Guest Blog-My New Favourite Therapy Tool

Congratulations to all you SLPs who made it through another year! I’m sure you are now getting ready for summer and a change of pace. I know many will work summer school, many will work in a clinic or private setting, and many will take this break to get rest and recharge for next school term. Whatever you do, I hope you make this the best summer ever.

Today’s blog entry is a change of pace for us, as we are featuring our first guest blog. When I read this featured blog last week, I thought this is totally a 2 Gals type blog and needs to be shared with our readers. This is a repost of Reka’s blog from her site (http://easyspeakideas.blogspot.com) Reka is a beautiful, shoe-lovin’ SLP from Barbados who has graciously allowed us to share this with you. I love this idea and know without a doubt you will love it too.

Hey everyone!

First of all I'd like to thank you all for your feedback on my last blog post "Green Analogies". I really appreciate it and am glad that you liked my random ramblings. I was able to draw reference to the analogy last night, as I gave a talk to a church congregation on children's speech and language development, and it was well received :)

Those who have been following my blog, would know that I love making resources, and I love when therapy tools can be used for a range of topics. Last week I bought my most useful therapy tool so far: my magnetic white board. It was on sale too!

Everyone loves it and I've been trying to find lots of different ways to use it in therapy. This was aided by my trusty laminator and some adhesive magnetic strip.

I wanted to share with my readers some of the cool uses of my new companion:

This one worked on categorizing sky, sea and land, as both a receptive and an expressive task.

This next one is my favourite, as I love the "Five little monkeys" rhyme. The children love that Mr. Crocodile can actually snatch the monkeys off the "tree".

The next one I adapted from a file folder game which works on big and little. Children have to choose the big or little object called, then put it on the appropriate side of the board.

Another one I made up on the spot was for prepositions 'on' vs 'under', which worked a lot better than I thought.

It also came in handy when I had to quickly draw some minimal pairs for /s/ and /n/ in final position, but those ones I definitely won't dare to share (they were ridiculed enough during the session).

These are my newest resources so far for my white board, but I have a few running around in my head which I will try to make over the next week, and share as an update to this post.

I want to hear from you readers. Do you use white boards in therapy? How do you use them?

Thanks for reading :)

Aren't those just the best ideas? Thanks Reka for sharing your creative ideas with us!

I hope you will bookmark Reka's blog site and become a regular follower.

We will see you next week!

Leah and Dean

www.2galsspeechproducts.com

BETTER SPEECH AND HEARING MONTH

PRIVATE SALE!!! 20% OFF

In recognition of Better Speech and Hearing Month and as a treat for our loyal readers, we are offering a private sale on our Adventure Pack games software and ALL our FAME Cds from now until midnight (EST) May 31^st 2011. Because this is an unadvertised special event, purchases can only be made by fax. You will need to email me, dean@2galsspeechproducts.com to request the special order form. I will email one back to you.

You can preview our Adventure Pack software and our FAME CDs on our website. Our online shopping cart does not allow for discounts, which is why you will need to fax your order.

Simply complete the order form and fax it to me at 1-606-638-3098.

Thank YOU for your dedication to better speech and hearing!

Leah and Dean

www.2galsspeechproducts.com

ELICITING SOUNDS /r/

Good Morning SLPs!

This will mark the final entry on our series Eliciting Sounds. We are going to talk about /r/ which has been labeled by many as the "hardest" sound to teach. There are many suggested techniques to try so keep in mine these two things: 1. go with the strategy that you are most comfortable and confident and 2. keep trying different strategies until you find one that works for the kid sitting in front of you. Just because it worked with the last kid does not mean it will work with this one! Now with that in mind here are our tips.

TIP #1 Visual Verbal Label

I’ve heard the R sound labeled as many different and creative things. Here are a few from which you might wish to choose: (1) the Rooster Sound; (2) Growling Dog/Bear Sound “grrrr”; (3) the Seal sound; (4) the Siren Sound; and (5) the Pirate Sound. I think your choice will be guided by the particular R sound you are trying to teach, as well as, with which the child can identify.

TIP #2 Shape from /i/ (long E)

Have the child produce /i/ several times until s/he can grasp the concept that the tongue is wide and touching the sides of the upper teeth midway back in his mouth. Once you are sure they fully understand and have control of their tongue tell them to keep the tongue touching their teeth as they slide the tongue all the way back to their molars. They should shape from /i/ to an /r/.

