Start with a five minute warm-up of words containing the target sound.  Practice these words in sentences as well. 

Next, depending on how much time you have and if you have daily chores to attend to, encourage your child to use the target sound while engaging in the types of activities listed below, while conversing with you.

There are a variety of ideas that span age-ranges. The structure of the activity will help maintain the goal: To say the target sound consistently in conversation.

Keep the goal in mind at all times during the activity, and remind your child as necessary.

Make sure you are always monitoring for the correct target sound.  If you hear errors, simply try modeling instead of correcting.  This method will have a more positive effect and won’t interrupt the flow of your game or conversation, etc.  For example:

Georgia: I’m going to watch the THookeeper feed the THealTH.  (Translation: I’m going to watch the zookeeper feed the seals.)

Mom (while bending down so Georgia can see her mouth): We ARE going to watch the zookeeper feed the seals.  Hurry, we don’t want to be late!  (Mom emphasizes the target sounds.)

You may need to manipulate the vocabulary to have a more optimal choice of target sounds in words (e.g., try “rabbit” instead of “bunny” if you are working on the R sound).

Household Ideas

Sort the clean laundry (e.g., Daddy’s sock, Joey’s shirt).

Bake cookies.

Food shop, run errands.

Clean the apartment (your child can use the Swiffer, recycle, clean up toys, etc.).

Games / Crafts

Hedbanz

Pretend play (tea party, school, doctor, Legos, Star Wars, etc.).

Playdoh

Make a collage.

Play games without too much strategy involved: Pop-up Pirate, Thin Ice, Twister, Perfection (At first don’t set the timer right away.  Later, with the timer set, the excitement will make it more challenging to practice target sounds).

Fingerpaint inside or sidewalk chalk outside.

Sing songs.

Other favorites

Narrate a picture book.  You can use wordless or worded picture books.

Talk about your favorite movies.

Look through family pictures.

Have your child tell you about his day (if you weren’t together).

If your child watches a television show, have him give you summary.

Go to a museum.

Browse through toy catalogues.

Playground time – maintaining target sound(s) while being physically active is challenging.

Go out for ice cream to celebrate how well your child is doing with his articulation! 

Keeping the goal in mind during these structured tasks will help you learn to monitor your child more effectively throughout each day.

Making an effort to set aside the time to practice carryover of your child’s target articulation sounds will help reduce time in speech therapy.

These are tips I often share with parents to use as homework activities in my own practice.  You can learn more about me, Stephanie Sigal, on my website.  Thanks for reading!

Some parents who have not yet provided kindergarten test prep are wondering what the best last minute activities are to prepare their child for kindergarten tests.

The skills required for kindergarten tests and the activities completed in my kindergarten prep sessions are best taught over a six to twelve month period.  If its crunch time for your child, here are a few important kindergarten games to play and skills to build:

1. Help your child to sit and attend to books and games he or she will happily enjoy for about 60 minutes.

2. Teach your son or daughter to define everyday words.  For example, “What is a cup?”  or “What is a blanket?”  Sometimes task directions require practice.  Playing a vocabulary and word reasoning game such as Hedbanz can be motivating and make kindergarten test prep fun! 

3. Block play - create a design or pattern with colored blocks or tiles.  Have your child copy your design and you can copy your child’s.  As bicolored blocks are used during testing, choose two colors of construction paper and cut out two triangles from at least  eight 4×4 squares.   Tape the triangles together to form bi-colored squares.   Practice making larger triangles, stripes and larger squares with the bicolored squares.  Try Pixy Cubes too.

4. Help your child understand analogies by talking about how and why things go together.  Check out this analogy puzzle.

5. Make your child think!  Ask open ended questions for your child to formulate meaningful verbal responses.  For example, “Why is it important to brush your teeth?”   “Why should you eat healthy food?” 

As a parent myself, I know how it can be difficult to work with your own child.  If you’re looking for guidance in helping your child get ready for kindergarten or for kindergarten test prep, please feel free to contact me and we can make a plan that’s a good fit for you and your child.

