One more time for the little folks in the front row!
Today on the podcast, we’re going to wrap up our exploration of literacy-based therapy with practices for our earliest learners, and I’m thrilled to have our guest, pediatric SLP Allison Cloutier, on the mic to add her voice and experience.
If we can connect with kiddos (and their parents/caregivers) early in their learning journey to identify needs and goals, it sets everyone up for success in the long term! AND, play-based therapy is as fun as it sounds. (When else do you get to engage with your students by playing hide-and-seek, giggling at a pig puppet, or rolling on giant bean bags?!)
In spite of all of the fun, working with wee ones also presents its own challenges, as any parent-of-toddlers will confirm — little ones might be all-in for the first 7 minutes of your painstakingly-planned session, and then have an energy shift which only the most adaptable and egoless therapist (or parent) can conquer!
Are you up to the challenge? 💪
Grab your beverage of choice (coffee is always in order when hanging with toddlers – amiright parents?), put your feet up, and listen in.
Key Takeaways + Topics Covered
– What drew Allison to private practice + working with peds
– How Allison builds connections with daycares and preschools
– Building rapport with little ones through play
– Incorporating physical movement to encourage engagement
– Toys and games to give some (but not too much!) structure
– How SLPs can utilize books to enhance language with younger kiddos (and get parents on board!)
– Integrating play with a variety of goals
– Being nimble in your approach to therapy!
Links Mentioned in the Podcast
– Enchanted Cupcake Party
– Spot It Jr
– Fat Brain Toys
– Blue Orange Games
– Critter Clinic
– Tot tube
– Rapid motion imitation antecedent training
– Polar Bear, Polar Bear, What Do You Hear?
– Poke-a-Dot books
– Allison’s recommended resources
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Thanks so much!
Here we go. Hello there and welcome to The SLP Now Podcast. I am so incredibly excited to have Allison Cloutier here with us today. We've been getting some questions about therapy ideas for the younger students on our caseload and she is an amazing resource and before we dive into all of her questions, I just wanted to share a little bit of her experience.
So she has worked in a pediatric private practice setting since 2011 and she graduated from the University of New Hampshire with her Masters Degree in Speech Language Pathology and she also concentrated in early childhood and augmentative and alternative communication and she has some amazing resources.
She does a lot of education for parents and for people growing their private practice and childcare centers, all of the good stuff and she'll be able to do that description much more justice, but I'm really excited to talk to her today just to hear a little bit more about her experience and she is going to be sharing so many practical therapy ideas that we can use with the younger students on our caseload. So without further ado, here is Allison.
Thank you for having me here today.
Yeah. I am really excited to dive into this topic, but before we go into all of the amazing therapy tips and ideas, I'm really curious just to hear a little bit more about your background and just how you decided to focus working up with the younger population and just where you're at now and what you're up to.
Yeah, I think really looking back at just kind of who I am as a person, I have always been really interested in working with kids. I know I've spent most of my teenage years either babysitting or working in afterschool programs.
It's just really a population that I love to work with. I love their energy and just having fun and they're just so involved in everything that you're doing. It's just really a place that I love to be and when I was doing my graduate clinical placements, I was in all the different settings they have as try and when I was in the pediatric private practice setting, I also had the opportunity in that clinic placement to co-treat with an OT and I just found that I just loved the environment of having some more of that flexibility and I really loved the connection I was able to make with the parents in addition to the children being in that setting.
And I'm always has been ... I've always been very drawn to that play-based family-centered format and that setting really allowed me to do that. So I also found that when you're in that private practice setting, it kind of caters logistically to that younger population.
You have your early intervention kiddos and then you have kiddos who get picked up from the school district and then there's somewhere that in between where they've aged out of early intervention, but they might still be in like a daycare setting or parents haven't pursued the school district for services and so we kind of have that age in between where sometimes they're looking for supports without those resources.
So just logistically, I found that that age has fallen onto my caseload a lot. So other than that, it's really just my comfort level and I love playing with them and figuring out a way to take their goals in their knees and integrate it into a format that is really meaningful for them.
Yeah. I can totally relate. I'm definitely a school-based SLP at heart, but I did get to work in some clinics and grad school and I love the ... Because it's like a different level of collaboration when ... Because in the schools, we can collaborate with other professionals, but I don't know about you, but when I was in the clinic, I shared an office with several other physical therapists and occupational therapists like we had lunch together all the time.
And we saw our clients together sometimes. So it was just really cool, just an awesome opportunity to really collaborate and then I definitely saw that too in the ... The transition between early intervention and the schools and getting to work with those kids and they are definitely so much fun and I'm especially excited to talk to you about it today because I feel like for a lot of us, it's not our natural area of strength.
We feel a little bit overwhelmed with what to do and especially if we are in the schools and we're ... We primarily work with older students. I'm really excited for you to share your tried and true tips and tricks to help us gain a little bit of confidence.
Yeah, and I think as I've done a lot more education with parents or early childhood providers or even other speech pathologists, it's ... I wasn't as aware of how easy that play-based and that connecting comes to me and it's something I've had to remind myself that this is easy for me and it's a comfort level, but it's not for everyone else.
So I really had to take another perspective on that and that's really what's led me down the path of doing more education for other professionals as well is being able to take my knowledge and share that information in a way that's helpful in the same way that when I was asked to consult with a high school student, I was like, "Okay I can do that, but let me tap into some of my resources first." Just being able to share that expertise is really helpful within our field.
Yeah, I love that and because I know you've had a lot of experience with like connecting to and creating relationships with local daycares and preschools and doing that education with those providers and parents and everything. Can you tell us a little bit more about what that looks like and what you're doing there? Because I think that's a huge component of it too.
Yeah. I think one of the places we would start with there is that the private practice I work for is actually in the same plaza as a daycare. So we first built a relationship just with them and a lot of that was mostly for ease of the parents.
So we do either bill insurance or have cash pay. So we have a little bit of flexibility with the location of where we provide those services and what we found was for the parents whose children are in those daycare settings, they're usually full-time working parents.
So it was very helpful for us to be either onsite or be able to take that child. We would just walk across the sidewalk into our office. So we did one or the other. It was really helpful for those families to have that as a resource and then what we also found was that those teachers were so ... What's the word I'm looking for?
They so were, had such a desire to help those children that it was ... It created some really great conversations between myself in those childcare providers of how they could support that child within that setting.
So I would also then start to do some of my sessions in their daycare classrooms. So similar to what a push-in session would be and I was able to then be in their environment, their teachers could see how I was working with the child and then their peers also started to understand a little bit more as well.
If it was a child who had more significant needs, we could do a little bit of educating with the peers and so overall, I just found it was ... Became a really valuable resource to everybody that was involved and then of course, the parents, we would keep them updated.
I would write a note every day and if it was a parent that I didn't get to see face to face very often, we would have regularly scheduled phone calls just to kind of give them an update and answer any questions they would have and then I also found that as I worked with this age population that the parents were looking for the same thing at their centers.
So when I first started creating relationships with other centers in our area, a lot of it came from my client connections. So their parents would ask for either giving their teachers some tips or being able to provide services on site wherever their child was attending.
So I started to build a relationship by seeing certain children on site. I then became a familiar face. The teachers were familiar with me and the work that I did and I slowly started getting referrals from them and thus far, I would say that most of the majority of my referrals either come from word of mouth from an existing client or they come from those daycare centers where I have built a relationship with them.
And then another part that I found was as those teachers were trying to learn a little bit more about that child's specific needs, that I was giving a lot of education to them and so then by necessity and some need, I actually started creating workshops for those teachers and that then allowed me to share more in depth information, allow for asking and answering questions.
And then I was able to take that information and outreach to other daycares and preschools and then from there, it just kind of snowballed into just creating more relationships which helps them, it helps me, it helps the client and it's actually been a really wonderful thing.
Yeah, and that's so cool and I love ... One of the things that I struggled with a little bit working in private practice was that it felt like it was disconnected from the child's context because I just saw them 30 minutes twice a week or whatever it was [crosstalk 00:10:29] and I would like try and ... I would teach the parents strategies and they'd sit on the sessions and we do all that, but I love that you are working in those childcare centers or preschools, whatever they, whatever contexts those are and like that's their environment for a huge component of their young lives. So that's amazing. I love that you were able to find a way to get that context.
Yeah, and I found that I ... As I went in and I was just doing I called it speech and language therapy basics and I would talk about what was typical for each age as far as speech and language development goes, when you should refer a child, talking to parents about it, collaborating with other professionals, how do you know who to refer to based on what you're seeing.
And I would get so many questions from the childcare providers that they really are looking for what's best for those children and then it gave them really a gateway to talk to the parents with confidence as well and then sends them to someone who could then really do the evaluation and take on that information. So it does, it's been a way that's really created a great collaboration between everyone.
Yeah, I love that. That makes a lot of sense and thanks for giving us a little bit of insight there and then I'd love to get into the therapy side of things. So in your Biodynamic, you mentioned play-based approached for therapy and I think that's what we hear a lot of when we're talking about intervention for those younger students and I'm curious if you could share a little bit of what that looks like for you and any tips that you'd be willing to share just to like help us kind of ... If we are feeling like we're struggling with that, what could we do to set us, set ourselves up for success?
Yeah, I have a few kind of different thoughts and tips here. So the first I tend to do is just really figure out what motivates that child and typically at the onset for me it's ... Well, I mean, I guess it would be for most therapies, but really for those younger ones is really building that rapport with them.
So I often ask parents or teachers if that child has a specific topic or interest or characters or things that they like and I will try to integrate that into our initial session.
Just really trying to create that positive environment for them and one thing too. It takes a lot of self-awareness which I think is a little bit tricky sometimes is really when you're building that rapport to get to that Playbase level is really gauging where the child's at in their energy levels.
