Wednesday, February 29, 2012

Card Set Activity: Speech Caterpillar


This idea is super simple. I cut out 8 circles that were 3.75 inches in diameter each. That made the circles just big enough for my free printable speech cards. Then add a slightly bigger head with antennae, eyes and a mouth and laminate (or stick together with contact paper) and you have a speech caterpillar. It is inexpensive, easy to make, travels well, and makes artic drill a little more interesting.

You place a card on each body segment and then one prize per child (treat, sticker, token, etc.) on the last segment. They get the prize when they reach the last word on the caterpillar. You can easily modify difficulty. One child might simply imitate the word while another might say it three times in a row. A third child might use it with a carrier phrase and a fourth child might be using it in a sentence.

It rolls up easily for storage and or transport. You could keep it in a pencil box along with several card decks. You could also make a train, snake, racetrack, chain of boats, etc and keep them rolled up in the same box and then the children can choose the one they want to use that day.


If you liked this activity idea you might also be interested in top-bottom puzzles, or this activity and game list.

Tuesday, February 28, 2012

L-Blends (/bl/, /pl/, /fl/): Free Speech Therapy Articulation Picture Cards

Description

This articulation picture card set is designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for this set is young children or children with more severe speech delays that need intensive practice with sounds at a one-syllable level. No blends (other than the targeted initial blend) or vocalic /r/ sounds are included in this set. All syllable shapes are kept as simple as possible to allow the child to focus as much as possible on producing the initial blend. Syllable shapes are CCV or CCVC only.(Scroll down to preview set.)

Key Features

  • This set includes 15 therapy cards with the target word and picture on the front, and the difficulty level and a carrier phrase on the back.
  • The words are all CCV or CCVC in syllable shape.
  • The words are simple and are easily understood by or easily taught to young children.
  • Combines the L-blends with all possible vowel sounds at least once.
  • Words are sorted by difficulty level for an easy progression from easy to hard.

Permissions

I give permission to copy, print, or distribute this card set 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 this card set. Let me know if you find errors or 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 Set

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.

I recommend you print on cardstock and laminate for durability.




Monday, February 27, 2012

How many words does it take to be a late talker?

The Twenty-Five Words Every Toddler Needs to Know is getting a lot of press. This article is pretty much a fluff news piece with very little substantive content and no references. It was a written summary of someone's take home message from a talk a researcher did at a conference. I am not at all criticizing the researcher / presenter. I wasn't there. I have no idea of the quality of the research or presentation. I am questioning the "factual" information presented in this news article and the potential impact on parents who read it.

There are two concrete bits of information printed in the article.
  1. A late talker is a child who is using fewer than 25 words at age 2.
  2. When helping late talkers build their vocabulary, the 25 words that should form the building blocks of that vocabulary are: all gone, baby, ball, banana, bath, bye bye, book, car, cat, cookie, daddy, dog, eye, hat, hello/hi, hot, juice, milk, mommy, more, no, nose, shoe, thank you, and yes.

Now I have no major objections to the 25 words listed as good building blocks of an early vocabulary with one caveat. The caveat is that when working with children with a severe speech delay, sometimes you have to take whatever you can get and build from there rather than holding out for specific words you got from a list. You might have to start with exclamations, sound effects, or animal sounds before moving on to other words. You might have to kick start expressive language with a communication board or signs. A parent and therapist of a child with severely delayed speech need to be flexible rather than focused on any one ideal list.

I do have a major issue with the accuracy of the first statement: a late talker is a child who is using fewer than 25 words at age 2. Older research in the area of speech and communication disorders often defined "late talkers" as children who were using fewer than 50 words or lacked two-word combinations at age two. Even dated research wanted two year old children to be using at least 50 words at age two, not 25. More recent research shows that the average number of words girls produce at 24 months is 346 and boys produce 252. A vocabulary of below 92 for girls and 63 for boys puts a 24 month old at the 10th percentile. I'm taking this data from the introductory section of Language Outcomes of Late Talking Toddlers at Preschool and Beyond which is an excellent article.

The popularity of the Twenty-Five Words Every Toddler Needs to Know article concerns me because it may persuade parents that they can wait to have their child evaluated by a professional. In fact, children with a vocabulary of 25-50 words who are not using two-word combinations at 24 months should probably be evaluated by a professional.

On a personal note, reading the criterion for concern as a 92, 50, or even 25 word expressive vocabulary were all depressing. Ava had 3-5 words at that age. My worries at that time were completely valid and I certainly do not regret seeking a professional evaluation (other than my own) and early intervention. In fact, I credit intensive early intervention by excellent professionals and the work we do here at home for all the progress she has made in the past year.

Sunday, February 26, 2012

Surprise Gift

A couple of months ago we had some friends visit from out of town. They came over to our house for the evening. Their daughter spent an amazing evening playing with our children while the adults hung out and played with their baby. We had recently gotten our tea maker and our friend indulged me by letting me make her a pot of tea. We talked about how much we both enjoy drinking tea made with loose-leaf tea leaves. We were sad at the end of the night to say goodbye to the family as we will miss them until their next visit.

Imagine my surprise yesterday when I got a package from them in the mail. Inside I found a very sweet picture drawn by their daughter and addressed to Ava. I also found two packets of loose-leaf tea.


It was a great surprise and I am excited about trying the teas. These teas are particularly interesting. The one you see on the bottom is actually an herbal tea made that is made from the leaf of the rooibos plant grown in South Africa. It is a caffeine-free alternative to traditional tea leaves. I am particularly excited about the caramel rose flavor.

I can't be sure because the label does not say, but my guess is that the top bag containing Emerald Surprise is a green tea. Green tea is made from the same kind of tea leaves as traditional black tea, but is processed differently. Green tea leaves are dried before they begin to ferment resulting in a tea that retains more of the natural health benefits, has less caffeine than black tea, and tastes a little lighter and fresher than black tea.

It was an extremely thoughtful and sweet gift and a wonderful surprise. Thank you!

Saturday, February 25, 2012

Rory's Story Cubes - Action Version: A Mini-Review

Last year I did a review of Rory's Story Cubes. It is a simple, yet amazing game that consists of nine dice. Each die has a different picture on each side. Most of the pictures are of things (lock, phone, flower, castle, apple, etc.). You take turns rolling the die and making up a story. I think the game is wonderful. It is small and compact. It is great for either speech or language therapy. It is very reasonably priced on Amazon.