Stephanie Sigal works with children in their Upper East Side, Manhattan homes.  sayandplay@yahoo.com or 646-295-4473.

 Articulation

Sometimes a child can say a sound (e.g., /s/) in sentences, but needs extra practice in conversation. Wordless books and funny pictures can bridge the gap between sentence level and conversation.

 Language

Take turns with your child describing the pictures in the wordless books. If your child leaves out important information when describing scenes in books or pictures, you can ask an open ended question (e.g., “Hmmm – What’s happening over here?”). If he can’t describe what’s happening, describe it for him. Perhaps your description will improve his awareness to be more specific next time.

Pre-Reading With Wordless Picture Books

When appropriate, before turning the page, excitedly ask “What’s going to happen next?” When given the opportunity to make a prediction (a pre-reading skill), children combine verbal and critical thinking skills.

With Funny Pictures

Describing funny pictures is entertaining! An instant smile appears when a child is shown a picture of the Statue of Liberty holding an ice cream sundae. This task allows your child to link visual and cognitive skills, which is crucial for pre-reading. Funny pictures need to be carefully examined, just as words need to be looked at closely to notice blends. What’s more, when a child focuses and attends to a funny picture and can explain why it is crazy a polar bear is on the beach, he is using attention and reasoning skills and making inferences.

 Social-Emotional Awareness

A child may better appreciate the feelings of others if he can interpret and describe feelings. When the opportunity presents itself, ask your child how a main character feels. You may need to be more specific: “How does Jack the dog feel after his family left him without breakfast?” Provide explanations as necessary.

Looking for some wordless picture books and funny pictures?

“Jack” Books

The “Jack” books by Pat Schories are a great introduction to wordless picture books. While the Jack books do not need to be read in any particular order, the following order works nicely:

Breakfast for Jack

Jack Wants a Snack

Jack and the Missing Piece

Jack and the Night Visitors

When Jack Goes Out

Children are interested in the characters in Jack’s life. Searching the detailed pictures for surprises is motivating, facilitates attention and assists in developing visual scanning skills.

Frog Series

The Frog Series by Mercer Mayer (and sometimes Marianna Mayer as well) is an appropriate series to try next. Again, the books don’t need to be read in any particular order, but given the language skills required within each book, this order may be preferable:

Frog, Where Are You?

A Boy, A Dog and A Frog

One Frog Too Many

A Boy, A Dog, A Frog and A Friend

Frog on His Own

Frog Goes To Dinner

I was first introduced to The Frog Series in my graduate school clinic. School-age children described scenes in a Frog book chosen for them during an evaluation so we could obtain a narrative sample.

More Favorite Wordless Picture Books

Changes, Changes by Pat Hutchins

Pancakes for Breakfast by Tomie DePaola

Carl Goes Shopping by Alexandra Day

Good Night, Gorilla by Peggy Rathmann

Hug by Jez Alborough

Rosie’s Walk by Pat Hutchins

Chalk by Bill Thomson

Window by Jeannie Baker (best for older children, purchase a used copy)

No, David! by David Shannon (My favorite, essentially wordless book, also a Caldecott*)

You can also use picture books with text, as long as the pictures are detailed. This is generally more difficult than using wordless picture books, but if you try, it will work best with *Caldecott Medal / Honor Books. One of the criteria for the Caldecott Award is that a child can interpret the story directly from the pictures. A child doesn’t need to know how to read the text, in fact, cover text if your child can read, so he can freely choose his own words.

Caldecott Favorites

Knuffle Bunny: A Cautionary Tale by Mo Willem

Knuffle Bunny Too: A Case of Mistaken Identity by Mo Willems

Flotsam (This is also a wordless picture book) by David Wiesner (Tuesday and Sector 7 are good for school age children)

The Hello, Goodbye Window by Norton Juster, Illustrated by Chris Raschka

When Sophie Gets Angry, Really, Really Angry by Molly Bang

The Paperboy by Dav Pilkey

Rumpelstiltskin by Paul Zelinsky

King Bidgood’s In the Bathtub by Don and Audrey Wood

A Chair for My Mother by Vera B. Williams

One Fine Day by Nonny Hogrogian

Where the Wild Things Are by Maurice Sendak

Umbrella by Taro Yashima A Tree Is Nice by Marc Simont

Madeline by Ludwig Bemelmans

The pictures in books by Leo Lionni and Ezra Jack Keats also allow for great descriptions.

