Tuesday, April 29, 2014

Spring-Time Thoughts and Therapy

Well guys, we are officially immersed in the Spring season! I'm sure lots of you are waist-deep in theme-based therapy involving bugs, flowers, etc. All I can think about right now though is that it is the end of the month!

No reaction? I know my fellow home-health speechies know what I'm talking about. Two more days and the therapy world will reset essentially and I'll have a full 31 more days to get in all 9 of my kiddo's monthly visits. This time of the month can feel like a race to the finish line, and let me tell you, I am running...but it's taking me multiple Frito Pies and blended Dr. Pepper blended floats to get there.

Anywho, I've got a couple new therapy things ready for you all, in case you're looking for something to spice up your sessions. I recently made these Spring-time picture scenes that are primarily made to target "who" and "where" questions but are equally capable of targeting prepositions and sentence structure. This download is only a buck and comes with 4 picture scenes and two sentence structure prompts with visuals for each prepositional concept.

This is such a flexible therapy tool for the month of May and I'm planning on using it for all my preschool-aged kiddos!




Also, here's a non-themed freebie for you guys, perfect for group-based and/or elementary articulation students. Fill in or let them fill in their target words on these Articulation Tic-Tac-Toe boards and them let them go at it in pairs! Perfect for working on peer or self-monitoring, too.



Happy End-Of-The-Month! Please let me know if you enjoyed any of these downloads or what you're loving for therapy right now in the comments so I can steal your ideas. :) 

Friday, April 25, 2014

Managing Bilingual Therapy : Part 1

One of the things that I know SLPs struggle with in today's world is how to approach and manage the increasing presence of bilingual clients on their caseload. I know this can be tricky for not only monolingual SLPs but SLPs who consider themselves bilingual but were not dual-language learners from birth and/or doubt their competency in this area. I have, like many people, four years of high school Spanish under my belt and minored in Spanish in college, and despite lacking some higher-level linguistic skills, finally do consider myself bilingual. But it wasn't an easy road getting here, and I still experience that feeling of incompetency from time to time.

That being said, I wanted to share with you all some tips, in the form of a blog series, from my journey slowly transitioning into bilingual therapy as an SLP in hopes that it might give those of you considering making this transition a bit more confidence and remind you- we are all just doing the best we can out here! That being said, here is my first tip, or opinion rather:





#1: Never let your lack of "perfect proficiency" deter you, but be able to admit when your skill set prevents you from completing an assignment ethically or effectively.

For instance, the fact that I still have trouble using past subjunctive tense or higher-level grammatical forms does not really affect my ability to work with preschoolers with speech and language disorders or evaluate their linguistic abilities. That being said, however, I do realize the limitations of my Spanish fluency and do NOT accept monolingual Spanish evaluations for children older than 7, generally speaking, nor do I attempt to treat higher-level Spanish language skills as I recognize I lack competency in some areas that could affect my ability to accurately assess and treat. So the point is simple: Do what you can, with what you have! Recognize your own strengths and abilities and be willing to refer to another therapist if necessary.

According to the ASHA Code of Ethics (and I quote loosely), you should employ the assistance of a bilingual therapist to translate or a trained interpreter when attempting assessments and intervention if you are not personally competent in the language being assessed. Meaning, you cannot do what we ask many children to: request, comment, judge whether a sentence is grammatical or not (based on the child's age), etc. For example, I know how some conversational French but I would not assume competency in judging a bilingual French speaking-child's articulatory skills in French. And the reason this is significant is that true articulation and phonological disorders are typically present across sound systems in bilingual children, and it is important to be able to identify whether sound substitutions are really errors or just dialectal influences.  That brings me to my next point:

#2 Educate. Educate. Educate yourself on differences in speech and language development in Spanish-only as well as bilingual language learners. 

