Making Articulation Therapy Fun!

Hi everyone!

I know articulation goals can be very difficult to target since the child tends to get bored. Below I have mentioned some creative ways to target articulation!

1. Playing Basketball: For every 1-3 sounds produced correctly the child can shoot at the hoop.
2. Bowling: Place the target sounds/words under the bowling pins. Have the child produce the target for each pin that falls.
3. Playing Catch: throw a ball back and forth while practicing words with each throw.
4. Table Top Games: (Connect Four/Jumping Monkey/Operation/Break the Ice/Jenga) have the child produce the target sound/word before taking a turn
5. Sensory: search for the target sounds/words in the box
6. Hop-Scotch: set up the numbers for hop-scotch using index cards and place target words on top and have the child produce the target sounds/words they jump on
7. Twister: place target sounds/words on the different colors, when a child lands on the card they have to produce it.
8. Arts & Craft: have the child complete a craft by producing the target sounds/words in order to get glue or another piece of the craft
9. Play-Doh Squish Mats: make little balls of playdoh on each card, for every correct target sound/word the child produces they can squish the playdoh on the card
10. Card Games: (Go Fish/Matching) use the target sound/word cards
11. Feeding the Animals: print the face of your animal of choice, glue cut the mouth out, and glue it on a box. The child has to produce the target sound/word in order to feed the animal the card. (THIS REQUIRED PREP).

Here are just some ideas! Just remember the order of targeting the goal sounds:

1. Isolation

2. Syllables

3. Words

4. Phrases

5. Sentences

6. Reading (skip of the child does not read)

7. Conversations

HAVE A GOOD WEEK EVERYONE!

Pediatric Feeding Workshop

Hi Everyone!!

Meghan our OT found this fantastic flyer about a Pediatric Feeding Workshop that is being held at the Nicklaus Children's Doral Outpatient Center on April 29th! If you would like to sign up or curious to know more about the information can be found on the flyer below. 

See you there! :)

The Caterpillar Reading Passage

Hi Everyone,

My previous posts have been mostly directed towards our younger populations so with this post I thought I would target some of our older patients who read. In this post I'm going to discuss "The Caterpillar" passage and its utility in examining motor speech performance. "The Caterpillar" passage was designed to provide a contemporary, easily read, contextual speech sample with specific tasks (e.g., prosodic contrasts, words of increasing length and complexity targeted to inform the assessment of motor speech disorder). Another common reading passage that is used is "My Grandfather", however it is not particularly well suited for examining speech motor skills that differentiate among motor speech disorders. In addition to utilizing the passage to assess motor speech disorders I have used it with fluency and literacy evaluations; in addition to assessing inflection. Has anyone found research or benefits in using these reading passages for other tasks as well? If so how? I have attached a journal article comparing both reading passages and their benefits below. In the article you can also find both reading passages in the appendix section if you wish to utilize it in therapy.

https://drive.google.com/file/d/0B2mXnf4_eYIpMXlsMDA2b2xkTHc/view?usp=sharing

Love/Hate Relationship with Pacifiers

How do SLPs feel about infants and children with pacifiers? I have come to the conclusion that it's a love/hate relationship depending on why the child is seeking therapy. Below I have listed positive and negative aspects of pacifiers. 

Love Pacifiers:

Pacifiers are a beneficial part of the swallowing processes for new born infants or infants with swallowing difficulties in order for them to develop a strong non-nutitive suck (NNS). NNS is believed to aid in the transition from garage feeding to nipple feeding. Usually a pacifier is used in initiating this, but a finger can also be used. The benefits of NNS are faster transition to bottle feeding, higher sucking pressure and sucks per burst (preterm infants: 2-5 sucks per burst/ normal: 10-30 sucks per burst), and improved state of regulation. 

Dislike Pacifiers:

According to the American Dental Association children 3-5 years old who are still utilizing a pacifier tend to have an anterior open bite, posterior cross bite, mean over jet, and smaller inter canine distance of the upper arch. So how does this affect the jobs of SLPs? Most children who present with these malocclusions tend to have articulatory difficulties; especially with the fricative and alveolar phonemes. In addition to the articulation being affected, if an infant uses a pacifier for an abundance of time this can obstruct the oral cavity and cause a delay in babbling and imitation of sounds/words. The World Health Organization also reported a positive correlation between pacifier use and an increase incidence of otitis media. 

These are just a few reasons to like or dislike pacifiers. Have you had a patient that uses a pacifier? If so how did it positively or negatively affect your treatment?

REFERENCES:

https://drive.google.com/file/d/0B2mXnf4_eYIpNkJxczJuX2VvSFk/view?usp=sharing

https://drive.google.com/file/d/0B2mXnf4_eYIpZ0U2dTdSTkxoZEk/view?usp=sharing

Chaining

Happy Friday everyone!


