Category: Treatment Suggestions

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DI or SP: Why it’s important to know who is treating your child in Early Intervention

Recently on the American Speech Language Hearing Association Early Intervention forum there was a discussion about the shift in several states pertaining to provision of language services to children in the early intervention system.  Latest trend seems to be that a developmental interventionists (DI) or early childhood educators are now taking over in providing language intervention services instead of speech language pathologists.

A number of parents reported to SLPs that they were told by select DIs  that “they work on same goals as speech therapists”.  One parent, whose child received speech therapy privately with me and via EI kept referring to a DI’s as an SLP, during our conversation. This really confused me during my coordination of services phone call with the DI, since I was using terminology the DI was unfamiliar with.

Consequently, since a number of parents have asked me about the difference between DIs and SLPs I decided to write a post on this topic.

So what is the difference between DI and an SLP?

DI or a developmental interventionist is an early childhood education teacher.  In order to provide EI services a DI needs to have an undergraduate bachelor’s degree in a related health, human service, or education field. They also need a certificate in Early Childhood Education OR at least six (6) credits in infant or early childhood development and/or special education coursework.

A DI’s job is to create learning activities that promote the child’s acquisition of skills in a variety of developmental areas. DI therapists do not address one specific area of functioning but instead try to promote all skills including: cognition, language and communication, social-emotional functioning and behavior, gross and fine motor skills as well as self-help skills via play based interactions as well as environmental modifications. In other words a DIs are a bit like a jacks of all trades and they focus on a little bit of everything.

SLP or a Speech Language Pathologist is an ancillary health professional. In order to provide EI services, in the state of NJ for example, an SLP needs to have a Masters Degree in Speech Language Pathology or Communication Disorders as well as a State License (and in most cases a certification from ASHA, our national association).

Unlike DIs, pediatric SLPs focus on and have an in-depth specialization in improving children’s communication skills (e.g., speech, language, alternative augmentative communication, etc.). SLPs undergo rigorous training including multiple internships at both undergraduate (BA) and graduate (MA) levels as well as complete a clinical fellowship year prior to receiving relevant licenses and certifications. SLPs are also required to obtain a certain number of professional education hours every year after graduation in order to maintain their license and certifications.  Many of them undergo highly specialized trainings and take courses on specialized techniques of speech and language elicitation in order to work with children with severe speech language disorders secondary to a variety of complex medical, neurological and/or genetic diagnoses.

As you can see from the above, even though at first glance it may look like DIs and SLPs do similar work, DIs DON’T have nearly the same level of expertise and training possessed by the SLPs, needed to address TRUE speech-language delays and disorders in children.

What does this all mean to parents?

That depends on why parents/caregivers are seeking early intervention services in the first place. If they are concerned about their child’s speech language development then they definitely want to ensure the following:

  1. The child undergoes a speech language assessment with a qualified speech language pathologist and
  2. If speech language therapy is recommended, the child receives it from a qualified speech language pathologist

So if a professional other than an SLP assesses the child than it cannot be called a speech language assessment.

Similarly, if a related professional (e.g., DI) is providing services, they are NOT providing “speech language therapy” services.

They are also NOT providing the ‘SAME‘ level of services as a speech-language pathologist does.

Consequently, if speech language services are recommended for the child and those recommendations are documented in the child’s Individualized Family Service Plan (IFSP) then these services MUST be provided by a speech language pathologist, otherwise it is a direct violation of the child’s IFSP under the IDEA: Part C.

So how can parents ensure their child receives appropriate services from the get-go?