I recently discovered that there is a new Rory's Story Cubes game - the Action Edition. The game is still nine dice. There is still a different picture on each side of each die. This time the pictures depict actions (build, play, kick, jump, read, dig, etc.). Combine these die with the original set and your stories become even more complex. Again, it is a small, compact, reasonably priced therapy tool to address either speech or language goals.



Friday, February 24, 2012

The Weekly Review: Week 49

Blog Post of the Week

I loved Amalah's Valentine's Day Recap. First of all, I definitely need those bracelets. I thought it was only my husband and I who had that exact same exchange. Second, the story about her putting the baby to bed while listening to alarming noises from downstairs was hilarious. I read it at least twice and laughed out loud each time. I loved her description of her silent, gasping laughter when listening to her husband's description of the events because I do that too. Somehow, the pain of others often causes me to laugh (in a completely sympathetic, yet uncontrollable manner). I get that from my mother.

Ava this Week

First, the making silly faces at daycare has been a complete success. (Please don't let me saying that out loud jinx it.) Dropping Ava off at school takes a fraction of the time and is fun from start to finish. Now, if I were the type to be self-conscious I might feel a bit like an idiot sticking my tongue out, my fingers in my ears, crossing my eyes and bobbing up and down in front of that window while countless other parents walk by with their angelic children. I'm not though. I'm self-conscious about plenty of things, but all bets are off with children. I think other parents are pretty understanding.

Second, I have decided that Ava is an /l/ genius. This late-emerging sound that is the bane of so many children's speech journey has come so easily to her. She's even using some l-blends in conversational speech after working on them for only a couple of weeks. What is it about her wiring that makes some difficult sounds so easy for her (/l/, /s/) and some easy sounds so hard (/k/, /g/)?

Weekly Michael

Michael had his 4 year checkup this week (three months late). He was amazing. He charmed our pediatrician. He did wonderfully on the developmental checklist. We ran out of questions before we hit three negative answers. He was brave during the first and even the second immunization even though he was scared and he shook off the tears and moved on the second the stickers came out. I was so proud.

Our pediatrician evidently forgot that I'm an SLP and asked me if I had ever had his speech screened. So, his speech errors are becoming more noticeable and age-inappropriate. I told her that I was aware of the errors and was working on them. I haven't had him evaluated, because the errors he is making are still considered to be age appropriate according to school districts (who are crazy) and so he wouldn't be eligible for services. Therefore, I told her, I am handling it myself for now.

On a completely separate note, we have a computer program that lets Michael design and print his own "book". He insisted I staple it together just like a real book. I asked him to read it to me, expecting him to just tell me the story in his own words. Imagine my surprise when he read the story word for word to me only needing help once the first time he encountered the word Pierre. "One day, Pierre went to a park. Up in the sky he saw the sun. At the park, Pierre saw a cat. Pierre decided to fly a kite."

Weekly Procrastination Update

I have finally gotten started planning for Ava's birthday. We're getting her an art desk for her birthday. She loves arts and crafts, but right now all the art supplies are kept put away except during special projects. I want to make them available to the children all the time (well, not paint perhaps...) and so an art desk sounds perfect. I think she'll love it. Once I've decided on a "perfect" gift I have so much trouble waiting until the actual birthday to give that present.

Weekly Realization

Ava turns three in less than a week. Also in less than a week, all of our early intervention services cease and she'll have her first group session conducted by school district personnel. Somehow that snuck up on me. Oh how I hate transitions. I have such high hopes for this speech group though. I think the structure and use of the Hodson's Cycles Approach could work very well for her. It is sad to say goodbye to our early intervention therapists though. They've been part of our lives for a long time now. The transition seems so abrupt. We'll miss them.

Ava's Weekly Home Therapy Focus

Ava is continuing to do well with final /s/ and /sh/. We run through those relatively quickly alternating nights. Our main focus right now is on the /bl/, /pl/, and /fl/ l-blends and the /sn/ s-blend. Just this week we have also started /st/, /sp/, and /sm/. Ava does very well with the l-blends needing only moderate to light prompting. The s-blends are still quite difficult requiring significant prompting, but I can see the motor planning beginning to kick in for them. She finds them noticeably less difficult than ten days ago. I notice the difference in subtle ways. She still requires significant cueing, but she is less frustrated. It takes fewer attempts before we get a correct production. We can practice longer before she gets fatigued. We get more repetitions in during a 25 minute session than we did a week ago.

Michael has begun to notice the attention and praise Ava receives during our nightly speech therapy sessions and has asked to be included. This is a blessing in disguise. Ava's therapy becomes a little less intense when she shares her session with her brother, but now I get to do some official work with Michael on his errors. The final /s/ cards and s-blends allow me to address his interdental /s/ production. The /f/ blends allow me to address his /th/ for /s/ substitution.

When asked to keep his tongue behind his teeth for the production of /s/ ("keep the tiger in the cage") he can do it. He accomplishes this by clenching his jaw and keeping his teeth closed through the production of the entire word including during production of the vowel and other consonants. This seems less than ideal. Do any of you other SLPs have thoughts on this manner of production? He obviously needs to stabilize his jaw in order to produce the /s/ properly. Is it all right (for now) to let him maintain that position through production of the entire word, or should I discourage that? Any thoughts?

Thursday, February 23, 2012

A Question You Don't Want Your Son to Ask His Preschool Teacher

We were sitting down to breakfast yesterday when Michael announced that when he grows up he wants to design a huge gun to blast tires in a junkyard. After a moment when my brain simply stalled attempting to formulate an appropriate response, I tried the following: "Well, actually, they usually recycle old tires into things like rubber mats and playground mulch like we saw on that show How Things Are Made. Perhaps you could design a huge tire recycling machine when you grow up?" After a millisecond of thought he rejected that idea. "No, I'll just design a really big gun."

Umm. Okay. I obviously needed a new strategy. "Well sweetheart. You can be anything you want to be when you grow up. You can learn all kinds of things at school." He perked right up at that suggestion and happily told me, "Great! I'll ask Miss Marlene to teach me to make a big gun at preschool tomorrow." At that point there was a huge awkward pause while I contemplated exactly the extent to which that strategy had backfired. Finally I stuttered, "No, don't ask Miss Marlene that..." and kind of trailed off. He came right back with, "Why not?"

