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Marisha

The Cycles Approach for Articulation Therapy: A Case Study

May 20, 2019 by Marisha 2 Comments

We shared a review of articulation approaches, and now we’re diving into a case study for the Cycles Approach.

Why the Cycles Approach?

ASHA summarized a systematic review of the Cycles Approach by Hassink & Wendt (2010).

Here’s a snippet of what they had to say:

“Although evidence was limited, several studies indicated that ‘it is plausible that the Cycles Approach results in improved consonant production in conversational contexts …, that children with less severe phonological and language impairments improve in both domains when the Cycles Approach is used …, and that earlier implementation of the Cycles Approach results in improved outcome’ (Suggestive Evidence; p. 4).”

Check out the full review (it’s free!) for a closer look.

A Case Study for the Cycles Approach

Jayden is a four-year-old preschooler.

He consistently uses the following sounds: bilabials /p, b, m, w/, alveolars /t, d, n, l/, palatal /j/, glottals /h, ʔ/. He was stimulable for /f, v, s, k/ when significant verbal and visual cues were provided. Phonemes /g, ŋ, z, ʃ, t͡ʃ, d͡ʒ, ð, θ/ were not stimulable.

Evaluation results reveal a phonological disorder characterized by cluster reduction (90% of opportunities), fronting (100% of opportunities), and stopping (100% of opportunities).

Jayden’s speech is very difficult to understand. His parents say they understand about 70% of what he says; Jayden’s teacher understands about 50% of his speech.

His teacher reports that Jayden gets frustrated easily and tends to get distracted after about 3 minutes of work.

Sample Target Selection for the Cycles Approach

We started our first cycle with cluster reduction (/sp-/, /st-/, /-ts/, /-ps/) and fronting (final /k/, initial /k/).

If you’re wondering how to select your own targets and structure your therapy sessions, this blog post by Banter Speech is super helpful! Playing with Words 365 also has a planning sheet that can help you organize your therapy steps.

Sample Goals for the Cycles Approach

Example Long-Term Goal

Jayden will increase his intelligibility by independently producing /s/-clusters (/sp-/, /st-/, /-ts/, /-ps/) and velars (/k/, /g/) in sentences during structured language activities with 80% accuracy by ____.

Example Short-Term Goal

Jayden will independently produce /k/ in words with 80% accuracy during structured language activities by ____.

• Provide verbal and visual cues as needed, explaining and demonstrating placement

• Baseline Data: Jayden is stimulable for /k/ in single CVC words with 60% accuracy all positions. This data was collected when a new level of target was introduced.

• Carry-Over Probes: Probes after each 2-3 week cycle before moving on to the next level (e.g., phrase, sentence, etc.)

Sample Activities for the Cycles Approach

Literacy-Based Activities to Target /k/

1. If You Give a Cat a Cupcake by Laura Numeroff

2. Caps for Sale by Esphyr Slobodkina

3. Cupcake by Charise Mericle Harper

Drill-Based Activities

Shannon from Speechy Musings also makes a fabulous toolkit that helps break down the process.

If you’re an SLP Now member, I love using the SLP Now Articulation Stickers and Phonology Sheets! See them in action here.

Race to Color: I print a sheet of paper with 30-50 figures (e.g., super heroes, robots, vehicles, animals). Students are able to color a figure after each target is said accurately 2-4 times. The goal is to get at least 100 trials. The student is able to pick a reward (e.g., a sticker) after the sheet is fully colored.

Beat the Timer: The student practices saying target word as many times as he/she can before the sand timer runs out. Students can “compete” to see if they can beat their past scores.

Filed Under: Therapy Ideas Tagged With: Articulation, Therapy Plans

#002: How to Get Organized

May 15, 2019 by Marisha Leave a Comment

Listen on Apple Podcasts Listen on Spotify

Is your speech room a disaster?

In this podcourse, Marisha shares the three-step process she uses when organizing her speech therapy materials, so it’s a great tutorial for how to get organized at any time of year. With a focus on facilitating more meaningful outcomes for students and streamlining the therapy planning process, SLPs will walk away with practical tips and strategies to “work smarter” in their speech therapy sessions.

So, grab your favorite beverage, put your feet up, and listen in.

Key Takeaways

This episode about how to get organized is incredibly insightful and actionable. Here are a few key takeaways:

> 1. Declutter before you organize!
> 2. Prioritize the materials that you currently need for your caseload.
> 3. Find ways to organize those materials in a “smart” way.

Links Mentioned in the Podcast

> The Decluttering Guide (FREEBIE)
> The SLP Now Membership
> Epic (Free digital books for educators!)
> The Life-Changing Magic of Tidying Up by Marie Kondo (affiliate link)
> Caseload at a Glance (FREEBIE)
> Therapy Tote Tour

Subscribe & Review in iTunes

Are you subscribed to the podcast? If you’re not, please subscribe today to get the latest episodes sent directly to you! Click here to subscribe in iTunes!

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” and “Write a Review,” and let me know what your favorite part of the podcast is. Thank you!

Transcript

Transcript
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Welcome to the second episode of the podcast. I am really excited to dive in and answer the question of how to get organized as a speech-language pathologist. This is a question that I get all the time, and it's one that I love to answer. Organization is my love language, if you can even consider that a love language, but it's something that I've always really liked to do, and it's something that helps me feel just a little bit more in control when life gets a little bit extra chaotic. It's one that has helped me solve a lot of problems. Like, it helps me be more efficient and get more done and not have to think about all the things all the time.

But I hope that you're trying to get organized for that reason, to solve a problem. Like, you're trying to get organized to make it easier to find what you need for your therapy sessions, or you're trying to get organized so that your therapy room isn't quite so distracting for your students. Now, I don't hope that that's the case for you, but I hope that if you're trying to get organized that it's a reason like that, and that you're not getting organized just because you want an Instagram-worthy speech room, because that's not really going to serve us. It might get you some likes on Instagram, but that's not really the goal, right? We're trying to solve problems to help us become better SLPs, and you don't have to have a beautifully organized, color-coded therapy room to be successful, to be an amazing therapist, and to really impact your students.

If you are setting those organization goals, I just challenge you to take a step back and look at the why. As you're making your goals and you're coming up with your solutions to get more organized, definitely think about what's going to give you the most bang for your buck, because we do not have a lot of time, and our caseloads are always growing. We have such a heavy workload, and the time that we spend towards solutions should be the best use of our time. It can be counterproductive if we're so focused on all of the beautiful color-coded stuff, and if we need it to be exactly perfect. First of all, if your speech room is messy and it's working for you, you can embrace the mess, then own that. That's totally amazing. I actually wish I could be more like that, because I am a little bit of a perfectionist, and I tend to be the type of person that I was just talking about, where I spend too much time focusing on some of those little things.

But I've definitely learned a lot along the way. Sometimes I choose to do all the beautiful color-coded stuff even though it's not going to make me be that much more productive or really step up my therapy game that much, but it just makes me happy. It makes me smile when I walk into my therapy room, so I sometimes choose to spend some of my free time working on those types of things. But I really try to focus on making the most of my time while I'm at school and while I'm supposed to be serving my students, so the extra color-coded stuff just has to be something that I do for fun.

As always, I have a plan and some step-by-step processes to help us get more organized. The three main things that I want to talk about today are, one, decluttering your speech room, because that is a very important first step. I also want to talk about figuring out which materials are the most important for your caseload and how to use that to have an organized room that helps you be more productive in therapy and just makes the process that much easier. Then third, we're going to talk about some of my favorite ways to organize those materials once we have that all figured out. But as you noticed, organization is actually the last thing on the list. There's some work that we have to do ahead of time to make sure that we're being productive in our organization, and we're not falling down that rabbit hole where we're just trying to make pretty things, because we want to make the most use out of our time.

Let's dive into the first topic, which is decluttering. Let's address the elephant in the room. Why even talk about decluttering? It's definitely not a glamorous topic, and it's not something that sounds very fun, but it has been a serious game-changer for me. When I was a CF, I was so excited, because I had tons of therapy materials. You know me, I'm the organization nerd, so I spent a bunch of time at the beginning of the school year getting pretty color-coded organization set up, and everything was super organized when I started.

But it wasn't really organized, because I had everything I could possibly ever need for probably a hundred years of therapy. I just had too many choices, and it really made it harder for me to plan therapy. I couldn't find what I needed, or I was stuck standing in front of the bookshelf looking at like five different workbooks that I could choose from to pick worksheets, and it was just too much for my new clinician brain.

My room was also packed. I noticed that it distracted the kids. We were more focused on the what, like what are we going to play, what book are we going to read, what thing are we going to do, instead of the how, like how am I going to help them become better communicators? It just ended up distracting from what we wanted to accomplish.

I realized this. I realized that I was feeling overwhelmed, and that having that much was distracting for us. I spent some time purging my materials, and it made such a big difference. It was pretty amazing. I still had a lot of materials, but I was feeling a lot better.

But then a few years ahead, I started in a speech room with like no therapy materials. I think I didn't even have Super Duper decks. I had very few things. I maybe had like one game and some paper and paperclips. There was not a lot in the therapy room. I had just moved from a new state, so my personal therapy materials hadn't been delivered yet, except for the few things that I decided to pack in my car. I'm not going to lie, I was a little worried, because I was used to having such a full speech room. I had so many materials at my disposal, even after I did the decluttering in my last district. Yeah, I was worried. I didn't think I would have enough. I just had, like I said, the few staple materials, my favorites, and that was it.

But it turned out that only having a few materials was like a game-changer for me. I was more resourceful, I was more creative, I was more productive in my sessions. We had tons of room to move around. Like, we weren't kind of navigating different bookshelves and piles of materials. We just had ... There was so much empty space. Kids weren't distracted, and I wasn't overwhelmed. I knew I just had this therapy tote of materials, and that's all that I had to choose from. It made it so much easier to plan for therapy and get things done.

That was really a fortunate accident, or I was really able to turn that around. I was really nervous at first, and it ended up being absolutely amazing having an empty speech room. That's good news for those of you who are stressed out about having very few materials, because you're already ahead of the game, because you don't have to do this decluttering step. But for those of you who have more materials, we're going to be diving into how to make this happen, and for those of you who don't have the materials, stay tuned to see the ideas that I had on how to pick your most important materials, because I think those will be very valuable for both situations.

When I had less materials, I wasn't reaching for games or worksheets or card decks. I was a little more motivated to collaborate with teachers and use materials from the curriculum. Those are free, and they're super easy to access when you're in a school setting. I do use the SLP Now membership. I'm the founder of it. But you can totally build your core library of materials using any number of resources. There's so many good ones out there. But I used the SLP Now membership and pulled up materials on my iPad, so I didn't even have to have a lot of papers. I had all of my visuals on there.

I was even able to access books on there, like if I couldn't find what I wanted on the library. Two of my favorite apps for books are Epic!, and you can find that at getepic.com. If you go to the Educator tab, it's on the top of the page, you can sign up with your school email and get free access. I also really like finding books on YouTube. Those are really fun resources. So I was able to ... I didn't need anything for that. I just had my iPad, and even if I didn't have my iPad, I could just pull these things up on my computer. I didn't have to have any of those materials prepped or printed or anything.

I also had just a few reinforcers, like a dice and some highlighters and some of those favorite tools that get students super excited. But that's all I really needed. I didn't need any of my other materials. I didn't need my games, I didn't need my decks of cards. I just had a really core set of materials, and we were having so much fun in therapy, and making so much progress with hardly any materials.

But like I said, a lot of us don't have the, quote-unquote, "luxury" of an empty speech room, so I am doing a quick recap of the process that I used to declutter my super full speech room. I read The Life-Changing Magic of Tidying Up by Marie Kondo while I was in my CF, and I was so incredibly inspired. I decided to go all-in, and I just invested a good chunk of time to just unload all of the shelves and do a massive decluttering. I unloaded my desks, my bookshelves, all of the different ... Like, I had a bunch of different bookshelves. I didn't have a closet or anything. But I made the most glorious mess in the world. I wish I had pictures to share, because it was a mess.

But I just unloaded everything, and I used her process to go through my speech room and figure out what I wanted. I sorted the different materials. I put all of the different types of card decks together, all of the art supplies together, all of the papers together, and I categorized things, because I had decks on this shelf, and then the shelf by the door and the shelf by the window, and I had some in my desk. By making sure that I had all of the decks in one place, all of the papers in one place, it was a lot easier, and I noticed that I had duplicates of a lot of things. It was just really helpful to see it all laid out like that.

It could've been super overwhelming to see the ... It looked like my speech room had been in a massive storm, and people always commented when they walked by, but luckily it didn't last a very long time. But it was just so incredibly helpful to be able to see exactly what I have, and then like I said I grouped all of those things together, and I was able to just quickly see everything that I had, and kind of going through all of that.

Oh, and then the paper. I mentioned that I kept the paper ... I tried to put all of the paper together. But I think I had three giant filing cabinets' worth of worksheets, plus all of the ... Well, not three. I think there were two cabinets of worksheets, and then one cabinet that was ... Like, there were IEPs in folders in there from like 10 years ago. So that was a lot.

The biggest thing that I did with the paper was, for the old files, I really wanted to make sure that I had a good system in place for that and that I was following the district's rules on how long you're supposed to keep paper and all of those good things. But I checked in with my district and I figured out which files I could shred, or which files I had to send to special education, and which ones I needed to keep. Then I put together a system, because I think we ... I don't remember the exact rules that they had, but there was something about, I have to keep files for seven years, and then I send them to special education, and if they've been around for longer than that, then I'm supposed to shred them. I don't know. I don't remember the rules, so don't quote me on that. Just check with your special education department and figure out what needs to happen there.

But I came up with a system to figure out how long I needed to keep the files, so then at the end of every school year, I could just get rid of the ones that I didn't need. That ended up freeing up a bunch of space, and it also made it easier, because I was able to get those organized. Sometimes students would move out and then they would come back and all of that, so it just really helped solve that problem, because they were not organized at all, and so I was kind of going to all over the place trying to figure out what was what. But now, with that system, when a new students came in I could quickly check to make sure that they weren't already in my cabinet. That made a big difference, too.

Then when it came to the worksheets, that was a whole other thing. But like I said, I think I did all of the therapy materials that one time, and then I saved the paper for another time, because that was a huge project, and I didn't have enough time to do it all at once. But as I was going through the speech room, I made sure to keep any papers and just stuff them in the file cabinet until I was able to go through those.

But if it's too overwhelming to do your entire speech room at once, you can work in zones. This isn't something that the genius, Marie Kondo, recommends, but you could start with your desk, and then move to the first bookshelf, and then go to your cabinet, or whatever order you want. But you could just write down, "Okay, I want to do this first, then this, then this, then this," and then just cross them out as you make progress. But the only thing is, if you have art supplies in your desk and your cabinet and on your bookshelf and in the whatever other location, then you really want to think about how ... like, maybe think ahead of time where you want to put your art supplies, and then just keep them there until ... Like, as you find them, just put them in that place, and then organize them when you get to that section. But I thought it was really helpful to just unload it all and organize it all, and then decide where it went once I was done going through.

