Tuesday, February 6, 2018

Helping Students Who Are Orally Defensive in Speech Therapy

I was working with a group of students last week and I wanted to help them grasp proper tongue placement for /s/. I pulled out the mirrors, tongue depressors, and toothettes when all of a sudden one second grader flipped out. With his hand covering his mouth he pushed himself away from the table and expressed with terror in his voice, "I don't like things in my mouth!" Okay," I responded, "no worries we don't have to use these." He remained fearful even with reassurance that I wouldn't come anywhere near him with the toothette. His peers on the other hand, were eager to use the cherry flavored tongue depressors. That session was lost for him and yet I still needed to help him understand tongue placement. I have a Super Duper Jumbo mighty Mouth Hand Puppet, but I wanted him to have a more personalized experience.

In the car on my way home (where all my ideas/thoughts happen) I decided that in order to have him develop comfort with his own mouth, he had to make one and not just a paper mouth, but a mouth where he could move the tongue. I've seen mouth craftivities with mini marshmallow teeth, but I wanted this one to be used more than once. I also didn't want to spend too much money as lately I've been a little too spendy. I ordered 1/4 inch white pom poms to be used as teeth and found pink baby socks at Walmart. I bought the 0-6 month size. I made a mouth template from card stock that the students traced on pink paper with a small rectangle where the sock tongue would be glued. Unfortunately, the pom poms didn't arrive in time, so we used crumpled tissue paper for teeth. I wish I had thought of that before I bought the pom poms!  I struggled stapling the tongue in when it occurred to me to use hot glue. I also trimmed about two inches of the sock cuff off, so there wasn't excess sock.

My little ones placed their fingers in the sock and moved it all around their mouths. They used tongue depressors and toothettes to touch all around the teeth and tongue. My colleague from our PK had a great idea to add some texture to the alveolar ridge I had drawn on. I think I'll outline it with white glue and sprinkle sand, glitter or salt on top. I'd like them to understand that the alveolar ridge is bumpy.

Years ago, I worked with twins one of whom was very orally defensive. His parents were at their wits end, because he was having considerable dental problems, yet they couldn't get him to the dentist. We are fortunate to have a dental program in our school whereby a dental hygienist comes and cleans students' teeth.  They asked for help so I ordered some dental tools. Never fear, they were never placed in the student's mouth, they were simply to desensitize him to the tools. He used them on the Jumbo Mighty Mouth and used the mirror tool to look in my mouth. It worked like a charm.
I'm fairly certain it's going to take repeated exposure "playing" with these mouths before this particular student becomes more at ease. It may never happen, in fact, but at least he will have  a greater awareness of his tongue in his mouth and will be less anxious when I pull out tongue depressors for use with his peers.

One last picture. I was able to find some white pom poms in my big ole bucket of pom poms, so one student glued them on his mouth as teeth. I actually think I like the look of the crumpled tissue paper better, plus there was no drying time because we used glue sticks.

Any other suggestions? How do you help your students with oral defensiveness? I am open to any and all suggestions!

Friday, February 2, 2018

Carnac The Magnificent in Speech-Language Therapy

I was working with a student last week, in science class. He was getting very frustrated with me because I was asking him about the group plan and needed to ask for clarification several times. What became very clear was that I didn't have all the information and he wasn't giving it to me in his responses, despite asking him clarifying questions. Herein lies the rub with social communication difficulties, "you think I know what you're thinking." I don't I'm not a mind reader!

In the car on my way home I was drafting my weekly email to his teachers...in my mind. I wanted to help them understand that our student has difficulty understanding that he has to communicate what he thinks and knows in order for us to all be on a level communication playing field, because we aren't mind readers. That notion jogged a memory of Johnny Carson and his Carnac the Magnificent character. How could I bring Carnac to speech therapy?

I immediately ordered a giant turban from Amazon because who doesn't love a little kitsch in speech? I plan on helping my student understand that others don't know what's on his mind using a mind reader scenario and some games from my therapy closet. I found three games I believe will lend well to this concept: Inklings, Buzzword, and Whoonu.

