SLP Mommy of Apraxia

Tag: Clients

  • Superhero Brave

    Superhero Brave

    For those of you familiar with my blog, I’ve spoke of “Ben” before. A little boy on my school caseload from a Spanish speaking family who has CAS and is nonverbal. However, IQ testing shows him in the 75th percentile! He’s sooo smart. I met him last year in Kindergarten, and we formed an instant bond.

    His Kindergarten teacher was frustrated that he wouldn’t talk; and I’m not sure if she felt it was a reflection on her, but she really wasn’t that supportive of him.
    This year is different! He has a new teacher and she sees what I see, what I saw. She’s sees a smart, friendly, lovable little boy who wants to talk, but just needs people to believe in him and boost his confidence. Every time I see her she starts a sentence with, “you won’t believe this” or “I LOVE him.” Yesterday she told me she believes this year is going to be HIS year. Starting from the first day when she was going around having kids do introductions, she frowned upon getting to Ben and having the other children speak up and say, “Oh he doesn’t talk.” She immediately stuck up for him, telling the other children yes he did talk and that people talk in different ways. Some use Spanish, some English, some use their hands, some use gestures, and some use devices.
    Ben’s corners of his mouth got just a little bit wider.
    Another day, one of the kids noticed that Ben appeared to be talking to the class frog and remarked, “Look! I think Ben is talking!”
    Her reply?
    “Of course he’s talking! Didn’t I tell you Ben talks?”
    Ben’s chest puffed out just a little bit further.
    And then there was today. The icing on the cake.  I picked him up and she calls me over to brag about an assignment he finished first and attempted to share with the class. Picking up on her hint, I praised him loudly in front of the other children. As we leave the too, a little classmate returning from the bathroom enthusiastically called, “Bye Ben!” Now Ben knows how to say bye with perfect clarity. In fact, he says it to me everyday. He pressed his lips together, but the anxiety was too much and the boy left before Ben uttered a sound. I decided to scratch the lesson plan for that day, and instead I asked him if he knew what brave meant.
    I had him draw a picture of someone he thought was brave and I told him I would do the same. We sat at different tables, and I told him not to peek.
    When he was finished, he drew a picture of Hulk and Captain America. I asked him why they were brave and with a smile he pantomined strength and then pantomined a sword motion. I verified he thought they were brave because they were strong and had swords to which he eagerly nodded his affirmation. I then wrote on the back that Hulk and Captain America are brave because they are strong, have swords, and I added they fight bad guys. He tapped my arm and held up three fingers. I said, “three bad guys?” to which he nodded apparently satisfied.
    He then pointed to my picture. I asked him if he wanted to see mine and he again nodded yes. As he looked at a picture of a little boy with a blue school uniform, he looked at me puzzled. I asked him, “Don’t you know who this is?” Ironically, I had also just happened to also draw him holding a sword fighting a word bubble in his head! What luck!
    “It’s you Ben.”
    His eyes lit up and he pointed to himself incredulously.
    “Yes” I said. “You are my superhero because even though talking is so scary, you still try, and that’s what makes you brave.”
    Now that smile was a full blown grin.
    I went onto tell him I needed him to be even more brave than he already was though. I needed him to be superhero brave when it’s time to talk. We then stapled the pages and walked back to class.

    At the end of the day, the Facebook support group had convinced me to tell his parents about the lesson; and since they only spoke Spanish, I decided to go out with the teacher at dismissal and have her translate. When I walked in the classroom, all the kids were sitting on the carpet with their backpacks on their backs in preparation to go home.  In the middle was Ben, with his backpack on, but our book in his lap. It did mean something to him!  As luck would have it, BOTH parents came to pick him up that day.  As the teacher translated, his mother choked up and gave him a big hug as they left to go home.

    Now his chest was puffed out just about as far as it go!  That’s what superhero brave is all about!

