Sunday, August 21, 2016

Why Back to School Just Got Less Frenzied! Super Speech Therapy Tips and a Bonus Sale

This SLP went home Friday and fell asleep on the couch.

Why Back to School Just Got Less Frenzied! Tips for SLPs

I just finished my first week back to school, and I have to admit, it kinda kicked me in the ____! 

With five ARD meetings (That's what we call IEP meetings in Texas), new software to learn, several move-in students added to my already bulging therapy roll, staff meetings, presenting my in-service on CAS, unearthing my therapy room, staff meetings, welcoming and orienting my new paraprofessional and my new SLP-A, and the staff meetings....did I mention the staff meetings? Whoooo! I was frenzied and exhausted. I'll bet you know exactly what I mean.

Why Back to School Just Got Less Frenzied! Tips for SLPs

Students start on Monday, and those bright shiny faces are expecting a great year. I'm going to help give it to them too. We are going to have fun, make some awesome progress and have our best year ever. But sometimes we need a little help, because time is at a premium.

Super Speech Therapy Tips and a Bonus Sale

The Frenzied SLPs know how crazy it can get- 

we are all headed back to school too! So we are getting together to offer you some terrific therapy tips and tell you about amazing therapy materials to cover your caseload and help make your year, well.... a little less frenzied!

So here are my tips for therapy planning:

1. Plan for high-interest themes and activities in speech therapy. 

When students are engaged, therapy becomes a breeze and a pleasure. I love themes, it keeps me interested too! We'll be thinking about yellow school buses, apples, owls, monsters, spiders, pumpkins and turkeys this fall.

2. Use visuals whenever possible! 

So many of our students with language delays are not strong auditory learners. Visuals can really help.

One of my favorite activities in my store, Associations and Describing: In The Doghouse. combines a favorite theme (pets) with strong visuals to assist children in describing similarities or associations. The describing mat gives children cues to helps them decribe the similarities. For example: They both have...., they are both part of...... The puzzle mat helps students format their sentence in reply to "How do they go together?"

The cute little puppy-dog themed game is fun, and adds a few more language opportunities. What is the dog doing? Why did his pawprints change color?

3. Use one versatile activity that's adaptable for multiple goals, mixed groups, and ages. It will save you time and your sanity!

I aim to build in versatility to my packs for this reason- pull one and done!

Associations and Describing in the Doghouse works great for pre-k to 3rd grade. Little ones work on vocabulary and basic go-togethers. Older children work on describing the associations. Modify up or down by requiring more attributes per description. Voila! Easy planning.

If you don't know,

Teachers pay Teachers has a back to school sale every August

I plan to pick up some products to help me plan out my fall and early winter too because this one-day-only sale means 25% off in most stores. Everything will be on sale at Speech Sprouts store including In The Doghouse.

More Tips and Great Speech Therapy Resources

Be sure to check more tips and must-have products from the Frenzied SLPs and friends. Just click any of the following links! I hope you find some awesome new activities you'll love.

Speech Universe
Speech is Sweet
Gold Country SLP
SLP Runner
Speech 2U
Old School Speech
Looks Like Language
Kidz Learn Language
The Speech Owl
Badger State Speechy
Talkin' With Twang
Speech Snacks

Until next time!

Thursday, August 18, 2016

How to Create an Amazing Therapy Plan for Childhood Apraxia of Speech

This is Part 5 of my series for SLPs on Childhood Apraxia of Speech: Let's Talk!

Today, we are going to talk about planning your therapy for CAS.

Create an Amazing Therapy Plan for Severe Childhood Apraxia of Speech

Congratulations, speech peeps, we made it through a lot of information on assessment together. I have been sharing what I learned from a top expert in the field, and wonderful clinician, Dr. Edythe Strand of Mayo Clinic.

I hope you have a better understanding of how to plan an evaluation for a child whom you suspect has childhood apraxia of speech and a better understanding of how to make your differential diagnosis. I really think that's the hard part! We even learned how to identify emerging skills that will be great starting points in therapy.  So now, it's time to get a therapy plan going and get some progress rolling for your student.

If you are just joining in, I recommend reading the earlier posts and then catching up with us here. You can find the first post in this series here: Childhood Apraxia of Speech: What SLPs Need to Know. It's okay, Go ahead. I'll wait!

So let's talk about the principles of motor learning theory and making progress with childhood apraxia of speech.

This is important to your therapy plan, I promise. Let's think about this. We want to improve skills in motor planning, retrieval and carrying out the muscle movements (motor movements) needed for speech. So we need to know what research says is the most efficient way to do that.

Motor learning theory has been applied to the rehabilitation of limb movements for many years, and in the last 10-15 years,  to the treatment of CAS. 

Some studies have supported it's application to speech movements, others have not. Speech is, after all, a complex behavior, involving language and motor movements. The severity of CAS appears to be a large factor.

