Conversation Tree

I got this idea from my friend and guest poster, Angela. 

Each student gets their own set of colored question cards and comment cards.  The teacher or students pick a topic of conversation and the students get a chance to ask questions or comment.  The goal is to have a tree that is colorful and very tall.  When an off-topic comment is made we put a branch instead of a colorful card.  Obviously, a tree without branches sticking out all over is the goal.  The topic of this conversation tree was....

Click on me to find out

I was hoping for tears and inconsolable kids yelling "noooooooo".  That's not quite how it went down. Some kids immediately started asking questions, while others I don't think got what I was trying to tell them.  A group of my kindergartners kept asking when I would be coming back from my move.  Either way, I wanted to make sure to give my kids plenty of notice that I will not be returning next year as their speech lady.  This is what the tree looked like when I was using it with some older kids that had lots of questions to ask about my impending move.

So there is the activity.  It's great for working on conversation skills, expansion of utterances, asking questions, answering questions etc. 

Now for more on the move....

I figured I would let you all in on my exciting news.  This speech lady is moving to Chicago in 2 months.  Chicago has always been in the back of my mind (my sister and her husband have lived there for several years), but the day I felt the baby inside my sister's stomach kick, I was a goner.  I knew I needed to be near this little being or I would go insane.  Well my sweet little niece is 7 months old now, and everyday away has been absolute torture.  

I mean she was cute then, but you should see her "Michelin Man" arms and precious face now.

Luckily, my new job in Chicago will force me to do even more lesson planning than I do now, which means more ideas for you all. I will be sad to leave Austin and leave the wonderful friends I've made here.  I don't even want to think about saying goodbye to my classroom neighbors and besties Angela and Jessie.  Gahhh hold back tears! 

Anyways, I'm extremely anxious and thrilled about the exciting things ahead of me and wanted to share it with my blog family (you all of course!).

Interactive Speech Therapy

Just came across this fun website with lots of interactive games dealing with language concepts.

Check it out here

Giving The News

A great article that I think SLPs should be required to read every year.  This article is not just for when you diagnose a child with apraxia, but when you're telling parents about any delay or disorder with their child. 

Giving the News:  How to Talk to Parents About the Apraxia Diagnosis

by Sharon Gretz, M.Ed.

The hardest requirement for many healthcare professionals that provide services to children is to deliver news to parents and caregivers that is perceived as "bad news." In this sense, speech-language pathology is no different than other health related professions. Caring individuals enter into helping professions and thus are usually sensitive to the feelings of the individuals whom they serve.

While there is no one answer to the question of how to tell a parent that his or her child has apraxia of speech, we can address the concern about upsetting the parent. The reality is that it is likely that the parent will experience a range of emotions, including disbelief, sadness, guilt and fear. Whether it is in your office or later when the information has had time to sink in, parents are likely to feel and express upset when confronted with the news that their child has a significant speech disorder. The parents will likely have concerns for the future and feel overwhelmed by what they don't know yet about their child's condition. You cannot prevent this! But, what happens next can mean a lot to how the parent responds.
What follows is a list of suggestions for helping families after the diagnosis:

