Treatment Suggestions | Smart Speech Therapy

Posted on February 1, 2015January 5, 2022 by Tatyana Elleseff — 1 Comment

For the Love of Speech Blog Hop: February Edition

Today I am very excited to participate along with 27 other talented SLPs in the For the Love of Speech Blog Hop. I love being an SLP, and to spread that love around from February 1-4 I am giving away a Valentine’s Day Product: “The Origins of Valentine’s Day: At thematic language activity packet for middle and high school students” .

This thematic packet was created to target listening and reading comprehension of middle and high school students diagnosed with language impairments and learning disabilities. The packet contains Response to Intervention (RTI) Tier 2 vocabulary words in story context. Expressive language activities for the packet include production of synonyms and antonyms, fill-in the blank, as well as sentence formulation using story vocabulary. Comprehension questions pertaining to story are provided in an open ended question format. It is great for teaching reading comprehension and sophisticated vocabulary in a thematic context related to familiar to the student events.

You can grab this product for free for a limited time only in my online store (HERE) and then head on over to Teach Speech 365 to grab her freebie as well. Collect all freebies by the time the blog hop ends on February 4th!

For more useful FREE and PAID products check out my online store by clicking HERE or on the picture below

Posted on November 13, 2014January 5, 2022 by Tatyana Elleseff — 1 Comment

Dear School Professionals Please Be Aware of This

I frequently get emails, phone calls, and questions from parents and professionals regarding academic functioning of internationally adopted post institutionalized children. Unfortunately despite the fact that there is a fairly large body of research on this topic there still continue to be numerous misconceptions regarding how these children’s needs should be addressed in academic settings.

Perhaps one of the most serious and damaging misconceptions is that internationally adopted children are bilingual/multicultural children with Limited English Proficiency who need to be treated as ESL speakers. This erroneous belief often leads to denial or mismanagement of appropriate level of services for these children not only with respect to their language processing and verbal expression but also their social pragmatic language abilities.

Even after researchers published a number of articles on this topic, many psychologists, teachers and speech language pathologists still don’t know that internationally adopted children rapidly lose their little birth language literally months post their adoption by English-speaking parents/families. Gindis (2005) found that children adopted between 4-7 years of age lose expressive birth language abilities within 2-3 months and receptive abilities within 3-6 months post- adoption. This process is further expedited in children under 4, whose language is delayed or impaired at the time of adoption (Gindis, 2008). Even school-aged children of 10-12 years of age who were able to read and write in their birth language, rapidly lose their comprehension and expression of birth language within their first year post adoption, if adopted by English-speaking parents who are unable to support their birth language.

So how does this translate into appropriate provision of speech language services you may ask? To begin with, I often see posts on the ASHA forums or in Facebook speech pathology and special education groups seeking assistance with finding interpreters fluent in various exotic languages. However, unless the child is “fresh off the boat” (several months post arrival to US) schools shouldn’t be feverishly trying to locate interpreters to assist with testing in the child’s birth language. They will not be able to obtain any viable results especially if the child had been residing in the United States for several years.

So if the post-institutionalized, internationally adopted child is still struggling with academics several years post adoption, one should not immediately jump to the conclusion that this is an “ESL” issue, but get relevant professionals (e.g., speech pathologists, psychologists) to perform thorough testing in order to determine whether it’s the lack of foundational abilities due to institutionalization which is adversely impacting the child’s academic abilities.

Furthermore, ESL itself is often not applicable as an educational method to internationally adopted children. Here’s why:

Let’s literally take the first definition of ESL which pops-up on Google when you put in a query: “What is ESL?” “English as a Second Language (ESL) is an instructional program for students whose dominant language is not English. The purpose of the program is to increase the English language proficiency of eligible students so they can attain academic standards and achieve success in the classroom.”

Here is our first problem. These students don’t have a dominant language. They are typically adopted by parents who do not speak their birth language and that are unable to support them in their birth language. So upon arrival to US, IA children will typically acquire English via the subtractive model of language acquisition (birth language is replaced and eliminated by English), which is a direct contrast to bilingual children, many of whom learn via the additive model (adding English to the birth language (Gindis, 2005). As a result, of subtractive language acquisition IA children experience very rapid birth language attrition (loss) post-adoption (Gindis, 2003; Glennen, 2009). Thus they will literally undergo what some researchers have called: “second-first language acquisition” (Scott et al., 2011) and their first language will “become completely obsolete as English is learned” (Nelson, 2012, p. 2).

