Therapy Techniques

Need some fresh ideas for your therapy sessions? Check below for original and submitted activities to try. If you would like to add your favorite to this list, go to the Forums and submit it there.

Share One Thing
As a way of encouraging early generalization skills, I allow my students a "share one thing" time at the beginning of therapy. They are expected to try to use their target sound correctly during this time. They are very motivated to correct an error if pointed out, as they are anxious to "share one thing" with the group. Charting can be used to track errors or self-correction so the child can see improvement.

Chewing /R/
It is often difficult to get a child to elicit the /r/ sound correctly. A technique that sometimes works well is to have the child chew gun energetically with the mouth open while attempting to say /r/. Chewing the gum really gets the tongue moving and exploring different positions.

Word Board
As a way of making articulation therapy relevant to a child's real-life environment, I keep track of the words that the child misprounces in day-to-day conversation. I write these words on little colored cards. When the child comes in for therapy, we quickly go through these words for a beginning warm-up drill. Sometimes I attach them to my Word Board bulletin board with their name nearby. After they no longer have difficulty with these words, they can remove them from the board and throw them away, or take them home to read to their parents.

Rather than have my students stay in one place throughout the therapy session, I have stations set up around the room. Once they are able to self-monitor their speech, they can move from one activity to another, while still staying focused on the personal goal they have for the session.

Listen Up
In my therapy sessions, I use a cue when I am about to give directions, to make sure everyone knows that this is "tune in" time. The kids know this "listen" signal means that in case they have mentally wandered off, they need to immediately practice good listening skills again, such as sitting up straight, face the speaker, hads and body quiet, etc.

Two Points!
Sometimes when the therapy session is nearly over, I have the child finish the worksheet they are working on, stand back a bit, crumple up the paper they have just completed, and make a basket into the trash can. It's such a satisfying way for them to end the session, and they leave with a smile on their face as I cheer loudly for them!

Standing Tall
This technique probably won't appeal to all therapists, but the kids love it as a reward for good performance, or as a way of breaking up the monotony of drill word lists! I draw large footprints on my table with a washable marker and then the child is allowed to stand up on the table and go through their drill one more time. It's fun for them to have their head up by the light fixtures, sending down the words or sentences, while seeing admiring grins from their fellow students and the therapist down below!

Talk With Me
My young adult student uses a Dynavox for communicating. As happens with many individuals with AAC devices, over the years he had learned passivity in his communicative interactions, only answering simple questions, and never initiating conversation. We decided to begin a story-writing project. I would ask him what he wanted to write about and he would answer with a simple topic. I would then ask him questions about this topic, gathering information to be used in the story. I would compose a sentence about what he had told me and he would answer "yes" or "no" as to whether it was accurate. I would make changes accordingly until he would indicate that it was what he wanted to say. He also carried a three-ring binder with him on the wheelchair with copies of his stories in it. After the story was written, I would program it into his device. I also programed the messages "Would you like to hear my new story?" and "You can follow along if you like. It's in the binder on the back of my wheelchair", and "Thanks for listening"! We then would travel throughout the school and meet with various school personnel, who would be happy to take the time to hear his story. I often would meet with these people beforehand to share with them what was about to happen and some suggestions for interaction with AAC users. My student would find great joy in these assignments and worked hard to carry them out. He was in charge of his communication, enjoyed the communicative interaction with others, and his communicative partners had the opportunity to learn more about this young man and his capabilities.

Online Stuttering
I have found that many of my stuttering students, since they have not met another stutterer, feel that they are the only ones who struggle with dysfluency. One way to make them more aware that there are others with similar difficulties is to take them on a tour online to stuttering sites, such as The Stuttering Home Page. Here they can read about others who stutter, (many of whom are famous people), their feelings, and techniques they learned to help overcome dysfluency. When the student reads about these people (this can be a good time to practice their techniques for smooth speech), they begin to understand that they are not alone, and sometimes feel more comfortable discussing their feelings about stuttering, so we can begin to find strategies to deal with these feelings in a positive way.

