Toy Box Communication


Two things I’ve noticed when working in Multiple Disabilities classrooms:  (1) the students don’t know how to play with a variety of toys, and (2) there is little peer-to-peer interaction.  There’s an easy way to address both of these needs while also building choice-making, visual discrimination of pictures (photos/symbols) and objects, and core language.  I call this therapy activity “toy box communication.”

Magformers.jpgFirst, you’ll need a variety of toys that provide a variety of sensory input: movement, sound, lights, vibration. Examples include:  a pull-back race car, fire truck with lights and siren, a vibrating bumble ball, a lightsaber, a light-up, musical magic wand, a fidget spinner, magnet blocks, wind-up toys, a light-up mirror, a radio or iPod, Simon game, battery-operated animals and toys, a doll that talks or cries,sound-activated toys, etc.  The toys should be age-appropriate and appealing to both boys and girls.  Also, consider the students’ physical abilities;  battery interrupters and switches may be needed for those who can’t turn on a toy’s small switch.  You’ll need a box or basket to contain the toys.

Create a communication card for each toy using labeled photos or symbols, or use these visual representations on a communication board or speech generating device, as appropriate to the students’ needs and abilities. In addition, provide a way for the students to move beyond choice-making to initiate, terminate, and comment during the activity by creating extra cards or adding messages to the communication board or device.  Examples include: “my turn,” “more,” “all done,” “That was fun!,”  “Boring!,” “turn it on,” “turn it off,” “stop,” “go,” and “help.”  The communication cards can be Velcro’d to a clipboard, binder cover, or eye-gaze frame.  Display at least three choices, or more if the students can handle a larger field.311xIo2mxmL.jpg

Working with a small group of 2-3 students, I introduce a few toys to the students, naming each, describing how it works, and exclaiming when the toy operates to acquaint the students with the toys and to get their attention.  I then put 3-4 picture cards on my binder cover and ask, “Who wants a turn?”  Any movement or vocalization counts as “I do!”

Student #1 touches, looks at, or gives me a toy card to make a choice.  I label it, “Oh, you picked the firetruck!”  I then offer two toys, the firetruck and another, to see if the student selects the correct toy.  I hand the student the desired toy and pause to see if the student can operate it independently.  If not, I present the card for “turn it on” or “help.” When that request is made, I show the student how to operate the toy and allow the student a minute to play with it.  I ask “do you want more or are you all done?,” modeling those choices on the binder.  If the student selects “more,” I allow another minute.  At the end of the minute, or if the student indicates “all done,” I ask the student to hand the toy to the next student for brief exploration. Once the toy has been passed to each student in the group, it goes back in the box.  Then Student #2 has a turn to make and play with his/her toy selection for a minute or two, passing it around the group when finished.  And so on….until everyone in the group has had 2-3 turns making toy choices or until attention to the activity fades.

Mead-The-Fidget-Spinner.jpgOnce the students have participated in this activity a few times and are showing familiarity with and even preferences for toys, I’ve added a “not here” symbol in the choice array so the students can indicate that they want something other than the 3 toys I’ve offered on the binder. “Oh, you want something different! What do you want?”  The choice cards are changed to include the toy you know the student prefers, and the activity continues.  It should go without saying that I am modeling, commenting, using a prompt hierarchy, and pausing throughout the activity, in a way that is individualized for each student.

The activity as described offers opportunities to practice:

  • initiating a turn
  • terminating a turn
  • choice-making
  • picture-object matching and discrimination
  • pointing, grasping, handing, or eye-gazing to communicate
  • fine motor manipulation of the toys
  • accepting a variety of sensory input
  • learning to give and get
  • attention to and interaction with peers
  • waiting and anticipation
  • making comments and requests through core and fringe vocabulary

It is possible to extend this activity in many ways to build additional play, communication, and motor skills with each of the toys.  Here are just a few ideas:

  • Sending the pull-back car to peers.
  • Rolling, kicking or throwing the ball to peers or other target
  • Building/knocking down blocks
  • Choosing hairstyles, accessories, makeup using the light-up mirror
  • Requesting the vibrating pad for relaxation
  • Making choices with radio/iPod — headphones or no headphones, what station or songs to listen to
  • Extending switch use learned in this activity to operate other devices for recreation, vocational training, and communication

Using toys in this way offers so many opportunities for skill development that can transfer to other activities and settings, and that can enrich a student’s life by expanding his/her range of leisure activities.



