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Tips to Implement Literacy-Based Therapy for Students with SLI

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This is a guest blog post by Monica, a school-based SLP, all about tips to implement literacy-based therapy for students with SLI. 

Where to Start

If you’re looking for where to start with your students that need additional support for literacy-based therapy, this blog post is right up your alley. I’ll be going over how I modify literacy-based therapy for students with specific language impairment/speech-language impairment (SLI).

First, I will go over some recent research really quickly! It’s important to know where these suggestions are coming from.

Pico et al. (2021) just released a meta-analysis of narrative language interventions. This article had the conclusion that “findings from this corpus of studies suggest that measurable and lasting improvements in macrostructure and microstructure elements of narrative production can result from a variety of interventions even when provided in relatively small dosage.” They also found that many different types of interventions were successful including “manualized and/or scripted curriculum, explicit teaching of story grammar, and verbal and visual prompts.” The interventions included children with “diverse learner characteristics”.

My takeaway from this article is that it isn’t HOW we’re using contextualized narrative intervention; it’s that we’re just using it in the first place. This gives me the green light to keep modifying narrative therapy to support my caseload in a way that is individualized for my student’s unique needs. That’s what EBP is all about anyway, right?

I also reviewed two articles specifically studying children with specific language impairment. Both articles outlined methods that did not teach all of the story grammar elements in one lesson.

📕 Gilliam and Gilliam (2016) “Narrative Discourse Intervention for School-Aged Children with Language Impairment”
This study introduced story grammar one by one in individual lessons highlighting the “causal connection that exists between them” when teaching them (“e.g., He ran because he was afraid the bear would eat him”).

📗 Hessling and Schulele (2020) “Individualized Narrative Intervention for School-Age Children With Specific Language Impairment”
This study used individualized sessions to target the story elements that students had difficulty with and paired them with coordinating elements. For example, if a student struggled with the “character” element, they paired it with feelings. After that, they would move on to another element after they were confident the student understood that element.

Now, on to how to shape narrative-based lessons for your students with SLI!

How do I scaffold the literacy-based therapy framework for my students?

Research has shown that you can teach story grammar before (Gillam & Gillam 2016) you start putting events together or during (Spencer & Petersen 2020). Use your clinical judgment to choose what works best for your caseload!

Gillam and Gillam (2016) outlined having students learn story grammar parts first before targeting retell with the story grammar elements. I tend to lean towards this method because students with SLI “often have deficits in auditory memory and verbal working memory” (Hessling & Schuele, 2020). During these sessions, you’re gauging and scaffolding supports for a student’s working memory and also adding extra vocabulary exposure.

How to Adjust Literacy-Based Therapy for SLI Students

➡️  Activate pre-story knowledge with what makes sense for your students. I use songs, videos, and play therapy. If we’re doing a book about penguins, we might watch a video about penguins as we describe them (pre-teach vocabulary), talk about what we already know, and act like penguins.

➡️  Next, you can make a decision here to teach story grammar first, or to teach it while you work on sequencing/retelling based on what works best for your caseload. If you are pre-teaching story grammar, complete that step before reading the story.

➡️  Do a book walk and make predictions based on the title and cover page. You can chart your predictions on a story grammar graphic organizer.

➡️  Use shared reading strategies and point out story grammar elements as you are reading. In later stages, you can have the students identify it using gestures or verbally (Spencer et. al., 2015). Then, have your students sequence/retell with the supports that work for your students (ex: acting it out, retelling with a story grammar visual). If your students need extra support, you can chart the story grammar elements while you are reading.

➡️. After you’re done reading you can go back to your story grammar graphic organizer and fill out more details. When you look at it from this perspective you can see how the supports that you put in place and then take away are working memory supports.

➡️  After reading the book and retelling the story, you can work on other goals like expanding sentences and describing.

➡️ Last but not least, create a parallel story giving as much support as needed for your students. If this is a difficult task for your students, you can create the parallel story together until your students can do this without support.

Here’s a link to a free literacy-based planner to help you plan and organize all of your activities!

Literacy-Based Therapy Planner

What if my students aren’t ready to learn all of the story grammar elements?

You can adjust how many story grammar elements you teach.

Sometimes I may only start with 3-4 story grammar parts (character, problem, plan/attempt, solution/consequence) and build from there. Spencer & Petersen (2020) suggest that at a minimum episodes will include the “problem, attempt, and consequence”.

What if my students need support with temporal words?

After students are able to put 3-4 story grammar elements in order, I’ll switch to building up to using temporal words independently. I use lots of modeling and visuals!

I adapt all of the SLP Now materials to fit my needs. There was a new update to include simple retell pictures and sentence icons so that you can support your whole caseload!

Here’s an example of how to do this with SLP Now materials. We will use Room on the Broom as our story.

✓Do any pre-story activities you want!

✓Go on a book walk and predict what might happen in the story.

✓You don’t have to read the story word for word! I may scaffold a story and just describe the pictures and what’s happening for some of my students.

✓After going on a book walk, we read the story.

✓For the retell we talk about how first there was a witch (the character).

✓Next, she flew into the sky (setting).

✓Then, she had lots of animals on her broomstick and it broke (problem).

✓Last, she made a new broomstick in a cauldron (plan/consequence).

Adjust the retell for how much support your students need. They may need you to just model it at first. You can use pictures from the SLP Now book activity for your retell (pictured below).

You can add support by using story grammar icons and placing them next to the coordinating picture (Spencer et al., 2014). You can do this while you’re reading or during your story retell. It’s a great way to get your students familiar with story grammar before they’re ready for it.

SLP Now Story Retell

What about students that are working on WH questions?

You could also use the same worksheet to practice WH questions.

WHO: The witch is a character, and when we talk about WHO questions it’s the character.

WHEN: The night is the setting and that’s the answer to our WHEN questions. 

WHERE: A broomstick is a place because she sat ON the broomstick and that’s the answer to our WHERE questions. 

WHAT: At the end of the story, they make a new broomstick. That solved the problem and is the answer to our WHAT questions. 

This is also a great time to talk about causal relationships between the story elements.

Here’s an example:

The broomstick broke (problem) BECAUSE there were too many animals on the broomstick, so the witch (character) had to make a new one (plan/consequence).

I like to highlight to parents and students that they need to remember all of the key details (story grammar elements) in their working memory to be able to answer WH questions. I tell students that’s why we pick out the important parts and put them in our memory to keep for later! 

What about students that are working on expanding sentences and describing?

The book activity packets also contain icons that are great for students working on putting sentences together after retelling.

The icons also include describing words from the story. That’s a home run for mixed groups! I pair this sheet with the SLP Now Sentence Pack, a whiteboard, or sticky notes. 

Sentence Pack Icons

What about students that aren’t ready for the literacy-based therapy framework?

For students that I know won’t be able to start with picture books, I lean into supporting their vocabulary skills (learning about story grammar first) and work on creating a retelling schema to build up to working with the literacy-based framework.

This means that I want my students to know what story grammar elements are and be able to independently retell a simple story using pictures (basic episode). For students who are still working on putting words and sentences together, I adjust my visual supports. We’ll use core boards and sentence frames as needed. 

When working on simple story retells, I will model the story first then turn over the pictures. I want my students to imagine what’s happening in their heads and then retell it to me using whatever mode of communication they prefer, using lots of verbal support. Later on, we might act out the story together. The last step would be to take the pictures away and have them retell the story independently. I use vocabulary like “character” and “setting” while I’m talking about the story, but don’t expect students to use the terms. That way we have lots of exposure to the story grammar elements before we even start going over them! 

This progression is backed up by an article by Dempsey (2021), that showed that strong story comprehension skills were best predicted by a child being able to use a verbal account of a story (without pictures), followed by enactment (acting it out with prompts), then sequencing (retelling a story with pictures). This sets up a natural progression for fading support. 

Another way you could adjust retelling for preschool students is using scaffolding, as outlined in an article by Spencer et al. (2014). These steps are for the retell phase. The article also outlines supports for a personal generation phase. 

✓Model (show the pictures, model the story, put icons with coordinating picture, identify the story grammar parts)

✓Retell with pictures and icons (have pictures out for retell with icons, give support to the student with retell)

✓Retell with icons (take away pictures for retell, have icons out for visuals, support the student with retelling)

✓Retell without pictures and icons (no icons or pictures for retell, support student with retelling)

 

I hope that some of these strategies help you with your caseload and being able to provide literacy-based therapy! If it feels overwhelming, start small! You can start with a couple of groups to get the hang of it and expand from there. 

Don’t forget that SLP Now members have access to The Academy which has lots of information about literacy-based therapy if you ever wanted an in-depth course! 

 

References

Dempsey, L. (2021). Examining the validity of three methods of measuring pre-readers’ knowledge of storybook events. Child Language Teaching and Therapy, 37(2), 137–148.

Gillam, S., & Gillam, R. (2016). Narrative Discourse Intervention for School-Aged Children With Language Impairment. Topics in Language Disorders, 36, 20–34. 

Hessling, A., & Schuele, C. M. (2020). Individualized Narrative Intervention for School-Age Children With Specific Language Impairment. Language, Speech, and Hearing Services in Schools, 51(3), 687–705. 

Kamhi, A. G. (2014). Improving Clinical Practices for Children With Language and Learning Disorders. Language, Speech, and Hearing Services in Schools, 45(2), 92–103.

Pico, D. L., Prahl, A. H., Biel, C. H., Peterson, A. K., Biel, E. J., Woods, C., & Contesse, V. (2021) A. Interventions Designed to Improve Narrative Language in School-Age Children: A Systematic Review With Meta-Analyses (world) [Review Article]. ASHA Wire; American Speech-Language-Hearing Association. 

Spencer, T., Petersen, D., Slocum, T., & Allen, M. (2014). Large group narrative intervention in Head Start preschools: Implications for response to intervention. Journal of Early Childhood Research, 13.

Spencer, T. D., & Petersen, D. B. (2020). Narrative Intervention: Principles to Practice. Language, Speech, and Hearing Services in Schools, 51(4), 1081–1096. 

Ukrainetz, T. (2006). Contextualized language intervention: Scaffolding PreK–12 literacy achievement. Eau Claire, WI: Thinking Publications. 

The SLP’s Guide to Speech Sound Disorders: Articulation & Phonological Development

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This is a guest blog post by Holly, a school-based SLP, all about speech sound disorders: articulation and phonological development. 

Speech Sound Disorders

This post is a comprehensive guide to speech sound disorders, which is an umbrella term used to categorize difficulty with the production of speech sounds (the ASHA Practice Portal page for Speech Sound Disorders is a great reference for this topic).

There are speech sound disorders with known underlying causes (organic) including cleft lip/palate, orofacial conditions, deafness, dysarthria, and apraxia (check out this post for more information on childhood apraxia of speech). In this post, we’ll focus on types without a known cause (functional), including articulation and phonological disorders.

We’ll take a deep dive into these terms, but for now, here’s a quick refresher:

What is an articulation disorder?

An articulation disorder is characterized by difficulty producing individual speech sounds. The impairment is at the phonetic/motoric level, meaning that a sound may be substituted or distorted in a predictable way.

Example: A student produces the /s/ and /sh/ sounds with lateral airflow (e.g., a lateral lisp).

What is a phonological disorder?

A phonological disorder is difficulty organizing sounds in the brain. This impairment is at the phonemic/linguistic level, meaning that overall syllable structures and groups of sounds are omitted, substituted, or simplified. These phonological patterns often lead to reduced speech intelligibility.

Example: A student simplifies entire classes of sounds; they can produce /k/ and /g/ in isolation but habitually swaps in sounds that are produced in the front of their mouth as [t] and [d] (i.e., fronting phonological patterns, “tan” for can and “dough” for go).

Because this is a longer post, here’s an outline of everything we’ll cover:

1. Typical Speech Sound Development
– Articulation Norms
– Phonological Pattern Norms
– Speech Intelligibility Norms
– Contextual Factors
– Dialectal Considerations

2. Differential Diagnosis

3. Treatment Approaches
– Traditional Articulation Therapy
– Principles of Motor Learning
– Complexity Approach
– Phonological Contrast Approach
– Cycles Approach
– Metaphonological Approach
– Core Vocabulary Approach
– Multimodal Intervention

4. Literacy, Language, & Social-Emotional Considerations

Typical Speech Sound Development

To distinguish between typical development and speech sound disorders, let’s first consider what “typical” speech sound development looks like. We can use norms for sound acquisition, elimination of phonological patterns, intelligibility ratings, and contextual factors. For this post, we’ll also consider how dialectal differences in speech production can be distinguished from speech sound disorders. The information below is based on Mainstream American English (MAE).

Articulation Norms

There are different milestone sources to consider, which vary based on the population (who was included in the normative samples) and criteria for acquisition (what percentage of children can produce the sound at a given age, in order for it to be considered “acquired”). There is a wonderful post on the Informed SLP blog about interpreting speech norms! Here is a previous post that includes a free Speech Sound Development Chart. 🙌

The Iowa-Nebraska norms (Smit et al., 1990) were based on monolingual children (specifically, speakers of the standard Midwestern dialect), excluding children with any known conditions such as hearing loss, repaired clefts, or motor speech impairments. This data set was used to determine at what age 90% of children have acquired a sound at the word level.

The chart below (also found in our materials collection under Therapist Tools) outlines the Iowa-Nebraska Norms for each phonetic target (articulation). When looking at each sound class (phonology), you’ll notice that young children tend to acquire nasals, glides, and stop consonants first. They subsequently go on to acquire fricatives, affricates, liquids, and consonant clusters.

Speech Sounds

Next up, we have a summary of cross-linguistic developmental speech norms by McLeod & Crowe (2018), which included 64 studies and 27 languages. In a follow-up article (Crowe & McLeod, 2020), English consonant acquisition norms were compiled from 17 studies and a mean age of acquisition based on a criteria of 90%.

The chart below outlines the McLeod & Crowe Norms for each phonetic target (articulation). In an analysis of each sound class (phonology), plosives, nasals, and glides were typically acquired by 3;11, affricates by 4;11, liquids by 5;11, and fricatives by 6;11.

Speech Sounds

Phonological Pattern Norms

When children are learning to speak, it is natural for them to use just a few sounds and to simplify words. As their speech system develops, many of these simplified patterns are expected to fade away (phonological pattern elimination). These patterns can affect the way sounds are accidentally copied/pasted in a word (assimilation), the presence of sounds/clusters in syllables (syllable structure), and the place/manner/voicing of these sounds (substitutions).