Then the second step is to start going through all of the things. A lot of times, they'll talk about like a three-box method, where you box the things that you want to keep, the things you want to donate, and the things that you need to trash. With therapy materials, there's some things, like random just trash that we can get rid of, but a lot of times in the schools we can't just throw out old therapy materials. I would definitely check before you just start throwing things in the trash.

But I started to go through the materials, and there were some old worksheets and things when I got to the papers that I could throw away. But most of the things ... Like, there were books that were ... I don't know, they must have been almost a hundred years old. Probably not that old, but there were some really old books and some really old therapy materials. But I didn't want to just get rid of them, because I was in a district that the SLPs, we didn't have a budget at the time, and I knew a lot of SLPs weren't in the same situation as me.

I decided to share some of the resources with ... Like, I shared the resources that I didn't want with the other SLPs in my district. I took pictures of all of the materials that I didn't want to keep, and I posted them in a Google Doc, and I just listed ... I just laid a bunch of them out on the floor, and then I took a big picture of a bunch of things, and then I listed the names of the materials. Like, this following directions deck, or the name of this game, or the name of this book. Then shared it with all of the SLPs in my district, and then they writed their ... Writed. They wrote their name next to the things that they wanted.

I cannot tell you how fast that list filled up. They were so excited to get new materials. Pretty much everything got requested or claimed within, I don't know, I felt like it was a matter of minutes. It just went so fast. They were totally on top of it. So then I just packed that stuff up and brought it to the next speech therapy meeting, and everyone got to go home with materials. It was really awesome. It was really fun, and I feel like it kind of boosted everyone's morale, because I was so incredibly excited to be getting rid of those materials, and I was able to share them with other SLPs when they really needed it, which was so amazing. I felt like I could breathe in my therapy room, and I knew that the materials were going to a good place, so I didn't feel quite so guilty about it. It was just a really amazing process altogether.

I actually created a little cheat sheet, because I know it can be so challenging to figure out what you need to keep and get rid of and all of that. So I made a little decision tree to make things easier. If you go to SLPNow.com/too, you can access that free handout to help you go through the process, and hopefully that'll make it a little bit easier.

Then the third step is to ... Like, once you sort all of the things into different boxes, like I had the things I wanted to keep, and I then put them in the place that they need to go. Like, I put all of the art supplies in one place, I put all of the children's books in one place, I put all of the therapy workbooks in one place, put all of the decks in one place. You get the idea. Then I put those things away, and then like I said, I shared the resources, or the materials that I didn't need with the SLPs in my district, and then I got rid of the ones that were okay to throw away. Then that was it. Then I got to celebrate.

But this last step is so incredibly important, because you don't want to just let those things sit around. You really want to take care of them as soon as possible. Yeah, like I said, it was an absolute game-changer for me. It was a small step towards the complete freedom that I felt coming into a totally empty therapy room, but it was just really awesome. Decluttering is a huge first step. Once you do that, you don't need quite so many organizational tools, and just, you don't need so much stuff. You don't need to do all of that crazy organization because you don't have that much stuff. Even if you have a really small speech room, it'll just be so easy to organize because you just don't have that much stuff.

But like I said, there are definitely some benefits to having some good organization systems, so we're going to dive into that in just a moment. Before we dive into all of my favorite organizational tools, I wanted to share some strategies that you can use to figure out what you actually need for your caseload, which goes back to, if you're getting stuck with the decision tree and you're just overthinking it, and it's like, "I don't know what I'm going to need, and I'm just having a hard time purging these materials or decluttering," this will be incredibly helpful for you.

I wanted to take a step back, because one of the most important things that we do in therapy is teach. We teach our students these new skills, and that is such an important part of our therapy process. It's so easy to forget about that when we have ... because we have all of these therapy materials that are geared towards practicing the skill, and it's so easy to skip the initial teaching. We forget that it's such an important part of the process, and there's so much research showing that teaching first increases student understanding, levels of performance. That's an article by Swanson in 2001. There's so many more things that we could reference, but I want to stay super practical here. But it's just remembering that we really need to make sure that we have the materials that we need to teach our students.

One of the best ways that I think that we can teach our students is by using visuals. There's so many benefits to using visuals. There's lots of research, like Shelton 1999, Stoner, Meaden, and Angell in 2014 cite visuals as an effective tool for therapy. They help us structure our sessions. They allow us to increase student independence, because we don't have to do quite so much talking. Students are often ... at least the students that I see are often more visual learnings. They benefit from seeing things visually versus having to process them auditorially.

Visuals are kind of magical, because we can easily fade their use. We can start by really kind of having the visual in the student's face. Not really in the student's face, but we can have it right by the student. We can point to it, we can refer to it, and we can have that be something that we do. Then over time, we can just have the visual on the desk. Then we can move the visual away. We can have the student access the visual independently when he needs it, instead of us cuing him to use it. So it's really amazing for that purpose. Like I said, it makes it so that we don't have to do so much talking, and it really empowers our students. And it's really great for generalization, because they don't need us to be there. We can share the visual with teachers, and it can, like I said, make that generalization that much easier.

I want to share a quick story of how this worked for me. I was working on WH questions with a student, and he was doing really well in the therapy room, and he was really loving the visual that I made for him. I ended up sharing it with the teacher too, because they were doing a lot of worksheets at the time where they had to answer WH questions, and they were doing multiple choice reading comprehension quizzes, and he kept failing them, and kept missing the ... Like, he misunderstood the meaning of the WH word. So he retained details from the story fairly well, but he would answer like a who question with a what. The multiple choice answers were structured in a way where he was able to get away with that, or not really get away with it, where it had a what answer for the who question, and it was just really tricky for him.

So we brought that visual into the classroom and I told the teacher how it worked, and so she was able to give a little bit of prompting. But because I had taught him to use that visual in the therapy room, he was able to use it on his own in the classroom. It was amazing, because the teacher immediately saw the value in that visual, and the student was able to use it. It was just a win-win situation. The teacher even ended up using it with multiple students. It was the best feeling ever. I walked into the classroom, and I did a little happy dance because I saw my student using it, and then I looked around and I saw even more students using the visual, which was so amazing. The teacher had just made some copies of it, and it was just really exciting to see that in action. It really benefited my student, but it also benefited other students in the classroom, which was amazing.

Again, just emphasizing the importance of having those different visuals. It's just a really great way to give feedback, too. If we're working on answering WH questions, and like, I ask who is in the story and he answers with a what, I can point to the who, and have that be a feedback tool, and I don't have to say anything. But it's just a great way to provide that feedback and facilitate success. Then we don't have to have quite so much negative practice. It's a little bit easier to do that cuing. I could've been, in the example I just gave, I could've been more proactive and I could've said, "Who was in the story?" as I'm pointing to the icon that represents who, and then I would be setting that student up for success without having to give any verbal cues. That's a really effective strategy. They're more successful, they're more engaged, and it just has a lot of benefits overall. It just gives us more options in our prompting hierarchy to support the student and set them up for success, which is absolutely amazing.

How do I figure out which visuals I need, which assessments I need, which materials I need to have at the forefront of my therapy room? I do this by mapping out my caseload using a caseload at a glance sheet. You can access my template at SLPNow.com/too, but you can also totally just pull out a piece of paper and draw some lines and make an equally effective caseload at a glance. What I do is, I put the main areas of goals that I'm targeting. I typically do, like, articulation, or speech sound disorders, then I do language, grammar, vocabulary. Some people might cringe at my categories, but they help me organize things and they make sense to my brain. Pick whatever makes the most sense to you. Just pick your broader categories.

That's going down ... Each row has one of those. Then I make columns that have the different grade levels. I might have preschool, kindergarten, first grade, second grade. Whatever levels of students that you work with. Then I go through my students' goals. I'll start with preschool, and I'll look at Johnny's IEP or Johnny's datasheet, and I'll just map out his goals. Johnny is in preschool and he's working on final consonant deletion and naming antonyms. So I would go to the articulation row and put it in the preschool column, and I would just write K, and then I would put a 1 next to it. Then I would also go down to the vocabulary row under the preschool column, and write down, "Antonyms." Then if I go to the next IEP and Sally is working on K and synonyms, I would add a dash next to the K that I just wrote, because there's two kids working on the K sound, and then I would go down to vocabulary and add synonyms, and put a 1 next to it.

Then I just go through, and then by the time I'm done going through all of my IEPs or datasheets, I have a really good idea of what my caseload looks like. I know how many students are working on articulation, I know how many students are working on vocabulary, and so on and so forth. That makes it really easy to figure out which materials I need, because I can do a quick inventory and look at which materials I already have. Like, do I have ...

Before you start doing your inventory, you can make a copy of this sheet. You can do one where you look to make sure that you have assessments for all of these. You can use another copy to make sure that you have teaching materials for all of those skills. You can do another one to make sure that you have practice activities for all of those skills. Although I would argue that with especially grammar and vocabulary, you don't necessarily have to ... if you have good teaching materials, you can use pretty much anything to target the skills, so you don't need a lot. But whatever you feel like you need, you know your therapy style best. I definitely have my own style and preferences, so just organize it the way that makes the most sense for you.

Then I just go through, and I will highlight the areas that I feel like I have enough materials for. Then you could use a color-coding system too, if you want to do, like, okay, I feel really good, I'm green for all of these areas, but the yellow areas, I could use some more materials. You can organize that however makes the most sense for you. But that's a really fun way to, and a productive way, to figure out what you need for your caseload. When I went through this, I made sure that I had those teaching materials, because I use those day in and day out. I made sure that I had them right by my therapy table so that I had instant access to those materials. Then I made sure to have a system that has the activities that I need to practice those skills with students super accessible. But having this all mapped out makes it really easy to know what I need for my current caseload.

I know that this doesn't answer the question, because you don't know what kind of student is going to be on your caseload tomorrow. But in terms of what you need to do ... Just think about what you need to do therapy today, and make sure that those materials are easily accessible, and prioritize those and make sure that you can access them when you need to, especially if you're getting into that flow where you're planning as students walk in the door. It'll do yourself such a huge favor if you're able to have easy access to those materials. It's kind of like doing your planning ahead of time. That's a huge component of planning for your sessions if you have those materials ready to go, because then you just have to plan out a really basic activity to kind of glue all of those things together. So it's just a really huge productivity booster too, in addition to having a more organized therapy room and saving yourself time in between sessions and all of that.

That is the second topic that I wanted to go over, because it's been such a huge game-changer for me in terms of mapping out my caseload and figuring out what I need. For the things that I don't have, like if I don't have any materials to work on K, then that's definitely a priority and something that I want to access. That'll be more of another topic, in terms of building that library, but I just wanted to kind of allude to that so we can talk about that more some other time.

So we've mapped out our caseload and we're working on decluttering our therapy room, and we're making sure that we keep the materials that we need for those types of goals. That doesn't mean that we have to throw out all of the other materials that we have, but it really helps us prioritize. Then we might keep some of those other materials, but maybe we will store them elsewhere, like not right by our therapy table, or we might even store them offsite if it's something that we're not using right now. I know a bunch of SLPs who store materials in their garage or in a spare closet at home. Those are some options too if you just want to simplify your speech therapy room but you're not ready to get rid of those materials.

Then I would challenge you, if you have been keeping those materials for several years and you haven't even opened the box, we might not need it anymore. You could kind of set up a rule for yourself. If I don't use this in this amount of time, then it can go away. So yeah, those are some of the tips to map out the caseload.

Now we get to the fun part, organizing our most-used materials. This is when we've gone through the decluttering, we've gotten everything all prioritized, and we know what we're using in our sessions day in and day out. The first thing that we talked about was those visuals and the materials that we need to teach different skills. I definitely have my favorite way of doing this. I use this therapy tote that I found at a craft store. I use it to keep all of my teaching materials. It all just fits into this tote. I like that it's a certain amount of space. I have plenty of space in there, but it helps keep it contained, and I make sure that I don't go too, too crazy with my different materials.

But I have a file box that fits perfectly into the tote, and that's where I put files. I use that to organize my different visuals. I put them in sheet protectors so that I can use dry erase markers as I'm introducing a skill. It's super helpful, because then it just gives me so many different options. I also store those dry erase markers in the tote. If you go to SLPNow.com/too, you can access, or you can see a picture of the tote, and I'll link to a blog post that goes into it in more detail. You can see a video going through the tote, and then you can also get links to all of the different materials if you're interested in building your own tote. That is the first thing that I store in the tote. I keep my visuals in a file box, and the papers rall in sheet protectors. That's been super helpful.

Then the second thing that I have is a little ... I think it's called a tackle box. It's just a little craft organizer. It fits right next to my file tote, so it's like the perfect system. It took me a little while to figure out all the different components, but I'm really happy with it now and I've been using it for a few years. The little craft organizer box is what I use to store my little decks of cards. I use those when the student needs more structured practice in that initial teaching to really understand a skill. So I'll use that if I'm introducing, like, past tense verbs, or teaching them how to follow directions, or whatever it may be. I just have a little box, and I just open that up and pull the deck of cards that I need for any given skill when I need it. That's been a really amazing system.

I also have a binder in there with assessments. If I'm starting to work on a new skill or if I feel like we're stuck, I can go through the assessment binder and just pull up the assessment for that skill and run through it to help myself troubleshoot a little bit and figure out exactly where we need to start. It can also be helpful for just progress monitoring or updating present levels or whatnot. But those are very specific to the different skills, and they're just helpful when I need some help.

I like that I can just pull that, because often, especially as a newer SLP, I wasn't always sure of exactly ... Like, it wasn't as intuitive to me, I think, as it was to some other SLPs. So it was really nice being able to have an assessment to lean on, because I felt like having a little bit more data made it ... it helped me break down the skill, and the assessments that I use do a really nice job of that.

For example, there's a following directions assessment. It has different levels in the assessment, so I can start with one-step, two-step, three-step directions, and then it has different types of directions within that assessment, so I can look at the one-step directions and ones that include prepositions or other basic concepts, or different syntax. I can really look at those different components and figure out what they need help with, because if they're not able to follow directions because they're missing the vocabulary, that gives me a really good idea of what I need to focus on, whereas if they understand all of the vocabulary but they're getting confused when I use different types of syntax, then I know what I need to target on there.

That's just such a helpful and important part of my therapy process that I want to have those really easy to access. So when I'm going through my caseload at a glance, I want to make sure that I have the assessments and the visuals, and then just other teaching tools for those different skills, and they all live in my therapy tote. It's amazing. I love it because I can take it ... If I'm at different locations, it's easy to move around. I can bring it into the classroom and just have everything that I need in one place.

Then the second piece that we talked about is, so we've got all the materials that we need, we're ready to target pretty much any goal, at least any goal on our caseload, and now we need something to glue our therapy sessions together. I personally love using books in therapy. I'm a huge fan of literacy-based therapy. So for me, I have a lot of books and themed units around those books so that we can really get some quality practice. We'll talk about this another time, but there's a framework that I like to use to make sure that I'm making the most out of my therapy time using literacy-based therapy, and there's a whole process around that.

But the basic system that I use is, I just have a bunch of books, and then I used to store them in big ... in totes, like file totes, and I had them organized that way. But then I switched to book bins, because I like to be able to keep the books that I'm not using in a separate place, and just have the current set of books close by. It was just overwhelming to have all of that stuff right by the therapy table, so I just pull one book bin for whatever we're working on, and just all of the books that I'm currently using with my students, and I just keep those there, so it's a little bit less overwhelming.

I have all of my materials pretty much ... they're pretty much digital now, and then I can easily print those out when I need them. But then inside of the book, I use a little pocket, and I put the visuals that I need for like comprehension and vocabulary and those types of activities. So those are always stored in the book, and I have easy access to those. If I need any supplementary activities, I just print them out, or I pull them up on my iPad.

Then beyond that ... Yeah, that's the basic system there. But if I need something additional, I also love, love, love, love using no-print books, and I've made a bunch of those. If I'm not able to prep the materials for a particular book, I can always use the no-print book companion, and it has all of the different visuals and tools that I need, especially when combined with the different tools that I use, so the different visuals and teaching tools that I have in my therapy tote.

Really, that's pretty much all I need, because I keep my iPad in my therapy tote. So I just have my tote and a box of books, and that's pretty much all that I need. The tote has different pockets in the sides, so I have my different reinforcers there, like stylus, pens. I have little fidgets when needed, I have behavior tokens, I have magic highlighters, I have my smelly pens. Like, those are all in that therapy tote. That's all I need. It's super easy and super fun.

I don't do crafts so much in therapy, but I do have a little ... not a little, but it's a fairly large ... I believe it's called an art bin. I use that to organize some of my most commonly used art supplies, so I can pull those out when needed. But that's not something that I do a ton, so that's really all that I need. My therapy tote also has some ... I do my articulation therapy either using apps, like I love Articulation Station, and then I have some different interactive activities that I use. Those also fit in my therapy tote. That's really all that I need, and that's how I organize it. Like I said, you can check out the website to see visuals and links to all of these different resources. But yeah, that's how I organize all the things and how I make it work for me.

Then just a quick recap. The first thing is to declutter. I cannot emphasize how incredibly important this is. Arguably, you should probably map out your caseload before you do the decluttering, but I feel like those really go hand-in-hand. You need both of those components to really get the best organization setup set for your caseload. But yeah, I map out my caseload and use that caseload at a glance to really drive how I organize all of the things and to figure out what I actually need. Then I organize my most-used materials. A lot of that includes just the therapy tote with my different teaching materials, and then I have books and materials for different themed units.

If you are working with younger students, you might want some more seasonal games and activities and things like that. I have a lot of those at home now, and I use boxes to store those, and then just have them organized by theme. Then the ones that I like the most, I have in a cabinet.

Yeah, that's how I do all the things. Let us know if you have any questions. We'll see you next time.

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Filed Under: Podcast Tagged With: Organizing Therapy Materials

The Developmental Approach to Articulation Therapy: A Case Study

May 13, 2019 by Marisha Leave a Comment

Last week, we shared a review of articulation approaches. Now, we’re diving into a case study for the Traditional Approach.

A Case Study for the Traditional Approach

Casey, an eleven-year-old fifth-grade girl, had difficulty producing the “r” and “th” sounds (/r, ɚ, ɝ, ɪr, ɜr, ɑr, ɔr, θ, ð/). Results of a speech-language evaluation reveal a speech sound disorder characterized by sound substitutions (e.g., /ə/ for /ɚ/, /w/ for /r/, /s/ for /θ/, and /d/ for /ð/). When given verbal and visual cues, Casey is stimulable for these sounds; however she has more difficulty with vocalic /r/ than the others. Although her speech is reportedly about 90% intelligible to most listeners, Casey’s peers are starting to comment on her speech as “baby talk” Casey’s teacher says that she is a hard worker and performs average to above average in most subjects. The teacher has noticed that Casey is reluctant to participate in class and worries about her self-confidence as she approaches the sixth grade.

Sample Target Selection for the Traditional Approach

We’ll start with earlier developing sounds and move towards the sounds that are developed later.

1. Initial /r/ in isolation until benchmark level is met (e.g., 80% accuracy)

• Progress to trials in syllables, words, phrases, sentences.

• Continue trials at each level until benchmark is met (e.g., 80% accuracy over ___ consecutive sessions).

2. Voiced “th” in isolation until benchmark level is met (e.g., 80% accuracy)

• Progress to trials in syllables, words, phrases, sentences.

• Continue trials at each level until benchmark is met (e.g., 80% accuracy over ___ consecutive sessions).

3. Voiceless “th” in isolation until benchmark level is met (e.g., 80% accuracy)

• Progress to trials in syllables, words, phrases, sentences.

• Continue trials at each level until benchmark is met (e.g., 80% accuracy over ___ consecutive sessions).

Sample Goals for the Traditional Approach

Long-Term Goal (Example)

Casey will produce /r/ in 4-5 word sentences with 80% accuracy during structured language activities given verbal and/or visual cues by ____.

Short-Term Goal (Example)

Casey will produce /r/ in 2-3 word phrases with 80% accuracy during structured language activities given verbal and/or visual cues by ____.

Sample Strategies for the Traditional Approach

Provide verbal and visual cues (e.g., providing a mirror for feedback) as needed, explaining and demonstrating placement.

Sample Activities for the Traditional Approach

I love using the SLP Now Articulation Stickers! This blog post shows how you can use them to create perfectly tailored activities for your students.

Home Speech Home offers free targeted word lists for easy practice.

Mommy Speech Therapy also offers free worksheets!

Filed Under: Therapy Ideas Tagged With: Articulation, Therapy Plans

Articulation 101: A Review of the Approaches

May 6, 2019 by Marisha Leave a Comment

When I was working as a school-based SLP, I consistently had a handful of “articulation only” students on my caseload. I always enjoyed working with these students, especially since it felt a little bit less overwhelming when it came to developing treatment plans. It was a lot more straightforward than language treatment, that’s for sure! I knew which articulation sounds I needed to target, thanks to the articulation norms my district provided me. I also had my “speech ladder” to guide my treatment. I was feeling good!

And then I came across this article… Brumbaugh and Smit (2013) conducted a survey and found that SLPs are not familiar with all evidence-based treatments for speech sound disorders.

I was fresh out of grad school. Didn’t I learn what I needed to learn about evidence-based strategies for speech sound disorders? I started to doubt myself… Was I doing what was best for my students? I thought my students were making “good” progress…

As I read more, I realized that I was one of those SLPs. I was missing a few pieces!

It took me a few years, but I decided to write this series of blog posts on articulation approaches for a few reasons:

1. Many of us are treating speech sound disorders! Based on ASHA’s 2014 Schools Survey, 92.7% of SLPs regularly serve students with articulation/phonological disorders.

2. Our caseload numbers keep growing, and it’s becoming more and more challenging to manage “all the things.” Refreshing our “toolbox” of approaches with students could help us “work smarter” and see more rapid progress with these students. (It’s not an immediate fix, but this could help us decrease our caseload size if we’re able to exit students more quickly!)

3. I’m still learning, but I’ve seen some amazing results from using a variety of evidence-based approaches with my students. I want to share those with you!

I’m collaborating with Lilly Manzi on this series! Lilly is an SLP working in a public elementary school near Richmond, VA. She can usually be found speed-walking around the school to work with all the awesome kids, reading up on new treatment ideas, or strolling outside to enjoy the sunshine.

You’ll hear from both of us as we review the approaches and share some case studies.

Before we dive in, let’s do a quick recap of the different types of speech sound disorders–just to make sure we’re on the same page!

Different Types of Speech Sound Disorders

Here’s a recap of different disorders that we may see:

Anatomic, Sensory, or Motoric Disorders

We may also see speech sound disorders related to structural/anatomic anomalies or motor execution/planning difficulties (e.g., dysarthria, apraxia of speech).

We will focus primarily on articulation and phonological disorders throughout this series, but we want to keep these in mind as we’re evaluating students and planning treatment!

We also have to recommend this free training by Dr. Edythe Strand for a great overview of Childhood Apraxia of Speech!

Articulation Disorders

Articulation disorders impact the production of specific sounds. Students will often produce substitutions or distortions.

Phonological Disorders

Students with phonological disorders make incorrect productions of sound classes (rather than just a few sounds). They may exhibit patterns in errors (e.g., final consonant deletion).

It can be difficult to differentiate articulation disorders from phonological disorders, which is why some clinicians/researchers refer to these disorders as “speech sound disorders” (Bernthal, Bankson, and Flipsen, 2017).

Need a recap? This visual by Dr. Caroline Bowen is super helpful in breaking down the different types of disorders.

A Quick Review of Approaches for Speech Sound Disorders

This list is not comprehensive, but it includes a sampling of the most commonly used approaches as well as approaches with stronger evidence.

We review each approach by breaking down the What, the When, the How, and the Who.

• What includes a quick description of the approach.
• When includes a quick description of how the treatment approach and/or targets are chosen.
• How includes a quick description of how treatment is planned/implemented.
• Who refers to which types of students we might benefit from the approach.

Traditional Articulation Therapy

• What: This is a developmental approach to target selection, where sounds are targeted based on 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.
• Who: This is appropriate for children with a few errors scattered across sound classes.

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.

Complexity Approach to Therapy

• What: This is a non-developmental approach to target selection, where 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. The objective is to make fast changes.
• Who: This is appropriate for children with low speech intelligibility who are missing several sounds from their phonemic inventories.

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

Cycles Approach to Articulation Therapy

• What: Phonological patterns are treated in cycles of 5 to 16 weeks. The error patterns are targeted in each cycle.
• When: The child presents with many sound omissions and some sound substitutions.
• How: A new cycle begins upon completion of a previous cycle.
• Who: This is appropriate for children with patterns of omissions and sound substitutions.

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.

For an overview of even more approaches, check out ASHA’s Practice Portal.

Want to hear more? We’ve got you!

Stay tuned for case studies to see how we implement these approaches with our caseload!

Filed Under: Therapy Ideas Tagged With: Articulation, Therapy Plans

5 FREE Resources to Educate Teachers During National Speech-Language-Hearing Month

April 29, 2019 by Marisha 3 Comments

It’s almost National Speech-Language-Hearing Month (formerly Better Hearing Speech Month)! In May, the American Speech-Language-Hearing Association (ASHA) encourages us to raise awareness about communication disorders and what we have to offer as a field!

It can feel incredibly overwhelming to take on another project on top of our already overflowing workload, but here are a few free and low-prep ideas to participate in BHSM! Every little bit helps!

Free Resources to Celebrate National Speech-Language-Hearing Month

1. ASHA

ASHA posts materials (e.g., posters, coloring pages, handouts) to get us started!

2. Bulletin Board Display

I love this bulletin board display by Short and Sweet Speech! It would be super easy to print out some of the visuals and attach them to a bulletin board or door.

An SLP also used the cards in the free download to set up a little treat station for her teachers:

 

View this post on Instagram

 

A post shared by Claire King (@c.king88) on May 9, 2017 at 2:22pm PDT

3. Handouts and Gifts

Natalie Snyders is the queen of speech therapy handouts, and this freebie bundle does not disappoint. The free download includes handouts (Tips to Promote Better Speech and Hearing in the Classroom and What Does an SLP Do Anyway? and Hearing Protection), a trivia contest, and gift tags (for a water bottle and a highlighter).

 

View this post on Instagram

 

A post shared by Natalie Snyders, SLP (@slpnataliesnyders) on May 16, 2018 at 10:20am PDT

4. Bookmarks

These bookmarks by Queen’s Speech make for a super cute gift!

5. Blow Pop Tag

This Blow Pop gift tag by Speech Room News is sure to catch your teachers’ attention!

Do you have any favorite resources to celebrate National Speech-Language-Hearing Month? Let us know in the comments below!

If you want even more free materials, sign up for free trial to SLP Now! You’ll have instant access to our library of 6,000+ evidence-backed therapy materials, and you can download 5 materials for free! Here are some of my favorites:
Most Popular Materials

Filed Under: Outside the Speech Room Tagged With: Teacher Communication

Stuttering Tools and Resources for SLPs Working with Parents

April 22, 2019 by Marisha 2 Comments

When it comes to helping children who stutter, involving and supporting parents is just as important as the therapy itself. In this episode of the SLP Now podcast, we’re continuing our stuttering series with a special focus on communicating effectively with parents—whether you’re in a school setting with limited access or working one-on-one in a clinic.

Our guest, Jessica Hudson, M.A., CCC-SLP, brings over a decade of specialized experience to this conversation. She’s the owner of Stuttering and Speech Therapy of Arizona, teaches the graduate-level Fluency Disorders course at San Jose State University, and holds extensive training in approaches like Palin PCI, RESTART-DCM, and Avoidance Reduction Therapy. She’s also a dedicated volunteer with the National Stuttering Association and holds the Ally of Stuttering Seal®.

Jessica’s passion? Creating a world where children who stutter—and their families—feel empowered, understood, and supported.

Listen on Apple Podcasts Listen on Spotify

4 Challenges Parents of Children Who Stutter Face

When supporting children who stutter, SLPs often wear many hats—but one of the most vital roles is guiding and supporting parents. These caregivers bring passion, concern, and often a wide range of experiences (and misconceptions) to the table. So what happens when their expectations clash with the goals or methods used in therapy?

Let’s unpack some of the most common hurdles SLPs encounter when communicating with parents of children who stutter.

1. Mismatch in Expectations

One of the biggest challenges Jessica Hudson, a seasoned fluency specialist, highlights is the disconnect between what parents expect from therapy and what’s actually possible—or appropriate. Many parents come in hoping for one thing: fluency. But when a child isn’t particularly bothered by their stutter, or when stuttering itself isn’t the primary issue, therapy goals may need to shift toward confidence and communication effectiveness.

2. Limited Access and Communication Barriers

Especially in school settings, SLPs often have minimal time to connect with parents. Quick drop-offs, full inboxes, and language barriers can all create a communication gap that’s tough to bridge. As Jessica puts it, even in private practice where access is easier, communication still isn’t guaranteed—it’s about knowing how to connect in the way that works for the family.

3. Misinformation and Oversimplification

From well-meaning pediatricians to random blog posts, misinformation about stuttering is everywhere. Some families are told to “wait and see” or that their child will “grow out of it.” Others view stuttering as something that must be “fixed.” These beliefs, while understandable, can hinder collaborative care if not gently addressed.

4. Cultural Differences

Cultural views on communication, disability, and success also influence how families perceive stuttering. Some cultures may see it as a sign of weakness, while others may ignore it entirely. This diversity requires sensitivity and ongoing dialogue—not a one-size-fits-all approach.

