Summer Freebies!

travelGuidesI’m sure that, for the first few weeks of summer vacation at least, school will be the last thing on your mind. But did you ever consider that summer could provide a treasure-trove of free therapy materials that you can use throughout the school year?? Here are some ways to make therapy fun and functional, and relevant to the curriculum for all of your artic, language, fluency, and voice students:

 

  1. Tourist brochures – Hotels, rest stops, and tourist destinations always have racks upon racks of cards and brochures that promote all of the attractions in the area, and they are FREE. Help yourself! These provide interesting stimulus material for reading aloud, discussion, and writing activities.
    1. Our fourth grade studies Pennsylvania history, so brochures from historical sites in our state are very relevant to their classwork. And it’s always surprising (in a sad way) to learn how many students have never visited local historical sites. Maybe sparking their interest will lead to family day trips in the region.
    2. Brochures from outside the state offer the opportunity to talk about history, geography, distance, and observable differences in the photos compared to your immediate environment. What do you see? What do you think it’s like there? Does it remind you of any place you have already visited? How long would it take to get there? What would be the best way to travel there? What would you have to pack for that trip?
    3. Provide brochures from a variety of locations and have the students discuss the pros/cons of each from their point of view.
    4. Use brochures as a reference for writing activities, such as writing a letter or postcard to someone about an imaginary trip or writing an ad to promote a tourist destination. Video the students presenting their ad – lots of fun, great carryover for artic, and useful for self-monitoring via playback.
  2. Postcards – not free, but usually cheap. Use as above, and also as creative story starters about “my best” or “my worst” summer vacation. Sort by common features (location, type of attraction, etc.). Locate the places on a large wall map.
  3. Maps and regional travel books – free to members of AAA. Maps alone offer so many language opportunities! Older students will enjoy learning how to look up tourist destinations and then plot them on the map to create an interesting itinerary. Read the hotel and restaurant listings, comparing amenities and price. Create math word problems related to these materials for students who struggle with that language. And don’t forget the maps that are often provided in amusement parks, zoos, historic villages, etc. With just a little thought, I’m sure you can come up with all kinds of storytelling, describing, categorizing, auditory memory, and sequencing activities that the students would really enjoy.
  4. Menus – lots of restaurants have take-out menus so, again, help yourself! With your artic, language, social skills and life skills students, use menus for:
    1. artic practice with multisyllabic words
    2. discussion of likes/dislikes and healthy vs. not so healthy choices
    3. role play ordering and taking orders in a restaurant – good for social skills, auditory memory (can the waiter repeat and/or write down what the customers ordered?)
  5. Bus and train schedules – available at all stations and depots. These provide practice with functional life skills, in addition to artic and language. Can they locate the quickest route to their destination? How much will it cost? How long will it take?
  6. “This Week in (vacation location)” booklets — use for planning a daily or weekly itinerary, comparing/contrasting and expressing opinions about listed activities, writing and then verbally delivering “ads” to get folks interested in the various events. (My students love to do news, weather reports, and commercials on video — motivating speech and language practice that provides playback for self-monitoring).
  7. Photographs of your travels — use for labeling, describing, writing captions.

Students love using these unconventional materials in therapy. Beyond the activities I create to support their goals, these materials spur the students to share stories from their own travel experiences, giving me the opportunity to assess their conversational artic, vocabulary, grammar, and ability to tell a story in sequence and with sufficient detail.

So, while you are out and about this summer, be on the lookout for these materials and ask your friends and relatives to do the same. Then create a “travel agency” nook in your therapy room and enjoy using these materials throughout the year!

