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Early Intervention Part V: Assessing Feeding and Swallowing in Children Under Three

  1. General speech and language assessments of children under 3 years of age.
  2. Assessments of toddlers with suspected motor speech disorders 
  3. Assessments of children ~16-18 months of age
  4. Assessments of Social Pragmatic Abilities of Children Under 3

Today I’d like to talk about the assessment of feeding abilities of children under 3 years of age. Just to be clear, in my post, I am not offering tips on the assessment of medically fragile or neurologically impaired children with complex swallowing and feeding disorders such as severe food selectivity. Rather, I am offering suggestions for routine orofacial and feeding assessments of young children with normal swallowing but slightly immature feeding abilities.

First, let take a look at what the typical feeding development looks like in children 0-3 years of age. For this, I really like to use a resource from Dr. Joan Arvedson entitledDevelopmental milestones and feeding skills birth to 36 months from her article Swallowing and feeding in infants and young children which was published online in 2006

Age (months) Development/posture Feeding/oral sensorimotor
Source: Adapted from Arvedson and Brodsky (pp. 62–67).
Birth to 4–6 Neck and trunk with balanced flexor and extensor tone
Visual fixation and tracking
Learning to control body against gravity
Sitting with support near 6 months
Rolling over
Brings hands to mouth
Nipple feeding, breast, or bottle
Hand on bottle during feeding (2–4 months)
Maintains semiflexed posture during feeding
Promotion of infant–parent interaction
6–9 (transition feeding) Sitting independently for short time
Self-oral stimulation (mouthing hands and toys)
Extended reach with pincer grasp
Visual interest in small objects
Object permanence
Stranger anxiety
Crawling on belly, creeping on all fours
Feeding more upright position
Spoon feeding for thin, smooth puree
Suckle pattern initially Suckle  suck
Both hands to hold bottle
Finger feeding introduced
Vertical munching of easily dissolvable solids
Preference for parents to feed
9–12 Pulling to stand
Cruising along furniture
First steps by 12 months
Assisting with spoon; some become independent
Refining pincer grasp
Cup drinking
Eats lumpy, mashed food
Finger feeding for easily dissolvable solids
Chewing includes rotary jaw action
12–18 Refining all gross and fine motor skills
Walking independently
Climbing stairs
Running
Grasping and releasing with precision
Self-feeding: grasps spoon with whole hand
Holding cup with 2 hands
Drinking with 4–5 consecutive swallows
Holding and tipping bottle
>18–24 Improving equilibrium with refinement of upper extremity coordination.
Increasing attention and persistence in play activities
Parallel or imitative play
Independence from parents
Using tools
Swallowing with lip closure
Self-feeding predominates
Chewing broad range of food
Up–down tongue movements precise
24–36 Refining skills
Jumping in place
Pedaling tricycle
Using scissors
Circulatory jaw rotations
Chewing with lips closed
One-handed cup holding and open cup drinking with no spilling
Using fingers to fill spoon
Eating wide range of solid food
Total self-feeding, using fork

Now, let’s discuss the importance of examining the child’s facial features and oral structures. During these examinations it is important to document anything out of the ordinary noted in the child’s facial features or oral cavity.

Facial dysmorphia, signs of asymmetry indicative of paresis, unusual spots, nodules, openings, growths, etc, all need to be documented.  Note the condition of the child’s mouth. Is there excessive tooth decay? Do you see an unusual absence of teeth? Is there an unusual bite (open, cross, etc.), unusual voice or a cough, in the absence of a documented illness?  Here’s an example from a write up on a 2-8-year-old male toddler, below:

Facial observations revealed dysmorphic features: microcephaly (small head circumference), anteriorly rotated ears (wide set), and medially deviated, inward set eyes. A presence of mild-moderate hypotonicity (low tone) of the face [and trunk] was also noted.  FA presented with mostly closed mouth posture and appropriate oral postural control at rest but moderate drooling (drool fell on clothes vs. touching chin only) was noted during speech tasks and during play.  It’s important to note that the latter might be primarily behavioral in origin since FA was also observed to engage in “drool play” – gathering oral secretions at lip level then slowly and deliberately expelling them in a thin stream from his mouth and onto his shirt.

