*I am assuming you know what a tongue thrust is if you are reading this...but if not check out this awesome website: http://www.asha.org/public/speech/disorders/OMD/

There are times I feel like tongue thrust is outside of my scope as an SLP, it isn't really a huge part of speech or language unless there are sounds affected by the tongue thrust.  Sometimes, a lot of times, there are sound errors as well.  But not always.

So why are SLPs part of the diagnostic and treatment team for a client with tongue thrust?  Because we are experts on the muscles inside your mouth!  AND we are experts in behavioral modifications.  If you need someone to help you get your tongue in a better place in your mouth at rest, during swallowing, and during speech, an experienced SLP can make that happen.

I am just finishing a month and a half of physical therapy.  While doing my exercises I couldn't help but notice how similar my tongue thrust program is to the physical therapy routines I have been given.  My PT helps me get my knee and ankle the placement and support they need to jump and twist in zumba.  SLPs help give your tongue better placement and support during eating, talking, and while at rest.  Both are super important, both programs require practice and consistency.  And both programs can have excellent results.

​

My family loves to camp!  We find it a great time to unplug, slow down, and explore.  Turns out those elements make for some great language development opportunities.

Here are some of my favorite things to do while outdoors:

• Discover our senses (name 2 things I can smell, hear, see, taste, touch...)
• Discuss animal habitats and eating habits, "Who might live in this tree?  I see an acorn!  Who might eat an acorn?"
• Play "I Spy" games with a twist..."I spy something that is sweet and sticky!"
• Teach and review new routines (how to make a s'more, start a campfire, tie a knot)
• Compare/contrast leaves, bark, animals, camping food, etc.,
• Practice sorting outdoor things by what they look like, where you found them, what they are for, etc.
• Play "One Small Square" - a game from the "One Small Square" series by Donald M. Silver.  You use a twig to draw a square on the ground about 4 ft. x 4 ft. and then explore inside that square very closely.  The book is fabulous for expanding this activity, here it is on amazon.com 
• Practice following directions!  "Before coming into the tent, take off your shoes!"  "Always walk around the fire pit!"...lots of direction giving happens on our trips.

There are SO MANY fun ways to enjoy a trip to the great outdoors.  What are some of your favorite ideas? 

Let me get this out there right now:  each child is different so we are all going to use different strategies while parenting our children.

​In the past year I have become pretty concerned about some of the new parenting ideas floating around the internet.  It seems like we are in this "hands off, let kids learn on their own" phase, where it is a problem when a mom teaches her child to share...or say thank you...or heaven forbid a parent actually put their kid in time-out!  

As a mom when I read these articles I just come away scratching my head.  So I can't teach my kids what is right and wrong, but somehow they are still going to turn out ok?  WHAT?

I totally get behind some of the non-adultism movements, like I agree we shouldn't be forcing our kids to dole out kisses or hugs, sure.  I totally get that kids need to be respected, and that they are human beings just like adults.  BUT it has been pretty heavily researched...for almost 100 years (think of Piaget people) and today it still seems applicable:  the mind of a child is not the same as the mind of an adult...it is still growing. 

Kids are still developing!  You can expect an adult to understand what someone else is feeling/thinking and (hopefully) share without being prompted.  BUT our really young kids don't have that skill.  They are still learning that everyone doesn't feel the way they do.  

WE NEED TO TEACH THEM!  I can tell you from my professional experience, how we interact with others involves social skills that need to be taught.  Kids need parents to help them learn to say please, and thank you, and answer the door politely, and not cut in line.  Just sitting back and watching is not enough, in my experience.

Suddenly it's not ok to give your kids positive reinforcement?  I seriously read that we should not be using praise because it will manipulate behavior...WHAT?  Again, look at the research people!  Yes we should be careful about using rewards to control behavior because that does result in being extrinsically motivated (which we all are to some extent so chill).  BUT using rewards to inform, support, and challenge, like praising effort, increases intrinsic motivation! See research by Mueller, C.M., & Dweck, C. S. (1998).  

Sometimes kids do things that are not ok, not to be mean, or rude...because they are still developing and learning.  How do you help them learn?  You praise them for good choices, you model correct behaviors, you consistently help them succeed.  If a child needs a break, you give them one, and in our house...that's called a time out.

I feel like some of the advice out there that is so fluffy that if I tried to follow it all I would go crazy.  Here is the best parenting advice I have read this year:

As a parent, you probably don’t want to play referee within the walls of your own home. Good news—you shouldn’t have to! You’re a coach, and your children are on the same team, even if they don’t realize it yet. As you try to coach your children instead of referee them, they will feel secure in your love and grow to love each other more.

