Walk the Red Carpet

Maybe your client is a bit of a diva, in that case “walk the red carpet”!

In this variation, you are essentially playing “Red Light-Green Light” but the presentation changes.

The child is the one who moves their way down to you (a.k.a. paparazzi).  Good production?  Great!  They take a giant step forward and pose for a “picture”.  At this point the clinician “snaps” a photo, real or imaginary.  Oops!  Was that target word a bit off its mark?  Looks like the paparazzi is focused on someone else!

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Red Light-Green Light

Does good speech stop you in your tracks?  Show your students what an impact they can have with this speech variation of Red Light-Green Light. 

  1.  Find a hallway where you won’t disturb anyone or head outside.
  2. Stand facing the student, approximately 10 paces from one another.
  3. Give the student a target word.  You can either give it verbally, have them generate one, or have a stack of artic cards nearby.
  4. The student says the word.  Is it incorrect?  Using monster claws and a dramatic expression, take a giant step toward the child.  Is it accurate?  Freeze with an expression of delight.
  5. You can either have the child continue to say the same word, or switch to another (but you’ll get more trials in if you stick to one word/game)

Once you “catch” the child, you can play in reverse:

  1.  Again, stand facing each other, 10 paces apart.
  2. The student says the target word, moving ahead one giant step for an accurate production; staying in place if they “miss”.

If you are working on discrimination, you might also consider playing the part of the child and having them “judge” your productions.

This game is great in aiding carryover since it gets you out of the treatment room, standing up and moving, and adds a bit of a pressure element.

Stay tuned!  On Wednesday, I’ll show you that it’s all in the presentation.  Same game with a more sophisticated slant!

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Othello: A Speech Strategy

I love board games and Othello is one of those classic, perfect two player games.  Do you remember this one?  The board consists of 64 green felted squares and each player has 32 thick black and white disks that clack snugly into a space on each turn.  The tactile aspect is hugely satisfying, in addition to encouraging fine motor skills.

You begin with four disks in the middle of the board, two whites diagonal from one another and two black diagonal from one another.  Decide which player is which color (black goes first).

On your turn, place a disk on the board trying to “capture” at least one disk of the other color between a previously placed disk and your newly placed one.  Here’s the fun part!  You turn over each disk to “your” color that falls between “your “ two ends, whether it be horizontal, vertical or diagonal.  “A minute to learn, but a lifetime to master” is Mattel’s slogan, and it’s true.  The game involves a great deal of strategy and is fun for both children and adults.  Somewhere around 8 years old/3rd grade is where this game tends to gain popularity.

Now, let’s tailor it!  I buy boxes of plain circle stickers at office supply stores.  They fit perfectly inside the little squares and the felt allows them to stick but not fully adhere (so you can switch the stickers easily with no residue).  On 64 circles, I write the child(s) target words and place one in each square.  We then begin to play the game, saying the words we cover as well as those we uncover when we flip the disks.  This is a very fun way to get a lot of trials! 

I like to provide auditory stimulation, so I usually say my “own” words, but it would be easy enough to place all the production burden on the child.  And the game easily adapts to carrier phrases “I cover (target word)”, “I see (target word)”, “I said (target word)”, depending on what sound you need to in/exclude from the phrase.

P.S. The rows of disks have a very Oreo cookie look to them.  I think a cookie or two in conjunction with the game could be a very therapeutic experience.

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Beyond Bubbles

Ah, the magic of bubble solution. What therapist hasn’t used this tool, over and over and over again? A hit with recalcitrant toddlers, distractible preschoolers, even too cool early elementary aged students. The magic bubble solution is cheap and easy to carry. If you can overlook the periodic spill, it’s nearly perfect.

Bubbles also lend themselves easily to language development—i.e. requests/demands (depends on your perspective), joint attention, turn-taking, size concepts, etc. And even more so to early articulation acquisition by offering a wealth of bilabials with early vowels—i.e. “pop”, “bubble”, “more”, “big”, “uh-oh”, “up”etc.

