Thursday, June 30, 2011

Another reality check.

Another piece of information I picked up this weekend from Ms. J. was the results of the test of phonological processing she did with Ava. Ms. A and I had already given Ava a basic articulation test several weeks ago and she did pretty poorly. I also wanted to give Ava a phonological processing test because that gives you a completely different set of information. Ms. J offered to administer the test and she had the test scored by the weekend.

I don't have all the specifics, because she had forgotten to make a copy for me, but I did get the bottom line. The test scores fall into one of five levels. The best is in the normal range, and the worst is a profound phonological processing disorder. Ava scored one tier higher than profound. Her score fell into the very severe phonological processing disorder range.

Sigh. Again, this isn't a huge surprise. Six months ago she had so little speech we couldn't even have administered the test. But it definitely puts things into perspective to realize that compared to other girls her age, the phonological processing patterns in her speech put her in the very severe range.

I'm looking forward to seeing the detailed results because that is where I'll get more clues about what exactly is going on.

Wednesday, June 29, 2011

K is here!

This past weekend was one of Ava's twice a month therapy sessions with Ms. J. When I walked in the therapy room at the end of the session, Ms. J very matter of factly told me that we'd be adding final /k/ to her list of things to practice because she can do it now. Then she said to Ava, "say, /k/." And she did. I was completely surprised and so pleased.

It is hard for her. She still substitutes a /t/ for the /k/ the vast majority of the time. I always feel mean when I tell her, "No baby, that's /t/. We need a /k/." and I have to ask her to say the word again. In order for her to even have a chance of getting it, I need a slight pause between the first half of the word and the final /k/ sound. So, I say, "boo - k". And when I make that final /k/ sound it has to be really guttural. If I just make a regular /k/ sound she'll repeat with a /t/ every time.

But /k/ is here and we can finally start to work on some back sounds. Progress!

Tuesday, June 28, 2011

Toddler and Preschool Online Activities

I made a list of some of websites Michael and Ava spend time on when we let them have computer time. Some of the sites have animated songs, some have animated stories, and some have simple games appropriate for young children. With some basic computer skills my kids are even pretty independent with most of these. I usually sit down and watch everything with them or play each game with them once showing them how it works, and they can take it from there in the future. Everything listed has a link that will actually take you to the site, so check them out and let me know if you enjoy visiting them with your little ones.

Toddler and Preschool Online Activities

I'll be adding to the list as I remember ones I've forgotten and as I find more. If you have some favorites I should check out tell me about them in the comments.

Monday, June 27, 2011

How the "Mighty" Have Fallen

I was one of "those" new mothers. I so wanted to do everything perfectly. I exclusively breastfed Michael for six months. I stubbornly continued for those six months even though it was miserable due in part to what I now think was undiagnosed reflux (his, not mine). Then I did the homemade baby food from organic fruits and vegetables thing and refused to let my parents give him anything else when they babysat.

By the time Ava came along I now had a 15 month old toddler. Well, I still did the exclusive breastfeeding which went much better the second time around. Ava was diagnosed with reflux and was on medication for it so perhaps that plus a more experienced mama made the difference. I tried to do the homemade baby food thing again even though it was crazy with two babies so young, but Ava just refused to eat it. Sure, she ate a little, but she just didn't like baby food. She wanted to eat the toddler food she saw her brother eating and so we switched over pretty quickly.

Skip ahead to yesterday morning and you find me feeding Ava a cookie for breakfast as we rush out the door to make it to therapy on time. Sigh. Guess I couldn't keep it up forever. And you know what? Now I realize that the cookie won't ruin her for life. Let her enjoy a cookie once and a while. Even for breakfast.

I suppose having a third baby just so that I can feed him or her cookies sooner is not an appropriate response to this epiphany.

Sunday, June 26, 2011

Final P: Free Speech Therapy Articulation Picture Cards

Description

These articulation picture card sets are designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for these sets are young children or children with more severe speech delays that need intensive practice with sounds at a one-syllable level or simple two-syllable level. No blends or vocalic /r/ sounds are included in these sets.

Key Features

  • Initial and Final sets include 30 one-syllable words that begin or end with the target sound.
  • The words are simple and are easily understood by or easily taught to young children.
  • Combines the target sound with all possible vowel sounds at least once.
  • Words are sorted by difficulty level for an easy progression from easy to hard.
  • Describes the progression from most intense prompts to least intense.
  • Provides a simple carrier phrase for every word.
  • A gestural prompt for the target sound is explained.
  • A list of therapy activities is included.
  • Includes 30 therapy cards with the target word and a picture on the front,
    and the difficulty level and the carrier phrase printed on the back.

Permissions

I give permission to copy, print, or distribute these card sets provided that:
  1. Each copy makes clear that I am the document's author.
  2. No copies are altered without my express consent.
  3. No one makes a profit from these copies.
  4. Electronic copies contain a live link back to my original and print copies not for merely personal use contain the URL of my original.

Looking for Feedback

I would love to hear back from anyone who uses the word sets. Let me know if there is anything you would change. Comment on this page, or send me an email at testyyettrying(at)gmail(dot)com.

Where can I find more?

More sets are on my Free Speech Therapy Articulation Cards page.

Card Sets

To download click on the image to open it full size. Then right click on the image, choose "save as" and save the page to your computer.

Instructions for printing and using the cards are included in the set.







Saturday, June 25, 2011

Initial P: Free Speech Therapy Articulation Picture Cards

The Initial /p/ set is finished and it is a significant upgrade over the previous sets (I will be updating those to the new format soon.) Here are the features of the new card sets. For those of you who read this blog regularly, I apologize in advance for the fact that this introductory section will be exactly the same for each new set posted. It is the only way to be sure that someone who finds this website by searching for a specific set gets the full set of information. In the future feel free to skip down to the actual pictures and skip the introduction.

Description

These articulation picture card sets are designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for these sets are young children or children with more severe speech delays that need intensive practice with sounds at a one-syllable level or simple two-syllable level. No blends or vocalic /r/ sounds are included in these sets.

Key Features

  • Initial and Final sets include 30 one-syllable words that begin or end with the target sound.
  • The words are simple and are easily understood by or easily taught to young children.
  • Combines the target sound with all possible vowel sounds at least once.
  • Words are sorted by difficulty level for an easy progression from easy to hard.
  • Describes the progression from most intense prompts to least intense.
  • Provides a simple carrier phrase for every word.
  • A gestural prompt for the target sound is explained.
  • A list of therapy activities is included.
  • Includes 30 therapy cards with the target word and a picture on the front,
    and the difficulty level and the carrier phrase printed on the back.

Permissions

I give permission to copy, print, or distribute these card sets provided that:
  1. Each copy makes clear that I am the document's author.
  2. No copies are altered without my express consent.
  3. No one makes a profit from these copies.
  4. Electronic copies contain a live link back to my original and print copies not for merely personal use contain the URL of my original.

Looking for Feedback

I would love to hear back from anyone who uses the word sets. Let me know if there is anything you would change.

Where can I find more?

More sets are on my Free Speech Therapy Articulation Cards page.

Card Sets

To download click on the image to open it full size. Then right click on the image, choose "save as" and save the page to your computer.

Instructions for printing and using the cards are included in the set.







