Language Worksheets Website

Okay just a quick post. I have 3 minutes until my next group starts but I had to share. During my prep time here at work I was trying to find some worksheets for possessives and I found this awesome website! It has lots of free language worksheets and you can download them as editable documents or as pdfs. Thank you, thank you, thank you to the person who made this site! Check it out!
http://freelanguagestuff.com/

Rethinking Language Therapy

Dear Speech Friends,

If you haven't noticed I've been Missing In Action lately. The past few months I have been questioning my techniques for language therapy and instruction. You probably could have guessed since I'm doing this whole language disorders review. I'm just not convinced of the validity of some of the techniques I've seen. It feels like language therapy is similar to trying to solve an entire puzzle with only one or two pieces. This whole questioning phase has been crazy. It has seriously rocked my "beliefs" in what I do as a speech language pathologist. I feel lost in purpose.

It surprises me how much this feels like a time in my life when I questioned my belief in God. I am a person of faith. Religion was part of my upbringing. But my faith in what I believe came from my own questioning, deep reflection and personal experiences. This is in no way meant to be a religious post. It's just truly a perfect analogy for what I'm going through right now and I'm trying to describe the reason behind my MIA status.

Have any other SLPs out there gone through this same questioning of our validity as Language Therapists? Don't get me wrong, I seriously think we do a world of good out there. SLPs are the smartest, most creative, fun and caring group of people out there. And our ability to think through and adapt lessons to individual children's needs is like our superpower. But are we doing it the best way? Are our techniques proven? Are our models of service delivery adequate?

Let me tell you this, I have no doubt that we are helping kids! I'm just not posting awesome ideas of therapy techniques right now because, well, I'm going through a shift of therapy emphasis and it's taking some time to "convert" if you will.

I hope I haven't offended anyone with this post. I'm a lover of all people, religious or atheist or don't-care-ist. But be it said that we are all speech language pathologists and we should probably believe in the validity of what we do. :)

Hope all is well with you speech friends of the world. If you are a school based SLP my thoughts are with you and the dreaded end of year paperwork and filing that ensues. WE CAN DO IT!!! Think of how great you will feel in a week or two!

Best,

Annie

Want to Join our Language Disorders Review?

A couple friends from graduate school and I have made a goal to review our old textbooks and notes. Right now my life does not allow for constant study, but I figure I can give 10 or 15 minutes a day to review my notes. I did pay a pretty penny for graduate school so I think it's well worth it to maintain that investment. And it's good for my career, particularly good for my clients.

We are starting with language disorders. Language disorders are complex and there are so many different goals and approaches you can work on with each client. A good solid review of language disorders will help us decide the most relevant and important goals and treatment methods for each client. I'm excited to relearn the material. And having worked in the real clinical world for a number of years now, I am sure I will have a whole new perspective.

I was thinking it would be cool if we could all do a review together. I know we were all in different programs and had different textbooks and professors, but that's what's so cool about it. If we all made a goal this week to review chapter 1 of whatever language disorders textbook we have and everyone left 1 comment with a little something they relearned or found interesting we could all learn from each other.

So here's my challenge. In the next 7 days let's review some basic language disorders information. It doesn't have to be a monumental goal, maybe 10 minutes this week or 10 minutes a day if you think you can commit to that.

I didn't want to agonize over where to start, so I just started with chapter one of my language disorders textbook from graduate school. Because I read in small doses (10 minutes here, 5 minutes there) it took me 9 days just to review the one chapter but I feel awesome that I actually did it!!!

Do you want to join us? PLEASE DO! and share 1 thing you relearned or found interesting.

The goal this week is to.....Review the first chapter of your language disorders textbook.

Here we go! We can do it!

*P.S. If you need more focused attention to an area, by all means review that material. Find your old Language Disorders textbook, look at your old notes, read a journal article, talk to an experienced colleague or a professor, do anything to review a bit of language disorders knowledge.

