Friday
Jun272014

Why is "R" so hard

Written by Jessica Hawkins, MA, CCC-SLP

It's the question I hear often. Whether from a distressed parent or a curious professional, such as doctors and dentists....everyone wants to know: "Why is "R" so hard?" As a speech-language pathologist, it is my job to "fix" "R" difficulties, but, the truth is, it's a challenge for me too! There are several reasons why "R" is so difficult for SLP's to teach and for kids to learn to produce.

Unlike sounds such as "T,F,M, and B," there is not a "one size fits all" placement for producing "R." Some people produce the sound with their tongues bunched up and elevated in the back of their mouths while others elevate and curl their tongue tips to form a backward "C." It is key for your SLP to help your child figure out how they naturally produce "R" and to work through placement activities to find the optimal position for their individual production.

Additionally, "R" is not just one sound. Not only does "R" occur as a consonant at the beginning of words, such as "red," but it also occurs after vowels (vocalic "R"). When "R" is vocalic, there are several variations of "R" depending on the vowel (ar, air, ear, ire, or, er). Because each vowel is produced differently, these vowels influence the way "R" is produced. These combinations can be produced in the initial "airplane", medial (fairy), and final (fair) positions of words and may be influenced by the other sounds within the words. Furthermore, "R" is also produced in difficult "rl" combinations (girl) as well as consonant blends (cr, br, dr, etc). When you take all of this into account, there are over 30 forms of "R"!

Further complicating issues is the fact that "R" is not a visible sound, meaning it is difficult to see what movements are necessary to make the sound correctly. When you look in the mirror, it is easy to see that to say "F" you need to position your upper teeth on your lower lip or that to make a "B" you put your lips together. When making an "R" sound, however, it is a variety of external cues such as diagrams, model mouths, tactile prompts (e.g., touch cues, lollipops, tongue depressors) and kinesthetic cues to help their clients visualize and feel how and where "R" should be produced. They also do their best to verbally describe placement and give specific feedback during practice. While these are helpful tools, they are still not a replacement for being able to clearly see placement.

When it comes to articulation, "R" is one of, if not the most, complex sounds to teach and learn. Given the above information, it is no wonder that many children make this common articulation error and need to work to remediate it. As with all articulation errors, consistent therapy is key to success. Once initial placement is accomplished, children gain a sense of confidence and control. It is important to emphasize repetition and incorporate ongoing feedback to help establish the motor pattern to correctly produce "R" in a variety of contexts. It is also crucial to ask your SLP for activities you can use at home to facilitate generalization of skills. To you and your child, "R" therapy may seem like a long and winding road; however, hard work and diligence (and maybe a few lollipops along the way) will lead to success!

Monday
Dec092013

Holiday Blog

The holiday season quickly approached! Need some last minute gift ideas?? Need some ideas for what to do with the presents that have already arrived?? Read on!

Pretend play items are always a great choice for younger ages, such as a Supermarket Cash register. This toy can be used for a wide range of skills including play, receptive language, expressive language, auditory processing, memory, basic concepts.....sky is the limit! Add in a shopping cart and transform your basement into a grocery store.  If you are working on the concept of "except," you may ask "I would like all of the cans except the red one." If you are working on memory, pretend to send your child to the store and ask for 3 items (don't forget to have them rehearse them!) (www.cptoys.com has a comprehensive one). **If you are buying a toy that the child does not have a lot of experience with, such as a vet play set, then read a book first from the library to set the stage. 

Pretend play ideas do not always have to be a fancy, expensive toy! Often a unique blankey with the child's name on it is a perfect gift. It can turn into a magical flying carpet or a cape! Where will it take you? What are you going to see? Who will be there? Stay at your child's level.

Books are great for building pretend play or ideation! "From Head to Toe" by Eric Carle is a good one to help children realize that they can "pretend" to move like animals. Say & Play Storytelling Boxes (www.lakeshorelearning.com) are good for adding manipulatives to a story and/or adding their own unique spin on the story. 

Games are great gifts for all ages! They can double as pretend play toys as well! Operation is a good example. Playing the game by the directions is great for working on turn taking, fine motor skills, and coordination. It can also be turned into a real patient who comes in complaining of certain ailments (e.g., "My knee is hurting. Can you help me doctor?". Have your child inference into what may have happened. 