I know many monolingual SLPs are put in the tough position of having to implement Spanish assessments and resources for children who are assigned to their caseload, but it is important to be educated on what it is you should be looking for exactly. For example, I can't tell you how many times I've seen goals for voiced and voiceless /th/ written for a Spanish/English bilingual child. And it drives me crazy, because this is a classic case of disorder vs. difference, and unless there is education happening to teach therapists the differences and warning signs of true impairment we are wasting a whole lot of time on goals that are not even valid. And telling parents that their child has errors when they truly do not. Again, this kind of goes back to the principle of realizing your limitations, but once you've identified those limitations, stretch to push yourself beyond them!

A great website with resources for assessment and treatment of bilingual speech and language disorders is Bilinguistics.com.


#3 Easy in slowly.

My jump for monolingual therapy was not immediate. I am lucky to live in a state where many children are bilingual and are happy/willing to let me test out my Spanish with them and honestly, make errors! Before I went in full-force with a Spanish-only child, I worked with an English-speaking child whose family members were bilingual and I knew would probably be responsive to me incorporating some Spanish into our sessions. I played around with my own skills; a direction in Spanish here, a vocabulary word there...and when I saw the pleased looks on both the child's face and the family members that I was attempting to incorporate even a small part of their bi-cultural identities, I was hooked. 

I also kept tabs on what I felt comfortable expressing as well as my comprehension. There were times I noticed real gaps in my vocabulary or realized the family used a colloquial term I wasn't familiar with, but these were great entry points for learning and made me a better therapist. For example, often preschool therapists use farm animals as a popular starting point for vocabulary and play. I had no idea walking into some of my first bilingual sessions that some animals make different sounds in Spanish than they do in English! Or that in Spanish "oveja" is a very formal term for a "borrega", or sheep. These are things I did not learn through my formal Spanish education.

Beyond this, I started my transition into bilingual therapy by administering Spanish assessments, such as the PLS-5 Spanish, where I had the prompts/translations there for me to read if I needed them. After that, I began translating for a monolingual SLP in gathering case history information and soon felt at least moderately competent in administering a complete eval in Spanish independently. 

#4 Analyze pre-made Spanish materials, i.e., apps, flashcards, etc. closely for accuracy and functionality before implementing them.

It's amazing to me that many expensive, well-researched Spanish assessments such as the CPAC-S as well as Spanish Super Duper products use vocabulary that is outdated or non-colloquial. The problem with this is then that you must prompt the child to say the word the test is looking with creates a validity issue. I have had so made of my Spanish kiddos laugh at words or pictures on a worksheet, or better yet, laugh at something in an app that to them, is just a silly way to say something in their native language. Therefore, my recommendation is that to the best of your ability, try to double-check vocabulary and resources with a native speaker or colloquial source so that you can assess and implement speech and language intervention that is both functional and relevant based on the child's dialect. I say "gorra", you say, "cachucha"...if you say that means "hat", I'll say "cachucha" then, too. 

I also have on occasion double-checked a vocab word with a parent in terms of, this is the word I use for this object or verb, is that what you would use in your home? For example, I had been correcting a Spanish-speaking child who was saying (in a literal sense), "I'm painting," whenever he was coloring. The verbs are different in Spanish. However, I noticed that this was a trend amongst all my Spanish-speaking kiddos and I thought, this just might be difference and not an error. Sure enough, after checking with a couple parents, they said that verb usage was pretty typical. So I stopped correcting it.

#5 Invest in a Spanish dictionary app or website on your phone that you can use in a cinch. 

This is a simple tip but one that has been very essential in my work in those moments when a child asked me, "Que es eso?" while pointing to a completely random object that is not part of my everyday Spanish vocabulary. Once you say the word you've looked up, you can usually pretty quickly gauge by the look on the child's face whether that word is acceptable to them or not, haha.


That is all I have for you guys for Part 1; stay tuned for Part 2 of this series in which I will be discussing my tips for Assessment! 

If you currently work with bilingual children on your caseload, what have you found to be the most challenging aspect of assessment/intervention? Please share in the comments below!

