Not ANOTHER /r/ Post! Visual Cues for /r/ Production

Photo by Mizuno K

Yes, here it is. Another post on working on that /r/. It's the bane of most school-based SLPs' existence. There. I said it. It's not easy. The sound is so complex and the student has to remember a million different things! (Maybe not a million, but it will seem like it!) As my experience has grown, I'm discovering more ways to explain to students how to make the /r/. Self-awareness is such a huge part of it. I tell my students that I can't do it for them...all I can do is tell them what to do. It's up to them to feel the tongue position and to hear how the production sounds. It's tough, for sure. 

Making the Student Accountable for Self-Awareness

I've written a few posts on /r/ production. It's only been in the past few years that I've discovered a way to make the student accountable for self-awareness. For years I've had a chart hanging on my way with the "3 Things to Make a Good R"; this begins with using /i/ as a starter. I have now increased the 3 to 4 and also use /a/ as a starter. 

One of the important things the child must do to achieve the tongue stretch necessary for a good /r/ is to have the correct motion of the tongue. At first, the motion is exaggerated. This is when I discuss "checkpoints" with the child. 
  1. Start with the tongue at rest
  2. Lightly touch the tongue tip to the alveolar ridge (behind the top front teeth)
  3. Lightly touch the tongue tip to the top part of the hard palate (roof of the mouth)
  4. Lightly touch the tongue tip to the part of the hard palate that slopes down.
  5. Lightly touch the tongue tip to the "bony part". (This is where the hard palate meets the soft palate)
While all of the checkpoints are important, I tell my students that #2 is very important: if they don't hit 2 the tongue won't stretch as it should. I show them with my arm the difference between hitting #2 and not hitting #2. When my tongue doesn't hit #2 my arm goes straight up instead of swooping out and up. I have the student do the arm motion with me and have them feel the stretch in the arm when the arm swoops out versus when it doesn't. 

I made a couple of visuals for the /r/: one with /i/ as a starter and one with /a/. These charts can be printed off, placed in a dry-erase folder, and used with the students. Or, you can copy it and send it home. These charts can be found in my TpT Store: 4 Things for a Good /r/

How I use the Charts

Before we start each session I will review what the tongue has to do for an /r/. Eventually, I have the student tell me and then the chart goes away and the student tells me without looking. I have the curved pvc pipe and a mirror ready. Following a production, we look at the chart and the child tells me what was/wasn't done. To begin with, I will make a mark in the box: x for 'no' and a check for 'yes'. After a few trials or sessions (depending on the student), the mark is made by the student on the top line and I will mark what I observed. I have used this with students as young as first grade. If it's not understood at first, eventually it is. At times, I focus on just 1 of the 4 things. If the student continuously missed the #2 checkpoint, we will focus on that until it is hit. 

As all SLPs are aware, therapy is all about visuals. Unfortunately, we can't make the sound for them. We can try to manipulate the tongue but ultimately it's up to the child to make the sound and to be aware of what the tongue is doing during attempts. The /r/ is a sound that has to be felt and heard

One More Visual Idea

With my students who are in 3rd and 4th grade who still just can't get that /r/, I use the Voice Memos app. It is a free app that allows the student to see the difference between correct and incorrect production. It gives them immediate visual feedback as to whether or not the tongue is loosening or if it's staying tight.
** Just a reminder: always delete recordings of your students on your devices, even if it is a school-owned device.
Correct vs. Incorrect /r/

Have you tried any of these things? Or, do you have a sure way to target the /r/ that works? 

How do Students Know WHEN to Produce the Target?

Photo by Ashwini Chaudhary(Monty) on Unsplash

Raise your hand if you have students/clients who will generalize their target sound into other positions of the word. ✋ I am definitely right there with you. Here's my thought: If a child doesn't know where to make the sound, how will the sound be made in the correct position? It's frustrating, I know. I've been there and I continue to be right there in the thick of it.

I am big on using children's books in my therapy. In fact, it's rare when I don't use one throughout the school year. I will use a book for several weeks before starting a new one. With my artic students, I start off the book by reading each page slowly, emphasizing the target by holding the sound out. The students make a mark on their sheet (see below) for every word they hear with the target. I have counted the targets ahead of time and put the number on a sticky note that is placed on the inside cover of the book. Then we compare the percentage to the previous book and see how they did. If I suspect a student is randomly marking, I will watch closely. If a mark is made when the target wasn't said, I will ask them the word they heard that had the sound in it. That usually does the trick and the student pays closer attention. If there are more marks than there are instances of the sound in the book, it doesn't count. 