Who Am I?
A truth that many stutterers have trouble grasping is that they are a product of many different pieces of personality, all pieced together to make up the wonderful person that they are. An activity I often use with individuals who are dysfluent is to give them a homework assignment that they can work on with their parents and siblings. They are to come up with a list of as many attributes as they can that discribe the stutterer, such as "pizza lover, slow-moving, cute, sometimes silly, athletic", etc. After they bring this list back to therapy, we put a digital picture of them (or write their name in big letters) on a piece of poster board. Surrounding their picture, we write these attributes, using a variety of letter sizes, colors, positioning, etc., being sure to add "sometimes stutters" as one of the attributes. I have plenty of creative materials on hand to decorate the poster, such as markers, glitter, paint, glue, etc. While we work, we discuss how being a stutterer is just one small piece of who they are. The student can then take this poster home and hang it on the refigerator, in their room, or wherever they want, to remind them how special they are. This is a great visual reminder of how being dysfluent is just one small part of the total person. It always involves the family and keeps the stuttering in perspective for them to. I have also walked with the student to the principal's office, or the classroom teacher, and encouraged the student to show them the poster and explain what it's all about.

I Say - You Say
When teaching irregular plurals, I show a picture of an object, such as "mouse" and say, "I say mouse. You say mice", while showing a picture of more than one mouse. After awhile the child understands the pattern, and then I say "I say goose. You say -----", and the child will fill in the missing word. When we are finished with all the pictures, I lay them on the table in pairs, and the child reviews them, saying mouse and mice, goose and geese, etc. while pointing to the correct pictures in the pair.

Fluency and Hot Glue
I have found that my stuttering clients appreciate a break from always being "on" when they are speaking. On occasion, I suggest they try out their strategies of easy onset, light contact, good phrasing, etc. when they are doing more unstructured activities in my room. I use this technique when I need to remove seasonal items from the walls, and put up new materials. They help me take down and redecorate, as we chat. The focus is not solely on them, and they can feel comfortable practicing their fluency strategies in a more natural, relaxed environment. (Also, as long as I'm on the topic of decorating, I don't know about you but I have struggled for years to keep my posters, pictures, etc. hanging on the walls of my room. I tried various types of tape, sticky putty, etc. Nothing stayed. Then I discovered the hot glue gun, found in craft stores, Target, etc. It's quick, easy and has staying power for the entire school year. I find the glue is easy to remove when needed, but just to be sure, test an inconspicuous area first to be sure the surface area isn't damaged) .

Magicians Never Tell
For additional drill, I hold up a picture containing the target sound with the front facing me. They have to "guess" which one I'm holding. They're always right and loving it! (the picture shows right through the paper I've copied it on!) It's amazing what good guessers they are, and when I ask them how they do it, they reply, "Magicians never tell!"

Quick Eyes!
When the child is drilling with minimal pair pictures, etc., it is sometimes hard to stay interested when asked to go through the words yet another time. To disguise more practice, we play the game of "Quick Eyes". I make sure they're ready and looking, and then I flash the picture very quickly, allowing just the tinest peek, and they have to tell me what they saw. I vary the speed according to the child and always give lots of praise when they say the word, telling them that they have such quick eyes in seeing the picture I have just flashed.

Hallway Therapy
Sometimes as the children leave my therapy session, I give them an assignment to do quietly in the hallway, if two or more have to walk in the same direction to get back to their classroom. This can include finding words containing their target sound on their walk back to their class, talking about a certain topic while using good speech, counting to 100, etc. Each child acts as the "teacher" for the other, making sure they are using the correct sounds. This adds on a little more practice time, and encourages using good communication skills in other environments.

Don't Leave Yet!
When it's time for the children to leave the therapy session, I ask them to think of three words, sentences, or whatever is appropriate. They have to whisper their responses in my ear before they can leave the room.

