Sank/Sunk, Whatever

Okay I'm back for a second post of the day with a really easy activity and FREE printable you can do to work on summertime verbs and past tense!

Sometimes you get really excited about an activity and then begin second-guessing it completely, like I did today. Whew. Dodged a bullet there.

The game is basically the whole "throw stuff in a bucket and see whether it sinks or floats" situation, and very simple to tote around.

All you'll need is:

A bucket
Water
A "surprise" bag filled with various age-appropriate toys; I included balls of different weights, cars, plastic eggs, pennies, etc.

I first introduced the visuals (flashcards included in the download) for "sank" and "floated" and explained the difference, how some things stay at the top of the water and some go to the bottom. We talked about how generally things that are heavy will sink and things that are lighter will float. Which led me to a very philosophical question...am I holding on to things that are too heavy that one day may cause me to sink? 

Alright, LD. Let's take a moment. Refocus.

Anyways, my kids thought it was hilarious to drop things into the bowl and pull them back out while getting their hands and clothes a little wet (which I attempted to minimize). I mostly focused on language scripting with my little ones such as "put it in", or with a more advanced kiddo, "I put it in the bowl." I also let them play in the water with the object and just have fun while exploring the different properties going on in there.

For my oldest kid (who is exiting kindergarten), we filled in the following worksheet and then read each sentence back. He loved being able to spell several of the words independently (car, ball, etc.) and then it was great to work on sight words/sound correspondences as part of targeting past tense for my own purposes. Triple/quadtruple win!

Grab the visuals and sentence structuring worksheet for free HERE in my TpT store! 

*Updated June 3rd to include Spanish versions of both the worksheet and visuals!*

And just for the record, it's definitely "sank". 

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!

Monday Musings

Good morning, guys!

It is the beginning of a new week and I am trying to find some motivation to get up and work out before my day starts. It is the last day of the month, and even though this day is usually cray-cray for us home-health girls I'm actually not too stressed. Kind of like I've done all I can do and now just have to let the chips fall where they may.

A few things I'm pondering this morning:

How true is this comic. I can literally see the horror in some patient's eyes when I try to "excitedly" introduce flash cards. Here's a tip: half of them can see past your fake enthusiasm. The other half, however buy in and I'm like, MUHAHA. You fools. You believed me! This is going to the most boring 10 minutes of your life.

I'm all out of this tea and oh so sad. I drink it every morning for the healthy caffeine and antioxidants and I suppose I could go to the store for more but...yoga pants. 

Speaking of yoga pants, these Nike ones (well I suppose they're technically sweatpants, but whatever) from Academy are my JAM. They were a birthday gift from the boyfriend and beyond comfy. 

In other news, I wanted to touch on my current love-hate relationship with Teachers Pay Teachers and the whole materials-making spree everyone and their Mom is on these days. I, too, have been attempting to make some products that are useful for not only myself but other SLPs but lately I have been completely overwhelmed by all the product sharing and giveaways I see on Facebook. 

Don't get me wrong, I LOVE all of the amazing products my fellow professionals are pumping out (that phrase is awkward and is going to bother me, I know it) but I simply do not have the printer ink as a home-based SLP to support this habit. I guess Staples is the answer? I don't know. My other issue is that I really do not use many paper-based activities with my kiddos, as most of them are under 5. My plan for future products includes mostly bilingual and lesson-plan resources that incorporate real-life objects along with visual supports. I think this will be what is most useful to me and other preschool SLPs.

If you are preschool SLP, what kinds of ready-made products would you like to see in my TpT store for download? I'd love to hear your thoughts. 

Have an amazing last day of March, everyone!

This Week as an SLP and Otherwise Regular Human Being

Alright, I swore up and down to steer away from personal posts and focus on speech-only blogging. But honestly I have nothing new to tell you guys, speech-wise! No wisdom (cough) to impart. Only maybe a few highlights of the work-week and musings of this speechie's brain.

I think I often get caught up in the fact that I'm not "the best". Therefore, everything I do "doesn't count." Does this ring true for anyone else? I don't have any great new speech units I'm employing or comprehensive Home Exercise Programs I'm implementing...I am honestly just doing my job. Still loving it. But wondering when I will get that burn again to stay up all night printing, cutting and organizing. Maybe when I have a real work space? Who knows.

