Interactive Calendar in Therapy

  ebay calendar link

 

This is another one of my favorites.  It is easy to build a routine, use with a variety of ages/grades, and versatile, as it can target so many skills.  I use it primarily with my 2nd-5th graders, but depending on the students and their needs, I have used it with slightly older and younger students as well.  Big surprise, I typically use it once a month.  The kids always want to do it on the first day of a new month, but I actually prefer to wait until we are at least a week in.  That way we can talk about both past and future events, targeting verb tensing.

From an expressive and receptive language perspective, it's great for asking and answering questions (ex. What season is it?  When is the field trip?) and building vocabulary...there are so many activity magnets in addition to the holidays.  It's great for working on time and sequence concepts (before/after, next week, first/last, two days ago, etc.) as well understanding year/month/day and season vs. weather, which so many of my students get confused.  The calendar is also great for practicing giving and following directions.  

Believe it or not, the calendar is also great for targeting speech articulation, specifically "th".  Just think about it...month, Thursday, third, thirteenth, 30th, fourth, etc.  Many of my Deaf and Hard of Hearing students need this direct instruction to understand that you say the date using ordinal numbers.  

For my Deaf and Hard of Hearing students, I can also readily make the calendar a listening/auditory skill development activity by using the acoustic hoop.  This would be for my students working at the levels of discrimination, identification, and comprehension at the sentence level.    

Kids find this pretty motivating when they get to put events that are meaningful to them on the calendar.  These include birthdays, field trips, lost teeth, sports, family outings, and appointments.  And let's face it, when kids can personally relate to something they are more likely to learn and remember.  

Life Unlabeled

 

 

Ok, some people may disagree with me on this one, but it's something I feel strongly about.  Working in a school, I am often asked to support and incorporate curriculum-based vocabulary in my speech/language therapy.  And that's fine, for my students with a reasonably established language foundation.  When an EL (English Learner) student comes to school, they typically have a language foundation in their native language.  They have something to map English onto.  But many of my students with hearing loss don't have that foundation.  When I ask them what they had for breakfast, they have no word or sign to tell me.  When I ask about their favorite movie or what they did yesterday...no words or signs.  I show them a picture of a basic household item (ex. microwave, rake, sink) and they say, "I have that," but don't know what it's called.  They are living life unlabeled.  Children with hearing loss don't typically have the same opportunities of incidental learning that children with typical hearing have.  And frankly, most children with hearing loss are not born into families that are fluent signers.  

So, yes, I do try to teach the vocabulary of everyday life.  We're going to learn the names of furniture, appliances, and other household items.  We're going to label foods and basic everyday actions.  We're going to learn family relations (aunt, cousin, grandson).  Vocabulary requires direct, explicit instruction with repeated exposures and contexts.  While schools are shying away from acknowledging holidays, I am in my room playing games that incorporate Halloween vocabulary.  If the student celebrates Christmas, then I'm going to do lessons and activities using that vocabulary.  Curriculum is important too, but, in my opinion, being able to actively participate in conversation, express your wants and needs, and share your life experiences is more important.   

You tell me...which is more important?  Donut or rhombus?

 

 

         

Mailbox - Speech, Language, and Listening

 

 ebay mailbox link

I have repurposed this mailbox coin bank and used it in my therapy sessions for the past 20+ years.  It is a HUGE hit with the younger students, and I still get requests from some of my older students to keep using it.  I own two, and would recommend you do the same, so that you can use it in small group sessions more readily.  However, you can definitely get by with one.  It is the perfect size for "mailing" the articulation decks we all have (or any card from a standard-sized deck or smaller).  Kids love to put things into the mailbox and then open it back up and no longer be able to see it.  And, of course, the best part of all is opening it up with the key at the end.  

