Monthly Archives

July 2013

Pretend Play, Uncategorized, Uncategorized

The Power of Pretend Play

What is “pretend play?”


Pretend play is any play that involves the use of imagination to create a fantasy world or a situation. Typical children spend a lot of time engaging in pretend play (i.e. feeding the dolls, building a tower with legos, tea parties, flying a rocket ship, etc.). 

Why is pretend play important during childhood years?

Young children learn by imagining and doing. Pretend play is correlated with other positive attributes. Preschool age children who have imaginary friends are more creative, have better social understandings, and are better at taking the perspective of others (Taylor, 1999). Research has also shown significant positive relationships between pretend play and social competence and involvement in children aged five to seven years (Uren and Stagnitti, 2008). When children pretend to be different characters they learn to put themselves in other people’s shoes and they start to learn about other people’s emotions. This is called “perspective taking” and it’s a skill that is typically lacking in our kiddos with Autism Spectrum Disorders. Pretend play also helps children learn problem solving and language skills. Have you ever heard children dress up their dolls and play mommy and daddy? When I was a preschool teacher I saw this all the time. These children did such a great job imitating their parents word by word. They would also come up with problems that they typically saw in their house and they would try to solve it. I’d hear things like (i.e. “Oh no the doggy ran away; we have to look for him now.” or “Aidan did not put his toys away; he needs to clean before daddy gets home.”)

Tips to promote pretend play:

1- Imagination Box: Have a box in your house filled with random objects such as fabric pieces, kitchen utensils, dishes, dolls, old clothes, cheap jewelry boxes, shoe laces, cans, old cellphones, magazines, etc.

2- Have a Picnic: Use food play and dishes to have a picnic at home. Pretend like you are washing and cooking the food. Feed the teddy bears or dolls, wipe their faces, and clean up the dishes.

3- Weather Man: Ask the kids to be weather man/woman when they wake up in the morning and report about the weather for the day. Help them look out the window or step outside to check the weather. 

4- Restaurant Play: This was my favorite when I was a kid. My mom made lunchtime super fun by telling us we could have our own restaurant for the day. Each day during lunchtime, my brother and I got turns pretending like we were restaurant owners. We had to come up with a name for our restaurant, take orders, bring the food, and clean up.

5- Cars: Pretend like the floor is a city and the cars are driving around, stopping by to get gas, getting groceries, etc. 

6- Play-Doh: Let your kids play with Play-Doh. Help them create people, scenes, animals, etc. Then have them tell a story about what they made. One of my kids in therapy made me, himself, and our office staff out of Play-Doh and we put smily faces on our Play-Doh figures and talked about emotions. 

7- Nap time/ bed time: When you are putting your kids down for a nap, help them put their stuffed animals down for a nap. We put these monkeys down for a nap in my therapy room last week. We sang the “five little monkeys jumping on the bed” song then the kids gave the  monkeys hugs, and put them on the bed to sleep. 

8- Cardboard Box: Did you know that you can make almost anything out of a cardboard box? Just check out Pinterest or google cardboard box crafts. We made a car out of a cardboard box last week and my son loved it. We pulled him around the house in it and then he ate his breakfast in it the next day. 

9- Legos: The possibilities are endless with this one. Help your kids build rocket ships, cars, towers, etc. I read this great article about legos a few months ago (Hi Zeba). Here is the link to the blog post –> http://lovedelara.com/2013/04/02/limiting-technology-exposing-our-kids-to-focusconcentration-activities/

10- Get Engaged: If you see your child having  a tea party, ask them questions (i.e When are the guests arriving? Who is coming over? Where would you like to set up your tea party?)

And lastly, here is a picture of a box I found! See, you really can do a lot with a cardboard box.
Have a great weekend everyone! 
Sanaz
References: 
Taylor, M. (1999). Imaginary companions and the children who create them. New York, NY: Oxford University Press. 

Uren, N., & Stagnitti, K. (2008). Pretend play, social competence and involvement in children aged 5-7 years. The concurrent validity of the Child-Initiated Pretend Play Assessment, 56 (1), 33-40. 
Speech-Language Pathology Career, Uncategorized, Uncategorized

Top 10 Reasons Why We Love Being Speech-Language Pathologists

We’re back again with another top 10 post. Though there are many reasons why we love doing what we do, we wanted to share the top 10 reasons why we love our profession and being SLPs.



