2018 Updates

2018 marked a year of many transitions and new chapters work-wise. Here are a few highlights and new resources that I have to share:

  1. I was interviewed for my first podcast related to screen-time by Talking with Tech. This was a really fun opportunity to collaborate with other speech therapists who are doing amazing things for our field. That podcast can be accessed HERE and on iTunes or in Google Play stores. My interview starts at approximately 20 minutes in.
  2. I completed another screen-time webinar, this time for early education specialists through http://www.continued.com. That webinar can be accessed for a price HERE.
  3. I’ve also thoroughly enjoyed another part-time job where I review professional development courses from Sensational Brain. Sensational Brain is a new ASHA CEU provider and they have many current and informative webinars to choose from HERE.
  4. In Feb. 2018 I had my last tour with Summit Education in the Denver, CO area. Summit afforded me a wonderful opportunity to provide professional development courses to clinicians around the U.S. on early intervention and screen time. After about a 18 months presenting with Summit, I was able to go out on my own, providing presentations across CA for various agencies, regional centers, and county programs. You can see my current presentation schedule and a list of past presentations HERE.
  5. The Infant Development Association of CA invited me back to do presentations for both their northern and southern CA conferences on several topics (parent coaching, autism, screen time).
  6. I am halfway through my LEND (Leadership Education in Neurodevelopmental and Related Disabilities) Fellowship at Children’s Hospital of L.A. and L.A. County Dept. of Mental Health. This is the COOLEST learning opportunity I’ve ever had. I highly encourage every SLP to find their nearest LEND program and apply (there is at least one program in every state and it is a fully funded opportunity)! The program is helping me to expand my scope of practice for the inclusion of mental health work, which is so relevant for many children I work with who can also benefit from behavior and social-emotional support. There is so much learning and professional growth happening for me in LEND that I will need to write a new blog post in the future reflecting on it.
  7. On a more personal note, I’ve been dealing with some health issues (asthma and allergies) and my doctors have advised me to limit my in-home work due to some scary asthmatic episodes I’ve been having since 2016. Since in-home early intervention is my FAVORITE role as a speech therapist, this was pretty upsetting. BUT, it did push me a bit out of my comfort zone and I pursued a new (part-time) job working in the public school system with moderate to severe children with autism. The coolest part was re-connecting with 2 students (at age 7) who I worked with when then were ONE year old! It was amazing to see them 6 years later and how far they have come!!! I feel fortunate to keep learning and growing professionally as I challenge myself to explore new settings. I am also VERY happy that I can still do some in-home early intervention at this point!

Play Books

Looking for a language-stimulating gift idea for children ages 2-6? I LOVE these Play Books (so much that I had to devote 3 hours of my life to writing this blog post about them). Warning – These ARE paper pop-up books.  While quite sturdy, my own young children required a lot of support to handle these gems gently.

*This review is based on my own experience and is my genuine opinion of these books. I have no personal or business relationship with the author, illustrator, or publisher. I have not been offered any incentive or payment to write this review.*

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 BOOK & TOY! TWO-IN-ONE: Playbooks can be read page by page, like a book.  They can also expand NINE times the size of 1 single page into brilliant play-mats.

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Playbook Castle view when you open the box. The envelope (left) holds numerous paper pieces that accompany the book.
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Pages in Playbook Castle and a paper knight manipulative
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Playbook Castle expanded into the play-mat

 

 

For a better view, check out these youtube snippets:
Playbook Farm, Playbook PiratesPlaybook Castle

FUN FOR ALL: These play books do not light-up, they don’t talk when you push a button, and they don’t have famous TV characters associated with them…So I was worried that some children might be bored by them.  This toy-tool provides old-fashioned fun. Kids don’t realize that they’re learning and adults forget that they’re teaching.

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This ship is 1 of 6 pop-ups featured in Playbook Pirates. The parrot, monkey, and pirate are a few of the separate paper manipulatives included to move throughout the book. The steering wheel actually turns too! 

PERSPECTIVE SHIFT: As therapists working with young children, we know it’s important to be eye-level with a child and to face them. These Playbooks will have all adults doing just that, intuitively. It’s a different experience when viewing the play-mat from up above, versus down on the floor with the child.  At the child’s level I get lost in a world of make-believe, where my biggest problem is helping a paper cow find his way to a greener pasture.  This literal shift in my physical position always helps me to see the world through a child’s eyes.

