Post Pediatrician Visit Update (tongue-tie / mouth breathing)

As such things often are, Michael's pediatrician visit was oddly anti-climactic. I think I tend to build doctor visits up in my head as Super-Important-Life-Altering-Decision meetings when often they are pretty routine. Our pediatrician was -completely- uninterested in the tongue-tie. She had been educated that clipping a tongue-tie rarely fixes speech problems and didn't want to give it further thought.

I've been thinking about why the tongue-tie bothers me even though I know that Michael can produce 4/6 alveolar sounds. It bugs me that he cannot stick his tongue out horizontally and cannot lift his tongue up on command. If it isn't the tongue-tie restricting that movement I want to know what is. Is it weakness? If so, what is the origin of the weakness? Can habitual mouth breathing result in low enough tone to impact tongue strength? Our pediatrician was uninterested. She said, some people can curl their tongue up. Some can't. Perhaps Michael just can't lift his tongue. I have to say, I was unsatisfied.

She was, however concerned about the mouth breathing. After examining him, she declared his tonsils of normal size. She can't see his adenoids though and wants him to see an ENT to get an opinion about the tonsils/adenoids/sinuses. She said I could ask the ENT about the tongue-tie if I wanted another opinion.

Her bet however, based upon my husband's history of needing allergy shots as a child and Michael's history of eczema, is allergies. She referred us to an allergist and wants him to take Flonase at night and Claritin in the morning. The receptionist for the allergist told me that they always allocate time for skin testing even when scheduling an initial appointment so I need to pull him off the Claritin 5 days before the appointment just in case the doctor decides he needs skin testing.

Hmm. Skin testing my 4 year old. That sounds... interesting. Other than educating him before hand, bringing something distracting to watch on the iPad, and some super special treat for when he's done does anyone have any suggestions for what to expect or how to handle it?

Presumably, when we figure out why Michael can't breathe through his nose and address the underlying issue the mouth breathing will cease. Perhaps some improved tongue strength and mobility will follow? It'll be two weeks or more before we get through the specialist appointments and begin to get some answers (I hope). I sure do hate waiting.

The Weekly Review: Week 54

Crafty SLP Idea of the Week

Katie at The Red Kitchen made 26 beanbags out of old t-shirts (one for each letter of the alphabet). She stitched the capital letter on the front of each beanbag and the matching lowercase letter on the back. They are adorable and you should definitely follow the link to her tutorial if you're interested.

If you made some for the consonant sounds you could play a ton of games with them. Kids could toss them back and forth and say the sound each time they catch the bag. They could toss them in a bucket or through a hoop. They could play hot potato with them. You could use them for practicing the sounds in isolation, or have older kids think of a word that contains the sound.

Ava this Week

Ava's been bitten by the I'll-do-it-myself bug. Every time I try to help her with something only to have her firmly and often rudely reject my assistance, I have to take a deep breath and remind myself that this is a good thing. She's becoming more independent. Letting her do things herself improves her self-help skills. It would all be easier if she said it sweetly, with a pleasant smile and managed to do it just as quickly as if I were helping. Is that too much to ask?

Weekly Michael

The littles were playing in the backyard together by themselves (oh, the joy) the other day. The back door opened with a boom and Michael came running inside looking for me with quite the sense of urgency. I mentally prepared myself for some kind of minor disaster. Instead, he just had a question. "Mama, is sod a word?"

We've been having fun with rhyming and playing games with word endings, so we have been having lots of discussions of what is and what is not a word. So I wasn't completely surprised by the question. I told him "yes" and launched into a somewhat long-winded discussion of what sod is. As soon as I finished, he rushed back outside shouting to his sister, "Sod is a word, but it doesn't mean jump!"

I was left wondering what exactly their discussion had been about before Michael came in to request my expert opinion.

Ava's and Michael's Weekly Home Therapy Notes

The children have enjoyed the change of pace provided by the magnet cards and switcheroo game, and we met my goal of slowing down to focus on quality over quantity. I think next week we'll go back to drill fueled by bribery though and focus on some intense practice again.

It explains some things... (Calling for tongue-tie experts)

So here's the situation. Earlier this week I took the children to the dentist. She informed me that Michael has a mild-moderate tongue-tie. My mental response: Umm what? Are you sure? How on earth could I have possibly missed that!!! Did you make that determination based upon physical examination or behaviors?

I wasn't present for his examination because they accidentally scheduled the children at the same time and I was busy with Ava keeping her very overloaded sensory system calmed down just enough to get a little cleaning in through holding her in my lap, trying to simultaneously cover her ears and hold her hands, and singing soothing songs. But that's another story and I digress.

I knew Michael can't raise his tongue on command and that he can't stick it out very well. When you ask him to stick his tongue out he can get it out, but it curls down and sticks to the outside of his lower lip. He cannot stick it out forward at all. He can't raise it at all. I had always assumed that that was part of the same motor-planning spectrum that I've become so familiar with in Ava - or possibly a weakness issue. Well, look at where assumptions get you.

When we got home, I grabbed a clean cloth and pried up his tongue. Sure enough, you can't get it up very far and his lingual frenulum extends pretty far towards the tip of his tongue. On top of that, the lingual frenulum doesn't stretch at all and therefore even with some gentle manual pulling you can't get a lot of distance between the tongue and the bottom of his mouth. On top of that, he cannot get any upward curl of the tip of his tongue at all.