This brings us to our second problem: the question of “eligibility”. Historically, ESL programs have been designed to assist children of immigrant families acquire academic readiness skills. This methodology is based on the fact that skills from first language was ultimately transfer to the second language. However, since post-institutionalized children don’t technically have a “first language” and their home language is English, how could they technically be eligible for ESL services? Furthermore, because of frequent lack of basic foundational skills in the birth language internationally adopted post-institutionalized children will not benefit the same way from ESL instruction the same way bilingual children of immigrant families do. So instead of focusing on these children’s questionable eligibility for ESL services it is important to perform detailed review of their pre-adoption records in order to determine birth language deficits and consider eligibility for speech language services with the emphasis on improving these children’s foundational skills.

If the child’s pre-adoption records specifically state that s/he has birth language delay then it should be taken seriously (Gindis, 1999) since language delays in the birth language transfer and affect the new language (McLaughlin, Gesi, & Osani, 1995). These delays will not “go away” without appropriate interventions. “Any child with a known history of speech and language delays in the sending country should be considered to have true delays or disorders and should receive speech and language services after adoption.” (Glennen, 2009, p.52)

Now that we have discussed the issue of ESL services, lets touch upon social pragmatic language abilities of internationally adopted children. Here’s how erroneous beliefs can contribute to mismanagement of appropriate services in this area.

Different cultures have different pragmatic conventions, therefore we are taught to be very careful when labeling certain behaviors of children from other cultures as atypical, just because they are not consistent with the conventions and behaviors of children from the mainstream culture. Here’s a recent example. A mainstream American parent consulted an SLP regarding the inappropriate social pragmatic skills of her teenaged daughter adopted almost a decade ago from Southeast Asia. The SLP was under the impression that some of the child’s deficits were due to multicultural differences and had to do with the customs and traditions of the child’s country of origin. She was considering advising the parent regarding requesting an evaluation by a SLP who spoke the child’s birth language.

Here are two problems with the above scenario. Firstly, any internationally adopted post-institutionalized child who was adopted by American parents who were not part of the culture from which the child was adopted, the child will quickly become acculturated and immersed in the American culture. These children “need functional English for survival”, and thus have a powerful incentive to acquire English (Gindis, 2005; p. 299). consequently, any unusual or atypical behaviors they exhibit in social interactions and in academic setting with other individuals cannot be attributed to customs and traditions of another culture.

Secondly, It is very important to understand that institutionalization and orphanage care have been closely linked to increase in mental health disorders and psychiatric impairments. As a result, internationally adopted children have a high incidence of social pragmatic deficits as compared to non-adopted peers as well as post-institutionalized children adopted at younger ages, (under 3). Given this, if parents present with concerns regarding their internationally adopted post-institutionalized children’s social pragmatic and behavioral functioning it is very important not to jump to erroneous conclusion pertaining to these children’s birth countries but rather preform comprehensive evaluations in order to determine whether these children can be assisted further in the realm of social pragmatic functioning in a variety of settings.

In order to develop a clear picture regarding appropriate service delivery for IA children, school based professionals need to educate themselves regarding the fundamental differences between development and learning trajectories of internationally adopted children and multicultural/bilingual children. Children, who struggle academically, after years of adequate schooling exposure, do not deserve a “wait and see” approach. They should start receiving appropriate intervention as soon as possible (Hough & Kaczmarek, 2011; Scott & Roberts, 2007).

Posted on October 30, 2014March 18, 2022 by Tatyana Elleseff — 1 Comment

Word-Finding Remediation: EBP Resources for SLPs

It’s on the tip of my tongue! How many times have you used this expression or heard it from other people. Oftentimes when we think of word-finding deficits we automatically think of it as an adult affliction, however, you would be surprised how many children including even very young children (4+ years of age) are affected by it. Did you know that “up to 7% of children have specific language needs and around 25% of children attending language support services have word-finding difficulties (WFD; Dockrell et al., 1998)?”

If you participate in various speech language and education related forums you may frequently see a variation on this question: “How would you assess and treat a child with word finding difficulties?” Before I provide some recommendations on this matter I’d like to talk a little bit about what word-finding is as well as what impact untreated word finding issues may have in a child.

