Archive for December 2012

iPhone world!

Sunday, December 30, 2012

I promised a new post today! However I am currently on the road back to San Diego to enjoy the last week of my vacation at home! While up in the Bay Area, I decided it was time to get a new phone. I switched phone providers and I am now the proud owner of an iPhone 5! Which I happen to be blogging from at the moment.

Technology really does get more advanced every day. In the spirit of all things Apple I also have a new MacBook Pro and iPad for use at work...tomorrow I will share with you some of my favorite apps! Stay tuned.

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It's Christmas in the Speech Room!

Saturday, December 22, 2012

 It's beginning to feel a lot like Christmas!
Dollar Store tree and little table decoration from WalMart. 

I have a fireplace on my wall, students decorated stockings with Christmas wishes on them.

For students who do not celebrate Christmas I have winter themed activities and Hanukkah decor.

Snowmen at night worksheet I found on a blog (see post below regarding Snowmen at Night)


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Trying to Feel Safe

Monday, December 17, 2012

I am sure I shared the feeling of apprehension towards returning to school, as many others who work in the school systems today.

As a Speech-Language Pathologist I have students entering and leaving my room every 30 minutes, so I usually keep my door unlocked. Today that changed.  We now have a sign on the door asking students to knock and wait for us to let them in.

Frankly, it was hard to hide my anger and sadness that such ugliness could happen in the world. That I have to keep my door locked, practice lock down after lock down, and review why school is safe with my students.  We all know in reality the world is not safe. No where is safe. We may go around thinking it will not be us, but it could.  In the end we have to be prepared and be able to protect our students and ourselves.

Many of my students were confused, and asked lots of questions today. A great resource posted by was a little book by Jodi Southard of Fun in First 

You can find the book here for FREE:

My younger students did well with this and enjoyed coloring in the pages. The last page has a bit about why or why not students feel safe. A lot of them wrote they felt safe because of their teacher or because the police take away the bad guys. It made me feel good that students still feel safe.

Tomorrow is a day of silence in the blog world to honor the loss and all those affected by Sandy Hook Tragedy. 

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Heated Debate-Selective Mutism

Sunday, December 16, 2012

Yet another puzzling disorder, with much debate. 

property of

Selective Mutism is diagnosed by a Psychologist using the 2000 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

  • "consistent failure to speak in specific social situations (in which there is an expectation for speaking, such as at school) despite speaking in other situations.
  • not speaking interferes with school or work, or with social communication.
  • lasts at least 1 month (not limited to the first month of school).
  • failure to speak is not due to a lack of knowledge of, or comfort, with the spoken language required in the social situation
  • not due to a communication disorder (e.g., stuttering). It does not occur exclusively during the course of a pervasive developmental disorder (PPD), schizophrenia, or other psychotic disorder."(Directly quoted from
Many suggest (including ASHA) that an SLP be involved in therapy despite 90% of children with this disorder presenting with a social anxiety disorder. A team approach in which the child's doctor, psychologist, parents, and SLP work together.

As an SLP, assessing a child with this disorder would pose some challenges. The child has a phobia of speaking, so many of the standardized tests would be deemed invalid. Receptive language measures would be appropriate in some cases or a dynamic approach where other means are used to assess their abilities in a variety of situations (e.g. recording them talking at home, teacher interviews, assessing how the child currently communicates and determined what they can and cannot do).


ASHA outlines a treatment structure that may be helpful as a starting point. You can find that here.

I also found a great powerpoint here, that outlines the ABC's of treatment
  •  reduce Anxiety
  • Build self-esteem
  • increase Confidence in communicating
 property of pediastaff


Now, in my opinion this is where the lines between the disciplines (Psych/SLP) get blurry. As professionals we are not to practice outside our expertise or discipline. To be honest, I am skeptical of the treatments conducted by an SLP, as the treatment for selective mutism appears to be more of a counseling role to treat anxiety, not treating a speech or language impairment.

Selective mutism is far more anxiety based disorder than language based. Although research shows 10-30% (I found differing evidence) may have a speech and language impairment in addition to selective mutism. This is where we would come in with that small percentage.

In my limited experience with this, the students are diagnosed by a counselor and assessed by a psychiatrist. Then usually given counseling for anxiety or anti anxiety medication (short term until they are confident to speak). This website says students are often misplaced into speech and language therapy, and I do partially agree.

Many of the treatments listed on ASHA's website could also be conducted by a psychologist or parent. Which could be a possibility with consultation done on the part of the SLP to assist in training parents or helping teachers understand how to talk to the child. Direct 1:1 or small group therapy conducted by SLP would be helpful to gain confidence speaking without pressure of whole class (again could be conducted by a counselor). Tricky....