Based on the work of Bowen (1998) and Peña-Brooks & Hegde (2015), here is a list of phonological patterns and the age that a child typically grows out of using the pattern:

Phonological patterns

Speech Intelligibility Norms

Speech intelligibility is used to determine how often a speaker is readily understood by their listeners. As you can imagine, this data may be impacted by the person judging intelligibility (a familiar listener vs. an unfamiliar listener) and the context (single words vs. utterances in connected speech; a known topic vs. a novel topic). ASHA’s guidelines state that by age 3, it’s expected that familiar people understand a child’s speech and by age 4, most people understand a child’s speech. We can also consider the following data across different sources:

Speech intelligibility

To measure speech intelligibility, you can use an estimated percentage or calculate utterances using a speech-language sample. You can also gather input using a questionnaire by McLeod, Harrison, & McCormack (2012). The Intelligibility in Context Scale (ICS) has been validated across many languages and rates the degree to which a child’s speech is understood by different communication partners.

Contextual Factors

We can also consider a range of factors when determining if a student has a speech sound disorder. In an article by Storkel et al. (2019), the authors advocate for gathering student-centered information about the potential academic and social impact:

“Best practice entails using a richer representation of development, specifically reflecting the range and variability inherent in development. Moreover, diagnosing the presence of a speech sound disorder requires more than just a single measure.”

Based on these recommendations, it is valuable to consider students’ capacity for speech perception and production, overall intelligibility, stimulability, phonological awareness, academic/social impact, and student/family insights (Storkel, 2019).

The Paperwork Binder on the SLP Now Materials site has a helpful Speech Sounds Assessment Checklist that can be used to consider factors beyond standardized testing numbers (see below).

Checklist

Dialectal Differences vs. Speech Sound Disorders

As clinicians, we must consider the sound systems of all the languages/dialects our students are using when we provide services. You’ll see at the top of the assessment checklist, there’s a prompt to consider factors for culturally/linguistically diverse speakers. This is important, because we don’t want to penalize students for using valid dialectal differences in their speech production.

For instance, the phonological features of African American English can include final consonant/cluster reduction at the syllable level, or substitution of “th” to /d/ and /f, t/ depending on the word position. These patterns are not counted as errors, just like a British English speaker wouldn’t need therapy to address vowelization of post-vocalic /r/. When considering a bilingual speaker, it is helpful to list out all the patterns that a student is using and cross-reference between languages to see if they could be explained by a dialectal difference or disorder. Here is a compilation of Phonemic Inventories and Cultural and Linguistic Information Across Languages from ASHA.

 

Differential Diagnosis of Speech Sound Disorders

Based on assessment data related to the information above, disordered speech production without a known cause can be differentiated between articulation disorders and phonological disorders. Here are some ways to distinguish between the two:

Speech Sound Disorders

Treatment of Speech Sound Disorders

These different diagnoses lend themselves to different treatment approaches. In this section, we’ll identify which populations benefit from a variety of intervention options. Building off a previous post (Articulation Approaches), here is an expanded version:

Traditional Articulation Therapy

Who: This is appropriate for children with 1-2 errors (e.g., /s/ or /r/), who have difficulty with the physical production of certain sounds.

What: Sounds are targeted based on the order of acquisition.

When: The child’s errors are not a part of a class of sound errors.

How: Stimulable sounds are targeted first, in order of age of acquisition. Therapy activities often include auditory discrimination, shaping of target sounds, and a hierarchy of practicing in subsequent contexts (isolation, syllables, words, words, phrases, sentences, structured conversation, unstructured/carryover).

Source: Tambyraja, S. R., & Dunkle, J. T. (2014). Target Selection in Speech Therapy: Is a Non-Developmental Approach More Efficient Than a Developmental Approach? EBP Briefs, 8(5), 1-9.

Principles of Motor Learning Approach

Who: This is appropriate for children who have difficulty with the physical production of certain speech sounds.

What: Using the principles of how we learn new movements, speech sounds are taught and practiced with high levels of repetition.

When: The child has access to therapy in distributed sessions, rather than longer/massed practice.

How: We explicitly teach and shape the target sounds, then randomize practice opportunities across contexts (e.g., words, sentences, connected speech).

Source: Maas, E., Robin, D. A., Hula, S. N. A., Freedman, S. E., Wulf, G., Ballard, K. J., & Schmidt, R. A. (2008). Principles of motor learning in treatment of motor speech disorders. American Journal of Speech-Language Pathology, 17, 277-298.

Complexity Approach to Therapy

Who: This is appropriate for children with low speech intelligibility who are missing several sounds from their phonemic inventories.

What: Sounds are targeted based on the level of complexity. Research shows that children acquire skills needed for less complex sounds while working on complex sounds and that articulatory skills trickle down to foundational sounds.

When: The child doesn’t yet produce the sound and is not stimulable.

How: We target more complex, later-developing sounds first, including clusters with 2-3 sounds (like “throw” and “splash”). The objective is to make fast changes. Check out an earlier podcast episode detailing the Complexity Approach!

Source: Strokel, H. L. (2017). The Complexity Approach to Phonological Treatment: How to Select Treatment Targets. Language, Speech, and Hearing Services in Schools.

Phonological Contrast Approaches

Who: This is appropriate for children with mild-severe phonological disorders, including developmental and non-developmental errors.

What: Phonological patterns are targeted to help re-organize a child’s linguistic system by teaching meaningful contrasts between sounds and syllable structures.

When: Students consistently substitute or omit sounds using phonological patterns (e.g., fronting, backing, stopping, consonant cluster reduction, gliding).

How: We use sets of words that differ by one sound, which may deviate by one feature (minimal pairs) or many features (multiple/maximal oppositions, empty set). Using these words, students practice discriminating between the targets, then producing words in meaningful ways.

Source: Blache, S. E., Parsons, C. L., & Humphreys, J. M. (1981). A minimal-word-pair model for teaching the linguistic significant difference of distinctive feature properties. Journal of Speech and Hearing Disorders, 46, 291–296.

Cycles Approach

Who: This is appropriate for children with patterns of omissions and sound substitutions.

What: Phonological patterns are treated in cycles of 5 to 16 weeks. The error patterns are targeted in each cycle.

When: Students present with many sound omissions and some sound substitutions.

How: A new cycle begins upon completion of a previous cycle. Check out a podcast episode with Shannon Werbeckes diving into the Cycles Approach!

Source: Hassink, J. M., & Wendt, O. (2010). Remediation of Phonological Disorders in Preschool Age Children: Evidence for the Cycles Approach. EBP Briefs, 5(2), 1-7.

Metaphonological Approach

Who: This is appropriate for children with phonological disorders.

What: The phonological structure of sounds within a language is taught to help remediate the underlying lack of awareness.

When: Students lack self-monitoring skills in the area of speech sound production but are stimulable with cueing.

How: We target phonological patterns by explicitly teaching features of sounds (long/short, voiced/voiceless) and linking phonological awareness to speech production.

Source: Dean, E., Howell, J., Waters, D., & Reid, J. (1995). Metaphon: A metalinguistic approach to the treatment of phonological disorder in children. Clinical Linguistics & Phonetics, 9, 1–19.

Core Vocabulary Approach for Speech Sound Therapy

Who: This is appropriate for children with severe speech sound disorders, especially if their errors are inconsistent.

What: Select functional, high-frequency words and work on producing them consistently in a variety of contexts.

When: Students are highly unintelligible, motivated by certain interests, and where family involvement is available to support practice.

How: We collaborate with family members to create a list of target words and visuals, practicing in batches until repetition is consistent and mastery is reached.

Source: Dodd, B., Holm, A., Crosbie, S., & McIntosh, B. (2006). A core vocabulary approach for management of inconsistent speech disorder. Advances in Speech-Language Pathology, 8(3), 220-230.

Multimodal Intervention for Speech Sound Disorders

Who: This is appropriate for children with severe speech sound disorders with low speech intelligibility.

What: Supplement speech with visual supports, either using low-tech or high-tech augmentative and alternative communication (AAC) options.

When: Students and families are facing communication breakdowns and in need of a functional method of communication ASAP.

How: Simultaneously targeting natural speech and AAC speech using an integrated multimodal approach can be effective in producing positive changes in both overall communication and speech production goals.

Source: King, A., Hengst, J., DeThorne, L. (2013). Severe speech sound disorders: an integrated multimodal intervention. Language, Speech, and Hearing Services in Schools, 44(2):195-210.

 

Literacy, Language, & Social-Emotional Considerations

The link between speech sound disorders and additional communication concerns has been studied for good reason! Here are some resources to brush up on your knowledge in these areas:

Literacy

Not only are students with speech sound disorders at a higher risk of reading difficulties, but working on phonological awareness skills can help when targeting speech sound production in therapy (Tambyraja & McCauley, 2012). Win-win!

Because of this, phonological awareness has been a topic we’ve taken a special interest in lately on the SLP Now podcast and blog!

Blog Post: Phonological Awareness Development + Chart

Podcast #28: Where to Start with Phonological Awareness

Podcast #98: A Quick Review of Phonological Awareness

Podcast #99: Phonological Awareness Assessment and Goals 

Podcast #100: Phonological Awareness Treatment Ideas

Podcast #101: What We’ve Learned About Phonological Awareness

Language

Speech sound disorders and language disorders are also known to co-occur (with rates estimated between 50-75% in preschoolers, and 15% by age 6; Macrae & Tyler, 2014). There’s still a lot of growing evidence in this area (Combiths, 2019), but something to consider is the overlap of phonological and morphosyntactic skills for students (e.g., word-final consonant clusters to mark plurals, possessives, and verb tense).

Social-Emotional Considerations

It’s no surprise that when students encounter difficulty clearly expressing themselves, the risk of social-emotional impact also rises. In a study by McCormack et al. (2009), childhood speech sound disorders were found to be associated with activity or participation restrictions related to communication, academic skills, relationships with family/friends/authority, and job skills. Because of this, it’s valuable to assess and address our students’ perceptions, feelings, and attitudes about their own speech, plus barriers they may encounter across social settings. This gives us a better picture of the impact of their speech sound disorder and leads to student-centered focus with our intervention!

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Whew, you made it! Thanks for checking out The SLP’s Guide to Speech Sound Disorders. We reviewed typical development, considerations for differential diagnoses and intervention, plus overlapping factors with speech sound disorders! What questions do you have and is there anything else you’d like to see related to this topic?

 

References

Baker, E., & McLeod, S. (2011). Evidence-Based Practice for Children with Speech Sound Disorders: Part 2 Application to Clinical Practice, Language, Speech, and Hearing Services in Schools, 42(2), 140-141

Bauman-Waengler, J. A. (2012). Articulatory and phonological impairments. New York, NY: Pearson Higher Education.

Bernthal, J., Bankson, N. W., & Flipsen, P., Jr. (2013). Articulation and phonological disorders. New York, NY: Pearson Higher Education.

Blache, S. E., Parsons, C. L., & Humphreys, J. M. (1981). A minimal-word-pair model for teaching the linguistic significant difference of distinctive feature properties. Journal of Speech and Hearing Disorders, 46, 291–296.

Bowen, C. (1998). Developmental phonological disorders. A practical guide for families and teachers. Melbourne: ACER Press.

Bowen, C. (2011). Children’s speech sound disorders. Retrieved from http://www.speech-language-therapy.com/ [Updated on Tuesday, 12 October 2021]

Coplan J, Gleason JR. Unclear speech: recognition and significance of unintelligible speech in preschool children. Pediatrics. 1988 Sep;82(3 Pt 2):447-52. Erratum in: Pediatrics 1988 Dec;82(6):862. PMID: 3405680.

Combiths, P. N., Barlow, J. A., Richard, J. T., & Pruitt-Lord, S. L. (2019). Treatment targets for co-occurring speech-language impairment: A case study. Perspectives of the ASHA special interest groups, 4(2), 240-256.

Dean, E., Howell, J., Waters, D., & Reid, J. (1995). Metaphon: A metalinguistic approach to the treatment of phonological disorder in children. Clinical Linguistics & Phonetics, 9, 1–19.

Dodd, B., Holm, A., Crosbie, S., & McIntosh, B. (2006). A core vocabulary approach for management of inconsistent speech disorder. Advances in Speech Language Pathology, 8(3), 220-230.

Fabiano-Smith, L., & Hoffman, K. (2018). Diagnostic Accuracy of Traditional Measures of Phonological Ability for Bilingual Preschoolers and Kindergarteners. Language, speech, and hearing services in schools, 49(1), 121–134. https://doi.org/10.1044/2017_LSHSS-17-0043

King, A., Hengst, J., DeThorne, L. (2013). Severe speech sound disorders: an integrated multimodal intervention. Language, Speech, and Hearing Services in Schools, 44(2):195-210.

Maas, E., Robin, D. A., Hula, S. N. A., Freedman, S. E., Wulf, G., Ballard, K. J., & Schmidt, R. A. (2008). Principles of motor learning in treatment of motor speech disorders. American Journal of Speech-Language Pathology, 17, 277-298.

Macrae, T., & Tyler, A. A. (2014). Speech abilities in preschool children with speech sound disorder with and without co-occurring language impairment. Language, Speech, and Hearing Services in Schools, 45(4), 302-313.

McCormack, J., McLeod, S., McAllister, L., & Harrison, L. J. (2009). A systematic review of the association between childhood speech impairment and participation across the lifespan. International Journal of Speech-Language Pathology, 11(2), 155-170.

McLeod, S., & Baker, E., (2017). Children’s Speech: An evidence based approach to assessment and intervention. Boston: Pearson

McLeod S, Harrison LJ, McCormack J. (2012). The intelligibility in Context Scale: validity and reliability of a subjective rating measure. J Speech Lang Hear Res. 2012 Apr;55(2):648-56. doi: 10.1044/1092-4388(2011/10-0130). Epub 2012 Jan 3. PMID: 22215036.

Peña-Brooks, A., & Hegde, M. N. (2015). Assessment and treatment of speech sound disorders in children: A dual-level text. PRO-ED, an international publisher.

Shriberg, L. D., Austin, D., Lewis, B. A., McSweeny, J. L., & Wilson, D. L. (1997). The Speech Disorders Classification System (SDCS) extensions and lifespan reference data. Journal of Speech, Language, and Hearing Research, 40(4), 723-740.

Shriberg LD, Kwiatkowski J. (1982) Phonological disorders III: a procedure for assessing severity of involvement. J Speech Hear Disord. 1982;47:256–70.

Smit, A. B., Hand, L., Freilinger, J. J., Bernthal, J. E., & Bird, A. (1990). The Iowa articulation norms project and its Nebraska replication. Journal of Speech and Hearing Disorders, 55(4), 779-798.

