SWS Therapy Materials Now on TPT

For years, I’ve been making materials to use with patients. I just recently decided to offer some of those materials for purchase.

I recently started selling therapy materials I make on Teachers Pay Teachers, which is a marketplace for educators, including specialized providers such as speech language pathologists. Creating materials is not anything new for me–I do it all the time–but selling those materials is a new adventure. 

These materials may be the most helpful for speech language pathologists or parents who are wishing to do home practice with their child beyond therapy sessions. Materials do not remediate skills alone and parents are always recommended to seek an evaluation and treatment for communication and language impairments by a certified speech-language pathologist.

Many materials are games, which capitalizes on the children’s most natural learning process! This is intentional. In addition to the learning piece, it’s fun and games engage and grow executive function skills. Executive functions are the building blocks for life and include skills such as attention, memory, organization, inhibition, etc. An added bonus of games is that they are highly motivating for children and often don’t feel like ‘work’ at all.  

All materials are digital downloads and are non-refundable. There are only a few materials in the store currently but the variety and number will grow as I have time to create and publish more–so check back.  

Please visit my store at https://www.teacherspayteachers.com/Store/Speech-Tx-With-Sara

Sara Martin is a certified speech-language pathologist and owner of Speech With Sara LLC based in Grosse Pointe, Michigan. She is licensed in Michigan, Ohioand Pennsylvania offering individual speech therapy specializing in literacy impairments, speech sound disorders, early language deficits and orofacial myofunctional disorders. Contact her for additional information at sara@speechwithsara.com.

Measurability, Structure, Evidence: Keys to My Literacy Intervention Practice

The difference in treatment of literacy impairments by a speech language pathologist are many. I have struggled with defining these differences when parents have asked–not because they don’t exist, but because it’s difficult to describe what I am doing that others are not. I know what I’m doing and how that works but it’s difficult to describe how what I’m doing differs from say a teacher or a reading specialist at school sometimes. After all, those are the titles of people we expect to know everything there is to know about reading, right? 

I recently listed to the podcast Sold A Story. It’s the chilling history of reading instruction specifically in the United States and how the now debunked 3-cuing system derailed reading instruction for nearly the entire U.S. public educational system. Oh, and about how many school districts continue the use of ‘instruction’ and ‘testing’ that is NOT research-based, reliable or even actually helpful to determine a child’s reading ability. 

It’s alarming to say the least. However, it along with my own experiences in public schools as well as private practice have helped me to better delineate how my reading instruction differs and why it makes such a difference for the students with whom I work. 

First, as a speech language pathologist, my entire professional education and clinical experience is focused on the brain.

  • how it works
  • how the brain develops
  • how the brain stores information
  • how the brain retrieves information 
  • where the brain stores different information
  • how the brain connects to the rest of the body
  • how the brain ages
  • how to rehab skills lost following a brain injury or event (think stroke, car accident, falls, etc.)
  • how to stimulate learning a new skill, remember/recall it (creating neural pathways)
  • how to assist the brain in remembering new information,
  • how to assist the brain in retrieving new or old information

All of this information is used on a daily basis in treatment decisions. My job is to make sure the treatment method I pick will work with the patient’s brain function. For children, this is especially important when a popular method of teaching doesn’t work–we have to try other methods that help the brain function at its best, not just keep trying the most common method over and over again. 

Second, this brain-centered education and experience involves the entire life-span–> in utero through end of life stages.

Third, all of this information about the brain helps me as a treatment provider select therapy strategies and methods that best suit the brain’s needs in order to learn, retain and use information it is learning. Therapy includes teaching/re-teaching a skill and then helping patients achieve the skill independently (meaning they can do it on their own without help). Evidence-based practice is a big term within the speech language pathology field. It’s all about using research-based/backed strategies, tools and methods that are proven to be effective. One of the most important parts of making selection of evidence-based materials is that it’s being chosen based on the patient and their needs. Being evidence-based doesn’t mean it universally works for everybody every time. It means if it’s applied with the targeted patient, it can/will have a positive impact. So regardless of what type of disorder we are treating as speech-language pathologists, our practice and treatment is based in science and research. 

In treatment, speech language pathologists are responsive to patients and their needs. What this means is that if one method or strategy isn’t working, we change the method we are using at that moment. No waiting to see if it’ll eventually work. We change the method until we find one that works for that patient. Then the progress begins. This is one of the major differences in reading treatment by a speech-language pathologist.

