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.

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

Scrambled Sentences! {no prep therapy}

If you're like me, you love therapy activities that require minimal to no prep, especially on Fridays! I wanted to share one of my favorite go-to language activities called "Scrambled Sentences". All you need is a piece of paper and a pen!

This activity can be used to target the following goals:

- Sentence structure; (duh)

- Judging whether a sentence is grammatically correct or not;

- Expanding basic sentences using modifiers and the like;

- Tense and other parts of grammar;

- Sight word recognition; AND

- Articulation practice depending on your choice of words

This activity works best for children kindergarten and up who at least are beginning to decode words and utilize sight words for reading. The first-grader I use this activity with loves using his emerging literacy skills and I will usually prompt non-frequent words after allowing him to attempt to decode the word initially. You could also do this activity using Boardmaker pictures cut up and scrambled for non-readers. :)

All you do is simply:

1) Write a sentence on your paper containing either language or articulation targets and then tear off the words one by one. 

2) Allow the kiddo to "shake, shake, shake!" them up in their hand and then let them re-order the words into a complete sentence. In the picture above I used sentences to help my friend describe his day at school using past tense words. After we order the sentence correctly we usually read it through 1-3 more times.

That's it! It's like a puzzle you can make on the fly and it really gets kid's brains thinking on multiple levels. Hope someone else can make this activity work for them!

Scoopin' Up Final Consonants! {+ cat-assisted therapy organization}

Hello, all!

It's been a minute, I know. I'm sure you guys are all caught up in summer-time therapy as am I! What have I been up to exactly? Well for one, I have been organizing the mountain of therapy activities, worksheets, and resources in my bedroom. It isn't the most convenient set-up, but hopefully in a few months here I will have a second bedroom to transition into an office. Until then, I work/sleep/watch Gilmore Girls all in the same place.

Ava, my kitty cat, helping me organize my Spanish articulation worksheets.

How are cute are these folders?:) 

Part of organizing my Spanish articulation materials was challenging in that I had to re-research all of my Spanish phonemes and organize them in order of typical acquisition, which was confusing as I usually have English on the brain. 

At one point in going through all the paperwork, I found the therapy plan I wrote from my first day as an SLPA back in 2011. I had a moment thinking about how far I've come. Also thinking about how much more prepared I was back then, haha. 

Last week my theme for therapy was ICE CREAM!:) 

We talked about related verbs (melt, freeze, lick, etc.), watched Youtube videos of ice cream melting, and used my new "Scoopin' Up Final Consonants!" packet! 

Find it HERE on TpT:) 

I created this packet because I have a couple kids with several phonological processes right now, namely final consonant deletion across multiple sound classes. They are able to focus on suppressing one final consonant in a given phrase but when multiple final consonants come into play something gets left out. I created an activity where the kids can combine words with various final sounds and then pronounce them one after the other in a phrase structure ("On this cone...") with increasing speed to aid in development of motor planning. 

The packet contains stimulus pictures for phonemes /n/, /t/, and /k/ on vanilla, strawberry, and chocolate ice cream scoops. The stimulus pictures range from 1-3 syllables for the greatest variety of targets and difficulty. 

Overall, there are three parts to the packet:

1) Auditory Discrimination: 

    The packet comes with 3 sorting mats for phonemes /n/, /k/, and /t/, which you can see above. I mixed all     the stimulus pictures up and then produced each word and asked my kiddo to identify the final sound by       adding it the correct cone. I also purposefully deleted final consonants in several of my own productions to     see if my kiddo could catch it to help foster self-monitoring skills.

2) Production Practice: 

    When all the cones were finished, we drilled all the words at phrase level using the cones. Then, my kiddo    received his own "final consonant cone" for which he requested ice cream scoops from all different final     

   sounds to glue to his paper. After he was finished, he "read" his entire cone while self-monitoring for final 

   sounds in connected speech.

3) Pattern Practice:

    There is an additional worksheet that includes 4 cones that have various ice cream scoop "patterns"         

    (pink, white, pink, what comes next?) that the kids can complete and then produce the colors of the               scoops in order for more motor planning practice. 

My kiddo had a lot of fun writing the final consonant in each word on each scoop as he went to help prompt himself. :)

I also used this packet for my language kiddos in that we worked on naming each stimulus picture/scoop, requesting them to glue to our ice cream cones, using expanded language to describe objects, talk about preferred flavors, etc. It's just an all-around win in my book in that I can take it to nearly all my sessions and make it work.

That being said, I am having a FLASH SALE on this packet right now along with my Summer "On the Road Again: Beach Edition Activities for Artic and Language" in my TpT store until the end of the day tomorrow! 
That means you can get both of these great packets for only .80 each and have activities for next 2 weeks ready to go. :)

I'd love for you to check them out!

What products are you loving for summer? Did anyone else utilize an ice cream theme?:)

Guess Who's Back, Back Again

It's not Eminem. It's me!