 Funny Pictures

I often provide What’s Wrong coloring books to children I work with so they can discuss one page a day with a parent as part of their homework. I often leave the wordless picture book that we read together in therapy for homework as well.  What’s Wrong by Anna Pomaska is good to start with. Then try What’s Wrong with this Picture? also by Pomaska.

Try this incredible set of silly photographs. Wacky Wednesday by Dr. Seuss is fun to read together. Practicing describing a worksheet or two each day from Super Duper’s 150 “What’s Wrong With This Picture?” Scenes can also help carryover speech and language skills.

Making photo books with your kids is a fabulous way to help increase their language skills. It matters not if you are a mom simply looking for creative ways to provide your toddler with a language-rich environment or a dad looking for ways to help your kindergartener learn to tell stories– photo books are a flexible tool than can be used in a huge variety of ways.

How to use picture books? The general idea goes a little something like this:

Take pictures during a fun event such as a trip to the zoo or the beach,

Capture key moments in the pictures,

Print the pictures that highlight the key moments from the event,

Spend a few afternoons gluing the pictures onto construction paper, letting your children help cut, glue and color around the pictures; if your child is old enough, help him to write captions for the pictures, and

Laminate the pages and have them bound into a book that can be read over and over.

One you’ve done this, you’re all set up to use the books to help increase language. Kids love these books because they are based in experiences that they had; this makes the books both meaningful and fun. And children usually want to read the books over and over again– as annoying as this can be, it makes picture books the perfect vehicle for developing language.

With toddlers, you can use the pictures to build on language. Most toddlers love to start looking at pictures of themselves around 12-24 months, right when they are starting to rapidly increase their vocabulary and move from one-word phrases to two-word phrases. Photo books create excellent opportunities for using parallel talk, description, and expansion to help children develop new vocabulary and help them make the jump from one to two words.

Check out this video. I use expansion with my daughter, who is looking at a picture of herself riding a toy motorcycle with her brother, James. First, I wait for her to say something (“ride!”). Then I build on her words by putting them into short phrases, two different times. As a result, she comes back with a two-word phrase of her own (“James riding”)! No, it doesn’t always work this quickly….I’ve been using parallel talk, description and expansion with her for the past year and it’s only really starting to pay off now.

Toddlers aren’t the only ones who benefit from photo books, though. Using these books with preschoolers and early elementary age children can be great way to work on a whole variety of language-related skills. You can:

Work on sequencing by having your child lay out the pictures in the right order as you make the book,

Work on pre-writing and writing skills by having your child trace words you write or write his own words and sentences as you make the book,

Work on vocabulary by defining new words and integrating those words into the story and by using time words such as first, next, then and finally,

Work on language by using indirect correction, in which you correct errors in your child’s grammar by restating what he said, correctly and conversationally (e.g. Your child: “I runned really fast!” You: “You did. You ran so fast!”), and

Work on memory by having your child practice telling the story with and without the picture book in front of him.

Finally, photo books are a fantastic way to work on narrative (story) development. Developing an understanding of narrative structure (the typical flow of stories) is essential to being able to engage in conversations, tell others about things that have happened, and understand academic texts later in the elementary years. Enhancing narrative development is an asset for any child; I work on it with my son, often. It’s also a skill that can be very hard for children with language delays and specific diagnoses such as autism, so working on it with these children is essential. Using photo books to visually show stories in which children actually participated helps make narrative structure more concrete and easier to understand. At first, you can use photo books to help your child understand that the story has a beginning, a middle, and an end. Later, during the early elementary age years, you can help your child form a story that has the following elements:

Setting (“We were at the zoo”)

Goal (“We wanted to see the animals,”)

Problem (“But Sally was scared of the lion.”)

Feelings (“I was so mad, because I wanted to see the lion.”)