Let's summarize. Michael does appear to have a mild-moderate physical tongue tie. He has speech problems with /f, v, s, z, and th/. He produces all of those sounds as an interdental /s/ that is produced auditorily as a nice sharp /s/ sound. So, his /s/ sounds sound fine but are produced "incorrectly" and his /th/ sounds are produced with proper placement but sound like an /s/. He can, however, produce /t, d, and l/ just fine and those involve alveolar placement.

So here's my question for anyone out there who wants to chime in with an opinion. Given that he can produce /t, d, and l/ is it likely that the tongue-tie is the issue with the other speech errors? If there is no functional consequence of the tongue-tie I'm reluctant to have it clipped. However, if it is likely that the tongue-tie is impacting his speech errors, even in part, getting it clipped seems like an option to consider.

I already have a pediatrician appointment set up for Friday to discuss Michael's chronic mouth-breathing and nasal congestion and I intend to get her opinion about the tongue-tie issue then. However, she's not a speech-path so her opinion on whether it is effecting his speech isn't going to be an expert one. She's more the person to offer information and pros and cons on the procedure itself.

Thoughts and opinions from SLPs with some experience with tongue-tie? Please. :-) I tried to get some pictures for reference, but it was tricky. I had to try to manipulate his tongue with my left hand while taking the picture one-handed with my right. I apologize for the picture quality.

The first picture is what he does if you just instruct him to stick his tongue out.

The second picture is what he can do if you model sticking the tongue straight out without letting it curl downward.

The third is his attempt to curl his tongue up. He tilts his entire head backward and tries to push it up with his bottom lip and bottom jaw.

The fourth picture is my attempt to get an actual picture of his lingual frenulum.

Speech Card Set Activity: Magnetic Speech Cards

As the next installment in my quest to slow the kids down so I can focus on quality s-blend productions I decided to make some of our /s/ blend cards into magnetic cards.

It took me a good half hour to get the magnetic speech cards ready. I printed two copies of my chosen card set and put purple dot stickers on one set and green dot stickers on the other set. I had 22 cards total. Then I cut 22 rectangles out of a cardboard box. The rectangles were slightly bigger than the speech cards. I taped two jumbo paper clips onto each piece of cardboard and then taped the speech cards over the paper clips. Voila. Now I had a speech card set that would attract to magnetic wands. (You could get the same effect by just putting staples or paperclips onto the plain cards, but they wouldn't be as durable.) This is my set when I was finished.

I played several games with the kids. First I just put all the cards face down in a pile and mixed them up. I told Michael that the green ones were his and Ava that the purple ones were hers. They fished one out of the pile with their magnet wand and said the word for me. They got to keep the card if it was their color and had to put it back in the pile if it was not their color. They continued to take turns until all the cards had been distributed. This worked really well. The kids liked playing with their cards while the other child took their turn. Michael lined all of his up in a row to display them with pride.

Next we played a memory game with the cards. The kids liked the novelty of playing memory with magnetic cards and so they were very engaged.

As one last game we piled all the cards in the middle again. They took turns trying to fish out as many cards as possible at one time with their wand. Michael managed to get six at once on one of his tries. They would then pull them off, count them, and say each word they had "caught".

One activity we didn't get to, but I intend to try soon is to bury the cards in a bin filled with rice, beans, or dried pasta and then try to fish them out using the magnetic wands. I think they'll really enjoy that one too.



If you liked this card set activity you might also like:

• 10 Card Set Game and Activity Ideas
• Simple Speech Card Puzzles
• Speech Card Stories
• Speech Card Caterpillar
• Speech Card Game: What's Hiding?
• Speech Card Game: Speech Switcheroo (An Uno-Style Game)

Initial /s/ Homework Booklet: Free Speech Therapy Articulation Picture Book

Initial /s/ Homework Booklet

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 for durability.

Description

This articulation homework booklet is designed to be an extension of my single-syllable card sets. The target words are all CV or CVC in syllable shape and include no blends or vocalic /r/ sounds. This booklet is designed to be read by a parent (or therapist, older sibling, classmate, teacher...) and child together. The child should be familiar with the target therapy words/pictures from working with the initial /s/ card set. The helper reads the typewritten words pausing for the child to "read" the picture words. Each time the book is read, the helper can put a sticker/stamp/checkmark in one of the boxes on the front of the book. This will encourage multiple practice readings. The child's fluency should increase with each repeated reading. The words on the back page can be used for either auditory bombardment before reading the book together or for drill after finishing reading the book (or both). The target audience for these cards are children with severe speech delays who are ready to practice initial /s/ sound in a more natural context. Move to these exercises to add complexity and increase generalization after the child has achieved good accuracy with single word, single word repetitions, and simple alternating single words with the initial /s/ picture cards.

Key Features

• This booklet features 12 initial /s/ words incorporated into a simple story to be read by a helper and child together.
• The words are CV or CVC in syllable shape.
• The words are simple and are easily understood by or easily taught to young children.

Permissions

I give permission to copy, print, or distribute this booklet 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 booklet. 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 card sets and related printables are on my Free Speech Therapy Articulation Cards page.

Here is a picture of a homework booklet (the /l/ booklet) printed on cardstock and folded into the booklet. It slides nicely in between board books to be pulled out and read during bedtime story time.

_________________

One year ago I wrote about how to use songs and rhymes and a cloze technique to get a young child to verbalize.

Speech Card Set Activity: Speech Switcheroo (An Uno-Style Game)

I needed to slow the kids down so they could focus more on making quality productions rather than on simply making lots of sloppy productions, so it seemed like the perfect time to introduce a new speech card set game. I turned our /st/ cards into an uno-style game I called Switcheroo. The kids had a blast playing and I was really pleased with the experience. It should take you no more than 10 minutes to prepare any of the free speech sets for your own Speech Switcheroo set.