Coffee Can Echo
I take a large coffee can, cover it with shiny, fancy paper, and cut a slit in the plastic cover. I use this can often when the child is doing routine drills, practicing responses while looking at picture/word cards. After the child says the word, he puts it into the can, and then speaks into the can, saying the word one more time. This produces a delightfully spooky, amplified, echo-y sound that is fun for the child to hear, while encouraging additional practice of the target. I tell them that the can is filling up with wonderful sounds, getting heavier all the time. When the child is finished, we take the top off the can, releasing all these correct responses into the air, as we say the correct target response over and over again, with the sounds flying through the air and filling the room, after escaping from the can!

End-of-Year Fun
Near the school year's end, I have scissors, colored paper, pens, pencils, crayons, markers, tape, stickers, etc. available when my students arrive. Their task is to make themselves an assignment, which they will be expected to complete when they return in the fall. The children are very creative and come up with ideas such as writing letters to themselves which are loaded with "hard words" containing their target sounds or language objectives, creating games, complete with spinners, moving pieces, etc. We then put these assignments in individual envelopes and the students write their names on them. In the fall, we open them on the first day of therapy and they really enjoy remembering and seeing what they had done that past spring. We read the letters, play the games, and get reacquainted, while celebrating their cleverness.

Twirling Words
Put three words or pictures containing the target sound on a piece of paper measuring about 6" x 2". Add different words or pictures to many slips of paper this size. Put the students' chairs facing each other in a clear area about 2 feet apart. Have the students pretend to put glue on their chairs and then sit down, reminding them that they cannot leave their chairs. Choose one person to be first and toss a slip of paper up in the air above her/his head. The student's job is to catch the twirling piece of paper without leaving the chair. If it falls to the floor, it is left there to be picked up later for a "second chance". If the student catches the paper, h/she reads the words and puts them into a sentence, using good speech. It is then the second person's turn. This is a noisy, active game that always provides alot of fun and laughter while the children practice their target sounds in a natural spontaneous setting. If you like, you can count who has the most at the end.

Let's Decorate!
I used to spend much time decorating my room prior to my students' arrival, and then stress out because I didn't have sufficient time to organize my caseload, locate the classrooms and teachers, etc. It then occurred to me that "getting the room ready" was an activity I could share with my students on the first day of therapy. Before the children arrive, I prepare and arrange my materials on the table in my room. As we do our decorating, we can discuss what each of us has done over the summer. The children love it, it saves me time, and I have the opportunity to listen to each child's speech, checking for regression or development during the break.

Teacher/Student Communication
At the end of each month, my language students have to go back to their classroom teacher and tell them what they have worked on that month, goals/objectives they have achieved, and goals/objectives they are going to continue with for the next month.

Adolescent Speech Students
For middle/high school articulation students, put the students in charge of listening to each other’s sound productions.

Articulation Folders
I find articulation folders beneficial. Each student has a folder that they can carry practice sheets home in. When it comes back completed, they get a sticker on their chart and when the chart is full, they get a prize from the box. The younger kids love this and ASK for their homework!

Point System
I provide a point system for my students 3rd grade and older for remembering to come to speech on their own.

IEP Goals/Objectives
I show the students their IEP goals/objectives. I have them cross off the ones that they have met. I think this makes it clear to the students the reason they come to see me, the progress they are making, and what must be done in order to be dismissed from speech.

Generalizing Skills
These is great for maintenance or as intervention for a speech sound the student is able to produce but needs to generalize; develop a “secret signal” that is known only to the teacher and student. (When the teacher tugs on her earring, accompanied by a verbal cue of just the student’s name, this is a signal to the student the he/she needs to restate the utterance appropriately.)

Concept Development
For concept development, I say, “I am thinking of something, chicken belongs, but elephant doesn’t. Pig belongs but zebra doesn’t.”

Activities Upon Arriving
If there are times when you are not ready to start with students right when they arrive, have pre-set activities/assignments for them to do without you. (Tell/write two things they did over the weekend, put a phrase on the board and have them find small words, rhyme with a specified word, etc.)

