Summer Postcards for Social and Language Skills

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As the school year winds down, parents often ask me for easy summer activities to support goals we’ve been addressing all year. Some of my favorite tips involve postcards.

Dear Me

Writing a daily postcard each night of vacation builds sequencing skills (or grammar or vocab or any expressive language skill). I ask families to come up with three to four activities they did that day or three to four elements from a big event. Parents may take (verbatim) dictation, but I always ask that the child sign off. I often suggest doing this in a restaurant while waiting for food to arrive, because family meals are a typical time to discuss what happened that day.

If it’s feasible, I ask parents to mail the postcard home each day. If not, they act as postmaster once home by mailing one a day.

This mail generates a lot of post-vacation excitement. The little one gets mail several days in a row and hears or reads activity sequences again. Kiddos love stories they star in! They are also a great keepsake and less arduous than keeping a travel journal.

I ask parents to bring the postcards in for a couple of sessions once school starts again. They give me and my students something tangible to review and I have a reference point for topics and questioning. They also provide a great starting point for class projects on “what I did on my summer vacation.” Our students appreciate the memory boost for generating detailed, sequential information about events that happened several weeks earlier.

Goal Nudging

I also use postcards to push goals along during the break from our sessions, which is especially important for fluency students.

My student and I come up with five to seven summer goals (with a variety of difficulty). Each goal gets written individually on a postcard (hometown or generic), stamped and addressed to me. As the student completes the goal, they simply sign their name and drop it in the mail. I encourage a sentence or two of feedback, particularly from older students, but I don’t insist. If I don’t receive a postcard within the first month or so of summer break, I send a postcard reminder of my own!

I use these activities with K-12 students, but I think they would adapt easily to adult populations as well.

Kimberly Swon Lewis, ME, CCC-SLP, is a pediatric speech-language pathologist in Greensboro, North Carolina, and the author of the ActivityTailor.com blog. kim.lewis@activity.tailor.com

 

 

10 Low-Cost, Low-Tech Tools for SLPs Treating Teens and Adults

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With summer—and client travel—around the corner, I’m sharing ideas for non-electronic treatment activities that are low-cost, portable and ideal for adults with developmental disabilities. Use these activities in the treatment room and for families who want to work on speech, language and communication goals between sessions. Encourage clients to take these materials along during summer travel, on the beach or on a short trip in the community.

Whenever I work with older teenagers and adults with developmental disabilities, I focus on finding age-appropriate activities. An older client might feel disempowered by a childlike activity.

Most people also already own these materials!

  1. Newspapers. A newspaper—which may cost less than $5, depending on the paper—serves as a multipurpose treatment tool. Even better—some papers are free! Target literacy, answering and asking questions about current events, searching for a movie time and location, and social skills or abstract language in the comics section. Check out how to use comics to meet speech and language goals.
  2. Magazines. I love using magazines as a treatment tool with adults. Age-appropriate and interesting, magazines contain a variety of articles, pictures, advertisements and more. Also, the magazines your clients choose may give you insights into their interests and motivations. I recently asked one of my clients to choose a magazine at the local convenience store. I expected him to choose a food or car magazine, but he gleefully went straight for the gossip rag. We had a productive session afterward discussing various sections in the magazine via his communication device.
  3. Grocery circulars. Use free circulars to learn money management, categories (such as food groups) and new food vocabulary. Other goals include facilitating commenting and describing. Circulars also act as conversation starters: “What would you buy at the grocery store?” “I want to make steak and eggs for breakfast. What do I need to buy?”
  4. Brochures/catalogs. Brochures and catalogs—another free option—motivate and engage clients depending on their interests. If your client likes electronics, bring an electronics catalog, for example. Discuss prices, various types of equipment and what they like versus dislike. The same approach works for clothing, gardening or home décor catalogs.
  5. Subway/bus maps. Also free and functional! Work on travel training, literacy and map reading with these resources. Language concepts include problem-solving, sequencing and answering “wh” questions.
  6. Menus. I’m sticking with the free theme, here! And what’s more functional than being able to read a menu and make a choice? Check out my previous article on using menus as a treatment tool.
  7. Employment applications. Stop into any fast-food establishment, restaurant, movie theater or retail store and ask for an application. Filling out an application facilitates improved literacy, answering “wh” questions, recalling information, expanding vocabulary, and sequencing by writing the order of educational or work history.
  8. Dominoes. A set of dominoes offers an inexpensive, portable, age-appropriate and fun developmental activity for adults. Practice matching, taking turns, solving problems and following directions.
  9. Playing cards. Ideas for card games include Uno, Go Fish and War. Again, thiese low-cost games double as age-appropriate, accessible, portable and functional treatments. Examples of targeted goals include matching, solving problems, taking turns and prediction.
  10. Board games/bingo. How about a game of Sorry or Connect Four? These games are less than $10 each and teach taking turns, learning colors, following directions and solving problems. A generic bingo game or a customized bingo set also works well. If you have clients who need work on specific vocabulary related to actions, send them home with an action bingo board. Instruct them to use it with family or friends to build vocabulary, practice taking turns and forming complete sentences.

