Smart Speech User Rewards Program

Smart Speech User Rewards Program

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Speech Language Pathologists (SLPs) for Evidence Based Practice

Last year a new Facebook Group was launched for SLPs interested in evidence-based practice in speech-language pathology. It was created for clinicians to explore and make sense of a myriad of intervention promises and questionable treatments in the fields of health care and education.

The group was established specifically for the purpose of research inquiry.   It has now reached almost 10.5K membership and contains numerous threads on a variety of scientific and pseudoscientific methods, assessments, and interventions for a wide variety of conditions.

Please join us in our efforts of continually improving the quality of services for clients in our care! 

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Spotlight on Syndromes: an SLPs Perspective on Treacher Collins

Anteroposterior view of 2-month-old boy with TreacToday’s guest post on genetic syndromes comes from Amy Locy, who is contributing an informative piece on the Treacher Collins Syndrome (TCS)TSC  occurs in 1 out of every 50,000 live births with 40% of children born with TCS having a family member with the syndrome. TCS is distributed equally across genders and races. It can often occur in conjunction with the Pierre Robin Sequence.  

Developmental Anomalies

There are many developmental anomalies associated with TCS that are restricted to the head and neck and vary from person to person. Continue reading Spotlight on Syndromes: an SLPs Perspective on Treacher Collins

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Why ESL Doesn’t Fit: What Parents of Internationally Adopted Children Need to Know About Language Support

During my recent webinar, Navigating Language Development of Older International Adoptees (April 3, 2025), hosted by Holt International, one of the most frequently asked questions from parents was:

“Why shouldn’t my internationally adopted child attend ESL classes?”

It’s a reasonable question—and one I hear often from well-meaning parents and educators who want to ensure their adopted children receive the support they need. But this question also reveals a widespread misunderstanding about the language needs of post-institutionalized internationally adopted children.

This blog post is my response to that conversation—written for families, educators, and professionals who want to better understand why ESL services are not appropriate for internationally adopted children, and what to do instead.

If you weren’t able to attend the webinar live, the full recording will be available through Holt International’s educational webinar series. You can find it on their website HERE.

Let’s unpack why ESL isn’t the right fit—and what kinds of support internationally adopted children actually need to thrive.

Myth: “My child isn’t fluent in English, so ESL must help.”

Reality: Internationally adopted children are not bilingual learners.

Most ESL programs are designed for children who still use their native language at home and gradually acquire English in school. These kids are developing two languages at once and benefit from strategies that build on both.

But internationally adopted children? They experience something very different.

According to Gindis (2005; 2008), children adopted between ages 4–7 lose their birth language within just a few months of arriving in their new home. They’re immersed in English almost immediately—and their native language is rarely maintained because most adoptive families are monolingual.

So, they’re not truly bilingual. But they’re also not fully fluent in English yet. They’re in a unique in-between state that ESL programs aren’t designed to address.

ESL programs don’t target what IA children actually need

While ESL helps students bridge language barriers tied to cultural and home-language continuity, IA children are dealing with something else entirely: language deprivation and language loss.

Many older adoptees spent years in institutions with:

  • Minimal one-on-one interaction
  • Low language stimulation
  • Unaddressed medical or developmental concerns

This means they’re not just “behind in English”—they often have underlying language delays or disorders that impact comprehension, expression, and even literacy (Scott, Roberts & Glennen, 2011; Desmarais, et al, 2012; Kornilov et al., 2019).

They sound fluent… but can’t keep up academically

A major source of confusion is that many IA kids sound great conversationally. They can talk about their favorite games, pets, or foods. But when it comes to classroom work—reading comprehension, writing essays, understanding abstract language—they start to struggle.

This happens because they develop Communicative Language Fluency (CLF) quickly—but take years to develop Cognitive Language Mastery (CLM), which is necessary for school success (Gindis, 2005).