Smit, A. B. (1993). Phonologic error distributions in the Iowa-Nebraska articulation norms project: Consonant singletons. Journal of Speech, Language, and Hearing Research, 36(3), 533-547.

Storkel, H. L. (2019) Using Developmental Norms for Speech Sounds as a Means of Determining Treatment Eligibility in Schools. Perspectives of the ASHA Special Interest Groups, Vol. 4, 67-75.

Williams, A. L. (2000). Multiple oppositions: theoretical foundations for an alternative contrastive intervention approach. American Journal of Speech-Language Pathology, 9(4), 282-288.

#105: Comprehensive Emergent Literacy: Favorite Strategies + Resources

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In today’s episode, Benita shares her favorite strategies and resources for comprehensive emergent literacy.

You’ll walk away with some great ideas and new resources to add to your toolbox. 💪

As we wrap up this month’s series, we want to remind you that you, as an SLP, already have a lot of these tools and knowledge in place, and now you have a framework for implementing them for students who use AAC. You’re doing an amazing job and we hope that this information will help. It certainly has helped us and the purpose of this series is to help you do what you’re doing, but to do it even better!  So we encourage you to just keep doing what you’re doing, and you are going to do amazing things to help support your students who use AAC to learn to read and write.

Keep it up, SLP! 💛

Comprehensive Emergent Literacy Framework

Shared Reading

Shared Writing

Alphabet and Phonological Awareness

Independent Writing

Self-directed Reading

Favorite Strategies and Resources

– BIGmack
– Story Grammar Marker
– Braidy Doll
– Tarheel Reader
– Epic Books – FREE with an educator email
– OverDrive – FREE with a local library card
– Novel Effect – Sound Effects for the book and help with engagement
– Literacy Through Unity – FREE resources on the AAC
– Saltillo – FREE Calendar support
– Tell Me curriculum – Elementary population
– UNC Center for Literacy  – Training
– Vooks – Engaging Video Books
– Comprehensive Literacy for All: Teaching Students with Significant Disabilities to Read and Write
– Speechie Side Up
– @speechiesideup on Instagram
– Core Calendar Club Facebook group

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Bonus points if you leave us a review over on iTunes → Those reviews help other SLPs find the podcast, and I love reading your feedback! Just click here to review, select “Ratings and Reviews,” “Write a Review,” and let me know what your favorite part of the podcast is.

Thanks so much!

Transcript

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Marisha: Hello there and welcome to the SLP Now Podcast, where we share practical therapy tips and ideas for busy speech-language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode.

Marisha: This month we are talking all things AAC and literacy with Venita Litvack. So, head to episode 102 to get a getting started face, and if you've already been listening to the episodes, just join us to continue learning more about AAC, literacy, and comprehensive emergent literacy.

Marisha: We've got one more question. What are your go-to resources when you're implementing these strategies and just incorporating AAC and literacy in your sessions?

Venita L.: This is probably my favorite question because there's so many great resources out there and I don't know that everybody knows that they're available. And you kind of wonder, "Where are these resources?", but they're so disseminated. So I'd like to summarize them all here.

Venita L.: In terms of AAC and literacy, or just literacy in general, Tar Heel Reader is an amazing resource. It was developed by the University of North Carolina's Center for Literacy and Disability Studies, and what you can do on Tar Heel Reader is you can create your own books or you can look for books and you can look for books based on keywords. So if let's say you're doing a core word of the week or the month or the day, then you can look up books that have that core word in it. So that's a really great resource that you can use online, you can pull up on a projector or SMART Board and implement it within a group setting. And then Epic Books, which I'm sure you probably mentioned. I know that's a hot one in our field, but Epic Books is great and you can access it for free if you have an educator's email or a school email. And then OverDrive is also great. You can access thousands, tens of thousands of books that are available at your local library for free, you just have to put in your library card information.

Venita L.: And then this one's not as well known, but I've spoken about it in other trainings that I've done, it's called the Novel Effect app. And the reason I like that one is because it provides sound effects for popular books and they're building their library all the time. So if you're reading Brown Bear, Brown Bear, it's crazy. It knows when you are onto the next page without you even clicking anything on the app, just based on your reading of the book. So if you say, "Brown bear, brown bear, what do you see?", and then you pause, it'll play music just for that page and sound effects just for that page. So I think that's a really great way to get especially younger kids engaged in the reading.

Venita L.: And then PRC or the Prentke Romich Company, the creators of LAMP Words For Life and Unity and other AAC language systems and devices, has a resource called Literacy Through Unity on the AAC Language Lab, which is a phenomenal program that's online that you can go to and they have free resources on the AAC Language Lab, and they also have a paid subscription, but it's very little for the year. I want to say it's like 20 bucks for the year, maybe even less, but they have a Literacy Through Unity program that, actually, Karen Erickson helped develop. So if you have a student who uses Unity or LAMP, then I would check that out.

Venita L.: And then Saltillo, if you have a student who uses a NovaChat or the TouchChat app, they have these calendar supports. So for the month of January, they give you a book and then the words that you can target with that book and some other literacy-based suggestions for that month. So I love that resource and it's free.

Venita L.: The TELL ME curriculum, I just wanted to mention it here. I, in full disclosure, don't have a lot of experience with that book just because I think it's primarily geared towards the preschool population and that's not a population that I work with, that I support at this time. I would love to learn more about it, but in my department, we kind of provide resources and trainings to the areas that you work in. So at some point, I'm looking forward to diving into that curriculum a little bit more, but I just don't know a lot about it. But if you work with that population or the elementary population, then I would really encourage you to look into that curriculum.

Venita L.: And then any of the resources from UNC's Center for Literacy and Disability Studies is phenomenal. They have trainings on there and modules, so check that out. Now we have this resource, and I'll just say the name one more time, because I think it's worth noting. A lot of the information I spoke about today is from this book, and it's just a really helpful book. I will forewarn you though, that it is like a textbook, which I wasn't really expecting because it has this beautiful cover. It's very dense and it is bringing me back to grad school days, but you know what? It is just so amazing, and every page is like a mic drop, so I really encourage you to check it out. It's called, again, Comprehensive Literacy for All: Teaching Students with Significant Disabilities to Read and Write by Karen Erickson and David Koppenhaver.

Marisha: Oh, I love books like that, where there's just so many mic drops and knowledge bombs. It can be hard to find those types of answers, so when you find a resource that really breaks it down, you just kind of hone in on that.

Venita L.: Mm-hmm (affirmative), definitely.

Marisha: And those were so many amazing resources. I'll definitely, if you're listening and you had a hard time keeping up with all the amazing ideas, I'll list and link to everything that I can at slpnow.com/42, so you can start checking those out.

Marisha: Is it okay if I add one more that came up for me too?

Venita L.: Sure.

Marisha: I just discovered this, maybe a few months ago, it's called Vooks, so V-O-O-K-S. They make animated videos for a lot of popular books, so I think it could be a great activity for that independent or self-directed reading time because it really draws students in. And then I think they even animate the words in some or all of them, so it's just a great way to draw attention to the literacy piece, but it supports the students in reading that too, and just keeping them engaged. The students I've used it with have loved it, so I really like that one too.

Venita L.: I love that. I've heard about that resource. I haven't actually had the opportunity to look at it, but I think it is a great idea for that self-directed reading, so thank you for sharing that.

Marisha: And then, I also just want to emphasize, 'cause I feel like one of the biggest barriers is getting access to books, because you feel like some SLPs aren't able to go to the library or they don't want to use library books in therapy because things happen. And so, I just think the resources that you mentioned to get books for free, like Epic and OverDrive are so incredibly helpful because you don't even have to go anywhere. You have instant access to these digital books for free. So I don't think that budget or time to drive and get physical books should be a barrier here.

Marisha: And if those options don't work, YouTube has books as well. They have lovely grandmothers who record themselves reading books, and definitely check out the video first, but there's lots of ways to make this happen. And I feel like after listening to this episode, you are equipped with so many strategies to use literacy in therapy. And so, I feel like that's just the last step to start practicing and working on implementing this.

Venita L.: Yeah, absolutely.

Marisha: Venita, is there anything that you would add or that you just really wanted to emphasize?

Venita L.: No, I think that you, as an SLP, already have a lot of these tools and knowledge in place, and now you have a framework for implementing them for students who use AAC. So you're doing an amazing job and I hope that this information will help. It certainly has helped me as I'm reading through that book because it was just really nice to see like, okay, we're doing the right thing, but this is how we can do it even better. So I encourage you to just keep doing what you're doing, and you are going to do amazing things to help support your students who use AAC to learn to read and write.

Marisha: I love ending on that note. Thank you so much for sharing your time and wisdom with us. And if people want to find out more about you, where are the best places for them to connect?

Venita L.: Good question. I tend to hang out on Instagram @speechiesideup, and then my website is also speechiesideup.com. And if you want to come join us on that Facebook group called the Core Calendar Club, we would love to have you. We do ask two questions in the beginning and one includes taking a quiz. The reason that we have you take the quiz is because we're gathering data that we are hopefully going to present at a conference in the near future, and we also want to see if the group is helping you from the start to finish. So you'll take a quiz at the beginning and you'll take a quiz at the end, but it's a fun quiz. It has maybe 5 to 10 questions, and then you find out if you're more like Ariana Grande, Lady Gaga, or Beyonce, so we make it fun for you.

Marisha: Oh, I love that. Definitely something fun to check out. Okay, that's a wrap. Thank you so much, Venita. You are amazing and such an inspiration, and I definitely appreciated all of the information that you shared, and thank you to the listeners for tuning in.

Venita L.: Thank you so much for having me, Marisha. When you asked it was such an honor and I think you are so inspiring too. And again, I love that we were able to combine both of our passions into this episode today.

Marisha: Yeah, this was definitely a highlight, so thank you.

Venita L.: Thank you.

Marisha: Thanks for listening to the SLP Now podcast. This podcast is part of a course offered for continuing education through SpeechTherapyPD. So yes, you can earn ASHA CEUs for listening to this podcast. If you enjoyed this episode, please share with your SLP friends and don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.

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#104: Comprehensive Emergent Literacy: Step 3-5

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In today’s episode, Benita shares multiple strategies for the last 3 steps of the Comprehensive Emergent Literacy framework.

Comprehensive Emergent Literacy Framework

Shared Reading

Shared Writing

Alphabet and Phonological Awareness

Independent Writing

Self-directed Reading

Activities for Steps 3+4 of the Framework

Alphabet and phonological awareness

Time: Erickson and Koppenhaver recommend doing this for about 20 to 30 minutes a day, explicit alphabet and phonological awareness instruction.

Phonological Awareness is the ability to identify and manipulate sounds and spoken language.
Activities: Letter-of-the-day approach
Overview: Reteach every 26 days using the following routine. Identify the letter, identify the sound of the letter, find the letter in text and write the letter.

Those four components are really important for teaching a letter.

Alphabet Knowledge includes the ability to distinguish letters, shapes, name them, write them and identify the sounds they represent.
Activities: Clap out syllables, listen to nursery rhymes, raps, poetry, and playing alliteration games. 

Independent writing

Strategy: Provide access to a variety of writing materials, such as crayons, pencils, dry erase markers, alphabet letters, computers, AAC devices. 
Time: 20-30 minutes a day
Overview: Then make sure to ask the student to read aloud what they have written and write it down for them and publish the material but putting it up on a board or in the classroom.

Self-directed Reading

Strategy: Build a library of reading materials. Providing access to magazines, newspapers, song lyrics, reading apps, comic books, audible, all of those different ways that they can access reading, because believe it or not, audible reading, like read alouds, is reading. There’s tons of research to support that. I just heard it recently and it reaffirmed that.
Time: 10-15 minutes a day
Overview: Have the students share what they read about at the end of the self-directed reading.

Links Mentioned in the Podcast

– BIGmack
– Story Grammar Marker
– Braidy Doll
– Tarheel Reader
– Epic Books
– OverDrive
– Novel Effect
– Literacy Through Unity
– Saltillo
– Tell Me curriculum
– UNC Center for Literacy
– Vooks

Subscribe & Review in iTunes

Are you subscribed to the podcast? If you’re not, subscribe today to get the latest episodes sent directly to you! Click here to make your listening experience auto-magic and as easy as possible.

Bonus points if you leave us a review over on iTunes → Those reviews help other SLPs find the podcast, and I love reading your feedback! Just click here to review, select “Ratings and Reviews,” “Write a Review,” and let me know what your favorite part of the podcast is.

Thanks so much!

Transcript

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Marisha Mets: Hello there and welcome to the SLP Now Podcast, where we share practical therapy tips and ideas for busy speech language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode. This month we are talking all things EAC and literacy with Venita Litvack. So head to Episode 102 to get the getting started phase. And if you've already been listening to the episodes, just join us to continue learning more about AAC, literacy and comprehensive emergent matters.

Venita Litvack: The third area is alphabet and phonological awareness. We're going to be talking about different activities to use for that area. But I think when we talk about the terms phonological and alphabet knowledge, it brings back nightmares from grad school. I'll just provide some brief definitions for both of those, because if you're anything like me, it was definitely crossed over the two definitions. Phonological awareness is the ability to identify and manipulate sounds and spoken language. Then alphabet knowledge includes the ability to distinguish letters, shapes, name them, write them and identify the sounds they represent. Now that we've talked about both of those, let's get into the activities that we can address for both.

Venita Litvack: Interestingly, what I read in that book that I referenced in the beginning is that Treiman, Levin and Kessler in 2007 found that teaching a letter of the week or month is not the appropriate amount of time to learn each letter. I thought that was so fascinating and super applicable to even a core word-of-the-week approach, which that's a whole nother topic. But they found that this is the case, because if they're doing a letter of the week, it's going to take 26 weeks for that letter to be revisited again, unless it's being embedded in daily routines. But really to be specifically targeted, it's going to be another 26 weeks before it's reintroduced. It's almost the entire school year. It just is not enough time for students to embed that letter, use it in functional ways.

Venita Litvack: Instead, what they recommend is that you use a letter-of-the-day approach so that letters are retaught every 26 days using the following routine. They want you to identify the letter, identify the sound of the letter, find the letter in text and write the letter. Those four components are really important for teaching a letter. Any questions about that? Because I know that was a lot of information.

Marisha Mets: No, I think that makes sense. I really appreciated just defining what we're talking about with phonological awareness and alphabet knowledge. I think that's a really great tip of focusing on using the letter-of-the-day approach versus the week or the month. I love the four strategies that you shared too, because I feel this is so incredibly actionable. I'm curious to hear if you have any other tips for this area.

