Speech therapy at home

 I thought I would write another post describing a speech therapy session.  This session’s activity specifically focuses on the use of bubbles during therapy.  If you look under my speech therapy toys page…you will see that bubbles are on that list….little ones love bubbles….and bubbles are a great activity to encourage spontaneous language….encourage social play…..and it really is a motivating activity.  Even the little ones that are sometimes extra shy…hard to motivate….and have difficulty in attending….I am sure to use bubbles during play. 

Below is a typical therapy session…I specifically describe the words I would use and how I would play with a little one to encourage language development….both receptive language (understanding of language) and expressive language (use of language).

 Set up:  I usually keep my bubbles in a Ziploc bag…and then place the sealed bag in front of the child….and I do not say anything…why?…I am looking to see if the child will use any form of language (verbal or non-verbal) to make her needs known.  Sometimes the little ones will say…bubbles….sometimes they will say….open…..and some of the little ones that do not have verbal language…they will hand the Ziploc bag to me and non-verbally indicate that they want to blow bubbles. 

THERAPIST: (now the session) Once this happens…the little one tells me either verbally or non-verbally that she wants to blow bubbles….I am sure to use the parallel talk strategy (filed under the teach me to talk page)….and I say: Open Bag.  The reason I say: Open Bag….even though she did not say open bag….is because she non-verbally is telling me that she wants me to open the bag.  The parallel talk strategy requires that the therapist say the words that the child can not…and tie those words with action.  So….saying the words: Open bag…as I am opening the bag will help your little one to not only understand language…but also to eventually use her own words to say: Open bag.  

The parallel talk strategy bombards the child with simple words without placing any language demands upon her. Once the bag is open…next I would say: Bubbles out….as I am taking the bubbles out of the bag.  Remember when you tie words with action….you are helping your little one to understand language.  The more she hears simple sentences tied with action…the easier it will be for her to eventually understand language.  I tell parents if you were just saying the words: Bubbles out……and you do not have the bubbles in the Ziploc bag in front of you….so they are in her visual field….so she can actually see the bubbles…she may not have any idea as to what you are sayingHowever…..if you are taking the bubbles out of the bag….as you are saying: Bubbles out….and she sees you doing this….you are improving her understanding of language.  This is because you are also tapping into the visual area of her brain…as well as the language area.

 
EXTRA TIP…..I have talked about music before….but will bring it up again….music stimulates language development.  Why??? because music is on the right side of the brain…and language is on the left….so when you tap into the right and left side at the same time…you are helping to stimulate language development.  Now, you DO NOT have to sing well…you do not even have to be able to carry a tune….just put some melody to what you are saying….a sing-song voice while you say: Bubbles out. After you have the bubbles out of the bag….use the self talk strategy (you can find this on the teach me to talk page)…..basically you will be describing what you are doing with simple words…so as you are opening the bubbles….say: Bubbles open…..then when you take the wand out….say: Wand out

What is great about this strategy is that you are not placing any language demands on your little one….however you are bombarding her with language…using simple phrases….tieing action and words together and using music.  All of these strategies will help your little one to become a better communicator.

On a side note…what I love about the self talk strategy is that you can use this strategy in ANYTHING you are doing….bathing….cooking….setting the table…folding laundry…on the slide….at the beach.  Wherever you are….you can use simple phrases…tieing action and words together…incorporating music to help your little one communicate better and to understand language better.

 

Okay….so now back to the session…..you are ready to blow the bubbles….take the wand out….get ready to blow the bubble…and everytime you are ready to blow a bubble….use this carrier phrase (find out more about carrier phrases under the word finding page)..so here is the carrier phrase: “Ready…..set….________.”  Okay so initially she is not going to say GO….so you will fill in the blank and say: “Ready, set, go.”…..however…..after you have blown the bubbles a few times and used this phrase…..you will then use the same phrase…but omit the word GO…..to see if your little one will fill in the blank and say the word GO

