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10 Ways to Use the Post Box Game in Therapy

With Valentine's Day approaching, many SLPs are looking for theme related ideas.  One game that I bring out often, is Orchard Toys Post Box Game.  Children as young as three can play it and children as old as five and six still like to play it.  Here are some way I use it.  The general preface for the game is to pick up a letter and put it on the right mailbox.  The letters are colour coded and are addressed to different animal characters.  

1. Building vocabulary.  For younger children, it's great for learning colours and animals.  Most of the animals are common (e.g. pig, rabbit, dog, rhino) and great for teaching colours. 

2. Expanding Sentences.  Because the letters are four different colours (red, green, blue, yellow) you can start to use those colours to increase the length of sentences (E.g. "I have a red letter.")  

3. Prepositions.  This is great for teaching in for those younger children.  It can also be used to teach in front and behind (the cards fall behind the mailbox).  I will ask where a certain card and have the children answer.  A version of this is to hide the letters in various places in your therapy room. Either tell the children where they could find a letter or have the children tell you where they found the letter. 

4. Following directions.  This can be work on one-step directions (e.g. "Put a red letter in the mailbox." or "Put the duck's and the cat's letters in the mailboxes.").  You can also work on two-step directions (e.g. "First put a red letter in the mailbox, then put a green letter in." or "Before you put the rhino's letter in, put the duck's letter in.")

5. Pronouns.  I will put out pictures (a boy, a girl and a group) and divide the letters among them.  The children will pick out a letter from one of the piles and have the children say who is mailing the letter. I will also put out pictures of the different animals.  The children then deliver the letters that were mailed.  They can then say, "She/he/they get a letter." or "Here is your letter." or "You get a letter" etc...  

6.  Possessive Nouns.  The children pick a letter and look at the animal on the letter.  The child then would say, "It's the ________'s letter." 

7. Articulation.  The obvious sound to target is "L" by saying letter. I frequently incorporate the possessive noun activities into therapy which is great if you are working with mixed group.   I will also take smaller artic cards I have and use removable glue dots to put them on the letter.    Then have the child choose a card and then say the word.  As well sometimes I will just have the children put artic cards in the mailboxes.  

8. Categorization.  One activity, is to flip the letters colour side up.  Then name a category and have a child pick out that animal's letter.  (E.g. Find an animal that lives on a farm) or I will ask for the all the animals in that category.  Another version is for the child to pick a letter then say the animal's category (e.g. A child picks up a letter with a rhino.  The child says, "The rhino is a zoo animal.").  I will sometimes ask them to name another animal in the group.

9.  Describing.  Have the children play clue by either describing the animal or guessing what animal is being described.  This is a great activity for small groups.

10. Similarities and Differences.  Take two letters and say how the animals are the same or different.

Lastly, I have the children help me set up the game.  This is another way of targeting following directions.  It is also great for working on sequencing as you have to set up the game in specific way.  It can also work on some problem solving skills because the triangle supports that keep the mailbox  up must be in a specific direction or the mailboxes are very  wobbly and tend to fall over.  As always this post does not contain affiliate links.  If you are interested in other Orchard Toys that I use in therapy check out this post. Overall the children really enjoy playing this game and I'm able to target a wide variety of goals which is  a win for all.

Doing Therapy Outside in the Snow

Everyone has had the experience where you have planned a great therapy session only to have to "throw it out" at the last minute. That was me a couple of days ago. I was unexpectedly going spend the day playing outside in the snow. Of course I was thinking about different activities I could do to work on goals. Turns out there was lots we could and did do.  Here are a few.

1. Asking for help.  Many young children needed help forming snowballs, putting their mitts and toques back on, help standing up and, every once in a while, and help putting their boots back on (it can be hard to do and not get your socks wet!). This fit very naturally into the day.

2. Sequencing.  Many children needed help forming snowballs and making snowmen.  We showed some children how to make snowballs and then we had those children teach other children how to do it. The snow was perfect for making snowmen, the children made snowballs and then I pretended not to know to put it together.  The kids laughed and giggled as I had the balls in all combinations but the right one.  They liked telling me how to put the balls in the right order.

