235. The 4-Step Routine That Builds Visual Motor Skills in Every Single Speech Session
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Speaker 3: Being an SLP is a mission.
Let's discuss topics that matter. What are the game changing strategies? How can we treat the whole child?
How can we create the shiniest versions of ourselves and of our clients? We're here at the drawn board for a reason, you bring your own unique gifts together. Let's create.
Speaker 4: She's a fire she's following.
Today I am gonna take you behind the scenes and show you what I do on my back porch to improve visual motor integration within your speech and language therapy sessions. This is a really cool strategy I'm gonna show you, and it's just a four-step process that I'm gonna share with you [00:01:00] that I do with every child I work with practically, ~and it's something I do on a consistent basis.~
~It's baked into the intervention as we're treating the whole child. ~So what is visual motor integration? Visual motor integration is basically where your eyes are guiding what your hands are doing. It's a very complex skill, and the research indicates it tends to be more challenging for children with autism, children with ADHD, children with developmental coordination disorder, children with Down syndrome or cerebral palsy, and even children with speech and language delays are at greater risk for having visual motor integration issues.
Now, if the child has both a speech and a language delay, they're even more likely to have difficulty. Lastly, children who are born preterm are likely to have visual motor integration difficulties. So what I'm gonna do today is I'm gonna take you behind the scenes. This is ... I'm gonna show you a SIS activity that I've done from the past.
I'm gonna use this as an example that I use with my kiddos and that they love, and I'm gonna show you. This is what I do at [00:02:00] step one, step two, steps three, and step four that's part of the intervention process that's gonna improve visual motor integration. So the first one is we have our treatment target.
Now, I always sh- do the same routine, and that's because I want the children to feel safe and secure. There's something to be said about being predictable. Every week the book changes, the content changes, so there's new learning occurring. The treatment target's gonna change every now and then, but what I want them to do is I want them to focus on these challenging treatment targets, because challenge does create change.
So I always go for challenging speech and language targets. So if I look at my treatment target, I could use, of course, a sentence, I could use a paragraph level, I could use a complex sentence, and that depends on the child, and it depends on the moment to moment basis. So sometimes the child may be, in starting off, and I might be doing a simple sentence with them.
Very simple [00:03:00] three word. I might be doing a simple complex sentence, a simple ... or a more complex sentence that cont- con- contains three clauses, or I could be doing a paragraph where we're combining- four or five sentences. So what I'm gonna do is, if the child's highly engaged and the child's kind of showing mastery, I will go to the paragraph.
If the child's attention is waning, if the child's just emerging in this concept, I'll go to the sentence. So I dial it up and dial it down, the task and the target, depending dynamically on a moment-to-moment basis, just very much like you would with cueing. So if the child is getting a little sloppy, you're going to up the cues so that the child is not developing poor habits.
Or if the child's becoming frustrated, you're gonna up the cues so the child can have more success. You're always moving these two dials. One is I'm gonna work at the sentence level, the complex sentence level, paragraph level. That's one dial in terms of task difficulty. The other [00:04:00] tile is in terms of the level of prompting.
Am I gonna be at a maximal model of prompting? Am I gonna be a moderate? Am I gonna be a minimal? Is the child gonna be independent? You're always gonna be manipulating these two to ensure that you have a quality interaction going on in which the child is 80% accurate at all times. So the first step is always the treatment target.
Now, the way visual motor integration is improved is I start off with a maximum level of multimodal cueing, which I'm moving my hands, the child's moving their hands and imitating me as they're illustrating what they're doing in the mouth. So for instance, if it's an S sound, I might make a snake, make the snake sound.
I go put my teeth and my finger together, and I pull it out, sss. Just like I want their teeth to do. Now, because of entrainment, because the mouth is gonna do what the body does, SSS, the child's gonna make a stronger S because of the support of what the fingers are doing. It's like when the children are cutting and they open and close their mouth [00:05:00] when they're cutting, when they're drawing and their tongue is making a circle as they're drawing a circle.
That's that entrainment, that connection of the fine motor in the fingers and the fine motor in the mouth. So as they're moving their hands, later on I'm gonna stop talking, and they're gonna be the teacher, and they're going to see, for instance, the snake, and when they see that snake, they're going to, with their hands, make a snake, SSS, and pull it out against their mouth.
