A Speech Pathologist Mother and Her Daughter Diagnosed with Childhood Apraxia of Speech
Friday, February 17, 2012
Thursday, February 16, 2012
Trying for blends (/sn/, /bl/, and /pl/)
We've starting working on blends with Ava. She's had a lot of success with both /s/ and /l/. Typically, /s/, /l/, and all blends would not be sounds you'd choose to work on with a two year old child. However, Ava struggles to make herself understood. She has motor planning problems with speech and for whatever reason, /s/ and /l/ are easier for her than other sounds that would typically emerge earlier (like /k/). So, if we take the time to improve the sounds that are more stimulable, we'll improve her intelligibility sooner. Sure enough, /l/ is definitely popping into her conversational speech and it sounds great. To a lesser extent (mostly in initial position), /s/ is popping in as well. So, we decided to try for some /s/ and /l/ blends.
Her /sn/ words are: snow, snap, sneeze, snip, snail, snore, and sniff. She is pretty good with all those final consonants (notice, we aren't doing snake).
We are cueing her on multiple levels. First, we are using semantic/visual cues. For "snow" we use the visual cue for /s/ followed by shaking our head "no". For "snap" we use the visual cue for /s/ followed by tilting our hands on our head to visually cue "nap." For "snail" we use the visual cue for /s/ followed by pretending to hammer a "nail." And so on...
This works well when we keep the /s/ sound completely separate from the second part of the word. As soon as you ask her to imitate the blended word, she loses the second consonant. Snow becomes so. Snap becomes sap. Snail becomes sail.
Using an auditory prolongation cue was also unsuccessful. Ava, say "sssssssssno." Her response was simply "so".
Visual cues were unsuccessful. Semantic cues were unsuccessful. Auditory cues were unsuccessful. I finally tried incorporating some tactile cues. I happened to do this with feet because Ava thought it was funny, but you could do this with hands, fingers, or knees as well. I first grabbed one foot and giving it a light squeeze I asked her to say, "Hi sssssss." She repeated, Hi sssssss." Then I grabbed the other foot and gave it a squeeze and asked her to say, "Hi no." Again, she repeated, "Hi no." Then I squeezed each foot in succession as I said, "Now say ssssssss-no." She had the tactile cues of me squeezing each foot in succession with each part of the blend. She had the auditory cues of the prolonged /s/ sound followed by an emphasis on the /n/. She was also watching my face and mouth at the same time. This time she was successful.
We continued to practice that way about three additional practice sessions and then I was able to fade the cues. First I was able to stop using the tactile cues. Then I was able to minimize the prolonged /s/ sound. Now I can simply show her the card and give her an auditory cue with a just the slightest prolongation of the /s/ and a slight emphasis on the /n/ and get a /sn/ blend production from her. It's like the motor planning finally kicked in and now she has it. We still have a lot of work to do. It is inconsistent and we get no carryover to other s-blends (/st/, /sp/, etc.). At least the variety of cues and prompts managed to help her experience some success with the specific blends we are working on right now.
I used the same strategies for /pl/ and /bl/. Our /pl/ words are plum, play, please and plane. Our /bl/ words are blue, blood and blow.
Quick summary of cues/prompt types you may find useful:
Her /sn/ words are: snow, snap, sneeze, snip, snail, snore, and sniff. She is pretty good with all those final consonants (notice, we aren't doing snake).
We are cueing her on multiple levels. First, we are using semantic/visual cues. For "snow" we use the visual cue for /s/ followed by shaking our head "no". For "snap" we use the visual cue for /s/ followed by tilting our hands on our head to visually cue "nap." For "snail" we use the visual cue for /s/ followed by pretending to hammer a "nail." And so on...
This works well when we keep the /s/ sound completely separate from the second part of the word. As soon as you ask her to imitate the blended word, she loses the second consonant. Snow becomes so. Snap becomes sap. Snail becomes sail.
Using an auditory prolongation cue was also unsuccessful. Ava, say "sssssssssno." Her response was simply "so".
Visual cues were unsuccessful. Semantic cues were unsuccessful. Auditory cues were unsuccessful. I finally tried incorporating some tactile cues. I happened to do this with feet because Ava thought it was funny, but you could do this with hands, fingers, or knees as well. I first grabbed one foot and giving it a light squeeze I asked her to say, "Hi sssssss." She repeated, Hi sssssss." Then I grabbed the other foot and gave it a squeeze and asked her to say, "Hi no." Again, she repeated, "Hi no." Then I squeezed each foot in succession as I said, "Now say ssssssss-no." She had the tactile cues of me squeezing each foot in succession with each part of the blend. She had the auditory cues of the prolonged /s/ sound followed by an emphasis on the /n/. She was also watching my face and mouth at the same time. This time she was successful.
We continued to practice that way about three additional practice sessions and then I was able to fade the cues. First I was able to stop using the tactile cues. Then I was able to minimize the prolonged /s/ sound. Now I can simply show her the card and give her an auditory cue with a just the slightest prolongation of the /s/ and a slight emphasis on the /n/ and get a /sn/ blend production from her. It's like the motor planning finally kicked in and now she has it. We still have a lot of work to do. It is inconsistent and we get no carryover to other s-blends (/st/, /sp/, etc.). At least the variety of cues and prompts managed to help her experience some success with the specific blends we are working on right now.
