Bailey Womack 0:03
All right, welcome to the sixth episode of our Therapy Insights Resource Roadmap Show. Today we’re going to talk about some of the resources and our Access Pass library in different ways. If you’re already subscribed to Access Pass, and you have the printables feature included, you have instant access to everything that we’re talking about today. And if you don’t, you can easily sign up at our website at therapyinsights.com.
Bailey Womack 0:23
If you’re listening to this episode on a podcast or watching on YouTube, and you want official CEU credit, go to therapyinsights.com. Go to CEUs and then find the form for Pediatric SLP Resource Roadmap Show episode number 6, for your certificate of completion.
Bailey Womack 0:37
I’m your host Bailey and we have our writers Tasanyia and Heidi with us today. And Megan is behind the scenes pulling up our resources to display.
Bailey Womack 0:45
So I need to verbalize our disclosures because we offer the show for CEU credit, we’re talking about Therapy Insights products today. And we’re also all getting paid by Therapy Insights to run the show. So we have a great collection of resources this month. Lots of variety, we’re going to be talking about phonology, articulation, bilingualism, grammar, and even pulmonary conditions. So let’s get started.
Bailey Womack 1:07
Alright, the first resource we have is Spanish Language Phonological Inventory Card Set. And Heidi, you created this resource, can you tell us about this?
Heidi Miller 1:17
Sure. So um, we have another resource in our library, that’s for English with these phonological inventory cards. And they were really quite popular. So I thought, let’s do this. For Spanish, which you wish you could do it for all the languages, but we started here. So it starts off and it gives you like the IPA, the International Phonetic library, sort of like, it tells you what sounds are aware in the Spanish language. So that helped. I don’t speak Spanish. So I don’t, I didn’t know a lot of the stuff I was creating this resource. So I found it actually really helpful to just have this, this cheat sheet almost to know how to make certain sounds like I know, in my head, I’ve heard. And actually through the course of making this, I started to feel a lot more comfortable understanding how to pronounce certain words, and then thinking about how I am a monolingual therapist, but there are situations you end up in where there is literally no other options. So this is a nice, hopefully resource for people to use.
Heidi Miller 2:19
So it has that little table with all the different sounds. And then it also it’s really nice at the bottom, it has some other websites to explore. So like Portland State University was frequently cited, as I was researching for this article for this resource. And they just have a wealth of information, they have stuff and other languages other than Spanish as well. So that was a great starting point for me. So we just put those there. And then these cue cards and community language that is produced by Eastern Health. And then we also wanted to shout out and list some other Instagram accounts you can follow that are bilingually focused. So there’s about six right there that if you follow, that’s what I do, I follow them. And that’s where I get ideas or think about, they also have some of their own resources that we would encourage you to seek out if that is what you needed for your therapy services or for to provide your services. So then, the other part of this resource is three pages. And there are these front and you fold the cards so that you can use them where the child can either just be looking at the picture and name them or you can be talking about the sound. So we use so we used the phonetic library from Spanish, and then the words are written there.
Heidi Miller 3:36
And you can kind of use those to practice and even if you don’t speak Spanish, you’re able to maybe get some buy in or access to the language using these. So, you know, I don’t want to go through and pronounce them all. But you know, there’s, there’s our all of our sounds and it kind of tells you how to pronounce them. So this was definitely a leap of like, I think this is something our field needs more of, Am I the best person always to make it? No. So we tried to pull in other therapists to chime in to help us make this but hopefully, it’s the start of being able to build out more of these types of resources, because it’s so needed. And I think something I think is important with this activity in this set is it can at least offer you a starting point to understanding like do they actually have a phonological issue? Or is it a language, they haven’t acquired these things in English and so we don’t want to penalize a student or a child that can’t do it in their second language if they’re able to do it in their first so sort of kind of my other reasoning for building out something like this because you should be able to use these for like quick stimula bility probes and to figure out can they make the sound just like you would want to know in English and then maybe that’s a nice place to start. So yeah, They’re really pretty little cards. And like I said, we have a lot of buy in with the ones we made for English. So kind of jumping out here and seeing if we can get some buy in and a second language. So
Heidi Miller 5:18
You’re still muted.
Bailey Womack 5:19
Sorry, I’m just talking away. I was just gonna say I love this resource and like maybe could possibly even be used like as part of an evaluation maybe like totally. So it’s very versatile in that way. And the images are beautiful.
Bailey Womack 5:36
I was also going to say it might be a nice segue into our research article, if we want to move on to that. So this is a great topic, y’all. The title is Phonological Acquisition and Bilingual Spanish English Speaking Children. So this article was done, the study was done in 2010. So the takeaways the main takeaways from the article are that bilingual learners demonstrate some separation between their two phonological systems. But those systems do interact to aid in the rate of acquisition. Most bilingual children were less accurate in their speech sound productions in comparison to their monolingual peers. However, their skills still fell within the normal range for their age, super important. In this study, bilingual and monolingual learners showed very similar rates of acquisition of phonetic inventories, researchers did not find a correlation between high sound frequency in each language and more early our accurate acquisition of those sounds. Overall, bilingual language learning did not negatively impact speech on acquisition and young children in the study. So I think this is just really great information.
Bailey Womack 6:38
And just kind of quickly, the study looked at speech, sound production, between monolingual speakers and bilingual learners, they were things that were eight of each group, so a smaller study. And of course, they said, you know, more research research is needed with a larger sample size. But it did find some really great info. I also found it really interesting from this study. So it says results of the analysis on constant inventory showed that all bilingual children demonstrated typical acquisition for their chronological age. And then similar to their peers who are monolingual later developing sounds were not accurately produced. So a lot of similarities and parallels there, comparing the two, and then I think this is a nice time to bring up. Just, you know, I would love to hear Tasanyia And, Heidi, your thoughts on this, too?