So that is visual-motor integration in which the eyes are guiding what the hands are gonna do. They see something, they see the Ls on the smiling Ls for the word please, and then they're going to make Ls with their own fingers when they see it on the paper. Please. Because I faded out the verbal prompt over time, and now that they're looking at the treatment target, they're seeing all the pictures of the different gestures that were used, and they're doing different gestures with their hands based on the pictures.
So this is one way, through [00:06:00] repeated, meaningful practice, consistent practice, i- that they're guided practice, that they are improving their visual-motor integration skills. They're seeing symbols on their treatment target, and they're going ahead and they're making different hand signals and doing something d- different with their hands as a result.
So that is the first step always. The second step is the child locating the sticker from an array. Now, this is really where you're working on that comprehension, and the clues tend to be a function, feature, or class cue. So I take a clipboard, and on that clipboard I have soft Velcro, and I have my different stickers.
These are different elements of the story or song that we're doing. This is Pete the Cat I'm showing you an example of in The Wheels on the Bus book, right? So I will give a clue, and I might say, "I'm looking at something that you open and close so you can go inside of the bus. What do you think it is?" So I'm giving a function clue.
So the child is going to [00:07:00] look at the visual array, so they're using their eyes to guide the hand movement, and they're gonna pick The door. So this is step two of the process, and once again, we're working on visual motor integration in a different manner.
But we're hitting it again. It's part of treating the whole child. Then the third step we have is the child's gonna locate the sign that's gonna be hung up on the wall, or it's going to be hung up on my dry erase board, on a magnet board. So I have this sign of the bus hanging up. So they're gonna look with their eyes, and that's gonna guide where they stick their sticker, their hands.
So they see the doors. We're seeing the door on the bus goes open and shut as they're going through their obstacle course to get to the bus. Now, the task here is that we need to put all the parts on the bus so the bus can go to school. So we have a task-oriented movement activity. But we, first thing we have to do is get everyone on the bus and get all the bus parts on the bus.[00:08:00]
So then the child, the last step, so you see the visual motor integration. Their eyes are looking where they're supposed to place the sticker to match, and then they're going to go and stick it on. Then there's step four. Step four is the child's going to take their dry erase marker, and in my membership, there's always a checklist.
They're gonna check it with a checklist. So maybe they're going to s- trace it, and they're going to see an, a dotted X that they're gonna trace X. Okay, I got the door on the bus. Let's check it and make sure it's complete. Or maybe it's a check mark, slide down, slide up. Or maybe it's a number. They're gonna trace the number one for the first thing they put on, trace the number two for the second thing they put on.
So it's always gonna be something different, but once again, they're using their eyes to guide what their hands are doing. So this is a field of occupational therapy. We're not doing occupational therapy. We're just making our activities educationally rich, in which we're baking in visual-motor [00:09:00] integration, realizing that the children we work with, if it's just speech and language impairment, or if it's both speech and language impairment, they're more likely to have visual-motor integration difficulties.
And then as we get into these more severe, more complex delays or being pre-term, you're more likely to see the visual-motor integration difficulty. So we don't wanna ignore that. We want to treat the whole child and bake that into what we're doing. So as we're doing this here and improving visual-motor integration, the next question we need to ask is why?
What's the payoff? As a speech-language pathologist, we work on sounds. We work on speech. This is different than speech, but it's also language. And that's because when we're working on eyes and h- and guiding the hands, we're looking at how can we turn shapes And connect shapes to sounds to create letters.
So it's very important for children to have visual motor [00:10:00] integration skills so that they can have letter knowledge. Knowing your letters is really important for developing fluencies. Being able to quickly look at the letter A and to write the letter A in terms of writing skills, in terms of spelling skills, in terms of handwriting.
Being able to look at the letter L- A and recognize it, and combine letters to create words. You're using your eyes, and once again, you're moving letters together, and that is you're using... They're guiding your hands to create words, or whether you're writing a word. This is visual motor integration.
This is literacy. So we care about visual motor integration because it does impact literacy. Does the research suggest it affects phonological awareness, like the sounds of language and connecting them to letters? No. Or how words are formed? No. Does it, does the research suggest that it affects language comprehension?
Not so much. It does affect print knowledge, the understanding of how a book, it goes [00:11:00] from left to right, and how words are formed on pages and the concepts of a book and exploring a book. So it's not all of literacy, but a very big part of literacy in terms of the encoding, the decoding of the letter formation and the letter knowledge.
