Creative Speech Therapy Ideas: Using Stickers for Articulation, Apraxia and Language Goals

I want to shine a spotlight on an often underrated but inexpensive versatile resource for targeting goals in our speech therapy sessions. They are  lightweight, require minimal prep, and the kids absolutely LOVE them! Yes, I’m talking about……

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What is it about sticky pieces of paper that is so intriguing? 

Recently, I’ve been using a Paw Patrol Puffy Sticker Book that I found at Marshalls (they also had a construction vehicle one!). It’s become a favorite among my kids, and I just had to share all the ways we can use stickers to target both speech and language goals.

Use stickers for……

Speech Sound Practice

• Working with kids with Childhood Apraxia of Speech. When adding stickers to a page or background scenes model  “power phrases” like “put on”, “take off” and  “my turn” and use self advocacy phrases like “help me” and  “it’s stuck”.

• Sticker Charts: Create a chart with different articulation targets. Each time a child successfully practices a target sound, they get to place a sticker on the chart. This visual reinforcement can be very motivating (ok,  so this one is overused and underwhelming, but I had to add it!)

• Sticker Stories: Have the children create a story using stickers. Each sticker represents a word or sound they are working on. They can narrate their story, practicing their target sounds as they go.

Language Development

• Sticker Sequences: Use stickers to create sequences or patterns. Have the child describe the sequence, focusing on using words like "first," "next," and "last."

• Sticker Descriptions: Give each child a set of stickers and have them describe what they see. This can help with vocabulary building and descriptive language.

• Sticker Scenes: Provide background scenes and let children create their own stories using stickers. Have them narrate their story, focusing on sentence structure and vocabulary.

STICKER SCENES

Add sticky magnets from a magnet tape roll to stickers to create magnetic stickers!

Social Skills

• Sticker Conversations: Use stickers to prompt conversations. For example, place a sticker of a happy face and ask, "What makes you happy?" or use a sticker of a group of friends and discuss friendship and social scenarios.

• Emotion Stickers: Use stickers depicting different emotions and discuss each one. This can help children identify and express their feelings.

Following Directions

• Sticker Maps: Create a simple map or scene on paper and use stickers to give directions. For example, "Place the dog sticker next to the tree" or "Put the car sticker on the road."

Examples with Paw Patrol Puffy Sticker Book

To give you some concrete examples, here’s how I’ve been using the Paw Patrol Puffy Sticker Book in my sessions:

• Prepositions: Receptive and expressive use. "Put Chase under the tree," "Where is Chickaletta?"

• Expanding Utterance Length: Targeting 2+ word phrases. "Go Ryder," "Marshall wants a ride," "Bye ___." I model and repeat these phrases throughout the session.

• Working with children with Apraxia: Power phrases like “put on”, “take off” and “my turn”. Self-advocacy phrases like “help me” and “it’s stuck”.

• Gestalt Language Processors: Mixing and matching phrases. For example, if a child uses "Rubble on the double" and "I'm fired up," I model a combination like "Rubble is fired up."

• Production of 2+ Syllable Words: We worked on "Mayor Humdinger" - a motivating 3-syllable word!

• Verb Tense: Using background scenes with minis, we practiced past tense: "The car jumped over the sign," "He drove away."

• Negatives: Using stickers on background scenes. "I don’t want it there," "Not in," "Not on my nose!"

PAINT STICKS WITH PACKING TAPE

Use paint sticks or tongue depressors and cover them with packing tape for repeated articulation trials.

Low Prep, Low Expense Ideas

Here are some additional low-prep, low-expense ideas to get plenty of repetitions with stickers:

1. Paint Sticks or Wooden Tongue Depressors: Add stickers for each target the child gets correct. I add packing tape to my paint sticks so kids can put on and take off stickers over and over for multiple trials!

2. Body Parts: Stick stickers on different body parts on you and the kids following each production, then have the kids take them off again while practicing their target sounds, words, or sentences.

3. Matching Games: Add matching stickers onto milk or juice lids, or cardboard circles or squares and play a matching game with them.

Stickers are a fantastic tool for making speech therapy sessions fun and engaging. I hope you find these ideas as helpful and enjoyable as I do. Happy sticking!

Using Power Words with Minimally Verbal Children

POWER WORDS

“Starting initially with a selection of 3-5 power words lays a sturdy foundation for accelerated progress and nurtures the child's communicative confidence.”

The use of "power words" in speech therapy for emergent talkers can make a big impact on communication and confidence!

So, what exactly are power words ? In speech therapy, power words are those functional vocalizations that empower children to control their environment with minimal language. They serve as essential tools for communication, aligning closely with the child's interests and needs.

It's important to recognize that what constitutes a power word for one child may not necessarily hold the same weight for another. Personalization based on individual preferences and family input is paramount.

Picture this: a child who struggles to articulate complex sentences or express their desires suddenly finds their voice through a simple, yet powerful word like "go" or "up." These words are not chosen at random; they're carefully selected based on what matters most to the child and their family. From "me" and "my" to "stop" and "push," each power word holds significance, serving as a bridge between thoughts and actions.

Starting initially with a concise selection of 3-5 power words lays a sturdy foundation for accelerated progress and nurtures the child's communicative confidence. Initiating with sounds within the child's phonemic repertoire ensures that their utterances remain intelligible, fostering successful communication exchanges. The Apraxia Cards BUNDLE of visual cues for many of these words can help elicit production.

To illustrate the practical application of these concepts, here are some power word suggestions along with simple activities that can be seamlessly integrated into therapy sessions or at home::

1. Me: Encourage the child to point to themselves in a mirror or in photos while saying "me." or while using Magnet tiles, as you put a tile onto a tower, continue to model the word “me” each turn.

2. My: Have the child bring personal items like a favorite toy or a family photo album while labeling them as "my” or  stick stickers all different places on you “my hand”, “my nose” then on the child continuing to use the word “my”.  Use “my” during turn taking while playing indicating it is “my” turn.

3. Animal sounds: “moo”, “quack quack”, “meow” count as words and are fun for children to say. Most of these sounds have a CV, VC or CVC pattern perfect for children with apraxia of speech (Visuals for animal sounds can be found here)

4. Go: Set up a simple obstacle course or use toys that move (e.g., cars, trains) and prompt the child to say "go" as they navigate through or initiate movement. 

5. Up: Incorporate actions like jumping, stacking blocks or pillows, or lifting toys into containers while encouraging the child to say "up." This activity reinforces spatial concepts and enhances motor skills.

6. Come: Utilize games where the child needs to come to you or follow simple instructions like "come here" while using preferred toys or activities as motivators or you run across the room and run to the child while modeling “come”.

7. No: Introduce scenarios where the child can express negation in a silly way using "no," such as putting a shoe on your head or pretending to eat a toy. 

8. Stop: Incorporate activities involving movement (e.g., dancing, playing catch) and prompt the child to say "stop" to pause or end the activity. 

9. In: Create opportunities for the child to place objects into containers or hide toys in designated areas while labeling the action as "in." This activity reinforces spatial understanding and enhances object manipulation skills.

10. Poo: Introduce simple bathroom routines or use picture cards depicting toileting activities while encouraging the child to say "poo." This fosters functional communication related to toileting  and promotes self-care skills.

11. Push: Provide toys or objects that require pushing (e.g., toy cars, buttons) and prompt the child to say "push" as they engage in these actions. Using a balloon pump where the child says “push” while you pump the balloon to inflate it.

12. Exclamatory sounds: “ohuh”, “oh no” and “weee” count as words and these have tons of uses in daily life. Try dropping items on the floor and modeling “uhoh” or “oh no each time” (visuals for Exclamatory words can aid with production of words).

These suggested words are often words that young children use daily, they are functional and they are powerful! But remember- your child’s power words may be completely different and it is important to consider the child, their phonemic repertoire and their environment. 

These activities serve as starting points for incorporating power words into therapy sessions, fostering meaningful communication exchanges and supporting the child's overall development. Moreover, the journey begins with sounds that a child can already produce, ensuring that their utterances remain intelligible. By using sounds within the child's phonemic repertoire, we lay a solid foundation for clear and effective communication exchanges.

Using Plastic Eggs in Speech Therapy

Spring is in the air, and as speech-language pathologists (SLPs) we're always on the lookout for engaging activities to keep our therapy sessions fresh and fun!  Using plastic “eggs” in the spring and year round is an easy low prep way to target all your speech and language goals. 

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Plastic “eggs” now come in so many different shapes and sizes like animal shapes, vehicles, dinosaur eggs!  They are easy to find in March and April at Dollar stores, grocery stores and big box stores).

Here are 11 easy, low prep activities to use these plastic eggs for Speech Therapy ....

• Sound Guessing Game: Shake, rattle, and roll! Fill plastic eggs with various objects and challenge your students to guess what's inside based on the sound. It's a simple yet effective way to work on auditory discrimination skills.

• Categorization: Get cracking on categorization skills by sorting eggs into different categories such as animals, vehicles, colors, or shapes. This activity helps with language organization and expanding vocabulary.

• Concepts "Same" and "Different": Explore the concepts of "same" and "different" by placing matching or mismatched objects inside eggs. Have students open them up and identify whether the contents are the same or different, fostering cognitive flexibility.

• Descriptive Language: Encourage descriptive language by having students describe the eggs or the objects inside using adjectives like colors, sizes, textures, or functions. It's a great way to expand their expressive language skills.

• Positional Concepts: Hide eggs around the room and give clues using positional concepts like "under the table," "next to the bookshelf," or "behind the chair." This activity reinforces spatial awareness and following directions.

• Following Directions: Give students one, two, or three-step directions on where to hide the eggs. This activity not only targets listening comprehension but also provides opportunities for following multi-step directions.