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Your Moment of Zen: Becoming One with /r/

In my last post, I wrote about how various technology – from free and cheap apps to expensive high-tech equipment – can be used to help students improve their articulation of vocalic /r/. But that’s not all I use. There are lots of useful, hands-on ways to increase a student’s awareness of position and tension, some as old as our profession itself.

image_20813The first tools I always use – and ones we revisit time and time again – are the trusty flashlight and mirror. Looking inside the mouth becomes a lesson about the “speech helpers.” Kids love exploring the structures and tongue movements, laying a solid foundation for all future instruction. We talk about how the lips, tongue, and jaw move for each speech sound, then work on motor imitation skills, beginning with obvious movements, such as popping one’s lips for /p/, then to more difficult and subtle movements, like raising a wide tongue up to the back molars. We explore the contexts of /k/ and /ee/ as a way to get to /er/.   Tongue Elevators (raising the tongue from low, mid, high) and Train Tracks (elevating the tongue, then sliding back on the molars) are part of the drills I’ve developed in my /r/ packet, and exercises that we use as warm-ups at every session. All of this is done with the flashlight and mirror. Old school still works.

A-427_Totally_Zen_FrogOnce we’ve gotten good visual information about the articulators and their expected position/movement/tension for /r/, we do all of the above….but with our eyes closed. This allows the students to really focus on proprioceptive feedback as I lead them through a variety of speech sounds and tongue movements. “Where’s your tongue? What do you feel?” This “moment of Zen” is invaluable in increasing their focus on and awareness of what their tongue is actually doing. This is a technique we revisit often. It’s amazing to see how much information the students get and can convey when their eyes are closed.

Screen Shot 2018-06-03 at 3.34.54 PMSometimes we need to “wake up” the tongue. The Speech Gizmo (really, a dental flosser) can be used for this. We rub-rub-rub on margin of the tongue, then the other, then lift the tongue to the molars. This is a useful strategy to start each session. The Speech Gizmo can also be used to gently guide the tongue up and back for /er/, as described in a previous post. I send these home with students and ask that they use them 10 times, each time they brush their teeth.

SW-032717-SillyPutty-Map1To further increase awareness of tongue shape and position, we make tongues out of Silly Putty. I use them in mouth molds from the dentist. This opens up discussion and awareness of wide/skinny, high/low, front/back.  See my previous post about this.

Earth_globe_stress_ball1Tension is critical for /er/, so we do tense/relax exercises with hands, arms, shoulders, jaw, tongue. We explore all of the vowels, again with eyes closed – which are tense, which are relaxed? Where do you feel the tension? When working on /er/, I often give the students stress balls to squeeze. This is especially helpful for students who have low tone. Standing up also helps increase tension.

IMG_0188And, in an activity that is both instructive and fun, we take a whole body approach as each student “becomes a tongue.” One by one, they step into the mouth (the doorway to the speech room), spread their arms and press hard against the molars (the sides of the door jamb). We notice how far away the tip of the tongue (their head) is from the front teeth (top of the door jamb). Again, words like “wide, back, tense” are used. As the student presses against the door jamb, he tries to replicate this with his tongue, making his best /er/. With this experience fresh in their minds, we return to the mirror and flashlight to see if our real tongues can do what the “student tongues” just did

Of course, there are many other tried-and-true techniques that might be needed: pressing up with the thumb at the root of the tongue, lying backwards over a therapy ball to let gravity help, working in contexts they can do to get to once they can’t, etc. As mentioned in a previous post, Char Boshart’sChar Boshart’s seminars, video presentations, and publications are a wealth of information about how to get inside the mouth and tame the tongue for /r/. Be sure to visit her site for /r/ and other invaluable information. I learn something new every time I visit! What tricks work for you? Please leave a comment so we can all benefit from your experience!