So this is important stuff that we have here. So what I would say i- here is we care about visual motor integration, and especially at the preschool years and up through grade one. Now, the visual motor integration has lesser of an i-pa- impact on literacy as the child gets into older elementary grades.
But if you're working in early elementary or if you're working in preschool, you care about visual motor integration, and that's because of the Matthews effect. Those that have, that will have more. We want children to have a strong letter knowledge. We want children to have, the ability to form letters, to form words, to be able to write.
That is [00:12:00] something that if you're able to do it, you're able to do it more. If you're able to write words, then you're able to write a paper. So it's all connected. Those who have, will have more. So this is something you really care about if you're working with populations with communication impairments.
They're at greater risk for challenges in this area, and this is something you can simply bake in to task-oriented movement therapy activities when it comes to working with preschoolers or elementary-aged children, so you can treat the whole child and create lifelong change. So thank you so much for stepping on my back porch with me.
I want you to do what you do best on your back porch, and that is make the world a better place one child at a time. You are always gonna be first.
Today I'm gonna show you a really fun way to integrate social-emotional literacy into your speech [00:13:00] therapy sessions or your speech and language groups. This is really gonna help improve the children's social-emotional vocabulary. Now, according to the research, we really wanna expand that and have the gradations of social-emotional vocabulary so that children are able to precisely identify others' feelings as well as their own.
When we have that, the research suggests you're gonna have better outcomes in terms of social skills, in terms of emotional regulation, in terms of emotional knowledge. So language is a container of thought, and the more words the children can have to express their feelings, the better. So how are we gonna accomplish that?
I'm gonna show you a really cool way to do it. I've done it on my back porch. I've tested out our materials. I'm excited to share these materials in the SIS membership this Friday at the 5:30 AM email. So it's coming on your way. I field tested it. The children loved [00:14:00] it. So I know that they're gonna love it on your back porch too, SIS members.
If you're not a SIS membership, I'm still gonna open up the curtains, and I'm not a gatekeeper. I'm gonna tell you exactly what I did so you can try it on your back porch. So the first thing, this is a six-step process. The first thing I did is I made magnifying glasses that were different colors. So if you're using the zones of regulation, you have four different colors.
If you're using spots for emotion, you have eight different colors. So you have your different colored magnifying glasses, and what they're gonna do later on is they're gonna have a variety of emotions. So you're gonna have those gradations of emotions, so when we're looking at the color blue for sad, we're going to have maybe under that sick, that down feeling, maybe we're gonna have under that tired Bored, those blue feelings that are beyond sad.
You're not sad, you're tired, right? So having those feelings is gonna be really important for children to [00:15:00] precisely identify their feelings and others' feelings. So what we're gonna do is we are going to find those, those different emotions, those pictures. They're gonna have the word on it, they're gonna have the color blue on it, and it's gonna be attached to, this is the best part, an animal, right?
So what kind of animal? What I do is I go to the dollar store, this is an SLP hack for you if you haven't done this already, and I buy from the dog and cat toys different animals. And the reason I do that is 'cause they feel good, they make sound, they're way cooler than the plain old plushy toys, right? So I will go ahead and get 12 of the bears that crinkle and have a squeaky in them.
I'll get 12 of the mice. I'll get 12 birds. I'll get 12 panda bears, 12 skunks, 12 pigs, 12... So you get it, right? And I will go to all of the dollar stores in my area. I'll be like, [00:16:00] "Okay, they only have six here." I'll go to the next dollar store. Oh, they got four here. That's 10. Okay, I'm gonna go to the next dollar store.
There's 12. Okay, I have 12 bears now. I have 12 lions now. I have 12 foxes now. So I go ahead and make collections of these fun, hands-on, cool toys, and I get 12 of them. So I do 12 because I have 12 children in each of my groups, so I have one for each of the child to find their specific emotion, right? So we have 12 kids, they all have their magnifying glasses.
So if you have, if you're using the zones and those four colors, you'll make three sets of them, right? So you have 12. Every child has their own magnifying glass. Every child has their own bear they're gonna find. So last week we went on a bear hike. This next week, for instance, if it's going to be the letter C, we'll go on a cat hike, and they're gonna find different wild cats, right?
And they're gonna have different emotions attached to them, those gradations of emotions. The children are gonna find the [00:17:00] emotions, and then they're going to go back to the teacher, stick the sticker on that you have stuck to the animal, and we do that through Velcro. They're gonna stick it on the, the chart from the teacher.