Here's a peek into this past week:

1) A whole lot of driving to far-away clients. Like an hour away. Four days this week total, as of tomorrow. Here's a hint...the farther you have to go to see clients, the less sessions you will actually DO. I did take advantage of the existence of a Smoothie King on my drive today...Apple Kiwi Kale Smoothie, you won me over!

2) My first real peds feeding eval. You know you always expect in grad school and during your CF that any feeding evals that get thrown your way will most likely be sensory-based and you'll give the ole' chaining method a try. Then the parent mentioned something about a swallow study done a year ago indicating esophageal phase dysfunction and inwardly I just:

I want a new swallow study done. I wanna see if we're got any premature spillage going on here before I'm ready to hear that noise.

Anyways. Moving right along.

3) I got back in the groove of clean eating and working out! Let's all cheer for my attempts at not treating my body like the human equivalent of a dumpster. My go-to workout is this bad boy:

If you haven't done her "30 Day Shred" series, it's on Youtube and you should do that one first. That was the series of workouts I used in 2012 to get my body back after a long-term relationship in which I consumed far too many Dr. Peppers and stuffed-crust pizzas during Netlflix marathons. All good and and fine things in and of themselves. But turns out you have to move your ass to not put weight on in the process. Go figure. Anyways, "Ripped in 30" is a great in-home, 30-minute workout that truly kicks my butt and makes me feel strong. It combines cardio, weights, and abs for a total body training experience. I'm starting to sound like an infomercial. I just love Jillian Michaels. #sorrynotsorry

4) I started organizing my therapy materials by goals. Seems odd but not really. Sometimes I really just need to be able to reach into a file that says "body parts", "prepositions", etc. and pull out an activity or list of activities. Therefore I am making that happen. The sad part was I forgot that I needed file folders and everything just ended up in criss-cross stacks on the side of my wall. Sigh.



I didn't really do any "Spring" therapy things this week other than introduce the book, "Happy Easter, Biscuit!" which amazingly entertains even my kids up to 5 years old. They love opening the flaps to find the eggs with Biscuit.

Overall I am just trying to get in as many sessions as possible as it is the last Medicaid week of the month and for all of us in home health, the busiest week of the month. Thankfully we're getting an extra day Monday to get in those visits.

I hope you all have had a fabulous week! Do you have any recommendations for a feeding eval in which the end result turns out to continually be esophageal dysfunction? I'll take all the advice I can get. :)

Psst...my Abstract "Where" Questions download is free right now in my Teachers Pay Teachers store...I'd love if you snapped it up and left me some feedback!:)

Things I Accidently Taught Myself While Teaching Kids

There are a lot of times during speech sessions I will be working with a child and make a passing statement to them that causes me to think, "Man. I think I meant to tell myself that."

Here's a list of semi-profound statements I have accidentally made while working on some kind of mundane puzzle that made me stop and think.


"That piece doesn't go there. You can't force it to fit. If you push too hard, the whole thing might break apart."
Say hello to the queen of, "I am going to force this to work and if it doesn't, I will just keep trying."

"You're not using your thinking brain." 
When am I ever using my thinking brain?

"You need to wait."
Why wait when I can exhaust myself by doing anything in my power to force something to come to fruition?

"Just because we are scared of something doesn't mean there is something to be scared of."
I am the adult version of the little girl who is scared to use the other toilet in the adjoining room because one time it made a really loud noise that scared me sh*tless. No pun intended.

"Sometimes friends don't want to share or play with us, and that makes us sad. That's okay. We can find something different to do that is just as fun."
It's okay to be bummed out when people don't share our passions for things. Do your own thing and the people who think you're super awesome will support you in what you love.

"I need you to calm down and then use your words, please."
The best way to be heard: express your needs simply and concisely when you achieve a moment of clarity following an emotional experience.

"What's important in this picture? Is it this tree? Or this person in the middle."
What's really important in this situation you've somehow managed to blow out of proportion? Are you focusing on a tree in the background when the main idea is right in front of you?