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View from up above (toy cars are not included with the purchase of the book)
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View from the floor (at the child’s level)

WIDE VARIETY OF LANGUAGE TARGETS:  If you want a toy that will encourage literacy and pre-literacy skills, look no further.  And If you want a book that will promote play development, you’ve got it at your fingertips – in fact you’ve got 3 of them.  Below are some of the goals I’ve targeted with these Playbooks during speech therapy.

i. Promoting Play Development: Pretend play, role play, and dramatic play skills all promote imagination, creativity, self-regulation skills, executive function skills, and language development (research reminds us that improving play skills, improves language skills). The following activities are just a few ideas that require children to use their hands and their imagination (something Paper Engineers do all the time, but not something typically encouraged by tablets, TV, or apps).
A. Play dress-up as a pirate, mermaid, princess, knight, dragon, farmer, or farm animal depending on which Playbook you’re using.
B. Use the Playbooks in a tent or a fort, but pretend you’re in a sunken pirate ship, a farmer’s haystack, or the castle dungeon.
C. Create paper boats, paper hats, or simple eye patches to go along with the Playbook Pirates theme.

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I take familiar toys that kids already know and love (like the toys pictured here) and incorporate them into a new activity (like these Playbooks) to pique an interest. This method of toy-chaining often helps children who have difficulty changing their usual play routines. 

ii. Following Directions with Prepositions: Put the pirate in the ship; Put the cow behind the barn; Put the rooster on top of the gate; Put the shark next to the octopus;  Put the dragon under the drawbridge, etc. Try using a flashlight to search for specific objects, such as buried treasure in Playbook Pirates, a little lost lamb in Playbook Farm, or a Damsel in Distress in Playbook Castle. In group therapy children can take turns hiding/finding objects and giving/following directions with peers.

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Hunting for buried treasure with a flashlight in Playbook Pirates

iii. Following Directions with Actions: Make the horse jump; Make the cow graze; Make the shark swim faster; Throw in a rope and pull out a pirate, etc.

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Keep some string handy to rescue pirates from sharks

iv. Improving Vocabulary:
Opposites (Day/Night): Talk about and act out what happens during the daytime (ex. the farmers work, eat, drive tractors, milk cows…).  Then turn off the lights, get some tea light candles & flashlights to discuss nighttime routines while playing (ex. the animals sleep, the farmer puts the tractor in the garage, everyone gets ready for bed…). This can lead to discussions about the child’s own daily routines and practicing those routines while modeling appropriate language for the family to use with their child.

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Above: Lights on (discuss daytime routines on the farm).  Below: Lights off (discuss night routines).  I used plastic tea-light candles and flashlights while playing in the dark.

night scene

Negation: Get a bunch of random items (paperclips can be linked together to make a necklace, stickers, etc.) and put them in a small bag or box. Call it a treasure chest and hide it. Take a flashlight and go searching for the treasure (here’s a good opportunity to practice turn-taking skills during group therapy too).  Practice negation while treasure hunting (it’s NOT behind the book, it’s NOWHERE in the closet…).  When the treasure is found children get to choose trinkets from the treasure chest.  For children with sensory processing deficits, you might also consider making a treasure chest sensory bin like some of THESE.

Thematic Vocabulary: Based on the type of vocabulary, I like Playbook Farm best for younger children and Playbook Castle best for older children.
Playbook Farm possible vocabulary words to target: animals, farmhouse, orchard, pasture, scarecrow, silo, windmill
Song Idea: Old MacDonald had a Farm
Playbook Pirates possible vocabulary targets: octopus, treasure chest, alligator, crocodile, flying fish, jellyfish, shipwreck, starfish, seaweed, ahoy matey
Song Ideas: Yo Ho Yo HO, A Pirate’s Life for Me & Slippery Fish
Playbook Castle possible vocabulary targetscatapult, countess, damsel, jester, archer, dungeon, drawbridge, highness, royalty, unicorn, watchtower, feast
Song Idea: Puff the Magic Dragon

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We propped the play-mat between a wall and a rug to create a tunnel for cars to drive through (a sneaky way to get past the fire-breathing dragons in Playbook Castle)

What else? Please share your ideas with me too!  =)

Happy PlayBooking! Happy SpeechTheraping! Cheers!

Playbooks can be purchased here on Amazon and may also be available at your local Barnes & Noble store.

Author Corina Fletcher’s adorable website can be accessed HERE.  A big thanks to this creative and inspiring Paper Engineer! Corina, if you need any more Playbook ideas, I would LOVE to see a Playbook House (with a bathroom toilet, bathtub, washer and dryer, bed/bunk beds, kitchen sink/table, backyard/swings/slide, etc.)