• Sensory Bins: Create sensory bins filled with real or paper "grass" and hide plastic eggs inside. The sensory experience enhances engagement and provides opportunities for natural language expansion.

Stack Eggs with Play Dough to target corewords like “more, up, fall down and uhoh”

• Play-Doh Egg Stack: Stack 'em up with play dough! Use play dough as a base for stacking eggs and prompt students to use core words and phrases like "up," "down," "stick”, “uh-oh”, “oh no” and "hard" as they build. Click here and I’ll send you some free visuals for the play dough stack!

• Pair Eggs with Books like First the Egg by Laura Vaccaro Seeger, The Good Egg by Jory John  and The Extraordinary Egg by Leo Lionni.

• Open-ended Play: Allow students to dump the eggs out and explore freely. Encourage imaginative play, storytelling, and conversation as they interact with the eggs. Usuallythe most language comes from kids when they are leading the activity.

• Articulation Targets: Sneak in some articulation practice by placing target words or pictures inside eggs. Students can practice their speech sounds as they open the eggs and say the words aloud.

These egg-citing activities are not only educational but also tons of fun for students of all ages. Add some plastic eggs to your therapy toolkit!

Targeting /s/ Clusters for Children who are Exhibiting /s/ Cluster Reduction

As speech language pathologists, we see many children in speech therapy with specific predictable patterns of errors or phonological processing disorders, with /s/cluster reduction being a frequent challenge, and one that I love to work on because of the quick increase in intelligibility!

“Cluster reduction” involves the systematic omission or simplification of consonant sounds in clusters, significantly impacting speech intelligibility. Specifically, our focus lies on the complexity of producing /s/ blends –  combinations of consonants like ST, SN, SM, SP, SW, SK, SL, where the initial consonant is an /s/. You might hear a phrase like “Let’s go play in the no” instead of “Let’s play in the snow”, “Top the car” instead of “stop the car” and “I pilled my juice” instead of “I spilled my juice”.

Cluster reduction featuring /s/ should ideally be eliminated by the age of five, but there are considerable individual differences among children. The American Speech Language and Hearing Association (ASHA) reports that the average developmental age of elimination for cluster reduction with /s/ is 5 years old and Shriberg and Kwiatkowski (1980) reported that 4-year-olds correctly produced 90% of consonant clusters in spontaneous speech. Understanding these age-appropriate expectations is important so we can get an idea when children should be producing the correct /s/ cluster, however, if a child can correctly produce both the sounds that are in the cluster separately, it is a good indication that they can produce the cluster with help. 

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/k and g/ Velar Fronting
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I have found that addressing /s/ cluster reduction with children is often dependent on their receptive language skills; how well they can understand the hand cues, picture cues and movement from one sound to the next. 

The Traditional Method involves working on one sound at a time, progressing gradually from isolation to conversation. 

The Cycles Approach targets each different phonological process that the child is using for a specific amount of time and “cycles” through other phonological processes. This works well for children exhibiting many phonological processes. Hodson and Paden (1983, 1991).

Minimal pairs Approach, where words differ in only one phonological element, prove effective in honing in on the target sound with the meaning of the words being different. Think of the words “snow and no”, they only differ by the /s/ sound but they mean completely different things. I found that children really love the silliness of using the minimal pairs approach (i.e. “you want a nap?” oh you need to snap!”). When they can assign meaning to the words, they work to say the correct words.

How to help with /s/ cluster production:

1. Within the minimal pairs approach for /s/ cluster reduction I use speech sound picture cues to name the sounds, children have a visual cue for production paired with a hand cue. We call the /s/ sound the “snake sound” and use our hand and arm moving outward like a snake as a hand cue. 

2. When the child is elongating the /s/or the “snake sound” and using their hand during the vocalization, they land on the next sound in the cluster (it will sound like “sssssssssst or ssssssssnnnnn”). 

3. Movement is the key for the child to understand the elongation of the /s/ moving into the next sound. I often use a wipe board and draw a line from a snake while the child is vocalizing the /s/ then move the marker to the rest of the word- and I draw a picture of the minimal pair word (ie. ssssss–Knees for “sneeze”). Breaking down the /s/ blend into smaller parts, such as 'sss”  'm is the key. If you are looking for minimal pair words for /s/ clusters I have a Don’t Break the Ice for /s/ Cluster Reduction printable activity that the kids have been asking for over and over!

10 Games and Activities for /s/ Clusters

1. Any game with a spinner is great where kids have to say “my turn to “ssssspin” for each turn working on the /sp/ cluster. 

2. “Spot it” Games where you have to find 2 of the same pictures on 2 cards. Encourage kids to day “I spot___” to work on /sp/ cluster.

3. “I spy” games and “Where’s Waldo” books work for working on /sp/ in the word “spy:

4. “Stop/Start” Motor Activity where children “stop and start” when the caller says the words,then the child becomes the caller.

5. Try Don’t Break the Ice /s/ cluster Minimal Pair Game with pictures of all those /s/ clusters and their errored pair.

6. Board games can target the /sp/ cluster (like Candy Land)- “Move one space”

7. Stepping Stones are fun to incorporate movement into the session  while also working on the word “step”.

8. Digital activities like Phonological Processes Play Scenes and Brush Your Teeth for Articulation are no prep quick activities 

9. Play open ended activities and incorporate a target /s/ cluster into play (ie. pirate play: skull, stick, scrape, swim) (ie. Vet play with stuffies: sleep, scale, skin, snout, swab, stray) (play house: school, sleep, snuggle, spoon, stairs).

    10) Read books with /s/ clusters embedded in the story (ie. The Snowy Day, Sneezy the Snowman, Space,

The Very Busy Spider, That’s Not a Stick).

Teaching Production of the /k/ and /g/ Sounds in Speech Therapy

If a child is making errors on the /k/, /g/ and /sh/ sounds and producing sounds like /t/, /d/ and /s/ consistently instead, this is called fronting. Speech therapy can benefit children who are exhibiting the phonological process of fronting after age 3 ½. With children who are continuing to exhibit fronting, you might hear “o-tay” instead of “ok”,  “I want the tea” instead of “I want the key”, “pet the dod” instead of “pet the dog” or “Let’s do” instead of “let’s go”.

As children are developing their speech sound skills when they begin talking, they make predictable errors patterns (called phonological processes). As kids develop, these processes are expected to extinguish naturally. When children continue to exhibit fronting after age 3 ½, intervention may be required (Bowen, Caroline, 2011. Elimination of Phonological Processes in Typical Development).

I love working on /k/ and /g/ because once children get these sounds, their intelligibility increases dramatically. That’s not to say working on these sounds isn’t tough at first, but the work is worth it!

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HOW TO PRODUCE A /k/ sound:

The back of your tongue will touch your soft palate (velum), the tip of your tongue will stay down.( If your tongue tip goes up, you will end up saying the /t/). Then release a burst of air.

HOW TO PRODUCE A /g/ sound:

Same as the /k/ only you turn your voice on! (if your tongue tip goes up, you will end up saying the /d/)

I usually start with the /k/ sound and often, once kids get the /k/ sound, it gengeneralizes over to the /g/ sound and we don’t even have to work on it!

1) ELONGATE THE VELAR

Start with elongating the /k/ or /g/ sound (sounds a bit like you are clearing your throat). I call the /k/ sound the coughing sound and the /g/ sound is called the gulping sound in my speech sound cue cards resource. We are showing the child what a “back” or velar sound feels like as opposed to the sounds produced in the front of the mouth.

2) ADD A LOW VOWEL

Try to add a vowel to the /k/ or /g/ like the sound a crow makes “caw”. With the word “caw” the tongue doesn’t require much movement between /k/ and “aw” and the “aw” sound helps facilitate the child to keep their tongue tip down and mouth open.

If the /k/ or /g/ plus the vowel seems to be too difficult, try starting with the vowel and ending with the /k/ as in “aaak”. The positioning between the “aaaa” and the “k” is similar and again, both sounds require the tongue tip to be positioned down and the back of the tongue raised.

3) GET AS MANY REPETITIONS AS YOU CAN

Whichever combination of vowel-consonant (aaa-k) or consonant-vowel (k-aw) works with the child, try to get in as many repetitions as you can for that motor movement. Use activities with crows, and crafts to elicit “caw” as many times as the child will allow. There are many activities with food you can use and have the child say “aaak” for foods they think are yucky. Try my Velar Mini Books for practicing in speech therapy and at home!

4) ADD MORE VOWEL SOUNDS

After the child has these VC and CV combinations try using different vowel sounds in combination with the /k/ and /g/. The vowel sounds that work best for children who have difficulty with the velar sounds are “low front and back” vowel sounds (meaning the vowel is produced with the tongue at a level close to the bottom of the oral cavity and the jaw may also be lowered). This position of the tongue assists the facilitation of the /k/ sound that is paired with it. The vowels that I find work best are “aaa” (as in back), “aw”(as in bought) and “ai” (as in bike). After the child is able to use these vowels in combination with the /k/ sound, add different vowels like “uh” as in up and “E” was in “bet”.

5) USE REAL WORDS

When the child has some good /k/ sounds in combinations with vowels, try moving to real words using those “low” vowels again. Words like “bike”, “back”, “kite” and “caught”. These Velar Sound Mini Books work great for practicing real words including nouns and verbs!

6) USE MINIMAL PAIRS

I usually use a minimal pairs approach when working with children who are using front sounds /t/ and /d/ for back sounds /k/ and /g/. A minimal pairs approach takes two words that are similar but has a one sound (or phoneme) difference like “tape and cape”, “bite and bike”, “go and dough”, “bud and bug”. This technique helps children understand that speech sound errors they make change the meaning of the words they are trying to produce.