So I always like to have some kind of movement with my younger kiddos, but some kids, if they're a little bit anxious, if I'm super excited, it might be a little intimidating to them or if they're a child who moves around a lot and needs a lot of input and I am really quiet, then sometimes, they don't connect to me as well.
So it's kind of having to morph a little bit more into their comfort zone just so you can get into a place that the work that you're doing will be really receptive from them. So one of the first suggestions to beyond that is definitely that movement piece I found for this age.
It's just so important for them to be learning through movement and I do some really simple things just like ... Even just crawling through a tunnel. In my office, I do a lot of hide and seek, so whether it be little figurines or puzzle pieces or pictures or cards and I'll place them around my room and of course when they're younger, I don't really hide them necessarily, but they're just placed in different areas and they get to go collect them and bring them back to me. I have a lot of things with sensory input. I don't know if you've ever ... Have you ever heard of a Yogibo before?
Okay. It's like a massive beanbag basically and they're a little pricey, but in my book, I use it almost every single day, so it's been well worth it. They're kind of like a massive beanbag, but they have little tiny beads inside and you can take that outside zipper off to wash it when you need to which is wonderful, but I use it for letting kids run and jump on top of it.
I might squish them up inside of it. I do a lot of singing songs where I like will rock the Yogibo back and forth. So they're getting some movement and some input, but they're in a safe space as well.
So I guess those would be my first points would be that find out what motivates them and really get on their level to build that rapport, gauge where your energy level is compared to the child and then adding in a lot of movement for them if that's what works well for them.
Yeah, that's perfect and I definitely want to check out a Yogibo now. That sounds amazing.
They're really comfortable to sit on yourself if you're writing reports too when children aren't in your office.
Oh, I love it. Yeah, I used to have a, just a cheap beanbag. I don't even remember. I might've gotten it from a teacher or something, but it was super fun to use in therapy, but the massive beanbag seems even more amazing and you can wash it.
And I know that wasn't the highlight, but ...
It is [crosstalk 00:16:13] actually for most therapists and parents and we'll even do like I'll have them sit in a cube chair or on a circle square so they know their space and I'll even sometimes take like a Buffalo drum and as they run, I go like do, do, do, do, do, do boom and as they jump and they just think it's absolutely hilarious. So I do have some more tips there too, but I just didn't want to get too far ahead of myself in answering your question, so.
No, this is perfect. Keep on rolling.
Okay. So another thing I do a lot of is that imaginative play. So I will have a lot of materials and have them more like acting out and playing with figurines and moving the pieces around because of course, if you're looking at or like three and four year olds specifically, some kids will sit and do more drill work with you, but a lot of them, we'll do that just for a moment and then it's not meaningful to them.
So I'll find ways, I actually have little bags that I call sound bags and I'll have them labeled with ... I have all the vowels and I have like beginning constant sounds and just as I'm going to little thrift stores or things that my own daughter has, if I see like a little figurine that has that sound in it somewhere, I'll add it into my sound bag.
And then I'll use those either for the hide and seek or digging in a bean bucket or sticking them into Play-Doh and we pull them out and then I use that to address the sounds and it's great because then you don't have to be constantly brainstorming for a session.
Does this game, does this activity actually target what we need? But it is a way that you can easily integrate those into play-based therapy. So then you can use them in multiple context as well.
And then another thing I do a lot of is books of course. So I have an endless supply of books for kiddos and we do different sounds or whether it just be engagement or we talk about the pictures, having them do repetition and I think there's just so many different ways that I can use those books in therapy with those kiddos as well.
Yeah, that sounds great and I'm a huge fan of using books in therapy. We could go on and on about that. Awesome. So just a quick recap, finding out what motivates a student and you can, or the child and parents and daycare providers and all that are a great resource for that.
Gauging the child's energy and matching that, like getting on their level, incorporating movement, imaginative play, using books, is there anything else that you would add or like any favorite therapy materials along those lines?
Yeah, I would also say anything that adds that element of surprise is typically highly motivating at this age. So I do a lot of really simple like hiding something under a little blanket and we do either the peekaboo or we're trying to say like, "Oh, what is it? Oh, look what we found inside."
A lot of element of surprise. I do a lot too of having like a box or a bag where I put something inside and just try to get their engagement that way and then also really getting comfortable with being a little bit silly because that's how really to get some of these kiddos to be engaged especially if we're looking for already three or four or even five, but we're on a developmental delayed pattern of some sort.
We sometimes are needing to backtrack really that engagement piece so that element of surprise typically keeps them engaged much more. I also have this little pig puppet, but he eats different things.
So I'll do a lot of the pig puppet will hide and we have to ask for him and then when he eats something, he does a little bit of tickling. So using that same sensory piece to engage them as well and if you have a space that allows you to explore different sensory experiences without making too much of a mess, I would say that that's another way I often engage these younger kiddos as well.
I do also have access to a swing in my office, so that typically has been a really great resource for me as well adding in that movement, that engagement piece. It's really easy to do when you have access to something like a swing.
As far as some of my specific favorite like actual activities that you could or gains you could buy for this age, I really love, if you haven't heard of the company that they're called Fat Brain Toys.
