Follow the Narrative Road - Ep. 046

Let’s hear it for Narrative Intervention! Kids learn so much language with narrative therapy. But what if they seem ready for stories, but still can’t quite grasp narratives? Even when you use the most basic story they still struggle. Maybe they need to work on sequencing. In this podcast we discuss how to get our not-quite-ready-clients from here to there, by following the narrative road.

--- Podcast Links ---
Picture the Sentence 
Balloon Car 
The Story of My Life by Helen Keller 

Phonological Awareness Tracking Form 

Related Podcast Episodes
How Do You Solve a Problem Like Maria? 
Narrative Language with Doug Petersen Part 1 
Narrative Language with Doug Petersen Part 2

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

Transcript

Denise: Yeah. I asked Doug Peterson, what do children need before they can tell stories? And one of the things he said is they need to understand sequence. They need to understand order. Well, that totally makes sense, stories happen in order to have to happen in order my phonological awareness tracking form that has the early listening skills, it's got some sequencing. It's got a little bit of it, like having them remember two sounds in sequence or follow two directions, but it's really minimal, it's not enough to get some of these kids to the point where they can tell stories.

Welcome to The Mindful SLP, the show that explore simple, the powerful therapy techniques for optimal outcomes. I'm Denise Stratton, a pediatric speech language pathologist of 30 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.

Dan: Welcome back to The Mindful SLP. Today, we're talking about following the narrative road. Now when I saw this podcast, I immediately thought of the yellow brick road. And I guess it kind of fits because we're talking about the road to telling stories. How do you get a child to go from zero to having that ability to tell a story?

Denise: That's a really great question. Some of our preschoolers come and they're ready to dive into telling stories and some of them aren't.

And in our previous podcast, that was episode 45, How Do You Solve a Problem, Like Maria? I talked about three clients, that I was able to take from not even forming complete sentences to telling stories. Right. And the previous podcast talked about using my phonological awareness tracking form and early listening skills and how that got them halfway there. Well, this is the rest of the story.

Dan: Earlier this year, you did an interview with Doug Peterson. He's the guy behind Story Champs. That is a great program for helping people develop storytelling skills. You're talking about something that happens even before that.

Denise: Yeah. I asked Doug Peterson, what do children need before they can tell stories? And one of the things he said is they need to understand sequence. They need to understand order. Well, that totally makes sense. Stories happen in order, they have to happen in order. My phonological awareness tracking form that has the early listening skills, it's got some sequencing, that's got a little bit of it, like having them remember two sounds in sequence or follow two directions, but it's really minimal. It's not enough to get some of these kids to the point where they can tell stories. There are three main things I noticed that these clients needed to do before we could do narratives effectively. So that's what we're going to talk about.

Dan: Okay. So there's three things. What are they?

Denise: An idea of order or sequence even if not perfect. Being able to talk about what they have done and not just being absolutely just in the present, not having a past or a future. They need to be able to use direct objects in their sentences. And beginning propositional phrases, although direct objects in my mind come first. I mean, imagine trying to tell a story without being able to use a direct object. You're going to have really, really simple sentences.

Dan: Stories are all about direct objects and what happens to them. And there were three?

Denise: Describing a related sequence. So what you're describing is connected to each other, right. Using direct objects, early prepositional phrases. So it's a combination of the above skills and the cause and effect kind of naturally follows from that.

Dan: Okay. Well, let's dive into this a little bit, then. Let's start with number one, an idea of order or sequence.

Denise: One of the things I noticed about my clients is they couldn't go into the waiting room and tell their parents, what they had done, what they had just done in therapy. And I thought, oh, that's gotta be important to telling stories, right? Exactly. You don't even know what you just did or maybe, you know, but you don't know how to tell it. So I started making therapy books with them.

Dan: What's a therapy book?

Denise: It is so low tech, the best kind. I couldn't even put a freebie out there for it because all you need is a piece of paper for me, you know, a piece of computer paper, I fold it in half and I get the crayons out. And what I've got is a four-page book. So what we do is we document every activity we do as we go along and they draw it. And I write at the top what we did. Next activity, we turn the page, we go to the next page, they draw it and I write what we did. Now, me writing what I did has a twofold purposes. So I'll say first we played ball. Next we played with Play-Doh, right? But also it gives the parents a clue what happened, right? Because their pictures aren't always even pictures. The pictures aren't always clear, but also I want the child to use it as we go through therapy. And if their pictures aren't clear to them, I will sketch a little bit too, because this is their visual reminder.