So what needs to happen to learn a motor skill? We need practice. Lots and lots of repetitive practice of the movement. How did you learn to ride a bike? Steer a car? Did you do this smoothly at first? Probably not, but the more practice you got, the better you were.  You practiced until the movements came automatically.


First things first.

We need a few skills in place to make the most progress. The child needs to be able to imitate you, be willing to watch your face, maintain attention. If these are not in place yet, build these into your therapy plan.

Here's how:
Create an Amazing Therapy Plan for Severe Childhood Apraxia of Speech www.speechsproutstherapy.com1. The child needs to imitate your movements. Do a few minutes of warm-up, where you practice imitation of your movements.  Reinforce imitation of large movements- arms waving, clapping, then finer movements, fingers wiggling, then oral movements: moving your jaw, lips, and tongue. Talk about and practice the difference between big movements and little movements, fast movements and slow movements. Draw attention to how the movement feels. Does it feel tight? Now let's try it loose.

2. The child needs to watch your face: Hold activities and reinforcers near your face, not on the table, which encourages the child to look away. Place the child at eye level with you. Raise the child, or lower yourself! Dr. Strand sometimes puts them on top of her desk. I tried that, and it works great. Face to face, with no table in between. Attention is on your face.

3. The child needs to sustain attention on you. Use activities that are motivating, but really quick. Don't let them distract the child's focus. Get back to practice immediately. The more responses per session, the faster the progress!

Now let's talk about what motor learning theory says about scheduling practice.


How often should therapy sessions be scheduled? How many words should I work on in a session?

Motor learning theory tells us about the benefits and drawbacks of different schedules of practice.

* Mass practice may be scheduling 5 sessions in one day or one really long session a week.  It can also mean working on a very small set of words per session. You get a ton of practice in a short period of time. Mass practice will lead to quick development of a skill. However, carryover and generalization to other motor movements and words is poor. So this might be the initial option for severe, highly unintelligible children to help them be more accurate with a small core vocabulary they can use, and get them communicating verbally.  Work on only 5-7 words per session, and schedule many frequent sessions. Later, you will want to move to distributed practice.

* Distributed practice may be working on 10 different words in a set during a session, or scheduling less frequent sessions. Distributed practice yields slower progress, but better learning and generalization.

* Block Practice is practicing each word in a block of many repetitions. For instance, practice "me" 50 times, them "mine" 50 times, then "up" 50 times. You get better performance on trained words, but less generalization. A "modified" block may look like 50 reps on "me", 50 reps on "mine" 20 reps on  "up".

* Random Practice is taking those same words and mixing them up randomly. Say "mine" then "me" then "up". This yields better motor learning, but slow progress.

Vary your set of practice words and how they are presented. 

Movement sequences should be practiced under different conditions and contexts to improve motor learning. Choose a movement sequence, but practiced varied examples, different coarticulatory contexts and manners of production. For instance, you could choose a bilabial to a vowel. Your set could include me, my, bee, baby.

Don't forget prosody!

Work on this early and often. Once the child is successful in one context, practice the word or phrase loud and soft, hi and low, normal or slow. Say it as a statement or with rising question inflection. Go out! Go out! Go out? Just be sure you never segment your model. Teach "shhhhhhhoooo" and not "sh"+"oo".


What should feedback look like?

There are two types of feedback that play a part in learning:
* Intrinsic feedback is sensory information- what the child hears or sees or feels. Sensory feedback may not be enough in CAS.

* Extrinsic feedback, which provides information on how accurate the attempt was "That's right!" and what the child needs to do differently "Be sure your lips are together." This is especially important early in treatment. As a child progress, reduce extrinsic feedback, to so the child does not become overly dependent on it, and can improve self-monitoring. 

The amount of feedback needed changes over time. Start with frequent, immediate feedback, and move towards intermittent feedback with greater delays in delivery.


So what do you do exactly? 

For the child with severe apraxia, start with mass practice and blocked practice, with frequent and immediate feedback.

Create an Amazing Therapy Plan for Severe CAS www.speechsproutstherapy.com1. Start off with a small stimulus set of 5-7 utterances.
2. Plan shorter, more frequent sessions using block or modified block practice.
3. You may want to choose stimulus words with two different vowels.
4. Target functional words such as hi, bye,  out, ow or down. Check with family to see what words are important to the child: a pet's name, favorite toy, family names, his own name, are all good targets to include for functional speech.
5. Provide immediate, frequent and very specific feedback.

As the child progresses, move toward distributed practice and random practice, with less frequent feedback, delivered with greater delays.  

1. Increase the number of stimulus words: up to ten.
2. Sessions can be longer and less frequent.
3. Don't provide feedback for every trial. Make it less frequent and less immediate. I would continue to make feedback specific.


You've done it! You have an awesome therapy plan in place for your student. 

We have our diagnosis, we have identified emerging skills and functional words to target, and have designed a therapy plan with careful consideration to the intensity and frequency of practice and feedback. As our preschool teacher would say... "Kiss your brain!"

