How Do You Solve A Problem Like Maria! - Ep. 045

Basic listening skills are critical to language and reading development, but if they’re missing how do you begin to work on them? Episode 45, “How Do You Solve a Problem Like Maria?” is full of ideas and activities for building this foundational skill. This is one of the most useful things I do with young clients!

--- Podcast Links ---

Sheep Coloring Page is available in my Free Resource Library! 

Phonological Awareness Tracking Form 

Simple Tools with Denise B-I-N-G-O! 

Music: Simple Gifts performed by Ted Yoder, used with permission

Transcript

Denise: Well, I had my puppets out one day and stuffed animals. I can't remember what I was doing, but she sees them and she goes, puppet show, 'Niece! That's what she calls me, is 'Niece. And she ran over and grabbed these adult chairs that have holes in the backs, and she ran behind them. She started talking her puppets through the holes, which is great, great for imagination, but she didn't need to work on imagination.

We're supposed to be working on this thing. I'm not quite sure how to work this in. And if I pull you away, you're just going to lie on the floor. So it was a bit tricky to navigate. I felt like I had her attention, but only on the surface, I have a surface attention. I couldn't get underneath.

Welcome to The Mindful SLP, the show that explores simple but powerful therapy techniques for optimal outcomes. I'm Denise Stratton, a pediatric speech language pathologist of thirty years. I'm closer to the end of my career than the beginning, and along the way, I've worked long and hard to become a better therapist.

Join me and I'll do my best to make your journey smoother. I found the best therapy comes from employing simple techniques with a generous helping of mindfulness. Joining me in the conversation is Dan, my technical wizard and office manager.

Background Music: Um, how do you make her stay, and listen to all you say, how do you keep her wave upon the sand? How do you solve the problem, like Maria? How do you hold a moonbeam in your hand?

Dan: Well, that comes from one of our favorite musicals, The Sound of Music, and it actually describes one of Denise's clients really, really well. She has a client named Maria and she is a moon beam on the sand. Tell us a little bit about how this ties in today, Denise.

Denise: And she's not really named Maria, just saying. We're protecting her privacy, but she was one of those clients that we talked about in our podcast, That Thing That's Not APD, the thing that's not Auditory Processing Disorder. But she definitely had difficulty processing auditory information. So wherever category you want to put that in, however you think about auditory processing disorders. We are thinking of it as children have difficulty processing auditory information and they need direct intervention.

Dan: And so that's what we're going to talk about today is some of the things that you've been working with Maria on trying to help her.

Denise: And I've been working with her for quite a while but when she first came to me, this is what she was like. Yeah. She is on the autism spectrum. But as with many girls who are on the autism spectrum has some impressive social skills.

In fact, she had some impressive language skills. I mean, she was speaking in sentences, not grammatically correct sentences. You could have a conversation with her. She didn't understand wh questions, she couldn't describe past events or a sequence, her imagination is super strong. I mean, really good imagination, as stubborn as any autistic kid could be.

Dan: And when you have a good imagination with a stubborn autistic kid...

Denise: Once an idea was in her head, it had to be executed.

Dan: And that's where she was like the moon beam on the sand.

Denise: As this came to me, I was singing the song How Do You Solve a Problem Like Maria, I came to that line and I was like, I have a Maria. Just imagine you have an activity all planned. You have certain goals you want to meet. And I do like to do child therapy to a certain extent. But when Maria sees it and we're just like, woo, we are doing this all of a sudden, like...

Dan: Wait a minute, how did we get to do a puppet show all of a sudden?

Denise: I had my puppets out one day and stuffed animals. I can't remember what I was doing, but she sees him and she goes, puppet show 'Niece. That's what she calls me, is 'Niece. And she ran over and grabbed these adult chairs that have holes in the back. And she ran behind them, she started talking her puppets through the holes, which is great, great for imagination, but she didn't need to work on imagination.

