Therapy Games Are Serious Business

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Speech language pathologists (SLPs) have 30 minutes to motivate and maximize speech-language learning and production; we must use our minutes wisely.

“Hi Jimmy!  What did you do last year in speech in your old school?”

“We played games.” 

“What were you working on?”

“Hmmmm.  Well…I ugh…I’m not sure.”

Yes, we speech therapists play games with our kids.  To the casual observer, playing a game during speech therapy looks a lot like, well, playing a game. 

The game itself is overt; the part that people see. The speech-language therapy piece is covert.  We covertly observe and strategize to give them what they need at that moment in time.  We analyze intensively, then do, to shape and ease the child into improvement.  It’s therapy, not teaching.

And the game itself is not therapy.  The game is a tool that facilitates therapy.

So what qualifies an activity to be a therapy-game?  Any activity with a structure that allows verbal give-and-take and interaction, and turn-taking. 

A game can be ready-made, or something you make with paper or blocks, a barrier or a pocket-chart.  It can be an activity you do on your device or something you create with PowerPoint.  It can be a read-aloud story with cards or questions; or artic practice-tasks.  A game is anything that provides an enjoyable motivating framework for learning.

Electronic games have taken over board games in accessibility and popularity.  You’ve probably met a few kids that have no idea what a board game is.  That’s okay; use the novelty of counting and moving around a game-board to your advantage, they’ll enjoy it.

Benefits of Therapy-Games

Games Motivate.  Most of the kids we work with don’t like words, i.e., LANGUAGE.  Yet here we are, two times a week working on LANGUAGE.  Games through personal challenges enables them to overcome, participate, and learn something they are less than thrilled about.  It gets them to therapy, and helps them focus (hopefully on the material!) and stay on track. 

Games Offer Therapy Structure.  In the classroom, stories provide structure for learning and activities, e.g., “Write the answers to these questions about the story.”  In therapy, we dissect, drill down, and focus on areas of lack.  We dissect articulation into sounds and words, etc.  We dissect language into parts:  semantics, morphology, grammar, pragmatics, etc.  Games provide cohesiveness for segmented targets and concepts.

Games Provide Social Interaction.  Some of our kid’s dislike talking, or when they do, they get in trouble.  In therapy, they talk up a storm and it’s okay to do so.  In fact, it’s encouraged.  But also, it’s our job to help them develop and organize expressive social standards in their language; such as, turn taking.

Games Require Turn-Taking.  For the child who would love to be the center of the world, turn-taking is tough.  And it’s not just about knowing when to stop sharing, it’s about being willing and able to pass the floor to the next person.  To be courteous, e.g., establish eye contact, listen, nod, give encouragement, etc.  Yes, it’s a long-term process--just lay the expectations!

Games Nurture Processing:  You control the pace of the game, not the kids.  Some children need extra time to process the question and formulate their answer.  You be the judge.  For reeeeally slow processers that you want to speed up, you may consider using a timer, like on your phone.  The rule is, everyone in the group has to respond within 7 seconds (your choice).  Prompts for the slow processer are also appropriate, e.g., give them a choice between 3 words, or mouthe the first sound of the correct answer, or give them a synonym or antonym of the answer word, etc.

Strategies & Suggestions

Get the Game Started Quickly and Easily.  Tired of using your minutes to figure out who goes first?  Try these apps (if you haven’t already):  1) