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Creating A Learning Rich Environment for Language Delayed Preschoolers

Today I’m excited to introduce a new product: “Creating A Learning Rich Environment for Language Delayed Preschoolers“.  —This 40 page presentation provides suggestions to parents regarding how to facilitate further language development in language delayed/impaired preschoolers at home in conjunction with existing outpatient, school, or private practice based speech language services. It details implementation strategies as well as lists useful materials, books, and websites of interest.

It is intended to be of interest to both parents and speech language professionals (especially clinical fellows and graduates speech pathology students or any other SLPs switching populations) and not just during the summer months. SLPs can provide it to the parents of their cleints instead of creating their own materials. This will not only save a significant amount of time but also provide a concrete step-by-step outline which explains to the parents how to engage children in particular activities from bedtime book reading to story formulation with magnetic puzzles.

Product Content:

  • The importance of daily routines
  • The importance of following the child’s lead
  • Strategies for expanding the child’s language
    • —Self-Talk
    • —Parallel Talk
    • —Expansions
    • —Extensions
    • —Questioning
    • —Use of Praise
  • A Word About Rewards
  • How to Begin
  • How to Arrange the environment
  • Who is directing the show?
  • Strategies for facilitating attention
  • Providing Reinforcement
  • Core vocabulary for listening and expression
  • A word on teaching vocabulary order
  • Teaching Basic Concepts
  • Let’s Sing and Dance
  • Popular toys for young language impaired preschoolers (3-4 years old)
  • Playsets
  • The Versatility of Bingo (older preschoolers)
  • Books, Books, Books
  • Book reading can be an art form
  • Using Specific Story Prompts
  • Focus on Story Characters and Setting
  • Story Sequencing
  • More Complex Book Interactions
  • Teaching vocabulary of feelings and emotions
  • Select favorite authors perfect for Pre-K
  • Finding Intervention Materials Online The Easy Way
  • Free Arts and Crafts Activities Anyone?
  • Helpful Resources

Are you a caregiver, an SLP or a related professional? DOES THIS SOUND LIKE SOMETHING YOU CAN USE? if so you can find it HERE in my online store.

Useful Smart Speech Therapy Resources:

References:
Heath, S. B (1982) What no bedtime story means: Narrative skills at home and school. Language in Society, vol. 11 pp. 49-76.

Useful Websites:
http://www.beyondplay.com
http://www.superdairyboy.com/Toys/magnetic_playsets.html
http://www.educationaltoysplanet.com/
http://www.melissaanddoug.com/shop.phtml
http://www.dltk-cards.com/bingo/
http://bogglesworldesl.com/
http://www.childrensbooksforever.com/index.html

 

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What do Auditory Memory Deficits Indicate in the Presence of Average General Language Scores?

I frequently see a variation of the following question on a variety of speech language forums: “My student scored within the average range on all the tested subtests with the exception of working memory and sentence recall. What other testing do you recommend to determine whether these difficulties are impacting their academics?”

First, lets provide a definition of working memory (WM). WM is the memory used for temporarily storing and manipulating information so we can perform a particular task. It’s one of the executive functions (EFs) and contains two important subcomponents: a phonological loop that stores verbal information and a visuo-spatial ‘sketchpad’ which stores visual and spatial information (Baddeley & Hitch, 2007). Together they are responsible for acquisition of sound-letter correspondence, phonemic awareness and ultimately reading comprehension since WM influences the duration the information stays in memory as well as its eventual transfer (or lack of thereof) to long-term memory.

In other words, students with adequate working memory will have enough capacity to appropriately decode, fluently read and adequately comprehend text while students with poor working memory will expend all their capacity on basic tasks such as decoding, which leaves them with very little capacity to devote to comprehension of read material.

Outside of testing, WM deficits typically become glaringly apparent as students move up grade levels and are given challenging subject-specific abstract texts, requiring in-depth analysis.  This is when parents and professionals start to see that in addition to experiencing difficulty comprehending the read texts, students with poor WM also tire easily when presented with lengthy texts, and tend to evidence increased frustration and decreased self-efficacy during reading tasks.

