Tag: speech

R is the Most Menacing of Sounds

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“‘R’ is among the most menacing of sounds. That’s why it’s called ‘murder’ and not ‘mukduk.’”

Dwight Schrute speaking directly to SLPs everywhere

Raise your hand if “R” is your least favorite speech sound to treat?! Me too. Addressing “R” in articulation intervention is almost always a long road.

Why is “R” so hard?

First, accurate placement for “R” requires a complex sequence of lingual, lip, and jaw movements, which are often challenging for young children to see and execute. Second, the shape and sound of “R” is influenced by the surrounding vowels and consonants making it kind of like a shape-shifter. Third, “R” is generally regarded as one of the last developing sounds, which often translates to intervention being delayed.

When should I intervene with the “R” sound?

There are many considerations involved in eligibility decisions, including age, sound inventory, intelligibility, and stimulability.

Generally, I begin intervening for “R” sound errors by mid-first grade, around 6-6.5 years old.

How to Make the “R” Sound..

I find that multi-sensory instruction is extremely helpful when eliciting “R.”

Auditory Discrimination

I always begin with the auditory discrimination tasks to ensure that the child can perceive the sound. Can the student distinguish between the target and the error sound? If they cannot hear the difference, they will not be able to self-monitor. There are two ways that you can practice auditory discrimination. You can read a list of target words aloud and have the student identify whether you said the target sound correctly or with the error sound. For example, saying “wabbit” and seeing if the student identifies the production as an error. Alternatively, you could use minimal pairs and ask the student to hand you the target that they heard you say. For example contrasting “ring” and “wing.”

Visual & Kinesthetic Training

I am about to share my go to “R” trick, and it almost always works!

First, I ask the student to show me their muscles by flexing their arms. Next, I explain to them that their tongue is really just a big muscle, like the muscles in our arms. Just as we can flex our arms to show our arm muscles, we can flex our tongue to show our tongue muscles. Now, I am ready to model the sound. I stretch my arm out straight and begin modeling “ah” with my tongue flat on the bottom of my mouth. Then, in slow motion I carefully show the student how I curve my arm up and back toward my head and I do the same with my tongue.

I think the key to this being successful is practicing the tongue and arm movements absent of sound at first. I will usually carefully explain and model the tongue and arm movements to parents, and encourage them to practice 10x morning and night. I give them the visual below to tape to the bathroom mirror to help them remember. You can download a PDF of this visual in my freebie library.

Proprioception

To increase proprioception, I always begin with practicing in a mirror for visual feedback and I often use Dum-Dums for increased proprioception. You can rub the Dum-Dum on the sides of the tongue to help the student match up the sides of their tongue to the roof of their mouth. More often though, I have the student place the Dum-Dum in their mouth and carefully bite down on the stick. Then I instruct them to curl their tongue behind the Dum-Dum to ensure they are retracting their tongue far enough back into the oral cavity.

Fine Tuning Tips

If the student is curling their tongue back sufficiently, but the “R” does not sound quite right consider jaw height and lip retraction. I always tell my students to smile, because practicing “R” is soooo much fun. Increasing lip retraction can improve sound quality. We also play the jaw game. I teach the students that when we open our mouth all the way that is like eating a giant cheese burger, when we open it slightly that is like nibbling a slice of cheese, and when we open our mouth just right for “R’ that is like eating a french fry. We will practice opening our jaw to different heights by calling out hamburger, cheese, french fry and matching our jaw opening to the food called.

Combining all of these tips is successful for so many of my students. Hopefully, your student has found this successful too. If these tips worked, your student is now successfully producing “ar.”

Transitioning to Other “R” Variations

Once you have “ar” the other vocalic variations are easy to target. Using visual and auditory feedback, I show the student that “R” sounds different based on the vowel that precedes it. To change the sound you begin with the target vowel and transition to a flexed tongue position. I have my students practice transitioning from the vowel to a flexed tongue position slowly at first and then we speed it up, before we transition to words.

Carryover

The most important part of any articulation intervention plan is that everyone is on the same page: the therapist, the student, their teacher, and their caregivers. If you are looking for a handout that includes all of this information written in parent-facing and teacher-facing language with easy ideas to incorporate daily practice at home and school, you do not have to reinvent the wheel, check out the articulation classroom and home support plans!

Generalization

Okay, so you guided your student to accurate articulation and you have the whole team on board with cueing and daily practice. The student says their sound clearly with you and even with their teacher or caregiver, but the minute they hit the lunchroom that beautiful “R” disappears! That means it is time to really focus on generalization. Here are a few ideas to get you started.

Story Retell

Read sound loaded picture books to your student and have them retell the story using their best speech. Check out this Road Map to R resource from Ashley Rossi at Sweet Southern Speech. It is a free download (when you sign up for her email newsletter) that includes a list of books and corresponding bookmarks with the list of R targets for each book.

Explanation Videos

Check out The Dr. Binocs Show by Peekaboo Kidz on Youtube. They have tons of kid friendly, animated informative shorts about things animals can do, how human biology works, what causes inclement weather, the story of modern day inventions, and the history of holidays. I like to watch a video with my students and then have them summarize the information we learned from the video using their best speech.