Teachers and random people can get trained or ‘certified’ in specific reading programs that are promoted to the public as the fix all solution for a child with reading programs. While some of those programs might have a positive effect on some students, there isn’t a one-size-fits-all approach to reading. Just like anything else in life, we all learn differently in comparison to each other, which is why one-size-fits-all approaches are not conducive to everyone everywhere every time. The biggest problem with these programs is they try to make their method exclusive by telling their trained users to exclude the use of any other materials from outside the program. Additionally, the programs outline exactly what to teach and when AND there is no straying or changing up the order at all. So children getting reading intervention sometimes get stuck at a level and the specialist believes they cannot move on. As a speech-language pathologist, however, I use a variety of resources, methods, materials purposefully. I also change the order of how I might introduce the skills to best meet the need of the child. In some cases, some aspects of reading might fall into place quickly while other aspects take a while–sometimes they need to jump to another skill, learn it and come back to the other skill. Sometimes once they know more in other areas, it helps to understand the piece that was the disconnect.  

So speech-language pathologist not only use multiple methods, materials and strategies, but also all of them are evidence-based related to brain function. They are also independent from one program that dictates what they are and are not allowed to do. That’s why we are diagnostic clinicians–we are constantly reassessing what needs to be done to achieve brain function success. We have to be dynamic in our treatment for all disorders regardless of age. 

Another disconnect with reading instruction and intervention is the separation of literacy intervention in schools. Schools assign all reading related intervention to reading specialist teachers and do not want SLPs to be part of that. SLPs are restricted in schools to mainly speech sound production disorders and language disorders, which is only a small slice of our scope of practice. In schools, SLPs are restricted from much of their medical expertise including swallowing, feeding, orofacial myofunctional disorders, reading, etc. This separation leads to misunderstanding by parents and the general public–sometimes even within the field of speech language pathology. I’m sure some of it’s a liability issue for the schools, such as swallowing, but written language and/or reading are easily appropriate within a school setting to be treated by the SLP. Ultimately, it’s a disservice to the children, especially those with concomitant speech and/or language deficits. 

Within our professional education, a major focus is the big picture components of reading: phonology, semantics and orthography. These areas are important in their own respect for our purposes but combined, they are the big picture skills required for reading.

  • Phonology is the speech sound system (including production of individual sounds as well as team sounds). 
  • Semantics is the meaning (including vocabulary, background knowledge, syntax, etc.).
  • Orthography is the written form of language (including what letters or sets of letters make what individual sound).

This is a very simple overview of how reading happens but it’s a complex task requiring the entwining of many skills that require individual practice as well as collective practice. A nice visual that shows the complexity but also breaks it down a bit is Scarborough’s Reading Rope. This is research-based. 

Based on the Sold A Story podcast and the serious reporting completed by education reporter Emily Hanford, many teachers are not provided with much education about how to teach reading. Many are now feeling duped, embarrassed and upset about believing their districts would select research-based curriculum and products only to find out it was quite the opposite. I feel for teachers. It’s an awful place to be in knowing that instruction your district adopted and implemented was not beneficial and even harmful to children they believed they were helping. Unfortunately, the reality is we now have a reading crisis and it’s continuing to unfold. Yet, there are districts near and far that continue to use progress monitoring assessments and programs that are not backed by research.  

Another major difference in reading intervention with a speech language pathologist is measurability of skills. Those progress monitoring assessments often involving levels are ambiguous and subjective based on the authors. The “levels” do not specify specific reading skills such as syllable types, phonemic skills, affixes, vocabulary, etc. So when I receive a report from a school interventionist, it often includes their ‘level’ of reading based on this arbitrary line in the sand and it does not easily translate to everyday books that you can check out from the library or purchase at the book store. This is the a gigantic red flag to me–if it’s not easily understood across reading professionals, there is a problem. If you are a reading professional, you know the lingo–you should easily be able to understand where the reader is in their learning journey. This is where measurability comes in. Goals I write (and all speech-language pathologists) are measurable. Meaning, I can give you a percent-to-goal number on all goals for a patient, including those working on reading. These goals are specific skills: identify sound and symbol correspondence (what sound goes to what letter or group of letters), identify vowels and consonants, identify syllable types, etc. These are specific and therefore measurable. Meanwhile, those ‘levels’ do not have any or enough distinct separation to make them meaningful for intervention planning. This is further supported by the variability in scores–a student may score in one level one day because the book was about a favorite topic and the next day score in a lower level because the book was about a topic the child was less familiar with. Reading is a culmination of many skills, which is why structured teaching/intervention is important. Each skill relies on the skill before it to advance.  