Wednesday, April 23, 2014

Ladybug Artic

Hi, guys! This is just going to be a quick post while I sip my green tea and listen to Ava (my cat) cry in the kitchen because I won't let her eat leftover pizza. It's a hard life.

This week (lol "week", it's Wednesday already) I'm going to start a ladybug theme. I only have three kiddos this morning so I wanted to find a quick printable for this and found it.



I'm planning on using this for artic today two ways:

1) Having the kids glue on spots for productions; and

2) Placing pennies on top of their spots afterwards for a fun "cover-up" game.

Yes folks, gettin real fancy with the therapy activities today. Sometimes simple is best!

Hope you all have a fabulous Wednesday. 

"Sometimes you just have to put on lipgloss and pretend to be psyched." - Mindy Kaling

Friday, April 18, 2014

Friday Favorites


My spur-of-the-moment Easter treats for my kiddos today. 

Getting to wake up one more day next to the person I love.

Making banana nut muffins for breakfast. 



My hair finally having all of the dead ends cut off. Even though I ended up with a bit darker strands then I intended, at least my hair is healthier. Also, I love being a cat mama. Even though she is truly cray cray. 


This. 

~

Happy Friday everyone! Have a blessed Easter. :) 








Thursday, April 17, 2014

What A Crazy World

Good morning, guys!

It has been a crazy week so far and I am starting my day a bit later today, albeit with green tea in hand, like I always do. I was pleasantly surprised to get on Blogger this morning and see some surprising traffic on my dear blog here and it warmed my heart. So thank you!

Today I'll be going to see my most furthest away kiddos and ironically, they all are toddlers or younger, so many of the Easter activities I've been using lately just won't cut it. I'm mourning the loss of a couple pieces of Mr. Potato Head's body but the kids don't seem to care. I think this is maybe the fifth Mr. Potato Head that has been a part of my traveling therapy circus since 2011. :)

Anyways, yesterday was one of those days that I didn't have anything *new* for therapy really but I was proud to be able to make a few things "work" for my kiddos in a new way.

Take the cult favorite, "Articulation Chipper Chat" from Super Duper- I used it with a kindergarten friend who is working on an odd goal in my opinion, word-finding. We played a version of "I Spy" in which she both had to work at using descriptive terms to help me find objects and vice-versa, and then had to name all of the objects suggested. I purposely picked non-everyday vocabulary in each photo scene. Yes, it is struck me as very odd that I have found myself using some of the same strategies I used in grad school for my adult Wernicke's patients with a 5 year-old and it's actually been working. I might do a little more research into this as time goes on.


For the rest of my kiddos, we played with the Articulation Easter Basket Hunt game again, this time looking for the carrots. I'm for real, this game has been a hit and I can't believe I've already gotten 2-3 sessions out of it. I even was able to use it for grammar and language goals.

I also decided to make a visual for one of my kids working on using appropriate volume at home...it has a picture of a "loud lion" and "quiet mouse" to help them learn to self-identify their own vocal behaviors. You can get it for free right now for download in my Teachers Pay Teachers store!

                                                         Mouse/Lion Voice Poster 

I just want to encourage you guys, wherever you are, to keep doing what you can, with what you have, where you are, to quote one of my favorite sayings. If you are anything like me, your heart may be feeling a little heavy right now, but it is not anything you are not equipped to handle, no matter how much you may feel otherwise. Dig in your heels, do some killer therapy, and worry about the rest later.

The only things I can really control are my songs, and my behavior. The rest? If I focused on it, that would lead to insanity.” — Taylor Swift, in Glamour UK

Tuesday, April 15, 2014

The Train Ticket




I think some of you could agree with me that change is often just as hard for adults as it is for some of our kiddos. The only difference is that when they cry and throw a fit because something happened they didn't see coming, we let them off (sometimes) with the statement, "Well, it's a change in routine. It's hard for little guys."

Truth is, it can be hard for adults, too, especially when it is at least somewhat outside of our control.