  • Find out in advance before the assessment who are the professionals (from which disciplines) coming to evaluate your child
    • If you have requested a speech-language evaluation due to concerns over your child’s speech language abilities and the SLP is not scheduled to assess, find out the reason for it and determine whether that reason makes sense to you
  • Ask questions during the assessment regarding the child’s performance/future recommendations
  • Make sure that an IFSP meeting is scheduled 45 days after the initial referral if the child is found eligible
  • Find out in advance which professionals will be attending your child’s IFSP meeting
  • Find out if any reports will be available to you prior to the meeting
    • If yes, carefully review the assessment report to ensure that you understand and agree with the findings
    • If no, make sure you have an adequate period of time to review all documentation prior to signing it and if need to request time to review reports
  • If an SLP assessed your child but therapy services are not recommended find out the reason for services denial in order to determine whether you have grounds for appeal (child’s delay was not substantial enough to merit services. vs. lack of SLP availability to provide intervention services)
  • If speech-language therapy services are recommended ensure that therapy initiation occurs in a timely manner after the initial IFSP meeting and that all missed sessions (by an SLP) are made-up in a timely manner as well

EI Service Provision in the State of New Jersey: DI vs. SLP 

(from  Service Guidelines for Speech Therapy in Early Intervention)   

The following are the circumstances in which a DI will be assigned to work with the child instead of an SLP (vs. in conjunction with) in the state of NJ (rules are similar in many other states)

  • If a child, under 28 months of age, presents with a “late-talker profile” (pg 27)
  • If child with speech-language delays  also has delayed prelinguistic skills (e.g., joint attention, turn-taking, etc), the DI will work with the child first to establish them  (pg 29)
  • If a child under 28 months has expressive language delay only and has intact cognition, receptive language, and motor skills
  • If the child has a cognitive delay commensurate with a receptive and expressive delay (p 30)
  • If a child has a hearing impairment and no other developmental delays, DI services will be provided while  information is being obtained and medical intervention is being provided (pg 31)

Understanding who is providing services and the rationale behind why these services are being provided is the first important step in quality early intervention service provision for young children with language delays and disorders.  So make sure that you know, who is treating your child!

Useful Resources:

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Improving Social Skills of Language Impaired Children

social kids

Many children on our caseloads have social pragmatic language goals aimed at improving their social emotional functioning in a variety of settings.  In therapy we often target our clients ability to engage in interpersonal negotiations, interpret ambiguous facial expressions, as well as appropriately relate to peers.

However, oftentimes finding appropriate and relevant real-life photos is a challenge for busy clinicians. That is why I created the “Social Pragmatic Language Activity Pack“.

This 30 page social pragmatic photo/question set is intended for children ages 6 and older. It is organized in a hierarchy of complexity ranging from basic social scenarios to more abstract and socially ambiguous situations.  Some photos contain additional short stories with questions that focus on auditory memory, processing, and comprehension.

There are on average 10-20 questions per each photo, and each photo takes up one page.  While some scenarios may be suitable for younger children, most are suitable for children ages 8-9 and older. Select scenarios containing abstract concepts may be suitable only for upper elementary or middle school aged students.   These sets are suitable for both individual therapy sessions as well as group work. Depending on the student’s abilities and extent of deficits, one set (one page) may take up to 30 minutes to complete.

Areas covered by the questions:

  1. Recognizing Emotional Reactions
  2. Explaining Facial Expressions
  3. Making Predictions
  4. Making Inferences (re: people, locations, thoughts, feelings, and actions)
  5. Multiple Interpretations (of actions and settings)
  6. Interpersonal Negotiations
  7. Sympathy/Empathy
  8. Peer Relatedness (Support)
  9. Interpreting Ambiguous Situations
  10. Problem Solving
  11. Determining Solutions
  12. Determining Causes
  13. Determining Perspectives
  14. Social Judgment
  15. Safety Rules

So don’t delay and grab your set today. You can find it HERE in my online store.

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Guest Post: Simple Activities to Help Your Child with Language Impairment

If your child has been identified as having a language impairment, there are simple activities you can do at home that facilitate language development. These activities work in conjunction with your child’s formal therapy sessions and the activities he or she may participate in at school, either in the classroom or in an adjunct therapy session.

Such activities have three characteristics:

  • They are fun.