“Sometimes I’ve experienced quite a few times actually where a child maybe doesn’t really care that they stutter… and the parent is the one who really cares and they’re the one who’s really worried. And there’s such a disconnect of what the parent thinks and wants compared to what the child thinks and wants.”

— Jessica Hudson, M.A., CCC-SLP
Owner of Stuttering and Speech Therapy of Arizona, Fluency Disorders Instructor at San Jose State University

Practical SLP-Parent Communication Tips

Once we understand the roadblocks, how can we start building bridges? Jessica Hudson offers a refreshingly human approach to working with parents—one rooted in empathy, curiosity, and connection.

Here are some of her top strategies for creating meaningful, productive communication with families of children who stutter.

1. Lead with Listening

Before jumping into goals or handouts, take time to truly listen. Jessica encourages SLPs to approach conversations with curiosity, not correction. That means setting aside assumptions and really hearing a parent’s fears, hopes, and lived experience.

💬 Ask instead of assume:
“What are your hopes for your child’s communication?”
This reframes the conversation away from fixing stuttering and toward building confident communicators.

2. Use Clarifying Follow-Ups

When parents say things like “I just want them to stop stuttering,” dig deeper in a supportive, nonjudgmental way:

  • “What would be different if your child stuttered less?”
  • “Can you help me understand what you mean by ‘better’ or ‘worse’ days?”

These questions help uncover the deeper emotional goals—like confidence or participation—that can guide more meaningful therapy.

3. Shift the Mindset Around Tools

Many parents are laser-focused on strategies—“Why aren’t they using their tools?” Jessica offers a brilliant way to flip this perspective: ask the parent to describe their breakfast without using the sounds /s/ or /z/. It’s difficult, exhausting, and often awkward—just like trying to control every word to avoid stuttering.

This exercise creates immediate empathy and helps parents understand that fluency tools aren’t a cure—they’re just one part of a larger picture.

“I want you to tell me about what you had for breakfast or lunch without using the sound S or Z… think about how much you just had to think about how you were talking, right? And it took away from your message… that was just one sentence in five seconds.”

— Jessica Hudson, M.A., CCC-SLP

Owner of Stuttering and Speech Therapy of Arizona, Fluency Disorders Instructor at San Jose State University

Making Home Communication Meaningful

Involving parents in therapy doesn’t always mean formal meetings or scheduled calls—especially in school settings, where face-to-face time is limited. Jessica shares creative, flexible strategies that SLPs can use to keep families in the loop and empower children to be part of the process.

Here are a few ideas you can try (or share with your team!):

✉️ 1. Letter from the Student

Invite students to write a letter to their parents or family about their experience with stuttering. They can share:

  • What helps them when they’re talking
  • What makes it harder
  • How stuttering feels for them

This not only gives parents insight into their child’s perspective, but also validates the child’s voice—literally.

📝 2. A Quiz for Parents

Turn education into a game! Have students co-create a quiz with facts about stuttering:

  • How many people stutter?
  • What causes stuttering?
  • What helps or doesn’t help?

Then let the child “grade” it. It’s a fun, empowering way to boost parent knowledge without a formal sit-down.

📓 3. Journals, Drawings, or Digital Notes

Not every student wants to write an essay—and that’s okay. Jessica suggests giving children a space to draw or jot down what they did in therapy that day. If you’re in a school, consider snapping a photo of the activity and sending it via a parent communication app (like ClassDojo or Remind).

This consistent but low-pressure sharing helps families feel informed and included.

“One of the things I was thinking about for schools is having some sort of communication that’s actually coming from the student directly to the parent… let me teach you about how stuttering feels for me. So it’s coming out of the child’s mouth and how they’re really experiencing it.”

— Jessica Hudson, M.A., CCC-SLP

Owner of Stuttering and Speech Therapy of Arizona, Fluency Disorders Instructor at San Jose State University

📚 Sharing Trusted Stuttering Resources with Parents

Parents want to support their children—but when they’re overwhelmed or misinformed, it can be hard to know where to start. As SLPs, one of the most impactful things we can do is connect families with resources that are evidence-based, accessible, and parent-friendly.

Jessica Hudson recommends starting with a few go-to organizations and tools that offer excellent education and community support.

🧭 Top Stuttering Therapy Resources to Share with Parents

  • National Stuttering Association (NSA)
    Offers parent resources, educational materials, and virtual support groups.
    westutter.org
  • Friends: The National Association of Young People Who Stutter
    Hosts parent and youth workshops and support groups.
    friendswhostutter.org
  • SAY (Stuttering Association for the Young)
    Provides community-building programs and parent groups.
    say.org
  • Stuttering Therapy Resources
    Handouts, blog posts, and books by Nina Reeves and Dr. Scott Yaruss. Especially useful for busting myths and guiding families through the stuttering journey.
    stutteringtherapyresources.com

Jessica also curated a helpful Instagram post summarizing these groups visually:

 

View this post on Instagram

 

A post shared by Stuttering & Speech Therapy of Arizona (@stutteringtherapyaz)

“One of the other resources that I love is getting parents connected with some sort of support group… it’s free and they can connect with other people who also might be experiencing things that they are and ask questions.”

— Jessica Hudson, M.A., CCC-SLP

Owner of Stuttering and Speech Therapy of Arizona, Fluency Disorders Instructor at San Jose State University

📄 Section 5: Practical Handouts to Support Parent Education

Sometimes a well-crafted handout can make all the difference. Whether you’re sending it home in a backpack or attaching it to a follow-up email, providing clear, digestible information helps parents feel more confident and involved.

Jessica Hudson recommends using handouts to supplement conversations and reinforce key concepts. The goal? Make stuttering less intimidating and communication more collaborative.

🗂️ Handouts for SLPs to Have on Hand for Parents

  • Preschool Stuttering Parent Handout
    Explains typical vs. atypical disfluency and offers supportive strategies.
  • Developmental Stuttering Handout
    Helps parents understand what stuttering is, what causes it, and what it isn’t.
  • General Stuttering Tips for Parents
    Provides easy-to-follow advice on how to support children at home without pressure to be fluent.
  • Customizable Speech Therapy Summaries
    Templates where students can write or draw what they did in sessions—great for keeping parents in the loop.
  • Links to Stuttering Foundations and Trusted Blogs
    Include QR codes or direct links to resources mentioned earlier, such as the NSA or Stuttering Therapy Resources.

These handouts serve as both a communication bridge and a confidence boost, especially for parents feeling unsure or overwhelmed.

🎯 Helping Parents Set Realistic and Supportive Goals

When a parent says, “I just want them to stop stuttering,” it’s often coming from a place of deep care—but it’s also an opportunity to gently shift the focus. Jessica Hudson emphasizes the importance of guiding parents toward goals that empower their child as a communicator, not just as someone who speaks fluently.

🧭 Reframing Progress

Instead of centering therapy goals around “reducing stuttering,” Jessica encourages SLPs to ask:

“What are your hopes for your child’s communication?”

This opens up the conversation to broader, more meaningful targets: confidence, participation, joy in speaking.

🔍 Dig Deeper with Why

If a parent does say they want fewer stutters, try following up with:

  • “What would be different for your child if they stuttered less?”
  • “How do you define progress?”
  • “What’s your biggest hope for their future as a communicator?”

These gentle prompts help uncover the underlying fears or dreams that can shape therapy goals in a more supportive and collaborative way.

✅ Examples of Healthy, Functional Goals

  • “Participates in class discussions without avoiding speaking.”
  • “Shares stories with family even when stuttering is present.”
  • “Advocates for themselves when they need more time to speak.”

By helping parents understand that progress can look like confidence, resilience, and authentic self-expression, SLPs can foster a team approach rooted in possibility—not pressure.

“So many parents do say something like, I want them to be confident, or I want them to participate, or… I don’t want stuttering to hold them back in whatever they have in their future. And those are really things that we can create actual speech therapy goals around.”

— Jessica Hudson, M.A., CCC-SLP, Owner @ Stuttering and Speech Therapy of Arizona

🎉 Conclusion: Supporting Families, Empowering Communicators

At the heart of effective stuttering therapy is connection—between the SLP, the child, and the family. Jessica Hudson reminds us that successful outcomes start with empathy, informed conversations, and a shared understanding of what truly matters: confident, empowered communication.

Whether you’re in a school setting with limited parent contact or working closely with families in private practice, your role as an educator, advocate, and partner is powerful. By listening deeply, offering clear tools, and focusing on whole-child communication goals, you’re not just helping children who stutter—you’re building stronger communicators and more supported families.

💡 Next Steps for SLPs:

  • Follow Jessica Hudson on Instagram for more strategies and real-world insights.
  • Explore her website for additional resources and support tools.
  • Encourage parents to join virtual support communities like NSA, Friends, and SAY.

At SLP Now, we are hard workers… but we also like to work smarter.

That means we’re constantly improving our materials, therapy planning resources, and the ways we support SLPs like YOU — so you can skip the hard work part and just work smarter. 👇

Inside the SLP Now membership, you’ll find 400+ therapy plans and an organized library of 6,000+ (and counting!) evidence-backed speech therapy materials to help you differentiate your therapy in a matter of minutes.

How is that possible, you ask?

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We’ve talked about so many activity options during this series… but there are even more literacy-based ideas and evidence-based resources waiting for you on the other side of SLP Now. 🤗

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Transcript

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Marisha (00:01.39)

Hello there and welcome to the SLP Now podcast. We are continuing our stuttering series and I'm really excited because we have Jessica Hudson with us here today. She is the owner of Stuttering and Speech Therapy of Arizona. And she's licensed in several states and has a really cool wealth of knowledge and experience. And today we're going to be chatting about

like working with parents of children who stutter and some different strategies around that communication. But before we dive in, welcome, Jessica. So excited to have you. And before we dive into all of the content, I'm just curious a little bit more about your story, like what led you to start your private practice and kind of build such a wealth of knowledge in this area.

Jessica Hudson (00:41.378)

Thank you.

Jessica Hudson (00:58.785)

Yeah, of course. So speech therapy is not my first career. I actually didn't know what I wanted to do when I grew up and through a very roundabout way found speech therapy and didn't even know that it was a career and decided once I was already married and had a life to go back to school for speech. So in grad school, Patty Walton was my supervisor and teacher of the course and of the stuttering course. And she

lit a little fire under me in the world of stuttering. And I said, ooh, this is it. This is where I'm supposed to be. And my first client at the university clinic was a person who stutters. And I was just in love. I was like, this is it. This is what I want to do when I grow up. So I kind of was a little bit older and more established. And I did my CF year and kind of

got through that and quickly started my own business. I have actually this year, October of this year will be 10 years of my company, which is so exciting. So I've been doing almost exclusively stuttering for over 10 years. And I love it. I love it so much. So it's my life.

Marisha (02:18.068)

that's amazing. And congratulations on 10 years. Yeah, I love that. And so I guess we could dive into maybe before we start talking about strategies and tips and all of that, what are some potential challenges that we might come across when working with our students' parents or clients' parents, depending on the setting?

Jessica Hudson (02:21.162)

Yes, thank you.

Jessica Hudson (02:42.762)

Yeah, of course. So you just said something that I think is one challenge right there. We're all in different settings and a lot of speech therapists are in the school setting. And so that in of itself is, it can be a challenge because a lot of SLPs who are in the schools do not have access to parents or they don't have maybe as easy of access to parents as a private practice or a clinic based SLP. So, that's a challenge right there is just the setting.

And I think we're going to talk about it a little bit later of how to maybe work through some of these challenges, but trying to find some maybe out of the box ways of communicating with the parent if you're in the school system. And we can talk more about that as we go through some tips and strategies. One of the other big challenges that I find no matter what setting you're in is the

disconnect between perspectives and expectations of parents compared to the SLP, compared to teachers, compared to the child. So maybe everybody having different expectations or even different ideas of what stuttering is and what progress looks like and, you know, the basics of stuttering, like what's the cause of stuttering. Sometimes parents really have no idea and

Maybe they've read something on the internet or they've heard somebody say something. Sometimes there's cultural differences or beliefs of what causes stuttering. So all of that comes into play when parents make up their ideas and minds of what stuttering is and then also what the progress is going to be and what the therapy plan is going to be like. So that can really be challenging.

Marisha (04:39.874)

Yeah, that would have a massive impact on communication because if we have completely different beliefs and we're like, yeah, that could make for a lot of confusion, yeah.

Jessica Hudson (04:50.432)

Yeah. Sometimes I've experienced quite a few times actually where a child maybe doesn't really care that they stutter. They are saying everything that they want to say. They're really confident. They're doing sports. They're part of student council. They're doing all the things and they really don't care. And the parent...

is the one who really cares and they're the one who's really worried. And there's such a disconnect of what the parent thinks and wants compared to what the child thinks and wants. And that can be a real challenge for therapy because then what do we even do in therapy if the child doesn't care or maybe it's not impacting them?

Sometimes they care a little bit, but it's not impacting them and they're doing everything they want. And so that is, I've seen that a lot.

Marisha (05:52.738)

Yeah, and then, because every challenge that you're mentioning, it's like, I want to talk about the tips and strategies. But I think it's kind of like put the different challenges out on the table and then we can go through them. But are there any other big ones that you've seen or experienced?

Jessica Hudson (05:59.277)

I mean, we can.

Jessica Hudson (06:07.029)

Yeah.

Jessica Hudson (06:13.676)

Sure. I think another one, I sort of touched on this when I was talking about expectations and perspective, is maybe some misinformation that parents find out on the web or maybe even somebody that they really trust has said something to them about stuttering. Like a pediatrician, I've had lots of families tell me our pediatrician just told us to wait and see, or they said, they'll grow out of it. It's a normal...

development. And now the child is 10, 11, 12, maybe even a teenager and they haven't grown out of it. so just the misinformation that is out there about stuttering can definitely be a challenge because then we're sort of backtracking and having to share, okay, this is the current research, this is actually what we know about stuttering.

And along those same lines, think parents sometimes, maybe not just parents, a lot of people, adults, teachers, SLPs too, sometimes we oversimplify stuttering and they maybe only think about frequency of stuttering events. And so they're saying, they will come in and they'll say, I just want my child to stop stuttering or stutter less.

And that's really oversimplifying stuttering because as a lot of your previous guests have talked about stuttering has so much more to it. Not only does the stutter itself have more to it, like it's not just the frequency, it's the type of stuttering, the length of the stutter. I mean, there's so much more to the stutter, but also those impacts of stuttering. how people...

feel about it, how they're reacting to it. That is the really, I think probably the bigger part of stuttering. And parents don't always see that they just want less stuttering and they think that will fix everything. So again, I think all of this really ties into mindset of stuttering, perspectives of stuttering and just their expectations of what therapy might look like.

Marisha (08:38.466)

Yeah, absolutely. then, so what do you think, like, what are the tips and strategies that you have to kind of address that and facilitate?

