The Weekly Review: Week Thirteen

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

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

Sibling Moment of the Week:

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

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

Michael's Update of the Week:

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

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

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

Does anyone have any ideas or suggestions?

Project of the Week:

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

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

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

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

Apraxia Therapy Materials: Webber Jumbo Articulation Drill Book

Book Review: Webber Jumbo Articulation Drill Book

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

Target Audience

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

How to use the Webber Jumbo Articulation Drill Book

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

What is inside the Webber Jumbo Articulation Drill Book?

You can view sample pages of the book.

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

Therapy Ideas using the Webber Jumbo Articulation Drill Book

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

Pros and Cons of the Webber Jumbo Articulation Drill Book

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

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

Bottom Line

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

You might also be interested in the following articles:

Apraxia Therapy Materials: The Big Book of Exclamations

Apraxia Therapy Materials: Talking Carl iPhone / iPad App

Apraxia Therapy Materials: Doodle Buddy iPhone / iPad App