Things to mail:

pics of classmates/staff

articulation cards

verb cards (all present tense or past/present/future)

theme-based vocabulary pics 

big/medium/small vocabulary pics

minimal pairs

he/she/they + actions

singular vs. plural   

If there is only one student in the session, I will place a set of pictures on the table in front of them.  As I put them down I model them in spoken English as well as sign language.  We can work on turn-taking if I also put a set of pictures on the table in front of myself.  If I make the sets different, that is great for working on perspective-taking and helps reduce simply pointing to the pictures.  The child has to realize they can't just point at what's in front of them.  They have to look at your pictures and communicate in some way which one they want you to mail.  If you only have one mailbox, you can simply pass the mailbox back and forth.  This also helps the child realize they have to take turns.  If you have two students, they can each have a set of pictures (same or different) and each have a mailbox.  They can simply take turns communicating with each other what to mail, or you can have a "teacher chair" that you take turns sitting in.  Whoever is sitting in that chair is the one who tells everyone else what to "mail".  That way you can model both telling and listening.  

For my students with hearing loss, these mailbox activities are a great way to target auditory skill development by making them listening-based activities as well.  At the same time, when it's their turn to tell you and/or their peers what to mail, they can work on expressive sign language and spoken language and articulation.  Literally working on at least three skills at once!!!  You can make this into a listening-based activity by choosing your pictures carefully and using your acoustic hoop.  For example, you might put minimal pair cards on the table, differing by presence/absence of a final consonant, vowel sound, or ending sound (ex. bow/boat, bye/bite/bike, bee/me/pea, etc.).  I often put out sets of seasonal vocabulary in singular vs. plural forms (ex. acorn/acorns, apple/apples, tree/trees, etc.).  Now, I'm targeting vocabulary, auditory discrimination/identification, and grammar all at the same time.  You can present single words or embed them in a repeated carrier phrase (ex. Mail the ___. Put the ___ in the mailbox.).  Another favorite is mailing small/medium/large pictures of theme-based vocabulary.  Bonus...the "small" pictures fit in the coin slot without even opening the mailbox door, which the kids think is amazing.  ***Just remember, it is only a true "listening" and auditory skill development activity if the students have the vocabulary in at least their receptive repertoire.  We don't know if they misheard bye vs. bite if bite isn't a word they know/understand.

When we have mailed all our pictures, students need to request the key.  Often, younger students will need help, particularly to close/lock the mailbox back up once it's empty.  

Core language and basic concept targets include: your turn/my turn, in/out, open/close, full/empty, want, all done, help.    

1, 2, 3...STOP!!!

 Bingo Paint Dabbers 

I love to use these paint dabbers to drill/practice any kind of skill requiring high repetitions.  Students of all ages/grades seem to love this activity.  First, I select and print out seasonal/theme-based printables.  There are many available for free on the internet.  I typically grab them off of Teachers Pay Teachers.  I try to have at least 3-5 options for the student to choose, so that they are more invested and so that I can elicit the language required to make that choice (ex. I want ___.).  So, for back to school, I might present a school bus, backpack, and crayons.  Once the child has made their choice, we start practicing the targeted skill.

My students have all learned that we do things in 3's in my room.  They learned 1, 2, 3...GO! with the wind-up toys.  With paint dabbers, they learn 1, 2, 3...STOP!  So, whatever skill we are targeting they practice it three times.  If we're targeting word-final /t/, then I will put out three articulation cards or scroll through three pictures of final /t/ words on my i-Pad.  If we are targeting is/are +verb ending -ing, then I will lay three verb/action cards out on the table.  

Once they have completed their three practice tasks, then it's time to paint.  For my younger students that are still building their vocabulary and working to expand their utterances, I will hold the basket containing the paint dabbers just out of reach but fully visible.  If they don't yet know their colors expressively, I will let them point to/touch the one they want but not take it.  Once they have made their request, I hand them the paint, making sure the cap is nice and tight.  Again, for my younger students, I am hoping to build in an opportunity to request help to open it.  My OT coworkers also love these dabbers because they are great for targeting the two hands working together and the fine motor needed to turn and open them.  When the student has the paint and opened it, we paint for a count of three and then stop ("1, 2, 3...STOP!"), put the top on, and return the paint to the basket.  They get one color per turn.  For the younger students, they may actually paint well more than three dots, but the point is that they stop after the count of three.  As the students get older, and they are building their understanding of 1:1 correspondence, then we focus on only painting three dots.  Eventually they understand that because they practiced their target skill three times, they can paint three dots.  This often leads to the students negotiating.  For example, if they are painting the bus and the wheel has four circles and they want them all to be the same color, they might indicate wanting to finish it or do one more.  I can then elicit one more practice of their target skill to "earn" that extra dot.  

