Marisha: Welcome to the podcast, SLPs have submitted a lot of questions about speech sound disorders and some specifically asking about the cycles approach. I'm so excited to tackle some of those questions with our guest today. I knew our guest would be able to break down the cycles approach for us because she's a little bit of a research nerd like me and she's incredibly talented when it comes to creating practical speech therapy resources and materials. In particular, she created a resource to make the cycles approach incredibly easy for SLPs and she'll mention this during her presentation. I know you're going to love all of the practical tips and strategies she has for us today. Without further ado, let's introduce Shannon Werbeckes, she's a rockstar SLP, she's worked in outpatient pediatric clinics and in the schools, particularly, in preschool and middle school. She also shares practical tips and resources and creates materials, and you can find her on her blog at speechymusings.com and on social media. Welcome, Shannon.

Shannon: Hello, thank you. I'm excited to be here.

Marisha: Yeah, and like we were just talking before we went live, I'm so incredibly excited to hear your answers to these questions because you have such amazing resources. I know you'll have lots of great tips for us. But before we dive into all of the nerdy stuff, I'm really curious about how you got to learn about the cycles approach and what led you to create a resource to help us with the cycles approach?

Shannon: Yeah, it's a good question. The first couple years after I graduated, I worked in an outpatient clinic, and there I saw mostly students or children with autism. I was doing a lot of AAC, and then when I switched mid-school year, I switched into a school contract job and it was mostly preschool. I had never done cycles, I had actually I don't think I'd worked with someone with a phonological disorder since grad school so I just dove in and realized I think it was like 50% of my caseload had phonological goals. Shortly after starting my job, me and my husband went on a vacation and I was just ranting about how confused I was about cycles. I just started jotting in my notebook all my thoughts about it, trying to figure out what I was going to do when I got back. When you're contracted into a school, at least, I was just thrown in, I had a whole caseload.

Shannon: They were missing minutes from earlier in the year, so I didn't have a whole lot of time to be reading research and organizing this all during the school hours. That's when I dove into cycles and tried to figure out an easy way that I could get everything set up for the whole school year for a lot of my caseload.

Marisha: That's amazing.

Shannon: Yeah, it worked out great.

Marisha: Yeah, and I know it's an incredibly popular resource that people love so it works.

Shannon: Yeah, it did and it helped me so much. I was so drowning, like I said, it was just a whole different population when I switched so it was from a need from myself too.

Marisha: Yeah, awesome. Now we'll get to dive into the nitty gritty pieces of it. What is the cycles approach for those of us who are [inaudible 00:03:16]?

Shannon: Yeah, so the cycles approach, just as a basic, is an evidenced way to treat phonological disorders in children. It was developed by Barbara Hodson, I think, maybe in the '70s. It was a long time ago, and it's just recently, I think, in since maybe 2010, actually, started posting about it, doing a lot of research on it. What makes it different than an articulation approach is that it treats sound patterns and processes instead of individual sounds. What makes it different than maybe a traditional phonological approach is that you cycle through sounds even before a child might have mastery on a sound, you keep moving. An example of the cycles would be you might do final consonant deletion first, and you target each sound for 60 minutes. I can talk more later how I organize this all, but you might do final consonant deletion first and target Final M, then Final P, then Final F, then you might move on to cluster reduction.

Shannon: And then target SM, SP, SK, and then you keep cycling through processes and sounds. I have an analogy that I give to parents because sometimes I think the hard thing for me, and I think parents, when trying to understand the cycles was like when do I move on to a different sound? When do I switch processes? Am I cycling through sounds or am I cycling through processes? It gets confusing what you're actually cycling through, so I did the analogy of if you're doing a physical body workout, cycles style, you would have your arms, your legs, your abs, those would be your processes. Then within those are specific muscle groups, that would be like your sound. Within arms, you'd have your biceps and your triceps. If you're doing a cycle based workout, you would do arms for a week and you'd do biceps for 60 minutes, then triceps for 60 minutes. Then the next week you'd move on to legs and you'd do different leg groups broken up like that.

Shannon: The perk of cycles is that when you're working on the different body groups, let's say you move on to legs, your arms are given time to recover and you might actually see growth even when you're not targeting it. Because you just keep moving along, which is really nice. I try to give parents that analogy because I think it helps them understand what's working on these big groups that have separate small things within them and then cycling through to give those body parts arrest, so you're not just doing arms nonstop and working to the point of fatigue. They appoint a break to build up and see growth when you're not just directly targeting it.

Marisha: That is an amazing analogy, I've never heard that and I love it. So good.

Shannon: Yeah, that helped my brain, I think the hardest part about cycles, like I said, is just imagining when am I moving on? What groups are we moving between? There's just a lot of moving pieces, so for some reason thinking about a physical workout makes a lot more sense to me. Because, I don't know, you don't want to just do arms all the time or your arms would just be jello and never have recovery time. It's you don't have to be able to do a push up before you can move on two legs, for example. You'll just keep on chugging, so that helped my mind visualize what I was doing.

Marisha: Yeah, I love that, so helpful. You touched on this already, but why would you choose this over another approach? Like the traditional approach to articulation or complexity or whatever else is out there?