Now let’s get back to our original question: “What other testing do you recommend to determine whether these [memory] difficulties are impacting their academics?”

Typically when asked that question I always tend to recommend that a trained SLP  performs a series of tests aimed to determine whether the student presents with reading and writing deficits.

In my clinical experience (which is of course substantiated by research) in 99% of cases, reading disabilities are the hidden culprit behind seemingly average oral language skills and working memory deficits.   For more information on what testing is recommended to tease out the presence of reading disorders, see my series posts on Comprehensive Dyslexia Testing (HERE) as well as on the validity of (C)APD diagnosis (HERE).

keep calm and don't ignore the signs

So the next time you encounter this perplexing pattern of strengths and weaknesses don’t just ignore it as inconsequential and not recommend or dismiss the student from language services.  Delve into it further! You will often find that it is representative of reading difficulties, the cumulative impact of which may significantly affect the student’s academic performance and ultimately school outcomes, unless appropriate therapeutic interventions are provided.

References:

  • Baddeley, A. D., & Hitch, G. J. (2007). Working memory: Past, present…and future? In N.Osaka, R. Logie & M. D’Esposito (Eds), Working Memory – Behavioural & Neural Correlates. Oxford University Press.

Useful Resources:

  1. Help, Student Tested Average on ALL Standardized Tests but is Still Struggling
  2. Is “Dyslexia” a Useful Label for Diagnostic and Treatment Purposes?
  3. Quality Assessments for Students with Suspected/Confirmed “APD”

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Have you Worked on Morphological Awareness Lately?

Last year an esteemed colleague, Dr. Roseberry-McKibbin posed this question in our Bilingual SLPs Facebook Group:  “Is anyone working on morphological awareness in therapy with ELLs (English Language Learners) with language disorders?”

Her question got me thinking: “How much time do I spend on treating morphological awareness in therapy with monolingual and bilingual language disordered clients?” The answer did not make me happy!

So what is morphological awareness and why is it important to address when treating monolingual and bilingual  language impaired students?

Morphemes are the smallest units of language that carry meaning. They can be free (stand alone words such as ‘fair’, ‘toy’, or ‘pretty’) or bound (containing prefixes and suffixes that change word meanings – ‘unfair’ or ‘prettier’).

Morphological awareness refers to a ‘‘conscious awareness of the morphemic structure of words and the ability to reflect on and manipulate that structure’’ (Carlisle, 1995, p. 194). Also referred to as “the study of word structure” (Carlisle, 2004), it is an ability to recognize, understand, and use affixes or word parts (prefixes, suffixes, etc) that “carry significance” when speaking as well as during reading tasks. It is a hugely important skill for building vocabulary, reading fluency and comprehension as well as spelling (Apel & Lawrence, 2011; Carlisle, 2000; Binder & Borecki, 2007; Green, 2009). 

So why is teaching morphological awareness important? Let’s take a look at some research.

Goodwin and Ahn (2010) found morphological awareness instruction to be particularly effective for children with speech, language, and/or literacy deficits. After reviewing 22 studies Bowers et al. (2010) found the most lasting effect of morphological instruction was on readers in early elementary school who struggled with literacy.

Morphological awareness instruction mediates and facilitates vocabulary acquisition leading to improved reading comprehension abilities (Bowers & Kirby, 2010; Carlisle, 2003, 2010; Guo, Roehrig, & Williams, 2011; Tong, Deacon, Kirby, Cain, & Parilla, 2011).

Unfortunately as important morphological instruction is for vocabulary building, reading fluency, reading comprehension, and spelling, it is often overlooked during the school years until it’s way too late. For example, traditionally morphological instruction only beings in late middle school or high school but research actually found that in order to be effective one should actually begin teaching it as early as first grade (Apel & Lawrence, 2011).