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 (free), then put in this URL:  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.

Preventing Screen Addiction

A recent article in The Telegraph describes a very scary trend: “Children as young as four are becoming so addicted to smartphones and iPads that they require psychological treatment.”  Popular and professional literature are full of such warnings, yet parents continue to use digital devices to keep their babies, toddlers, and young children occupied.  One in seven parents polled in a study admitted their children used digital gadgets for four or more hours a day!  Although 81% of the parents surveyed expressed a concern that their children were spending too much time with digital devices, this hasn’t stopped them from allowing their children to have this access.  Indeed, the article states that according to psychiatrists, “digital dependency” in  adults and children has grown 30% in recent years. This addiction in young children is evident by obsession with devices and uncontrollable tantrums when the devices are removed, and leads to difficulties with social interaction as the children get older.

With so many warnings about the potential detriments of excessive screen time, why do parents still allow their infants, toddlers, and even older children have so much access to digital devices?  One reason might be that parents are discounting these warnings as an overblown extension of warnings in the past about letting children watch too much TV.  After all, generations of kids dating back to the 1950s watched hours of TV each day and they didn’t grow up to be TV addicts, right?  While it’s a fact that when people are home, the TV is more likely to be on than off, most people don’t go through withdrawal when the electricity goes out or the TV is on the fritz and they are unable to watch TV for any length of time.  But have digital devices go dark and there is very clearly a visceral reaction. I’m not a neuroscientist, but I’m guessing that the major difference is the way we engage with digital gadgets vs. TV screens.  Unless we are binge-watching the latest Netflix series, engagement with the TV is much less intense.  We move around, get something to eat, page through a magazine, cook dinner, fold laundry, knit, and engage with others while the TV is on;  the TV does not capture and hold our undivided attention.  In many cases, it is simply background noise to other activities in the home.  Engagement with handheld devices is much more intense;  it is the primary focus of attention, often to the exclusion of all other activities and interactions. This releases endorphins that excite the pleasure centers in our brains, which feeds the addiction.

Another reason for parents to rely on digital devices to occupy their children — and this one horrifies me — is that parents themselves are hooked into devices, so keeping the kids quiet with device use allows the parents uninterrupted time on their own handheld screens.  As an article in Huffington Post states, over 70% of children surveyed feel their parents spend too much time on mobile devices.  Remember, parents of infants and young children are themselves “digital natives,” meaning they grew up with technology and don’t know life without it.

As SLPs, we see the effects on language and pragmatic skill development caused by  overexposure to screens, be it smartphones, tablets, or video games — not to mention the effects on attention, executive functioning, fine and gross motors skills, imagination, and higher level thinking.  The question is: how can we help parents understand the critical importance of hands-on experiences and interpersonal engagement and how to incorporate these experiences and engagement in everyday life?  Ironically enough, there’s an app for that!

Screen Shot 2016-03-24 at 5.11.48 is a website, app, and e-newsletter that encourages parents to be “brain builders” through simple activities already occurring in the home:  mealtime, bath time, daily errands and chores, etc.  Downloadable activity cards and daily videos teach parents how to engage their infants and children using eye contact, chatting, taking the child’s lead, expanding on the child’s language, and turn-taking, all in the context of daily living.  No special equipment or skills are needed. is really all about being a fully present, hands-on parent.  I heartily recommend this resource to all parents of infants and young children. Although geared toward children ages 5 and younger, parents of older children who have special needs will be able to use many of these ideas to stimulate growth and engagement in their children, too.

The kind of parenting encouraged by will seem intuitive to most SLPs and reflects the kind of parenting that was common before the digital age.  I encourage every SLP working in early intervention and preschool to share this with parents on their caseload. And, for the rest of us, consider recommending this site to all new parents and others who would benefit from these back-to-basics parenting tips.  Share this post on your social media for May is Better Hearing and Speech Month.   Keeping parents and children engaged in these hands-on and interactive activities just might prevent the need for “digital detox” in their future.


The “Path” to Learning Core Words

As so often happens, a post on on December 29 really caught my eye. “PrAACtically January: Resources for a Year of Core Words”  provides links to two years of core words, downloadable lists from 2013 and 2014 in Minspeak/Unity, PCS, Speak for Yourself, SymbolStix, and LessonPix symbol.  At the end of the post are a list of children’s books that can be used to practice the words for January.  One of my kindergarten students is a new user of Word Power on an Accent 1000. The monthly lists of core words struck me as the perfect way to acquaint him, his parents, and teacher with his device, to build his expressive language skills, and to incorporate literacy development.