     

  • “I see” with DIY binoculars

    “I see” with DIY binoculars

    If you have a child in speech, or a speech language pathologist yourself, you are probably familiar with the term “carrier phrase.” A carrier phrase refers to the initial component of a sentence that stays constant (usually a subject and verb, allowing for a fill in the blank at the end (the predicate). Common examples include:
    “I want ______.”
    “I have ______.”
    “I see _______.”
    “I like________.” 
    This list is not exhaustive, but does give you an idea. In the educational arena, these are frequently referred to as sentence stems. 
    Carrier phrases are used in a variety of therapy strategies for a variety of disorders. The predictability allows the child to practice learned skills beyond the word level, moving into the phrase and sentence level.  It decreases the cognitive load needed to form a sentence AND remember the learned skills, because the sentence stem, or initial phrase remains constant. In this way, the child can practice their skills at a higher level of complexity (phrase or sentence level) but doesn’t have the increased demand to also generate a new and novel sentence.
    To practice her words in a sentence I have a great idea that comes from my fabulous and creative mentor Deborah Comfort, who is currently the private practitioner seeing my daughter. She had Ashlynn pick out some fabric swatches from a book she had at the end of the session last week.  For the next session, she had hot glued the fabric onto two toilet paper rolls and then hot glued the toilet paper rolls together side by side. She poked some holes in the top and threaded some yarn, and Presto, they gave a set of DIY binoculars. Using the carrier phrase “I see_____” they practiced a variety of words with targeted sounds at the sentence level. 
    Ashlynn loved it of course! It’s also more fun than sitting at a table practicing flash cards. As you’ll frequently read in my posts, I am a big proponent of multi-sensory learning and this fits the bill. Maybe tomorrow we will take it to the zoo! Great carryover practice and lots of fun!

  • Instant connection with “Ben”

    So, I went back to work this past month.  As I was going through my new caseload and reviewing files, I came across a boy I’ll call Ben.  Ben was a nonverbal Kindergarten student in the Spanish classroom with above average intelligence.  Ben had suspected Childhood Apraxia of Speech.  The SLP who was substituting for me, wrote me an email saying, “he has no motivation or desire to communicate right now. I think he doesn’t really understand how powerful it can be for him. He can also be very sensitive and shut down at the slightest moment.”  Various assisstive technology devices had been trialed, but he showed no interest in using them beyond a therapy session.  The substitute SLP also told me the teacher hadn’t been really helpful.  I consulted with the special education teacher who also reported that Ben seems smart, but doesn’t talk in her class either, but that she keeps trying.

    Of course, I had to see Ben right away.

    I walked into the classroom and interrupted a reading group to pull him out.  The teacher, I guess not wanting to interrupt her group, snapped her finger at him toward me.  He immediately came over and hugged me.  Ben had never met me, or seen me.  Sometimes though, I think there is just an indescribable connection that occurs between two people, and this was one of them.  I instantly loved him.  We made are way down to my room and he avoided eye contact and as promised, didn’t talk.  Once we got to my room, I brought out a beach ball.  I wanted to see if he would try and imitate at least a sound, and I picked ‘b’ since that is what his name started with.  We tossed the ball back and forth for a few minutes, until I stopped and told him I wanted him to try and say ‘b.’  He whispered it, but I took it.  As we played more, we were laughing, and I kept saying “ball” and telling him to turn his voice on.  He finally did!! I high – fived him, and praised him.  He just beamed.

    I got out some simple CV Kaufman cards.  For those of you not familiar with these, these are cards designed by Nancy Kaufman, who is considered an expert in apraxia.  We started with some simple bilabials (p, b, m).  He just imitated the mouth postures at first, but I praised him and told him that was exactly how you make them.  Now he just needed to add sound.  He did shortly after.

    After I took him back to class, I decided to change up his IEP.  This kid was getting 30 minutes in the classroom and 30 minutes pullout.  I called the parents to arrange a meeting so I could see him for a short time everyday I was there.

    Ben is my little buddy.  I love picking him up.  I look forward to seeing him everyday I go to work.  I’m pretty sure he feels the same way, because when I enter his classroom his eyes shine and he waits in anticipation until I call his name and then comes running.  I promised him I’m going to help him, and I will.

    The following week, the special education teacher came running in my office after school.  She asked me what I had done to Ben.  Concerned, I hastily ask her what was wrong?  She smiled and replied, “look at this probe.”  It was a paper with upper and lower case letters arranged in varying order.  More than half of the letters had checks over them.  She informed me that a month ago, Ben didn’t attempt to say any letters or sounds, but today, he said, or at least attempted over half!!

    The next week she came in my office and told me Ben is now doing choral reading with her during group.  This means that he will attempt to read along with her simultaneously.  My heart smiled so big.  “Thatta boy Ben,” I thought, “I knew you could do it.”

    Since then, we are immersed in full on motor based therapy.  He is so motivated and I am so proud of him.  During therapy, he sometimes holds my hand and looks up at me with these shining brown eyes.  I can’t wait until he can say what he is thinking.