But where can you go with this if you fear your head is the next thing to pop? Perhaps your kiddo still requires all the same vocabulary practice but you need to shake things up. Perhaps your new blouse won’t take well to glycerin spots. In any case, check out these ideas for a “same but different” experience:

1. Bubble wrap: I adore bubble wrap. I save it from any packaging that arrives at my house, but you can also purchase it fairly cheaply. The teeny bubbles can be popped with fingers, fists, feet, elbows, bottoms, or a wooden mallet. Think how happy your OT will be! For a more able child consider twisting out the last few pops as well.

2. Air Bombs: Surely they have a name other than this, but it’s what they go by at my house. These are the more modern bubble wrap on steroids that arrive in lots of packages. Usually they have perforations to separate each bubble. These require a bit more heavy work, big stomps or jumps, but think of the possibilities with your SI kids. Consider using some double stick adhesive to keep them in place. They can also be batted around like a balloon lending themselves to “my turn” and “up”.

3. Pop Ice Cream: My son loved this thing when he was little—a soft foam ball on a string that fit onto a plastic cone. When you depress the button on the side, “POP”, it makes a thrilling shot into the air. (search Amazon for “Ice Cream Shooter”)

4. Poppers/Suction Cup Poppers: These are a tremendous value; usually found in the cheap bins at toy or party stores. The classic popper is simply a small plastic dome, about the diameter of a silver dollar. You turn it inside out, set it on a table or the floor and step back. The suction cup poppers usually have a cute character sitting atop a spring, attached to a suction cup. You press the character down firmly and “pop”, up it shoots. The exciting element of either of these is that you don’t know exactly when they will detonate!

5. Fisher-Price Corn Popper: Remember this gem? How exciting to take turns pushing the corn popper around the room! And, you may want to sit down for this, it comes in a keychain size as well! More practical in some situations, you’ll still get the pop action just not all the movement.

6. Panic Pete Squeeze Toy: You’ve seen this, an odd sort of squishy stress relieving ball shaped like a little man. When you squeeze the body, “pop” his eyes, nose and ears protrude! Sure to elicit giggles.

7. Stomp Rocket: A huge hit with the preschool crowd and, again, great for those kids that might have additional SI issues. You set the rocket on the end of a plastic hose, and stomp down on a good sized plastic “balloon” (remember, bottoms work as well as feet!) to shoot it into the air.

8. Playskool Busy Poppin’ Pals: These classic activity boxes require some fine motor dexterity to pull levers, push buttons or twist dials. With a little searching you can find variations in difficulty. Also provides a gratifying opportunity to slam the little door back down. Lends itself easily to “open”, “down”, “bye-bye”.

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Paperwork? Still?

I always thought one of the benefits to being on my own would be that I could streamline the paperwork.  But you know what?  It’s everywhere and there really isn’t getting around that much of it.  You do have a chance here though to set it up the way you like it.  Hope you’re feeling energetic—you have some forms you’ll need to create!

  1.  Fee Schedule:  You’ve already done your research and you know how much you’ll charge for evals/treatment/etc.  Put it in writing!  And while you’re at it come up with…
  2. Billing Policy:  Will you collect at time of service?  Bill monthly?  Stay firm!  I know you can fix that /r/.  You know you can fix that /r/, but if mom hasn’t paid you for the last few session, no one should be fixing that /r/!
  3. Cancellation Policy:  Come up with something humane that doesn’t do you in when it needs to be enforced.  Oh, and have them sign it.
  4. Privacy policies:  Have a release to discuss info with other professionals (both ways).  You may also need to confirm the ability to leave voice mails and/or converse by cell phone and email.
  5. Case History:  Here’s your chance to get the info you really need and not what was on previous forms that you had to use.  This may be one of the earliest communications you have with a family and gives you a chance to express a personal interest.  Find out a client’s hobbies/favorite toys/etc. and make the initial eval that much smoother!
  6. Insurance forms:  Even if you dn’t file for your clients, you’ll need to create a form to fill out on a monthly basis (or as a receipt per session) for them to self file.  You’ll need appropriate codes listed, time seen and in what setting (i.e. out patient)
  7. Treatment notes/Monthly Progress notes:  Create an easy template that you can use for all clients.  I know that lots of clinicians are switching to software.  I haven’t made the jump myself.  I’m all ears if someone has an inexpensive solution to this!