Jessica Hudson (08:50.378)

Yeah, so I think this might be difficult in certain settings. So the school setting is going to be different. So we can kind of talk about maybe how to navigate the school setting. But one thing that's just so important is for us to really hone in on our counseling skills as SLPs.

which no matter what setting you're in and no matter which population you're working with, we all do counseling of some sort, right? Like sometimes I think SLPs are like, no, I don't want to do stuttering therapy because there's counseling. And I'm like, but if you think about it, you're already doing it and you're already really good at it, I'm sure, because you're an SLP. So honing in on those counseling skills, because not only are we going to use those for our

client or our student, we're going to be using it with the parents as well. And one of the biggest tips I have is to just listen. As SLPs, sometimes we like to talk and explain a lot and remembering to listen and to really listen with no judgment and no expectations or no

coming in with our own ideas and beliefs, but really just hearing their stories and where they're coming from and using those counseling skills of asking them follow-up questions to really get to know why they feel like they want less stuttering as an example or what they find important in therapy and why they feel that way. So.

for any SLP in any setting, really trying to listen and be prepared for some counseling with the parents. So that's for anybody in any setting. And so thinking about the settings, one of the things I was thinking about was for the, I'm not in a school, so I have the luxury of seeing parents all the time.

Jessica Hudson (11:09.206)

But I will say that some parents don't feel comfortable being in sessions or sometimes the child feels better being in the session without the parent. And so they don't always come into sessions, but I at least get to see them before and after. So one of the things I was thinking about for schools is having some sort of communication that's actually coming from the student directly to the parent.

So a few little ideas would be something like the child writing a letter to the parent. And maybe it's, what is helpful when I'm talking? What's not helpful when I'm talking? And really, to be honest, it might not be just the parent. It might be a whole family unit. So siblings can cause some difficulty sometimes.

Or they could be really part of the support system and really helpful for our students too. So it might be a letter to the whole family, our grandparents or cousins or whoever's in that family unit. But that's an idea of having, if the child feels comfortable writing a letter of like, what's helpful, what's not, let me teach you about how stuttering feels for me. So it's coming out of the child's...

mouth and how they're really experiencing it. And then the parent can't say, that's not factual because it's coming straight from them. Another thing that I've done with some clients is, and they think this is so fun, we'll create a quiz for the parents to take or a test. And so we have things on there like how many people in the world stutter? What's the cause of stuttering?

What does stuttering feel like? So just some different questions. And then the parent has to take the test and the kid gets to grade it, which they are always so excited about. So they get a red pen and they grade their parents and they say, you got an F. But it helps to teach the parents some information about stuttering that they may not have known in a fun way, right?

Jessica Hudson (13:30.336)

And that's not the SLP having to talk with the parent because again, if you have the school environment, you might not get that physical time with the parent, but it's still a way of communicating with them. And then the other thing that I was thinking is sending parents or having the child do a like a journal and they can even write or

draw pictures depending on their level of what they did in speech therapy that day. And so then the parent is involved in knowing what's going on. think I've heard from a lot of parents who say that they don't feel like they're involved in the therapy process sometimes at schools just because of the nature of the schools. And so any way they can feel involved I think would be helpful for them.

So those are just a couple of ideas of that setting challenge that I was thinking of.

Marisha (14:35.34)

Yeah, I love that. like when I, like as a school based SLP, like in my experience, a lot of times like sending home papers, like I would always find them at the bottom of the student's backpack all crumbled up. But these ideas are amazing. Like I love the letter, the quiz, the journal, like those are fabulous ideas. And

Jessica Hudson (14:48.858)

Yes.

Marisha (15:01.154)

Like maybe having, if they have a designated folder or something where the papers can stay like in together, that's, that has been a great solution for me. But then also using different communication apps. So a lot of times schools will have apps set up and you can just send a picture of whatever they produce during the session and have that. And it's, yeah, it's amazing how like,

Jessica Hudson (15:06.815)

Yeah.

Jessica Hudson (15:26.173)

Exactly.

Marisha (15:30.894)

like calling a parent, I would call certain parents like 10 times and have no answer, but then sending them a text through the platform and they respond within seconds. So it's always interesting how that.

Jessica Hudson (15:41.739)

Right. And I have that too, and I'm in private practice, but I have the same thing where some parents will text me back immediately, but if I call them, I'll never hear from them. Or even in the lobby, don't want to, like they're so busy and they need to get out, get out. And so I think it's just a communication challenge as a human, right? And we all have our preferences of how we communicate.

Marisha (15:47.361)

Yep.

Marisha (16:07.832)

And I think text is really easy because you can be out and about and just be able to do a quick response and all that. So yeah, but I love those ideas. then, and I don't, so do you have like, I'm just trying to decide where we wanna go. Do you wanna share more strategies or?

Jessica Hudson (16:16.778)

Right.

Marisha (16:32.558)

Because I think it'd be helpful, maybe we can do this at the end to go through an example of what it might look like, like with the example that you gave of.

like a parent who has the goal of wanting to decrease stuttering, kind of going through like what, and you did, you shared some examples of questions, but I'm curious kind of what an example of like what the follow-up could look like. But I'll let you decide, do you want to do more strategies or walk through?

Jessica Hudson (16:45.344)

Mm-hmm. Mm-hmm.

Jessica Hudson (16:58.848)

Sure.

Jessica Hudson (17:03.43)

Let's talk about that. I might have the talking to parents about expectations and what their beliefs are about stuttering. think, I mean, I talk, it's a huge, huge, huge part of what I do every day, especially during an initial assessment. So it might be during that IEP meeting or in private practice after your evaluation.

having those conversations with parents. And I think that it's an ongoing conversation and everybody's coming in at a very different place. And so kind of meeting them where they're at. so I'll give some examples, but remember that everybody again is coming in at a different place and maybe they've had previous speech therapy, maybe they haven't. And of course the age of the child. So there's lots of variables here, but.

I'll give more like a general what I hear a lot and what I experience a lot is parents will come in and they'll say, so I'll do the evaluation maybe. And then at the end, we'll talk about what treatment looks like. And I usually ask parents, what are your hopes? Tell me your hopes for your child's communication. And I usually phrase it in that way.

of like really just what do you, I hope that they're thinking more like, what do I hope not what are my goals? Sometimes goals can be very like, okay, a goal on an IEP is I want to decrease stuttering. Don't write that goal, don't do that. But sometimes we see those, right? And parents might think that. So that's why I phrase it with the hopes. And I also say communication rather than stuttering.

because it is everything. I mean, you can be an excellent communicator and stutter. You can be a not such an excellent communicator and not stutter. And so that's why I use communication. So I will ask, okay, what are your hopes for communication for your child? And from there, I will find some things that they say. So maybe they'll have some key words in there that they've said that I can

Jessica Hudson (19:28.736)

then give them a little bit more information about. And a lot of times parents will say something like, well, I have a few things parents often say. They'll say something like, well, I just want them to stop stuttering, or I want them to stutter less. And from there, I might say something like, well, what would be different if they stuttered less? Or how would their lives be different if they stuttered less?

and then they'll answer. And I think that starts their wheels turning of like, well, what really would be different? So at least sometimes we don't get to a place of saying like, okay, fluency is not necessarily the goal during the evaluation or the assessment. But I have some ideas from there of where maybe we'll go in sessions to help that parent.

Maybe shift their perspective a little bit. Another thing that I get a lot is parents will say words like good or bad. And they'll say, my child's stuttering was really bad last week. Actually, this happened to me yesterday. During an evaluation, she said,

Oh, well, her stuttering was so bad last week, but then of course we made this appointment and her stuttering is fine now. It's so good this week. Like she's not having any problems. And so I will even ask parents or even clients too, how do you define good and bad or better and worse? Because it's so subjective. And I might even

use an example like, okay, well, what foods do you think are good? And maybe they'll list a couple of foods and I say, well, I don't like this one, this one and this one. So I think those foods are bad. And so those words are hard to use when we when we talk about stuttering. So it's helping parents to start to reframe how they're thinking about stuttering and questioning them in a, again, non judgmental way, but a way that's

Jessica Hudson (21:45.121)

just giving them a little push of, what about this? Did you ever think about this? So just guiding them on a journey that they're already on, but helping them to understand, again, we're not trying to eliminate stuttering necessarily for most kids. I had another thought, but then I lost it.

Marisha (22:10.914)

No, and these are such great examples. I think this, so in episode 208 with Wendy Taylor, we talked about parent input as well. And this was just related to more of a conversation around like legally compliant IUPs and stuff like that. But a lot, so I'm, when you were sharing some of your examples, I was like, I've heard this. So what, and for anyone listening, if you want a little bit more.

Jessica Hudson (22:21.761)

Mmm.

Jessica Hudson (22:27.581)

yes.

Marisha (22:39.938)

like more examples of what this could look like. Episode 208 would be helpful to look at. But it is such an important part of the process in like asking those questions and understanding like what the parents' hopes are for their child. And that can help with just being on the same page when it comes to something like stuttering. And then also just the plan for the

Jessica Hudson (22:57.238)

Mm-hmm.

Marisha (23:09.312)

child in general. And I think that applies regardless of the setting. It's just important to have that open communication. But this also helps us with better IEPs at the same time. But yeah, so and this was a, I loved your examples of different things that we can ask and just some other scenarios. Yeah.

Jessica Hudson (23:14.198)

Right.

Jessica Hudson (23:17.836)

Mm-hmm.

Jessica Hudson (23:21.343)

Yes, yeah.

Jessica Hudson (23:33.143)

There's one example that I sometimes give parents that because a lot I for me, I get a lot of people who come who are either already in school based speech therapy or maybe who have had previous speech therapy. And because I work a lot with older kids and adults, a lot of times they've already had some experiences. So then they're really coming in with those

ideas and they've already had some experience. And so maybe they know about tools or strategies or techniques, like the ones that we always hear about are things like easy onset or light touch or things like that. So they may have learned about that in previous speech therapy. And sometimes parents will come in and they will tell me

well, my child's just not using their tools that they're learning in XYZ therapy at place XYZ. And I really want them to use tools and you specialize in stuttering. So I know you can get them to use tools. I'm like, well, you may be, let's think about it. So one of the examples I like to give parents is I want you to tell me about what you had for breakfast or lunch.

Marisha (24:45.666)

Listen.

Jessica Hudson (24:57.428)

without using the sound S or Z or S or Z. So tell me what you had. You can do it if you want. What you had for breakfast without using those sounds.

Marisha (25:13.966)

I failed on the first syllable!

Jessica Hudson (25:15.4)

See? Okay, yes. So it is very, very, very hard. So if a parent does it, they do exactly what you just did, and they're like, my gosh, I can't do it. And I say, well, think about how much you just had to think about how you were talking, right? And it took away from your message. You now were no longer thinking I had...

eggs and pancakes and toast or whatever it was, you're now thinking, oh, I can't say the S sound. can't say the Z sound. What words can I substitute? How can I do this different? Oh, am I supposed to use a easy onset? Right. And that was just one sentence in five seconds. And so parents have a little light bulb and they're like, Oh, and I say, so if you want your child to be using tools and strategies and techniques all day, every day,

and think about all the other demands on this child during the day, that's hard. It's really, really, really hard. Not that people can't use them and not that in certain situations they can be maybe helpful. I don't want to totally bash those things mostly, but it's just a way of thinking about stuttering and the fact that it's really hard to

change how we talk and it takes so much effort and to help parents understand that in a really tangible way is sometimes a fun exercise to do either some time-long treatment or even in an evaluation and you can have everybody do it and it's kind of a you know you people get silly about it but then you get back serious and it's like okay think about it yeah

Marisha (27:05.112)

Yeah, I love that as an example because then it really puts the parents, like it helps take the perspective of the child or the student. That's great. I love that. And that's probably good for therapists too because this is still like a paradigm shift for some of us as well. So yeah, I love that example.

Jessica Hudson (27:13.174)

Mm-hmm.

Jessica Hudson (27:17.035)

Yeah.

Jessica Hudson (27:28.456)

Absolutely, it is. I mean, I SLPs have been thinking about fixing or eliminating stuttering for a long time. it does, there is a shift now that probably has always been there, but it's been lower, maybe on the priority list or not as talked about. And now it's finally people are.

realizing like, okay, we're not trying to fix somebody. We're not trying to eliminate stuttering. There's lots of other parts of this. Yeah.

Marisha (28:07.51)

Yeah, and I think most parents, if you ask them what their hopes are for their child, like most parents probably don't say, I want them to stutter less. Like they get bigger picture of like what actually mattered, I would assume.

Jessica Hudson (28:23.412)

Yes, yeah, yes. And I do, I think, especially when you're phrasing it as like, what are your hopes for their communication? So many parents do say something like, I want them to be confident, or I want them to participate, or they'll say something like, I don't want stuttering to hold them back in whatever they have in their future. And those are really things that we can create.

actual speech therapy goals around and things that we can see progress towards. I think that's another whole other thing that I talk to parents about is progress and how are we gonna know somebody's making progress because that's another word we have to define kind of like that good, bad, worse. Okay, how do you define that? Because my definition might be different than yours. How do you define progress? So that we're all on the same page.

from the beginning. So that's another one.

Marisha (29:25.1)

Ooh, I love that. I think going back to kind of the asking what the hopes are for the child's communication, even if the parent says, well, we want to reduce their stuttering, then why do they want to reduce that? Like what's behind that? And I think we can always get to the root and having that root and being able to revisit that in all of the subsequent conversations, I think is really helpful.

Jessica Hudson (29:53.333)

Absolutely, absolutely, Yes, yeah, there's always something deeper. I'm sure on some of the previous podcasts you've had, people have talked about the iceberg analogy of stuttering. So we've got the top, which is the stuttering and then everything underneath. I think parents probably have their own iceberg, right? Like they've got a lot of stuff underneath the water that we can help them.

Marisha (29:55.074)

Yeah, the why behind all of it.

Jessica Hudson (30:23.474)

work through. so it's not just I want stuttering to go away, or I want my child to be fluent or whatever. It's okay, then the why like, what would that mean for you? What would that mean for their lives and, and digging into their iceberg to? Yeah.

Marisha (30:43.318)

Yeah, yeah, and it really doesn't have to be an adversarial kind of thing. Because I feel like I've heard conversations about like, like these parents are difficult or they don't understand or whatnot. But if we're asking those questions, like the tips that you gave would help us to really understand the parents and all anyone wants really is to be understood.

Jessica Hudson (30:50.124)

Hmm.

Marisha (31:08.256)

I think that's my perception. So if we are like listening and asking the questions and in a non-judgmental way, I think we'll get to kind of get to the root of all the things and be able to have like successful, happy, productive communication and ultimately do what's best for the child.

Jessica Hudson (31:08.257)

Mm-hmm.

Yes.