Articulatory structures including lips, tongue, hard palate and velum appeared to be unremarkable and are adequate for speech purposes. FA’s dentition was adequate for speech purposes as well.  Oral motor function was appropriate for lingual lateralization, labial retraction, volitional pucker and lingual elevation. Lingual depression was not achieved.  Diadochokinesis for sequential and alternate movements was unremarkable.  Overall, FA’s oral structures and function presented to be adequate for speech production purposes. 

FA’s prosody, pitch, and loudness were within normal limits for age and gender. No clinical dysfluencies were present during the evaluation.  Vocal quality was remarkable for intermittent hoarseness which tended to decrease (clear up) as speech output increased and may be largely due to a cold (he presented with a runny nose during the assessment). Vocal quality should continue to be monitored during therapy sessions for indications of persistent hoarseness in the absence of a cold.

From there I typically segue into a discussion of the child’s feeding and swallowing abilities. Below is an excerpt discussing the strengths and needs of an 18-month-old internationally adopted female.

During the assessment concerns presented regarding AK’s feeding abilities only. No swallowing concerns were reported or observed during the assessment. As per the parental report, at the age of 18 months, AK is still drinking from the bottle and consuming only puréed foods, which is significantly delayed for a child her age. AK’s feeding skills were assessed at snack time via indirect observation and select direct food administration.  The following foods and liquids were presented to AK during the assessment: 2 oz of yogurt, 18 cheerios, 4 banana and 2 apple bites, and 40 ml of water (via cup and straw). AK was observed to accept all of the above foods and liquids readily when offered.

Image result for toddler biting foodSpoon Stripping and Mouth Closure: During the yogurt presentation, AK’s spoon stripping abilities and mouth closure were deemed good (adequate) when fed by a caregiver and fair when AK fed self (incomplete food stripping from the spoon was observed due to only partial mouth closure). According to parental report, AK’s spoon stripping abilities have improved in recent months. Ms. K was observed to present spoon upwardly in AK’s mouth and hold it still until AK placed her lips firmly around the spoon and initiated spoon stripping.  Since this strategy is working adequately for all parties in question no further recommendations regarding spoon feeding are necessary at this time. Skill monitoring is recommended on an ongoing basis for further refinement.  

Biting and Chewing Abilities on Solids and Semi-Solids: AK’s chewing abilities were judged to be immature at this time for both solid (e.g., Cheerios) and semi-solid foods (e.g., banana). AK was observed to feed self Cheerios from a plate (1 at a time). She placed a cheerio laterally on lower right molars and attempted to grind it.  When the cheerio was presented to AK midline she was observed to anteriorly munch it, or mash it against the hard palate.  Notably, when too many cheerios were presented to her, rather than grasping and consuming them AK began to bang on a plate with both hands and throw the cheerios around the room. 

During feeding, the most difficulty was observed with biting and chewing solid and semisolid fruit (e.g., apple and banana pieces). When presented with a banana, AK manifested moderate difficulties biting off an adequately sized piece (she bit off too much). Consequently, due to the fact that she was unable to adequately chew on a piece that large, manual extraction of food from the oral cavity was initiated due to choking concerns.  It is important to note that during all food presentations AK did not display a diagonal rotary chew, which is below age expectancy for a child her age. Feeding strengths noted during today’s assessment included complete mouth closure (including lack of drooling and anterior food loss) during assisted spoon and finger foods feeding.

Image result for toddler drinking from strawCup and Straw Drinking: AK was also observed to drink 40 mls of water from a cup given parental assistance.  Minor anterior spillage was intermittently noted during liquid intake. It is recommended that the parents modify cup presentation by providing AK with a plastic cup with two handles on each side, which would improve her ability to grasp and maintain hold on cup while drinking.

Straw drinking trials were attempted during the assessment as it is a skill which typically emerges between 8-9 months of age and solidifies around 12-13 months of age (Hunt et al, 2000).  When AK was presented with a shortened straw placed in cup, she was initially able to create enough intraoral pressure to suck in a small amount of liquid.  However, AK quickly lost the momentum and began to tentatively chew on the presented straw as which point the trial was discontinued.