1) PROVIDE A TACTILE CUE:

Even with the above facilitating contexts, the child cannot produce the /k/ sound, we may need to assist them with keeping their tongue down. I use a spoon and have the child open their mouth and place the spoon on the front-middle of the tongue and ask them to say the /k/ sound. Sometimes the child really pushes up on their tongue trying to get that tongue tip up! I have also used a gloved finger, tongue depressor (but I myself am not a fan of the feel of a tongue depressor in my mouth), popsicles and lollipops to hold the tongue tip down which can work well for motivation. Visual Cues such as Speech Sound Cue cards work well for naming the sounds (the coughing sound or the gulping sound) and allow children to associate a hand cue and picture to the sound they are learning.

2) LET GRAVITY HELP

I have also had a child lie down flat on the floor face up and attempted production of the /k/ or /g/ sound. In this position, gravity will take the tongue to the back position, which can help in production. 

3) KEEP THE TONGUE TIP DOWN

Can use cereal like Cheerios,or fruit loops and have the child hold the piece of cereal with their tongue tip against their front bottom teeth:

This will help kids keep their tongue tip down where it is supposed to be 

Same thing with the /g/ just tell the student to turn on their voices

IF THE CHILD IS NOT READY

Sometimes I have put the production of velars on the back burner and worked on other sounds because the child was not ready for work on these back sounds. 

Best Christmas and Winter Books for Kids Ages 3-5

Winter and Christmas books are some of my favorite to use in speech therapy for facilitating language skills in preschoolers. Following is a list of books I use in my speech sessions each season with different target goals in the descriptions. I wanted to post this blog now if you are thinking about gift for this age children.

For more information on choosing books for children, go to Choosing Books for Preschoolers to Encourage Communication Skills

Each title has a link to the book on Amazon (these links are affiliate links, so I get a few cents if you purchase one- at NO extra cost to you). You can also find most of these books at your local library!

Holiday Books

Holiday and Winter Books can target an array of speech and language goals

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The Snowy Day by Ezra Jack Keats

  This is a classic book with simple colorful contrasting pictures of a journey of a little boy and his adventures through the snow.  I use the concepts of “toes pointed in” and “toes pointed out” when walking to incorporate some motor movement into speech therapy. I use my book companion for this story each winter!  We also work on opposites like “down the hill” and “up the hill”. You can have tons of supplemental craft extension activities with this sweet story.

The Snow Globe Family by Jane O’Conner. 

This story is about a real family living in a house, then the snow globe family living in a snow globe in the real family’s house and only the baby sees the snow globe family.  This is for 4-5 year olds and is also great for older children also. It lends itself to working on “pretend” versus “real”, “big” versus “little” and working on finding solutions for problems. This one has fun extension activities like making snow globes. 

Merry Christmas Big Hungry Bear by Audrey Wood

This is really a perfect Christmas book for this age! A little mouse initially tries to hide his presents from the big hungry bear, then realizes that the bear needs some presents too! 

This story has repetitive text and the reader is talking to the mouse keeping children interested in knowing how this will end up! I target asking the mouse questions for information and kids love to join in talking to the mouse. We also target “big and small” when talking about the bear versus the mouse, what they wear, the presents and where they live.

Are You Grumpy Santa by Gregg Spiridellis

Santa is grumpy in the beginning of this wonderful rhyming story then comes around. This is fun to read and kids think this grumpy Santa is hysterical because of all the reasons  he is grumpy (itchy suit, he’s on a diet..). This one is for 4-5 year olds and is perfect for working on emotions like “grumpy, happy, sad, frustrated, annoyed”. 

Merry Christmas, Stinky Face by Lisa McCourt

Stinky Face loves Christmastime...but he still has plenty of questions. What if a big, wintry wind blows his Christmas tree away? What if one of the reindeer gets his antlers stuck in the branches that hang over the roof? His  Mama knows how to answer these questions. This one is fantastic for working on “wh” questions!

Snowmen at Christmas  by Caralyn Buehner

This is one book in a series of 5 about Snowmen at different time (Winter, Night, Play). There are hidden items throughout the story that children can try to find (although it’s not easy even for me!).  Working on concepts like “behind’, “under” and “on top” when describing where the snowmen are as well as using descriptive language when describing the different snow people works well in this book. There is quite a bit of text, but remember, you do not have to read it all if you have a younger child.

Llama Llama Jingle Bells  by Anna Dewdney

This is a book for younger children or children with difficulty attending to longer stories. It has rhyming phrases where children can attempt to fill in the words. The pictures are engaging and good to work on pointing to pictures named. 

The Snowman by Raymond Briggs

This is a story about a little boy who makes friends with a snowman. I like the “lift the flap” version of this book with my younger children. There is very little text (or no text in the original version), so children can use their own words to tell the story.

Dream Snow by Eric Carle

This is one of my favorite winter books! A farmer dreams that snow has covered him and his farm animals. There is a snow cover plastic page covering each animal in the story, so children can guess what is under each page. This works well for answering and answering  “who” questions and labeling animals and using animal sounds for minimally verbal children.

Max’s Christmas by Rosemary Wells

Max has plans to stay up late to see Santa Claus, but his big sister, Ruby, won’t let him. Max asks questions throughout the book making it perfect for working on “wh” questions with children. It has limited text which is perfect for younger wiggly listeners!

Gingerbread Baby by Jan Brett

The repeated phrasing in this story makes it easy for children to “help” tell the story. The people and animals that the Gingerbread Baby meet continue to grow lending this story to working on sequencing of events with children. There is a “hint” with the side pictures of what is coming next, that children love to guess! You can find a ready made book companion here!

The Night before Christmas by Clement Moore

Need I say more?  Just had to include this for those of us who had to read this every Christmas Eve!

Check out my Winter Book Companion Kit in my TPT store for activities to use with some wonderful winter and holiday books!

Visual Supports for Preschool Classroom Routines and Procedures

Visual Supports for Preschool Classroom Routines and Procedures

Visual supports in the classroom can provide your preschool students cues for classroom routines and procedures assisting with behavior, predictable routines, choice making and communication skills. Visual supports are a seemingly magical tools that can help your classroom move from chaos to calm! When implemented throughout the day, these supports can assist our students with communication needs, behavior difficulties, emergent talkers AND all other children in the classroom as well.

What are Visual Supports?

Visual supports can be anything in the classroom that is presented visually to assist children with understanding and communicating their wants and needs. They are pictures or symbols that represent different behaviors or actions. These visual prompts allow children to understand what comes next, what options they have and what is expected of them. 

A Visual Supports Tool Kit checks all the boxes.

6 Practical easy ways you can implement visual supports in the classroom:

1) Choice Pictures for Centers: Foster Independence and Communication

Pictures indicating activities in the classroom allow for children to feel that they are in charge of what is happening. Letting your kids decide their activities not only fosters independence but also adds communication requests into their learning journey. I have a choice board for centers where children choose the velcroed picture off of a large choice board to let the teacher know where they want to head following circle time. With some children, they bring the picture they chose to the specific center and velcro it on a board in that center to make the choice more representative. Children can independently move from one activity to another if they know the consistent and predictable routine.

2) Transitioning Between Classroom Activities

Change can be difficult and often frustrating for our young students resulting in some behavioral issues. By visually preparing them for transitions, children can see what is happening and what is next- it’s predictable and therefore decreases anxiety over the unknown.  Whether it's from circle time to the playground, these visual cues allow for smooth transitions, minus the stress.

I show students a picture of the activity they are doing and a picture of the activity that comes next. Often I put these pictures on a “first/then” visual so the children know what to expect next.

3) Picture Cues for Teacher Directions

Placing smaller pictures on a lanyard and showing children the picture about upcoming activities and tasks helps them understand what is expected of them. Pictures like “line up”, “wait” and “wash hands” provide a picture cue for all children. When children understand the picture, often we only need to hold up the picture for the children to follow directions without saying a word!

4) Visual Schedules

Having a visual schedule about what happens first, next and last creates a predictable routine for children. We know that when we know what to expect, our anxiety is reduced, the same goes for children. Once children know and see the routine visually, they become comfortable which leads to better learning readiness. Children don’t have to be concerned about what comes next in the day because they can see and know the routine.

5) Visual Aids for Real-life Adventures

Because education isn't confined to four walls, visual aids for bathroom and playground routines are also important. It's about creating predictability and consistency in learning, whether inside or outside the classroom. Kids love to flip over the routine arrival tabs in the Visual Toolkit after each task is complete! Take boots off , check, hang backpack in cubby, check, put shoes on, check…..(it’s like checking off our own list of to-do’s on our phones!). Completing the tasks gives children a sense of mastery and improves confidence!

6) Core Visual Boards for Classroom Activities

Core Boards are boards that have common pictures or symbols on them representing things that a child might say in a specific area or during a specific activity. Having core boards available in each center of the classroom provides minimally verbal children or children with verbal communication difficulties with the tools for communication. In the Visual Supports Resource common classroom centers like Block Center, Kitchen center or Art Area have communication boards available for teacher modeling the boards a use and children using the boards to communicate with the teacher and peers. 

In our roles as speech language pathologists and educators, our mission is to champion every child's journey towards effective communication and personal growth. Visual supports can help children build confidence and independence with behavioral, educational and communication growth. 

What Counts as a Word?

As a speech-language pathologist, when evaluating children for speech therapy I have to ask the parents, “How many words does your child have?” Then we talk about what actually counts as a word? This post will answer that question!

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“Words need to be consistent, independent and intentional.” 

1) Consistent: Children use this sign, vocalization, sound for the same thing over and over. They might say “beep beep” for car. If they use this sound always to indicate a car, then this counts as a word!

2)Independent: Children spontaneously use the word. They use the word by themselves without directly imitating an adult or another child. If they repeat what you’ve said, it does not count as a word yet.