Here are four ways to help your children learn to get along:

• Give your children words and phrases to use. Instead of just saying, “Use your words,” tell your children exactly which words to use. “Say, ‘I would like a turn now’” or “Say, ‘I would like to play with you.’” Little ones don’t have quick access to very many words yet, and it will take a lot of practice before they do.
• Use stories. Children will like hearing about the times you learned to appreciate your brothers’ and sisters’ differences, especially if those brothers and sisters have grown into favorite uncles and aunts.
• Call time outs. Coaches call players off the field to rest and regroup. With rest instead of punishment in mind, you might provide a cozy time-out space for your child, like a comfy chair.
• Point out the good. When children are having fun together, make sure they notice. “I’m so grateful you have each other!” and “That was really nice of your sister to share with you. She must really love you.”
  
  ​For Parents of Little Ones (2017, June). The Friend

Generally my clients are children BUT every so often I get an adult interested in speech therapy to correct a sound error that they still are struggling with.  I have had adult clients who have a hard time shaping the /r/ sound, adult clients with a distorted /s/ sound, or adult clients who have a tongue thrust that has interfered with orthodontia work.

SO...is it ever too late to correct a sound error?  Is speech therapy just for kids?  Can you teach an old(er) dog new tricks?  Of course you can!  

I LOVE LOVE working with adult clients because they have a lot going for them right out the door.  Adults are motivated to make a change, they want to fix the sound, they are paying for the help!  Because adults are motivated they generally practice more consistently and with a greater focused effort.  Adults have a longer attention span and don't mind drilling, they don't need games because they are not here to play...they are here to work!  Adults are good listeners, they watch and remember instructions because adults are paying attention.  Adults are able to think abstractly and figuratively so it is easier to work on sounds and shapes that they can't see you making in your mouth.  And my very favorite part about working with adults:  Adults are willing to take responsibility for their sounds!  They work hard to be able to hear differences and correct errors on their own.  

If you are an adult who would like help, but tried speech therapy and had a bad experience, or an adult who has never even tried speech therapy, don't give up!  It is never too late, adults can ROCK speech therapy!  Some of my most rewarding sessions have been with adults as they conquer sounds that have eluded them for years.  

Here are some ideas to try to help your child talk.  These are great for those 1 year olds who mostly "point and grunt", because as fun as that stage is...it is really not much fun.

Parent Speech:
Use clear simple speech with your child during play routines. The goal is to talk in phrases you want your child to copy – 1 to 2 words.
Example: Instead of saying “Go down the hall and get your shoes” say “Get your shoes”. When getting undressed use short phrases “Shoes off…shirt off…etc.” Try to use grammatically correct phrases, just shorter ones.

Echo-Expansion Modeling:
Add 1 or 2 words to what your child says when you respond back to him or her.
Example: When your child says “up” say “up… you want up”.

​Don’t Anticipate Your Child’s Needs or Wants:
Mom's and dad's are great at knowing what their kids want or need.  BUT mind-reading doesn't give your child a change to use words and ask.  Don’t anticipate your child’s every need or want before they have a chance to make them known to you.
Example: When you know your child wants a drink – instead of just handing them the drink, point and wait to see if they will request it (pointing, signing, or saying “drink”).

Sabotage the Environment:
Mess up routines so your child has to communicate his or her needs.
Example: During mealtime give everyone a spoon but “forget” to give your child a spoon. Wait and see if your child initiates they need something. If they don’t initiate what they need, help them by saying. “What do you need?” or “Are you missing something” or “Uh-oh!” Label the item before you give it to them.

Play “dumb” when your child points to a desired object.
Example: When your child points to the counter for their drink (or another desired object you know they want), say: “What do you want?” (pause) “A spoon?” (pause) “An apple?” (pause) “A drink?” …. “Oh, Drink!”

Self-Talk:
When your child is within hearing range, talk about what you are doing while you do it.
Example: When washing your hands at the sink say “wash hands”, when the phone is ringing say “I hear the phone”.

Parallel Talk:
When playing with your child, describe what your child is doing while they are doing it.
Example: When your child picks up a car – say “pick up car”. When your child drops a block – say “drop block”.

Describe what he is seeing and hearing.
Example: “That’s a ball”, When listening to music say “Music, listen to music”

My advice: take one or two ideas and try them out.  Remember when working with kids the idea is not to frustrate them more, but to model how they could do something differently.  Waiting for them to talk works wonders...demanding that they talk can really backfire.  Try to keep things light and fun and find ways to repeat, repeat, repeat!

Any quick search will help you find developmental norms for when kids start to talk...a rough estimate would be starting to use words around a year (no, ball, mama) and starting to combine words around 18 mo - 2 years (more nana, big cup).

BUT that is a long time of not talking before things get cooking...what should you be watching for in the 12-18 months before your baby really starts talking?