If she is struggling to make the G sound…I have the strategies filed under the articulation page…but to make it easier I will include them here as well and then get back to the therapy session.  So below you will find strategies to elicit the G sound….I included the K sound also….read below to find out why. The G sound is a stop sound that is made in the back of your throat.  It is a voiced sound…motor on…which means that your vocal folds move or vibrate.  When you make the G sound your tongue retracts to the back of your throat and touches your soft palate(where is your soft palate?…..you know the little thing that hangs in the back of your throat…that’s your uvula..and your uvula is attached to your soft palate). Often times when children have difficulty with the  G sound they also have difficulty with the K sound.  Why??  Because both K and G are stop sounds that are both produced in the back of the throat with the retraction of the tongue to the soft palate .  So the K and G sounds are both velar sounds (velar or velum is another word for soft palate) that stop. 

So…what is the difference between the two…when you make the G sound your vocal folds move…when you make the K sound they do not move.  So the K sound is a motor off sound and the G sound is the motor on sound.   

Can’t say the K or G sound: Typically when children can’t produce the K  sound they will substitute the T sound.  When they can not produce the G sound they will typically say the D sound.  Now I find this particularly cool…because D is a voiced sound just like G and T is the unvoiced sound just like K.  How amazing is it that when children substitute a sound for another…they typically replace it with a sound that is similar with regard to voiced and unvoiced.  Also amazing to me is that most kids that can’t make the K sound…substitute it with the T sound…and typically most kids substitute the D sound for G.    

 

 

HOW TO TEACH THE G SOUND:

Physical Cue/Visual Cue: I’m trying to find a good visual picture to describe this physical action….but have not found one yet.  So I am going to do my best to describe how to use the physical cue.  First….pretend you are doing the hand movement for a choo-choo train (but do not call it the choo-choo sound because you may confuse her and make her think that you are working on the production of the CH sound).  Okay….so back to the position of your arm and fist……remember the hand movement for choo-choo train: You know with your fist in the air….and then you move your arm up and down.  Well…keep the same position with your arm and fist…however….move your elbow back and down behind your body.  I apologize if this description does not make sense…I will work on getting a picture included.  Anyway…the goal of this cue is to show that your tongue is going back in your mouth…to the back of your throat….just like your arm is going back and down.  You will use this cue while saying the G sound. 

Tactile Cue: Since G is a vibrating sound you can have your little one feel the vibration on the back of your throat.  This cue will let her know that when you make the G sound your motor is on.  You can use the physical cue above (and have her do the physical cue as well) while she is feeling the vibration on the back of your throat.

Get your mouth ready: Okay….so you have shown her the physical cue…and she felt the vibration…but now what…how do you get your little one to get her mouth in the correct position.  Especially if she is making the D sound for G….because when she makes the D sound instead……her tongue has not been retracting to the soft palate…instead it has been moving forward to the bumpy spot (the alveolar ridge) that is right behind the teeth.  So what can you do…. 1. Tell her to open her mouth wide 2. Tell her to say ahhhhhhhhh 3. Then practice the G sound  

 

Tip: If she is really struggling to get her tongue in the correct position…lie down on the floor….on your back and practice saying ahhhhhh…..and then try making the G sound.  Why?  Because in this position your tongue naturally moves to the back of the throat….and this may make it a bit easier.  You even can use the physical cue…a little awkward due to position…but it can be done. Once she is able to make the sound in isolation…the G sound all by itself… practice in syllables such as: Ga, ga,ga Ge, ge, ge Gi, gi, gi Go, go, go Gu, gu, gu Then in  single words, then short phrases, longer sentences and in conversation.  Click on this link for “G IN INITIAL POSITION WORKSHEET”. 

