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! :)