 

Rebecca Eisenberg, MS, CCC-SLP, is a speech-language pathologist, author, instructor and parent of two young children. She began her website, www.gravitybread.com, to create a resource for parents to help make mealtime an enriched learning experience. She has worked for many years with children and adults with developmental disabilities in a variety of settings, including schools, day habilitation programs, home care and clinics. Contact her at becca@gravitybread.com or follow her on FacebookTwitter or Pinterest.

How Do You Know When it’s a Language Delay Versus a Disorder?

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Editor’s Note: This is an excerpt from a blog post that originally appeared on Special Education Guide. 

How do you know when it’s a language delay versus a disorder?

Unfortunately, there is not always a straightforward answer to this question. A language delay is just that—a delay in acquisition of language skills compared to one’s chronological and cognitive/intellectual age-peers. A young child with a language delay may exhibit a slower onset of a language skill, rate of progression through the acquisition process, sequence in which the language skills are learned, or all of the above.

However, there is a subset of children who continue to demonstrate persistent difficulties acquiring and using language skills below chronological age expectations (by preschool or school age) that cannot be explained by other factors (for example, low nonverbal intelligence, sensory impairments or autism spectrum disorder) and may be identified as having a specific language impairment (language disorder).

In contrast to a delay or a disorder is a language difference. With a language difference, communication behaviors meet the norms of the primary speech community but do not meet the norms of Standard English. This difference can exist whether the person in question is a child from a different country or simply from a different neighborhood in the same city.

So, what are some options for addressing language delays and disorders?

Intervention for a delay may take on several forms:

  • Indirect treatment and monitoring
    • Provide activities for parents and caregivers to engage in with the child, such as book-sharing and parent-child interaction groups.
    • Check in with the family periodically to monitor language development.
  • Direct intervention, including techniques such as:
    • Expansions—repeating the child’s utterance and adding grammatical and semantic detail.
    • Recasts—changing the mode or voice of the child’s original utterance (for example, declarative to interrogative).
    • Build-ups and breakdowns—the child’s utterance is expanded (built up) and then broken down into grammatical components (break down) and then built up again into its expanded form.

Intervention for a language disorder is child specific and based on that child’s current level of language functioning, profile of strengths and weaknesses, and functioning in related areas, including hearing, cognitive level and speech production skills. The overall goal of intervention is to stimulate language development and teach skills to enhance communication and access academic content. The developmental appropriateness and potential effectiveness on communication and academic and social success should be considered when developing treatment goals.

 

Aruna Hari Prasad, MA, CCC-SLP, is ASHA associate director of school services.  ahariprasad@asha.org

How to Evaluate Misbehavior

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Editor’s note: This is an excerpt of a blog post written by Tatyana Elleseff for her Smart Speech Therapy blog. Her full post can be read here.