Based on the feeding assessment AK presented with mildly decreased abilities in the oral phase of feeding. It is recommended that she receive feeding therapy with a focus on refining her feeding abilities.”  

I follow the above, with a summary of evaluation impressions, recommendations, as well as suggested therapy goals. Finally, I conclude my report with a statement regarding the child’s prognosis (e.g., excellent, good, fair, etc.) as well as list potential maintaining factors affecting the duration of therapy provision.

So what about you? How do you assess the feeding and swallowing of abilities of children under 3 on your caseload? What foods, tasks, and procedures do you use?

   

 

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Birthday Extravaganza Day Twenty Five: There was a Silly SLP Who Got Stuck to Some Categories

It’s DAY 25 of my Birthday Month Giveaways and I am raffling off a giveaway by Teach Speech 365, which is  There was a Silly SLP who Got Stuck to Some Categories .

This catchy little mini-book activity targets categorization skills. The silly SLP gets stuck on all sorts of things. There is also a complementary silly male SLP [named Sam] which contains the same activities!

Packet Contents:

  • Pre/Post Test pages for data collection
  • Mini-book
  • Sequencing mat and pics
  • Following Directions cards
  • Category Sort pics
  • Creative writing pages
  • Comprehension questions worksheet
  • Silly Sam pages
  • and much more!!

You can find this product in  Teach Speech 365 TPT store by clicking HERE or you can enter my giveaway for a chance to win.
a Rafflecopter giveaway

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But is this the Best Practice Recommendation?

When adopting best practices isn't your best practiceThose of you familiar with my blog, know that a number of my posts take on a form of extended responses to posts and comments on social media which deal with certain questionable speech pathology trends and ongoing issues (e.g., controversial diagnostic labels, questionable recommendations, non-evidence based practices, etc.). So, today, I’d like to talk about sweeping general recommendations as pertaining to literacy interventions. Continue reading But is this the Best Practice Recommendation?

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Effective Vocabulary Instruction: What SLPs Need to Know

vocabulary-picHaving a solid vocabulary knowledge is key to academic success. Vocabulary is the building block of language. It allows us to create complex sentences, tell elaborate stories as well as write great essays. Having limited vocabulary is primary indicator of language learning disability, which in turn blocks students from obtaining critical literacy skills necessary for reading, writing, and spelling. “Indeed, one of the , most enduring findings in reading research is the extent to which students’ vocabulary knowledge relates to their reading comprehension” (Osborn & Hiebert, 2004)

Teachers and SLPs frequently inquire regarding effective vocabulary instruction methods for children with learning disabilities. However, what some researchers have found  when they set out to “examine how oral vocabulary instruction was enacted in kindergarten” was truly alarming.

In September 2014, Wright and Neuman,  analyzed about 660 hours of observations over a course of 4 days (12 hours) in 55 classrooms in a range of socio-economic status schools.

They found that teachers explained word meanings during “teachable moments” in the context of other instruction.

They also found that teachers:

  • Gave one-time, brief word explanations
  • Engaged in unsystematic word selection
  • And spent minimal time on vocabulary devoted to subject areas (e.g., science and social studies in which word explanations were most dense)

They also found an economic status discrepancy, namely:

Teachers serving in economically advantaged schools explained words more often and were more likely to address sophisticated words than teachers serving in economically disadvantaged schools.

They concluded that these results suggest that the current state of instruction may be CONTRIBUTING to rather than ameliorating vocabulary gaps by socioeconomic status.”

Similar findings were reported by other scholars in the field who noted that “teachers with many struggling children often significantly reduce the quality of their own vocabulary unconsciously to ensure understanding.” So they “reduce the complexity of their vocabulary drastically.” “For many children the teacher is the highest vocabulary example in their life. It’s sort of like having a buffet table but removing everything except a bowl of peanuts-that’s all you get“. (Excerpts from Anita Archer’s Interview with Advance for SLPs

It is important to note that vocabulary gains are affected by socioeconomic status as well as maternal education level. Thus, children whose family incomes are at or below the poverty level fare much more poorly in the area of vocabulary acquisition than middle class children. Furthermore, Becker (2011) found that children of higher educated parents can improve their vocabulary more strongly than children whose parents have a lower educational level.

