Thursday, October 13, 2016

Targeting /s/ blends through Literacy activities

Like most of my slp peeps, I am a planner!  I have theme-based lessons and materials that I have treasured over the years, so prepping for my private sessions is fairly easy.  Every once in a while though, I decide to gather some new materials to target common articulation, phonological, and/or language delays.

Just recently, I polled my colleagues on Facebook and searched my Pinterest boards to create a list of books for preschoolers that target /s/ blends.  Much to my surprise, I had several of the books that I needed on hand.  I only needed to order three of the seven books to complete my /s/ blend library. Here is the criteria that I used for my collection:
  • Short readings with no more than 2-3 sentences per page/picture
  • Repetition of early /s/ blend targets (i.e., stop, small)
  • Appropriate for children aged 4-6 years old
  • One book for each /s/ blend target
  • No more than two /s/ blend targets per book to meet cycles approach 
  • Seasonally appropriate books (I am a theme girl)
Now that I have my books on hand, I can use each in my session with my clients working on improving both listening and expression of /s/ blends.  Since the books are mine to keep, I wrote the /s/ blend target in permanent marker on the cover and I used a highlighter to mark the /s/ blend words in the books.  You can likely find any of these books at your local bookstore, library sales, or Amazon.  Maybe you have some already in your materials collection!!  I will close this post with a photo gallery of my Fall and Winter books.  Next Spring, I hope to compile my warmer weather collection.



























Tuesday, September 6, 2016

Crack the Books by Mobile Education Store {{SEPTEMBER SALE}}

This post summarizes my experiences with using Crack the Books during speech and language sessions.  The unbiased opinions discussed below are solely mine with no other compensation other than redemption codes for these apps for trial and review purposes.  

The Crack the Books series by Mobile Education Store (MES) is such a favorite among my upper elementary and middle school clients and why wouldn't it be with all that it has to offer?!  Here is a great description of this product quoted directly from the MES website:

"Crack The Books™ is an multiple award-winning, state of the art, interactive book series for upper elementary students. Developed in collaboration with top universities, scientists, educators and specialists, Crack The Books™ is the first standard based, core curriculum aligned digital book series that includes both interactive enhancements and universal design accessibility features. Designed for all students, from children with special needs to students who are academically gifted, Crack The Books™ gives educators a powerful new teaching tool to help students of all academic skill levels meet state standards for reading comprehension."
The best thing about these books is their versatility.  You can adjust reading levels for 1st through 8th grade to suit the reader's ability with a simple click all while maintaining content.  This adjustment makes it possible for all students in one classroom to participate in a unified curriculum regardless of their reading ability.  The icing on the cake for a private practitioner is that you can target 3rd to 5th grade science and social studies core curriculum in your clinical settings.

This summer, I had some time to look at all the new updates and was delighted to see additions of coloring pages, activities, word searches, memory matching, and puzzles which include vocabulary and visuals from each of the subjects featured in the apps. What a great way to carry over curriculum vocabulary in a leisurely way!  Like the series, you can even adjust the difficulty levels during word searches, memory matching, and puzzle play so it can be fun, yet challenging for a variety of children.


COLORING PAGE 

LESSON PLAN

WORD SEARCH- 12 LETTER GRID

MEMORY MATCHING- MEDIUM DIFFICULTY

PUZZLE GAME- EASY LEVEL

In my opinion, the interactive interface in this series is what captures the attention of my clients.  One of my favorites in the Grassland series allows you to adjust temperature and rainfall and then visualize what the terrains would look like under specific parameters.  Many of my private clients ask to review these visuals long after we have completed reading chapters.  I believe that the interactive links and high resolution images and videos enhance learning and assist in retention of new information.






If you fancy the ability to navigate around the Earth's biomes, then you can find 3D interactive globes filed in the video gallery for each book.  These videos are incorporated into the chapters; however, if you want to find one quickly for review, then you can go directly to the index.  Again, I have found that using these models along with text enhances learning, especially for clients that I work with in private practice who need to visualize information and see images on a wider, dimensional scope. 