Speed Activities
I use “speed activities”, using 25 words or 25 pictures. Time a student reading/naming a list of target words to get a baseline time. Each time they read/name the list correctly and beat the baseline time by two seconds, they earn a reward.

Use a visual schedule (Polaroid shots) for students with ASD.

MSMI Team Teaching
Working with MSMI and MMMI students at the middle school, I team teach with the instructors to give the students a very functional approach to language. Some of the units I cover with the special education teacher are: phoning skills, food groups, cooking, laundry, problem solving, career planning, and holding a conversation.

Labeling Clothing
For early childhood, have the children name/imitate/sign outside clothing.

If a student isn’t really into what you have planned, but wants to work with something else, modify – be flexible. It helps to always have the student's goals/objectives in front of you so when you switch to some other activity, you will still have a clear idea where you're headed and choose an appropriate activity.

Progress Charts
I provide progress charts for my articulation children. I have a graph so they can see their percentage after each session. Then, after so many in a row, they move to the next level. Words move to phrases, etc. They like to figure out the percentages on the calculator and see their progress.

Speech Folders
I laminated a bunch of folders (one per student) and I both film the students with the week’s lessons/therapy activities or I send them home as “speech folders” so that homework gets home and back to me. So far, I’ve seen more progress in the children who take their folders home.

Self-advocacy skills are essential for every student who is communicatively disordered. Begin with defining self-advocacy, teach the necessary skills, and then spend time with role-playing to make the skills taught real to the student.

Social Language Group
I conduct a social language group with either the sped teacher or the social worker. Students invite friends for a cooking activity.

Stickers work to motivate young children! I often find them very inexpensively at rummage sales.

Team-teaching is helpful. I create stations or centers that focus on concepts, vocabulary, phoneme awareness, etc. for primary age students in the classroom.

Generalization Skills
When I feel my students are at a level where they are beginning to carryover their skills outside of the speech/language room, I have regular education students join us for a few sessions. This educates the regular education children as to what is happening in the speech room. I then assign them speech buddies. They help monitor and remind the speech student to “guard their speech skills” outside of the speech room. I find it is especially beneficial to my articulation and fluency children.

Making Materials
Students enjoy helping to make materials, so I often make flashcards, etc. during the session. We get lots of articulation and language practice, and I get to keep the materials.

Minimal Pairs
I have great success using minimal pairs and contextual-based strategies rather than just drilling.

Stuttering Home Page
I have used the The Stuttering Home Page quite a bit over the past couple of years and have found it to be very helpful. Last year my 4th grade student became an “email pal” with another stuttering student.

Adolescent Material
If adolescent speech materials are not age-appropriate, they are not very motivating. I use a lot of regular board games that they enjoy, such as Scattergories, TRI-Bond, etc.

Social Studies for Adolescents
I go into the Social Studies classes with older elementary students. Social Studies seems to have the most difficult vocabulary material for my students to grasp.

Remembering to Come
To help students remember to attend speech, use one telephone ring as a signal. The teacher doesn't have to interupt the class to answer it, and the student recognizes the signal that it's time for speech. Using a student planner works well too.

Hokey Pokey
Read the book “Hokey Pokey”, talking about right and left and various body parts. Then listen to the song, have everyone stand in a circle, and do the dance, emphasizing the concepts right and left. Put a piece of red tape on their right had to help them.

Tne flow and rhythm of music seem to enhance many language and speech skills. Use a piano, guitar, autoharp, etc. or just pound a rhythm on the tabletop, or clap in time to the music for added reinforcement.

Have the students graph their own data per therapy session so they are responsible for their own progress in speech/language class.

Data Collecting
For students who are close to being dismissed, allow them to be the teacher for the day; they can choose a game, modeling the sound or language items. It’s a change of pace and you can use the session to monitor the students’ speech, language use, and collect data.

Who Wants to be a Millionaire?
I have had my 4th grade language students create a “Who Wants to be a Millionaire?” activity for their teachers. They have to create 14 multiple-choice questions, and hopefully, will stump their teacher. Lots of vocabulary is involved.