This is building memory for them, right? So sometimes you need to be a little bit of an artist too, and they can color what you drew. So for example, a book might be, first we read a book. Next, we played with balloons. And last of all, we played with puppets.

Dan: Okay. And that gives them something that they can take and show mom and dad. And even the parents can, you know, you're going to take this artwork home and post it on the fridge. Throughout the week, they can talk about now what did you do at therapy again? And bring that back in.

Denise: And I encourage parents to make books at home about what they did and talk, talk, talk about it. As we're going through the therapy session, we refer back to this book, you know, every time we do an activity, but we go back to the beginning and start at the beginning. First we did this, next we did this, and then we draw the next picture, review it again. And right before they go home, when we review it again. Maria's mom commented after we had been doing therapy books for a while, that she was starting to be able to answer wh questions.

Dan: The what were why when...

Denise: Yeah, those and what I love about this, this is a subversive way to work on wh questions. I mean, they don't even know they're working on wh questions, right? And sometimes we have a lot of games, a lot of special cards, a lot of special activities just to work on wh questions. Well, you don't really need that.

Dan: And this is something that's so natural and they can, and being low tech can be done at home.

Denise: Yes. And it's so conversational. I'm not actually asking them a lot of wh questions. I do ask them a few, try to help them remember, oh no, what did we do? But we talk about what we're doing. It's a very conversational, very natural way to teach them a whole ton of things. Sequencing, wh questions, conversation, a whole ball of wax. It's great. This is one of my number one favorite things to do SLPs with the kids who need it. And it's so drop-dead easy. These therapy books fall under the simple tools, optimal outcome tagline that we have, the simplest tool and the most optimal outcome.

Dan: I can hardly wait to get out the crayons. Number two, using direct object.

Denise: It's really hard to tell the story, as I said, if you can't even put a direct object in your sentence, So for clients who have difficulty with building a basic sentence, there is an app that I love and it's called Picture the Sentence.

I hardly ever use apps in speech therapy. I'm just too lazy to go find new ones, but this one is great, that I stumbled across several years ago. And what it is, it's really a receptive app. Although I use it for expressive language, it's got pictures of the pronoun he, she, or they and a verb. So first you've got, he is running. She is eating and they have to identify which picture matches. But what I use it for is after they identify receptively, which is super easy for them, I have them repeat the sentence and then it goes to the next level. She is eating a cookie. So then you've got your direct object in there and I have them repeat that.

And then it's got a next level, which includes a prepositional phrase and it just goes up and I only do like 10 sentences max and then we go on, but it kind of sets them up for success. It gives them a sort of a template. This is how a sentence goes. This is how a sentence goes, it has a direct object, or this is how a sentence goes, it has a prepositional phrase. That's a great and I'll link that.

Dan: Picture the sentence, okay.

Denise: And now there's lots of other activities I do also for direct objects and prepositional phrases that are play-based, like we go shopping, put things in the basket, lots of things. You know, you can think of them all, but this is a really great activity to do before you start that.

Dan: Finally the third one, related sequences.

Denise: So what'd you want to do is have an activity where you've got steps that are related and that lead to an effect. Okay. So I use my balloon car. It's a really cool cause and effect toy, and it's got three steps. So I have a picture of each step. It's a highly motivating activity too, and that's great.

So I lay the pictures out in order and we have to go over each step before they can actually do the toy. I don't have them say the first step. Do the step, say it, do it because that breaks up the whole sequence if you're trying to blow up a balloon. You don't want to stop it, right? Uh, so we just cover the sequence, they have to say all the steps.

Dan: It helps with the memory as well.

Denise: And then we let the balloon go, so we're not interrupting it. Right. So they have to say, put the car on, fill it with air or blow up the balloon. Uh, huh, push the button. I mean, it can be that easy.

Dan: Yeah. And for those who haven't seen this, this is a little car that has a balloon it uses to, to propel the car, but you have to hook it up to the little pump so that it'll hold it there while you're pumping up the balloon.

And it has a great little handles for pumping up the balloon. So nobody's getting spit all over the place, which is great. And then there's a button to release the car, which allows the car to go shoot off across the table or the floor.

Denise: And what is fantastic about doing this kind of activity is they don't say it the same way every time, which is what you want.

You want that flexible language. Sometimes they might say, fill it with air. Sometimes they might say, pump the handle. Sometimes they might say, make the balloon big. And I just let them say whatever they want, as long as they say something about the step. And so they're exploring all these different ways to talk about a sequence and it's related, it's a cause and effect thing that they're not using the because yet that's down the road.

Dan: But what if they get the sequence out of order?