Venita Litvack: Okay, perfect. We'll move on to ideas for phonological awareness instruction. These are fun. I'm sure that a lot of these you've heard of. You can go on Pinterest for some ideas on addressing phonological awareness. But things like clapping out syllables, listening to nursery rhymes, even [RAPs 00:03:33] for your older students, poetry and playing alliteration games. Like I said, Pinterest has so many different activities that you can do to address those areas. Then in terms of alphabet instruction, same thing. You can use alphabet books, alphabet puzzles, games, student names, environmental print. There's so many different ways that you can address that just by looking at ideas on Pinterest. If I didn't say this already, Erickson and Koppenhaver recommend doing this for about 20 to 30 minutes a day, explicit alphabet and phonological awareness instruction.

Marisha Mets: Perfect. I think that's a really great overview and starting point. Each of these areas could potentially be a whole podcast. I think we'll leave it at this. And maybe we can revisit if we have time at the end, just to break it down a little bit more. But I think this is a really awesome place to start. So what's the next step?

Venita Litvack: The next two areas, they're much shorter. They're not as dense. We'll go through those pretty quick. The last two areas are independent writing and self-directed reading. Some ideas for promoting independent writing 20 to 30 minutes a day is to provide access to a variety of writing materials, such as crayons, pencils, dry erase markers, alphabet letters, computers, AAC device. The idea here is to provide access to a ton of different writing materials, not just a pen and paper or pencil and paper. Then make sure to ask the student to read aloud what they have written and write it down for them.

Venita Litvack: A training that I just attended, it was so fascinating, because she had us go through different writing examples. We know that emergent writing is not letter based. It's forming circles, forming lines, doing little drawings that communicate a message. She had us look at these drawings. Then she told her what the child explained the story behind the picture was. Then she would ask us, is the student and emergent writer or a conventional writer? I just thought that was so fun. If your students are not writing conventionally, like with letters, you can definitely have them tell you the story behind their drawing or their writing and summarize it for them on another page by writing it down so they can see what that looks like.

Venita Litvack: Then one really special thing is when your parents would put up your writing on your refrigerator or a board, it's really special for kids to be motivated to keep writing more by publishing their writing that way. If you can put it up in your speech room or in the classroom, maybe have a writing corner or a board, that would be really helpful as well.

Marisha Mets: No, that's perfect. Those are such great ideas. I'm curious too, because you could potentially use some of the RAP strategies that you talked about here, too. With some of these students, if we ask them and they don't respond within a couple of seconds, we probably want to wait a little bit longer. Do you have any additional strategies when it comes to talking to students or asking students about what they wrote?

Venita Litvack: That's a really, really good question. I would assume that they dive into that in the book that I presented in the beginning. I would recommend looking at that. On the top of my head, I don't have a framework for writing, like I do with the shared reading. But it's a really good thought, because if it hasn't been developed, then that might be a nice thing for somebody to look into.

Marisha Mets: If they don't have well researched answers for us, I think we can definitely pull from some of the other strategies you've shared to make that happen. I love that. I'm loving these tips so far. What about self-directed reading?

Venita Litvack: Self-directed reading, that was the last area of comprehensive emergent literacy instruction. Some ideas that are recommended to promote independent reading include building a library of reading materials. It's important to note that this should be done about 10 to 15 minutes a day. Depending on the time that you see this child or the time that you see the group, that might not be feasible for your group, if you're only seeing them for 30 minutes, but again, working with the teacher to provide that additional time for self-directed reading. Providing access to magazines, newspapers, song lyrics, reading apps, comic books, audible, all of those different ways that they can access reading, because believe it or not, audible reading, like read alouds, is reading. There's tons of research to support that. I just heard it recently and it reaffirmed that.

Venita Litvack: It's definitely questionable, but it is still considered reading. It's important for people to keep that in mind and provide access to that for students. Then you want to provide a variety of materials so that all the students have access to something they want to read. Not necessarily materials, but maybe genres. Some students might like to read comics. Some students might like to read fantasy, fiction, sports. So it's important to provide a variety of reading materials to them. Then at the end of the self-directed reading, this is really important, have students share out what they read about.

Marisha Mets: That is perfect. You just shared a ton of different strategies, lots of different resources and things that we can use. But there's a lot, definitely way more than can fit in one session. So how do you go about planning your group lessons to incorporate these strategies and just tips for making this happen in general?

Venita Litvack: Okay. That's such a good question. I think it's so important, because looking at the research is one thing. But putting it into practice is a totally different thing. You explained what my role is now. I'll just be very transparent here, I am an assistant technology specialist. Now, I support teachers and SLPs in the middle school. But I did work in a charter school for children with autism when I first got started. I'll explain what that looked when I was doing AAC and literacy in group lessons, when I was doing collaborative lessons with the teacher. It's going to look a little bit different than what I described and I think you do what you can until you know better. I'll explain what I did. Then maybe some things I might change knowing what I know now.

Venita Litvack: One of the things that I did in terms of shared reading is that I would pick a book for theme of the week, which I know you're really passionate about. And that's great. I'd pick a book or theme of the week. If it could go along with the academic lesson, all the better. I would talk with the teachers about what they were working on and try to pick a book that went along with that. Then I would identify core and fringe vocabulary that can be modeled while reading, which is important when you're doing that RAP strategy. And then I provide access to AAC. Students could use their personal AAC systems or BIGmacks. And on the BIGmack, I might put a repetitive phrase that I want the student to say.

Venita Litvack: If we're reading a book like Brown Bear, Brown Bear, What do you See? I might have that whole phrase or I might have, what do you see on the BIGmack. And the students that don't have a ACC system, they can take turns pushing the buttons so they feel they're helping me read. I don't know, Marisha, are you familiar with Story Grammar Marker? I feel you would be.

Marisha Mets: Yes.

Venita Litvack: Okay. I love Story Grammar Marker. I would use the Braidy doll to discuss story elements after the reading. We would talk about the character, the setting and the story sequence using the Story Grammar Marker doll. Then in order to address shared writing, I would pick a phrase that relates to the book, such as, say we're reading Brown Bear again, maybe I see a... Then the students could do that predictable chart writing with them filling out what they see. Each student would say, "I see a teacher, I see a chair," whatever they see at the moment that they want to say for their little phrase.

Venita Litvack: I like to reiterate this. Depending on how often you go into the classroom, you can do each step of the predictable chart writing or some steps and help the teacher, or even assign homework to the parent. And then in order to address alphabet knowledge and phonological awareness, every day I would sing a letter song with my groups. You can find these on Pinterest or TPT. Mine were cards. For each letter, it had a sound that went with the letter and we would sing it out as a group. This was really for my younger elementary school aged kiddos.

Venita Litvack: Then in order to also address the phonological and alphabet knowledge, we would incorporate the academic words. The programs that the teachers that I worked with `provided words of the month. These tended to be a lot of sight words. There's a lot of crossover between sight words and core words. We put it up on a word wall or they might already have it up on a word wall. We would try to read the words, clap them out, spell them out. There's other research out there, other strategies that are pretty well known, at least in the education field, on how to target those words as a group and do phonological awareness instruction with those words.

Marisha Mets: I love the practical examples here, and just what this could look in practice. Then I have just a quick experience to share, too. I worked in an autism preschool. This was my first job that I had. I didn't know all of this research yet. I totally resonate with what you said about you do what you can until you know better, because there's definitely no way to know it all when we first start out. But I was able to use a lot of these strategies when I went into the classroom. For me, circle time was a really good time to make that happen, because the teacher was already using, like we did songs that we could work on. We had an alphabet song. We would show the letters. We had a lot of that alphabet-phonological awareness aspects built into that routine. Then I would always bring in a book and do some different activities around that.

Marisha Mets: At this level, a lot of the students were just using a single switch, that and the BIGmack or whatnot. We included some of those different activities. We identified the core vocabulary that we wanted to target during that. If I were going back, I think I would have done the RAP strategy. And I don't know, did they say in the book, which ages you would start this with? Would you do the sentence activity with preschool, too?

Venita Litvack: They did say that you can start pretty young. I haven't gotten to a point where they said there's a specific age limit. They give ideas for targeting these areas with different age groups. But they didn't say that a child is too young. But I haven't completely finished it so I don't want to say that they do or they don't.

Marisha Mets: That's amazing, because I was in a typical preschool too, where they definitely did activities. In the autism preschool, they also did activities with their names and letters and all of that. But I know in the general preschool, they cut up sentences and things like that. I've seen it in practice. I've seen little kiddos do it. I am definitely going to check out this book, because it sounds an amazing resource for this population. I'm so grateful you shared that. But I think it's just really helpful, because I think a lot of us, as we're listening to this, we're able to identify strategies that we've used in our practice. And this is just a way to celebrate what we're doing and reinforce those activities that we are using. Then maybe think of some things to add to our own session or to work with the teachers on, like, "Hey, I heard that this was really great."

Marisha Mets: The reason that I wanted to share my preschool experience was I would go in on Monday with the book and I would model all of that. Then the teacher and the para educators would be in the classroom with me, too. It's the best thing, when you walk into a classroom and they're using those strategies that you modeled the day or earlier in the week. So I definitely led it a couple of times, but it was just really cool to see them reinforcing that throughout the day, too. We definitely get to use a team approach to make this happen. It's not all us.

Venita Litvack: I love that. I, like you, I've done both sides. Recently I had to help cover for SLP services. I got to work with the gen ed population in the schools. I could see why that collaborative teaching wouldn't work because their goals are very different. Maybe we're working on sound specific goals. But even in your group settings, you can definitely address those areas of literacy at the same time that you're targeting those other goals.

Marisha Mets: Mm-hmm (affirmative). So amazing. Thanks for listening to the SLP Now Podcast. This podcast is part of a course offered for continuing education through SpeechTherapyPD. So yes, you can earn [Ashesi CEs 00:17:18] for listening to this podcast. If you enjoyed this episode, please share it with your SLP friends. And don't forget to subscribe to the podcast to get the latest episodes sent directly to. See you next time.

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Phonological Awareness Development Chart [Free Download]

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This is a guest blog post by Monica, a school-based SLP, all about the importance of phonological awareness development. Scroll down to access the free download!

The Importance of Phonological Awareness

Phonological awareness always feels like something you hear about everywhere, and with good reason! It’s the earliest indication of reading skills in students (Gillon, 2000) and working on phonological awareness has been shown to improve speech sound disorder therapy outcomes in preschool students (Tambyraja & McCauley, 2012).

It makes sense when we think about a phonological disorder as a language disorder (Bowen, 2011). I love incorporating phonological awareness in my sessions because it’s a small effort for a big reward! You’re probably already using phonological awareness in your sessions (hello, minimal pairs)!

Phonological awareness is quick and easy to both assess and include in your therapy sessions. I promise! In doing so, you can also prevent your students from developing reading difficulties later in life (Gillon, 2000).

SLP Now has you covered if you want to know more about phonological awareness! I’ll link to some of our podcasts, blog posts, and give you a preview of the available materials to members.

 

But first… Click here to access the Phonological Awareness Development Chart freebie!

Phonological Awareness Development Chart (free download)

SLP Now Phonological Awareness Resources

SLP Now Blog Posts (free)

How to Target Phonological Awareness in Speech Therapy

SLP Now Podcast (free)

Podcast #98: A Quick Review of Phonological Awareness

Podcast #99: Phonological Awareness Assessment and Goals 

Podcast #100: Phonological Awareness Treatment Ideas

Podcast #101: What We’ve Learned About Phonological Awareness

SLP Now Membership

Phonological Awareness Skills Pack

Phonological Awareness Smart Decks

Phonological Awareness SLP Now Resource

Bonus Resources

The ATLAS-PA is a free phonological awareness test. The best part is that you can use it for students who have disabilities related to speech production.

The CUBED Dynamic Decoding Measures include a segment that quickly tests phonemic awareness, word identification, and decoding. This test is also free!

I hope you’ve found some helpful information that you can start incorporating phonological awareness into your sessions.

References

Bowen, C. (2011). What is the difference between an articulation disorder and a phonological disorder? Retrieved from http://www.speech-language-therapy.com/ on 10/29/2011.

Gillon Gail T. (2000). The Efficacy of Phonological Awareness Intervention for Children With Spoken Language Impairment. Language, Speech, and Hearing Services in Schools, 31(2), 126–141.

Tambyraja, S. R., & McCauley, R. J. (2012). Do Phonemic Awareness Interventions Improve Speech in Preschool Children with Speech Sound Disorders? EBP Briefs. Volume 7, Issue 3. In EBP Briefs (Evidence-based Practice Briefs). NCS Pearson, Inc.

#103: Comprehensive Emergent Literacy: Steps 1-2

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In today’s episode, Venita Litvack shares a brief overview of the Comprehensive Emergent Literacy framework and breaks down strategies for the first two steps of the framework.

It’s nice to have a framework and know where we should start with the student rather than just saying, okay, they need literacy, let’s read books. Because we know literacy is so much more than that. And today, we’re going to touch on the five different areas that encompass comprehensive emergent literacy instruction and break down the first two steps with some strategies.

Comprehensive Emergent Literacy Framework

Shared Reading

Shared Writing

Alphabet and phonological awareness

Independent writing

Self-directed Reading

Activities for Steps 1+2 of the Framework

Shared Reading

Strategy: RAAP: Read, Ask, Answer and Prompt
Time: Erickson and Koppenhaver recommend that you do this activity at least two times a day for 10 to 15 minutes a day.
Overview: RAAP is an interactive reading strategy for improving literacy experiences for individuals who use AAC. It encourages aided language input and is a form of modeling on the AAC system, which is really critical for our emergent communicators. It gets the communication partner to slow down and allow the AAC user more processing time.

Step 1. Read page and model two symbols on the device
Step 2. Pause for 5 seconds by maintaining eye contact and look at the AAC learner expectantly. Then ask a WH Question and model two symbols on the device and again, wait five seconds
Step 3. If they didn’t answer the wh question, you’ll answer it for them and model two more symbols on the device, and then pause again.
Step 4. And if they don’t say anything, or if they do say something, you’re going to provide a two to three-word response using the AAC system and verbally. Example: show me the (blank) on the page, like a caterpillar, show me the caterpillar.
Step 5. Repeat this process for every single page of the book.

The RAAP strategy really helps the student who uses AAC to be more active in the reading and less of a passive listener.

Shared Writing Strategies 

Strategy: Predictable Chart Writing
Time: 20-30 minutes a day over a 5 day period
Overview: Predictable Chart Writing is a fun and easy shared writing activity that supports emergent and conventional writers and readers. It’s a way of providing some structure while allowing students to generate their own ideas.