Shannon: For students of phonological, like if you have an articulation disorder, I wouldn't choose this, but for students that have phonological disorders, I like it in the school setting because it's super, super structured. Once you're set up, it takes very little work to keep going, and it has a really good carryover piece. I found it really easy to implement, I've seen good growth. I do use other approaches, I'll be honest that most of my preschoolers we start on cycles, and then if it's not appropriate, we move on to something else. I think I just like it because it's structured, it's been really effective, and when you're really busy, it's a really easy way to implement an evidence based structured approach to your phonological therapy.

Marisha: Yeah, that makes sense. Then so you touched a little bit on the types of students who would benefit. Do you have any more on that, or are there students who definitely wouldn't benefit from cycles?

Shannon: Yeah, students that have severe phonological disorders, that are hard to understand, that have significantly lowered intelligibility to me are like perfect for cycles. It's best if they can sit and attend to activities because you got to get really high drill work in, this is really drill based. I've had some success doing a play-based method, but they still have to be able to play and get that drill in. If I'm chasing the kid around and they're not repeating any words and I'm getting five repetitions a note a session, which does happen, I might work on something like the core word approach. Just to where you're focused on intelligibility on a smaller set of functional words, and then sometimes I'm able to move back into cycles. But that would be the type of kid where I might question. I might start with cycles and then realize we're just not getting in the repetitions and they're not adhering to, "I have a really rigid session schedule and I go through this thing."

Shannon: If they're not able to do that, then I might shift approaches. Again, sometimes I would shift back into cycles, so it's not just like a pick one and that's it for the next three years, I might move back. But if I'm having trouble getting that drill in, sometimes another approach makes more sense.

Marisha: That sounds good. I assume you use a different approach for your older students? Maybe like they have less sounds, when would you decide in asking?

Shannon: Yeah, I have done zero cycles since going to middle school. To me, they're just more, if my kids are... by the time we get to middle school, either kids are on an AAC device because of lowered intelligibility. We're working on just core functional words and that. To me, I mean, I haven't done, honestly, I haven't done a lot of upper elementary, I switched straight from the real lowers to the middle. But, middle, I'm doing no cycles at all. Preschool, I think it's super, super awesome, and then either you're going to start to see progress in a year or two of cycles or your approach should just be shifted into the upper years anyways.

Marisha: That makes sense, that's super helpful. Before we dive into all of the treatment stuff, we want to start with an evaluation. Do you have any tips or strategies on doing an evaluation that will set us up for success and give us what we need inaudible to the cycles approach?

Shannon: Yeah, so when I evaluated in preschool, I usually did a complete standardized assessment that specifically looked at phonology skills. I've heard good things about the HAPP, it's Hodson's Assessment of Phonological Processes. That one is strictly from Hodson who's the creator of cycles. I haven't used that one myself, but I think that's probably a pretty gold standard for this. I've heard good things about the DEAP as well, the Diagnostic Evaluation of Articulation and Phonology. The one I'm most familiar with is the KLPA, the Khan-Lewis, and because you can use that one with the Goldman-Fristoe, so it just analyzes the errors in the Goldman-Fristoe. I'll tell you what phonological processes are happening, if any. Once you do that, I would really spend time analyzing the years, and I think that's a huge part of these tests. You're looking at not just what processes you're seeing, but are they getting vowels correct, are their errors consistent throughout the test.

Shannon: You might look at the types of errors, they might have omissions, substitutions or distortions, so you're seeing are they all omissions? A lot of my phono kids are a lot of omissions, so they're just not saying any sound there at all. Then I'll also do something informal, I usually do a specific informal measure that I just made because I use that throughout the cycles, so just to measure progress. I like to do that right at the beginning just so I have a good baseline on the informal thing that I'll be doing. That's to look at the phonological disorder, there's also lots of other parts that I usually add on for these students like an oral motor evaluation. I would recommend ruling out hearing, I've caught a lot of hearing impairments from these types of students. I would strongly, I wrote like seven exclamation points after this, strongly recommend looking at language because phonological disorders are language based.

Shannon: A lot of my students end up in the getting special ed services for reading or pre-literacy skills, so just looking at a lot of the language skills as well. Again, look at consistency of productions, stimuli ability. I usually spend a long time assessing stimuli ability for what they missed on the phonological assessment because, actually, a lot of the students I've worked with, with phonological disorders have really good stimuli ability, which is really helpful in the cycles approach. When I note that like, "Oh, they're actually really stimulable for a lot of these sounds," to me that's a really good indicator that the cycles approach might be really, really appropriate. If they have low stimuli ability, it's trickier to do cycles because they have to be... you're only practicing stimulable sounds and words, so if they're not stimulable for very much, I would, again, maybe resort to something like core vocabulary.

Shannon: Then I always do a connected speech sample. I read recently on the informed SLP that the percent consonants correct, the PCC, so you're looking at how many consonants are correct in a connected speech sample or in a word list. I usually look at PCC, again, just as a way to measure overall progress, overall intelligibility. That might be like a good long term goal, so that's a lot, but that's all the different parts that I might do in an assessment, an initial assessment.