Homework Survery Results

Thank you to everyone who participated in the homework programs survey! I wasn't expecting such a GREAT response. It turns out that the free version of survey monkey caps the number of surveys at 100 and we quickly hit that cap. I am sorry to those SLPs who did not get to take the survey. If you have any input you'd like to share about successes or failures in speech homework programs please share!

I have to admit, I am rather grateful that there was a cap on the number of surveys that could be submitted. For the past two weeks I have been trying to organize and analyze the data from these 100 surveys. I was feeling slightly overwhelmed by the avalanche of information but it is pretty exciting stuff! (and this is the point where my husband would say "nerd-alert!")

I have to make a disclaimer that I am not a statistician so I haven't run any regression tests on the data. I thought about it, but for now I am rather busy with my cute husband, our insanely adorable 6 month old baby, and my high caseload at work. Also I don't really feel like delving into my old Research Statistics notes from grad school to figure out how to properly analyze the data. I am only reporting raw data with basic percentages for each variable. Someday I'd love to go back and get a Ph.D. and maybe do some more focused research but this is not that day. So without further ado, here are the most interesting raw data results of this survey filled out by 100 speech language pathologists across the country.

I'm going to add some opinions in here that should be separated from the facts of the survey. My opinions will be in italics, like this.

One of the major points the survey confirmed is that a majority of SLPs report that their homework programs are unsuccessful. So if you are feeling frustrated and discouraged with your homework programs YOU ARE NOT ALONE! The criteria for the categories was determined as follows 0-20% homework returned was defined as unsuccessful, 40-60% of homework returned was defined as less successful, 60-80% of homework returned was defined as more successful, and 80-100% of homework returned was defined as most successful.

 Here is a quick comparison of variables between the most successful group (those reporting 80-100% homework returned) and the least successful group (those reporting 0-20% homework returned).

Though I haven't run any statistics besides calculating simple percentages, the comparisons between the two groups seem to be pointing to some key elements. 

CONSISTENCY in assigning homework seems to be playing a major role in the success of our homework programs. If we are consistently giving homework, the students are more likely to be consistently doing it. Successful homework programs sent homework at least one time each week. Interestingly, it appears that assigning homework every other week or once per month is not effective. Being assigned homework one week and not the next week might be confusing the students and their parents. It is easier for them to remember if it is a consistent expectation.

The Use of CONSEQUENCES when homework is not returned was another big variable between successful and unsuccessful homework programs. Successful homework programs had a set consequence. Here's an interesting note: the type and severity of the consequence did not appear to make a difference. Most of the consequences were a simple withholding of the child's homework sticker, prize or game. As long as the consequence was well defined and consistently enforced it seemed to do it's job. Another very interesting note was that withholding "extra" prizes did not appear to be very motivating to students. For example, many SLPs report that they give their students prizes (or stickers, or other reinforcements) just for coming to speech or behaving well during speech sessions. Then on top of those rewards the student can earn even more rewards for doing their homework. While these systems may help control behavior during the speech sessions, they do not appear to be very effective in encouraging completion of homework. Try to think like your students, if you know that you'll get a prize no matter what, why do your homework?

Many SLPs left comments that said "if I gave a consequence for not doing homework, my students would hate coming to speech."  I feel like this is an unfortunate attitude among SLPs in general that may getting in the way of success with our speech homework programs. Many SLPs do not believe students are responsible enough to do it, and it may be creating a bit of a self-fulfilling prophecy. If you don't believe in them, or don't expect them to do it, then why would they do it? I loved a comment from one SLP that said "homework and good behavior are just expected of my students, they know what I expect of them and they expect things of me as well."

Here is my personal thought on consequences. They do not have to be "terrible" but they need to be strong enough that the child is at least aware that it's a consequence. Give the consequence but continue to be a happy and encouraging therapist during your sessions. I have my students call home and ask their parents to help them remember to do their homework. I don't get mad, or give them a lecture I just point to the phone. It's just something that they know they have to do. If they forget their homework one week, I don't give them a hard time the whole session, but I also don't feel like I need to let my students get away with things just so they will like coming to speech. I try to make it enjoyable and productive. 

