Friday, August 16, 2019

How to Swap Crazy for Zen in Speech Therapy

Mixed groups can get a bit crazy sometimes in speech therapy

Zen coloring articulation activities for r, l, s and th sounds in mixed group speech therapy sessions that are calm and engaged. Elementary and middle school kids love coloring the beautiful patterns on these printables, and they are no-prep for you! #speechsprouts #speechtherapy #articulation #noprep
No-prep printables perfect for mixed articulation groups in speech therapy.

We've all had 'em if you are a school-based speech-language pathologist. The challenges are real, especially as groups grow larger. And they are, with so many school settings tossing crazy high caseloads at SLPs. (But that's another topic I could spend a day on. Grrr.)

 Does this sound familiar? You have three or four or...gulp!.. five or more kiddos head your way for a session of working on articulation with maybe one or two of the kids with language goals as well. These children are antsy after doing work for the better part of the day. Quietly. With no talking.

So now you're asking them to drill, then quietly wait as you take a turn with each of the other students in the group?


Yeah... not going to happen without a plan. Nope! So what do you do? I shared a bunch of great ideas in this post, Three Sure-Fire Secrets to Solving Mixed Group Madness.

I talked about three rules:
1. Reduce wait time and keep kids busy between turns.
2. Don't make kids wait as you shuffle a pile of prompts trying to find the right list for the next student.
3. Have a data-taking method that's quick and simple to.... you guessed it...reduce wait time.

Sensing a theme here? Wait time is your enemy.


You need an activity that keeps kids actively engaged, but won't eat up speech therapy time.

I love quick-play games, playdough, slime, and puzzles. Something to keep hands busy as others in the group take a turn practicing. Ordinary coloring sheets are fun for little ones, but my older students get bored with those.

 So how about kicking it up a notch for your older students in elementary or middle school? 

My second through fourth graders love coloring intricate patterns...even the boys.


Zen coloring articulation activities for s and th sounds in mixed group speech therapy sessions that are calm and engaged. Elementary and middle school kids love coloring the beautiful patterns on these printables, and they are no-prep for you! #speechsprouts #speechtherapy #articulation #noprep
No-prep Zen articulation activities for S and Th sounds

So when I saw these amazing Zen letters, I knew I had to create Zen articulation activities for you. There are three gorgeous patterns: paisley, flowers and hearts. I sprinkled all 3 in each pack, so kids would have a choice of patterns. Or choose a different one each session.

They are so fun to color, and kids absolutely love them.  A quiet, highly engaging, calm activity? Check!

  A few more reasons these work really well in mixed groups...

You need all your prompts handy and easy to find so there's no hunting and shuffling around for the right one.


Here's the challenge in speech therapy groups...You may have one student working on medial /l/ at the word level, another one on sentence-level vocalic r and a third on final voiced 'th' at the phrase level. Everybody's working on something different!

When you start digging for the right prompt, you run the risk of losing the kids as they wait... and that's when those off-task behaviors kick in. Reduce idle wait time! (Yep, that's my mantra for mixed groups.)

These no-prep pages make that super simple for you. Just pull a page with the right phoneme for each student's goals.

Stay organized with word, phrase and sentence level prompts all on each page.


Zen coloring articulation activity for vocalic R practice in speech therapy. These no-prep printables are perfect in mixed groups. Click to see more!  #speechsprouts #articulation #speechtherapy #noprep
Vocalic R Articulation Zen coloring

Super convenient, because you can address any level with a single page.

I like to have my sentence-level kiddos warm up on the word and phrase levels, before taking data on the sentence level prompts.

For kiddos that have mastered sentence level, there are also sound-loaded challenge pages with 4-5 target words per sentence.

Sound-loaded printable articulation activities for vocalic r sounds.  Swap the crazy in mixed group speech therapy sessions for calm and Zen. Elementary and middle school kids love coloring the beautiful patterns and they are no-prep for you! Click to check it out. #speechsprouts #speechtherapy #articulation #noprep
Sound-loaded practice provides extra challenge.

Tip:  I find when you use coloring pages printed on an inkjet printer,  the black lines sometimes smear a bit when using markers. Pages off the office copier don't seem to as much. If you find they smear, just use colored pencils instead.

What about working on language goals with this activity?


Will that work? Absolutely. Here are a few ways to work in language practice when you have a mixed group with both articulation and language goals.
  1. Define the word. 
  2. What category?  (If it's a noun)
  3. Use the word in a sentence.
  4. Tell an adjective/ adverb to describe the word, and use it in a sentence. (Prompt: ran. Answer: ran quickly)
  5. Provide a synonym/antonym for the word.
  6. Does the word have any other meanings?

Have fun with this Zen coloring bundle! Articulation practice of r, l, s and th sounds that's perfect for mixed group speech therapy activities.. Elementary and middle school kids love coloring the fun patterns on these no-prep printables. Click to see more. #speechsprouts #speechtherapy #articulation #noprep
No-Prep Zen Articulation Bundle

To make tackling those mixed groups easier, I bundled my Zen Articulation sets together for these phonemes:
  • L
  • L-Blends
  • S
  • S-Blends
  • Initial R
  • R-Blends
  • Vocalic R
  • Voiced Th and Voiceless Th coloring pages.


You might even find yourself coloring the beautiful patterns too. 


Can you resist? I couldn't. So grab the colored pencils. It's fun. And relaxing.

I hope you give it a try! You can check out the bundle HERE.  Have fun.

Sunday, July 28, 2019

17 Genius Ideas to Organize Your Speech Therapy Room


Speech Therapy Room Organization Can be Challenging!


Many SLP's are given small spaces to work in, sometimes practically minuscule, especially in schools. Combine that with the fact that you need storage for a  huge variety of materials... because we see a myriad of students at different levels and different needs.

If you're like me, you want to be able to offer hands-on activities to engage children as you work on those speech therapy goals. Games, crafts, sensory bins, toys all need a place. Then there's your cards, books, worksheets and... if you're lucky a tablet or two. Plus, don't forget all those office supplies that are essential to cranking out the required paperwork.

So, because we all need a little speech room inspiration, I've gathered up 17 genius ideas from SLPs and teachers to make your organization quest a bit easier! Here you go:

Note: I've provided suggested links to where you can purchase some of these items for your convenience, so you can see what the items look like. They are not affiliate links, and I'm not receiving any compensation for providing them- just hope it's helpful!

Organizing your office space:


Organize your computer cords. Great idea for organizing your office space. from www.landeeseelandeedo.com

1. Cords: Label your cords with Washi tape and manage that tangle of computer cables with this pretty and practical solution from Landeelu. When I leave for the summer, I'm required to unplug all the cords and cables to my computer and other devices. That usually results in a tangled nightmare when I get back! "Where does this cord go?" is a frustrating game I'll no longer need to play with this tip.

2. Forms: Store frequently needed forms in a letter-sized pocket wall organizer like this one at Walmart. I have this filled with papers I frequently need to grab: therapy logs (if you keep yours on paper), baseline forms, screeners to send to teachers, parent handouts, welcome letters and supply lists for new students.

3. Files: Use color-coded dividers in your file cabinet to organize your workflow. You can purchase pretty ones, or simply label and laminate construction paper.


Organize your speech therapy files with colored and labeled dividers by your workflow. This way you can see what needs to be done at a glance. Read more speech room organization tips at www.speechsproutstherapy.com #speechsprouts #speechtherapy #organization #speechroom
Organize your workflow with colored file dividers

4. Clean keyboards: Here's a neat trick- before you toss out those old sticky notes, run them between your keys on your keyboard to clean out the dust and... crumbs.  Yeah, unfortunately, it's true, I do eat over my computer at lunch.

Do you know this sticky note hack?  Read more speech room organization tips at www.speechsproutstherapy.com #speechsprouts #speechtherapy #organization #speechroom
Use a sticky note to clean  between your keyboard keys


5. Office supplies: Organize office and therapy supplies in a toolbox, especially if you have no room for a desk in your small space. Label each drawer yourself or find plenty of cute pre-made labels that are editable on TpT.

Organizing Your Therapy Materials:


Organize your speech therapy articulation activities, cards and worksheets for each phoneme in a bin. Easy to grab and go! Read more speech room organization tips at www.speechsproutstherapy.com #speechsprouts #speechtherapy #organization #speechroom
Articulation bins organized by phoneme

6. Printable Materials can be stored by theme or skills. Store them in clear plastic bins so you can easily see what you have. I use large bins for themed packs. I love the bins above for organizing my articulation materials.