Marisha: Awesome, that's so helpful. Then so you've got all of this information, all of the data, how do you make sense of it and how do you start identifying treatment or treatment targets?

Shannon: Yeah, so that it is a lot of information and I think this is the step that gets really tricky. A lot of people I think know how to do these assessments, and then when you're actually moving into an approach, it's like how do I organize all that information? As a general rule of thumb, I target sounds and processes that are stimulable, like I mentioned. During this eval process, I'm trying to keep track of they can say Esplen, they're just not in their speech, that would be a great target. I assess each process on that informal screener. I usually just do 10 words in each process, and then words that were produced or, yeah, sounds that were produced correctly between 40 and 70% of the time are usually my initial targets. If final consonant deletion, if they were stimulable between 40 and 70%, I'd throw that right into my list. If they were able to produce clusters with 50% accuracy, I'd throw that in. I try to jot down anything they're stimulable for and producing 40 plus percent of the time. Those are great first targets.

Shannon: If they're only struggling with a sounder process in a specific position, which I'll be honest, was rare for me, usually, it's just like a complete mess. There's lots of things going on, but then you just target that, that specific position or sound. Generally, the first four that I work on are syllable reduction, syllable structure, cluster reduction, and final consonant deletion. I'll say that, not 100% of the time, but that's pretty consistent. Then I usually do those four processes first and then I add in other ones like stopping, fronting, or gliding as they're demonstrating mastery on those first four. I only target four processes at a time in one cycle, so starting with those four is usually just a good general rule of thumb. It also gives my students a lot of success, so syllable reduction, you're not even looking for sounds in that, you're just trying to get those marked syllables.

Shannon: Usually, I can get that pretty quick and then my students are excited and it's a good way to start. Then within each session, I usually only use five words. I try to get 100 correct productions. Again, just target all the stimulable sounds within a process. That sounds like a lot but what I always remind myself is four processes, five words, 100 productions. Then, again, all that should just be stimulable, if they can't say it, exclude it for now, and stick to the things that are stimulable, that they can say in a rapid 100 correct productions a session. If they're not stimulable enough to get 100 correct productions, that's not a good target at that time. Again, like this might lead us to say you might start cycles and you're not able to get 100 correct productions because they're just not stimulable for really anything. Then, again, I might back up, do the core word approach, introducing AAC and then maybe come back to cycles until they're stimulable for enough to cycle through.

Marisha: I think that's super helpful. Four cycles, five words, and 100 productions.

Shannon: Yeah, 100 productions.

Marisha: Then with those five words, are you targeting like do you have a mix of different sounds, or do you do one day you're just doing?

Shannon: Yeah, so each sound should be targeted for 60 minutes. I like to write minutes for 60 minutes a week, if you can, if not, it's fine. It's just easier in my mind to separate it week to week, but you might target final consonant deletion first, then you're going to do Final P for 60 minutes, then Final M, 60 minutes, Final whatever, 60 minutes and then move on. You're targeting all the final sounds they're stimulable for 60 minutes at a time. The cycles, I'll say, when you're doing it in real life feels that it moves very slowly because it takes a long time to get 60 minutes. One week, you might, work Final P, the next week Final M, then the next week final something else, then cluster reduction. You might do 60 minutes of SM, 60 minutes of SK, 60 minutes of SN, and then keep cycling through that. Then move on to a different, then you might do stopping, for example. You're doing 60 minutes of each sound, if that makes sense.

Marisha: Okay, cool. That's super helpful. Then so that is a long time, what strategies do you use to keep that, to keep it moving and to keep it fun and engaging? Because you use five words for those 60 minutes, so what's your assumption?

Shannon: For each session, honestly, I probably do, do five words for 60 minutes, but in the school setting, I'm often not doing 60 minutes, they're broken up 2 times 30, 3 times 20, or 4 times even 15 for our movers. I try to do shorter sessions whenever appropriate. I've seen progress on 30 minute sessions, I've never done the 60 where you do a full thing, but I do have a really structured session schedule that I mentioned earlier. I have a visual schedule, it says listen, practice, listen, check. At the beginning in the listening portions is that auditory piece, so I actually do amplified me, we're just reading a word list. I recorded those on my computer so that my kids just sit hooked up to my computer right at the beginning and they just listened to me reading the word list. That way I can amplify it as needed, they love it because they get their little headphones on. I liked it because I could get my session setup while they were listening. The listen, practice, listen, check system works really well.

Shannon: It keeps, in 15 minutes that's a lot to get in, so it keeps things moving really fast. In the practice section for the longer sessions I do drill, and then I might do a game like bowling with the same five words but just to give it some difference so we're not just sitting at the table. But even the drill, we'll do coloring, we glue them into books, we do dubbers, the classic speech motivators. But I keep it really simple because those sessions with those four parts, sessions go really fast. That's part of the reason I like it too is that it's really structured and there's four parts to each session, my kids like the routine of it, and it does, it goes very, very quickly once you're trying to get those 100 Productions. Then the check is checking for stimulability at the end, and that's where I get all my data and I just do 10 words to gather data right at the end.