They create a lot of really ... They're simple, well, the younger ones, they're very simple like cause and effect, but they're not all musical and lights and everything. So one I really love is called the SpinAgain and it's kind of like plastic gears that you put one on top of like a plastic pole and it just spins all the way down.
So it's a really quick cause and effect, but kids really seem to love watching the spinning. They also make one called Dimpl Duo and it's like silicone poppers so you'd have like a tray. It's kind of hard to explain without seeing it, but it has like a tray with six different colored like silicone ovals, but when you push it, it pops through and then you can just flip the board over and you can pop them back through the other way.
So my kids really enjoy that one. I love another company I really enjoy is they're called Blue Orange. I'm not sure if you've heard of them. They have like the Spot It Jr. and Telltale. Those are two of my favorite.
They're just a little round tin and they have picture cards inside of them and this would be for the older end of that young population or into early elementary. Spot It Jr. is where you have animals and there's a match.
So every card has one animal that matches on the other card. So you can flip them over and then they're scanning. They have to find the match and then they name it and then typically, I expand on that and we either talk about that and well, depending on what their goals are, we either describe the animal, we talk about what it does, or I'll be like, "Oh, that's a fish. It swims. What's another animal that swims?"
So we're able to expand on that language with those games. I wrote down some notes for myself and I had mentioned the Yogibo, but we already talked about that and then one that I have to mention I really love it is again for a little bit older because it has some small parts, but it's called Enchanted Cupcake Party and it's like little ... They're all princess themed, but they're little cupcakes and there's a cup, a cake, a frosting, and a topper.
And I've used it for working on lots of different sounds. I most often do it for sequencing for kids. So whether they are receptively listening to my directions as I'm describing or I have them expressively described to me when it is that I'm supposed to be making.
And then once we're done, we like go through the whole sequence again. Then we do a little bit of pretend play, putting it in an oven, taking it out. Sometimes we'll make like a little shock with it. So that's like one activity that you can do a lot of different levels of play with and then one thing, whenever I have a graduate student with me who's learning, I give them this very specific challenge.
So it's something I think that would be fun for your listeners to try as well. So I challenge them to take like one theme box. So I have a lot of plastic boxes that I put like a bunch of materials that are under one specific theme and I tell them that they have to use that box for all of the clients that we're seeing.
So it really makes you try to take like one group of materials and figure out how would this target receptive language, expressive language, speech sounds, engagement, social pragmatics and it's really getting ... You're used to looking at materials in a different way. So that's a fun way to kind of take what you have in thinking about how you could use it in different ways.
Ooh, I love that idea and we're going to ... We are going to get to do a little bit of that in just a moment ...
Which is super exciting.
So I think, I'm sure once we're off, I will probably think about all kinds of other ones that are my favorite for this age, but I was really trying to think about ones that were a little different.
Of course, I always have like a baby doll and stuffed animals in the typical toys you would think for that age, but those are a few that are a little less common that I thought listeners would enjoy to have as resources.
Yeah, and I always use ... A lot of the ones you listed are new to me. I don't think I've used Fat Brain Toys. I have used the Blue Orange like Spot it Jr. and Telltale, the Enchanted Cupcake Party sounds amazing.
It is and it's hard because it does have ... The pieces are fairly small so it's not really for super young kiddos, but the kids, I can tell you, they just ... They love building them. They love talking about them, they love telling stories to pretend play.
It's definitely a very versatile toy at my office and that one actually stays. It doesn't leave because it can be used in so many different ways.
Yeah, I love that. And I definitely use lots of baby dolls, stuffed animals, the play house and the play farm are big ones, all the Fisher-Price stuff.
And then I can't remember what it's called but I love the, I don't even know ... I know it's at Target but it's like a ... I don't know, it's kind of like a jail.
Oh, the one with the keys?
Yeah, it has all the different doors and then they have to match the keys with the shape and the color and you can put ... I think it probably ... Yeah.
I think it's like an animal hospital or like animal critter hospital.
Yeah. I think critter is the name.
Critter, yes because I use that one too.
I think it's amazing for ... To target so many of the goals that we talked about like describing, following directions. You can use it for articulation. If you have your little small figurines, you could put ... You could just pick whatever or categories and just grabbing whatever items we have, but that was one that was huge.
Yeah, I have that one too and what's great about it is that's one where like the product itself is just one thing, but you can always change what's inside to match the season or match a theme so kids continually enjoy.
One thing my kids, my younger ones that they really love in that one is putting a lot of windup toys so they get to open it and then we have a windup toy. I actually thought of two more too.
So another Fat Brain Toy is called Squigz. They are, picture like little builders that would have a suction cup on them. So my daughter right now, she's 20 months old and she'll take it and she'll like push it on the table and then when you pull it up, it makes like a pop sound.