So how do word-finding deficits manifest in children? In a vast variety of ways actually! For starters they could occur at the word level, conversational level or both. Below are just a few examples of word-level errors from German, 2005:

Error Pattern 1- Lemma Related Semantic Errors
- “Slips of the tongue” or semantic word substitutions such as fox→ wolf; clown → gnome
Error Pattern 2 – Form Related Blocked Errors
- “Tips of the tongue” or responses characterized by word blocks, pauses, fillers (um, ah, etc), repetitions, metalinguistic or metacognitive comments such as “I know”, “I don’t know”, etc.
Error Pattern 3 – Form & Segment Related Phonologic Errors
- “Twists of the tongue” which include phoneme omissions, substitutions and additions such as cactus → catus; octopus →opotus, etc.

Further complicating the above may be the speed (some delay or no delay) with which they retrieve words as well as accuracy/inaccuracy of their retrieval once the words are retrieved. Additionally, a number of secondary characteristics may also play a role which include gestures (e.g, miming a word, frustration, etc) as well as extra verbalizations (metalinguistic and metacognitive comments).

At discourse level, students with word-finding deficits typically occupy one of two categories: productive vs. insufficiently productive language users. While their narrative language profile may be marked by frequent pauses, word fillers, as well as word and phrase revisions and repetitions.

Moreover, word-retrieval deficits are not limited to discourse, they are also found in reading tasks. There word-finding issues may manifest as omitted words or almost stuttering/cluttering like behaviors. Interestingly German and Newman (2005; 2007) found that students with word retrieval difficulties are able to successfully correctly identify the words they missed during oral reading tasks in silent reading recognition tasks.

Difficulty coherently expressing oneself can have significant detrimental effect on the child’s academic performance, social relationships and ultimately self-esteem, which without appropriate intervention may potentially lead to poor school performance as well as mental issues (e.g., anxiety, depression, etc.)

So how can word-finding deficits be assessed for free? You can assess word-finding at narrative level using the clinical narrative assessment.

At word level you can adapt single word standardazed tests such as the Expressive One Word Picture Vocabulary Test (EOWPVT) in order to test the efficiency of the student’s word retrieval in single word context. Here, the goal is not necessarily to test their expressive vocabulary knowledge but rather to see what type of word finding errors the students are making as they are attempting to correctly recall the visually shown word. Depending on the extent of the child’s word finding deficits you may have some very useful information to derive from the presentation of this test.

To illustrate, I recently informally administered applicable portions of this test to a four-year old Russian speaking preschooler. Based on his performance I was able to determine that his errors are primarily Error Pattern 3 – Form & Segment Related Phonologic Errors or Twists of the tongue”. This was further confirmed when I had the child to participate in the narrative retelling task.

So where can we find reputable evidence-based practice information on effective assessment and treatment strategies for word finding deficits? Start with Dr. Diane German’s website, entitled Word Finding. She has a lot of good information to offer there for free to both speech language professionals as well as parents. Take a look at her recommended materials and resources, they are very helpful when it comes to assessing and treating children with word finding deficits. Now have fun and evidence-base practice on!

PS. Calculating percentage of word-finding difficulties in children.

Dr. German recommends the following procedure: “Obtain a language sample of 50 T-units (kernel sentence + subordinate clause) in length using stimuli of interest to the learner (or use one you have as long as all utterances in the sample are included). Then asses each T unit for the presence of one or more of the following 7 WF behaviors in discourse: repetitions, revisions (reformulations), substitutions, insertions (comment that reflects on the WF process like I cannot think of it, etc. ), time fillers (um, er, uh), delays with in the T unit, and empty words (thing, stuff). Learners with WF difficulties manifest one or more WF behaviors in 33% or more of their T units (often 40% – 50%). Typical language learners display WF behaviors in 19% or less of their T-Units (German, 1991)“ (German, 2015: SIG 16 Topic: Assessing Word-Finding Skills)

Helpful Related Materials:

References:

Dockrell, J.E., Messer, D., George, R. & Wilson, G. (1998). Notes and Discussion Children with word-finding difficulties-prevalence, presentation and naming problems. International Journal of Language & Communication Disorders, 33 (4), 445-454.
German, D.J. (2001) It’s on the Tip of My Tongue, Word Finding Strategies to Remember Names and Words You Often Forget. Word Finding Materials, Inc.
Dr. German’s Word Finding Website: http://www.wordfinding.com/

Disclaimer: The views expressed in this post are the personal opinion of the author. The author is not affiliated with dr. Diane German nor PRO-ED publications in any way and was not provided by them with any complimentary products or compensation for this post.