Directions for Making Your Own Speech Switcheroo Game

1. Print 4 copies of the free speech card set of your choice. (You probably need no more than 12-15 cards to make a large enough deck, so I recommend printing four copies of only one page of the sets.)
2. Print 1 copy of the special cards. (Found at the bottom of this page. Click to open full-size image then right click on that and save image to your computer for printing.)
3. Before cutting the cards out, put yellow stickers on each card of the first sheet and one one of the skip cards and one of the +2 cards. Then do the same for green stickers on another sheet, red stickers on the third sheet, and blue stickers on the fourth sheet. No stickers need to be placed on the Switcheroo cards. You could also use colored markers to make dots on the pages if you don't have stickers in the four colors.
4. Cut out all the cards and shuffle. Then deal 7 cards to each player and play the game uno-style. Have the child say the speech word as they play each card.

If you liked this card set activity you might also like:

• 10 Card Set Game and Activity Ideas
• Simple Speech Card Puzzles
• Speech Card Stories
• Speech Card Caterpillar
• Speech Card Game: What's Hiding?

____________________

One year ago, during a speech session with our early intervention therapist, I encountered a very concrete example of the oral apraxia exhibited by both of my children.

Reading Eggs - An Online Reading Program

I am trying a free trial of Reading Eggs which is an online reading program. You can sign up for a free two week trial. After you sign up, you can add multiple children to the account. Then you can enter the code ABC1034 to extend the free trial by an additional 4 weeks (you can enter the same code for each child extending the program trial for multiple children). You have the option to have your child start at the beginning with letter recognition, or have them take a test to determine an appropriate starting level. Michael got 19 of 40 questions right and the program started him at the Level 4 Map.

Each map has about 10 lessons. Each lesson takes about 15 minutes to complete and has a variety of activities. The first lesson Michael completed was about the letter G and the second was about the letter L. He practiced letter recognition in isolation and in words. He practiced phonics with three letter words that included the featured letter in initial or final position. He practiced sight words featuring the letter. They even include an exercise that uses a connect the dots format to teach how to write the lower case letter. You can download a printable sheet of exercises for each lesson. He enjoyed the "game" and we've barely scratched the surface.

I haven't tried it yet with Ava, but given that the program starts with letter recognition, I may have her try it too beginning with the first lesson. She doesn't recognize all of her letters yet, so it might be really nice for her. She did enjoy watch Michael play through his lessons, so she might be interested in doing her own lessons.

If the children continue to enjoy playing with the program, I'll consider subscribing when our free trial is up. Has anyone else seen or used this program? Does anyone have recommendations of other online reading programs we should check out (particularly if they have free trials)?

Now I've Done It (Bad Speech Habit Acquired - Help!)

Ava has been doing so well with her blends. She went from simply eliminating the second consonant in an s-blend to being able to include both consonants almost every time. I was excited about that achievement and simply failed to notice that she began inserting a pretty prominent schwa to the end of the /s/. So, instead of saying "snow" or even "ssssssno," she's saying "suh no". (or "suh pin", "suh tep", etc...) I think it happened gradually and I just didn't catch it early. I really should have caught it, but I'm just not perfect. In fact, I'm only aware of it now because one of her speech teachers pointed it out to me. I was pretty embarassed. Now adding that schwa seems firmly ingrained in her motor planning for s-blends and I can't figure out how to get rid of it. Her therapist recommended shortening the /s/ and overemphasizing the second consonant when modeling, but that isn't helping.

Does anyone have any strategies they use under such circumstances?


_____________________

One year ago I reflected on my jealousy when watching other babies smile and the possible impact of oral apraxia on the infancies of my children.

The Weekly Review: Week 53

SLP Idea of the Week

Christie at My Ocean of Notions did a post on making alphabet picture sticks using pictures she cut out of old workbooks and popsicle sticks (one for each letter of the alphabet). Hers are adorable and definitely worth checking out.

You could easily use my articulation picture cards and do the same thing as an alternative to just using the cards flashcard style. With the popsicle sticks attached they could be used as puppets to tell stories. They could be distributed among the children in a group and they could take turns holding up one stick at a time for the others to say (at the single word, phrase, or sentence level).

Ava this Week

Ava's preschool has been incubating a dozen chicken eggs for a couple of weeks now. On Tuesday when I picked her up she talked her teacher into bringing me into the room where they've been keeping the incubator. Most of the eggs had little volcano shaped protrusions in the shells where the chicks were beginning to peck their way out. One chick had actually pecked a hole and you could see the beak through the hole. We were all quite excited. Two days later, when I went to get Ava from school, we checked on them again. Now there were 11 fluffy yellow baby chick. Michael had the opportunity to see too because he is on spring break this week. The children were captivated. I had them keep their voices low and their movements slow. I told them they could touch, just once, gently with one finger. They both reached into the box and followed my instructions perfectly. I was so proud of them for treating the chicks with respect even though they were quivering with excitement. They talked about how soft and cute the chicks were all the way home. I'm so grateful to her preschool for going through all the trouble to give their students such a wonderful experience.

