Listen up!

In my career, I’ve known all kinds of listeners:  some who take in all of the message, some who only get part of it, and others who need multimodality support to attend and process.  Personally, the auditory channel is not my best way to take in information.  I need to hear the message more than once to recall the details, have the auditory combined with visual input, or I write it down.  Fortunately, I was well taught in the art of note-taking in elementary school so that my notes were salient and well-organized.  Note-taking not only provided me with a useful written account of the verbal information that I could review over and over as needed, but also helped me to stay on task and fit the information immediately into a schema, which increased my understanding from the get-go.

Graphic organizers abound for gathering all kinds of information.  But before we can teach the skills of winnowing out main ideas and supporting details, separating what is important from what is not, and linking new information to prior knowledge, we first have to get the student to attend.  For years, I’ve used “Whole Body Listening” prompts based on the work of Susanne Poulette Truesdale.  And apparently, I’m not the only one.  A quick search on Teachers Pay Teachers produces a long list of materials based on this strategy.

Screen Shot 2019-04-01 at 3.48.51 PMI love to use books in therapy whenever possible because they combine the auditory with the visual, and engage the students in the topic through stories.  Imagine how happy I was, then, to find these two illustrated children’s books by Kristen Wilson and Elizabeth Sautter:  “Whole Body Listening Larry at School!” and “Whole Body Listening Larry at Home!”  Both books begin with an explanation to adults about the conceptual basis of using one’s whole body — head to toe — to increase attention through sensory integration, executive functioning, and perspective-taking.  This is followed by suggestions on how to use the book to encourage understanding, self-awareness/control, and functional strategies for self-advocacy in listening situations, plus accommodations that can be tried with students who are especially challenged in this area.  The story ends with a section on how to teach and implement Whole Body Listening throughout the day with preschool and elementary school students, and includes a coloring page handout to further engage the students.

In the school-based book, twins who are new to the school do not display characteristics of good listeners;  indeed, they sometimes interfere with their classmates’ ability to listen.  In an effort to help them learn the rules of the school, Larry politely points out how they can listen better and distract others less by active and passive use of their body parts.

In the home-based version, Larry helps his younger sister learn to use Whole Body Listening strategies to be a better communication partner with family members and friends.  As in the school-based book, this home version contains information and strategies for parents.

The story lines are simple, the illustrations are engaging, and the approach to Whole Body Listening is consistent.  The authors even weave in elements of Michelle Garcia Winner’s Social Thinking to help students understand what others are thinking when they do (or don’t) apply Whole Body Listening strategies.  I love that there are two versions that can be used simultaneously to encourage carryover and generalization.  The fact that parents and teachers will be using the same vocabulary and prompts will surely help young children internalize the expected listening behaviors.  Once students have improved their ability to listen, the work on processing and recall can begin.

One caveat to keep in mind:  I have had students for whom looking at the speaker is actually a distraction for them.  I remember one little guy in particular who was continually being prompted by the teacher to “look at me, look at me” when she was reading books to the class and giving directions.  We instituted a 10-question, multiple choice with symbols follow-up quiz after each weekly story that I read as part of their classroom therapy.  The scores went up on all of the students over time, except for the little guy who was getting frequent prompts to pay attention.  The teacher and I decided to ignore his looking at the ceiling or the pattern on the rug to see if that made a difference.  Lo and behold, it did!  When left to look wherever he wanted, he actually took in more information than when he was prompted to “use his eyes to listen.”  This is just another reminder that children have different learning styles, and the wise educators will tune into and accommodate for those differences.

“Whole Body Listening Larry at School!” and “Whole Body Listening Larry at Home” are available through Make Social Learning Stick!

What does that mean??

Some years back, my son moved to Brazil to marry a lovely Brazil college professor.  During his time there, my son became fluent in Portuguese, and this became my grandson’s first language.  When little Miguel was 2 years old, my son started exposing him to English in preparation for their planned move to the US a year later.  When Miguel arrived here at age 3, he had some conversational English, but Portuguese was still his go-to language.  One of the first things I taught him was to ask, “what does that mean?” when encountering unfamiliar vocabulary.  Now he is nearly 6 years old and his language skills are off the charts, mainly because parents and grandparents speak to him in an adult-like manner and read to him constantly (his favorite activity).  He has a deep love for words and is always happy to learn new ones.  Here’s an example of a recent conversation as we walked home from the bus stop;  mind you, he does know what some of the words mean but enjoys playing this as a game.