3. Concepts: big, little, heavy, light, lots, little, high, low, on, top, middle, bottom, tall, short, cold, and wet.  There are more concepts you can target but these were the ones I used.  The kids loved to make snowballs and this is where you could talk about the weight, size and feel of the snowballs.  The children were only allowed to throw snowballs at one wall.  So as they threw snowballs, I targeted location concepts by talking about where their ball landed (the snow stuck to the wall so it was easy to tell where it went) or by telling them where to throw the snowball (e.g. "throw it under Suzie's ball").  We also worked on comparing snowballs and how high the snowball hit the wall. 

4. Articulation.  S-blends are a natural and easy target with snow.  We practiced the words: snow, snowman, snowball, slippery, slide, and splat.  We also made penguin nests by digging a hole in the snow and then made snowballs for eggs.  Here I was able to target some other sounds, /n/: nest  /p/: penguins, up /g/: dig and eggs.  

5. Asking and answering where questions.  When the children went hunting for good snowball snow, they would sometimes forget where the nest was.  We then worked on asking "Where is the nest?" As well, sometimes the eggs would "disappear" and the children would ask, "Where did the eggs go?"  When they found the eggs they would then answer questions like "Where did you find the eggs?"  This also gave them practice using different location words, e.g. "Beside the tree."

6. Increasing the use of/understanding of  verbs. We used throw, roll, make, dig, sink/sank (some kids sank down in the snow drifts), lift, carry, run, slide, and slip.  

Overall while it wasn't my plan going into the day, I would say it was very successful. The children were able to work on their goals and have an amazing time too!

9 Tips for Reading to Children

In a previous post,  I wrote about why you should be reading to children.  This week I thought I would talk about some tips to help increase the value of reading.

1. Have children pick out the books to read.  They will be more interested in the book.   Take them to the library to choose some different books.  Many libraries have free memberships for young children. 

2. Don't worry if you have read the same book "hundreds of times."   It's important to read a book more than once.  They will get a better understanding of the story, learn more vocabulary and pick up on small details that they might of missed the first few times they  heard it. If a child gets "stuck" on a book (i.e. the only book they will listen too and you really have read it hundreds of times), then try first/then statements.  For example, "First we will read book X, then we will read your favourite book."

3. Pick out a variety of fiction and non-fiction stories.  If they are like Thomas the Train, then also have a variety of books about real trains available too.  

4. When picking out a story book, pick ones with good "story structure." Let it have a beginning, a middle and an end. You can then ask questions like, "Who is Thomas?" or "What do think is going to happen?" or "What else could Thomas do?" or "Why was Thomas in the forest?"

5. Don't hurry through the book.  Read slowly and pause at the end of a page.  This is like talking, you need to let children have time to understand what they have heard and they need time to come up with comments or questions.

6. Think about the children's language levels when picking out a book.  You may not want to read a book with lots of text if your child is understanding and/or talking in short phrases.  If you have a book that you feel has too much text, it's okay to edit.  You don't have to read every word.  Shorten the story as much as you can or just look and talk about the pictures.

7. Highlight new vocabulary.  Books often use words children may not hear everyday.  Talk about what that unfamiliar word means. For example, "Gloomy is another word for sad." If you can, act out the word (e.g. pretend you are sad when you read the word "gloomy.")

8.  For teachers and daycare staff, read in small groups (i.e. three-five children in a group).  This will allow you to gage whether the children are understanding the story.  Also it will allow the children to talk about the book.  Let them interrupt you.  Teach them to put up their hand and then respond when they do.  This shows they are interested in the book and are learning.  I will fully admit that it is a pet peeve of mine when adults shush children  when the children have questions or comments because the adult is reading.  Children get more out of the book when their questions/statements are being acknowledged and answered.  