So now that we know that we need to target morphological instruction very early in children with language deficits, let’s talk a little bit regarding how morphological awareness can be assessed in language impaired learners.

When it comes to standardized testing, both the Test of Language Development: Intermediate – Fourth Edition (TOLD-I:4) and the Test of Adolescent and Adult Language–Fourth Edition (TOAL-4) have subtests which assess morphology as well as word derivations. However if you do not own either of these tests you can easily create non-standardized tasks to assess  morphological awareness.

Apel, Diehm, & Apel (2013) recommend multiple measures which include:  phonological awareness tasks, word level reading tasks, as well as reading comprehension tasks.

Below are direct examples of tasks from their study:

MATs

One can test morphological awareness via production or decomposition tasks. In a production task a student is asked to supply a missing word, given the root morpheme (e.g., ‘‘Sing. He is a great _____.’’ Correct response: singer).  A decomposition task asks the student to identify the correct root of a given derivation or inflection. (e.g., ‘‘Walker. How slow can she _____?’’ Correct response: walk).

Another way to test morphological awareness is through completing analogy tasks since it involves both  decomposition and production components (provide a missing word based on the presented pattern—crawl: crawled:: fly: ______ (flew).

Still another way to test morphological awareness with older students is through deconstruction tasks: Tell me what ____ word means? How do you know? (The student must explain the meaning of individual morphemes).

Finding the affix: Does the word ______ have smaller parts?

So what are the components of effective morphological instruction you might ask?

Below is an example of a ‘Morphological Awareness Intervention With Kindergarteners and First and Second Grade Students From Low SES Homes’ performed by Apel & Diehm, 2013:

Apel and Diem 2011

Here are more ways in which this can be accomplished with older children:

  • Find the root word in a longer word
  • Fix the affix (an additional element placed at the beginning or end of a root, stem, or word, or in the body of a word, to modify its meaning)
    • Affixes at the beginning of words are called “prefixes”
    • Affixes at the end of words are called “suffixes
  • Word sorts to recognize word families based on morphology or orthography
  • Explicit instruction of syllable types to recognize orthographical patterns
  • Word manipulation through blending and segmenting morphemes to further solidify patterns

Now that you know about the importance of morphological awareness, will you be incorporating it into your speech language sessions? I’d love to know!

Until then, Happy Speeching!

References:

  • Apel, K., & Diehm, E. (2013). Morphological awareness intervention with kindergarteners and first and second grade students from low SES homes: A small efficacy study. Journal of Learning Disabilities.
  • Apel, K., & Lawrence, J. (2011). Contributions of morphological awareness skills to word-level reading and spelling in first-grade children with and without speech sound disorder. Journal of Speech, Language & Hearing Research, 54, 1312–1327.
  • Apel, K., Brimo, D., Diehm, E., & Apel, L. (2013). Morphological awareness intervention with kindergarteners and first and second grade students from low SES homes: A feasibility study. Language, Speech, and Hearing Services in Schools, 44, 161-173.
  • Binder, K. & Borecki, C. (2007). The use of phonological, orthographic, and contextualinformation during reading: a comparison of adults who are learning to read and skilled adult readers. Reading and Writing, 21, 843-858.
  • Bowers, P.N., Kirby, J.R., Deacon, H.S. (2010). The effects of morphological instruction on literacy skills: A systematic review of the literature. Review of Educational Research, 80, 144-179.
  • Carlisle, J. F. (1995). Morphological awareness and early reading achievement. In L. B. Feldman (Ed.), Morphological aspects of language processing (pp. 189–209). Hillsdale, NJ: Erlbaum.
  • Carlisle, J. F. (2000). Awareness of the structure and meaning of morphologically complex words: Impact on reading. Reading and Writing: An Interdisciplinary Journal,12,169-190.
  • Carlisle, J. F. (2004). Morphological processes that influence learning to read. In C. A. Stone, E. R. Silliman, B. J. Ehren, & K. Apel (Eds.), Handbook of language and literacy. NY: Guilford Press.
  • Carlisle, J. F. (2010). An integrative review of the effects of instruction in morphological awareness on literacy achievement. Reading Research Quarterly, 45(4), 464-487.
  • Goodwin, A.P. & Ahn, S. (2010). Annals of Dyslexia, 60, 183-208.
  • Green, L. (2009). Morphology and literacy: Getting our heads in the game. Language, Speech, and Hearing Services in the schools, 40, 283-285.
  • Green, L., & Wolter, J.A. (2011, November). Morphological Awareness Intervention: Techniques for Promoting Language and Literacy Success. A symposium presentation at the annual American Speech Language Hearing Association, San Diego, CA.
  • Guo, Y., Roehrig, A. D., & Williams, R. S. (2011). The relation of morphological awareness and syntactic awareness to adults’ reading comprehension: Is vocabulary knowledge a mediating variable? Journal of Literacy Research, 43, 159-183.
  • Tong, X., Deacon, S. H., Kirby, J. R., Cain, K., & Parrila, R. (2011). Morphological awareness: A key to understanding poor reading comprehension in English. Journal of Educational Psychology103 (3), 523-534.
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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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Friend or Friendly: What Does Age Have To Do with It?