They found that emotion, and the teacher's gonna re-review the emotion with them, and she's going to use simple call-outs. So you take this complex word such as tired, you know, and what does it feel like when you are tired? That means that you really wish you could go to sleep. You didn't get enough sleep, and sometimes you feel tired if you really wanna go to sleep and take a nap, you know.
You just explain it in plain, plain English, and then you can give an example. I feel tired at night. At nighttime, I just wanna go to sleep. I don't wanna play anymore. I'm too tired. What about you? And you just kinda talk it out with the child. Now, right now that you're giving the child a lot of input, you're giving the child a lot of examples.
They see the picture. They see the word. They see [00:18:00] the color. They're getting a lot of input at this stage. Later on in the year, the child's gonna be giving examples when they feel tired. Later on, the child's gonna be using the word tired and coming up with different emotional vocabulary. But at a starting point, they're just being introduced to these gradations of emotions, and they're getting this hands-on experience of finding the bear that has the tired symbol on that's blue Right?
So as the child's walking around looking for the different bears, you're gonna see a yellow one when you're walking. "Well there, that one's yellow. Now yellow means happy. So, hmm, we're not looking for happy, we're looking for tired. You know, this one says excited. You, you know, we don't feel really excited when we're tired."
You can just talk it out when you find different bears with different feelings. So it's a lot of fun. You get to go outside. You get to go and look under trees and under grass, and it's g- you're gonna have a lot of fun in this kind of big feelings hunt. [00:19:00] So the way we sing the song is I put on the PowerPoint, and it's gonna be on the PowerPoint every week, what kind of hunt we're going on, right?
So last week was the letter B. We went on a bear hunt. So for the bear hunt and the PowerPoint, we're going to say, "We're going on a bear hunt. We're gonna find big feelings." So instead of saying we're gonna find a big one, we say we're gonna find big feelings. So the next week, if we're gonna go on a cat hike, we're gonna say, "We're gonna go on a cat hike.
We're gonna find big feelings." So we're gonna keep doing that. We're not scared. It's the same song. We're just changing the name of the animal. It can be a dinosaur hike. You get it, right? But it keeps it really novel and fun for the children. Then w- after they give the, the sticker to the chart, they're gonna check the checklist too, of course, and check it to completion, the task, with a little marker for the teacher as well And so that is [00:20:00] the scavenger hunt, and then they come back in.
Now, this is what you do. This is how you put emotions into practice using universal design for learning in which you're multi-sensory, multimodal, they're seeing it in print, you've got objects, you're acting it out, you know, you're looking for, you have a purpose, you're, you're going on a scavenger hunt, you're looking for big feelings.
So i- and it's just brings it all to life. It's more than just a chart and, oh, pick, pick a picture and a chart, that means this. So I think you gotta try this on your back porch. It was a total hit with my kiddos, and I'm not looking at it as something that we're one and done. We do one time, okay, we covered it.
Check. We covered our emotions. We did emotion week. This is something we're gonna do every single week. So not only does it give us that improved emotional knowledge that has the improvements in behavior, improvements in [00:21:00] self-regulation, improvements in social skills that's associated with it, it also gives us a movement break.
It also gives us a little vitamin N. We get to go outside and take a movement break and then get back to the challenging treatment targets, which are very important, uh, to create change. You, you, the challenge does create change, but it's nice to have this nice movement break so the kids are 100% ready to learn.
So I want you to do what you do best and roll up your sleeves and to make the world a better place one child at a time. You are always gonna be first. If you're in the SIS membership, you are gonna receive this as a bonus for the month of October, the social emotional learning scavenger hunt, and not only that, you're also going to have the whole, "Hey, how do you feel today?"
emotion chart to check in. That is going to be your October bonus. Both of them have been an absolute hit with, uh, my kiddos on my back porch. I know they're gonna be a hit on [00:22:00] your back porch as well. And if you're not a SIS member, try for a month. Join for a month and receive all of the treatment target library the minute you join, and join for a month.
If you like it, then you stick on. You know, you can tr- you can easily transfer to the annual membership for a discount, or you can simply cancel. And the treatment target library and all of the social emotional literacy bonus for this month is definitely worth $47. You won't be disappointed. So I'll see you there hopefully at the SIS membership, and if not, I'll see you next week.
Thank you so much for being with me. I appreciate you. Bye-bye.
Speaker 5: Yeah. She's Brian shell. She'll get, yeah, she's Brian. [00:23:00] She.
