Tuesday, July 30, 2013

Selective Mutism, Tips for Successful Communication! - A Guest Post

Hello blog visitors!  Today we have a fantastic guest post on the social communication anxiety disorder of Selective Mutism.  It is written by a kind- hearted and very intelligent, Speech- Language Pathologist named, Becky Lulai. Mrs. Lulai is a Speech- Language Pathologist in the Minneapolis-St Paul area with over 15 years of experience working with a variety of communication disorders.  She owns and operates Able Speech Language Services, a private practice specializing in education, consultation and treatment of selective mutism.   She provides in-home, on-location, or web-based services for families or other professionals interested in selective mutism.   Becky is also a Clinical Specialist for the Department of SLHS at the University of MN-Minneapolis and she can be reached at  ablespeech@gmail.com or 612-251-6021.  

We hope that you find this post as informative, interesting, and helpful in as many ways as we did! Thank you for stopping by the blog today and a HUGE THANKS to Becky for all of her hard work on this WONDERFUL guest post!
Manda & Shanda, SLP's
Twin Sisters Speech & Language Therapy

Selective Mutism, Tips for Successful Communication!
By Becky Lulai,  M.A.  CCC-SLP

Many SLPs experience a little anxiety of their own when coming across the diagnosis of Selective Mutism (SM).  Very little time is spent discussing this issue in graduate school, but more of us are finding these kids on our caseload.  Although this is a complicated social communication anxiety disorder, there are many simple things that we as “communication experts” can do to help these children overcome their communication difficulties.  Below are 10 guidelines when considering a diagnosis of SM. 
1.       Lay off a little!
Decrease the pressure to speak.  As counter-intuitive as it seems, the focus of our treatment for a child with SM should not be to get him to talk.  This child will most likely talk when he feels comfortable in his environment and is socially engaged with another person.  Never, ever create a power struggle over speaking.   Quite frankly, you will never will.  Even if you try to wait a child out, eventually you will both need to go home for the day.  A child’s anxiety does not decrease in this type of situation, and it will not get any easier for him to talk.   
2.       Let’s get non-verbal!
Communication, of any kind, is our focus in SM.   It is our role to provide methods of communication that are comfortable for the child. If we are able to meet the child at her level of comfort and provide opportunities for her to engage and communicate in a manner she can handle, she will feel successful.  As in all things, success begets success.  A simple way to start doing  this is to provide “tickets” (Index cards for “yes”, “no” and “I don’t know”. )
3.       IDK is AOK ! 
Often kids with SM have perfectionist personalities and do not like to guess or take the chance of being wrong.  This makes the traditional trial and error learning style of American schools quite intimidating.  In my experience, once kids know that it is OK not to know every answer, there are many more options for exchanges.  Along with the yes, no and IDK tickets, I will often provide a child with a “free pass” to use when he knows the answer but just doesn't want to say.  All of these messages are valid social responses and should be accepted without consequence or further questioning. 
4.       It’s no big thing!   
If this child has been mute for a while, there have likely been a lot of adults giving him lots of attention and trying to make him talk.  The biggest way to decrease the pressure is to take the “it’s no big deal” approach.  Casually acknowledge that the child is not talking, but try not to express concern.  Do not be surprised or react if he does speak.  Our SLP instinct would be to provide lots of verbal praise when a child speaks.  However, this would likely draw attention to the child.  Usually, the last thing a child with SM wants is to be singled out for something, good or bad. 
5.       SM (Plus?)  
It is necessary to rule out other speech/language issues.   Recent research is showing that 30-40% of children with SM also have other speech/language issues.  A complete assessment of a child with SM needs to include a representative sample of the child’s speech and language skills when she is comfortable speaking.  This means we have to get creative.  Utilize video or audio recordings of the child at home or when speaking to her friends.  Assess the child in her home.  Teach a parent to present the stimuli for a standardized test and then score it from a video recording.  These are all valid assessment tools as long as some preparation has taken place.
6.       It’s more than just not talking.  
Selective mutism is the manifestation of severe anxiety.  Mutism is a neuro-biological response to a lower threshold of excitability of the limbic system.  SM starts as a coping mechanism to a situation that causes extreme anxiety.  At its core, mutism is not a choice, but an inappropriate coping behavior.  Unfortunately, if the child’s anxiety decreases when he withdraws into mutism,  this coping mechanism will reinforce itself.  It is important to treat SM appropriately and early to decrease the chances of the behavior becoming engrained.   
7.       Take baby steps.
There is no cure for SM or anxiety disorders.  A person can learn to utilize healthier coping skills to respond to anxieties.  This is a slow and systematic process.  Often, a very subtle difference in the setting will determine if a child will be able to speak or not.  As SLPs we can use alternative communication strategies to provide successive approximations of the desired behavior.  Just as we do not begin treatment at the conversational level with a child working on /s/, we need to start slowly with the child with SM.  When learning any new skill, a child may have periods of slight regression.  Meet the child where she is and nudge her forward. 
8.       Don’t go it alone.   
Ideally, all children would have a team of trained professionals guiding their daily treatment.  However, that is not always the case.  Consultation with a mental health professional can be very insightful and should be utilized whenever possible.  However, a child encounters many people throughout the day.  Twenty minutes twice a week with an SLP is not going to make a difference outside of the therapy room.  Children need consistent responses and consistent opportunities for successful communication.  When all adults in the child’s life are using the same strategies, the likelihood of generalization of social comfort is greater.  Educate yourself, along with staff, family members, teachers, even lunch and playground staff to encourage social engagement without pressuring a child to speak.  Also, don’t forget about the subs!  One well-meaning adult who pressures the child to talk can take away weeks of progress.
9.       Get comfy, fix later. 
If your testing does reveal a co-existing speech, language, fluency or voice disorder, the child needs direct speech therapy.  However, that fluent, error-free speech may have to wait.  If a child is not comfortable communicating with you in the treatment room, drawing attention to her speech errors is not going to decrease her anxiety.  Once the child is socially engaged in activities with you in a variety of settings, then go ahead and practice those /r/s as you would with any other child. 
10.   Kids just wanna have fun.
All kids  want to play,  to be silly and  have fun.  The more opportunities a child has to have fun and be relaxed, the less anxiety a child will feel.  Find ways for your kids with SM to be involved in group games.  (eg., time keeper, clock watcher, score keeper)  Sometimes, just getting these kids sitting at the same table with their peers is a huge success. 