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Catch a Cootie!

This is a quick articulation activity I use that the kids love and when I send it home, I know they practice!  It also has the added benefit of aiding in carry-over, because cooties are fun to share!  It’s a good old fashioned cootie catcher, but in this case it catches good speech productions as well.

  1.  You need a square piece of paper.  I take a sheet of computer paper and fold one corner to the opposite edge, making a neat triangle, and either cut or rip off the “extra” rectangle strip that is left on the side.  Unfold back to square.
  2. Fold each corner into the middle.  Now you are looking at a small square made up of four triangles.  Flip it over.
  3. Same thing—fold each corner to center.  Again, you’ll end up with a smaller square this time made up of four split triangles.  Keep this side facing up.
  4. Fold in half one way, then unfold.  Fold in half the other way and pick up.
  5. Pinch the bottom fold on each end between your thumbs and index fingers, kind of tucking your fingers beneath the triangles.
  6. Gently push your fingers together.  You are shooting for a cone type shape.
  7. Write a target word and number (for # of trials) on each outside triangle.
  8. Open, and write another target word and number on each triangle.  Close.  Open the other direction and fill those triangles in as well.
  9. Now, lay the square flat.  Lift each “double” triangle and write two fortunes beneath it.  I angle each fortune in a different direction so it “belongs” to the target above it.  Refold to cone shape.
  10. Time to play!  The child chooses a word on an outside triangle.  As he repeats it (based on the number of trials listed) open and close the cone.
  11. He choose an inside triangle word (and number of trials).  As he repeats the target, open and close the cone again.
  12. Now the child chooses a final target word.  I don’t typically as for repetitions here.  Lift to reveal the fortune.

Enjoy!  I’ve listed 30 “Good Fortunes” on my download page that would work with most K-5 students.  If you’re tricky, you might also create your own that incorporate the child’s target word(s).

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How many shoes is that?

Remember, in private practice you are only paid for patient contact hours (and there may be a lag between time of service and collection). Do some calculation ahead of time, so you don’t find yourself in trouble later. For the purposes of an easy example, let’s assume you will charge $100/hr.

What is your typical tax rate? It is worth checking in with your accountant for an estimate of this. It may be very different now that you are self-employed. Assuming a total rate (federal and state) of 30%, you will “make” $70/patient contact hour. But don’t go shoe shopping yet!

Add up known expenses for the year. (*note: I am not taking into account expenses if you decide to rent space, but for the typical clinician making visits to a home or contract location) These will include: ASHA dues, state license fee, malpractice insurance, continuing education expenses, forms, and possibly others. Let’s estimate the total for these items at $1200, and then, just in case, add another 10% to the number—wiggle room in the event of surprises. Now we have $1320 of known expenses.

Come up with a realistic number of contact hours you will have per week. Consider that holidays, vacation, illness, cancellations will have a greater impact on you now, plus you are just getting started….Ok, multiply that number by 52 (weeks in the year) and then, to be safe, decrease it by 10%. So, as an example, you are thinking you’ll work part time, about 20 hrs/week. Taking in to account travel time, paperwork, marketing and missed sessions this will probably average 10-12 hrs of patient contact time/week. Let’s be conservative, 10 contact hours x 52 weeks= 520 hours. Subtract 10%, and you have 468 hrs. Divide your expenses (estimated at $1320 above) by contact hours (estimated at 468). This works out to just under $3/hr ($2.82 actually).

Which means the maximum you can pay yourself is $67/hr; and, if you do, you will have, theoretically, no additional monies for materials, tests, etc. Honestly, in a young business you’ll have lots of “surprise” expenses and wants. Personally, I “pay” myself half my net rate, choosing to leave more to invest in my business. But I’m not the breadwinner in my family, so who am I to judge? Best of luck!

(Disclaimer: I am NOT an accountant. I have never taken an accounting class, nor plan to. This is my common sense way of planning for myself. Use at your own risk!)

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