Choices and Consequences- Language for Cause-Effect

Choices at Home and in Speech/Language Therapy

Choices and Consequences- Teaching cause-effect at home and in therapy

Your little one who was running headlong into trouble is finally starting to get some idea of what they can do (safe) or can’t do (dangerous.) Whew! But, don’t relax for too long! Just when you take your eye off of them, they manage to get into some kind of trouble.

Preschool is the age when children are ready to learn that actions have consequences. They may not like the consequences, but they are realizing that they exist and are starting to show some skill at pushing your buttons. That means it is time to start teaching them that their actions have consequences, including on the feelings of others.

Choices and Consequences- 3 Tips for at Home
You can help the development of language, thinking skills and good choice making by offering choices with  consequences. This involves making statements like these:
"If you...., then...."
"When you ...., then..."
"If you want to....., then you need to....."
"You did...., so he feels...."
"When you ...., I feel.....because...."

Natural Consequences
Explain to your child what will happen next if inappropriate actions are occurring.  That is the natural consequence.  For example, “You can dump all of the toys out and make a big mess. Then you will have to clean them all up before TV time. Or, you can just take out the toys you want to play with. Then you will be able to clean up faster.”  Be sure to make the consequence you stated happen!

Make Consequences Actionable
Apply a consequence that lets your child  know what your rules are, why you think that and what he can expect to happen. In very simple terms, of course.  For example,  “Screaming in the store is not polite. If you can’t calm yourself down, we will have to go home and take a nap to calm down.” Be sure to have consequences that match the severity level of the behavior and that you can act upon consistently. Be careful of words like ‘never’!

Teach the Consequences for Feelings
Help your child see that actions have impact on other’s peoples’ feelings. Since that doesn’t have a large impact on children’s actions in the beginning, be sure to have another consequence, as well. “When you say mean things,  it hurts your friends’ feelings and makes me sad. You have to use nice words or I will have to stop setting up play-dates for you.”

Choices and Consequences- 3 Tips for SLPs

Choice Time
Making time during the session for the preschooler to be able to have a preferred choice is the easiest way to start teaching that actions have consequences. While we try to make all of our activities engaging, some are more preferred than others and some are harder work! To help our students grow, we are always pushing to get the most we can from them. Sustaining that attention and effort can be tiring, so having a little free choice time as a consequence for making good choices and responding to our demands (even if they are couched in play.)

Teach Cause- Effect Skills with Toys and Books
Little ones have to be able to think ahead to the effects, or consequences, of actions in order to make good choices. 

The easiest way to start teaching this is though toys. They are fun and children can see that their actions have consequences. There are so many great preschool toys for teaching cause-effect. The picture to the left has just a few fun examples. 

Students who have learned the language associated with cause and effect toys are probably into building and imaginary play. You can continue to expand their language skills through modeling in play, but it is a good idea to start incorporating some great cause-effect picture books!
The picture shows are a few of my favorites. Laura Numeroff's books are just general fun, showing 'what happens when,' as are Margery Cuyler's "That's Bad, That's Good!" series. 

David Shannon's series of David books shows the consequences of little David's poor choices, with such great pictures! Kids just love seeing other kids get into trouble! 

Alexander and the Terrible, Horrible, No Good, Very Bad Day by Judith Viorst is a classic book that lets you introduce perspective taking skills. Does your student think the same way as Alexander?

Actions and Feelings- Social Language
It is so very important that we provide our students with the language for emotions, both verbally and non-verbally, for thinking about how others feel, whether we are modeling sharing during our play with toys or choosing books with appropriate themes for discussion.  

SO many of the choices a student makes all day long after entering school have emotional impacts on others! Students who are not able to think about the consequences their actions have on themselves and others lack the basis for making good decisions. 

When instructional time is spent dealing with behaviors, the student isn’t learning. Having the language skills does not guarantee good behaviors and choices, but it does provide a way to intervene!

5 Tips for Toddlers- Language for Choices

Do you need good language skills to make responsible  choices? Definitely! Language and thinking skills are so intertwined.  My last post was about why choices are so important. Now, let’s take a look at the language involved.

Toddlers don’t yet have the language skills to really make choices since they are in the here and now, while making choices is about decisions for the future. When we provide toddlers with two simple visual choices, such as graham cracker or cookie, and label the items, we are doing more than just increasing their vocabulary and requesting skills! We are showing them visually that they have choices and giving them the language they need to make that choice! 

Think about their play skills, too- working on learning cause and effect. This is a building block for making responsible choices!