Tackling /r/ with Technology

A /t/ is a /t/ and a /k/ is a /k/. But, oh, that vocalic /r/ – the most complicated phoneme in the English language! Volumes have been written about how to fix an /r/ distortion. My go-to bag of tricks includes Char Boshart’s “The Easy R Therapy Program” and “The Entire World of R” books and cards. I’ve learned so much from Char’s books and presentations about how to facilitate tongue movement and tension; her website is a treasure-trove of great information, including free materials, videos, books, and blog posts.  Char Boshart’s “The Easy R Therapy Program” comes in hardcopy and digital versions, and there is even a condensed version for quick reference.   From “The Entire World of R” I learned that there are more than 20 allophones of /r/, each depending on the vowel context and position in the word, and that students can have some of these /r/ sounds perfected, while others remain stubbornly distorted.   Indeed, as part of my own /r/ remediation packet, I developed “Hit the Mark with /r/,” a quick screener to help me determine the vowels and positions in which the student can produce a good vocalic /r/ and those in which production breaks down.   “Hit the Mark with /r/” presents three words for each of the vocalic /r/ sounds (initial, medial, final) and a rating scale that breaks down production into 3 categories: “vowel and /r/ are distorted,” “vowel is OK but the /r/ is distorted,” and “acceptable vowel and /r/.” I follow this up with more in-depth probes, using Artic-U-Checks, which uses a similar rating scale of “incorrect,” “close,” and “acceptable.” A pattern I see over and over in my students: most initial and medial vocalic /r/ sounds are acceptable, but /er/ in all contexts is distorted, and so are all final /r/ sounds.

So, once I have assessed the type, place, and severity of a student’s /r/ distortion, therapy begins. In my experience, there is no one-size-fits-all approach to /r/ that will work for every student. Therefore, I am constantly expanding my bag of tricks, searching for that one cue, one technique that will flip the switch for each student. Multimodality instruction is key.

Screen Shot 2018-06-03 at 12.43.09 PMBecause vowel context is so critical to producing acceptable /r/ sounds, my favorite app is Vowel Viz Pro by Complete Speech. This awesome app analyzes vowel production in real time. As the student produces words with vocalic /r/, the spaceship zooms to and hovers over high, middle, or low planets, representing the various vowels. The visual feedback is very reinforcing to the students and is definitely a motivator. The effort I’ve seen students expend in achieving the goal with this app is amazing – far more than I could ever get with flashcards or word lists. You can read more about Vowel Viz Pro in my blog post, “Apps for Vocalic /r/.” If you use an iPad in therapy, you definitely want this app.  Another app from Complete Speech that you might find useful is “Speech Racer.”

smartpalate_system-1Another very useful piece of technology, also by Complete Speech, is a palatometer, called the SmartPalate System. A custom-built mouthpiece shows students exactly where their tongue is touching the palate (or not). I wrote about my experience with the palatometer in my post, “Watch that Tongue: A Trial with a Palatometer.” This tool is not only very useful for /r/, but was also great for lateral and frontal distortions of /s, z, sh, ch, j/. The downsides for school use: (1) the software is expensive, and (2) each student has to have a mouth mold made by a dentist, then a custom-built palate with sensors – also expensive. The best approach is to see the students every day for short periods of time. Research done by Complete Speech indicates that 20 sessions is the average for fixing a speech sound error. Imagine cycling students through 4 weeks of intense therapy with the palatometer, and it could actually mean a cost-savings or break-even, compared to traditional weekly therapy that could go on for months or years. Still, it could be a tough sell to most school districts.  A new product by CompleteSpeech is the TargetPalate:  a custom-made plastic palate that has bumps where the tongue should be touching for sounds that the student is making in error.  I haven’t yet tried this with my students, but imagine the tactile feedback could be very helpful.  Please leave a comment if you have already had experience with the TargetPalate.

Students can get good information from seeing and hearing themselves on video, using a free program like PhotoBooth on my Mac. I just had a fourth grade boy who was convinced his /er/ was pretty good, until he heard the playback on PhotoBooth. The look on his face when he heard the distortion reflected an important “aha” moment for him. Another student with a wicked /r/ distortion heard the app, “Talking Tom,” repeating the /r/ words spoken by him and other, more advanced, students. I’ll never forget the puzzled look on his face when he asked, “Why is Tom saying their words correctly and my words wrong?” (Note: Talking Tom apps are available for iOS and Android, but I caution their use as they have gotten to be a bit raunchy for school use).

In my next post, I’ll share my no-tech tricks for working on /r/. By combining these “tried and true” old school techniques with new technology, students remain motivated and make measurable progress.