ROTATE AND ZOOM THE GLOBE FOR 3D

One of my middle school clients will make all kinds of bargains with me when she needs to read aloud during our comprehension drills, but she NEVER wants me to take a turn when it comes to reading a Crack the Books topic!  Just yesterday, she commented that the author is "funny" and she made sure that I connected with her mother about purchasing these apps for her home iPad.  This particular client also delights in exploring "Fun Facts" and quickly hearing how new words are pronounced via links in the text.  



CLICK ON THE FUN FACTS FOR TRIVIA

QUICKLY HEAR WORDS PRONOUNCED AND READ DEFINITIONS

I cannot wait to see the additional series that Mobile Education Store promises to release in the future!!  Right now, these five titles are HALF off for the month of September.  You can purchase them for $5.99 each or buy the bundle for $14.99 right now. Happy Learning!!

  • Pines to Vines- The Forest Biome
  • Blades- The Grasslands Biome
  • Seashores to Sea Floors- The Ocean Biome
  • Parched Planet- The Desert Biome
  • Aquatic Earth- The Freshwater Biome




Wednesday, August 24, 2016

Category Game Bags- A Perfect Activity to Start the School Year


As many of us embark on a new, school year, I wanted to take this opportunity to wish you all a fabulous, stress free speech life!  With that, I would like to share a quick and easy lesson plan for your classroom, small group, or individual sessions that will take you just minutes to put together. This game was my "go to" activity for classroom instruction at the beginning of the school year and it is sure to earn you the reputation as the "fun" professional while at the same time build vocabulary and speech skills with your clients.

I had the good fortune to work with some exceptional Speech-Language Pathologists early on in my career.  During one of my observations, I watched students play a lively, category game using just brown paper lunch bags and small sheets of paper.  This game can easily be adapted for students in 1st through 5th grade.  If your clients are younger and have a hard time reading, then you can always put pictures on the bags in place of words.

Before you begin, get at least 10 paper bags and write the names of various category groups on each one.  Then, make a list, using a small piece of paper or half of an index card, of 4-5 group members.  If you need to use pictures instead of words on the bags, you will need to create those and attach them to your bags.  You can make groups like Colors even more challenging for your upper elementary students by listing members such as African violet and Fuchsia instead of naming primary colors.



Wednesday, August 3, 2016

Using Pool Noodles to Support Speech and Language Development


Buon Giorno!! It's late morning on the train ride from Rome to Florence and with my coffee in hand and family in tow, I thought I would write some blog posts!! Just prior to the start of this fabulous, long getaway, I completed my second summer speech and language pool group session. This year, my participant size doubled from last summer with nine registered children between the ages of two and seven years old. Once again, I was surrounded by smiling faces and lots of gestures and vocalizations with a side order of splashing.

This group has been a passion of mine from early on in my career and despite my best attempts at planning, I always stumble upon a creative idea during the group. A couple weeks into this year's session, I walked by a container of pool noodles at our facility and asked each child to pick a color. My intent was to help position participants on their bellies for some kicking and splashing during our opening "wake up" routine of Motor Boat, but the noodle served an even greater benefit for many little ones and their caregivers.

Keeping Roaming Nomads close to Caregivers
While most children stay close to their caregivers, some enjoy exploring throughout the group. Having had a toddler who NEVER stayed with me during mommy and me group times, I understand the need for those "motivated to move" in order to fully attend. Given that the majority of my participants were working on generalizing skills into group settings and socializing with peers, I didn't want to allow for constant escape from social opportunities to play in the water alone. That's where the pool noodle came in quite handy! Caregivers wrapped the noodle around their child and then positioned themselves directly behind little ones. I'm no expert, but this arrangement may have given my little swimmers a better sense of where their bodies were in space which reduced the need to move. The most active children ceased movement and appeared content, not restrained. Those who remained near caregivers without the noodle, protested having it wrapped around them for the entire 30-40 minute group, so we simply put the noodle aside for them.

Body Wake-Up with Increased Water Resistance
After a couple quick rounds of Motor Boat go so slow/fast, I typically extended some body wake-up time with the song: The Wheels on the Bus. I really like this song for three reasons. First, just about everyone knows the words to it. Second, kids DELIGHT in being lifted up and down in the water when we sing about the windows and kids on the bus. Third, there are several opportunities for using water resistance to stimulate attention and alert our muscles. In all honestly, I happen to use the pool noodle while singing this song by accident when I realized it increased water resistance. Everyone loved swishing the noodle underwater to make waves during the sequence about the wipers on the bus and it was fun trying to motor plan using the noodle ends to spin like the wheels on the bus. With all this water resistance, our bodies were alert and we were ready to make some noise!