Blog

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Course Instructor: Stacey B. Landberg, M.S., CCC-SLP   Register for this course HERE and see course testimonials HERE

What is “Innovative” early intervention?

Probably not what most people would expect! When we hear “innovative,” we may often think new or cutting-edge (like technology). Some synonyms for “innovative” are originalunusualinventive.  Common objects and traditional/original toys (those which do not require batteries or chargers) are actually much more innovative than the newer trends of electronic toys.  blocks-503109_1280

There are countless inventive, unusual, creative, and innovative ways to play with old-school toys like blocks or a box (see HERE for some examples). Dissimilarly, using electronic toys or Apps in a wide variety of creative and imaginative ways may be challenging for parents and their young children. That’s because these gadgets are typically designed to be played in a very specific way, which rarely leads to exploration, creativity, imagination, or symbolic play (e.g. pretending a block is a hat). Symbolic play and pretend play are very important and fairly easy to do with common objects and traditional toys (but not so much with tech-toys). Click HERE for more information about why speech therapists care so much about pretend play.

Don’t just take my word for it!  HERE are some relevant research findings.

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Creative Commons 2.0

For tips on how to choose toys, I like THIS handout.

There is another fairly common misconception that Apps and so-called “educational” videos are effective learning tools for very young children. Unfortunately these misleading claims are usually made by large, multimillion dollar marketing companies (which rely on endorsements for their sales, instead of solid evidence). Scientific research consistently finds that young children show more robust learning and better retention when they are interacting with real people and using real objects (compared to learning from a screen). Until about 3 years of age, it is very challenging for children to transfer anything they learn from 2D media into their 3D lives!

For a few of my favorite “Screen-Time” resources, see HERE and HERE and HERE

Wanting a few innovative play ideas that will hopefully inspire your own creativity? Here are a couple snippets of my own ideas.

 

 

Finding Free and Affordable Speech Therapy for your Child

There are certain situations where no matter what, private speech therapy IS the best option. If your child had a heart condition, you probably wouldn’t take him to see a podiatrist, even though both a podiatrist and a cardiologist are technically “doctors.” The same is true in the world of speech therapy. If your child has a fluency disorder, I recommend that you take him to see a speech pathologist who specializes in fluency. You may be able to find this type of a specialist through your health insurance, or the public school system. If not, you may need/want to pay big bucks for private therapy. 

The information included below is specific to Los Angeles, however, many of these resources will be available in other places throughout the U.S. I use a double asterisk (**) to indicate resources that may be available outside of Los Angeles as well.

Here’s a quick list of all the free and affordable therapy options I know of, which are detailed in length below.

  1. Public Schools (ages 3-22) – Free
  2. Scottish Rite Centers (Free for eligible children based on age and diagnosis; wait-lists can be lengthy)
  3. Regional Centers in CA (ages 0-3) – Annual Family Program fee (there are some exceptions)
  4. University Clinics (some are more expensive than others and most have wait-lists)
  5. Non-Profit Clinics (especially if you qualify for a sliding scale rate)
  6. Private speech therapy with an individual SLP (lower costs might be possible if you can work with a SLPA under the supervision of a speech-language pathologist)
  7. Private speech therapy with a clinic (non-profit clinics will most likely be more affordable than private clinics, even if you don’t qualify for a sliding scale rate).

Speech therapy is typically expensive, especially if it’s ongoing. In Southern CA, private speech therapy typically costs $100-$200, for a single therapy session (which usually lasts 45-60 minutes). The tips here will hopefully help parents whose children would benefit from speech-therapy, even if they cannot afford to pay privately.

**PUBLIC SCHOOLS: If you are a parent with a child age 3 or older who has a speech and/or language delay and/or impairment:

1. Contact your child’s home school district: NOW (unless you’ve already done so, or your child is already receiving school district services – in that case you can skip this section). Google your home school district’s special education phone number or call the local school and ask to be connected to their special education department.  Public schools are federally mandated to provide services for eligible children from ages 3-22 years old. I repeat. Public schools are required to service qualifying children from ages three to twenty two years old. That means you don’t have to wait until your child starts kindergarten to get speech therapy from the public school. It does mean that your child must be at least 3 years old.  So, even if you intend to home-school or send your child to private school, he/she can obtain speech therapy services from the public school district from age 3 until Kindergarten.  Call your local public school district and ask to schedule a speech-language evaluation today.  You want to get an evaluation date on the calendar ASAP and here’s why: the public schools have specific timelines they must adhere to.  If you give written and verbal consent for an assessment of your child, the school district has 15 days after receiving consent to send home an “assessment plan.” Once the “assessment plan” is signed by the parent and returned to the district, the district has another SIXTY days to assess your child and hold an Individualized Education Plan Meeting (IEP). The school based speech pathologist will often screen your child first to determine if an evaluation is actually needed. The school district is able to deny requests for assessments if the child passes their screening. I do see children right now who were denied an assessment because their child passed a screening, even though their speech and language skills are impaired. It is important to remember that the school districts have their OWN eligibility requirements. Your child could still have a delay or an impairment, but not enough to qualify for speech therapy through the school district.

