More Flip Books On Sale

For those of you who thought the Phrase Flips book looked interesting, there are three more Flip books on sale at Super Duper this week. (No, I am not affiliated with Super Duper, I just like some of their products and I monitor their weekly 50% off sales.)

This announcement is just for your information. I haven't actually seen these books yet although I did order them. I'll do reviews of them when they come in.

The three on sale (50% off through Sunday, October 16, 2011) are:

• Say and Do Sound Production: This one focuses on production of vowels and consonants at the sound, syllable, and word level and comes bundled with an activity book with worksheets and therapy activities and a CD-ROM of reproducibles.
• Turn and Talk Early Sounds: This one focuses on initial, medial, and final /p, b, m, t, d,n/. Contains 600 illustrated words.
• Word Flips: This one contains three sets of identical picture cards for single syllable words. Sounds are sorted into sections by placement (bilabial, alveolar, velar, and palatal).

Apraxia Therapy Materials: Phrase Flips

Therapy Materials Review: Phrase Flips - Flips for Learning Intelligible Production of Speech

This is a review of Phrase Flips. This flip book is published by Super Duper Publications. The flip book is designed to let you easily address target sounds at an easy level (single syllable) level, moderate level (2-3 syllables), and advanced level (4-5 syllables).

Target Audience

The target audience for the Phrase Flips will usually be children ages 3 and up although I can imagine using the easy level with even younger children. The pictures on the cards are appealing to children. This book would work well for children using a traditional articulation approach to therapy. In skilled hands, this book would also be useful for variety working with clients needing intense practice using a motor speech approach to articulation however the book isn't really designed with that approach in mind.

Description of Phrase Flips

This product is a 11 inch by 4.5 inch spiral bound book with hard covers. The book has a built in easel so you can stand it upright. Inside you'll find three sets of picture cards divided by tabs into sections according to place of articulation (bilabial, labiodental, alveolar, palatal, and velar). The set of cards on the left are easy (single syllable). The middle set are moderate (2-3 syllables). The set on the right are advanced (4-5 syllables).

Phonemic Breakdown
The main focus is on initial and, at the multi-syllable level, functional medial productions of these sounds. In general, the easy level introduces 4 single-syllable words for each phoneme. The moderate level introduces a second word or syllable targeting that phoneme and the advanced level introduces a third. That gives you a total of 12 words per phoneme most in initial position.

• Bilabial (/p, b, m, w)
• Labiodental (/f/)
• Alveolar (/p, d, s, n, l)
• Palatal (/sh, ch, J, r)
• Velar (/k, g)

How to Use the Phrase Flip book

In a traditional articulation framework this book would be a great set of stimulus materials to practice phonemes in initial and medial position at increasing difficulty levels. The book would also be useful for generalization and practice for children with motor speech articulation problems (such as Childhood Apraxia of Speech) for specific phonemes that have already been taught and established at the single word or syllable level, but need additional drill at multi-syllable levels.

Pros and Cons of the Phrase Flips book

Pros:

• The Phrase Flips book is compact and easy to carry around.
• The Phrase Flips book covers a lot of territory. It has 16 phonemes in initial and medial position at three increasing difficulty levels. It will not help you get into great depth on any given phoneme, but if you need to carry something with you that covers a lot of territory, this might fit the bill.
• The book is sturdy and has a built in easel.
• The illustrations are well done and appealing to children at a wide variety of ages.

Cons:

• The Phrase Flips book does not focus on phonemes in final position.
• The Phrase Flips book does not go into any one phoneme at great depth.
• The flip format is something of a gimmick in this particular book. I cannot see a huge therapeutic reason to address one phoneme at the easy level, a different phoneme at the moderate level, and a third phoneme at an advanced level simultaneously. The only advantage is that you can take a level completely out of play by turning the entire set over so that a blank card shows at that level.