 If you are using rewards to encourage good behavior in speech I would suggest trying to keep your behavior reinforcement system completely separate from your speech homework reinforcement system. Maybe if they behave well or come on time they will be able to participate in the therapy game, but if they forget to do their homework they do not get their homework sticker.

The SLP's Belief in the Importance of Homework also appears to be a key player in success of homework programs. 100% of the SLPs who had successful homework programs said homework is important for their students' progression. Whereas, only 58% of those with unsuccessful programs said homework is important.

SLPs with successful homework programs often had a set system to keep track of homework they had sent in the past. These SLPs in general reported more organized homework systems. Some of the great suggestions for keeping track of previous homework included writing it down in your data logs, using a homework tracker, leaving all previous homework pages in the child's homework folder (which is awesome because the student can review it at a later date and you do not have to reprint it) and other similar suggestions.

The TYPE of Reinforcement does not appear to make much of a difference in success of homework programs. Most of the reinforcements reported for both successful and unsuccessful homework programs were exactly the same and often included small stickers, prizes, candy, or steps toward a prize. There did not appear to be any "super rewards" that the kids were just dying to get. However, a good percentage of the unsuccessful homework programs reported that they did not have a DEFINED reinforcement for homework.

The Socioeconomic Status of the area did not appear to effect success of homework programs. The distribution of SES for the surveys is shown in the graph below. It was interesting to me that some of the most successful programs were in areas where the majority of the families were very poor, while other very successful programs were in areas where families were average middle class to very well off.

The TYPE of homework assigned did not appear to significantly effect the success of homework programs. The most commonly reported types of homework included: worksheets, suggested activities, suggested books to read with parents, and packets. Some of the least successful types of homework were websites and packets given over breaks.

Other interesting notes from the survey..... 

• almost all people surveyed reported a significantly faster rate of progress for students who practice homework versus those who don't.
• notebooks with secured papers appear to be more successfully transported from school to home and back again compared to loose leaf papers and packets.
• an open communication relationship with the parents seems to play an important role in the parent's willingness to help their student with speech homework. There were a lot of great ideas to keep good communication with the parents including: a communication log in the student's homework folder, email correspondence, phone calls, a good clear homework description page in the student's homework folder, attending parent-teacher conferences and others. Any communication with the parents, no matter how small or big, seems to help.
• homework assignments that were only 5 to 15 minutes were the most likely to be completed.
• elaborate and overly creative homework is time consuming and draining. Conserve your creative energy for your therapy sessions. Have a simple, but consistent homework program and I think you will be so much happier with your homework outcomes.

There are a few specific notes from this survey that I would like to discuss more in future posts. But for now my bed is calling my name and I've already spent too much time away from my family tonight writing this post. I really hope these results help someone. Have a wonderful night!

Using the iPad as a speech & language therapy tool

Well it's been 3 weeks back at work and I tell you what, speech language pathology is a mighty fun job! If I'm gonna leave my cute baby it sure as heck better be for a job that I love. Lucky for me, I'm an SLP! Thanks to everyone who reads the blog! You're emails and comments are awesome! I'm glad to say I'm back in the blogging world.

The newest development for my speech room this year is that our school district got a grant that bought iPads for all of the SLPs. Isn't that awesome! I've been trying it out in my therapy sessions this week. I have to admit it hasn't "rocked my world" like I thought it would but there are some serious advantages to having an iPad as a tool in therapy. Here is a brief list of pros and cons after this test-run week. Keep in mind I'm new to the iPad. But it's a pretty intuitive device, even for people who are not technologically savvy.