Jessica Hudson (31:31.157)

Absolutely. think parents too, just the, this is, think human nature when we don't know about something or when we don't understand something or maybe when we feel out of control, we have so much more fear and we have so much more worry and anxiety about it. And so if we can help educate parents and just give them some resources, I mean, it doesn't have to be anything fancy or elaborate or,

pretty even. It's just giving them information so that they feel more empowered and educated and they understand what their child might be going through. So sharing things like the National Stuttering Association website or I know you had Nina Reeves from Stuttering Therapy Resources on in the past. Stuttering Therapy Resources has so many resources. Imagine that.

on just everything and they have videos, have handouts, they have blog posts. And so depending on how that parent likes to absorb information, you can give them all different types of things to really just help them understand. And then it really eases the parent and you can then work as a team with the families and school personnel and the child too.

They really just, they do, they want the best for their kids and it's not like they're, maybe there are some difficult parents, but I think it's because they care so much about their kids, right? So yeah, yes.

Marisha (33:13.548)

Yeah, mama there a And there's like, if we're having those types of conversations, like you've been sharing throughout this whole episode, like we really get to get to the bottom of it. And, yeah, no, these are great suggestions. And I love all of the practical examples because it, feel like it's super applicable of, like these are things that will.

definitely be singing in practice too. Do you have any other resources or suggestions that you wanted to share?

Jessica Hudson (33:43.98)

Yeah.

Jessica Hudson (33:50.379)

Yeah, one of the other resources that I love is getting parents connected with some sort of support group. And COVID was a bummer, but there were some good things that came from COVID. And that was that a lot of these support groups went virtual and now they meet monthly. And so it's just really accessible for parents all over the world, really. And it's free and they can connect with other people.

who also might be experiencing things that they are and ask questions. The three that I know of are the National Stuttering Association. So they have a parent group and Friends has another parent group that meets monthly and also Say, which is the Stuttering Association of the Young, I think is the full name. But I know they have virtual monthly parent groups. And if you just go on their website,

all those websites, they'll link to whatever days and times. And all of them have kids and teens, and some of them have adult groups too. But for parents specifically, I really encourage them to get connected through my office. Sometimes we'll have some connections, like some social groups or support groups for parents, but those are more, you know, these three that I mentioned are more accessible probably.

to parents.

Marisha (35:20.866)

Those are great. And you had a really nice Instagram post. Like I'll link that in the show notes as well. But it was just like a nice little graphic showing those different options. So we'll add that in the show notes. Anything else that you wanted to share? I don't want to.

Jessica Hudson (35:36.831)

Awesome.

Jessica Hudson (35:42.316)

I feel like I have so much, but.

I don't know. think just again, listening, listening to our clients, listening to our parents, listening to the other SLPs and just supporting one another and yeah, in a caring, open-minded way, right?

Yeah, and meeting people where they're at because everybody is on such a different path and in such a different place in the journey. So, yeah.

Marisha (36:22.19)

Absolutely. Well, this was so helpful. Thank you for being so generous with your time and expertise, And then to everyone who's listening, thanks for joining us. Again, we'll link to the show notes for all of the resources mentioned as well as Jessica's Instagram and website. But definitely give her a follow on Instagram. then, yeah, we'll see you next time.

Jessica Hudson (36:47.573)

Awesome, thank you so much.

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Filed Under: Podcast, Therapy Ideas Tagged With: Fluency, Parent Communication, Stuttering, Therapy Plans

Stuttering 101: Teaching Fluency Strategies in Speech Therapy

April 15, 2019 by Marisha 1 Comment

We happen to have a massive toolbox of evidence-based strategies that we can use to help our students who stutter become more fluent. Every student is different, and part of therapy is exploring the different fluency techniques and seeing what the student prefers and/or what helps the most. A student may only need one technique, or a student may benefit from multiple techniques. A technique may work for a day, or it may work for years.

That said, it is unlikely that any one of these techniques will decrease stuttering by 100%. That’s why we talked about how to set the foundation for stuttering therapy last week.

Here’s an example of how I would teach the “Cancellation” technique.

Introduce the Technique (What Is it?)

A cancellation is a stuttering modification strategy that is used after a disfluency occurs. It helps the student produces a less tense disfluency.

How Will It Help?

Many times, people who stutter will ratchet up a lot of tension in their mouths and throats as they try to wrestle their words out. The Cancellation Technique allows people who stutter to “let out” that tension and say their desired word more fluently.

Demonstration of the Cancellation Technique

Prerequisites:

• Being aware of and identifying when you’re in a moment of stuttering.

• Being able to release tension in certain parts of the body.

How Do I Do It?

1. Once you’ve started stuttering on a word you want to say, stop. Pause.

2. Bring your attention to where the stuttering is happening in your mouth or throat and become aware of the tension built up there.

3. Consciously release the tension. (Practice learning how to release tension in your body with the Progressive Muscle Relaxation Technique).

4. Then, say the word again, strrrrretching out the sound you stuttered on now with less tension and keep on speaking.

Check out a quick video demo below:

Want more of these techniques (including handouts and practice sheets)?

We have 24 of them (plus accompanying video tutorials) in the SLP Now Membership!

Filed Under: Therapy Ideas Tagged With: Fluency, Stuttering, Therapy Plans

Stuttering 101: Where to Start with Fluency Therapy

April 8, 2019 by Marisha 6 Comments

You just finished evaluating a student who stutters. You delivered a stellar report, and the student qualified for services. Now what do you do? Do you just dive into fluency strategies? Will that do the trick?

If you’re wondering where to start, you’re not alone!

Before Teaching Fluency Strategies

There are several reasons why we need to address more than fluency strategies.

One fluency strategy may increase a student’s fluency by 20% percent in the speech room. However… What does that look like in the classroom? Will the increase in fluency persist over several sessions? Into next year?

I love the proverb “give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.” This applies to so much of what we do in therapy, but it especially applies to our students who stutter.

We know that “school-age children will, in all likelihood, continue to stutter in some fashion throughout their lives” (Yaruss, 2018). They are going to need more than a strategy or two to understand their stuttering and navigate their way through moments of disfluency.

By teaching our students about stuttering and helping them understand how the speech system works, we’ll be teaching students to “fish” (i.e., understand their stuttering). We’re empowering them and giving them the tools to speak fluently.

Here are some strategies (and free resources!) that I use to accomplish these goals in stuttering treatment:

Step 1. Normalize Stuttering

I love doing a mini-unit on famous people who stutter. (Stuttering Help has a super helpful resource.)

We also take time to discuss the fact that we all have moments of disfluency from time to time, and that’s okay. We emphasize and drive home that it’s okay to stutter.

Step 2. Introduce the Speech Machine

This is foundational when it comes to teaching any fluency strategies. If students understand how the “system” works, they’ll have the tools they need to “change the system” and speak more fluently. Lacey from Speech Me Maybe has a free interactive activity that makes it easy to introduce the speech mechanism to students.

 

View this post on Instagram

 

A post shared by Speech Me Maybe 🌵 (@speechmemaybe) on Jan 7, 2019 at 1:20pm PST

Step 3. Talk About Stuttering

Once students understand the speech mechanism, we can talk about what happens when we stutter. We can move through the different parts of the speech mechanism and talk about what would happen if the different components are tight versus loose.* For example, if I try to say “ball” with tension in my lips, it might come out as “b-b-b-ball.” I often model what the tightness looks like and have students try it themselves.

* We might have to teach the difference between tight versus loose! I start with larger body movements (e.g., making a tight fist) to show the difference.

Step 4. Become a Speech Detective

We then get to become speech detectives!

I model different types of stuttering, and we identify what happened in the speech mechanism to make that happen. For example, if I say “passsssssport,” we can guess that I had tension in my tongue.

Students can then take turns imitating me and/or creating their own disfluencies to “experiment” with the speech mechanism. We might also find videos of students who stutter (like this one) and “analyze” their moments of disfluency.

Step 5. Increase Awareness of Stuttering

The student can then start to identify stuttering in his/her conversational speech and “analyze” the disfluency using what we learned about the speech mechanism.

After going through these steps, students are armed with knowledge that they can use to understand their stuttering. This is key when it comes to implementing strategies.

If you want to learn more about this stage of therapy, check out Nina Reeves and Dr. Scott Yarus’s book, School-Age Stuttering Therapy: A Practical Guide.

If you can’t wait to learn more about fluency strategies, then join us again next week!

Hope to see you next week as we dive into fluency strategies!

Filed Under: Therapy Ideas Tagged With: Fluency, Stuttering, Therapy Plans

Stuttering Assessment: A Guide for School-Based SLPs

April 1, 2019 by Marisha 1 Comment

Stuttering assessments can feel a little overwhelming—especially when you’re balancing a full caseload and trying to make every session count. But getting it right can truly change the game for our students. It’s not just about identifying disfluencies—it’s about understanding the whole child, their experiences, and how stuttering impacts their daily life.

In this expert guide, we’re excited to share insights from Victoria Dertouzos (Giacalone), M.A., CCC-SLP—owner and lead therapist at Speech & Stuttering Therapy of New Jersey. Victoria brings a wealth of experience as a former school-based SLP and a specialist in fluency disorders. She has published research, presented at both NJSHA and ASHA, and is currently a candidate for Board Certification in Stuttering, Cluttering, and Fluency Disorders. Her passion for supporting those who stutter, combined with a practical and research-informed approach, makes her guidance invaluable for school-based clinicians.

This guide breaks down the assessment process step-by-step, offering concrete strategies, helpful tools, and plenty of encouragement to help you feel confident and capable when working with students who stutter.

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Understanding Stuttering in Children

Stuttering is more than just a speech difference—it’s a unique way of communicating that can deeply impact how a child feels about themselves and how they engage with others. For school-based SLPs, it’s important to understand that stuttering isn’t just about what we hear; it’s also about the child’s internal experience.

While stuttering may include visible behaviors like blocks, repetitions, or prolongations, it’s also shaped by less obvious factors—like anxiety, avoidance strategies, or even the child’s personality and temperament. These internal factors can influence the frequency and intensity of stuttering and may not always show up clearly in a speech sample.

Children who stutter may avoid raising their hands in class, hesitate to participate in group activities, or feel overwhelmed in social settings. That’s why the goal of assessment isn’t just to document disfluencies—it’s to truly understand how stuttering affects the child’s overall communication and confidence.

By keeping a holistic lens, we can better support the child’s needs—not just in speech therapy, but in every corner of their school day.

“So the reason for that is because stuttering is pretty sensitive to nervous system changes… trying to take those things into account, not just for stuttering frequency, because we care a little bit less about that, but just for helping the person understand why it’s happening, when it’s happening, and maybe helping them to… manage those situations to see if it can support them a little bit better.”

— Victoria Dertouzos, M.A., CCC-SLP

Step 1: Initial Intake and Background Assessment

The foundation of a meaningful stuttering assessment starts long before the student ever says a word—it begins with the intake. A strong intake process gives you context, reveals patterns, and helps shape a more empathetic and effective therapy plan.

Start by gathering the usual background info: medical history, developmental milestones, and family history of stuttering. But go deeper. Victoria emphasizes the importance of learning about the student’s temperament, personality, emotional regulation, and any signs of anxiety. Since stuttering can be sensitive to nervous system changes, these insights are essential.

Make sure you’re hearing from all key players:

  • Parents: Ask about their understanding of stuttering and what they’ve observed at home. Do they see it as a problem? Are they worried? What are their expectations for therapy?
  • Teachers: Check in on classroom participation. Does the student avoid speaking? Do they participate in group work?
  • Students: When possible, hear from them directly. What do they think is happening when they stutter? What’s their experience like?

This collaborative, whole-child approach doesn’t just make your assessment more accurate—it also builds trust and sets the tone for a positive therapy journey.

“First, as always, getting a really good intake from the parents or from the person if it’s an adult… it actually is really important to include information about the temperament and the personality of the person, if there’s any additional anxieties… because stuttering is pretty sensitive to nervous system changes.”

— Victoria Dertouzos, M.A., CCC-SLP

Step 2: Behavioral and Affective Assessments

Stuttering assessments aren’t just about what we observe—they’re also about what the student experiences. Victoria recommends dividing the assessment into two parts: behavioral (what we see and hear) and affective (how the student feels).

Behavioral Assessment

This includes the classic features of stuttering: blocks, prolongations, repetitions, and secondary behaviors. Tools like the Stuttering Severity Instrument – Fourth Edition (SSI-4) can be helpful, but Victoria suggests using it descriptively—not as a score. Stuttering is highly variable, and a numerical score can be misleading or unhelpful in understanding the true impact on the student.

Behavioral assessments should also include direct observations and conversational samples, but with care. Avoidance behaviors can mask the severity of stuttering, and students may appear more fluent than they feel.

Affective Assessment

To understand the impact of stuttering, we need to dig into the child’s personal experience. Victoria recommends the Overall Assessment of the Speaker’s Experience of Stuttering (OASES), which provides a comprehensive look at how stuttering affects the student socially, emotionally, and academically.

The OASES not only helps set meaningful goals, but also supports eligibility decisions by providing a clear “impact score.” This is especially helpful in school settings where eligibility often depends on demonstrating educational impact.

Together, these assessments help create a clearer picture of the student’s needs—both visible and invisible.

“So the first one that maybe SLPs are a little bit more familiar with would be the behavioral assessment… The testing… usually comes along with that is the SSI-4… However, the difficulty with the SSI is that it’s only based on what we are hearing as the clinician… there’s also another side to this. There is the person’s experience of the stutter.”
— Victoria Dertouzos, M.A., CCC-SLP

Tools and Techniques for Effective Assessment

With so many tools out there, it can be tricky to know which assessments truly add value. Victoria encourages SLPs to think critically about the purpose behind each tool—and how it fits into a bigger picture.

Standardized Tools

  • SSI-4 (Stuttering Severity Instrument – Fourth Edition): While commonly used, Victoria suggests using it descriptively rather than for scoring. Stuttering is highly variable, and a numerical score can be misleading or unhelpful in understanding the true impact on the student.
  • TOCS (Test of Childhood Stuttering): Another standardized option that can be helpful in capturing fluency patterns in younger students.

Informal Assessments

Victoria often leans on informal strategies like language samples, conversational speech, and reading tasks—but with a twist. She encourages asking the student reflective questions during the process (e.g., “Did you feel a stutter there?”), which gives a fuller view of their experience.

Affective Tools

  • OASES (Overall Assessment of the Speaker’s Experience of Stuttering): A standout tool for exploring the emotional and social impact. It’s available for multiple age groups and gives both qualitative insights and a quantitative “impact score” that can help support eligibility and guide goal writing.

Ultimately, it’s about blending standardized tools with real conversations and thoughtful observation. Tools should serve the assessment—not define it.

“Personally, I still use the pieces of the SSI, but I never score it… I cannot completely judge the stuttering severity because of the experience of the person as well that has to be involved… and then to also account for what I might not be hearing, I’m always asking the child as well.”