In my social pragmatic language groups I target a wide variety of social communication goals for children with varying levels and degrees of impairment with a focus on improving their social pragmatic language competence.  In the past I have written blog posts on a variety of social  pragmatic language therapy topics, including strategies for improving students’ emotional intelligence as well as on how to teach students to develop insight into own strengths and weaknesses.  Today I wanted to discuss the importance of teaching students with social communication impairments, age recognition for friendship and safety purposes.

Now it is important to note that the focus of my sessions is a bit different from the focus of “teaching protective behaviors”, “circles of intimacy and relationships” or “teaching kids to deal with tricky people. Rather the goal is to teach the students to recognize who it is okay “to hang out” or be friends with, and who is considered to be too old/too young to be a friend.

Why is it important to teach age recognition?

There are actually quite a few reasons.

Firstly, it is a fairly well-known fact that in the absence of age-level peers with similar weaknesses, students with social communication deficits will seek out either much younger or much older children as playmates/friends as these individuals are far less likely to judge them for their perceived social deficits. While this may be a short-term solution to the “friendship problem” it also comes with its own host of challenges.  By maintaining relationships with peers outside of their age group, it is difficult for children with social communication impairments to understand and relate to peers of their age group in school setting. This creates a wider chasm in the classroom and increases the risk of peer isolation and bullying.

Secondly, the difficulty presented by friendships significantly outside of one’s peer group, is  the risk of, for lack of better words, ‘getting into trouble’. This may include but is not limited to exploring own sexuality (which is perfectly normal) with a significantly younger child (which can be problematic) or be instigated by an older child/adolescent in doing something inappropriate (e.g, shoplifting, drinking, smoking, exposing self to peers, etc.).

Thirdly, this difficulty (gauging people’s age) further exacerbates the students’ social communication deficits as it prevents them from effectively understanding such pragmatic parameters such as audience (e.g., with whom its appropriate to use certain language in a certain tone and with whom it is not) and topic (with whom it is appropriate to discuss certain subjects and with whom it is not).

So due to the above reasons I began working on age recognition with the students (6+ years of age) on my caseload diagnosed with social communication and language impairments.   I mention language impairments because it is very important to understand that more and more research is coming out connecting language impairments with social communication deficits. Therefore it’s not just students on the autism spectrum or students with social pragmatic deficits (an official DSM-5 diagnosis) who have difficulties in the area of social communication. Students with language impairments could also benefit from services focused on improving their social communication skills.

I begin my therapy sessions on age recognition by presenting the students with photos of people of different ages and asking them to attempt to explain how old do they think the people in the pictures are and what visual clues and/or prior knowledge assisted them in the formulation of their responses. I typically select the pictures from some of the social pragmatic therapy materials packets that I had created over the years (e.g., Gauging Moods, Are You Being Social?, Multiple Interpretations, etc.).