How to store and organize your Teachers pay Teachers products plus more speech room organization tips at www.speechsproutstherapy.com #speechsprouts #speechtherapy #organization #speechroom #teacherspayteachers
Use poly envelopes and binder clips to organize Teachers pay Teachers materials

7. My TpT Materials live in these in poly envelopes (above). TpT materials may include cards and manipulatives combined with page-size printables. Poly envelopes can handle cards, dice, booklets and more, plus they're clear so you can easily see the contents and find what you need. I love binder clips to keep card packs together. Keep the filled envelopes in your file cabinet or in bins.

8. Sensory Bins: Sand, beads, pompoms, noodles, oh my! Separate your materials into clear plastic tubs or recloseable bags. Collect materials that can be used for multiple themes to cut down on how much you need to store.

9. Games: Keep these in a cabinet or behind a curtain. This cuts down on begging for a specific game when you have another activity in mind! Put open-ended games together, and games that address specific skills together. Note: If you are really space-challenged, keep just the basics in your room, and bring games from home as you need them.

Ways to store card decks:



Store your speech therapy articulation and language card sets in labeled photo storage boxes. Read more speech room organization tips at www.speechsproutstherapy.com #speechsprouts #speechtherapy #organization #speechroom
Photo boxes are great for storing cards in speech therapy


10. Store cards in a photo storage case like the one above from Michael's or Walmart. These also come in clear if you want to easily see the contents. These will often fit two packs of cards per box. Clip each pack with binder clips to keep them together.  Add labels so you can find what you need.

11.  Store cards in a hanging shoe organizer.

12. Hole punch frequently used cards and prompts and store them on a binder ring. If you have a metal bookcase or file cabinets near your therapy table, hang 'em there on magnetic utility hooks.

Organizing Books:

 13. Use ice cube bins like this one at Target as a cheaper alternative to book bins. I like to organize many of my books by theme, so it's easy to grab and go. Add a cute label to the front of the bin and you are good to go!

14. Organize storybooks alphabetically on a shelf. I do this for the books I use for multiple goals or themes. This way, they're easy to find by the title. Use paint sticks or simply laminated paper like this.

Organize your storybooks alphabetically in your speech therapy room and use dividers to easily find the titles. Read more speech room organization tips at www.speechsproutstherapy.com #speechsprouts #speechtherapy #organization #speechroom
Alphabetize your storybooks so you can find them by title

Organizing Arts and Crafts Materials:


15. GlueMake a couple of glue sponges. Click the link to see how Lucky Little Learners does it.  Ditch the bottles of white glue and all those glue sticks that your preschoolers mash into their papers and keep these instead. Way less mess, and will last you for months.


Great idea for storing tempera paint! Read more speech room organization tips at www.speechsproutstherapy.com #speechsprouts #speechtherapy #organization #speechroom
Store paint in ketchup bottles

16. Paint: If you use tempera paint with your kiddos, you'll only want to store small amounts to work with. Empty ketchup bottles make great containers for this.

17. Construction Paper: Store construction paper and card stock in hanging file folders in your file cabinet or a bin. A paper organizer on your shelf (if you have room) or hanging pocket chart also works well.

A few more great organizational tips:


  • Keep things you use the most within reach.
  • Keep only the most needed folders and papers on your desk.
  • Use your wall space to your advantage: hang supplies and materials.
  • File things weekly or better yet daily so your desk doesn't get piled up.
  • Purge old files!  If you don't need it forever, mark on files when it can be tossed or shredded. 

I hope you found a few ideas you love to help you feel organized in your speech room.

Here are a couple more posts you may enjoy while you're in an "organizing" frame of mind!



If you have great ideas, leave them in the comments, I'd love to hear them!


Follow my Organize Your Speech Room Pinterest Board for more organization and inspiration ideas, and pin the ones you like for later, so you can find them.

Until next time my friends,

Sunday, April 14, 2019

14 Preschool Songs and Fingerplays for Spring Speech Therapy


How do you grow speech and language skills in your preschool therapy sessions this spring? Try these songs and fingerplays!


