-themed speech activities pack. #speechsprouts #fingerplays #speechandlanguage #preschool #fallpreschoolactivities #spidertheme #wheelsonthebus #nurseryrhymes #backtoschool #bustheme
Wheels on the Bus Speech and Language Activities

This CVC Articulation Smash Mats with Wheels on the Bus lets children enjoy smashing the play dough to make wheels as they practice articulation in initial or final word positions. A BW version works great for dot markers and this activity is no-prep easy peasy.


Wheels on the Bus is just one of the fabulous fall songs and fingerplays for preschool speech therapy in this post. Lisette shares links to the best Youtube videos to teach them, speech and language targets and more autumn speech and language activities like this bus-themed speech activities pack. #speechsprouts #fingerplays #speechandlanguage #preschool #fallpreschoolactivities #spidertheme #wheelsonthebus #nurseryrhymes #backtoschool #bustheme #articulation
Wheels on the Bus Articulation Smash Mats
Read this post for more great ideas to go with this rhyme: Wheels on the Bus: Transportation Week!

I hope you've enjoyed this autumn round-up of songs and fingerplays!


Leave a comment with your favorite songs, rhymes and fingerplays for fall. I'd love to find some great new ones.

Until next time my friends, happy fall!

Monday, September 10, 2018

Speech Therapy Activities Your Kids will Beg For: Smash It!


How you can use hands-on speech and language activities like this fun ice cream scoop smash mat for SK blends to keep wiggly children engaged in your speech therapy groups.  www.speechsproutstherapy.com
From Speech Sprouts' Articulation and Language Activities for SK


Group speech and language sessions can be a challenge.

Sometimes sessions can get a little craaazy for sure when kids are bored waiting their turn to talk or play a game. The problem multiplies when you have several children in a group. Billy interrupts constantly, Sarah is talking to Myah and Cole is pinching and poking everyone at the table.

You spend so much time redirecting behavior, that you can only manage to get a few repetitions for each student and by the end of the session you're frustrated and exhausted. Sound familiar?  Here's the secret:

Use hands-on, high-interest speech therapy activities that keep little hands engaged!


Add an action verb to the task, and the kids are all for it. I'm going to share my favorite hands-on activities to keep those wiggly, antsy little ones engaged and focused during sessions. Activities that are low to no-prep and don't interrupt the flow of your sessions. 

This week, let's talk about a favorite way to use play dough...

Keep children engaged with play dough and smash mats.

Using play dough in speech and language therapy is a great fine motor and sensory activity- it's really very satisfying. Kids love the feel of the dough as they roll, pinch, and poke the dough. (Instead of each other!) 

There are lots of ways to use play dough. Sometimes I simply hand each child some playdough and let them get creative with it. We also love smash mats.


How to use smash mats in speech therapy.


    1. Grab your favorite smash mat, or make a simple one yourself. Just draw circles (or silly smiley faces) on a page and laminate it. You can also pop it into a page protector if you don't have lamination.

    2. Give each child some dough and have them roll small balls to put on top of each circle. I like to give my kiddos extra so they don't have wait time after rolling the balls. They can continue rolling and squishing their extra dough while waiting their turn.

    3. Practice your target goal. Ready-made smash mats may have questions or words to practice on each circle. Open-ended ones are great too.

    4. My favorite part... Smash it! After your students give you a response. they take a fist or palm and squash that ball of dough flat. 

    5. Add an extra element of practice each time they smash a ball of dough. If you're working on:
  • final "sh" or verbs: Have your student say "squish, squash" as they smash their dough.
  • the pronoun "I" or verb tenses:  Prompt students to say "I will smash it. Smash!  or "I smashed it."
  • Expanding sentences or using descriptive words: "I smashed the green one. I smashed the red one."

How to keep children busy and engaged with hands-on speech therapy activities like this fun wheels on the bus smash mat. Smash balls of play dough to make the wheels as you name the CVC articulation pictures. www.speechsproutstherapy.com
From Speech Sprouts' CVC Articulation Smash Mats


There are so many ways to use play dough in speech therapy. What's your favorite?