— Victoria Dertouzos, M.A., CCC-SLP

Goal Writing Strategies for Stuttering Therapy

One of the most common questions school-based SLPs ask is, “How do I write meaningful goals for a student who stutters?” Victoria offers a refreshingly practical approach: let the student’s experience guide the way.

She recommends using tools like the OASES to directly inform goal creation. For example, if a student rates themselves low on confidence as a speaker, that becomes a measurable and meaningful target. Instead of aiming for fluency (which is unpredictable and variable), the focus shifts to communication confidence, self-advocacy, and reducing avoidance.

A Sample Stuttering Goal Structure:

  • Baseline: The student rates their confidence in speaking at a 2 out of 5.
  • Goal: The student will increase self-rated confidence to 4 out of 5 over a set period.

This strategy not only empowers the student—it gives SLPs a way to track progress with data that actually reflects change. Plus, it’s flexible enough to adjust over time based on the student’s evolving needs.

By reframing goals around impact and participation, rather than frequency or “fixing” the stutter, therapy becomes more personalized and effective.

“The goal might look like: the student will self-rate their confidence and speaking ability at a 4 out of 5, maybe when the baseline was a 2 out of 5… And to me, it’s actually more accurate in a way than the SLP judging something… you’re getting the information like straight from the horse’s mouth.”

— Victoria Dertouzos, M.A., CCC-SLP

Practical Tips for School-Based SLPs

Working in a school setting means juggling a lot—IEPs, therapy groups, assessments, documentation… the list goes on. Victoria gets it. With five years of school-based experience, she’s all about strategies that are realistic and sustainable.

Here are a few of her go-to tips:

1. Think Holistically

Keep the focus on the whole child. During assessments and therapy, consider emotional regulation, classroom functioning, and how stuttering may be impacting academic participation or social interactions.

2. Collaborate Actively

Include teachers and parents in the process. They bring valuable insight, and their support helps extend progress beyond the therapy room.

3. Use Mixed Groups Wisely

Don’t be afraid to talk about stuttering even in mixed therapy groups. The key is to create a space where the student feels safe and heard.

4. Focus on Feel, Not Just Fluency

Instead of chasing fluency, help students explore how their speech feels. Use your SLP knowledge—voice, articulation, pacing—to support more comfortable communication, without labeling everything as a “strategy.”

5. Shift the Message

You’re not fixing a stutter. You’re supporting a communicator. Your messaging (with students, teachers, and parents) sets the tone for the entire therapy journey.

These small mindset shifts can have a big impact—not just for your students, but for how empowered you feel as a clinician.

“I totally understand the feeling of having to have a million balls in the air… I think that thinking about the whole picture… just trying to keep the mindset that you’re treating the whole child… It’ll just naturally help you gather the information a little bit more because ultimately, again, we’re looking for increasing the well-being of the child.”

— Victoria Dertouzos, M.A., CCC-SLP

Importance of Messaging and Communication

How we talk about stuttering—with students, families, and school staff—matters just as much as the therapy itself. The language we use during assessments and in sessions can either empower or unintentionally discourage.

Victoria emphasizes the importance of normalizing stuttering as a valid way of speaking. From the first assessment, it’s crucial to set the tone: stuttering is not something to be fixed—it’s something to understand, support, and work with.

This messaging helps students begin to view themselves as capable communicators. It also influences how teachers and parents interact with them, helping everyone involved take a more supportive and compassionate approach.

For school-based SLPs, this might mean:

  • Choosing descriptive, nonjudgmental language in reports
  • Educating staff about what stuttering is—and isn’t
  • Helping families reframe their expectations from “be fluent” to “feel confident”

When we shift the narrative, we create space for students to communicate freely, advocate for themselves, and take ownership of their voice.

“Understanding that a stutter is part of the way this child communicates. So using that as the foundation for all of the rest of the things that you’re doing. And assessment’s a really good place to start because it kind of sets the tone for working with the child and the whole speech therapy process.”

— Victoria Dertouzos, M.A., CCC-SLP

Conclusion

Stuttering assessment isn’t just about ticking boxes—it’s about understanding the child behind the speech. From thoughtful intakes to impact-driven goals, every step of the process offers an opportunity to support our students in becoming more confident, empowered communicators.

Victoria’s insights remind us that the most effective assessments are the ones that consider the whole child: what they experience, how they feel, and how they interact with the world around them.

Additional Stuttering Resources

If you’re looking to deepen your understanding or explore the tools mentioned in this guide, check out these helpful resources:

  • SLP’s Guide to Stuttering: How to Evaluate and Write Goals for Stuttering Fluency
  • Fluency Strategies for Stuttering: Time to Let Go
  • SLP’s Guide to Teaching Stuttering Modification and Fluency Strategies for School-Age Students
  • ASHA’s Assessment Guide for Stuttering
  • KiddyCAT (for 3- to 6-year-olds)
  • CAT (for 6- to 15-year-olds)

For more from Victoria, including upcoming workshops and downloadable resources, visit stutteringtherapynj.com/slps.

Frequently Asked Questions About Stuttering Assessment

1. What assessments are used for stuttering?

There are several assessment tools used to evaluate stuttering, including standardized options like the SSI-4 (Stuttering Severity Instrument – Fourth Edition), TOCS (Test of Childhood Stuttering), and OASES (Overall Assessment of the Speaker’s Experience of Stuttering). Many SLPs also use informal assessments such as conversational speech samples, reading tasks, and interviews with the child, parents, and teachers.

2. What does the SSI-4 measure?

The SSI-4 focuses on the behavioral characteristics of stuttering: frequency, duration, and physical concomitants. However, it does not capture the student’s internal experience or the emotional/social impact of stuttering. For that, tools like the OASES are more effective.

3. What is the 5-point scale for stuttering?

Tools like the OASES allow students to self-rate their experience of stuttering using a 5-point Likert scale (e.g., from “never” to “always” or “not at all” to “a great deal”). These ratings can guide therapy goals and track progress in a way that reflects the student’s own perspective.

4. What can be included in an assessment of fluency disorders?

A comprehensive fluency assessment includes:

  • Intake information (medical history, temperament, emotional factors)
  • Behavioral assessment (e.g., speech samples, SSI-4)
  • Affective assessment (e.g., OASES)
  • Parent/teacher/student input
  • Clinical judgment on co-occurring language or articulation issues.

This holistic view helps SLPs understand how stuttering affects the child’s communication, learning, and social participation.


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Marisha (00:01.358)

Hello and welcome to the SLP Now podcast. I'm really excited to be chatting about stuttering assessment today. Our guest is Victoria Dertouzos. She is the owner and lead therapist at Speech and Stuttering Therapy of New Jersey. So she has a private practice. She also worked as a school-based SLP for five years and obviously managing all the school-based things.

So she has a really cool set of experiences, just starting with a very broad practice space and now specializing in stuttering. And I'm really excited to learn more about assessments with her. But before we dive into all things assessments, first of all, hello, Victoria.

Victoria Dertouzos (Giacalone) (00:53.071)

Hi Marcia, thanks for having me.

Marisha (00:56.844)

Really looking forward to diving in. But before we do all that, would you mind telling us just a little bit more of your story? The bio I shared obviously doesn't do you justice. But what led you to specialize in stuttering and kind of the road to your own practice?

Victoria Dertouzos (Giacalone) (01:15.653)

Yeah, I would love to talk about that. I think stuttering itself kind of fell into my lap. After going into speech therapy, I ended up in an undergraduate college that didn't actually provide a major for speech therapy. So I kind of had to go out and find my own experiences. And I think it was just kind of by chance I found a board certified specialist in stuttering. And through my time observing with her,

It was just kind of something that hit me where like when she was working with her patients, I could tell it was a little bit more than what I thought speech was. She was really connecting with them and I could see how she was really changing that quality of life and how, you know, the difficulty they were coming to her with was really, really negatively impacting their life in a way that I didn't really think about with other, you know, speech knowledge that I had previously. So.

I kind of had the seed planted from college and then as I continued to go to grad school and go out into the field, you know, there were so many clients and kids and adults that I saw that I was like, okay, this is what I need to do because it's such a passion project for me. So it kind of led me to make all the decisions I've made up until this point. And ultimately I'm thrilled with where I'm at now and very

feel very lucky that I can work with the clients that I do now.

Marisha (02:48.314)

I love that. And I think, I don't know, there's just something really cool about all of our journeys because I feel like the types of students or patients or clients that we're meant to have just kind of, they just end up on your caseload. because like some SLPs have like, they might have one start like student on their caseload who stutters or I don't know. It's just funny how that variation happens and how, I don't know.

Victoria Dertouzos (Giacalone) (03:02.871)

Yes.

Marisha (03:18.958)

Some weird stuff at play, I guess.

Victoria Dertouzos (Giacalone) (03:21.337)

I agree. think I'm a person that thinks you kind of end up where you're supposed to and the people that need to find you find you for whatever reason. So I think that happened.

Marisha (03:29.388)

Yeah, I love that. Okay, so now let's dive into assessment. I, throughout this whole series that we've been like, we're releasing a bunch of episodes on stuttering, because there's been a lot of changes in the field, and just kind of some shifts from what we might have learned in grad school. So that's why we're talking about assessment again.

But what, from your perspective, what are the current best practices in terms of an effective assessment? What do we want to be thinking about?

Victoria Dertouzos (Giacalone) (04:09.101)

Yes, it's a great question and something I just want to comment on too while you mentioned it is that like there's a shift, right? And I think of course best practice always in our field is to use the research and the data that's there. I just want to note that this research has actually been around for a while, like even dating back to like the mid 1900s. That sounds really far away, you know? Everyone knows what I mean by that.

So yeah, just keeping that in mind when we're talking about this. So when we're looking at assessment, there's definitely key pieces. First, as always, getting a really good intake from the parents or from the person if it's an adult. And that not only includes the medical history and all of the basic things that we usually collect, but it actually is really important to include information about the temperament and the personality of the person if there's any

additional anxieties that are present or any emotional challenges that are present. And the reason for that is because stuttering is pretty sensitive to nervous system changes. So when you hear people say misconceptions like, they're stuttering because they're nervous, right? It's not because they're nervous, but maybe when they're nervous, you see it a little bit more. So trying to take those things into account, not just for stuttering frequency, because we care a little bit less about that.

but just for helping the person understand why it's happening, when it's happening, and maybe helping them to, and even the parent, to manage those situations to see if it can support them a little bit better. And again, in the intake, we're always kind of getting the parent, if it is for a child, we're getting the parent's view because they're filling it out usually or they're speaking with us, but something really important to get from them is also what they understand about stuttering at the start.

and then what their view of their child's stutter is. So if they're viewing it as a problem, if they're viewing it as something they're just really worried about, if they know or if they believe that the stutter is going to go away through the speech therapy process, these are all things that we want to kind of inventory so that we can either educate appropriately or continue to support their views of stuttering as the therapy process goes on.

Victoria Dertouzos (Giacalone) (06:36.835)

And then within the assessment, I think it's pretty easy to digest when you split it into two sections. So the first one that maybe SLPs are a little bit more familiar with would be the behavioral assessment. So that is actually talking about the concrete aspects of stuttering that you hear most frequently, right? Like those stuttering-like disfluencies, are there blocks? Are there prolongations? Are there repetitions, right?

And the testing, right, because we're usually looking for a test to use that usually comes along with that is the SSI-4. That's the most up-to-date one right now. However, the difficulty with the SSI is that it's only based on what we are hearing as the clinician or we are seeing as the clinician and our judgment. So something that is

different about stuttering is that there's also another side to this. There is the person's experience of the stutter. And believe it or not, that can actually be different than what we are hearing. So the person might be either feeling a block and we're perceiving it as a pause. So we're not actually noting it as a stutter. A little bit, something that can be a little more hidden or hard to kind of realize is that the person may also be using an avoidance strategy. So maybe they know the block is gonna come.

And they're actually adding the pause in to try to move past the block or they're adding in a word to switch it around. And, you know, even kids can be really adept at these coping strategies that can even become automatic. They may not even know that they're doing them, but it's something that their body is doing to manage the stutter, make it feel a little bit better for them. So personally, I, I still use the, pieces of the SSI, but I never score it.

So the reason for that is that I wanna be describing what I'm hearing. Always in the narrative, I'll explain that, you know, I cannot completely judge the stuttering severity because of the experience of the person as well that has to be involved, but I do wanna note like some of the pieces that I'm hearing. And then to also account for what I might not be hearing, I'm always asking the child as well. Like if I have a little bit of a suspicion, you know, I...

Victoria Dertouzos (Giacalone) (09:04.421)

I'm doing a lot of listening to stuttering. So I feel like my ear has gotten tuned just like anything, right? As speech therapists, we have to tune our ear to certain things. But I might ask, like, did you feel a stutter there? Or when they do the reading sample, I might say, like, I'm just wondering, did you notice if you stuttered in there or not? Never with a judgment, never to point it out to them, but just to see what they're aware of and to see if they feel something that I didn't hear, because that's important information, too.

So yeah, not scoring that also helps the parent not to hang on to something. Because a lot of times we'll get a question from parents that is, okay, well, how bad is it, right? They're using these judgmental words too. But if we tell them, the stutter is moderate or the stutter is very mild, right? It actually says nothing about how the stutter is impacting the child. And that's going to be the next part that

is the most important that I'm going to talk about now. But lastly, I just want to note about the SSI is that just another piece of why we're not scoring it why we're not giving it a severity is because stuttering at its core is variable. So parents and kids who stutter need to understand that their stutter is going to change depending on different factors, depending on the day, depending on the week. And that's actually just part of the experience.

So it kind of comes along with the acceptance piece of knowing, you know, that it's going to change. So if we're giving them this clear cut number or this clear cut word for it, then we're kind of setting them up for failure if it changes, if it gets the frequency increases or decreases.

So that next piece right I'm splitting it kind of into two behavioral we just talked about and then effective Which is the experience of the person? There are a bunch of different inventories out there to kind of survey how the person feels about their stutter and what their experience of it is like My favorite one is the Oasis so There are different age groups or different Oasis for different age groups

Victoria Dertouzos (Giacalone) (11:18.917)

starting at age seven and then going up to adult. And that's gonna give you a really good picture of how this center is impacting the child. So if we're kind of talking about the schools, right? We're looking to figure out, you know, what are really the areas of need? I know you talked about goals with Nina, but you know, the assessment always drives the treatment. So this test survey questionnaire, right?

Is really where personally I pull my goals from because it's telling me all that I need to know about how it's affecting the child And just to kind of note on something that I think school SLPs, especially are always looking for is how do I justify services? This is where you justify services At least in my state there's still a stuttering percentage a number of stutters that they're looking for unfortunately to qualify

However, your way around that is to show, hey, this is having an educational impact. They're not comfortable raising their hand in class, or it's having a social impact. They are feeling completely too nervous to even initiate conversations with their peers. And to me, that is just as good as giving a concrete number. And the OASIS does give you a number. It gives you an impact score at the end too. So you're still getting that.

that quantitative information. Yeah. So that's kind of like the overview, you know, including the screening parts and everything else that comes with being an SLP, right? If there are language difficulties that you see or speech difficulties that you see, just using your clinical judgment to figure out, is the language impacting the stutter? Is the stutter impacting the language?

speech, vice versa, and deciding what you're prioritizing in therapy. Sometimes you have a student where they're not very intelligible, and that's impacting them a little bit more at the time. But again, I keep using the word impact, and that's really the most important piece is figuring out how is this affecting, how is the stutter affecting the child.