And let me tell you, I hate not being in control.

I'm mad at the sun, I'm mad at the people who try and tell me to be okay with it, and I'm mad that I apparently can't self-regulate well enough to have faith that it will turn out like I'm told it will.

I'm questioning whether this is happening because of some fault inside myself and whether this is all my fault. Or if none of it is.

I'm questioning if God is punishing me in some sadistic way. And reassuring myself that this is not the case. And that I still believe He has good planned for me.

I'm trying to tell myself not to be sorry or apologize or suppress the feelings of the things I need and want.

People love to distract themselves in times of change and pain. Why? Because it offers them some sense of control. But right now, I don't care about getting a beach body, or taking up a new hobby, at least not for distraction purposes. I'm not trying to run my heart into the ground. I'm not interested in "proving" something to myself or anybody else for that matter.

Maybe in times of uncertainty the best thing to do is what I try and teach my kids to do: identify and accept that you're feeling afraid. Offer those feelings of helplessness up to God and let me tell you, He knows. He already knows. He will give you the strength you need at exactly the moment you need it.

                                                                        ~


“At last we heard Father's footsteps winding up the stairs. It was the best moment in every day, when he came up to tuck us in. We never fell asleep until he had arranged the blankets in his special way and laid his hand for a moment on each head. Then we tried not to move even a toe. 

But that night as he stepped through the door I burst into tears. "I need you!" I sobbed. "You can't die! You can't!"

Father sat down on the edge of the narrow bed. "Corrie," he began gently, "when you and I go to Amsterdam, when do I give you your ticket?" I sniffed a few times, considering this. "Why, just before we get on the train."

"Exactly. And our wise Father in Heaven knows when we're going to need things too. Don't run out ahead of Him, Corrie. When the time comes that some of us will have to die, you will look into your heart and find the strength you need--just in time.” 

Saturday, April 12, 2014

Chips, Ranch, & Easter Articulation Fun

Saturday. I've had a splitting headache since yesterday around 8pm and it has yet to completely go away.

That being said, I just had to make a run to Albertson's a little bit ago and pick up some tortilla chips, salsa and ranch dressing. If you're not from Texas or not from the South, you should know that this trifecta is highly addictive and popular among us women down here. You can find many of us sitting at Chili's just getting our chips and salsa on for hours. Personally, I started craving this yesterday at the onset of my headache and finally just decided to give in.


Now that my craving's been conquered and my head is throbbing just a little bit less, I wanted to let ya'll in on Friday therapy going-on's. All of my kiddos were "afternooner's" which gave me time to put together a fun, new Easter-themed game: "Articulation Easter Basket Hunt"!




Using our articulation words/bunny puppet from "Bunny Body Parts"...


Going on an egg hunt...


It's hard to see through my less-than-professional iPhone photography skills, but the idea is that you cut out the hole in the Easter basket and then the kid can move it across the other page and wait for either a carrot or egg to pop into the "viewfinder", so to speak. Then the kid simply produces their target word as many times as is indicated on the egg or carrot! I slowed the activity down by giving them an actually Easter egg to put in a bag as they produced their target word.

All my kiddos thought it was super fun and enjoyed moving the basket around in search of an egg (we only looked for eggs yesterday). Next week I'll be using the same game but have the kids look for carrots, instead.

You can download "Articulation Easter Basket Hunt" in my TpT for a buck or like & share the link on the blog's Facebook page for a chance to win it free! No one has shared the link yet so I will be extending the giveaway until tomorrow (Sunday) night at 6pm. So go share and be the first to grab it! Facebook page is HERE @ Speech-Love-Texas.

Is there a snack popular to your region that you just crave time to time? Is it my beloved chips and ranch?

Let me know in the comments along with your favorite Easter/Spring themed articulation activity floating around right now. :)

Have a fantastic weekend, ya'll!