Attempt to solve the problem (“So we went to see the owls instead. Then Sally was ready to see the lion. Mom just covered her eyes.”)

Conclusion (“After that, we had a really fun day.”)

It doesn’t have to be perfect, of course. Stories are messy, just like life. They won’t fit perfectly into those elements, nor should they. But telling stories in a way that wraps loosely around those story elements, over and over and over again, will help your child begin to internalize the flow of stories.

There is so much to do with picture books that the possibilities seem endless. What’s more, at the end of the day, you also have a book full of memories that your children will cherish for years to come. And that’s just priceless.

Becca Jarzynski, M.S., CCC-SLP is a pediatric speech-language pathologist in Wisconsin. Check out her blog Child Talk and follow her on facebook at facebook.com/ChildTalk.  Becca publishes with Stephanie Sigal M.A., CCC-SLP on ASHAsphere, the blog for The American Speech-Language and Hearing Association.

Oral placement therapy had previously been addressed.  Nikki’s jaw, lips and tongue were strong and stable to support all speech sounds.

Nikki’s mom found it frustrating to frequently remind Nikki to use our techniques, and Nikki didn’t enjoy the nagging.  What to do?  We added Sticky Tape (AKA Sticky Spot)!

Sticky Tape acted as a tactile reminder.  Nikki’s tongue tip was naturally drawn to the tape.  We also found when Nikki’s mouth was at rest, she did not exhibit her classic open mouth / tongue protrusion posture.  Sticky tape helped to habituate appropriate tongue and lip position. 

Sticky Tape is a smooth, thick, medical grade tape.  We fixed a small square (about 2cm x 2cm - sometimes a slightly bigger size is more effective) just behind, but not touching, the two top central teeth (upper central incisors) at midline on the hard crescent shaped area (alveolar ridge).

This spot might also be called the special spot, secret spot or as Robyn Merkel Walsh calls it, The Smile Spot.

The tape may be purchased from activeforever or flavored Sticky Spot (cherry, bubble gum, mint) may be purchased from myomadeeasy (you have to call or email to order products from the later).

When I asked Rhonda Collier of myomadeeasy what the Sticky Tape is made of, she wrote:

My prior research into concerns about possible allergens revealed that the content of the product is free of common irritants or vegan objections. The main ingredients are pectin (if you’ve ever made jam you know how sticky this is!) and fruit cellulose which is technically the cell walls of plant fiber. We use similar flavorings as used in orthodontic offices to flavor impression molds.

The unflavored tape from activeforever and the tape from myomadeeasy are both Stomahesive Skin Barrier made by ConvaTec.  Myomadeeasy just adds flavoring.

Children enjoy the option of the flavors, but the flavor wears off quickly. 

I found Sticky Tape to work most effectively when it was applied after meals.  The tape may dissolve, fall out on its own, or it can be carefully removed.  Some children don’t mind eating with the tape in place.  Generally, three small squares are used each day. 

The Sticky Tape sticks best when a child swallows saliva first.  Next, dry off the alveolar ridge with a small piece of paper towel.  Take the small square of Sticky Tape you have previously cut and hold the tape in the correct place while you sing a song or tell your child about your day.  After about a minute, the tape should adhere. 

In addition to using the Sticky Tape, Nikki and her mom followed the plan below for homework:

Tongue Tip Placement Reminders:

1. Nikki should follow the rules below for swallowing all food and liquid.  These rules are adapted from Sara Rosenfeld Johnson’s Therapeutic Straw Drinking / Single Sip Swallow technique:

A. Place the top ¼ inch of the straw between your puckered lips at midline (or if you drink from an open cup, lips only on the rim (no teeth)
B. Sip in the liquid until you feel it in your mouth
C. Remove the straw but do not swallow the liquid
D. Close your lips as you put your tongue tip up to the secret spot
E. Freeze
F. Swallow the liquid without moving your tongue tip
G. Open your mouth, your tongue tip should still be on the secret spot

2. Tongue Tip Elevation Tool - Please read about how to use this tool.

3. Tongue Tip Elevation with Cheerio - Place a Cheerio on the secret spot. Nikki should place her tongue tip into the center of the Cheerio. Her jaw should be relaxed and open about one inch.  She should hold the Cheerio with the tip of her tongue for 50 seconds, 3 times per day.