Language Sample
Playing with Play Dough is a wonderful opportunity for me to sit back and listen to the child’s language. It’s important to remember to not always have it be teacher directed, but, rather, let the child take the lead.

Mystery Box
When working with language students targeting descriptive words, or when working in the preschool, I have a mystery box the children take turns taking home. The student puts an item in the box and writes three clues about the object. The other students try to guess the object.

Since the fourth graders work on poems, I have my articulation students read poems to other classes, or share their memorized poem with their class or teacher, using awesome articulation skills.

To encourage carryover for articulation, I have the student choose a 2-minute period in class to listen for words the teacher says that have the target sound (raise your hand; read pages 10-12).  The student writes down read, raise, your and reports back to me. Be sure teacher is aware of activity.

A scheduling idea that has worked well is to overlap the times children come for therapy. If I have a child come at 9:00-9:30, I may schedule another child or group to come at 9:20. When the new children arrive, the first child is asked to explain what s/he’s been working on, and this child then teaches the new group the lesson, in the remaining minutes. This offers practice in a more natural setting and meets needs such as receiving/giving directions, social/pragmatic skills, practice of sounds in a real-life environment, and allows the child to experience a leadership role, while getting additional practice on the lesson.

A child enters the room and begins talking to me. Without explaining, I begin to write any word spoken that contains the target sound, on the white-board. The child usually quickly catches on to what I am doing, becomes very aware of correct sound production, and begins to use many more words containing the target sound. The white board quickly fills as I beg for them to stop working me so hard. The child then uses each word in a sentence, erasing one word at a time.

Story Writing on the Computer
When one of my students reaches the generalization stage for articulation therapy, the child is invited to write a story using the computer. This is a highly anticipated event and each child is encouraged to be as creative or silly as s/he wishes. When the student has completed the story. I import a graphic to the story that fits the subject matter and change the font color to one of their choice. Using the “replace” feature on the edit menu in Word for Windows, I highlight all the target sounds (ex: /r/) in a different color. The story is laminated and added to the “library” with all the other stories that have been written. These are then used by many other children, for practice of their target sounds. I always make other stories by deleting the colored target sound and repeat the process, highlighting other sounds that may need remediation. Since these stories are “kid-created”, they are always very popular with the other children. OR....if you want to do it the easy way - go to the "Story-Making Machine" link!

The Clubhouse
In my room is another room, like a larger closet, that had been used for storage. I hung curtains over the shelves on the wall, leaving the bottom shelf uncovered for storing books. I added pictures on the walls, large pillows for sitting on, and hung up “The Clubhouse” above the door to the little room. This small space has been great as a read-aloud nook, to listen and respond to tapes, board game-playing area, a place for a child to work independently on an appropriate lesson while another child receives necessary one-on-one attention, as a reward, etc. Last year I kept Sandy, the Goldfish in a tank on the shelf and the children enjoyed practicing their lessons there while Sandy “listened”. This cozy, secret area always elicits lots of language and is special to the children. If an extra closet isn’t available, part of the room could be sectioned off for a cozy corner nook.

The Mailbox
“The Mailbox” has been a big hit with all my students. I attached a small toy-size mailbox with a flag, on the wall with wide sticky Velcro. (A sturdy cardboard box with an opening flap and a cardboard flag will work too). Choose a certain day as “mail day”. When the child(ren) arrives, if they notice the flag is up, it means that the box can be checked for mail. The “mail” could include:
• A story containing lots of their target sound, to read aloud.
• A message, instructing them to “ask questions” about the story to another. The other child will need to answer in complete sentences.
• A list of “answers” that are read one at a time to another child. That child must invent a question that will fit the question. Ex: because I felt sick – Why did you stay home from school today?
• A message to look for hidden pictures in the room that contain their target sound.
• A letter written by me, filled with their target sound for reading aloud.
• This activity is always exciting for the children and adds a lot of fun to our day.

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