Posted on October 13, 2014March 12, 2022 by Tatyana Elleseff — 4 Comments

Test Review of CELF-5 Metalinguistics: What SLPs Need to Know

In mid-2014, I purchased the Clinical Evaluation of Language Fundamentals®, Fifth Edition Metalinguistics (CELF®-5 Metalinguistics), which is a revision of the Test of Language Competence–Expanded.

Basic overview

Release date: 2014
Age Range: 9-21
Author: Elizabeth Wiig and Wayne Secord
Publisher: Pearson

Description: According to the manual CELF–5M was created to “identify students 9-21 years old who have not acquired the expected levels of communicative competence and metalinguistic ability for their age” (pg. 1). In other words the test targets higher level language skills beyond the basic vocabulary and grammar knowledge and use. The authors recommend using this test with students with “subtle language disorders” or “those on the autism spectrum”.

The test contains 5 subtests:

The Metalinguistics Profile subtest of the CELF-5:M is a questionnaire (filled out by caregiver or teacher) which targets three areas: Words, Concepts, and Multiple Meanings; Inferences and Predictions; as well as Conversational Knowledge and Use. Its aim is to obtain information about a student’s metalinguistic skills in everyday educational and social contexts to complement the evidence of metalinguistic strengths and weaknesses identified by the other subtests that comprise the CELF-5:M test battery.

Questions address such topics as the child’s comprehension of idioms and abstract language, their predicting and inferencing abilities, their ability to deal with unpleasant situations, participate in group discussions, as well as understand jokes and sarcasm, just to name a few. A maximum of four points can be obtained on each of it 30 questions. The following is the rating criteria: a score of one is obtained when a child ‘never’ does something in a particular category (e.g., doesn’t get the punchline of jokes). A score of two is given when a child is capable of understanding or using something ‘some of the time’. A score of three is given when a child is able to understand or perform something ‘often’. Finally, a score of four is given when a child is capable of comprehending something ‘always’ or ‘almost always’.

A word of caution, when giving this profile to either teachers or parents to fill out, the SLP must ensure that no overinflation or underestimation of scores takes place. Frequently, some parents may not have a clear understanding of the extent of their child’s level of deficits. Similarly, some teachers, especially those who may not know the child very well, or those who have worked with a child for a very short period of time, may overinflate the scores when filling out the questionnaire. However, the opposite may also occur. A small group of parents may underestimate their children’s abilities, and provide poor scores as a result also not providing an objective picture of the child’s level of deficits. In such situations, the best option may be for the SLP to fill out the questionnaire together with the parent or teacher in order to provide explanations of questions in a different categories.

The Making Inferences subtest of the CELF-5:M evaluates the student’s ability to identify and formulate logical inferences on the basis of existing causal relationships presented in short narrative texts. The student is visually and auditorily presented with a particular situation by the examiner. S/he is then asked to identify the best two out of four written answers for the ending and come up with her own additional reason other than the ones listed in the stimulus book.

On the multiple choice portion of the subtest errors can result due to provision of contradictory, unrelated and irrelevant responses. On the open ended questions portion of the subtest errors can result due to vague, confusing, incomplete, unlikely or illogical responses as well as due to contradictory and off topic answers.

I must say that this is my least favorite subtest. Here’s why. In real life students are not provided with multiple choices when asked to make predictions or inferences. That is why I do not believe that performance on this subtest is a true representation of the child’s ability in this area.

The Conversational Skills subtest of the CELF-5:M evaluates the student’s ability to initiate a conversation or respond in a way that is relevant and pragmatically appropriate to the context and audience while incorporating given words in semantically and syntactically correct sentences. S/he are presented with a picture scene that creates a conversational context and two or three words which are also printed above the pictured scene. S/he are then asked to formulate a conversationally and pragmatically appropriate sentence for the given context using all of the target words in the form (tense, number, etc.) provided.