Shannon: I might check to see where we're going next and write it down because I tend to forget things between sessions so I'll be like, "Oh, we're going to do this next time." And then I get to see them next time and like, "Oh, my gosh, what did I..." I can't remember what I wanted to do anymore, so I do right at the end that check time. I'll usually write a little note to myself like, "Do stopping, target the F next time or something, whatever." That check at the end is a nice time to wrap up and see where I'm going next.

Marisha: Awesome, super helpful.

Shannon: Thanks.

Marisha: I'm not disappointed at all, so good. Okay, and then we always get this question about any topic we talk about, but how do you tackle writing goals for these types of [crosstalk 00:20:34]?

Shannon: Yeah, so I have a goal written that I use for each process. My final consonant deletion goal is will reduce final consonant deletion by producing final consonants in CVC words with 80% accuracy. Obviously, I can alter that, if a kid is making slow progress, I might isolate one final consonant that I'm assessing instead of in all of them. If I want to look at more big picture gains, I might write a goal for... I know some districts have to do long-term and short-term and all that, my district's they just write straight goals. Like mine, that would be perfect for my district because it's easy. I know some people have to write a big one and then little objective, so a big one might be, again, the percent consonants correct measure or an intelligibility measure. Then I write specific goals for each process. I usually only write two processes because they're not going to be able to correct. Actually, some kids do but you don't want that to be the expectation, but you don't want to write six processes.

Shannon: Even if you're cycling through them, I tend to not write a goal for everyone I'm cycling through because that's just a lot. Usually, I stick to the hierarchy like syllable reduction, syllable structure, cluster reduction in a specific order. Then I write goals for the lower ones that they haven't yet mastered. I might just write two goals for two different processes that they can't yet get rid of. My goal writing is a little bit easier, and I usually use word level too when I do cycles. Cycles really does stick to the word level, they don't do a lot of phrases. Sometimes I use phrases with the cluster reduction, but other than that, most of my goals are pretty much word level as well.

Marisha: Awesome, and then do you have any other tips for organizing the actual treatment piece of it?

Shannon: Yeah.

Marisha: I think there's a lot but-

Shannon: It is, I feel like organization is 75% of the battle with cycles. It's like once you're in it, it's so good but it's, I don't know, I'm really a messy, pretty tight B SLP, which I know might be rare in the world. But I feel like for some reason the organization is clutch for me. I have a spreadsheet for each student that's doing cycles, I print it because I like writing, and it has a column for the process that I targeted, the specific sound I targeted. And then I have the dates that I write down when I did them and then an accuracy that I take every day. That helps me keep track, so then if the student has 20 minutes sessions, for example, I might have three columns because that would total to the 60 minutes. Then I have to write, "I saw them on September 9th, then September 10th, then September 12th." Then I know, "Okay, we're moving on to another sound because I've filled up my three columns."

Shannon: Then that also gives me the data, so then I can write data each time a quick percentage as well. I like having this spreadsheet printed to just keep track of all of my dates because I think that's the trickiest thing. You need to target each sound for 60 minutes, so unless you're having 60 minutes sessions, you got to have a way to keep track of how many minutes you've targeted each sound. Those forms work really well for me but I know people who have little check boxes or some system. But I think that's the trickiest part is getting the dates and the sounds or the minutes to total up for each sound.

Marisha: Nice, and then you do, you collect your data at the end during the check?

Shannon: I do, yeah, and I know people who do it different. Some people do it right when the kid walks in, they just do 10 quick ones. I feel like the beginning of sessions for me is really chaotic, kids are coming in, and I liked the routine of them getting their headphones on and getting settled in my room. Then I liked just doing it at the end before they left just like a checkout, "Oh, you got to do this before you can leave." But I know a lot of people when they walk in, they do the quick checks so that they're not... that might lower their accuracy a little too and be more accurate because they're not thinking about all of their sounds. If you're having trouble like I'm assessing at the end and they're getting them all right, at the beginning might make more sense to but depending on what works for you. I like the structure that I have, and I saw mostly preschoolers too where they still have a lot to work on, so assessing at the end, they're not getting all of them right all the time.

Marisha: I think as long as you're consistent, your rate is going to be interesting across that.

Shannon: Exactly, it is what it is and you're hearing it apples to apples [crosstalk 00:25:06].

Marisha: That's awesome. Yeah, and whatever works best for the structure is that makes total sense. I had another question but I can't remember. Oh, so in terms of your target list, do you have the list of the 10 words for the different processes just ready to go, or how do you choose which words you're going to-

Shannon: I have it ready to go, so it's in a binder. I have a page for each process that list. It might say like cluster reduction at the top and then it has each cluster and then a word list underneath it. I keep that in a binder, I keep my assessment pages in there, I keep the little assessment pictures that kids label in there, I keep my parent letters in there. I send home a lot of home carry over for cycles, so I keep that on there.

Marisha: This is all part of your toolkit, right?

Shannon: It is, yeah, this is the part that I... this is what I put all together was wordless session notes, flashcards, just so it's all self-contained, I suppose. But, yeah, you could use... I know a lot of people who do cycles with no materials as well or they have the materials, like they have our tick cards and stuff already so they don't need. A lot of SLPs might have everything that they need already but, yeah, that's what I put together for my own ease.

Marisha: Yeah, and so you also mentioned the home carry over piece, what does that look like?