  • Me: Miguel, I have a proposal for you.
  • Miguel:  What’s proposal mean?
  • Me: It means a suggestion.
  • Miguel: What’s a suggestion?
  • Me:  It’s an idea I want you to consider.
  • Miguel:  What’s consider mean?
  • Me:  It means to think about something to see if it is a good idea or not.
  • Miguel:  Oh, so you have an idea you want me to think about, like “I propose that we go to the Crayola Factory!”

Bingo!  By encouraging Miguel to ask for definitions, by using vocabulary and reading books that are above his age level, and by making word-play (puns, riddles, knock-knock jokes) fun games that we play, he has become a very competent speaker of English and has learned a very useful strategy for life-long learning:  if you don’t understand something, ASK!

product_wad_Storyteller_s-Word-a-Day-three-assembled-illustration-and-facts_900xI recently purchased a stand-up book for Miguel from MrsWordsmith.com called “Storyteller’s Word a Day.”  The book is kept on an end table in the living room and is the first thing Miguel goes to when he comes over.  A recent word was “incessant.”  After we reviewed the meaning, he told me that they had a fire drill that week and the alarm was incessant.  Then he flipped back a few pages to another word and said, “It was this, too — grating!  The noise was incessant and grating!”   Pretty good carryover for a kindergartener, don’t you think?

This book would be ideal for SLPs to use in school, as there are words for every day from September to May.  Each page has a cartoon drawing depicting the meaning, the word, the definition and part of speech, and an easy to understand example.  (That’s as far as I go with Miguel right now).  For those who are really into words, the back of the page provides etymology, word pairs, synonyms, frequency of use, and a story starter.  Wow!  Just think of how many IEP goals you can hit with this!  “Storyteller’s Word a Day” is designed for ages 6-13, making it ideal for your middle-grade language students. Also available through this website are a similar book for 3-6-year-olds and an illustrated dictionary.  All use colorful, humorous cartoons to bring the words to life.

While this book is new to me, the strategy of teaching students to ask goes way back in my career when I developed a game I call “Hit or Miss” for my language students.  I realized that reading comprehension issues are often related to vocabulary deficits AND the student’s tendency to read the word fluently but never stopping to figure out the meaning.  I liken this to the students as Swiss Cheese reading:  they are solid on a lot of the words but they do have some holes that can greatly affect their comprehension.  The “Hit or Miss” game goes like this:  As a student reads aloud from his textbook or grade-level library book, he is to stop and ask the definitions of any unfamiliar words and earns a point (a “hit”) each time he does that.  If he doesn’t stop at a word that I suspect might be unfamiliar, I will stop him and ask for the meaning.  If he does know the word, he gets another point.  If he doesn’t know the word, that’s a “miss” and I get the point.  After the first session or two, the student nearly always wins because he has learned to ask for help when he needs it.  I’ve shared this strategy with their classroom teachers, who have then used it in small group reading instruction — ideal carryover support!

 

Make Social Learning Stick!

When I was getting my Bachelor’s and Master’s degrees in Speech/Language Pathology, social skills were not mentioned in the context of young children, only in terms of functional life skills for adults with aphasia.  Of course, that predates the rise of autism spectrum disorders.

Early in my career, students with social skills issues were referred to the guidance counselor or school psychologist.  Gradually, students with these needs were moved to the SLP, which left some of us scrambling for materials and strategies to use in therapy.  Enter Michelle Garcia Winner with her books and presentations on “Social Thinking” and Carol Gray’s introduction of “Social Stories.”  Whew!  Now we had published materials to guide us into this new phase of therapy.