Weekly Michael

Michael is maturing before my eyes. He's calling me "mom" more often than "mama" or "mommy". He's more confident and independent. He's had a busy week this week even though his school is out for spring break. He spent one morning with his grandmother and they had a wonderful time together. He adores her (rightfully so). We had a friend over another morning. The three children played hard all morning. Michael raced his older friend on his big boy bike (with training wheels) and won several times. He climbed his first tree. I must say that I wish that his first tree climbing experience could have been with a tree that had branches lower than five feet up (pretty much my head height). However, he was excited and proud and had to be peeled out of that tree. He went on his first unsupervised playdate. It was so strange to just drop him off. He had a great time for two hours and can't wait to go back. He and I went to lunch - just the two of us. I didn't realize until halfway through the meal that it was the first time we'd done that. It was nice to have that one-on-one time together. As much as I love/enjoy/need those mornings when the children are both at preschool, this week has actually been a lot of fun.

Ava's and Michael's Weekly Home Therapy Notes

All the sounds are the same (/f/ and /s/ for Michael and /s/-blends for Ava) so I won't go into that again. I've been doing a lot of experimenting. I tried moving all the cards to a binder system. I thought it was brilliant, but when actually using it during a session it was awkward and slow. The children were more focused on choosing their next marker than actually making their speech sounds well. I was focused more on helping them with the mechanics of the binders than on the speech. I know all of that would get better as we all became used to the new system, but I certainly didn't love it out of the gate.

On the other hand, I love the homework practice books (/l/, and /sh/). They integrate seamlessly into our evening book reading routine. She reads one or two of her articulation books to me, and then I read 2-3 storybooks to her. She loves reading her speech books and getting to put a sticker on the front of the book. She gets better and more fluent at the story with each repeated reading and that's useful too. I'm going to make several more when I get some time.

I also love the articulation rubric for working with /s/ with Michael. It's such a quick, efficient method of feedback and works so well for those sounds that have to be shaped.

Favorite New (to me) TV Show

I don't have the time to watch a lot of television. When I do have the time and desire to watch some I use Hulu on the computer (or my iPhone) to watch. I discovered a show that's showing exclusively on Hulu right now called Endgame. I am really, really enjoying it. It's a procedural in the sense that there is a mystery of some kind solved in each episode. The twist is that it isn't being solved by the police or a medical examiner. The characters are engaging and the interplay between them is fun. The main character, and mystery solver, is a chess grandmaster who is agoraphobic and stuck in a hotel due to a trauma in his past.

Just thought I'd mention it since I've been enjoying it so much. 12 episodes are currently available and the 13th and final episode will be available on Monday. The show was cancelled after those first 13 episodes, but rumor has it that the show has done so well on Hulu that there are talks of bringing it back.

Scholastic Teacher Express Dollar Downloads Are Back

Scholastic has a Teacher Express store where they have hundreds of teacher resource books available for purchase and immediate download in .pdf format. Several times a year they have a dollar download sale. Through Saturday (3-24-12) they have over 700 books available from $1 to $5 each. The vast majority of the books are only $1. This is a link to the dollar downloads sorted by price from lowest to highest. You can narrow the selections by grade or subject area. When you click on the book you can preview every page. The .pdf is immediately available for download and I love having the books in that format because I can easily print out whichever pages I want at the moment without having to drag a book to a photocopier.

Some of my favorites (in no particular order) are:

Little kids... Cut!
50 Learning Songs Sung To Your Favorite Tunes
Quick-and-Easy Learning Games: Phonics
Lift & Look Science Mini-Books and Manipulatives
Circle-Time Poetry: Math

Seriously, there are hundreds of these books available for $1 each right now. I lost a morning just browsing and adding things to my cart. Then, when I actually noticed that my cart total was over $70 I decided it was time to pare things down a bit. Ok, time to pare my selection down a lot.

Enjoy the sale.

(I am in no way affiliated with Scholastic, or reimbursed by Scholastic in any way for mentioning Teacher Express or their sale.)

___________________

One year ago, I was reveling in Ava's transition to speaking in two-word utterances. What a difference a year has made. I am grateful every day.

Initial /sh/ Homework Booklet: Free Speech Therapy Articulation Picture Book

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 for durability.

Description

This articulation homework booklet is designed to be an extension of my single-syllable card sets. The target words are all CV or CVC in syllable shape and include no blends or vocalic /r/ sounds. This booklet is designed to be read by a parent (or therapist, older sibling, classmate, teacher...) and child together. The child should be familiar with the target therapy words/pictures from working with the initial /sh/ card set. The helper reads the typewritten words pausing for the child to "read" the picture words. Each time the book is read, the helper can put a sticker/stamp/checkmark in one of the boxes on the front of the book. This will encourage multiple practice readings. The child's fluency should increase with each repeated reading. The words on the back page can be used for either auditory bombardment before reading the book together or for drill after finishing reading the book (or both). The target audience for these cards are children with severe speech delays who are ready to practice initial /sh/ sounds in a more natural context. Move to these exercises to add complexity and increase generalization after the child has achieved good accuracy with single word, single word repetitions, and simple alternating single words with the initial /sh/ picture cards.

Key Features

• This booklet features 9 initial /sh/ words incorporated into a simple story to be read by a helper and child together.
• The words are CV or CVC in syllable shape.
• The words are simple and are easily understood by or easily taught to young children.

Permissions

I give permission to copy, print, or distribute this booklet 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 booklet. 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 card sets and related printables are on my Free Speech Therapy Articulation Cards page.

Here is a picture of a homework booklet (the /l/ booklet) printed on cardstock and folded into the booklet. It slides nicely in between board books to be pulled out and read during bedtime story time.

Initial /l/ Homework Booklet: Free Speech Therapy Articulation Picture Book

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 for durability.