3)Intentional: It counts as a word if a child uses a word, sound or sign for a specific reason. They might use the sign, vocalization or sound to request an item (looking toward a juice and saying “mmmm”, to comment (pointing at a car and saying ‘beep”), to label (seeing a broken toy and saying “uh oh”) or negate (i.e shaking their head no when asked if they want to nap).

So let’s see what counts as a word:

Do exclamatory sounds count as words?

YES! A child may say “uhoh” when they spill their drink, or when they fall down. They are using this as a word because they are spontaneously using the sounds over and over for a specific event. Often exclamatory sounds are the first sounds that children use. These words do not demand as much motor speech control as other words and they are fun to say! Some other examples of exclamatory sounds are “wheee”, “yummy”, and “Boo”. I developed  a set of 21 EXCLAMATORY SOUND PICTURE CARDS to use during play activities or use as flashcards to facilitate production of these early words.

Do animal sounds count as words?

YES! Animal books, puzzles and figures are early learning toys that can promote production of animal sounds like “quack quack”, “meow” and the sound a pig makes (not necessarily “oink”, but the intake of air through the nose). All of these vocalizations count when they are consistently used for the same animal. These ANIMAL SOUND PICTURES CARDS can assist with facilitation of production of animal sounds!

Do word approximations count?

Yes! Remember, if the approximation is intentional, independent and consistent it counts as a word, even if the word does not sound like it should. When beginning to talk, children often use words that might sound a little like the “real” word but not exactly. A child might say “mu” for “more” or “ow” for “outside”, but this still counts as a word. As a child’s speech and language develop, these words should become closer to sounding like the true word, and if they don’t, that may indicate that there is a speech or language delay or disorder.

Do gestures and sign language count as words?

This answer is yes and no.

If we are talking about intentional communications or messages that the child is using, then the answer is yes. The child might use the “eat” sign for food consistently and intentionally. This would count as a “message”. 

If we are talking about vocalizations that the child is using, then sign language or gestures would not count as words. That is not to say that gestures and sign language are not important  communication methods. Gestures and signs should always be encouraged and are a part of meaningful communication and can also augment or assist verbal communication.

I often categorize a child’s messages into groups:

1) Vocalizations (what a child says verbally)

2) Gestures or sign language 

3) Using pictures for communication. 

This classification system helps determine the method a child is currently using to get their message across to a peer or adult. 

Does pointing to or giving pictures count as a word?

Again, the answer is yes and no. 

When counting messages or communicative instances, then yes, pointing to a picture to request or comment would count. A child may use AAC (augmentative/alternative communication) to point to or access a picture to communicate their message. If children are having difficulty using spoken language, AAC is an important tool for the child to be able to communicate.

If we are talking about verbal words, then no, pictures do not count as vocalizations. Using the classification system I mentioned above is important so all messages are “counted” in some way. 

Do letters and numbers count as words?

They can, but it depends on the scenario. If a child is rote counting or saying the ABC’s one after the other, then no, that does not count as a word.

If a child is using the word “one” to indicate “one more”, or “two”  to indicate that they want  “two cookies” then it would count as a word. As far as saying the name of a letter, this gets a little tricky. I may count a letter as a word if they are requesting a specific letter (but I would not count each letter as a word because that would inflate the child’s communicative word count).

What counts as 2 words versus 1 word?

Words that are often chunked together with one meaning like “all done” or “Thank you” would be counted as 1 word (even though they have 2 words in them).

Two words that each hold different meanings in the message count as 2 words, for example, “go out”, “my cup”.

Beginning words are an important milestone for children and now you can answer the question “How many words does your child have?” with more confidence!

Treatment of Childhood Apraxia of Speech

About 15 years ago, I got my first case of Childhood Apraxia of Speech (CAS) that was diagnosed by a developmental pediatrician as “verbal dyspraxia”. From that moment, I did some big digging into what CAS really is. Since then, I have had many children that I have worked with with CAS (most whom I diagnosed) and although complex, I really love working with kids with CAS because of the difference I can make! Kids with CAS are close to my heart and I want you to feel as comfortable as I do know with techniques for treatment. Understanding it better can help us make a significant impact on the lives of our young clients.

I recently took a refresher course by Alonna Bondar that I would highly recommend if you need more information on CAS, choosing targets and applying treatment techniques. There are also some videos on YouTube by Edyth Strand that provide some really practical therapy and treatment information!

1) What is Childhood Apraxia of Speech?

CAS is a speech disorder that affects a child's ability to plan and execute the precise movements required for clear speech. It's like the brain and mouth are not on the same page when it comes to talking. Unlike other speech sound disorders, CAS isn't caused by muscle weakness or muscle coordination problems but rather by neurological issues that disrupt the planning process.

2) How CAS Differs from Other Speech Sound Disorders

Unlike phonological disorders or articulation disorders, CAS is not about substituting one sound for another. It's about the brain struggling to coordinate all the movements required to produce the planning of speech sounds and combinations of sounds. CAS can sometimes be mistaken for other speech sound disorders like phonological disorders or articulation disorders. The key difference lies in the motor planning aspect. In CAS, the child knows what they want to say, but their brain has trouble coordinating the precise movements necessary for speech. This makes CAS unique and requires a different approach in therapy (see the earlier Blog Post: Principles of Motor Learning in CAS).

3) Early Signs of Apraxia of Speech

1. Limited babbling before 12 months

2. 5 or less consonants between 17-24 months

3. Limited vocalizations

4. Simple syllable shapes (vowel or consonant-vowel only)

5. Late or difficult development of first words

6. Words that appear then disappear

(Bondar 2023, Bjorem Speech Informal Motor Speech Assessment 2020, Davis and Velleman 2000)

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4)What characteristics distinguish Childhood apraxia of speech from other speech sound disorders?

• Awkward transition from one sound and/or one syllable to another

• Groping behavior while attempting word or sound production

• Vowel Distortions

• Errors with prosody (stress, loudness, intonation, pitch and rhythm

• Inconsistent voicing errors

• Inconsistency of word or phrase production over repeated trials 

• Struggling with longer and more complex words

• Inconsistent errors when trying to repeat words

(ASHA 2007, Strand 2020, Bondar 2023)

5) How do we know a child is ready for CAS Treatment?

• Does the child have an internet to communicate? Are they using some type of communication to make  wants and needs known (i.e. pointing, grunting, pulling the hand of a caregiver)

• Is the child able to focus on an activity (i.e focus on a favorite toy).

• Can the child imitate motor movements (i.e opening their mouth, pursing their lips)

• Is the child able to request items with gestures like pointing or reaching?

• Will the child look at an object near your face?

6) Techniques for Children with CAS

Let’s get to the fun part!  Treatment!  When working with kids who have CAS, we've got to be creative and choose the approach and feedback that best fits the individual child. Whatever treatment approach is used the key is working on MOTOR MOVEMENT.  Multisensory approaches work well for children with CAS.  Here are a few techniques that have worked for me (and many others based on the research!) this is not ALL of the treatment procedures, I am highlighting some that proven to be successful for my students:

• DTTC (Dynamic Temporal and Tactile Cueing): 

This is a dynamic approach that combines touch and sound cues. It helps kids improve speech motor planning by guiding them through the correct movements.

With DTTC, there is a specific hierarchy and cueing methodology to facilitate the acquisition and generalization of movement accuracy for speech. It is structured to slowly lengthen the amount of time between the clinician’s production of a motor movement and the child’s production of the word or motor movement. Initially the child says the word at the same time with the clinician, then the child voices the word while the clinician only produces the mouth shapes of the word and later is cued to say the word with no cues.

DTTC is designed for children with more severe CAS and is not intended for long-term use. 

For more detailed information regarding the DTTC hierarchy please see the references below
(https://www.bjoremspeech.com/collections/free-resources/products/dttc-hierarchy-flow-chart-for-apraxia-therapy, American Journal of Speech-Language Pathology, Strand, Edyth,  Vol. 29, 30–48 • February 2020, Apraxia Course, Bondar, Alonna 2023)

• Speech Sound Cue Cards: 

Visual aids can be a game-changer! Using cue cards with pictures and written prompts can help children understand and produce specific sounds. You can find the speech sound cue cards that I developed for my students with CAS that provide visual (pictorial and hand cues), and auditory cues to aid in motor movement. 

Using cue cards with pictures and written prompts can help children understand and produce specific sounds. Using a finger or pointer or marker on a wipe board to move from one sound cue card to another showing the child movement while elongating the sound (if possible) works well for a visual representation.

• Promote Functional Communication:

Encourage children to communicate using signs, gestures, or alternative communication methods while working on speech goals. This helps reduce frustration and builds their communication skills. 

7) Appropriate Target Selection

Choosing the right targets is key for the child to feel successful in the therapy program. Initially, if a child has very little verbal productions, begin with sounds and sound effects such as animal sounds (“baa, moo, neigh"), sounds like a car sound or “beep” and “uhoh” or” eeekk”. These sounds are fun to produce and promote the child’s engagement. It is important to reinforce the child’s attempts at vocalizations and imitate their vocalizations and assign some meaning to them. 

Start with functional verbal words that are relevant to the child's daily life and communication needs if the child is at this level. As progress is made, gradually work your way towards more complex sounds and words. Words like “on, up, pop, bye, ma, poo” are great powerful words for kids to start with, but what is meaningful to the child is the best way to choose the targets. Use words that are meaningful to that child such as favorite toys, family names, friends names and favorite foods.

Using games that have lots of pieces to them can provide many trials and motivation for CV, VC and CVC words like “out, in, up, pop, push, my, me and see”.(Games like Pop-up Pirate, Banana Blast and Jumpin’Jack are great for this!). 

Remember, progress may be slow, and that's okay. Every small victory is a step in the right direction. Celebrate those wins, no matter how tiny they may seem! CAS is a unique and challenging speech disorder that requires a specialized approach. By understanding the nature of CAS, spotting it early, and using appropriate techniques, we can make a world of difference in the lives of our young clients.