Therapy is almost always more effective for small children if it’s fun. Observe the therapist and note that almost all of the activities during the session are based around something that your child already likes to do.

  • They are part of “ordinary” interactions.

While formal therapy sessions are important, the activities at home don’t need to resemble therapy. Instead, they should be built into the normal course of everyday interactions to facilitate language skills naturally.

  • They build receptive language and vocabulary.

As you help your child develop language at home, the process becomes a natural part of your day together. Instead of being singled out as “language impaired,” your child is a loved and “normal” part of your family, and building his or her language skills becomes something that you do with your child just as you would with anyone. In addition, the interaction as you work together to strengthens your bond as you communicate.

Some simple activities to help your child include:

  • Reading aloud

Every child loves to be read a bedtime story; it’s a special time to snuggle with Mom or Dad and to hear a favorite story, again and again. Children find this repetition comforting; it also helps build both receptive and communicative language because as they learn the familiar words – both what they mean and how to say them – they can repeat them as you read the story together. This is perhaps the most perfect activity to help your child because you can do it every day. In fact, your child will look forward to it and probably even demand that it be done.

  • Telling stories, repeating rhymes, and asking your child to “complete the sentence”

Nursery rhymes and familiar stories are additional fun ways to expose your child to both communicative and receptive language. These activities develop language skills in a playful and non-stressful manner. For example, as your child develops familiarity with a rhyme, story, etc., simply pause at the end of a phrase and have him or her complete it.

  • Singing and listening to songs

Music is a wonderful facilitator of language too, and great to include in activities to help your child with language impairment issues. Spend some time each day singing together or listening to songs while driving, for example.

  • Playing the game, “What comes next?”

The “alphabet song” is a good example of how to play the game, “What comes next?” with your child. Since this song helps most children learn the alphabet, begin by singing the song together, and then as your child learns the alphabet, drop out so he or she sings the next letters alone.

“What comes next?” can also be played with days of the week, months of the year, counting, and more. The beauty of “What comes next?” is its applicability to anything language-based. Customize it to suit your child’s likes and dislikes, and it never gets boring.

  • Providing appropriate language modeling

Among the best activities to help your child is modeling correct language during conversations. Your child will watch, learn, and ultimately respond correctly, with gentle prompting at first.

About the author:

Erica L. Fener, Ph.D., is Vice President, Strategic Growth at Progressus Therapy, a leading provider of school-based therapy and early intervention services.

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In Case You’ve Missed it – Multisensory stimulation: using edibles to enhance learning

Last week one of my posts was a part of Speech Snacks Blogiversary . In case you missed it, read below some of my suggestions on how to creatively use edibles to enhance learning.

There are times when we (speech-language pathologists) encounter certain barriers when working with language impaired children. These may include low motivation, inconsistent knowledge retention, as well as halting or labored progress in therapy. Consequently, we spend countless hours on attempting to enhance the service delivery for our clients. One method that I have found to be highly effective for greater knowledge retention as well as for increasing the kids’ motivation is incorporating multisensory stimulation in speech and language activities. Continue reading In Case You’ve Missed it – Multisensory stimulation: using edibles to enhance learning

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Dear Neurodevelopmental Pediatrician: Please Don’t Do That!

Recently I got yet another one of the dreaded phone calls which went a little something like this:

Parent: Hi, I am looking for a speech therapist for my son, who uses PROMPT to treat Childhood Apraxia of Speech (CAS). Are you PROMPT certified?

Me: I am PROMPT trained and I do treat motor speech disorders but perhaps you can first tell me a little bit about your child? What is his age? What type of speech difficulties does he have? Who diagnosed him and recommended the treatment.

Parent: He is turning 3. He was diagnosed by a neurodevelopmental pediatrician a few weeks ago. She recommended speech therapy 4 times a week for 30 minutes sessions, using PROMPT.

Me: And what did the speech therapy evaluation reveal?

Parent: We did not do a speech therapy evaluation yet.