Alrighty then... I launched into a huge discussion about how first you go through preschool where you learn letters and art and science and then grade school and high school where you learn reading and math and science and history and art and music.... And then, I explained, when you get to college you can choose to study what you want to be when you grow up. I told him that mommy learned how to be a teacher and a speech teacher. Daddy studied computers. Grandpa studied chemistry. His grandmother learned how to be a nurse. I then suggested that he could study to be an engineer who makes prototypes and plans for things to be built in factories.

At that point, I'm pretty sure he had stopped paying attention. Hopefully the huge long conversation will at least have distracted him from his original intention of asking his preschool teacher to teach him how to build a gun. A mama can hope, right?

Wednesday, February 22, 2012

Sometimes It's Just Normal

In retrospect, it is so clear that even as infants my children were not developing typical early communication milestones. The first smiles and laughs were not on schedule. We never really had cooing at all. Babbling was both very late and extremely reduced. This is for both children, not just Ava. In fact, all of those delays were even more extreme and exaggerated for Michael than for Ava.

Now Michael's speech started to kick in around the age of 15 months. It was odd. His first consonants were ones like /k/. He was using clicks in place of consonant sounds which was even more strange. I was so very worried.

In fact, I can remember having a conversation the night of Ava's birth with a fellow SLP about how concerned I was about Michael's speech. He was 15 and 1/2 months old that night. I know that it sounds strange that I just happened to be talking to a SLP on the night of my daughter's birth. However, that SLP was a close friend and former coworker who also happened to be a doula. She was my doula and with me for the birth of both of my children and so it was natural for us to be discussing Michael. She was there for his birth and she was a fellow SLP.

At 15 months all Michael had was a couple of vowels, a /k/, and a lot of clicks. However, by 24 months he was talking in 5 word sentences, had an age appropriate sound repertoire, and was intelligible enough that his speech was constantly commented on positively by strangers. It was such a relief. Over the course of those nine months, the worry I had carried in my heart for the first year and a half of his life faded and I was so grateful to let it go.

That history of Michael's delay followed by a remarkable recovery to above average was a huge part of why I delayed so long before acknowledging that Ava's speech was delayed. Then we fast-forward to the present day.

Now, at the age of 4, it is apparent that Michael does have some speech errors that are going to need intervention. He has a distorted interdental production of /s/, /f/, /v/, and /th/ that results in all of those sounds being produced in an identical fashion that is visually distracting and impacts his intelligibility on words that include those sounds. And so I worry.

I spend a lot of time worrying about speech. I worry about Ava's speech. I worry about Michael's speech. But sometimes, a speech error is completely normal - even adorable. Michael is completely convinced that one of his favorite foods is "grabioli" rather than "ravioli". I smile a little every time I hear him say that because it is such a normal speech error. I smile, and gently correct him. It is nice to occasionally engage in a correction that is without stress or subtext. Because sometimes it really is just normal.

Tuesday, February 21, 2012

Help me tell a story. - A Speech Card Set Activity

I had 15 cards left over from my Initial /s/ card set after making some top-bottom puzzles yesterday. I was trying to think of an activity to do with the remaining cards.


I decided to try to come up with a story to tell about the cards. I told the story and paused to let Ava fill in the words prompted by the appropriate cards during the storytelling. The story is pretty silly, but it works fairly well given it was just made up to include 15 random initial /s/ words.

Here are the words I was trying to include: suck, seed, saw, soup, soap, sock, sick, seek, seal, sack, soil, side, sell, sub, and same.

Here is the story I used. It isn't exactly great fiction, but it includes all the words and Ava thought making up a story was fun. I thought of the story ahead of time and put the cards in the order they would appear in the story. Then, I just told the story off the top of my head as prompted by the cards.

Mommy was trying to suck some juice out of her juice box. It was all empty though. She decided to make some more from this watermelon. First she had to take out this seed and all the others. She was having some trouble so she cut it with a saw. Then she made her juice and drank all of it. When she was done she was still hungry so she decided to eat some soup. Her hands were all sticky from the watermelon, so first she had to wash her hands with some soap. Mommy didn't have a towel, so she dried her hands on a sock. How silly! Then she ate her soup. After she finished all her soup, she felt a little sick so she laid down and took a nap. After her nap she decided to go for a walk. While she was on her walk she saw some children playing hide and seek. She walked by the zoo and saw a mama seal and a baby seal. She saw a sack full of soil that had fallen on its side. All the soil fell out and made a big mess. Then mommy saw a man trying to sell a hot dog and realized that all that walking had made her hungry so she bought one and ate it. Next she walked by the lake and was surprised to see a sub. Finally, mommy decided it was time to go home. She was thirsty, so she went back to the same table to drink some more juice. The end.

Ava enjoyed the story and being able to help out by adding words to my story. I'd pretend that I had forgotten the next part of the story and she was helping me by telling me the word on the card.

Again, this isn't the most intense type of articulation drill, but taking five minutes out of a session to do this type of activity works on language skills, and teaches a story that you can use later to work on generalization to the phrase or sentence level. You could do this type of activity with any of the card sets.

Monday, February 20, 2012

Card Set Game: Top-Bottom Puzzles

Usually I just do drill with Ava. She tolerates it fairly well if I bribe her with a treat (I use the Gerber Graduates Yogurt Melts so I don't even feel guilty). I give her one treat for every set (15-30 repetitions or so) and two treats when we're all done.

For variety, I decided to try the top-bottom puzzle idea from the card set game and activity ideas list I posted a while back.

I printed a fresh copy of the fronts of my Initial /s/ set. First I cut them out using a paper cutter. Then I chose 15 out of the 30 cards that I thought would divide well into top and bottom halves and cut those in half. (I'll save the other half of the cards for a different game another time.)




I shuffled the half-cards and started setting them out on the table. I separated the tops from the bottoms to make it a little easier this first time. Every time Ava saw a match, she said the word and set the match aside.


She really enjoyed the activity. I thought it was fun, but the actual speech practice was much less intense than our usual therapy session. It sounds terrible to admit that I prefer drill, but speech therapy for motor planning problems needs to be heavy on repetitions. The child cannot automatize motor sequences without actually talking, and talking a lot.