We all still have lessons to learn as adults. I'm sure I heard these very things at one point in my childhood. I'm just thankful I get to hear them again, because they still make me stop and think.

Is there anything you say to your kids that you are really saying to yourself?

Home-Health vs. Private Therapy Settings: A Review

Good morning everyone!

I am back with a monstrous headache today, that as the SLP part of my brain identified, is running from my frontal lobe all the way to my left temporal lobe. The weekend was just a little too crazy (in other words, non-routine) and I think my brain spent most of Monday trying to integrate everything and re-orient to the usual schedule. Man, change really screws me up. Sometimes I really identify with some of my kiddos in that way. :)

Anyways, as I have been fortunate to have been able to dip my toes into several SLP settings thus far, I wanted to give you all a short "review" of home health and compare it to a clinic or private setting if you are curious about switching to either.

First just let me say, I love home-health. But I truly believe (like any setting) that the company, district, or management makes all the difference. It is definitely possible I would not be quite as happy working for another home-health company. And as we all know, every setting has their horror stories. The company I work for, however, is extremely ethical, caring, and an advocate for their therapists on a professional and personal level. I have been with them since my first semester of grad school starting out as an SLPA, through my Clinical Fellowship, and now as a certified SLP. I am blessed to be a part of the work they are doing. We offer ST, OT and PT, but the majority of our therapists are SLPs and SLPAs.

Pros:
- You can set your own schedule.
Only want to work 4 days a week? Only want to work mornings from 8-1? You got it. Provided you stay within the guidelines set by insurance (some require 2 sessions per week from day Y to day Z, cough cough, TMHP) and work with parent schedules, you can make clients fit into your preferred work hours.

- You can work as little or as much as you want to.
This is ideal for therapists who have children or want to split home-health with another setting. You can take on a part-time or full-time caseload depending on your availability. Full-time caseload is currently around 15 kiddos in my world. You can also pick up evaluations for extra money in nearby locations for treating therapists who do not have time to evaluate for whatever reason.

- You can choose to accept or decline a client (within reason).
Even if you choose to evaluate a child, you may be able to decline accepting them onto your caseload if you feel your caseload is too heavy or time restraints currently make it difficult to fit them in.

- Sessions are typically shorter.
In my experience, I found that while all my home-health sessions lasted 30 minutes in length, often my private setting sessions lasted up to 45.

- Compensation rates may be higher, depending on the company.
This may be relative on a case-by-case basis, but I hear many home-health therapists agree with this statement.

- You can target goals in the child's natural setting.
To me, this is one of the biggest pros. I love being able to show a parent how to integrate HEP (Home Exercise Program) into activities using the child's own toys and environment.

- Scrubs.
One word: comfy.

- You can stop at Starbucks in the middle of the day.
Self-explanatory.


Cons:
- You're in the car. All. The. Time.
Sure, you get to have some great car dance sessions, and you better believe I've had the time of my life during the summers belting out some Blink-182 while sipping an Icee on the way to sessions. But believe me, it gets old, and when your friends/boyfriend/husband mentions driving somewhere after work, even if it's 20 minutes away, you'll feel like bursting into tears.

- Some companies may not reimburse you for gas or travel expenses.
My company does not. However, I do believe my session rate is higher to compensate for this. I also use my personal vehicle for visits which obviously puts me at a greater risk for traffic violations, accidents, etc.

- You may not have access to a wide-range of materials or more expensive programs such as Boardmaker, like you would in a clinic.
Seriously, I am dying to get my hands on a copy of Boardmaker.

- The rooms of your home and backseats/trunk of your car will be filled with toys.
As I tell my boyfriend, I am a traveling preschool. I miss having an adult bedroom.

- You are isolated from other therapists/adults.
One thing I definitely miss about the private/clinical setting is daily interaction with other therapists, including OTs and PTs. Home-health can be lonely and you will have to make the effort to stay in contact with friends and other therapists so you don't get too bummed out.

- Parents may take advantage of the fact you are coming to them instead of the other way around.
I have experienced more cancellations in home-health than in private settings, in general. Because my company works with Medicaid only, I believe some families take advantage of the "free" nature of the evaluations, sessions, etc. and will cancel moments before you arrive.