SLP tips for toddler’s choices in therapy:

1. Attention spans are sort, so have lots of activities available.

2. Baskets can really helpful for having similar toys available to grab or put away quickly. Toddlers will use eye gaze first to show their choice when two objects are held up. That is our cue to label the one they want!

3. When eye gaze is established, that is our cue to delay gratification a little and wait for a vocalization to occur. Listen for some variation in vowel sounds to occur between the different toys in your basket, and hopefully some consonant sounds will be emerging, too.

4. For children who are having problems vocalizing, are a little older, or could possibly be on the spectrum, this is the perfect opportunity to start developing a pointing response. Pointing is much easier to prompt than vocalizations for a child who is not naturally starting to do that.

5. Shape a Pointing Response-Hold up two toys to see which one is being looked at. Quickly set down the other toy and scoop that hand under the child’s hand. It is probably already out, trying to grab the toy! 

Use your hand to mold the child’s hand into a pointing gesture while naming the desired object. Be sure to only let the child get the toy after a pointing response, not a grab! While this feels awkward at first, you will soon become adept at prompting a point. Help yourself out a little by holding the usually preferred toy in your non-dominant hand at first so you can get used to the steps using your dominant hand most of the trials.

5 Tips for Teaching Toddlers How to Make Choices- and why you should!
I like this technique for several reasons. First, you are shaping a natural gesture (grabbing) into a communicative behavior (pointing.)

Next, you are pairing the child’s eye gaze with that point, since they are already looking at the item they want. This is so important as prerequisite step for joint attention (the child looking at what you are looking at.) 

Once the child realizes that pointing goes with looking, it opens the door for teaching that your point is telling them to look! You are also starting to teach some of the skills the child will need if he has problems leaning verbal language and has to start by using an alternative communication method. 

Last, and possibly most important, pointing and waiting is such a better social skill than grabbing and taking!

How do you use choices in therapy? If you are still interested in this topic, pop on over to Speech Time Fun this Friday for a summary of my ideas! I'm so grateful for the opportunity to guest post there!

SLP Love Hurts- 5 Tips for Difficult Kids
The Frenzied SLPs are sharing their stories about how sometimes love hurts for this Valentine's Day. I'm happy to link up!

I still remember the day when I was reassigned to a new school and walked into the classroom to meet my new students. Some were spinning, some were rocking, and some were staring into space. All of them were autistic, non-verbal and had something that I needed to watch out for. I will probably always have that memory. I was in such shock. How was I supposed to teach these children to communicate? Nothing in my experience had prepared me for this!

I immediately began learning;  from courses, from the internet, and especially from watching the staff in the classroom. Even with the biters, the spitters and the hitters I had for years to come, I luckily only got injured once, by accident. Want to hear my tips?

Feel the love in your heart for these children with broken communication systems. They aren’t mean! They just get frustrated and lack the means to express it appropriately.
Get to know your students before placing learning pressures on them. Most severely impacted students on the spectrum have sensory issues. Some sensory input makes them happy and others overload them. When students are overloaded and have no way to communicate, “STOP!” their behaviors will be their communication system.
Kids on the spectrum are not auditory learners, they are visual learners. Find a way to show the child what your expectations are and what they will get in return. Did you ever wonder where my name came from? This experience cemented my belief in using visual supports.
If you are constantly on your toes, you will see the signs of frustration as they begin to occur. Before the child acts out, react to the difficulty the child is experiencing and the agitation on the part of the child. Go back to an easier task. Think about how you can make your expectations more visual before you try that activity again.
Mix it up!
Have lot of activities prepared. After a few trials of something that is hard to do, do some easy/fun/ review trials.

So, the time I actually got hurt? I was covering a class of children who I didn't know at all. I sat behind the chair of a little guy who was getting antsy and put my hands on the chair so it wouldn't tip over and get him hurt, when he suddenly jumped up and hit my chin with his head! It is ironic that after all of the hours of the close contact that occurs during our speech/language sessions, narrowly avoided injuries, watching out for my biters and suffering through getting spit at, my first real injury was by accident!

Of course, no matter how much we learn, how hard we work, or how hard we try, we may end up getting in harm’s way at some time or another. But, we still come back, seeing the positive qualities of the child in addition to the difficulties.  SLPs are dedicated to helping their students improve their communication skills!

For more stories of how love hurts, go visit the rest of The Frenzied SLPS!

The SINGLE Most Important Strategy for Dealing with Children

Help your students make better choices! Tips from Looks-Like-Language!
I know, you must be saying, “The single most important….really?”

YES, really! And the answer is… CHOICES!!