Pretend Play
Originally, I worried that having a noodle handy throughout the group would lead to children hitting others with them while swinging them around. Thankfully, I didn't see anyone start this particular trend. What I hadn't intended was that I could use the noodle for symbolic play. Once again, during the Wheels on the Bus song, I curved my noodle and positioned it into an arch over my head to pretend it was a building in a town. I encouraged others to imitate this new action by building their own homes in our town and the crowd loved it. I yelled out greetings to Mason in his town and Riley in hers and children responded to hearing their names by looking and attending. It occurred to me while writing this post that I could have used the noodle as a log during the song about the frogs that sit on a log and then jump into a pool or maybe made the noodle into a bridge for children to circle "under" during the motor boat song. Oh well, there's always next summer!


Monday, May 16, 2016

Summer Speech and Language "Work"

Across the US, many SLPs are braving the end of the school year madness with final progress reports, IEP meetings, and sessions with children ready to start summer vacation!!  I say to you, "Hang in there, you've got this people!!  

While I am thankful to have those manic school days of 75 plus students behind me, I have not dodged all of the end of the school year bullets in my private practice world!  I need to first navigate the waters of my family life and son's busy, summer schedule (oh to be 10 years old again and have summers off!!)  Then, I have to steer clear of summer school schedules as I plot a summer work schedule.  Next, all of my paperwork, planning, insurance calls, and new patient consultations need to be done by early May in preparation for my summer speech and language pool group sessions.  Finally, I have to plan for holiday closings and vacations by preparing carryover work for my families.  Little by little, I'm getting there though and I wanted to share some freebies and ideas with you that will hopefully make my life and transitions easier this summer!  

Before I show you my activities and plans for summer sessions, I want to give you a sense of my mindset.  I believe that every child deserves some down time and the opportunity to participate in some summer fun, which is why I have decided to offer 6-week summer speech and language pool groups through Naperville Therapediatrics.  I also firmly believe that taking too much time off from practicing communication skills can lead to regression.  So how do I find a balance between these two worlds of taking a break and continuing practice?  It isn't easy, but I strive to offer some fun, thematic sessions that don't feel like "work." This year, I'm taking my plan one step further and providing families "work" for home use in the form of sand/water play buckets, bright and colorful flashcards, and pencil boxes filled with all kinds of goodies.  Luckily, my practice is small with under 20 clients, so I can spend a little on materials, but I understand that this may not be the case for all practitioners. If you can't afford gifting supplies, then please feel free to share the lesson plans that I have included in this post.  You can also find all sorts of summer carryover work on Teachers Pay Teachers.  Let's take a look at what I have prepared. 

Years ago, I found pencil cases at Walmart on clearance for 25 cents each, so naturally, I bought 20 of them.  I completely forgot that I had these boxes until I was Spring cleaning this year.  I decided to finally put these to good use, so I packaged several of them for individual clients.  There are three types of boxes.
  1. This one is for my youngest client who is working on increasing vocalizations and single word utterances.  I found the beginning words deck and ocean-themed lacing cards at the Dollar Tree.  You will also notice a pile of stickers on the bottom and a bingo dabber because this client loves creating artwork and can sit for hours to play with stickers and dabbers! This little one will also receive some dabber pages for expressive language practice so the dabber marker can be put to good use!
     