Denise: Well, we just refer back to the pictures, right?

Dan: Yeah. But do you let them, do you correct them?

Denise: Yes, yes I do. Because I want this sequence correct. No, I'll do it say it this way.

I learned that from Story Champs. You know, you just go back and I make them start at the beginning, actually. I want the sequence from beginning to end to be correct, uninterrupted, so they get this template in their mind. Okay. Now what they say. Their sentences don't have to be perfect. I let them struggle a bit to figure out how to say it.

Sometimes I stop for a minute and they struggle with the word at the end of the sentence, that direct object or that prepositional phrase. And there could be verbs could be wrong. Uh, articles can be omitted. It's fine. It's fine. I've got this great quote by Anne Sullivan that she wrote about Helen, as Helen was going through this stage of just learning language.

She wrote, she makes many mistakes, of course, twists words and phrases, puts the cart before the horse, and gets herself into hopeless tangles of nouns and verbs. But so does the hearing child, I am sure these difficulties will take care of themselves. The impulse to tell is the important thing.

Dan: That's important.

Denise: And that's exactly what I see with these kiddos. Ah, they get the words mixed up sometimes. They get the order mixed up. It seems like a tangle, but if the steps are there, we're good to go. And it does sort itself out the more they practice it. And the more they practice it, it starts to, their language starts to sort itself out, but they have the impulse to tell the story.

They have the impulse to go out into the waiting room and say, this is what I did. Finally, if something goes wrong in this activity, like a balloon popping, oh, boy, then you got a problem and you've got a story. So that's what happened to me. I was working with Maria when she overinflated the balloon and it popped.

And I thought, well, maybe she's ready to tell a story. So I grabbed a new piece of paper for a new therapy book, right, for the steps of our story now. We were playing with the balloon, the balloon popped. I was scared. You know? Cause you jumped a little bit. Yeah. We got a new balloon. We pumped it up and let the car go, you know, then she had a story and she could tell it.

And so then with my other two kiddos, I was like, oh. How can I create a problem? Let me see if they're ready to tell a story. And they were pretty soon after that, ready to tell stories too.

Dan: So you used a pin on the balloon?

Denise: I can't remember exactly what I did to be honest. Um, and with kids who are sensitive to loud noises, you might not want to pop the balloon.

Maria can handle it, but yes, you can kind of test them. Oh, I re are they ready to talk about the problem?

Dan: Problems are natural and happen all the time, and that can help them deal with problems when they arise.

Denise: Well, it helps them tell the story, right? Cause that's how every story has the problem, the feeling about the problem, and the action.

Dan: But that helps them also in their life to be able to deal with problems because they can frame it in the context of a story as they go.

Denise: That's why we teach them stories. Well, one of the reasons.

Dan: Let's go back to the phonological awareness tracking form. How does this fit in again?

Denise: That is a great question. So what I realized when I was working with these clients on the early listening skills is they were not ready, after they had mastered those early listening skills, to jump into phonological awareness.

They weren't ready to jump into the rhyming with both feet. I've got this quote I want to read, it's from a website called Reading Rockets, but this is about prerequisites for phonological awareness. Prerequisite to phonological awareness is basic listening skill, that's what we worked on, acquisition of a several thousand word vocabulary, the ability to imitate and produce basic sentence structures and the use of language to express needs, react to others, comment on experiences and understand what others intend.

So a lot of that stuff, the acquisition of the vocabulary. Imitating and producing basic sentences. That's tied up in... Yeah, that's part of this road. So it's not on my tracking form because it's not part of that, but it can be a nice little insertion. If you have a client who completes the earliest needs skills and is not ready to jump into the rhyming, you can do this.

And I do do lots of, um, rhymey books with them, and nursery rhymes, things like that. To help them get ready, you know, and I so encourage parents to do that with their kids too, but they aren't ready to start thinking about rhymes, generating rhymes, telling me what rhymes in the rhyme families, that kind of stuff.

It just blows their minds. Yeah. So this is a great way to not only prepare them for beginning phonological awareness, but also to prepare them to tell stories.

Yeah. And that makes sense. I mean, when you're starting on a road, It's really nice to have it start out simple and easy, like Dorothy, where the yellow brick road started in a little tiny circle and she just had to walk the circle before she went off into the forest.

Get some confidence, get them used to doing things, and help them kind of ease into some of these harder things so that they can just naturally progress right along the narrative road.

Oh, you summed that up very well.

Dan: Well, thank you. All right. Well, come back next time. We'll have some more therapy tips for you. Thanks for listening.

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