Expressions Speech

Let's Hear It For /R/! Webinar

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Cycles  Information (click the title for the link)

 

    1)  Cycles For Phonology--Barbara Hodson's Program

                a)  Cycles for Phonology--Main Outline  

  Sample Cycles Sessions for 4 Complete Cycles!

                 Cycles Guidelines and Organizational Chart:  
                 This brand new version is set up in chart format and helps you design your Cycle by
                  asking you YES/NO questions about the primary patterns you need to target.  There
                 are also lists of target words to use for each pattern!  This is a MUST have for those
                 new to Cycles. You can find it on Teachers Pay Teachers:  


 
 
                 Cycles Tracking Sheet:  This sheet is for your working file.  It will keep track of your
                 sounds, each date you have targeted them, the auditory bombardment file number,
                 and any additional notes you need to keep regarding structure or cueing.  
 


                    bPictures I have complied for HAPP-3

                    c)   Pictures I have compiled for HAPP-3 SCREENING

                    d)  Cycles Data--Actual data/progress from my therapy cases that used Cycles

                    e)  Corbin's Cycles Data--Data recorded during actual therapy sessions

                    f)  Pictures I have compiled for APP-R

                g) Phonological Norms:  Caroline Bowen's Phonological Chart Link 

                    h)  Parent Friendly Explanation of Cycles

                  i) How I finally ORGANIZED my Cycles Cards! ~ Using a shoe organizer from Walmart!

                    j)  Labels for Cycles Card Organizer ~ Use these ready made name tag labels as seen in the picture above.
                              Sheet 1
                                        Sheet 2
                                        Sheet 3

                   kParent Resources--Summer program,  Home program,  and Treatment plan                     
                         1)  Home Program
                                 2)  Summer Program                     
                                 3)  Treatment Plan

 

Cycles Goals:  These goals are written for BOTH Cycles and Traditional Articulation so you don't have to hold a meeting to change the goals if the child has to move to traditional articulation drill. 

                                  Goals For Cycles

 

 

Cycles Modifications 

This program has been updated and is a COMPLETE program available on Teachers Pay Teachers.  It is a chart of step-by-step instructions on how to implement this MODIFIED approach complete with a Tracking Sheet and 1, 2, 3-Syllable Drill Sheets.  This will teach you HOW to use a modified version of Cycles.

 https://www.teacherspayteachers.com/Product/Modified-Cycles-Packet-2268245

                    
These modifications can be used with

  • Young children
  • Children with apraxia in need of early consonant drill
  • Lower functioning children in schools with various disorders and syndromes.  Very useful in children with Autism that are babbling and verbal, but not using true speech. Down’s syndrome too!
  • Children with profound phonological delays who are not ready for true Cycles…yet!          

  2)  Cycles Literature--Efficacy and Information on Apraxia

                    a)   ASHA Position Statement on Apraxia--A MUST READ!

                    b)  LinguiSystems Link-Apraxia--Great resource!

                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

    e) ASHA's Practice Portals have a lot of great information which I often forget about.
                       Here is the one for Apraxia!


 

 
Articulation Information

     1)  Let's Hear It For /R/!  (Formerly A Method For Correcting /R/)

                   a)  Let's Hear It For /R/! ~ Main Outline--WEBINAR HANDOUT

                  Let's Hear It For R! Hierarchy:  Download this from on Teachers Pay Teachers for
                   step-by-step organization for each of your kids.  Use it for the following:

      • To keep track of your students' progress
      • To keep yourself on track with the program and the steps
      • To show parents their child's progress and progression through the program
      • To show parent WHY their child does not qualify for services (i.e., Because they are already at sentence level, etc.).

                   https://www.teacherspayteachers.com/Product/Lets-Hear-It-For-R-Hierarchy-2257696

               b)  Nonsense Words  

                c)  Animated Articulation Website--Great way to show your kids lateral views of all sounds!

               d)   R-Carryover Competition Idea by Pam Wiggins, SLPA

                     e)  Articulation Stories--Great stories for r, s, l, th, sh, ch!

                f)  Norms ~ See Below in Norms Section

    /R/ WEBINAR--Learn how to correct /r/ with a structured approach!          
                   This is the "Let's Hear It For /R/!" outline explained in
                      detail with video and audio files.  Learn more here.                             
 
 
 
   /R/ Workshops--LIVE three-hour workshops via webcam are
                           available
over the Internet! 
                               Email for more information or
click here.

 

 Artic Tips &Placements

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!  