Bailey Womack 7:25
So historically, you know, there seems to be some SLPs out there who tell families who come into evaluations and therapy, who are bilingual or multilingual, that bilingualism causes a language delay. And only is that just inaccurate. I think we can all agree it’s just it’s inherently racist, and it’s rooted in white supremacy. And it’s also just unfounded. It’s not evidence based, it directly contradicts what was found in this research article, and many other research articles too. And it’s just inaccurate. And I also find that just kind of go against our code of ethics, and it just seems unethical. And just, you know, I feel like the only reason that a therapist would tell a family that is that English and whiteness is superior or better, and that seems to say that it’s better than their culture and their background. And I think another thing I thought about was just like how that makes that family feel in that moment, like, what if one of the parents or caregivers or family member doesn’t speak English, like so what are they supposed to do just not, you know, communicate with the child. And I’ve I’ve been told by co workers and therapists before a few times, that the child should pick a language, just just pick one, which just felt completely wrong to me in all of levels. And then just again, directly contradicting what research has shown us and it also isn’t a demonstration of like, family or child centered care. So anyway, I wanted to hear your thoughts on that.
Tasanyia Sebro-Calderon 9:00
So it’s interesting because I was listening to it and a lecture that I was looking at this piece and I was thinking about some families I work with as a multilingual clinician, and I work with families who are Spanish speaking, Creole speaking French and American Sign Language. And more often, I hear it with ASL is a whole different perspective. But what we all speakers and Spanish speakers, many of these children, their families are instructed to pick the language like you said, or they’re told that if they don’t speak English only with their child, and that’s the language you’re told, if they don’t speak, or use English only with their child, that a child’s gonna have significant delays, they’re gonna do poorly academically. And we know from research that this is is not true and, and more research is being done, because people are becoming more aware of the fact that it makes no sense and that it’s culturally insensitive. And we started showing that these children actually succeed, it actually helps them succeed to use both languages.
Tasanyia Sebro-Calderon 10:20
And what we also notice that they actually do acquire a set of skills in both languages, in English as they may have been their primary language to secondary language. But as they grow older, they develop it more, right. So they’re having they have a good amount of receptive skills in Spanish, for example, and they’ll have the other half in English as the role play development that children has to pick the language and, you know, you may think that it’s something that SLPs argument as often now, because Ash is pushing this whole cultural competence thing, but it still isn’t permanent. And what’s dangerous about it is that children are not only losing their language, they’re also not just losing out important aspects of their culture. But they’re not able to maintain that bond between family members who only speak their other language.
Tasanyia Sebro-Calderon 11:35
Going to have to get into the habit of not doing that. But people who claim these parents who are sometimes they migrate, or they emigrate to the country, they already come with the idea of one of your children’s act to acclimate into the culture better. So it’s very dangerous, because they themselves acquire this thinking that their language and their culture is not as important as the English or the American culture. So as SLPs are 2023, we need to get, we need to advocate a little better for these families and start telling them that they have that language.
Heidi Miller 12:18
Yeah, when I was working through these, because the next resource we have as well, one of the other ones today we talked about is like sort of just like a, where would you even start with these clients if you’re not familiar with them, because there isn’t a lot of support in our field. And like you’re saying, it’s just so it’s not morally okay to go about treating that way, treating families that way or treating disorders that way? Because one of the biggest things that flagged across all the resources I was looking at is we’re override were identifying children that are not on that are bilingual as having disorders. And maybe they don’t, and then you’re getting in a slippery slope where, like you were saying, Bailey, you’re, you’re imposing like another culture on them and saying, Well, you’re disordered because you’re not like, you don’t speak English well, or you’re not white, or you don’t fit in with wherever you live. And so I think that, you know, in some ways, these making these resources made me uncomfortable in the sense that I was like, This is not something I’m super familiar with. But I think that’s what our field shies away from is stepping into those and saying, let’s try something or let me at least start really thinking through this and combining these resources. So it’s accessible to our subscribers to start thinking, What should I do, maybe I can’t solve it all, in one resource or one treatment session, but I can at least have a better deeper understanding of where things are coming from, and can build out to be better, a better support and advocate for these students and these kids. So I feel like, you know, maybe my main takeaway from building needs was like I need to keep doing better there is there are resources there we just need to find a way to make them the norm and kind of swim against the tide that’s been going have negative connotations for bilingualism, or you guess over characterizing disorders or not serving these families as well as we could even if we are a mono lingual therapists, like not letting that just be an excuse anymore to say, well, I don’t speak that language. So I guess you’re gonna have to figure out mine. We’ll go from there. So anyways, interesting stuff, but I agree. There’s a lot more research lately and a lot more resources. So it’s up to us to kind of use those.
Tasanyia Sebro-Calderon 14:34
Yeah, I think, you know, you mentioned something but I think academia is one of the places where we could start because I know a lot of I have a lot of classmates or colleagues who said that their program made it mandatory that it took out speech therapy themselves, either for accident, electrical radiation and and many of them work program and I’m sorry for students to graduate as SLPs with master’s in SLP, they have to take and they have to change the whatever region they are studying in. So we have to start, I mean, that’s not the only place that we can start. That’s one of the main places that we should start that you have to start with our programs that we are being educated for. Because what happens is, as SLPs, wherever, bilingual people who have dialectal variations, and even as those of us who are monolingual. And we’re seeing this model from our academic programs that we attend, go, and we do this to our patients, my clients. So one of the places that we can start.