Limitations of Poor Readers:

—Poor readers often lack adequate vocabulary to get meaning from what they read. To them, reading is difficult and tedious, and they are unable (and often unwilling) to do the large amount of reading they must do if they are to encounter unknown words often enough to learn them.

—Matthew Effect, “rich get richer, poor get poorer”, or interactions with the environment exaggerate individual differences over time. Good readers read more, become even better readers, and learn more words. Poor readers read less, become poorer readers, and learn fewer words. —The vocabulary problems of students who enter school with poorer limited vocabularies only exacerbate over time. 

However, even further exacerbating the issue is that students from low SES households have limited access to books. 61% of low-income families have NO BOOKS at all in their homes for their children (Reading Literacy in the United States: Findings from the IEA Reading Literacy Study, 1996.) In some under-resourced communities, there is ONLY 1 book for every 300 children. Neuman, S., & Dickinson, D. (Eds.). (2006) Handbook of Early Literacy Research (Vol. 2)In contrast, the average middle class child has 13+ books in the home.

The above discrepancy can be effectively addressed by holding book drives to raise books for under privileged students and their siblings. Instructions for successful book drives HERE.

So what are effective methods of vocabulary instruction for children with language impairments?

According to (NRP, 2000) a good way for students to learn vocabulary directly is to explicitly teach them individual words and word-learning strategies .

For children with low initial vocabularies, approaches that teach word meanings as part of a semantic field are found to be especially effective (Marmolejo, 1991).

Many vocabulary scholars (Archer, 2011; Biemiller, 2004; Gunning 2004, etc.) agree on a number of select instructional strategies which include:

  • Rich experiences/high classroom language related to the student experience/interests
  • Explicit vs. incidental instruction with frequent exposure to words
  • Instructional routine for vocabulary
    • Establishing word relationships
    • Word-learning strategies to impart depth of meaning
    • Morphological awareness instruction

Response to Intervention: Improving Vocabulary Outcomes

For students with low vocabularies, to attain the same level of academic achievement as their peers on academic coursework of language arts, reading, and written composition, targeted Tier II intervention may be needed.

Tier II words are those for which children have an understanding of the underlying concepts, are useful across a variety of settings and can be used instructionally in a variety of ways 

According to Beck et al 2002, Tier II words should be the primary focus of vocabulary instruction, as they would make the most significant impact on a child’s spoken and written expressive capabilities.

Tier II vocabulary words

  • High frequency words which occur across a variety of domains conversations, text, etc.
  • Contain multiple meanings
  • Descriptive in nature
  • Most important words for direct instruction as they facilitate academic success
    • Hostile, illegible, tolerate, immigrate, tremble, despicable, elapse, etc.

According to Judy Montgomery “You can never select the wrong words to teach.”

Vocabulary Selection Tips:

  • Make it thematic
  • Embed it in current events (e.g., holidays, elections, seasonal activities, etc)
  • Classroom topic related (e.g., French Revolution, the Water Cycle, Penguin Survival in the Polar Regions, etc)
  • Do not select more than 4-5 words to teach per unit to not overload the working memory (Robb, 2003)
  • Select difficult/unknown words that are critical to the passage meaning, which the students are likely to use in the future (Archer, 2015)
  • Select words used across many domains

Examples of Spring Related Vocabulary 

Adjectives: 

  • Flourishing
  • Lush
  • Verdant
  • Refreshing

Nouns: 

  • Allergies
  • Regeneration
  • Outdoors
  • Seedling
  • Sapling

Verbs 

  • Awaken
  • Teem
  • Romp
  • Rejuvenate

Idiomatic Expressions:

  • April Showers Bring May Flowers
  • Green Thumb
  • Spring Chicken
  • Spring Into Action

Creating an Effective Vocabulary Intervention Packets and Materials 

Sample Activity Suggestions:

  • Text Page (story introducing the topic containing context embedded words)HVD text
  • Vocabulary Page (list of story embedded words their definitions, and what parts of speech the words are)
  • Multiple Choice Questions or Open Ended Questions Page
  • Crossword Puzzle Page
  • Fill in the Blank Page
  • True (one word meaning) Synonym/Antonym Matching Page
  • Explain the Multiple Meaning of Words Page
  • Create Complex Sentences Using Story Vocabulary Page

Intervention Technique Suggestions:

 1.Read vocabulary words in context embedded in relevant short texts

2.Teach individual vocabulary words directly to comprehend classroom-specific texts (definitions)

3.Provide multiple exposures of vocabulary words in multiple contexts, (synonyms, antonyms, multiple meaning words, etc.)