Due to the complexity of reading and the intersection of so many skill sets and knowledge, it requires explicit, structured teaching. This means specific skills are first taught, then practiced and eventually mastered. As mastery is being reached with that skill, the next skill is first taught, then practiced and eventually reaching mastery. As a speech language pathologist, this is what I do every single day since I began my career. Not just with reading but with every single patient I’ve ever worked with for any deficit. Structured teaching, practice skill and reach mastery. Guessing, as mentioned in my last post, is not a part of the process. I would never ask a child to guess at a word. In fact, I often find myself telling patients to stop guessing and use the tools they’ve acquired during our work to figure out the word.

In the speech-language pathology world, cuing refers to helping a patient be successful with a skill. The use of cuing fades as a patient achieves success with a particular skill and eventually is removed entirely as the patient does a task independently. That debunked 3-cuing system mentioned earlier immediately sounded suspicious to me before I even learned more about what it was–cuing it NOT a strategy but a TOOL to help a patient reach success (i.e. achieve independence.). Also, speech-language pathologists don’t use pictures to guess words–> instead we use pictures to help learn more about the meaning of a word. Pictures provide great context and meaning. It’s a strategy I share with parents of children who are experiencing a language delay because it helps them acquire vocabulary long before reading is ever something they are trying to do.

There is nothing in life that we learn successfully by guessing at it over and over again. Reading is a life skill not an academic one. We use it to access academic information to learn about different places, people, and concepts certainly, but we also use it to figure out what we’ll order for dinner at a restaurant, to read a map while traveling, to figure out the bus schedule to get somewhere, while driving, while playing games, etc. It’s a life skill and my knowledge/practice as a speech-language pathologist are perfectly matched to offer effective assistance in acquiring it. 

Brain-focused instruction + explicit, structured intervention + evidence-based methods = reading success. Speech Language Pathologists have always followed the brain science to teach all skills among them is literacy intervention. 

Sara Martin is a certified speech-language pathologist and owner of Speech With Sara LLC based in Grosse Pointe, Michigan. She is licensed in Michigan and Pennsylvania offering individual speech therapy specializing in literacy impairments, speech sound disorders, early language deficits and orofacial myofunctional disorders. Contact her for additional information at sara@speechwithsara.com.  

  

 

 

 

Literacy for Life: Guessing is Not a Strategy

Nearly everyday, I work with children who are struggling with learning to read. For some, they are years behind on their ability to read. For others, their struggle became obvious earlier and they are not considered to be as behind but are behind nonetheless.

Universally, though, all of these children have negative feelings about reading. About themselves. Often their confidence is destroyed. They are usually compliant at first because they understand their parents want them to get the help but they are not trusting that work we will do is going to help them.

Honestly, I cannot blame them. Typically they’ve been through a lot of people who identified themselves as someone that was going to help them with reading and it wasn’t successful. From the child’s perspective, I’m just one more of those people–until I’m not. Until we get working and they start experiencing success. Then they experience a huge shift and their whole attitude changes. They start showing some excitement even about our sessions, about their ability to be successful and this is where their whole reading journey is re-routed onto a positive path.

Much of this is due to systemic problem within education. It involves reading instruction that is based on guessing words rather than teaching the skills so a word can be decoded (fancy word for read) by a child. Children are instructed to guess a word that makes sense with the context of stories. They are told to guess a word that makes sense based on the first letter of the word. None of this is helpful to a struggling child and it only leads to misunderstanding. They misunderstand the story because they guessed the wrong word. They misunderstand the story because their reading was so interrupted by the need to guess the word, they’ve forgotten the contents of the story. Guessing actually interrupts reading fluency, which is the fancy term used to describe the smoothness and efficiency of a person’s reading.

I work to undo this ‘guessing’ strategy on a daily basis. For some children, they easily adapt to not using this strategy as they’ve learned the appropriate skills to decode (sound out) words. Others, however, persist in using this guessing strategy because it was so heavily engrained in their learning to read journey at some point.

Unfortunately, this can have long term negative impacts for children. Some just end up getting by but never truly become a proficient reader and when they do read, may misread words. This can have a negative impact on academics after they’ve switched from the ‘learning-to-read’ mode to the ‘reading-to-learn’ portion of education.

As an example, a student who reads the following sentence:

‘The ants invaded the kitchen.’ as ‘The ants invited the kitchen.’  

