In our speech room we use it to work on:
- Parts of speech
- Multiple meanings
- Expanding vocabulary
Happy Monday Morning! I know many of you have started summer by now, but here in San Diego school is still going strong. As the regular year starts to wind down I really start to look at ways to maintain skills over the summer, and giving families ideas about great apps that are fun and still educational is a favorite tip of mine. I think when you can bring a family together by playing a game and maintain skills- its a homer for everyone One of my favorite ways to work on parts of speech, semantic relationships, and multiple meanings is Mad Libs. This free app is a fun new way to use Mad Libs with students- and a MAJOR bonus you can do them more than once, sometimes we compare our first run to second using screen shots or email.
After you choose a story the app prompts you with the parts of speech. You enter them one by one and create a quintessential, crazy MadLibs story.
Once you have completed the story you can share it or just enjoy as a group!
In our speech room we use it to work on:
Valentine's Day Themed Snake Craft
This is a long-standing favorite craft of mine. As many of my favorite ideas do, this one came from my dad who taught Kindergarten for many years. It is simple, cute, and kids get really into it. Below are some of the results from my artists this year, as well as ideas for how to use the activity as a tool to support speech and language.
1. Prep: Cut out a bunch of hearts in three or more different colors. When I was interning at a school, I was able to use the shape cutters in the teachers' supply room. This year, I just printed a random heart outline that I liked and traced it onto the paper. To save time, I folded each paper in half length wise, and then folded that into thirds - for every cut I got 6 hears and used a whole sheet of paper. As usual, I recommend grabbing whatever you have lying around for decorations; in this case I used googly eyes, string, and a pen.
2. Starting with the tail, glue hearts one at a time so that each point overlaps the previous heart's top (see top image below, the tail is to the far right). I did 9 hearts for the craft, so that we could use 3 of each color. Once you have them all glued together, you can leave them as they are, or flip the snake over. If you choose to flip the snake over, I like to put another heart on top to make the head stand out (see bottom image).
3. This is where things get creative. I had intended for these to be lateral/profile views of snakes, but the preschoolers couldn't seem to wrap their heads around only giving the snakes one eye. I loved that kid after kid after kid insisted on the same adaptation (two eyes). It was also fun to see which kids wanted to add features like a nose or hair - and those that thought the suggestions were hilarious, because "nakes don't have hair", etc. I tried to intervene as little as possible when it came to putting the crafts together - in the end, each piece turned out to be unique, and perfectly imperfect.
When building the snake, you can easily target sequencing, modifiers, phrases, requesting, following directions, answering questions, making choices, taking turns, plurals, negation, executive function, retell/narrative, or just about any other language goal. For some of my kids, we were aiming just to get through 10 steps without having a breakdown.
Have fun with this easy and adorable activity - I'm sure you'll end up with "snakes" "nakes" "sakes" and "fwakes" that could brighten anyone's week.
“You can’t use up creativity. The more you use, the more you have.” – Maya Angelou
Interprofessional Collaboration - Why And How
Speech-language pathologists (SLPs) work alongside a plethora of allied professionals across medical, private practice, research, home care, and school settings. Due in part to existing systemic structures and impacted curricular programs, service providers have historically worked parallel to rather than in tandem with each other. Recently, there has been a cross-disciplinary initiative (initiated by the WHO) to provide better health services through collaboration. We at Inspired*In*Speech believe that this is a critical movement that will ultimately benefit patients as well as providers across the board.
Why is this so important?
In the traditional health care model, practitioners are trained to adopt the social and educational perspectives of their chosen discipline. Each disciplinary perspective incorporates a unique set of theoretical and practical principles that shape clinical practice (D’Amour, Ferrada-Videla, Rodriguez, & Beaulieu, 2005). Highly trained and skilled professionals may be aware of but not truly knowledgeable about other disciplines that serve a shared population of people. Moreover, many work environments are not conducive to wide-scale coordination. The unfortunate result is a segmented system that has been proven difficult to reform (D’Amour et al., 2005). On a more concrete level, this lack of synergy has resulted in may problems that directly impact the people who we are all trying to help:
If this is such a big problem, why haven't we already fixed it?
There are significant challenges that practitioners face when it comes to implementing true collaborative practice.
One substantial barrier is the current model of reimbursement. The fee-for-service reimbursement model has worked sufficiently for parallel service delivery, however time spent co-treating and meeting with professional collaborators is not always compensated (Rodgers & Nunez, 2013). This reduces incentive to prioritize collaboration, and even sparks competition to earn what compensation is available (Rodgers & Nunez, 2013). In my experience with private clinics, most insurance companies will not reimburse for collaborative sessions because the professional to client ratio would be 2:1. This is unfortunate, because many children could maximize their response to treatment if dually treated (such as occupational and speech therapy).