2. Negotiate or Renegotiate with the public school system: If you think your child should be receiving speech therapy from the public school system, a re-evaluation, a second opinion, or if you disagree with the amount or type of therapy being provided, you can click HERE for some information that will help you make those requests to the school district.  There are lots of other similar resources on the web, also.

Click the box above or go to ASHA for more information regarding eligibility and dismissal from public school speech therapy. 

NON-PROFIT CLINICS (for children of varying ages):
A. Scottish Rite Centers** provide FREE speech therapy for qualifying children ages birth to 6 years old.  They have lengthy wait-lists, so google the center closest to you and call to be put on their wait-list right now. I believe there are 3 locations around Los Angeles (Long Beach, Pasadena, Santa Ana).

B. HEAR Center is a great non-profit clinic that has been in business for 60 years in Pasadena, CA! They offer a sliding scale application and qualifying families pay significantly less.   Click HERE for more information

C. **Do a google search for other non-profit speech therapy clinics.  It’s very likely you’ll find some others with lower costs or sliding scale applications. I did a quick google search and found Pediatric Therapy Network in Torrance, which is also a non-profit organization (I’m not sure if they offer a sliding scale application, so you should call and ask). Many non-profit organizations get funding through private grants for providing reduced cost services to qualifying families. In order to meet their grant quotas each year, these organizations often provide reduced rates to anyone who completes a sliding scale application.  So, even if you doubt that you’ll qualify for a reduced rate, it may be worth trying just in case.

 **UNIVERSITY CLINICS Most public and private universities with communicative disorders programs at the Bachelors or Masters degree level, have on-campus university clinics for adults and children to be seen for speech-language therapy.  If you take your child to a university clinic, a student pursuing an career in speech-language pathology will provide speech therapy to your child under supervision by a speech-language pathologist.  University clinics usually have lengthy wait-lists. While therapy at a university clinic is typically not free, it is usually significantly less expensive than private therapists and private clinics (i.e. At My alma mater, University of Redlands, the therapy fee is currently $250 per semester. That comes out to about $15 per therapy appointment if your child goes once weekly). It is not always easy to find University Clinic information online.  First you need to know if a University even has a communicative disorders department (most colleges do not). Here are a few links to some public and private university speech-language clinics in and around Los Angeles: Cal State University Los AngelesCal State University Long Beach,  Cal State University Northridge,  Cal State University Fullerton,  University of Redlands, Biola University,  Loma Linda University 

REGIONAL CENTERS (for children birth to 3 years old): In California Regional Centers are nonprofit private corporations that contract with the Department of Developmental Services to provide or coordinate services and supports for individuals with developmental disabilities. You may be asked to pay an annual fee ($150-$200 per year) – small in comparison to what you’d be paying otherwise for speech therapy services.  **The same services exist in other states, but each state has a different early intervention program, which you can find out more about HERE.

Regional Center will pay for your child’s speech therapy if your child:

A. Is under age 3

B. Qualifies for speech therapy services according to their eligibility requirements

C. Does NOT have health insurance that covers speech therapy. Regional Center will ask you to provide proof that your child’s health insurance does not cover speech therapy before providing this service for free. They might start speech therapy for your child, but they will require you to produce proof that your health insurance does not cover speech therapy within 30-90 days.

  • If you are unsure if you’ll qualify for Regional Center services, you should contact the Regional Center that serves your specific address (similar to school district zoning). You will need to call and ask to speak to an Intake Coordinator regarding testing and services that your child might need.
  • Research indicates that Early Intervention (therapy for children ages 0-3) should be conducted in the natural environment if possible. Speech therapists contracted with Regional Center frequently provide therapy in the child’s home or at their preschool/daycare (although there are exceptions to this depending on the child, availability, etc).
  • In California there are 21 different Regional Centers. To contact the one for you, Google search “Regional Center” and note your zip code OR search this link Q. What happens after your child turns 3 years old? A. Regional Center will help your child transition to the school district (if you allow them to). The school district will usually evaluate your child before their 3rd birthday. If the district agrees that your child will qualify for speech therapy, then the service will typically begin on or shortly after your child’s 3rd birthday. A re-evaluation with the school district before age 3 can allow for continuous service as your child transitions from Regional Center to school district speech therapy.