Download 

2015 Articulation Techniques and Tips--Elicitation techniques for common articulation errors

 

Sound ~ /f/

Ann Kulichik taught a four year old how to say /f/ by having him put a cotton ball in paper cup and then had him put the 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!   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.    

Bunched

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

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
  1. Have the child look in the mirror to see where their tongue is when they try "ray‟. Tell them to smile! Use a flashlight.
  2. Look at your tongue and see how you make /r/. If you use the bunched, let them see your tongue and where it is in your mouth.
  3. Tell them their tongue is going to smile inside their mouth.
  4. Have them speak with only their tongue in the back of their mouth—this is really funny and you can have them say “My name is ______” while only moving their tongue. It‟s hard, but important to show them they are only going to use theirtongue to make /r/, not their lips.
  5. Have them try to bite (gently) both sides of their tongue at the same time. This shows them how their tongue needs to be wide across the mouth.
  6. Explain the tongue will be in the middle of the mouth (meaning both vertically and horizontally).
  7. Use a flashlight (mini maglites work great here) so they can see the back of their tongue. They can have great placement in the middle of their mouth, but if the back of their tongue drops when they try to produce /r/, they will only see it with the flashlight.
  8. Have another student in the group that has the correct placement teach the other kids. It works wonders sometimes when you are not having any luck!
  9. NEWEST:  A parent gave me this one during therapy ~ Make your teeth brushing face!  And then we added kind of like a Pirate growl or mean voice into it to keep the lips apart.  It really worked!

 RETROFLEX R

  1. Have the child point the tip of the tongue up to the roof of the mouth.
  2. The sides still need to be touching the upper back teeth as the tension in the tongue, not the type of /r/ placement you are using, is what makes /r/.
  3. If you are not getting a decent /r/ (that is not a /w/) you need to either have the child move the tongue more to the middle or more to the back of the mouth. Be careful: Too far back will yield a glottal and too far front will yield an /l/.
 
 
 
  Tongue Tie ~ Updated 2015
 

        My experience in Early Intervention and private practice over the last three years has led me to realize tongue
           tie is more of an issue than I ever expected and it is largely ignored.  The number of children I have seen with
           suspected tongue tie continues to amaze me on a daily basis.  The number of children referred for feeding
           difficulty is on the rise and I have to ask myself "Is it because tongue tie is no longer corrected?"  The answer is              most likely YES!  

           Below you will find a website that will start you on the journey to understanding tongue tie, lip ties, and the                    struggles those affected face on a day to day basis.  The handout is one that I share and discuss in my                              workshops and the collective sigh of the SLPs is almost audible because someone FINALLY said:

  "Yes, tongue tie CAN impact speech!"  

 To hear a BEFORE and AFTER surgery audio,
click to go to the Tongue Tie Page
  

           Up until that point, so many SLPs have struggled with children not making progress and wondered why they                (both the child and themselves) could not correct their errors.  It seemed the usual bag of tricks did not work                  for these kids.  This leads to serious self-esteem issues for both the child and the SLP! Have you ever had a                      child like that?  If you have practiced long enough, I bet you have!  Most of the time, this part of my workshop                ends up being the most anticipated and favorite portion of the entire day!  

           So, what is our role?  I have been told that we cannot technically diagnose tongue tie, but we can suspect and                refer to the appropriate medical doctor.  I will warn you that not all doctors are equal when it comes to                              correcting tongue tie.  Click here to go the Tongue Tie page with a list of preferred doctors/dentists.

           If you want to know more, please consider joining the Facebook Groups listed below.  Learn about the signs                  and symptoms of uncorrected tongue tie listed below.  Realize the evidence base in this area is so limited, but                that does not mean we cannot help children and that the condition should be ignored.  The anecdotal                              evidence provided by the leaders in the field (dentists and a few ENT's) is also part of the evidence base and                    is overwhelmingly positive!

           As SLP's, it's time we realize having a MAJOR articulator anchored to the bottom of the mouth is NOT good                  for so many reasons.  Will everyone that is tied have speech issues?  No!  However, they will ALL have oral                    swallowing difficulty that will lead to so many other problems.  As a trained orofacial myologist, I have seen
           this issue in a lot of my clients and I am saddened to know they could have been prevented!

          Tongue Tie Questionnaire ~ Use this for a detailed parent history based on symptoms
                                                               from infancy and beyond.