Errors on this subtest can result due to pragmatic, semantic or syntactic errors. With respect to pragmatics errors can result due to illogical, nonsensical, vague or incomplete sentences as well as due to sentence formulation which does not take into account presented scenes. With respect to semantics errors can result due to missing or misused target words as well as due to vague, incorrect or misused verbiage. With respect to syntax errors can result due to use of sentence fragments, morphological misuse of target words (changing word forms) as well as syntact deviations on non-target words.

The Multiple Meanings subtest of the CELF-5:M evaluates the student’s ability to recognize and interpret different meanings of selected lexical (word level) and structural (sentence level) ambiguities. S/he are presented a sentence (orally and in text) that contained an ambiguity at either the word or sentence level. S/he are then asked to describe two meanings for each presented sentence.

Errors can result due to difficulty interpreting lexical and structural ambiguities as well as due to an inability to provide more than one interpretation to presented multiple meaning words.

The Figurative Language subtest of the CELF-5:M evaluates the student’s ability to interpret figurative expressions (idioms) within a given context and match each expression with another figurative expression of similar meaning given verbal and written support.

Errors on this subtest can result due to difficulty explaining the meanings of idiomatic expressions, as well as due to difficulty selecting the appropriate meaning from visually provided multiple choice answers containing related idiomatic expressions.

Based on testing the following long-term goal can be generated:

LTG: Student will improve his/her metalinguistic abilities (thinking about language) for academic and social purposes

It can also yield the following short-term goals

Student will improve ability to make social inferences with an without written support
Student will improve ability to to make social predictions with and without written support
Student will produce (choose one/all: syntactically, semantically, pragmatically) appropriate compound and complex sentences with and without visual support
Student will improve ability to explain context embedded multiple meaning words
Student will improve ability to explain ambiguously worded language
Student will improve ability to explain figurative language and idiomatic expressions

A word of caution regarding testing eligibility:

What I am concerned about:

It is rather costly with a sticker price of $376, which is far above other tests assessing similar abilities on the market.
Test administration begins at 9 years of age. However, metalinguistic abilities develop in children much earlier than nine years of age. Children and young as 6 years of age can present with glaring metalinguistic deficits but unless the examiner has access to another testing which could assess the children’s metalinguistic abilities we have to wait until the child is nine and is clearly behind his or her peers in their metalinguistic development in order to confirm the presence of deficits.
I also don’t understand the presence of visual and written stimuli on select testing subtests. Children are not provided with multiple-choice answers or written support in daily social and academic situations. As a result of the presence of these aids score overinflation may occur with those children who do well given compensatory strategies but who have difficulty generating novel spontaneous responses.
Similarly, I am concerned that higher functioning yet socially clueless students may be administered this test because the examiners may believe that it would accurately assess their higher functioning social pragmatic language abilities. However many higher functioning students will pass this test with flying colors, which is why I urge considerable caution when selecting student population for testing administration
- Very Important: See the sensitivity and specificity details of CELF-5M above.

Consequently the CELF-5: M administration is not for everyone. As mentioned before I would only administer portions of this test to higher functioning (but not too high functioning) students undergoing language assessment for the first time or to higher functioning students receiving a re-evaluation, who have previously passed the Clinical Evaluation of Language Fundamentals-5 with ease. This test would not be appropriate for Severely Challenged and Challenged Social Communicators (see Winner, 2015)

I would also not administer this test to the following populations:

Students with intellectual disabilities
Students with severe language impairment and limited vocabulary inventories
English Language Learners (ELL) with suspected language deficits
Students from low SES backgrounds*

I would not administer the CELF-5:M to the latter two groups of students due to significantly increased potential for linguistic and cultural bias stemming from lack of previous knowledge and exposure to popular culture as well as idiomatic expressions.

I would also not administer this test to Nuance Challenged Social Communicators (Winner, 2015). Specifically to Socially Anxious and Weak Interactive Social Communicators (Winner, 2015). These are the students with average or above average verbal language abilities most of whom did not have language delays when they were young. They have a ‘well-developed social radar’ and they’re highly aware of other people feelings and thoughts. However they have difficulties navigating subtle social cues of others. As a result this particular group of students tends to score quite on metalinguistic and social pragmatic testing of reduced complexity yet still present with pervasive social pragmatic language deficits.

Consequently, Clinical Assessment of Pragmatics (CAPs) administration would better suit their needs.