Screen Shot 2016-01-25 at 12.17.38 PMLooking over the 2013 list of January words, I was inspired to write a story that uses the core words in sentences that the student could read aloud on his device, and that he can use in real-life contexts.   Here’s the process I used to write “The Hungry Dog:”

  • First, I sketched out a simple story containing the core words and typed it into PowerPoint, my favorite platform for creating print books.
  • Next, I went to Google Images to search for photographs and clip art to illustrate the story, and added them to the PowerPoint.
  • Then, I tested out the story by using the Accent to read it.  This proved to be a critical step in the process, as I discovered that some words were not on the device. Others were inconveniently placed or coded, necessitating too many hits to locate the words or return to other screens.  As a result, I needed to do some programming to streamline his access to the words.  I also found that some sentences in my story needed rewording to facilitate smoother expression.
  • Because the device is also new to his parents and teacher, I added at the bottom of each page the “path” to finding any words that weren’t on the present screen. All words to be spoken on the device are underlined; navigation hits are not.
  • Finally, I printed the book as 2 unframed slides per page, cut the pages apart and stapled the book together. Copies were made for home, classroom, and s/l therapy use.

Screen Shot 2016-01-25 at 12.19.52 PM“The Hungry Dog” January story of core words was met with great enthusiasm by the student, his teacher, and his parents.  In fact, it was so successful that I made a “Play Date” book using February core words!  Both of these books are posted on the new Core Words section of the Materials Exchange under AAC on Speaking of  (Note: I’ve left these as PowerPoints so you can edit for your AAC users. The path on my stories is specific to the modified Word Power 60 cell user on an Accent 1000).  I’ve also used this strategy of including the navigation path to personalized social stories.  Adults all agree that this makes modeling much easier and more fluent.

Keys to success:  simple sentences, repetitive vocabulary, careful story editing and device programming to refine message construction, and the inclusion of the path for navigating to vocabulary.  As vocabulary and competence grow, this path will not be needed, but at this stage, it is a great support to the adults who are learning right along with the student.

Speaking of Core Words….there was such a request for discussion about Core Words on the ASHA Sig 12/AAC board that I created a forum specifically for that purpose.  Sign up (free), then post your questions, add your suggestions, and share your materials!  Here’s the link:  This is brand new, just waiting for you to add some content.  With your participation, this new Core Words forum will grow in content and value, just like the other message boards in the SLP Message Center on Speaking of!



S/L Therapy is Child’s Play….with LEGOS!

LegosThe majority of boys on my K-5 caseload are LEGO maniacs.  I couldn’t be more thrilled, as I am all in favor of any creative activity that doesn’t include a battery or video screen, so I have been searching for ways to use LEGOs in therapy.  Having had a son who had the same affliction years ago, I’m fortunate to have large plastic totes filled with LEGOs and DUPLOs that he left in the basement when he flew the nest.  Since possession is 9/10th of the law, I have declared them mine and now use them for therapy activities and motivation. The boys love them….and so do the girls!

Here are some of the FREE resources I discovered that can easily be adapted for all kinds of therapy goals, including artic, language, following directions, social skills, basic concepts, and more:

7 Skills Kids Can Develop Playing Legos — justification that might lead to therapy ideas and IEP goals

LEGO Foundation’s Six Bricks Booklet — your lesson planning is done for you!

75+ Fun LEGO Ideas from Kids Activity Blog

A Mom With a Lesson Plan’s free LEGO board game and directions How LEGO therapy can help children with special needs

The Speech Knob:  LEGOs + PECS (or AAC) = Great Idea!

Cooking Up Good Speech:  Barrier Game and others

Speech2You: Ideas for sentence building and morphology

LEGO Game Board on BoardmakerShare

Counting Syllables with LEGO Bricks

LEGO Learning with Fun Activities

Of course, Pinterest and TPT are loaded with other ideas, some that come with a price tag.  And there are many free and cheap LEGO and DUPLO apps that could be used in therapy, so check out the App Store if you want a virtual LEGO experience for your students.  How do you use LEGOs in your therapy room?