Pros:

• Storage solution! The IPAD is a great way to store an incredible amount of therapy stimuli in a small portable device. It's an unfortunate but true fact that most speech pathologists work in tight quarters. That is, if they are lucky enough to even have a room. For example, if you looked at the master map of my school last year, my speech room was labeled as a "closet". I know many SLPs across the country don't even have a room to do therapy in. The ability to carry around a huge variety of material on one small device is a serious advantage that can't be overlooked.
• Access to A LOT of Materials: There are so many apps out there it can be overwhelming! But it is nice to avoid buying tons of books from Super Duper or Linguisystems or other publications, then wait for them to be shipped to you, then find a place to store them.
• Easy simple data tracking. Most IPAD apps for SLPs have built in data tracking and a lot of them have the ability to track data for multiple kids at a time. Very cool.
• Voice Recording and Video Capabilities. We all know self-monitoring is absolutely necessary if the student is going to use targeted skills in their every day life. Voice recordings are among my favorite tools to help a student develop their self-monitoring skills. A lot of the articulation apps have recording features that I really love. I'm also loving the video feature with my language students. I can give them a scenario to role play or record them in actual interactions with friends. It's fun for the kids to see themselves and we can pause and discuss what they did great and what they could do better next time.
• Conversation Starters at your Fingertips: You can use the iPad for some pretty sweet conversation starters. Just look up kid friendly websites with articles about things they're interested in. Pull up some funny pictures and have your kids describe them. Watch a short video clip and have your students try to role-play it.
• Motivation: Come on, don't tell me you haven't heard of the game Angry Birds! And if you have been living in denial of the days current obsession with "Apps" believe me, your students haven't. Sure, it's slightly terrifying how "hooked on devices" the world is becoming, but why not use it to your advantage to get some good quality work out of your students. 28 minutes of hard work for a 2 minute game at the end is a pretty good compromise.

Cons:

•  Data Holes: This may be my lame, old-fashioned dependence on paper and pens but there are some "holes" in relying on the IPAD to track your data. Sure it is nice to say "yea" or "nay" just by the click of a button and then have that fancy device ring up the percentage as you go. But hopefully nobody depends completely on these cut and dry data trackers. Technology can't take the place of a good speech therapist. One of the things I love most about our profession is that it requires us to always be on our toes, actively thinking about what will benefit our students/clients the most. Adapting our therapy to the needs of the individual kiddo. Listening for patterns, identifying appropriate future goals, etc. For me, it's a lot easier to keep notes on how little Johnny is responding to certain techniques or write a reminder to work on a different goal when I have a piece of paper in front of me. Instead of taking the IPAD from him in the middle of it all and saying, "hold up! I gotta type in a note on this thing." I do have to say, there are some promising data apps out there and I might eat my words as I try them out. But from this week of working with the IPAD I find that either you use the IPAD as your stimuli and take your data on your usual paper logs, or you use the IPAD as your data tracker and have flashcards, games, other things as your therapy stimuli.
• The "EASY" Planning Trap: SLPs are genius' at "winging it", right? With 80 plus students on your caseload per week there is no way you will plan out every minute of every session with every kid. I sincerely hope that these ready made apps do not encourage any SLPs to become lazy about analyzing their students and adapting to their needs. I guess what I'm really saying is, it is best used as a supplement to therapy, not a replacement. However, I find SLPs as a whole to be a very unlikely group to be lazy.
• It's Not "Natural": Remember sitting in your graduate courses and hearing your professor emphasize the importance of a "naturalistic" setting. I'm pretty sure the IPAD is the opposite of that "natural" setting your professor was talking about (though it can be used to encourage some great conversation as noted above). It'd be fancy if your student could perfectly repeat a sentence that the IPAD chanted to her but it's useless unless she is talking appropriately with her teachers and friends. 
• It's Expensive: Remember how we all had to shell out the big money to get our master's degrees but most of us make less than someone with the average 4 year degree? Yeah, we're not made of money. So, if I hadn't been given an iPad to try out I probably wouldn't have the iPad leap right away. The iPad itself would take a large chunk of my monthly paycheck and the cost of the applications can add up quickly. So even though it's pretty neat, I would probably use the money to pay off my student loan instead.