Using a game instead of drill significantly reduced our number of repetitions. Perhaps a compromise would be to do drill for the first 2/3 of a session, and bring a game out at the end of the session for extra motivation when the child is getting fatigued.

Sunday, February 19, 2012

Lowe's Build and Grow Kits

My uncle is a garage sale person. As he is a wonderful man, he keeps my children in mind as he searches for great deals. For Christmas he gave Michael a bunch of Lowe's Build and Grow kits he had picked up for a quarter each. I am officially telling him that the the gift is amazing. Thank you!

The kits are simple. They are wooden pieces with pre-drilled holes and nails. There are instruction sheets and stickers to decorate the finished product. Some examples are fire truck, helicopter, race car, pirate ship, and monster truck.

Michael, Ava, and I assembled our first kit last week. I just grabbed one at random and our first project was the monster truck. Here's a picture of the kit. They sell for about $9 at Lowes.


We all had fun assembling the truck with hammer and nails. Ava didn't have enough strength and fine motor control to hammer in the nails with her left hand so her job was to take the nail and push it down as far as possible into the predrilled hole by hand. Michael would follow up by hammering the nail down as much as he could and I finished off each nail.

I was pretty impressed with the way the kit went together. The pieces were well made and everything fit together well. The final product was sturdy and has held up to some pretty enthusiastic play.

After the monster truck was mostly assembled, but before we put on the stickers I suggested painting it. The children enthusiastically agreed. Ava painted the wheels black while Michael painted the truck red. We put on two - three coats and then let it dry overnight. Now we were painting it with washable tempera paint and I was a little concerned that it would rub off with sweaty hands so I finished it off with a coat of mod podge. Then we applied put the wheels on the truck with the last two nails and applied the decals.

Here's the final product. The children were delighted and Michael and Ava showed it off to every new guest to arrive in the house for days. Michael took it to his room to play with at every naptime and bedtime for days. I felt we got well more than $9 value out of the activity and the toy we got as a final result.

Saturday, February 18, 2012

Painting a Polar Bear Landscape with Preschoolers

Gail from www.thatartistwoman.org posted an amazing tutorial on painting polar bears with her first grade students. I was inspired. I thought the paintings were beautiful and that I might be able to do the activity with my preschool aged children.



Here's how I adapted the activity for my two and four year old children. The key was to do the activity in stages during the day. They would go play while one stage dried. The break in between stages allowed them to come back excited about doing the next part of their polar bear painting.

I began by taping watercolor paper down to the table. I set out purple liquid watercolor paint, paintbrushes, toilet paper rolls covered in a paper towel held on with a rubber band, a pencil, and some coarse salt.


I showed them a picture of what the painting would look like when complete and we talked about the different parts of the painting. We identified the purple sky, blue ice, moon, mama polar bear, and the two bear cubs. We talked about how it looked like there was snow in the sky and how the ice looked cracked.

I introduced the term "horizon" and explained that the horizon is the line where the land (or in this case, ice) meets the sky. I told them we were going to draw horizon lines on our paper and asked them if they wanted a hill. Each child showed me with their finger the shape of the horizon line they wanted and I lightly drew it in with the pencil.

I reminded them that their purple paint was for the sky and so they needed to paint the part of their picture above the line purple and leave the bottom white for now. They did a great job painting the sky. While the sky was still wet they used the paper towel covered toilet paper rolls to blot up paint in the shape of a circle to make the moon (press firmly and hold for a count of ten). Then they sprinkled salt onto the still wet sky.



Then there was a drying intermission. The children went off to play for half an hour or so. I cleaned up the purple paint and replaced it with blue watercolor paint and I cleaned the paintbrushes. I also put away the salt and toilet paper rolls and got out a roll of cling wrap.

Half an hour later we all came back and brushed off the now dry salt. Then the children painted the bottom half of their painting blue and helped me press cling wrap onto the wet ice. The "cracked" appearance to the ice is formed by the wrinkles in the cling wrap, so the more wrinkles the better. Press down firmly and leave to dry.


We all dispersed for a 45 minute intermission. This time I cleaned up the blue watercolor paint and brushes and got out a container of white tempera paint. I also got out some polar bear stencils I had made the night before by printing out polar bear coloring sheets from the internet onto cardstock and cutting them out.

When we all came back I let the children decide where they wanted to place their polar bears. I held the stencil steady while the children dabbed on white paint (dab with the brush instead of moving it back in forth to minimize paint getting under the stencil).


Then it was just a matter of letting the final product dry and admiring the final result. They were so proud.

Friday, February 17, 2012

The Weekly Review: Week 48

Blog Post of the Week

Swistle gets the nod two weeks in a row, this time for her amazing OpportunityThink post. If you too are frustrated when someone offhandedly remarks how much you must enjoy your "free time" when the kids are in preschool, you would probably love this post as much as I did.

Ava this Week

I have a new trick for pleasantly dropping Ava off at daycare. She is no longer traumatized by drop-off. She hasn't been for months now. She continued to put on a performance for the attention though. I finally decided enough was enough. One morning late last week as we were walking in I simply told her that I didn't want any more whining and leg hugging when I left the room. We were going to play a new game instead. We're going to make silly faces at each other through the window before waving goodbye. It was a simple idea, but rather effective. Now she can hardly wait for me to exchange a few words with her teacher before pushing me out the door so she can make a few silly faces at me. The other children rather enjoy it too and I'm collecting quite a crowd of silly faces on my way out. It's cut my drop off time in half and made the process infinitely more pleasant.

Weekly Michael

I went to Michael's preschool Valentine's Day party. He knew I was going to be there. When I got there the class was in the gym and only a few parents were in the classroom. A few minutes later the class returned to the room. The look on his face when his searching eyes found me was priceless. The run to my side and tight hug was even better. It completely made the trip worth it in the first 30 seconds.

Weekly Procrastination

Hmm... I still haven't done anything to get ready for Ava's birthday. I really, really need to fix that before next week's review.

Ava's Weekly Home Therapy Focus

Yesterday's long-winded post on blends was probably already way more than you wanted to know about Ava's therapy focus this week. Let's just say that she's continuing to make great progress on final /s/ and /sh/, /l/, and a few blends. Now that her accuracy on /s/, /l/, and /sh/ has improved so much I'm doing the cards in pairs (for example, "Say rush, wash."). At first she was dropping the targeted consonant at the end of the first word in the pair, but with appropriate cues she's getting them now.