Description

This articulation homework booklet is designed to be an extension of my single-syllable card sets. The target words are all CV or CVC in syllable shape and include no blends or vocalic /r/ sounds. This booklet is designed to be read by a parent (or therapist, older sibling, classmate, teacher...) and child together. The child should be familiar with the target therapy words/pictures from working with the initial /l/ card set. The helper reads the typewritten words pausing for the child to "read" the picture words. Each time the book is read, the helper can put a sticker/stamp/checkmark in one of the boxes on the front of the book. This will encourage multiple practice readings. Hopefully the child's fluency will increase with each repeated reading. The words on the back page can be used for either auditory bombardment before reading the book together or for drill after finishing reading the book (or both). The target audience for these cards are children with severe speech delays who are ready to practice initial /l/ sounds in a more natural context. Move to these exercises to add complexity and increase generalization after the child has achieved good accuracy with single word, single word repetitions, and simple alternating single words with the initial /l/ picture cards.(Scroll down to preview set.)

Key Features

• This booklet features 12 initial /l/ words incorporated into a simple story to be read by a helper and child together.
• The words are CV or CVC in syllable shape.
• The words are simple and are easily understood by or easily taught to young children.

Permissions

I give permission to copy, print, or distribute this booklet 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 booklet. 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 card sets and related printables are on my Free Speech Therapy Articulation Cards page.



Here is a picture of the book printed on cardstock and folded into the booklet. It slides nicely in between board books to be pulled out and read during bedtime story time.

Wading and Water Play

Last week the weather around here was gorgeous. Temperatures were in the high 70s and it was sunny. We have a park about a three minute drive from our house that has a creek running through it and I decided this year was the right year to scramble down the hill and let the children play in the creek.

We went to the store and bought a wide variety of inexpensive toys that would make for fun play in a creek. Off the top of my head that meant buckets, watering cans, small shovels and rakes, colanders, turkey basters, big kitchen stirring spoons, a small plastic dump truck, etc. I also picked up a small laundry basket to dump all the wet toys into at the end of play to stick in the back of the minivan. And of course, there was the first pair of rain boots/wading boots my children have owned. Boy were they excited about the boots.

Ava was tentative. After briefly testing the water at a depth of about one inch she decided to stick to the shore. Before letting Michael go, I explained that he should only go in until the water reached to about two inches below the top of his boots. I got his attention. I looked him in the eye. I pointed to the two inch from the top spot on his boots. Then I set him free. He loved it. He went further and further in. I just let him. When he had reached the point at which I could see the water pouring into the tops of his boots I inquired, from my sunny spot on the bank of the creek, "Sweetheart, do you notice anything about your boots?" He looked towards me is puzzlement and replied, "Huh?" So I told him, "Nevermind," and just let him go.

I always seem to learn the hard way...

Lesson Learned the Hard Way: Number One

So, recently my husband and I bought our first ever high end vacuum cleaner. We'd been making do on the $40 sale upright I'd gotten in college. I don't even like cleaning, but I was excited. We did our first room and loved watching the bin fill up an embarrassing number of times in just that first room.

The next morning the children went to preschool and I was still excited enough about the new vacuum cleaner to decide that spending some of my precious "me" time vacuuming was recreational in nature and I moved on to the berber carpet in the living room. I was humming along happily vacuuming when I met my first snag. Someone really should have warned me about what would happen when high-end vacuum cleaner meets an exposed loop in a berber carpet. A fraction of a second was all it took and I ended up with this:

At first I simply stared at the torn carpet and tried to process exactly what had happened. Then I tipped back the vacuum cleaner and stared in amazement at the long piece of carpet wound around the beater bar. Then I texted my husband because I couldn't stand being amazed all by myself. Finally I removed the pulled up carpet from the beater bar saving it so that my husband could appreciate it too when he came home and resumed vacuuming.

Because I want you all to think that I have a super fast learning curve I won't mention that after cleaning up all the mess from the first snag I promptly went over a second loop in the carpet and repeated the entire mistake causing an additional strip of torn carpeting. At that point, I did take a pair of scissors and go over the carpet on my hands and knees to trim any remaining snags before finishing vacuuming.

I suppose I could be upset about it, but in the big scheme of things, there are so many "better" things to spend that mental energy on that I'd just rather see the humor in the situation. I didn't like that carpet much anyway. And the two new rips will match the ketchup stain from the day I let the children eat in front of the tv nicely.

Lesson Learned the Hard Way: Number Two

So, cloud dough is amazing stuff. It is inexpensive, easy to make from two ingredients you have around the house, smells nice, and is fun to play with.

Do not, under any circumstances, put it in an outdoor sensory table.

Oh, sure, it all looks beautiful and pristine in the picture. And yes, the children did play in it happily for over an hour. But then I forgot it in the rush to make lunch and get the children down for nap. To make things worse, I hadn't even put the top on the sand table. And then it rained. Flour, oil, and now water were in the sand table.

I might have rescued the situation had I noticed and dealt with it at that point, but we had several busy days. So it sat there in the hot sun for another couple of days and then got some more rain. Then I went out on the deck yesterday and it was the smell that hit me first. It's really difficult to describe. Fermenting maybe? And so not in a good way. And it was a paste that was just stuck to the many surfaces of the sand table. It took at least a couple of hours of work to clean that mess up. And we had to toss all the sand on the other side because the children, blissfully unaware of how nasty it was, managed to mix a bunch of the fermented cloud dough in with the sand.

I think I can still smell that stuff on my hands. From now on, the cloud dough is exclusively an indoor activity.

Lessons learned. My personal theme of the week.