4.Maximize multisensory intervention when learning vocabulary to maximize gains (visual, auditory, tactile, etc.)

5.Use multiple instructional methods for a range of vocabulary learning tasks and outcomes (read it, spell it, write it in a sentence, practice with a friend, etc.)

6.Use morphological awareness instruction (post to follow)

  • An ability to recognize, understand, and use word parts (prefixes, suffixes that “carry significance” when speaking and in reading tasks

 Conclusion:

Having the right tools for the job is just a small first step in the right direction of creating a vocabulary-rich environment even for the most disadvantaged learners. So Happy Speeching!

Helpful Smart Speech Resources:

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Phonological Awareness Screening App Review: ProPA

pro-pa-img1Summer is in full swing and for many SLPs that means a welcome break from work. However, for me, it’s business as usual, since my program is year around, and we have just started our extended school year program.

Of course, even my program is a bit light on activities during the summer. There are lots of field trips, creative and imaginative play, as well as less focus on academics as compared to during the school year. However, I’m also highly cognizant of summer learning loss, which is the phenomena characterized by the loss of academic skills and knowledge over the course of summer holidays.

Image result for summer learning loss

According to Cooper et al, 1996, while generally, typical students lose about one month of learning, there is actually a significant degree of variability of loss based on SES. According to Cooper’s study, low-income students lose approximately two months of achievement. Furthermore, ethnic minorities, twice-exceptional students (2xE), as well as students with language disorders tend to be disproportionately affected (Graham et al, 2011;  Kim & Guryan, 2010; Kim, 2004). Finally, it is important to note that according to research, summer loss is particularly prominent in the area of literacy (Graham et al, 2011).

So this summer I have been busy screening the phonological awareness abilities (PA) of an influx of new students (our program enrolls quite a few students during the ESY), as well as rescreening PA abilities of students already on my caseload, who have been receiving services in this area for the past few months.

Why do I intensively focus on phonological awareness (PA)? Because PA is a precursor to emergent reading. It helps children to manipulate sounds in words (see Age of Aquisition of PA Skills). Children need to attain PA mastery (along with a host of a few literacy-related skills) in order to become good readers.

When children exhibit poor PA skills for their age it is a red flag for reading disabilities. Thus it is very important to assess the child’s PA abilities in order to determine their proficiency in this area.

While there are a number of comprehensive tests available in this area, for the purposes of my screening I prefer to use the ProPA app by Smarty Ears.

pro-pa-img14

The Profile of Phonological Awareness (Pro-PA) is an informal phonological awareness screening. According to the developers on average it takes approximately 10 to 20 minutes to administer based on the child’s age and skill levels. In my particular setting (outpatient school based in a psychiatric hospital) it takes approximately 30 minutes to administer to students on the individual basis. It is by no means a comprehensive tool such as the CTOPP-2 or the PAT-2, as there are not enough trials, complexity or PA categories to qualify for a full-blown informal assessment. However, it is a highly useful measure for a quick determination of the students’ strengths and weaknesses with respect to their phonological awareness abilities. Given its current retail price of $29.99 on iTunes, it is a relatively affordable phonological awareness screening option, as the app allows its users to store data, and generates a two-page report at the completion of the screening.