Click on the picture for your free copy.

Every now and then I have a student who just doesn't "get it"; it just isn't clicking. I created a "Where in the Word" series (available in my TpT store) to aid students in determining the position of the target sound in a word. Digital (no internet required) and BOOM Decks are available. The BOOM Decks are ideal for assigning home practice. The digital version may be printed out. 

If only certain sounds are needed (and not the bundle), the following sounds are available as of 09/05/2022: /f, g, k, l, r, s/. 

If I have some extra time at the end of a session, I use Where in the Word as a review. It's quite telling when you have been working on a sound with a student but they have difficulty with this task. It will definitely aid with carryover if the student knows where the target sound is in a word. It's really just common sense.
I make it as simple as I can for my students: Only identifying if the target is in the beginning, middle, or end of the word is required. If the position is not correctly identified, all of the sounds in the word are broken down. Being able to identify beginning, middle, and end is a requirement.

Below is a preview of the digital version.

And the BOOM Version.
I regret that I didn't begin doing this at the beginning of my career. I get caught up in drilling my students that I forget this important piece. When using picture cards during therapy, I make use of the word under the picture by having the student look at the word and find the red letter (the target sound). Reminders are given that the tongue must be in the correct position where the red letter is. That works most of the time, but Where in the Word takes it to another level for those students who are in need of that skill.

Taking Baseline Data and Progress Monitoring for Articulation

Is it a true baseline if the responses are imitative?

Taking baseline data for my articulation students has been a huge dilemma for me. Sometimes I will just use the data from the previous school year; other times I will use the S-CAT (Secord Contextual Articulation Tests by Wayne A Secord and Richard E. Shine)- Contextual Probes of Articulation Competence. In using this, however, there are a couple of things I'm not real crazy about.  1) there are no pictures so the responses are imitative, and 2) some of the words are not in a child's vocabulary, especially in the cluster analysis section. My question has always been, "Can I get a true baseline if the child is not spontaneously producing the words or sentences?"

Are baselines required in IEP Goals?

A colleague recently told me that she heard in a presentation that some states are requiring that baseline data be included within the goals. I Googled everything I could think of to include the key words and came up with very little. What I did find:
  • Wrights Law: The IEP team must collect baseline data that describes your child's present levels of performance and serves as the starting point for developing goals.
  • Wisconsin Dept of Public Instruction: In order for an annual goal to be measurable, the goal must include a baseline measure to use as a starting point for measuring progress and a level of attainment to identify the desired end point. (Sample IEP Forms Frequently Asked Questions (FAQ)-Updated 3/25/19)
  • “You cannot know how far you have come if you don’t know where you started.” Arlene B. Crandall Regional Special Education Training Specialist RSE-TASC
    • In addition, Ms. Crandall lists the lack of data as a common IEP development pitfall
So, it would appear that no, baselines are not required to be included in IEP Goals. I contacted ASHA for more information and was referred to IDEA, Section 1414 (d)

(d) Individualized education programs

    (1) Definitions

  • In this chapter:
    • (A) Individualized education program

        (i) In general

      • The term “individualized education program” or “IEP” means a written statement for each child with a disability that is developed, reviewed, and revised in accordance with this section and that includes—
        • (I) a statement of the child’s present levels of academic achievement and functional performance, including—
          • (aa) how the child’s disability affects the child’s involvement and progress in the general education curriculum;
          • (bb) for preschool children, as appropriate, how the disability affects the child’s participation in appropriate activities; and
          • (cc) for children with disabilities who take alternate assessments aligned to alternate achievement standards, a description of benchmarks or short-term objectives;
  • (II) a statement of measurable annual goals, including academic and functional goals, designed to—
    • (aa) meet the child’s needs that result from the child’s disability to enable the child to be involved in and make progress in the general education curriculum; and
    • (bb) meet each of the child’s other educational needs that result from the child’s disability;
  • (III) a description of how the child’s progress toward meeting the annual goals described in subclause (II) will be measured and when periodic reports on the progress the child is making toward meeting the annual goals (such as through the use of quarterly or other periodic reports, concurrent with the issuance of report cards) will be provided;

I definitely think it is best practice to include baseline data in your present level and develop a goal from there. 
Check with your school district to determine how your goal and present level should be written.

I know I need baseline what?