These are just a few of my thoughts on the iPad. It's great, but it didn't change my life. Overall, I'm liking it as a supplement to therapy. I'll write a post on some of my favorite apps soon.

What are you thoughts on the iPad? Do you love it? Do you hate it? Please share!

Hints to Successful Speech Homework Programs

I am a HUGE believer in homework for my speech students. I only have 30 minutes each week with most of them and guess what...that does diddly-squat unless they practice on their own! Homework can be a pain and sometimes the parents don't take it seriously since their kid isn't really graded on it. But I am convinced that most parents will do it if they realize how important it is for their child. This year I tried a few things that really helped my students and their parents get in the habit of doing homework at least once a week, if not daily. With this new system I have gotten weekly homework from 85-90% of my students! Keep in mind the parents at my school are pretty awesome so I'm not sure it's realistic to expect that high a percentage everywhere. But a little follow through goes a long way! Warning: this is a LONG post!

Here are some hints on how to get your speech students to do their homework consistently.
 -Write a letter to your student's parents at the first of the year introducing yourself, explaining why good speech and language is important, and that they will be expected to do homework daily. Explain how your time with the student is limited and that improvement will be minimal unless the child practices at home. Make sure the parents know what day and time their child has speech and that homework folders need to come to school on that day. Here is an example of my letter from earlier this year. You'll have to click on it to get the bigger view. The second page is some suggestions on how on speech and language at home.

-Make a speech homework folder. Here are some examples of what it could look like. I like to have the student decorate the front so they are proud of it and have some ownership in it. I've considered having the parents buy a strong folder for their child since I'm a poor SLP and can't afford to buy awesome sturdy folders for my kids. I actually got my folders this year for 1 penny each at the back to school sale at Office Depot. I bought 100 for $1.00! AMAZING!

-To get the student's and parents to do homework daily I provide them with a little daily homework tracker that I keep at the front of their speech homework folders. The students know they need to bring their folder to speech every week. See an example of the tracker sheets below. The first one is one I use with my articulation kids. The second one is one I use with my language students. The language student's tracker is more detailed because language therapy requires a lot more anectdotal information and a little more explaining to help the parent understand what they can work on at home.

-Provide rewards for doing homework weekly and EXTRA SPECIAL rewards for doing it daily. I use a sticker chart that works like this.

• 1 sticker for any homework done in the week. 
• 5 stickers = a LITTLE PRIZE 
• 15 stickers = a BIG PRIZE. 

 I know, that's a lot of work, but having the little prizes every 5 weeks keeps them motivated.

I like using these sticker books. They only cost a few dollars and they last a LONG time!

Here's my sticker card template. I know a lot of SLPs who give reinforcements to their students for coming on time and working hard and other stuff. I think kids can be expected to do certain things without rewards and I'm not really into behaviorism. However, homework is so important that I will gladly do anything to help my students get in the habit.

-For the extra incentive to do homework everyday I give out a HOMEWORK HEROES TICKET. It's basically a raffle ticket. Every student who does at least 5 days of homework for the week gets a raffle ticket. At the end of the week I draw a name out and one of those students gets a BIG PRIZE. Remember big prizes take 15 weeks worth of homework to earn, so getting a big prize is a BIG DEAL!

-Need more motivation? If my kids don't do their homework they have to call their parents and ask for help to remember to do their speech homework EVERY time they forget. They know this will happen. I tell them at the very beginning of the year. If they forget their homework I don't yell at them or make them feel bad I point to the phone right at the beginning of the session and they know to call their parents while I start working with the other student in the group. I start this pattern off at the very beginning of the year and usually after a couple weeks everyone is bringing their homework consistently.
-Not enough? If you use games during therapy make a rule that the student is not allowed to play unless they do their homework at least once during the week. This has been a good motivator for my students. I have this rule posted on my wall. I love having things posted on the wall because you can just point to the sign and they can't argue with a sign :)

An Evidence Based Speech and Language Treatment Approach

Read more for a great therapy outline that has been researched and proven effective for children who present with both articulation and language disorders.