Day 1. Write a chart and repetitive phrase and have every student create a sentence. Example: I like to…
Day 2.  Reread the chart and sentences
Day 3. Cut up the sentences
Day 4. Assign students a word and have them act out the sentence
Day 5. Make a class book

Links Mentioned in the Podcast

– The effect of pause time upon the communicative interactions of young people who use augmentative and alternative communication. (Hilary Mathis)
– Video of RAAP method in action
– Predictable chart writing

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Transcript

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Marisha: Hello there. Welcome to the SLP Now Podcast, where we share practical therapy tips and ideas for busy speech language pathologists. Grab your favorite beverage. And sit back as we dive into this week's episode.

Marisha: This month we are talking all things AAC and literacy with Venita Litvack. So head to episode 102, to get the getting started phase. And if you've already been listening to the episodes, just join us to continue learning more about AAC, literacy and comprehensive emergent matters.

Marisha: Just a quick recap. So we've got three main types, immersion, conventional, or both in terms of the intervention that we can use. That really just depends on where the student is at. Are they identifying letters of the alphabet? Are they engaging in shared reading? Do they have a method of interaction? And do they understand that print has meaning? Did I get that?

Venita Litvack: Yeah. Thank you for summarizing that.

Marisha: Awesome. So, just one more time too, because you said 80% of AAC users...

Venita Litvack: Yeah. Like I said, I was trying to find the reference for that because I recently heard it in a training.

Venita Litvack: They said something like 80% of individuals who are nonverbal, which I don't like that term, and I know we're trying to move away from that term, so I said, individuals who are non-speaking, are at the emergent literacy level.

Marisha: Okay, amazing. So this is a super important conversation then, because we definitely want those kids moving towards literacy.

Venita Litvack: Yeah. And they're set up differently, the type of instruction. So it's nice to have a framework and know where we should start with the student rather than just saying, okay, they need literacy, let's read books. Because we know literacy is so much more than that. And we're going to talk about the five different areas that encompass comprehensive emergent literacy instruction.

Marisha: Okay. Let's do it. I can't wait.

Venita Litvack: Great. So I'll briefly share those. The first area of comprehensive emergent literacy instruction is shared reading. Then you have shared writing. Then you have alphabet and phonological awareness, independent writing with full access to the alphabet and self directed reading. And all of these are outlined in that book. So when we start to talk about the different activities that I would recommend when teaching literacy to students who use AAC, I will break them down by those five different areas.

Marisha: Perfect. Let's do it.

Venita Litvack: Great. Are you ready to dive into those activities?

Marisha: Yes.

Venita Litvack: Perfect. In terms of shared reading Erickson and Koppenhaver recommend that you do this activity at least two times a day for 10 to 15 minutes a day. Now I know SLPs, we have different schedules, different settings. So you have to do what you're able to do. When I worked in a school for children with autism, I actually got to go into the classrooms every day for about an hour, but I know that looks drastically different in other types of school settings. Maybe you're only seeing the student one time a week, two times a week. So take this with a grain of salt or what you can do. And we'll actually talk about some ways that you can incorporate these strategies in group lessons. And I am sensitive to the fact that you might not see the child every day of the week so we'll talk about that later.

Venita Litvack: But in terms of shared reading Marisha, you brought this up earlier. One of the strategies that I really like and talk about is the RAAP strategy. And I like it one because I actually studied under one of the researchers, Dr. Kent Walsh, and got to see the impacts that that research got to help present at the ASHA convention, but it was developed by doctors, Cathy Binger and Dr. Jennifer Kent-Walsh. And it's not rap music, but it actually stands for read, ask, answer and prompt.

Venita Litvack: And it is an interactive reading strategy for improving literacy experiences for individuals who use AAC. It encourages aided language input. So a form of modeling on the AAC system, which is really critical for our emergent communicators. And it gets the communication partner to slow down and allow the AAC user more processing time. And along with that processing time, I do like to highlight what the research tells us in terms of the amount of time it takes students to process questions or information that we present to them. So there was a study by Hilary Johanna Mathis entitled "The effect of pause time upon the communicative interactions of young people who use augmentative and alternative communication". And in that they suggest that we provide a wait time of up to 45 seconds and that would support AAC users to claim more conversational turns and use more words.

Venita Litvack: Now, I know 45 seconds seems like a really long time. So I think on average, the research says that between 10 to 20, that was the only reference I was able to find them, that's why I brought it up, but it just illustrates the importance of how much time we need to be giving. And in reality, we're probably giving closer to two to three seconds. So the framework for the raap strategy, when you're reading a book together with a child is on every single page, you're going to do the raap. So the first step is to read the book or read the page and model two symbols on the device. Then you pause for five seconds by maintaining eye contact and looking at the AAC learner expectantly. Then you're going to ask a wh question and model two symbols on the device. And again, you're waiting for five seconds.

Venita Litvack: The reason you're waiting for five seconds is because you're allowing the child to comment, to answer the wh question, whatever they want to do in order to be a active reader along with you. And then the third step is if they didn't answer the wh question, you'll answer it for them and model two more symbols on the device and then pause again. And then if they don't say anything, or if they do say something, you're going to provide a two to three word response using the AAC system and verbally. So you might say something like, your turn or show me the, you know, if there's something on the page, like a caterpillar, show me the caterpillar and you actually repeat this process for every single page of the book. And it really helps the student who uses AAC to be more active in the reading and less passive, less of a passive listener.

Venita Litvack: So that's my shared reading activity that I wanted to share. Do you have anything you want to add to that before I move on to the next area?

Marisha: No, that was perfect. I'd be super curious to see this in action. Do they have examples of this? On YouTube or anything?

Venita Litvack: That's a great question. They definitely have videos. I'm not sure if they're sharing it on YouTube, but there's a name of the lab and I'll try to get that for you. What I'll do is I'll share that in email with you and you can put that in the show notes, but they have a lab and I would assume they put the videos on there, but I'll do my best to get those for you.

Marisha: Okay. Amazing. Thank you so much.

Venita Litvack: No problem.

Marisha: Were there more strategies under shared reading?

Venita Litvack: That's it, but I really could talk about this stuff all day. So I tried to condense it.

Marisha: Okay. So let's do some shared writing strategies then.

Venita Litvack: All right, perfect. So in terms of shared writing again, Erickson and Koppenhaver recommended to do this for 20 to 30 minutes a day, and this doesn't have to be done just by the SLP. This can be done by the classroom teacher as well. So if you're finding this information helpful, you can share this framework with the teachers that you collaborate with, but predictable chart writing has been found to be really helpful for these shared writing activities. So I'm going to talk about the framework that was outlined by Hanser, Cunningham, Hall, and Williams, separately of course, they had different research studies looking at predictable chart writing, but in summary, predictable chart writing is a fun and easy shared writing activity that supports emergent and conventional writers and readers. It's a way of providing some structure while allowing students to generate their own ideas.

Venita Litvack: And it provides many different activities that occur around the predictable chart over a five day period. So this is going to look very different depending on whether you are in the classroom every day, doing collaborative teaching, or if you see the student one to two times a week, but again, the classroom teacher can definitely implement this. So I'm going to discuss the activities across all five days with you. So on day one, you are going to write a chart. So for that, you're going to need chart paper, or you can use a big dry erase board on the front of the classroom and a single message device. So what happens is that you're going to pick a phrase that's repetitive. So let's say we're going to use the phrase, I like to. If you're working in a group, every student who uses AAC in the group, or every student in your group, they're going to tell you something that they like to do.

Venita Litvack: So the phrase is repeated for each student. So let's say you have five students. Maybe student one says, "I like to swim." The next student may say, "I like to sleep." The next one might say, "I like to eat." And the only word that changes is the last word, but they get to write their own sentence or finish their own sentence by providing something that relates to them. And then on day two, you are going to reread the sentences as a group, and you're going to put them on individual sentence strips. So you're going to together as a group, reread the chart while pointing to each word, you can clap out the words. You can rap the word, you can sign the words, but it's just getting them to recognize that those words are individual units of meaning as you're rereading them. And then on day three, you're going to cut up the sentences.

Venita Litvack: So you want to make sure that you have the students sentence, their own sentence on two separate sheets of paper, because they need one as the model and the other one you're going to cut up and they're going to rearrange the words to remake the sentence and play with the words, maybe they can even make a new sentence. So the goal of this step is to help support students in understanding that sentences are made from left to right. And that students don't have to create a perfect sentence. They just have to get comfortable with using these words, manipulating these words and the process of writing. And then on day four, they get to act out the sentence, which is fun. So you would give each student their AAC system or a single message device with the word of the sentence programmed into it. So let's say you have five students in the group.

Venita Litvack: One student would be I, the other student would be like, another student would be to. And then it can be one of the words that the students had said, maybe I like to swim. So they're going to read the sentence together. So the person that has I was going to do I, and then the next one's like, and the next one's to and the last person would say swim. So they're acting out the sentence by saying their individual words, and you can actually have them if possible, depending on their physical limitations line up in the order of the sentence too. And that gets them to understand like the structure of a sentence. And then on day five, the last day of the week, you would make a book with all of the students' sentences. So one-on-one, you're going to support the students in making their page, which will be part of a class book.

Venita Litvack: So if the first student said, "I like to swim", you would help them find a picture to go along with that, to support the texts. And then they get to make one page of the class book. Then the next student might have, I like to eat and they'll find a picture for that. And they get to make the second page of the class book. And at the end you can print it out and add it to your class library. And it's really nice because it's a book that they created together as a group and can reference and get to know each other a little bit better. And one resource for making the book, which I really like is called Tarheel reader, which I'm going to talk more about later.

Marisha: Thanks for listening to the SLP. Now podcast. This podcast is part of a course offered for continuing education through speech therapy PD. So yes, you can earn ASHA CEU's for listening to this podcast. If you enjoyed this episode, please share with your SLP friends and don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.

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Tips to Implement Literacy-Based Therapy with Autistic Students

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This is a guest blog post by Monica, a school-based SLP, all about tips for implementing literacy-based therapy with autistic students.

I’m using “autistic” instead of “students with autism” because that’s the preferred term when using a neurodiversity-affirming approach. Research articles will be reviewed in this post, but keep in mind that each study has a limited population used, and it may not match the population of your caseload. I see the research as a great starting point to direct what we do in our sessions. It’s just as important to use clinical judgment (with information from the autistic community) and consider what your students and their families want to work on.

Why literacy-based therapy?

Literacy-based therapy is a great way to include perspective-taking and inferencing goals in an academically relevant context.

Research has shown that working on narratives with autistic students has been correlated with improvements in perspective taking, verbal memory performance, overall story complexity, and story grammar knowledge (Gilliam et al., 2015).

Some research has shown that narratives are an area of difficulty that could carry into adulthood (Hewitt, 2019).

Improvements in narrative abilities with literature have also been linked to improvements with personal narratives (Petersen et al., 2014).

How do I know what goals to target?

Including narratives as part of your testing is the easiest way to know what to target.

You can use the CUBED: Narrative Language Measures (Petersen & Spencer, 2016) as a formal or informal measure of narrative language skills. It’s FREE and covers listening retell, story grammar, language complexity, story comprehension, vocabulary, and personal generation.

If you’re interested in a dynamic version, the DYMOND (Petersen & Spencer, 2017) is currently in development. You’ll get a wealth of information from this test (and a great language sample from the personal generation).

Here are some examples of areas you could target (not a complete list):

📚 Retell a story using X number of story grammar elements (emphasizing the story grammar elements students were not able to produce during testing).

📚 Identify story grammar elements in a story (e.g., problem and solution).

📚 Identify what a character is feeling and/or a character’s point of view.

📚 Identify why a character felt a certain way and what they plan to do about it.

📚 Use causal language when retelling a story (because, so).

📚 Use mental states/feelings when retelling a story (think, know).

📚 Answer comprehension questions.

📚 Generate a personal narrative using X number of story grammar elements.

How do I set my students up for success?

Here are some quick ways to modify literacy-based therapy!

When we’re using a neurodiversity-affirming approach, we’re looking at how we can modify the environment and add supports rather than requiring the student to change.

Environmental Supports

✏️ Do a check-in with students before and during your lesson to make sure their sensory and emotional systems are regulated.

✏️ Add support for regulation by going over the plan. (I put everything on the table we will be using in the order we’re doing it and give time estimates for each task.)

✏️ Add sensory breaks between tasks.

✏️ Have a backup lesson for days when sustained tabletop activities are not doable. (You can focus on expanding vocabulary and acting out scenes from the book if you need to get up and move or do something more interactive.)

Internal Motivation

📖 Have clear expectations and a routine for your lessons.

📖 Introduce what you’re going to do, incorporate breaks, give time estimates, set up clear transitions, and provide visuals as needed.

📖 Choose books that students are interested in. (I will switch to a focused interest for a book instead of picking a themed book if it will help with engagement.)

📖 Explain why you’re working on that task. (I ask students what’s hard for them at school/when talking to friends and connect it to what we’re working on in speech.)

📖 Use play-based activities leading up to the book during pre-story activation to build excitement and interest for the book.

Executive Functioning

🖍 Help students’ working memory by providing visuals (Gilliam et al., 2015).

🖍 Use graphic organizers (Gilliam et al., 2015).

🖍 Modify the pace and content of your lessons (Gilliam et al., 2015). (You may have to spend more time teaching story grammar elements before going into retells with all of the elements or reduce the amount of story grammar elements you teach.)

What should my sessions look like?

You can run your lessons like the typical literacy-based sessions with some modifications to increase engagement and dedicate more time to certain targets (like perspective-taking).

I tend to teach story grammar elements before using the full literacy-based therapy framework based on my students’ needs.

5 step literacy based therapy
Instagram: @slpnow

I reviewed two articles (Gilliam et al., 2015 and Petersen et al., 2014) about using narrative language interventions for autistic students. Both studies taught story grammar elements first before moving on to the other parts of the intervention. The study by Gilliam et al., 2015) had three phases.

The first phase taught story grammar elements, the second phase covered “connecting and elaborating phrases,” and the third phase focused on “creating and editing stories.”

In the second phase, the following was covered: causal language (e.g., because, so), mental state and linguistic verbs (know, laughed), adverbs (if/then), and elaborated noun phrases (two green frogs). The researchers suggested that adverbs and elaborated noun phrases should not be included for students who need more support to reduce the overall cognitive load during sessions. In this study, they added two story grammar icons for support (dialogue and plan again).

Both studies highlighted the use of supports and scaffolding to reduce those supports.