This student has a very different understanding of what happened with the ants. In one, they entered the kitchen by force while in the other, they were asked kindly about/into/near the kitchen?? It’s not clear because there are some words missing. Imagine how this could negatively impact a child’s understanding of an event from history, their understanding of a story or even for non-academic purposes, such as reading a recipe for cooking or baking. When children are taught that guessing is a good strategy, they start using it, they feel successful despite getting the word wrong. The implications on the comprehension end are massive.  

Reading is a skill that requires the intersection of knowledge of 3 major areas: individual speech sounds within a language, the meaning of words and the symbols representing the sounds. Reading is a culmination of all of these skills and requires explicit teaching, a lot of practice and use of multiple areas of the brain. There is science behind how to teach reading and guessing is not supported by the science. It’s also not supported by outcomes–just ask the children and families who seek out my services. 

Sara Martin is a certified speech-language pathologist and owner of Speech With Sara LLC based in Grosse Pointe, Michigan. She is licensed in Michigan and Pennsylvania offering individual speech therapy specializing in literacy impairments, speech sound disorders, early language deficits and orofacial myofunctional disorders. Contact her for additional information at sara@speechwithsara.com.  

Toy-Gifting? Skipping Batteries Can Lead to More Learning, Growth

Toys are so much fun. They inspire children to use their imagination and to be creative. Toys also have the power to promote an incredible amount of learning for children–but not the academic kind of stuff that might pop into your mind like the ABCs. Instead, toys have the potential to help children learn problem solving, strategy and patience.

There is also a great deal of opportunity for toys to help promote and encourage communication. Children love to show off their newest creation. Sometimes they need to ask for help with a toy when it’s not working how they think it should. Other times, they may want to share in using the toys and creating together, which invites conversation to happen. 

Batteries interrupt all this opportunity however. 

Generally battery-powered toys involve buttons and when the buttons are pushed, a pre-determined sound/light/reaction happens. Every single time. It’s the same. That sound/light/reaction is automated by the push of the button and the child doesn’t get to figure out how to make that sound/light/reaction happen by their own means. 

In a society obsessed with making children smarter earlier and earlier, all of the toys sold as ‘promoting’ academics such as the ABCs, numbers or colors, these button-pushing battery-powered toys can seem like they might do some good. The problem is it eliminates the opportunity for your child to use the toy differently, to make the noise/sound the toy is making and eliminates the ability to use any imagination. The ‘play’ part of the toy is already done for them. Just a quick push of the button and the play is over. Finished. That’s it.

This holiday season, when a lot of gifts are being purchased and donations are being made, consider finding toys that inspire actual play. Pick some toys that will allow a child lots of exploration, imagination and communication. As a pediatric speech-language pathologist, I’m a bit of a toy connoisseur. I’m picky about the toys I use with patients and for good reason. I want to promote all of that creativity, imagination and communication with my patients. I want them to create the play, not a button. 

If you’re in the market to purchase a gift for a child this holiday season, here are some recommendations to help you choose the perfect gift: 

–skip the batteries

–choose toys that are open-ended, such as building blocks, train tracks, play houses, etc. 

–choose toys that can be shared with others

Here are a few specific ideas that may spark your interest or at least get you thinking along the creativity ideas.

For children who are ages 18 months to 4 years old:

–Fisher Price Little People are a great example of an open-ended toy that involves creativity. There are many different people of a variety of ages, including babies, children, adults, workers/community helpers, animals, etc. To go along with all of the characters, the line also has a house, furniture, cars, buses, and other structures/lifetime items.

–building blocks made of wood or another sustainable material. Nothing fancy, just blocks that can be stacked and re-stacked over and over again in different configurations, different heights, different ways every time. 

For children 4-7 years old: 

–pretend play activities are a big recommendation with this age range. Think pretend food, tea sets, play kitchens where you can pretend to eat out at a restaurant, play grocery store or cook some food. 

–to complement pretend play, some of the dress up costumes can really get your child into the part, such as a firefighter, a pet veterinarian set, or a chef’s hat and apron.

–art supplies such as crayons, water colors, markers and an oversized pad of paper

–early board and card games such as Candyland, memory or Uno.

 While this is a quick list, it’s meant to help get you thinking more along the lines of imagination, creativity and the enjoyment of playing. Eventually the learning of letters, numbers, colors, etc. does become important, but there are many other skills that should be acquired and developing before the introduction of these ‘academics’ that actually support learning. Those include the ability to interact, to pay attention to others, to problem solve and to have patience.