I used the same strategies for /pl/ and /bl/. Our /pl/ words are plum, play, please and plane. Our /bl/ words are blue, blood and blow.
Quick summary of cues/prompt types you may find useful:
- auditory (slight separation of blend consonants, prolongation of first consonant in blend, emphasis on the second consonant of the consonant blend, clapping or snapping for each section of the blend word, etc.)
- visual (use gestural prompts for specific phonemes, use gestures to represent semantic cues, have child watch your mouth)
- semantic - assign meaning to the second part of a blend word (the "no" of snow, the "nap" of snap, etc.)
- tactile cues - tap or squeeze a hand, finger, or foot to emphasize each part of the blend word you are trying to produce in sequence
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Wednesday, February 15, 2012
Science on the Light Box: Oil and Water Revisited (with a little color theory)
I wanted to revisit our light box experiment with oil and colored water. Last time I noticed how well the different colors of water blended together in the experiment and how beautiful the colors were when backlit by the light box.
We always blend our secondary colors. I only have red, yellow, and blue tempera paints because that saves a little money and storage space. So the children are very familiar with making orange, green, and purple by mixing red, blue, and green. I had never done a formal introduction to the color wheel and the terms primary and secondary colors though. So, first we did a brief (5-10 minute) activity using paints and cardstock to introduce the color wheel. We put the three primary colors on the paper. Then we mixed the secondary colors in between each pair of primary colors.
Next I took small squeeze bottles filled with clear water and set them next to each color on the color wheel. First we colored the water with the three primary colors and then we mixed those to make each secondary color. We ended up with six squeeze bottles filled with different colors of water (red, blue, yellow, purple, green, orange).
I got out both light boxes and trays so that each child could play on their own. We took a moment to appreciate how pretty our bottles with colored water looked in an empty tray backlit by the light box.
I poured a small amount of cooking oil into each tray. I just put enough to cover the bottom of the tray with a shallow film of oil. Then the children began to squirt colored water onto the oil. The drops of water stay separate in the oil and float around like individual colored puddles.
If you are careful you can even make some simple shapes. I was able to make caterpillars and flowers for the children.
After a few seconds the surface tension of the oil releases and adjacent droplets of water combine. We were using the word "absorb". The children learned they could direct a stream of water from a squeeze bottle to manually break the surface tension and force a big drop to absorb smaller droplets. They made up a game of superheros and villains where the large superhero drops would absorb the small villains trying to attack them.
Everyone had a great time and we didn't quit until all the water had been used up from the squeeze bottles about an hour and a half after we began.
If I repeat the activity again, I will give each child a set of the three primary colors and encourage them to do their own color mixing as they play. I'll ask them to make a purple drop, green drop, and orange drop from the appropriate component primary colors. I'll see if their fine motor skills are good enough to make their own adjacent drops of primary colors without breaking the surface tension. Then we can all wait until the surface tension dissipates and the two colors swirl together to make the secondary color. It is all beautiful on the light boxes.
We always blend our secondary colors. I only have red, yellow, and blue tempera paints because that saves a little money and storage space. So the children are very familiar with making orange, green, and purple by mixing red, blue, and green. I had never done a formal introduction to the color wheel and the terms primary and secondary colors though. So, first we did a brief (5-10 minute) activity using paints and cardstock to introduce the color wheel. We put the three primary colors on the paper. Then we mixed the secondary colors in between each pair of primary colors.
Next I took small squeeze bottles filled with clear water and set them next to each color on the color wheel. First we colored the water with the three primary colors and then we mixed those to make each secondary color. We ended up with six squeeze bottles filled with different colors of water (red, blue, yellow, purple, green, orange).
I got out both light boxes and trays so that each child could play on their own. We took a moment to appreciate how pretty our bottles with colored water looked in an empty tray backlit by the light box.
I poured a small amount of cooking oil into each tray. I just put enough to cover the bottom of the tray with a shallow film of oil. Then the children began to squirt colored water onto the oil. The drops of water stay separate in the oil and float around like individual colored puddles.
If you are careful you can even make some simple shapes. I was able to make caterpillars and flowers for the children.
After a few seconds the surface tension of the oil releases and adjacent droplets of water combine. We were using the word "absorb". The children learned they could direct a stream of water from a squeeze bottle to manually break the surface tension and force a big drop to absorb smaller droplets. They made up a game of superheros and villains where the large superhero drops would absorb the small villains trying to attack them.
Everyone had a great time and we didn't quit until all the water had been used up from the squeeze bottles about an hour and a half after we began.
If I repeat the activity again, I will give each child a set of the three primary colors and encourage them to do their own color mixing as they play. I'll ask them to make a purple drop, green drop, and orange drop from the appropriate component primary colors. I'll see if their fine motor skills are good enough to make their own adjacent drops of primary colors without breaking the surface tension. Then we can all wait until the surface tension dissipates and the two colors swirl together to make the secondary color. It is all beautiful on the light boxes.
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