Working with a child with selective mutism can be challenging, frustrating and extremely rewarding!  With the proper approach applied from the start, a child can make rapid progress.  As SLPs we need to arm ourselves with the information and training necessary to change the lives of a child.  

For more information about Selective Mutism , check out the Links pages on my website.  www.ablespeechlanguage.com

Becky Lulai,  M.A.  CCC-SLP


Friday, July 26, 2013

GIVEAWAY of Games, Games, Games!!! Speech Therapy is Fun, Fun, Fun!!

We've created game boards using the fun Slides & Ladders Themed game in order for you to work on five of the most commonly worked on sounds in speech therapy!

Enjoy this fun and useful document called, "Speech Sounds Slides & Ladders S, R,,TH, SH, & L Sound Game Boards & Articulation Homework Sheets in the initial, medial & final position of words!"

Your students will have a lot of fun trying to be the first ones to get up the ladders while avoiding the slides in order to end the game a winner on square #50! And when the therapy session is over, you can hand the student a pre-made homework sheet targeting their sound in either the initial, medial or final position of words! How awesome is that?!

A purchase of this document will make any speech language pathologist well prepared for a large variety of their students working on the commonly misarticulated sounds of S, R, TH, SH, & L.

Please see the preview at our TpT and TN stores for the contents and game page and worksheet examples.

We are giving away TWO of these documents folks.  Please don't forget to enter the giveaway at the bottom of this post when you are done reading it! 

And that's not all that we have to talk about today game players!! Keep reading to see the specifics of our other new document! 


 We have provided over 100 pages of game boards in the packet! You won't be short for a game board at anytime during the year if you own it!