Frequently, I see a variation of the following scenario on many speech and language forums:

The SLP is seeing a client with speech and/or language deficits in either school setting or private practice, who is having some kind of behavioral issues. Some issues are described as mild such as calling out, hyperactivity, impulsivity, or inattention, while others are more severe and include refusal, noncompliance, or aggression such as kicking, biting, or punching.

Well-meaning professionals immediately offer an array of advice. Some behaviors get labeled as “normal” due to the child’s age (toddler), others are “partially excused” due to a psychiatric diagnosis (ASD). Some might recommend reinforcement charts, although not grounded in evidence. Letting other professionals deal with the behaviors is common: “in my setting the ______ (insert relevant professional here) deals with these behaviors and I don’t have to be involved.”

These well-intentioned advisors are overlooking several factors. First, a system to figure out why particular set of behaviors takes place, and second, if these behaviors may be manifestations of non-behaviorally based difficulties such as sensory deficits, medical issues or overt/subtle linguistically-based deficits.

What are the reasons kids present with behavioral deficits? Obviously, there could be numerous answers to that question. The underlying issues are often difficult to recognize without a differential diagnosis. In other words, we can’t claim that the child’s difficulties are “just behavior” if we don’t appropriately rule out other contributing causes. Here are some steps to identify the source of a child’s behavioral difficulties in cases of hidden underlying language disorders (after, of course, ruling out relevant genetic, medical, psychiatric and sensory issues).

Start by answering a few questions: Was a thorough language evaluation—with an emphasis on the child’s social pragmatic language abilities—completed? And by thorough, I am not referring to general language tests, but a variety of formal and informal social pragmatic language testing. Let’s say the social pragmatic language abilities were assessed and the child found/not found to be eligible for services. Meanwhile her behavioral deficits persist. What do we do now?

Determine why the behavior is occurring and what is triggering it (Chandler & Dahlquist, 2015). Here are just a few examples of basic behavior functions or reasons for specific behaviors:

  • Seeking Attention/Reward
  • Seeking Sensory Stimulation
  • Seeking Control

Most behavior functions tend to be positively, negatively or automatically reinforced (Bobrow, 2002). Determine what reinforces the child’s challenging behaviors by performing repeated observations and collecting data on the following:

  • Antecedent or what triggered the child’s behavior.
    • What was happening immediately before behavior occurred?
  • Behavior
    • What type of challenging behavior/s took place as a result?
  • Response/Consequence
    • How did you respond to behavior when it took place?

Once you determine behaviors and reinforcements, then set goals on which behaviors to manage first. Some techniques include modifying the physical space, session structure or session materials as well as the child’s behavior. Keep in mind the child’s maintaining factors or factors that contribute to the maintenance of the problem (Klein & Moses, 1999). These include: cognitive, sensorimotor, psychosocial and linguistic deficits.

Choose your reward system wisely. The most effective systems facilitate positive change through intrinsic rewards like pride of own accomplishments (Kohn, 2001). We need to teach the child positive behaviors to replace negative, with an emphasis on self-talk, critical thinking and talking about the problem instead of acting out.

Of course, it’s also important to use a team-based approach and involve all related professionals in the child’s care along with the parents. This ensures smooth and consistent care across all settings. Consistency is definitely a huge part of all behavior plans as it optimizes intervention results and achieves the desired outcomes.

So the next time the client on your caseload is acting out, troubleshoot using these appropriate steps in order to figure out what is REALLY going on and then attempt to change the situation in a team-based, systematic way.

 

Tatyana Elleseff, MA, SLP, is a bilingual speech-language pathologist with Rutgers University Behavioral Healthcare and runs a private practice, Smart Speech Therapy LLC, in Central New Jersey. She specializes in working with multicultural, internationally and domestically adopted children and at-risk children with complex communication disorders. Visit her website for more information or contact her at tatyana.elleseff@smartspeechtherapy.com.