Traditional Carryover Tasks:

1. Nikki should read wordless picture books aloud.  These books will create structure when trying to produce accurate S’s and Z’s.  Describing funny pictures will do the same.

When Nikki is turning a page, encourage her to self-monitor.  Encourage Nikki to point to a drawn out “happy” or “sad” face to let you know how she thinks she did.

2. Talk about using accurate S’s and Z’s before school, when she gets home, and before you practice.

3. Have a focused period of time (about 15 minutes) each day where Nikki is concentrating on using S and Z properly in conversation. Set a timer, as necessary.

4. Choose high frequency target words that she must always say correctly (e.g., please, strawberry, school).

5. Use a mirror for visual feedback or a video camera to record a sentence or two Nikki says.  Have her critique her own speech.

6. Encourage Nikki to speak slowly all the time.

Additional Notes / Tips:

Nikki has a bad habit of clenching her jaw when she tries too hard to say s/z or when she fatigues. Encourage her to relax her jaw if this occurs.

Watch out for words that trip her up: S at the beginning and at the end of the same word (e.g., socks) – and TH blends close to S and Z (e.g., the zebra).

We also found it helpful to recruit Nikki’s teacher to help with carryover.  Nikki and her teacher made up a private hand signal.  If Nikki mispronounced S or Z, her teacher made eye contact with her and touched her own nose.  Nikki knew to slow down and say s/z correctly. Her teacher also gently reminded Nikki to use her special swallow at snack and lunch time.

Additionally, a few therapy sessions in the outside world (e.g., grocery store, library, toy store) using our techniques with store employees helped to solidify our work. 

This summer, Nikki is happily using correct productions of S and Z in conversational speech without Sticky Tape or reminders!

Stephanie Sigal is a New York City speech therapist working on Manhattan’s Upper East Side.  She works with children with articulation and language delay.  You can read more about her work at sayandplayfamily.

This speech and language task also allows a child to demonstrate the ability to link visual and cognitive skills, which is crucial for pre-reading.  A child has to carefully examine a What’s Wrong picture, just as he needs to look closely at printed words to notice blends.

When a child focuses and attends to a silly picture and can explain why it is crazy a polar bear is on the beach, he is using reasoning skills and making inferences. 

Picture completion (pictures that have something missing) subtests appear on intelligence tests, such as the WPPSI (Wechsler Preschool and Primary Scale of Intelligence), the WISC-IV (Wechsler Intelligence Scale For Children) and the Stanford Binet (Picture Absurdities).  A child’s visual acuity and reasoning skills are measured when asked to identify a missing part of a familiar pictured object. 

Try What’s Wrong coloring books.  What’s Wrong? by Anna Pomaska is good to start with.  Then try What’s Wrong with this Picture? also by Pomaska.  I often provide these coloring books to children I work with so they can discuss one page a day with a parent as part of their homework.

An incredible set of silly photographs is a great informal activity / ice breaker at an evaluation.  You can read Wacky Wednesday by Dr. Seuss as a therapy activity or provide a few worksheets for homework from Super Duper’s 150 “What’s Wrong With This Picture?” Scenes.

Stephanie is a pediatric speech therapist in Manhattan.

Ask questions during the story. Perhaps there is a vocabulary word the children might not be familiar with. In the book Don’t Let the Pigeon Stay up Late by Mo Willems, the pigeon insists the children listening to the book let him stay up so he can watch an educational program on television. You can ask, “What does educational mean?” You can also explain to the children how the pigeon is trying to “trick” (manipulate) them into letting him stay up late. Then, ask the children “How have you tried to trick your parents?”

At the conclusion of a story, ask children to carry over a main theme from a book into their daily lives. For example, after reading My Friend Rabbit by Eric Rohmann, ask the children “What does it mean to be a good friend?”