Remember to follow the articulation process…after the sound is mastered…and remember to practice the sound first in different syllables…..then practice the sound in a single word in isolation(that means just say the single words like: GATE….then the word in a short sentence…then a longer sentence….then in conversation.  INITIALGWORDS  

 

 

HOW TO TEACH THE K SOUND:

Now let’s work on K…..because K and G are both similar sounds….they are both made in the back of the throat and are called velar sounds….however…when you make G…your vocal folds move and when you make K…your vocal folds do not move.  K sound in the initial position   Since the K and G sound are both the same with regard to placement (velar sound/soft palate sound)……and they are both stop sounds……you can use the same strategies for K as you are using for G.  THE ONLY DIFFERENCE IS THIS: YOU WILL NOT HAVE YOUR LITTLE ONE FEEL THE BACK OF YOUR THROAT TO FEEL THE VIBRATION.   WHY?  BECAUSE K IS A MOTOR OFF SOUND.  YOUR VOCAL FOLDS ARE NOT MOVING.   K IS A MOTOR OFF SOUND.  K IN THE INITIAL POSITION WORKSHEET: INITIALKWORDS    

Hope the strategies above are helpful…..now back to the session.

 

SHE CAN’T BLOW A BUBBLE ON HER OWN…WHAT SHOULD I DO: If your little one can not blow a bubble on her own…an easy trick and a good starting point to help her to learn is for you to blow the bubble….catch it on the wand and ask your little one to blow it off.  If she still has trouble model it for her so she understands what you want her to do…if she is still having trouble….ask her to: “make a kiss with your lips, then blow.”  Kids are so excited once they realize they can blow the bubbles on their own.  

Now……to prompt your little one to say the word: more during the session….stop blowing bubbles….place the wand and bubbles in front of you…but do not blow any bubbles…..see if she says anything….can she say bubble…or more….or go?  Can she use any word form or sound to indicate that she wants you to continue the bubble activity….because right now you should be sitting there….with-holding the desired activity….to see is she is able to say something to let you know that she wants more.

If you know she can make the M sound….you can prompt her to say the word MORE….to indicate that she wants more bubbles…..how can you do this…..use the M strategies under the articulation page to prompt the M sound….I will add them now…so it makes it easier for you.  The strategy below is very helpful in eliciting the  M sound.  Once you can get her to make the M sound…try and elicit the word MORE.

 

 

HOW TO TEACH THE M SOUND:

M also is a bilabial sound-which means that your two lips come together.  M also is one of the three nasal sounds (which means that the air escapes out of your nose not out of your mouth).  M is one of the earliest sounds that children will acquire…..I guess that’s why we are called “mommy or mom or mama”-it’s easy to say! 

Tactile Cue: To help elicit this sound you can have your child feel the vibration M makes on your lips.  Have your child place her hands on your lips….and ask her if she feels the vibration M makes.  Next you can help her obtain lip closure (two lips together) by using your thumb and pointer finger to close her upper and lower lip.  Once she has her lips in the right placement,  take her hand again and place it on your lips,  you make the M sound…..and stretch the sound out….meaning make it continue…..next see if she can make it also.  Giving her the tactile cue (feeling the sound), helping her with placement of her lips by using your thumb and pointer and modeling (saying) the sound for her will help her to say the M sound.  Next be sure to try in syllables such as:  mama, mimi, meme, momo, mumu.  Then try in easy words such as: me, my, moo (cow sound).  Next in short phrases: Mom is nice.  Moo says a cow.  Remember to try and put the target word first….this makes it less challenging while your little one is mastering the sound.  Finally, into longer sentences. 

 

Visual Cue/Physical Cue: One last tip……to show her that M is a sound that continues like S….show her this: with your hands palm down on your lap…..move your hands down your thighs until you reach your knees.  As you are doing this….produce the M sound.  This visual cue shows her that M is a sound that continues.   Click on this link for M worksheet…these are M words in the initial position. INITIALMWORDS  

 

Remember to follow the articulation process as indicated below: Remember to practice sounds using the order of articulation: 1. Target sound in syllables: Ma, ma, ma, me, me, me, mi, mi, mi (I usually practice the target sound followed by a vowel…working through all of the vowels). 2. Target sound in single words 3. Target sound in words….. in short sentences: Milk is good. 4. Target sound in words….. in longer sentences: Milk is white and I like milk. 5. Target sound in words in conversation.    