Whether you are a parent, teacher or SLP, we all have the same long term goal: to help the children in our lives to learn and grow up to be responsible, independent adults.  Nothing else helps them along the way like being able to make choices.

NO ONE gets to make choices all of the time, that is part of being responsible. But, we all love to have some control and impact in our lives, which is where making choices comes in. Imagine this scenario: Your students/children learn their academics and get to college, having never had any practice making choices.

Suddenly,  there’s a myriad of choices: which friends to make, what courses to take, showing up for class (or not), spending time studying (or not), whether or not to go to that party. Imagine facing all of that, and more, for the first time without ever having any practice! It could be like letting a child loose in a toy store!

Of course, this is an extreme example, but did it get you thinking? Responsibility is knowing what you have to do, and then doing it. Making choices, and sometimes mistakes, gives students the real life practice they need to be able to know when they just need to do what they are told and when they can make their own responsible choices.

5 Tips for Teaching with Choices

As adults who are helping children to grow and learn, we can guide them along the way by giving them the experience of making choices, when appropriate. This covers a wide range:

Toddlers:  Beginning choices are just based on having two appropriate, responsible choices.
Would you like this book or that one?
Which kind of cookie do you want?
Would you like to eat your fruit first or your cereal first?

Preschoolers:  Present choices along with natural consequences to help young ones start learning to think ahead and make the responsible choice.
You can play nicely with your toy and keep it, or you can bang it and break it. Then you won’t have the toy.
You can eat your dinner and have dessert, or you can throw it on the floor. Then food is done for the night.

School Age:  For situations that can allow choices, try  brainstorming possible choices and their effects, followed up by a discussion of possible consequences (pros and cons.) It is important to model the methods for problem solving and making responsible decisions to build those critical thinking skills.

Middle School: Students at this age are going to make their own choices, often regardless of what you think or whether a choice was being offered. Try to only offer possibilities after you know their plan for how to deal with a situation and see that they haven't thought it all the way through. Of course, students this age still need boundaries and consequences!
High School:
By now, you are hopefully reaping the rewards of years of teaching students to make responsible choices. In the later teen years, the goal is to increase decision making skills  until the student is able to function as independently and responsibly as possible. This means that students need to be able to determine when they can make choices and solve problems independently and when it is time to ask for help.

Next week, I will be be sharing some more practical tips for how to use choices, focusing more on helping young children communicate  I hope you’ll be joining me!

Do you need some tips now? Check out my post: 5 Tips for a Tough Caseload.

5 Tips for a Tough Caseload

Tips for working with tough kids! Looks-Like-Language

Or, ways to cope when you aren't having fun!

After years of working with students who can’t make it in a regular school setting, I’ve accrued a variety of hints for working with more difficult students. Here's some ideas for older students that have worked for me.

1. Include your students' interests!
Incorporating your students’ interests into therapy is always helpful for getting them to engage. Currently, for older students, this involves using YouTube links and video clips. Since my students have much more time to spend surfing the net than I do, I’ve found it helpful to let them choose a video clip to watch at the end of the session. As you become familiar with the types your students like, you can figure out ways to incorporate them to meet your IEP goals. In a pinch, if I can’t get students to respond in any other way during the session, I can count on being able to work on answering WH questions, having a conversation, retelling or summarizing  the video’s story, sequencing the events, and eliciting specific grammar or speech sounds when a surprise video is completed. This week's mailing includes a FREE worksheet to use with one of the standby YouTube links that my students love. Be sure to open it! If you aren't on my mailing list and want to receive my follower freebies, just add your email on the top!

2. Make a connection!
Many students with significant difficulties in their lives won’t really respond to you at all until they feel like they have a connection with you.  Getting to this spot often involves playing games, doing what they are interested in, and being open to listen to them before ever approaching your therapy goals.  This can be very difficult to do, as we have to be addressing our goals every session, but it can pay off in the long run.

3. Use many different formats to work on a skill!
My students often need a significant amount of practice, using specific strategies, in order to make any gains. However, they don’t have long attention spans and don’t like to do the same activities every day (unless they are on the spectrum, and that’s another post!) This is the reason why most of my products include multiple activities for the same skills, as well as ways to vary the difficulty levels.  Giving students choices about their work, even if it is as simple as offering a conversation spinner, conversation cards or a conversation game, can get students working since they have made the choice.

4. Provide choices!
Choices are a big option, and this includes the student’s behavior. I often tell my students that I can’t make them work, but I hope that they will think about their choices and make a good decision. While the students are contemplating taking off their hoods and looking like they might interact with me, I keep busy with doing my attendance sheet and getting out some easy, hopefully more engaging work choices than the one I had hoped to do that day.  I make it a point to have varied options for each IEP goal, and lots of games, available at all times for just this reason.

