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Cycles Information (click the title for the link)
This is the handout discussed on Laura Mize's Podcast regarding how to modify
Cycles for younger children, lower functioning children, and those with suspected
apraxia. This will not work with all children and will need to be modified BASED
ON THE INDIVIDUAL CHILD. This is just a framework and it is a ROUGH draft.
It will be updated as much as possible.
2) Cycles Literature--Efficacy and Information on Apraxia
c) Gierut, J.A. (1998). Treatment efficacy: Functional phonological disorders in
children. Journal of Speech, Language and Hearing Research, 41, S85-S100.
d) Tyler, Ann A., Edwards, Mary Louise, Saxman, John H.
Clinical Application of Two Phonologically Based Treatment Procedures
J Speech Hear Disord 1987 52: 393-409
1)a) Let's Hear It For /R/! ~ Main Outline--WEBINAR HANDOUT
h) Hierarchy for R-Drill-Download this for a simple road map of r-drill. Great to document
student progress and to show parents how you will progress through therapy. This can also
help you to explain WHY a student does not qualify for therapy (i.e., they are already at the
sentence/reading level etc.).
i) Norms ~ See Below in Norms Section
Artic Tips &Placements
Welcome to the newest section of this page ~ Articulation Tips! We all have certain ways to elicit sounds and sometimes there are kids we see that just do not respond to them. This section will deal specifically with tips on common articulation sounds gathered from message boards, Facebook, personal experiences, and anyone that wants to suggest a new way they were able to get a child to produce that difficult sound. If you have a picture, send that too as the visual makes it even better! The more we share, the better we all become!
Sound ~ /f/
This is Ann Kulichik teaching a four year old how to say /f/. She had him put the paper cup over his bottom lip and bite, then blow. It was the first time she got a real production out of him. She also put a cotton ball in the cup, and had him put the cup under his chin, while blowing down over the bottom lip. This makes the cotton ball jump up and hit you in the chin. He liked this very much! This was posted on Facebook in the group SLPeeps and reposted here with permission. Be sure to check out Ann's website at www.akspeech.com
Sound ~ /r/
No section on articulation would be complete without reference to /r/. Of course, there is an extensive section dedicated to /r/ above and you can watch the on-demand webinar any time to learn how to implement a structured program. Here are the two placements I use in therapy. If you have ever wondered what each of these placements look like, I have my daughter, Kyla, demonstrating each in the pictures below (she was in the webinar). I typically start with bunched as this is the most common position for most people. However, I will switch to retroflex if I don't see good progress with the bunched placement.
Tongue is pulled back and the tip disappears. The sides should be touching the upper side teeth (Kyla's are not touching in this picture, but it is a good start). The tongue is essentially smiling.
Bunched or Retracted Retroflex
Tongue tip is up and you should not be able to see it. The trick with this placement is that the sides of the tongue still have to touch the upper back teeth. The tip of the tongue should not touch the roof of the mouth. Middle of the mouth placement is crucial here as too far back yields a glottal and too far front yields an /l/ or an /l/ like sound associated with each /r/ if the tongue flips down too fast. Kyla's placement for this position is even better and I found out as we have gone through therapy that she is a retroflex /r/ kid.
Placement ideas for obtaining an approximation of /r/ instead of a /w/BUNCHED R
Here is a form that you can fill out or you can give to parents to help you gauge the inventory of a child with extensive errors.
Therapy Forms for Schools & Private
All of these forms are in Excel or Word and can be modified. You can add your school/business name in the header of each form and save them to your computer.
2) Where can I get materials to make my Category Cards?
I struggled with finding appropriate pictures to use in my category assessment and in
therapy. I finally found the solution in the Click and Create Vocabulary Board Games from
Linguisystems. I just called up the categories I wanted to add to the board (need 10 pictures
of each for your assessment) and fit as many on the board as I could. Then, I printed them out
in color, cut them out, and laminated them. They are not big, but you can glue and laminate
them on index cards if you want larger pictures. I have found the size to be perfect. I then do
the assessment by presenting one from the category I am testing and one distractor. I based
this assessment on what I saw on the First Categories which are already mastered
FREE Pictures Link: Kids Pages Flashcards (Thank you AmySLP!)
Asking questions is one of the biggest deficits in kids with autism. Download this to
find out how to improve this skill.
Have kids on your caseload that struggle with memory and processing? This is a great program for
teaching the auditory strategies we have all heard about but are not sure how to teach. Do you know
about "sub-vocalizing?" Neither did I until I got this book. It is a GREAT resource and I highly recommend
This is a necessary skill for children to develop good language manipulation skills. What
does that mean? Children need to be able to do many tasks with words and this skill teaches them
how to it as it encompasses attributes, categories, function, and location. It is hard when you first
begin, but you will hear the children come up with comparisons you hadn't even thought of!