Here’s an example of modifications you could make using the SLP Now literacy-based therapy planner. Here’s a link if you need it!

Literacy-based therapy planner

 

How do I explain it to parents?

In meetings, my district goes over strengths and challenges as a team, so it’s easy to bring up narrative therapy as a tool to cover a wide range of challenges.

I talk about how narratives target verbal working memory, perspective-taking/inferencing skills, and are relevant to what students will be working on in the classroom. Because narratives are so interwoven in our daily lives, I also talk about how there is evidence that working on narratives with literacy can generalize to improved personal narratives (Petersen et al., 2014).

Working on story grammar elements gives students a mental checklist and structure (schema) of what a story should have, which makes it a lot easier to tell a story independently. Microstructure is also targeted with narratives, so we’re able to target a lot of goals with literacy-based therapy!

I hope these tips were helpful! SLP Now members can always reach out for help through our membership site if they have questions about implementing literacy-based therapy with their students.

References

Gillam, S. L., Hartzheim, D., Studenka, B., Simonsmeier, V., & Gillam, R. (2015). Narrative Intervention for Children With Autism Spectrum Disorder (ASD). Journal of Speech, Language, and Hearing Research, 58(3), 920–933.

Hewitt, L. E. (2019). Narrative as a Critical Context for Advanced Language Development in Autism Spectrum Disorder. Perspectives of the ASHA Special Interest Groups, 4(3), 430–437.

Petersen, D. B., Brown, C. L., Ukrainetz, T. A., Wise, C., Spencer, T. D., & Zebre, J. (2014). Systematic Individualized Narrative Language Intervention on the Personal Narratives of Children With Autism. Language, Speech, and Hearing Services in Schools, 45(1), 67–86.

#102: Getting Started with AAC & Literacy

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In this episode, I sit down with SLP Venita Litvack and discuss how to get started with AAC and literacy.

This field goes even deeper than the average speech pathology education, using a range of techniques to bring communication and literacy tools to folks with significant disabilities.

It’s important, it’s challenging, and it’s rewarding!

This episode is a great starting point if you’ve been looking to dig deeper in toe AAC! And Venita shares some amazing (and some FREE) resources to support us in teaching those whose functional literacy skills may not be served by general literacy programming in schools.

In the following weeks, she will share a powerful framework for comprehensive emergent literacy.

What might be the most inspiring thing about Venita is her commitment to the Literacy Bill of Rights — that all persons, regardless of the extent or severity of their disabilities, have the right to use print. 👏

I’m so excited to review this top with Vinta and can’t wait to dive in for more!

Stay tuned for more on this topic this month!

Let’s get to it!

Key Takeaways + Topics Covered

– Venita’s background and some AAC preliminary reading
– RAAP framework (read, ask, answer, prompt)
– Literacy Bill of Rights – every learner has the right to this education!

Links Mentioned in the Podcast

– First Bite podcast interview: “Speechie Side Up” Presents AAC – Venita Litvack, MA, CCC-SLP
– Speechie Side Up
– @speechiesideup on Instagram
– Ten Ways to Boost your Knowledge of AAC
– Core Calendar Club Facebook group
– Comprehensive Literacy for All: Teaching Students with Significant Disabilities to Read and Write
– Literacy Bill of Rights

Subscribe & Review in iTunes

Are you subscribed to the podcast? If you’re not, subscribe today to get the latest episodes sent directly to you! Click here to make your listening experience auto-magic and as easy as possible.

Bonus points if you leave us a review over on iTunes → Those reviews help other SLPs find the podcast, and I love reading your feedback! Just click here to review, select “Ratings and Reviews,” “Write a Review,” and let me know what your favorite part of the podcast is.

Thanks so much!

Transcript

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Marisha: Hello there, and welcome to the SLP Now Podcast, where we share practical therapy tips and ideas for busy speech language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode. Hello there, and welcome to the SLP Now Podcast. I am so excited to introduce today's guest, Venita Litvack. She is a speech language pathologist currently serving as a full-time augmentative and alternative communication and assistive technology consultant for public schools in Florida. So she has a passion for using AAC, AT, and literacy to support individuals with complex communication needs, autism, and other disabilities.

Marisha: Venita has also delivered poster presentations in several topics related to AAC at ASHA. She also coauthored two articles published in the ASHA Leader, as well as the Lou Knows What to Do book series published by Boys Town Press. She's also an amazing fellow podcaster and blogger at Speechie Side Up, and just an all around rockstar SLP and person. So today, we're going to be breaking down all things AAC and literacy. This is like AAC 102, maybe 201. So before we dive into all of the things, I just wanted to give a really quick recap of some other amazing resources that Venita has shared. Her Speechie Side Up Podcast is amazing. First of all, if you haven't subscribed yet, definitely do that.

Marisha: She has several episodes on AAC. So I will link to those in the show notes at slpnow.com/42. And then she also did a podcast interview with my colleague and fellow podcaster in the SpeechTherapyPD network for Michelle Dawson's First Bite, and she has a really great crash course on AAC there as well. And then she has an absolutely amazing blog post with some tips to help you start navigating AAC, if it's new to you. So it's called Ten Ways to Boost Your Knowledge in the Area of AAC. And so I'll link to all of those resources in the show notes, in case you're just trying to start navigating AAC because I think that would be an amazing supplement to all of the tips and tricks that we're sharing here today. That was a little bit of a longer intro. But hello, Venita.

Venita Litvack: Hi, Marisha. thank you so much. That was such a nice intro. And I think you covered a big part of where I would recommend people get started before they dive into a topic like this with AAC and literacy, because this is definitely going to be a very comprehensive and dense topic, but I'm really excited to chat with you about it.

Marisha: Yeah. I have been nerding out. We've been going back and forth, and I cannot wait to hear from you on this topic. As you guys know, I am a huge advocate of using literacy in therapy. And a lot of you have been asking about how to use this with students who use AAC. So I just cannot wait for us to break this down, and you're the perfect person for it.

Venita Litvack: Oh, yay. Well, I'm excited that we were able to combine both of our interests.

Marisha: I know, that is so amazing. And I think we're going to have a blast, or I know we are. And then I'm curious, is there anything else that you'd like to highlight in terms of places to get started, if there's anything in particular that really stands out to you from your blog posts? Or do you think that's a good enough place to start at this point?

Venita Litvack: I think you mentioned some really great resources. One other one that I might recommend is the Core Calendar Club Group on Facebook that I am doing with Anne Page from Beautiful Speech Life and Kristen Powell from the Daily Dose of Speech. It's a year long AAC challenge where we provide you with weekly resources for a specific core word. And then we also present discussion topics weekly, where people share their favorite AAC tradings, the troubles that they have with AAC and how they're addressing them. We have 1,100 people in that group, and it's just a really great supportive group. We have a goal in mind, which is to increase your AAC knowledge. So it's not just going in there and asking questions whenever they come up, but structured format for learning more about AAC across the school year.

Marisha: That is so amazing. And that's a free group?

Venita Litvack: It's free. Yep.

Marisha: Oh, my gosh. That's so valuable. That is amazing, especially if you're really wanting to tackle AAC in your practice as a listener. And just having these resources, plus the Facebook group to just get continued inspiration, I mean, that's amazing. I'm so glad that you guys are doing that. So helpful.

Venita Litvack: Thanks. It's a lot of fun.

Marisha: Oh, yeah. And I will definitely link to that group as well in the show notes, if you can't find it with a quick search. So I think we are ready to dive in. So let's just get straight to the strategies. So let's start with some evidence-based strategies for teaching literacy to children who use AAC. I've heard you talk about, and it's R-A-A-P. I forget how you say that acronym. Is it RAAP?

Venita Litvack: It is. Yep.

Marisha: Okay. I know you've shared a lot of other strategies as well, but it'd be amazing just to get an overview of some of the ones that you found in your research and just help break that down for us a little more.

Venita Litvack: Sure. Yeah. I think this is a really important topic and a great starting point. I will definitely reference the RAAP strategy as we get into specific activities that you can use. So in the timeframe from when you first asked to an interview and we decided that the topic would be literacy, this amazing book came out. And as soon as I saw it, I was like, "I have to get that." And this book has taken the AAC world by storm. Everybody's getting it. And it's called Comprehensive Literacy for All: Teaching Students with Significant Disabilities to Read and Write by Karen Erickson and David Koppenhaver. I hope I'm saying that right. And it's amazing. I mean, they have just synthesized all of the research on teaching individuals with significant disabilities to read and write.

Venita Litvack: And their basic premise is that all students, no matter how severe their disabilities, can learn to read and write, and they provide a framework for that. So I'd like to start with providing the Literacy Bill of Rights, because I think that that's really important for people to keep in mind when they're working with students who use AAC, and keeping in the back of their mind maybe it doesn't seem like they could learn to read and write at this point, but here are their rights that they're entitled to. So I'll briefly summarize these, and these were outlined by Yoder, Erickson and Koppenhaver back in 1997. So number one is that all students have the right to the opportunity to learn to read and write. All students have the right to accessible, clear, meaningful, culturally and linguistically appropriate texts at all time.

Venita Litvack: All students have the right to interact with others while reading, writing, or listening to texts. All students have the right to life choices made available through reading and writing competencies. All students have the right to lifelong educational opportunities incorporating literacy instruction and use. All students have the right to teachers and other service providers who are knowledgeable about literacy instruction methods and principles. And I think that's really important for us to keep in mind. And there's two more. All students have the right to learn in environments that provide varied models of print use, which we're going to outline later today. And then all students have the right to learn in environments that maintain the expectations and attitudes that all individuals are literacy learners. And I love that last right because I think it's so important that attitude makes a huge difference.

Venita Litvack: And when we presume or assume that the child has the ability to grow and has the ability to learn and read and write, then we're already setting them up for success. I know that was a lot. And I definitely encourage anybody who has not seen that Literacy Bill of Rights to go look at the full version because that was an overview, even though it may have not seem like it. But I like starting there because I think it's important. Then the next thing, this book, the Comprehensive Literacy for All that I told you about earlier, they share in there that when you are starting with literacy instruction for students who use AAC or any individual who uses AAC, you need to determine where you're going to start and what the student needs.

Venita Litvack: Do they need comprehensive emergent literacy instruction only? Do they need conventional instruction only? Or do they need a combination of both? And that's really for a group-based setting. And the way that they tell you to determine that is by asking four questions. The first question is, does the student identify most of the letters of the alphabet most of the time? The second question is, does the student engage and interact during shared reading? The third question is, does the student have a means of communication and interaction? And then number four, does the student understand that print has meaning? So if you answer no to just one or any more of those questions, then you should start with comprehensive emergent interventions.

Venita Litvack: If you're able to answer yes to all four of those questions, then you would start with comprehensive conventional interventions. So for today's purpose, I'm going to be sharing mostly about emergent interventions because according to Janice Light, she said, "Currently, the majority of individuals who require AAC do not have functional literacy skills." And I heard a quote recently where something around 80% of individuals who use AAC or non-speaking verbally are at the emergent literacy level. I tried looking for the research reference prior to this interview, but I wasn't able to find it. So I did quote Janice Light instead. But I think that's really important. And I'll stop here, in case there's anything you wanted to say about those.

Marisha: That is such a helpful overview. I'm just so excited to keep diving into all the other things. Thanks for listening to the SLP Now Podcast. This podcast is part of a course offered for continuing education through SpeechTherapyPD. So yes, you can earn ASHA CEUs for listening to this podcast. If you enjoyed this episode, please share with your SLP friends. And don't forget to subscribe to the podcast to get the latest episode sent directly to you. See you next time.

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Sequencing Shouldn’t Be Targeted in Isolation

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This is a guest blog post by Monica, a school-based SLP, all about the importance of sequencing in narrative therapy and why it shouldn’t be targeted in isolation!

The Importance of Sequencing

I want to expand on how sequencing shouldn’t be targeted in isolation, but in the context of narrative therapy.

I hope that this post will also help give you some language for explaining your goals to parents during IEP meetings and why it’s important to work on them. I’ve found that I strengthen relationships with my student’s families when I give them a lot of information and explain my next steps because it shows that I’m always planning for their student’s future.

Therapy Ideas

If you want to jump straight to therapy ideas, head over to this blog post, How To Target Sequencing. I talked about ways to target sequencing in therapy sessions (and possible goals!). Keep in mind that sequencing is just one part of the overall literacy-based therapy framework! 

Sequencing and Narratives

First things first, I’m going to clarify what I’m talking about when I say sequencing. The term “sequencing” gets thrown around a lot and can refer to sequencing steps to follow a direction or sequencing to retell a story.

If you’re looking for following directions resources, I’m going to direct you to these excellent blog posts:

Following Simple Directions: Speech Therapy Activities & Worksheets

Teaching How to Follow 2 – and 3 – Step Sequential Directions

In those posts, you’ll find that there may be many things that you want to target, like executive functioning (hello working memory!), vocabulary, and grammar. It’s also vital for therapy and materials to be contextualized (think real-life situations) instead of using a deck of cards because it’s convenient.

I know, I know! Sometimes it is just easier to use something we’re used to, but the research is pointing towards decontextualized therapy being more like working on making the leaves of a tree grow instead of the roots and trunk (which would be contextualized therapy).

To give us some context, let’s review where your students should be developmentally with telling stories. We’ll keep in mind that the population these studies were focused on probably does not match a population that needs more support, so take it with a grain of salt if your population isn’t a homogenous group.

Screen Shot 2021 10 22 at 11.26.44 AM
Click here to access the SLP Now Sequencing Cheat Sheet!

From ages five and up, we can also use Common Core State Standards as a developmental framework for what would be expected of a student at that age.

When we look at the developmental profile and common core standards, basic sequencing should be developed around 3-4 years old, and 4-5 year olds should be able to sequence/retell basic stories.

Kamhi (2014) talked about how sequencing shouldn’t be targeted in isolation and that working in the contexts of narratives is the perfect way to make it relevant to a student’s life.

This article talks about working on sequencing with contextualized narrative intervention and that clinicians have wrongly assumed that you need to work on sequencing on its own because sequencing is tested as its own in subtests on formal assessments. Narratives do encompass a large part of a student’s day, whether academic or their ability to communicate with others.

The article also states that “correctly recalling the sequence of events thus depends solely on attention and memory processes”. We can reduce the memory demands of retelling a story using macrostructure or “the logical, conceptually coherent order of events” (Kamhi, 2014). We know that macrostructure = story grammar parts and that microstructure (ex: temporal/causal words and grammar) is also an important part of narratives.