There are also a number of less structural but equally robust barriers to allied treatment. Functionally, it is difficult to coordinate schedules, especially when coming from different locations of service. There are also social caveats that obstruct progress. For example, the lack of intimate knowledge and/or respect of different professional contributions can lead to perceived hierarchical standings. For example, a doctor, nurse, and SLP in the hospital all have different but critical roles in their patient's recovery. The doctor’s extensive medical knowledge, the SLP’s expertise in swallowing, and the nurse’s intimate knowledge of the client must all be valued equally and incorporated into the treatment plan. If any of those team members feels devalued, the triad of care is compromised.
What can we do to support progress?
This is clearly an issue that requires global coordination towards systemic change. Fortunately, there are a number of things that professionals can do right now to promote better collaborative practice.
Constantinidou F., Wertheimer J.C., Tsanadis J., Evans C., & Paul D.R. (2012). Assessment of executive functioning in brain injury: Collaboration between speech-language pathology and neuropsychology for an integrative neuropsychological perspective. Brain injury, 26(13-14), 1549-1563.
D’Amour, D., Ferrada-Videla, M., Rodriguez, L.S.M., & Beaulieu, M.D. (2005). The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. Journal of interprofessional care, 19(1), 116-31.
Ewashen, C., McInnis-Perry, G., & Murphy, N. (2013). Interprofessional collaboration-in-practice: The contested place of ethics. Nursing Ethics, 20(3), 325-335. doi:10.1177/0969733012462048
Johnston, J., & Truluck, C.A. (2011). Writing & research. Interprofessional Collaboration. Radiologic Technology, 83(1), 97-99.
Lee, A., Pettigrew, C., O’Sullivan, C., Henn, P., & O’Flynn, S. (2008). Strategies for Interprofessional Education in Health and Social Care. Powerpoint presented at the Speech-Language Hearing Association
Oandasan, I., & Reeves, S. (2005). Key elements for interprofessional education. Part 1: The learner, the educator and the learning context. Journal Of Interprofessional Care, 1921-38. doi:10.1080/13561820500083550
Prelock, P. (2013, June 01). From the President: The Magic of Interprofessional Teamwork. The ASHA Leader. Retrieved from http://www.asha.org/Publications/leader/2013/130601/From-the-President--The-Magic-of-Interprofessional-Teamwork.htm
Prelock, A., Beatson, J., Bitner, B., & Broder, C., (2003). Interdisciplinary Assessment of Young Children With Autism Spectrum Disorder. Language, Speech, and Hearing Services in Schools 34, 194-202. doi:10.1044/0161-1461(2003/016)
Rodgers, M., & Nunez, L. (2013). From My Perspective: How Do We Make Interprofessional Collaboration Happen? The ASHA Leader. Retrieved from http://www.asha.org/Publications/leader/2013/130601/From-My-Perspective--How-Do-We-Make-Interprofessional-Collaboration-Happen.htm
What Is Speech-Language Pathology Anyway?
What is a Speech-Language Pathologist?
Speech-language pathologist, or SLP, is the professional name for speech therapist. SLPs work in hospitals, schools, and private practice to treat people of all ages with a variety of communication needs. As experts on vocal cords and other structures in the throat, SLPs in the medical setting also treat disordered swallowing. SLPs hold either a master’s degree or a doctorate degree from a university that is accredited by the American Speech-Language Hearing Association (ASHA). State licenses are necessary in order to practice. In California, SLP practices are regulated by The Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board, and the specifics may vary from those in other states.
What is a speech-language pathology assistant?
A speech-language pathology assistant, or SLPA (referred to as a "slippa"), has a similar job to assistants in allied fields (like occupational therapy assistants, or physical therapy assistants). SLPAs are highly trained in providing direct speech-language serves. In other words, they are licensed to run speech therapy sessions and activities in order to help people meet their communication goals. Each SLPA has a designated supervising SLP, who will administer assessments, make diagnoses, council families, and support the SLPA. Together, SLPs and SLPAs collaborate to provide high quality services.
What exactly is communication?
Communication is the exchange of ideas between beings (in our case, human). We typically think about it as being verbal (meaning word-based, such as talking and writing), however it is actually a much broader system. If you imagine yourself in an emergency situation with someone who speaks a different language, how would you communicate? Facial expressions, gestures, imitating environmental noises, placing stress on certain words - these are also considered to be communicative.
What is language?
Language is the symbolic representation of ideas. It is symbolic, because ideas are infinite and abstract. We have to take our thoughts and convert them into consistent, meaningful words so that other people can translate them into their own thoughts correctly. Language can be expressive (writing, talking, making gestures, etc.) or receptive (reading, listening, understanding gestures).
What is speech?