Thursday, April 10, 2014

Free Spanish Artic download - Final /s/ Easter Egg Hunt/Coloring Page


This coloring page, featuring my amazing Sharpie artwork, is free in my Teachers Pay Teachers store for download!

This activity encourages children to identify the presence of final /s/ in one-syllable Spanish words. 

There are also 2-3 different shapes in each Easter eggs that the children can count for extra practice in producing final /s/ in the words "dos" or "tres" for carryover.

Hope some of you can find use for it!

Tuesday, April 8, 2014

I'm in a love/hate relationship.


I'm torn, Medicaid.

I love you, but I hate you.

I love your reimbursement rates, but I hate the way you don't listen to anything I say.

Doesn't matter how good my narrative is, you'll glide right over all that functional implication talk and zero in on my standard scores.

I mean, aren't I more than a number to you?

All I want is a little validation here.

The biggest complaint I have is your wishy-washy ways. You change the rules of our relationship faster than I can say compliance.

I guess the biggest elephant in the room would have to be a little something called...Home Exercise Program (HEP). You want me to implement one, document it constantly, and if I don't change things up frequently enough, you get bored with me and slap me on the wrist.

I need a solution. I'm not saying we need to break up...I just need to simplify the process so I can find "me" again.

That being said, here's my new plan:


This 11-page .pdf includes parent/caregiver hand-outs for seven common goal areas for preschool and early receptive/expressive language skills.

I also created a HEP Data Log that can be filled out by you and the caregiver on a session-by-session basis to track weekly HEP implementation. 

These hand-outs include practical suggestions for functional, in-home HEP activities for the following goals:

- Requesting
- Body Parts
- Clothing 
- Early Prepositions (in/out, on/off)
- Advanced Prepositions (under, behind, in front of, next to)
- Vocabulary (Nouns)
- Descriptors (Adjectives) 

All you have to do is make a copy of the data log for each child, give the parent a corresponding hand-out, and circle an activity.

Voila- simplified HEP implementation.  Check it out HERE

Please let me know if you check out this hand-out packet or have any questions!:) 

Monday, April 7, 2014

Bunny Body Parts + A Sad Tail (I Mean Tale)

I'm going to start this post off with a sad tale.

When I was 11, I had a German lop-eared rabbit named Nibbles. She was my pet and parent's answer to me and my brother's severe fear of dogs following the trauma of a dog attack. I fed her spinach, chocolate rice-krispie treats, and included her in family home videos over the course of a year together. 

We were a good fit.

One day, she got spooked by a cat outside and attempted to make a break for it through the closed door of her wire hatch, which didn't go so well. Nibbles paralyzed herself from the neck down and spent the remainder of her days watching me from pillow where she could only wiggle her little brown nose and gaze up at me adoringly.

Nibbles had a short life but a good one, despite a freakish and unfortunate demise. 

Moral of the story: you can't rehabilitate a paralyzed rabbit. Also, rabbits are good companions and fun for children.

They're cute, they're cuddly, and they're also an endless source of inspiration for April-themed speech and language activities. 

That being said, this morning I decided to get creative and put together a new printable activity called "Bunny Body Parts"! You can find in my Teachers Pay Teachers store here.




I chose to use this today to put together puppets with my kids to target some of the following goals:

Age 2-3:
- Receptive/expressive body parts
- Imitation of gross actions (pointing to body parts in imitation, placing corresponding picture to body part on self, actions such as "hopping")
- Requesting 
- Imitation of single syllables/words
- Spring vocabulary

Age 4-5:
- Articulation: /f/ in initial position of words ("Do his eyes go on his /f/ace or body?"); drill to receive each body part; received an "egg" for the bunny for each page of drill completed
- Possessives: "Who's eyes are these? His eyes." 
- Expanded sentence structure: "I want to glue the __________."
- Verbs/actions
- Pronouns: pick a verb card: "I jump. Do you jump? Do bunnies jump? They jump." 