10. Community: The SLP community is one of the best out there (okay we may be a little biased)! The SLP community allows us to share ideas, learn new information, get therapy ideas, answer tough questions, and collaborate with a great group of professionals. This group is one of the friendliest and most inspiring group of professionals we have ever encountered!



9. Creativity: Being an SLP gives us a chance to show our creative side whether it be through crafts we create for our kiddos or by coming up with creative service delivery models (i.e. delivering therapy on a playground)! You can probably tell by now from our previous posts that we both enjoy being able to get a little creative!



8. Intellectual Stimulation: In this field we are constantly learning new materials. Since the beginning of our carriers we have learned something new every single day. Speech-Language Pathology is a new and growing field; therefore, there is a plethora of research being done out there on topics related to our field, and there is so much to learn.



7. The American Speech-Language-Hearing Association (ASHA): Through ASHA, we stay connected with the bigger community of SLPs. We can attend conventions, get access to the most current research, learn about evidence-based practice, and find out about career benefits. ASHA also provides a variety of continuing education opportunities.






6. Flexibility: We are both very thankful that being an SLP means flexibility with our schedules and service delivery models. The flexibility with scheduling helps women be able to be both a mom and a professional at the same time! Not many jobs allow women to work part-time because they are moms! SLPs also have flexibility when it comes to service delivery models, particularly in the school setting, being that they can shape the way in which they choose to provide services (i.e. classroom based, pull-out therapy, response-to-intervention).




5. Diversity: The possibilities for an SLP straight out of grad school are unlimited. This is one of the reasons we both fell in love with this profession. There are so many different routes that an SLP can choose from: school, private clinic, hospital-pediatrics, hospital-adults, skilled nursing facility, etc. The amount of doors open to SLPs as professions is bountiful! You can always choose and specialize in one area/setting or branch out and explore the different possibilities.

4. Job Security: We know SLPs are “in demand” and when we say in demand we mean it. There are so many people (kids and adults) on waiting lists in different settings waiting to receive SLP services. No matter what setting, you will get multiple job offers as an SLP. There is currently an increasing demand for SLP services everywhere.

3. Collaboration: Whether it be in the clinical setting or the school setting, we feel that the ability to collaborate with other professionals is a definite perk of being in this profession. We both feel that we have learned so much from our colleagues whether they be fellow SLPs, occupational therapists, physical therapists, psychologists, nurses, teachers, or parents! We both feel that there is also so much more to learn and being able to share/gain ideas from your colleagues is truly valued in both of our eyes.  

2. Making a Difference: As cheesy as it may sound, we both got into this field because we wanted to make a difference. Sometimes it may be hard to see progress, especially if it is minimal or gradually over time, but we have learned the importance of rejoicing in the small accomplishments our kiddos that we serve have made. Though it may take baby steps to reach a long term goal, it is humbling to know that we are helping someone with their ability to find their voice and communicate effectively throughout multiple environments.

1. Reliving our childhood: Okay, this is probably one of the main reasons why we became SLPs. We both enjoy working with children (most of the time) and we transform when we are in our therapy sessions. We feel like we’re kids again and we love it! We chase after bubbles, we get competitive playing board games, we make crafts and get dirty. What other profession allows you to do that? And this doesn’t even end in the therapy room. Sometimes we feel like we’re kids outside of therapy and we ride in little cars around the mall, and go up and down the escalators backwards (true story) –> See pictures:

These are just a few of many reasons why we love being SLPs! Share your reasons why you love being an SLP or any interactions/experiences you may have had with an SLP in the comments below!


Christine and Sanaz
dysphagia, feeding, swallowing, Uncategorized, Uncategorized

Feeding and Swallowing Disorders (Dysphagia) in Children

Eating and swallowing food may seem like very
simple tasks to us but for some children getting adequate nourishment is far
from simple. It takes about 50 pairs of muscles and nerves to accomplish
the simple act of swallowing. I  realized how complex eating and
swallowing were when I completed a practicum in a Nursing Facility working with
the elderly who had lost some of these abilities. According to Dr. Kay
Toomey (2010), a pediatric psychologist, eating is the MOST complex physical
task that human beings engage in. It is the ONLY human task which requires
every one of your organ systems and requires that those systems work correctly.
In addition, EVERY muscle in the body is involved. Plus, eating is the ONLY
task children do which requires simultaneous coordination of all of our sensory
systems. 

