Can't Make a / _ / to Save Their Life

Today is Sunday. Why do I always start out by telling you guys the day of the week? I'm sure you're aware. I'm sure you even aware of not only the day but the approximate hours left of weekend freedom before Monday hits. I don't mean to insult you.

Either way, my declaration of Sunday is more so made to inform that even though it is not a workday, I am bringing you something work-related in nature. That being, a speech post about one of my favorite topics...articulation and stimulability!

I love how whenever I type stimulability into Word or an evaluation that annoying red, underlined swiggle comes up suggesting it's not a real thing. Of course its a real thing. And something worth talking about since what works for one child often does not work for another.

That being said, here are my favorite stimulability tricks for my favorite consonant sounds. Some of these are grad school "duh" suggestions, and others are a result of me just playing around. Just depends on how cray-cray you want to get. Or how cray-cray you're going trying to stimulate a particular sound with minimal or no luck. Ah. Such fun.

Stimulability Tricks & Tips

/k/, /g/:
Baby trick: Tilt head back, pretend to drink water.
Advanced ninja: Tongue depressor for exterior tongue base movement while approximating sound.
SLP master move: Can of (cream cheese) frosting. Dip spoons into frosting and demonstrate the above trick using the spoon; encourage child to imitate. If child will allow you to use the spoon to help with tongue base movement also do so.

/f/, /v/:
Baby trick: Use verbal cue "bunny sound". Bring stuffed bunny rabbit toys or pictures to use as a visual and verbal stimulus. Demonstrate over-articulation of sound with front teeth coming over bottom lip.
Advanced ninja: Use phone camera app during simultaneous production while prompting with verbal cue, "Where's your bunny sound?"
SLP master move: No real master move. If none of the above have worked, you're SOL.

/l/:
Baby trick: Use mirror to encourage imitation while demonstrating tongue tip to alveolar ridge.
Advanced ninja: Use phone camera app to replace mirror in above tip.
SLP master move: Place peanut butter, frosting, or other "lickable" spread on alveolar ridge and ask client to lick it off while approximating sound. You may also use a exaggerated production of /l/ by sticking the tongue out of the mouth and approximating tongue tip to the front face of the upper teeth before retracting.

My general preferences for encouraging placement accuracy are:

- Touch cues (provided the child will tolerate);
- Initial over-articulation;
- Corresponding handcues; and
- Mirrors/camera apps.

These can apply to any number of consonant sounds.

Do you have any favorite stimulability tricks?:)

Rainy Day Speech

Good morning, ya'll. Today it is a rainy day in Texas and I have been trying to figure out what kind of theme I wanted to use for the rest of February since Valentine's is over. Weather it is!

The obvious choice was to look for content related to the book, "Cloudy With a Chance of a Meatballs", but believe it or not, I do not currently own the title. I'm sure I will make it to the library soon but until then I have once again pulled some random Internet resources and cut/paste activities to last until then.

Here are my "Rainy Day Speech" activities for today:

- Cut/paste raindrops (from construction paper) with cloud stickers for artic/language scripting
- Seasons cut/paste - Kids will match pictures related to weather/holidays to the corresponding seasons
- PECS weather pictures - for conversation, artic carryover, and general language scripting

Nothing fancy but it will get the job done!

And yes, those raindrops are not to scale. Like my 4-year olds care.

Do you have any favorite "weather" based activities, maybe some that are more motor or sensory based? Let me know in the comments. :)

It All Spilled Over

This blog post will be a monster post symbolic of the past few days. Everything has spilled over.

You know, life gets moving and so you start taking things and put them on the back burner to deal with, but before you know it, even the back burner is full. The past few days have been full of a whole lot of wonderful and a bit of stress. Most of it I managed to capture in pictures.

To begin, last Friday was Valentine's Day, as I'm sure every single one of you were aware of. Amazingly, my Facebook newsfeed was NOT flooded with a million pics of flowers men sent their perspective wives and girlfriends.

Hence the reason I feel comfortable showing you all this beautiful bouquet of roses and lillies that Jake showed up with at my door. The best part was the strawberry cheesecake chocolate sticks poised at random throughout. He did good.

Anyways, not to get ahead of myself, Friday was a therapy day that consisted of dessert Skittles articulation therapy and various Valentine's language activities. I was given a cupcake by a 3-year old that I professionally scarfed down with my bare hands like a savage immediately following the session. That red food dye does NOT wash off skin easily, P.S.

