Treatment Tricks: Introducing Structure to Young Preschoolers

I've got a little one on my caseload that's just turning three.  He's highly entertaining and loves anything with wheels.  He's a little buddy who demonstrates characteristics of Childhood Apraxia of Speech, and is very self-conscious about imitating speech sounds or words for me during our sessions.  I've been working with him for approximately 10 months, and during that time his vocabulary has grown from less than ten words to well over 100.  Most of our treatment time has been child-directed, which you would expect with a two-year-old.  Most of my attempts to introduce activities with specific targets have been met with a strong, emphatic, two-year-old "NO!"  He's using several word shapes, his vowels are mostly accurate, he's got most of the early developing sounds in his repertoire, and he's producing 3-4 word sentences.  However, as his language complexity increases, his intelligibility of speech decreases, making things more frustrating for him than ever.  So what's a girl to do, to get a little compliance?

I threw caution to the wind and decided to make a plan for a little structure.  And guess what?  It actually worked!  Even better than I'd hoped it would!  I'll share it with you now.

First I found three little boxes to "hide" activities in.  I made them appealing (I hoped!) by putting vehicle pictures on them.

Each box contained either an entire activity or a piece of an activity that I had prepared but wouldn't fit in the box, and a paper vehicle with velcro on the back.

The vehicles each had velcro dots on them to attach two wheels.  One of my targets was the word "wheel", as he is learning to make the /w/ sound with rounded lips.  During this sequence of activities, he had many opportunities to practice that word.

I displayed all three boxes on the table and let him choose which one we would open first.  I removed the other two from the table, and together we opened the box.  He removed the paper vehicle, and I showed him that we would put it on the road that I had displayed on the back of my bench after we played a game with the other item or items in the box.

One of the targets of the day was words beginning with the /h/ sound.

Inside the box he found six items to practice words that begin with /h/:  hat, horse, heart, hop, hot and high.  We said the words as we removed them from the box, again when we played with them, and again when we put them back in the box.

When the activity was completed, we put the wheels on the vehicle (after he said "wheel" of course) and then put the vehicle on the road.  By the way, my choice of vehicles was also planned ahead of time.  he uses a generic "word" (wah-we-oh) to refer to all emergency vehicles, so I chose police car (pees car), fire truck (fa ya tuk) and garbage truck (ga ba tuk).  He made great attempts to imitate all three with very little reluctance.  After putting the vehicle on the road, we chose another box.

My little buddy loved this format.  I was hoping that maybe we'd get through two boxes, but we actually completed all three!  Success!  Smiles all around.  I wonder if it will work next time...?

What are your tricks for working with young preschoolers?  I'd love it if you'd share!


Pam

Answers: YesNo HD app: Choice Making for Toddlers

The Answers: YesNo HD app has been on my iPad for awhile now, but it was one I rarely used, because it didn't really suit the needs of my caseload.  Suddenly I find myself with two pre-verbal toddlers that need to work on making requests and building vocabulary.  One is learning to use the PECS system, and the other needs some symbol support to make specific requests.  I remembered that the YesNO app could also be used as a two-celled AAC device, so I checked it out.  It worked great!  Let me show you how fast and easy it is to make simple communication boards with photographs of your own materials.

First, you choose the Favorite Button Set Up option.

Touch either button to set it up.

Select a photo to add to the button.  I used photos of the toy choices that I took using my iPad.  You can also add text and a voice recording on this screen.  Press done, and then repeat the steps to add a second choice to your page.  It will look like this when you're finished:

You have the option of creating six different pages that you can access quickly with just the touch of a button.

When you are finished with your pages, you are ready to go.  Just touch the "favorites" button, and select your choice board.

This was a fast, easy and very effective way to create a simple choice board system.  I highly recommend it!