14 fun kindergarten and preschool songs and fingerplays for your spring speech therapy sessions  #speechsprouts #speechtherapy #preschool  www.speechsproutstherapy.com
Spring songs and fingerplays are great for building language skills


When you think about spring, what comes to mind? Gardens, worms, rain showers, bunnies, and flowers? Check. Chicks, ducks, butterflies, bugs, caterpillars, frogs and rainbows? Yep.  All super-appealing themes that preschoolers and kindergarteners really get excited about.

So use 'em to engage and captivate little ones in speech therapy. Even my not-so-little ones love these topics.

If you've been hanging with me for a while and reading my posts, you know I love using themed activities in my therapy sessions. It's a fabulous way to activate a child's background knowledge and provide a foundation for rich language experiences and learning. 


I'm a huge fan of songs, rhymes, fingerplays and movement activities for preschool speech therapy.

This is the third seasonal round-up post I've published to share favorite songs and fingerplays for the season at hand. To see more of how and why using music and movement can supercharge your sessions read:

14 Songs and Fingerplays for Fall in Preschool Speech Therapy, and

14 Preschool Songs and Fingerplays for Winter Speech therapy

Can you seriously target speech and language skills while singing, dancing and having fun? 

You betcha, just take a look at some of the skills you'll practice:
1.  Rhyme
2.  Vocabulary
3.  Prosody
4.  Sentence structure
5.  Increasing sentence length
6.  Turn-taking ("The Itsy Bitsy _______?" )
7.  Auditory memory
8.  WH questions
9.  Adjectives, describing
10. Positional words/ prepositions
11. Story-retelling
12. Yup. Even articulation. 

Here are a few ideas and tips I shared in my Winter Songs and Fingerplays post, and of course, they apply to our spring selections as well:

Tips for using songs and fingerplays for language development

  • Repetition: Repeating words and phrases in songs offers multiple opportunities to practice.  Don't sing the song or do the fingerplay just once. Enjoy the same one several times in a session and over multiple sessions. Repetition is powerful!
  • 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-teaching: Start by teaching the words and motions at a slower pace... you can speed up a bit later.
  • Using visuals: Use pictures, story-telling pieces or other visuals. A picture IS worth a 1000 words and can help your children comprehend and focus. 


So let's talk about some spring songs and fingerplay favorites

And... a few ideas to go with them to expand on the theme and build vocabulary in your speech and language sessions.

The King County Library System has a great list including videos so you can see how the fingerplays and motions are done.

Weather songs and fingerplays:


14 preschool songs and fingerplays for spring that are perfect for speech and language therapy  #speechsprouts #speechtherapy #preschool  www.speechsproutstherapy.com
Using music, rhyme and rhythm really engages children when teaching language skills. 

Little Raindrops Falling Down, sung to the tune of London Bridge, repeats "falling" for practice with initial /f/ and -ing verb endings. You can also target size concepts as the drops are "little" at first, then "bigger" then "giant."

Come Under My Umbrella repeats the word umbrella (great for syllables practice) and come for initial /k/ articulation practice. I also like it for weather words: thunder, lightning, and rain.

Why not open a big umbrella and let the children come "under"? Bring a spray bottle, put it on mist, and make it rain. The kids will love it! Then try "under" a few more things... the table, maybe your desk or a cardboard box.

Gilly's Galoshes is fun as Gilly splishes and sploshes.
This rhyme is great for practicing "she." and s-blends too. Bring a pair of big rainboots in for the children to stomp around in and act out the story.

She'll stamp and she'll stamp
But her feet don't get damp...

Rain is Falling Down in Drops is sung to the tune of the Ants go Marching. It repeats "drops" and adds in "stops" for final s-blend practice.

The rain is falling down in drops
We can't go play until it stops...

Walking in the Sunshine repeats initial /w/ "walking" and final /p/ (skip, whip, creep, leap, slip). Great for articulation practice

Gardens


Dig, Dig, Dig the Earth is sung to Row, Row, Row Your Boat. You'll practice final /g/, and talk about seeds, rain, sunshine, and flowers.

Bring in a flowerpot with real seeds and dirt, or fill one with black beans. Use a few beans of a different color to "plant." (seeds). Count them, one seed, two seeds, three seeds... great plurals practice.