This week I will be writing about a technique called chaining. Chaining is a technique primarily used with children who are highly unintelligible. The therapist would teach one phoneme or syllable of the desired word at a time, and then bring them together in a sequence. This could be done forwards or backwards.

For example:

1. Forward Chaining: "Basketball", /bæskətbɒl/

• "Say, /bæs/,  say, /bæskət/, say /bæskətbɒl/"

      2. Backward Chaining: "Bicycle", /bajsɪkəl/

• "Say, /kəl/,  say, /sɪkəl/, say /bajsɪkəl/"

It's up to the therapist which type of chaining they would prefer to do, however it's important to keep in consideration the child's phonological process errors. There is not much research on chaining that I could find, but I did upload the link to where I got most of my information. 

http://www.pammarshalla.com/blog/2012/03/making-speech-targets-salient-classic-auditory-training-tools-for-amplifying-speech/

If anyone has used this technique please leave a comment below with more information (has it been helpful, what population do you use it with, etc.)

Social Stories

Hi everyone!

So this week I thought I would tell you all about social stories!

To begin a social story is a tool used to help individuals (primarily those on the Autism Spectrum) to develop appropriate social skills for a particular situation, event or activity that they might face. These stories can be created by a therapist or parent who best knows the child. Here are some helpful tips to consider when writing a social story:

1. Picture the Goal: consider the purpose of the story and what the child needs to understand to achieve this goal. 
2. Gather Information: the individual creating the social story should take into consideration the child's age, interests, attention span, and level of ability and understanding. For example: where does the situation occur, who is it with, how does it begin and end, how long does it last, what actually happens in the situation and why?
3. Tailor the Text/Images: the social story should include pictures and words that are familiar to the child and specific to the situation. For example, include the child's picture in the story, the specific location the child will be in, etc..

So once the social story is made what now? When and how do you introduce the social story?

Carol Gray has developed guidelines on how to use social stories effectively. The information below is from her book The new social story book (1994), which you can find on The Gray Center's website.

1. Present the social story to the person at a time when everyone is feeling calm and relaxed. This will maximise their learning and help them develop positive associations with the story. Social stories should never be used as a punishment for misbehaviour.

2. Use an honest and straightforward approach when introducing the story, eg I have written this story for you. It is about thunderstorms. Let's read it together now. Soon we will review it.

3. Review the story as often as required - some social stories will be reviewed initially once a day, others prior to the situation for which they were written.

4. Maintain a positive, reassuring and patient attitude when reviewing the story. This is essential for the social story to have the desired effect.

5. When reviewing the story, use a calm and friendly tone of voice and make sure the environment is quiet, comfortable and free of distractions. 

6. Involve others in the review of the story where appropriate. For example, a story that is focused on a situation or activity at school could also be reviewed with the child's teacher or learning support assistant.

7. Introduce one story at a time to maximise learning and to make sure the person does not become overwhelmed with information.

8. There are two main ways of 'fading' a social story:

• increase the period of time between reviewing it, ie if a story was initially reviewed once per day, increase the review period to every two days, then every three or four days, and so on 
• change the content of the story to reflect the person's new skills. For example, remove directive sentences from the story, or rewrite them as partial sentences where the person is required to recall the missing information. However, some people with autism may find such changes distressing; alternative approaches should be explored if this is the case.

Below I have attached four sample social stories for different situations that a child might have difficulties with. As therapist what are some other situations that a child might have difficulties with and would benefit from a social story?

https://drive.google.com/file/d/0B2mXnf4_eYIpcDZsa1U3d3UzdGc/view?usp=sharing

https://drive.google.com/file/d/0B2mXnf4_eYIpcDVIUm1POERoaTg/view?usp=sharing

https://drive.google.com/file/d/0B2mXnf4_eYIpQlUxX3ZHLXUxdUE/view?usp=sharing

https://drive.google.com/file/d/0B2mXnf4_eYIpV0h6c21IVS1sQ1k/view?usp=sharing

Importance of shoulder girdle strengthening

I came across this website that discusses the importance of shoulder girdle strength in children.  I always emphasize the importance of shoulder girdle strength with parents and explain how it effects their child's fine motor capabilities.  Without proximal stability, distal mobility is difficulty to achieve.  This website provides fun exercises to do with kids both in therapy and at home.  Some include bear and crab walks, and other activities to do with a partner that involved pushing.  These are exercises I like to incorporate into my session, but the website provides visuals.  Enjoy!

http://www.ot-mom-learning-activities.com/shoulder-exercises-for-kids.html