Homemade Dough Stamps

I made these with a glue gun and recycled tops from single serve chocolate milk bottles (from fast food restaurants). We had six caps, so I sat down with the kids and a piece of paper and we planned our six designs. They each got to choose three. We ended up with square, pumpkin, smiley face, triangle, snowflake, and flower. Then I made the designs on the tops of the lids with the glue gun and we let them set for 24 hours. (I also did some designs on cardboard rolls, but those didn't work as well.)

We made some cloud dough the next day from flour and baby oil and the kids used the stamps. They really enjoyed using the stamps and they worked fairly well. (Cloud dough takes 5 minutes to make and is wonderful to play with. If you haven't tried it you definitely should.)

The Weekly Review: Week 52

Week 52. Wow. A whole year of weekly reviews. Well, let's hop to it.

SLP Resource of the Week

Jenae at Icanteachmychild.com did a post on making duplo puzzles. You could definitely take my articulation picture cards and trim them to fit onto two rectangular duplos. Then cut the card in half and tape them to the sides of the duplos. Voila. Articulation duplo puzzles. You could easily use this for simple word building, matching upper and lowercase letters, matching mama to baby animals or any number of other matching activities.

When Michael is ready for some more independent practice with his /s/ I'm thinking of taking some of his duplos and slapping the initial /s/ cards on them and tossing them into their own bin and letting him discover them on his own. Hopefully he'll say the words as he fits the puzzles together.

Ava this Week

Ava loves her new "big girl" speech class. I guess she was ready to graduate from early intervention after all. She has speech twice a week for 45 minutes. Her sessions are right after preschool. Yesterday morning she begged me to take her to speech first and then school second. I had to explain to her that it just didn't work that way. I'm happy to see her excited about going though.

Weekly Michael

When Michael came down from naptime yesterday he found me reading in my glider. He crawled into my lap and snuggled under my arm resting his head on my chest. He told me that he dreamed there were red dot lights in the sky. As he reached up to touch each one with his finger, they burst into fireworks. It is interesting to note that I'm pretty sure he didn't actually sleep yesterday during nap time. He was either telling me about a daydream or a dream he had overnight. I didn't call him on it though. I just enjoyed the cuddle and story.

Ava's and Michael's Weekly Home Therapy Notes

/s/ and /l/ blends are chugging along well. Ava is doing a great job at getting both phonemes of the blend in with very little prompting. She's starting to habituate a rather long prolongation of the first consonant of the blend though. Pretty soon I'll have to start addressing that.

Michael is doing beautifully with the articulation rating scale. Using the scale helps him self correct to clear /s/ sounds for about 20-25 productions. Then he tanks. I think there is some actual oral-motor weakness there and he just fatigues to the point at which good productions just aren't possible any more. We'll just have to continue to practice and build up stamina.

Articulation Rating Scale - Picture Rubric

We are working on Michael's interdental /s/ production. His standard production is a visually distracting interdental production that sounds like a clear /s/. When asked to keep his tongue behind his teeth, he gets a lot of lateral air escape making the auditory result more like a /s/-/sh/ hybrid. When he is coached, is paying attention, and is not fatigued, he can occasionally produce a crystal clear /s/ with appropriate placement.

His production varies widely from repetition to repetition and I was having trouble giving him appropriate, useful feedback quickly and efficiently without disrupting the flow of practice and slowing us down significantly. Then I saw a post on The Learning Curve about an articulation rating scale she had made. I thought making something similar scaled down to the toddler/preschool level might help me give Michael more consistent feedback.

So I made this:

When we sat down to use it the first time I explained that this was going to help us with our /s/. I reminded him that making the /s/ with his tongue sticking out was incorrect and told him that if I saw him make it that way I'd point to the stop sign. If he made a beautiful clear /s/ sound (I demonstrated) I'd point to the smiley face with the fireworks. If the /s/ looked good, but sounded mushy (again, I demonstrated) I would point somewhere in between. He grasped the concept immediately and loved using the chart as a feedback tool. I was able to give him feedback instantly and quickly without needing a lot of words to explain what needed to be corrected. Every time I pointed to something below a 5 he was able to self-correct with no other cues needed (Until he got fatigued. At that point I just couldn't get any more clear /s/ sounds.).

The chart could be used in a similar fashion with any phoneme production that needs to be shaped. You could also use the rubric for just about anything with small children because the stop-sign to smiley face progression makes sense to little ones. You could use it to show children how well they cleaned up a room. You could use it to show a child how close his written "A" matched the one he was trying to copy. It's a really flexible visual scale.

As a funny side story, this is version 2 of the rubric. The first one I made had this:

instead of the stop sign. I was pretty pleased with my rubric and was showing it off to my husband. He thought the sobbing face was a bit harsh for little ones and suggested switching it for something else. I granted him the point and switched to the stop sign. Sometimes a second opinion is useful.

Any other ideas for how to use the scale?

Inspiration

My children inspire me. I don't mean that in a generic "I'm a better person." way. They inspire me to stretch a little and step outside of my comfort zone. Arts and crafts is a great example. Historically, I considered myself to be a decidedly non-artistic person. It doesn't come to me naturally. I don't have a good eye for color, design, or form. The only kinds of coloring I enjoyed as a child were color-by-number. As for crafts, I liked cross-titch. There was a pattern and I all I had to do was follow the pattern on a cloth grid.