9. Lastly have fun and enjoy this time. Don't be scared to be a little goofy.  Get animated.  When you show that you are excited, then children will be excited. This is not just about helping them do well in school.  This is a great time to bond and have fun. 

Moving Away from Sign Language and Towards Other Forms of AAC

When I started working as an SLP, I was a huge supporter of introducing signs to the children I worked with.   Why?  Well first off I have a strong background in American Sign Language (ASL).  When I first started with children who were severely delayed* using signs was a comfort to me, it was something I knew how to do well. Parents were more receptive to signs than using pictures. As the years have gone by, I have introduced less and less signs to the children I work with and I am more choosy about who I introduce sign to. Here are some reasons why:

1. Not everyone knows how to sign.  While in some ways it has gained popularity with the introduction of baby sign programs, the number of people who could communicate with the child is limited.  What if there is an emergency and the child has to communicate?  Will the person who is communicating with them understand them? Added to that ASL vocabulary (which many people borrow signs from) can vary greatly from region to region. Will the person know the regional variations  that could affect communication? Pictures or written words are much more easy for the lay person to understand.  

2. The next hurdle is what kind of sign system are you going to use?  Are you going to use proper ASL?  ASL is a different language with it's own grammar.  Do you or the parents know those rules and have enough vocabulary to teach their child to communicate?  Probably not.  I liken it to asking a parent who only speaks Italian to communicate with their child in English.  We don't do it because we want strong language models.** 

Are you going to use some form of signed English?  If you do then many signs you use will look different from ASL signs.  Also all the English morphemes (e.g -ing) and functor words (e.g. is, to, at) are going to have their own signs. You run into the same challenge as you do when introduce a system with pictures, people end up using signs telegraphically.  We know that telegraphic communication is not ideal. 

3. In my experience, many children who have severe language delays also have fine motor delays.  This can make being able to form the signs correctly challenging.  As a result, the child, or the SLP, or the parent modifies it.  So unless you know how that child's sign for that word, people who do sign will have troubles communicating with him or her.  Fine motor delays can also mean that combining signs into phrases and sentences could be more difficult.  This limits the child's capacity to communicate. Picture systems of communication have developed direct and indirect access to those pictures.

4. There has been a lot of talk about cultural appropriation in the media these last few years. I wonder if this is what we are doing to the Deaf*** community when we borrow signs?  The Deaf community has not had a good history with teachers or SLPs.  Should we be borrowing signs from them when, unless the child is Deaf, they will not be apart of that community? Apparently all those classes on Deaf culture and power dynamics stuck.

5.  Before the advent of iPads and tablets, some parents felt using speech generating devices (SGD) drew attention to their child's differences.  This was particularly true for children who used AAC to augment their speech.  Now that people carry around smartphones and iPad/tablets everywhere, those children stand out less.  This can still be a challenge with low tech forms of communication but it seems a slightly smaller hurdle these days.  

6. People have a greater access to speech generating programs with the advent of Proloquo, LAMP and such apps.  Where I live, children who might not qualify for other SGDs now have an alternative means to access speech generating programs.  As well, where I work now has a greater access to some of these apps.

7. Pictures, even lines drawings, are often easier to understand than signs (my opinion).  While some signs closely resemble gestures, many many signs are more abstract.  As well,  pictures help provide the child longer time to help better understand the message than many signs. The pictures don't "disappear" like signs do.  Non-verbal and low verbal children tend to learn to point to pictures faster than learning the different signs (my opinion only). 

8.  As my education on using core words, PODD and even PECs grew, I was able to educate team members. These other members then went and did their own education on using pictures to communicate. I was able to get better buy in (not perfect but growing).  As a result we were able to introduce more and more picture forms of communication.

Signing has a place in the world of AAC but it must be applied as thoughtfully as other forms of communication.

*These children did not have a hearing loss.
**There are programs to help provide children with a hearing loss and their parents supports form the Deaf community, including language models. 
***Deaf = someone who associates with Deaf culture and is usually involved in the Deaf community.  Most have some form of hearing loss but not necessarily.