These four areas start developing before a child turns 1! One of the earliest problem-solving activities for young children is building with blocks. To build, it requires strategic positioning of the blocks to ensure they remain upright. When a child plays with real blocks and builds a tower, it’s likely they built it many times over before achieving the tower. The blocks likely fell frequently and each time the child tries again, they place the blocks a bit more strategically to get them to stay upright. In addition to problem-solving, this builds patience and resiliency.

Meanwhile, a child who completes building blocks on a tablet, doesn’t experience the trial and error phases of building the tower–the blocks click into their digitally pre-determined spot and voila, it’s complete. For this child, when they do encounter real blocks and they are not successful the first time they attempt to build a tower, they are likely to become highly frustrated and may even reject playing with the blocks. They lost out on the growth opportunity because they were used to using a button to build rather than to build themselves.

I’ll be on the lookout for new toys that wow me this season. Let me know if you find any–comment below and share your favorite toy and how it inspires creativity, imagination and play! 

Sara Martin is a certified speech-language pathologist and owner of Speech With Sara LLC based in Grosse Pointe, Michigan. She is licensed in Michigan and Pennsylvania offering individual speech therapy specializing in literacy impairments, speech sound disorders, early language deficits and orofacial myofunctional disorders. Contact her for additional information at sara@speechwithsara.com. 

Literacy: Seek Responsive Treatment, Not Scripted

I treat literacy impairments. This means I help children learn to read. It’s an area of passion for me. Similar to communication, which is weaved into EVERYTHING we do on a daily basis, so is reading. 

We read menus at restaurants, signs on the road, instructions when installing something new at home, building legos or the weekly school newsletters. We read emails. We read texts. We read things on television too. We especially do a lot of reading when we travel to new places we’ve never been to before. It’s easy to get stuck in the mindset of children must learn to read for book-reading purposes but that is only one tiny bit of the reading we do every single day. 

Often, however, I get the side-eye skeptical look paired with the question: a speech therapist treats reading?? Sure do, and it’s an area that I specialize in. Children with speech sound production impairments are at a much higher risk for reading acquisition problems. Any speech sound production problem puts them at higher risk for reading acquisition problems but some disorders– phonological and apraxia impairments–put children at an even higher risk for reading struggles.

This is why having a child with speech production issues evaluated when they are young is so so important. Speech sound production issues that persist take longer to remediate and eventually have a negative impact on reading and even writing. The academic demands upon children are vastly different today than even 20 years ago, which means reading demands are much higher at younger ages. Children who have reading acquisition struggles can develop negative feelings about reading pretty quickly, and well, it can make their academic road ahead treacherous. 

Reading is within the scope of practice for speech-language pathologists, which is often surprising to many people. However, if you really start thinking about it–we work with children to help them blend and segment words/speech sounds for communication purposes long before any reading expectations are upon them. Reading and writing are part of communication as a child ages and advances in school.

Additionally, reading is based on individual speech sounds. Yes, you read that correctly. Speech sounds are the basis for reading and writing. In English, it’s incredibly challenging sometimes to learn to read because the language itself was developed with influences from many other languages. This means there are a lot of what I like to call “rule-breakers” because the word doesn’t follow the ‘typical’ pattern.

In schools there is a HUGE focus on teaching reading from a letter perspective. In pre-school and kindergarten, there is a focus on letters and their sounds. This alone is a disservice to children because the 26 letters in the English alphabet only represent 23 sounds of the more than 44 total sounds in English. We have written representation of those additional sounds but they are not introduced until children are ‘older’ (think late first grade and second grade). Yet at the end of kindergarten and throughout first grade we want their reading fluency to be getting smoother and smoother. How can that happen when they are only given a fraction of the sounds they may encounter in a book? 

Sometimes this is done through ‘books’ created to include only words students should know but this isn’t necessarily very functional. Road signs, after all, don’t take into account what words a driver may or may not know/be able to read. Subway directions don’t either. Neither does a restaurant menu or a job application. 

Seeking out help with literacy treatment can be overwhelming. There is no shortage of information ‘out there’ when parents are looking. No shortage of opinions. No shortage of reading programs that promise this, that or the other thing in 2 weeks. No shortage of reading apps that will solve the world’s reading deficits. 