Bailey Womack 15:56
You read my mind, Tasanyia. Yeah, I was just going to say that, like, I totally agree, you know, how are we training and educating students, grad students and clinicians? You know, from just from the start, I can’t recall, maybe we had one discussion in our language development class about this, you know, about multilingualism. So yeah, that’s absolutely a great starting place.
Bailey Womack 16:18
Thank you guys for contributing your thoughts to that, let’s move on to our next resource. So Heidi, you wrote this one, this is titled Working with Bilingual Clients When You Only Speak English. So continuing this great discussion we’re having this is a three page resource with tons of just packed info in here. divided up into paragraphs and bullet points. Tell us more about where you are going with this one?
Heidi Miller 16:44
Well, this, like you guys are saying, it’s like, if I could take a class on this, these would be the five sections, I would want to learn about more. So I tried to give you guys like a brief overview. And like, we collaborated a lot with a bilingual therapists that we looped in to make this even richer and more appropriate. So I’m just gonna go through the sections, because I think those are the most useful parts of this resource. And again, it’s kind of just something, you need to read it and then digest it and think how can I implement this because I found myself after putting this piece together being a little more critical. In my planning for my own, like my job job, I work with patients and thinking, okay, reminding myself that language learning is a system, it’s a, it doesn’t matter what language we can still find ways to understand where deficits may or may not be, it doesn’t have to be solely based on what language the child is using.
Heidi Miller 17:43
So anyways, the first part just like we sort of are talking, this is a thorny issue in our field. So there, we just have a little note on the ethics. And just mentioning, it is a great area to be a monolingual therapists giving services in a in an to a non same language, child, I mean, there’s just inherently all kinds of pitfalls. And, again, are you promoting one over the other things like that. So your best thing is, your best thing you should be doing is finding a bilingual therapist, but you can’t always make them appear out of thin air, especially in different areas of the country, you’re not going to find that. So but that is the most ethical thing to do is if you can’t provide services in their native language or their home language, then you need to seek out someone who can. And that’s been that advocate piece for talking about, again, if you can provide an interpreter service, that’s kind of a nice middle of the road, not ideal, it’s super awkward, a lot of the times it’s not reliable, it’s not available.
Heidi Miller 18:42
But another option, you could you know, a professional translator where you’re, it’s either a service your facility has or something comparable. Really, the last thing you want to be doing is trying to get a sibling or a family member to be translating things that just gets thorny, because you don’t know if they’re gonna You can’t assess everyone’s proficiency in every language. And that’s just that’s putting a lot on. Sometimes a child, I’ve had situations where yes, that’s like a teenager has come in and been like, well, I’m going to translate for my mom, so she understands what you’re doing with my sister. And you know, if that’s really the only thing that there is, you can kind of plod through that for a little bit, but that shouldn’t be your standing treatment model. And so, but ultimately, if you’re willing to put in the work and make an effort, it is okay. it’s ethical to try it’s better to try to provide services than to if you’re comfortable, I guess would be the caveat there than to just let a child languish and not have services if there’s nothing else available.
Heidi Miller 19:48
So we also then like we were talking in the last little bit here, just the framework for bilingual child development. It doesn’t cause a delay. There’s language confusion, actually, a lot of times if you find kids splice seeing languages together that showing an elevated understanding of both languages. So we shouldn’t be critiquing that. If there is an identified language delay, you should still present both languages, you don’t have to stop, you don’t have, you don’t want to enforce that idea of picking a language. And again, if you were gonna pick one to cut back on, it would probably need to be the second line, you know, you want to support their home culture and where they’re from, not say, Well, okay, time to move to English, because you’re you live in America. Now, you know, like, I hear that, unfortunately, more than I wish I did in all parts of my life, but and something that’s just so beyond the ability, a lot of times have a mono lingual therapist, especially to understand is there dialectical differences in every language. So you really have to, if you can figure out baby where the child as from and then get a little more information, maybe speak to a Spanish speaker, or someone who’s more familiar with the language, even if they’re not part of your session and sort of say, is there a dialectical difference going on, you know, we have quite a variety of Afghan refugees on our in our community here, and there’s quite a few dialects are their language and it varies greatly. And sometimes we have trouble with interpretation services, because they don’t line up.
Heidi Miller 21:20
So just being aware that we don’t want to again, assume that somebody doesn’t understand what we’re saying, or that even the interpreters not understanding, we want to assume that maybe there are just too many differences still, just like there are in the US people use different words in different parts of the country for different things. And something I found most useful was researching the native language phonology, kind of like we did with that Spanish phenological inventory, trying to understand a little bit from your perspective, so you can know how to identify different phonological processes. So that kind of works, if you perceive they have a, an articulation disorder, the assessment evaluation piece, there are a couple that are translated, we’re kind of, again, in a narrow silo of front of Spanish, sorry. So the pls comes in Spanish. And there’s a new one called the bilingual English Spanish assessment. Again, those are designed with the right intent, probably, but again, any standardized assessment, it doesn’t matter, where, who, what country, they are inherently biased in their creation. So you know, using words or scenarios that kids in different cultures may not have access to it comes from a very white English centric model. So just being aware that you still have to have a critical eye, even if you’re able to give an assessment in Spanish. You know, we don’t want to assume that their deficits because there could be just a breakdown in well, I’ve never been to that place, or that place doesn’t exist in my world, or we don’t use that kind of social situation.