Also, you will be happy to see that the packet not only includes game boards, but BINGO games, mazes and puzzles. Awesome, huh?!

We are proud to say that it is possible that you may not find a more comprehensive game board packet anywhere on-line! 

Enjoy the fun and benefit of completing games with your students all year long!!


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Wednesday, July 24, 2013

Beach Themed Speech Therapy Week!

Greetings Dudes & Dudettes!
We are having a splash this week at the clinic with our beach themed speech and language week.  Here are some pictures to illustrate what we've been working on with our speech students.

We greeted our students with colorful and cool door signs from All Y'All Need and put some in our therapy room too. Cute, huh?! You can pick up a set of your own colorful signs by heading over to the All Y'All Need TpT store.  This surfing set is wonderful, but they also have a lot of other cute bulletin board themes to choose from.  I especially like the superhero and rock star themes!

We bought some beach buckets for the students at the local party store and some summer themed stickers from Target and practiced naming summer items, and using verbs in full sentences as we decorated the buckets for a fun take home summer themed gift.

Other craft activities this week were:
1) Beach sticker scenes
2) Tropical themed visors.
3) Letter and number identification beach themed coloring sheets.

Here's a link to Oriental Trading if you want to buy the visors for yourself. The visors are turning out super cute and we are getting some fun laughs from the parents when we bring out our summertime students at the end of their speech sessions.

We completed upper to lowercase letter matching, put puzzle pieces in the correct places, counted shells on a picture, and looked for differences in beach pictures right at the speech therapy room door.

We played in the "sand" (shredded brown paper).  We asked the students to dig for ocean themed objects or cards that had their targeted speech sounds on them with a shovel and to put them in a beach bucket once found. 

We have a lot of kiddos working on the "s" sound right now and this is working out great for beach week: sand, sunglasses, towels, swimsuit, shells, fins, sea, surf, waves, swim, sun, sun screen, starfish, and summer.

We got out a few of our favorite beach themed games. 
The kids love these two: Pop-up Pirate and Curious George Discovery Beach.  We also read beach themed books and completed beach themed puzzles of all sorts.  

We always have a game to get the students moving and this week it was a simple game of needing to throw the ball into the beach bucket until you have earned 100 points. They read or repeated beach themed words during that activity.

We worked on listening comprehension and pronouns with our Summer Pronoun Activity.  This activity has been a lot of fun and it is helping children to learn their pronouns and to increase their auditory comprehension skills because they have to listen to a story and follow a direction to move the correct ocean animal onto a sorting mat.  This is FREE at our stores.  Click here to download it for yourself.
There's a ton of great beach themed materials, games and crafts out there for addressing speech and language goals with our students and this is just a small sampling of the activities that we did this week!  We hope that maybe we've inspired some of you to also have your own beach themed therapy week this summer or maybe in the middle of the up-incoming cold winter?!  That is because the beach theme makes us think of the SUN and the SUN brings smiles to all of our faces!! :)

  Happy summer everyone and a BIG HANG 10 to you all!
Shanda & Manda, SLP's
Twin Sisters Speech & Language Therapy

Thursday, July 18, 2013

Love It & List It Linky Party: Favorite games to play in speech!

Jenna Rayburn from Speech Room News asked all of us bloggers what our favorite games were to use in speech. She's starting a new feature called Love It & List It Linky Party.  We wanted to join in on the fun so we decided to reshare our top ten favorite games to play in speech list. It's below!


Here is our top 10 favorite games to use in speech therapy! We included links to Amazon if you would like to go there to buy one or two for yourself.

It was very hard to choose just 10!  We knocked it down from an original list of 30! Other games that get an honorable mention from us are:

Cariboo, Chutes and Ladders, Operation, deck of cards, Uno, Guess Who, Don't Break the Ice, Twister, Scrambled Eggs, Don't Say It, AB Seas, Scrabble Alphabet Soup, Don't Spill The Beans, Sequence for Kids, Guess Who, HedBanz, Hi Ho Cherry-O, Let's Go Fishin, Trouble, Jenga, Sorry, Monkeying Around, Checkers, Connect Four, Would You Rather?, and good ole Candy Land!