Sadly I get these type of phone calls at least once a month. Frantic parents of toddlers aged 18 months to 3+ years of age call to inquire regarding the availability of PROMPT therapy based exclusively on the diagnosis of the neurodevelopmental pediatrician. In all cases I am told that the neurodevelopmental pediatrician specified speech language diagnosis, method of treatment, and therapy frequency, ALBEIT in a complete absence of a comprehensive speech language evaluation and/or past speech language therapy treatments.

The conversation that follows is often an uncomfortable one. I listen to the parental description of the child’s presenting symptoms and explain to the parents that a comprehensive speech language assessment by a certified speech language pathologist is needed prior to initiation of any therapy services. I also explain to the parents that depending on the child’s age and the assessment findings CAS may or may not be substantiated since there are a number of speech sound disorders which may have symptoms similar to CAS.

Following my ‘spiel’, the parents typically react in a number of ways. Some get offended that I dared to question the judgement of a highly qualified medical professional. Others hurriedly thank me for my time and resoundingly hang up the phone. Yet a number of parents will stay on the line, actually listen to what  I have to say and ask me detailed questions.  Some of them will even become clients and have their children undergo a speech language evaluation.  Still a number of them will find out that  their child never even had CAS! Past misdiagnoses ranged from ASD  (CAS was mistaken due to the presence of imprecise speech and excessive jargon related utterances) to severe phonological disorder to dysarthria secondary to CP.  Thus, prior to performing a detailed speech language evaluation  on the child I had no way of knowing whether the child truly presented with CAS symptoms.

Before I continue I’d like to provide a rudimentary definition of CAS.  Since its identification years ago it has been argued whether CAS is linguistic or motoric in nature with the latest consensus being that CAS is a disorder which disrupts speech motor control and creates difficulty with volitional, intelligible speech production.  Latest research also shows that in addition to having difficulty forming words and sentences at the speech level, children with CAS also experience difficulty in the areas of receptive and expressive language, in other words,  “pure” apraxia of speech is rare (Hammer, 2007).

This condition NEEDS to be  diagnosed by a speech language pathologist! Not only that, due to the disorder’s complexity it is strongly recommended that if parents suspect CAS they should take their child for an assessment with an SLP specializing in assessment and treatment of motor speech disorders. Here’s why.

  • CAS has a number of overlapping symptoms with other speech sound disorders (e.g., severe phonological disorder, dysarthria, etc).
  • Symptoms which may initially appear as CAS may change during the course of intervention by the time the child is older (e.g., 3 years of age) which is why diagnosing toddlers under 3 years of age is very problematic and the use of  “suspected” or “working” diagnosis is recommended (Davis & Velleman, 2000) in order to avoid misdiagnosis
  • Diagnosis of CAS is also problematic due to the fact that there are no valid or reliable standardized assessments sensitive to CAS  (McCauley & Strand, 2008). However, a new instrument Dynamic Evaluation of Motor Speech Skill (DEMSS) (Strand et al, 2013) is showing promise with respect to differential diagnosis of severe speech impairments in children
  • Thus for children with less severe impairments SLPs need to design tasks to assess the child’s:
    • Automatic vs. volitional control
    • Simple vs. complex speech
    • Consistency of productions on repetitions of same word
    • Vowel productions
    • Imitation abilities
    • Prosody
    • Phonetic inventory BEFORE and AFTER intervention
    •  Types and levels of cueing the child is presently stimulable to
      • in order to determine where the breakdown is taking place (Caspari, 2012)

These are just some of the reasons why specialization in CAS is needed and why it is IMPOSSIBLE to make a reliable CAS diagnosis by  simply observing the child for a length of time, from a brief physical exam, and from extensive parental interviews (e.g., a typical neurodevelopmental appointment).

In fact, leading CAS experts state that you DON’t need a neurologist in order to confirm the CAS diagnosis (Hammer, 2007).