The Many Uses of Wordless Picture Books

There is no moment more magical than the first time a child reads — actually reads — a book independently.  Such focus, such concentration on the text as the child decodes the printed words!  This is the first step on a lifelong journey across time, space, cultures, and ideas that a love of reading will provide.

29313But firing the imagination is not limited to books with text.  Indeed, wordless picture books may tap into more imagination, more language, more critical thinking, and more projecting of one’s self into the story.  Whether illustrations are simple or lush, the reader uses them to answer so many questions, because that is the only way the story can be told:  Who or what is in the picture?  Where and when is this taking place?  What is happening?  Why is this happening?  What is the problem?  What are some solutions?  How did the character’s actions work out?  What is the difference between this picture and the one before and the one after?  Did anything change?  How does the character feel? What is the character thinking?  How would you feel?  What would you do?  What will happen next?  And on and on….

Wordless picture books are ideal for speech/language therapy.  Just think of how many 17165875goals can be addressed by a single wordless book by letting the child take the lead in “reading” the story:  describing, labeling, grammar, predicting, articulation, and fluency are just a few of the typical s/l skills that can be practiced and measured.  Add to that joint attention, answering questions, turn-taking, and perspective-taking, and you’ll see that wordless picture books are ideal for working on pragmatic skills.  When the child has finished “reading” the book, review it for practice in recall, retelling, and sequencing.  Have a student who is weak in written language?  Use wordless picture books to practice sentence and story writing. Working with very young children or children with cognitive impairments?  Use the books to build receptive skills and basic concepts:  Show me —.  Point to —-.  Where is —?  What color/shape is —?   He is clapping;  now you clap.    Imagine — all of these communication skills can be  worked on, no reading required!

the-lion-and-the-mouseWordless picture books are especially good for children who use AAC.  In addition to building all of the skills detailed above, the children can use their AAC system at the single word, phrase, or full sentence levels to tell the story, answer your questions, and ask questions of their own.  This builds fluency with the system as they learn how to navigate to needed core and fringe vocabulary, and helps AAC users increase their mean length of utterance.

22750286If you Google “wordless picture books,” you’ll find a lot of “top ten” recommendations.  If you want to find titles of a hundreds wordless picture books, join Goodreads.com (free), then put in this URL:  https://www.goodreads.com/shelf/show/wordless-picture-books.  I guarantee you’ll find a year’s worth of books that will appeal to and be appropriate for all of the students on your caseload, regardless of age, gender, personal interests, or IEP goals.  Many may be available in your school or public library.  To add to your own collection, you can search local booksellers or find nearly all on Amazon.

Umm…can you give me a hint?

I’ve been supporting a few young children who desperately want to be verbal communicators but they have multiple articulation errors that affect their intelligibility. Yes, we have introduced them to communication books and AAC apps on iPads, but these were met with resistance.  The truth is, when you know the context, you can pretty much figure out what they are saying.  Without context, you’re lost. A couple of these students will keep repeating their message or will search for other ways to help the listener understand, but it’s been noticed that one student is now very quick to give up with a shrug and “never mind,” and his overall communication attempts have dwindled at home and at school.  Without some kind of support, all of the students may become discouraged and withdrawn, to the detriment of their self-esteem, social relationships, and academic progress.

Screen Shot 2016-02-27 at 5.42.10 AMSince none of these students are proficient readers/writers, the simplest and most effective solution was to give them a topic-setting board that can be used for to establish context and clarify misunderstood messages.  With plenty of adult modeling during conversation, these students learn how to identify when they are talking about a place, a person, a TV show, etc.  As their literacy skills develop, they can use the alphabet section to spell out whole words. For now, just giving the initial sound of a misunderstood word can be a big help to the listener.

Meanwhile, the students continue to receive therapy for articulation and phonology. That, plus maturation, may be all they need to become intelligible speakers. If AAC support is needed in the future, they’ve at least started down that road by using the topic-setting board. In the meantime, the topic-setting board helps to clarify their messages, reduces frustration, and keeps them talking.  You can download a free copy of this topic-setting board from the Materials Exchange on Speaking of Speech.com, under the heading AAC.