The object of Inklings is to write clues to help your teammates guess the seven answers on the subject card. The idea is to get your teammates to guess your seven answers using as short a clue as possible. More points are awarded for shorter clues.  For instance, if the subject is things that are yellow and the answer is lemon, a possible clue could be sour.  After we play using the subject cards provided with the game, I am going to add more social subjects such as relating an experience from school with answers including subjects, date, place, discourse, conclusion, etc.

Buzzword will be wonderful for helping students express a specific message. The object of Buzzword is to have your team guess the answers to the clues around a central theme. I think I am going to modify the rules so that the Buzzword isn't given at the outset of the turn, but needs to be guessed. So players would give the clues and the others would guess the theme or buzzword. I'll have to select specific cards and omit some more obscure clues, I think.

The last game I plan on using is Whoonu. In Whoonu players win the most points by correctly guessing other players' (the Whoozit's) favorite thing. The snag is that the players guess the Whoozit's favorite thing from the cards in their hands.

These games are introductions of sorts and will pave the way for more discussion and activities around sharing thoughts to improve communication. The bottom line is I want to help my student understand he bears a portion of the responsibility to provide information to others to prevent communication breakdowns as well as to learn to ask questions about what others may or may not know. I''l let you know how it works

Does anyone have any suggestions as to how I can make this different or better? I would love to hear your thoughts, I'm not a mind reader after all! :)

Thursday, January 25, 2018

R.I.P. Rosie the Riveter

Naomi Fraley (nee Parker), the woman believed to be the inspiration behind J. Howard Miller's wartime "We Can Do It," poster died on Jan. 20, 2018 at 96 years of age.  Although there is some controversy around whether Naomi is in fact the model for the poster, it appears her claim is valid. Like many women during World War II, Naomi went to work as a machinist at the Naval Air Station in Alameda, California. In 1942 while working in Alameda, a photographer for the Acme news agency photographed her as she leaned over a lathe. She was sporting the now iconic red bandana.  The original poster was meant to encourage employees at Westinghouse Electric.

The recognizable image of "Rosie" epitomizes feminine fortitude, spunk, and determination, which is exactly why I modeled my logo after her. As an SLP and a woman, I draw strength from the women who paved the way for me to be an independent, college educated professional.  With a flexed bicep held high, I say thank you Naomi. Rest in peace

Wednesday, January 24, 2018

The Instax Camera in Speech-Language Therapy

While visiting family at the Jersey Shore this summer, my nephew's wife was taking pictures with the neatest little camera. I was surprised when the film shot out the bottom and developed right before my eyes! It was a blast from the past! Of course many of you will recall Polaroid cameras that provided instant gratification with a pretty badly developed picture. Well, Fuji has developed a new and improved version, the instax mini. It is small and convenient and comes in some kicky little colors. The picture quality is much sharper with vivid colors, than the Polaroids of the past. A number of different types of frames are available including rainbow, stars, solids, comics, and more. I immediately thought how this little gem could be used in speech-language therapy, but at 50 plus dollars, I put it on the back burner.

This Christmas my wonderful nephew and his sweet wife bought my children each an instax of their very own. Nora didn't take hers to school with her when she returned and so I asked if I could borrow it. Of course, she obliged. I have only just begun to explore how I can use this camera in therapy. The film is fairly expensive (I ordered the value pack here), but I think with the right applications it will be a great investment. If today's therapy session is any indication of how effective and motivating therapy with the instax can be, it will be entirely worth it.
Today students posed in a way to help them remember to use "new" speech sounds and adhered the photos to decorated reminder signs with washi tape. Their excitement was barely contained!

These little ones are leaving these pictures as reminders on their desks.
I've been brainstorming other uses for the instax including:

  • Students can write on an exit slip what they did or learned in speech-language therapy and take a photo. The picture can encourage discussion with peers, teachers, and parents and will be helpful in transfer of skills.
  • I like the idea of having students write their therapy goal as an "I can" statement and snapping a pic. Again these pictures can be the springboard for discussion afterward as well as reminder of why they are coming to speech. I ask students every time they enter the speech speech room what "they are working on." I then write their I can statements on the whiteboard. Using the photo will provide more of a personal connection to what they are participating in.
  • For social groups I thought it would be fun to take pictures of students showing different facial expressions or emotions.
  • Pairing two items in one picture, students can then do comparisons.
  • It might be fun to snap some candid shots and use them as the basis for a narrative.
I'm sure more ideas will come to me as I start using the instax, this is a pretty good start, though. I know you're all super creative SLPs, so if you have any ideas or suggestions, please comment. How would you use the instax in speech-language therapy?