Yes, I know you can hardly believe your screen but it is I, LD, CCC-SLP, coming to you in the flesh...in the form of a blog post. I took a self-imposed blog vacation because simply I was burned out. And that's okay, and to be honest I don't feel bad about it. As all of you home-health therapists know, end-of-the-month is a little bit cray. Here are some of the things I have been doing therapy-wise lately:

Watermelon Week
- Classic color, cut/glue seeds to a watermelon slice found on Google images;
- Integrated language and fine motor activity of scooping watermelon "seeds" from a bag using a spoon and walking them across the room to put them in a bowl without spilling them;
- Language activities related to "Mouse's First Summer", in which they eat a giant slice of watermelon.

During one session, I experienced this little gem:

"Uh oh! What did she do?"

"She's drowning!" 

Lol I mean let's not get ahead of ourselves, I'm not sure the situation is that serious.

Other than that I've been piecing together the most random activities, from using alphabet puzzles to target final consonant deletion by sorting them into groups of final sounds, to frantically searching for Barney songs online during a session on my phone to quiet a screaming child. It's been fun.

I also put together a new all-in-one articulation and language packet for the Summer! Rather than re-state myself completely, here's what I had to say about it on TpT:

On the Road Again! (Beach Edition)

This summertime speech packet is part of a vacation series! In this "Beach Edition", you'll receive 10 pages of easy-to-implement themed activities for preschool and elementary including:

- Visuals for transportation/locations: "what", "where", and "how" questions;- "What Should I Pack?" cut/paste game for categories, wh- questions, different/same/sorting, attributes, negatives;

- "Beach Ball Past Tense Flashcards" for regular/irregular verbs related to playing with beach balls (easy functional activity) along with matching for colors or requesting using 1-2 attributes in a Go-Fish-style game;

- "Shell Search"- Using a shovel for a "viewfinder", kids can search for shells in the sand and then produce their target word the number of X pictured on the shell;

- Cut/Paste Bucket for corresponding cut/paste to "Shell Search"; provides choices for the child to analyze their own speech and need for prompting such as: "I feel like using my speech sounds was ___ easy ___ a little hard ____ tough today." Great for /sh/ kiddos, obviously. :)"Shell Search" can also be used as a simple cut/paste activity. I recommend laminating it, however, if it will not be used in that fashion.

Stay tuned for the "Camping Edition" coming soon!:)

Yes, I was quite excited upon putting together the packet. Hence the exclamation marks. But for real, this packet will stretch me all week and I hope at least one of you can get some use out of it, too.

In non-speech news, I have been:

- Working out more frequently. I just joined FitFusion.com which is a subscription-based service that is essentially Netlfix for workouts. And I love it. All of Jillian Michael's workout DVDs are there, including her new "1-Week Shred." I did the strength workout for the first time last night and it kicked my ass.

- Eating enchiladas like they're going out of style. I just learned how to make them. I won't shut up about them. Ask my roommate. 

Grass-fed beef enchiladas and a very frozen margarita. My manifesto.

- Enjoying these screen caps/quotes from "How To Lose a Guy in 10 Days". One of my all-time favorite movies that I would integrate more in daily conversations if I could.

- Feeling this tweet. Even though the handle "The God Light" is a little much.

And that's all I got. For now. :) Have a great week, ya'll. 

Happy Sunday! {what I'm loving & new expressive language game!}

Oh this weekend. I've been literally going non-stop, I don't know what has me so full of energy but I'm going to roll with it. Maybe it's my morning green tea but something's pumping through my system making me want to be productive. Who would've thought?:) Maybe it's my #slp bracelet...

I bought this customizable bracelet (made by BCBG Generation) from Macy's in December. It comes with a bazillion gold letters and symbols that you can arrange in any way you'd like; I decided to rep SLP life. I've worn it off and on to sessions but I've been wearing it this weekend and getting a kick of motivation out of it. So cute, right?

Yesterday my roommate and I ran a few errands and then I kicked out a re-eval report, all before 12pm. This is not my usually way. I am the hugest procrastinator but I think I'm starting to realize that that method doesn't do me any favors. Afterwards I got a workout in and did some grocery shopping at Whole Foods. My favorite find was the fajita meal combo they have going on right now- buy the fajita meat and get the veggies, salsa, and tortillas for free! So that's what we cooked up last night. I also tried out a new flavor of kombucha, Green Apple Ginger by holykombucha:

Yum. I actually blended that up with a bit of the that delicious coconut-pineapple juice next to it, added some ice and made a kombucha-rita with a pina colada flair! It was a great addition to our fajitas.

I'm really feeling coconut lately, that's probably why I love this shower cream from The Body Shop.

It is not a "soap" and therefore not drying; instead it's incredibly creamy, moisturizing and has me dreaming about a beach vacation.

Later that night my roommate and I just kicked around and I decided to get to work making a new game for some of my older language kiddos:

"Information Detective: Wh-at's Missing?"

I have a few kids who continue to struggle to provide crucial and relevant information in their discourse, or who use imprecise language such as, "I went there and then played that game," without giving me the head's up of actually where they went or who they were with. I get no context for their stories. This game puts you kiddos in the role of a detective who has to listen to a friend's statements about their weekend and decide what information is missing. They can then work to devise a wh- question to find out the missing information. A table is also included for them to fill in what they know and what they still need to know. 

What are you guys loving this weekend? Do you like kombucha or do you think it's the grossest thing ever? Most people fall on one side of the spectrum or the other, haha.:)