Adding props and puppets to group story time can engage kids with various levels of attention. In Caps For Sale by Esphyr Slobodkina, the peddler walks around carrying many caps on his head. The children can do the same with caps that you have previously collected for story time, or they can use their winter hats, or caps that they make as an art project to accompany the theme of the book.

Using different voices and revealing the characters’ emotions while acting out the story can also help children attend and relate more effectively. The mother dog in Bark, George by Jules Feiffer gets frustrated with her son, while he makes great animal sounds. The children will laugh when you over-act the role of George, his mother and especially the veterinarian reaching deep down into George’s mouth to pull out all the animals he has consumed.

Children are inspired to verbally participate when their peers say the repetitive line in a story together. In Tikki Tikki Tembo retold by Arlene Mosel, the older brother’s name is Tikki tikki tembo-no sa rembo-chari bari ruchi-pip peri pembo. Opportunities to say this long name come up numerous times, sometimes fast, sometimes slow, and children listening will want to try to say the name along with you.

Always read the title, author and illustrator’s names. Ask the children “What is an author?” “What is an illustrator?” Provide the information accordingly. If the author has written other books the children may be familiar with, ask them “What other books has this author written?” If necessary, name one or two of the books and you may notice how excited the children become when they realize they have shared a previous experience with you.

If you need help choosing the right books based on your child’s needs, you can ask your speech therapist, child’s teacher or librarian.

This article was written by Stephanie Sigal M.A. CCC-SLP.  It appeared today on the American Speech-Language-Hearing Association (ASHA) blog, ASHAspere.

Stephanie Sigal, M.A. CCC-SLP, is a speech language therapist practicing on the Upper East Side of Manhattan, NYC. She works with babies, toddlers and school age children with expressive language delay and articulation disorders. Stephanie provides home based speech therapy and encourages parents to facilitate their children’s speech and language skills. To learn more about Stephanie, please visit sayandplayfamily.

Always read with your child face to face with the book next to your face, not in front of your mouth. This will allow your child to see how you move your mouth when you say words, see your facial expressions and engage in eye contact. With a baby, you can create this opportunity while he or she is on the change table, floor, car seat, bouncy chair or on your thighs facing you.

Reading with your child everyday should start from birth. At this time, you can read anything to your son or daughter, even The New York Times. What matters is HOW you read it. Read with feeling, show emotion and pause to allow your baby to vocalize back to you.

Initially, choose books with a story and meaning. Vocabulary board books (e.g., books by Roger Priddy or select DK Publishing books) will be boring for you and not provide much benefit for your baby. Reading longer stories during the first months will help to build your child’s attention. Books like The Three Bears by Byron Barton, Summer by Alice Low and Chewy Louie by Howie Schneider will be fun for you and your baby.

If your toddler has trouble paying attention to a book, try reading when he or she is “trapped” (e.g., in the highchair eating, in the car seat while traveling, just waking up from a nap in the stroller). I once worked with a two year old boy who would only happily pay attention to an unfamiliar book while standing in his crib facing me. Once he became familiar with a book, we could read the book elsewhere.

Choosing the right books can help target speech and language skills you want to develop.

If your child is not talking, choose books that contain words that begin with bilabial sounds. These are sounds where your upper and lower lips come together (/m/, /b/ and /p/). Bilabial sounds are generally early sounds produced by children because they can see how an adult is moving their lips, which is helpful for imitation. Favorite books that include bilabial sounds are It’s Not Easy Being a Bunny (Marilyn Sadlow), The Berenstains’ B Book (Stanley and Jan Berenstain) and any book that contains animal sounds (moo, baa, maa). Overemphasize /m/, /b/ and /p/ and make eye contact with your child when saying bilabial sounds in any book.

Selecting books with repetitive phrases may allow your child to participate during story time. Great examples include: Dear Zoo (Rod Campbell), The Very Busy Spider (Eric Carle) and The Gingerbread Boy (Richard Egielski). Give your child the opportunity to complete the repetitive line, or if he or she is ready, the whole line. Hopefully, these words will carry over into daily vocabulary.