Social pragmatic language and expressing ones emotions can be targeted using "Let's Talk! Conversation Starters (5 & up) (www.lakeshorelearning.com). Great game to help the transition to bedtime as one last time to connect before bed OR if you have a morning little person, try it after breakfast.

Cooking kits are great for ages 2 and up! Work at your child's level.  Build vocabulary (i.e., pour, measure, flour, butter, etc). Develop expressive language skills (e.g., Child says "First measure the flour and pour it in the bowl"). Target receptive language skills (e.g., Find the big spoon. Mix the batter). Whatever the age or skill targeted, you are bound to wind up with a tasty treat!

Please consult with your therapist for additional ideas specific to your child. Have a very fun, safe holiday season!

-Diane

 

 

 

Thursday
Oct102013

Tips for maximizing screen time with your speech and language learner

Today's ever-expanding world of technology has introduced us to many amazing learning tools. From computers to smart phones, iPads, and tablets, there is a wide variety of screens for children to play with and learn from. As parents, it is important to reflect upon both what children are learning from screens as well as what they are missing out on. When children are occupying themselves with screens, they are often not engaging in communicative interactions or pretend play, 2 key components of language learning. How can you, as a parent, use technology while still incorporating social interaction and imagination to carryover speech and language goals?

Time it Right

 The AAP recommends that children and teens should limit screen time to one or two hours daily of content that is rich in quality. Times that children are able to access screens should be controlled and try to limit the locations that children have access to the screens (e.g., not in bedroom or during dinner). Additionally, the AAP recommends that parents should avoid exposing infants and children under age 2 to television and other entertainment media (AAP, Council on Communications and Media, 2010). For healthy brain growth, it is vital that infants and toddlers engage in direct interactions with parent and caregivers (AAP, n.d.). This is a critical period for learning language, social-emotional, problem solving, and motor skills.

Get Appy

Not all apps are created equal. you want to make sure that the apps you are selecting have educational value and will teach concepts or elicit communication. Cynthia Chiong, an educational researcher for A Matter of App, Yogiplay, Common Sense Media, and formerly, Apple, has created a thorough rubric for evaluating apps. 

1. Apps need to be developmentally appropriate for your child's age and teach concepts that are pertinent to what they are learning at home or school. One would also assess the motor skills necessary to manipulate the screen.

2. Apps should be balanced with engaging content that is not too distracting.

3. Apps should be motivating enough to prevent boredom and keep a child from coming back for more. Repeated exposure to material leads to learning.

4. Parental involvement is key. Although many apps do not have explicit opportunities for parental involvement, it is important to evaluate apps based on the potential for parental involvement to teach skills. 

Facilitate the Experience

While there are many educational apps on the market, it is not enough to site your child down with a device and expect maximum learning to occur. Adult participation is essential in helping children learn the concepts and skills conveyed in an app. No matter what app your child is using, there are many ways to facilitate speech and language learning at every level. Use enthusiasm and affect to engage your child while using the app as a tool for teaching. The following are just a few ways you can facilitate this process. It is very important to prepare your child with your expectations of the upcoming screen time to avoid negative behaviors (e.g., "Joey, let's have some fun and play the train app. We are going to take turns together.")

Turn Taking: With any simple game, take turns with your child. They take a turn and then you take a turn. You can even involve siblings. This helps to build the foundation for interpersonal communication. You can even use this strategy with your older child who is addicted to Angry Birds or other video games! It's an excellent strategy for teaching self-regulation, patience, perspective taking, and flexible thinking.

Choice Making and Requesting: This can be done with apps such as Toca Boca apps and Cookie Doodle. Elicit choices between materials such as, "Should we feed the girl a carrot or broccoli?" or "Do you want chocolate or peanut butter cookies?" You can also give choices about which character they would like to use when playing games. Have your child make requests such as, "Open the barn door" or "I want the blue frosting." At a very basic level, you could use a bubble app to have your child request "bubbles" before they get to pop them on the screen.

Labeling and Categorization: Ask  questions to elicit labeling of nouns and verbs during play. You can do this with virtually any app. For example, you can use Peek-a-boo Barn to label animal names or Toca Boca Kitchen to label foods. this strategy facilitates categorization of vocabulary. You can create additional opportunities to categorize by challenging your child to name all of the 'big' or 'small' animals to form more specific categories. Additionally, ask questions related to action words. Encourage them to form full sentences such as "I am cutting the carrot."

