Ok, so we finally get to the component where the clinician is working directly with the child. Even then… this should be a three way activity with the parent joining in and gradually taking over from the clinician. This allows the clinician to evaluate the viability of, and any issues with, the parent doing the same at home. Parents really look forward to watching me show a new idea for how to do talking practice at home.
There are so many types of activities for doing talking practice at home. Some children and their parents need lots of variety to keep practice fun and fresh. Other children love Lego or cars so much that talking practice is continually tweaked around one theme.
For structured talking practice, I tend to start with book shares. Books are used in two main ways. Firstly, I use a dialogic reading format where the adult scaffolds the dialogue allowing the child to join in by answering questions, finishing a sentence for the adult or taking a turn at telling the story. Secondly, I use books as a vehicle for ‘spotting’ or ‘spying’. Books like Usborne’s First 1000 Words in English, or the Big Book of Things to Spot; Spots Big Book of Words; Nick Sharratt’s ‘Just Imagine, or “You Choose’; and the Playtown flap book series all work well. I set up the spotting format by explaining that we will take turns at saying one thing about the page, modelling in my turn first, so I can set the language level at the child’s capacity to be stutter free.
Next, I introduce picture cards and we start doing talking practice while we play memory, matching, Snap, Go Fish, fishing, trails, hide and seek, Kim’s Game and story creations. Picture card sets have endless possibilities. I posted about this here on 25th October 2018: https://fionakcurtis.com/archives/604
From cards, I show the parent how to do talking practice with a puzzle. I like puzzles such as Orchard Toys Doll’s House and I do the puzzle in a lucky dip format where we take turns at grabbing a piece and describing it so that the other person guesses which piece it is (from the picture on the box). From Puzzles, I then try out various games such as Crazy Chefs, Red Dog Blue Dog and Shopping List. These are all simple Bingo/Lotto type games. Other games like Guess Who, and Secret Square work well for many children. I also use construction games like Build a Beetle and Mr Potato Head. In all of these activities, taking turns is key. This helps control the dialogue so that the child is fluent and the adult uses their turn to model an appropriate language level for the child to follow suit.
Next, I show the parent how to do talking practice with toys such as Lego, cars and Coles Minis in barrier games or more open instruction games. Active games with balls and scavenger hunts can also be adapted for talking practice. As the child’s stuttering severity decreases, less structured talking practice is possible and also necessary, for reaching the holy grail of carryover into every day talking.
There are numerous other considerations besides what activity to use. One consideration is how to pitch the task for optimal therapeutic value. Much of my coaching, focuses on eliciting the right language level so that the child says as much as possible but without stuttering. I want parents to be able to flex up and down from single words to longer sentences depending on the child’s capacity at that moment. Future posts will look at how to ensure that talking practice has impact.
My Mantra is “Are We Having Fun?”. One aim of treatment is that when the child is much older, if they can remember going to therapy, they may recall that it was fun but not much else.
Have Fun everyone!