SLP Mommy of Apraxia

Tag: speech and language therapy

  • Switching private SLP’s

    There is no easy way to “break-up” with an SLP, but  I made the decision to discontinue private services through the SLP that was seeing Ashlynn.  A lot of parents wonder what is the best way, and I don’t think there is a right or wrong way.  I personally just wrote an email and said I was switching her to my mentor.

    I am very appreciative of all that she did; however, I feel like we had hit a wall with her therapy style.  Her style was to have my 3 1/2 year old daughter sit in a chair across from her for the entire 30 minutes.  The first 15 minutes she would do Kaufman cards, and the last 15 minutes she would play with a fun toy and have my daughter request and comment on it.  However, it was very controlled and my daughter couldn’t hold the toy or play with at all.  It had to be done all her way.  If Ashlynn threw a temper tantrum, she would look at me and tell me that when she has kids they are going to hate her because she won’t put up with that.

    Ya, well, good luck lady.  Kids throw them whether you “put up with them” or not.  It’s called being a toddler.

    After a couple months of this, my daughter was pretty over it.  The first 15 minutes turned into more like 20-25 just trying to get her to say the cards.  Apraxia therapy can be boring, but my goodness, I needed her to get creative!  I did bring up that maybe we could put it in a more naturalistic setting, having them play etc.  In her defense, she did try; but she still had Ashlynn sitting in a chair.  If she didn’t get something accomplished, she just told me to do it at home.  I remember thinking to myself that Ashlynn is one of the most compliant toddlers I have seen.  I wondered how “typical” toddlers who need to MOVE do in therapy with her?

    I tried to be polite, but I informed her that as a school based SLP, I don’t have the luxury of having my carryover plan include parents doing homework.  I have to get creative!  Kids need to be having fun, and besides, that’s how they learn the best!

    I had a great mentor whose therapy plans usually included 3-4 different activities in one thirty minute session. They were multi-sensory in nature, which are methods that involve using any sensory and motor input available to enhance verbal skills.  This usually involves some type of play activity that might have them throwing a bean bag, walking like a crab, or even using felt and velcro boards just to do something different with those same old picture cards.

    David Hammer, a well known CAS expert out of Pittsburgh does this as well.  I’ve been to a couple of his presentations now and he shows a lot of video.  I rarely see a child required to sit in a chair across from him. He has them doing puppet shows, hitting the cards with a nerf gun after they say their sound, or tossing bean bags in and out of a huge dinosaur’s mouth aiming at the artic cards.  He has them banging on drums to represent each sound or syllable etc.  This is the way to promote carryover, and I could see this SLP wasn’t going to do that.  She may have known the Kaufman method, but her therapy style wasn’t what I was looking for.

    That’s the thing.  There are always going to be reading programs, math programs, and speech programs out there, but teaching style or therapy style plays a big if not bigger part in facilitating change.

    When I was an SLPA (assistant SLP), I worked under a lot of supervisors and was able to see a lot of different styles.  All therapists are qualified and trained professionals that will most likely get the job done, it’s just some got the job done a lot faster.  That’s the kind of SLP I strive to be, and that’s who my mentor is.

    Since it’s summer and my mentor is off, I”m switching Ashlynn to her.  I know Ashlynn would have progressed, but I need her to progress faster, which means I need someone more multi-sensory. This is where I have seen my mentor shine and I’m excited for Ashlynn to start with her.

     

  • 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.

  • I Know an Old Lady Who Swallowed a Pie, book of the month

    I Know an Old Lady Who Swallowed a Pie, book of the month

    Product Details

    I Know an Old Lady Who Swallowed a Pie is a knockoff from the classic children’s song, “I know an old lady who swallowed a fly.” 

    This is a great repetitive book I use with the kids to get ready for Thanksgiving.  The book chronicles a lady who goes through and eats certain Thanksgiving items. 

    In therapy, I have cutouts of all the various items that the kids hold.  When it’s their turn, the visuals may serve as a reminder to help them remember their word.  At the end, my older kids are required to do a summary and may use the visuals to help them complete it.  However, that’s further down the line for Ashlynn.

    For now, I gave her the word “pie” since this another bilabial she is still mastering.  In addition, it’s also one of the speech words used in the Kaufman apraxia card set.  As before, I read the sentence, “She swallowed the cider to moisten the___, the Thanksgiving___ which was really to dry…” pausing and pointing to her visual to remind her to say the word.
    By the end of the book, she was doing great and said “pie” in the cutest voice when I would pause for her to complete the sentence.  Her daddy even stopped in the hallway the other night to listen as we were reading it before bed.