Description: Elicit descriptive language by playing guessing games. The Bag Game is perfect for this, however, you can use many apps to encourage this kind of language. While playing with the Toca Boca Kitchen, you might encourage your child to describe the food they want to feed the character, such as "A vegetable that is long, orange and crunchy." Model descriptive vocabulary including color, size, shape, amount, texture, taste, and sound words. Encourage your child to describe the pictures they see and include details (e.g., who, what, actions, where, when, why).

Answering and Asking Questions: Ask a variety of basic "what, where, who, and when" questions or encourage higher level thinking and reasoning with "how" and "why" questions. The Bag Game is a great app to encourage your child to ask questions to gain information about what you have hidden in the bag (e.g., "Is it a fruit?" "Where do you see it?").

Following Directions and Language Organization: Take turns giving directions. Give single or multi-step directions to your child such as, "Get the apple" or "Cut the broccoli and put it in the pot." When it is your child's turn, give them feedback about the quality of their directions when they miss the mark. This will help establish skills in the areas of word retrieval, sequencing, and organization.

Articulation: Consult with your SLP about the specific sounds that your child needs to target for the week. Choose apps that would target your child's sounds. For example, a child working on the /k/ sound would get lots of practice while playing with the Toca Boca Hair Salon (e.g., cut, comb, color, curl). You can branch from using single words to short phrases, sentences and conversation depending on the level of your child. Give them feedback about the accuracy of their performance.

Tie to Real Life Experiences: Encourage your child to think critically  or "tie" these apps to real life. For example, upon seeing that a character dislikes a food in the Toca Boca Kitchen, you could ask your child if they like or dislike that food. Further the activity by making a food in your own kitchen to create a hands on experience. If you use a video modeling app such as Social Skill Builder, talk about real life social experiences your child has had that are similar to those portrayed. For the youngest learners who have had a good time popping bubbles on the screen, make sure to go outside and blow some real bubbles too! 

No matter what your child's speech and language goals are or what technology you have available to you, screens can be a valuable, motivating tool for teaching and generalizing skills. Be sure to evaluate which apps you allow your child to utilize and be mindful of how much screen exposure your child is getting. Use technology as a supplement, not a substitute, for hands-on learning and play. Most importantly, maintain interactions with your child to maximize learning and opportunities for communication while having fun with your child at the same time!

Consult with your SLP to obtain specific apps that are recommended for your child!

-written by Jessica Hawkins, MA, CCC-SLP 

(Jessica is a talented therapist and has been with Speechtree Therapy since 2008)

 

Friday
Aug022013

Collaborate for Carryover

Your child spends several hours every month working on targeted speech and language skills in the therapy setting. You feel proud as your SLP tells you that your child's performance is steadily improving every week. You eagerly observe your child watching for proof of their hard work and practice. Why are you not seeing the same results at home and in spontaneous interactions with your child? The missing link is generalization, or the ability to transfer learned skills from a structured, therapeutic setting to real life. How can you, as a parent, assist in this process? The key is partnering with your SLP to open the lines of communication and to learn strategies to use at home.

A starting point is to observe your child's therapy sessions. By observing both your child and SLP in action, you will be able to conceptualize your child's speech and language strengths and needs. Your SLP can provide you with concrete examples of the speech and language behavior they are trying to remediate so that you can conceptualize the difference between your child's current level and the desired performance. You will also be able to observe how your SLP elicits the targeted outcome as well as what kind of reinforcement might improve their performance (e.g., stickers, high fives, a victory dance, a turn at a game, etc.) Is your child shy or reluctant to perform in front of you? Ask your therapist to videotape the session so that you can watch it at a time when your child is not around.

Utilize time before and after sessions to discuss any improvements or concerns you've had since the last session and to identify speech and language priorities. During this time, your therapist can provide you with suggested activities for home practice. Homework is highly effective if completed, therefore work with your SLP who will be able to identify ways to work homework into your day-to-day routines and activities. For example, if your child is working on the /s/ sound and is on the soccer team, you might try to have your child practice using good speech while talking about soccer, on the way to practice or when recalling what happened in the game. Your SLP can help you identify targeted sounds, language structures, concepts, and vocabulary that are pertinent and applicable to your family's real life.