Shannon: Yeah, so I send home a little letter that just says... Well, so when I did preschool, I had a lot of itinerant students which was actually really great. The parents would come into my sessions, and then there's very little to explain because they're seeing what I'm doing. Again, I usually use that home workout analogy that seems to help them understand when we're moving between muscle groups or processes and when we're switching muscle groups or processes. I usually just explain the general, I usually explain with that analogy what cycles is, and then I send home a little note that says, "Practice these 10 words this week." Again, that's why it's sometimes easier if you can write minutes for 60 minutes a week, I find it easier for family to understand, "This week is this, is SM words. Next week will be SK words, the following week will be..." But that's a little bit easier, but I literally send home black and white flashcards.

Shannon: I make little paper envelope, so I just fold a piece of paper in half and I staple the outside edges, fold that in half, paper clip it closed, and just keep black and white. Usually, they're colored because my students color them during our sessions, send them home. It's usually like five to 10 words, like I said, I try to keep the words that really small and then I just say drill them, I don't know, for a really, really good student. I actually worked with a mom that was a speech pathologist and I worked with her daughter. She was drilling like two or three times a day, but for most families I just say if you can read them through once a day, have the student produce them once a day every day. That's what I ask parents to do.

Marisha: Awesome, and so they're doing the same practice that you're doing in the sessions?

Shannon: Exactly, yep, and because I'm only doing stimulable words, it works, and I don't send anything home that the student isn't stimulable for but the cycles approach is all based on they should be stimulable for this. It actually makes, again, the parent carry over piece easier because they're not struggling through sounds that you have to use specific elicitation techniques to produce, it's just the kids should be able to say it given a focused, structured setting. Yeah, it's a pretty easy home carry over because it's literally just practicing five words repeatedly throughout the child's day.

Marisha: Awesome, that's such a good system. I like that a lot.

Shannon: Yeah, that's why I like cycles, it's a system. I think I like systems, it's when you're busy and if this can take off 20% of your caseload, or it's just done you, because they're doing cycles and you know what you're doing next session. To me, that's like where that the time saving comes in because it is a system.

Marisha: Yeah, and it takes a little bit of time to wrap your head around it and get it set up. But you could get these materials set up, and if you have the card decks or whatever, you could do it in an hour or so.

Shannon: Yep, exactly, I say the card decks, getting the card decks is the part where my hands starts to cramp and I'm cutting them. That's the laborious part, but beyond that, this is really just getting spreadsheets, getting a whole system where you do this, then this, then this, and then you're good for your career as long as you want to do cycles. That just then the kid just starts in to the whole system and it's pretty easy.

Marisha: Yeah, and I know now is a little bit of a crazy time. When this comes out, some SLPs might already be on summer break. It's the perfect time to assemble some of those materials. If you're listening to this in the middle of the school year and like, "I want to start it now." Yeah, do all the things, like you can totally just print the fine black line versions to print and go.

Shannon: I say even mommy speech therapy has those printable free cards online and just go on there, print those, and you can implement this with anything. It's easy, once you get something that's consistent, it's just done for you. There's no secret to this, it's just it's a complex system of funnels that you're putting this student through. But once you have that done, you can do that pretty much with any materials with the spreadsheets and you can make in Google or Excel or something. It's all pretty easy once you get that setup, so yeah. The summer I set mine up in the summer, I actually went over, I think we were watching The Bachelorette or something. Me and a bunch of friends cut apart the whole toolbox in one night, and since then... I don't know how long ago I even made that, five years, and it's still perfect. You can just pull it out and use it. It totally takes upfront work to get everything together, but once it's there, then you're good. You don't have to prep every week for those students anymore.

Marisha: Yeah, working smarter.

Shannon: Yes, working smarter, exactly.

Marisha: Doing a little bit of work ahead of time and then reaping the benefits four years to come, which is so neat.

Shannon: Exactly.

Marisha: I love that idea of making it into a party or just a prepping party. Well, if you have friends that aren't SLPs, they can do some of the work for you or-

Shannon: My mom laminates a lot.

Marisha: My mom does too. There are parent volunteers too. Like you can totally just print those out and have them cut for you. When I was in the elementary school and working in the preschool, there was a mom who really wanted to help out, but she couldn't come in during the school day because she was asking, "I really want to help, what can I do?" I just found home stuff for her to cut it and she was really happy and it's just amazing. We can get really creative in making things happen.

Shannon: That's true.

Marisha: Even if we don't have an hour to put aside now, we can get creative and make this happen.

Shannon: I had my itinerant parents, like I said, I saw a lot of itinerant that came in and some of them were so bored during the sessions, while I'm working, that they were like, "Can I just cut this pile?" I'm like, "Sure." They would just be cutting in the corner and I'm like working. It works so nicely, and then I had my next week done for me.

Marisha: That's right.

Shannon: Yeah, and the nice thing about cycles or any reusable material is, again, it just takes that upfront time and then you're ready to go forever. There's I don't do themes when I do cycles, I don't do anything that's different throughout the whole school year. Every single it's the same, and that keeps kids from being bored inherently just because they're constantly moving through different targets. To me cycles is one of those things that's really super time consuming in the beginning but, again, really super good once it's set up. Because you're not switching through themes or different... The timing of the school year doesn't really matter once it's set up.