Furthermore, “NO SINGLE PROGRAM WORKS FOR ALL CHILDREN WITH APRAXIA!!” (Hammer, 2007). Hence SLPs NEED to individualize not only their approach with each child but also switch approaches with the same child when needed it in order to continue making therapy gains. Given the above the PROMPT approach may not even be applicable to some children.

It goes without saying that MANY developmental pediatricians will NOT do this!

But for those who do, I implore you – if you observe that a young child is having difficulty producing speech, please refer the child for a speech language assessment first. Please specify to the parents your concerns (e.g., restricted sound repertoire for the child’s age, difficulty sequencing sounds to make words, etc) BUT NOT the diagnosis, therapy frequency, as well as therapy approaches.  Allow the assessing speech language pathologist to make these recommendations in order to ensure that the child receives the best possible targeted intervention for his/her disorder.

For more information please visit the Childhood Apraxia of Speech Association of North America (CASANA) website or visit the ASHA website to find a professional specializing in the diagnosis and treatment of CAS near you.

References:

  1. Caspari, S (2012)  Beyond Picture Cards! Practical Assessment and Treatment Methods for Children with Apraxia of Speech. Session presented for New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  2. Davis, B., & Velleman, S. L. (2000). Differential diagnosis and treatment of developmental apraxia of speech in infants and toddlers. Infant-Toddler Intervention: The Transdisciplinary Journal, 10, 177–192.
  3. Hammer, D (2007) Childhood Apraxia of Speech: Evaluation and Therapy Challenges. Retrieved from http://www.maxshouse.com.au/documents/CAS%20conference%20day%201%20.ppt.
  4. McCauley RJ, Strand EA. (2008). A Review of Standardized Tests of Nonverbal Oral and Speech Motor Performance in Children. American Journal of Speech-Language Pathology, 17,81-91.
  5.  Strand, E, McCauley, R, Weigand, S, Stoeckel, R & Baas, B (2013) A Motor Speech Assessment for Children with Severe Speech Disorders: Reliability and Validity Evidence. Journal of Speech Language and Hearing Research, vol 56; 505-520.
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Product Review: Interactive WH question Megabundle by Speech2u

coverToday I am excited to review a cool WH question 97 page Mega Bundle  by Kelly of Speech2u.

Kelly created this activity to help children with significant language impairments (e.g., ASD, intellectual disability, etc) answer who, what and where questions given fun visuals.

Her intent was to allow the SLPs to control the levels of difficulty by adjusting the # of choices or selecting similar choices to reduce the task complexity.

Bundle content:

48 WHERE cards

where mat
32 WHO cards

36 WHAT cards

126 QUESTION cards

who magic xharacters
Teaching slides/graphic organizers for each question type

locations

Question sorting Mat

wh mats

Game and Activity ideas for each set of cards

9 homework sheets with generalization questions

who questions list
Sample Goal Hierarchies

smaple goals

If using Sorting Mats Kelly recommends printing, laminating and cutting out PEOPLE, OBJECT and LOCATION cards. Then having the students sort the cards based on the type of question they need to answer.  Some of her game recommendations include personalization: such as cutting out Logos from popular stores/restaurants from ads (ex. Walmart, Target) and asking questions like “Where do we go to get ______, or What is your favorite ______? etc. Other game suggestions include adding pictures of familiar buildings or places: favorite parks, museums, relatives houses and asking questions like:  “Where did you go on ____?” Or “Where did ____ last week?”

I love how many activities games and suggestions Kelly offers in this bundle.  In contrast to other ‘wh’ question sets available on the market from popular SLP vendor companies, hers just happens to be very visually appealing in terms of graphics, as well as offers a number of extra features for teaching concrete ‘wh’ questions.  You can find this bundle in Kelly’s TPT store HERE  or you can head over to her BLOG and enter to win a free copy in a Rafflecopter Giveaway!