Now what's the big idea!? The thing I took away from my research was that students with selective mutism need intervention and they need it early! I am reconsidering my role and I should be working directly with counselors to provide appropriate education environment in which they can communicate effectively using whatever means possible.
 property of


Each student is different and the method of assessment and treatment will vary, but as SLPs we must do our due diligence and assess the best we can to rule out a speech or language impairment. We need to be willing to work as a multidisciplinary team and be open to treatment options.


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That Darn Lingual Frenulum!

Friday, December 14, 2012

Hey! Did you know that "little web thing" under your tongue has a purpose? 
Well it does, and it is pretty darn important.

Your lingual frenulum connects your tongue to the base of your mouth. If your frenulum is too short, it can cause what the medical world calls ankyloglossia. We would call it "tongue tied"!

Ankyloglossia is congenital. There are some syndromes that exist where this is a common symptom. The frenulum can be part or completely fused to the base of the mouth causing ankyloglossia. 

How do you look for this? 
  • I complete an oral motor examination on every student that comes through my doors. 
  • The easiest way I have found is to ask the student to stick their tongue out and imitate me. 
    • ask the student to reach tongue to the roof of their mouth, this should be difficult.
    • ask them to stick their tongue out, you will notice the end of their tongue looks heart shaped and they will have trouble lifting tongue up to nose and down to their chin.
property of intelligent dental 

Ankyloglossia can cause a variety of problems:
  • Difficulty breast feeding, the baby would have difficulty latching onto and maintaining suction of the breast. This may result in a fussy baby, weight loss, or chewing on nipple (instead of sucking)
  • Some suggest anykloglossia may cause difficulty with speech sounds, specifically sounds made on the alveolar ridge /t, d, n, l/ and others involving careful placement of tongue tip /s, z, and r/.
  • Although a relationship has been made by some, there is currently no evidence to back this up! Some students may speak perfectly fine with a short frenulum and others may have difficulty. They may also be two different things that occur together...confusing enough?
  • Go with the evidence!!!  Kummer, 2005,  ASHA Leader Article
  • Leave it alone! Unless it presents with a problem in infants with feeding, a personal annoyance or difficulty as an adult (can we say french kissing? ha ha).
  • Frenulectomy- snipping of the frenulum by a doctor to allow more movement of the tongue. Hooray, it's free to move about! This is a short procedure usually and done while patient is awake. In more serious cases the patient is sedated. 
    • Although some believe that a frenulectomy is the "cure", it's not! In fact most of the time this surgery is not effective in fixing the student's articulation errors. So be wary what you suggest to parents! Best thing to do is treat the articulation and try different tongue placements the student can actually do successfully.
My own opinion: I have three students on my caseload with ankyloglossia. They present with difficulty with /s, z/ and /th/, as well as multisyllabic words (interesting it's not the /t, d, n/, like some suggest).   The student's articulation skills are improving without the surgery, however it seems to be slower than most students. Otherwise their speech is completely intelligible and there may be other factors affecting their articulation (Spanish influence or parent's history of articulation errors etc).

This picture is just too funny, I bet our students feel like this sometimes!
Property of Mr. Fibble

NOTE:Opinions are my own and not the views of my employer, some information summarized, including evidence regarding treatment was obtained from Kummer, 2005,  ASHA Leader Article

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Teachers Pay Teachers Review-Christmas Grammar

Thursday, December 13, 2012

The lovely Jenna Rayburn with all her awesomeness created this: Christmas Grammar for Speech and Language Intervention   If you have not seen her blog yet, check it out here!

This was my FIRST Teachers Pay Teachers purchase. I am a little late on the trend! 
 All of these activities for only $4.00 What a steal!
 She inspired me to group all my activities into ziplock bags and so far it is working out great! I printed all the activities and laminated them this morning.
 I have used the games with multiple ages this morning and so far they are a huge hit! The activities target all kinds of goals and can be used in many ways. For example, the Elf Irregular Plurals can be a matching game, drill, or use in full sentences. The students also loved the irregular verbs and they played in teams to try to beat each other!

Thank you to Speech Room News for creating such cool stuff! I will be using these all week!

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Snowmen at Night

Wednesday, December 12, 2012

My mom shared this book with me a few years ago. It's great for working on verbs! 

Snowmen at Night by, Caralyn Buehner

Ideas for completing the sentence: 
Another blog with more pictures 

Great ideas to have the students act out being a snowman and make it a game, it can even involve following directions!!!
I wanted to go through the book and pull out vocabulary to target. I made these into flash cards and quizzed the students after.
(fall down) slide by accident for a short distance, typically losing your balance
A secure grip with one's feet
Bend or hang downward
sudden intense feeling of fear.
a feeling of surprise mingled with admiration, caused by something beautiful, unexpected.
to be worried, uneasy, or nervous, typically about an event.
small body of still water.
player who delivers the ball to the batter. OR A large container  to hold liquid
measurement of how tall someone or something is,
exhausted or worn out (tired)
feeling of excitement and pleasure
Bring things together
bent or twisted out of shape or out of place.