For more information: (https://www.bjoremspeech.com/collections/free-resources/products/dttc-hierarchy-flow-chart-for-apraxia-therapy, American Journal of Speech-Language Pathology, Strand, Edyth,  Vol. 29, 30–48 • February 2020, Apraxia Course, Bondar, Alonna 2023)

Principles of Motor Learning for Treatment of Childhood Apraxia of Speech (CAS)

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When learning about treatment for Childhood Apraxia of Speech (CAS), we hear that we need to use the principles of motor learning (PML), so what does that mean? These principles or processes are how we all learn new motor skills or plans. 

Speech is a motor skill that can improve using these principles. 

Treatment may be designed differently depending on the child (with differences in severity, attention and motivation ), but applying the PML will provide a roadmap to support and treat children with CAS.

Following is a guide for using principles of motor learning that I use when I treat children with CAS (based on research):

1) PRACTICE, PRACTICE, PRACTICE:

Imagine learning to swim. You didn't jump in the water and swim right away,  you had to practice moving your body in different ways to float and stay afloat, then to move forward, all the while breathing at the same time. The same goes for children with CAS. Regular practice is the most  important aspect for generalization of speech production. 

It's all about getting enough practice trials per session to make the motor speech movements second nature and automatic. But remember, quality matters as much as quantity. Be attentive to the child's response, and adjust cues accordingly. As they progress, you can gradually fade those cues.

2) MASSED PRACTICE VS. DISTRIBUTED PRACTICE:

Think of this as the difference between cramming for an exam and studying consistently over time. For CAS, research suggests that frequent, shorter sessions spread out over time are more effective for progress and generalization.

Starting with massed practice (practicing all at once- think one session weekly for a longer time period)  to build a strong foundation, then transitioning to distributed practice (therapy spread out across sessions- think 4, half hour sessions weekly). I know sometimes we don't have the luxury of changing a schedule like that in schools- but see principle number 3 for ways to change up practice within time constraints.

3) BLOCKED VS. RANDOM PRACTICE:

Blocked practice is practicing one target extensively before moving on, then later randomizing practice by mixing several targets together. An example is initially you might choose 5 words including bilabials plus vowels (like poo, ba, me, ma, and pee) and focus on those only. As the child improves, you can randomize the targets for example adding a vowel consonant productions in (i.e. “up, oop, um”)

The severity of CAS can be your guide here. For severe cases, more blocked practice might be necessary, but you can modify it by mixing targets within blocks. This variation allows you to get more repetitions of target movements within each blocked practice.

4) VARY CONTEXTS AND PROSODY

Facilitate practice in different contexts. Vary the types of consonants or vowels and the positions that they are in . For example, change the initial set, going from CV (consonant-vowel) to CVC (consonant-vowel-consonant). Increase complexity of movements as the child gains the accurate motor movement sequences.

Experiment with prosody, loudness, and emotional intonation. This variability engages different muscles, enhancing motor planning processing and efficiency – our ultimate goal.

5) FEEDBACK MUST BE EVER-CHANGING

Feedback is dynamic throughout a child’s therapy program. Feedback can be intrinsic (what the child perceives) or extrinsic (what we provide for the child). Extrinsic feedback can be knowledge of results (was that right or wrong) or knowledge of performance (specific guidance on what specifically needs improvement). 

Initially, provide more feedback to guide the child, but gradually fade it as they become more accurate and independent in their speech movements. We don’t want too much support for too long otherwise the child could become dependent on the supports. We want to fade supports so children know how to produce the movements independently.

Often the type of feedback can change depending on the target and the accuracy of that target.

Using the Principles of Motor Learning:

Using the Principles of Motor Learning is like having roadmap in the world of CAS therapy. These principles guide speech therapy leading our children toward improved communication skills. So, practice often and adapt to the child's needs whether it be with feedback, type of practice or contexts.

Top Children’s Books for Speech and Language Development

“Remember, the best part is not just reading the books but also engaging your child in conversation, asking questions, letting them add to a story with words and phrases and creating new language with literacy.”

As a speech-language pathologist, I get to dive into the magical world of children's books every day, and if my bookshelves could talk they would tell you I have a bit of an obsession! 

There's something about watching kids light up as they explore the wonders of language through books. Not only do I love books, but I love sharing them with friends!

I'm excited to share some of my top picks for children's books that nurture speech and language development. I have divided them into categories that promote engagement and language learning. (Amazon affiliate links included on titles)

BOOKS WITH INCORPORATED MOVEMENT

Who says reading has to be a sit-still activity? Incorporating movement into storytelling is a genius way to keep those little minds engaged. So, get ready to wiggle, jump, and roar as you read some fantastic books that'll have your kiddos imitating animal moves and dancing with joy!

Movement helps kids attend to longer stories. By incorporating movement it builds imitation skills and assists with memory or concepts.

1. Tip Tip Dig Dig by Emma Garcia

2. We’re Going on a Bear Hunt by Rosen and Oxenbury

3. Press Here by Herve Tullet

4. Is Everyone Ready for Fun? By Jan Thomas

5. I’m a Dirty Dinosaur by Janeen Brian

6. Toot Toot Beep Beep by Emma Garcia

7. Tap Tap Bang Bang by Emma Garcia

8. Plinka Plinka Shake Shake by Emma Garcia

9. 5 Little Monkeys Jumping on the Bed Eileen Christelow

10. Stir Crack Whisk Bake by America’s Test Kitchen Kids

BOOKS WITH REPETITIVE TEXT

Children's books with repetitive text are like musical earworms that stick in your head (in the best way!). They'll have your little ones predicting what comes next and filling in the blanks like pros. So get ready for some rhyming, rhythmic fun!  Familiar text  helps children comprehend the story and remember due to repeat phrasing.

1. Bear Wants More by Karma Wilson

2. Too Many Carrots by Katie Hudson

3. The Seals in the Bus by Lenny Holt

4. The Bear Came over to My House by Rick Walton

5. Today is Monday by Eric Carle

6. Thank You Mr. Panda by Steve Antony

7. Brown Bear Brown Bear by Eric Carle

8. Polar Bear Polar Bear by Eric Carle

9. The GingerBread Baby by Jan Brett

10. Little Blue Truck by Alice Schertle

11. Pete the Cat I Love My White Shoes by Eric Litwin

12. Pout Pout Fish books by Deborah Diesen

13. Duck in the Truck by Jez Alborough

14. Sheep in a Jeep by Nancy E. Shaw

15. I say Ooh You say Aah by John Kane

LIFT THE FLAP BOOKS

Surprise! There's nothing quite like the excitement of lifting a flap to reveal hidden treasures within a book. These interactive gems not only captivate kids' attention but also help target important language skills like answering questions, predicting what's behind that flap, and learning about "open and close" concepts.

1. Dear Zoo by Rod Campbell

2. Oh Dear by Rod Campbell

3. Peek a Who by Nina Laden

4. Open the Garage Door by Christopher Santoro

5. Find Spot books by Eric Hill

6. Do Cows Meow by Salina Yoon

7. Gotta Go Buffalo by Haily Meyers

8. Tree by Britta Teckentrup (Peek through book)

9. Inside Outside by Lizi Boyd (Peek through book)

10. How Does Bunjee Feel?: An Interactive Lift Flap Book by Josie Mott

INTERACTIVE BOOKS

Moveable parts and tasks to complete during storytime? Yes, please! These interactive books keep those little hands busy and their minds buzzing with curiosity.Interactive books keep kids engaged and moving with moveable parts. Kids love to have a task during book reading!

1. Nita’s Day by Kathy McMillian (sign language)

2. Nita’s First Signs Kathy McMillian (sign language)

3. Find the Duck by Stephen Cartwright

4. Find the Puppy by Stephen Cartwright

5. All Better by Henning Lohein

6. The Cheerios Play Book by Lee Wade

7. Print and Laminate Books by SpeechieTrish

8. Hey, Seymour Books by Walter Wick

9. Drive the Firetruck and Drive the Car by Dave Mottram

10. Poke-a-Dot: Construction Vehicles (Board Book with Buttons to Pop) and other “Pop” books by Melissa and Doug

11. Hi-Five Farm! (A Never Bored Book!) by Ross Burach

CHAIN OR CIRCULAR STORIES

Wait, did the story just go back to the beginning? You bet! Chain or circular stories are like literary roller coasters that take you on a looping journey. Not only are they entertaining, but they also help reinforce storytelling skills and make kids feel like master storytellers themselves.

The storyline is linked so the ending goes back to the beginning in these books. 

1. The Napping House by Audrey Wood

2. If you Give a….. Books by Laura Numeroff

3. I know an Old Lady Who Swallowed a …Books by Various Authors

4. Little Blue Truck Books by Alice Schertle

5. 5 Little Ducks  by Various Authors

6. The Very Hungry Caterpillar by Eric Carle

WORDLESS OR LIMITED TEXT

Who needs words when pictures can speak a thousand of 'em? Wordless or limited text books are a feast for the imagination. They encourage kids to create their own stories, build vocabulary, and improve their narrative expressive language skills.

1. Carl’s Birthday by Alexandra Day

2. Not a Box by Antoinette Portis

3. Not a Stick by Antoinette Portis

4. Mix it up By Herve Tullet

5. Moo Baa La La La by Sandre Boyton

6. Maybe by Chris Haughton

7. Goodnight Gorilla by Peggy Rathmann

8. Flashlight by Lizi Boyd 

9. Big Bear Little Chair by Lizi Boyd

10. Let’s Go Puppy by Holly Rosensweig

11. Wishy Washy: A Board Book of First Words and Colors for Growing Minds by Tabitha Paige

12. Gravity by Jason Chin

 Let the language adventures begin!