Rhyming books help children with word prediction, which is crucial for reading development. Once familiar with a rhyming book, have your child try to fill-in the rhyming word. Dr. Seuss’ The Foot Book begins: Left foot, Left foot, Right foot, Right – Feet in the morning, Feet at _____ (child should say “night”).

If your child’s speech therapist has determined that understanding and using prepositions is an important goal for your child, use books to reinforce what occurs in therapy. Trashy Town by Andrea Zimmerman and David Clemesha, Up Above and Down Below by Sue Redding and Around the House the Fox Chased the Mouse by Rick Walton are all loaded with prepositions.

A child with more developed language who has difficulty providing details and descriptions may benefit from “reading” wordless picture books to you. Pictures in the story should be described so that the story makes sense. You can use picture books with text, as long as the pictures are detailed themselves. (You may cover the text with your hand if your child can read.) This works best with Caldecott Medal / Honor Books. Excellent examples include Knuffle Bunny books (Mo Willems), No, David! (David Shannon) and Where The Wild Things Are (Maurice Sendak).

Other favorite wordless picture books include A Boy, a Dog and a Frog Series by Mercer Mayer, Pancakes for Breakfast by Tomie DePaola and The Jack Series by Pat Schories. If you feel your child leaves out important information, ask an open-ended question (e.g., “Ooo – What’s happening over here?”). Provide a description if you feel this is too challenging. Perhaps this will increase your child’s awareness to be more specific and when you sit down to read the book again, the new information will be included.

Sometimes it is helpful if you “read” a wordless picture book to your child first. Describe what you see or make-up the story-line. For example, when David, the main character in the book No, David! is about to fall off the chair while reaching for a cookie, you can say: “Be careful David, you’re going to get hurt!” or “No cookies before dinner!!”

Look for Part Two Coming Soon:  Encouraging Speech and Language Skills while Sharing Books with a Group of Children
 
This article was written by Stephanie Sigal M.A. CCC-SLP.  It appeared today on the American Speech-Language-Hearing Association (ASHA) blog, ASHAsphere.

What did I see this week?

1. A pacifier in a toddler’s mouth while he was happily walking around the playground.  He clearly wasn’t using the pacifier to sooth himself.  How could he even try to speak to a potential playmate?

2. I turn around to find a nanny named Katie speaking to her two year old ward Johnny.  She asks “Can Johnny throw the ball to Katie?”  If Katie used pronouns (e.g., Can you throw the ball to me?), Johnny would learn to use pronouns.

3. A parent sitting on a park bench complaining on her cell phone about her Mother-in-Law, while her adorable 6ish month old girl tries to get her attention.  You will never win with Mother-in-Law.  Why not use that precious time to speak with your baby, teach her something new and strengthen your bond?  Same goes for listening to your ipod, watching television and catching up on your emails.  Try to turn off technology and tune into your child.

4.  Eating at a sidewalk cafe, a young boy refuses to stay seated.  His dad tells his son ”You’re not going to get any lunch if you don’t sit down!”  Is he really not going to feed his child?  Empty threats are the worst, and everyone seated around you knows it too.  Effective communication with your child is critical.  Say what you mean and mean what you say!

5.  I’m waiting for the light to change and a man jogs up with his ipod blaring.  I am concerned for his hearing and safety.  I can hear Jennifer Lopez singing Let’s Get Loud.  She sings:

…You gotta prove it
You gotta mean what you say

Maybe he was playing his ipod loudly for the dad at the sidewalk cafe?

6. Have you ever seen a child too old to drink from a bottle using one?  When a child continues to use a bottle (or sippy cup or pacifier) past age one, he may develop a tongue thrust / lisp.  Step into any kindergarten classroom and you will quickly notice a number of children with tongue thrusts.

7.  In the bookstore, turned rainy day escape destination, an ambitious mother reads an exciting book to her son.  She has him so engaged in the story it’s impressive.  He starts to tell her something about the story and the mom says “Wait!  There’s more!  Listen to the whole story Adam!”  Poor Adam, he had something important to share.  Another missed communication exchange.
 