Since then, a great deal of research has been done in the areas of social skills, executive functioning, and behavior.  In common use in schools today are “the Incredible 5-Point Scale” (Kari Dunn Buron), “Zones of Regulation” (Leah Kuypers), the “SCERTS Model” (Emily Rubin), and “Integrated Play Groups” (Pamela Wolfberg), to name a handful of research- and evidence-based resources available to SLPs, teachers, and parents.  Still, we recognize that our students have very complex and diverse needs.  We can’t count on a “one size fits all” approach;  therefore, we often find ourselves cobbling together elements of various strategies and that, in itself, can be daunting.  After all, social skills don’t only happen in the therapy room.  Students need to be able to apply learned skills in a wide variety of settings, with a wide variety of social communication partners.  This generalization requires educators and caregivers to work closely together in support of the student.  And while SLPs and teachers now receive training in social skills, parents do not.

Screen Shot 2019-02-24 at 11.45.07 AMTo answer this need, Elizabeth A. Sautter, M.A., CCC-SLP, pulled together the best practices outlined by the above-mentioned authors to create an amazing resource for educators and caregivers to support social and emotional competence and participation by simplifying targeted needs of “following directions, thinking about others, being flexible, reading nonverbal social cues, working in small groups, participating in conversation, advocating for themselves, seeing the ‘big picture,’ and making friends.”  Her book, “Make Social Learning Stick! How to Guide and Nurture Social Competence through Everyday Routines and Activities,” is a must-have for anyone supporting young children with these needs.  This well-organized and illustrated book is divided into three sections:  At Home, In the Community, and Holidays and Special Events.  Each of the nearly 200 daily routines is distilled onto a single page to help the adult guide the child through observation, critical thinking and decision-making, recognizing social cues, understanding expected behavior, and active participation and interaction with adults and peers.

IMG_1187Each page presents “Hidden Rules”:  those unstated social contracts and expectations that are often missed by students on the spectrum. Scattered throughout are examples of “job talk,” modifications in how adults speak to children that result in more active participation.  Additionally, social learning vocabulary is italicized;  this helps all adults to be consistent in the words they use with the student.  The book ends with an extensive resource list, visual supports, sample narratives, and a great list of recommended games and social activities for after school and weekend play dates and family interactions.  At $21.95, this comprehensive book from AAPC Publishing is an affordable resource for all team members, and that is the key to carryover.

Be sure to visit Elizabeth A. Sautter’s website.  There you will find two children’s books about Whole Body Listening Larry, her blog, her events/presentations schedule, and additional resources.  Sign up for her free e-newsletter to keep abreast of useful information in the field of social learning.

 

Oldies but Goodies

I once saw a t-shirt that said “I get paid to play board games.”  Well, we all know that we do WAY more than that, but there is no question that games keep the kids engaged in therapy.  The challenge is always making sure that the game doesn’t take up valuable therapy time.  Because I need to get as many repetitions as possible in a session, I am always looking for games that are super quick but also engaging.  In previous posts, I have described the stick game (an all-time favorite that’s dirt cheap and easy to make), commercially-available Feed the Kitty and Cookie Crumble, and the sound-specific games I’ve made based on old childhood favorites, Jump! and Square Off!  Pop-Up Pirate is another game that appeals even to my 4th graders. Lots of SLPs have blogged about the creative ways to use Ned’s Head, Guess Who, and Jenga — google or check Pinterest for those ideas.  And, of course, we all know about Go Fish and Memory games with therapy cards. A fun twist on using those cards is described in my post about “Hide the Sticker.”

A recent report from the American Academy of Pediatrics states that there is not much proof that tablet-based toys and games benefit brain development in toddlers, and concludes that hands-on toys like blocks and puzzles are far more beneficial for hand-eye coordination, problem-solving, creativity, and interactive play with adults and peers.  While there is certainly a place in therapy for some of the great speech/language apps, such as those by SmartyEars, I’ve come to realize that some of our students today, who are of the “digital generation,” don’t even know how to play with games and toys that we all grew up with.  And that got me to thinking about how to use other free or cheap toys and games to build brain power, concentration, social skills, and language.  Here are some suggestions, based on games and activities I’ve used in therapy.  Of course, you will want to modify the games to build language and social skills and meet IEP goals and work in AAC for those with low verbal skills.