And there's another one I'll put around the room, I'll go stick it on different surfaces and they'll get to go and kind of pull them off and pop them and then another great activity for this age and of course, I love like a lot of the themes are really great, but it's also fun to have those open-ended toys. So similar to the critter. There's one called Tot Tube. Have you ever heard of a Tot Tube before?
okay. So it's basically like a long plastic tube, but what's nice about it is it breaks into three separate parts. So you can put it in a box that comes in and store it away when you don't need it and so it's kind of ... It's like three plastic pieces and you put them together, but the middle is clear, you can see through it.
So I've used this for kids if we're just putting cars or balls that roll like down them and we do ready, set, go, car in, blue car, car go, all those simple combinations, but I've also found that since it's a really smooth plastic, if I have any kind of plastic figurines, recently, I was just doing an Arctic animal theme so I had little plastic Arctic animals and if you put that in the top, it slid right down.
So it went, it doesn't have to be something that rolls or has wheels. A lot of things would get sent down there. I've also used the Tot Tube with a little bit older kiddos where I have ping pong balls and I draw either letters or words on them so we get to send something down and then either name the letter, tell me what sound it makes, give me a rhyming word or reading like all of those things.
So it's a fun way just to add another element of movement and engagement with those different goals and then what I like about the middle part being clear plastic is when I've had really younger ones where we're really just working on initiating or basic signing or basic speech.
I will put something in there and then I'll hold it so they can like see it kind of floating in the middle and then I wait for whatever word it is that we're using, whether it just be vocalizing or out or please or ball or my turn or whatever it is that I'm using as a target. I'll wait for that and then I can dump it out and then they get to receive whatever it was that was inside.
Yeah, I love that. Yeah, I've never had the Tot Tube, but I used, I mean this sounds way better because you can manipulate it a little more to have more control over the ... Just set up opportunities, maybe manipulate a negative connotation, but we ... We're very strategic in how we set things up.
Some of our kids aren't super excited to communicate so we're setting up those opportunities, but I always use a ball track.
And that was, I would use it for that purpose too and that was super fun, but the Tot Tube we can use all different figurines and have five bazillion more options which is ...
Yes, and that's what ... So as a product, but it does leave, it has a specified use, but it leaves a little bit more open-ended flexibility depending on what you want to use with it.
Yeah, and those like especially with limited budgets, we want those kinds of choice where we can get lots and lots of bang for our buck and use them over and over and still have it be like fun and engaging and all that.
I think the Tot Tube, I haven't listed on my website with a link to Amazon, but I'm trying to ... I think it's around $30 I think which ... I had someone that was like, "Oh, but you can buy a plastic tube for a lot cheaper."
I was like, "Yes, but this one has the clear middle and it packs in a box nice and neat." So those two to me are worth spending the money on.
I just looked at that, then it's like 19.95.
Okay. [crosstalk 00:32:40]
Right now, so it could definitely change, but yeah, it looks so fun.
I'll also link to it in the show notes, but yeah, I love it. I want to go work in with these kiddos again.
Yeah, I know [crosstalk 00:32:58]
This is so fun.
It is a lot of fun, but it sometimes, I work with middle schoolers right now, two days a week too and I'm like, "Oh my energy level is a lot different at the end of the day when I'm not trying to run around and play too."
Yeah, play is tiring sometimes.
Yeah, [crosstalk 00:33:17]
But it's a whole different challenge with the older [crosstalk 00:33:21].
Yes, it is, but I think it's more like because you're taking their, what their needs are and trying to integrate it, that's really how Playbase therapy becomes the most effective. So you have to be a little bit on top of your game while you're playing with them.
Mm-hmm (affirmative). And you never know how a kid is going to show up.
[crosstalk 00:33:43] activity and then they show up in a mood and then it's like, "Oh wait, nope, let's rethink this whole thing." So you're making teeny-tiny decisions like all day long every minute of your session."
Yeah, I have a ...
Which is [crosstalk 00:33:58]
I have a two year old right now who has very minimal words and I'm like, "Oh yes, he's going to love this." And then I show up and he's like, "No." And I'm like, "Oh man, I was, I thought for sure I had a home run."
So yeah, that would be another suggestion I get, I guess is really having some backups too and being flexible because like you said, they could show up in a mood or they might not be interested.
So really playing with that flexibility because if you're just trying to push the same thing like then you're just going to likely frustrate them and then that gets nobody anywhere, so.
Yeah, we don't want to end up in a battle with a three year old.
You do not because you will most likely lose it.
They are very determined. I love this. And then so our plan is to go through a specific theme and just talk about how we can use different materials, but I'm curious too, because I know when I was first starting out with this population, I was like, "I don't even know what's appropriate to target."
Could you throw out just a handful of goals that you find yourself ... Goals or areas that you find yourself targeting a lot? What are or maybe we can start with, well, articulation I think is pretty simple, right?
We can easily determine that and not simple, straightforward is a better word. Thank you. But what types of like for receptive language skills are you often working on?
Yeah, as far as receptive language, it's a lot of I would say identifying vocabulary which is another reason why to have a lot of those figurines as you can, and I have a lot of them, but it's taken me time, overtime to kind of build up that.