• Have good and valid reasons for diagnosing apraxia of speech in children. Remember, that little speech or receptive skills that are higher than expressive skills, alone, is not enough for an apraxia diagnosis. Be sure you have good reasons before you give a diagnosis to a parent. Explain what you saw in their child that led you to your diagnostic conclusion and how you are able to rule out other possible diagnoses.
• Compassionate honesty it is important to both express empathy with the parent and explain that apraxia is a complex and often difficult speech disorder. Do not minimize the news or the impact on the child and family.
• Assure parents that they will play a strong role in helping their child. Explain that you will want them involved in their child's treatment, to the extent that they desire or can participate.
• Do not offer absolutes in regards to prognosis. While there may be both positive and negative prognostic indicators known from the evaluation, it is not fair to the child nor the parent to make immediate predictions for the child's future performance (i.e., Don't say, "Your child is not likely to ever speak clearly"... or, conversely, "With therapy, your child will be fine within a years time.") Do share with the parent information about their child's speech and language skills. Explain the relative contribution of these skills or lack of skills to their child's present communication difficulties, while noting any positive indicators that will help the child in therapy. Be sure to share your observations on the child's abilities, not just their deficits.
• Tape-record your meeting and send the audiotape home with the parent. Often parents feel overwhelmed and later will not recall the words you said to them. The tape recording will allow them to review exactly what was said and help them absorb the information.
• If at all possible, consider calling the parent in several days. It is kind to tell parents that they can call you if they think of more questions, but often parents feel as if they are imposing on a busy professional.
• Offer resources. For example, copy pages from the Apraxia-KIDS web site and place them in an envelope that the parent can take home with them to read they feel ready to learn more. Offer to introduce the parent to another parent of a child with apraxia. Even after treatment has begun, check in with parents frequently to see if they need information or resources.
• It is ok to say, "I don't know." Most parents are quite grateful when clinicians acknowledge what they do not know and when possible, make efforts to find information or help. 

Most parents will need time and your patience while they fully absorb the information that their child has apraxia of speech. Most will also go through the range of emotions mentioned earlier and also face having to explain it all to family and friends. While you cannot spare them from these understandable feelings, you can be a positive and productive force in helping parents move from emotions to productive action on behalf of their child.


(Sharon Gretz, M.Ed., is the founder of the Childhood Apraxia of Speech Association of North America (CASANA). She has her Master's Degree in Counselor Education and has worked for many years with families of children with disabilities. In 2001, she was awarded the National Distinguished Service Award for her work on behalf of children with apraxia from the National Council on Communicative Disorders at the Kennedy Center in Washington, DC.  Currently, she is a doctoral student in Communication Disorders and Sciences at the University of Pittsburgh)

Oh and by the way, I'm lucky to call this amazing lady my aunt :)

Pinterest

I decided I needed a better way to pin my therapy ideas.  It was driving me crazy the way I had no organization of all the cool things out there.  Therefore, I created a new Pinterest account where I will now be pinning all the wonderful therapy ideas out there.  Feel free to continue following my old one (I like to think I have great taste in food and clothes :)  ), or unfollow and follow my new account.  I will slowly but surely be adding lots of new ideas. 

K and G

I have a whole crew on my caseload that are working on their /k/ and /g/.  All of these kids do something called fronting (for you parents out there reading this, that is when a child turns their /k/ to a /t/ and their /g/ to a /d/.  They produce the back sounds in the front of their mouth).  There are a number of strategies that I use when I work on these two sounds. 

The first day of speech and then periodically throughout the year I will read the book The Case Of The Missing G.  I bought this book at the last CASANA workshop I attended and I couldn't wait to use it!

This book has so many opportunities for auditory bombardment (mostly ng, but it gets us talking about our "missing" sounds) and then later on in your therapy sessions it has opportunities for practice. 

Once we've read the story, I like to start out my kids each session with some auditory discrimination tasks. The first day I just have them listen to me say these words.

    

         

  When I do auditory discrimination, I will go over each card several times and point to which one I'm saying as I go.  Then I'll have the child listen and point or place an object on the word that I say.  After that I will have the child say the words and I point to the one I think they are saying.  Sometimes this is a "light bulb" moment for them.  They don't realize that what they think they're saying is not what I'm actually hearing. Click on the images for the free download.  

Then, I like to get them in front of the mirror so they can see their tongue and where it is going.  I may use a tongue depressor to hold that tongue tip down, I might have the kids lay on their backs and aim for that placement or gargle, or cough or let's face it all of them at once! I have found that it may take them a little bit of time to get these sounds, but once they do a majority of them can make the sounds consistently in isolation after that.  

I'll sometimes use a miniature plastic rocking chair as a visual.  When the rocking chair goes back they make the /k/ or /g/ sound and when the rocking chair goes forward they make a /t/ or /d/ sound.  You can explain that the rocking chair represents their tongue and where the placement is for each of these sounds. 

Addi tonal books that are good for carryover of skills:

Check out Speaking of Speech for some more /k/ and /g/ activities.

Good Luck!