Here are questions that now need to be answered: 
  1. Where am I going to get my baseline data from? 
  2. How am I going to progress monitor? 
  3. Can a test be considered “baseline data”? 
  4. How can you indicate progress if you don’t have baseline data and use different materials to progress monitor?
Here are my answers:
  1. First, check with your school district and see if there is something you should use. If not, there are a number of products on TpT. Or, if you have the S-CAT, you could always use that.
  2. Whatever you use for the baseline should be used to progress monitor. Otherwise, you're comparing apples to oranges. Clinical Management of Speech Sound Disorders (edited by Carol Koch), states that The same stimuli selected for baseline procedures are typically not utilized during subsequent treatment sessions. Rather, they are reserved for progress monitoring and are considered nontreated, or untreated, target words. (Chapter 8, page 185)
  3. Good question, but I would say "no". If you are using testing as the baseline data, shouldn’t part of the goal be written as, “___ will decrease the error of /r/ from 7 to 3”?  If you use a test as baseline data, that should be used for progress monitoring, which can’t be done since a test is considered invalid if administered within a year of the last administration.
  4. Well, you can't. (See the answer for #2.)

Exactly what am I looking for?

There are some products on Teachers Pay Teachers that address baseline data, but I wanted something that was tailored to what I want and how I want to use it. I wanted something that I could put on my iPad so I wouldn't have to flip through pages of pictures to find the target, but I also wanted the option to print. Other wants:
  • Pictures for eliciting spontaneous responses
  • The option to isolate the target in a specific position or have 1 page with mixed positions
  • Data that doesn't take up the whole therapy session
  • A mixture of CV, VC combinations
  • No duplication of the target in the word
  • Space on the record form to transcribe the response if needed
  • Space on the record form to record responses for the whole year
Baseline Data and Progress Monitoring for Articulation

It took me quite a while but I came up with a product that is just what I was looking for. It took me about a year to decide exactly what I wanted and then a few months to actually make it. While I don't know all of the stimuli in the Weber Articulation Cards/Fun Decks (Super Duper), I did my best to make sure I didn't duplicate the words. If I duplicated any, I will take those cards out of the decks so the student will not be progress monitored on "treated" words. 

This is a comprehensive baseline data and progress monitoring system that includes all sounds. By using the pictures digitally, I save paper and ink (and space). 
Baseline Data and Progress Monitoring for Articulation
The spaces in the recording sheet have plenty of space for transcriptions and notes. There are 4 columns: 1 for baseline data and 3 more for end-of-period reporting.
Baseline Data and Progress Monitoring for Articulation
With 10 stimulus pictures per position, collecting data won't take the whole session. In fact, it won't take any time at all! Suggestions for using the system are included in the "Read this first" pdf. The goal is for the student to spontaneously say the word. For sentences, the student makes up a sentence. 
Baseline Data and Progress Monitoring for Articulation

Whether you use my system or another one, use baseline data to write more functional goals for your students. Progress monitor using the same system to show progress.

Using Book Companions for Virtual Home Practice & Therapy

Photo by Agung Pandit Wiguna from Pexels 

I love using book companions for in-person learning. Once the initial prep is completed, my planning is usually done for at least 2 weeks, sometimes longer. With distance learning being a reality, how can you use book companions for virtual home practice? It takes a little bit of planning, for sure. I've begun using a lot of virtual learning techniques with my in-person students. Sometimes I will let my students choose if they want paper homework or Boom™ decks. Guess which one most of them choose? 

Steps for Getting the Book Ready

  1. Take pictures of the book with an iPad, then crop so only the book is showing.
  2. In the photo app, choose "Select" & then "Select All". 
  3. Tap the download icon, then "Save PDF to Books"
  4. When the pdf opens in Books, tap the send icon and send it to an email address. Or, you can just use it in the Books app if you are going to use an iPad to record or if you will be reading it during a teletherapy session.
    1. To use in a teletherapy session, just open the pdf in a separate window and you're all set to read it to the students!

Now for the Fun Part!

