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.

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?

Concrete vs. Abstract WH- Questions

So here's the dealio.

I learned something during my final semester of grad school internship in a Spanish-only Early Childhood Education school that I still think about on a daily basis.

And I wanna break it down for ya'll.

And when I say break "it" down, I mean this WH- question business.

Now I'm sure this is old news to most of you, but somehow I managed to get through almost the entirety of my SLP education thinking there was only one type of WH- question and one way to write these goals.

"Child will answer WH- questions with a complete sentence with minimal verbal/visual cues and 80% accuracy."

Or if you wanted to get really fancy:

"Child will answer 'what' and 'where' questions with a complete sentence and minimal verbal/visual cues and 80% accuracy."

Most therapists are familiar with designating the appropriate type of WH- question depending on the client. I'm not working on "WHY" questions per say with my 3-year old's, per say.

However, I was encouraged back in grad school to think of targeting "questions" within a different kind of hierarchy; that being:

1) YES/NO questions to accept/reject ("Do you want the car?");

2) YES/NO questions to affirm/deny ("Is this a car?" or on more advanced level, "Do we fly cars?");

3) Concrete WH-questions ("What is this?" "A car."); and finally,

4) Abstract WH- questions ("What do you ride in to get to school everyday?" "A car.")

As much as I love Super Duper and Linguisystems and all the products they churn out, every time I download an app for targeting WH- questions they all seem to target the more abstract spectrum of questions and geared more for the elementary crowd. As I am primarily a preschool/early intervention therapist, I needed to find some materials that brought things back down a notch to the emerging abstract level for my little guys.

So I made this. So fancy. So excite.

Abstract "Where" Question Cards for Pre-K

This is a set of 15 "WHERE" question cards with matching realistic photo prompts to allow you to provide as much assistance as desired or needed. They're sitting over in my Teachers Pay Teachers (TPT) store if you'd like to take a look. 

I am super excited to start learning how to make more of my own therapy products that fit my individual needs as a therapist. Let me know if you decide to try these cards out yourself and if you find them helpful. I also plan on creating other WH- question card sets for "WHAT", "WHO", etc. so if anyone is interested in those too give me a shout-out.

I mustache you a question: WHERE do you like to go for your WH- question targeting needs?:)