Using Behavior Routines in Speech Therapy

What are behavior routines?

Behavior routines are sets of expectations consistently implemented and reinforced in order to support attention, self-regulation, and autonomy.

Why use behavior routines?

First, establishing behavior routines frees up cognitive resources allowing you and your students to focus on what is really important–the intervention. As with anything, when you are learning to do something it requires attention and effort, but after you do it CONSISTENTLY and REPEATEDLY it becomes automated. Once your students have learned the behavior routines, they will implement them automatically allowing them to focus their effort and attention on you and the skill you are targeting.

Second, establishing behavior routines supports self-regulation and increases autonomy. I can relate to my students who feel disregulated when things are unexpected or outside of my control. Establishing routines provides your students with consistency, which supports self-regulation. Additionally, once the routines are established your students do not need to rely on you to know what to do, which gives them autonomy and a sense of control.

What do behavior routines look like in speech therapy?

FREEBIE! Click here to download the visuals pictured above.

My school district uses the Responsive Classroom Model, which is a student-centered, social and emotional learning approach to teaching and discipline. It is evidence-based and emphasizes building interest in learning through engaging academics, positive community, effective management, and developmental awareness. I use many of the components in my own behavior routines.

One component of classroom management that they teach is the idea of using “teacher language” to effectively communicate expectations to your students. I use “teacher language” (i.e., reminding language, reinforcing language, and redirecting language) to consistently reinforce the routines I have established with my students. They have an excellent book about this topic called The Power of Our Words by Paula Denton Ed.D. I wrote a four-part blog series about how it applies to Speech Language Pathologists, if you are interested you can check that out here.

In my description of my personal speech therapy routines above, I mention two resources that I incorporate into my routines that help establish a rhythm to the session: goal nameplates and speech bins. You can read more about those tools here: goal name tags & speech bins.

What do behavior routines look like in your speech therapy sessions?

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Structure Your Speech Therapy Sessions Using Speech Bins

If you asked me, what is one thing you learned in your graduate clinical placements that you still use in your practice today? My answer would be speech bins. Speech bins are an adapted work system consisting of three numbered plastic bins (I use a three drawer Sterilite container). At the beginning of each session, you place an activity or set of activities in each bin. During the session, the student(s) work through the bins until all of the activities inside have been completed. Speech bins define the amount of work expected and establish a definite ending to when the session is over.

The idea of speech bins comes from the Structured TEACCHing approach.

What is TEACCH?

The TEACCH Autism Program is based out of the University of North Carolina. It is a university-based system of community centers that offer programs providing clinical services and trainings, and conducting research.

TEACCH stands for:

  • Teaching – Sharing knowledge of Autism Spectrum Disorder and increasing the skill level of professionals and practitioners through innovative education, teaching, and demonstration models.
  • Expanding – Commitment to expanding our own knowledge and that of others to ensure that we offer the highest quality, evidence-based services to Autistic individuals and their families across the lifespan.
  • Appreciating – Appreciating the strengths and uniqueness of Autistic culture.
  • Collaborating and Cooperating with colleagues, other professionals, Autistic people, and their families.
  • Holistic – Adopting a holistic approach, looking at the person, their family, and their communities throughout the lifespan.

TEACCH is known for utilizing a Structured TEACCHing approach, which is designed to respond to the needs of Autistic people using the best available, evidence-based methods known so far, for educating and teaching autonomy. It is not a curriculum or program, but rather a framework to support access to academic instruction and therapeutic intervention.  The framework includes physical organization, individualized schedules, work systems, and visual structure of materials in tasks and activities.

Primarily, Structured TEACCHing aims to carefully construct the student’s environment to support self-regulation and the highest level of independence.

Work Systems

One component of the Structured TEACCHing Framework is work systems. Work systems are bins, each containing an activity to be completed. Work systems, as they are described in the Structured TEACCHing approach, are intended to be completed independently. Therefore, only already mastered activities with clear start and endpoints should be placed in each bin. Work systems teach independence, NOT skills. Work systems help the student answer the following questions:

  1. What work needs to be done?
  2. How much work needs to be done?
  3. How do I know when I’m finished?
  4. What do I do next?

Speech Bins

Okay, so speech bins are basically just an adapted work system. TEACCH emphasizes that teaching organizational and environmental management skills supports not only independence but also self-regulation. Using consistent routines helps our students with regulation challenges by providing a sense of predictability and control. I use speech bins to structure my sessions in a way that is visual and consistent. It is important for consistency and predictability purposes that you always complete all three bins, even if you only spend one-minute or complete one trial on one of the activities.

Image of speech bins (three-drawer black Sterilite container on wheels) to the right of the bookshelf.

For my preschool students and early communicators, I have labeled each bin with a picture of a numbered shape. During the session, I give the student(s) the appropriate image, and they match it to the coordinating image on the proper bin. Using this system provides autonomy within the session and a quick movement break. I use the phrase “1-2-3-Play” to support the students in understanding our schedule. You can find a free download of the basic speech bin labels, speech bin schedule reminder visual, and editable digital speech bins template I use in the Freebie Library.

Image of speech bin routine visual for preschoolers and early communicators. Shows three speech bin labels followed by an image representing play.

Adapting to COVID

In the spring, when I first switched to teletherapy, I continued to use my speech bins to structure my sessions. I relocated my plastic bins to my new bedroom office. I would show the label, place it on the bin, and then pull out the activity. As I transitioned to using more digital activities I created a simple editable, digital speech bin template on Google Slides. I have included access to a copy of the editable, digital speech bins template in the freebie library. I paste pictures or screenshots of the activities I have planned into the boxes on the template and check each activity off as we complete it. Because the speech bins are hosted on Google Slides, you can duplicate the “schedule” as many times as you need and make small adjustments to plan ahead for all of your students.

Thanks for reading!