Now comes the fun part: recording the book for your students! I use Screencastify and Loom, but I'm partial to Screencastify. Probably because that's the one I used first and am more familiar with. Both have free versions, but if you have a school address, you can upgrade to Loom Premium for free! (Screencastify's upgrade is $29/year, which is still a bargain! With the free account you will have up to 5 minutes of recording time.)
  1. Pull up the pdf on your computer. There may be a way to record the pdf on your iPad using Loom; I haven't quite figured it out yet.
  2. Once you have the recording service of your choice open and recording, make sure the pdf is in full screen.
  3. Scroll through the pdf, reading the book as you go.
  4. Once the book is read, you can snip out the parts you don't want the students to see. I usually snip the beginning and the end of the clips off since those are the parts where I am getting the book ready or have finished the book. 
  5. You can save to your Google Drive, YouTube Channel, to your computer, or just to the Screencastify or Loom website.

Sharing Your Recording for Home Practice

       Options to share through Screencastify:

Loom appears to only have the options to download and to copy the link. If you wanted it on YouTube or Google Drive, you could always download and then upload it to your preferred site. 

My school system is using Seesaw for elementary schools. This is an example of an activity using a Loom recording I shared with my students:

Here is an example of a Seesaw activity using Screencastify:

One of the advantages of using a Loom link is that the site will notify you of the number of times the video has been viewed. The negative for Loom is that when the student clicks on the Loom link, he is directed to the Loom website. With Screencastify, the video plays in the window where it is clicked. 

I just happen to have several book companions in my Boom Store. They may be purchased as a bundle, or, if you only need pieces of the companion, decks may be purchased individually. 

I am enjoying extending the use of book companions to virtual home practice. When my school system was in the extended closure, I used them with my students through teleservices. Book companions are a great way to pique the interest of reading while practicing speech and language skills. My students prefer to be assigned Boom Cards as opposed to paper homework. It looks like it's going to be a new way of doing things from here on out!


Back to School in a COVID World: Part 2

Photo by Janko Ferlic from Pexels

If you're a school-based SLP (and I'm assuming if you're reading this, you are) who is preparing for the return to school, you may be anxious and quite nervous. I get it. The unknown of what the school year will look like; the changes you're going to have to make before and maybe even from week to week are going to make your life a little hectic, for sure. Quite honestly, I think the school systems are doing the best they can in trying to figure out the best way to have students educated while keeping everyone safe. First, let me say this: COVID is a real thing. It's a bad thing. You're probably a little worried about getting sick. It's like a co-worker said to me, "It's not a matter of if, but when." Just as I stated in my previous post, I realize everyone has different immune systems. Someone you've been in a room with may test positive yet you have no symptoms and test negative.

Hybrid: It's a new concept

Just 1 week after I wrote the last post, my school system has altered the "back to school schedule". We are now on a "hybrid" schedule, meaning that those who opted for in-school learning are on another staggered schedule: half of the alphabet comes one day and they rotate days with the other half of the alphabet. On the days they aren't at school, they are expected to be in "virtual class" with their teacher. We had a professional development day a few days ago, and the teachers have come up with some creative ways to teach their students virtually. 

But that's the classroom teacher. What am I, as a school SLP, doing? I serve 2 schools (+ a high school), which makes my schedule a little more challenging. Normally I'm at each school every other day, being at my home school 3 days/week. If I stick to that schedule, I would be seeing my students every other week. Even though my director said she didn't expect us to change our schedules, I opted to change mine. I now go to each school 2 days in a row, still being at my home school on Friday. That way I see each of my students once each week. Just to keep things a little simpler, once we go back to our normal schedule (with students being at school every day) I plan on keeping my schedule as is for the year. I think it will be a nice little experiment to see if my students progress more having speech 2 days in a row versus every other day. Or will it slow progression? Time will tell.

In my school system, we are mirroring what the gen. ed. teachers are doing: 50% face-to-face, 50% "virtual". That doesn't mean that we're providing teleservices. It means giving the students home practice, assigning BOOM Cards, or using Screencastify or some other platform to read books or explain what they are to be doing. The elementary schools have moved away from Class Dojo and Classtag to Seesaw, meaning I have yet another platform to learn. Luckily, they are all very similar so it hasn't been too challenging. My students are used to having homework every week so it shouldn't be very much of a change for them.

The fact is: we are essential workers. Just like the nurses, doctors, basically all medical personnel, we are expected to be at work. Even if we've been exposed. Because, really...think about it: Unless you've stayed in your house since March, chances are you've been exposed at some point. 

10 Key Takeaways After Being in School

Here are some takeaways I've learned in the past few weeks:

1. WEAR YOUR MASK. Unless you're in your classroom by yourself, have your mask on. You don't know who other people have been around, or who their families have been around. At this moment, the CDC's guidance for contact tracing is being within 6 feet for at least 15 minutes.