So even if they “sound fluent,” they may:

  • Misunderstand instructions
  • Struggle with academic vocabulary
  • Fall behind in reading and writing
  • Feel overwhelmed and shut down in class

These are not second-language issues. They are language development issues that require specialized intervention.

So what should you do?

Instead of agreeing to an ESL placement, here’s how you can better support your child:

  1. Get a comprehensive speech-language evaluation—especially if your child had speech or language delays in their birth country, or came from an institutional background.
  2. Ask about school-based speech services—not ESL. Many IA children qualify under criteria for language disorders rather than language differences.
  3. Advocate for academic support that targets vocabulary, inferencing, grammar, and literacy.
  4. Monitor progress over time—some delays won’t show up until years later, especially as school demands increase (Glennen, 2009).
  5. Be aware of trauma and sensory history—many IA children also have social, emotional, and attentional challenges that impact language.

Bottom line

Your child may not need ESL. But they do need support.

If your internationally adopted child is struggling in school—even if they speak English well—don’t accept a “wait and see” approach. Push for a full language evaluation. Ask for help from a speech-language pathologist who understands adoption, trauma, and language loss. And most of all, trust your instincts.

Because these kids don’t just need English—they need someone who gets the whole picture.

References

  1. Desmarais, C., Roeber, B. J., Smith, M. E., & Pollak, S. D. (2012). Sentence comprehension in postinstitutionalized school-age children. Journal of Speech, Language, and Hearing Research, 55, 45–54.
  2. Elleseff, T. (2025, April 3). Navigating language development of older international adoptees [Webinar presentation]. Holt International.
  3. Gindis, B. (2005). Cognitive, language, and educational issues of children adopted from overseas orphanages. Journal of Cognitive Education and Psychology, 4, 290–315.
  4. Gindis, B. (2008). Abrupt native language loss in international adoptees. Advance Healthcare Network for Speech/Language Pathologists and Audiologists, 18(51), 5.
  5. Glennen, S. (2009). Speech and language guidelines for children adopted from abroad at older ages. Topics in Language Disorders, 29(1), 50–64.
  6. Kornilov, S. A., Zhukova, M. A., Ovchinnikova, I. V., & Grigorenko, E. L. (2019). Language outcomes in adults with a history of institutionalization: Behavioral and neurophysiological characterization. Scientific Reports, 9, 4252.
  7. Scott, K. A., Roberts, J. A., & Glennen, S. (2011). How well do children who are internationally adopted acquire language? A meta-analysis. Journal of Speech, Language, and Hearing Research, 54(4), 1153–1169. 
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Hurray for Book Companions: What will the pig want next?

Is there anything more fun then literature based speech language intervention?

Rhetorical question of course, but seriously how much fun is it?  Even the simplest books are jam-packed with a variety of language concepts, “wh” questions, target vocabulary, prepositions of location, and much, much more.

Of course, it’s always a bonus when I manage to create or obtain a book companion as a complement to the story, so the clients benefit the most from the activity.  I also find book companions particularly useful when it comes to passing out the homework activities to the parents, many of whom require a little guidance regarding how to work at home with their children in order to increase carryover and ultimately reduce the child’s overall time in therapy. This is why I jumped at the opportunity to review one of Denise’s (Speech Language Pirates Blog) several book companions: “If you give a Pig a Pancake.” Continue reading Hurray for Book Companions: What will the pig want next?

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Preventing Learned Helplessness in Students with Language Impairments

A few weeks ago in one of my private speech language therapy sessions, I was reviewing the homework  of an 11-year-old student,  part of which involved  synonym and  antonym production describing abstract feelings (e.g., disinterested, furious, etc.). These words were in the client’s lexicon as we had been working on the concept of abstract feelings for a number of weeks. I was feeling pretty confident that the student would do well on this assignment, especially because prior to assigning the homework we had identified the exact emotion which required the generation of antonyms and synonyms. So all was going swimmingly,  until she made the following comment when explaining one of her answers: “I was thinking that this word ____ is not really an appropriate synonym for _________ but I put it anyway because I couldn’t think of any others.”