I make sure to carefully choose my pictures based on the student’s age and experience to ensure that the student has at least some degree of success making guesses.  So for a six-year-old I would select pictures of either toddlers or children his/her age to begin teaching them recognition of concepts: “same” and “younger” (e.g., Social Pragmatic Photo Bundle for Early Elementary Aged Children).

Kids playing in the room

For older children, I vary the photos of different aged individuals significantly.  I also introduce relevant vocabulary words as related to a particular age demographic, such as:

  • Infant (0-1 years of age)
  • Toddler (2-3 years of age)
  • Preschooler (3-5 years of age)
  • Teenager (individual between 13-19 years of age)
  • Early, mid and late 20s, 30s, 40s
  • Middle-aged (individuals around 50 years of age)
  • Senior/senior citizen (individuals ~65+ years of age)

I explain to the students that people of different ages look differently and teach them how to identify relevant visual clues to assist them with making educated guesses about people’s ages.  I also use photos of my own family or ask the students to bring in their own family photos to use for age determination of people in the presented pictures.  When students learn the ages of their own family members, they have an easier time determining the age ranges of strangers.

My next step is to explain to students the importance of understanding people’s ages.  I present to the students a picture of an individual significantly younger or older than them and ask them whether it’s appropriate to be that person’s friend.   Here students with better developed insight will state that it is not appropriate to be that person’s friend because they have nothing in common with them and do not share their interests. In contrast, students with limited insight will state that it’s perfectly okay to be that person’s friend.

This is the perfect teachable moment for explaining the difference between “friend” and “friendly”. Here I again reiterate that people of different ages have significantly different interests as well as have significant differences in what they are allowed to do (e.g., a 16-year-old is allowed to have a driver’s permit in many US states as well as has a later curfew while an 11-year-old clearly doesn’t).  I also explain that it’s perfectly okay to be friendly and polite with older or younger people in social situations (e.g., say hello all, talk, answer questions, etc.) but that does not constitute true friendship.

I also ask students to compile a list of qualities of what they look for in a “friend” as well as have them engage in some perspective taking (e.g, have them imagine that they showed up at a toddler’s house and asked to play with him/her, or that a teenager came into their house, and what their parents reaction would be?).

Finally, I discuss with students the importance of paying attention to who wants to hang out/be friends with them as well as vice versa (individuals they want to hang out with) in order to better develop their insight into the appropriateness of relationships. I instruct them to think critically when an older individual (e.g,  young adult) wants to get particularly close to them.  I use examples from an excellent post written by a colleague and good friend, Maria Del Duca of Communication Station Blog re: dealing with tricky people, in order to teach them to recognize signs of individuals crossing the boundary of being friendly, and what to do about it.

So there you have it. These are some of the reasons why I teach age recognition to clients with social communication weaknesses. Do you teach age recognition to your clients? If so, comment under this post, how do you do it and what materials do you use?

Helpful Smart Speech Resources Related to Assessment and Treatment of Social Pragmatic Disorders 

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Language Processing Deficits (LPD) Checklist for School Aged Children

Need a Language Processing Deficits Checklist for School Aged Children

You can find it in my online store HERE

This checklist was created to assist speech-language pathologists (SLPs) with figuring out whether the student presents with language processing deficits which require further follow-up (e.g., screening, comprehensive assessment). The SLP should provide this form to both teacher and caregiver/s to fill out to ensure that the deficit areas are consistent across all settings and people.

Checklist Categories:

  • Listening Skills and Short Term Memory
  • Verbal Expression
  • Emergent Reading/Phonological Awareness
  • General Organizational Abilities
  • Social-Emotional Functioning
  • Behavior
  • Supplemental* Caregiver/Teacher Data Collection Form
  • Select assessments sensitive to Auditory Processing Deficits