Friday, June 24, 2011

The Weekly Review: Week Fifteen

Best Blog Posts of the Week

  • Linda at All and Sundry makes the list again because she's just so funny. Seriously, given the following quote, how can you skip this post?
    Before beginning to work from home, she thought perhaps... "while I periodically take a break to wave at my cherubic children, who have naturally occupied themselves with some peaceful and industrious activity such as polishing the stainless steel appliances while independently serving their developmental needs, Montessori-style."
  • Amy at Amalah wrote a post to tempt fate about her new baby and sleep. The pictures are a nice bonus.

Website Resource of the Week:

Ok, you're probably only going to think this is the "coolest thing ever" if you're a Speech-Language Pathologist and a particularly geeky one at that. Learning Fundamentals is a company that makes software for SLPs (apparently, I haven't actually checked out any of their software). On their website they have a tool that lets you specify exactly what types of sounds you want in what order and then it spits out a list of words that meet your criteria. Very, very cool.

The Weekly Michael

Michael is all of a sudden extremely interested in spelling words. He'll sit at the computer and ask for help spelling random words. If I help him sound out the word he can pretty much spell it himself. He'll even make editorial decisions. For example, he decided that "mommy" needed to be spelled "momme" because that just made more sense. He made the same decision for "dadde" We've also spelled Michael and Ava. He made the observation that his name is bigger. I believe cat, dog, and monster were also spelled. It's fun watching him explore writing. Well, typing. He loves typing things out but isn't the slightest bit interested in writing on paper.

The Weekly Ava

Last night as I was putting Ava to bed we got into a tickling game. Then she stopped me by saying, "Be careful Mama! No want to make hole in Ava!" I understood every word. I wonder, if I had an audiotape and played it for someone else if they would have understood it. Not that it matters if someone else would understand. I knew exactly what she was saying and it was wonderful.

Thursday, June 23, 2011

Speech-Language Pathology Topics: The Flap

As I was working on my one syllable word lists I was reminded of two things: one rather obvious and the other pretty obscure.

The obvious: If you are not using blends, medial consonants are not used in one syllable words. So, if I want a list of simple words that use a medial sound I'll need to use very simple two syllable words (CVCV, CVC, CVCVC).

The obscure: I completely forgot about a rather obscure sound. When a /t/ sound appears between two vowels in connected speech it is produced as a flap. When a /b/ sound appears between two vowels in connected speech it is often also produced as a flap. Say the following two sentences quickly and naturally.
  1. Look at the bike pedal.
  2. Look at the flower petal.
The /d/ in "pedal" and the /p/ in "petal" are produced in almost exactly the same manner - as a flap instead of as a clear /t/or /d/.

My conclusion: If you want to practice the /t/ sound, it is not useful to try to practice it in the medial position of a simple two-syllable word (bottle, button) because when those words are spoken in natural speech a flap is produced rather than a /t/. Once your child has mastered /t/ in the initial and final position of words it would be a better use of your time to practice it in connected speech with short phrases (on top).

You might also be interested in the following articles:

Wednesday, June 22, 2011

Random Story and Random Contemplation

It was raining as I dropped the children off at preschool yesterday morning. The dropoff at our school is a horseshoe and the entrance to the horseshoe is at the top of the hill so you can see the entire parking lot as you pull in. As I was pulling in, I saw the person in the spot closest to the door pulling out and thought to myself, "I actually got lucky!"

Now you have to understand that although I am very lucky in the big things in life (wondeful husband and children, home over our heads, food to eat, extended family to love us), I am not so lucky in the little things in life. I do not gamble because (as one of many reasons) it just isn't that much fun to spend three minutes putting $20 of quarters into a slot machine and then walk away. I'm never the person that wins the free soda when I take the cap off the promotional bottle. I never get the best prize in the scratch off in the mail. So, I was genuinely surprised and pleased that on a rainy day the closest spot to the front door magically opened up as I was pulling in.

Then I noticed that another car was leaving as well, so I slowed down to allow her lots of room to back up before I continued pulling around the horseshoe. Well, she backed up and instead of leaving, took the closest spot. There! Classic example of my luck. :-)

_________________________

Sometimes, as I am waiting at a red light at a busy intersection watching a river of cars pass in front of me I find myself thinking about their passengers. I think about how every one of those cars has a person (or people) in it. Every one of those people has a life just as rich, complicated, and interconnected as mine. Every one of those people is essential to the people who love them. I think about the web of connections that spreads out from this exact geographical point. And I very genuinely wish all of them a safe journey.

Tuesday, June 21, 2011

Windows

Speech is a window into someone's mind. For Michael that window is wide open. His mind forms a thought, his mouth speaks it, and I comprehend it. The process is effortless and easy. In fact, that boy's mouth has no filter. Every thought just comes out of his mouth in a continuous stream. I will admit that occasionally I wish for a pause button.

And then there is my daughter. It is painfully obvious that she has just as much to say. She'll come running in from the other room just bursting with something she wants to share. She'll tell me a one or two or even three sentence story and then pause excitedly for my reaction. In a typical conversation I would effortlessly understand her and immediately respond. Instead, I pause while my mind tries frantically to figure out what she said. Often I fail. So far, she doesn't seem too upset. She'll often just run off back to whatever she was doing. But I missed it. I missed that window into her mind and that opportunity to know her better and share her thoughts. And I'll never get that particular opportunity back. I just have to wait for the next one and try again.

Monday, June 20, 2011

Speech-Language Pathology Topics: Consonants

What are consonants and why are they important to speech?

Consonant sounds are produced by constricting or interrupting the air flow at some point during the production of a sound. In contrast, a vowel is a sound produced with a relatively open vocal tract. Consonants are combined with vowels to make syllables and words. When consonants are produced incorrectly, that makes speech very difficult to understand.

There are 24 consonant sounds used in spoken American English. These sounds may or may not match up with English letters and the phonics typically associated with those letters. Here is a chart of the 24 American English consonant sounds. The symbol on the left is the phonetic symbol most Speech-Language Pathologists use to represent each sound. On the right is an example of a word with that consonant sound. The letters used to spell the sound are in bold.


What are the characteristics of consonants

What makes a "p" different than an "v"? The consonants sound different from each other because they are made in different ways. They differ in their place of articulation, their manner of articulation, and their voicing status. Speech-Language Pathologists use a consonant chart to keep track of the consonants and their characteristics.


What are the different places of articulation?

A consonant is made by constricting the airflow between where it starts with the exhalation in the lungs and where it exits the mouth at some point. One reason sounds differ is because the point of constriction happens at different places. If the point of constriction is at the lips (/p/, /b/, /m/, /w/) then the place of articulation is bilabial. If the point of constriction is just behind the top teeth (/t/, /d/, /s/, /z/, /n/, /l/, /r/) then the place of articulation is alveolar. Here is a list of the places of articulation and a picture to help you visualize those places.


  • bilabial - constriction between both lips
  • labio-dental - constriction between top teeth and bottom lip
  • dental - constriction between top and bottom teeth
  • alveolar - constriction between the tongue and the alveolar ridge (top of mouth just behind top teeth)
  • palatal - constriction between the tongue and the hard palate (roof of mouth)
  • velar - constriction between the tongue and the soft palate (roof of the very back of the mouth)
  • glottal - constriction at the vocal folds

What are the different manners of articulation?

A consonant is made by constricting the airflow between where it starts with the exhalation in the lungs and where it exits the mouth at some point. One reason sounds differ is because the method of constriction happens in different ways. If the airflow is completely stopped and then released in a puff of air (/p/, /b/, /k/, /g/, /t/, /d/) then the manner of articulation is a stop. If the the airflow is redirected through the nose (/m/, /n/, /ng/) then the manner of articulation is a nasal. Here is a list of the manners of articulation.