TIP #3 Shape from /j/ (Y sound)

This utilizes the same basic approach as for /i/. You are going to say /j/ as they move the tongue back until it comes out /r/. The difference is that the /j/ will position the tongue higher in the mouth!

TIP #4 Manually Move the Tongue Back

There are an assortment of things you can use to push the tongue back. One is the ever popular tongue depressor, but I’ve never liked it as I feel like I’m hurting the child. (That’s just my personal opinion.) Instead I use a dental swab. I push the tongue back with it and have the child bite on the stick portion that is now extending out of their mouth to hold placement and tell them to say /r/ after me (with the dental swap in their mouth). I like this because it keeps the child from relaxing the tongue and sliding it under the swab, due to the sponge on the end. It is just one of those things that works for me.

I read just this week in a blog by Alexandra Streeter (http://community.advanceweb.com/blogs/sp_2/default.aspx) that she likes to use a dental floss holder as a tongue placement tool for R.

There is also a product called Tongue LifteR that is readily available in the speech catalogs. I’ve never used it.

There is a new product on the market called Speech Buddies that are designed to get correct tongue position for R and a few other sounds. I have not tried them personally, so I can’t attest to their effectiveness, but the premise sounds like it would work wonderfully!

TIP #5 Cue with WIDE, UP, and BACK

I verbally cue with those words to remind the child of correct placement. The tongue has to be up high, all the way in the back of the mouth, and it has to be wide-touching the side of gums above the molars! I also use a hand signal as I am saying that. My hand signal is the letter Y from the manual alphabet, which represents wide for my purpose, I move it up high and back beside my face as I give that cue. I fade the verbal cue and use just the hand signal as therapy progresses. Leah uses this cuing as well and reminds us that instead of moving our hand towards the back of our mouth, to move it forward towards the child for further emphasis of back in their mouths.

Again referencing Alexandra Streeter’s blog, she suggests using peanut butter on the sides of the molars to cue for placement. I would also remind you to check for food allergies before using food products in therapy ;-)

TIP #6 SMILE

A simple strategy to eliminate the insertion of /w/ is to tell the child to smile. You just can’t say /w/ while you are smiling!

TIP #7 Touch Above Back Teeth

As you have heard me say 1000 times already in previous posts, some kids just don’t “get it” when it comes to what you are wanting them to do and many times all it takes is a simple adjustment in our instructions. One such adjustment is to tell the child to put their tongue ABOVE the back teeth. That will usually get that tongue higher up in the mouth and will make a world of difference in their production.

TIP #8 R Trrrreasure

You know I couldn’t possibly write a blog without mentioning Dr. Caroline Bowen. She has an interesting strategy that involves teaching /r/ from /tr/ I’ll share it via this link

http://www.speech-language-therapy.com/tx-facts-and-tricks.html

I would like to mention a few programs currently on the market that are popular with many SLPs for working with R. (no particular order-just as they come to my feeble mind) I’m not endorsing any of these I’m just making you aware of them in case you had not heard of them.

The Entire World of R http://www.sayitright.org/EntireWorldofR.html

Successful R Therapy by Pam Marshalla http://www.pammarshalla.com/catalogue/alph/srt.html

Speech Buddies https://www.speechbuddy.com/

Let’s Learn R CD ROM http://www.violettelearning.com/index.php?page=products

I will now unabashedly ask you to remember us and our products as you order your materials for next school year!

Leah and Dean

www.2galsspeechproducts.com

ELICITING SOUNDS /f/

Good Monday Morning to You! I hope you have a big cup of coffee or other caffeinated beverage to jump-start your day! Today we are going to talk about the /f/ sound. This is a relatively easy sound to teach and most therapists have few problems with getting correct production, so this entry should be fairly short.

TIP #1 “Bite Your Bottom Lip and Blow”

I find that to be standard instruction for telling a child what to do in order to produce the

/f/ sound. However, most kids will bite their lip and block the air and it will escape laterally in most all instances. So to get them to understand that you want the air to flow over the lip and under the teeth to produce friction for that fricative, simply begin that instruction with the word lightly. “Lightly bite your bottom lip and blow.” To get the air to come straight out the center place the tip of your index finger vertically at the center of the child’s mouth and tell them to blow on your finger. That helps cue where the center of their mouth is for them.