Our top 10 favorite games all promote movement, turn-taking (so we can target a speech goal while playing them), and bring a fun challenge of some sort to the therapy room.  The kids love them and so do we! 

And the TOP 10 LIST IS...

1.  Kerplunk-Product Details $16.97 at Amazon

2.  Hold on Scooby Doo Product Details$14.44 at Amazon

3.  Honeybee TreeProduct Details$13.99 at Amazon

4.  Pop Up Pirate      Product Details  $22.89 at Amazon

5.  Pop The Pig Product Details   $29.99 at Amazon

6.  Rhino Rampage Product Details $17.99 at Amazon

7. Topple Product Details  $8.68 at Amazon

8.  Lucky Ducks

                                Product Details   
 $16.06 at Amazon (Sesame Street Edition)

9. What's In Ned's HeadProduct Details $34.95 at Amazon

10.  Crocodile DentistProduct Details $9.99 at Amazon

We hope you find this list helpful! Perhaps there's a game or two that you didn't know about or one or two that you've been meaning to purchase for your therapy room?

Shanda and Manda, SLP's

Wednesday, July 17, 2013

Describe It To Me App Review

We are happy to say that Smarty Ears has put out another awesome app!  This one is called Describe It To Me, and it is a fun game show themed app for working on receptive and expressive language skills with our students. Describe It To Me presents a variety of questions designed to help students build a deeper understanding of everyday items.  For example, each picture shown has six questions surrounding it to help the student think about 1) what category the item should be in, 2) what function the object has, 3) what parts the object has, 4) where the object can be found, 5) what it looks like, and 5) it also gives the student a chance to tell you what else he or she knows about the object shown. 

On the opening page the user has the opportunity to quickly go back to iTunes, read about the app, contact Smarty Ears for app support, and to see a video tutorial of how to use the app. Very helpful!

By clicking on PLAY the user can go to the SELECT PLAYER page.  All players are added here.  The user can enter a picture from their picture library or use an avatar photo to go with the students name.

After selecting one player or even up to 5 players from the player screen or the Therapy Report Center, get ready, uh, uh, (I'm clearing my throat right now to get ready to say this in my loud game show voice...)          

A colorful object will appear on the screen after an user is selected from the fun game show style spinner. Choose to work on receptive skills (shown on the left) by swiping your finger up the TV volume button to R and/or choose to work on expressive skills by moving the button down to the E. Choose to work on category naming, object function, object parts, location, visuals, and "extras" by swiping the button on the top of the page. Extra chances are given to find the correct answers.  A cool ribbon comes out to show correct choices!


Click on DONE to get to the REPORT CENTER.  This is where one can see the report cards and even the awards that can be collected during the playing of the app after the child has gotten ten questions in a row correct.  This is a fun and creative way to award the players for their hard work!

Click on the HOMEWORK SHEETS button to find a large variety of worksheets that can be printed out on a printer or sent to your email to be printed out for students to do in the same therapy session or to take home for follow-up practice.  LOVE THIS!!!

  • Great app, but may be best for older kids that can read (as I had to do for this second grader).  Not a big deal, but if you were looking for an app that required independence with the younger crowd, this app would not meet that need.
  • Colorful pictures. In fact, it provides over 160 clear pictures.
  • Great for group therapy sessions as it can accommodate 1 to 5 users at a time.
  • Provides terrific homework sheets that help to increase the student's understanding of the objects presented during the app.
  • A large amount of goals can be targeted in both the receptive and expressive language areas.
  • Data can be collected for each student and stored in the Therapy Report Center.  Very nice for the busy SLP who can later access the data for progress note or IEP writing!
  • Easy app to navigate.  It is not complicated at all. 
  • A wonderful app for helping a child increase receptive and expressive language skills!
  • Super fun theme.  Creative!!!
Have fun trying out this app everyone.  I would suggest that you go buy it for your own iPad today.  While you are at the iTunes store, you should just grab a few other Smarty Ears apps.  Why not?!  You will use them!They are even having their summer sale right now and many of their apps are only 4.99!