  • stop - airflow is completely stopped and then released
  • fricative - airflow is constricted causing slight hissing noise
  • affricate - This is a combination of a stop and a fricative. First the airflow is completely stopped and then it is constricted causing a slight hissing noise with the consonant.
  • nasal - airflow is redirected out the nose
  • liquid - airflow is constricted significantly more than a vowel, but not enough to cause a hissing noise with the consonant
  • glide - similar to a liquid, but with slight movement during the production of the consonant

What is voicing?

There is a third characteristic of consonants. /s/ and /z/ are made with exactly the same place and manner of articulation and yet they are different. /z/ is made while vibrating the vocal folds. If you place your hand on your throat while making a /z/ sound (buzz like a bee) you will feel the vibration of your vocal folds. /s/ is made without vibrating the vocal folds. If you place your hand on your throat while making an /s/ sound (hiss like a snake) you will not feel the vibration. So the third characteristic of consonants is the presence or absence of voicing.

Why are consonant characteristics important to understand when planning therapy for Childhood Apraxia of Speech?

First of all, understanding the characteristics of consonants can help you understand why some consonants are harder than others for your child. Affricates are going to be harder than stops or fricatives because they require more complicated motor planning. Words with consonants that are all produced in the same place (dot) are going to be easier than words with consonants that change place (pod). Words with consonants that move from the very front to the very back are going to be even harder(back). Voiced sounds are going to be harder than their coresponding voiceless sound because the motor planning is more complex. Speech-Language Pathologists take all of these factors into account when choosing targets for speech therapy.


You might also be interested in the following articles:

Sunday, June 19, 2011

Let the Games Begin

We've had the game Don't Break the Ice for a long time. The children love it. They never actually played the game mind you. I would spend three minutes carefully setting it up and they'd spend 5 seconds frantically pounding out all the pieces of ice in a fury of excitement. They simply couldn't grasp that the concept of the game was to prevent the bear from falling down.


This weekend Michael asked to play Don't Break the Ice. I pulled it from the shelf and set it up and in a rather pessimistic way told him, "Now, you lose the game if you make the bear fall. You win if the other person makes him fall." He got it. He loved it. I even loved it. Now that we were actually taking turns and using strategy to try to keep the bear from falling, each "game" lasted longer and I had an opportunity to play too. So far, he's a good sport no matter who wins. Game playing finally became fun.

I got really ambitious and pulled out the Candy Land game I bought ages and ages ago when Michael learned his colors and I overly optimistically assumed that meant he was ready for Candy Land. Turns out he's also ready for Candy Land. We played 4-5 games in a row. He wanted to discuss every character and really wants to build a real Candy Castle. I have rediscovered the fact that I personally find Candy Land to be a little boring and I think I'll search out some other games that might be fun. Any suggestions?

Oh, and Happy Father's Day. Enjoy it everyone.

And to my husband: Happy 7th Anniversary! I love you. (And Happy Father's Day - You are an amazing Daddy.)

Saturday, June 18, 2011

Simultaneous Relief and Sadness

Oh my goodness is she talking. The other day Ava commented that, "Daddy put peanut butter on Ava's really really big pancake." That's a 10 word sentence coming from my little girl who's only 27 months old. It is such a relief. 6 months ago she had only three words in her vocabulary and couldn't imitate. Now she's talking in multi-word sentences. Obviously her language is fine.

However...

More and more, I can't understand her at all. I'm pretty good if she's talking about something immediate and in front of us (like Daddy and the pancakes). If I have some context and we can see and point at it I can understand most of what she has to say. But if she's talking about anything else I'm clueless. You often can't understand a word of what she's saying. If she starts rattling off her opinion of a tv show I haven't watched or telling me about something she did at her grandparents' house I often have no idea.

As you would expect for Childhood Apraxia of Speech, the longer the utterance, the less you can understand. It's killing me. She has so much to say. Her little mind wants to tell stories. She wants to engage in back and forth conversation. Instead she says something which I hear as, "Garble, garble, garble, garble, garble" and I just look at her and reply, "Uh huh sweetie." And then I try to change the subject. Sometimes I say, "I'm sorry, sweetheart, Mama didn't understand you. Can you tell me again?" But I only do that when I think I have some chance of getting it. Otherwise, she just gets frustrated at trying to tell me over and over unsuccessfully.

I know we're working as fast as we can. I know she's made phenomenal progress in a relatively short time. I know she can communicate so much more than before. But honestly, I feel that it is terribly unfair that she's worked so hard, she's finally got so much to say and is actually trying to say it, and she still can't communicate successfully much of the time with her loved ones. That sucks.

Friday, June 17, 2011

The Weekly Review: Week Fourteen

Best Blog Posts of the Week

  • Linda at All and Sundry writes an online column at CafeMom. She wrote an incredibly brave and honest post that is definitely worth reading.
  • To continue with the more serious theme of the best blog posts of the week, Rob Rummel-Hudson at Fighting Monsters with Rubber Swords wrote a post this week about an outing his family had at the pool, the connection his daughter made with another child, and the feelings and observations he and his wife made during the experience.
  • To finish with something lighter, at the end of this post, Swistle links to a site where people are posting really cool pictures. They take a picture from their past and go to that same location. Then they line the old picture up with the real life background and take a picture of the picture and write a caption. Hmm. That description doesn't make much sense, but the pictures are really touching somehow and you should definitely check out the site. It is Dear Photograph.

The Weekly Michael

    "I'm going to get you with my slapula!" - Several hours earlier I had taken the toy spatula from the kids' play kitchen and was poking Ava with it making her laugh. Apparently Michael was unfamilar with the word spatula and given the context, interpreted the name of the device as Slap - u - la. My husband's parents were in town at the time and we all laughed long and hard. We made jokes about it for the rest of the visit.
  • "Mama, are you making a baby?" - Wow, that one came as a complete surprise out of nowhere right before bed a few nights ago. Last week, Michael and I had a brief conversation about how you can't buy a baby at the store because mommies have to make babies in their tummies. In response to his question, I told him that, "No, Mama is not making a baby right now. Mama is probably done making babies. I have a Michael and an Ava and that is enough babies for Mama." At that point he promptly began begging, "Please Mama! Please make a baby." Ava jumped right on the bandwagon also chanting, "Please Mama, please!" Don't think I didn't hear my husband laughing as he eavesdropped from the other room.

The Weekly Ava

Ava is counting everything. She'll just randomly burst into sequences of numbers. They tend to go something like this: "one, two, three, five, seven, eight!" Eight seems to be her favorite ending number. So, we'll be climbing the stairs, or I'll be putting grapes on her plate, or there will be five (eight according to Ava) frogs in a book and the counting will begin. It's adorable. The teacher in me wants to correct the counting, but the Mama in me just smiles in adoration.

Project of the Week (or month, or year):

The card sets are definitely the obsession of the week. I do not use the word obsession lightly. I have been pretty much been spending every spare minute on them. I'm pretty sure that I will not be able to maintain this level of intensity for long, but I'm hoping to do about one new card set a week indefinitely. Let's do the math. There are 24 consonant sounds and theoretically I'd like to do an initial, medial, and final card set for each one where appropriate. (Not all of the consonant sounds appear in every word position so there will not be three for every one of those 24 consonant sounds). That's approximately 65 card sets. Hmm. Over a year's worth at one per week. We'll see.