What I do like about this test:

This test allows me to identify more subtle language-based difficulties in verbal children with average to high average intelligence (or Emerging Social Communicators as per Winner, 2015) who present with metalinguistic and social pragmatic language weaknesses in the following areas:

Social predicting and inferencing
Conversational rules and breakdown repairs
Knowledge of high-level and abstract vocabulary words
Identification and usage of ambiguous and figurative language
Coherent and cohesive discourse and narrative formulation
Knowledge and use of multiple meaning words in a variety of conversational and text-embedded contexts

Overall, this is an nice test to have in your assessment toolkit. Consequently,if SLPs exercise caution in test candidate selection they can obtain very useful information for metalinguistic and social pragmatic language treatment goal purposes.

NEW: Need a CELF-5M Template Report? Find it HERE

3-1-19 Update: Since this review was written in October 2014, I have reviewed other tests, including the Clinical Assessment of Pragmatics (CAPs), which can be substituted and effectively used to delve into metalinguistic abilities of students with social communication difficulties. As such, while I still use the Multiple Meanings and the Figurative Language subtests of the CELF-5M rather frequently due to its suitability for a select number of students that I assess, given its described limitations, I would approach its purchase with caution, if it were the only test to be owned by the therapist for the purpose of assessment (it’s perfectly suitable as part of a battery but not as a standalone and only option).

Helpful Resources Related to Social Pragmatic Language Overview, Assessment and Remediation:

Disclaimer: The views expressed in this post are the personal opinion of the author. The author is not affiliated with Pearson in any way and was not provided by them with any complimentary products or compensation for the review of this product.

Posted on June 25, 2014January 5, 2022 by Tatyana Elleseff — 3 Comments

Pediatric Background History Questionnaire Giveaway

peds questionnaire Today I am very excited to introduce my new product “Pediatric Background History Questionnaire”. I’ve been blogging quite a bit lately on the topic of obtaining a thorough developmental client history in order to make an appropriate and accurate diagnosis of the child’s difficulties for relevant classroom placement, appropriate accommodations and modifications as well as targeted and relevant therapeutic services.
Continue reading Pediatric Background History Questionnaire Giveaway

Posted on June 20, 2014January 5, 2022 by Tatyana Elleseff — Leave a comment

What is ND-PAE and how is it Related to FASD?

The DSM-5 was released in May 2013 and with it came a revision of criteria for the diagnosis and classification of many psychiatric disorders. Among them a new proposed criteria was included relevant to alcohol related deficits in children, which is Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure (ND-PAE) (DSM-5, pgs 798-801). This proposed criteria was included in order to better serve the complex mental health needs of individuals diagnosed with alcohol related deficits, which the previous diagnosis of 760.71 – Alcohol affecting fetus or newborn via placenta or breast milk was unable to adequately capture. Continue reading What is ND-PAE and how is it Related to FASD?

Posted on June 18, 2014January 5, 2022 by Tatyana Elleseff — 7 Comments

Why is FASD diagnosis so important?

Recently, I’ve participated in various on-line and in-person discussions with both school-based speech language pathologists (SLPs) as well as medical health professionals (e.g., neurologists, pediatricians, etc.) regarding their views on the need of formal diagnosis for school aged children with suspected alcohol related deficits. While their responses differed considerably from: “we do not base intervention on diagnosis, but rather on demonstrated student need” to “with a diagnosis of ASD ‘these children’ would get the same level of services“, the message I was receiving loud and clear was: “Why? What would be the point?” So today I decided to share my views on this matter and explain why I think the diagnosis matters.
Continue reading Why is FASD diagnosis so important?

Posted on May 16, 2014March 12, 2022 by Tatyana Elleseff — 12 Comments

Articulation Assessment ToolKt

In February 2013 I did a review of the Sunny Articulation Test by Smarty Apps. At that time I really liked the test but felt that a few enhancements could really make it standout from other available articulation tests and test apps on the market. Recently, the developer, Barbara Fernandes, contacted me again and asked me to take a second look at the new and improved Sunny Articulation and Phonology Kit (SAPT-K), which is what I am doing today. Continue reading Articulation Assessment ToolKt

Category: Treatment Suggestions

For the Love of Speech Blog Hop: February Edition

Word-Finding Remediation: EBP Resources for SLPs

Pediatric Background History Questionnaire Giveaway

Articulation Assessment ToolKt

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