What are feeding and swallowing disorders?
-Feeding disorders include problems gathering
food and getting ready to suck, chew, or swallow it.
-Swallowing disorders (dysphagia) can occur at
different stages in the swallowing process: oral phase, pharyngeal phase, and
esophageal phase. For more information about these phases, please check out the
ASHA website listed in our references.
Signs and symptoms of feeding and swallowing
disorders in children
According to the American Speech-Language-Hearing
Association (ASHA), these are the signs and symptoms of feeding/swallowing
disorders:

  •       arching
    or stiffening of the body during feeding
  •       irritability
    or lack of alertness during feeding
  •       refusing
    food or liquid
  •       failure
    to accept different textures of food 
  •       long
    feeding times (e.g., more than 30 minutes)
  •       difficulty
    chewing
  •       difficulty
    breast feeding
  •       coughing
    or gagging during meals
  •       excessive
    drooling or food/liquid coming out of the mouth or nose
  •       difficulty
    coordinating breathing with eating and drinking
  •       increased
    stuffiness during meals
  •       gurgly,
    hoarse, or breathy voice quality
  •       frequent
    spitting up or vomiting
  •       recurring
    pneumonia or respiratory infections
  •       less than normal weight gain or growth
What to do if your child has some of these signs
and symptoms?
Talk to your child’s pediatrician and s/he will
refer you to the right professional based on the nature of your child’s
problem.
How do Speech-Language Pathologists treat
children with feeding and swallowing disorders?
As SLPs we also specialize in feeding and
swallowing treatment. We work as part of a team of other professionals such as:
a physician, a nurse, an occupational therapist, a physical therapist, or a
dietitian. As SLPs we work on: strengthening the muscles of the
mouth, improving chewing and sucking ability, increasing tongue movement,
helping infants coordinate the such-swallow-breath pattern, and modifying food
textures and liquid thickness to ensure safe swallowing. A Videofluoroscopic
swallow study (VFSS) or flexible endoscopic examination of swallowing
(FEES) may be needed for assessment of dysphagia. 
Developmental milestones and feeding skills birth
to 36 months

Hope this was helpful! Happy Friday 🙂 
Sanaz
References:
http://www.spdparentzone.org/resources/TOP%20TEN%20MYTHS%20OF%20MEALTIME%20IN%20AMERICA.pdf
http://www.asha.org/public/speech/swallowing/Feeding-and-Swallowing-Disorders-in-Children/
http://www.nature.com/gimo/contents/pt1/fig_tab/gimo17_T3.html
clinical fellowship, materials, Uncategorized, Uncategorized

Top 10 Materials Every CF-SLP Needs

Entering into your clinical fellowship year (CFY) can be kind of daunting so we thought we would make these post dedicated to all of your entering your first job as a SLP. We wanted to share with you the top 10 materials/resources we felt helped us through our first year out on our own. This post is for those of you who work in preschools, schools, and private clinics working with children.



1) Gameboards: Check out Sanaz’ post here



http://thespeechchicks.com/2013/07/12/seven-must-have-games-in-speech-roo/. Gameboards are great reinforcers to keep a child engaged in whatever activity you may be working on- articulation or language- and they help to build social skills.



2) Teachers Pay Teachers: As Christine has said in previous posts, starting SLPs aren’t always given the biggest budget (especially in the school setting). This resource provides an outlet for SLPs in the field to create and post materials for just about anything at a low cost to those who need it. Christine has also found many materials on this site for free. We love that the materials are made for SLPs by SLPs. Christine’s favorite thing to purchase on the site are book companion packets which go along with popular stories used in the classroom. You can find just about anything on Teachers Pay Teachers!



3) Social Media: Blogs, twitters, and facebook are great resources.


4) Bubbles: How do you go wrong with bubbles? Bubbles are something that we always have within close reach. They are a great way to elicit language, social interaction, or to just sooth a kiddo that is upset. What kid doesn’t love blowing bubbles or chasing after bubbles and popping them.

5) Boardmaker or Symbolstix software: Software that you can use to create symbols for your kiddos in an invaluable tool. These kinds of software can be used to create communication boards, picture schedules, and visual aids. One thing that Christine has been using these softwares for is to create materials for use in my therapy room. We find both of these softwares easy to use. They are a bit pricey but we feel they are definitely an investment worth making.

6) WH Question/Answer Cards: As SLPs we always have kids with “wh” questions as their goals. You can buy these from Super Duper Publications or simply print your own. You can do a google search and you will come across many different cards/worksheets with “wh” questions and answers.

7) Visual Schedules: Creating visual schedules really helps our kiddos know what is going to happen each time they come to speech and it helps transitions run smoothly as Christine mentioned in her previous post about “Trouble with Transitions.” Keep these handy and you will have less meltdowns.