Thursday, June 16, 2011

Busy, Busy, Busy

This month we have had two sets of out-of-town visitors. My cousin (Michael's godmother) and her boyfriend came to visit from Louisiana first. It was an amazing visit full of our introduction to Erector sets, a trips to the zoo (the baby elephant was my favorite part), and lots of play.

After a brief, one weekend break, my husband's parents came into town. Their visit was perfect. The weather was beautiful. We went to the Botanical Gardens which has an absolutely amazing Children's Garden full of grand play structures, small creeks, and a water play area. We went to the Magic House which is a local children's museum.

Grandpa introduced Michael to the concept of building Erector Set cars purely for the purpose of an Erector Set Demolition Derby. Michael was also introduced to the fine art of "trash talk". The boast, "I'm going to crack your axles!" has been immortalized. After 20 minutes of each competetor designing and building their car, someone would play announcer and set up the battle scenerio complete with silly car names like "Roller-skate car" and "Derailer." After some trash talk, the furious 3 minute battle would commence and the competitors would bang their cars together until one fell apart. The car that managed to stay together would be declared the winner and then repairs would begin.


My husband has been rebuilding our old rotten deck. Demolition is complete. A contractor put in the new support posts and beams. We were able to salvage the old frame. In the evenings and weekends my husband is rebuilding the stairs and rail posts. Then he'll move on to the new floor boards and eventually the new rail. Of course, that means that the children and I are getting extended quality time together as I am watching them on my own during the evenings and weekends in addition to during the day. But the deck will be beautiful someday when it is done.


I've also been working on restarting structured speech therapy at home with Ava. It is going well, but I've been frustrated with the lack of materials that fit my needs perfectly. So in my spare time I've been making new card sets. That has pretty much been sucking up every last bit of available time.

And now you're caught up.

Wednesday, June 15, 2011

Free Speech Therapy Articulation Picture Cards: Final T

This version is out of date. Go here for new, easy to download, version and additional sets.

There are a lot of articulation cards available for working on just about any sound for your child. There are many commercial sets that you can buy and there are many that you can find for free online. I've done both. I was frustrated that most of those sets did not meet our needs very well.

When you are working with a young child who has Childhood Apraxia of Speech you need the words to be relatively simple in structure. Many of the lists were half full of two and three syllable words that are way too complicated for a young apraxic child to imitate. Also, children with apraxia need to practice their target sound paired with as many vowels as possible, and most sets are not designed with that goal in mind. Also, if you are working with a toddler, the words need to be relatively easily understood concepts for a young child. A word like "beg" is harder to understand and make a picture for than a word like "bed."

I have complied a set of 40 one-syllable words that I feel are easily understood or taught to a young child and I have made picture cards for them. I also have written out some directions for making the cards and some ideas for activities to do with the cards. The words are divided into levels by difficulty. I suggest you begin with the easiest cards and include the harder levels as your child is able to practice them too. I also describe the different levels of cueing you can use and provide suggestions for very simple one word carrier phrases you can use when you want to move to a two word level.

You are welcome to download the set for use with your child. I will be posting sets as I complete them.


For an easy to print version, download a .pdf of the five-page One-Syllable Final T Articulation Picture Cards file.

This is an old version of the card set. You can find the new version and additional sets in an easy to download format here: Free Speech Therapy Articulation Cards

Tuesday, June 14, 2011

Apraxia Therapy Materials: Kaufman Speech Praxis Kit 1 (Basic Level)

Therapy Materials Review: Kaufman Kit 1 (Basic Level)

This is a review of the Kaufman Speech Praxis Treatment Kit for Children (Basic Level). The kit was developed by Nancy Kaufman, MA, CCC-SLP. Nancy Kaufman is a nationally acclaimed expert in apraxia who has developed assessment and treatment materials in the area of apraxia. This kit contains a small manual that explains the treatment methods recommended and 201 picture cards sorted into category by syllable shape. The back of each card shows a hierarchy of acceptable responses for the picture on the card depending on the current performance level of the child.


Target Audience

The target audience for the Kaufman Kit Basic Level will usually be children between the ages of two and six. The pictures on the cards were designed with those ages in mind. These cards will be most useful for children who are struggling with producing simple syllable shapes and need to focus on the early emerging consonants /p, b, m, t, d, n, h/.

Description of the Kaufman Kit (Basic Level)

This kit is a boxed set of treatment materials including a 52 page manual and 201 stimulus cards sorted by type.
  • Manual
    The manual is the same for both the Basic Level Kit 1 and the Advanced Level Kit 2 so some of the pages in the manual do not apply to Kit 1. The manual begins with a note to parents that describes Childhood Apraxia of Speech, gives an overview of the Kaufman Speech to Language Protocol approach to treating Childhood Apraxia of Speech, and briefly describes some things parents can do at home. The rest of the manual is pretty technical and written with a Speech-Language Pathologist in mind as the target audience for the manual. The rest of the manual describes the Kaufman evaluation hierarchy, treatment hairarchy, describes cueing techniques, gives examples of goals for IEPs and describes general treatment considerations.
  • Stimulus Cards
    The cards consist of 201 full color 5" by 7" cards. The cards are seperated into sections that are color coded so that you can easily pull the cards, use them in therapy, and then sort them back into their sections. The early emerging consonants are included in kit one. Those consonants are /p, b, m, t, d, n, h/. Syllable shapes include CVCV, VC, CV, VCV, CV1CV2, C1V1C2V2, CVC, and CVCVCV. There are also more complex versions of some of those basic syllable shapes.

How to Use the Kaufman Kit Cards

Through formal or informal assessment, determine which syllable shapes are missing and which of the missing ones the child is stimulable for. Then work with the card sets for the missing syllable shapes that are easiest for the child. Remember that any of the responses on the back of the card can be considered to be correct. The responses on the back of the card are all acceptable, but get closer to the actual production of the word as you move from bottom to top. When you start working with a particular card, figure out which is the highest production the child can successfully imitate and start there gradually working your way up by using the cueing techniques described in the manual.

Therapy Activity Suggestions for Kaufman Kit Cards

  • You can always simply drill the words offering a verbal reward, sticker, or turn at a game after every 5-10 responses.
  • Make a laminated train engine and caboose. Line your cards up in between the engine and caboose making a word train and place a small reward (sticker, cheerio, etc.) on the caboose. Have the child say each word 1-5 times and when they reach the end of the train they get the reward. Then set up a new train.
  • Tape the cards in a line on the wall. Make the room as dark as possible and let the child light up each card with a flashlight. They must say the word 1-5 times before they can light up the next word.
  • Hide the cards around the room. Tell the child that you are playing hide and seek with the words and that they need to find 10 (or however many you hid) words. As they bring each word to you they need to say it 1-5 times before going to find the next word. Once they find all the cards they get a small reward. Then they cover their eyes while you hide a new set of cards. Or, you can trade and let them hide the words for you to find. They still have to say each word 1-5 times when you bring the card to them before you go find another.
  • Lay the cards on the floor in some kind of pattern and play a beanbag toss game. They say the word the beanbag lands on 1-5 times before getting to throw the next beanbag.

Pros and Cons of the Kaufman Speech Praxis Kit 1 (Basic Level)


Pros: This kit provides materials for systematically building speech from least difficult to most difficult in terms of syllable structure. Within each syllable structure, there is also a hierarchy of acceptable responses from the least motorically complex to most motorically complex (and accurate). That makes this kit ideal for working with children who have Childhood Apraxia of Speech particularly those children who are minimally verbal.