  2. The next box has a collection of items for one of my early elementary, speech only clients who typically comes to sessions with an older sibling, so I included an I Spy Snap card game for the two of them to enjoy.  I also updated my flair pen supply recently, so I am donating my older flairs and some crayola thin markers for articulation writing work. I cleaned out my arts and crafts bin and found some decorative tape and stickers, so I added these for some crafting fun.
  3. This final box is for my oldest client who is in middle school. We have been working on memory drills so I included a sticky note pad and mini writing notebook as a way to encourage using the strategy of writing things down in order to improve recall.  My hope is that this client can use the flair pens, pencils, and paper to work on carryover tasks. Finally, I will be adding the free, summer idioms deck that my Frenzied colleague from Old School Speech recently had featured in the TpT newsletter.   I added fish and seashell stickers to these cards to designate the idiom cards from the definition ones.  
While the pencil boxes worked well for some clients, I found something better suited for my young clients with autism.  Last summer, I purchased some colorful, blue bins at the Dollar Tree to store some materials, but have since re-arranged my office and no loner have room for these on my shelf. Rather than recycle them, I am going to gift them to some families to use as a sand/water play bin.  As luck would have it, one of my neighbors just offered me a large bag of blue, Crayola sand that she no longer needed, so I divided the lot and used a Ziploc bag to store the sand in each bin.  Next, I picked up some sand toys and summer die cuts at the Dollar Tree.  Some of my clients have been working on answering "WH" questions so I used three different objects for "WHO", "WHAT" and "WHERE" with my Smarty Ears Custom Boards app to create a matching deck for each question type.  All of the questions pertain to the summer and seasonal activities to keep things functional.


Each pencil box and bin will have an instructional sheet included with it. I wrote a few different handouts to meet the needs of three, different clientele groups. First, I created this sheet appropriate for toddlers needing to build expressive speech skills and early elementary clients working on improving articulation of target sounds. 

Next, I wrote this handout for my young clients using either PECS or speech generating devices to communicate.  Many of my tasks are carryover ones that we have worked on during speech sessions over the last six months.

Finally, I have monthly homework sheets for June, July, and August that suite my upper elementary and middle school clients working on language skills.

I am really pleased with how these collections turned out and cannot wait to share them with my clients!  The best part is that I didn't spend a fortune on materials, but rather used supplies that I already had in my practice and purchased some great items at the local Dollar Tree.  I hope that you all enjoy a wonderful, relaxing summer and that you can use some of my materials from this post to make your speech lives easier!!  




Sunday, April 17, 2016

Implementing Therapy Outside of your Speech Therapy Room~ A Frenzied SLPs Link-up


Happy Spring!!  Here's hoping that you are seeing some spring-like temperatures in your neck of the woods!  We are finally enjoying warmer days as we pack away our winter coats in the Midwest. The Frenzied SLPs want to help you celebrate new beginnings this Spring by hosting this linky party about taking therapy outside.  Be sure to check out the links below for more inspiration!  We also welcome you to join us by linking your post at the 'Add Your Link' tab on the bottom, left-hand corner of this post.

As you may already know, I have been in private practice for a couple years now in my home office: Naperville Therapediatrics. Life is good as my days are filled with a nice balance of work, home management, play time with my puppy, and quality time with our ten year old, sweet son.  At first, I struggled with coming up with ideas for this topic of taking therapy outside because I do not have the luxury of a fenced-in yard or safe space to play outdoors with my active clients.  Then, it dawned on me that I could put my own spin on working "outside" of the four walls in my therapy room.  In fact, I have been doing this for quite some time.  Here's what a typical entry looks like at my practice:

No matter how old you are or what you are working on to enhance communication, everyone can benefit from practicing using eye contact, gestures, words, or sentences when greeting each other at the front door.  Next, it's time to follow directions to remove shoes and place them either under a bench in the entryway or in a hallway closet.  Sometimes, clients need to use the bathroom, so there may be an opportunity to make a request using speech or even a speech generating device. Otherwise, we head down the hallway to the closed speech room door with the child safety lock and wait until the client initiates a request for help to open the door.  If we look at this scenario that typically takes place in the five minutes before we walk into the actual therapy room, then you can count up to four communicative opportunities (greeting, responding to directions, requesting, asking for assistance.)

Then there's this guy...,
Gryffindor the Vizsla at 15 months old



Most of my clients enjoy seeing my overly friendly puppy.  Some even head from the door straight to the treat cabinet in the kitchen to reward Gryffindor for following commands such as, "Go to your bed", "Sit", "High-Five", and "Down."  Even the shyest of all my clients lights up with a big smile when she hears Gryff barking and she also tends to be more vocal around him than she is when it's just me at the door greeting her on arrival. The best part about my pseudo clinical dog is that he helps me with transitioning clients from the therapy room to the entryway door at the end of our sessions.  I don't mean to brag, but many little ones protest when our session is over.  Guess that's a good sign that they are having fun while learning!  I have found it to be rather effective to say, even in the mist of a tantrum, "Do you want to see Gryff and give him one more treat?"  Works.  Every. Time.  Before we can say, "Speech is over", kids are heading to the coat rack and getting jackets on so they can see that crazy puppy again!  As luck would have it, Gryff is happy to comply with more attention.  It is pretty handy having him around to break the ice, practice speech skills, and make for smooth transitions!!