Sequencing and Working Memory

I also reviewed three articles (Singer & Bashir, 2018 ; Montgomery, Magimairaj & Finney, 2010; Boudreau & Contanza-Smith, 2010) that talked about how when we’re working on sequencing, we really want to target working memory. If we are only working on having a student listen to directions and do them, it’s targeting short-term memory skills that won’t generalize. By working on sequencing with narratives, you’re targeting a more complex system that will help with later comprehension. When we use narrative therapy, we’re teaching students to create a schema in their minds with story grammar.

We’re giving them a way to organize information and to know what to grab on to. This frees up their working memory to shift through the information given in a story to retell it and answer comprehension questions.

References

Boudreau, D., & Costanza-Smith, A. (2011). Assessment and treatment of working memory deficits in school-age children: The role of the speech-language pathologist. Language, Speech, and Hearing Services in Schools, 42(2), 152–166.

Kamhi, A. G. (2014). Improving Clinical Practices for Children With Language and Learning Disorders. Language, Speech, and Hearing Services in Schools, 45(2), 92–103.

Montgomery, J. W., Magimairaj, B. M., & Finney, M. C. (2010). Working Memory and Specific Language Impairment: An Update on the Relation and Perspectives on Assessment and Treatment. American Journal of Speech-Language Pathology, 19(1), 78–94.

Singer, B. D., & Bashir, A. S. (2018). Wait…What??? Guiding Intervention Principles for Students With Verbal Working Memory Limitations. Language, Speech, and Hearing Services in Schools, 49(3), 449–462.

Speech Sound Development Chart for Speech Therapy [Free Download]

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This is a guest blog post by Monica, a school-based SLP, all about speech sound development. We also share a cheat sheet that you can download for free! 

Speech Sound Development (By Age of Acquisition)

If you’re looking for a speech sound development chart to help you determine where to start with your speech articulation goals, it’s right here! 

The chart has been updated with the results from McLeod & Crowe’s (2016) study.

The study compiled 60 articles with 64 studies in 27 languages.

They found that “children produced at least 93% of consonants correctly” by 5;0. 

When looking at these norms, the age listed is when most children have acquired that sound–not that children have up until that age to acquire that sound.

For example, a child may develop the /r/ sound at age three but not master it until five, which would be typical development (Hogan, Storkel & Farquharson, 2019).

Articulation Cheat Sheet

Click Here to download the FREE Speech Sound Development Articulation Cheat Sheet!


What Does Speech Sound Development Mean for SLPs?

Spoiler Alert: The answer isn’t simple! 

We shouldn’t just be relying on speech sound norms when considering eligibility or to make a diagnosis. Helping SLPs with their high workload is why Marisha started SLP Now! Considering the impacts on our caseloads, this also means we need lower workloads and more advocacy.

Kelly also linked to two podcasts that are definitely worth your time:

1. Speech Norms, Eligibility for Speech Treatment, and Advocacy with Holly Storkel and Kelly Farquharson (Tiffany P. Hogan’s podcast episode 3)

2. We Have Been Interpreting the Articulation Norms All Wrong (SLP Toolkit’s podcast episode 19): They talk about things for SLPs to think about when providing services to students with speech sound disorders and the McLeod & Crowe article.

If you’re tackling burnout, here’s a link to a recent article by Lessa Merante and Kelly Farquarson for school SLPs. It’s a great read! They give lots of a lot of strategies for switching things up. Some are doable on a small scale (e.g., changing your service delivery model) and some require changes on a larger scale (e.g., RtI and advocacy). 

Reduce Your Workload with Ready-To-Go Articulation Materials

Since we were just talking about reducing workloads, I’m going to leave a preview of just SOME of the SLP Now materials available for speech sound disorders. New materials are added regularly. As a school SLP, I know that we love quick and easy resources! These resources plan everything out for you with very little prep required. Right now, there are hundreds of pages of speech sound disorder materials! 

Here’s a peek at a few of them:

📒 175 picture book and 45 non-fiction units with word lists by sounds

Articulation Later Sounds

📒 Silly sentences for articulation practice

Silly Sentences for Articulation

📒 Practice sheets for articulation, phonology, and complexity

Articulation Cards

📒 Articulation stickers (with placement cues and pictures for words by sound)

Articulation Stickers

📒 Smart Decks for articulation, phonology, and complexity

Articulation Smart Deck

Just to name a few!

Need these materials in your life? Sign up for a free SLP Now trial (no credit card required) to check out the entire library. 

References 

DeVeney, S. L., Cabbage, K., & Mourey, T. (2020). Target Selection Considerations for Speech Sound Disorder Intervention in Schools. Perspectives of the ASHA Special Interest Groups, 5(6), 1722–1734. 

Hogan, T. (2019). Episode 3. Speech Norms, Eligibility for Speech Treatment, and Advocacy with Holly Storkel and Kelly Farquharson [Podcast]. Retrieved 8 October 2021, from https://www.seehearspeakpodcast.com/episode-3/episode-3-speech-norms-eligibility-for-speech-treatment-and-advocacy-with-holly-storkel-and-kelly-farquharson.

Krueger, B. I. (2019). Eligibility and Speech Sound Disorders: Assessment of Social Impact. Perspectives of the ASHA Special Interest Groups, 4(1), 85–90. 

Marante, L., & Farquharson, K. (2021). Tackling Burnout in the School Setting: Practical Tips for School-Based Speech-Language Pathologists. Perspectives of the ASHA Special Interest Groups, 6(3), 665–675. 

McLeod, S., & Crowe, K. (2018). Children’s Consonant Acquisition in 27 Languages: A Cross-Linguistic Review. American Journal of Speech-Language Pathology, 27(4), 1546–1571. 

 

#101: What We’ve Learned About Phonological Awareness

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This Week’s Episode: What We’ve Learned About Phonological Awareness

Today we will wrap up our Phonological Awareness series with a quick review of all that we’ve learned. So far in this series, we’ve done a quick review of phonological awareness and why is it is so important. We shared phonological assessment resources and phonological awareness goal examples. And last week Monica shared some of her favorite treatment ideas and examples on how to use them in the therapy room.

We are excited for you to take all that we’ve learned and start embedding the practice into your therapy! Let us know what worked and what didn’t. We love to hear from you!

Let’s get to it!

Phonological Awareness Review

– Phonological awareness is your ability to “identify and manipulate units of oral language: words, syllables, onsets (beginning sound c in cat) & rimes (end sounds -at in cat)”.

– Phonological and Phonemic Awareness

– Free Phonological Awareness Assessment: The PAST Test Screener: David A. Kilpatrickby + Two Peas In A Pod (TPT): Free PA Assessment

–  Phonological Activities: University of Florida Literacy Institute (Multi-Sensory) + Phonemic awareness activities: from Children’s Learning Insitute at University of Texas (UT)

– Goal Examples:

When given a CVC word orally as a prompt and asked to identify which position a particular sound (initial. medial, final) in the word is in (example: “Say the word tap. What is the medial sound in “tap”?”), STUDENT will identify the sound being requested for each prompt with 80% accuracy in 2 out of 2 trials as measured by teacher-made assessment.

 When given the onset and rime (/b/ + /at/ , /h/+/ot/) for 10 different 3-letter short vowel words (CVC words), STUDENT will blend those sounds (onset and rimes) into words with 100% accuracy in 2 out of 2 trials as measured by teacher-made assessment.

–When given 3 phonemes as a prompt (example: /c/ /a/ /t/ or /p/ /i/ /g/), STUDENT will orally blend those phonemes into words with 80% accuracy in 2 out of 2 consecutive trials as measured by teacher made assessments.

Links Mentioned and Additional Research

– Kelly Farquharson, PhD, CCC-SLP Instagram: @classlab_fsu
– ASHA Evidence Map: Systematic Review: Effectiveness of Early Phonological Awareness Interventions for Students with Speech or Language Impairments
– ASHA Evidence Map: Early Childhood Education Interventions for Children With Disabilities Intervention Report: Phonological Awareness Training
–Article: Al Otaiba, S., Puranik, C., et al. (2009). Across the eight studies investigating the effects of phonological awareness training in students with speech impairments, all studies indicated improvement of the trained phonological skills.
– Ukrainetz Pearson EBP brief
–EBP brief on phonemic awareness efficacy
–Do Phonemic Awareness Interventions Improve Speech in Preschool Children with Speech Sound Disorders?
– Cabbage Et al article (Decision Tree + Sample Assessment Checklist)
– Test for multisyllabic words! Can they blend them together?
– “Hesketh (2009) says, “My intervention principle is to incorporate PA-type activities in support of speech change using stimuli relevant to the child’s target processes, syllable structures, contrasts or sounds, rather than seeing PA skills as a target in their own right. A typical intervention session will involve the child in listening to, thinking about and producing sounds but the balance between these three elements varies enormously across children and across sessions.”
–Gillion, 2000:
Compared traditional articulation to phonological awareness intervention (check out the article for the full details, but we’ll share some of the activities today). The children who received phonological awareness intervention made significantly more gains in their phonological awareness ability and reading development than the children receiving the other types of speech and language intervention. The phonological awareness intervention also improved the children’s speech articulation.

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Are you subscribed to the podcast? If you’re not, subscribe today to get the latest episodes sent directly to you! Click here to make your listening experience auto-magic and as easy as possible.

Bonus points if you leave us a review over on iTunes → Those reviews help other SLPs find the podcast, and I love reading your feedback! Just click here to review, select “Ratings and Reviews,” “Write a Review,” and let me know what your favorite part of the podcast is.

Thanks so much!

Transcript

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Marisha: Hello there and welcome to the SLP Now podcast, where we share practical therapy tips and ideas for busy speech-language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode. Hey there SLP, this month, Monica and I are diving into all things phonological awareness. So in episode 98, we did a quick review of what phonological awareness is. And we're going to spend the rest of the month talking about assessment, goals, treatment ideas, all sorts of good stuff. So, without further ado, let's dive into this week's episode. Now, let's wrap it all up. So what are some last thoughts or things that you think SLPs should be thinking about or considering when they're implementing this?

Monica: I think probably one area of caution would be with students who have apraxia, just to be really cognizant that you don't want to be doing these phonological awareness things if you're doing that practice. Because it involves a lot of segmenting the sounds and you're teaching a motor plan. Just to be very intentional about your teaching and bringing phonological awareness. Then from where you're really practicing those sounds and to make sure the student knows... This is not the way that we're saying it, we're just working on being able to hear these sounds, being able to rhyme them, or whatever it is. Because it's still important to practice with that population, but just to be kind of intentional about that practice part.

Monica: I think also to know that this isn't a magic wand situation. Just because we work on phonological awareness that they're not necessarily going to be a successful reader. This is not just for us, this is for the classroom as well, and everyone who's working on it. That it's going to help them improve those skills, but maybe if you're talking to parents that... We still might expect that they have some difficulty later on, but that it's definitely going to help with future spoken language impairments and reading. And, of course, all of those things that are related... Writing, spelling, comprehension, kind of all of those things. So that's, I think, important to note. There's no like end to that. No, it's not like a speech sound disorder where you do that and then they're dismissed from it. It might be something that's kind of ongoing. That's where the literacy supports come in, too. The people who have done a lot more professional development and who really specialize in that... There's tons of different approaches out there.

Marisha: Awesome. Any other tips or words of advice or anything we need to consider?

Monica: No, I don't think so. I think that it's just, in the end, there's that little bit of assessment piece that you can add on that wouldn't take very long. It might be 10, 15 minutes. And then just incorporating things into your sessions using materials and target [inaudible 00:03:16] that you already use where... It sounds like a lot. It sounds like you're doing a lot more, but I think it really isn't a lot more. But the trade-off for doing this little bit of incorporating, I think, it's such a huge, huge trade-off with being able to be there. And making sure the kids get the right intervention and being able to incorporate the phonological skills with those kids who have speech sound disorders or don't have speech disorders. For all of the kids to get that exposure that are in your groups, the payoff is potentially really big.

Marisha: Yeah, absolutely. And you have a really interesting quote from Hesketh in 2009 about their intervention principle. Can we talk about that a little bit?

Monica: So I'm just going to quote from that article. It says, "My intervention principle is to incorporate phonological awareness type activities in support of speech change using stimuli relevant to the child's target processes, syllable structures, contrast or sounds, rather than seeing phonological skills as a target in their own right. And a typical intervention session will involve the child in listening to, thinking about, and producing sounds, but the balance between these three elements vary enormously across children and across sessions." So I think it just kind of mirrors what we've been talking about. That you're incorporating it into your sessions as you're going along, and its not necessarily its own separate thing. That it's very much so embedded and should be embedded in practice.

Marisha: Yeah, that's super helpful. And that's what we've been talking about. All of that, but I thought that was a really nice way to wrap things up and put it all together. So just a super quick recap of what we've talked about. We've been talking about phonological awareness. Then we're working on identifying and manipulating words, syllables, [inaudible 00:05:22], and rhymes. And underneath that we've got the phonemic awareness. Then we went through all of the different types of activities that fall under phonological awareness, as well. And we talked about tons of really cool research studies that look at how phonological awareness does have a really significant impact on, or it can have a really significant impact on, reading development and just improving those skills. And then super interesting from a speech language perspective is that targeting phonological awareness can also improve speech production, which is super interesting.

Marisha: Also just emphasizing, Dr. [inaudible 00:06:06] does amazing, amazing work, and her Instagram that you shared is so incredibly helpful. But I think this discussion brought up the idea that a lot of our students... We might think of them as speech only, but how often are they really speech only? And I thought this was a really cool way to start thinking about that a little bit more and maybe adding a few tools to our toolbox if we haven't been using those yet. And just considering that when we are fighting through that assessment.

Monica: And I think that's helpful for SLPs that are trained to fight for full assessments for their speech sound kids. Sometimes you'll get a little bit of pushback... Like we don't have time... But it's either you do it now or they struggle years and years later. So I think all of these articles are great to have for everyone out there that's trying to push for that. I know I talk to my friends a lot in other districts. And then also when you're looking for ways to make those improvements faster and get the kids out faster... We're always looking at LRE and being able to work with the classroom teacher and collaborate and be able to get them out sooner.

Marisha: Yeah. If we can support their progress with their speech sounds and help them make more progress there, plus get the added bonus of that boost with the reading, that's pretty awesome. That's a huge win. And I loved how you found different tools that we can use if we don't have that support. If for some reason, the team isn't assessing that phonological awareness, we've got some really cool assessments that we can pull like the [inaudible 00:07:51] test. And then the [inaudible 00:07:53] article has some really cool tools that we can use as well in assessment. The Gillen 2000 article that I mentioned at the very beginning also talks about the treatment procedure. So some really, really awesome resources in the show notes if you're wanting to learn more. We'll put some goals in there too, if you need a recap of that. And I really liked how we were able to go through... If you have a bunch of different treatment strategies and get some really nice examples of what that would look like and how we can implement that into our therapy.