Marisha (13:36.406)

Yeah. Wow. This was such a great overview of just like, yeah, what to consider when looking at an assessment. we're looking just a quick recap. We're looking at, we're doing a thorough intake, looking at medical history, temperament, personality, anxiety, emotional aspects. and then checking in with the parents on like perspectives and beliefs, because that can really impact.

how we set up therapy too, or at least how we communicate it with them. And then also looking at the behavioral and effective aspects. And you gave some great examples of things to consider in both of those areas. So yeah, this is awesome. And then I wanna ask this just because I know SLPs are always like, but how do I write the goals? So would you?

Like, would you be open to giving an example of how, like, how you would look at the oasis to, like, kind of navigate your goal writing?

Victoria Dertouzos (Giacalone) (14:41.529)

Yeah, 100%. So I think like anything, once you kind of shift your mindset on it and you look at it through a new lens, it actually becomes really easy. So you can take it pretty literally. So let's just say there's one item on the Oasis, right? And I'll just use feeling confident in your abilities as a speaker, right? That's the first one that comes to mind. So that's almost, we're very close to word for word, kind of what it says in the Oasis.

And they can choose, you know, always to never. And you can tell if they have like a pretty low view or a low confidence level. So what we want to do is we want to raise their confidence in their ability as a speaker. So we're going to put that as the goal. Now, the part that I think gets SLPs tripped up is, well, how do I make that 80 % accuracy? How do I make that one out of 10 opportunities, right?

And what you can do is, again, simple. You can use that same rating scale and the same way that you collected that information from the child, which was having the child decide, you're actually going to have them rate it again whenever you want. So now you have a progress measurement whenever you want and you have a measurement for your reevaluation or whatnot. So the goal might look like

the student will self-rate their confidence and speaking ability at a four out of five, maybe when the baseline was a two out of five. So really, whether you want something to go down or you want something to go up, you still have a measurement of it. And to me, it's actually more accurate in a way than the SLP judging something. Because technically, it's pretty subjective when you're when you're saying, OK,

the sound is being produced with 80 % accuracy, right? But when you're actually asking the person who's experiencing it, you're getting the information like straight from the horse's mouth. And it also helps to really encourage the fact that we wanna be listening to what they are feeling versus kind of just telling them, hey, we're gonna practice this thing today.

Marisha (17:04.066)

Yeah. And that's the, I think that's the overarching theme that we've been seeing in a lot of these episodes too, is that it's really, it's really like, and like you've been mentioning this whole episode, it's really all about the impact. And our goal is for our students to be confident communicators and what better way to measure that than by asking them. And because like, we, if we collect a language sample, it's so incredibly variable. It's not.

a good data point anyway, even if it might feel better of like, using our clicker to track these occurrences. if we ask them, even the context of what we ask them could significantly impact the, yeah. So I love that. again, you're so skilled at just giving really clear and practical examples. So thank you for that.

Victoria Dertouzos (Giacalone) (18:01.093)

Yeah, of course. If you don't mind, I want to touch on something you mentioned, the language sample. Again, I think that's something else that SLPs can get bogged down on. But if we're thinking about shifting, and we're thinking about communication effectiveness and communication competence, maybe when the child starts out, that language sample is going to look like a ton of avoidance strategies.

Marisha (18:03.08)

okay.

Victoria Dertouzos (Giacalone) (18:27.885)

repeating or going back and starting the sentence over because they want to rewrite over the stutter to fix it. We're adding in lot of ums, right? And in reality, if the child just stutters and lets it out and doesn't use any of those things, the language sample is going to look different, but it's actually not going to change how many stutters are in it. But you'll probably increase confidence, you'll increase communication effectiveness, and things like that. So.

That's kind of what we're looking for.

Marisha (18:59.139)

Yeah, now that makes so much sense. Okay, so, and this feels like what you outlined feels super doable. But I'm just curious, especially since you've had like five years in the schools and most people listening to this are school-based SLPs. But do you have any tips or strategies for SLPs who are juggling a bunch of different things in just making sure that they're able to

actually implement this. Like it feels really practical, but do you have any like tips or strategies that might make it a little bit easier?

Victoria Dertouzos (Giacalone) (19:39.181)

Yeah, I totally understand the feeling of having to have a million balls in the air and maybe, you know, feeling like your job isn't understood completely, the responsibilities and all that kind of goes into just being an SLP in the school. I think that thinking about the whole picture, right, we talk about that with like any student, just trying to keep the mindset that you're

you're treating the whole child. So keeping that open mind when you're going into the assessment, like I mentioned, when you're talking with the parents, even when you're talking with the teacher, that's an important part I missed in the intake, just seeing how the child functions in the classroom and what they notice. And again, of course, hearing from the child. But functionally, I think if you kind of keep that lens,

It'll just naturally help you gather the information a little bit more because ultimately again, we're looking for increasing the wellbeing of the child. We're not looking for, you know, parents maybe asking, okay, how can we practice or how are we going to make him more fluent? If that doesn't feel right to you and it probably shouldn't, I'll erase probably, then go with that, right? Anything that you think is going to increase his wellbeing in school, outside of school.

go there. But I think it is tough to juggle, right? You may have a group that you need to see and you have the one kid who stutters in there and you're trying to figure out how do I make this work? Talking about stuttering is also going to help making it not the elephant in the room. Again, kind of just another simple thing. know, kids can feel how you feel about things. So.

even if they are in the articulation group, it's okay if they're talking about stuttering, as long as you notice that they're comfortable. But I think, I know I'm kind of going broader instead of specific, but I think that's kind of what will help the most. But I know it's tough, like, I think a lot of SLPs have heard this message of like, not using fluency shaping strategies, right, not encouraging fluency, but

Victoria Dertouzos (Giacalone) (22:02.287)

They're not really sure what to replace it with. I think that's where the difficulty lies. So I guess I'll just give kind of one more thing. When you're in treatment, right, or you're in therapy and you're thinking about the stutter, we have this lens of strategies, right? So shifting away from those and into something else, what you can replace that with is all of your knowledge of being an SLP, everything else that you know about voice.

Everything else you know about articulation. Within the lens of stuttering, it falls under this idea of tension, really. So how can you help the child with the underlying message of, your stutter's not gonna go away, it's gonna be there, but let's work and play with your speech system so that we can make it feel better. And it doesn't need to be called an easy onset. It doesn't need to be called stretchy speech, right? You can let the child come up with something and just figure out.

Let them have the ownership over like, it feels better when I stutter a little bit easier and let them call it whatever that is. So I think just that lens, again, you're looking at the whole child and you're trying to make it feel better for them, whether that's emotionally or physically. Yeah.

Marisha (23:22.358)

that's great. was there anything else that you wanted to like wrap up with? I mean, I feel like we did, you did a phenomenal job kind of going through assessment and I feel like SLPs will have, if you check out the show notes, anyone listening, there's a link.

In the episode description, you'll find just like a quick outline of what we talked about. So you can use that to create your like your own little assessment checklist, as well as links to some of the assessments and all of that. But yeah, was there anything you wanted to add Victoria?

Victoria Dertouzos (Giacalone) (23:59.845)

I think I touched on a lot, but I guess just to kind of leave everyone with like the messaging that you're sending to both the child and the parents and the teachers and the staff in the school, right? Understanding that a stutter is part of the way this child communicates. So using that as the foundation for all of the rest of the things that you're doing. And assessment's a really good place to start because it kind of sets the tone for

working with the child and the whole speech therapy process.

Marisha (24:31.628)

Yeah, that is so true because if like based on the types of questions we're asking and just what the assessment looks like and also how we report it, that'll really shift how like parents and teachers and the student are kind of being introduced to the intervention too. So yeah, this is where it all starts.

Victoria Dertouzos (Giacalone) (24:40.794)

Yes.

Victoria Dertouzos (Giacalone) (24:52.141)

Yes, 100%.

Marisha (24:54.38)

Amazing. Well, thank you so much, Victoria. This was super helpful. And thank you to everyone who listened.

Victoria Dertouzos (Giacalone) (25:02.637)

I'm so glad. Thank you for having me.

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Filed Under: Podcast, Therapy Ideas Tagged With: Assessment, Fluency, Stuttering

Marisha’s Birthday Giveaway

March 25, 2019 by Marisha 24 Comments

It’s my birthday! I am so excited to celebrate with you, and to do that we are doing a GIVEAWAY — 10 of my favorite tools and resources as an SLP.

Enter below for a chance to win:

a Rafflecopter giveaway

Here’s a peek at the prizes:

1. SLP Now Membership

This has been a game changer for me as an SLP! I feel about 3,432 times more confident about my therapy plans, student progress, data collection, and documentation. Don’t tell anyone, but I actually kind of enjoy Medicaid billing, too.

2. SLP Now Following Directions Deck

This is perfect for the busy SLP who wants fun, engaging, evidence-based therapy materials but is not excited about pulling out the old printer and laminator.

 

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A post shared by SLP Now® (@slpnow) on Mar 14, 2019 at 8:39am PDT

3. SLP Now Sentence Pack

This guy takes some time to prep, but it is one of my most used materials! Perfect for grammar and early MLU goals!

 

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A post shared by SLP Now® (@slpnow) on Nov 23, 2018 at 2:38pm PST


4. Starbucks Gift Card

You know how much I love my no-water chai latte! An essential for SLPs navigating the craziness of a mega caseload!

5. Target Gift Card

Who doesn’t love a trip to Target? 🙂

6. Amazon Gift Card

I love Starbucks and Target, but I absolutely could not live without Amazon! My “go-to” for therapy materials and organizational goodies!

7. Teal Yeti

This is my absolute favorite tumbler! I carry it with me all the time. I’ve always struggled to drink enough water, but the large tumbler does the trick!

8. Stadtler Pens

These pens are #amazing! They don’t bleed and come in a beautiful organizer. An SLP’s dream come true!

 

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A post shared by SLP Now® (@slpnow) on Jan 2, 2018 at 4:38pm PST

9. Children’s Book: Little Elliot in the Big City

This is my favorite book. It includes beautiful illustrations and an incredibly sweet story, is filled with targets, and contains just the right amount of text. Perfect for kids working on /l/, synonyms, antonyms, basic concepts, describing, inferencing… The list goes on and on!

10. Children’s Book: Giraffes Can’t Dance

This is a close second! I love encouraging my students with this story of perseverance, and it also happens to be a great vehicle for a variety of therapy goals!

Now I’m curious… What are your favorite SLP gifts?

Filed Under: Outside the Speech Room

Best Articles for Vocabulary Goals

March 18, 2019 by Marisha Leave a Comment

I love sharing tips and tricks to help SLPs implement literacy-based therapy, but it’s not always easy to find the perfect reading resource for you mixed group! This series of blog posts will help you find fun, engaging articles that also make it easy to target your students’ goals. (I know I am always on the hunt for amazing resources to use in therapy!)

Next up is…VOCABULARY!

Compare and Contrast

Predicting the Future – This nonfiction article about travel in the future is written at a 6th grade reading level. Students can compare and contrast travel now and what it might look like in the future.

From Earth to Outer Space – This nonfiction article about space travel is written at a 6th grade reading level. Students can compare and contrast space travel as depicted in the movie, A Trip to the Moon, with how it was described in the article.

Siblings – The fiction passage about two siblings is written at a 4th grade reading level. Students can compare and contrast the two siblings.

Multiple Meaning Words

The following articles include a variety of multiple meaning words:

Snow Day Fever – This fiction passage about a boy who is sick on a snow day is written at a 5th grade reading level.

Focus: What’s Inside? – This nonfiction article about focus and attention is written at a 5th grade reading level.

Winter Worries and Health Hazards – This nonfiction article about winter hazards is written at a 4th to 5th grade reading level.

Prefixes and Suffixes

The following articles include a variety of words that include prefixes and suffixes:

Tag–I’m It! – This fiction passage about a game of tag is written at a 4th grade reading level.

Louis Braille – This nonfiction article about Louis Braille is written at a 6th grade reading level.

Jump Jump Jump – This fiction passage about two boys’ adventures during recess is written at a 4th grade reading level.

Looking for more resources? Check out the SLP Now Membership! You can search for materials to help you teach these skills, as well as articles that include targets for all of your students’ goals. Try it today (for free)!

Filed Under: Therapy Ideas Tagged With: Books, Literacy-Based Therapy, Vocabulary

Best Articles for Language Goals

March 11, 2019 by Marisha Leave a Comment

I love sharing tips and tricks to help SLPs implement literacy-based therapy, but it’s not always easy to find the perfect reading resource for you mixed group! This series of blog posts will help you find fun, engaging articles that also make it easy to target your students’ goals. (I know I am always on the hunt for amazing reading resources to use in therapy!)

Next up is…LANGUAGE!

Facts and Opinions

New Debate: Virtual Education – This nonfiction article about virtual education is written at a 6th grade reading level. This article provides two points of view regarding whether cyber schools are a valid option for education, giving students multiple opportunities to identify facts versus opinions.

Looking for more debate articles? ReadWorks has plenty!

Tiger Watch – This nonfiction article about tigers and their near extinction is written at a 6th grade reading level. The article includes several facts and opinions as they describe the dangers that threaten these animals.

Up in the Air – This fiction passage about a boy who travels on a plane for the first time is written at a 4th grade reading level. Students have the opportunity to identify facts and opinions as the boy shares his experience.

Inferences

Confessions of a New Girl – This fiction passage about a new girl’s experience is written at a 4th-grade reading level. There are multiple opportunities to make inferences as the new girl describes her experiences at a new school.

Walk the Plank! – This fiction passage about two boys who are playing a pirate game is written at a 5th grade reading level. Students have multiple opportunities to make inferences as the two boys play together.

Magic in the Classroom – This fiction passage about Emma’s first day at a new school is written at a 5th grade reading level. Emma encounters several students who treat her very differently. Students can infer why this is happening and how it affects Emma.

Main Idea/Summarizing

Music and Your Mind – This nonfiction article about music’s power is written at a 6th grade reading level.

Nothing Left to Lose – This nonfiction article about a family’s escape from North Korea is written at a 5th grade reading level.

Time to Think – This nonfiction article about the length of a school day is written at a 6th grade reading level.

Looking for more resources? Check out the SLP Now Membership! You can search for materials to help you teach these skills, as well as articles that include targets for all of your students’ goals. Try it today (for free)!

Filed Under: Therapy Ideas Tagged With: Books, Language, Literacy-Based Therapy

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