Finally, if you have multiple therapists or specialists working with your child, make sure to put them in contact with each other. It is beneficial to connect providers so that they can communicate about diagnoses, therapy strategies, and observations. Your SLP may provide examples of speech and language targets to your occupational therapist (OT) and your OT may provide positioning or sensory strategies to your SLP. Sharing information will lead to optimal performance in both environments bringing your child one step closer to generalization.

It is exciting to see any type of progress in your child's speech and language skills. Watching your child's performance climb in accuracy is fulfilling and proof that their hard work is paying off. The ultimate reward is seeing your child spontaneously use their new skills in a genuine communicative interaction. Practice, patience, and open communication make perfect!

Written by -Jessica Hawkins, MA, CCC-SLP

(Jessica is an experienced clinician who has worked on the Speechtree team since 2008)

Friday
Jun082012

Fun Summer Activities

Summer is here! The kids are out of school and are looking for entertainment! Here are a few ideas to keep minds busy while enhancing speech and language development! Suggestions are offered for a variety of ages. If you need help adapting any of the activities for your child, contact your SLP for assistance.

Water play: It’s hot outside and what better way to cool down than add a little water!

  1. Give the kids different size cups or containers. Have them catch water from a sprinkler. See what containers fill up the fastest. Then use the water to give a nearby plant a drink!
  2. Spray bottles of water are so much fun and great for “water wars.” This is a great social pragmatic activity if you are working with multiple kids (e.g., “Does my play partner like to be sprayed in the arm, face, feet?” by reading body language and listening for verbal clues).
  3. Paint with water! Give the kids buckets, paintbrushes, or rollers and let them design pictures or paint the patio, deck, house, etc. Incorporate concepts such as high/low, short/long strokes, fast/slow, etc.
  4. Bathtub Alphabet Soup! Great way to get clean while learning your letters/sounds. Give your child a large spoon, dump in some foam letters, and mix! Grab 3 out and stick them to the wall of the tub. Target a specific sound and have the child identify the letter. Mix it back into the soup again!

Nature/Outdoor Suggestions: For the children who like the great outdoors!

  1. Pretend to set up a campsite. Have your child identify and gather things that you need to camp with (e.g., tent, flashlights, various foods, bug spray, sticks for a campfire, marshmallows). Add real friends or make believe!
  2. Draw a road map with chalk on your driveway or patio of a fun town! Have your child brainstorm different ideas on what would be in the town and where it would be found on the map (e.g., ice cream store, amusement park, library, pool). Then enjoy your town while playing!
  3. A great activity that doesn’t involve any props is I SPY. It works such a wide range of skills from vocabulary to articulation. Grab a blanket and a cold drink, sit in the backyard and play using lots of descriptive language (e.g., I spy something that is green, shaped like an oval, and is attached to a branch…..LEAF!). Or target phonological/articulation skills by saying they have to “spy” something that has the sound “k” in it.

Indoor Suggestions: When you need a break from the heat and just want to cool down, try these activities!

  1. Make lemonade: This is a great language sequencing activity that works on vocabulary and concept development as well. Older kids can identify all the items that are necessary for making the lemonade (e.g., cups, spoons, sugar, water, lemons, etc).
  2. Freeze bananas or grapes. Dip them in yogurt, peanut butter, or chocolate. Use the activity to work on oral motor awareness or pacing for speech (e.g., “Dip in the _____).
  3. Read a book and then act out the story.  Incorporate props when the ideas start to flow!
  4. For older children: Brainstorm a list of ideas that they want to do over the summer. Have them defend why they want to complete the activities.  Works on organization, planning, ideation, and reasoning skills. Reward them by completing some of their wishes….within reason!
  5. Playdough letters: Give your child a template for a letter and have them create the letter using playdough.  Add color accents using different colors (e.g. polka dots on a “p”)!
  6. Make homemade finger paint for a fun sensory experience and target creativity! Parents: mix 5 cups of cold water with 2 cups of flour in a saucepan over low heat. Stir in ¼ of a cup of salt and add food coloring. Once cool, pull out the paper and let the creative juices flow!

Summer vacation plans???? Remember to take plenty of pictures of activites of your trip that are meaningful to your child. Help them to create a photo album. Older children can write sentences below the pictures. Younger children can verbally tell about the pictures. Pretend to be a newsreporter and videotape the child reporting about their trip. Great memory to look back on years later!

Have a great summer!