Heidi Miller 22:58
So using Dynamic Assessment is really the best one of the better ways to go about this, like teaching a child something or so first you test it, you kind of say, whatever you whatever the stimuli is, you know, trying to get them to say, or say request something, you try to teach them that in the session. And then you go back, you do something else, and you retest it and see if they can show the skill. So that’s really hard, especially as a novice clinician to kind of pull that off. But as you become more seasoned, you can sort of teach and reteach or teach and retest these different stimuli that you’re trying to understand whether it’s a language piece, like expressive receptive, or it’s an articulation, you want them to produce a sound. And then again, criterion based assessments, where you’re just kind of measuring the child where you’re starting with them and how they make progress is probably a better route as well than relying heavily on standardized assessments for these. This group of students and again, as much as you can doing really thorough interview so you can understand where these families and children are coming from, where are the breakdowns? What can they describe? Are they having trouble understanding the child and the native language and their home language or our that’s not really the issue, it’s, they’re having trouble with English or whatever, you know, trying to understand all the different pieces. I also came across when building this that I don’t know if people are familiar with the school age, language, assess school age, language, assessment, measure salt, or slam sorry, and then there’s salt as well.
Heidi Miller 24:35
Those are platforms, you can use and do a language sample and they actually will translate into a couple different languages. So that could be helpful to where you basically just record the child interacting with you. And then it can do a language sample. And that could be super helpful when you’re not totally familiar with the morpheme morphology and syntax of another language, but it would give you a starting point to understand. So there’s actually like we’re saying, there is stuff out there, it’s just not always easy to find or understand. So you have to take the time, kind of speeding up your goal for me goal formulation, you can kind of use, use resources online, figure out what the phonemic inventories are, if you’re dealing with articulation, and find what error sounds or patterns that would align, and you could make that a goal, you want to make sure that the family can understand the goals, it’s not useful if it just you only understand it. So being really cognizant of that. And again, making sure even though it’s going to be difficult finding a way to understand how their communication is impacted at home, and that these goals align with things that they want, not things that we think they should be able to do, if that’s not what the struggle is, it’s not an appropriate goal at home.
Heidi Miller 25:52
So I give some examples of each and then for treatment, again, your you can still use the same research based treatment, you just have to find a way to either utilize, you know, I think of like working with the like maybe two year old population where you’re trying to just teach simple requesting behavior or teaching vocabulary, you can learn that too in another language. You know, that’s why pictures are really great to have access to and if you’re able to do that research on your own outside of the session to provide them not that you’re trying to provide the session in Spanish unethically, but you’re trying to say let me give you more familiar stimuli and words that you may recognize so that you’re I’m kind of teaching you the skill, and then the goal would be to teach the family at home how to engage in these activities. So anyways, I think that the big thing here is you have to keep learning. I mean, I finished this resource, and then I was like, there’s so much more I want to add. I feel like I’m so behind in this area. But you know, I think you have to kind of say I’ve got to jump in and get some sort of framework to start from and maybe that will be helpful. So that’s kind of what this resource is trying to do so.
Bailey Womack 27:07
Awesome, Heidi, thank you. Go ahead Tasanyia.
Tasanyia Sebro-Calderon 27:12
Yeah, I really liked this resource Heidi, because I feel like there are way more monolingual SLPs than there are bilingual and multilingual and we treat so many children encounter so many children who are bilingual, bilingual, who need services. And like what was mentioned before they either don’t get it because some people just like, you know, what am I touching that they’re bilingual? Or multilingual? I mean, I’m, I’m monolingual. Or they attract, they try to work with children, but the culture is just not right. So this is a nice, this is a nice video, and you had mentioned something about differences with dialect. And I think that’s really important. Because so for example, with like Spanish speaking, patients sometimes will get an interpreter. And that interpreter is supposed to be versed in knowing that there’s going to be variations of wildlife, but they are communicating with the family and with Spanish from Spain, and these families are from Ecuador, or, you know, and there’s so many differences in terminology that’s used as a land barrier, person to intervene, it’s still not, it’s still not most optimal, but you know, I think just keep that in mind. And still always will, you still have when you have someone who speaks the language, you still have to keep ethics in mind, and you still have to, you know, keep cultural variations in mind when you’re working with these families.
Tasanyia Sebro-Calderon 28:58
And also, some, some facilities don’t have some one that like a live interpreter, and they go for what’s there, you know, they have the ritual interpreters, which I think is amazing, because it’s always about trying to find someone to intervene, who can help to make the intervention work requests are more effective. But we have to also keep in mind it is a cognitive component, that the virtual is not always the best either. So I want to say that it’s okay sometimes to pull a family member in or someone who’s there keeping HIPAA guidelines with plus in mind, but just to have someone there a live person to help because sometimes things are two concepts are too abstract. What isn’t cognitive component that’s there. So you might have you might be doing your best to have a virtual interpreter there. But the individual still is not understanding because for somebody have to understand that talking to a screen, or listening to a speaker phone when someone’s talking to them. So there’s a lot that’s involved in that.
Tasanyia Sebro-Calderon 30:10
So the point is that, even in trying to be politically, ethically sensitive, we still have to continue to do so as we bring to the session, all these other factors that we’re using to try to help our patients or our students, but I love this resource, I completely love it. And I would add it to, again, give my interns packet when they come in. And this is something I would have to like intends to use with throughout their packet.