         Presentation Handouts April 2016--NCSHLA

Facebook Groups

              Tongue Tie Babies Support Group: https://www.facebook.com/groups/tonguetiebabies/

              Speech Therapy & Tongue Tie:  https://www.facebook.com/groups/speechtherapyandtonguetie/

Coalition of Speech-Language Pathologists for Tethered Oral Tissues: https://www.facebook.com/groups/500245043460710/ 

               Tongue Tied Adults Support Group:  https://www.facebook.com/groups/1494393564165999/?fref=nf

               Website by Australian SLP Carmen Fernando:  Tongue Tie--From Confusion to Clarity

         Symptoms Lists

          Fact Sheet Tongue Tie Kotlow

             Tongue Tie Symptoms

            Websites

          Dr. Ghaheri:  http://www.drghaheri.com/ 

         Handout with Pictures from Workshops (with info from Dr. Ghaheri)

             Tongue Tie--Handout
 
          ASHA Article
 
 


 

Phonetic Inventory

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. 

      Phonetic Inventory in Excel

 



Therapy Forms for Schools & Private

Practice

 
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.

      1)  Blank Schedule--Excel

      2)  Blank Roster--Excel

      3)  Therapy Log with one data box--For Language Therapy

      4)  Therapy Log with data boxes--For Artic/Phono Therapy

 



Language Documents

 

   Concepts

          1)  Basic Concepts List--Broken Down by Age & Type

                  a)  Concepts Data Sheet--Keep your data on here!

                        b)  Concepts sheets instructions--How to use the Concepts Data Sheet and Target Concepts

                        c)  Hallan's Concepts Data--Example of Actual Therapy Data

                        d)  Large-Small Concepts Sheet

                        e)  Long-Short Concepts

     Categories        

          1)  Category Levels--PK-1st grade (I made this list myself)

                    a)  Category Levels--Level 1--Here is a spreadsheet to help with pre/post assessment

                          b)  Category Levels--Level 2--Here is a spreadsheet to help with pre/post assessment

                          c)   Category Data Sheet

                          d)  Catgories--Learn how to assess and use the Category Data Sheet

                          e)  Hallan Categories Data--Example of Therapy Data

             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
                            (usually 80%). 

                     FREE Pictures Link:  Kids Pages Flashcards  (Thank you AmySLP!)

                           Lesson Pix ~ Make Boards or Cards Instantly for $36 Year!  


   Autism--Asking Questions

           Asking questions is one of the biggest deficits in kids with autism.  Download this to
           find out how to improve this skill.

                   Teaching Kids HOW to ask questions

 

     Auditory Processing

            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
             it!

                     Auditory Processing

 

     Compare/Contrast

            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!

               Compare and Contrast

 
   Worksheets Online

             Websites for FREE worksheets!

                  English For Everyone    

      
    Bloom's Taxonomy

             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.

                   Language Processing Treatment Model--Bloom's Taxonomy

                   More PDF's on Bloom's Taxonomy

   

   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!

                     Jill Kuzma ~ SLP Social & Emotional Skill Sharing Site

 




Goals

             I took a class last year on Policies & Procedures in Special Education as part of my continuing
               education.  I thought it would be good for me to learn more about the law that governs what I do. 
               I have to admit, I foolishly thought I already knew what I needed to know in order to get a good
               grade.  While reading the text, I spotted one of my typical articulation goals:  Mary will produce /r/
               with 80% accuracy in words, phrases, sentences, and conversation.  I was pretty geeked to see my
               goal in this text UNTIL I read the title of the chapter:  The Wrong Way IEP's!  So much for my smug
               attitude.  I learned a great deal from this class and one of the greatest things was to make my present
               level of performance detailed and my goals individualized.  This is fairly easy with
               articulation/phonology.  The struggle I had was with language.  The goals in the link below are based
               on using the concepts and category information above (pre/post assessments) and drill and practice
               on these items.  Our biggest problem with language is that we make our goals too vague.  We need to
               be specific if we want to make them measurable and to show progress.  It's hard to do this at first, but
               when you can actually start crossing things off of an IEP because the child mastered them, you will
               always want to write your goals this way.  The days of writing the same goal over and over again
               each year need to be done.  These are just examples.  You will need to adopt your own style....just
               make sure it is individualized and specific to that particular child.  If you ever have to go to due
               process over your goals, I can tell you a judge will not like goals that are the same year after year.  I
               was guilty of writing my goals that way for a long time.  Learn from my mistakes!

                           
Goal Examples

 




 Evidenced Based Practice & Articles

          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
             link!).