8. Also in the children’s section, Thomas the Train is up on a high shelf.  A little boy points toward Thomas.  Grandma, well intentioned, involved, and well-versed in Thomas the Train lingo isn’t sure if he is pointing to Thomas, James or Percy?!  Grandma points to Thomas and asks “Do you want this?” The boy shakes his head.  “Do you want this?” as Grandma points to James.  “NO!” says the boy.  “Oh, you must want THIS!”  Grandma then hands Percy to her grandson, who has been deprived of an opportunity to try to use the names of the trains and deprived of learning how to make a verbal request instead of just pointing.  Next time grandma could try offering choices.

9. I hop into the elevator with a mom, her toddler and another woman.  The woman speaks directly to the toddler and asks “What ‘s your name?”  The mother responds “Joe.”  The woman asks “What are you eating, Joe?”  The mom replies “A cracker, right Joe?”  Give your child an opportunity to participate in spontaneous conversation.   Afterall, the woman didn’t want to talk to you, she wanted to talk to your cute baby.

Hopefully this information has improved your awareness about communicating with your child.  If you feel you would like personalized strategies to maximize communication exchanges with your child, please email me and we can set up an appointment.  I work with children and their families in their homes on the Upper East Side of Manhattan.

Question: Stephanie, I am working with a 6 year old boy who is drooling. He had his adenoids recently removed. His parents have noticed a decrease in his drooling, but the problem still persists.

He does not have open lip posture, his top teeth slightly protrude and he swallows nicely on command. His awareness of his excessive saliva is poor. This saliva impacts his articulation. When he swallows, his speech (articulation and vocal quality) are more intelligible.

What can I do to help this student? Any specific oral motor exercises you recommend?

Answer: Take a look at his tonsils. I’m wondering if he has a tongue thrust since you noticed his top teeth are protruding. The tongue thrust may be occurring for a variety of reasons, including large tonsils (the tongue will be misplaced anteriorly if the tonsils take up too much room posteriorly).  If you feel his tonsils are enlarged, it may be appropriate to revisit the pediatric otolayngologist (ENT). 

If you are in NYC, you can find a list of pediatric ENT’s here.

As with any oral motor work, you have to start from the bottom-up. Make sure his body posture and jaw are strong and stable, then the tongue, and finally the lips. Weakness at any of these levels needs to be addressed. Have you taken any good oral motor courses?  Try renting Talktools / Sara Rosenfeld Johnson’s level one class to get started, if you feel this is an area you need experience.  Once you know his jaw, lips and tongue are strong and stable, here are some Ideas To Eliminating Drooling:

1. Help him become aware of his mouth

2. Improve his swallowing frequency and efficiency (he needs to fully retract the saliva)

3. At rest, his lips should always be closed

Talk to him about wet vs. dry mouth, lips and chin to build his awareness.  Have him wear terrycloth wristbands. Ask him to wipe his lips and chin when they are wet.  Each time he wipes his lips and chin, he should be reminded (until he does this independently) to swallow. You may need to teach him the concept of swallow.  Wristbands will also act as a visual reminder to dry his face and to swallow.  Purchase a few pairs as they need to be washed daily.

If you or his parents do catch him with lips apart, remind him to keep his lips together, especially at rest and when he is actively involved in a task. Can he keep his lips closed during a fine motor task?

To help him build awareness of his lips, have him put on flavored Chapstick, make “raspberries” and smack his lips. If it is safe to, and he can tolerate vibration, use a gentle, child-sized battery operated toothbrush to brush his teeth, inside of his cheeks and tongue. With firm (not too hard / not too light) pressure, run the toothbrush over his lips, to stimulate them / make him more aware.

Good luck – please let me know if you have more questions.

P.S. Should you actively work with this child for 4 weeks (and speech homework is consistently practiced) and improvement is not observed, a follow-up pediatric ENT visit is critical.

Stephanie Sigal, M.A. CCC-SLP is a New York State and ASHA certified Speech and Language Therapist.  She works with children with articulation and language delay, as well as with children that drool and suck their thumbs on Manhattan’s Upper East Side.  You can contact Stephanie at sayandplay@yahoo.com.