Keep exploring new ways to use your iPad,

Pam

Nature Scavenger Hunt

With summer quickly coming to a close, how about one more outdoor activity to savor the fresh air and sunshine?  Try this nature scavenger hunt!  With my office being part of my home, we were able to go right in my backyard and find everything on the list.  If you're not so lucky to have nature right outside your back door, you could collect a box of items ahead of time and have your students hunt for them right in your office.  Or you could put them in a texture table, or a large box.  Another idea:  send the list home and have your students hunt for things in their own neighborhood with their parents and bring the items back to you.

This activity was wonderful for working on attributes, but it also lent itself well to other goals.  Some of my early elementary kids need a little help with organization, and following a list to complete a task was more difficult than one would think!  It was also another great EET activity:  we chose three items and used the EET method to talk about them.  We also compared and contrasted the different leaves we collected, and several types of flowers.

If you've been following my Camp Journal posts, you know we are earning badges this summer.  After completing this hunt and the tasks associated with their goals, the kids happily added the Nature Badge to their journals.

I adapted this list from an idea I saw on Pinterest, from thefrugalgirls.com.  If you'd like a copy of my list, you can download it here.

Enjoy these last lazy days of summer!

Pam

Camp Journal: Olympic Champion Badge

Here's an example of the Olympic Champions Badge page of a Camp Journal.

We completed three activities:  Making a torch, painting the Olympic Rings (see previous post) and earning Olympic Medals.

This child is working on naming members of a group and their functions as part of the EET program.  As he collected foil to decorate his Olympic torch, he named 8 things he would see at a birthday party.  As he decorated his torch, he needed to describe two things each item does.  For example, he named "Balloons" as something he would see at a birthday party.  Then he said, "you hold them, you punch them and make them go back and forth".

Our next task was to name 8 items in each of 5 categories; you can find a photo of that activity in my previous post.

Our Olympic Competition was the highlight of the day.  The kids attempted to earn bronze, silver and gold medals by completing a task that contained one of their goals.

I used cards from Jenna Reyburn's Speech Room News Olympic Activity Pack to make my own Olympic events.  I wrote the names of different activities on the back side of the medal cards.  Kids selected a card from the Gold Medal, Silver Medal and Bronze Medal piles to determine what "event" they needed to "compete" in.

For example, this child selected the Amazing Ball Skills card, and had to say one of her target words or phrases before hopping over the block with the ball between her knees.  Once she said all 10 words/phrases correctly, she earned a medal.

The Sandwich Stack event required the child to say her target words to earn pieces of a large fabric sandwich.  After earning 8 pieces, she had to walk across the room and back with the sandwich balanced on her head.  I'd say that's Bronze Medal worthy, wouldn't you?

After completing the tasks listed in their journals, the kids were awarded the Olympic Champion Badge, which they glued on the page.  My little Olympians really enjoyed their speech time today!


Be creative and have fun,

Pam

Let the Games Begin!

I don't know about you, but I have caught Olympic Fever!  I can't wait for the opening ceremonies to begin!

Today I borrowed an idea from Pinterest, using an Olympic Rings printout, which you can find right here.  I used this handout for a categorization/word association activity.

I wrote different category names in each circle, and got my dot paints out.  I instructed the child to name  eight items in a category, and to paint a dot after naming each one.  To make it a little more difficult, I used my stopwatch to see if she could name all eight in less than one minute.  Easy!

I used this same idea earlier in the week as an articulation activity, too.  We just glued pictures of the target words in the center of each ring, and said each word eight times.


One of the things I like to do each summer is make "Camp Journals" for each of my kiddos.  I plan my summer around Summer Camp Mini-Themes, and the kids collect "merit badges" for completing tasks centered around each theme.

I make the covers out of foam, and add five blank pages to each.  You can download my template for the pages here.   The kids decorate their journal covers with the letters of their names and other fun foam stickers.