Um, and I'm like, we're supposed to be working on this thing. I'm not quite sure how to work this in. And if I pull you away, you're just going to lie on the floor and refuse to do anything. Um, so it was a bit tricky to navigate. I felt like I had her attention, but only on the surface. I have a surface attention, I couldn't get underneath.

Dan: Kind of reminds me of this movie we saw, uh, this is going to date us a little bit, is called Parenthood. Way back in 1989, Steve Martin, Mary Steenbergen. But in there, there is this one couple, and Rick Moranis and I can't remember the actress, but he is so focused on his daughter, absolutely focused, he is going to make her into an Ivy League graduate at age six. And he is just, just laser focused on everything she does. The marriage has fallen apart and she actually gets these cards. Cause he's always using flashcards with the daughter. And so she's sitting there and making him read one flashcard at a time. 'This is the only way I can get your attention. I want a divorce.'

Denise: And she got his attention. So that's what I felt like with Maria. Like I needed some kind of flashcard thing to get her attention. And so that's when I first thought of the bingo activity, which I released that Simple Tools video a few weeks ago of me clapping hands with a client while we're singing the bingo song.

Dan: It's cute, you got to go see it, folks. SLP proadvisor.com. Look for the Simple Tools video B I N G O. It's also on YouTube.

Denise: Yeah, that client is darling, that's not Maria. Obviously, it's a boy, but it was for her and the goal was for her to look at me with attention. Now she did have eye contact. I mean, it wasn't like she couldn't make eye contact, but I wanted her focused attention.

And the goal is not to necessarily clap in rhythm all the time. Especially when you're tapping on your knees, which is how we do this. There was a farmer, had a dog and Bingo was his name oh. I don't have to mark every syllable accurately. She was a preschooler, but when we clap our hands together and sing B I N G O of course, she's going to be in sync with me.

And the idea is that she had to look at me in order to match my hands. That's the idea with every client and what was so interesting is her eyes would go off in different directions, she'd look up at the ceiling off to the side and she'd miss my hands because she wasn't watching me. So this child with some strong language skills, very strong imagination, some strong social communication skills, was missing my hands because she wasn't looking at me and didn't realize that she needed to, and that bingo activity, just that one activity, it kind of broke the ice for us, made a huge difference. And then I started to be able to make some inroads.

Dan: So tell me about some of the other early listening activities that you have that you worked with her on.

Denise: I'd love to, I'm so excited to share these activities with you because these form, the first section of my phonological awareness tracking form, and I call it listening games. This comes under early listening. I didn't know quite what to call it. It's not quite phonological awareness, but it's definitely needed.

Dan: You can get a copy of that phonological

awareness...

Denise: Phonological Awareness tracking form, like I couldn't think of a shorter name.

Dan: That tracking form is available at slpproadvisor.com and also Teachers Pay Teachers.

Denise: The first activity on the list is identifying environmental sounds.

Dan: What's an environmental sound?

Denise: Like water dripping, a police siren. Now those are pretty easy. But what was interesting is when she wasn't paying attention, when she wasn't looking, she'd choose the wrong picture to match the sound that she heard. She was missing it because of her attention, not because of lack of knowledge. That was pretty easy for her to get through once I got her attention focused on that, and then we moved to identifying animal sounds, which you could call it environmental sounds, but animal sounds are great. There's so many of them. Yeah, you're kind of narrowing down your ability to discriminate from these wide environmental sounds to just animal sounds.

Right. And by the way, I'm developing lots of products to support this and they'll all be available at some point.

Dan: Yeah. We, it takes us a while to get it, but trust us, we will get it out there eventually. So keep checking back.

Denise: So identifying animals sounds again, they just hear the sound like the dog barking, and suppose they have two pictures in front of them. Or three, depending on where they're at and they have to choose the picture that matches the sound. Yeah, these are pretty easy for most clients, but they're kind of important to get them set up for where they're going to go. So I don't skip them. I just check that they can do them. And if they need to spend a little bit of time on it and we do.