Remember, the best part is not just reading the books but also engaging your child in conversation, asking questions, letting them add to a story with words and phrases and creating new language with literacy. Happy reading! 📚✨

SLP Essentials for Back to School

To make sure we kick speech off with a bang, I've put together a list of essential items that will make our lives a breeze during those first few weeks back in school. Check 'em out:

(Keep in mind that we may receive commissions when you click the Amazon links and make purchases. However, this does not impact our reviews and comparisons.)

Binder Rings

Binder Rings with Speech Sound Cue Cards

1. Binder Rings: I use these ALL the time!  I have my speech sound cue cards on them for on the go access to the visuals. My students love to flip through them to find “their sounds”. I also use them to hang visuals around the classrooms on plastic hooks.

Velcro Dots

2. Velcro Dots: Using velcro for visual schedules, adapting books and them for behavior charts is key! I no longer have to cut my velcro with these time saving dots!

Copier Paper

3. Copy Paper: Let's face it, we can never have enough of this stuff. Gonna be printing out activities, resources and screening record forms like crazy!

Laminating sheets 5m

4. Laminating Sheets: I laminate SO MUCH! I can keep activities year after year and kids can’t rip the pages! I use 5 mm sheets for even more durability for my visual sentence strips and books (check out my printable Back to School book for preschoolers!)

plastic sleeves

5. Plastic Sleeves: Slip those printable resources into these sleeves for use with dry erase markers when don’t have the time to laminate!. Plus, they're super easy to wipe clean. Score!

mesh storage bags

6. Mesh Storage Bags (the big ones): I used these to store my games paired with books in one place! I have a fun S’mores speech activity that includes articulation marshmallows that can all be stored in one bag.

7. New Play-Doh: Opening play-doh for an activity and finding it gray and hard is no fun!! Who doesn’t love the smell of new play doh any way? It's time to restock our Play-Doh stash. Love using play-doh for smash mats!

8. Nice Pens: Treat yourself to some smooth writing action with good quality pens. They make note-taking way less boring!

9. Dry Erase Markers: I always have a stash of these for making on the spot speech sound visuals and they are perfect for writing on whiteboards or laminated materials. 

Plastic Container with attached Lid with Sensory Materials

10. Plastic Bins with Attached Lids: Seems like I always need one to make a sensory bin for a new theme, and the bins with the attached lids work the best for me in my therapy bag since they don’t open unless I want them to.

11. Water Bottle: My goal for this year is to drink more water and even though I have SO MANY water bottles, I want to motivate myself, so I’m buying a new one!

12. Dot Painters: These bad boys can be used for all kinds of cool therapy activities, dot articulation comes to mind and can be used with little prep and kids love to use them!.

13. Glue Sticks: Never can find my glue sticks, so this year I am putting one in every pocket of my therapy bag. I like the clear ones to use with the small pieces that I laminate. I stick inside the laminating sheet to hold the pieces in place while they run through the laminator.

14. Clipboard with Storage: This was a game changer for me last year!  I keep each child’s daily sign in sheets inside the storage portion and the child’s sheet that I am working with on top plus my monthly time sheet. 

Now that we're armed with these essential speechie necessities, we're all set for an amazing start to the school year. 

Here's to a fantastic school year ahead!

Movement Activities in Speech-Language Sessions: Boosting Engagement and Language Skills

Get those bodies moving and minds buzzing with excitement in our speech-language sessions!

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Why is it helpful to incorporate movement activities in speech-language sessions? Let’s explore why adding motor movement can be beneficial for children with communication impairments. Here we go…. jump right in!

Research-backed Reasons to Get Moving:

• Increased Attention and Engagement: We all know how tricky it can be to hold a child's attention during therapy sessions. Integrating movement activities captures kid’s focus and boosts active participation. When children are physically engaged, they become more invested and motivated to learn and the activities become more functional!

• A Calming Touch: Have you ever noticed how certain movements have a magical calming effect? It's like waving a wand of tranquility. Pairing learning tasks with motor movement helps children stay calm and relaxed. Those rhythmic motions, like rocking or bouncing, work wonders in reducing anxiety and promoting a sense of peace. This can work especially well for our autistic clients or children with sensory disorders.

• Increased Cognitive Skills: Let's give those brilliant minds a workout! Movement activities stimulate various cognitive processes, from problem-solving to spatial awareness. By engaging the body and mind together, we can enhance overall cognitive development  (including communication skills)and critical thinking skills.

• Help Decrease Behavior Problems: Frustration and difficulty expressing themselves can lead children with communication impairments to act out. Movement activities offer a constructive outlet for releasing energy and emotions. This, in turn, reduces behavior problems and promotes self-regulation.

• Boosting Memory: Ever wish there was a way to make those therapy sessions stick? Research suggests that movement helps facilitate memory formation and retention. By linking speech and language tasks with specific movements, children are more likely to remember and apply what they've learned.

10 Beneficial

Speech and Language Activities Paired with Movement:

1. Obstacle Courses: Create interactive obstacle courses that include language-based challenges. Children can identify objects, follow directions, and describe items along the way. Adding speech sound cards to the path provides motivation to get all those trials in!

2. Dance and Sing: Combine language-rich songs with dance movements to target vocabulary, sentence structure, and expressive language skills. Get those little feet tapping!

3. Yoga for Speech: Blend speech and language tasks with yoga routines to promote breath control, body awareness, and language expression.

4. Imitate Book Actions: Bring books to life by acting out characters' and objects movements, using gestures.  Watch comprehension and expressive language soar! I have an engaging book companion to the book “TipTip Dig Dig”, “The Napping House” and “Dinosaurumpus” and kids can act out what items and people are doing in the story (i.e.” tip like a dump truck”).

5. Ball Toss Games: Spice up ball toss games by incorporating speech and language targets. Children can say words, answer questions, or use target sounds before throwing or catching the ball. Write or draw target words or sounds on those plastic beach balls with dry erase markers and wherever the child’s hand is they say that sound or word.

6. Puppet Play: Unleash the power of puppets! Engage children in conversations, role-playing scenarios, and narrative development. 

7. Sensory Bins: Dive into sensory adventures by incorporating language-based tasks. Children can explore textures, categorize objects, describe items, and engage in meaningful conversations. I use sensory bins ALOT and have themes bins with book companions in my store.

8. Action Songs: Teach children catchy songs with accompanying movements that target specific speech and language goals, such as articulation, phonological awareness, or grammar. It's like a musical language extravaganza! Think 5 Little Monkeys Jumpin’ on the Bed, while kids jump off a mini trampoline acting like those monkeys.

9. Feed the Animal: Use target cards for kids to feed an animal, puppet or monster! Use cut out animals with holes for mouths that kids can drop cards into.

10. Ball poppers with targets: Attach articulation cards to binder clips to create a target to hit with a ball popper. 

If you want children to choose activities like ball poppers or swatting cards with a fly swatter, I have a free choice visual that children can use for what to do with speech sound cards.

Customize these activities to suit the unique needs and goals of your little communication stars. 

So, let's get those bodies moving and minds buzzing with excitement in our speech-language sessions! Embracing movement activities opens doors to dynamic and effective learning experiences, empowering our young heroes to communicate with confidence. 

Tips for Making the /s/and /z/Sounds in Speech Therapy

As speech therapists, we encounter various challenges when helping children achieve correct articulation of specific sounds. The /s/ and /z/ sounds are particularly tricky, with errors ranging from lisps to phonological processes like stopping.

HOW DO YOU MAKE AN /S/ and /Z/?

As SLP’s we know this, but here’s a review and a simple way to explain it:

Understanding Correct Tongue, Lip, and Jaw Positioning:

1. The lateral sides of the tongue should be elevated and touching the sides of the upper top teeth, specifically the upper molars. This positioning creates a narrow passage for the airflow.

2. Funnel-like Tongue Shape: The middle of the tongue forms a slight groove or funnel, allowing the airflow to travel smoothly through the oral cavity. The tongue tip should lower just slightly to create a channel that facilitates the passage of the airflow.

3. Jaw and Lip Positioning: The jaw should be in a high position, but it may shift forward slightly during the production of the /s/ sound. This subtle movement contributes to the precise articulation of the sound. The lips should be slightly relaxed and parted, allowing a smooth airflow.

4. Forward Airflow: The airstream moves forward and out of the mouth during the production of the /s/ and /z/ sounds. The airflow should continue while the tongue remains in place, ensuring a clear and crisp sound. 

COMMON ERRORS WITH /S/ and /Z/:

• Frontal Lisp/Interdental Lisp: This occurs when the tongue protrudes between the front teeth, resulting in a "th" sound instead of the /s/ or /z/ sound. The “typical” lisp.

• Lateral Lisp:  Air escapes over the sides of the tongue, creating a "slushy" sound rather than the crisp /s/ or /z/ sound. I have found that this can be really tough to remediate, especially with younger children!

• Stopping: The phonological process of stopping involves substituting the /s/ sound with a stop sound like /t/ or /d/, resulting in words like "sun" sounding like "tun." This is really where those picture and hand cues can be effective!

EFFECTIVE STRATEGIES FOR ELICITING /S/ and /Z/ SOUNDS:

1. Tongue Placement Similarities: The initial tongue placement for the /t/ and /s/ sounds is the same!  Encourage the child to produce a "long" /t/ sound, with the tongue lightly touching the alveolar ridge then elongate that sound (like the /ts/ the end of the word “cats”). Calling this a “new sound” can eliminate the child’s attempts to correct an errored sound.

2. Mirror Work: Incorporate the use of mirrors during therapy sessions. This enables children to visually observe their tongue placement and make necessary adjustments for correct /s/ and /z/ sounds.

3. Tactile Feedback: Utilize foods like popsicles or lollipops to provide tactile feedback. Instruct the child to touch the tip of their tongue to the alveolar ridge where the food is placed, reinforcing correct tongue positioning.