Kelly is also currently reviewing my Speech Language Assessment of Older Internationally Adopted Children packet on her BLOG . So I will also be giving away a copy of it in a Rafflecopter Giveaway below.

SO DON’T FORGET TO READ BOTH REVIEWS AND ENTER BOTH GIVEAWAYS TO MAXIMIZE YOUR CHANCES TO WIN BOTH Prizes!
a Rafflecopter giveaway

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And Now on the Value of Wordless Picture Books

Today I am writing on one of my favorite topics: how to use wordless picture books for narrative assessment and treatment purposes in speech language pathology.  I love wordless picture books (or WLPBs as I refer to them) for a good reason and its not just due to their cute illustrations.  WLPBs are so flexible that use can use them for both assessment and treatment of narratives.  I personally prefer the Mercer Meyer  series: ‘A Boy, a dog, a frog and a friend’ for sentimental reasons (they were the first WLPBs I used in grad school) but some of you may want to use a few others which is why I’ll be proving a few links containing lists of select picture books for you to choose from at the end of this post.

So how do I use them and with which age groups?  Well, believe it or not you can start using them pretty early with toddlers and go all the way through upper elementary years. For myself, I found them to be most effective tools for children between 3-9 years of age.  During comprehensive language assessments I use WLPBs in the following way.  First I read a script based on the book. Depending on which WLPBs you use you can actually find select scripts online instead of creating your own.  For example, if you choose to use  the “Frog Series” by Mercer Meyer, the folks  at SALT SOFTWARE already done the job for you and you can find those  scripts HERE in both English and Spanish with audio to boot. 

After I read/play the script, I ask the child to retell the story (a modified version of dynamic narrative assessment if you will) to see what their narrative is like.  I am also looking to see whether the child is utilizing story telling techniques appropriate for his/her age.

For example,  I expect a child between 3-4 years of age to be able to tell a story which contains 3 story grammar components (e.g., —Initiating event, —Attempt or Action, —Consequences), minimally interpret/predict events during story telling, use some pronouns along with references to the characters names as well as discuss the character’s facial expressions, body postures & feelings (utilize early perspective taking) (Hedberg & Westby, 1993 ). By the time the child reaches 7 years of age, I expect him/her to be able to tell a story utilizing 5+ story grammar elements along with a clear ending, which indicates a resolution of the story’s problem, have a well developed plot, characters and a clear sequence of events, as well as keep consistent perspective which focuses around an incident in a story (Hedberg & Westby, 1993 ).

Therefore as children retell their stories based on the book I am keeping an eye on the following elements (as relevant to the child’s age of course):

  • Is the child’s story order adequate or all jumbled up?
  • Is the child using relevant story details or providing the bare minimum before turning the page?
  • How’s the child’s grammar? Are there errors, telegraphic speech or overuse of run-on sentences?
  • Is the child using any temporal (first, then, after that) and cohesive markers (and, so, but, etc)?
  • Is the child’s vocabulary adequate of immature for his/her age?
  • Is there an excessive number of word-retrieval difficulties which interfere with story telling and subsequently its comprehension?
  • Is the child’s story coherent and cohesive?
  • Is the child utilizing any perspective taking vocabulary and inferring the characters, feeling, ideas, beliefs, and thoughts?

Yes all of the above can be gleaned from a one wordless picture book!

If my assessment reveals that the child’s ability to engage in story telling is impaired for his/her age and I initiate treatment and still continue to use WLPBs in therapy.  Depending on the child’s deficits I focus on remediating  either elements of macrostructure (use-story organization and cohesion), microstructure (content + form including grammar syntax and vocabulary) or both.