 What will the seeds and plants need? Where do the seeds go? Inside the pot, under the "dirt"  What did you do? (Past-tense verb practice: planted, watered.) What will happen next?

Before your students arrive for their next session, add some silk flowers to the pot. You grew these flowers! What happened?

The Farmer Plants the Seeds  This song and fingerplay repeats seeds and crops (plurals practice). There's also plenty of verb practice: plants, comes, begins,  picks. 


Explore the farmer and "crop" theme and bring in a few veggies. Cut them in small pieces and have a tasting. How are they alike? Different? Are they crunchy? Juicy? Name some that are green. Which ones are yellow?

Teach basic categories and sort pictures of vegetables and fruit or better yet use play food and sort them into baskets.

Worms and Bugs




Ladybug, Ladybug by Frank Leto is a fun song with a slightly slower pace. The little ladybug crawls on a thumb, wrist, arm, elbow, ankle, and leg... perfect for naming body parts and initial /l/ practice.

If you have a little toy ladybug, have it 'crawl" on the children as you sing. They squeal and laugh, it's so cute!



Caterpillar Change is a fun little fingerplay that's great for simple wh questions. What is he doing? (crawling) Where is the caterpillar? (inside) What happened?

 "There was a little caterpillar crawling all about..." Of course, he wraps himself into a cocoon (change that to chrysalis if you like) and becomes a butterfly.

Follow up by reading the Hungry, Hungry Caterpillar and make some little caterpillars to take home. These fruit cereal caterpillars were a big hit with my preschoolers!

A fun and easy fruit cereal caterpillar craft for preschool. Make this after learning the fingerplay "Caterpillar Change" One of 14 Preschool Songs and Fingerplays for Spring.  #speechsprouts #speechtherapy #preschool  www.speechsproutstherapy.com
A pipe cleaner, wiggle eyes and fruit cereal make this yummy caterpillar.


Wiggle Worms by Dr. Jean will have your little ones giggling as the worms wiggle everywhere.  This fun little fingerplay is great for opposites, position concepts and of course, there's plenty of initial /w/ practice too.

Dr. Jean suggests giving each child a worm made of fuzzy brown yarn, so they can "wiggle" along as they recite:

Wiggle your worms up, then wiggle them down.
Wiggle your worms around and around.
Wiggle them high, wiggle them low...

Bunnies. Chicks, Ducks and Frogs


14 preschool songs and fingerplays for spring that are perfect for speech and language therapy. Using visuals like this interactive flipbook for Five Green and Speckled Frogs help children with story re-telling.  #speechsprouts #speechtherapy #preschool  www.speechsproutstherapy.com
Five Green and Speckled frogs interactive book and activities 


Five Green and Speckled Frogs by the Kiboomers is a Youtube video with cute illustrations and a nice child-friendly slow pace.


 I especially like the Kibbomers videos for this reason. You can target initial /f/ (five) and /sp/(speckled) as well as plurals (frogs) and position concepts in and on.  Make some playdough logs and frogs after singing or play "in the pond, on the log (or bank) and work on listening.

1. Use masking tape or a carpet runner and create a "log" on the floor.
2. Tell the children that the area outside the box is "the pond."
3. Have some children start in the pond, some on the log.
4. Tell the children the only time the should move is to jump when they hear either "on the log" or"in the pond". Don't move if it's anything else!
5. Shout "on the log" or"in the pond" and sometimes trick them a little by saying something different, like 'on the rock" or "in the log".
6. With older children who handle competition well, you may want to have children that make a mistake be "out." With little ones, we just have fun playing.

Little Chick Waits by Dr. Jean is perfect for final s-blend and verb practice with "waits, taps, and pops."

Little Chick waits in his egg of white...

Five Little Bunnies Song for Kids by The Kiboomers is an easy-to-sing countdown song that repeats "hippity hop and hippity hey." Have anyone working on initial /h/? This is the perfect song.


14 preschool songs and fingerplays for spring that are perfect for speech and language therapy. These yellow duck visors are fun for acting out the story.  #speechsprouts #speechtherapy #preschool  www.speechsproutstherapy.com
Act out the song and target positional words over and far

Five Little Ducks
 This YouTube video by Super Simple Songs sings the Five Little Ducks at a pace your littles can easily follow. (Super Simple Songs has lots of great videos, explore their channel!)