Saturday, January 20, 2018

A Handy Social Skill Acronym

I've noticed a lot of references to "Say it, Think it" activities on social media as well as at workshops, recently. While it's gone by different names, this is not a new concept. Say it, think it activities are really helpful for helping students with social-pragmatic difficulties become more aware of blurting tendencies as well as putting that social filter into action.  So many of our students just say the first thing that pops into their heads, which leads to breakdowns in communication, problems with teachers and parents, and misperceptions by peers. Activities that help our students access the impulse control switch in their minds will serve them well in both school, social arenas and the workforce (as much as we might like to, we can't tell our bosses what we really think). As SLPs we use whatever is motivating and works;  wind-up mouths, squishy brains and mouths, sticky notes, and thought and speech bubble signs.  I really like these thought bubble and speech bubble sticky notes found on Amazon. I found the pictured squishy toys at Walmart.  There was an eye as well, but at $6.88 a toy, I exercised some purchasing restraint. These seem to be all the rage with the kids and they are super satisfying to squish.

I introduce the concept of a social filter by explaining the difference between thoughts and spoken words. That's easy enough, the former are quiet, known only to the student, and can be memories, ideas, words, or pictures.  Words are spoken and heard by all around the student. They have power and can make others feel a certain way or think certain thoughts.

We then practice. I present either a picture or a verbal scenario and give kids the opportunity to "blurt" the first thing they think of in the privacy and safety of the speech room. In doing so we can look at the impact of what they said on them personally and those around them. True story; I showed a video from the Everyday Social series to a student in speech therapy. It featured middle school students. My student's first thought (said aloud, of course) upon seeing the video was, "Well, he's never gonna get laid." This opened the door to the notion that a lot of what we think should not be uttered. In the context of speech therapy it is much easier to engage the social filter than when a student is emotionally triggered or trying to fit in socially.

Enter O.T.M. About twenty-five years ago, I was working in Hillsdale, NJ and I worked with an exceptional SLP. Geri, had created the aforementioned acronym and I use it to this day. O.T.M. stands for "keep It on The Mind, not Out The Mouth." I pair the acronym with the gesture of my index finger moving from forehead along the side of my face and out from my mouth. I like practicing this concept while doing in-class lessons. The whole class benefits and the teacher has some common language to reinforce the skill.

I can also dovetail using a social filter with plain old kindness. I really like the acronym THINK; is it true; is it helpful, is it inspiring, is it necessary, is it kind? Here is a little poster freebie for you highlighting the THINK  strategy. Click the picture or the link to be redirected to the download.

Well, I hope the O.T.M. strategy is something you bring to your speech programs and that you and your students find it productive. I'd love to hear if you use it!!

Monday, January 15, 2018

One Little Word 2018

For the past few years, I have participated in the One Little Word® project. Ali Edwards, the originator of "One Little Word," sums it this way:

A single word can be a powerful thing. It can be the ripple in the pond that changes everything. It can be sharp and biting or rich and soft and slow.

In 2006 I began a tradition of choosing one word for myself each January – a word to focus on, meditate on, and reflect upon as I go about my daily life. My words have included play, peace, vitality, nurture, story, light, up, open, thrive, give, and whole. These words have each become a part of my life in one way or another. They've been embedded into who I am and into who I'm becoming. They've been what I've needed most (and didn't know I needed). They've helped me to breathe deeper, to see clearer, to navigate challenges, and to grow.

The task in focusing on a word, as opposed to a resolution, is to encourage meditating on one concept that can have far reaching effect in my (and your) life. That concept can permeate how I view my relationships, my job, my past and my future. Becoming intentional with decisions after viewing them through a consistent lens allows me to interact with my story as I write and create around a theme.