Here is the final product also seen with some Spanish verb cards I used to target expanded sentences and actions. The kids thought it was hilarious to imagine bunnies doing some of the things we identified only people do, such as driving. 

I also brought along Play-Doh and Spring-time cookie cutters for a corresponding sensory/language activity. 

This download comes with all the pieces you need to make a puppet along with three bonus Easter eggs and a carrot for further reinforcement or activities.

You could also make each piece into a magnet and make a fun cookie sheet activity, too.

A couple things I should have done in advance to prep this activity:

a) Cut out all the pieces in advance and put them in baggies (unless your kids are older and can help, there are several body parts and the process is too time-consuming), and

b) Limit the number of body parts for little ones (i.e., only necessary parts such as the nose, eyes, etc.) 

Over all, these puppets got big "wow's" from all my kiddos. I used .39 cent white bags from Michael's which paired with the light/pastel coloring in the document made the activity very-cost effective.

Feel free to check out "Bunny Body Parts" and leave me any feedback if you decide to use it! 

Also, do you have any sad or strange Easter pet stories?


Thursday, April 3, 2014

Just Call Me Bret Michaels



I'm not going to lie. One of my guiltiest pleasures has always been trashy Vh1 reality TV, namely the "Rock of Love" series starring the great 80's rocker Bret Michaels. I typically don't find older guys attractive, but there's something about those blonde extensions that just speak to me.

Lately I've been re-watching the third season of the show, "Rock of Love Bus" in which Bret once again attempts to find true love by taking a handful of skanks on the road with him for a nation-wide tour. So here I am, watching this show, and it hits me- I AM Bret Michaels.

Exhibit A:

                       

Now, receptive language disorders are nothing to joke about. But does this not describe my everyday life? Bret exhibits some fancy communication skills unparalled by many men today in his attempt at facilitating conversation with individuals* who really don't have the capability to hold up their end of a conversation. It's uncanny the numerous times per day I am given the same kinds of blank stares I see on the show and I literally think to myself, "How much more can I possibly break this down?"

If I had Bret's blonde extensions, I'd probably want to pull them out from time to time.

*"strippers"

Exhibit B:



This is Rodeo from Season 2 of Rock of Love and here she's telling it to us straight what it takes to make it in the pediatric world. Bret, too, is a little bit country and a little bit rock and roll, just like myself. And he has successfully (from what I can ascertain) raised two children with only a cowboy hat and rockin' attitude. I'm still working on the cowboy hat, it kind of gets in the way with all the moving around I do but I know kids love me just cause of the vibe I put out there. Kids can tell. They KNOW you're a rockstar and will respect you for it.

Exhibit C:



Bret is analytical. He makes every attempt to understand a girl (however little there may be to understand) but isn't afraid to call them out on their bullshit when he knows he's reached the last layer of the onion.

I like to call this the, "Your Child Is Not Going To Grow Out of Their Non-Developmental Sound Distortions So Stop Arguing With Me About It" face.

Exhibit D:



Bret clearly understands that his hair is the source of all his power. I, in a similar vein, attempt to compensate for my lack of height with seriously long and vivacious hair. Except it's not vivacious, just long. Like I said, me and Bret, two of a kind.


Exhibit E:

"If at first you don't succeed, try, try again" goes the old adage. Well, Bret took three seasons of asking, "Wassa goin on'?" to discover exactly what was going on- he didn't really know what he wanted, or that at least what he thought he wanted was not functional for his daily life. Sometimes it takes me multiple go's at addressing a particular goal before I realize that what I want to do is not and never will be the right way to go about things if I want to see improvement. Maybe the best thing to do is to invite all my clients and their parents on the road with me. "Rock of Therapy Bus"? I can see it.


Exhibit F:

You can't turn a hoe into a housewife, and you can't turn a dysfunctional parent into a functional one in sporadic thirty-minute sessions.





Do you have any reality TV addictions? Can you relate to anyone as I do the Bretster?


I think I'll just start discharging kids by saying, "Your tour ends here."