Marisha: Yeah, perfect.

Shannon: Yeah, it's a perfect summer project if you're in the summer listening to this.

Marisha: I love it. Given us some homework.

Shannon: Yes.

Marisha: Then I'm curious too because you mentioned that a lot of times these students will have like they'll also have language delays and other things going on. Oftentimes, I assume we won't just have the goal for the process, or for those few processes that we're doing. How do you manage that then? Does that just determine their treatment minutes or?

Shannon: For what I did personally, which I don't know is doable in all settings, I separated out their minutes so we would do cycles for certain sessions and then we would do their language based goals in a totally separate session. Because, like I said, I think have the structure down. It really does take a full session for me to do the listen, practice, listen, check schedule. For my students that I could write increased minutes for, I might write 80 minutes a week and then use 60 for cycles, 20 for a language school. For students where that's not possible or districts or SLPs where that's not possible, that's when you might spread a cycle or targeting a sound across two weeks, for example. You might do 30 minutes one week, 30 minutes the next week, and then the other session do a language, a language target. I try not to mix them just because, honestly, cycles is it's so much work.

Shannon: Like these little kids are such hard workers, they're really, really, really in it, they're so focused and it's like I just feel like switching all the targets on them, "Okay, we're going to do this for 15 minutes. Oh, and now we're doing something that feels totally different, feels a little bit, I don't know, confusing I guess and a little bit overwhelming." I would try to separate out, even if you have to do cycles slower, like I said, across two weeks, I would just separate the sessions if possible. That's nice, too, because I try to keep my cycles groups only cycles groups as well. Then your other group can be more of a mixed group, you can always put them into a mixed group to do more language objectives another session.

Marisha: Yeah, that makes a lot of sense, that's perfect. Then in terms of the mixed groups then too, that's all the good stuff. Kids are usually working on different words in the... They might be working on the same process or they might not, they might have the same words or they might not, so do you round robin through their sounds?

Shannon: Yeah, I do you them in my cycles, like a cycles group where they're working on different projects. Yeah, so then I'm round robining through. Like I said, we do a lot of book... Honestly, my favorite activity is taking black and white flashcards, cutting them apart, and gluing them on the index cards and then putting a hole punch through the index cards, putting a binder ring because then they can take that home. Well, as I'm round robining, they're gluing, they're coloring, they're whole punching, they're doing all the assembly part and then I just work through. I usually try to get five or 10 productions while I'm working with them before I move on to the next student. I'm not like, "Say one word, say one word," across the group. Because that takes forever to get their attention. I might work with a student for a minute and have them get 10 productions and then they color and work on those cards then to the next student.

Shannon: It's okay if they're working on different processes. If you can get them in line, that would be great. Like I said, there's, usually, in preschool to me there is like the four heavy hitter processes. Some of the time it is possible to get them in the same routine in order, although, it's just with absences and all sorts of stuff. It's definitely not possible all of the time.

Marisha: Yeah, and that's cool when that lines because then they get additional auditory development too.

Shannon: Exactly, so they're listening to me say it over and over. I even had a girl she was working on a different process than her group mate and she then she was always wanting to work on their sound because she was like, "Oh, I know that one." Then we're like, "No, no, stick to this one." But it is really good because they're hearing it, there's hearing the same processes, the same wording, the same queuing over and over so that works nice.

Marisha: Yeah, and do you ever use the auditory bombardment, the headphones piece, as an alternating thing, too?

Shannon: Yeah, I've done stations like centers, and I did that with my groups that were really like we had a high energy, high energy bunch. But then I would literally have like a station for doing jumping jacks and squats, and then a station for listening, and then a station for working with me. That works too if you have a lot of movers, and just all sitting at a table coloring their cards is not the reality. Centers worked really well for me, too. I literally had posters that just said center one, center two, center three. I usually only have three kids in preschool in a group together, so one's working with me, one's literally like I'm a drill sergeant and I'm like, "Do push ups, keep jumping, keep your body moving." I have little pictures that they have to follow, yoga works great, and then the other one is sitting at my laptop doing the headphones. I have the big noise canceling ones too, so they think they're the coolest. These tiny little kids with these huge headphones is always sweet.

Marisha: Oh, I love it. That's cool because then each of the centers is exciting in its own way. They get to work with you or they get to move around or they get to wear the cool headphones.

Shannon: I think some like the time away from me because when you're working one on one with an adult, you get a lot of feedback. You get a lot of, "Try that again, nope, that's not quite right." Then they're like, "I just need like a breather break." It's nice to just go do something the teacher is not necessarily monitoring what you're doing. Just go get your energy out for minutes, you can calm and have a focused, productive drill based time with me.

Marisha: Yeah, it's so good. Then one other question too about just... because you talked about this a little bit but in terms of what to expect for progress because you said you typically expect about two processes in a IEP period.