After much contemplation, I have chosen the word discipline. I don't mean discipline in a legalistic, unyielding, have to, need to, must, sort of way. I mean discipline in a "I choose to be disciplined in this because it will bear out results or I will feel temperate, accomplished or strong afterward."  

Pondering this word should be fairly straightforward. Applying the concept to my life is going to require discipline. One thing I have learned over the course of 56 years is, in order for me to grow I need to practice another little word. Can you guess which hand is mine?

I encourage you to find your word.

Saturday, January 6, 2018

It is Definitely Winter

Winter has arrived! In fact, it has arrived all across the country. There is snow in states that rarely see snow. In NH we have had 3 snow days already. January 2nd was our scheduled return to school. We had a two-hour delay due to cold (it was -22)! Last night it was -100 atop Mount Washington. That's some frosty weather. Yes, winter has arrived and in NH, it sticks around into April. This video captures the trip to my car yesterday!

After the frenzy and inconsistency of December, school-based SLPs are contending with more of the same because of weather and student absences. Next week I will be getting a little help from my friends who have authored some fun and therapeutically effective winter-themed materials. I decided to do a therapy week round up in order to "snowcase" these wonderful therapy activities. Since I will be using these activities next week, I don't have pictures of the products in action. Sorry. (My husband did get me a beautiful new camera for Christmas, so my pictures should be improving) All of these items can be accessed by clicking the respective images.

The first is Gold Country Speech's All Around a Winter Wonderland. Tracy's candyland-based game is perfect for mixed groups and more. She has included cards targeting problem solving, describing, wh-questions, multiple meaning words, following directions, articulation, AND a design your own option. Click here to grab this amazing product.

Laura, of All Y'All Need has created a series of jokes that are so fun to use in therapy. I've used her jokes for articulation, social pragmatics, fluency, and targeting ambiguities. They are "snow" punny and offer wonderful opportunities for discussion. Winter Jokes can be found right here.

Are you "yeti" for this one? Sparklle SLP's materials are the carrot for my snowman. She always includes a variety of materials that are perfect for mixed groups. "Mixed groups" seems to be the term du jour for how my groups have been for 35 years.  Homogeneous grouping is extremely difficult in our line of work, so I've always had to tailor my activities for multiple targets. Sparklle's Yeti packet targets "snow" much including: describing, comprehension, tier 2 vocabulary, informational text passages with QR code links, grammar and syntax practice, analogies, conjunctions, spatial concepts, positive reinforcement, AND recipes for snow and snow paint. To add an extra element of fun, this packet can be used as a complement to the game Yeti in My Spaghetti. Sled on over here to find it.

If you haven't used Small Talk SLP's Find it on the Go materials, ski, don't snowshoe, to get one. They are perfect for younger students and the format is easy to use and motivating.  Add to that a plethora of speech and language targets and you've got a winner. Pam has included multiple targets in three areas: concepts, receptive language and expressive language. While I don't laminate all my seasonal materials (I am trying to consider the environment before I wrap everything in plastic), I have laminated this one. I give my students a wipe-off marker and they draw right on the pages. It can be found here.

Mary of Old School Speech has put the "bomb" in "bomb cyclone" with her Joke Dominoes.  This game is played like traditional dominoes, which is fun because kids will then know how to play traditional dominoes! Joke Dominoes is a wonderful way to address articulation, fluency, social-pragmatics, multiple meaning meaning words, and more. It is easy to prep and easy to use and the price is right at $1.00. This winter staple can be found here.

I "met" Mia many years ago, as a TpT customer. I have files on my computer named Mia. I remember a snow day many years ago, when I received an email from her, whereby she sent me her most recent winter product for free. She wrote something along the lines of, "You've been such a good customer, I want you to have this." It was the start of a lifelong friendship. Mia has created a wonderful series of interactive books that encourage true language interaction. Each interactive book comes with cue cards explaining what each wh-question answers. She then provides information about the theme and targets various questions along the way. I like her interactive books because they create a very naturalistic context for language therapy. Grab this Louisiana girl's All About Winter Interactive Book here.

I hope you see this post is about more than winter-themed products; it's about friendships and support. It's about how we all can try to make life a little easier for each other in a very demanding job. Oh, and for your wintry viewing pleasure here is the video of my return trek up the mountain to home.