Websites for FREE worksheets!
This is a great treatment model for language processing. Ever wonder WHY we work on labeling,
functions, associations, categories etc.? There is a reason! I sure wish we spent more time on this model
in graduate school in reference to treatment! It looks like you will have to ask to become a member of this WIKI to
view the document as it is not available to the general public anymore. I already author a few WIKI's myself, so all
I had to do was ask to join. If you are not part of a WIKI and have not registered on WIKI spaces, you may have to
do so to access this information. Even then, since the information was originally from Linguisystems, I am not sure
if it will be available on the WIKI once you gain access. I have found some additional PDF files on Bloom's
Taxonomy and have provided the link to that page below.
Social Skills (Pragmatics)
If you work in a school, you have children that have issues with social skills, some on the autism
spectrum, some not. This area can be difficult for many clinicians as most of the situations that arise
need to handled "in the moment" they happen and not in a contrived setting. However, children with
severe delays will need specialized instruction in social skills. I have recently come across a wonderful
site that I had to post on here. There is sooooo much information on this site that I have only just
skimmed it, but the information I have found so far is wonderful! I cannot wait to see what other
treasures it holds!
I will be adding to this list as I come across more resources. There are a LOT out there! Click on the
disorder to follow the link (the highlighting removed the blue color from the font indicating that it's a
Apraxia of Speech Information from ASHA regarding the lack of one clear diagnostic
indicator distinguishing apraxia from other disorders (phonology), that
WE are the professionals to diagnose this disorder, and references
to articles for treatment options that are based in evidence.
Autism ~ Information from the National Professional Development Center on Autism
Cycles ~ Cannot link many of these articles. You will have to look them up.
Gierut, J.A. (1998). Treatment efficacy: Functional phonological disorders
in children. Journal of Speech, Language and Hearing Research, 41, S85-S100.
Tyler, Ann A., Edwards, Mary Louise, Saxman, John H. Clinical Application of
Two Phonologically Based Treatment Procedures J Speech Hear
Disord 1987 52: 393-409
Baker, E., Carrigg, B., & Linich, A. (2007). What's the evidence for...? The cycles
approach to phonological intervention. Acquiring Knowledge in Speech,
Language, and Hearing, 9, 29–31.
Baker, E., & McLeod, S. (2010). Evidence-based practice for children with
sound disorders: Part I Narrative review. Language, Speech, and
Hearing Services in Schools (Papers in Press, published online Sept. 15, 2010).
Baker, E., & McLeod, S. (2010). Evidence-based practice for children with
speech sound disorders: Part 2 Application to clinical practice.
Language, Speech, and Hearing Services in Schools (Papers in Press, published
online Sept. 15, 2010).
Common Core + Speech = ????
So most of us have heard about Common Core, right? Now, the BIG question....How do I implement it into my therapy every day? The answer: YOU ALREADY DO! Common Core has really taken a large part of the language activities we have done for YEARS and put them into common state standards for everyone to follow. Now, when the teacher asks why you are taking little Johnny for speech when he speaks fine, you can graciously point out the LANGUAGE goals he is working on based on the Common Core. Now, I would love to sit down with the CC and pick out the areas that focus on my specialty, but who has time for that?
Thankfully,the wonderful people that call themselves Speech-Language Pathologists are the most generous individuals in education and many have already done it! Why reinvent the wheel when it was created so perfectly already (in reference to both the wheel AND the Common Core references below). These are links of some of the best CC adaptations I have found. I know there are others out there! I will be adding more and more as I come across them. If you have any you believe have to be added, please let me know.
The link above will take you to Teachers Pay Teachers and you can buy this list of goals for
$5.00 which is a great deal.
Workload v. Caseload
Are you feeling overworked? Should your job be split between you and another SLP (or 4)? Here are some tools to present your argument to administrators. Even if you live in a state with no caseload cap, these worksheets will give you an idea of how many hours of direct service, which unfortunately has become the least of our jobs, makes a full-time position by multiplying that number by 1.5 to factor in all the "other" things you have to do . They are links to other websites for Caseload Worksheets, Workload Calculations, and ASHA's Workload Activity Clusters.
The above site has the Speech Language Caseload Worksheet and Workload Calculation sheet you can download. There are a lot of other useful documents on this site. Many of them apply to North Carolina, but others apply to Speech Pathology in general. Be sure to check out the
PowerPoint on SLP's Role in Schools which you can use for an in-service for your teachers.
Great resources for pragmatic checklists, informal observation forms, teacher checklists, and too
much else to list!
How Much Speech Therapy to Give?
I know we have ALL struggled with this question at some point in our careers. What is the answer?