Conversation Starters

Choose a conversation starter and give the student a tally clicker to keep track of how many times they use their sound in the conversation.

News Anchor Role Play

My absolute favorite way to target generalization in speech sessions is by using the Newscaster Articulation App by Erik X. Raj. The app lets the student select a target word to build a breaking news story around. Then, the student records themselves telling their breaking news story and the app generates an awesome clip with a really cool breaking news opening sequence.

Before recording our breaking news story, I always discuss the important role News Anchors play in informing people. We discuss why it is important for listeners to understand the news. For example, when a storm is coming or if there is a dangerous animal loose.

After the student selects their target word, we write out their news announcement. Depending on the student’s level of generalization we may highlight words with their target to reinforce accuracy. Once the student records their video, we carefully watch it tally how many times we noticed the old sound or challenges with intelligibility.

Do you have any favorite generalization activities for “R”? Comment them below!

Thanks for reading!

Trello

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Trello is a web-based organization tool that is essentially digital to do lists. But also, it is so much more than that! Trello has so many tools that can help you automate your to do list and organize the chaos in your brain.

Trello Boards

Image of my personal Trello Boards

Think of them as actual boards to which you would pin your real life to do lists. You can have as many boards as you would like. You can also have one board with many different lists. I have three boards, work, home, and Seldom Speechless. Each of my boards has five to ten lists. Having different boards is helpful when you are trying to time block. In my planner I block out time for work, home, or Seldom Speechless and then I complete tasks on the board I assigned to that time slot.

Trello Lists

Image of work lists on my personal Trello board

Once you have created a board, or multiple, you can add lists to the board. The lists help you organize your tasks by category, which is helpful for batch working, or targeting tasks that go together.

Work List Examples:

  • Priorities
  • Planning
  • Evaluations
  • Referrals & Screenings
  • IEPs
  • Evergreen Checklists
  • Miscellaneous

Trello Cards

The task items added to each list are called cards.

Image of card features available on Trello

Card features:

  • Assign another person to complete the task (yay delegation!)
  • Add checklists to breakdown the tasks (you can save checklists to quickly add them for similar tasks!)
  • Assign a due date
  • Add attachments
  • Add a cover photo
  • Activate power-ups (I like the card repeater power up, so you can set recurring tasks to be automatically added to your lists, like medicaid billing, progress reports, etc.)
  • Add comments or notes for later

Trello Checklists

You can save checklists to quickly add them to new task cards in the future. I save all of my recurring checklists to a list at the end of my board (pictured below).

Image of examples of recurring checklists that can be saved to use on Trello

Recurring Checklist Examples:

  • Evaluations
  • Screenings
  • IEPS
  • Current Caseload
  • Beginning of the Year
  • End of the Year

When you make a new task card, you can click checklist and select the one you need to quickly assign sub-tasks to the card.

In list view, you can quickly see how much progress you have made on each of your tasks. You can see in the image to the left that I have completed 0 of 17 items for A. Smith’s Evaluation, but I have completed 4 of 8 items for the Beginning of the School Year Prep.

Trello Power-ups

There are many different power-ups. You can add one power-up to each of your boards on the free version of Trello. In my opinion, the best power-up is the card repeater. It automatically duplicates tasks cards depending the frequency you set (daily, weekly, monthly, yearly options).

I also like to use the calendar power-up, which lets you visualize all of your task cards displayed on a calendar by due date.

Image of Calendar Power-up on Trello

Trello Rules

Rules are the reason that I upgraded to the paid version of Trello. With the Business Class membership you can add unlimited automation commands, which frees up so much space in my brain (#wortheverypenny).

The free version only allows you to have one rule, but you can have unlimited boards, cards, checklists, and one power-up (like the card repeater OR the calendar view).

You can add automation commands or rules under the “Butler.” The Butler automatically proposed rules based on patterns that you exhibit, which is helpful when you are getting started with Trello. Under the Butler, you can add general rules or rules by card, board, calendar, or due date. I will show you examples of rules that I have set for my Trello.

Image of rule builder on Trello

Trello uses a rule builder that requires you to set a trigger and outline the actions you want to occur whenever the trigger occurs.

Examples of Rules You Can Set:
  • Automatically create a progress report task card one month prior to the end of term with caseload checklist and a due date of the end of term.
  • Automatically add evaluation checklist to any card added to the evaluation list and move the card to priority task list 30 days before it is due.
  • Automatically add referral checklist to any card added to the referral task list and set a due date in 21 days.

I have included a list of specific rules with the exact wording I use on my Trello board in the Freebie Library, if you are looking to get started! Or send me an email at hello@seldomspeechless.com! Trello helps me stay organized and I would love for it to help you too!

Trello Aesthetics

Trello is not beautiful. I can forgive its lack of aesthetics for its awesome functionality. Did I mention they have a mobile app, so you can use it on the go?! However, with the paid version you can change the background image of your boards, which makes it a little prettier. There is also a work around for adding images to the top cover card of each list (available in free version).