That gave me a pause because I couldn’t quite believe what I was hearing. So I asked: “I completely understand that you might not have remembered some words but what could you have done to help yourself in this situation?” Without any prompting, the student readily identified a number of strategies including: looking up the words in a thesaurus/dictionary, “Googling” them, or even asking an adult to help her with choosing the best answers from a number of choices.

My follow-up question to her was: “Why didn’t you?” The student just shrugged her shoulders and looked at me in surprise, as though this concept had never occurred to her.

This incident got me thinking regarding the pervasive influence of learned helplessness, and how our students continue to be impacted by it long after they begin receiving the necessary therapies to improve their academic performance.

For those of you unfamiliar with this term, here is a brief overview. This phrase was coined by a US based psychologists Martin Seligman and Steven Maier in 1967. In a series of experiments they exposed dogs to electric shocks that they were unable to escape. After a little while the dogs stopped trying to avoid the aversive stimuli because they became conditioned to the fact that they were helpless to change the situation. However, the most fascinating aspect in these series of experiments was the fact that even after the opportunity to escape became clearly available, the animals still failed to take any action and continue to behave as though they were still helpless.

How does this apply to students with learning disabilities? 

Many students with language impairments and learning disabilities struggle significantly in school setting due to failing academic performance. The older they get, the more academic demands are placed on them.  This includes but is not limited to the amount of homework they asked to complete, the number of long-term projects they’re expected to write, as well as the number of tests they are expected to study for.

Because they are unable to meet the ever increasing academic demands, their parents begin to actively micromanage their academic life by scheduling the times when the students are expected to perform homework, study for tests, do projects, and much much more. As a result, many of the students do not know how to do any of the above activities/tasks independently because they are conditioned  by their parents/teachers to tell them what to do, how to do it, and how to lead their academic life at any given moment.

The students begin believing they they are helpless  to change even the most basic situations (e.g., take an extra step during the homework assignment and look up a vocabulary word without anyone telling them to do it) and continue to behave in this fashion long after they begin receiving the necessary therapies, coaching, or in school assistance. This is especially true of students whose language/learning disabilities are not identified until later in their school career (e.g., late elementary years, middle school, or even high school).

What are the Symptoms of Learned Helplessness in Children?  

The below poster from Dragonfly Forest Blogspot/Forest Alliance Coaching summarizes it quite nicely.

Other symptoms of learned helplessness include:

  • Lack of motivation/task initiation
  • Poor critical thinking abilities
  • Reluctance to make independent choices
  • Low self-esteem
  • Depression
  • Blaming a disability: “I act like this because I have _________”

It is important to note that the above symptoms are most applicable to students with learning disabilities and average cognition.  However, learned helplessness is equally pervasive (if not more so) in students with developmental disabilities (e.g., ASD, genetic syndromes, etc.)

Below are just a few examples of learned helplessness in students with developmental disabilities, which were inadvertently (and/or deliberately) reinforced by the adults in their lives(e.g., family members, educational staff, etc.).

  • Spoon feeding a three-year-old with ASD who has already mastered this particular ADL skill
  • Having a non-verbal eight-year-old correctly identify the PECS card for “open” but then always opening the door for him without giving him an opportunity to do so himself
  • Keeping a 12-year-old with ASD on puréed diet despite multiple MBS and FEES studies indicating that there are no structural abnormalities which would prevent this student from successfully trialing solid foods
  • Not placing basic expectations such as cleanup of toys on a verbal seven-year-old with Down Syndrome, simply because of her condition

Changing the Patterns of Learned Behavior:

According to available literature, when psychologists had tried to change learned helplessness in animal subjects it took them between 30 – 50 times of physically moving the dogs across the barrier before they proceeded to do so independently. Thus, it stands to reason that the process of rewiring the brain in humans with learned helplessness will be a lengthy one as well.