Schedule Boards

Holy Smokes have you ever used a schedule board? They are the best! This is my schedule board that I used this year for about a hundred-million different things. It was so useful in so many ways. I know I know it's just a black poster with a bunch of numbers velcroed on but seriously this beauty rocks my world! Read more of this post to find 6 ways to use a schedule board in your therapy.

Here are a number of uses for this fabulous therapy tool

Evaluation Count Down. When evaluating a kiddo I usually put up a number for each subtest that we need to do. After each subtest they get to take the number off the schedule board and put it in the "all done" pile. It helps them feel a sense of accomplishment and know how much more is ahead.

Incentive to work! I use it all the time to help little munchkins who have short attention spans. It is a visual that helps them know that they have to get so many "things" done before they get a break. Example of use with animal artculation cards below. Make sure that the child knows what they get when they complete the work and provide that reinforcement immediately. This kid LOVES bubbles so I always use the bubbles. Please observe the fabulous butterfly bubble bottle that I got at some wedding four years ago and is now an essential part of my therapy. One of my professors once said that bubbles were like crack for kids. He was right!

Picture Schedule. I use this with a few of my autistic clients. Autistic children are very visual and really crave routine. The schedule board shows them what they can expect to do in a session and what happens at the end.

Sequencing. The numbers are great to help children organize sequences of events.

Sentence Pacing Board. If you are working toward a longer MLU and the child needs a more structured approach you can use the numbers to make a pacing board. Put out 4 numbers if you want the child to use a four word sentence. Put your hand on the numbers as you say the words (e.g. for the phrase "the ball went down" touch 1 for "the", 2 for "ball", 3 for "went", and 4 for "down"). To fade this cue out try clapping instead of pointing to the numbers and then just doing it with a melody and then without any cues at all.

Multisyllabic Words Pacing Board. For kids who struggle articulating multisylabic words try breaking them up into the number of syllables. (e.g.watermelon can be broken up into 4 parts wa-ter-me-lon)

The possibilities are ENDLESS!

Idioms

Idioms are so hard for children with language disorders. This is because these children think of words in a very concrete and literal way. If you say "Go take a hike!" they might think that you want them to go grab their hiking boots and walking stick and head on out for a good nature stroll. Our world is full of these crazy confusing phrases that don't really make any sense but everyone seems to understand anyway. It's a dog-eat-dog world for these kids! Read more of this post for some simple therapy ideas and great resources for teaching idioms.

Riddle of the Week

Children with language disorders usually have a hard time understanding jokes. This is because the humor in jokes often involves an understanding of language relationships and/or social appopriateness. Man that is tricky for a little one with language problems! Our district sent out these jokes of the week to put up in our room. The kids love them and it leads into some very good language discussions. Try describing why a joke is funny to a kid...it's harder than you think but such a great language exercise.

Matt and Molly Stories

Matt and Molly stories are very simple and great for some of your language or austism kids. These stories come in a packet with language lesson plans and colorful story boards. Read this post for some ideas of what you can do with Matt and Molly Stories.

Getting To Know You Questions for Kids

Getting to know the kids is the fun part of therapy. The first week of school I quickly wrote down these questions, printed them and cut them into individual question strips and put them in a box. We played games, read the questions and talked for our first session. It helped to get a feel for each students communication abilities and it was a fun way to break the ice. These are not the best questions but feel free to copy them and use them for your own getting to know you activities. Click read more for the full list.

Language Progress Charts

As I talked about with the Articulation Progress Chart, motivating kids to improve can be easier when they themselves can see the progress. Charting progress in language can be more difficult, especially when the goals are more complex but we are required to have them in a measureable form anyway so you should be able to chart progress on goals. The best part about progress charts is that I don't have to type up a progress report. I just copy the progress chart and give it to the parents with a brief explanation of the students progress.

Here is one way I charted progress with a girl who needed help with syntax. I love the progress charts, but I'm still experimenting with how to make it really work with language goals. What works for you?