Cons: This kit is very expensive. It is only Kit 1. There is another kit that includes the later developing consonants and more complex syllable structures that you might want when a child outgrows Kit 1. That kit is also very expensive. There are only a few words (usually 6-12) in each category so if you are looking for a wide variety of words to increase generalization, that is not the purpose of this kit. Also, if your child needs practice with a wider variety of consonants, they will not be included in this kit.

For the price, I expected a big manual that was designed to educate a parent or novice SLP with little apraxia experience about the disorder itself. Then I would would like for the manual to explain in an accessible way the theory behind the Kaufman method and why it is so appropriate for treating the disorder. The manual should make it very easy to understand how to use the materials with children and give concrete examples of therapy activity ideas. To put it simply, I was underwhelmed with the manual.

Bottom Line:

If you already have the knowledge and expertise to understand how to best use these materials and you have several minimally verbal children on your caseload, this kit would be well worth the purchase price. If you do not meet both of those criteria, I believe the price is prohibitive.

You might also be interested in the following articles:

Monday, June 13, 2011

Free Speech Therapy Articulation Picture Cards: Final N

This version is out of date. Go here for new, easy to download, version and additional sets.

There are a lot of articulation cards available for working on just about any sound for your child. There are many commercial sets that you can buy and there are many that you can find for free online. I've done both. I was frustrated that most of those sets did not meet our needs very well.

When you are working with a young child who has Childhood Apraxia of Speech you need the words to be relatively simple in structure. Many of the lists were half full of two and three syllable words that are way too complicated for a young apraxic child to imitate. Also, children with apraxia need to practice their target sound paired with as many vowels as possible, and most sets are not designed with that goal in mind. Also, if you are working with a toddler, the words need to be relatively easily understood concepts for a young child. A word like "beg" is harder to understand and make a picture for than a word like "bed."

I have complied a set of 40 one-syllable words that I feel are easily understood or taught to a young child and I have made picture cards for them. I also have written out some directions for making the cards and some ideas for activities to do with the cards. You are welcome to download the pictures for use with your child. I will be posting sets as I complete them.


For an easy to print version, download a .pdf of the four-page One-Syllable Final N Articulation Picture Cards file.

This is an old version of the card set. You can find the new version and additional sets in an easy to download format here: Free Speech Therapy Articulation Cards

Sunday, June 12, 2011

Free Speech Therapy Articulation Picture Cards: Initial B

This version is out of date. Go here for new, easy to download, version and additional sets.

There are a lot of articulation cards available for working on just about any sound for your child. There are many commercial sets that you can buy and there are many that you can find for free online. I've done both. I was frustrated that most of those sets did not meet our needs very well.

When you are working with a young child who has Childhood Apraxia of Speech you need the words to be relatively simple in structure. Many of the lists were half full of two and three syllable words that are way too complicated for a young apraxic child to imitate. Also, children with apraxia need to practice their target sound paired with as many vowels as possible, and most sets are not designed with that goal in mind. Also, if you are working with a toddler, the words need to be relatively easily understood concepts for a young child. A word like "beg" is harder to understand and make a picture for than a word like "bed."

I have complied a set of 40 one-syllable words that I feel are easily understood or taught to a young child and I have made picture cards for them. I also have written out some directions for making the cards and some ideas for activities to do with the cards. You are welcome to download the pictures for use with your child. I will be posting initial sets as I complete them.


For an easy to print version, download a .pdf of the four-page One-Syllable Initial B Articulation Picture Cards file.

This is an old version of the card set. You can find the new version and additional sets in an easy to download format here: Free Speech Therapy Articulation Cards

Saturday, June 11, 2011

Apraxia Therapy: Articulation Practice

What is Articulation Practice?

Articulation practice is practicing making specific sounds. Children with all types of speech sound disorders have to practice making sounds.
  • Children with a simple articulation disorder only have trouble with one or two sounds and they practice those sounds first in isolation, then at the beginning, middle, and ends of words, then in phrases and sentences, and finally in conversation.
  • Children with phonological disorders have trouble with groups of sounds or patterns of sounds and their speech therapist chooses words in those groups or words that have those patterns to practice.
  • Children with Childhood Apraxia of Speech have trouble with the motor planning of speech movements. They need to practice all possible combinations of sounds in as many contexts as possible as often as possible to try to make that motor planning smooth and automatic.

How does Articulation Practice need to be different for children with Childhood Apraxia of Speech?

  1. Children with Childhood Apraxia of Speech need many more repetitions than children with other types of speech disorders in order to show improvement. It takes a lot of practice to improve motor planning.
  2. Children with Childhood Apraxia of Speech need to practice speech in a way that builds complexity much more gradually than children with other types of speech disorders. Instead of working with words as the smallest unit of complexity, they will look at specific types of syllables and work their way up from the simplest syllable shapes to more complex ones. For example, a Consonant-Vowel (CV) syllable shape such as the word "boo" is a very simple syllable shape. Another very simple syllable shape is Vowel-Consonant (VC) such as "at". A complex syllable shape is CCVCC such as "blast". Yes, boo and blast are both one-syllable words that start with B, but one is much simpler than the other.
  3. Children with Childhood Apraxia of Speech need to practice consonant sounds paired with as many vowels as possible. For children who do not have difficulty with motor planning, it is enough to simply practice beginning, middle, and ending consonants without thinking about the vowels in between. Children with motor planning problems have to practice each consonant with each vowel because a consonant paired with one vowel requires different motor planning than that same consonant paired with a different vowel.

    Here is an example: Say "bee, bee, bee" and then pause before making the next /b/ sound. Your lips are pressed together. Now say "boo, boo, boo" and then pause before making the next /b/ sound. Your lips are pursed as if you're about to blow a kiss. The motor planning for a /b/ paired with the "ee" is different than the motor planning for a /b/ paired with the "oo".

What are some speech therapy materials that can be used to practice articulation in a way that is best for children with Childhood Apraxia of Speech?

  • The only formal speech therapy materials that I know of that addresses syllable shapes is the Kaufman Kits (level one and level 2). The Kaufman Kit is designed to work systematically through the simplest syllable shapes in approximate order of difficulty. Alternately, you can simply take free word lists you find online and sort them by syllable shape and start with the simplest ones first gradually working your way up to harder syllable shapes.
  • I am not aware of any articulation picture sets that make a deliberate effort to include all vowels. I am currently creating my own picture sets to try to address this issue. The sets are designed as much as possible to include words that are familiar to young children or that are easily taught. The sets will include only one-syllable words and will include at least one example of all possible vowel pairings. Eventually I would like to create multi-syllable words lists as well but that will not happen for quite some time. Look for the sets to begin to appear on this site shortly.

Key Points to Remember about Articulation Practice for Childhood Apraxia of Speech

  1. Many, many repetitions.
  2. Move from simple syllable shapes to more complicated syllable shapes.
  3. Pair each consonant with as many different vowels as possible. Some pairings will be easier than others. Practice them until they become automatic.

Note: Remember that your child's production does not have to be perfect. For example, say you are practicing "spoon" because it has the "ooh" vowel paired with a final /n/. Your child says "soon". Great! They may have left out the /p/ in "spoon", but they correctly pronounced the vowel and final /n/ that you were looking for. Treat that as correct (for now - until you start working on the /sp/ blend) and heap on the praise.