The Pro-PA assesses six different skill areas:

  • Rhyming
    • Identification
    • Production
  • Blending
    • Syllables
    • Sounds
  • Sound Isolation
    • Initial
    • Final
    • Medial
  • Segmentation
    • Words in sentences
    • Syllables in words
    • Sounds in words
    • Words with consonant clusters
  • Deletion
    • Syllables
    • Sounds
    • Words with consonant clusters
  • Substitution
    • Sounds in initial position of words
    • Sounds in final position of words

pro-pa-img21After the completion of the screening, the app generates a two-page report which describes the students’ abilities as:

  • Achieved (80%+ accuracy)
  • Not achieved (0-50% accuracy)
  • Emerging (~50-79% accuracy)

The above is perfect for quickly tracking progress or for generating phonological awareness goals to target the students’ phonological awareness weaknesses. While the report can certainly be provided as an attachment to parents and teachers, I usually tend to summarize its findings in my own reports for the purpose of brevity. Below is one example of what that looks like:

pro-pa-img29The Profile of Phonological Awareness (Pro-PA), an informal phonological awareness screening was administered to “Justine” in May 2017 to further determine the extent of her phonological awareness strengths and weaknesses.

On the Pro-PA, “Justine” evidenced strengths (80-100% accuracy) in the areas of rhyme identification, initial and final sound isolation in words, syllable segmentation, as well as substitution of sounds in initial position in words.

She also evidenced emerging abilities (~60-66% accuracy) in the areas of syllable and sound blending in words, as well as sound segmentation in CVC words,

However, Pro-PA assessment also revealed weaknesses (inability to perform) in the areas of: rhyme production, isolation of medial sounds in words, segmentation of words, segmentation of sounds in words with consonant blends,deletion of first sounds,  consonant clusters, as well as substitution of sounds in final position in words. Continuation of therapeutic intervention is recommended in order to improve “Justine’s” abilities in these phonological awareness areas.

Now you know how I quickly screen and rescreen my students’ phonological awareness abilities, I’d love to hear from you! What screening instruments are you using (free or paid) to assess your students’ phonological awareness abilities? Do you feel that they are more or less comprehensive/convenient than ProPA?

References:

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Test Review: (OPUS) Oral Passage Understanding Scale

Today I am reviewing a listening comprehension assessment for students 5-21 years of age, entitled the Oral Passage Understanding Scale (OPUS) created by Elizabeth Carrow-Woolfolk, PhD, and Amber M. Klein, PhD, which is available via WPS.

The OPUS is a test of listening comprehension which assesses the following forms of knowledge: lexical/semantic (knowledge and use of words and word combinations), syntactic (knowledge and use of grammar, as well as supralinguistic (knowledge and use of indirect/complex language). Continue reading Test Review: (OPUS) Oral Passage Understanding Scale

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SPELL-Links™ Wordtivities Word Lists Review and Giveaway

In 2020 I reviewed a product kit (instructional guide and cards) from SPELL-Links™ Learning By Design, Inc. entitled Wordtivities: Word Study Instruction for Spelling, Vocabulary, and Reading. Today, I am reviewing a companion to that product kit: SPELL-Links™ Wordtivities Word Lists. This 180-page guide contains sets of pattern-focused word lists for whole class, small group, and 1:1 word study instruction purposes. Each grade-level word list supports the simultaneous development of pattern-specific phonological (sound), orthographic (letter), and semantic morphological (meaning) skills. The aim of this guide is to systematically address spelling, reading, speaking, and listening all together by developing a neural network for literacy and language.

SPELL-Links™ Wordtivities Word Lists are useful for students 5+ years of age who have or are in the process of developing the following knowledge and skills:

  1. Letter-name knowledge
  2. Alphabetic letter writing ability
  3. Mastery of early phonological awareness (PA) skills by being able to segment words into syllables, understand and create rhyming words, and isolate sounds in words
  4. Basic concept knowledge of directionality (left/right; top/down)

The book is organized by patterns and grade levels (K-6 grade) and by the instructional focus. For each pattern, word lists are organized to support a specific instructional focus: phonological code, orthographic code, morphological code, storage and retrieval of orthographic representations, and writing application.

The Word Lists feature 128 patterns across grades K through 6. The number of patterns taught at each grade level ranges from 9 (K) to 25 (grades 4 and 5).