Here are a few examples of story prompts I use in treatment with WLBPs:

  • —What is happening in this picture?
  • —Why do you think?
  • —What are the characters doing?
  • — Who /what else do you see?
  • —Does it look like anything is missing from this picture?
  • —Let’s make up a sentence with __________ (this word)
  • —Let’s tell the story. You start:
  • —Once upon a time
  • — You can say ____ or you can say ______ (teaching synonyms)
  • —What would be the opposite of _______? (teaching antonyms)
  • — Do you know that _____(this word) has 2 meanings
    • —1st meaning
    • —2nd meaning
Below are the questions I ask that focus on Story Characters and Setting —
  • Who is in this story?
  • —What do they do?
  • —How do they go together?
  • —How do you think s/he feels?
    • —Why?
    • —How do you know?
  • —What do you think s/he thinking?
    • — Why?
  • —What do you think s/he saying?
  • — Where is the story happening?
    • —Is this inside or outside?
      • —How do you know?
  • — Did the characters visit different places in the story?
    • —Which ones?
    • How many?

Here are the questions related to Story Sequencing

  • —What happens at the beginning of the story?
  • —How do we start a story?
  • — What happened second?
  • —What happened next?
  • —What happened after that?
  • —What happened last?
  • —What do we say at the end of a story?
  • —Was there trouble/problem in the story?
    • —What happened?
    • —Who fixed it?
    • —How did s/he fix it?
  • —Was there adventure in the story?
    • If yes how did it start and end?

As the child advances his/her skills I attempt to engage them in more complex book interactions—

  • —Compare and contrast story characters/items
  • —(e.g. objects/people/animals)
  • —Make predictions and inferences about what going to happen in the story
  • —Ask the child to problem solve the situation for the character
    • —What do you think he must do to…?
  • —Ask the child to state his/her likes and dislikes about the story or its characters
  • —Ask the child to tell the story back
    • —Based on Pictures
    • —Without Pictures

Wordless picture books are also terrific for teaching vocabulary of feelings and emotions

  • —Words related to thinking
    • —Know, think, remember, guess
  • —Words related to senses
    • —See, Hear, Watch, Feel
  • —Words related to personal wants
    • — Want, Need, Wish
  • —Words related to emotions and feelings
    • — Happy, Mad, Sad
  • —Words related to emotional behaviors
    • — Crying, Laughing, Frowning

So this is how I use wordless picture books for the purposes of assessment and therapy.  I’d love to know how you use them?

Before I sign off here are a few WDPBs links for you, hope you like them!

 Start having fun with your wordless picture books today!

Helpful Smart Speech Therapy Resources: 

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Types and Levels of Cues and Prompts in Speech Language Therapy

types and levels of cuesDo you need a handy guide explaining “Types and Levels of Cues and Prompts in Speech Language Therapy”?

Are you trying to understand the difference between cues and prompts?

Want to know the difference between phonemic and semantic prompts?

Trying to figure out how to distinguish between tactile and gestural cues? The grab my new handy guide which will succinctly explain all of the above information on just a handful of slides.

Does this product sound like something you need/you are interested in? You can find it in my online store HERE

 

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Introduction to Social Pragmatic Language Disorders

SPLDI have been making a lot of materials lately in order to disseminate information on a variety of helpful topics including insurance coverage for speech language services, improving feeding abilities in picky eaters, the importance of oro-facial observations during speech- language assessments  and so on. I’ve also created an “introduction” series, which offers handouts on popular topics of interest, most recently on the topic of Auditory Processing Disorders (APD), which can be currently found in my online store HERE.  Continue reading Introduction to Social Pragmatic Language Disorders

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Speech Language Services and Insurance Coverage: What Parents Need to Know

insurance coverageBased on popular demand I created this 26 slide presentation to provide basic information regarding insurance coverage for common outpatient speech language assessment and therapy services. This handout contains important questions parents must ask when speaking to their insurance representatives regarding service coverage. —It lists common pediatric diagnostic (ICD-9) and therapeutic (CPT) codes as well as discusses common service exclusions in policies. —It also provides some suggestions on how to initiate appeals for denial of services and includes links to helpful resources parents can access to obtain further elaboration on the information provided in this presentation. Continue reading Speech Language Services and Insurance Coverage: What Parents Need to Know