Here's a picture of my car mid-day Friday. Oh, who am I kidding. This is a typical home-health car, at least MY car typically. I guess I should note that my trunk is generally much more organized than my back seats. You can see I do not have children at the moment; where would I even put a car seat? I'd make room, though...just saying.

In the afternoon I did a bilingual penguin activity, which I know, is typically a January theme. But it was Friday and that's what I had. Here's the front and back, showing the way I used it to target basic verbs and subject-verb agreement:

Following therapy I headed back home to celebrate the evening with my handsome Valentine. We went to Torchy's Tacos, per my request. If you haven't been, you need to go. Just say, "2 Trashy Trailer Park's." Trust me, you'll be happy. 

                                                                Before Dinner


Those 4 evals I mentioned in my last post? I am just now finishing the fourth one. Like I said, everything began to spill over. I am feeling good about the month of March, however. As for now,
I am going to finish this last eval and begin working on a new pillow for the Etsy shop.

Also, stay tuned for a new therapy game in my next post! It is self-developed and has always been a winner with my preschool crowd. Target area: phonological processing goals!

I hope everyone had a lovely weekend and is finding productive ways of dealing with the stress that comes along with the workweek and life spilling over. :)

Where's My Charger?

Welcome to Wednesday!

I'm not going to go in-depth about how difficult it has been to get back into the groove of therapy (aka life) but it has been more difficult than just avoiding the Taco Bell drive-through. Something is going on with my health and energy levels that leaves me feeling completely zapped in between sessions and dreading the next. I know this blog isn't supposed to be a forum for my personal issues but I know there are probably some ladies out there who feel like their battery keeps dying. I'm just trying to figure out what it's going to take to make me feel alert earlier than 10am everyday.

I am, however, so thankful this week for the support of my boyfriend, Jake. He surprised me with this beautiful bouquet of "Pre-Valentine's" roses on Monday and has been additionally loving and supportive.

Anyways, therapy activities for this week have been largely what I included in my ever-so-appropriate post, "The Sleepy SLP's Guide to V-Day Activities". My iPad took a tumble later last week resulting ina  beautiful crack across the screen and has not been charging. So, technology free this week!

Today I also brought back the beloved "treasure chest" I used for prize "reinforcements" at the end of my sessions when I first started out as an SLPA. The kids are all like, "Candy!" and I'm all like, "That's not a choice, I'm pretty sure it's been in there since 2011."

I have four reports to write so I better get going, two of which I am contemplating discharge. In home health sometimes that decision is a combination of not only functional need but scores that Medicaid will deem "medically necessary" as well as distance required to travel to the child/scheduling. Still sorting these things out in my head but I will get them worked out.

I hope you all are having a lovely day and if you're in Texas, enjoying the first dose of sunshine we've had in days. :)

Unpacking the Activity

It is Tuesday and that means...a blog post actually relating to speech therapy. After all, it is a week day and technically part of the "work week" (side eyes).

I don't know where you, the reader, are currently located, but I feel like I could make a pretty general assumption that the weather is probably just as crappy where you are as it has been here. I mean warm, cold, FREEZING, warm, ARCTIC, SNOW, ICE, PANIC. You get the idea. Needless to say, I am not loving it. I pretty much want to hide out in my apartment at all times. And welcome to one of the biggest downsides of home health; that being, if you can't or don't feel like traveling, you're a bit out of luck.

Either way, I ventured out yesterday to do a few sessions and despite the minor depression I was in regarding the weather (complicated by a zombie-like personality thanks to some delicious McDonanld's fries), my brain kicked into therapy-mode.

If you are a seasoned SLP, this post will probably be a "no duh" kind of thing, but it's a therapy theory that I find helps me get the most out of single activities. It's called (announcer voice): "Unpacking the activity."

Unpacking the activity means that when you do an activity you just don't have the kid practice his words or language skills on the part specifically "designated" for practice. You take every part of the activity, from taking out the activity, to putting it away, and make. it. count!