8) Laminator: This is an SLP’s best friend and you can find cheap ones on amazon. Laminate, save, and reuse!

9) Music: This comes handy especially if you are working with younger kids. You want to have at least once CD with some popular songs (i.e. The Wheels on the Bus, Itsy Bitsy Spider, ABC Apple, etc.)

10) Planner/calendar: Keeping organized during your CF year is one of the most important things. A planner or calendar will help you see all of those important dates/deadlines you may have coming up. During your CF year it is important to stay on top of those deadlines so that you can give yourself plenty of time to complete any tasks especially if you are working in the school setting, IEP due dates/eval dates can sneak up on your when you have a large caseload.




Hope this post helps you in your first year as a clinical fellow or your first 18 months (if you are a part time SLP)!

Christine and Sanaz

game boards, materials, Uncategorized, Uncategorized

Seven Must-Have Games in the Speech Room!

In this post I want to share the therapy games
that I use daily as reinforcers with my preschool and school age kiddos.
Sometimes I see kids for one-hour sessions and we know that kids have a
difficult time staying focused on speech stuff for that long. I try to make
speech fun in my speech room and I often have ongoing competitions with my
kiddos when it comes to games. I focus on our specific speech/language
goals for a few minutes then I let my kiddos take a turn in a game. For
example, the child produces 10 words with the /r/ sound or answers 5
“Wh” questions, then we each get two turns in a game. We go back and
forth with our speech tasks and games to make each session fun and productive.
My goal in each session is to help the child make progress towards his/her
goals and leave speech thinking s/he cannot wait to come back and play with the
speech teacher! I try to play games that are simple to teach and play.

Playing Candyland while
targeting “grammatically correct sentences”

Playing Jenga while targeting
“social skills”

All set up to play Connect-4
and target the “bilabial sounds”
During my practicum in a school site I made notes
of some games that I was definitely going to purchase as an SLP. I bought most
of these games on amazon for reasonable prices and I have used them as therapy
reinforcers every single day since I started my current SLP job. 
Here are my seven favorite and super simple
games:
Candyland: Ages 3+
Classic “child’s first game
Simple racing board game
Children draw colored cards, and move their
plastic gingerbread playing tokens   to the next square of the same color
Good for following directions
Chutes and Ladder: Ages 3+
Game of rewards and consequences
Ideal for younger children who are still learning
to take turns
Helps kids learn to recognize numbers and count
to 100
Don’t Spill the Beans: Ages 3-6
Get rid of all the beans you’ve got, but do it without
tipping over the pot
Great for teaching turn-taking 
Don’t Break the Ice: Ages 3-6
Tap out ice blocks one by one and don’t let the
polar bear sink
To win, the bear must stay on top
Jenga: Ages 6+
Pull out a block without crashing the stack to
win at Jenga
Win by being the last player to remove a block
without causing the stack to crash
Makes kids think and focus
Guess Who: Ages 6+
Logic-based board game
Try to deduce the identity of their opponent’s
mystery person
Ask the right questions to eliminate the wrong
faces
Connect 4: Ages 6+
Vertical game of tic-tac-toe, but with a twist –
you have to get four in a row
The first player to get four checkers lined up in
a row in any direction-horizontal, vertical, or diagonal-wins the game
Makes kids think hard
And this concludes my speech Therapy game review!
Have a great weekend!
Sanaz

language, transitions, Uncategorized, Uncategorized, visual aids, visual schedules

Trouble with Transitions

This summer, I have been blessed with the opportunity to
work as a camp leader at a camp for children with special needs. We are
officially in our first week of camp and I absolutely love it! I love that camp
gives me an opportunity to work with these kiddos in environments I typically
wouldn’t be able to in the school setting (i.e. an animal farm, the pool,
etc.). Now I will admit that the first day of camp was rough for some of our
campers. They only spend half a day at camp but this was a brand new
environment that many of the kiddos haven’t been in over a year or ever if it
was their first time at camp.
One thing that stood out throughout the day was giving these
kiddos the tools they needed during transitions. I know transition time can be
one of the roughest times for kids at home, school, and/or out in the
community. This topic is what inspired my post for today.
Sometimes kiddos just need to take a break and adjust to
their new surroundings. This may mean giving your kiddo a moment to just
breathe before helping them through the next transition. I know many a times we
just want to get them from point A to point B but sometimes just letting them
sit for 30 seconds without saying or doing anything can really help. Just say to
your child, “Do you want to take a break?” and then revisit the topic of
transitioning after a little while.
Another tip is that you can never give too many warnings
that a transition is approaching. This means giving the child plenty of notice
BEFORE a transition begins to happen.
One of my favorite timers is the “Time Timer” which visually
shows the child when the time is all up. You can set the timer for your desired
amount of time. The desired amount of time is depicted as red on the timer and
it will slowly start to disappear as the time winds down. When using a visual
timer, it is always a good idea to draws your kiddos attention to it every once
in a while to remind them that the time has elapsed. I know “Time Timer” now
also makes an iphone/ipod/ipad app which is great if you are out and about.
New Time Timer Plus. N.d.
Photograph. Time Timer Plus. 09 July 2013. Web. 09 July 2013.