I think talking is probably the hardest thing humans learn...look at every other animal on the planet.  We are the only ones with an advanced system of communication!  Sure some gorillas and monkeys can sign BUT it takes them years of dedicated training to learn what our toddlers pick-up by just hanging out around us.  

That "hanging out" time that babies and toddlers enjoy is actually a pretty big deal...here are some of the skills they are learning when you think they are just playing around-

Attending - babies need to watch to be able to learn, your baby is always watching, the more you baby sees and sticks with the better.  Which leads to...

Eye Contact - babies learn to focus in on faces SUPER young for a reason, when they see your eyes they start picking up on facial cues, they watch your mouth form sounds, their little brains see you smile and then they can smile back!  That whole idea of "I am right here with you!" comes from good eye contact.

Object Permanence - babies start to figure out that when they can't see something it still exists, this is when "out of sight, out of mind" doesn't work so great any more...also when "Peek a Boo" becomes a big hit.

Mean-End - (tied into cause and effect) - babies start to understand that "If I do..... then this will happen!"  This idea is super important for later communication because babies need to get that "If I say... then this will happen".  Work with things like pushing buttons, pouring water, pulling string toys.  

JOINT ATTENTION - my personal big thing I watch for in young kids, this is the whole process of cluing into Mom and making sure she is clued into me.  It has two sides,
1) Mom points out something, the kid follows her gesture, and then looks back at Mom
2) The kid looks at (and might point to/hold up) his toy, looks at Mom, and then looks back at his toy as if to say, "Mom, are you watching this?"  
When kids are not able to use joint attention that is a big red flag for me.  Also you want to watch and make sure kids are not just trying to get something they need/want.  You need the social aspect of I want to make sure you are enjoying/seeing this with me!

Imitation - before babies begin saying words on their own they will imitate the sounds they see you make.  Usually imitation comes in these stages: actions, sounds, and then words.  I encourage parents to use baby signs once babies start imitating actions, might as well get them communicating as early as possible...and no, using baby signs will not slow down your child's use of words, it actually helps language develop faster!

Turn-taking - taking turns is key to good social skills and good language skills.  Babies learn turn-taking hand in hand with imitation (Mom does something and then it's my turn!).  Work on back and forth interactions because they build great foundations for language!

I found this fantastic handout for FREE from A Perfect Blend on teacherspayteachers.com  you can pick it up HERE.  What a fantastic resource for getting more out of car time.  I had a couple of additional ideas that came to mind as I read through Amanda Newsome's handout.  I thought I would share my ideas as well.  These are strategies that I have learned from my clients and suggested to my clients.  Pick one and give it a try!

Articulation Practice - 

• STOP LIGHT:  whenever you come to a stop light practice your target sound, I love to think of rhyming words that all end in your target sound.  Practice sounds and preliteracy skills all at once! (syllable/word level practice)
• TARGET SOUND "I Spy": this is a huge favorite of my clients, I think all kids love a good round of "I Spy", look for your target letter on signs, license plates, etc. or look for items that start with your target letter. (word/phrase/conversation level practice)
• 3 FUN THINGS:  as a kid I always had to report on three fun things I had done at school that day.  Now I use that activity as a great opportunity for focused sound practice at the conversation level.  You cue your child - I want to hear 3 fun things you did at school today, and I want you to think about using a really clear /r/ sound when you tell me each thing! (conversation level practice)

Language Practice - 

• 3 FUN THINGS:  (see activity above) instead of focusing on sounds, focus on past-tense verbs.  Listen for words like "painted", "played", "kicked".  If your child is missing that -ed ending you can restate to show active listening and provide a nice model.  ie. "we play on the slide", "oh, you played on the slide! that sounds fun!"
• I HEAR/SEE A...: great activity for young kids beginning to put sentences together, just watch for awesome things out the window and them model sentences with "I see" or "I hear", for example, "I see a police car!"  "I hear a big loud truck!".  You can also add 5 senses work by turning the sentence into "My ears hear a big loud truck!"
• SIMILE "I SPY": this is a fun twist on traditional I Spy, you take turns giving color or texture cues using similies (ie. I spy something as blue as the sky, I spy something as shiny as a diamond).

Social Skills Work - 

• DAILY REPORT:  I throw this onto the end of 3 fun things everyday when I pick my kids up from school.  After we talk about the fun things that happened I ask, "Is there anything about today that you would change?".  Your child can let you know what they might change about the day and how they would change it.  For example:  "At recess we played tag but I had to be "it" the whole time and I didn't like that"...then you respond, "You didn't like being "it" all recess?  So what would you change? Is there anything you can try next time to make that change?" This is a good chance to review problem-solving skills with daily interactions in a low-key loving atmosphere.  Of course, some things you can't change but then you can talk about the feelings your child experienced, help them name the feeling, and recognize it.