Core language and early concept targets include want, more, turn, help, open/close, on/off, go/stop, colors, theme-based vocabulary (pictures you print), and 1:1 correspondence.           

 

Animal Sounds vs Names Sign Language

  

 

OK, personal soapbox here, and I have made this mistake myself.  When you are teaching animals to young children and using sign language, you should differentiate between the name of the animal and the sound it makes.  It's a hard habit to break, but when the child sees a cow (real, toy, image), we want them to say/sign the correct label.  Not, "Mommy, look a moo!"  In therapy, when you produce the ASL sign for cow, say "cow".  Then you can point to your mouth or sign "sound says" and then say "moo".  I even like to add fingerspelling M-O-O for a more clear differentiation and a little bonus literacy.  While not an animal, the same goes for ghost.  It's not a Boo!!!  

Three Bear Puzzle

  Bear Puzzle - Amazon Link

This puzzle is so many things wrapped into one little package!  Clothing vocabulary, body parts, colors, emotions, pronouns, possessive -s, eliciting core language to request, and expanding utterances.  It can be an activity all by itself, or you can use it as a motivator to practice other target skills.  

As a stand-alone activity, I typically tie it in with seasons/weather or fairy tales.  We dress the bears appropriately for the season or refer to them as "Mama Bear, Papa Bear, and Baby Bear" (*great for reduplicated syllables and bilabials).

Core language targets include your turn/my turn, want, more, on/off, and yes/no.  For students at the one-word/sign utterance level, it's great for building longer utterances.  For example, when the child says/signs, "shoes," you can elicit whose shoes.  Once the child has indicated which bear, then you can lay out the six options and ask what color shoes.  After the child selects a color, you can model and hopefully prompt a 3-word/sign utterance ("Baby's red shoes.").  Once the child has mastered the basics (shoes, shirt, pants), you can start demonstrating more specific and varied vocabulary (sandals/slippers/boots, pajamas, suit, pant vs. shorts, apron, sweater, etc.).    

The "Baby's red shoes" highlights that this activity has both possessive -s and plural -s embedded.  These are typically challenging for students with hearing loss.  They are difficult to perceive acoustically, particularly when embedded in running speech.  They are also not marked in ASL the same way we mark it in spoken English.  This activity is a great way to highlight and practice these morphological markers.  

Of course, my favorite part is the emotions. I label them in speech and sign, make the corresponding facial expression, and, equally important, model the intonation.  This is another important part of auditory skill development for a student with hearing loss.      

As a motivator, I typically have the child practice their target skill (ex. word final /k/, present progressive -ing) and then they earn a piece of the puzzle.  It's just a great way to make drill-based activities more inviting and engaging.

Auditory Skill Hierarchy - Explained

 

If you have a student with hearing aids or cochlear implants then you can and should be writing IEP goals/objectives and incorporating listening-based activities into your therapy sessions that target auditory skill development.  These should be based off of the principals underlying and the skills included in the auditory skill hierarchy.  But what's that?

First is detection.  Just as the name implies, it simply means there was a sound and the listener heard it.  They may not know what it was or where it came from, but they heard a sound.  This happens in my therapy room when my phone dings because I got a text and forgot to silence it or the principal makes an announcement.  My students looks around for the sound because they heard something, but they don't know what.  

Next is discrimination.  This is when the listener is able to tell if two sounds are the same or if they are different.  Was one sound longer or shorter?  Was one sound louder or quieter?  Was one sound higher or lower?  There is not yet meaning assigned to these sounds.  This is how I feel in noisy environments like restaurants or concerts.  I heard you, I know you said something to me, but I have no idea what you said.     