I also keep cookie cutters and tiny rolling pins in a bucket for more dough-filled sessions. We talk about sizes, shapes, verbs, and textures as we play. Add an element to increase the fun: wiggle eyes for monsters, birthday candles, hand them a butter knife and a toy plate... the possibilities are endless.  Incorporate language and play with a purpose!


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


You can find the smash mats pictured above in my store:


CVC Articulation Smash Mats with Wheels on the Bus  This is an entire pack of smash mats (or dot marker pack with the included BW) There are pictures on the wheels of each bus for CVC words. Mats for initial and final phonemes are included.

Go Away Big Green Monster Book Companion  I included sentence construction and describing smash mats pictured above in this fun pack of speech and language activities. If you haven't read this book, it's so much fun for little ones. Read more in my Green Monster blog post HERE.

Articulation and Language Activities for SK This pack includes the fun ice cream scoop smash mat pictured in this post, plus a fun articulation story and more activities for the /sk/ blend.  

I'll be writing more posts soon with my favorite hands-on speech therapy activities.


To get notice of new posts filled with ideas, sign up for my newsletter. Just fill in the form in the column at the right and I'll pop into your inbox with all the latest news... and send you a great activity too!

Thanks for visiting!  Until next time, my friends,

Thursday, August 30, 2018

A Back to School Speech Therapy Backpack Craft Freebie

Free! A bright orange paper backpack craft to welcome your speech therapy students back to school and teach them about their therapy goals. #speechsprouts #backtoschool #speechtherapy #backtoschoolcraft
Teach students about their therapy goals with this back to school craft.


Back to school is a great time to review speech therapy goals with your students.

It's so helpful when students have a clear understanding of what they're working on in speech therapy. When someone asks my student "What do you do in speech?" I hope they can say "I work on___ ." That's so much better than the typical answer, "We play games."

Don't get me wrong, I love using motivational games, but students need to know why they're coming to see me each week! Knowing what they're working towards helps students get more focused, more invested and gives them a greater sense of accomplishment when they make progress.


Welcome your students back to school in style with this fun speech therapy backpack craft.

You'll need two colors of paper, I used construction paper for the backpack and a bright fluorescent paper to add some punch to the backpack straps. 



A fun and engaging FREE back to school backpack craft for speech therapy #speechtherapy #backtoschoolcraft


Here are the steps to make your backpack. Pretty simple!

  1. Download the free templates for this activity in my store HERE 
  2. Print the Welcome Back to Speech label on white paper
  3. Print the Name label in a fun color if you like, to match the straps.
  4. Cut out 2 straps per student of the brightly colored paper. I made mine about 1 1/2 inches wide and the length of the paper. (I've included a printable template page for the straps, or you can just cut your own.)
  5. Cut out a skinny strap about 6" long and 3/4 of an inch wide.
  6. Round the top two corners of your construction paper with your scissors.


OK, Now it's time to put your backpack together!



Simple directions for a FREE back to school backpack speech therapy craftivity with a purpose! #speechtherapy #backtoschoolcraft


  1. Glue the Welcome Back and Name Labels as shown.
  2. Fill in your labels as you discuss each student's goals. Have them verbalize what they are working on, and write it if they are able.
  3. Glue one end of the long strap to the back of the backpack as shown. give it a twist (see the completed backpack below) and glue the end to the back of the backpack. 
  4. Glue the top loop on, give this one a twist also.
Tip: If you are using white glue you may need to let the strap dry at the top before you twist it. (I used a glue stick and didn't need to wait.)


There are two versions of the Welcome Back to School Label


The download includes a choice of two labels: A "My Speech Goals" label and a "My Favorite Things about School" label.  This makes the craft terrific for your teacher friends to enjoy too. If you have a friend who would enjoy this craft, please don't share the file, just send them to this post or my store to download the file for themselves. Thanks!

TIP: Be sure to pin this post to Pinterest so you can easily find it again next year when you are ready for a back to school activity!



FREE! A colorful backpack paper craft to welcome your speech therapy students back to school and teach them about their speech and language therapy goals. #speechsprouts #backtoschool #speechtherapy #backtoschoolcraft
Download this Back to School activity in my store HERE.

If you enjoy this craft, I'd love to hear from you. Please leave feedback in my store when you download. I read each and every comment, and appreciate it greatly.

Happy Back to School!