Marisha: So I'm curious, if someone is listening now... There's an SLP who hasn't been incorporating phonological awareness... Let's see if we can think of three things that they could potentially do. Three easy steps and they could choose any one of them to get started. One that I would pick is to check out some of those assessments if your team isn't looking into that. So the next time you get a speech sound referral or a speech only referral, going through that I think that's a really good introduction. Just to get to know, oh, so these are the types of skills that they're looking at. And then just to see how a student does with that. I think that'd be a huge first step and not too hard. It's just downloading and printing a thing and running through it with a student for a few minutes. So what about you, Monica? What would you do? Maybe we can share a quick strategy that they can use in therapy?

Monica: I think the first one I would probably do is identifying the initial and the final sounds. Just because if the students can do that, you're really working on auditory discrimination and then you can shoo them back to get that self-awareness. Like, oh, wait, what was that fun sound? Or what was the final sound? I feel like that is probably going to make the biggest difference out of those. And it's not too far away, probably, from what everyone's used to doing. And then the third one would probably be checking in with the classroom teacher and asking if they'd been struggling on a benchmark test like the DIBELS or with their reading. Just you check in with that and it might be a really super, quick, easy way to get insight on where that student's doing.

Marisha: I love that. That's a great strategy. They can support in getting started, too. Awesome, so many great tips. Thank you, Monica, for breaking that down for us.

Monica: You're so welcome. This has been fun.

Marisha: [inaudible 00:10:35] next time. Thanks for listening to the SLP Now podcast. This podcast is part of a course offered for continuing education through SpeechTherapyPD. So yes, you can earn ASHA CEUs for listening to this podcast. If you enjoyed this episode, please share with your SLP friends and don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.

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#100: Phonological Awareness: Treatment Ideas

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Phonological Awareness: Treatment Ideas

We are chugging along on this PA train!

So far in this series, we’ve done a quick review of phonological awareness and why is it is so important. Last week we shared phonological assessment resources and phonological awareness goal examples.

This week we get to dive into treatment ideas. Are you excited? Because I know I am! Monica will share some of her favorite treatment ideas and tips on how to get the student engaged with the activity while still focusing on those PA targets!

Let’s get to it!

Phonological Awareness Activities

– The University of Florida Literacy Institute has a list of phonological awareness activities (some are multisensory and include movement)

– The Children’s Learning Insitute at University of Texas (UT) has some phonemic awareness activities.

– I do activities that are embedded in SSD practice, I just need a whiteboard *bolded are the ones I usually do in sessions

Syllable awareness
Example: Clap out how many syllables there are
How many syllables did you hear? You clap this one out, how many are there?

Rhyme awareness and production
Example: Minimal pairs/any kind of pairs

Alliteration
Example: Look for words that start with the same sound. What sound do you hear? What else starts with that sound.

Onset-rime segmentation
Example: What’s the beginning of cat? /k/ what’s the end /at/ -> put it together

Initial and final sound segmentation
Example: What’s the first sound? In tab? /t/ what’s the final sounds or end sound /b/

Blending sounds into words
Example: If I say /s/ /n/ /o/ what word is that?

Segmenting words into sounds
Example: Break down snow into sounds /s/ /n/ /o/

Deleting and manipulating sounds
Example: Say /nail/ now add and /s/ and say /snail/

Use the target words you already have. Most likely you’re doing these things already.

Links Mentioned and Additional Research

– Gillion, 2000:
Compared traditional articulation to phonological awareness intervention (check out the article for the full details, but we’ll share some of the activities today).

The children who received phonological awareness intervention made significantly more gains in their phonological awareness ability and reading development than the children receiving the other types of speech and language intervention.

The phonological awareness intervention also improved the children’s speech articulation.


– “Hesketh (2009) says, “My intervention principle is to incorporate PA-type activities in support of speech change using stimuli relevant to the child’s target processes, syllable structures, contrasts or sounds, rather than seeing PA skills as a target in their own right. A typical intervention session will involve the child in listening to, thinking about and producing sounds but the balance between these three elements varies enormously across children and across sessions.”

Subscribe & Review in iTunes

Are you subscribed to the podcast? If you’re not, subscribe today to get the latest episodes sent directly to you! Click here to make your listening experience auto-magic and as easy as possible.

Bonus points if you leave us a review over on iTunes → Those reviews help other SLPs find the podcast, and I love reading your feedback! Just click here to review, select “Ratings and Reviews,” “Write a Review,” and let me know what your favorite part of the podcast is.

Thanks so much!

Transcript

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Marisha: Hello there and welcome to the SLP Now podcast, where we share practical therapy tips and ideas for busy speech-language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode.

Marisha: Hey there SLP. This month, Monica and I are diving into all things, phonological awareness. So in episode 98, we did a quick review of what phonological awareness is, and we're going to spend the rest of the month talking about assessment, goals, treatment ideas...all sorts of good stuff.

Marisha: So without further ado, let's dive in to this week's episode.

Marisha: Now let's dive into some treatment strategies and what this could look like. You shared some ideas already, but do you have any other thoughts on what we can do in terms of treatment strategies?

Monica: Yeah. So the way that I usually incorporate phonological awareness is right when I'm first introducing that sound. And I think it helps to do a couple of these to see what helps them. So a lot of times, I'll just have a dry erase board, or they might have crayons or markers, or whatever they think is fun. You can do it with paint. I've seen teachers do it with shaving cream on the table, that's really fun. And then a nice way to shake up doing the usual, 100 trials too, and just to work it into teaching, and then to also to work it into when they're having a hard time saying that, and then you want extra strategies for it.

Monica: So it's a really good, not backup, but a really good place to revisit if they're having a really hard time with that. With my younger students, we work on a lot of phonemic awareness stuff. So, what is the very first sound? So identifying the first sound and the last sound. Or , "Can you tell me which words all start with your target sound?". So, especially for those kids that are really frustrated, we've all been working on eliciting a "K" sound, they can look for all of the words that have that "K" sound. So you can still be working on them having that auditory discrimination for that sound, especially if they're getting really, really frustrated. And they're really, really aware of that error, you can back up into doing some of these phonological awareness activities. So you're still working on it, and still working on those skills, but they need a little bit of a break from trying to work on doing that sound because that frustration level is ramping up. So that's where I'll work it in for that.

Marisha: And it's super interesting too, because the Gillon study that I shared at the beginning, that's all that they did. They didn't do a ton of production stuff, the actual production of sound improved. So it feels like a break to them, for sure. And it's a way to increase their success and reduce their level of frustration, but we're still doing work when we're doing that. It's super cool how that ends up. It's fascinating how the brain works.

Monica: I recently had a student who we were working on the "K" sound, and he was already in kindergarten and was so painfully aware of these sounds with sound error and was so motivated to do it. And we worked on so much auditory discrimination, identifying those sounds, doing rhyming words. Do you hear it in the beginning of the sound, do you hear at the end of that sound?

Monica: And so we could do that for all of the different positions. And once he actually was able to do that sound, it generalized to almost sentences very quickly. And I was very shocked. We didn't have this sound two months ago, but we had been working on all of those skills for a couple months before he was making that sound, like I probably shouldn't have been as surprised because we had been working on it that whole time, but you're with there with that student, with their frustration of not being able to make it. But I think that definitely is a case where it really, really helped all of those different phonological awareness things. The teacher noticed as well. I think that happened a lot faster than when you were trying to teach some of the other kids.

Marisha: Yeah, that's awesome. I love that you had like a super concrete example to drive that home too. Super helpful.

Marisha: So what else do we have?

Monica: I could probably just go through some of the activities down the list of the different type of phonological awareness things, and then some resources, there's one from university of Florida's Literacy Institute, I think. And it's just a full list. It goes from, they're just phonological awareness activities. So a word list, a syllable level list, onset rhyme activities, phoneme level activities. And a lot of these too are multi-sensory. So children hopping once for each syllable, being able to count out the syllables using bead strings, being able to toss a beanbag for onset and rhyme. So it's got a lot of these like little fun activities that could get them up and moving, rhyming bingo, sound detectives. So all the students have to listen for which word and the sound for the word, then the list that contains that sound.

Monica: So I'll do that with books a lot. So it would be, you are the detective for the "T" sound. You're the detective for the "ch" sound. And so that's fun for them too. I-spy, definitely got a lot of different ideas. And then there is also one from the Children's Learning Institute at the University of Texas. And it's just a long list of, I think they're just worksheets for all the different types of phonological awareness. If you don't know where to start and you just want a big resource for it. So that one was really neat, and they're free.

Marisha: That is so cool.

Marisha: They gave different instructions. They even have little cards and stuff that you can use.

Monica: Some of the ones that I do during speech sound practice, which is also really good to do during mixed groups too.

Monica: If you have someone working on vocabulary, they can do these things with the vocabulary word that you're maybe working on describing that day or something. So for syllable awareness, we'll just clap out how many syllables there are. And then I do try to check in with the teacher to see what specific movement they do in class to do some of these. So some teachers, they count down their arm or they bend a certain way. So I do try to do the same thing, but I mean, I've been working with the same teachers for six years now. So it's a little bit easier for me, but maybe if you're a new, what a site. It's a good, easy way to get a conversation going about different ways to collaborate, because that can be a really tricky relationship sometimes to navigate with collaborating with certain teachers.

Monica: Rhyme awareness and production - We have so many minimal pairs, right? All of the minimal pairs, or multiple oppositions, maximal oppositions, all of those are going to be different rhyming pairs. So you don't have to have extra materials. You're just using the ones that you have. You're just adding maybe a little bit of an extra verbal instruction. Like, "did you hear those two? How are they the same? How are they different?" And then just pointing out that awareness for the alliteration, kind of what we were talking about to be able to, "We're going to put all of these out on the table. I want you guys to find all the ones that start with the T sound" or whatever they're doing. So the kids feel like it's a game, and it's super fun, but we're working on phonological awareness.

Monica: Onset and rhyme - I don't necessarily work on this all the time in speech sessions, but it's just breaking it down into the beginning part and the end part. So, what's the beginning of "cat". It's "c". What's the end sound, it's "at". Then putting it together would be the blending it back in.

Monica: Initial and final sound segmentation - What's the first sound, and what's the final sound. If kids are in the trains, which so many of them are, that helps too as a visual... "Where's the front of this one, with the engine, where is the caboose of the sound." So kids have a lot, but if you're also prompting too, for kids, "Oh, what was that first sound supposed to be? What did we talk about?" And just work in that way too, helps with that independence, and then being able to self reflect on what it is. And then, so much of that auditory discrimination is happening with that. So that one, I feel like I do the most.

Monica: So if we're going over our target words for that session, then I'll ask, "What is the first sound in that one? What is the last sound?" Especially for kids who are fronting and they tend to switch sounds up a lot, that helps a lot for that, I feel like. Maybe just because I had a couple of fronting kids this year, so that's really at the front of my mind, but that helped a lot.

Monica: Blending sounds into words - I don't do that as much... Or segmenting words into sounds. So blending sounds would be, if I say, "S-n-ow, what word is that?" And then have to say "snow", or segmenting would be the opposite of that. I do a lot of deleting and manipulating sounds. So, "If I say s-nail and you have to add your S sound, what does that make?" And they would have to say "snail", and then we might incorporate different ones. You don't have to work on one of these at a time. Then it would be, "Oh, what was that front sound? That was your S sound. Right?" And then you can use these to give really specific feedback as well. Instead of "good sound", it's, "Oh, you put on your front sound", "You put on your S", or "You put all of those sounds together really nicely. You blended those together to make snail." That's definitely something else that I use it for is just to give that really specific feedback as well.

Marisha: And you touched on this a little bit already, but you just listed a bunch of different activities that we could possibly be doing. So can you give a couple examples of which of these you would incorporate, like with your student or one of your students who was fronting, would you do syllable awareness and rhyme awareness and initial and find out, would you put it into a certain hierarchy and only work on a couple?

Marisha: Or how do you navigate that?

Monica: I am sure there is probably a specific hierarchy, but I've just worked it in the way that's worked over the years. What's the easiest. So I think I'll just do an example. So say we're going to work on the word cab and this one, they are fronting to tab. So then I'll be like, "okay, let's write the word". And then if we have a contrasting picture between cab and tab, that works even better. If they can't write it, I'll write it first and then they'll trace it. So as we do that, "okay, what's the front sound? Oh, this one, the front sound is a T can you make that sound? Right? What is your tongue do? So I hear tab, right? What's the second part is that AB now this one is cab, what's the front sound for this one.

Monica: It's, a K. And where do we make that sound in our throat, right? And then what is your tongue do? Does your tongue go up for cab? No, it doesn't, it stays down. So that's something that happens that's different". [inaudible 00:12:11] our K sound and our T sound, then we do the rhyme. "So, can you hear it? Tab cab? That end sound is the same, but our front sounds are different, right? Our T goes up, our tongue goes up behind our teeth and for cab, right, our sound is in our throat and our tongue does not go up like that". So that might be something that different parts of that I come back to that they have a hard time with, if they have a hard time with their tongue. We can work that in and then we can talk about how that makes a different front sound.

Monica: But that's generally how it sounds like. So being able to go through and list out specifically how I do some of this stuff it was just one of those things, you do it and you get so used to just doing all of those, breaking it down and explaining it was really interesting to do.

Marisha: Yeah, absolutely. But that was really helpful. And just getting one example of what that could look like and how it could be incorporated. We definitely want to check with our scope of practice and what makes sense. But a lot of the articles, like I know the Gillon one that I mentioned at the very beginning, they kind of described their intervention and a lot of the different resources that we shared describe how they implemented that. So we can definitely get some more inspiration from there, that was super helpful.

Marisha: And just again, emphasizing that we can use whatever words we're already working on, and then we can get feedback from the teacher or the reading specialist or the RTI, whoever is working on that with the student, I'm sure they would have recommendations and they can help us figure out that hierarchy or what they need the most support in and really leaning on their expertise to, okay, we really need to work on some syllables before we can do that deletion or whatever it may be.

Marisha: I think that's super helpful. So I feel like we've got some really good strategies and activity ideas that we can use in therapy.

Marisha: Thanks for listening to the SLP. Now podcast, this podcast is part of a course offered for continuing education through speech therapy PD. So yes, you can earn ASHA CEUs use for listening to this podcast. If you enjoyed this episode, please share with your SLP friends and don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.

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