Then comes identification.  This is when it gets fun and more challenging.  Now meaning gets assigned to sound.  My student hears the text alert and knows it was my phone, but also hears the principal making an announcement and points to the speaker and says or signs "talk".  However, to move through this level of auditory skill development you must have LANGUAGE!!!  The student can't identify that you said "hot dog" if they don't know what a hot dog is.  And if they don't have spoken language or sign language, their only response option is to point to objects and pictures.  Imagine trying to have a child discriminate between CV (consonant-vowel) words differing by both consonant and vowel.  How can they do that if they don't have the language to at least understand "bee" vs. "pie"?  I love this level of the hierarchy because there are so many fun activities, but language therapy must be a critical part of your approach.  Students must have a large enough receptive vocabulary to draw upon.  I often start with photos of the student and their classmates/teachers or even their family members.  There is so much value in the student identifying these people, especially their own name.  You can make maximal contrasts in one-syllable vs. three-syllable names (ex. Liv vs. Anthony), or minimal contrasts with names with similar sounds (ex. Hannah, Anna, Abby).  

Last comes comprehension.  To be clear, you don't wait until after mastery of all other levels to target comprehension.  It is really always the underlying goal and should develop alongside the other levels of the hierarchy.  This level is about truly understanding spoken language through hearing.  It targets answering questions, following directions, and understanding stories.  So really, this level is very similar to what you may be targeting with many other students on your school-based caseload, simply with a focus on using the auditory channel.  In order to be a successful student in a classroom environment, following instructions and participating appropriately, you need to comprehend language.  One of my favorite components of this level is auditory memory.  I target this frequently using theme-based vocabulary and barrier-type activities.  I will definitely do a post on that and remind me if I forget!

Personal sidenote...these are a hierarchy of skills that we target to develop listening.  That said, I see great benefit to using sign language all along the way.  Not only does it provide a much needed foundation, it supports true comprehension.  In my Daily Sound Check post I talked about the auditory-visual-auditory sandwich.  Well, my sandwich has another layer...sign!  If I have presented my target word(s) three times and the student still hasn't correctly identified it, I'm going to sign it.  Even if they have correctly identified my target, I'm going to show them the sign so it's in their vocabulary.  Many of my students have speech articulation challenges that can make them hard to understand.  Why not provide sign language so that they can successfully communicate while they're still developing their other skills?  I love when I present a word/phrase and my student signs back what they think I said.  It gives me so much information about what they are and are not hearing, and the types of errors they're making drive my therapy.

Daily Sound Check (with Sign Language)...How?

 

Baby Loves Summer!

 

 Amazon Link to Purchase

Critter Clinic toy

Check out this video demo...

 Amazon link to purchase

This toy is another one of my absolute favorites.  It's available on Target.com and Amazon.com as well. It comes with two plush animals that are not overly realistic, so I use six different animals (one for each door) of my own.  I have a bear, dog, cat, bird, turtle, and shark (fun kid favorite).  It also comes with a set of six color-coded keys to match the doors.  I don't use any of the other "vet" tools that come with it.  

I use this, again, with preschoolers and students with limited language (sign or spoken).  Like the wind-up toys, it is great in a pinch for an initial evaluation when you need a language sample or to engage a student not interested in standardized testing materials.   

I typically hold the keys so that they are visible but out of reach of the child.  The keys come on a plastic ring that is screwed together.  You'll want to permanently remove the screw so that you can readily take on/off just one key at a time.  When the child reaches for the keys or points at them, I sign and say, "You want the key?"  Again, I don't expect them to initially copy my models.  When the child indicates "yes" in some way, I say and sign, "Which one?"  or "What color?"  During an evaluation this is a great way to assess color knowledge, both receptive and expressive.  If the child points to a desired door I again model through speech and sign the color they indicated and then give them that key.  This is a great time to see if the child understands matching things of like color.  Even though this toy is marketed for children ages 18+ months of age, many of the children I've worked with will have difficulty opening the doors.  This is a great opportunity to work on requesting "help".  During the process of opening the doors I use and model language like, "turn-turn-turn" (key), "open", "open blue", "take it out".  Once the child has the animal I label it.  Typically the child will explore it and play with it briefly.  I usually shake the keys to get their attention back and hope they want "more".  I always take the key back out of reach and have them slide the animal off to the side if they'll let me.  I then model requesting by saying and signing any combination of key, more, want, I, and please, depending on if the child is showing they at a 0-1, 2-, 3-, or 3+ word/sign level.  We repeat this routine until all six doors have been opened.  If I still have their attention and enough time, we also have a routine for putting them all back "in" and saying "bye-bye" to each one.  This is a great time to try receptive direction following, especially when evaluating or doing an auditory listening task (behind the acoustic hoop) and adding sign support as needed.  You can give directions with one or two critical elements (ex. Put the dog in.  Bye-bye bird.  Put the bear in green.).  This is a routine-building toy, so each time you repeat but build and expand, upping the communication ante whenever possible.