Back to the session…..be sure during play to describe what you are doing….using the self talk strategy to describe what is happening during play….so if the bubble is going up say: bubble up.  If the bubble popped say: bubble pop.  If the bubble landed on your head say: bubble on head.  Bubbles are a great way to work on body parts….as they pop on your head…feet….hands…..arms….and then clothing items….shoes…pants…shirt.

Work on turn taking…..and elicit words such as: Me…..if she wants a turn….see if you can prompt her to say Me….use the M strategy above to help her say the word ME.  If she can’t say the word me…..teach her to take her own hand and with her hand open….she should tap her shirt to indicate ME….this is a non-verbal means of communication…..once she is able to tell you non-verbally that she wants a turn….add the language…add the word ME and see if you can prompt her to say ME on her own. 

If you are working on eye-contact…..be sure to hold the wand up to your eyes when presenting the wand…….this way she is looking at the bubble wand because you know that she wants it….and it also is encouraging her to make eye contact with you….without placing too many demands on her.

Most importantly during play….use the self talk and parallel talk strategies to describe what you are doing and what she is doing during play.   I also make silly sounds while the bubbles are in the air.  Weeeeeeeee……wow…….weeeeeeee….up…up….up…..ah-oh!  Pop…pop…pop.  See if your little one makes any verbal attempt to imitate the sounds you are making.  Again…you are not placing any language demands upon her….however…you are stimulating her with sounds and words…..remember to incorporate melody into what you are saying. This activity is great to work  on the early developing sounds: M, B, P….K and G are a little more challenging. Work on saying the word Bubble and the word Pop……use the B and P strategy to elicit those sounds as well….I will post them below too:

 

 

HOW TO TEACH THE P SOUND:

The P sound is considered to be a bilabial sound.  This means that you are using your lips together to make this sound.  It is an unvoiced sound, which means that your vocal folds do not vibrate/move when you make this sound. 

Visual Cue/Physical Cue: To help your child produce this bilabial sound it is good to give her a visual cue/physical.  Which means that you are showing her what the sound “looks like” or the type of sound it is.  By this I mean……I like to teach children to understand the difference between a short sound that stops (like the P sound), a long sound that continues (like the S sound) or a vibrating sound/motor on sound (like the G sound).  When working on the P sound I use a specific physical cue to help the child “see” and “feel” what the sound is like…….the cue I often use during therapy works just like this (and remember your child’s speech and language pathologist may have one that works better for your child and elicits the sound more effectively).  Use the cue that works best for you and your child.  Okay, now back to the cue:  Make a fist with your hand and then open up your fingers as fast as you can.  While doing this action, produce the P sound.  Have your child watch you and then help her to do the same with her hand. 

Tactile Cue: You can also have your child feel the puff of air that comes out of your mouth when you make the sound.  That gives her a tactile cue….she feels the air on her hand.  I find in therapy that the more cues that I give a child, the easier it will be for her to make the sound. 

Verbal Cue:  Be sure to give her a verbal cue-this means that you are modeling the sound for her so that she can hear the correct pronunciation of the sound.  You can produce the sound in different vowel combinations.  Once she is able to make the sound, try it with different vowel combinations such as the following: Pa, pa, pa.  Pe, pe, pe. Po, po, po and Pi, Pi Pi.  Melodic cue: When saying the sounds be sure to put a little bit of melody to what you are saying….music is on the right side of the brain and language is on the left.  When we tap into the right and left side at the same time…it makes it easier for your child to say the sound.  I often give parents the bologna example.  If you can’t remember how to spell bologna don’t you sing the bologna song????  B O L O G N A.

Fun tip for P: Hold a tissue in front of your child’s mouth….about an inch and a half away….ask her make the P sound……when she makes the P sound…..she should be able to see that her puff of air made the tissue move.  I also do this with small colorful scarves.  WORKSHEET FOR INITIAL P WORDS: INITIALPWORDS   Remember to practice sounds using the order of articulation: 1. Target sound in syllables: Pa, pa, pa, pe, pe, pe, pi, pi, pi (I usually practice the target sound followed by a vowel…working through all of the vowels). 2. Target sound in single words 3. Target sound in words….. in short sentences: Pig is pink 4. Target sound in words….. in longer sentences: Pigs like to play in the mud. 5. Target sound in words in conversation.      