**PRIVATE THERAPY Perhaps none of the options above will work for you (which is probably the case if you are looking to start speech therapy ASAP, since there are typically wait-lists and timelines for all of the options listed above). In this case, there may be some ways to limit your expenses for private speech therapy.

1. I recommend calling around and asking clinics and private therapists for price quotes. Ask if they have sliding scales. Ask if the therapist or clinic provides a free consultation first to meet the therapist (even if it’s just for 20 minutes).  Not all Speech-Language Pathologists are created equal, but all of us (with M.A. or M.S. degrees and CCC-SLP licensure) do go through similar rigorous training. If someone is $50 less per hour, it doesn’t necessarily mean that the pricier therapist is better (they may be better at certain things…we all tend to specialize. I recommend asking therapists what their areas of expertise are).  Many therapists have contracts with the state or health insurance plans that bind us to a certain rate for a certain number of years (meaning less experienced therapists can charge $200 per hour right out of graduate school, while a more experienced therapist charges $100 per hour due to a contract they have binding them to a specific rate).

2. Next Consider the following: Finding a private therapist to tailor a therapy schedule to your child’s needs and to your budget. Perhaps your child is getting some speech therapy through the public school and you’re looking for supplemental service to help them make faster progress on a one-on-one basis. You can ask a private therapist to see your child for shorter sessions (i.e. 25 minutes per week) or less often (i.e. 1-2 times per month).  I see many clients in this situation.  These families often receive some speech therapy through the school district, but they are looking for additional one-on-one therapy to promote their child’s progress, or supplemental therapy during school vacations.  If you are willing and able to work with your child at home, speech therapy on a monthly consultation basis (i.e. 1 hour per month) is often a good, and affordable option.  A therapist seeing your child on a monthly or bi-monthly basis can provide homework activities and suggestions for you to practice daily in order to promote your child’s progress.

OR – Hiring an individual speech therapist instead of bringing your child to a private clinic for therapy.  By private clinic, I am NOT referring to non-profit clinics which can be very affordable (see “Non-Profits” above).   You might ask your child’s school district speech therapist if they are willing to see your child privately after school or on weekends (if they are comfortable and not bound to any non-compete agreements with the school district). There’s a chance that an individual speech therapist would be willing to provide additional therapy to your child for $50-$70/hour if you offer it to them (while not cheap, this is still much cheaper than you would pay most clinics or other private practice individuals).  If a therapist is willing to do this, be flexible with them. They likely do not have an office, so you should be willing to let them work with your child in your home or at a public place (i.e. park, library…).  If any speech therapists are reading this, I recommend that you buy your own private liability insurance whenever you are working with clients privately. You (SLPs) will also technically be an independent contractor for the family and required to pay self-employment taxes on whatever money you earn (over $600/year).

OR – Hiring a private speech pathologist who employs a SLPA (speech-language pathology assistant) A fully licensed speech-language pathologist will have:

  • A Masters Degree in Communicative Disorders
  • A valid state license
  • And most likely a Certificate of Clinical Competence (CCC) from ASHA (American Speech-Language and Hearing Association)

A SLPA (speech-language pathology assistant) should have:

  • A Bachelors Degree or Associates Degree
  • Additional coursework for a SLPA license
  • Fieldwork hours completed to satisfy the SPA license requirements for their state

A SLPA can only work under a speech pathologist’s license.  SLPAs are required to have ongoing supervision and they cannot work with every client (i.e. they cannot work with medically fragile clients unless supervised 100% of the time).  When your child is being seen by a SLPA, you might still be paying the same cost as you’d pay if your child were seen by a speech therapist.  You may however, be able to find a speech pathologist who employs an SLPA and can charge a reduced rate when your child is being seen by the SLPA. Not all SLPAs are created equal. I’ve seen some good ones and some terrible ones.

If you’re aware of additional ways for parents to save and still receive great service, please message me directly or comment below. I would love to add those resources to this site! Also, if any of the information I’ve included is false or becomes outdated, please don’t hesitant to draw my attention to it. Thanks for reading and sharing with anyone who might find this information useful!