Heidi Miller 30:46
I’m just saying like, after putting this together, I mean, like, this took a while because I, you, you’re dealing with trying to capture a really big issue and like make one one to two resources to start. But kind of like I said, my takeaways from it are we’ve got to try, and we’ve got to try to do better. And then I almost didn’t become overwhelmed, overwhelmed, because I was like, you know, whatever. I’m doing an early language session with a little kid. If I’m doing that in English, I’m not teaching 50 new words in this. Yeah, I mean, yes, you wish you could talk more in the other language, but it’s like, it’s not that hard for me to think about how could I just use colors in their native, you know, go find and how to learn and listen on Google. I mean, you can type it in and they’ll say it to you. Or just simple requests, like how much more progress we could make. If therapists were willing to kind of put themselves out there and try, you know, asking questions like or different free just short phrases, like it’s not, we’re teaching language, like I was saying, it’s a system, it’s a way to learn something, it’s not a silo, that’s English, you only learn English this way. You learn every language in that way. So what things kind of challenging myself to find? What are the similarities of things I could do so that I can just learn a couple of things and get started somewhere? So just definitely a big area for growth for everybody? Probably, in our whole field. And just Yeah, so.
Bailey Womack 32:21
That’s so true. Like what you said about being an area of growth and like, what you were saying Tasanyia, how you would, you know, provide this to like students or interns and maybe even like, I had the idea of maybe like doing an in service with other like, if there was like a bilingual or multilingual therapist at the facility, you know, they could maybe use this as part of like an in service or training. Just to, you know, have that have that discussion with the whole team, make sure everyone’s on the same page, and just keeping one everyone abreast of this, you know, this info. Awesome. I love it.
Bailey Womack 32:53
Alright, let’s hop over to our next resource. Tasanyia, you wrote this. This is called Pulmonary Conditions and Pediatric Swallowing Difficulties. This is a one page resource, it has a paragraph at the top and then a chart at the bottom. So tell us more about this resource.
Tasanyia Sebro-Calderon 33:10
So how many of us as SLPs working with this stage of you have gone into how say that your kids didn’t walk and what not just a kid, sometimes long term care, our patients and we’re consulted for complaints and swallowing difficulty, but there’s no related diagnosis is what we’ll hear from doorframe physician or practitioner. You know, like, oh, well, the child’s complaining, but there’s no reason for it. There’s no neurological reason. And then sometimes the chart review does not list a pulmonary condition. Or sometimes it’s there, but the practitioner doesn’t think about how that may impact swallowing, how that may be mirrored as a small component. So this is what I was thinking about when I created it. Because I know several times I’ve gone in and even encountered this wax with my colleagues were like, well, you know, it’s really like a pulmonary condition. And with our adults, different COPD, people tend to think right away. Okay, well, it’s, it’s the COPD, it’s not beyond it’s a chronic obstructive pulmonary disease. It’s not the feeding or they, they tend to have problems have little differently with adults we have to repeat. So that’s why I created this. So basically this contains two children, and the focus was-
Heidi Miller 34:53
Tasanyia Oh, no. I shall hopefully come back. I know she said-
Tasanyia Sebro-Calderon 35:06
Okay. Okay. So I’m gonna backtrack a bit, I don’t know what we missed. So this content, this piece has a little information on pulmonary conditions specific to the pediatric population. And even though I did focus a little bit more on asthma, it could be applied to other pulmonary conditions as well. And as SLPs are trying to try to add to evidence based practice, we should always be doing search anyway. So you would, when you’re working with this population will always be doing a search anyway, to see how this applies. But this just list some of the associated smaller events that we may see with children who have a range of mild to severe asthma. And what I did was I invited the stage of the swallow, and what impairment we will see. And then some of the characteristics and a little explanation.
Tasanyia Sebro-Calderon 36:06
So for example, during the oral stage of swallow, we may see a typical movement of the tongue. And, and it might be through poor strength coordination to control the tongue with liquids and solids. And it takes place during oral bolus formation and bolus propulsion. And we see it with well as severe cases of asthma but more so to put severe cases, we do come across children in various settings, but right often in the acute setting, who present with period difficulties that are associated with your condition, I created this piece. So I can tell you that I’ve sometimes went into to do an assessment with a child. And like I said, I mentioned before, the nurse might say, I don’t know why they’re complaining, they’re complaining about paying the costs and with everything. And then when you do your case, your history, sometimes you as one diagnosis you know, if you forget about it, or people don’t realize the impact of the asthma could have on on their swallowing function. Or sometimes their swallowing is fine. And we are showing signs and symptoms of airway protection, difficulties, such as coughing, no clarity. And it’s not anything to do with the swallowing function per se, but more so it is a characteristic of their asthma or their pulmonary disorder. So this is what this piece is all about. And I would say that SLPs use it, I would share it with nurses, I share it with physicians. And this is something that I give to whoever’s in charge of the unit for education of the unit and give the shares go ahead.
Heidi Miller 38:19
I love this because I was gonna say as you were listening to people, I was like, I’m gonna give this to the doctors in the ICU because the pediatric ICU I work in because they just think everything is a sight. Like, it’s just a breathing issue. There’s nothing to do with swallowing or like, it’s all right there. Why wouldn’t it you know, and just having or even pull the paper you’re referencing, and it does show them like actually it is very impactful. And you know, like you’re saying through the case history, sometimes it comes out like Oh, they’ve had pneumonia a whole bunch of times random and you’re like, actually it’s probably not that random.
Heidi Miller 38:54
And you’re like, here’s why. Because I think this is especially I feel like asthma, you know, the prevalence of it we have a lot of admits here for asthma, you know, severe asthma attack. And just intubation for long periods of time and the pulmonologist love us but we can’t always get to them through the attendings. I have to stay in our lane and I’m like I know the pulmonologist will love this so this is a good resource to use for them.