Mask selfie

2. Be flexible. Things change from minute to minute. As I stated above, I think the school systems are doing the best they can with the information they have at that minute. Unfortunately, we can't predict the future. We don't know if cases will climb (which they probably will once school opens) and if the school will need to change its initial plans. Just be open to whatever comes your way and take it one day at a time. 

3. Be a team player. Also, be prepared for added duties. In the past, my principals have been fantastic with not assigning bus duty to me. But, with students' temperatures having to be checked before they get out of their car or before they come into the building, there aren't enough teachers to go around. Be a team player...just get up a little bit earlier and help out.

4. Don't worry about "what if". That's a sure way to increase anxiety! We are all learning about taking things as they come and being ready to change plans at the drop of a hat. It is what it is. 

5. Get into an after-school routine. Plan for time when you get home to decompress...take a walk, ride a bike, or just sit outside with a beverage. Whatever will make you relax and transition from home to school, build it into your schedule. Personally, I take my dog for a walk as soon as I get home. It helps me refocus on home and leave school behind. (Plus, my husband is still working in his home office when I get home, so I can give him a little more quiet time to work.) Whatever you left at school is going to be there the next day. Leave school work behind (unless it's crunch time with an IEP and you have to have it written) and be present to your family, your pet, your roommate, whoever you live with. 

Gurl Dogg that time we got caught in a rainstorm
Gurl Dogg that time we got caught in a rainstorm

6. Don't panic when someone in your building tests positive. It's going to happen. It's inevitable. You will be notified that someone has tested positive, but you will not be told who that person is. Just don't panic. Again, it is what it is. Wear your mask (see #1) and wash your hands many, many times during the day. Many of us are in small communities, so of course, word is going to get out who it is. It's not leprosy. Do we run around talking about staff who have the flu? (I'm not downplaying COVID at all. The flu is just the most comparable thing I can think of.) Just be there for moral support for that person and the family. 

7. Know that the students fall quickly into their new routine. I have been amazed at how quickly students at my schools have fallen into their new routine. When I go to the car to greet a child to take his temperature, he waits and will often automatically pull his bangs up so I can get a good reading. Many get out of the car with their masks already on. In the hallway, most of the students are wearing their masks correctly. There are a few whose masks are under their noses, but for the most part, the kids are keeping distance and are wearing masks. It has been amazing to see the kids respond! It's like they've been doing it their whole school life.  IF you need a social story for wearing a mask, you can find one here.

School Hug Line

8. Reassure the students. When I walked a second grader to the classroom on his first day, he confided in me that he was nervous. I assured him that it was going to be okay, and it was alright for him to feel a little nervous. We talked about how weird it is that everyone has on masks but that we would grow used to it very soon. I checked on him a little later in the day and his teacher said he was doing fabulously. Kids are a lot more resilient than we give them credit for!

9. Know the facts. I don't know about you, but I am tired of hearing people talking about what is and isn't going on. There is a lot of misinformation out there, and people are spreading it like wildfire. Go directly to the CDC and look at the facts. Here is the data from the week ending 08/01/2020 regarding ages and hospitalizations: (click the picture for a larger view)

I chose those ages because that is the population most of us are working with, as well as the ages most of us fall in. At first glance, it looks like the hospitalizations greatly increase within the typical age range of teachers. But look just below the graph to put the numbers in perspective. Again, I have to emphasize that I am not downplaying COVID. I am urging everyone to think for themselves and do the research themselves. And absolutely follow the guidelines set by the CDC and your school system.

10. Take care of yourself. With my school schedule, I'm getting up quite a bit earlier. I don't think I've ever set my alarm as early as I am this year. It's important to get plenty of sleep, drink plenty of water, eat right, exercise, and vitamins couldn't hurt, either. Using antimicrobial sprays and better-for-you hand sanitizer are also good ideas. 

Rainwater Farm Hand Sanitizer and Antimicrobial Spray

If you are going back to school and will have to see the students face to face, I'm urging you to not be afraid or anxious. My advice would be to have a healthy fear of COVID, but don't let it paralyze you. I can't stress enough that everyone needs to wear a mask and wash hands. I also feel compelled to reiterate that I am in no way downplaying this pandemic. It is real and it can be serious, but I truly believe that with the proper precautions we will be doing everything we can to keep ourselves (and our students) healthy. 

Related Posts Plugin for WordPress, Blogger...