Top Three Therapy Activities
You may be wondering, “What does therapy look like? What can I expect in a session with Veronica?” Luckily, I will share some secrets with you here. I hope you enjoy!
Activity One: Book Sharing
When providing therapy in the birth to school age range, “pre-literacy” skills often play an important role in a plan of care addressing language delays, executive functioning, and/or speech sound disorders. Parents often will say, “My child won’t sit still for a book,” or “I’ve tried but they’re just not interested.”
This can be difficult! This is where we focus on progression, not perfection. Also, it’s time to put that high school drama class to good use and get really, really, silly.
Here are some principles of book sharing you may notice me incorporate, or perhaps you’d like to try yourself.
Joint Attention
Joint attention is desirable throughout any therapy session, because guess what: if you don’t have the child’s attention, there ain’t much happening therapy-wise! This term refers to two (or more) humans engaged and attending with some third object, person, or animal. “Look mommy, a bird!” is a moment of obtaining joint attention. During book sharing, we work to engage the child’s attention by choosing age-appropriate materials (I always like to present 2 or 3 for my client to choose themselves). Then, we focus our gaze and wonder on the book, and invite the child to discover what’s inside.
In some cases, if even my most kid-friendly interactive pop-up, fold-out, scratch-and-sniff books still fall flat, I may choose to show a short video instead. We can still practice joint attention by showing a clip, pausing, and talking about the actions and characters in the video.
Routine
Routine-based learning is another principle of book sharing and therapy activities in general that can be very powerful. When a child (or adult) experiences language deficits, they look to their environment, communication partners, and routines for information about what to expect.
I know many parents struggle to establish a bedtime or a morning routine-- daily life is just too chaotic! I suggest stringing together two common routines together to start, and building from there. You might set the evening’s book choices on the bathroom counter while you’re brushing teeth and make a choice of bedtime story together. For some clients, setting timers counting down to transitions can be helpful.
The key to remember: routine as a strategy for language facilitation creates a structure of repetition and expectation from which learning opportunities are found. It is from this foundation and structure that we can get creative and have fun!
Activity Two: Cooking
I love to cook! I also love therapy activities that are functional and have delicious, rewarding outcomes. Cooking is another fabulous way to continue to use those concepts of joint attention and routine based learning to expand vocabulary, sequence steps, and talk about what we’re seeing, smelling, tasting, and feeling.
Food preparation is evidence-based practice for working with children with feeding difficulties. An early step to weaning from gastrointestinal-tube feeds to per oral foods may simply involve touching and smelling foods. For more information about how food prep can be healing and educational for children with feeding difficulties, I recommend looking into the Get Permission Approach developed by Marsha Dunn Klein, OTR/L.
Here are a couple “dos” and “don’ts” I’ve learned through trial and error when incorporating cooking in therapy:
Do: give your helper a job they can do independently, whether that be peeling or cutting with a safe knife, or playing with bubbles in the sink while you do other food prep tasks. I always talk (or sign) through the steps, components, and take special care to offer tastes, touches, and smells of different ingredients.
Don’t: pressure a child to taste or touch a food they aren’t comfortable with yet. Listen to your child’s cues, watch their face and body responses. I also don’t play around with heat in the kitchen and little ones-- I set clear boundaries, role play when necessary, and take steps to ensure safety. Sometimes toddlers are too keen to experience “natural consequences,” and I don’t want anyone getting burned in therapy!
Activity Three: Treasure Chest
When I was training to become an SLP in Washington, DC, I was lucky enough to be mentored by James McCann, an ASL/English bilingual speech pathologist who worked in Prince George’s County, Maryland. Tagging along with Jim as an intern, I learned the basics of child-led therapy and saw communication bloom.
Jim was also always very laid back, a stark contrast to many hyper “type-A” therapists. I tried to emulate his calm and easy manner, even in the strange circumstance of entering someone’s home to play with their child!
One of Jim’s best tricks was a clunky plastic file box (his “treasure chest”) he carried as we drove around PG county for home visits. When asked what was inside, he would say, “Oh, I just toss different junk in every week.” Jim had an impressive materials collection, but insisted that materials never made the session, that a good clinician could make a therapy activity with an empty toilet paper roll or a pasta pot.
The magic of the file box was a mix of routine-based learning, joint attention, and surprise. The file box also incorporated a basic language-facilitation technique called “language temptation,” the process of anticipating what the child wants in play, and scaffolding communication at the appropriate level to get what they want. “Open,” or “Open the box!” are often the first words or phrases I elicit from my clients.
I hope this has given you some good ideas and a better idea of what my therapy services have to offer. Enjoy the communication!