 

HOW TO TEACH THE B SOUND:

 The B sound is also considered to be a bilabial sound-this means that your two lips work together in order to make this sound-they are making closure (lips together).  The only difference between the B sound and the P sound is that when you make the B sound your vocal folds vibrate.  Sometimes I tell the children that their “motor is on” when they make this sound.

Visual Cue/Physical Cue and Tactile Cue: Make a fist with your hand and gently bang on a table or on your thigh while producing the B sound.   You should ask your little one to do the same.  This cue is showing your child that the B sound is a sound that stops.  The S sound is a sound that continues during production, however, the B sound stops.  So be sure to demonstrate to your little one……by gently banging you fist on a table or your thigh.  While you bang your fist on the table place your other hand on your throat so that you can feel the vibration of your vocal folds.  Now when practicing with your child-you can do the movement with your hand making the fist and have her do the same with her fist…..and while you are both doing this….have her take her own hand and feel the vibration on your throat.  Be sure to explain to her that “your motor is on”.  By saying “motor on” you are telling her that her vocal folds are moving/vibrating.  The B sound is a stop sound…..and a motor on sound.  By using the physical cue (fist banging on table) and tactile cue (feeling vibration of the vocal folds) you are telling her two things: showing her that the B sound is a sound that stops and does not continue like the S sound and that when making the B sound your vocal folds move.

Verbal Cue: Be sure to always model the production of the target sound.  Remember this means that you are demonstrating how the B sound should sound like when produced correctly.  When she is ready….have her practice the B sound followed by vowels, then in simple words, next short phrases and then in longer sentences.

Melodic cue: Remember to use melody as a cue when producing target words.  It is easiest when the word has more than one syllable.  Words like: baby, baker, butter, and birdie.  Be sure to change your pitch and inflection…..that will help her to say the word.   

CLICK ON THIS LINK FOR INITIAL B WORDS WORKSHEET: INITIALBWORDS SAY THEM IN ISOLATION (JUST THE WORD-NOT IN A SENTENCE) SAY THEM IN A SHORT PHRASE SAY THEM IN A SENTENCE SAY THEM IN A LONGER SENTENCE TRY IN REGULAR CONVERSATION  

Clean up time definitely is a time to elicit words like: bye-bye…all done…bye-bye bubbles…bubbles in bag.  Have your child help you with clean up…and remember to tie your action and words together as you are putting the wand inside the bubbles….as you close the bubbles…and as you put the bubbles in the Ziploc bag.

Most importantly….have fun with your little one or big one!

Kim  

 

 

 

 

 

 

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About Kim

My name is Kim Marino and I have been practicing as a licensed speech and language pathologist since 1993. I work on Long Island providing diagnostic evaluations and services to children from birth to age 21. My experience is vast and am proud to say that I work with children that may present with articulation and phonological concerns, oral motor feeding concerns, Down Syndrome feeding, cognitive rehabilitation, auditory processing delays, receptive language delays, cleft palate feeding and sound development and expressive language delays. Most importantly, I am the mother of four amazing children and am happily married to my childhood sweetheart. I feel blessed to have my four children and so lucky to share this journey in life with my husband. I always had it somewhere in my head that I wanted to develop a blog or a website of some sort so that I could provide families with an additional resource....so that parents could help their little ones become a better communicator. And as I was developing this blog....I realized that I also needed to share the stories about my life and my children....and the funny things along the way that help to keep me smiling. Whether you are a working mother or not...finding balance between home, children and life can be a challenge....I hope that my blog helps to bring a smile to your face..and also some tools to help you help your little or big one. I hope you enjoy! Kim
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3 Responses to Speech therapy at home

  1. Virginia says:

    up early with Anna and thankful to have all of this great info to read! thanks Kim

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