After they can identify animals sounds, this is where the real meat of it begins. Remembering two sounds in a sequence.

Dan: That's important, the sequence.

Denise: The sequence is very important. And I do have some ideas for doing this. And I talked about it in my earlier podcast about the phonological awareness tracking form, but I really love this idea so much better, what I do now. I have them remember two animal sounds in sequence, because we've just gone over identifying them. So I have picture cards of animals, which I'll have available when this product is done. And I'll lay them out three, maybe four, face up and we just practice those animal sounds in order.

And then with the cards still face up, I will say two of them. And then I want them to repeat after me when they get really good at that, we turn the cards over or we hide them and I say two sounds, and they repeat it and that's where it gets kind of hard. They might remember the sounds. They might not remember

Are you making the sounds or are you saying the name of the animal?

No, I'm making the sounds.

Dan: Okay, and then they're saying the name of the animal.

Denise: And they're saying the sounds back.

Dan: Oh, they're just parroting the sounds back.

Denise: But yeah, we're just going cock-a-doodle-doo and hee-haw.

Dan: And they have trouble just parroting back what you do in order.

Denise: Yes, they have trouble remembering the sounds, and so when they get good at that, then I'll bump it up to three sounds. And when you bump it up to three sounds, you may have to keep the cards face up again and then turn them over so they can't see them. These are building this auditory memory, the ability to remember and repeat things in a sequence.

So it's like pre remembering letter sounds in sequence. Okay. That's the next two sections. Remember two sounds in sequence. And remember two-plus sounds in sequence. So I pretty much just go up to three sounds before I move on.

Dan: And then detecting changes and familiar words. That's another section, right?

Denise: And familiar wording. So a familiar wording would be like a very familiar nursery rhyme or sound like baa baa black sheep, which I love baa baa black sheep.

Dan: Because there's cotton balls and dots you get to play with.

Denise: First of all, four words, and two of them are the same. baa baa. Baa baa black sheep, so pretty easy entry-level to remember. And there's a couple of activities I do with this. And one of them is also an articulation activity. So there's a crossover there if you're just working on baa like someone who can't get the B followed by a vowel. So I have a picture of a mama and a baby sheep, and I have cotton balls and we put glue on the cotton balls and we put them on the mama and the baby sheep and on the clouds in the sky and all that.

So if you're doing our tick, you know, up for the sky, ma or mama, bah, all that kind of stuff. But if you're doing this for the early listening skills, you're going to practice saying baa baa black sheep, until they know baa baa black sheep. And then what you're going to do is you're going to say, I'm going to say it a little bit differently, can you figure out how I'm saying it differently and you might say baa baa purple sheep, or you might say baa baa black dog, and they need to hear where you change the rhyme. And where the colored cotton balls come in, is you can have a lot of fun with just changing the color name. And as you're doing this gluing activity, you can say baa baa pink sheep and choose pink cotton balls, the yellow cotton balls.

They only come in these pretty pastel colors. You get like three different colors, but that's really fun. As another way you can do this recognizing changes in familiar wording. So again, I'll use the example of baa baa black sheep, but I have these carpet dots. The kind that you put around a circle and preschoolers would sit on to know where they sit, right?

So I'll put four out, one for each word and baa baa black sheep, and we'll walk on each dot as we say each word. So that is a one-to-one word to marker correspondence, which actually occurs later on the phonological awareness tracking form. But you can avoid doing a little bit of this if you're trying to teach them just those four words. So this creeps in a little bit earlier in this activity, but if you don't make your rhyme too long, they can handle it. Then they can identify what marker you're standing on when you got it wrong and they'll try and imitate you. So it's really fun that way, you know, and you can change the animals sound too, like quack quack black sheep. Oh yeah. What did I do wrong? You know? No, that's a duck, and they have, and everything I do here, I should mention, I do the turn-taking. I'm also demonstrating. And when we do the backing up here, sorry, backtracking. But when we do the sequencing of the animal sounds, they take their turn. And they sequence to animal sounds and I have to remember it for them. So model, model, model, always model.