I don't suggest necessarily going out and spending a ton of money because we have so many resources in our world of kiddos who no longer play with things and they get sold at yard sales and now I guess on online avenues fairly easily.
But yeah, I would say it's a lot of basic identifying, but I prefer to have that be for actual items versus necessarily like pictures and then a lot of really simple following directions and a lot of those will be for routines versus novel.
So I would say at this age, there's not a ton of novel directions. It's more basic routine-based directions. So like put on our shoes, where's your coat? Be kind to the doggy, working on all of those things within our session as far as receptively goes and then also a lot of responding to their name and joint attention.
So joint attention kind of crosses that receptive, expressive boundary, but usually at this age when I have kiddos coming to me with more receptive things, we really have to work on that joint attention and being engaged and a lot of imitation as well too.
So imitation really is our foundation for learning, right? If you're typically developing children or children who are in speech therapy, a lot of the ways they learn both speech and language is that I say or do something you say or do something.
So there's that imitation piece. I once had a little one, I think he came to me at 19 months old and he had no words and he actually even had very minimal babbling and as I evaluated him, what one of our goals ended up being was just play imitation because I said we have our gross motor and then our fine motor and speech is really ... It's a finally complex fine motor task, but he wasn't even imitating like gross motor play.
So we had to go backtrack a little bit and if I would build up some blocks and knock them down, he wouldn't try to not ... He wouldn't try to do the same. So we really had to integrate imitation in there.
So that's something I definitely look for and when I'm working with younger kiddos and that becomes almost like a precursor goal that I work on a lot before we're actually saying like, "Oh I say ball, I expect you to say ball." Does that answer most of your question there as far as some of that receptive piece?
Yeah, and that just sparked a memory that I have. I haven't looked into the research on this in a while so definitely check it first, but because I love how you mentioned that you're using like the play imitation gross motor actions to be able to roll that into the speech kind of sound imitation pieces.
There's actually like a manual that breaks that process down and I think it's based ... It comes from the ABA world, but it's rapid motor imitation antecedent training. I just dabbled using that with some of my ... I worked in a autism preschool for a couple of years and that was something that I started trying towards the end of my time and it was just really cool to see because the concept is like you kind of build that behavioral progression and do like a bunch of more gross motor kind of imitations and then it was amazing how it actually works. So you got them falling that pattern and then they ... It was easier for them to imitate some of the [crosstalk 00:39:53].
Yeah, and I see that too in my ... Yeah, I see too in my conversation with an occupational therapist that I often we refer clients back and forth is she'll do the same, but like from a motor planning perspective.
So for her, it's building like motor sequences in a way that kind of sets the stage for creating more motor sequences. So that starts getting out of my realm of expertise as far as where that ... Actually, the precursor and the foundations behind that where her and I kind of cross paths with a lot of those kiddos who aren't talking at all like for questioning some motor planning where she works on it from one perspective and I work on it from another perspective and it seems to help them.
Yeah, and I think it's just that momentum plays a role too. I even had that, I'm thinking back because I worked in a clinic, I don't even ... It wasn't that long ago. I am the worst historian though, but I ended up using that strategy with some of my students who were just, I guess maybe resistant.
I felt like they were just kind of shy and they were really ... They knew that communication was hard so I think they just tried to avoid it, but if I combine those motor actions with it, then they just ... If we make our arms super big or we jump and we do all these things, then they're like having fun and we're doing it and then if I do the movement and pair it with a sound, then they [crosstalk 00:41:38] beautifully, but if I just have them say like, even just like ooh, if I just say ooh, and then they say nothing, but if I move my arms and do it, then they do it. It's so funny.
[crosstalk 00:41:49] there's a lot of research about motor and speech together and we obviously, won't get into all of that now, but even for adults they talk about when you're learning, if you're doing some kind of movement like either walking on a treadmill or something that it actually stores the information further. So in a place where the younger kiddos do, but we would have to find the specific research and steps to do that effectively.
Brush that part of our brain.
Yeah, and then I think that expressively is pretty simple. A lot of my kiddos at that age, they have some kind of delayed language or delayed speech. So most common in that preschool age I get initiating and then if we're supposed to be doing two word utterances and we're only doing one, building the length of utterance or if we're at a two word stage and we're supposed to be talking in three to four.
So really building the utterance length. I do a lot of social stuff with kids this age from an expressive standpoint because like you said, if there's a barrier to language or speech, we see a lot of them kind of shut down a little bit.
So getting them to learn how to effectively communicate. I teach a lot of sign language at this age. We're kind of talking about the more involved kiddos. I do have some preschool kids where that stuff is fairly intact and we're working on a lot of sequencing, storytelling, seeing the beginning of some executive function stuff, but at an earlier level. I would say the majority of them though would cover those basis when I'm working with them.
Yeah, that's super helpful and it just kind of helps kind of frame our reference point as we start diving into the theme-based ideas. So do you think we're ready for that or is there something else? Okay.
So we talked about, we chatted a little before we went live, but we decided to go through a zoo theme. So I'm curious, let's say that you're planning to use the zoo theme next week, what would you do to set that up and kind of prepare?