Many of my clients are working on generalizing speech sounds.  That means they have now figured out how to say the sounds they were struggling with, AND they can use them in their words, AND they can use the sound in phrases and sentences...BUT they are not using the sounds in conversations yet.

When we talk we have so much to think about (what we are going to say, waiting for our turn, checking to see if our partner is listening, being louder than the other noises around, using the right inflections and pacing...) it is hard to remember to correctly use sounds that we habitually have been skipping or saying the wrong way.  Getting new sounds into conversations will take time and is very difficult.  Give your child time!  

Lots of my favorite strategies to helping generalize sounds come from this activity book:
www.soundsforliteracy.com.au/documents/FBGeneralizeSounds.pdf

One technique in particular is called Talking Time.  Basically you set aside 3-5 minutes at least twice a day where you focus on speech sounds in conversations.  Your child speaks and you track his specific sound.  Only focus on one sound at a time, and remind your child before you begin which sound you will be listening for.



​​Today I hit the JACKPOT! Every speech therapist loves ready made games; and I just found  on GetAwayToday.com a bunch of activities that are PERFECT to use for Talking Time.   These games feature subjects kids are happy to talk about.  





You can find all of these activities here:

Would You Rather Games
Disney Would You Rather
Harry Potter Would You Rather
Star Wars Would You Rather
These games are awesome for getting some creative thinking and language practice in with your speech therapy time.  Your child needs to pick his answer and then explain his choice...why would you rather have a fairy godmother than a magic genie?

Mad Libs
Disney Princess Mad Libs
Star Wars Mad Libs
Also fantastic for literacy and grammar (parts of speech).  I like to encourage kids to try to think of nouns or adjectives or _________ that have their speech sound in the word.   Then when they read through their finished story you know there will be lots of opportunities for speech practice!  You can access nice lists to reference on homespeechhome.com.

Conversation Starters
Disney Conversation Starters
Fun for car rides and speech therapy!  Basically you ask a question and encourage your child to talk for 3-5 minutes about their answer.  Listen for their use of their target sound.

I like to track speech sound productions using a simple spreadsheet, + for if they got the sound right, - for if they missed it. 

I love using boardgames to add a little variety to my therapy sessions.  Games are motivating, promote good social language skills (turn taking, following directions, being a good sport), and can be tweaked to fit speech and language goals if needed.   This year I bought a few more additions for my boardgame closet and I thought I would share my new favorites with you.  A list of some basic boardgames that I like for speech and langauge can be found HERE.  I linked each of these games to Amazon but you can get them at other places. 

I Can Do That
Ages:  4-8 ish
Why I love it:
-Great for following multi-step directions
-Teaches prepositions
-Teaches verbs (can be modified for present progressive and past tense)
-Gets the kids moving while they are talking!
-Great extender for the book "The Cat in the Hat"
-Kids love it!

*tips to make it better:  take out the STOP cards, they are pointless if you are working multi-step drections, also this game is not great for kids with gross motor delays unless you modify it, plus it does have a lot of manipulatives that can be tricky for kids under 3.

Suspend
Ages:  6+
Why I love it:
-Great way to help target easy onsets (fluency)
-Good for generic drill (say __ 10x and take a turn)
-Slows kids down, makes them think
-Problems solving and critical thinking
-Interactive play, work together, talk cause and effect
-Targets fine motor skills
​

Busy, Busy Airport
Ages: 3-7 ish
Why I love it:
-Fantastic for pretend play
-Great for categories (weather, clothes, ect.)
-Makeing basic inferences
-Gets kids moving
-Uses reasoning and problem solving
-Good for basic math
-Fun pieces and game board

*tips to make it better:  I took out the little slots at the bottom of the gameboard that are supposed to hold the passengers...it takes FOREVER to put each passenger in a slot at the airport, now we just dump them all in and pick 1 or 2.  Also be gentle with the planes, they are just thick cardboard, not plastic...I wish they were a little more sturdy.

Busytown, Eye Found It
Ages: 3-7 ish
Why I love it:
-The gameboard is super big!
-Builds cooperative play skills
-Great to extend into language goals
-Find categories, functions, ect.
-Good for basic vocabulary and counting
-Describing and adding detail

*tips to make it better:  you can use the timer or not depending on your child's needs

Snap Circuits Jr.
Ages: 7+
Why I love it:
-Cause and Effect
-Integrages science with language
-Problem Solving
-Good for /r/ and /s/ target practice
-Following directions
-Predicting

*this comes in bigger sets but for the sake of a therapy session the Jr. version is perfect.
Con: the motor for the fan eats up batteries faster than I like