The first task on the part of adults  is active analysis of all the things  we may be doing  as  parents and educators,  which inadvertently  reinforces learned helplessness in our children/students.   Some  things may surprise you.   For example, I frequently ask the  parents of the students on my caseload what chores and responsibilities  they give their children at home.   In an overwhelming majority of the cases  my clients have  very few chores/responsibilities at home.  This  is especially apparent in families  of language  impaired children  with typically developing siblings. Conversations with parents  frequently reveal that many typically developing siblings (who are sometimes younger than my clients)  have far greater responsibilities  when it comes to chores,  assignment completion,  etc.

Did you know that an average 8-9 year-old is expected to remember to do chores for 15-20 min after school (“prospective memory”), independently, plan school projects (select book, do report, present in school), keep track of changing daily schedule, do homework for 1 hour independently as well as keep track of personal effects when away from home? (Peters, 2013)

Did you know that an average —12-14 year old is expected to demonstrate adult level planning abilities, have daily chore responsibilities for 60-90 minute in length, babysit younger siblings, follow complex school schedule, as well as plan and carry out multiple large semester-long school projects independently? (Peters, 2013)

While our language impaired children of the same age may not be capable of some of the above responsibilities they are capable of  more then we give them credit for given appropriate level of support (strategies vs. doing things for them).

Where do we begin?

It is important to recognize the potential of the children that we work with without letting their disabilities to color our subjective perceptions of what they can and cannot do. In other words, just because there are significant physical/cognitive handicaps, it does not mean that given appropriate accommodations, therapies, resources, as well as compensatory strategies that our student will not be able to reach their optimal potential.

Working with Physically/Cognitively Impaired Children: 

  • Uphold accountability 
    • You wouldn’t let a typical four-year-old get away with leaving a mess and not cleaning up their toys, so why would you let a four-year-old with Down syndrome or ASD slide?  It might take a tad longer to teach them what to do and how to do it but it certainly is more then doable
  • Do not excuse inappropriate behaviors and attribute it to a disability
  • Assign responsibility
    • Even in the presence of physical and cognitive disabilities students are still capable of performing a number of tasks and chores. This may include but not be limited to cleaning up own room, making up one bed, loading and unloading the dishwasher, taking out the garbage, vacuuming the floor, pushing the grocery cart in the store, loading and unloading food at the cash register, and much much more.
  • Encourage Hobbies 
  • Explore Adapted Sports 
    • Similar to hobbies adaptive sports can be incredibly beneficial to children with developmental disabilities. Movement helps to rewire the brain! Adaptive sports participation increases the child’s independence as well as fosters socialization with others.  Engagement in adaptive sports can also combat learned helplessness.
  • Support Quality of Life Experiences
    • Unfortunately the quality of life of the children with developmental disabilities that we work with is often compromised. Because there is inordinate focus placed on “just existing” and fitting in all the therapies, frequently joyful experiences are few and far between. If the situation allows it needs to change! There are so many simple activities we take for granted, which can bring true happiness to the children that we work with.
      • Swimming in the pool
      • Visiting a museum
      • Going into an amusement park
      • Picking berries or mushrooms in the woods
      • Going to the beach
      • Bird watching
      • Taking a vacation (if financially doable)
  • Expect more
    • Don’t let the child’s cognitive and/or physical limitations  stop them from reaching their true potential.
      • This may mean disagreeing with well-meaning but limitedly knowledgeable school-based professionals, who may tell you that your child with genetic syndrome such as Down Syndrome or Fragile X will never learn how to read (see Case C
      • This may mean finding accommodations and compensatory strategies for a student’s severe disabilities to make that person’s life more meaningful and enjoyable.  To illustrate, many years ago when I just started working for a school for severely medically fragile children, I’ve worked with severely physically impaired nonverbal young adult  (21) who had a limited use of his right arm (gross motor movements]only).  That did not stop us from ‘discussing’ works of literature, studying SAT level vocabulary, as well as learning Greek and Latin Roots of English.   It also didn’t stop his parents from exposing him to a variety of life experiences, aimed to make him feel like an average young adult, such as allowing him to taste a few drops of sake even though he was NPO (lat. for nothing by mouth)