Here’s an example of a 4th-grade instructional overview:

Overview of Weekly Instruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Pattern: Prefixes pre- (before); mid- (middle); post- (after) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Pattern: Prefixes over- (above, more than); super- (superior, exceeding); under- (below, less than);
sub- (under, subordinate) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Pattern: ‘l, r’ Clusters ‘lb, ld, lf, lk, lm, lp, lt, lth, lve, lse’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Pattern: ‘l, r’ Clusters ‘rd, rf, rm, rn, rp, rt, rsh, rch, rth, rve, rge’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Pattern: ‘l, r’ Clusters ‘rse, rce’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Pattern: Homophones Set 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Pattern: Suffixes -ion, -ation, -ition (N) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Pattern: Suffix -ment (N) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Pattern: Suffix -en (V, ADJ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Pattern: ‘m, n, ng’ Clusters ‘nd, nt, mp, mph, nth, nch, ngth, nge’ . . . . . . . . . . . . . . . . . . . . . . . . . 100
Pattern: ‘m, n, ng’ Clusters ‘nk, nc’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Pattern: ‘m, n, ng’ clusters ‘nce, nse’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Pattern: Homophones Set 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Pattern: Syllabic-r Vowel Sound as in bird, father . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Pattern: Suffix -ward (ADJ, ADV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Pattern: Unstressed Vowels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Pattern: Syllabic-l Vowel Sound as in bottle, pencil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Pattern: Suffix -al (ADJ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Pattern: Suffixes -able, ible (ADJ) …………………………………………….. 109
Pattern: Suffix -ous (ADJ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Pattern: Suffixes -ive, -ative, -itive (N, ADJ)………………………………………. 111
Pattern: Suffix -ure (N) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Pattern: Contractions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Pattern: Prefix tele- (far); micro- (tiny) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Pattern: Prefixes mono-, uni-, bi-, tri-, quad-, oct- (number affixes) . . . . . . . . . . . . . . . . . . . . . . . . 115
Pattern Review

The weekly instruction will look as follows:

  1. Monday-Tuesday: Review of Phonological and Orthographic Codes (these word pattern lists are organized into 3 groups to support differentiated instruction)
  2. Wednesday–Thursday: Morphology
  3. Friday: Mental Orthographic Representations and Application to Sentence Writing

The book comes with access to digital Materials Library, which contains access to the following materials:

  • List of pattern-loaded stories
  • SPELL-Links™ Pattern Inventory & Analysis Tool (PIAT)

The appeal of the product for me is that it offers numerous group-based opportunities for the solidification of evidence-based instructional practices.  The book comes with very detailed implementation instructions. A variety of daily activities allow students to further advance their abilities in the areas of prefixes and suffixes, numerous homophones and clusters, unstressed vowels and even contractions. The kit also offers several appendices that review the spelling rules for word roots prefixes and suffixes, as well as detailed recommendations for pattern-loaded reading materials. To me, the appeal of this curriculum is rather multifaceted. It continues to be very difficult to find an evidence-based group instruction curriculum, and Wordtivities Word Lists once again fit the bill for it. Because it focuses on skills integration of spelling, reading, speaking, and listening it allows the students to engage in contextually based opportunities to become better listeners, speakers, readers, spellers and writers.

You can find this kit for purchase on the SPELL-Links™ Learning By Design, Inc. Store HERE.

And now for the fun part. Want to win your own copy of SPELL-Links™ Wordtivities Word Lists? Enter to win here: I want to win SPELL-Links Wordtivities Word Lists! | Learning By Design They’ll send one lucky person a copy of SPELL-Links™ Wordtivities Word Lists. Entries are accepted until 3/1/24 at 5 pm CST. The winner will be notified by email.

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Clinical Assessment of Reading Abilities of Elementary Aged Children

Image result for kid readingSeveral years ago I wrote a post about how to perform clinical reading assessments of adolescent students. Today I am writing a follow-up post with a focus on the clinical reading assessment of elementary-aged students. For this purpose, I often use the books from the Continental Press series entitled: Content Reading for Geography, Social Studies, & Science.   Texts for grades 2-7 of the series are perfect for assessment of struggling elementary-aged readers. Continue reading Clinical Assessment of Reading Abilities of Elementary Aged Children

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Apraxia RainbowBee App Review and Giveaway

Today I am reviewing a fun new app Apraxia RainbowBee  developed by Virtual Speech Center  to enhance motor planning for children with speech production difficulties.

Similar to their other apps, on the first screen (featured left) the therapist can choose the option of customizing the app’s settings or viewing the informational video. Continue reading Apraxia RainbowBee App Review and Giveaway