NOTE: Next time I will be talking about Dynamic Temporal and Tactile Cueing (DTTC) and some awesome therapy techniques, tips, and tricks, so stay tuned, my friends.

See you soon, and please don't forget to share this post so we can spread the word!

Thursday, August 11, 2016

Best-Ever Books for Back to School Speech Therapy: The Kissing Hand and a FREE Treat too!

Welcome your children back to school with a favorite story: The Kissing Hand by Audrey Penn.

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! Freebie and book companion for this beloved story.

Mommy loves you. Many children feel anxious about the newness of heading back to school, and this sweet book assures them that they are loved and will have a wonderful time. It's great for preschool to second grade, you can find plenty of ways to share and target goals too.

Just so you don't miss it, I have a freebie for you too, so be sure you read all the way through!

The story begins with a little raccoon named Chester.

Chester cries because he is a bit scared to start school. He begs his mama to stay home with everything that is familiar to him, so he can play with his friends, his toys and read his books.

Mother gives Chester a family secret: the kissing hand. She places a kiss right in the center of his palm. Now, when Chester places it on his cheek, he can feel the warmth of Mommy's kiss, and he thinks "Mommy loves you."

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! Freebie and book companion for this beloved story.

Chester loves his kissing hand, and he knows his mother's love will go with him... even to school. He loves it so much, that he gives mother her own kissing hand at the end of the story. She presses it to her cheek and she knows: "Chester loves me."

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! Freebie and book companion for this beloved story.

The Kissing Hand is the perfect storybook for back to school.

Here's my plan for Week ONE! We'll read the Kissing Hand with my students. We will talk about feelings vocabulary. So many of my children with language goals have limited descriptions for their emotions: happy, sad, and mad. Sometimes scared. We will talk about words like worried, anxious, excited, fearful.

I needed book companion activities for The Kissing Hand!

I created a The Kissing Hand Back to School Speech Therapy Book Companion, so I could address the numerous goals of my growing caseload. I am really excited to tell you about it, I can't wait to kick off my year with this pack.

School hasn't started yet, but I understand my school has already gained 76 kids this year. That will surely mean more speech therapy IEPs for me. Yikes. This year I will be supervising an SLPA and will be all about multitasking and making things versatile. Starting with week one!

I love that I have small groups, and can really give individualized attention to my children. We'll start by drawing our worries, and talk about what made us feel better.

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! Freebie and book companion for this beloved story.
Talk about feelings and worries with this activity

There are plenty more activities to cover nearly everyone on the caseload.  Here are a few pictured here: Category sorting for school supplies. (Everything you see is also available in BW for those who need to be ink-conscious. I always include BW or gray-scale options for you.)

Check out the cute writing craftivity on the left:

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! Freebie and book companion for this beloved story.
Who would you give a Kissing Hand too?
Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! Freebie and book companion for this beloved story.
Category sorting fun with school supplies

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! Freebie and book companion for this beloved story.
A huge variety of  back to school activities
There are wh and yes/no questions, following directions, story sequencing, story vocabulary, and articulation too. 

I made articulation puzzles for minimal pairs. 

These will be great for my pre-k and kinders. 

I glued them onto file folders to make it easier for little hands and will be adding Velcro when I get back to school. The file folder makes it pretty convenient to hold the pieces. just pop them in a baggie, and into the inside pocket.

Like most of us, I have a range of ages on my caseload.

 I needed higher-level activities as well. Vocabulary task cards, more advanced category cards, story map, and an open-ended board game for back to school: Scamper.

I really love using mini-book readers. 

The children enjoy the hands-on activity and they are proud to share them at home, giving additional practice. So I created Chester, Chester, I Need a Kiss Quick! 

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! Freebie and book companion that includes this adorable
Fun reader to learn body parts and where questions.
Cut out the included heart shapes, or better yet use stickers or die-cut hearts if you have them. Fun! Stick the heart on the children on each page... on a hand, a head, a knee, and on the heart! Your students will practice basic body parts and answering where? questions with this cute little rhyming reader.

If you'd like to have your first two weeks back to school all planned out with these fun activities head over to grab it here:  The Kissing Hand Speech Therapy Book Companion 

We will wrap up our first day with this cute little treat.

I created these treat toppers for a sweet little welcome to go along with the story. You can print them double-sided to include a parent note, encouraging story re-tell when the children get home. Tell the children they will get a kiss for themselves and need to share a kiss at home with someone they love. 

You can download this FREEBIE in my store here: The Kissing Hand Treat Toppers

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too! FREE treat topper with a parent note to encourage story re-tell.

Prepping these is easy! Pop a few candy kisses in a baggie, Staple the labels on top, and you are ready to go!

I hope you have a terrific back to school, whether you are starting this week (like me) or in a couple weeks! 

Welcome your speech therapy students back to school with The Kissing Hand and a sweet treat too!  Download a FREE treat baggie topper too.
The Kissing Hand
Until next time my friends...