There are several versions of traditional songs, of course. I love the one where Daddy duck quacks at the end! That's the one I used in my Five Little Ducks Unit.


14 preschool songs and fingerplays for spring that are perfect for speech and language therapy. Using visuals like these magnet board story-telling pieces for Five Little Ducks help children with story re-telling.  #speechsprouts #speechtherapy #preschool  www.speechsproutstherapy.com
Pictures and manipulatives help children re-tell the story.

Round out your spring-themed units with books, crafts, and more activities.


This fluffy cotton ball lamb craft is super simple to make. 


And of course, be sure you've subscribed to my newsletter (the signup is in the right-hand column here) so you can download Where's Froggy? activity to go with the Five Green and Speckled Frogs. 

Check out my Pinterest boards for more spring-themed ideas, books, crafts, and activities:






Ready for more seasons of songs and fingerplays for speech therapy?

I've got you covered with these posts:

14 Songs and Fingerplays for Fall in Preschool Speech Therapy




I hope you enjoy these with your little ones, Happy Spring!

Thursday, March 28, 2019

Best-Ever Books for Spring Speech Therapy: The Black Rabbit


Have you read The Black Rabbit by Phillipa Leathers?


The Black Rabbit Book features a little bunny who is scared of his own shadow. A fun book for preschool and spring speech therapy
The Black Rabbit is a great storybook for speech therapy.

Rabbit-themed storybooks are perfect for working on articulation of initial /r/ or syllableness (bunny, rabbit). A favorite of mine is The Black Rabbit by Phillipa Leathers.

This story is sound-loaded with initial /r/. The main characters are Rabbit and Black Rabbit so of course, the word "rabbit" is repeated throughout the book, along with run, ran and right.

A cute little rabbit wakes up and decides to step out of his burrow on a lovely sunny day.

But he is not alone... he sees something scary. It's a great big black rabbit who follows him everywhere he goes.

My littles are captivated from the start as I read the story with a worried voice. They can relate to feeling scared. Rabbit tries to run away and hide, but no matter where Rabbit runs, Black Rabbit is right behind him.


In The Black Rabbit Book a little bunny is hiding from his own shadow! A story book sound-loaded with R for spring speech therapy


There are plenty of opportunities for wh questions and talking about feelings words while reading Black Rabbit. Who is behind Rabbit? Why is Rabbit frightened? Where you ever scared? What scared you? What does Rabbit do first? Next? Where does he go? What do you think will happen?

After making several attempts to shake Black Rabbit, Rabbit finally runs into the deep dark wood. 

Black Rabbit seems to be gone. But then, Rabbit sees two eyes in the dark! Pretty spooky for little ones right? At this point in the story, they are looking at me intently with worried little faces. On no! Who do you think it is? What will happen next?

A little bunny meets a scary wolf in the woods in The Black Rabbit. A great book that is sound-loaded with R for spring speech therapy.


It turns out to be a wolf and Rabbit runs as fast as he can out of the dark woods. Then, just when things seem desperate, and Rabbit thinks the wolf is about to get him, Black Rabbit shows up and scares away the wolf.


A little bunny walks off hand and hand with his large shadow. The Black Rabbit is a sweet book for preschool speech therapy.


After that, Rabbit is delighted that Black Rabbit is with him. And off they go together...because, of course, Black Rabbit is really just Rabbit's shadow!

Follow up with more Rabbit and Bunny-themed speech therapy activities 

Teach basic concepts with these resources:

Teach next to and between with Where is Bunny?

A set of three interactive books featuring a cute bunny in the spring garden. to teach the concepts of "next to" and "between" in speech therapy
Where is Bunny? Teach the position concepts of "next to" and "between."

I designed this set of three interactive books to systematically teach positional concepts of next to and between.

So many of my students who are working on basic concepts get confused when they're presented with an activity that targets multiple concepts. They need to learn a single concept at a time, with plenty of repetition, before they're ready to tackle mixed concepts.

This simple story features a little bunny who sneaks into the garden.