Sunday, April 3, 2016

Water Play: Pool Group Style


Happy Spring Everyone!!  I hope that the temps are rising and the sun is shining in your neck of the woods!  Here in the Midwest, I am enjoying seeing buds on our trees and flowers peeking through the dirt.  

This week, The Frenzied SLPs are posting about water play in speech and language therapy since April Showers bring May flowers.  Please take a moment to peek at all of the posts by following the links at the bottom of this one.

This theme seemed like an appropriate time for me to write a follow-up post about my mission to offer pool speech and language lessons.  I first wrote about my experience here and then was honored to have been featured in the Limelight section of the December 2015 ASHA Leader.  Months later, I am still getting emails filled with excitement and questions about how I researched and orchestrated pool groups.  Some of these messages have come from SLPs from as far as Germany and as close as my home state of Illinois.  In true SLP fashion, many professionals asked poignant questions, so I thought it would be a good idea to blog a FAQ post about speech and language pool groups.  


FREQUENTLY ASKED QUESTIONS ABOUT SPEECH
AND LANGUAGE POOL GROUPS
Coursework and Training:
  1. How did you got started in doing treatment sessions in the pool? Initially, I observed a pool group offered through an Early Intervention at a Jewish Community Center in 2003 in Rhode Island.  Shortly after, I submitted a request to the department that handled insurance and liability coverage at the hospital-based Early Intervention that I worked for in Rhode Island.  It took a couple months before my job site hosted speech and language pool groups at the Jewish Community Center.  There were fees involved for pool rental, but I never handled that part of the program. My only responsibilities were to promote the pool group with clients on my caseload, collaborate with a PT for planning, and write weekly service notes to submit with my billing to our office.
  2. Do you have any special certifications to help with your sessions in the pool?  All of my training was acquired from experience.  I was VERY fortunate to host my first pool group with an exceptional physical therapist who taught me so much about positioning and working with resistance in the water to help improve stability and attention.  
  3. Is there coursework or training for providing aquatic speech therapy services?  One of the emails that I received following the ASHA Leader article was from Susan Nachimson who shared that she has been teaching a course titled: Speech Therapy in an Aquatic Setting  since 1/2002 [California Board of Speech Pathology (PDP#129)].
Securing a Facility:
  1. How would I go about looking for other facilities that offer aquatic speech therapy services? If you are not interested in starting your own group and would rather observe pool group therapy, then I would start by calling rehabilitation facilities.  Many of these locations have heated pools that they use for physical therapy with clients.
  2. How did you secure the pool? I started researching for the pool group session that I wanted to offer through my private practice six months before the services were slated to begin.  First, I called three facilities and ask to speak with the aquatics directors.  Next, I followed-up with meeting those in person that were most receptive to my plan and/or were already renting their pool to other rehabilitative agencies.  In the end, I selected Rush Copley Healthplex because the director returned my calls and had availability that suited my scheduling needs.  
  3. Do you think a neighbor's pool with an outside shower and bathroom work?  Personally, I would not feel comfortable using a neighbor's pool as I am not a strong swimmer and I would not want to take on the liability and responsibility that comes with offering this type of group.  I also like being in the community and being able to offer pool group services to up to 10 families.  Having the ability to invite several participants also increases opportunities for peer modeling and expands socialization.
Billing, Insurance, and Liability Coverage:
  1. Do you bill for it like a normal group speech therapy session?  Yes, I bill my speech and language services using the speech group CPT code 92508.  This code is an "un-timed" one, meaning that you can expect the same reimbursement whether you spend ten minutes in the water or sixty. 
  2. Did you bill to insurance companies or do the group sessions private pay? If you did private pay, what were your rates?  I do a little bit of both depending on the insurance carrier and my network participation.  Some families have a required co-payment that is close to the full reimbursement allowed by the 92508 CPT, so I typically advise these families not to use their coverage, especially if they are also allowed a certain number of speech services per calendar year.  I would rather not take six individual sessions away if the family has a 25 session cap for a 30 minute group session and my clients concur.  Part of my research time was also spent requesting updated reimbursements from each of my in-network insurance companies so I could get a sense of what I should charge for my services. Every state is different, so I would suggest researching your reimbursements and deciding on your charges once you gathered that information.  You can expect to make significantly less for group services than for individual sessions.