One of the best parts of this toy is you can change what you put inside the doors.  So, if I am working on word initial /b/ I can put all B-objects in (ex. ball, backpack, button, bug, bear, bird, etc.).  If it's December and I am teaching about holidays I put in related objects (ex. bell, candy cane, Santa, reindeer, ornament, etc.).  Changing the objects also keeps the child engaged and excited with anticipation.

Daily Sound Check...Why?

1, 2, 3....GO!!!

 

 Wind-up toys - Amazon Link

Wind-up toys are one of my absolute favorite go-to activities when I am working with preschoolers or doing an initial evaluation for a child with little to no communication skills or little to no interest in taking a standardized test.  They're perfect for building Core language and they are highly motivating.  I got most of my favorites at a quaint little toy store in Portsmouth, but they can be purchased readily on Amazon.  I always present them in my small, velvet bag, shaking them inside to promote curiosity.  When the child pulls out each toy after I say and sign "one out" I of course label it (ex. mouse, shoes, caterpillar).  Typically, once the child has the toy in their hands they try to make it do something.  When a child doesn't realize it will do something, I give them a minute to explore it, then ask for my turn.  Most often, young children can not wind these toys themselves, or don't turn it enough to truly make something happen.  I will say and sign, "Go!" to the toy and then appear disappointed that nothing is happening.  This leads to the child needing help.  So, I model saying and signing "help", with no expectation of the child copying my model yet.  I then wind it up, while saying "turn, turn, turn" and while holding it still, say and sign, "1...2...3...Go!"  While the toy is doing whatever it does, I will say and sign the corresponding action word.  And, of course, when it runs out of steam I say and sign, "Stop!"  This most often leads to the child either handing it back to me wanting to see it again, or reaching for the bag to see what's next.  I then prompt the child to say and/or sign "more".  We repeat this routine for each toy in the bag, each time looking for the child to increase participation and communication.  As I repeat this activity in future sessions, I can up the ante of communication expectations.  I look for more spontaneous utterances without my model, or I might model and expect longer utterances to request (ex. help me, help please, want more, more please, I want more).    

Check out my video where I demonstrate!!!

My first selfie video! Introducing myself 🤣

 

Favorite Things

 

These are a few of my favorite things (and the kids love them too)...Looking forward to creating content to explain how I use them!!!

 Ebay Mailbox link

 Critter Clinic - Amazon link

 eBay Calendar link

 Bear Puzzle - Amazon Link

  Squirrel Game - Amazon Link

  Bunny Game - Amazon Link

All Karen Katz Lift-the-flap Board Books, seasonal and holiday themed, Where is Baby's ____? and Baby Loves _____

 Baby Loves Summer Where is Baby's Pumpkin? Where Are Baby's Easter Eggs? Baby Loves Winter Where is Baby's Turkey?  Baby Loves Spring

 Baby Loves Fall  Where is Baby's Christmas Present?

 Wind-up Toys - Amazon Link Velvet bag - Amazon Link

 Slapzi - Amazon Link

 Paint Dabbers - Amazon Link

Daily Sound Check - The How and Why

I have the pleasure of almost my entire caseload being students with some degree of hearing loss.  However, most school-based SLPs will have only a few or perhaps none at all.  With the advances in early detection and identification, hearing assistive technologies, and the increased likelihood of cochlear implantation at an early age, the probability that school-based SLPs will have a student on their caseload at some point is pretty high.  