Thursday, February 16, 2012

Trying for blends (/sn/, /bl/, and /pl/)

We've starting working on blends with Ava. She's had a lot of success with both /s/ and /l/. Typically, /s/, /l/, and all blends would not be sounds you'd choose to work on with a two year old child. However, Ava struggles to make herself understood. She has motor planning problems with speech and for whatever reason, /s/ and /l/ are easier for her than other sounds that would typically emerge earlier (like /k/). So, if we take the time to improve the sounds that are more stimulable, we'll improve her intelligibility sooner. Sure enough, /l/ is definitely popping into her conversational speech and it sounds great. To a lesser extent (mostly in initial position), /s/ is popping in as well. So, we decided to try for some /s/ and /l/ blends.

Her /sn/ words are: snow, snap, sneeze, snip, snail, snore, and sniff. She is pretty good with all those final consonants (notice, we aren't doing snake).

We are cueing her on multiple levels. First, we are using semantic/visual cues. For "snow" we use the visual cue for /s/ followed by shaking our head "no". For "snap" we use the visual cue for /s/ followed by tilting our hands on our head to visually cue "nap." For "snail" we use the visual cue for /s/ followed by pretending to hammer a "nail." And so on...

This works well when we keep the /s/ sound completely separate from the second part of the word. As soon as you ask her to imitate the blended word, she loses the second consonant. Snow becomes so. Snap becomes sap. Snail becomes sail.

Using an auditory prolongation cue was also unsuccessful. Ava, say "sssssssssno." Her response was simply "so".

Visual cues were unsuccessful. Semantic cues were unsuccessful. Auditory cues were unsuccessful. I finally tried incorporating some tactile cues. I happened to do this with feet because Ava thought it was funny, but you could do this with hands, fingers, or knees as well. I first grabbed one foot and giving it a light squeeze I asked her to say, "Hi sssssss." She repeated, Hi sssssss." Then I grabbed the other foot and gave it a squeeze and asked her to say, "Hi no." Again, she repeated, "Hi no." Then I squeezed each foot in succession as I said, "Now say ssssssss-no." She had the tactile cues of me squeezing each foot in succession with each part of the blend. She had the auditory cues of the prolonged /s/ sound followed by an emphasis on the /n/. She was also watching my face and mouth at the same time. This time she was successful.

We continued to practice that way about three additional practice sessions and then I was able to fade the cues. First I was able to stop using the tactile cues. Then I was able to minimize the prolonged /s/ sound. Now I can simply show her the card and give her an auditory cue with a just the slightest prolongation of the /s/ and a slight emphasis on the /n/ and get a /sn/ blend production from her. It's like the motor planning finally kicked in and now she has it. We still have a lot of work to do. It is inconsistent and we get no carryover to other s-blends (/st/, /sp/, etc.). At least the variety of cues and prompts managed to help her experience some success with the specific blends we are working on right now.

I used the same strategies for /pl/ and /bl/. Our /pl/ words are plum, play, please and plane. Our /bl/ words are blue, blood and blow.

Quick summary of cues/prompt types you may find useful:
  • auditory (slight separation of blend consonants, prolongation of first consonant in blend, emphasis on the second consonant of the consonant blend, clapping or snapping for each section of the blend word, etc.)
  • visual (use gestural prompts for specific phonemes, use gestures to represent semantic cues, have child watch your mouth)
  • semantic - assign meaning to the second part of a blend word (the "no" of snow, the "nap" of snap, etc.)
  • tactile cues - tap or squeeze a hand, finger, or foot to emphasize each part of the blend word you are trying to produce in sequence

Wednesday, February 15, 2012

Science on the Light Box: Oil and Water Revisited (with a little color theory)

I wanted to revisit our light box experiment with oil and colored water. Last time I noticed how well the different colors of water blended together in the experiment and how beautiful the colors were when backlit by the light box.

We always blend our secondary colors. I only have red, yellow, and blue tempera paints because that saves a little money and storage space. So the children are very familiar with making orange, green, and purple by mixing red, blue, and green. I had never done a formal introduction to the color wheel and the terms primary and secondary colors though. So, first we did a brief (5-10 minute) activity using paints and cardstock to introduce the color wheel. We put the three primary colors on the paper. Then we mixed the secondary colors in between each pair of primary colors.


Next I took small squeeze bottles filled with clear water and set them next to each color on the color wheel. First we colored the water with the three primary colors and then we mixed those to make each secondary color. We ended up with six squeeze bottles filled with different colors of water (red, blue, yellow, purple, green, orange).


I got out both light boxes and trays so that each child could play on their own. We took a moment to appreciate how pretty our bottles with colored water looked in an empty tray backlit by the light box.



I poured a small amount of cooking oil into each tray. I just put enough to cover the bottom of the tray with a shallow film of oil. Then the children began to squirt colored water onto the oil. The drops of water stay separate in the oil and float around like individual colored puddles.


If you are careful you can even make some simple shapes. I was able to make caterpillars and flowers for the children.


After a few seconds the surface tension of the oil releases and adjacent droplets of water combine. We were using the word "absorb". The children learned they could direct a stream of water from a squeeze bottle to manually break the surface tension and force a big drop to absorb smaller droplets. They made up a game of superheros and villains where the large superhero drops would absorb the small villains trying to attack them.

Everyone had a great time and we didn't quit until all the water had been used up from the squeeze bottles about an hour and a half after we began.

If I repeat the activity again, I will give each child a set of the three primary colors and encourage them to do their own color mixing as they play. I'll ask them to make a purple drop, green drop, and orange drop from the appropriate component primary colors. I'll see if their fine motor skills are good enough to make their own adjacent drops of primary colors without breaking the surface tension. Then we can all wait until the surface tension dissipates and the two colors swirl together to make the secondary color. It is all beautiful on the light boxes.

Tuesday, February 14, 2012

Happy Valentine's Day

Ava and Michael got custom hand-made Valentine's Day Cards from their personal Cricut cupid. When the children spotted the card envelopes they ran to sit down for the opening. Michael recognizes his name and therefore studies the envelopes and determines which is his and which belongs to his sister. They open the cards and I can barely get them out of the children's hands long enough to read the sweet message inside to the children and take a quick picture before they are reclaimed. As always, the hand-made cards bring something special to our holidays. We send a big hug and thank you to the people who make them for us.