Bailey Womack 39:26
Yes super unique resource and I love the chart at the bottom just how you have it like it’s just easy to read and like if you have to quickly reference it or if someone else in a different disciplines reading it it’s just it’s very like easily digestible, but like has really great detailed info in there. Thanks for that.
Bailey Womack 39:46
Let’s move on to the next resource. This is called Gliding Under the Ocean, it’s an articulation activity. Heidi wrote this- this is like so like pleasant to look at. It’s beautiful, beautiful colors really engaging. It’s four pages, and has instructions of beginning with some bullet points and then a nice scene with different ocean animals and then some individual cards. So how do you tell us more about this resource?
Heidi Miller 40:14
Well, you guys have really been interested, it seems like a more articulation resources, and we seem to do a really good job of making pretty ones that aren’t antiquated looking. So, and glides are always a tough one. So this is an ocean theme. Yeah, so and then I just give, like 10 ideas of different activities you can use. So there’s flashcards you could match them, you could turn the lights off and do like an under the sea hunt kind of thing where you could have them look at, you know, point the flashlight or pen light at one of the animals and say it get matching again. Or you can make a tongue twister with the words or a scavenger hunt with the cards around the room. This is a great like, please laminate and use for multiple people because you probably kill your color printer if you did this 12 times, but it’s good one to just have in your your filing cabinet. You could do rhymes that’s something I find it really helpful for glides to is like how you get to two attempts for the price of one kind of what what rhymes with whales and they could say snail and things like that. And then you can tap them sort these cards by sound position to try and get building more of that phonological awareness. Like where is the L sound is at the beginning or the middle or the end of the word and put them in groups. Using a mirror when you’re practicing these words, they could build their own story.
Heidi Miller 41:42
And this also, you could probably find a way to do a teletherapy kind of activity with this if you’re in the teletherapy world. So again, just an easy, very straightforward resource really just making it to bring materials into the 21st century. I hate doing flashcards that are old and ugly or tattered. So these are really bright and shiny. And I also made this one that whole submersible thing was going on. So it felt kind of like oh, everything’s in the ocean. Anyways, random thought but yeah, lots of cute things. So easy to use.
Tasanyia Sebro-Calderon 42:28
I love it. I like that you gave some sample activities that they can do with it. This is so gorgeous. And it’s so funny. Like you said, I pulled, I won’t say which one it was, I pulled an old deck of cards that I had. And I was like, Oh my gosh, this is so outdated. So dull, and some of the pictures are so inappropriate. This I love this, I absolutely love this.
Bailey Womack 42:55
I love it about our resources, like we’re just that kind of sets us apart. We just have really nice graphics and images. And I feel like a lot of the kids, I’ve worked with love ocean animals and just kind of a favorite, you know, among among kids, maybe not every kid but definitely a popular one. So definitely lots of ways to use this. Love it.
Bailey Womack 43:16
Alright, let’s hop over to our next one. This one is Dynamic Irregular Past Tense Practice Activities. I love anything with like grammar. Oh, I just love it. Heidi, you wrote this. And we have a couple of different pages. The first one we’ll talk about has different lists, numbered instructions, and then we have some images and graphics. So tell us more about your thoughts here.
Heidi Miller 43:42
Well, like this month, the theme for me, what are things I’m not good at doing in therapy. So bilingual therapy is a growth area. And I cannot stand teaching irregular past tense because it’s difficult and it’s like you are like we’ve said a lot of the resources around it are very boring or dull and they don’t move and they don’t, they’re not really you’re just kind of hoping eventually the child memorizes what you’re telling them is kind of how I feel. So anyways, the first page here kind of goes through it has seven ideas to use these resources. So I was trying to think of a way to make something move a little bit more and like because I just have time with trouble with that temporal aspect of for kids to understand what yesterday and today and like how do you get them to understand why and to switch and things so there’s these two frames so what you would want to do is cut those out the yesterday and today and you can kind of move them over. There’s two Blake landscapes. I think we have the slides will like move here in a minute. If you’re watching online, but we’ll wait a second. So things you can do. So having the child kind of just taking time to understand what past and present tense are so moving yesterday today and like you could move them One more. There we go. Beautiful. Here it goes. And so then you see these. They’re the same cards. They’re the same picture for the present and past tense, and they have the word on them.
Heidi Miller 45:11
And so again, it’s still a little hard because like, how is the child going to know the difference other than spelling, but you’re just going to have to, hopefully, you know, this is great for kids that can read. If they’re still pre literate, then you might have a few more struggles getting this concept through, but you’ll have to rely more on the auditory cues. And then sort so sorting is always a good activity matching pairs together. Then, drawing three cards from the same tense and making up a story and then trying to get them to tell the story in past tense and again, using these frames to kind of help them have something to do kinesthetically. Like, okay, I’m gonna move these down here, what makes made so yesterday I made the What is he doing? He’s painting yesterday, I made a painting activity today. Or I’m, he’s makes one. So again, even as I’m stumbling over my words, because it’s just such an awkward thing to teach.