You might also be interested in the following articles:

Friday, June 10, 2011

The Weekly Review: Week Thirteen

Favorite Blog Post of the Week - Men and their New Baby Toys

Amalah shares a story about getting a baby swing for her newborn Ike. My favorite quote from her post was about why her husband chose this particular swing, "It's like somebody attached a cradle seat to an iPad and taught it to fry bacon."

Sibling Moment of the Week:

Last week I taught the kids how to play a modified version of "Red Light, Green Light." We were each holding a hand bell and when I said, "Green Light" everyone shook their bells as fast as possible until I said, "Red Light" when everyone stopped. Then the kids would quiver in anticipation until I said "Green Light" again and the cacophony could resume. They loved it. Next we tried giving the red bell to Ava and the green one to Michael and the person with the red bell got to say "Red Light" while the person with the green bell was the "Green Light" person. They loved that too. We passed a fun and extremely loud half hour and played the game a couple more times over the course of the week.

A few days ago, I was in one room desperately searching a laundry basket for enough clothes to make up outfits to send the kids to school in. The children were crouched over something sitting on the kitchen floor. Two heads bent over a single object. I don't actually know what it was, because I was only half paying attention. All of a sudden I heard them playing "Red Light, Green Light". I have no idea what the game was exactly, but they were playing together and initiated the game entirely on their own while being ignored by their parents. It was a brilliant moment of sibling independent play.

Michael's Update of the Week:

Michael was moved up from one room to the next at his preschool. He was pretty happy in his old room. He always seemed excited to be dropped off and was reluctant to make his way over to me when I came back to pick him up. He liked his teacher and she loved him too.

His new room is more of a formal preschool room. Their routine is a lot more structured and their expectations are higher. He also moved in to a room with a group of rather rambunctious boys. In the two weeks since the move, I have noticed that he doesn't want to go into his room when I drop him off. He clings to my legs and is reluctant to let me leave. He's also practically waiting at the door when I come back to pick him up.

I'm not sure what to do about the problem. I spoke with his teacher and she said that many of the new children are having some trouble adjusting. She'll keep a closer eye on him, but suggested giving him some more time before deciding to be officially worried about the situation.

Does anyone have any ideas or suggestions?

Project of the Week:

This week I'm getting structured home therapy set up for Ava again. I made a speech bag, printed some articulation cards, and prepared a reward chart. We've had two 15-20 minute sessions so far and they are going fairly well.

I've been unhappy with the comprehensiveness of the articulation card sets I've been able to find online for free. Each set will have 20-25 cards, but I have to leave some of them out because they are too hard. In particular, I leave out the ones that are two syllables or include a /k/ or /g/. So we end up with only 10-15 words to practice.

I decided that I can do it better myself. I'm now working on making my own sets of picture articulation cards. My goal is that each set will have 40 one-syllable words that should be familiar to a young child. I am also trying to make sure that each set includes at least one word with each of the American English vowels and diphthongs. That way, the targeted consonant gets practiced with all the vowels. That's important for kids with Childhood Apraxia of Speech because the motor planning is different for each different vowel. You have to practice each different combination to make the motor planning automatic. So far I've made an initial /b/ set and a final /n/ set. I'm going to try to figure out how to share them soon and I'll make more sets as I have time. It takes me several hours per set, so it'll be a slow process, but I'm pleased with the results so far. If any of you have requests for specific sets, let me know and I'll move those sounds to the head of my list of ones to work on.

Thursday, June 9, 2011

Speech-Language Pathology Topics: Vowels

What are vowels and why are they important to speech?

A vowel is a sound produced with a relatively open vocal tract. In contrast, consonant sounds are produced by constricting or interrupting the air flow at some point during production. You can maintain a vowel until you run out of breath. For example, take a deep breath and say "eeeeee" for as long as you can. You can keep making that sound until you get bored or until you run out of breath. However, when you make the "p" sound, you can't draw it out. You simply make the sound once and then have to move on. Vowels are essential to speech because they are the core of every syllable we make. Every word has at least one vowel. When vowels are produced incorrectly, that makes speech very difficult to understand.

What are the characteristics of vowels?

What makes an "e" different than an "o"? The vowel sounds are different from each other because you change the shape of your mouth when making each vowel. There are two main ways you change the shape of your mouth. Some vowels are made in the front of the mouth, some in the center, and some in the back. At the same time, some are made with the mouth relatively closed while some are made with the mouth relatively open. Speech-Language Pathologists use a vowel chart to keep track of the vowels and their characteristics.


If you say "beeeeeeee" and then say "baaaaaaaa" (as in "bat") you'll notice that you open your mouth more to make the "baaaaaa" sound. Next, say "beeeeeee" again and then "baaaaaaa" (as in "body"). This time you'll notice that the first sound is made in the front of the mouth while the second is made in the back.

What is the difference between a simple vowel and a diphthong?

A simple vowel is a sound made by keeping your mouth in a single position. When making a diphthong vowel, your mouth changes position. So, when making the /aI/ sound as in "bike" your mouth starts in a very open position and then closes for the second half of the diphthong. This second chart shows the five common diphthongs in American English and how they move in the mouth.



Why are vowel characteristics important to understand when planning therapy for Childhood Apraxia of Speech?

First of all, understanding the characteristics of vowels can help you understand why some vowels are harder than others for your child. Diphthongs are going to be harder than simple vowels because they require more complicated motor planning. If your child has an easier time with front sounds, they'll probably have an easier time with front vowels. If you are trying to help your child learn a back consonant (like /k/) it should be easier for them to make when paired with a back vowel because that makes the motor planning simpler.

Remember that Childhood Apraxia of Speech is fundamentally a problem with the motor planning of speech. The child has to form a motor plan to get from one sound to the next in a word including the consonants and the vowels. So if your child is working on /b/ words, the motor planning will be different if they are saying "bee" instead of "boo" because the vowels are produced in completely different ways. When you set up practice word lists, you want to pair /b/ with as many different vowels as possible to maximize generalization.

You might also be interested in the following articles:

Wednesday, June 8, 2011

Apraxia Therapy Materials: Webber Jumbo Articulation Drill Book

Book Review: Webber Jumbo Articulation Drill Book


This is a review of the Webber Jumbo Articulation Drill Book by Sharon Webber, M.S. and M. Thomas Webber, Jr. The book is designed to be a resource for Speech-Language Pathologists that offers a kind of dictionary of words, phrases, and sentences that can be used in therapy for the most common consonant sounds in the English language.


Target Audience

This resource is useful for Speech-Language Pathologists working with all ages. If you need to target specific speech sounds, this book is a wonderful resource for you. The pictures are essentials with young children and the word, phrase, and sentences lists work well with older children and even adults.

How to use the Webber Jumbo Articulation Drill Book

You need to know what sounds you are going to target and in what context (Do you need to target the sound at the beginning, middle, or ends of words? Do you need to target the sound in words, phrases, or sentences?) Once you know what you need to work on, you simply turn to the appropriate section of the book, copy the page, and use it in therapy.

What is inside the Webber Jumbo Articulation Drill Book?


You can view sample pages of the book.

The book has word lists, pictures, phrase lists, and sentences in initial, medial, and final positions for the following sounds: R, S, L, (Initial R, S, and L Blends), Z, SH, CH, TH (voiced and voiceless), F, V, K, G, P, B, T, D, J, H, M, N, and Y. It also includes an articulation drill record form, progress chart, homework helper note, and awards. There are a total of 6,420 target words, 3,120 phrases, 3,120 sentences, and 1,710 pictures.