                    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
                                                  Spectrum Disorders.

 

                     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).

                                   Hodson Article Online

 




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.  

                   Crazy Speech World Blog -- CC and the SLP

                          K-5 Common Core Standards Supporting IEP Goals for English Language Arts

                               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.  

                      ASHA -Workload Activity Clusters

                      Link to Perry Flynn's Webpage - NC SLP Consultant

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.  



 

State Guidelines--Speech

              Great resources for pragmatic checklists, informal observation forms,  teacher checklists, and too    
              much else to list!

                   North Carolina Speech Guidelines

  
                  
Virginia Speech Guidelines--UPDATED JANUARY 2012

 
                   Tennessee Speech Guidelines


 

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!

                   Speech-Language Eligibility Criteria/Matrix for Schools



 

Educational Impact--Determination

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
              difficulties.

              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.

                          Educational Impact--From Department of Education to ASHA

             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.  

                         Dismissal--ASHA Document

          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.  

                         Educational Impact Statement--Articulation by E. Beckner


 

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. 

                            Pre-Referral Intervention Manual, Third Edition--Hawthorne

                 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
                located.

                       Hawthorne Book--Excerpts on Articulation Interventions

                            Cityview Middle School, MN Website

                            http://blog.wsd.net/slp/pre-referral-intervention/

                            http://www.davis.k12.ut.us/staff/waowens/forms.html


Miscellaneous


     Medicaid

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
                        Necessity

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.

                              Quoted from:  http://www.asha.org/uploadedFiles/SLP-Medical-Review-Guidelines.pdf


     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!  

                                 Oral Motor Exam Form

                                 Gregory Lof ~ Evidence Against Use of Non-Speech Oral Motor Exercises   

 

 

     Report Templates

                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. 

                                         Speech Only Report Template

                                  Speech as Related Service Report Template

               

     Intelligibility

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). 

                                  Information on Intelligibility - San Diego City Schools

 

      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.  

                                      
Speech Scheduling.doc

   

    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
                   access them!

                      Using IPA Fonts on Your Computer

                       IPA List

                       IPA: HAPP-3 List of Words in Phonetics

              

       Family Night Activities

                Great family night or speech workshop activities for NON-Speechies!  

                         If You Can Read This You Must Be......in IPA

                         International Phonetic Alphabet-DEFINED

                        IPA List of Words in Phonetics--for parents to try to decipher!

                        List of Words--ANSWERS

 

           Career Day ~ Talk about being an SLP!

             Are you responsible for giving a talk for Career Day at a school or other
                   organi
zation?  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.  
 

                   PowerPoint on SLP/Aud from TXSHA                

      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!  

                      Reward System and Game Idea

 

         Teacher In-Service Information--Handy tips to

      explain to teachers about what we do!


 
                            
Teacher Handout--Speech Information Every Teacher Should Know    

                       What is Speech?--Inservice for Teachers

                       HELLO!  I am your new Speech-Language Pathologist--Teacher Letter
 
                      The SLP's Role in Schools-Teacher In-service PowerPoint                      

                            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 

       classroom?
 

                        GREAT list of ideas for teachers to enhance communication!

 

       Norms


              Incredible list of norms from ASHA and the sound norm list I have used since
              graduate school

                        Norms--Great Comprehensive List

                    Neurological and developmental foundations of speech acquisition
                    Sharynne McLeod, PhD, Charles Sturt University, Australia (smcleod@csu.edu.au)
                    Ken Bleile, PhD, University or Northern Iowa, USA (ken.bleile@uni.edu)

                   Please visit Caroline Bowen's site for the above document:  

                   http://www.speech-language-therapy.com/

                   Speech Sound Development Chart--Eric Sander 1972

                     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
                      motor exercises.

                                  Gregory Lof's Speech Norm Information

          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'.

                      Tongue Thrusting--Information from Braces San Diego
                      

                      Tongue Thrust Link--Great article that shows what this condition does to teeth

                     
Swallow test for suspected tongue thrust           

              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.  

                         Article from General Dentistry

                         Another source

        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 Appropriate

     Referrals and Educational Impact


 
                         2015 Teacher Handout for Speech Referrals

                         (The above document will need to be modified for your district's referral policies regarding RtI
                                   and referral to Student Support Teams ahead of special education qualification.)  

                       Articulation--Sound Errors

                       Language

                       Stuttering

                       Voice

                       Functional Communication

                         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.

                         TOP 10+ Must Have Speech Materials/Tests

             

 


 

 




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