4. Forward Stream of Air: Particularly for lateral lisps, encourage the child to visualize using a "forward stream" of air (or making the air come out of the front of the mouth instead of the sides). Explain that this helps prevent air from escaping over the sides of the tongue. Using a straw on the middle lower lip and instructing the child to make the air come through the straw can help for more feedback.

5. Visual Cues and Gestures: Use visual cues (picture of a snake for /s/) and name the sound as the "snake sound" for /s/. Accompany the cue with a hand and arm movement resembling a snake, moving up and down. This adds a multi-sensory aspect to the therapy, aiding in sound production.

   
   Helping children produce the /s/ and /z/ sounds correctly can be challenging but with the right strategies, patience, and practice, success can be achieved. Remember, each child's progress may vary, so adapting these strategies to suit individual needs is crucial for optimal results.

For activities to elicit the /s/ and /z/ sounds check out some of my resources below:

SPEECH SOUND MINI BOOKS FOR PRACTICE

S’MORE ARTICULATION CRAFT AND ACTIVTIES

Supercharging Speech Therapy with Sensory Bins: Boosting Communication Skills and Beyond

Are you ever stuck wondering how to make your therapy sessions more engaging and effective? 

Lemonade Sensory Bin filled with play-do, plastic cups, spoons, limes, and lemons (plastic ice fruit shapes) and fruit coasters (all from the Dollar Store)

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Get ready to supercharge your speech therapy toolkit with the power of sensory bins! In this blog post, we're diving into the incredible world of sensory bins and how they can solve the age-old problem of finding engaging, functional activities to target speech sounds, motor speech movements, phonological processing disorders, expressive and receptive language goals, social communication and play skills. 

It does take initial work in the beginning adding items to the bins, but after you can pull them out year after year with no prep.

WHAT IS A SENSORY BIN?

It is a container filled with a variety of fillers like beads, sand, water, rocks, dried pasta, dried corn. Within these bins you can add small toys, spoons, cups, little people, storybook props, tongs, and scoopers.  You can fill your sensory bin according to themes like dinosaurs or sharks. I like to use plastic containers with lids so I can store my bins year after year.

Gardening Sensory Bin filled with green dyed pasta for grass, plastic flowers, flower pots and carrots, scoopers and herb markers.

WHAT ARE THE BENEFITS OF SENSORY BINS?

• Enhanced Sensory Stimulation: Children with sensory processing deficits often struggle with communication due to sensory challenges. Sensory bins provide the extra stimulation needed to activate their senses, kickstarting the brain and central nervous system for optimal communication development.

• Memory Activation: Our senses are memory superheroes! When we engage multiple senses during therapy, we unlock more opportunities for memory activation and retention. Sensory bins create memorable experiences that help children recall and apply speech and  language skills long after the session ends.

• Joint Attention and Social Interaction: Building connections goes hand in hand with building relationships. Sensory bins foster joint attention, turn-taking, and social interaction as children explore and play together. They're not just mastering language, but also honing crucial social communication skills during play.

• Building Brain Connections: Research confirms that sensory play, including sensory bins, builds strong connections in the brain's pathways. These connections enable children to tackle complex learning tasks, opening the door to remarkable progress in speech and language development.

• Descriptive Vocabulary Expansion: Step into the sensory bin wonderland, and watch descriptive vocabulary flourish! As children immerse themselves in the sensory experience, they explore colors, shapes, textures, and sizes, expanding their expressive language skills and painting vivid pictures with their words.

 WHAT GOALS CAN I TARGET?

1. Articulation and Apraxia: Say goodbye to dull articulation drills! With sensory bins, we can transform speech practice into a thrilling treasure hunt. Imagine burying small objects or pictures with target sounds and having your little ones search for them while practicing their speech.  Use a child’s one, two or three target words over and over forming those motor neural brain pathways for tons of trials for kids with apraxia. It's interactive, engaging, and super effective in improving speech intelligibility and motor planning.

2. Phonological Processing Disorders: Sensory bins provide a multisensory approach that works wonders for children with phonological processing disorders. Sorting objects based on initial sounds or creating new words by manipulating objects with target phonemes takes learning to a whole new level. The tactile experiences and hands-on exploration boost sound discrimination and syllable awareness, helping children conquer phonological challenges.

3. Expressive and Receptive Language Goals: Sensory bins are a goldmine for expressive and receptive language development. Whether it's using prepositions, expanding sentences, or describing objects with vivid descriptors, sensory bins provide the perfect backdrop for language growth. The best part? Joint attention and social interaction come naturally as children engage their senses, fostering communication skills while having a blast.

HOW CAN I USE THEM?:

• Have the child find small objects or pictures that contain their target speech sounds and use them in sentences or short stories.

• Encourage the child to bury small objects in the sensory bin and practice saying target words or sentences while retrieving them.

• Use objects with different textures, shapes, or sizes in the sensory bin and ask the child to imitate specific motor movements, such as sliding, twisting, or pushing, while describing their actions aloud.

• Introduce objects with different initial or final sounds and ask the child to sort them into corresponding containers.

• Use objects with target phonemes and have the child manipulate and combine them to create new words or syllables.

• Incorporate prepositions by placing objects in different locations within the sensory bin and asking the child to describe their position (i.e.., "The lemon is under the cup").

• Use action verbs related to the sensory bin materials and encourage the child to act them out or create sentences using the verbs (e.g., "The dinosaur is roaring," "I am pouring sand into the bucket").

• Expand sentence length and complexity by encouraging the child to describe the objects using descriptors (e.g., colors, sizes, textures) or by combining multiple sentences into a cohesive narrative.

• Use them with paired books and props and have children retell the story with the props in the sensory bin.

Sensory bins provide a versatile and engaging platform for targeting a wide range of speech and language goals in children. By harnessing the power of tactile experiences, therapists, teachers and parents can create a multisensory environment that promotes articulation, motor speech movements, phonological processing skills, as well as expressive and receptive language development. 

The possibilities are endless when it comes to sensory bins. Let your creativity shine, and watch your therapy sessions transform into captivating adventures that leave a lasting

Preposition and Spatial Concept Acquisition

“Hey Addie, please put your shoes in your cubby”, “Wyatt, stand in front of Cooper”, “Eliza throw the ball up in the air!” These are some real life examples of the functional need for children to understand spatial concepts.  

Working with young children, I find that the understanding and use of prepositions is incredibly important for daily life as a child (and the research backs me up!). Prepositions include words like “on, up, under,and behind” are critical in making requests, following directions and locating objects. 

I target prepositions daily in my work with pediatric children with speech and language differences.  A fundamental skill is being able to tell someone where an object is and being able to find an object when someone describes where it is- like “Mom, your keys are in the fridge”, and “Addie, your cup is under the table”. 

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Here is a chart that may be helpful for the acquisition of spatial concepts by age. Keep in mind that all children develop at different rates and these are estimates based on a compilation of  research literature. Click on the chart to get your own copy.

When Teaching Spatial Concepts or Prepositions the literature makes two important points to keep in mind:

•  1) Children should be hearing prepositions in many different contexts. “Target words said by a clinician in a variety of syntactic and situational contexts (i.e. with different objects) were more often acquired by the two-year-old late-talking children..” (Alt et al, 2014). Meaning the more kids hear prepositions in different ways, the more likely they are to acquire them. 

  Example: If a child is learning the location “under”, they hear the word under as they are crawling under the table, “Hey, Jake, you are going under the table”. Later the child hears the word “under’ again, “Your cup is under your blanket”.A third time that day they hear, “My keys fell under my seat” and so on. The objects are changing but the preposition is staying the same.

• 2) The second point is that it is important to vary those contexts where the prepositions are presented.  Those concepts should be presented in different places; at home, at the playground and the grocery store. 

  Example: If a child is working on the preposition “out”, The adult would say, “let’s go out the door”, then later in a different location, “Take the apple out of the cart” at the grocery store and later, “pull the piece out of the puzzle” when playing at home.

  How to Teach Spatial Concepts

Start simple and with objects that interest the child. If you are working on the concept “off” and your objects are a cup and a small pig, place the pig on top of the overturned cup and push the pig off and say “off”. Repeat this allowing the child to push the pig off several times. 

• Each time you or the child pushes the pig off you say “off”. Pause after at least five times to wait to see if the child says “off”. 

• Later use the same word, “off” with different objects and repeat the activity.

• Ask the child to push the pig off and celebrate when they do.

• This simple activity will allow the child to initially learn the concepts you are targeting.

After you have used the guidelines above, the fun part is helping children understand and use spatial concepts in play! 

HOW DO WE TEACH SPATIAL CONCEPTS ?

Here are some functional and fun ways to help a child learn spatial concepts:

1. “Hide” some plastic eggs around the room (allow the child to watch you hide them) and ask the child to find the eggs in different target locations  “Find the egg under the table”, “Look under the chair”, “Maybe under the blanket”.

2. Allow the child to “hide” them and tell you where to find them.

3. Place sticky notes in target locations in a book (ie. “on top of the dinosaur's head”, “on top of the car”, “on top of his shoe”.)

4. Use a playhouse to target prepositions “on top of the roof”, “Under the bathroom”, “next to the tree” and move people in the target areas.

5. Using play dough to target “between”. “Put the blue ball between the 2 yellow balls”.

6. Use a train track set to target “in front and in back”. “Put the engine in front of the red train”

7. Fill a bin with water and have items that float “on top” or stay “on the bottom”.

8. Incorporating motor skills is a great way to engage children in learning spatial concepts. Make a blanket fort or use a chair and ask them to move to different areas, “Hide under the fort”, “Stand behind the chair”, “crawl between your friends”.

Digital Work with Prepositions (click the picture for a preview)

Alt M, Meyers C, Oglivie T, Nicholas K, Arizmendi G (2014) Cross-situational statistically based word learning intervention for late-talking toddlers. Journal of Communication Disorders 52: 207–20.