Working with Language Impaired and Learning Disabled Children with Average IQ:

  • Increase their accountability in own education
    • Teach useful compensatory strategies
      • Have the children wear a watch to be more mindful of the passage of time (a child 6+ years of age could be an appropriate candidate)
      • Use of schedules, planners, and timers to be more mindful of time spent on homework, assignments, and test studying
      • Use charts listing various strategies of asking for help to teach children to increase ownership of their learning (FREE HERE)
  • Teach them to speak up regarding needed accommodations
    • Use of software applications
    • Time to prepare for oral responses
    • Use of choices when answering questions of increased complexity
    • Audio recording of newly taught information in the classroom
  • Develop their critical thinking skills and problem solving abilities
  • Change your outlook
    • Replace doing everything for them attitude or finger-pointing and blame attitude with solution- focused constructive criticism by teaching specific strategies which will help the student succeed
  • Encourage perseverance
    • Teach the students positive strategies of not giving up and persisting through the difficult situations

Changing the ingrained patterns of learned helplessness is no easy feat.  It requires time, perseverance, and patience. But it can be done even in children with significant developmental and learning disabilities.  It is a difficult but much needed process, which is instrumental in helping our students/children attain their optimal potential.

References:

  1. Seligman, M. E. P. (1975) Helplessness: On Depression, Development, and Death. San Francisco : Freeman.
  2. Peterson, C., S. Maier, and M. Seligman. (1993). Learned Helplessness. New York: Oxford University Press.
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Fun and Educational Summer Board Games: Recommendations for SLPs and Parents

 

children-playingAccording to the New York Times Article which summarized the results of Johns Hopkins University study: A  TYPICAL STUDENT WILL LOSE ABOUT ONE  MONTH OF LEARNING OVER THE SUMMER  TIME.

More troubling is that it disproportionately affects low-income students: they lose two months of reading skills, while their higher-income peers — whose parents can send them to enriching camps, take them on educational vacations and surround them with books during the summer — make slight gains.”  To continue: “the study of students in Baltimore found that about two-thirds of the achievement gap between lower- and higher-income ninth graders could be explained by summer learning loss during the elementary school years.”

BUMMER!

But then again it is summer and kids do want to have fun!

So with the recent heatwaves across the country, how about combining fun with learning on those sweltering summer days when lazing at the pool or going outside may not be the best option.

Let’s take a look at the few common and readily available  board games, which can be used to improve various language abilities: including vocabulary knowledge, problem solving, questioning, storytelling as well as other language related skills.

 A to Z Jr– a game of early categorizations is recommended for players 5 – 10 years of age, but can be used with older children depending on their knowledge base. The object of the game is to cover all letters on your letter board by calling out words in specific categories before the timer runs out. This game can be used to increase word finding abilities in children with weak language skills as the categories range from simple (e.g., basic concepts) to more complicated (e.,. attributes). This game is great for several players of different age groups, since younger children or children with weaker knowledge and language skills can answer simpler questions and learn the answers to the harder questions as other players get their turn.

 Tribond Jr – is another great game which purpose is to determine how 3 seemingly random items are related to one another. Good for older children 7-12 years of age it’s also great for problem solving and reasoning as some of the answers are not so straight forward (e.g., what do the clock, orange and circle have in common? Psst…they are all round)

 Password Jr-is a great game to develop the skills of description. In the game you guess passwords based on the one word clues. This game is designed to play with children ages 7 years and older as long as you help the non readers with the cards. It’s great for encouraging children to become both better at describing and at listening. You may want to allow the children to select the word they want to describe in order to boost their confidence in own abilities. Provide visual cheat sheets (listing ways we can describe something such as: what does it do, where does it go, how can we use it etc) to the child as they will be much more likely to provide more complete descriptions of the target words given visual cues.