Dan: What about following sequences in two directions? What have you done with that?

Denise: You want to make it directions they want to follow, because preschoolers don't necessarily want to follow directions. It's true. I have cards with lots of physical movement on it, like turn around and touch your nose, do a jumping jack.

And so they like to do that and I'm preparing that product too. I will again, have both cards in view, and they choose them. They choose what they want me to do, and I choose what I want them to do. And we take turns, then I'll turn the cards over so we can't see them and say, now, can you remember what to do? So it would look like this, you would hold up a card that said, touch your nose and a card that said, do a star jump. And they would do that. Then you put the cards away and give the direction again. You know see if they can remember both of them.

Dan: Touch their nose and do a star jump. You actually say the directions and then they have to remember to do them.

Denise: Yeah. I say them again with the pictures gone, cause they need that, and then they do it and then they get to do it for me. They get to tell me what to do. And when they're at a certain point, I'll mess up when they're at the point where they can recognize that I'm messing up. Cause they love to catch the SLP in a mistake, right? And once they're really good at that, then we bump it up to three directions and here's a little caveat, some kids are not ready to go to three directions for a long time. And I won't let that stop me from going onto the next section of the phonological awareness tracking form. I just recognize, I do want to come back sometime when they are ready and do three directions, but you'll, you can tell they'll just stop, won't be able to move on. And there is one more activity that I do for following a sequence of two or three directions, and that's with mini m&ms, and again, the carpet dots, which I just talked about, which half of my carpet dots on the bottom of them on the back of them are laminated pictures of m&ms.

And when one of those gets turned over, they know they get a mini m&m. Sometimes they need that extra motivation to follow directions, and we'll all just have different colors out and I'll say, touch the yellow circle and touch the blue circle. Just that simple and having them remember to follow that in direction, you'd be surprised how hard that is for some of them.

And then once they touch them in order, then they get to flip them over and there might or might not be a mini m&m, which keeps the game fun and exciting. Always make sure there's one.

Dan: Yes. So this has worked well for some of your clients. Tell us some stories.

Denise: Well, as I mentioned, it worked really well for Maria. I have another client too. When he came to me, I could only describe him as a wild child, very engaging, very social, but just could not listen to directions. At school they were going to put them on a behavior plan and this is a preschooler, but as he got better and better at listening, then the behaviors got a lot better and they didn't need to put him on a behavior plan.

And also. he would just say this one, this one, that was his go-to answer response to everything was this one. Cause he couldn't remember words, but he can remember this one. Yeah. That's what he grabbed onto and that's what he would respond to.

Dan: So that helped him get more and then he actually settled down.

Denise: Well, it helped him with word recall and with behavior. And if you can't really process what someone is telling you, he was kind of using it as an escape. Well, I can do what I want to because he knew what the expectations were. I think that like, I didn't hear you. I didn't process it. So I'll do what I want. Another client had been neglected as a baby and a toddler, and they're not even sure how much her mother even spoke to her.

So when she came, her language is just so poor, just really mixed up. And she had a lot of social emotional needs and difficulty listening, of course, just because all the trauma that had happened to her and it was a huge help for her too. She needed to learn that attention. These three clients. I started this with them all at about the same time and this got them halfway to telling stories.

Now, when a client can get to telling stories, that's huge because they learn so much complex language that's involved with telling stories. That got them halfway there. So come back next time to hear the rest of the story about how they got to the point where they could tell stories, which they are all three doing now.

Dan: All right. So we'll have to come back next time to get the rest of the story. Thanks for joining us today. Remember a lot of the information that we've talked about will be available for you on the show notes at SLP ProAdvisor. We look forward to talking with you soon. Thank you.

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