  3. How did you go about getting liability coverage to work with clients in the pool?  I asked the pool facility what they required and in my circumstance, I only needed to add the location name to my existing liability policy. This addition did not require any additional fees.  You should ask this question while researching pool facilities as this may vary depending on your state.
  4. Do you pay pool rental fees?  There are non-refundable pool rental fees at the facility that I use for group services; however, I ask families to cover these costs.  Families are expected to pay a designated amount per group for each of the six weeks of my program prior to the start date and this fee is not prorated should they miss a session.  I can not afford the risk of paying for weekly services for each family without being able to bill for a session if the family misses or decides not to continue for whatever reason.  
Goals and Session Outline:
  1. Do you have specific goals for each child or is it more a general group therapy targeting various aspects of language (engagement, imitation, vocalizing, following directions, etc)? Years ago, when I worked alongside an Early Intervention PT during pool group instruction, we created a service rendered form with the most frequently reoccurring tasks in our sessions (i.e., managing steps on a slide, using noodles for belly time, vocalizing to make needs known.)  I edited that note to meet the needs of the pool group that I now offer in my private practice for children aged 2-7 years old.  Many of my private practice clients attend my pool groups in the summer, so I prompt them according to the goals that we are working on in our individual sessions.  If I have a brand new student start the group, then I offer the family a free, 30 minute consultation at my home office before the group initiates to observe, collaborate, and manage paperwork.  I ask families to bring their child's current IEP for my records and review to that consultation meeting.  You can find a copy of my SOAP note at this link.  I designed this note to allow me an opportunity to comment and expand on tasks and I used a local printing store to make carbons of the note so I can quickly provide families with feedback about the session.  I also wrote an outline of all the developmental goals that you can address with children aged two through seven years old during pool group therapy.  
  2. Have you ever used pool therapy for middle school and high school students with autism?  And if, what kind of activities did you do?  No, I have only worked with children aged 2-7 in the pool.
  3. Would you mind sharing more details about a typical pool therapy session? For more details about my group agenda, you can follow this link.
  4. What songs do you use in pool groups?  The most popular songs are: The Wheels on the Bus, If you're Happy and You Know it (I use this tune for a directions game to sing, "Put the duck on your head, on your head"), Head, Shoulders, Knees, and Toes, Five Green and Speckled Frogs, Hello and Goodbye songs, All the Little Fish were Swimming in the Water, One Little, Two Little, Three Little Bubbles.
Other:
  1. Did you have an ongoing day/time for a number of weeks?  Yes, my summer groups are weekly at the same day and time for six weeks total.
  2. Did you have the parents in the pool too?  A caregiver at least 18 years of age is required to remain with each child before, during, and after pool group sessions.
  3. Were your classes 30 min or one hour?  My water sessions are 30 minutes long, but "therapy" begins in the changing room both before and after water play.  We talk about our sessions, what we wear in the water, and temperatures that day just to name a few.
  4. Did you co treat with a PT?  I currently work as a solo facilitator for my pool group sessions, but highly recommend working with a motor specialist when possible, especially if you are just getting started with pool group therapy.  
  5. How do you advertise (word of mouth, flyers at your clinic, etc.)?  I bought some ad space in local, neighborhood newsletters, but did not obtain a single client from those ads.  Last summer, four of my participants were seeing me at my private practice, one found me through social media on my speech2me Facebook/Instagram accounts, and another signed up for the session at a parent night meeting that I spoke at regarding summer programs at an ABA home base.  This year, I have already signed up five of my private clients and found another when my district special needs PTA (I was recording secretary in 2014/15) emailed members my pool group flyer.  I also personally emailed the school speech pathologists that I network with for my private clients in an effort to have these school professionals help me spread the word about my summer services.