These guides can help!
The first is the list of severity scales from the NC Speech Guidelines combined into one Word
document for easy reference. They are great for showing parents and teachers why you chose the
service time you did and will mean more than you just "saying" it.
Severity Scales for All Areas
This is a link to Speech-Language Eligibility Criteria/Matrix for Schools which is a
"must-have" for all school clinicians!
For forms for teachers that will help them determine impact,
please scroll down to the next to last item on this page.
We make these a part of the referral and the teacher is required to fill out/sign before we screen the child.
Educational Impact is DIFFERENT than Academic Impact. When you think about
academic impact, the only concern is grades. Educational impact encompasses so much more!
This is where articulation delays/disorders will fall--social/emotional impact, self-esteem issues,
immature speech, teasing due to sound errors (especially in the upper grades). Here are some
guides to help you to determine the IMPACT and it must be done on a case-by-case basis!
From ASHA's Website
Read statements from the U.S. Department of Education and learn how students with
disabilities cannot be denied access to services even though they have no academic
On November 2, 2006 ASHA sent a letter to the U.S. Department of Education seeking clarification
on the following issues that impact school-based speech-language services:
- eligibility for speech-language services when the student is not failing a course or grade, and reaffirms the letter issued in May 1980 that clarified when a speech or language impairment "adversely affects educational performance"
- how to handle missed sessions due to the child's absence from school, cancellation for a class or school activity such as a field trip or an assembly, or absence of the SLP due to illness or family emergencies
- the continuum of service delivery options to be considered for a student
The document below used to be on ASHA's website and the link took you there, but ASHA likes to move documents around on their website on a monthly basis or delete them altogether. For this reason, I found a new location for this document. Please let me know if this link doesn't work.
This document discusses dismissal procedures. The main one to focus on is dismissal is required
where there is no measurable progress as this is a problem for many of us in the schools.
This document was posted by E. Beckner on ASHA's forum and I LOVE how it's worded, so I copied it
and pasted it into a Word document.
RtI Interventions (Pre-referral)
Here are some useful books and websites regarding interventions to share with your teachers. As RtI is becomingthe first step in the referral process, many SLP's need a good source to access interventions that can easily be shared with teachers. While we all know what needs to be done, conveying this information to another person without our training can be very difficult.
This is probably the most comprehensive intervention manual on the market and MANY schools have this book (usually the guidance counselor or someone on the support team). You can find older versions (Second Ed) on Amazon as well. The link will take you to Amazon.com, but they tend to change their links, so just do a search to find this book.
Great websites for interventions for each disorder area in Speech!!!! Some include
data sheets and handouts for teacher. This list will be extended as more sites are
There is a lot of discussion regarding Medicaid billing in the schools. One of the key points of debate is how to prove Medical Necessity when we are working to prove Educational Impact. I finally found a document from ASHA that highlights the Medically Necessary piece in a way that makes sense. This is what it says:
Why Speech-Language Pathology Services Meet the Definition of Medical
Speech-language pathology services are medically necessary to treat speech-language, swallowing, and cognitive-communication disorders. Many of these disorders have a neurological basis such as head injury, Parkinson’s disease, stroke, autism, and cerebral palsy. Determining medical necessity takes into consideration whether a service is essential and appropriate to the diagnosis and/or treatment of an illness, injury, or disease, which Stedman’s medical dictionary (2000) defines as an “interruption, cessation, or disorder of body function.” Impaired speech and language, loss of hearing, and swallowing difficulties all reflect a loss of body functions and, therefore, services to treat such impairments meet the definition of medical necessity.
Developmental conditions refer to specific impairments that differ from the
normal condition and also meet the definition of medical necessity.
Developmental conditions may be referred to as developmental disorders,
developmental disabilities, and developmental delays. Stedman’s medical
dictionary (2000) defines development as “the act or process of natural progression in
physical and psychological maturation from previous, lower, or embryonic stage to a
later, more complex, or adult stage.” Development is a natural state, but when paired with
disorder, disability, or delay, it indicates an abnormal state. A diagnosis of
developmental impairment in a child indicates an abnormal state of
function, and speech-language treatment services are as medically necessary
for this patient as they are for an adult who has suffered a stroke and lost
speech and language function.
Oral Motor Exam & Information
Need a form for an Oral Motor Exam? Not sure what to look for? This link will provide a
printable form that can be reproduced FREE!
Do you have a child or children on your caseload that are tongue-tied? Have you struggled with
their progress in therapy and the reluctance by their doctor to have it clipped? Here is some
interesting information on the pros of having it clipped and what can happen to that child in the
future if it is not.
These are not short by any means, but they do contain descriptions of some of the most widely
used tests and tables for reporting scores. There are two reports. One is for Speech Only Testing
and the other is for Related Service Testing. They are based on North Carolina guidelines and will
require modification to conform to your state regulations.