Check out the Trello pricing guide here. The free version really does have a lot of great features! I used it and enjoyed the free membership for many years before upgrading.

Thanks for reading!

September Speech Therapy Planning Ideas

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I am officially back to school today! This will truly be an unprecedented year. Is anyone else tired of hearing that word? Unprecedented. I have heard the administration of the school I work for use that word in almost every email. To me, unprecedented seems to translate to no one knows what is happening, let’s all wing it!

I was recently reading Uniquely Human: A different way of seeing autism by Barry M. Prizant, PhD. In the book, he quotes a personal friend who said, “The opposite of anxiety isn’t calm, it’s trust.” In this time of uncertainty, many students (and adults) will seek to control anything they can to artificially create trust in an environment that is rapidly and unexpectedly changing. Dr. Prizant encourages educators, therapists, and caregivers to focus on being calm and consistent in the face of unexpected changes.

Well friend, that’s my plan–lean on my routines and focus on being calm and consistent for my students. My speech therapy planning routine has always been to choose a broad theme for the month and select picture books, articles, animated shorts, songs, games, and activities within that theme. Thankfully this style of planning works no matter the service delivery model, so I will be remaining consistent with my materials and therapy style.

Head on over to the freebie library to download a copy of the September Speech Therapy Planning Idea Guide pictured below. It has clickable links and features only no-print interactive resources that are great for both in-person therapy on an ipad and teletherapy.

Photo of September Speech Therapy Ideas Planning Guide with clickable links available in the freebie library.

Get it here. I hope this helps you transition into distance learning this month!

Thanks for reading!

Digital Data Collection using Google Forms

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Types of Data Collection

In graduate school, I remember learning about discrete data collection. I remember being told to take data on every trial, every single session. I was shown once, maybe twice how to take discrete data on a blank piece of paper. It was a one-size-fits-all approach to data collection.

There are actually many different ways to collect valuable data to inform your clinical decisions!

Discrete Data Collection

Discrete data collection is the most familiar data collection method. It involves writing down pluses and minuses for each trial and obtaining a percent accuracy by dividing the total pluses by the total trials. This method of data collection is great for objective, straight forward tasks like articulation, following directions, grammar, wh-question comprehension, etc. Discrete data collection can be challenging for more subjective tasks like story retell, writing, describing, etc.

In graduate school, I was taught to collect discrete data for every single trial, every single time. The problem with that is if you are constantly testing the student, it is easy to forget that you need to take time to teach the skill. That is why many SLPs opt to take discrete data only on designated data days or just during the first five-minutes of the session. Also, discrete data by itself does not capture scaffolding and cueing levels.

I do not take data every session! I make sure I take plenty of time to teach the skills and document subjective, observation data about scaffolding and cueing during the instructional phases. Once a skill has been taught and I have moved on to guided practice, maintenance, and generalization I take data more often.

Observational Data Collection

Subjective data collection is awesome, because it provides room to document changes in scaffolding and cueing! For many skills, the fine development in a student’s level of independence is not reflected in percent accuracy. I use rubrics and notes about level and type of cues to document those fine changes. I use several different rubrics, which I have embedded into my master data form.

My Data System

During my Clinical Fellowship, I quickly realized that the one-size-fits-all approach from graduate school was not working for me! First, I am terrible at organizing and managing paper! Second, I had a busy, full-time caseload that did not provide time to log, organize, and analyze the data I was collecting. I had tally marks on random scraps of paper, was always several weeks behind transferring the data to my data logs, and was guessing at whether my students were making progress at the end of each progress reporting period.

Photo of Getting Started with Google Forms for Digital Data Collection Guide

It was right around that time, that I met a teacher who was using Google Forms to administer self-grading mid-term and end-of-term quizzes for progress monitoring. I immediately thought, I can adapt Google Forms to manage my data collection!

Initially, I made individual Google Forms for each of my students with each “question” on the form focusing on the individual student’s IEP objectives. It was too time consuming!! Since that first year, I have streamlined my Google Form Data Collection System!

Now, I have one Master Template that features all of the building blocks to meet my data collection needs for ANY student. At the beginning of each IEP period or whenever I receive a new student, I simply make a copy of the template and copy and paste the student’s specific IEP objectives from my school’s IEP program on to the form. That is it, I am ready to take data!

Screenshot of discrete data and in-session notes available in freebie library.

I still take discrete data on a simple paper form (pictured left) that is available in my freebie library. Then, either before, during, or after the session, I pull up each of my student’s Google Data Forms and fill in the appropriate information for that session.

I LOVE Google Forms, because I never have to transfer information or file papers away. PLUS, Google Forms automatically exports data to Google Sheets, making data analysis during progress report season super simple!

I have created a free step-by-step guide to help you get started with Google Forms for data collection. It includes video demonstrations and a copy of my master data form, so you can get started right away! Check out the video below to see what is included!

Sign up below to have the Getting Started with Google Forms for Data Collection Guide sent to your inbox!

Do you have questions about using Google Forms for data collection? Post a question in the comments below, send me a message on instagram, or email me at hello@seldomspeechless.com! I would love to help you get started with digital data collection, because it was a game changer for me!

Thanks for reading!