Maddie and I had our session outside today. We played a frozen matching game using /f/ in the initial position at the word level. Maddie is able to produce /f/ but still requires max visual cues and verbal prompts to bite her lip. In connected speech, the coarticulation causes a challenge for Maddie making her speech less intelligible. We continued with a quick game of freeze tag to expend Maddie's energy and to introduce carryover of the /f/ sound. We also worked on /s/ in the initial position of the word level looking at pictures for "same and different".
Maddie was engaged and was able to practice /s/ through play. We used a ball to roll over the target word cards after we attempted them. Maddie demonstrates difficulty focusing during non preferred tasks and required multiple prompts to stay on track. We pivoted to join her class during the second half of the session and worked on initial fronting and backing during “duck duck goose” Maddie enjoyed this and was willing to attempt more accurate productions in between turns.
Maddie was in a hurry today. She would quickly change gears from one activity to another. This increased her rate of speech and decreased her intelligibility. We decided to go an animal hunt on the playground in order to burn off some energy. We then used auditory bombardment and listening skills to separate the animals in to different sound targets. (Initial /s/,/c/, /f/). Maddie was able to do this with 40% accuracy given visuals. We then shifted gears to a patience and turn taking task. Maddie picked a block from 3 different sound target baskets and we set up a domino run that we built as long as we could before accidentally knocking it over.
Maddie had a great day in speech today. She is doing better transitioning and beginning the activity as soon as we get to speech. Today we worked on initial /s/ and initial /k/. Maddie tends to replace /t/ for /k/. For example /tow/ for /cow/. This correcting is a bit more difficult since we are attempting to replace a visible front sound /t/ for a back sound /k/. We use tactile cues such as touching her throat to feeling the /k/ production. Overall Maddie was receptive to this but doesn’t quite hear the errors in her own speech yet. We used minimal pairs to help elicit discrimination between correct and incorrect productions. I provided her with multiple initial /k/ objects and requested she listen and slide the item down the slide when I said the word correctly. She was successful 45% of the time during this activity.
Maddie was in a happy mood today. We worked on /f/ and /s/ sounds by using air dry clay to make rainbow snakes and different fossils/imprints with shells and leaves we collected outside. She is doing well with her /f/ sound in the final position but in the initial position she still requires max prompting and visual cues to produce. She doesn’t seem as self aware of her errors and requires us to practice them directly in isolation and at the word level with a mirror for visual feedback. In addition, she has demonstrated some difficulty with following directions so we played a Robot game in which we took turns being the robot and operator to practice following different one and two step directions.
Maddie did a great job in speech today. We worked on /f/ and /s/ targets in isolation and then in the initial and final position of words by feeding a large dinosaur different snacks that began and ended with our target sounds. Maddie demonstrates difficulty with pretend play. She understands the concept but doesn’t sustain attention very long. We continued on the playground working on action verbs.
Maddie was eager to transition to speech today. We held our session outside. We began with a bag of initial /s/ objects. We worked on the “snake sound”. Maddie’s /s/ in isolation sounds great. Her initial /s/ is usually omitted but with prompting and a mirror can be elicited with 40% accuracy. She does better when we split the word up and slide from one sound to another.
Maddie did a great job today. We reviewed initial /f/ sound articulation placement and practiced accurate final /f/ coarticulation in the mirror. We continued by testing stimulability for /s/ in isolation and then /s/ in initial position of words. We also practiced slowing down by using breathing techniques. Maddie is quick to move from one activity to another and often times uses a quick rate of speech that decreases intelligibility.
Maddie demonstrated some difficulty transitioning into the speech room after returning back the routine following absence. We began with auditory bombardment of initial /f/ words. We continued with a game of finding objects that began with our speech sound. She was able to articulate initial /f/ with 30% accuracy. We continued by increasing accurate productions in the mirror by working on /f/ in the final position with 80% accuracy. This brings her attention to lip posture for accurate /f/ production.