5. Use Incentives!
Incentives to work are so important! Negative consequences, such as notifying the teacher or parents, may work in the short term but are not ideal for helping students to make better choices for themselves.  Games, contests, something fun to do at the end of the session and point systems all can help. Prizes for older students can include no homework passes, extra game or computer time passes, items from the dollar store that interest them, something special from the cafeteria or school fundraising events or an end of year speech pizza party.

What has worked for you?

5 Dollar Store Must-Haves for SLPs!

Shopping at the dollar store has made my SLP life so much easier! Thanks to Talkin’ With Twang for this linky idea!
I’ve made so many purchases from the Dollar Store to organize my therapy room, provide student prizes and find fun, inexpensive materials for therapy. I really had to think about what to include so this post wouldn’t be too long. Here's what I decided on:

Organizing: Materials

I posted here about how much I like using page protectors. While I buy them online, I really the pretty colors of the $1 binders and I love how easily they fit on a shelf or in a filing cabinet. Pop your TpT product pages in a page protector with the game and spinners in a separate one. Store the game cards in a plastic zip bag and stick them in with the game. Put all of this in a binder, along with similar materials, and you are ready to grab it and go! See how easy? Pictured is the game board from my Talk About SH- Spring packet.

Organizing: For My Students

I love having basic supplies that I need for every session within easy reach. A cute basket can hold whatever you need on your table and make it easy for students to pass around. My go-to items include a small dry erase board, varied colors of dry erase markers so students have choices, small make-up sponges for erasers, and of course, the basic pens, pencils, erasers and scissors in a cup.  All of the containers came from the Dollar Store. 
TIP: Be sure to keep your permanent markers stored somewhere else! If a student uses the wrong marker, just write over the permanent marker and erase while wet. After few tries, the permanent marker will erase.

Organizing: Just for Me!

Don’t we deserve a treat, too?  I couldn’t resist this cute little colored cork board to keep my To Do items on. It is small, so I can hang it up right near me while I work. That way, at the end of the day, my notes of what I need to get out, copy or prepare before the next session will be in one spot. The binder clips are cute for hanging small items that get lost easily, too!

Fun and Inexpensive:

I was so excited to find this 100 day poster! My students love big board games and this fits the bill! Just change ‘days’ to ‘sounds’ and your students can race their way to 100 productions! I’d play to let them keep moving their cute little vehicles (Dollar Store erasers!) on space for every correct sound production at whatever level they are working on. When they make a mistake, they have to stop there for the next student to take a turn. Can anyone make it to 100 before time is out?

Check out the erasers in this picture. They make great game pieces! (They are lousy erasers, though!)


While I have tried many prizes from the Dollar Store, these are the all time favorite with my older kids. They come in varied colors, with some even having their own carrying case. I only give out prizes about once a quarter, and with my caseload, it is very much worth the money I’ve spent to have a daily point system that lets them work toward a prize!

I’m sure you’ve shopped there, too! Do you agree that it should be named the Ten Dollar Store? Maybe more? What is your favorite purchase? 

For more ideas, remember to stop back in to Talkin’ With Twang!

The Best Laid Plans of .... SLPs?

One of those days...

Yes, I meant to get out to the dollar store and buy cute little colored cars that fit perfectly on the game board. But, you know perfectly well that speech/language therapy is a make-it-work field and real life gets in the way of beautifully organized plans! For me, anyway. Maybe you are able to organize everything on Sunday night and have everything go as expected. If so, please, please let me in on the secret! There are lots of comments sections below- just fill one up! You’d make me sooooo happy! :)

Back on track (ha-ha!) my car idea didn’t exactly work when I grabbed the larger sized cars I had around. The students had to keep the front of the cars lined up with the space they were on, but the cars kept getting knocked into because they were too big. Then, there were arguments about where each student’s car actually belonged.

I did get my students to start some conversations with each other, but the best part really was when I had them brainstorm ways they could politely express their opinions about which spot was where the car actually belonged. We assigned an emotion to how each of the different choices would make the other person feel and practiced saying the best choice with an appropriate tone of voice and facial expression.

So, what do you think I should do next time I play this game? Use the tokens that come with the game or pull out the too big cars again? Maybe actually make that trip to the dollar store for tiny cars? If you tried this game with the right sized cars, let me know if it is actually worth running another errand!

Would you share a story about a time when your plan failed but the therapy worked? I can't be alone!
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