Therapy Ideas using the Webber Jumbo Articulation Drill Book


  • You can practice the words in drill format by simply going through one at a time. Each picture card has boxes at the bottom for you to keep track of correct and incorrect productions if you like.)
  • You can make two copies of each page, cut the individual pictures out, and play a matching game or Go Fish style game with the pictures.
  • You can cut out the pictures and glue them onto a piece of cardboard in a kind of snake and make a game board. Have the children spin a spinner or roll dice and say the words they land on the number of times that they rolled in order to move forward.
  • You can cut out the pictures, glue them onto fish cut out of construction paper and then laminate the fish. Glue a small magnet on the back of each fish. Then make a fishing pole with a magnet on the end of the line and go fishing for the words.
  • If you have a small bowling pin game, you can glue or tape words to each pin. The child knocks down the pins and then has to say each word before they can set each pin back up for the new try.
  • Form a long train from the pictures. You can put an engine at the front and a caboose at the end. Put a small prize on the caboose like a sticker or piece of candy. When the child finishes saying each word that forms the train, they get the prize on the caboose.
  • You can let the children color the black and white line drawing pictures.

Pros and Cons of the Webber Jumbo Articulation Drill Book


Pros: This book can be very useful. It gives you some words to use in therapy for all common consonants in all three word positions. If you use the words and pictures creatively, they can make articulation therapy fun and productive. It is also great to have phrases and sentences included as well.

Cons: Young children often need practice with simple, one-syllable words. Often, there are only a small number of simple one-syllable words included for each phoneme in each position. You may not find a lot of exactly what you are looking for. Also, some of the pictures are hard to interpret for little ones or may not be the best illustration for the word.

Bottom Line

If you are looking for a single resource that will have at least a few stimulus words for almost any sound in any context, this is a hard book to beat.

You might also be interested in the following articles:

Tuesday, June 7, 2011

Home Therapy Plan - Rough Draft

Here's my first attempt (this time around) at structuring therapy sessions here at home.

  1. I made Ava a speech bag to store her speech materials in. Since we're really fancy around here, her bag is a ziploc decorated with stickers.
  2. I printed some very nice articulation cards I found at mommyspeechtherapy.com. I cut those out, paperclipped the different targets, and stuck them in the bag. Note: I printed these on cardstock at high quality to make the cards more durable and prettier.
  3. I found a site with some free printable reward charts and printed a butterfly one for Ava.

Now, my original idea was that Ava and I would sit down together and my charisma and enthusiasm would result in her wanting to practice speech sounds with me in exchange for the pleasure of putting stickers on the chart after each set of cards.

Hahahahahaha.

After that complete failure, I offered her two froot loops of her choice after doing each stack of cards. ("Two pink mommy." Hmm... what will we do when we run out of red froot loops?) That worked much better. We ended up with only one sticker on the chart. So I stuck the chart up on the wall and now we'll put a sticker up on the chart after each session.

My goal is to try to get in four or five 10-20 minute sessions per week. We'll see how it goes.

Monday, June 6, 2011

Therapy Progress - Small Details Add Up to Big Picture Progress (At least, that's the plan.)

I realized that I haven't done a real update on Ava's therapy progress and speech in quite a while.

Here are her previous updates, in order, for anyone who is just tuning in and is interested in the background:


It has become much more difficult to track Ava's progress. The difference between "My baby isn't talking!" and "My baby is starting to use words!" is pretty clear and exciting. The difference between, "She can't even imitate." and "She can imitate." is also pretty clear cut. The increase from single words to two-word phrases was obvious as well as was the increase to 3-4 word sentences. Getting a new sound is another simple, observable change. Well, we went through all of those easy to track changes and they were wonderful and I was feeling great. Then there was the reality check of a standardized articulation test. Overall, things are getting harder to track now, but I'll try.

Big Picture

Ava is certainly talking a lot. She pretty much never uses a single word utterance any more. She's rarely uses a two-word phrase. Oddly enough, now that she is more ambitious in her speech she is actually harder to understand. When her sentences are longer and particularly when I have no context, I have a lot of trouble understanding her. It is frustrating for me and for her. I can handle my frustration, but watching her get upset when I don't understand just kills me.

So, I suppose the good part of the "big picture" is that Ava's gained enough confidence to try more. In terms of the length of her sentences, she's pretty much age appropriate. Also, the more she talks the more opportunities you have to practice, refine, and correct. The challenging part of the "big picture" is that the more she tries to say the harder she is to understand.

Details

Specifically, we are working on two main areas. We are trying to add final consonants (only the ones she can actually make) to her words. She does best with /t/ and /p/. Those sounds are easier for her because they are voiceless. She can imitate a final /t/ (like in hat) and a final /p/ (like in up) pretty much 100% of the time. She's also using them on her own when talking roughly 30% of the time. We're trying to work on final /d/, /b/, /s/, /n/, and /m/ as well, but those are all harder for her. She can imitate some better than others, and pretty much never uses them on her own.

The other thing we're working on is trying to get some new consonants. Specifically we are trying to get the /k/ sound. Ms. J says that she has gotten Ava to make a /k/ sound in isolation during her therapy sessions, but I just cannot get her to do it here at home. I even tried bribing her with M&M's, but still no luck.

Why these specific targets? Well, adding final consonants is huge. Leaving those sounds out makes her much harder to understand and as she starts to add those sounds back in, that should improve her intelligibility. Improving intelligibility (how well she is understood) is the reason for trying to get her to make the /k/ sound. /k/ will be the gateway sound for /g/ because they are a voicing pair. There are a lot of words out there that use the /k/ and /g/ sounds and right now she either leaves the sound out or substitutes a /t/ or /d/. If we can introduce the /k/ and eventually the /g/ she should get a big boost in her ability to make herself understood.

And so we march forward. We choose targets that we hope will get us that much closer to our overall goal of helping Ava express herself in a way that can be understood.

My goal for the next few weeks is to reintroduce structured home practice. She needs more repetitions. That is the core of apraxia therapy. Even if I have to resort to bribing the girl with candy, we will somehow get it done.

Sunday, June 5, 2011

Picture Book Review: One by Kathryn Otoshi


Browsing the library books, I plucked this one off the shelf simply because the cover caught my eye. I briefly flipped a couple of pages and thought that the simple illustrations were quite beautiful and decided to bring it home. I knew nothing about the book. I didn't even know what it was about when I began to read it to Michael.

The characters are small watercolor splotches. The main character is Blue. The book begins simply by introducing him. We learn what he likes to do. We gain insights into his personality. We learn about his wishes and insecurities. We meet his friends: Yellow, Green, Purple, and Orange. Then we meet Red. As it turns out, Red is a bit of a hot head. He likes to tease and he particularly likes to pick on Blue.

After setting up the situation, Otoshi does a delicate, creative job of helping the colors stand up for their friend. You just need to find a copy and read it. It is a beautiful and unique book with a great anti-bullying message conveyed in a subtle and compelling way. Young kids will just enjoy the colors and numbers. Older kids will enjoy discussing the story as well.

I would never have gone out looking for an anti-bullying book to read with Michael. In fact, if I had read the book before reading it with him I might have hesitated due to the content (just because he is so young, not because it is objectionable). He found it compelling though. He was very interested in the different characters and talking about what was going on. Upon finishing he instantly asked to hear it again. In the morning he wanted to bring the book downstairs with him and he showed it to everyone who walked by (Ava, Daddy, Ava's therapist...).