We all talk a lot about how intelligible a child is, but it really is a subjective measurement and there isn't a lot we can do to change that. However, you can look at this document and the chart on page 40 to help you with this understanding (and to explain it better to parents/teachers).
Scheduling--How to do it!
Here is a great way to schedule every year that allows you to see your whole schedule
at the same time.
Free Downloads from Linguisystems
Here is the LINK: Free Guide Downloads
You will have to join Linguilist (free) to download their guides.
LinguiSystems Guide to Counseling
LinguiSystems Guide to Communication Milestones
This is one of the more comprehensive guides I have found for milestones. I particularly like
the concepts, pronouns, pragmatics, morphology, and questions sections as it tells you when to
target these particular forms. I still recommend using the concepts sheet shared above because I believe the combination of both complement each other. The guide also has intelligibility
percentages per age and vocabulary milestones which are always good to share with parents.
LinguiSystems Guide to RTI
LinguiSystems Testing Guide
LinguiSystems Guide to Evidence-Based Practice
IPA Fonts on Your Computer
You have these characters on your computer already. This document will show you how to
Family Night Activities
Great family night or speech workshop activities for NON-Speechies!
Career Day ~ Talk about being an SLP!
Are you responsible for giving a talk for Career Day at a school or other
organization? You could create your own presentation, but I have found
PowerPoint presentations online available for professional use for FREE! The link
below will open as a PowerPoint that must be downloaded to your computer. It will
not open as a webpage. If you have trouble locating it, please look at the TXSHA
website or do a Google search.
Reward System and Quick Game Idea
I am not using the reward system as much since my school has banned candy, but my kids LOVE the game and I got the idea from my clinical supervisor 12 years ago!
Teacher In-Service Information--Handy tips to
explain to teachers about what we do!
Teacher Handout--Speech Information Every Teacher Should Know
Great PowerPoint presentation by Perry Flynn, the state consultant for speech in NC.
You can download and customize to your state and district. A huge time saver!
What can Teachers do to support language in the
Incredible list of norms from ASHA and the sound norm list I have used since
Neurological and developmental foundations of speech acquisition
Sharynne McLeod, PhD, Charles Sturt University, Australia (email@example.com)
Ken Bleile, PhD, University or Northern Iowa, USA (firstname.lastname@example.org)
Make sure you are reading the above chart correctly. Gregory Lof's information
referenced below will explain how to do this in detail. I found out I had been
interpreting it wrong for years! He is also a very vocal opponent against oral
Tongue Thrust Information
I struggled for years to get help for my daughter's tongue thrust that I diagnosed at 2 years of age.
Her teeth are a mess at 7 and I finally found an orthodontist that believes in and treats the
condition prior to braces so I don't waste my money on dental correction only to have it undone
by the tongue thrust (like my sister). Tongue thrust tends to run in families. Here is a link to
information I share with parents. I typically copy and paste the information into a WORD
document and then print it out and go through and highlight some of the important aspects and
review it in the meeting, especially for those children I am dismissing that could not correct their
lisps due to the tongue thrust or as justification as to why I am not placing the child for therapy. It
usually helps explain it better than I can and parents react differently to material in print then they
do when I just 'say it'.
The swallow test is based on what I have found in my research plus my own unscientific research
with my own family and neighbors with the condition.
Mouth Breathing--Adenoid Facies
Many people do not realize the impact mouth breathing has on the face of a child whose bone
structure is still developing. For many kids, their face will morph into a crescent moon profile or
"long-face" shape. I have personally witnessed this in a set of twins. One a mouth breather, one
not. The difference in their face shape was shocking and happened so slowly over the years that it
went unnoticed. If you suspect mouth breathing, refer the child to the nurse to refer to the ENT.
If you don't have a process in place for this in your school, consider being the one to advocate for
it. The links below can explain this better and will help you to understand what this condition can
do to a child's face. It is called Adenoid Facies.
Missed Sessions--What are the rules?
We are NOT required to make them up! Know the law! However, your district can make you meet the
minimum you have documented on the IEP. Be sure to account for these sessions by making realistic
statements on service time. If you are to see a child once a week and have nine weeks in a reporting
period, you can write 7x/per reporting period and multiply by 7 for each additional session during
the reporting period. Be sure to have this discussion with your Director to protect both you the
district. Missed Sessions Link
Teacher Checklists--For Determining Impact
Pragmatic Checklist for Teachers
(Sources: Speech Guidelines for North Carolina, Tennessee, Virginia)
My Top 10 Must Have Speech Materials/Tests
I was asked to make this for Speaking of Speech and thought it would be better if I posted it here.
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