Then I found myself staying at home with two young children. Partly from a desire to expand their horizons, and partly from pure self-defense (we all needed something to do) I began to do some simple arts and crafts with them. After coloring with crayons and cutting snowflakes with scissors I ran out of ideas. Through the brilliance and generosity of some talented bloggers (That Artist Woman and Art Projects for Kids for example) I have been inspired to do a wide variety of beautiful crafts with the children. I have learned a lot myself along the way and we all have fun together.

Again, historically, I am not great at keeping plants alive. I pretty much accidentally kill any houseplant that isn't a cactus or succulent in short order. The few plants I do manage to keep alive I tend to tire of caring for and give away. As for gardening, I'm not really outdoorsy. I also don't much like getting dirty. So, I have very little gardening experience.

However, I think I'd like to try some simple gardening with the children. I think they'd enjoy growing some vegetables and perhaps the experience would encourage them to consume a few. I have fond memories of eating cucumbers, tomatoes, and carrots from my dad's garden when I was little. The children would have the opportunity to participate in a long term project with delayed gratification. It would force us all to get outside regularly. I am interested in perhaps trying cucumbers, carrots, and bell peppers with the children. Preferably in pots. Can you grow vegetables in pots? Specifically, can you grow those vegetables in pots?

That's the problem. I'm an starting with zero experience and knowledge. Online research should get me started, but there's a long stretch from reading an article on the internet to eating home-grown vegetables. It's kind of fun to take a leap and try something new though. And the project will be a learning experience for all of us no matter how it turns out. Online research here I come.

Initial Minimal Pair Rhymes: Free Speech Therapy Articulation Picture Cards

Description

This articulation card set is designed to be an extension of my single-syllable cards sets. The words are all CV or CVC in syllable shape and include no blends or vocalic /r/ sounds. This is a speech exercise of minimal pairs rhymes contrasting the initial early-emerging consonant sounds. The target audience for these cards are children with severe speech delays who need exposure to a minimal pair technique to emphasize that they need to differentiate production of two different words. Move to these exercises to add complexity and increase generalization after the child has achieved good accuracy with single word, single word repetitions, and simple alternating single words with these phonemes.(Scroll down to preview set.)

Key Features

• This set includes 12 therapy cards sequenced so that they form minimal pair rhymes.
• The words are CV or CVC in syllable shape.
• The words feature early emerging consonants.
• The words are simple and are easily understood by or easily taught to young children.

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.

Initial L Minimal Pairs: Free Speech Therapy Articulation Picture Cards

Description

This articulation card set is designed to be an extension of my single-syllable cards sets. The words are all CVC in syllable shape and include no blends or vocalic /r/ sounds. This is a set of minimal pairs focusing on contrasting the initial /l/ sound with four other initial consonants. Each different CVC /l/ word features a different vowel to maximize coarticulation variation. The target audience for these cards are children with severe speech delays who need exposure to a minimal pair technique to emphasize that they need to differentiate production of two different words. (Scroll down to preview set.)

Key Features

• This set includes 15 therapy cards. Three CVC /l/ words are contrasted with four other minimal pairs.
• The words are all CVC in syllable shape.
• The words are simple and are easily understood by or easily taught to young children.

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.

Organizing Speech Articulation Practice

This is hardly rocket science in the speech therapy world, but it was time for something new around here so we're switching to speech binders instead of using the articulation cards in deck style.

Name is on the front. I just printed out the pages of cards leaving off the backs and punched holes in them. Michael is working on /f/ and /s/ so his binder has those two sections. As soon as the children have adjusted to the new format I'll add a section for the s-blends to Michael's folder.

I plan to pretty much drill the children. I'll cross off any of the cards I don't want them using. Michael can do all of the cards, but for Ava I'll cross off any word that includes non-targeted phonemes that aren't in her inventory yet (so, any word with /k/, /g/, /ch/, etc.). Every time they say the word the requested number of times (3 times in a row) or in the requested way (in a phrase/short sentence), they get to mark the card. Marking options include a stamp, sticker, check mark or dot with a crayon or paint marker, dot paint, etc. If you switch the marking options each time interest should be higher and they'll collect a wide variety of "marks" on each card. They have a visual representation of all the work they've put in over time.

The other advantage to the binder format is documentation and notes. I can jot down the date on the blank opposite page and take notes about % accuracy, the level I'm working on that day (imitation, single words, x3, phrases, etc.), and any words that were particularly difficult. Over time, I can analyze those difficult words for patterns. I might notice that Michael has an easy time with /s/ on all the front vowels, but struggles with /s/ paired with back vowels and adjust therapy accordingly. This is an advantage over randomly shuffling a card deck. When we practice that way it is more difficult to document properly.

In a school setting using this format for therapy would make it easier to work with children on different phonemes during a single session. Do one row with child A from their folder and then switch and do one row with child B from their folder...

If you're working in a setting where you can send the binder home to a parent, you can make a homework section of words that are ready for parent led practice. Having a parent work in this way will let you see visually exactly how much practice happened at home because you can look for the marks on the cards. Parents could also easily jot down questions or comments for you to read and respond to on the blank backs of the pages in their section. You could check for parent comments in just a couple of minutes at the beginning or end of each session. You could possibly also use this format if you had a teacher, teacher aide, volunteer, or even super responsible classmate who could do speech work with your student in the classroom for 5 min/day.

Making Yarn Dolls

Pinterest is dangerous. I was browsing pinterest to find something quick to do with the children yesterday and came across a link to a page with a tutorial on how to make a yarn doll. I thought to myself, we have yarn. I bet the kids would like this activity.

Then I was sucked into a two-hour time warp where the first one turned out all right and was well received, but I knew the next one could be even better (and then both children could have one). After the second was complete I was so much better at it that I wanted to try a second girl doll.