This is what I had:

- A page of artic pictures from Mommy Speech Therapy
- Red, green, and blue wooden beads and two strings

Target: Final consonant deletion (/t/)

Unpacking This Activity:
- Produced targets individually by placing a bead on each picture post-production; also targeted making a choice from 2 (red or yellow?) as well as ID'ing colors
- Produced targets individually again by choosing/stringing a bead; also targeted making color comparisons as well as ID'ing colors
- Targeted basic counting (3-5) during activity; produced other final /t/ targets in the phrase, "I go/t/ i/t/!" after stringing each bead
- Produced final /d/ in the word "bead" while taking each off the string
- Grouped together beads by color and ID'd colors as requested followed putting them back in the box
- Non-routine directions integrated throughout the activity

I feel like as a beginning therapist I had a difficult time making activities last or integrating multiple goals into a single activity or session. These are just a few ideas of how to take simple materials and make them work for multiple purposes. I am a big fan of getting in as many productions possible for articulation clients and I find that "unpacking" activities provide multiple, non-traditional opportunities for this.

Do you have any special tricks for getting the most out of your therapy activities?

Sunday Feels

It is Sunday. Let me tell you how Sunday feels. 

Sunday feels like a McDonald's medium french fry and ice-cold Coke.

Sunday feels like a very heavy, scratchy grey blanket that I don't want touching me.

Sunday feels like a humid room with a barely functioning oscillating fan. 

Sunday feels like an all-too hot bath that you were dying to get into but five minutes later are dying to get out of. 

Sunday feels like a song you started writing but quit when you got to the chorus.

Sunday feels like the comforter you put in the dryer that you will purposefully forget about.

Sunday feels like the mess on the floor that is better suited for Monday's sense of purpose.

Sunday feels like an empty playground punctuated by the sound of a clanging flagpole.

Sunday feels like the ball you attempted to play with that you accidentally kicked out of reach.

Sunday feels like the tea you set aside to cool down but is now too cool and must be reheated.

Sunday feels like the excitement of wearing flip flops followed by the let-down of a chilly breeze.

Sunday feels like the shirt you want to wear so badly but never lays just right.

Sunday feels like the talk you will have with that good friend filled with long pauses. Those muffins you made, they weren't very good, were they? People are unreliable, aren't they? You don't want tomorrow to come. 

Sunday feels better in my head than it looks on paper. 

Restore to me the joy of your salvation. - psalm 51:12

The Power of Words

Today I wanted to touch on one of the most important lessons that I think exists in regards to language. It has a little to do with vocabulary, or word choice. A little more so with pragmatics. But it has everything to do with heart. And intention. The power of words.

So often we SLPs are working with children whose verbal capabilities are struggling to keep up with their mental processes and desires to communicate. For these children, speech and language is limited. But we still try to teach them that there is power in their words, that their words AFFECT others. And affect themselves. Communicative intent, anyone? Point + cookie = receiving cookie. Mama + arm = Mama attending to a hurt elbow.

But why don't we start teaching this lesson explicitly, especially to our children who have age-appropriate and higher-level verbal abilities? And why do some adults seem to lack understanding or empathy towards this concept? That is, you carry a dangerous weapon with you at all times. One must be careful to wield the gift of speech and language carefully, because words are powerful.

One of my favorite quotes is by Taylor Swift. I know what you're thinking but hang tight with me on this one. It says:

"Words can breaks someone into a million pieces, but they can also put them back together again. I hope you use yours for good, because the only words you'll regret more than the ones left unsaid are the ones you use to intentionally hurt someone."

If there is anything I have learned in my journey as a speech-pathologist, is that speech and language is a gift never to be taken for granted. Those of us who have the ability to communicate must be taught that these words have amazing power:

They can:
- Compliment.
- Encourage.
- Comfort.
- Assist.
- Engage in debate.
- Give perspective.
- Accept.
- Reject.
- Communicate who we are as individuals.

Conversely, they can also:
- Criticize.
- Bully.
- Test.
- Highlight other's weakest points.
- Mock.
- Shame.

We are sometimes so concerned with communicating what's going on inside our heads that we pick the most effective and cutting words possible, for convenience sake. Instead of taking the time to use the right words, we say what we "feel". Because "free speech", right? The results are not pretty.

And the best part is, once you say something, it can NEVER be taken back! Isn't that fun, I tell my kids. Sure, you can apologize, and hope that person forgets. But that ship has sailed. So live in the pause. And think about the power of your words, before you just go swinging that thing around willy-nilly.

Words are capable of expressing an infinite number of emotions, thoughts, and ideas. But the way in which we choose to wield this sword says a lot about who we are.

Please consider taking a moment listening to this song. It summarizes all of the above.