All of those options have limits. While some might be fantastic for one child, it might be awful for another child. It also gets much more complicated when a child has OR HAD a diagnosis related to a speech production issue–this could be articulation, phonological impairment, apraxia of speech, delayed language, etc. 

While many reading programs may be helpful to some, they are developed as a one-size-fits-all program. Those who become certified in them are strongly encouraged (told to be ‘certified’ they must follow the program to a tee) to ONLY follow the program and to NOT deviate from it, or introduce anything beyond what is strictly written into the program. This inflexibility is what often hinders student growth and progress. Especially for children with or a history of speech and language impairments. 

As a speech-language pathologist, treatment for any disorder is responsive in nature. That means treatment changes moment to moment to meet the child’s needs to help them achieve success. Sometimes this means, the most elaborate session plans that were created and prepped in advance are tossed to the side and the whole session is spent doing something else. It’s not because there was bad planning, it’s because it wasn’t working for the child. So change is needed. In the moment. 

Reading intervention needs to have a structured approach. This means that the intervention has organization, is cumulative and connected–if it’s scattered, that only further confuses the child. Some of the big name programs aim to provide that ‘structure’ to the interventionist but reading intervention doesn’t have to be boring or monotonous. In fact, in my clinical experience, the more fun, exciting and silly instruction is, the more quickly a new skill is acquired and mastered, and most importantly, not forgotten. Structure means that the intervention includes explicit instruction for each skill area while helping build/create connections of the skill within reading. 

All of speech therapy is this way–structured AND responsive to the student’s need with a focus on how to help the student achieve whatever goal it is he or she is working on. While the big name programs are trying to achieve structure, when the program cuts out the responsiveness, it’s providing a one-size-fits-all approach. For those it helps, it’s an amazing program, but for every person it helps, there are likely 3-5 people who ‘failed’ at it because it didn’t help. Intervention without responsiveness isn’t intervention by definition. Reading programs are only one tool in the treatment toolbox for speech language pathologists, not the only tool

When a child is learning to read and they have a history of speech production problems, those can surface again–even those production issues that were resolved or remediated. A speech-language pathologist who treats reading disorders is able to discern when a child is having a production problem versus a reading problem, and then able to provide the appropriate help to get through that moment and work on it so next time, it’s easier. 

A perfect example involves words that have consonant clusters–an inside term referring to when a word has more than one consonant in a row. Those are considered more difficult to produce for speaking purposes. If a child struggled with those for production purposes and now in reading is not producing one of the consonants, the story is interrupted. The child is unlikely to understand the word for its meaning but they might be skipping it because they don’t know how to sequence those consonants for production purposes. A speech language pathologist is able to address the speech production piece and then also make the connection with the reading portion with the ‘graphemes’–another inside term referring to the written representation of speech sounds. 

Reading is a culmination of many many skills. It requires visual tracking. It requires knowing speech sounds and their written representation. It requires attention to the writing. It requires comprehension and vocabulary knowledge. It requires self-monitoring. It requires flexibility and sometimes, just like babies have to learn how to stack and restock blocks many times to get them to balance, reading requires the willingness to try and try again. It’s not a one-size-fits-all skill that is turned on and turned off. It’s a skill that requires a great deal of coordination and effort, which is why responsive treatment is necessary. 

Questions about speech-language pathologists treating reading surface all the time. From parents, from other professionals, from teachers, from reading specialists, even from other speech-language pathologists, if you can believe it. One big reason, in my opinion, is that in public schools, speech-language pathologists are very much utilized to treat speaking, listening and language only while the designated reading specialist (often a teacher with extended training in this area) is slated to deal with ALL of the reading deficits. For a good portion of the children, the reading specialist teacher is exactly what they need, they get the boost and then they are done receiving reading support.

However, for those children receiving speech therapy services and reading support in schools, it would likely make a dramatic difference in the outcome and progress of the child if the speech-language pathologist were to treat reading in addition to the goals in their IEP related to speech production and language. This is not a small unique issue–it’s more of an educational system issue–that’s how it’s been set up and, of course, there are some sensitivities that surface about everyone’s specific role/responsibilities within the school setting. However, everyone would certainly still have a caseload I promise. If this shift would happen, many children would likely achieve success in reading more quickly. 

Isn’t that the point of support services of any kind anyway? Help the child be successful at a certain skill as soon as possible with the least support possible? That’s my goal and that’s part of why I love treating children with reading disorders. I want children to be able to experience success with it and experience joy with reading–it’s part of why I’ve chosen to specialize in it. The key to any reading treatment should be a responsive approach rather than scripted steps outlined by one program.