The author's website has an excerpt of One that takes you through the first nine pages or so. It gives you a feel for the artwork and the beginning of the story. I highly recommend you check this out.

Saturday, June 4, 2011

Tot Clock Promo Code


I love our Tot Clocks. We use them to let the kids know when it is all right to get out of bed in the morning (6:50 am). We use them to let the kids know how long they have to stay in their room for nap even if they aren't sleeping (1 1/2 hours). We use them for time out (2 minutes). All of these settings are customizable. Set them to whatever times work for you.

There are many other features like an activity timer that turns the clock green, a music and white noise player, a storybook reader, and an alarm clock that we don't use but may in the future.

The Tot Clocks have been out of stock for several months but will be back in two weeks. You can pre-order on their site now. I'm on their email list, so I received a promo code that is good through the month of June for 10% off. I'm not sure if the code is a one time use only code or if it can be used many times, but we don't need it so here it is if anyone wants to try it. MTCBIS10



Here is a picture of the back of the clock and a description of many of the features.


Disclaimer: I am in no way affiliated with this company. I just really like this product.

Friday, June 3, 2011

The Weekly Review: Week Twelve

Blog Posts - New Babies

Congratulations to Amalah on welcoming Ike to her family. He's adorable. Problem Girl got to be present at the birth of her friend's baby Olive and did an amazing job with the pictures.

Weekly Blog Post that made me want to cook:

I have a friend who writes a very successful food blog called the Cupcake Project. She's been featured in Better Homes and Gardens, People Magazine and the New York Times among other publications. She did a slightly off topic post this week on Roasted Onions Filled with Savory Bread Pudding that actually made me want to cook. They just looked and sounded very yummy.

Sibling Moments of the Week:

Michael did something we praised him for. I honestly don't remember what it was (terrible I know). What I do remember, clearly, is how Ava said, "Yea! Good job!" and clapped her hands for him. She wanted to praise him too. I loved it.

In the car: Michael asked me to hand him a car he wanted. Ava had it in her carseat, but she wasn't playing with it. As I was driving, I couldn't get it for him and I told him so. He paused for a minute and then said, "Ava, can you give the car to me please?" She said, "Sure Michael!" and handed him the car. Simple, and yet sweet.

Michael and Ava's Cuteness of the Week:

At naptime, I put the children down for their nap by myself. We read stories in Michael's room with both children in my lap and then Ava and I tell Michael goodnight and head off to her room for one last song. Recently, the children have made a game of kissing my nose. I've been encouraging it because it is such a great oral motor activity (and it is sweet!). You have to do a pretty good job of pursing your lips to kiss the tip of a nose. I say, "Don't kiss my nose!" and hide it behind my hand. They giggle and pull my hand away before giving my nose a kiss. They take turns. Then I pretend to wipe the kisses away and we start all over again. It is fun, and sweet, and they would be willing to to it indefinitely as far as I can tell. I eventually have to call a halt or they'd never get down for nap. It's a game we all enjoy.

Family News Bulletin of the Week:

We just found out that my husband's parents are going to come visit next week. It is something of a spur of the moment decision and we are so excited to be expecting them. I can't tell the kids yet, because they aren't quite old enough to understand the week long delay before their grandparents arrive. I'm looking forward to sharing the news with them when the visit gets a little closer. We're going to plan several special outings I think and I can't wait. I hope the weather cooperates.

"Big" Decision I'm Considering

Ava refuses to let me put anything in her hair. No headbands. No bows. No hair bands. Nothing at all is tolerated. Her hair is getting longer (finally) and although I love the little hints of curl in the back, the front is in her eyes all the time. I can tell it is bothering her. She's constantly trying to sweep it out of her way. I wanted to wait until she had lots of hair before getting her first haircut, but it is in her eyes, and quite scraggly to be honest. I'm thinking of getting her first haircut. Somehow, it makes me a little sad. Odd, I know.

Thursday, June 2, 2011

Extended Family

I grew up in New Orleans, LA. My mom is the oldest of five siblings all of whom lived within about 30 minutes driving distance of each other. Every weekend all the aunts, uncles, cousins, and assorted family friends would gather at my grandparents house to watch the Saints play football and eat my Pa-pa's Cajun cooking. It was boisterous, crowded, and loud but we were family. It was fun. To this day we are all close even though we are significantly more spread out around the country. My closeness with my extended family is a big part of who I am as a person and of the values I hold as important.

I am blessed to live only about five minutes away from my parents. We have them over for dinner once a week, and one of the kids spends the night at their house every weekend. It's wonderful for my children to have such a close relationship with their grandparents. It is a gift to the children and to my parents and watching those relationships develop and deepen is incredibly important to me.

It makes me sad though, that my children rarely get to experience the huge extended family gathering that I grew up with on a weekly basis. They don't know what it is like to be in a room crowded with family all talking at once. They haven't had the opportunity to become close to our extended relatives simply due to distance.

We prioritize visits. Many of my Louisiana relatives travel to us once a year and we go to them once a year as well. As the children get a little older, they remember those visits and begin to anticipate the next one. We also visit my dad's family in Arkansas once a year and my husband's family in Oklahoma once a year. My husband's parents are wonderful and come to us several times a year. They're here for both kids' birthdays and often for at least one bonus visit.


So we try to find different ways to stay close to family. And it works. But if I could only convince everyone I love to move into my neighborhood - that would be perfect. Weekend gatherings would be so much fun.

Wednesday, June 1, 2011

Complacency and Marathons

When I finally accepted that I needed to get help for Ava, she tested so low, and the label Childhood Apraxia of Speech was spoken out loud it had a huge, profound impact on me. I was very depressed. I had difficulty thinking about anything else. My mind constantly circled around questions that simply cannot be answered right now about how much progress Ava will make and what will the impact of all of this have on her childhood and future.

After a few weeks I passed through the "this has rocked my world and not in a good way" stage and into a more productive stage. There was a flurry of research, self-education, setting up appointments, starting therapy, getting hearing checked, surgery for PE tubes, learning and using sign language, making and setting up communication boards, IFSP meetings, considering and trying nutritional supplements, and blogging about all of the above. And, it was all worth it. We saw changes in Ava's ability to communicate - dramatic and celebrated changes.

I began to breathe a sigh of relief. Yes, the disorder is still there, but it is responding to treatment. I relaxed. I gave myself permission to stop pushing Ava so much at home. To be honest, she didn't respond well when I tried to sit her down at home and do structured therapy with her myself and so I stopped even trying. I switched to a more indirect method of working with her through books and songs and correcting the many utterances we get each day as a natural part of our daily life. So much positive change had taken place so quickly that I began to think that we were "okay." Perhaps we were lucky enough that Ava's apraxia was so mild that we could get her "caught up" in a 1-2 year time frame rather than a much more extended time frame.

Then, our first standardized articulation test was a bit of a reality check and I realized how she is still very far behind her same-age peers. I had become a bit complacent. The progress Ava had already made was such a relief that I forgot that there is still a long way to go. I haven't quite decided what to do about that yet, but over the next couple of weeks I'm going to be thinking about ways I can focus on Ava's speech more here at home again. I'd like to build in some speech time every day in a way that hopefully she and I can both enjoy. I need to remember that this journey is something of a marathon and that I cannot just simply hope that we've come far enough that the rest will magically take care of itself.
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