So, what is a daily sound check?  In order to ensure a student with hearing loss is getting the best access possible, you need to make sure they can detect and discriminate at least the six Ling sounds (oo, ah, ee, mm, sh, ss), and if possible the additional Estabrook sounds (f, h, t, p, th, and nothing/absence of sound).  These sounds cover the typical frequencies we need to hear to access spoken language.  Some children, even with their hearing aids may not have access to all of these sounds and that's ok.  You just need to have a baseline of what the student can typically access.  Doing a daily sound check at the beginning of the school day is the best way to catch malfunctioning equipment, dead batteries, or even identify a bad hearing day due to a cold or allergies.  

What do you need to do a sound check?  You need an acoustic hoop.  You can buy one online for $35, however I made mine for way less!!!  All you need is an embroidery hoop and some speaker fabric (just enough to cover the hoop with two layers).  Speaker fabric allows sound to pass through but blocks visual access to the lips/mouth while speaking.  These are typically readily available at your local fabric store. Copy/paste the link below for a quick tutorial video.

https://youtu.be/y0UmtcKHAZA?si=pSqC33wiu4FjFsdt

You also need a relatively quiet space.  Hearing in background noise is an added challenge I'll post about separately.  For younger children, children unable to accurately produce these sounds themselves, or children who have only recently gained access to sound (ex. newly implanted), you may also need visual supports such as objects or pictures to represent each sound.  For example, you can use a picture of a baby sleeping for "sh" or a snake for "ss" or a small toy babydoll and a plastic snake.  There are many premade, printable sound visuals available online.  Just be consistent with whatever you choose to represent each target sound.  Your goal should be to work toward no visuals, so that you can do this quickly and efficiently.  

How do you do a sound check?  At its simplest, you say each sound from behind the acoustic hoop at a comfortable listening distance (3-6 ft.), in random/varied order, and ask the child to repeat back what they heard or point to the appropriate picture/item that is on the table in front of them.  It's important to remember that this is a listening task, not speech.  So, if you present "sh" and the child just makes a blowing sound that's ok.  They detected and discriminated that sound.  If a child mishears, for example says "oo" when you presented "mm", I use an auditory-visual-auditory sandwich.  Present the sound behind the hoop, present the sound again with your mouth visible, then present the sound one more time behind the hoop.  Depending on the child's age and level of language and cognition, you may need to spend some time teaching them the task.  Children won't inherently know that "mm" goes with the ice cream or that "ah" goes with the airplane until you teach them.  Don't forget to pretend to say something to see if the child can identify silence.  My students all respond by saying "Nothing!".  If a child is bilaterally aided or has two cochlear implants, you should test each side by removing the other or turning it off.  My students that have CIs typically just remove the magnet long enough to complete the task.  In addition to the basic sounds, I often say familiar names or colors to my younger students and ask basic questions to my older students (ex. What is the weather today?).  This goes beyond the basic sound check and looks at sound and language comprehension, but I like to throw it in there!  

  
Auditory-Visual-Auditory Sandwich

 

Keep data!!!  If a student typically detects and discriminates "ss" and all of sudden can't, they might need their hearing aids adjusted or cleaned or their cochlears mapped.  If the left hearing aid/cochlear is giving the child full access and the right isn't, note it.  What sounds are they missing consistently?  Are there two sounds the child is struggling to discriminate between?  If the child can only get full access when wearing both together, note it.  Any information you gather about errors or patterns is valuable to the student's audiologist, whether you provide it directly or you share it with the family.  Again, there are numerous premade, printable data collection materials available online.   

Who should do the sound check?  Unless there is a Teacher of the Deaf in your building, you as the SLP will most likely be the expert.  But that doesn't mean you have to be the only one to do the daily sound check.  You can easily train other staff, including the classroom teacher and paraprofessionals, to make this part of their morning routine.  I always start my therapy sessions with a sound check, regardless of whether someone else has done one that day.  You'd be surprised how much can change during a school day!!! Family members can also be trained and encouraged to do sound checks at home.  You'd again be surprised by how many times malfunctioning equipment and dead batteries get missed in the rush of getting ready and off to school.