Happiness grows when shared, so I share them with you to bring a smile to your Valentine's Day.

Monday, February 13, 2012

Positive vs. Negative Reinforcement - One Case Study

At the age of four and a quarter, Michael is no longer sleeping during afternoon nap time. I simply have to accept that fact. For a while he would sleep on one day, and quietly play in his room for 90 minutes while his sister slept on the next day. Then the ratio was more like two quiet playing days for every one sleeping day. Then he was only sleeping twice a week. And now he pretty much never sleeps.

I wasn't overjoyed, to be honest. Still, I had little to complain about when he was contently playing in his room for 90 minutes during his sister's nap without even questioning this setup. There aren't many four year olds who will play quietly and happily in their room for an hour and a half.

Then he realized that I couldn't actually make him stay in his room and he started to wander. Once my husband found him quietly flossing his teeth in our bathroom (what?!?). That day he stayed in his room after being returned there. Another day I found him digging through an old box of toys in the hallway. Then he realized that he can sneak out of his room, and hide in just the right spot on the upper landing to spy on me at the computer. He began to leave his room and have to be returned at least every 15 minutes.

I'll admit it. I did not handle the situation with calm grace and dignity. By the time 2 pm rolls around I desperately want a break from childcare. I want to blog, read, watch television, or simply browse the web and have a little quiet time. Notice, chores do not appear anywhere on that list unless absolutely necessary.

I reacted instinctively. I fussed. The first time. And the second time. And the third time. By the fourth and fifth time I had escalated to slightly nasty hissing. By the sixth and seventh time, when he assured me he would indeed stay in his room this time, I had spiraled downward into quiet yelling (his sister was still sleeping after all) and accusations of lying. He ended up crying and I felt pretty crappy for yelling at a four year old child.

I needed a whole new approach. I printed out a sticker reward chart and hung it up in his room. We reviewed naptime rules (you may not leave your room, you have to play quietly enough so that you won't disturb your sister). I reduced the amount of time he needs to stay in his room by 15 minutes. I allowed him to bring some new toys in his room. I told him that every time he followed all the naptime rules he could put one sticker on the chart. Every time he gets five stickers he may choose a piece of candy.

He was so excited. We don't get candy often around here. We finally threw out the halloween candy a few weeks ago. That afternoon break is completely worth 1-2 pieces of candy a week to me. Since then, we have had two absolutely perfect nap times. He is proud and excited when nap time is over and he gets to put that sticker on his chart.

The combination of making my expectations clear and reasonable, bringing some toys up so his playtime is more interesting, and setting up a reward system worked wonders overnight. I feel great about saving my afternoon break and he feels great about his sticker chart. Taking the time to set up a positive reinforcement system was definitely worth it.

Sunday, February 12, 2012

How to Eat Green Beans - Cook Till Half-Past Ten

We were having green beans with lunch yesterday. Michael also had some ketchup on his plate. The ketchup was intended to be a dip for his chicken. My husband and I noticed Michael happily dipping his green beans in his ketchup as if they were finger food and munching away.

We raised our eyes a little and exchanged a subtle glance that said "ick," but didn't draw attention to the situation. After all, he was happily eating green beans and requested a second helping.

Then he sweetly offered me a green bean dipped in ketchup and asked me if I wanted a taste. I reasonably replied, "No thank you sweetheart, I already have my own." He was too smart for that though. Without skipping a beat he countered with, "But momma, this one is covered in ketchup!"

Well, that certainly put me on the spot. I wasn't the slightest bit interested in tasting that green bean. We've discussed the concept of taste buds before and how everyone has slightly different taste buds which is why different people like different foods. So, I told him that my taste buds like their green beans plain, but thank you for offering.

That seemed to be the end of that. Conversation, and the meal, moved on for a while with no more discussion of how to eat green beans. Then Michael started to explain how you make ketchup-covered green beans. First, you cook the green beans. Then you cover them in ketchup. Then you put them in the oven and cook them again until half-past ten. Then you get to eat them.

Nice to know he has it all worked out.

Saturday, February 11, 2012

So yummy! Dutch Chococcino Loose Leaf Tea

I have been using my new tea maker to make at least three pots of tea a day. I've tried several new loose leaf teas in the process. I intend to do a post about my favorites once my first wave of research is complete, but I wanted to share a new discovery that I particularly like.

I love the Dutch Chococcino from Vianne's Tea House. I opened the bag and it smelled heavenly. It smelled just like a really good dark chocolate bar. It also has an amazingly rich dark chocolate taste to it. It is the closest a tea has ever come to replacing a really good cup of hot chocolate for me. I made mine with plenty of raw sugar and a little milk in it.

If you enjoy making loose leaf teas and you enjoy chocolate you should definitely try this tea.

Friday, February 10, 2012

The Weekly Review: Week 47

Blog Post of the Week

I enjoyed Swistle's idea about spite charity. I love the way her mind works.

Weekly Pleasant Surprise

An old friend that I had lost touch with years ago sent me an email. Since then we have exchanged several more. It has been lovely catching up. It makes me sad that we are now living several states apart.

Ava this Week

Ava adapted to her cast amazingly quickly. She's capable of at least 85-90% of her usual activities with her right hand out of commission. Every so often, she'll want a little assistance though. She'll run up to me and ask for help, and then casually add on to the end of the request, "because I have a cast, you know." I love the way she continues to inform me as if I could possibly be unaware of the fact.

Weekly Michael

When Ava wants a snuggle, she'll come over to me and plop herself down in my lap. When Michael wants a snuggle he'll ask to be tickled. It's adorable. He'll come over and plop himself down in front of me demanding, "Tickle me Mama!" If he feels my initial tickle was too cursory he'll request, "Tickle me some more Mama." He also uses this as a delaying tactic after all the stories have been read and it is time to climb into bed.

Weekly Procrastination

Hmm... Ava's birthday is in less than three weeks. I should probably plan a party, order a cake, and think about a couple of presents.

Ava's Weekly Home Therapy Focus

This week we've dialed way back. We're taking a break from /k/. Ava's done so well with initial /s/ and /sh/ that we're taking a break in the initial position and just pushing those in final position. We're continuing to work on /l/. We're also testing the waters with s-blends. Specifically we're doing some /sn/ words.