Describe IT To Me is currently $4.99 in the iTunes store.

Best wishes,

Manda & Shanda, SLP's

Twin Sisters Speech & Language Therapy

Find out more at the SMARTY EARS WEBSITE!

Sunday, July 14, 2013

Book Companion GIVEAWAY! The Gruffalo Speech, Language and Literacy Packet!


Link to book companion at Teachers Pay Teachers:   HERE
Link to book companion at Teachers Notebook:     HERE
This book can be found for $6.29 at Amazon by clicking:      HERE
Link to the official Gruffalo website can be found by clicking:     HERE 

"The Gruffalo", is a wonderful book by Julia Donaldson that has accompanied adorable illustrations by Axel Scheffler. We have used this book to put together a very comprehensive book companion document that has enough activities to keep your students busy for several weeks! We have included exercises to work on everything from verbal expression, articulation, reading, writing, grammar to concepts and more! Please download the preview at our Teachers Pay Teachers and Teachers Notebook stores to read the details on the content pages. Also, please see the slides below.

We hope you love this book companion as much as we loved reading the book and putting the document together for you!

Manda &  Shanda, SLP's

Attention: This document can and should be used in conjunction with the book, The Gruffalo and it should be stated that Twin Sisters Speech and Language Therapy is not affiliated with the book’s talented author, Julia Donaldson, it’s illustrator Axel Scheffler nor it’s publishing company Macmillian.

Please enter the giveaway for this fun and useful document via the Rafflecopter contest format below. The comment question will ask, "What tasks do you like to see and use in book companion documents?"
Thanks a bunch early on for leaving a comment and thanks for stopping by the blog today! 
Manda & Shanda, SLP's
Twin Sisters Speech & Language Therapy

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Connect With Twin Sisters Speech and Language Therapy LLC!

We are loving all of the current ways to get and stay connected with our followers and we have recently added a few new ways! Here is a list of some of the ways to stay connected with Twin Sisters Speech & Language Therapy LLC (TSSALT)!

Twitter is an online social networking and microblogging service that enables users to send and read short 140-character text messages, called "tweets". Registered users can read and post tweets, but unregistered users can only read them. Users access Twitter through the website interface, SMS, or mobile device app.[9]
 Follow us on Instagram.  Instagram is a wonderful way to show moments through photos, videos, tips and news.  We plan on posting pics and video clips of our weekly therapy units in action. Please find us with a search "twinsistersspeech". Sign up for Instagram through the Apple App Store and Google Play. This can be done via a Iphone or Android phone.  Click here for an easy way to follow us once you are signed up: http://instagram.com/
 Bloglovin is the easiest way to follow your favorite blogs.  Bloglovin helps you follow them by letting you know when they are updated and keeps all of them in one place! Click here to add us to your list via searching "Twin Sisters Speech and Language Therapy":  http://www.bloglovin.com/

Facebook is the world's most popular social networking website. It makes it easy for you to connect and share with your family and friends online. We love posting therapy tips, flash freebies, discussions, trivia and shares of speech topics.  We especially love hearing from our facebook followers! Follow Twin Sisters Speech and Language Therapy via this link: https://www.facebook.com/TwinSistersSpeechandLanguageTherapy

Pinterest is a pinboard -style photo-sharing website that allows users to create and manage theme-based image collections such as events, interests, and hobbies.  We find so many wonderful ideas for our therapy units, speech therapy and teaching ideas of all kinds and are part of several groups that have similar interests. Come follow our boards and get pinning too- it's fun! 

Feed Burner: http://feeds.feedburner.com/TwinSistersSpeechAndLanguageTherapy
 Subscribing to feed burnerr email notifications is one of the best ways of staying in touch with the latest scoop on all posts by Twin Sisters Speech and Language Therapy. If we have a new post, it will be sent to your email!  Sign up to be our follow via the tab on the right or follow:

Thanks so much for staying connected with us!!  


Manda &Shanda, SLP's

Twin Sisters Speech & Language Therapy


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