I make the badges ahead of time, using my Cricut paper cutter, which can make just about any shape you can dream of.  I cut tons of two inch circles for my badges, and then shapes to match my mini-themes.  Here are some of my badges:

They include Forest Animal Expert, Sports Fanatic, Camping Pro and Olympic Champion.  I'm not sure what I'll name the one with the marshmallows on the stick yet, but I know we'll be making s'mores one of these days with my indoor s'mores maker!  We've got to earn a badge for that, right?

Each week, I write a list of goals on a blank page of each journal, and write the name of the badge at the top of each page.  For example, to earn the Forest Animal Expert badge, the child must name at least 5 different animals that live in the forest, name at least three important features of each, and tell me at least one interesting fact about each one.

I also make special badges for kids who are working on the R sound, and those who are working on establishing correct tongue positioning at rest.  My vocalic R pages look like this:

The symbol on the badge matches the vowel set:  a bear for AIR words, a star for AR words, a fire for IRE, and a deer for EER.  Sometimes I write the target words on each page, and sometimes the kids do it themselves.

The child above was working on vocalic R in single words, specifically the OR words.  He earned his badge because he was able to say the entire list correctly, which was the goal.

The kids enjoy earning the badges and are proud to fill their journal.  I keep them with me until they are complete, but the kids review each earned badge with their parents after each session, and then take them home at the end of summer.

If you're interested about what tasks I'll have my kids complete to earn their badges, let me know and I will post sample pages from their journals.  Next week we are working on our Olympic Champion badges so...

...let the games begin!!!

Pam

It's the Small Things

I've taken quite a long break between posts.  I haven't felt very motivated or inspired lately.  Here in Oregon, we had an unusually cold, grey June with SO MUCH RAIN.  I am a sun-lover through and through, so that totally grey month put me in a tailspin and sapped me of all my inspiration.  The sun came out after the 4th of July and began to pour its healing warm into my heart and soul.  You'd think that would be all I needed to get back on track, right?  Unfortunately, that didn't happen.  I'm not sure why I just can't seem to get back in the swing of things!  Maybe it's because several of my regularly consistent families decided to take the summer off, leaving large gaps in my predictable schedule.  Maybe it's because I took on several new kids all at once to take their place, and now I have piles of paperwork to complete.  Maybe it's because everyone takes vacations, and they never overlap with mine or the others on my caseload, making continuity very hard to manage.  I feel like I'm starting over every week with at least one child.  I don't remember other summers being so difficult!  And then there's this blog...I never knew writing a blog could make me feel pressured!  Here are some of the things that go through my mind when I think about my posts:  Will anyone read this? Does anyone care?  Is this actually helping anyone?  Why does it have to be so difficult to add a photograph in just the right place?  Did I choose the right photo to begin with?  Will someone "pin" my ideas on Pinterest?  Ugh!  Too much pressure!

So here's how I am attempting to get myself back on track.  I've been reading a book called One Thousand Gifts by Ann Voskamp.  Although I am only about half-way through, I am finding it to be life-changing.  The author took a dare from a friend to find one thousand things she's thankful for, and she chronicles her journey to find them in this book.  She has been transformed from someone who hated to get up in the morning to someone who finds joy and God in the small stuff, all day, every day.

I am trying to do this in my life, recognize how blessed I am, and recognize each tiny blessing for what it is.  If I am successful, I know I will be a better person for it:  a better wife, mother, friend and speech-language pathologist.  I know it will impact the way I do my job.  Already it's making me be more compassionate and acutely aware of the struggles my client's face.  Already it's making me appreciate each little body for who they are and how God made them.  So here is my challenge to myself.  For the rest of the summer, I want to find just FIFTY things I'm grateful for in my life as a speech-language pathologist, and I will list them on this blog.  I'll start with 10 in this post, and hopefully add 10 more each week.