Heidi Miller 46:11
But I felt like giving some more visuals and cut outs and things to move around would at least give you more flexibility versus just like here’s a worksheet fill this in, you’ve got to understand that makes goes to made or speaks goes to spoke things like that. Something I found works really well a saying it wrong, trying to get your client to say the wrong thing. Like when they’re starting to master it be like, okay, say that backwards or say that for today, even though it happened yesterday, or, you know, happened yesterday. And then you can also make a little mad libs. So again, trying to find, you know, I don’t even think I have all the right ideas for how to use these cards and these sort of frames and landscapes, but because it’s more mobile, and you can just cut them all up and have the different scenes, you can move things around in a different way to maybe give some more depth to the activity or help those, learn those people with, you know, kids that need more visual supports for this or the moving piece or the temporal understanding. So again, it’s a difficult one. So at least you’ll have some cards and some different frame, what are literally frames of reference to understand that two tenses, so maybe it’ll help.
Bailey Womack 47:33
Yeah, I’m always looking for different ways on how to address this particular just abstract part of, of our language. I love it. I love how, you know, there’s just like different ways to use it. And like, again, the images are like super engaging the conversation pieces and even like going past, you know, we can make even more sentences or a few different sentences, depending on the child’s functional level. Yeah, this is fantastic.
Tasanyia Sebro-Calderon 47:58
I think it was a good idea to use the same images as well, I think it will help to carry over the concept. You know, irregular past tense is one of those topics that I put into the basket with our difficult areas, like with our example, you know, that’s articulation. But that goes into that basket. This helps. This helps a lot. This will help a lot.
Heidi Miller 48:22
Yeah, I went back and forth on having like, the pictures be the same person, I was like, they have to be the same because that’s what kids aren’t under nothing is different, except the word that you use. So I am glad to hear that support. That’s a good choice. Because I was like it should they be like one half a different background color or something like that. So you could do that as well put like a little star in the corner of all the past tense if you wanted to help them identify. But again, you’re sort of just trying to make a really abstract concept concrete. And that’s always hard. So
Bailey Womack 48:56
All right, y’all, let’s move on to the case study. So I’ll go ahead and read it and I will talk about it and our resources that we chose. So the case study for this month. And just before I start, we always like to do a case study because it allows us to just talk about potential cases in different ways we all give our perspectives. And also, we’d like to tell you about some of the other resources in our archives that relate to the case study that you could use.
Bailey Womack 49:19
So we have a six year old female who has a diagnosis of childhood apraxia of speech. She has been in speech therapy two times a week for the past year. She recently changed schools, going from kindergarten to first grade with her parents report has caused an increase in challenging behaviors at home. Her speech pathologist also feels her progress has in therapy has been affected by this life change. As she is difficult to engage and often refuses to participate. Her parents are wondering if she could either take a break from therapy or increase therapy sessions while she is adjusting to this change. So we all chose some different resources from our archives. And the one on the screen now is something I chose. So this is a one page resource. It’s a really nice selectivity. It’s Spring Themed Apraxia Activity, and we call it the speech garden. So this has some CV VC different syllable shapes with pictures of flowers. So some examples are me, my bee, bow, pie, etc. And it has some instructions at the top and the child can place the flowers in the picture in whatever way they want to, by practicing each syllable, shape or word. And then again, depending on so this child, for example, might be past, you know, those smaller syllable shapes. So, putting those into sensitive sentences, because we know, practicing connected speech is so important with apraxia. And just using those words in different ways, you could do at the word level, phrase level, sentence level connected speech. So it’s a nice way to practice those different shapes depending on where the child is, and then incorporating them into where their current level is.
Bailey Womack 50:55
Alright, let’s move on to the next resource, I believe Tasanyia you chose this one. So it’s a one page resource called Therapy Techniques and Activities for Childhood Apraxia of Speech Without a Certification. So go ahead and tell us why you chose this resource.
Tasanyia Sebro-Calderon 51:10
So I just want to say that the family is requesting to either take a break or to increase. It’s very like, cloudy, I mean, it’s very confusing, you either take a break. Or you I chose the family could also try to be involved in doing some therapeutic stuff in the home setting. So it discusses what ces characteristics are, and some of the guiding principles, how to develop a treatment plan, what are my principles, tackling this ferocity, incorporating phonological awareness, and also a little bit about certifications and childhood apraxia of speech and even though this would be more so for, and as a clinician, I always think that the most therapy is done or the greatest therapies on at home. So um, I would share this with the family. And I, yeah, I wish it with this one with the family. So they have an idea of what their what they can do with some goal planning at home. You go to the next one.
Tasanyia Sebro-Calderon 52:38
So this one talks about Speaking Rate and Pacing. And there’s some ideas on how children with articulation errors and for logical processes, speech delays, practice with apraxia of speech, excuse me, how they generate, how they generally benefit from speech pacing, like I need to switch gears right now. So there’s some ideas on what the family can do at home. And again, I’ve chose this because it’s some stuff that the family can do at home to carry on versus they’re requesting, possibly increasing therapy, and there’s a high chance that they probably would not get increased therapy, or there’s a possibility that they may not get the increased therapy. So I chose this. So they can work at home with your child on it or so you can share it with their treating therapist, and also so that they can have something that’s fun to try to help keep her engaged him or her engaged in the her engaged in the activity next. Move on to the next one.
Heidi Miller 54:05
I think it’s interesting, like you brought up that a parent wants either more or less therapy. It’s like, I find that frequently we’re trying to figure out like, what what the breakdown is like is it sometimes kids are overdone and they just they do need a break. So one of the clinics I’ve worked in, we would cycle kids, they can only come for three months for like 12 sessions, and then they would have to take a month off and then we would revisit it just to see if some natural generalization could kind of occur so that was an interest, especially with CAS, which can be a really frustrating diagnosis. Sometimes you don’t always feel like you’re making leaps and bounds every week, but maybe a break is helpful. So
Bailey Womack 55:02
I agree. And I was gonna say too, it’s funny, you were talking about how like this case study, you know, the parents are kind of like giving us mixed signals here like, you know, do we want to stop therapy? Or do we want to, you know, increase it, you know, what’s what’s the best call? And that’s tough. You know, and I think with with apraxia, and with her only be in therapy for a year, I would not recommend stopping therapy, I know she’s had this major life change. So maybe I don’t know, reducing to once a week or something. But I know we all have kind of have different opinions about that. I mean, what what would you all do? Would you recommend to the parents, okay, let’s take a break for a couple weeks until she gets readjusted to this this change and these behaviors reduce how can we help with behaviors? Or do we keep going?