Reading is not a recipe or a set of directions. It’s a learned skill that requires specific support to the specific child and their specific needs. It’s about helping them in the moment to achieve success. Each moment then builds on the next and pretty soon, voila, they are reading. At home. At school. While riding their bike down the street. In a restaurant. At the doctor’s office. Everywhere. 

Sara Martin is a certified speech-language pathologist at Speech With Sara LLC based in Grosse Pointe, Michigan. She is licensed in Michigan and Pennsylvania offering individual speech therapy specializing in literacy impairments, speech sound disorders, early language deficits and orofacial myofunctional disorders. Contact her for additional information at sara@speechwithsara.com. 

Habituation is End Goal of Orofacial Myofunctional Therapy

Function matters to all body parts. Function allows us to complete and achieve many activities. Functioning legs allow us to run. Functioning hands allow us to write.

The same applies to the function of the tongue and lips. Their function matters to speech production, to eating and to an even more basic necessity of life: breathing. 

I recently had an orthodontist reference the exercises of orofacial myofunctional therapy as “never-ending.” The quick reference caught me off-guard and my immediate response was to explain the point of OMT is not to assign a never-ending exercise regiment for a patient’s mouth. After all, who would do those exercises forever anyway? No one. Absolutely no one. It’s not functional. Ever.

It struck me in that moment that even professionals who share in knowledge of the same body parts but practice in different disciplines don’t necessarily have a decent grasp on the goals of their professional colleagues.

The more unfortunate part here is that the orthodontist made that statement in a dismissive manner of my professional role and services when in reality, that orthodontist really needs to learn more about something that could even benefit his/her own patients. 

Every professional evaluates and assesses based from their professional lens. The list for professionals who deal with the mouth is lengthy, which means sometimes there is crossover between issues that a patient might be experiencing and the professionals who can help. Recognizing when to refer to another professional to help your patient is such an important piece of treating patients. It requires some knowledge about their area of expertise or a willingness at least to learn more about their area of expertise.  

So here is a quick synopsis of orofacial myofunctional therapy. 

The main goals are to help patients achieve optimal resting posture of their lips and tongue. 

There it is–quick, but not so simple.

(more…)

Cooking: A Natural Path to Language

Cooking together is a great way to support language development at home. It’s fun. It’s natural. It’s loaded with endless possibilities. 

Cooking together is always a great way to target and support language development but it’s a particularly great time to do it now that we’re all home for the pandemic. 

So just what areas of language can cooking together support? 

Vocabulary. Math. Sequencing. Following Directions. Reading. Description. Comparison. Verbs. Planning. Organizing. Measuring. Reasoning. Problem-Solving. Concepts.

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Tele-Practice Option for Speech Therapy

During these strange times, it is so nice to see all of the smiling faces of patients every day! I hear their laughter and we spend our sessions exchanging stories and sharing in conversation.

It’s not the way we normally do it–in person, but it’s still face-to-face.  We use toys, read books together and share a in a great deal of laughter.

Telepractice is an option I’ve offered at Speech With Sara for quite some time (long-before these shelter-in-place times) and a service format that isn’t too dramatically different from doing in-office appointments in the clinic. 

We’re still face-to-face. We’re using the same materials we’d use in person. We’re using books, cards, toys, games, bubbles and more! It’s so much fun! Plus, it provides both of us a break from the unusual times we’re enduring as a society.   

During a time when emergency mandates are being issued daily, when children are not going into school, parents are working from home and social distancing is the norm rather than the exception, having routine moments is important for all of us but especially for children. 

Sure there have been some adjustments–making sure screens are positioned so we can see each other’s faces, making sure the audio button is on so we can hear each other–but that’s about it.

Just like that, therapy continues. My patients continue to learn speech and language skills to grow their communication skills despite so much of their world coming to an absolute halt.

Don’t get me wrong, I’ll celebrate when we’re able to get together in person and zoom a car back and forth to each other or discuss the happenings of unsuspecting passersby in the business district where my office is located, but in the meantime I’m going to celebrate the continued growth of my patients! 

Have questions about speech and language development or need therapy in absence of services contact Speech With Sara at 313-815-7916 or by email. Speech With Sara offers individual therapy for speech-sound disorders, early childhood language delays, literacy & language deficits and orofacial myofunctional disorders.