Beyond Articulation: Don’t Forget Reading

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I have sometimes felt overwhelmed with the number of children on my caseload who struggle with reading.  It shouldn’t surprise me, as spoken language and hearing speech sounds is the foundation for reading text. We know that children with speech and language delays are at risk for reading failure. It’s important for the speech-language pathologist to understand how delays in early sound productions interfere with the process of reading and learn simple interventions to remediate both articulation and early literacy skills at the same time.

It is common to see many children in preschool, kindergarten and first grade struggling with articulation of sounds. Underneath that struggle is a child whose sound/symbol system is weak. That means this system may also be weak in hearing sounds, learning to read sounds and in learning to write sounds. This is the perfect time to get involved with the classroom teacher and use your skills to help all children make sense of sounds and print.  I have found it essential to teach an overlap of skills to the students on my caseload who present with moderate to severe articulation errors.

Reading and speech tips

Here are some general pointers on working on both speech and reading:

  • Review with the kindergarten staff how to teach all students how sounds are made, feel, look and touch as they are introducing alphabet sounds.
  • Talk about where the sounds are made in their mouths. Do they make the sound in the front of their mouth? Do they use airflow? Did their voice turn on or was it off? Was the sound made with their lips or their tongue? This practice helps students connect hearing the sounds to what their mouths are doing when saying them.
  • Teach children the correct way to produce sounds, making sure they don’t begin to add a “schwa” sound like ‘uh” onto the end of their productions. For example, the “f” says /f/ not /fuh/, the “h” says a silent /huh/ not a voiced /huh/, the “t” says /t/ not a voiced /tuh/, the “p” says /p/ not a voiced /puh/ and the “k” says /k/ not a voiced /kuh/. When children learn to produce sounds with the added schwa they may have trouble when they are sounding out words.
  • Be an active participant with the classroom teacher when they begin to assess the letters and sounds a child knows. Offer to help give the assessments and take a close look at the results. It’s amazing what you can learn about a child’s speech sound productions and early reading skills just by a simple sound assessment.
  • Consider an initial sound DVD that is very visual, repetitive and kinesthetically rich. Children can solidify alphabet sounds very quickly when given access to repetitive song-type DVD’s.
  • Phonemic awareness skills taught in the early grades are extremely important for children with speech articulation difficulties. Children need to be able to hear and play with sounds in words. Work with the child on the skills of blending and segmenting simple CVC words using sounds they are working on.
  • Teach classroom teachers and children about voiceless and voiced sound pairs. Make a chart and post it in the classrooms. When children understand how these sounds are related, spelling skills improve.

 

Voice Off Voice On
       f      v
       p      b
       s      z
       t      d
       k      g

 

When a child is reading text

Here are specific things you to can do to help when children read:

  • Use visual reminder cards with children to remind them to use certain reading strategies. A simple strategy card may include strategies such as “Get your mouth ready” or “Say what you see.”
  • “Say what you see” is helpful to say to children when they make an error when reading an initial sound in a word. So when a child is trying to read the word “dog” and he says “fat”, explain that if he sees a “d” in the beginning of the word his mouth has to make that sound.
  • Make simple books with beginning sight words tied to words with the sounds the child is working on. Books like “I see____” or “I like____”. Use blank page books or take a simple book that you own and replace the text with your own, targeting the sounds a child is working on.
  • Every time a child reads out loud they are practicing oral speech sounds.
  • Use highlighter tape to visually highlight the sounds a student is working on. Use the tape in books they are reading or in their writing to draw attention to sounds. Students love to use the tape to cover their sounds while another student in a group is reading.

Sue Lease is a speech-language pathologist at Glacier Edge Elementary School in Verona, Wisconsin. She has a particular interest in emergent literacy in young children.