- Every home is different in terms of cleanliness and overall atmosphere.
I have been in homes where I have fought off roaches while reading a story as well as homes that are nicer than those in North Dallas. It really is hit or miss. You just have to be willing to deal.

- You may have to fight the urge to stop at Starbucks in the middle of the day.
You don't need a grande Java Chip frappucino with no whip and extra drizzle every day after that session with Little Johnny but by golly yes you DO.

So there you have it. For me, the pros definitely out weight the cons currently in home-health. I know at some point I will attempt the schools again (I only did my internship there in grad school) but for now I am happy right where I am.

What setting are ya'll a part of right now? I'd love to hear along with a pro/con or two:)

There is nothing wrong with you.

I am going to try and tie this post into something speech-related so it makes sense in the context of this blog; however I believe this applies to the much bigger picture we're all familiar with known as life.

There is nothing wrong with you.

Ah, perfectionism. Being a perfectionist has its pros and cons.

The pros include always striving for the best version of yourself and striving to view yourself analytically.

The cons include always striving for the best version of yourself and striving to view yourself analytically.

Yes, these are both good and bad things in my opinion, simultaneously.

I grew up in a household that sought to make me feel accepted and loved for who I was, but at the same time never hesitated to point out where I feel short. Constructive criticism, you may say. But it instilled in me a very real sense that unless I attempted to alter myself in certain ways, I would not be deserving of love. Or support. Or acceptance. This is an exhausting, mental juxtoposition, one that the Christian faith attempts to soften with the concept of grace.

Society tells us to love ourselves for who we are but to never stop striving to better ourselves. When are you, as is, enough?

All I ever needed to know was that even if I didn't change, even if I didn't do this one thing, I would be loved and life would not cease to be fulfilling.

I had a youth pastor growing up who said something to me that has always remained lodged in my heart and has been a comfort in the face of such pressure.

He said, "There is nothing you can do to make God love you more than he does right now."

My friends, there is nothing wrong with you.

You are a human, and being human is hard. We have not been put here not to torture ourselves with internal and external pressures but to rest in the grace that God offers that says we are enough. 

We beat ourselves up for lack of achievements but hey, you are still living! You are still working at this thing called life! And God has not forgotten you.

I'm not saying there is anything wrong with formulating and working towards goals. That is an integral part of my life as an SLP.

But when those goals become so significant that they cloud our ability to appreciate ourselves for who we are today, I think it's time to sit back and rest in the knowledge that you will never be the best. Or the worst. And no one expects you or thinks you to be either. It really doesn't matter.

Happiness matters. You matter. So before you internalize outside pressures or expectations, sit back and remind yourself that the only one putting that pressure on you is you.

I am seeking to live life in balance. And I believe remembering that regardless of whether you got that workout in, or felt like you blew that evaluation or session, you are simply human. Which is nothing to be ashamed of.

There is nothing wrong with you.

"...i mean really. what is the the thing you are good at? what's your thing? what's the thing you use to make you feel like you're great? take it away, do you still think you're great? because you are." - jillian edwards chapman (http://ifyoufeellikereadingit.blogspot.com)

How To Get Your Motivation Back (Therapy-Wise)

Across my adult life thus far, since graduating high school, I have struggled with continuous low-grade depression. It affects me to varying degrees daily, and often I feel like my attitude towards work and life and general can be affected by things as insignificant as whether the sun is literally shining or not. I'm working on this.

One thing I continually come back to the drawing board on is how to re-gain my motivation in regards to work. Some people may find this strange; after all, you went to the effort of getting a Master's degree in your field, you must love your job! And I do. But home health can be very isolating; you have a lot of time to yourself to think; a.k.a., ruminate on your problems. Long drives between sessions become pressure cookers for insecure thoughts. Or Britney Spears karaoke sessions. It really is either or. Anyways, this isolation and time spent driving can lead to a monotony that slowly drives you insane. I am sure there are plenty of home health therapists that travel very short distances between clients but I am not that SLP. My closest client is 8 minutes away and my furthest is an hour and fifteen minutes.