 Blurt – a game for children 10 and up is a game that works on a simple premise. Blurt out as many answers as you can in order to guess what the word is. Blurt provides ready-made definitions that you read off to players so they could start guessing what the word is. Players and teams use squares on the board strategically to advance by competing in various definition challenges that increase language opportunities.

Games the facilitate asking questions: Guess Who (age 6+),  Guess Where (age 6+), and  Mystery Garden (age 4+) are great for encouraging students to ask relevant questions in order to be the first to win the game. They are also terrific for encouraging reasoning skills. Questions have to be thought through carefully in order to be the first one to win the game.

Game that facilitates Story Telling as well as Perspective Taking:   Fib or Not (ages 10+) encourages the players to fool other players by either telling an outlandish true story or a truly believable made up story. For the players who are listening to the story, the objective is to correctly guess if the story teller is fibbing or being truthful. Players advance by fooling the other players or by guessing correctly.

Games that improve verbal reasoning and problem solving abilities: 30 Second Mysteries (ages 8-12) and 20 Questions for Kids (ages 7+).

In 30 Second Mysteries kids need to use critical thinking and deductive reasoning in order to solve mysteriously sounding cases of everyday events. Each clue read aloud reveals more about the mystery and the trick is to solve it given the fewest number of clues in order to gain the most points.

In 20 Questions for Kids, a guessing game of people, places, and things. Children need to generate original questions in order to obtain information. Here again, each clue read aloud reveals more about the secret identity and the trick is to solve it given the fewest number of clues.

Now that you know which games to play and why, how about you give it a try.

Have fun playing!

References:

Smink, J (2011) This is Your Brain on Summer. New York Times: The Opinion Pages. http://www.nytimes.com/2011/07/28/opinion/28smink.html?_r=1

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Feed Maxi: App Review and Giveaway

Today I am reviewing a fun new app by Speak Easy Apps: Feed Maxi. Developed by a speech language pathologist, Pamela Mandell,  the app’s purpose is to introduce the child to food labeling and identification.

The goal is to feed Maxi the monkey a balanced diet of 80 food items which include: fruits, vegetables, proteins, dairy, grains and snacks. But Maxi doesn’t just request his food, he also comments, makes choices, rejects, as well as asks for more using sign language (ASL animations).

Intended Audience:

  • Toddlers
  • Preschoolers
  • Children with Special Needs (ASD, Down Syndrome, etc)
  • Young children with limited English proficiency

Targeted Skills:

  • Functional communication (expressing basic wants and needs)
  • Pragmatic communication via targeted use of language
  • Attention (to detail) and Concentration
  • Picture identification
  • Following directions
  • Receptive and expressive vocabulary knowledge and use
  • Categorization skills 
  • Cause/effect skills
  • Print Recognition
  • Visual Scanning and Fine Motor control

App Features:

  • Data collection for group therapy (up to 5 children as per federal regulations)
  • E-mail option to send results to self/parents, etc.,
  • On/off option for voice prompts, text, sound effects & statistics
  • Option to specify food item and food category selection
  • Option to specify level of play (choose between easy, moderate or difficult)
  • Parental control option (to avoid accidental level changes)

App Highlights:

  • Real photos of food items
  • High interaction level (tapping on various pictures will produce sounds and/or animations)
  • App highlights correct responses when the child picks a food item incorrectly
  • Fun rewards after correct responses (e.g., balloon popping)

Feed Maxi is a fun and functional app which via a seemingly simple yet engaging set-up (monkey feeding) fosters a number of important skills in emergent communicators. You can find this app in the iTunes store for 4.99, or thanks to Pamela’s generosity you can win your own copy by entering my Rafflecopter giveaway below.
a Rafflecopter giveaway