Bottom Line:

Nice resource for a SLP who typically needs to address articulation targets at multiple levels of difficulty just be aware that the book focuses mostly on initial and medial productions and doesn't provide a great deal of depth on any one phoneme.

You might also be interested in the following products:

Apraxia Therapy Materials: Free Speech Therapy Articulation Cards

Apraxia Therapy Materials: Webber Jumbo Articulation Drill Book

Sunny Articulation Test App - One Day Sale

I have been keeping an eye on an articulation test for the iPhone/iPad called the Sunny Articulation Test. I wasn't willing to buy it at the usual price of $49.99, but today (10/9/2011) it is on sale for $21.99.

It is a qualitative test, not a normative test, so it will not tell you how your child/student/client compares to other children his/her age. However, it will test all phonemes in multiple positions of words. It allows you to easily record productions of each test item so that you can go back later and listen again. It has a screening mode and a full test mode. The screening mode has fewer words and you simply indicate right or wrong for each target phoneme. The full test mode has more words and you enter the type of error for each incorrect phoneme. The test automatically calculates errors and does some simple analyses (how many voiced sounds were incorrect, how many voiceless sounds were incorrect, how many plosives, etc.). You can also automatically generate and email a simple report.

I will do a more complete review once I have had an opportunity to actually use the program, but I wanted to let you know about the sale in case you've been looking for an articulation test for the iPhone/iPad.

Speech-Language Pathology Topics: Choosing Targets - An Example

Speech-Language Pathologists have lots of tools available to them. One example is picture card sets that focus on a specific sounds like the ones I have been making and sharing here. However, it is not always appropriate to work on a specific sound with a child even when they are having trouble with that sound. That's when the experience and professional judgement of the SLP comes into play. I'll give you an example.

Let's take the final /b/ sound as a example. An SLP has two apraxic children both of whom are struggling with the final /b/ sound. That SLP also has a set of cards that focuses on the final /b/ sound. For Child A, using that card deck would be very appropriate, and for Child B it would not be her best choice. Why?

Child A: Child A is 2 1/2 years old. She isn't really talking at all and has only two "words" in her vocabulary /ma/ for "more" and /da/ for "that" which she uses for everything else. She struggles to even imitate sounds. Through informal assessment, the SLP has determined that /b/ is one of the only sounds that Child A is stimulable for. Child A has an easier time imitating /b/ in final position than in initial position. This would be a perfect time to work on the final /b/ sound and using a final /b/ card deck would be one way to work on it.

Child B: Child B is also 2 1/2 years old. Child B is doing a lot of talking, but it is difficult to understand anything she says because of the high numbers of speech errors. Child B can make most of the early emerging consonant sounds (/p, b, t, d, m, n, h/) and a few of the sounds that tend to emerge next (/s, sh, w/). One of the speech errors that is having the biggest impact on this child's speech is her tendency to leave final consonants off of words. With this child the final /b/ is not going to the the therapist's top priority. She would probably focus on final consonant production using voiceless, early emerging consonants because those specific sounds are the least complex in terms of motor processing. Final /b/ would not be included because it is a voiced sound.

Summary An SLP working with a child who has a severe speech disorder has more potential targets than there is time to work on. The SLP will use her expertise, professional judgement, and assessment of the child's current skill level and needs to determine which targets are most important at any given time.

You might also be interested in the following articles:

Voicing Pairs

Random Example of the Complexity of Motor Planning

Speech-Language Pathology Topics: The Flap

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

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

The obscure: I completely forgot about a rather obscure sound. When a /t/ sound appears between two vowels in connected speech it is produced as a flap. When a /b/ sound appears between two vowels in connected speech it is often also produced as a flap. Say the following two sentences quickly and naturally.

1. Look at the bike pedal.
2. Look at the flower petal.

The /d/ in "pedal" and the /p/ in "petal" are produced in almost exactly the same manner - as a flap instead of as a clear /t/or /d/.

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

You might also be interested in the following articles:

Voicing Pairs

Random Example of the Complexity of Motor Planning

Speech-Language Pathology Topics: Consonants

What are consonants and why are they important to speech?