Thursday, February 9, 2012

Final S: 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. No blends or vocalic /r/ sounds are included in these sets. (Scroll down to preview set.)

Key Features

  • This set includes 30 therapy cards with the target word and picture on the front, and the difficulty level and a carrier phrase on the back.
  • The words are all VC or CVC in syllable shape.
  • 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.

Permissions

I give permission to copy, print, or distribute this card set 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 this card set. Let me know if you find errors or 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.

I recommend you print on cardstock and laminate for durability.






Wednesday, February 8, 2012

Why does preschool registration begin in late January?

We just finished registering both children for preschool. Why on earth am I making decisions now about preschool that doesn't begin until August? My daughter is two years old and I am supposed to try and decide how many mornings a week of preschool I think she will be ready for eight months from now. I am just supposed to guess whether or not she'll still be taking an afternoon nap so I can decide if I want to enroll her in the crowded morning sessions or the less crowded afternoon sessions. Sure, I could wait to enroll her, but the program fills up quickly. If I wait, I'll probably lose the opportunity all together.

We decided to play it conservatively. We enrolled both children five mornings a week. We can always change our mind later and decide to only send them three mornings a week, but if we don't reserve all five mornings we won't have the opportunity to increase our number of days after the spots have all filled up.

We decided to move Michael up from the explore classroom (a mix of 3 and 4 year olds who mostly attend part-time) to the discover classroom (a pre-school classroom of 4 year olds who are required to enroll for all five days of the week). I feel like he is getting a little bored at home and wants to spend more of his time with his peers in a social environment. Of course, as soon as I made that decision I began second guessing it. I don't really want him to go all five weekdays. I'd like to have one more year where the three of us (Michael, Ava, and I) have a full day at home together. Still, I remind myself, I can change my mind in the fall.

We decided to enroll Ava at a different school all together. We enrolled Ava at the same school she'll be receiving her IEP speech services from beginning in March. The preschool program there is supposed to be amazing and some of the rooms are co-taught by SLPs. They can just pull her out of her classroom for her speech session which will save me an extra trip twice a week. Of course, as soon as I made that decision I began to wonder if I should have just enrolled her at our local school (Michael's school) for preschool. We know and like the explore room classroom teacher. If we had done that she'd be going to the same school as her brother. I'd just drive her from one school to another two days a week for speech.

All of this would be more straightforward if I weren't forced to make these decisions eight months ahead of time based on information that will be outdated by the fall. What's done is done. Fall will come. Everything will work out. The children will be older and more independent as it should be. I just need to relax and calm the decision anxiety a little.

Tuesday, February 7, 2012

No-Cook Oatmeal Playdough Treasure Hunt

Today, during our occupational therapy session we made oatmeal play dough. It is a no-cook recipe and requires only three ingredients.


Oatmeal Play Dough Recipe

1/2 cup oatmeal
1 cup flour
1/2 cup water

Step 1
Our purpose in making and playing with the oatmeal playdough is to decrease Ava's tactile sensitivity by having her use her hands with a messy activity. So we began by putting a half cup of oatmeal into a mixing bowl and letting her explore the dry oatmeal with her hands. She enjoyed the oatmeal and took several tastes of the oatmeal.

Step 2
Then we added the cup of flour into the bowl. Again, Ava explored the flour with her hands and tasted it. Then she thoroughly mixed the two dry ingredients with her hand (one hand is in a cast, so we were doing this activity one-handed).

Step 3
Next we poured in the half cup of water. At first we just observed it. We watched the water pool on top for a few minutes and some oatmeal float on the top like tiny boats. We talked about how they would be perfect boats for ants. Then the water was slowly absorbed into the dry ingredients and we began to mix with our fingers. The mix was extremely sticky. This is part of why it makes such a great occupational therapy activity for children who are ready (if your child is still demonstrating extreme tactile defensiveness this isn't the right activity). Once the mixture seemed evenly sticky we removed it from the bowl and started to work with it/play with it on the table. (Note: Over the next 10-15 minutes, the oatmeal continued to absorb the excess water and the texture became much less sticky.)

Step 4
To extend the activity and continue to keep Ava's hand engaged in the dough we played a buried treasure game with the ball of play dough. I took several glass marbles and gems and a penny and hid them inside the play dough. Then Ava would dig around in the play dough to find the treasures.

Overall, the activity went extremely well. The oatmeal play dough has several advantages.
  1. It is a no-cook recipe.
  2. It is made with a small number of inexpensive, easy to find ingredients.
  3. It goes through a variety of textures (dry, wet and sticky, traditional play-dough like).
  4. The end product is pretty stiff making it a great medium for increasing hand strength as a bonus.

Monday, February 6, 2012

Revising Our At Home Day

I have observed that when Michael is engaged in a planned activity he is an angel. He is engaged, focused, enthusiastic, and respectful and has a beautiful attention span. When left to his own devices to simply play with the many available toys in his home his behavior starts out fine and spirals downwards towards a hyperactive, attention-seeking, disrespectful mess. I think he is bored. I wish he could independently choose and engage in one of the many activities available to him, but he is just not doing that yet.

Without realizing it, over the past few weeks I have been coping with this behavior by slowly increasing television time to give myself a break. I think it has ultimately been counterproductive. He walks away from the tv even more wound up than before. This week I am going to attempt a detox. We will have little or no tv this week and a significant increase in planned activities.

In order to make the planning manageable I am going to try to hit several types of activities each day: art, physical activity, music, science, reading, and a fine motor focus activity. I will fill in an activity in each of those categories on each at-home day this week.

Today, for example, art is going to be making a collage. I'll give the children scissors, glue, paper, and lots of things to cut and glue onto their paper. This particular art project will be about process rather than product. For a physical activity we will play our run-around-the-circle game (our first floor has a continuous path through all the rooms around a central staircase). I sit in the playroom holding a play golf club about 3-4 inches off the floor and each time they run by they jump over the club. Then to change things up I'll raise it several feet off the floor and they crawl under it. They can keep this up for at least 15 minutes running around the circle a good 30 times. It is great exercise.