However, there are a few things that help me find the joy in what I do on days when I just don't know if I can handle another 30 minutes working on past tense verbs again with the little guy I have seen for several years straight. When 30 minutes seem like the longest 30 minutes of my life. One of them is telling myself that I'm a badass. A la Leslie Knope.

On top of that, here are some of my go-to strategies:

1) Take 10 minutes to print out a new themed cut/paste activity and make enough copies for all clients. Check out Teachers Pay Teachers and bring one new activity or toy to therapy today. 

Seriously. Stop using that same deck of Super Duper cards that only makes your kids cry and you want to hit your head against the wall. Even typing in "preschool March cut/paste" into Google can give me something quick to print out so I don't have to face the monotony of my usual go-to materials.

2) TREAT YO SELF.

Bring a new snack (aka bribe yourself with food, usually works for me) or stop at Starbucks for a midday pick-me-up. Being able to look forward to a treat or something relaxing in the midst of a busy day will help carry you through. I like to download The Jillian Michaels Show podcasts. New podcasts automatically download every Tuesday and therefore every Tuesday I actually look forward to my long drives so I can listen to this show. 

3) Emotionally re-invest in your clients.

Stop thinking about that one client as the 3-year old who's been working on past tense verbs for like forever. Instead, sit down and make a new game plan. Imagine this child finally mastering their goals and becoming functionally communicative in the way you want them to be. Remember their names. Enjoy their personalities. Think about them as if they were your own children before you scold them for scooting around the living room every second of the session. Love on them. 

4) Come up with a new game plan. 

In grad school when I was an SLPA and had only 3-4 clients, I used to come home and think through each child, their deficits, and formulate how I could use very effective activities to get them in and out of therapy fast. I had a lot more time on my hands, obviously. Regardless, consider coming up with three new activities to target goals you're just over, so you can feel more effective during therapy and break up the monotony.

5) Clean out your car. 

Home health speechies, I know you feel me on this one. Hey, who knew you had these auditory awareness dry erase worksheets in there?! It's amazing what you can forget you're lugging around after weeks of dragging toys in and out of your trunk and backseat. Pull everything out, take an inventory, make sure you're carrying only what you need, and then replace worn-out toys and activities with new and exciting ones. 

Also throw out all those Starbucks cups and fast food wrappers. That will be helpful in maintaining your sanity. 

I hope some of these ideas help shake things up for you. And when you're all alone in your car, drinking an Icee and eating another bean burrito from Taco Bell, driving an hour to your next session...know I'm here for you, girl. 

Lindsay

So You Want Full Auth

Most evaluating speech therapists are familiar with the struggle to obtain authorization for their clients. Personally, I operate in home-health, and deal with Medicaid only. As is widely known, different providers operate under different guidelines for authorizing speech therapy services which continually change. Some of the trends that I have noted as a therapist include:

- Minimal to no authorization for stuttering therapy;

- Denial of clients with standard scores lower than 75;

- Denial of clients whose scores appear to "regress", although they have celebrated a birthday since their last re-auth and now fall into a new bracket of standard scoring;

- Partial auth approval with high emphasis on implementation and documentation of a Home Exercise Program (HEP); and/or

- Partial auth approval (1-3 months) with request to re-evaluate with the same standardized test.

This can be frustrating as a therapist, especially when you have a client who performs well on formalized items but falls apart in carryover or whose true areas of deficit are difficult to test formally. 

While I still am forced to deal with my own share of partial auth's and denials, there are a few things I am careful to include on all evaluations in attempt to win at this game we call "authorization."

1) Magic Words:

"Medically necessary."

"Spontaneous recovery is not likely based upon..."

"Implementation of a HEP."

"Cannot communicate wants and needs in a age-appropriate manner."

If you want to get the attention of providers, you have to speak their language. Make sure to include key terms in your summaries that readers look for when approving evaluations. I like to especially note that a child's errors are NON-developmental and therefore spontaneous recovery is unlikely, as many people still hold to the "they'll grow out of it" theory, especially when standard scores walk the line around low average to moderate. 