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

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

What are the characteristics of consonants

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

What are the different places of articulation?

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

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

What are the different manners of articulation?

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

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

What is voicing?

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

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

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

You might also be interested in the following articles:

Speech-Language Pathology Topics: Vowels

Voicing Pairs

Random Example of the Complexity of Motor Planning

Speech-Language Pathology Topics: Vowels

What are vowels and why are they important to speech?

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

What are the characteristics of vowels?

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

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

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

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

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

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

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

You might also be interested in the following articles:

Voicing Pairs

Random Example of the Complexity of Motor Planning

Speech-Language Pathology Topics: Voicing Pairs

Here's a quick speech lesson of the day. Don't you always want a speech lesson on Mother's Day? (Happy Mother's Day everyone!)

Say, "Ssssssss" out loud like you're making a snake sound. Draw it out as long as you can and while you're doing it place your hand on the front of your throat near your adam's apple. Now say, "Zzzzzzzzz" out loud like you're making a bee sound. Draw that one out as long as you can too while keeping your hand on your throat.

The first thing you should notice is that your throat vibrates while you make the /z/ sound, but it does not while you make the /s/ sound. That is because /s/ is a voiceless sound. You can make the sound without vibrating your vocal chords. The reason you feel your throat vibrating when you make the /z/ sound is because it is a voiced sound. You have to vibrate your vocal chords to make the /z/ sound. Other than that one difference, voicing, the /s/ and /z/ sounds are made in exactly the same way. You raise your tongue tip near the roof of your mouth behind your teeth and blow. So /s/ and /z/ are a voicing pair. They are two sounds made in exactly the same way except that one is voiced and one is not.

There are lots of voicing pairs. /t/ and /d/ are voicing pairs. /t/ is voiceless while /d/ requires vibrating your vocal chords. /p/ and /b/ are voicing pairs. /p/ is voiceless while /b/ requires vibrating your vocal chords. /k/ and /g/ are another example. /k/ is voiceless while /g/ requires vibrating your vocal folds.

What does any of this have to do with apraxia? Well, making a voiced sound is a more complicated motor task. To make a /b/ you have to do everything you have to do to make a /p/ and then coordinate vibrating your vocal chords at the right time for the right duration. So often, children with apraxia will find voiceless sounds easier. /t/ and /p/ are often easier than /d/ and /b/. Just another example of how complicated the motor planning of speech is and why our children sometimes seem to have trouble with a sound or word for no reason when there really is a reason after all.

Speech-Language Pathology Topics: Complexity of Motor Planning - An Example

Childhood Apraxia of Speech is a neurological disorder of the motor planning of speech. Here is one small example of how complicated that motor planning can be.

You might think that a /b/ is a /b/ is a /b/. Or you may have thought, correctly, that making a /b/ at the beginning of a word is different than making a /b/ in the middle or at the end of a word. But it gets even more complicated than that.

Say the word "book" five times in a row out loud, but before you say it the last time, freeze your mouth in the position it is in when you are about to make the /b/ sound. Your mouth should be pursed a little, almost like you're about to give someone a kiss.

Now say the word "bee" five times in a row out loud. Again, stop before you say it the last time freezing your mouth in the position it is in when you are about to make the /b/ sound. Your lips should be pressed together, almost like you just put on chapstick or lipstick and are spreading it evenly around.

Even though the words "book" and "bee" both begin with the /b/ sound, the motor planning for producing the /b/ is very different. For the first /b/ in the word "book," the motor planning involves the muscle motions necessary for lip rounding (because the following vowel is a rounded vowel). For the second /b/ in the word "bee," the motor planning involves the muscle motions necessary for lip spreading (because the following vowel is a vowel that involves lip spreading).

The difference between those two initial /b/ sounds is just one small example of how complicated motor planning really is. I just thought the example was interesting and I wanted to share.