Another way to help provide warning is with a visual
schedule. I find that some kiddos like to see their day or a therapy session
mapped out. Visual schedules can range from using pictures on Boardmaker, words,
or even just pictures found on the internet. With a visual schedule, place what
activity will be happening first on the top and then work your way downward.
The Time Teller. N.d.
Photograph. SchKIDules. 09 July 2013. Web. 09 July 2013.

First- then boards are also a great tool! This is a way for
your kiddo to see what needs to happen before they can continue onto the next
thing. For example, I used this with a kiddo to show that first they needed to
hang into their swimsuit then after they did that they could do into the
swimming pool. There are also some great apps on the ipad for first-then
schedules.
Click on this link to my Tpt store for the FREE download: First Then Board
Let’s not forget the tool that everyone always has with them
wherever they may be… words! Sometimes a kiddo just needs you to talk them
through what will be happening next. Now Speech Language Pathologists are known
for being chatty but sometimes less is more when talking kiddos through
transitions. Just simply remind them that after “A” is complete then it will be
time for “B”.
Transitions are definitely a rough time for many but with
practice and consistent use of these tools they will get easier. Hang in there
and stick with it! I promise it will pay off! Hope you are all having a great
week and thanks for checking out this post.
Fourth of July, language, pointing, Uncategorized, Uncategorized

Let’s Get to the Point(er)!

My little family and I had a nice getaway on 4th of July! We went to Monterey (in Cali) and enjoyed the beautiful scenery. As an SLP and a mom, I tend to use every event as a learning opportunity for my son. I can’t help it; it comes naturally!!! I feel like I’m always doing therapy on the poor dude 🙂 One of my favorite things to do with him is pointing. When we are out together I do a lot of pointing and naming. 

I was telling the little dude all about the water here 🙂
For example if he looks at his bottle and vocalizes something, I point to the bottle and I say “bottle” or “This is your bottle.” I try to model pointing for him by pointing to objects/people myself and I supply him with the word/words he is looking for. Most children will start pointing to objects on their own. You can help them learn to point by doing lots of modeling for them. Pointing is a big step to naming and language learning. Here is what research says about pointing:
1- Pointing is a specialized gesture for indicating an object, event or location. Children start using pointing gestures at around 11 months of age (Camaioni, Perucchini, Bellagamba, & Colonnesi, 2004)
2- Pointing accounts for the majority (60%) of gestures by twelve months
(Kita, 2003).

3- Pointing is a stepping stone to learning language (Goldin-Meadow, 2007)
4- Pointing gestures function as part of a shared intentionality even at early stages of development (Tomasello, Carpenter, & Liszkowski, 2007)
5- One of the best predictors of the size
of a child’s comprehension vocabulary at 42 months
is the number of different objects to which the child
pointed at 14 months. (Goldin-Meadow, 2007)
There is so much I have to say about pointing but I will keep this post brief. If you want to learn more about pointing, check out the references I provided here. If your child is not pointing by 15 months of age, check in with your pediatrician to make sure everything is okay. 
Sanaz

References:
Camaioni, Luigia, Paola Perucchini, Francesca Bellagamba, & Cristina Colonnesi (2004). The
role of declarative pointing in developing a theory of mind. Infancy, 5, 291–308. 
Goldin-Meadow (2007). Pointing Sets the Stage for Learning LanguageFand Creating Language. Child Development, 78, 741-745

Kita, S. (2003). Pointing: Where language, culture, and
cognition meet. Mahwah, NJ: Lawrence Erlbaum. 
Tomasello, M., Carpenter, M., & Liszkowski, U. (2007). A new look at infant pointing. Child Development, 78,
705 – 722.