"Medically necessary" is a funny term. You can mention that in relation to a formal medical diagnosis or towards aspect of their deficits that is more specialized and requires formalized instruction, such as apraxia or hearing loss. 

For children under 3, you might need to highlight why Early Childhood Intervention may not be preferable to private or home-health services, if you are operating under that sphere. I like to note the difference in frequency of services between the two settings and whether or not the parent is specifically requesting home-health or private services.

2) Highlight informal implications of the child's deficits, such as an inability to communicate on an age-appropriate level with peers or safety implications.

Personal safety is always a good argument towards working towards communication skills.

3) Mention whether this will likely be the last period of authorization requested for the child, based on expected progress. 

This is obviously not possible for every child, but for children who I have had on caseload for a while and/or plan to discharge, I might note this if appropriate.

4) Include informal speech samples whenever necessary.

Seems obvious, but taking a short, paragraph-length speech sample can bring out aspects of the child's speech that was not noted through formal items. Personally, I have a child that struggles with word-finding on common vocabulary at times. Informal speech samples can bring these types of errors to light.

5) If standard scores are near or above 75, consider re-testing with a less sensitive yet appropriate test.

For example, the GFTA-2 is often too sensitive for my little guys 4 and under. If they score below 75, I will often follow up with the CAAP. For the PLS, the CASL or CELF can be a good follow-up since it uses subtests. 

And there you have it! Some of my favorite authorization tips and tricks. 

Let me know in the comments what you've found works for you!

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?

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!

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. :) 

Getting the "Talking Train" Moving: Tips for Working with Nonverbal Toddlers

Hey, everyone!

Lately I have been working with several toddlers who demonstrate moderate to severe expressive delays and have played around with numerous techniques to get that "talking train" moving. I've finally compiled a list of what I find to be the most useful techniques that I have self-employed and expressed to parents.

1) Encourage vocal play.

This includes squeals, animal noses, syllables/syllable repetitions, and onomatopoeia, in general. A good way to do this is by demonstrating play in front of the child using objects you have at least 2 of, so you can act out an action w/ a corresponding sound and then pause for the child to do the same. My favorite game is to take farm animals and have them take turns “eating” hay (“mm-mm-mm” or “mumumumum”). Integrate the sounds the animals make, and then when they are “done’ eating, push them away and wave, “bye bye!”

2) Use predictable play sequences with consistent sound usages.

For example, in the play routine I described above, I have about 5 animals at my disposal. I do the same play routine with each animal so the child learnsthe routine and therefore anticipates what will happen next, and eventually, hopefully, will chime in imitatively or spontaneously, perhaps with some pausing. 

The routine looks like this:

1) Pick up animal - expressively give animal sound: “MOO!”

2) Make animal eat hay - “mumumumum”

3) Push animal away - wave + “bye bye”

Once the child begins to master/participate vocally within this simple sequence, you can expand on it. For instances, I bring in a bed and we put each animal to sleep and say, “night night!” after they’re doing “eating”.

3) Keep in mind early developing sounds when choosing target syllables/words to approximate.

Use 1-2 word models that contain EARLY sounds.

For instance, I will generally encourage a child to say, “moo” before encouraging “cow”, because /m/ is a target sound at this point and /k/ is not. Once the child will imitate syllables and/or is attempting word approximations, you can start expressively labeling with greater precision. I will usually start introducing the animal, for instance, as “COW! Mooooo.”

4) Integrate play routines that prompt the child to say the same syllable or approximation multiple times at the BEGINNING of the session.

This means using a syllable or word approximation that the child uses semi-consistently to get the TALKING TRAIN GOING.

For instance, I often use a shape sorter for this kind of thing. We sort the shapes and after each one, say “done” (usually “duh”). There are enough shapes to get at least 15 approximations in a relatively short amount of time. This gets the kid talking EARLY in the session. In other words, I like to start with activities I know the child will participate verbally in before integrating new vocal play or verbal play routines.

This is certainly not by far an exhaustive list but just some things that I have found significantly productive.

What I want to know is: what are some of your favorite tricks for getting those nonverbal kiddos to begin vocalizing?

Leave a comment down below and let's get talking.