Speech describes the motor process (muscle movements) of producing sounds and words. For example, in order to say “pop”, my lips start together, then my mouth opens wide and comes back together again. While the word itself is a part of language, the controlled movement of the mouth is a motor function, which is controlled by a specific part of the brain. In speech-language therapy, people can be treated for speech, language, or both.
What is Assisstive Technology?
As described in the Individuals with Disabilities Act (IDEA) of 2004, assistive technology (AT) "is any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a (person) with a disability". Examples of AT are: prosthetic shoes; wheelchairs; hearing aids; augmentative and alternative communication devices; closed captions.
What is AAC?
According to ASHA, augmentative and alternative communication (referred to as AAC) " includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write." Less commonly, when people have more profound speech or language difficulties we might introduce a number of technology-based (also known as aided) AAC options. For example, the exchange of picture symbols is commonly used by people who are non-verbal (unable to speak). The most widely known system for picture exchange is PECS. Other options are computerized and produce voice output to speak for the person. For more information, see ASHA's website, or feel free to leave us a question in the comment section.
Have other questions about speech-language pathology? Please let us know what you would like to learn more about!
So, you're a speech-language pathologist? I know exactly what that is... said no one ever.
AAC Genie is an application that is intended to help SLP's with the diagnostic aspect of AAC assessments. For me, AAC assessments used to be incredibly intimidating. I had no idea what I needed to probe or how to go about creating an assessment protocol. Once I gathered all this information, how do you create a recommendation from all this data? AAC Genie was invaluable to me when I began doing these assessments. It streamlines most of the important information into a one stop shop for evaluating a variety of skills. As far as apps go (for me) this one ranks on the pricer side at $11.99 but it has more than justified the cost based on how much I use the app.
AAC GENIE: THINGS I LOVE
AAC GENIE: HOW I USE IT
So what exactly is AAC Genie? According to the manufacturer's website, AAC Genie "is an informal diagnostic tool that is intended to assist speech-language pathologists and others with identifying skill areas that relate specifically to the language representation methods commonly found on augmentative communication systems." It is important to remember that this app does not recommend specific AAC devices or apps, and nor should one assessment tool. AAC device or app selection should be the product of multiple assessment tools and decisions made through a feature matching process (you can find resources on what features to look for here, here, & here and some resources to compare apps here & here.)
When you finish with your assessment AAC Genie creates this handy printout that you can screenshot and/or save in your photos (watch those last names if you choose this option!) or send in an email. It is great for keeping data and monitoring progress.
The first 2 categories visual identification and visual discrimination are ways to assess the best button size and from what field the examinee can best select from. Visual identification prompts the user to find the _____ from an increasing field of choices and buttons of decreasing size where there is only one picture on the screen. Visual discrimination is laid out in the same way, only the user must locate the icon from a field of foils.
Next up are the language probes. All administered from a field of 3 and with simple probes.
The word association subtests ask the examinee to "find the one the ____ goes with" and even probe negation, "find the one that's not ______."
The final subtests are related to the Unity vocabulary specifically and may only need to be administered if that is a concern for you.
Overall- AAC Genie has been such a great tool for me and I use it so many different ways! I really can't recommend this app enough!
Upsee * Inspiring to the Max
This unique device was invented by a mother whose child has cerebral palsy. In the video, she describes how difficult it was to help him experience the sensation of walking, and the process of developing a functional system. The smile on his face while in the Upsee is priceless. Hopefully it will not only melt your heart, but inspire you too!
*For even more (mixed-emotion) tears, see Charlotte's, Daniel's, and Bethany's story at the bottom of the link.
"There needs to be a lot more emphasis on what a child can do instead of what he cannot do." - Temple Grandin
Lets be honest, kids are pretty bad at a lot of things. And who can blame them? Their eager brains learn from experience, which basically means trial and error. Some of the failures that kids experience while gaining new skills are immensely inconvenient and contribute to why I think that good parenting is one of the most difficult jobs around... letting children fail (and ultimately learn) takes intense patience, hard work, strategies, and sometimes even equipment!
According to the Children's Health Network, children should be able to start weaning to cups around 9-18 months old. Sippy cups can be used to help that transition, however they were designed as a convenience to parents, not because they are necessary for children. There is even some argument that the sippy cup design can have a negative impact on a child's development when used in excess. The way a child drinks from a sippy cup imitates the suckling motion used with bottles, as opposed to the tongue positioning and coordination used for drinking from a true cup. Because of this, there is potential that overuse of sippy cups - and the consequential lack of practicing the adult swallow - can inhibit a child's natural developmental process. In speech, we occasionally see children who rest with their mouths open, have misaligned teeth, and have tongue positioning that may be associated with over use of sippy cups and/or binkies. From this perspective, it is ideal is for children to skip the sippy cup altogether.