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Also, speaking of teaching our little ones, I would like to hook you guys up with one of the BEST general ed teachers I know and one of my oldest and dearest friends, Shannon, over at The Diary of a Nerdy Teacher. Her posts are full of of cute and practical classroom and curriculum ideas, many that I have thought would be great to integrate in a speech room, as well.

Check her out and some of her awesome freebies in her Teachers Pay Teacher's store!

The Sleepy SLP's Guide to Free V-Day Therapy Materials

Good morning, speech world! I am up at a very disturbing hour right now but nonetheless have already downed my favorite breakfast granola (LoveCrunch: organic chocolate granola, strawberries, and dark chocolate chunks). And continuing in the Valentine's theme, I have done a little "e-search" (that was a "Lizzie McGuire Movie" reference, no shame) for some free therapy materials that I can use to kick-start my day today. Therefore, I bring you:

The Sleepy SLP's Guide

To Free V-Day Therapy Materials

Uno of all: 

Google is a never-ending resource for free materials. Here are some of my favs:

Itty-bitty Valentine's Book - color/fold book with individual pictures of Valentine's vocab. Easily used for simple sentence constructions or conversation.

Parts of a Penguin - cut/paste penguin w/ matching words; great for vocab and other language stimulation activities.

Beginning Sound Heart Search - phonological awareness activity for initial sounds.

What Do You Love? Sentence Starters - "I love to eat, I love to play, etc." sentence starters. Easily adapted for a variety of language activties.

Segundo of all:

Teachers Pay Teachers offers up some fun activities too, and the best part is, I found a bilingual resource in there:

English/Spanish Cut/Up Valentine's Sentences - "I Can" sentences, all linked to Common Core standards. A must-download!

Valentine's Sentence Sequencing - Sentence sequencing for the elementary crowd related to V-Day.

And last but not least:

We All Love Language Valentine's Day Packet - Unlike the others, this download is not free but it is a HUGE resource of both pragmatic and language activities for only $4.50. I believe this packet will get me through more than a week and a half of therapy. It includes Word Association/Opposite Hearts, a following directions game, Valentine Transportation Bingo, Valentine Bugs Multiple Meaning Words, and "Good Robot or Faulty Robot?" (pragmatic judgment game).

So there you have it. Download and print away. And please, let me know in the comments if you've found any other free Valentine's resources I should know about!:) 

Too Many Nacho Cheese Chalupas, Not Enough Therapy Organization

Whew, the past two weeks have been something! But I return to you as LD, M.S.,CCC-SLP, finally shaking off that silly SLP-CF or CF-SLP title, whichever one it really was the past eleven months.

My ASHA certification and state licensure took a little more time to process than I expected so I ended up with a week and a half gap in therapy, which amazingly has flown by due to the fact I have started an Etsy shop and have kept myself busing crafting away. It is called "SLP Accessories" (etsy.com/slpaccessories) and I have re-discovered my love of paint and hand-stiching through designing custom SLP accessories such as keychains, pillows, and the like. My items are also great for general ed teachers and are customizable. Some of my favorite pieces include:

"The WH- Question Pillow"

"Love You" IPA Keychain/Gift Tag

And while this has all been good and fun, I am struck with the realization of how little therapy-related projects I have tackled in the meantime. Don't get me wrong, I have kept myself busy the past two weeks. So busy, in fact, I couldn't really tell you where all that time has gone, which is maybe what concerns me the most. 

I can tell you, however, that the Taco Bell drive-through has seen me at least 5 times in the past week. Nacho cheese beef chalupa, por favor. 

Despite this fact, I was able to finally set up a filing system for my articulation materials and was able to see what sounds I have the most materials for and vice versa. "/k/" won out by a long shot, unsurprisingly, as the majority of my caseload is 2-4 year-olds. "/j" as in "juice" (excuse my lack of the true IPA symbol) has gotten the least love, unsurprisingly as well, as I don't believe I have ever targeted this sound directly in therapy. 

Next up on the agenda is organizing the mountain of language materials I have stored in a huge box by my closet. As I do not have a classroom and only a one-bedroom apartment, sometimes storage is an issue. I worry that as my toy collection and printables accumulate I may find myself sleeping in a self-created preschool, which may already be happening. 

So there you have it. I am back albeit slow moving. Hey, I ditched the chalupas today and made myself a tuna sandwich. That's a start, right? I may have been stuck in a rut the past couple of weeks, but it's time I pulled myself out. 

Do you have any strategies for pulling yourself out of therapy or life ruts?  Let me know in the comments below. :)