Ann says in her book, "I discover that slapping a sloppy brush of thanksgiving in my life leaves me deeply thankful for very few things in my life."  I am always thankful for parents who arrive on time, checks that arrive each month as planned, kids who do the homework I assign.  I am not going to include those things in my list, for they are painted with the broad stroke of thankfulness. Instead, I am going to look for the small things.  Things that will make me recognize deep gratitude for gifts I receive while doing my job.

So here are 10 things that brought me joy this week.  Some of them are things that make me feel grateful, and some things evoked my compassion, which is an emotion I am grateful to have.

1.  The wonder and discovery in a two-year-old's eyes.

2. The look of surprise and pride on a father's face as he witnesses his toddler daughter imitate his actions on a toy for the very first time.

3.  The unexpected effort from a very-busy-little-friend-who-doesn't-like-to-sit-still to take that tongue depressor and make his tongue say the /k/ sound, and his beaming face after a successful attempt.

4.  A mom saying, "He couldn't wait to come here! You make talking so much fun."

5.  My little three-year-old friend, taking a toy coffee cup and a wooden top and pretending to make cappuccino with it, sound effects and all.

6.  The held-back tears of a mom as she watches her little one with Childhood Apraxia of Speech struggle to say a word that seems so easy to you and me.

7.  My second-grade friend who informed me that he is a flower collector.  Shouldn't we all be???

8.  Colored pasta shapes, all jumbled together...a rainbow in a bowl.

9.  Sweet baby babble, music to my ears.

10.  First words spoken.

Seek joy, my friends.  And find it in the small stuff.

Pam

Flingin' Those Bugs!

I saw this great idea for making a catapult using wooden craft sticks on Pinterest and I just had to try it.  Here's my version of it:

It was super easy to make.  I stacked five narrow sticks together and secured each end with a strong rubber band.  I stacked two wider sticks (i.e. tongue depressors) and secured one end with a rubber band.  I slid the stack of narrow sticks between the wider sticks and used two rubber bands to secure it in place, placing them diagonally across the top of the wider stick.  Then I used a dab of hot glue to secure a plastic lid from an orange juice container to the end of the upper tongue depressor.  That's it!

So, what did I use this nifty little device for this week?  Flinging bugs, of course!

I've got lots of little plastic and rubber bugs on hand, and today many of them flew through the air with the greatest of ease...

...toward the "bug catcher" on the floor and toward the garden we drew on the white board.  So much fun!

So how did I work in speech or language goals?  Easy!  We worked on following directions that include the temporal concept "before":

I wrote the word "before" on a sticky note as a prompt.  At the beginning of the activity, I placed the sticky note between two bugs and gave a direction such as "Fling the ladybug BEFORE you fling the grasshopper."  After a few successful trials, I removed the prompt and gave the instruction without it.  I added more bugs to the group to make it more difficult, and sometimes included descriptions instead of insect names.  For example, a more difficult direction might go like this:  "Fling a long green bug before you fling a bug that has stripes."  Then I switched the order, placing BEFORE at the beginning of the direction:  "BEFORE you fling the bee, fling the ladybug."  Again, I started by using my sticky note prompt, and I placed it above the bug which was supposed to be flung second.  I explained that when the direction starts with "before", we have to think backwards and do the second thing first.  The sticky note over the bug was a reminder that the bug without a sticky note was the one to go first.  Sounds confusing, but it really did work!

I've got lots of other activities in mind for using this cool device:
     *  Superlatives:  talk about which bugs flew the farthest, which bug was biggest, heaviest, etc.
     *  Comparatives:  fling all the bugs with stripes, all the bugs with large back legs, all the bugs with spots, etc.
     *  Articulation:  Display picture cards on a white board or wall.  Use them as targets, aim the bug flinger at the targets, and say the word closest to where the bug lands.
     * EET:  Display picture cards of items from various groups.  Use them as targets and name the group the item hit belongs to.

I'm sure there are plenty more ways to use speech and language skills with this fun activity.  What are your thoughts?

Have fun and nice chatting with you!

Pam