  • Checkers, Chinese Checkers, Connect 4, Battleship — all require some strategy
  • Pick up Sticks (a lot quieter than Jenga!) — good for patience and hand-eye coordination
  • Games like Cootie, Don’t Break the Ice, and Operation — also good for hand-eye coordination
  • LEGOs, Duplos, magnetic shapes, plastic gears — all good for cooperative creating, requesting, describing
  • Yahtzee! — scorekeeping and math
  • Card games like Hearts, Crazy Eights, and Uno –lots of interaction with peers
  • Jigsaw puzzles — have a 100 piece puzzle out on a table for kids to work on — lots of language as they look for and describe pieces.
  • For kiddos who need to build auditory skills and following directions, favorite old games like Red Light/Green Light, Simon Says, and Mother May I? will get them listening and moving, making these good warm-up or end-of-session reward activities.
  • Toss Across or a DYI beanbag toss game will also incorporate movement in therapy.

What oldies but goodies do you use in therapy??

 

 

 

Selective Mutism

Screen Shot 2018-11-27 at 3.09.18 PMYears ago I was assigned as a short-term sub for a colleague who had been injured in a fall.  When I entered a 4th grade learning support classroom, the teacher introduced me to each student.  When she came to a girl I’ll call Tara, she said, “This one doesn’t talk at school.  Come on, Tara! Say something for the new speech teacher!”  Then the teacher shook her head with a scowl and said, “She’ll never talk.”   Tara looked at the floor in silence as the other students giggled.  As for me, my jaw hit the floor.  Horrified, I returned to the speech room to look up Tara’s records.  The narrative on her IEP stated that Tara talked a lot at home with family and friends, and her articulation was good, according to her mother.  However, since entering kindergarten, Tara increasingly refused to speak on the bus or in school.  Clearly, she fit the definition of a selective mute.

Through conversation with her teacher and observation of Tara in various locations in the school, it became apparent that nearly everyone in the school badgered Tara to talk:  the teaching assistants, the art/music/gym teachers, the librarian, the cafeteria lady, even the bus driver and principal.  Perhaps they thought they were giving her encouragement.  What they were really doing is bullying her, making her stand out in front of her peers, and setting up a situation in which, if she WOULD ever say a word, one might expect fireworks, a brass band, and a ticker-tape parade to break out.  Talk about pressure!

I had a phone conference with Tara’s mother to verify that mom didn’t detect any problems with Tara’s speech or language.  Indeed, her mom reported that Tara talked up a storm at home. She wasn’t able to shed any light on why Tara refused to speak in school, but did say it had been a growing problem since kindergarten.  I shared some information about selective mutism during our conversation and followed up by sending an article home for her mother to read.

The next step was to take the pressure off the student by educating the staff.  I gave a brief inservice at the next staff meeting, and provided everyone with the same article I had shared with Tara’s mom. I provided Tara with communication boards with core language and fringe words/phrases she would likely use in the classroom.  In her individual speech therapy sessions, we played board and card games, again using communication boards with game-related vocabulary so Tara could name, request, refuse, comment, and direct actions. I provided verbal models as I used the boards during the games, and considered it a very positive step when Tara started using the boards appropriately during her turn.  However, I reacted calmly as though this was commonplace, expected behavior, and didn’t put any pressure on her to also use her voice.  I also spent several sessions in her classroom, helping to facilitate communication there and modeling for the teacher the kinds of interactions that would be engaging but non-threatening.  Because SM is more of a psychological issue, I tried to engage the school psychologist in her case.  Unfortunately, the district only used the psychologists for testing and attending meetings, not for counseling the students, so this went nowhere.  Ugh.

I’d like to report that Tara eventually began speaking, but after a month of subbing, the regular SLP returned and I went back to my assignment on the assistive technology team.  Before I left, I shared all of this information with the SLP and hoped that it would be followed through.  Unfortunately, the student later moved out of the area so I have no idea whatever happened to her.

As I said, this all happened years ago before the Internet (yes, I’ve been an SLP for that long!), so information was much more limited.  Today, there are many resources on the topic of selective mutism that SLPs can share with parents and school staff.  Here are some you should know about:

The SMart Center:  loads of information in their newsletters (definitely sign up!), professional development trainings and webinars, CommuniCamp for group treatment, and lots of downloads of research and intervention strategies.

What Teachers Need to Know About Selective Mutism:  informative article by We Are Teachers that would be great to share with school staff.

Selective Mutism Association:  books, articles, newsletter, and other supports for parents and professionals