BONUS: If you didn't know already the books have hidden pictures on each page!
Another bonus there are more Snowmen books:
  Snowmen At Christmas, Snowmen All Year, Snowmen At Work

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Tuesday, December 11, 2012

Don't be a GRINCH! Follow the code!

I might just enjoy Christmas a little too much.  I always check myself that I am not just "making crafts" because in speech therapy we target GOALS GOALS GOALS! 

Our school has adopted the Code of Conduct-consisting of 4 rules- Responsible, Respectful, Trustworthy, and Safe. 4 simple rules allows for maximum memorization, and almost anything students do can fall into 1 of the 4 categories.

I had students fill out "ornaments" to target social skills, vocabulary and syntax, that said "This holiday season I will follow the code by being____"

First, talk about your school rules and examples for each one as a group. Then have each student pick a rule and a way they will follow them at home over the winter break. For example: Helping mom clean up toys without being asked or not fighting with brothers or sisters and so on. 

I got some creative responses! We shared them all as a group, and students got to decorate the tree. Now my massive speech mirror looks festive!

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Inspired Organization

Monday, December 10, 2012

Jenna Rayburn, M.A., CCC-SLP over at Speech Room News organizes her lessons into ziplock bags.  She is so totally inspiring!!

Before                                             After

Honestly, I hardly ever look in my filing cabinets because they are overwhelming. I can't see what is in there. I didn't label appropriately, got busy and started shoving. Not to mention I took over an office full of worksheets and have not gone through everything yet.

Anything I have not used in the last 3 years, or that was older than me (yes, older than me) got thrown away.

I trimmed the edges of my worksheets, and slipped them into ziplock bags. Mine are stored in hanging file folders. I put detailed info on the front(areas of speech and language targeted) , and a little label on the side so I can see the title easily.

I am trying to use more books in therapy, and this way I can store the book and the activities together!

Let me know if you end up using this technique, or if you have another way to organize please share!

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Product Review: The Bridge of Vocabulary

The Bridge of Vocabulary-By, Judy K. Montgomery, PhD


3 out of 5 crowns

Who? Written by Judy K. Montgomery, PhD

  1. "Addressing the need for research-based vocabulary intervention", with public schools moving toward a Common Core Curriculum, SLP's have to keep up with our Evidence Based Practice (EBP). Everything we do in therapy should be backed up by evidence (research).  
  2. Evidence, evidence, evidence, which finding can be time consuming. This book does it for you.  Each lesson has a note about the evidence behind why it works to improve vocab skills.
  3. Addresses semantic (vocabulary) skills ages Preschool through Adults! Target speaking, listening, reading, writing, nouns, verbs, antonyms, synonyms, categorization and more!
  4. Specific lessons, with script, picture cards ready for lessons in vocabulary.
  5. Comes with a CD to print all lessons.
Why only 3 crowns? Remember that CD I just told you about? It takes forever to print out and get each lesson set up. I finally have all mine set-up and I have owned the book for well over a year. The book only gives you examples, the CD has everything you need on it. Then you have to find a way to organize it all...I will post about that later.

How? I start out with the preschool levels for many of many students with semantic needs and then move up quickly if they master the skills. Another option is just pulling out lessons for a specific area of need (e.g. verbs)

Want to learn more? Take a tour

The opinions expressed in this review are mine. No other compensation was provided. 

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The Start of Something New

Hello fellow Speech-Language Pathologists!

I have been wanting to create a space to share all my work related ideas, crafts and organizational skills for some time now! I have been rather busy, but that's the life of an SLP. Also, I could not come up with a name, my lovely fiance came up with this one. Love it.

About me: 

  •  This is my third year as a Speech-Language Pathologist 
  • I hold a BA in Speech, Language and Hearing Sciences from SDSU, MA in Communication Disorders from SJSU, Clear Speech Language Pathology Credential, my CA state license and my ASHA CCC's. Wow, that was mouth full! (not to brag or anything)
  •  My area of specialty is preschool through elementary age
  •  I currently work in a public school that is 90%+ bilingual and low income. I have become very good at knowing the different between language learning and a language disorder.
  • I have worked in a skilled nursing facility (SNF). It was a great experience, and something to fall back on should I ever need it. 
  • I am organized, crafty, a self-proclaimed data fiend (still tweaking most efficient ways to do this), and stressed!
  • I believe that therapy should be fun both for me and for the students!

I look forward to sharing all I learn with all of you!

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