Yes, so I have ... I found these plastic storage boxes that have handles on them and they are like the best thing ever. Maybe that's even a resource, I could send you that would be helpful to speech pathologist because then I can carry them around to different places, but what I do for my zoo theme, my zoo-like Safari theme, another actually great thing for this age are the poker dot books.
So again, that same physical, that pop, that cause and effect. So I grab, I have a polka dot Safari and then I grab some of my more classic books like Goodnight Gorilla, Dear Zoo, Polar Bear, Polar Bear, all of those and then I gather any of figurines I have.
So I have little people zoo animals. I have a couple of puppets, an old Beanie Babies stuffed animals and then any dress up that I have so right now in my Safari zoo box I have like a vest and binoculars.
Binoculars, they love to do the pretend play with binoculars and like a flashlight that they can shine on the animals and then I always have just some songs I tucked away that I enjoy. For this one, I specifically like ... There's a song, oh, I changed it to Down in the Jungle. I forget ... Actually, Down in the Jungle might be the original version.
I can't remember, but you can look up lots of songs, of course, but I like Down in the Jungle and then there is one that just talks about all different animals that are in the jungle and does some describing for them.
So I typically gather all those materials. Now, I've been working for so many years. I don't even really think about each child. I just bring the box with me and then I kind of ... When we start a session, I'm able to open it up and pull out the different things and use things like blankets or the hiding or the Tot Tube or surprise boxes that I just use those materials within those types of settings.
Yeah, I love that and then I think ... So we've got our materials organized and I love that you mentioned a specific storage box because that's definitely my thing. So we have this zoo like Safari theme box, we've got all of our materials.
Let's talk a little bit about maybe like some hypothetical therapy plans. So maybe we can pick like a couple of different types of students and how we could use the different materials. Do you have a student in mind that would be a good one to start with?
Let me think. Yes. Maybe if we had a child who was even ... Okay, so say we talk about some basic signing or one word utterances with our beginning sounds so more, please, all done, pop, boo, et cetera.
So these would be I would have singing songs with the puppets and then hiding them or doing the peekaboo with the different animals. Like I mentioned earlier, having the figurines and putting them in a bean bucket. So I sometimes will put like the cover on top of the bucket and wait for them to sign more or please or play and then we open it up and then when we find the animals, I do a lot of animal sounds so that like you've mentioned, that imitation and there's a lot of vowel sound, a lot of beginning sounds in there and I will simplify a lot of those too to just the vowel versus like the whole word if it's needed.
So basically, just using those themes more as like the motivators I guess for those simple structures for the kiddos we're working on really basic language and then I'm trying to think if we get to more preschool age.
I do a lot of taking turns, following directions like describing the animals, like what do they like to eat, what parts do they have? We go through a lot like that ... I forgot the name of it. There's like a visual checklist of like who, what, where parts name.
You go through all the different things like the different language to describe them and then that's another thing where the hide and seek comes into play because sometimes I actually will hide it and I'll say, "Oh, it's somewhere under a blue chair." And give them those prepositions, those items around the room for some following directions.
And then the opposite, I'll let them hide it and have to give me the direction of where to find it. Giving clues. If they have something hidden in a box or a bag, they can describe it to you.
If you have to guess it. I'm trying to think. I kind of jumped from your younger age to the preschool age there and then any of the stories. So you can always do a story retell. I do a lot of fill in the blank with stories so if it's repetitive, I will read the beginning of the phrase and leave off the end and have them do some of those closed phrases, those fill in the blanks.
And then a lot of those books like with the animals are so engaging so like Polar Bear, Polar Bear. I do a lot of like, "What does he hear?" And then we turn it and we say the animal and like it makes them all excited.
And then also for that preschool age, as I mentioned earlier, the flashlight or the binoculars, kids absolutely love to do this. So if you put the animals either around your room or like in a make a zoo, like a pretend zoo where they're in like their cages or whatever, having them either search through the binoculars to see what they can find or shining a flashlight on them before they tell you the animal's name and describe what it looks like to them. To cover it all, I [inaudible 00:49:56] get off on a little bit of a tangent there.
I love those ideas. No, that's perfect and I think it's ... I know it's so hard. I always travel with, because I love to give like concrete examples, but if ... It's so much easier to think of activities when you know like, "Okay, I'm seeing Johnny. This is what we did last time, this is what he's working on." You can really see that child and it's harder to come up with these [crosstalk 00:50:23]
... I do for this age like you mentioned earlier, a lot of naming, describing propositional phrases like following basic directions. So even though it's not really a here's the child, here's what we worked on. I feel like most of them would cover those bases somewhere. So hopefully, that would be some helpful information to just spark some ideas.
Yeah, and for the earlier communicators. There won't be as much of that, as much of the talking, but all if these things can be turned into a game and like play is that ... Those students or it is still for preschool too, but that's how they learn and so there's ... Yeah, we can totally set up the activity to elicit the signs or the one word phrases or whatever we're trying to target.