So, here they are. The first attempt is a girl doll. The second attempt was a boy doll for Michael. I tried adding a smile. I have to admit, the end result was a little creepy. The third is another girl doll and my personal favorite. She was bigger than the first and so we called her the mama doll.

The children adore the dolls and I had fun making them so I consider the activity a success.

The Weekly Review: Week 51

SLP Resource of the Week

I found this articulation rating scale at The Learning Curve. Michael's /f/, /v/, /s/, and /z/ are all habitually produced interdentally. When I ask him to close up his teeth to keep his tongue behind his teeth for the production of /s/, he locks those teeth together successfully, and then all the air escapes laterally. The sound of his /s/ production is much sharper if I just let him produce it interdentally. In fact, if I'm not looking at his mouth, I cannot tell it from an /s/ produced in the traditional fashion. You'd think it would sound like a /th/, but instead it comes out as a crystal clear /s/ sound.

So, I tested to see if he could hear the difference between a sharp clear /s/ and a mushy /s/ production with a lot of lateral air escape, and he could tell the difference when I do it. But I have difficulty giving him feedback. It is certainly an improvement if he keeps his tongue behind his teeth, but that isn't good enough. The visual rubric of the articulation rating scale might be just the thing to give him feedback that is more meaningful.

Ava this Week

We got the book The Seven Chinese Sisters by Kathy Tucker a while back. The children and I thoroughly enjoyed it. During the first reading the children were captivated and just the right amount of scared when the dragon snatched the baby sister. The book ended up in Ava's room and she's been requesting it nightly. Her second-favorite part is when the baby's first word is "help". Her most-favorite part is when the baby shouts "No!" at the dragon.

One morning this week, as I was downstairs in the kitchen early making breakfast for the children I heard Ava's voice coming clearly through the monitor. I knew exactly what I was hearing when I heard her saying, "No! No, no, no dragon." I stood there motionless hovering by the monitor straining to hear every word as she flipped pages reading the story to herself. It made me so very happy.

Weekly Michael

I wish I could capture this moment in parenting time. Michael has been a delight lately. I love him and enjoy him more every day. He is fun to be with. He's having true conversations with his sister. He is delivering appropriately timed, genuinely felt thank yous. He loves to sing, tell stories, create art, and build complex creations from legos. All of his songs/stories/art/creations have elaborate back stories that are actually pretty interesting if you just take some time to listen. And it is so simple to make him happy in return. All he needs is a little undivided attention. He absorbs the positive attention and then continues happily on his way.

Ava's and Michael's Weekly Home Therapy Notes

I've continued to work with both children together and we're finding a new rhythm. We work for 20-30 minutes a night (4-5 nights/week). Right now I'm pushing the s-blends and l-blends pretty hard. Our sessions are pretty intense and I probably get a minimum of 100 productions per child per session. I usually just drill. I tried my speech caterpillar just one time. It slowed us down too much. For the most part I stick to drill because my children will tolerate it and it allows us to get more speech productions in during the session. I'm going to stick with it as long as it works.

Ava began working on blends three weeks ago. At that time, they were almost impossible for her. She tried and failed to sequence the motor planning over and over until I finally found the right combination of simplifying the production and cueing that worked for her (very slow production, separate the two consonants of the blend, emphasize the second consonant of the blend auditorily, use tactile cueing to emphasize each consonant of the blend). When I switched blends it took her several attempts to reboot her system for a new consonant (sp instead of sm for example).

Since then, she has made amazing progress. She can produce the blends and switch from one blend to another with only light to moderate cueing. She still needs a slight separation of the two consonants in the blend. She also does better with a visual cue that emphasizes that she is trying to produce a two-part blend. And that's it. With those two aids, she's at about 85% accuracy in direction imitation of single CCVC words.

Colored Glue Tracing: Pre-Writing

Michael has only recently started to demonstrate a hand preference (leaning towards right hand). He starts with his right hand when cutting, using utensils, and when writing. Perhaps because he used both hands equally for so long, he still struggles with his writing grip. He still usually grabs writing implements with his fist and gets frustrated with crayons, markers, and paintbrushes because he doesn't have the fine control he wants.

He does well when tracing in sand though and enjoys that activity so I decided to do a similar activity with the children yesterday. I wanted to do another activity that would exercise pre-writing skills while removing the frustration of an actual writing implement.

I mixed up some colored glue using white school glue and liquid tempera paint and put them in small squeeze bottles I got here. (Those two ounce squeeze bottles have been a great purchase. I've used them to hold colored water, puffy paint, and colored vinegar for a wide variety of projects. They are the perfect size for toddler/preschooler hands.) I also printed some pre-writing strips I made in publisher on cardstock (Feel free to download them and use them yourself. They are at the bottom of the post.).

As you can see, Michael started with his right hand, but as he fatigued, he switched to using both hands. This activity was much more difficult for Ava. She started by trying to fill in the lines, but quickly switched to simply playing with the colored glue on the paper.

Michael also traced over some words. He was still excited about the project when I ran out of printed strips so I suggest we make a card for his Daddy. He dictated a message. I wrote it on construction paper. Then he traced it with glue.

All in all, the activity kept the children entranced for at least 45 minutes. Michael had more fun than Ava, but she struggled with it more. I have lots of colored glue left over for another project (yet to be determined) and Ava will enjoy it more when she can use it creatively. For the purposes of this project, I couldn't have been more pleased.

Here are the strips for anyone who is interested. Click on the image to open to full size. Then right click and save to your computer.