Hicks, S., Rivera, C., & Wood, C. (2015). Using Direct Instruction: Teaching Preposition Use to Students With Intellectual Disability. Language Speech and Hearing Services in Schools Lang Speech Hear Serv Sch, 46, 194-206.

Katrina Nicholasu, Mary Alt, and Ella Hauwille (2019).  Variability of input in preposition learning by preschoolers with developmental language disorder and typically-developing language.

Add a Word Strategy for Language Development

Description:

If a child is using one word to comment, request, negate, label, describe, answer or ask for more; add a word to their vocalization. If a child is using 2 words together, expand it to make a 3 word sentence and so on. The child does not need to imitate, simply hear the expansion. This will expand their sentences and the function of their communication and their vocabulary skills. Click here for the Full Resource of Speech and Language Strategies for Early Childhood.

Examples:

1) If a child is saying "bye-bye" to someone or something, you say, "bye-bye kitty" and if a child says "bye-bye Kitty, you say, "Bye-bye big kitty". Add a word to what the child says.

2) If a child asks for "more", expand their vocalization by saying "more milk", if they say "more milk", you could say, "more milk me".

3) If a child makes a comment on a picture or something happening in their environment by saying "plane", you say, "see plane" or expand to three words by saying, "see plane fly".

4)Introduce a new word each day and encourage children to use it throughout the day. This can help them build their vocabulary and learn new words in a fun and interactive way. You can also incorporate this strategy into daily routines such as snack time or bedtime.

Wait and Pause Strategy to Support Language Development

Description:

Pause and give the child time to respond during play activities. When you ask a question, make a comment or give directions, wait and pause for the response. Make sure to also pause after your child speaks.

During play, as you are talking, pause where there is a word you want the child to say.

Click here for the Full Resource of Speech and Language Strategies for Early Childhood

Examples:

1) Build a block tower: As you place each block on top say "block on" at least 3 times, on the fourth time say "block" and pause for the child to fill in the word "on", wait 3-5 seconds and say the word if the child does not. Continue each time you place a block on.

2)Hide some toys around the room, and have your child cover their eyes. Repeat phrases such as, "Where is it?" or "Where are you?" as the child is looking for the toys. Repeat the phrases several time and pause after at least 5 trials and shrug your shoulders and pause to see of the child will say "where". Continue to repeat the activity.

3) As you are reading a book point to the same item on each page of a book and say or sign the word (i.e. car). After at least 3-5 trials, point to the car and pause for the child to say or sign the word.

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Valentine Speech and Language Activities

Valentine’s Day is coming up next week but these early intervention and preschool speech and language activities can be used any time!

Preschool books for February

I often use inspiration from books that I have and Love, Friendship, Celebrations and Valentine’s Day are themes that I have plenty of books for! Even if you don’t have the books personally, make sure to visit your local library or get on YouTube for tons of read-aloud books.

Some books that I love this time of year are shown in this video (posted on my Instagram)….

One of the books that I use each February is “The Day it Rained Hearts” by Felicia Bond (link to YouTube Read aloud here).

With this story and the other Valentine Books I use some engaging language activities with my speech and language students.

1) CREATE A VALENTINE SENSORY BIN: Targets can include core words and phrases like “find the ____, I found it, Where is ____, see ____” and expanding vocabulary by matching pictures in the book to pictures that they find. Kids love to put the treasures into the plastic containers and we work on phrases, “in the heart” and “in the box”. Pictures can be added to sensory bins that target specific speech sounds that the child is working on as well,

I use a plastic container and fill it with like colors. I add pictures of items throughout the books that we read. I added plastic heart containers, sparkly hearts, gems, colored balls, cut up silver straws, red yarn, felt cup cakes and pom poms to this bin (I got everything at the Dollar Store). As we read the story, kids take out the pictures with plastic tongs (also working on those fine motor skills).

2) HIDE AND FIND VALENTINE LETTER ACTIVITIES: This one is easy prep for you and kids love to see what is inside the envelopes. I put either valentines inside envelopes or some felt hearts and I add the amount of hearts on the outside of the envelope to work on some counting skills also. You could also add Valentines with your child’s targets in them (i.e. if a child is working on the velar /k/, add valentines with cats inside the envelopes).

I hide the envelopes around the room and the children find them, open them up and talk about where there envelope was (working on prepositions and location) and describe what is inside the envelope (working on descriptors).

Simply fill envelopes with hearts or commercial valentines and add the same amount of hearts to the outside of the envelope with corresponding number. Hide them around the room and have the children find them.

3) DROP ITEMS INTO A TUNNEL: I happened to get a Valentine Cat Tunnel at my local Aldi’s last week for my sister’s new puppy (it was way to small, but perfect for a Valentine Drop!). We dropped articulation pictures down into the tunnel after the kids said them which was really motivating! I also used this activity with children with emerging expressive language targeting words like “in, down, go and uhoh” and phrases, “go down, see it, go heart”.

I also used it with a student with Childhood Apraxia of Speech (CAS) who was working on the /f/ sound plus a vowel and this activity facilitated her elongating the /f/ sound rather than stopping it before the vowel.

Use a tunnel turned upright to drop articulation cards, objects, and letters into.

Check out my Celebration book companions including “The Day it Rained Hearts” for activities and items to add to sensory bins!

Speech Therapy Tips for Minimally Verbal Preschoolers

How do I get my child to talk? What can I do at home to help my child communicate what they want and need? If my child isn’t talking, is there anything I can do? 

These are some initial questions that I hear when I first see a minimally verbal child for a speech and language evaluation.  Although it is important for intervention (speech therapy) to be tailored to the individual child, there are some intervention techniques that are helpful for all children.  Some experts (Fish, 2016; Velleman, 2003) suggest intervention for young children include the following (modified from article by Megan Overby, PhD, CCC-SLP original article Sharon Gretz, M. Ed.):

• Learning to imitate gross motor skills

• Large motor movements (such as clapping, hands up to be picked up)

• Actions with objects (banging two blocks together)

• Imitating vocal play (i.e. raspberries, tongue clicks)

• Imitating oral-facial movements (i.e.,puffing cheeks out, blowing kisses)

• Vocalizing visible early sounds such as /m/, /b/, or /d/ (e.g., /mmmm/, “muh” or “buh”)

• Vocalizing to get attention (e.g., “uh” and pointing to a cookie)

• Sound effects: animal noises (e.g., “grr” for a tiger, vehicle sounds)

As children start using more of the above and begin to use more sounds imitatively and spontaneously, focus can include more functional vocalizations: 

•  Words with distinctive pitch patterns (e.g., “uh-oh,” “wow,” “whee,” “yay”)

• Words with strong emotional meaning (“no”, “up”)

• Vocalizations that can be paired with actions (e.g., “whee” as a car goes down a track, “hi,” with a wave and  “oops” when an object falls)

• Sound effect words (e.g., “woof’, “beep,” etc.). There are great books that use sound effects (see Blog post, 13 Tips for Choosing Books for Preschoolers)

• Verbal routines and singing (e.g., songs  like “5 Little Monkeys Jumping on the Bed,” favorite predictable books like “Brown Bear Brown Bear What Do you See”) : (see Blog post, 13 Tips for Choosing Books for Preschoolers)

• Words with very early consonants and simple syllable shapes (e.g., “hi,” “me”, “mama”, “oh no”)

Some helpful speech therapy tips: 

•  Use sounds already in the child’s repertoire to build simple productions (e.g., if a child has /p/, can they learn to say “pop” “up,” or an approximation of those words)

• Hold toys or objects of interest near the speaker’s mouth to direct the child’s attention to mouth movements during imitation tasks. 

• Use movement during practice (push a car down a track to work on “wheee” or build a tower and place block on top and practice “up” then “uhoh” when they fall down.

• Make it fun and incorporate play with stuffies or whatever the child is interested in to elicit speech and language (i.e. let your child see you “hiding” toys in the room and have them find them)

• Books and music are extremely helpful to facilitate skills. 

• Keep in mind, once a child begins to use sounds, it is  more important to expand their sound and syllable repertoire than to have them accurately produce the sounds ( that will come later!)

• The more repetitions you can get the better! Using target vocalizations in play is not only fun for the child, but also encourages the most engagement and in turn increased repetitions.

The primary goals for children who are exhibiting minimal communication skills are (modified from Davis and Velleman, 2000):

• Help the child establish a consistent form of communication. This could include sign language, pointing to pictures, using approximations of words, pointing to what a child wants, gestures and facial expressions (or a combination of these!). It is important that the child and the people in their environment agree what a gesture, sound, picture, or word approximation represents or means.

• Using alternative communication such as sign language, gestures, or pictures can help move a child toward verbal communication by relieving frustration and establishing a consistent, reliable means of communication (Fish, 2016). 

Once my child/student starts vocalizing, where do I go from there?

A hierarchy is suggested for working on production of syllable shapes for children with Childhood Apraxia of Speech (modified from Fish, 2016 and Velleman, 2003) but can also be applied to minimally verbal children. I have include the initial steps in this hierarchy: 

• CV (Consonant plus a vowel) (“me”)

• VC (vowel plus a consonant “up”)

• Reduplicated CV.CV (“bye-bye” or “no-no”)

•  CV.CV with a vowel change  (“mommy”, “nehnuh”)

• Variegated CV.CV (“bunny”)

• CVC (“pop”)

•  CVC with different consonants (“top”)

These are techniques and suggestions that speech language pathologists use in therapy and caregivers can use at home to elicit some speech and language skills. If you are concerned about your child’s speech and/or language development, it is recommended that you contact a speech-language pathologist through your local county or early intervention or preschool program to have a thorough communication evaluation to determine if speech therapy is required. 

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