The pages are shaped like a garden gate, which makes it extra fun. Children place their Bunny stick puppet "next to" or "between" items on the page. Each page in the book offers practice with the position concept, answering where? and learning garden vocabulary.

The pictures below show the "next to" book.

Where is Bunny? interactive book with a bunny stick puppet and moveable garden-themed pieces. Teach the concept of "next to" with this book.
Put Bunny "next to" items in the garden, then complete the sentence.


Next, complete the sentence by putting the matching picture on the sentence strip. Bunny is next to the cabbage. The repetitive text and errorless format provide plenty of support for early learners and the visuals are great with students on the spectrum as well!


Where is Bunny? interactive book with garden-gate pages and moveable garden-themed pieces. Teach the concept of "next to" with this book.
Where is Bunny Next to Book
Where is Bunny? interactive book with garden-gate pages and moveable garden-themed pieces. Teach the concept of "between" with this book.
Where is Bunny? Between Book
After practicing the concept of "next to" with the first book, we practice the position concept of  "between" with a second book.

  

 Once a student has mastered the individual concepts,  it's time for the mixed practice book. 


Where is Bunny? interactive book with garden-gate pages and moveable garden-themed pieces. Teach the concepts of "next to" and "between" with this book.

The books intentionally use a repetitive format and the same little bunny character reduce the learning load and allow the child to focus on the positional words.

There's also a BW mini-book for homework and printables for extra practice.

A garden-themed cut and paste mini-book to teach the position concept of "next to" in preschool speech therapyGarden-themed printables to teach the position concept of "between" in preschool speech therapy


Click here to see more of Where is Bunny?


Teach same and different with Bunny Shapes

Clothespin task cards with bunny shapes and carrot shapes to teach the concepts of same and different in preschool speech therapy.


I have children that struggle with the concepts of same and different. These are pretty abstract concepts when you think about it. Matching is easier, you simply place the identical items together.

Choosing "the same" or "different" from a choice of three is just more difficult for some children.

My little ones really stay engaged with hands-on learning. I love incorporating fine motor practice too, so I designed these bunny and carrot clip-dot-punch cards and activities. It includes two sets: one targets the concept of "the same" and features cute bunny shapes. The second is a set with carrots that targets "different."


Clothespin task cards bunny shapes  to teach same and different in spring speech therapyClothespin task cards and more activities with bunny shapes and carrot shapes to teach the concepts of same and different in preschool speech therapy.


Get out the clothespins, dot markers or the hole punch and work those little fingers!


Use the cards 4 ways!
1.  Print the cards in color or BW and use them as clothespin task cards. Children fasten the clothespin on the correct shape. Or...

 Bunny shapes and carrot shapes: activities to teach the concepts of same and different in preschool speech therapy.

2.  Print them in black and white and dab the correct pictures with dot markers.

3.  Even more fun, especially for kindergarten and up... use a hole punch to mark the correct puncture!

4. They can also be printed out as a mini-book that includes a parent page to send for homework.


Get more practice with printables for folder games or cut and paste activities.


Folder games with bunnies and carrots to teach the concepts of "same" and "different" in speech therapy this spring.


I also included a fun open-ended game to use with any target.

An open-ended bunny shapes game for spring speech therapy.





What are some more fun themes for spring? 

Try ducks, frogs, gardens, flowers, bugs or farm babies. You can find some inspiration on crafts, books, and activities for spring on my Spring Pinterest Speech Therapy Activities Pinterest board HERE. 

I hope you are seeing the signs of spring where you are!


Until next time,


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!

Great news,  I have a copy of the DEMSS to give away! 

Brookes Publishing Company has kindly offered to provide a copy of the DEMSS that I can give to one lucky person. It's a $150.00 value, and a valuable tool, so I hope you enter!

You can enter on the form below between 12 am April 4, 2019 to 12 am April 7, 2019.

Click the first option to enter and leave your email address (so I can contact you if you are the winner.) You can also earn additional entries by completing the other options to follow me. I very much appreciate likes, shares, and tags on social media to help us spread the word.

Enter the Giveaway here:

a Rafflecopter giveaway

Good luck,  I'm excited to see who will win this awesome prize. Be sure to tell your SLP friends to enter!


Thank you, my friends. Until next time,