TIP#2 Cheerios or Fruit Loops

Once again you have caught me with my hand in a box of cereal! Yes, you can use either of these cereals to teach correct placement for /f/ as taught by Sara Rosenfeld-Johnson in her Talk Tools. This exercise will get across the idea of jaw-lip dissociation and oral segmentation better and quicker than anything else you can do, in my humble opinion. As you have heard me say several times previously in my blogs, I truly think the biggest barrier to kids learning their speech sounds has to do with them not understanding what is it exactly that we are wanting them to do. Non-oral motor speech exercises are very effective at helping them understand. It promotes oral awareness by assisting them in their understanding and identification of the parts of the mouth. It also promotes oral differentiation and teaches oral segmentation by performing acts that they can understand. Thank you Sara Rosenfeld-Johnson!

Mrs. Johnson’s procedure basically says you place a single piece of cereal in the middle of the bottom lip and have the child move it into their mouth by using only their upper teeth. (Dissociation and segmentation) You do this 25 times. Then you have them pretend to remove the cereal 50 times. At that point they should completely understand about the lip and teeth connection and what you mean by “Lightly bite your bottom lip and blow.” Now you can introduce /f/.

TIP #3 “Mad Cat” and “Fire Hose” Visual-Verbal Labels

As SLPs working with kids we like to be cutesy and perky, so we label the phonemes with cute little visual-verbal prompts, don’t we? Leah and I like the visual-verbal prompts of Mad Cat or Fire Hose for the /f/ sound. Either one works well but it does not hurt to make sure that the child is saying “fffffffff” and not “er-rare” for his interpretation of a Mad Cat. “Mad Cat” was first introduced to me in the Big Book of Sounds many, many years ago.

Catherine Chamberlain and Robin Strode introduced the “Fire Hose” visual-verbal prompt for /f/ in their Easy Does It for Apraxia and Motor Planning Program. I love it because it gives you a longer fricative than the short burst you get with the Mad Cat because they are pretending to spray water from a fire hose to put out a fire. Depending on what I am wanting from the child I will sometimes us both. Remember to do what works for you and that kid in front of you.

Tip #4 Hold Finger Under Bottom Lip

A simple visual cue to use to remind the child to use a correct /f/ sound is to place your index finger horizontally under your bottom lip. (Needless to say you will pair it with the sound as you are teaching the sound for it to become a visual cue they will recognize.) When they are drilling in words that simple cue can help them learn to self-monitor and self correct.

TIP#5 To Eliminate /fp/

It drives me crazy when a child learns the /f/ sound and says it so beautifully, but then inserts that /p/ when he starts using it in syllables or words! ARGH! What do you do? Well, there are two main solutions. This suggested solution may not be the best but it is one that has worked for me. When they begin saying their /f/syllables or words for the day, I have them use their own index finger (laterally) to push and hold the upper lip out of the way. I explain why I’m having them do this and demonstrate for them what they are doing and why it is coming out as /fp/. We continue with that days therapy activities with them using their finger. I encourage and coach the parents to do this during homework practice as well. It works. It may take a session or two but they finally grasp the idea that you do not need to use the lip, even though they have been substituting /p/ for /f/ all their little lives.

Now the better way to eliminate the /fp/ is taught by none other than Dr. Caroline Bowen. She teaches us how to use an aspiration trick to eliminate that stop. This is a no fail approach which I highly recommend. You know I love her therapy techniques! You also know I’m going to provide the link for you. Here is where she explains how to do it.

http://www.speech-language-therapy.com/tx-facts-and-tricks.html

And here is the link to her pre-made materials for us to use to teach it! Can she make it any easier for us?

http://www.speech-language-therapy.com/tx-/aspiration-trick-F.pdf

Beyond the tips we have just shared, I doubt you are having much difficulty with anything else related to the /f/, so we will conclude this blog. Ok, it may seem totally ridiculous to say this, but having seen well-meaning therapist do this I will remind you that you should not be teaching /f/ to a child who has no front teeth. If the /f/ is on his IEP as one of his targets it is OK to not work on it if he doesn’t have the oral structures to make the sound. Simply make note of it to report at the annual IEP meeting and go to another sound. If by chance you have no other sounds to work on, then call an IEP meeting to place the child on “Clinical leave” until his teeth come in. Yes, it is that simple.

For many of you the year is winding down, so enjoy and make the most of the days you have left with your kids!

Leah and Dean

www.2galspeechproducts.com