Low-Tech Ways to Keep Up with Speech & Language Skills during COVID-19

Right now, there are so many digital and online recommendations being made available. There is much generosity happening by authors, musicians, artists, museums, organizations, and the list continues. It’s wonderful.

Honestly, though it’s also a bit over-whelming. Especially for parents who are just trying to balance work, home, children, distance- learning, extended family, mealtime, self-care and more.

As a pediatric speech-language pathologist, I want to provide some low-tech ideas of how to continue supporting your child’s speech and language skills while you’re home. These ideas involve toys, games and books you already have in your house!

  1. Engage in conversation. Make an effort to have face-to-face conversations with your child. Put down your smart phone, laptop or tablet, and focus whole-heartedly on the conversation. If you need, designate specifics times or places that will be technology free so conversation can happen (i.e. at mealtimes, during the evening, in the living room, etc.).
  2. Read with your child. Picture books are fantastic for the younger child but even older children who already know how to read benefit from reading together. Pick a book to share—read aloud or have a book club format where you designate what chapters to read and then have a discussion about during designated ‘book club’ times. If your child is working on a particular sound, emphasize it while reading; a particular language structure, talk about it when it comes up in the book.
  3. Play board & card games. Bust out the Uno deck, Candyland, Monopoly or Sorry games. Games often help children’s executive function skills (i.e. memory, attention, planning, inhibition, etc.). Additionally, game play involves pragmatic skills (i.e. being a modest winner, not being a sore loser, turn-taking, etc.). Games also help children target receptive language skills (i.e. following directions/ rules, executing a move/changing a plan, etc.).
  4. Participate in physical play. Get outside and moving around with your child. Play catch, hopscotch, or tag. Blow bubbles, build an obstacle course or have a race. Movement activates more areas of the brain and physical play is a great time to build language, participate in conversation and introduce new or different concepts. With each activity there is different vocabulary—talk about what you’re doing together.
  5. Talk a walk around the neighborhood and play I Spy or set to do a scavenger hunt. There are a lot of these happening right now. I currently have a dinosaur on a front window for one happening in my neighborhood! I Spy targets semantic skills as well as conversational turn-taking. Scavenger Hunts can target a lot of vocabulary about locations, categories, functions, etc. Plus, who doesn’t like to go on a scavenger hunt?
  6. Cook or bake together. There is so much potential language in preparing a meal or baking a treat. Vocabulary is a big one—learning all of the words related to cooking alone is nearly endless: the tools, the preparations, the styles and methods, the dos & don’ts, etc. Math vocabulary is also another big part of cooking—it’s an area in which those math skills from the classroom can cross over into real-life experience. I recently related creating equal amounts for my first grade son to measuring cups and spoons. It was nothing fancy—a scrap piece of paper where I drew the pie charts he’s been doing in math for each of the cups to build the connection between the two ideas. Cooking also targets receptive language skills such as following directions.
  7. Make up a story, engage in pretend play or help your child craft their own book. Any of these activities help children learn communication within social routines, story narratives, character development, and more. Follow your child’s lead with these activities and encourage them to use what’s around—so pretending a lego is a phone is absolutely fine.
  8. To target specific speech and language skills that are being focused on in therapy, create games. They don’t have to be complicated or even make a lot of sense, they just need to be rewarding and engaging to the child. Egg cartons, are a great example. Make an egg carton into a toss & say game, for example. Write a word or place a picture of a word targeting the speech sound your child is working on; then toss a coin in, the child practices that word so many times; then you take a turn. This is an important piece—by participating, you are modeling the correct production for your child, and you are making it more engaging! Establish a point system ahead of time and then keep track to determine the winner.

There are a few themes among all of these suggestions: engagement is first; making it fun is second; and participating is third! By doing all of those pieces, you are helping support not only maintaining your child’s speech and language skills but likely helping advance those skills too. Generally, if you are achieving all three of these themes, your child is learning regardless of what you’re doing together.

Keep in mind, you don’t have to do all of these every single day. Pick one or two that are realistic. Schedule time to make it happen. Find time when you can disconnect from work and technology—a mid-afternoon break, a pre-meeting break, etc. Lastly, tell your child about your plans for the day—include them in the plan and make it known when it’s going to happen. This helps avoid meltdowns about expectations for this time.

Speech With Sara LLC provides private speech therapy and comprehensive evaluations in the areas of speech-sound disorders, early childhood language delays, language & literacy impairments and orofacial myofunctional disorders. Have questions or want more information, please email sara@speechwithsara.com or call 313-815-7916.