Shannon: Mm-hmm (affirmative), it just it varies so much, and I'll say like I'm only, I don't know, five years out of grad school so I think that this just comes maybe with time is knowing how fast kids are expected to demonstrate progress versus other students. I know there's diagnostic, there's indicators of good progress. Like I said earlier, really solid stimulability for a large amount of processes to me means faster progress. I see those kids just zoom through cycles. The tricky thing with cycles too is I do see it, I've seen almost in all of my kids who do cycles, correction of processes that we didn't even target. They have vowel errors and then we work through their primary processes and we fix them and their vowel errors self correct, or they have voicing errors that are really unusual and those correct through a couple of cycles.

Shannon: Predicting progress has been challenging for me, and usually, honestly, in a good way where I'm like, "Oh, they're going to... we're going to work on final consonant deletion." Then the next year they're not voicing errors, they don't have vowel errors. That's a bit tricky. For collecting the progress I usually just focus on, yeah, one or two different processes. Usually, for real little, it's cluster reduction and final consonant deletion because I just find that those impact intelligibility so much. They're easy for parents to understand, they're easy for teachers to understand progress on. Some words like fronting, stopping, backing, I find those things sometimes a little bit confusing for teachers to really understand. I actually do, I should mention this too instead of just a home carry over, I do classroom carry over too. A lot of my preschoolers do centers in their classrooms, where they're practicing sight words.

Marisha: Genius.

Shannon: Yeah, so then I put their cycles cards in their sight word bin and they practice them in the classroom as well. That's why I love that index card ring, that thing is like their words, and then I go into their classroom each week and I swap them for the next process we're working on and then swap them. They might have three card decks of the same words, one at home, one in the classroom, one with me. But then I find teachers, when I'm sending these things into the classroom for something like fronting, I find that they're a little bit more confused just as what is fronting? What kinds of words are we working on? What do all these things have in common? Versus cluster reduction, final consonant deletion to me make a little bit more sense to anybody. Yeah, so progress is tricky to predict but I just feel like most of my students who are really eligible for cycles where they're stimulable, they can sit and do drill.

Shannon: We make really fast, huge gains, which is awesome. But then, yeah, every caseload has those kids too that are totally they feel idiosyncratic, you're not sure what errors they're making, there's so much going on. Those ones I'll admit to having a hard time predicting what they're going to improve on or how fast.

Marisha: Yeah, and I know that was the tricky question. It's one that parents always ask, and so sometimes it's like, "No, what do I say?" I knew that.

Shannon: Yeah, oh, every time, I swear, every preschool or parent is like, "So when is this going to be corrected?" I'm like, "I don't know."

Marisha: There's not, I've tried looking for the research on this is what you can expect if you see these kinds of things, but it's not out there.

Shannon: It's not out there, and the things that I find are the obvious things, if they're more stimulable, obviously, they're going to make faster progress. If you have better attention, they can drill, they're going to make faster progress. But it's still what is faster progress? What is expected within a certain amount of time is still just totally tricky. I know therapists, I hear therapists talk about expected rate of progress, and I just think it might just take more years of experience doing something over and over to really see what average looks like.

Marisha: Yeah, for sure. If there's any researchers listening-

Shannon: Yes, tell us. Yeah, and definitely a struggle. I have that with my late talkers a lot too, they're like, "When are they going to talk?" I'm like, "Oh, I don't know."

Marisha: Yeah, and we can just talk about the factors that we're seeing and those things tell us that they're going to make more progress but it's just really hard to put a specific timeline on it.

Shannon: Yes.

Marisha: Even though we would all, like everyone would love to have that timeline.

Shannon: I know, or even just like a trajectory of... the tricky thing is typical development just doesn't really apply in a lot of these situations. That's what we have a lot of information on, and once a child is having a phonological disorder, it'd be so nice to have some sort of development or trajectory for that subgroup of students. But I have yet to find a lot of info on that.

Marisha: Yeah, well, I know we'll both keep looking and we'll share if we find anything else.

Shannon: Yes, put the informed SLP on that.

Marisha: Yeah, come on. She's got us covered in so many ways, though.

Shannon: Yeah, she does.

Marisha: Okay, cool. Then just one last question too, well, two more I guess. Do you have any other tips in terms of what to do if a student isn't quite ready for the cycles? Because you talked about the core word approach, is there anything that you can do? Do you ever see it where you use that approach and then you're able to switch into cycles, or what does that look like?

Shannon: Yeah, so usually, the core word is usually my favorite one to go to because I find that with kids like that, especially, when I'm feeling like progress in cycles might be slow. You have frustrated parents, you have frustrated kids, you have you just want to show something that. I want my students to feel successful in therapy like, "Oh, now I can do this thing I couldn't do before." Core word to me has been the best backup step down from cycles. I usually pick like 10 words that are really meaningful like mom or their own name and I work on those. After they might demonstrate some progress on core words, I might introduce that schedule, the listen, practice, listen, check, and do it with core words. I literally just make a voice recording of their core words, they listen to it, then we practice and we move into that session schedule.