Heidi Miller 55:54
I think I ended up having a lot of likes, how tough is not the word, but like, deeper conversations with the family in these situations? Where are we coming to a place where maybe we need to accept that this isn’t something that’s gonna like, go from nothing to go from having this language disorder to, or the speech motor speech disorder to not having it at all. And sort of, it reminds me sort of, of some of my stuttering training, where you talk about the iceberg where, okay, on the surface we have, what we can fix, but the reason all this is happening is not just related to how they’re speaking. So like, sometimes I’ve talked to families about like, what other supports are you getting? Are you receiving? You know, maybe she would want to go to a, like a different type of therapy or counselor if to adjust to this change? You know, not that that’s always our role to say that specifically, but sort of having that conversation of like a speech therapy, what really the the only thing here that we’re we’re up against and only if you have a good relationship with the family, would you have that conversation, but rarely, you know, would you get to this point, I don’t think without some sort of relationship to have those.
Bailey Womack 57:08
Definitely, especially if you’re that far into it. Okay, our resource is backup. Tasanyia, you chose this one for the case study- the No Prep Dice Game for Apraxia. A super fun game. Tell us more about why you chose this one.
Tasanyia Sebro-Calderon 57:23
Oh, again, because it’s a fun game. And the family mentioned that she’s often difficult to gauge and refuses to participate. And let’s be real sometimes, because the activities are boring, or because they’re very repetitive, or they seem like an exercise. So why not look for something that can be fun, or that can make it a little bit more exciting, helped to make the child look forward to the sessions. And again, it’s something that can be done at home. So this piece includes some CVC words, VC words and CVC words CVC V words, see, VC, V, and two syllable words. And I think it’s just a good activity that the family can carry over at home, I believe they don’t carry over directly at home, especially for something like, like apraxia of speech, because sometimes people just think there’s gonna be like an overnight change. And I think one of the reasons why, which is why I’d mentioned that first piece that I just mentioned, two pieces back. Sometimes a family just has to understand that it’s not gonna be something that will disappear after a year, or something that will be addressed after six months. So I think these activities are great for carryover at home, and they will be a good option to help keep their child motivated and engaged in the session.
Bailey Womack 58:51
Fantastic. Thanks for choosing those.
Bailey Womack 58:54
Let’s move on to Heidi’s resources. How do you choose this one, it’s called Ice Cream Syllables. So cute. Three pages, and it has little ice cream scoops with different shapes, and then some images at the end with ice cream cones. So tell us why you chose this one.
Heidi Miller 59:08
Same kind of as the dice game. It’s just fun. I think sometimes if a kid’s been in therapy that much it’s get like it is repetitive and boring. And we’re not magicians I mean, we can’t always like make up a new game every week. But if you haven’t used this one and most kids love ice cream, I don’t know why, you know, and cone so you would cut them out and you make the different words. And it really helps to with psychological awareness as well. And I don’t want to say spelling but sort of reading and eliciting and blending words. So you can even also have them make silly words too, because again, with apraxia of speech, you’re really just working on the production of the sound at that point. So just another fun cute activity that you might get a little more buy in from this little girl.
Bailey Womack 59:56
And you chose this one, two page resource called Toys and Games to Complement Speech Therapy Sessions. So tell us more about why you chose this resource.
Heidi Miller 1:00:06
Again, sometimes we just need ideas of things to do, we don’t have time to create something brand new every session, especially if you’re seeing somebody this frequently. So these are just common games, we list that a lot of schools or therapy departments would have. And it goes through the different. It kind of tells you what area you could focus on like voice residents articulation, phonology, receptive, expressive, or cognitive woman linguistic, but really, I think any game you could sort of tailor to what you needed if you were creative. So and I’m not a big board game person, like in my own life. So sometimes I don’t know all the stuff out there. So I was like, oh, these are cool games, I should should grab one of those. And you could just grab it off the shelf and use it. And again, similar to teaching the family, like maybe having the parents come in for a session and be like, Look, we’re gonna play Monopoly, here’s how I would make this an articulation type of activity or game so that they could learn a skill to practice it in a non confrontational, non therapeutic environment. So
Bailey Womack 1:01:10
I like that Heidi a lot, because you know, like, a lot of times you see comments made, like, oh, you’re just playing a game, like, what are you working on, you’re just playing like, we’re just paying you to play game with my kid that I can do at home. So you’re like, showing them which areas of development and skill areas that you’re working on, and then how they can do it at home, like you said, without, you know, overloading them with, like, super scientific, you know, words and just kind of an easy to do activity that’s, you know, functional and realistic for them. I think that was all the resources we chose for the case study.
Bailey Womack 1:01:41
So I think we’re going to wrap up everybody, thank you, again, so much for listening in and watching in. We want to thank all of you therapists for just continuing to be keeping therapy informative, empowering, and person centered. And then you see the bullet points on the screen, just some more info for you. And then we want to also say this is our last episode of the Resource Roadmap Show. So thank you so much for watching.