Wednesday, September 7, 2016

Using Spaced Retrieval/Delayed Imitation to Foster Learning in Pediatric SLP


If you're a geriatric/adults SLP, you're probably familiar with the concept of "spaced retrieval". Even as pediatric SLPs, however, we sometimes use this technique (most often unconsciously) to develop a child's ability to independently respond to questions. Most frequently, it just looks like drill or repetition of a concept:

Ex.:
SLP: "Where is the frog swimming?"
Child: No response.
SLP: "In the water!"
Child: "In the water."
SLP: "Where is he swimming?"
Child: "In the water."

So the child is exposed to the question and then answer, after which they are typically able to answer "independently", although the truth is they are answering in delayed imitation. Which is fine, totally great! I wanted to explain how I used the technique of spaced retrieval/delayed imitation for a 3-year old today who has been unable to name objects on command for quite awhile, despite the fact that she responds appropriately to directions to interact with said items and her imitation skills are intact. It's almost as if her short-term memory or retrieval abilities are somewhat delayed. Typically, or previously, our verbal interactions looked like this:

Me: "What's this?"
Child: "What's this?"
Me: "Cow."
Child: "Cow."
Me: "What's this?"
Child: "What's this?"

Working on vocabulary development with animal friends.
As you can see, this interaction is different from above in that she was not able to hold onto the semantic content long enough to respond appropriately to my question. I should note I'm making this assumption based on the fact that she is not "echolalic" in the true sense or in any other context as well as the fact that I know her comprehension skills are much higher than her expressive language abilities. Today, I utilized the technique of spaced retrieval/delayed imitation. Essentially, we repeat the question/answer format 2-3 times, quickly. Any significant pausing will impact her ability to respond correctly in delayed imitation.

Me: "What's this? (quickly) Cow (stressed). What's this?"
Child: "What's this?"
Me: "Cow."
Me: (quickly) "What's this?"
Child: *thinking* "Cow!"
Me: "Cow!" (pat on the back, visual excitement/verbal reinforcement).

We did this exchange for the majority of our noun targets today. I found that as time went on, we only had to go through the question/answer sequence about 2 times, and at this point, I started using more spaced retrieval to encourage her to hold the word longer in her short term memory. It looked like this:

Me: "Cow. (stressed) What's this? (quickly)"
Child: "Cow."
Me: pause 1-2 seconds..."What's this?"
Child: *thinking* "Cow!"
Me: "Cow!" (pat on the back, visual excitement/verbal reinforcement).

My hope is that the longer we continue using this spaced retrieval format, I will not have to go through the question/answers more than 1X (as in the example at the top) and can gradually add time to my second prompt to increase her semantic memory until finally she *learns* the name of the object and is able to label independently or following a WH- question.

Tell me: do you see delayed imitation skills as part of the learning hierachy for vocabulary? Have you used "spaced retrieval" with kids on your caseload recently? Chime in in the comments below.

Until next time,
L.L.

Monday, September 5, 2016

Falling Back Into The Groove

falling back into the groove (for lack of a quirkier title)...
speechlovetx.blogspot.com



Whew. It's really been a minute since I've taken the time to blog, but something about having the house to myself, four cuddly cats, and a vanilla sweet cream cold brew from Starbucks is making me want to write. So here we are. Hi everyone out there! I started this blog in the Spring of 2014 when I was a single, newly- licensed SLP driving an hour + back and forth each day as part of my home-health gig, and here in 2016 I am a married cat mama of four ridiculous little ones (see picture below) still working in home-health (with a company I love) and driving a whole lot less, thankfully. I'm now supervising and while that has been an adjustment it has been a welcome challenge. If I decide to continually update this blog, it may be gradually punctuated by more personal posts or I may start a completely new blog for that purpose all together.


when you try to take a family photo
but the kids start fighting on your lap.
So September. I always get so excited when Fall hits because ironically I have more Halloween therapy materials than for any other season. It's just such a language-rich time and there are so many verbs to describe the season with- scare! rake! jump!. I love it. I have to say though, I do want to take advantage of this time before Halloween truly hits and just enjoy the transition. We miss it so many times, in our excitement for October when the chilly air finally hits in Texas and it truly feels like Fall. This morning I blasted myself with cold AC in the car just to simulate the experience. And it worked. lol But I really think there is beauty in this in-between time when there's some warmth to the air but you're just getting a glimpse of changing colors and it's almost in your grasp. Gah.

So this month I will be trying to find some early Fall activities that are more "school-starting" and less Halloween-y for the time being. If you missed it, I have an awesome "Fall Choice Trees" product which is essentially a First-Then board that looks like a tree with the choices being leaves, and contains both English and Spanish versions. Check it out if you care to.

What I'm loving this month so far...

Drink: Vanilla Sweet Cream Cold Brew. Duh.
Therapy Toy: I'm really digging books, ya'll. I know, groundbreaking. But I love seeing how the kid attempts to "read" me the story before implement some verbal scripts and then after a week the language that they use to describe the pictures. I like to tell parents to read their children books using the same language each time and then turn the book around and say, "Now you tell me the story," giving hints with small words such as, "And then..."
Therapy App: Oh boy. I haven't bought many apps lately. I use Articulation Station a ton though and the My PlayHome app for language scripting and everything in between.
Therapy Activity: I enjoy using this backpack coloring page for a cut-and-paste this time of year using artic pictures:
Get it here!

And that's all I've got for now. Besides a couple of evals I might be putting off by writing this post...:)

Until next time,
LL