Shannon: Then I can always swap out less motivating cycles based words later, once that attention is... it's usually attention or behavior that's the tricky piece there. Then once that attention and behavior improves, then we can... they're already in the right schedule, we just swap out those motivating words and introduce more cycles based words. That's the progression I usually take for a student that just can't sit for cycles. I think maybe I had thinking it's got to be less than 10% of the kids that I've introduced cycles to that I've had to backup or had to do something because, I don't know, I call it putting on my dog and pony show. I am very animated in therapy, it is like cycles is the most fun thing in the whole world. I do think students like it too because we're only working on stimulable sounds, you're not stuck just like make the K sound, hey, go... For like 20 minutes where they're just not getting it.

Shannon: They're always saying words successfully, so usually cycles is pretty good, but the core word pushed into the cycles is the route that I would take if they just can't attend to that drill based.

Marisha: Awesome, and then any other tips or strategies or things that we left out that you think would be really helpful, or just for us to think about?

Shannon: I don't think. The one thing that maybe I haven't talked a little bit about is activities that I do. Which is probably really standard preschool activities, but I guess if you're listening and you are just starting to do cycles, usually, my practice sessions don't just do drill. I do, do drill but once they get to 100, then usually I do bowling. I like to put the cards under bowling pins. I can't think of the name of the house but it's a classic speech toy with little doors and doorbells on the different sides. There's four doors, which works really well when you only have like five words, I'll shove one in each door. I usually do, you have to get 100 and I use a clicker, and once we get to 100, we can play a game with these words or something to increase the motivation. Within that practice part, it's not just drill always, I usually incorporate some movement thing towards the end before they have to listen and check again.

Shannon: You can pretty much use any of your classic preschool activities even on train railroad pieces. I'll put the card on each track, for example, so you have to get 100 and then we're going to get your tracks out and we can build with this. That's how I used to increase that motivation piece for the little is I usually just say we just got to get to 100 and then we can do a scavenger hunt. It's just another common one, I'll hide them, close your eyes, and we go find these five words or whatever. I think that's the only thing that I had jotted down that we didn't get to, that felt really... that was a lot of info.

Marisha: Yeah, so much good stuff it's like, "I'm going to go to cycles now."

Shannon: Cycles for everyone.

Marisha: No, this is so helpful and it just makes so much sense.

Shannon: It does.

Marisha: But it's a little bit of work up front but once you do it like you're five years out and you're still using this and that, the same classes. Essentially, your whole therapy for the year is planned.

Shannon: Exactly, my big thing for saving time, for me, has been isolating a group of students on your caseload that you can get everything done for, and then you're always going to have tricky kids, you're always going to have ones that don't fall into what prescribed programs say that students should look like. Then those ones you can dedicate a lot of time to, but I like getting rid of huge subgroups of my caseload to really systematic therapy and then you just don't think about it. I really think kids prefer this over a lot of other things because, like I said, the workout thing. Well, if you're just working on arms 24/7 until you can do a pull up, I'm going to hate working out because that pull up seems really elusive and you're working and working and working and working and you're not getting anywhere and your arms are fatiguing and everything's frustrating. Versus saying, "We're gonna do this for a week and then we're going to move on to something else and maybe your arms will strengthen up while we're doing something."

Shannon: You just feel a lot more successful with the constant moving, "So you didn't get it, all right, no worries. Next week, we're doing a different sound or..." It just I feel like the frustration in preschool is so decreased doing cycles, so that's been really, really nice as well.

Marisha: Awesome. Well, thank you so, so much. This was incredibly helpful and I know people are going to love this. If they want to find out more about what you do and get more of your awesome tips, where can they find you?

Shannon: You can find me Speechy Musings anywhere, Instagram, Facebook, Pinterest, email, it's S-P-E-E-C-H-Y Musings, it's plural. Then I share daily on Instagram, I share lots of pictures of my products and different ideas of how to use them and different carry over ideas and things like that too.

Marisha: Awesome, and then you also have the cycles kit, where can they find that?

Shannon: Yeah, that's in my Teachers Pay Teachers store. Again, that's under Speechy Musings, it's my best seller. It's like the top one right when you click in, you can find it there. If you have any questions about cycles, you can feel free to email me. I'm pretty available via email, but that's where to find all the cycles. I think I have a blog post too about how I set it up with lots of photos and stuff as well. That's on my blog speechymusings.com.

Marisha: Yeah, and I'll share those links, all of those links in the show notes too. You'll be able to see, because I think you had a blog post explaining how you set it up and then you have different ideas on how to organize them.

Shannon: Yeah, so my original idea was in like a toolbox that I bought at a home improvement store. But I know a lot of people are itinerant or might move around a lot, so I have just different ideas of how to store all the flashcards and stuff you need for cycles for people who might move between schools and such. Again, like you can use those ideas with any flashcards, that's not necessarily... Mine makes it easy, if you're starting from scratch, mine makes it super easy. But if you have stuff already, you can just read through the information and organize your own materials in that way too.

Marisha: Awesome. Well, thank you and-

Shannon: Yeah, thank you.

Marisha: Yeah, check out these show notes for all of the other links and we'll see you next time. That's a wrap. What an incredibly helpful episode and I'm so grateful to Shannon for sharing all of her knowledge on this topic. If you want to check out the show notes and find all of the links that we mentioned, head to slpnow.com/five and that's where you can find all the good stuff. That's also where you can find information about earning ASHA's CEUs for listening to this podcast. Thanks for joining us and we'll see you soon.