That being said, I realize it isn't functional to bypass the sippy cup. I recently polled my colleagues at SmallTalk to see what their thoughts were on the subject. From a combination of speech-language pathologists, occupational therapists, and mommys, the general consensus was this: work on cups at home, by placing a small amount of liquid into a cup while the child is seated (e.g., during meals). That way if there is a mistake, the mess will be manageable. Use a cup that is spill proof when you are out and about, but look into options that support development. Cups with straws, for example, offer a more adult way to drink than sippy cups. We also love these cups, which are a great compromise because they mimic regular cups while keeping spills to a minimum. I've recommended them to a couple of parents who have come back with glowing reviews. I've been told that similar cups are available at Toys"R"Us and Walmart.
Best of luck with your transition to cups - please share your experiences and any gems of advice that you have for us!
"There's no learning without trying lots of ideas and failing lots of times."
Inspiring to the Max - Photographs of Joy
This week's Friday Fave is a beautiful reminder that we don't need the newest, fanciest gadgets in order to thrive. 30 Magical Photos of Children Playing Around the World is a refreshing way to spend five minutes, if you have them.
“You’ll miss the best things if you keep your eyes shut.” - Theodor Seuss Geisel
The Little Old Lady Who Was Not Afraid of Anything, by Linda Williams
This book is definitely a Fall favorite of ours. It is thematic without referencing any holidays, it has a recurring series of phrases that are easily paired with motions, and the fun follow-up activities can be catered to support a variety of goals. This Fall, I have been using the book in the clinic with children 1:1, but I've also had success with it in preschool groups in the school setting. If you haven't read the book yet, here's the basic plot: a little old lady - who isn't afraid of anything - goes into the woods to gather items and ends up walking home rather late. She is startled to see two shoes in her path, going CLOMP, CLOMP (I pair this with tapping my hands on the table, or stomping my feet if reading to a circle). The little old lady directs the shoes to get out of her way because she is not afraid of them, and keeps walking only to hear the shoes clomping behind her. As she walks home, she encounters a sequence of items in a similar way...
When I'm reading the story for the first time, I don't ask the kids to participate but try to create anticipation to see if they join in on their own - and they usually do. After the little old lady arrives home, there are a few more opportunities to go through the sequence in its entirety. *Spoiler alert* when they aren't able to scare her, the little old lady helps the items find a collective purpose by suggesting that they arrange themselves into a scarecrow for her garden.
I like to program language for my recurring activities into my own tablet. I have the iPad with TouchChat, but that is just one of many great options (for more info on finding the right set up for you, check out this post). For this story, I used a 4x4 grid and programmed in the language that children seem to be the most drawn to: the 6 items and their 6 actions, "get out of my way", and "I am not afraid of you." Here's what I ended up with:
*Check back next Tuesday for AAC programming tips inspired by this page!!
Art - I like to have the children color the pictures in, and we discuss things in a number of different ways depending on their specific goals. In the example below, we were working on negation. We used a piece of paper creased into 6 sections (fold in half lengthwise, then into thirds). The first section had the target written as a carrier phrase, and we practiced it with each of the items. I use similar set ups to practice sequencing the story by the order in which the little old lady encountered each item, and for semantic pairings (the noun went action, action). For other kids (executive function, following directions, etc.), we arranged and glued the images onto an un-creased piece of paper to make a scarecrow.
Pumpkin heads - This year at the clinic, we ordered miniature pumpkins and stick-on foam faces to make jack-o-lanterns for the kids to take home. This is quick, fun, and the kids love it! If you aren't in a position to send home pumpkins with everyone, you can always break out the gourds from earlier in the month and make amazing play dough pumpkin faces (the artist of this face placed the mouth on top of the pumpkin :)).
Shake your sillies out - This can be done before or after the reading. I typically do it before, as it can help some kids to sit down and focus for the whole book. There's also an argument that it primes them for the book by engaging them in music, play, and incorporating a number of the action words about to be highlighted in the story. The live concert of Raffi, who I believe is the Dr. Seuss of children's music, is the video I use.
We'd love to hear how you use the book in your practice in the comment section!
"You're never too old, too wackey, too wild, to pick up a book and read to a child" - Theodor Seuss Geisel
Augmentative Alternative Communication (AAC) is not only a modality for individuals to communicate their basic needs, but also for connecting with other people. This video clip captures what we at INSPIRED*IN*SPEECH see as the ultimate hope for all AAC users; laughing and connecting with the most important people in their lives. The video starts out a little bit slow, but it is short and quickly becomes an all-too typical conversation that leaves siblings laughing and parents trying to hide their smiles. Be sure to watch it to the end!
"Sometimes being a brother is even better than being a superhero." - Marc Brown
Molly and Larissa are speech-language pathologists in San Diego, CA, who are looking to share inventive, inclusive, fun ideas for developing communication. This is also their platform for highlighting the many amazing people and resources in the community.