We can just be like you said, the bean bucket and the binoculars could be fun too or like even, I don't know if you ever do this, but when I was in the preschool, we had a lot of songs and the teacher just had the CD, but I found them on YouTube too.
So maybe it's not like perfect for like we want to limit screen time, but that can be like a fun occasional activity because they'll definitely request more and like [crosstalk 00:51:54]
Yeah, and music is so motivating for this [crosstalk 00:51:57] even more into the session is another way just to reinforce what you're working on.
Mm-hmm (affirmative). Yeah. And then so I think a huge component of like what we're doing with these ... Well, in any type of therapy is being able to have the students continue like practicing the skills when they get home.
So I'm curious if we're using the zoo theme example, what would you, and maybe we can focus on the early communicator and the preschooler and kind of brainstorm a couple of quick ideas on how we would communicate what we did to parents and how we might be able to encourage them to carry some of that into ...
Yeah. I do, of course in private practice, I have access to speak to those parents so a lot of them will sit in on my sessions or I'll give them a very specific task of like, "Oh, they really loved playing ... Putting the monkeys and elephants and snakes down a slide or something."
And encourage that they take the one piece that was really motivating. When it's at school, you don't have that direct access, but sometimes, I'll write notes home to the parents or send a quick email.
So one of the biggest things I would say too is just really to start with those books and it's easy to get books from the library if we don't own the one that we're using and really just pointing out to them that, "Oh, I use the ..." "Oh, oh, oh on every single page."
Or really, I was just looking for them to like I would hold it until they gave me eye contact and then I would turn it. So really just picking one piece that targets that goal, but that would be easy for parents to carry over.
I think when you give them too much information, it's a little overwhelming and also encouraging them to do that pretend play, but I found that a lot of parents have a ... Not a lot of them, but when they aren't being models what I'm doing, they have a harder time kind of conceptualizing that.
So just really being as detailed as you can for them to take what you're doing and really encouraging them that here's the simplified version. We're not going, "I'm a monkey." We're just saying, "Ooh, ooh."
Encouraging them the simplified version is a step in the direction that we want to go, but at that child's level and kind of giving them the confidence to just start with something small based on what you're doing.
Yeah. I love that and that's so much more feasible and like they're more likely to remember that. I sometimes go ... This is a little tangent, but sometimes I'll go to physical therapy and she'll give me like five exercises to do and it's like, "Oh." Especially as ... Yeah, if you're a parent and you have a kid with special needs, plus probably multiple kids and a job and all these things going on, I think like really small specific things are so incredibly helpful [crosstalk 00:55:13]
... And then more likely to carry over one small task than to disregard five of them so I would rather they have one tangible piece of information that's actually going to be implemented than being overwhelmed.
Yeah, I love that and the examples you gave were perfect. Yeah, I love that, like if the child is working on drawing attention, maybe we can work on making eye contact or a precursor skill. We'll work on eye contact [crosstalk 00:55:45]
... rather than doing the whole book and then be like, "So what is it about?" Breaking it down for them. Yeah.
yeah. It's so good. I love it and that's totally doable. It's easy for us to ... We can easily think of one activity, especially if it's something that the student was especially engaged in.
That easily stands out and it's easy for the parents to implement too. I love those tips. So helpful. Okay, so I feel like we've got some good ideas going on here. [crosstalk 00:56:25]
Yeah, I mean, I'm just really hoping that [crosstalk 00:56:23] information just to even inspire people to kind of think a little differently about the materials they have and as I mentioned before, I can send you over my website where I have actually some Amazon links to a lot of the games and activities I mentioned and then also, there's a whole bunch on there that I didn't necessarily mention specifically, but are definitely some of my favorite. So maybe I can send that over to you so your listeners can browse through if it's something that they're interested in looking at.
Yeah, I would love that. That is perfect. So I'll put that link in the show notes. So that will be at slpnow.com/38 and then Allison, what would be ... If SLPs are wanting to learn more about working with early childhood or just [crosstalk 00:57:22]
Yeah, I do have my website which is allisonpcloutier.com and actually, you can probably link that as well so I won't have to spell my whole name there and I do have some trainings for speech pathologists.
They're up on there and now, I'm working on creating a more streamlined process for those, but people could certainly reach out to me and we could talk about it and that actually is including a lot of the content from my presentations that I give and encouraging everyone how to build those relationships with daycares and preschools.
So there's information on running the therapy, but also how to do that if it's something you're interested in and I also have a little bit of one-on-one coaching too that if someone feels like they want some specific feedback and ideas, they could do that.
And then you and I together have been working on some of those themes, ideas where people would have access to using those themes and kind of have it all compiled for them together. So I'm happy to have people send me emails to ask questions, to check out those as resources or within your system to take kind of that knowledge of the thematic units and apply them as needed.
I love it and amazing resources, so excited that people will get to find out more about you and what you do and I so appreciate your time [crosstalk 00:58:58]
Thank you for having me.
Thank you so much for sharing all of these amazing tips and tricks. I'm definitely super grateful. So thank you.
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