For music we will play the piano. For science we are going to try trapping alka seltzer tablets in a small container with a cap and watch the tops pop off. We'll talk about why that happens. We'll have a reading time with as many books as they'll listen to in one sitting. They can usually do that for at least half an hour. For a fine motor activity I'm going to get out the sand on the light box and we'll do a copy the pattern game.

I'm hoping that the plan will keep everyone happily engaged all morning without anyone getting crazy (myself included). Then we'll have lunch followed by nap. Wish me luck.

Sunday, February 5, 2012

Pinning Version 2.0

At the beginning of December we did a pushpin activity that was a huge success with the kids. The activity is wonderful because it is a great fine motor activity and allows work on concepts and patterns as well.

I decided to revisit the activity with a cardboard box instead of cork coasters. I took a big cardbox box and taped construction paper to it. I traced simple shapes onto the paper with stencils. Then I gave each child a bowl of pushpins and let them go to it. They loved it. Ava needed help because she was forced to use her left hand. I pushed each pin in halfway for her and then she pushed it the rest of the way. The kids loved the activity and spent at least half an hour the first time we played with it. They've revisited the activity several times since then as well.





Saturday, February 4, 2012

Unintended Realism

I wanted to do a volcano experiment at home. We had played around with baking soda and vinegar before, but not in volcano form. I knew the children would really enjoy it. I just wanted to do it in a way that the model could be reused time and time again.

I had a brilliant idea. I took a plastic needlepoint sheet and made a cone out of it. I held it in shape with fishing line. Then I hot glued glass gems all over it and glued the thing into a plastic container. It was all easy to rinse, let dry, and use again.

See...here it is. I thought it turned out pretty well for about an hour of work. Note: Exhibit A


I gathered the vinegar, baking soda, and food coloring and filled a flower vase tube with some baking soda and inserted it into the top of the volcano. Note: Exhibit B


We mixed up some red vinegar and poured it in. It worked beautifully. Note: Exhibit C


I was feeling pretty good about the whole thing. The children were asking to see it again and again. I knew that the whole thing would rinse easily and dry in a couple of hours. I was mentally patting myself on the back.

Then suddenly there was a loud cracking sound and one of the glass gems shot off the side of the mountain. This was quickly followed several more. And then many more. Apparently the baking soda and vinegar reaction was releasing the hot glue. They achieved a pretty surprising distance. I told the children it was like a real volcano shooting out rocks. I suppose the effect of shooting rocks fit the volcano theme rather well. And the children absolutely loved it. But my volcano was disintegrating before my eyes.

And this is what was left. Note: Exhibit D.


Sigh. Any suggestions for a better method of attaching the glass gems?

Friday, February 3, 2012

The Weekly Review: Week 46

This week's weekly review sponsored by:
Injury, Illness, Injury, and more Illness


Weekly Trauma Winner

Coming in with a total score of three, Ava is the clear winner with one late night on-call pediatrician phone call (croup and stridor), one pediatrician office visit (ear infection), and one specialist visit (orthopedist for broken hand).

Weekly Trauma Runner-Up

Coming in a distant second with a total score of one, Michael is the runner-up with one late night on-call pediatrician phone call for suspected head injury symptoms. He does get bonus points for behaving bizarrely enough that I was seriously concerned I had managed to cause a frontal brain injury by slamming a doorknob into his forehead.

Bonus Pictorial Review of Star Illness of the Week - Broken Hand





Thursday, February 2, 2012

Lesson learned. (Or - How we called our pediatrician three times in five days and yet managed to miss calling the most important time.)

Let's start this story from the beginning. As I believe I already mentioned, Ava tripped at the play place in the mall Friday night. She fell rather oddly onto her arm and was significantly favoring her right hand. After determining that there was little or no swelling and her fingers seemed to move fine, we decided that a pediatrician call for that incident was unnecessary.

The next day Ava woke up from nap with a croupy cough. That was followed by labored breathing and we made an after-hours call to the pediatrician. A late night dose of steroids obtained from a 24 hour pharmacy saved us a trip to the emergency room. Our sincere thanks went out to the on-call pediatrician.

Monday, I was walking into a room when Michael was walking out and I managed to slam him in the forehead with the doorknob. I hit him hard enough that he fell back onto his butt gasping for breath before the screaming began. I comforted and hugged and felt around the forehead for lumps but found none. I mentally moved on once the crying stopped.

It wasn't until some extremely bizarre behavior began at bedtime that I remembered the bump on the head and became concerned. He was scared and asking to sleep with us (never in his entire life has he been afraid at bedtime - never). He was desperately thirsty and drank so much water that we had to change his clothes twice in a row. Again, very odd. I was worried about some kind of brain injury. Another late night call. We got the same on-call pediatrician. Who knows what she was thinking of us at that point, but she decided at home observation would be adequate. Turns out, he was fine thank goodness.

Yesterday Ava had a fever. She was complaining that her right ear hurt. At least it was during regular office hours this time. We went to the pediatrician and sure enough, she has an ear infection in her right ear. Ten days of antibiotics here we come.

As we were about to leave, I remembered Ava's hand and quickly told our pediatrician the play place story and showed her the bruising on Ava's hand. At this point, all four knuckles have dark bruises and the bruise shows up on the palm of her hand as well.

Our pediatrician took one look and sent us down for an x-ray. Our pediatrician's office is adjacent to the hospital, so at least this trip only involved an elevator ride and walk down a long hallway. She told me to just go home after the x-ray. She would call me and let me know. Well, I told the x-ray technician that we were just going to take off per our pediatrician's advice. He gave me a significant look and asked me to stay just 10 minutes while he made a quick phone call. I knew right then that the x-rays showed something and that he didn't want me to leave until he got a doctor to take a look.

As it turns out, there is at least one and probably two fractures in the bones of her hand. Just give me a parent of the year award. Yes, I let my two year old daughter walk around with a broken hand for five days. I only found out because I mentioned it in passing during the pediatrician visit in which her ear infection was diagnosed.

Here's her x-ray. It's pretty subtle. At least, it is subtle to my completely uneducated eye. But, I'm told there is a fracture. I have learned that it is possible to have a broken bone with no swelling and no restriction in movement. Our pediatrician told me that as soon as I noticed the significant bruising I should have called. Ahh, hindsight.


Later today I'll be setting up an appointment with a pediatric orthopedist. Let the fun and games continue.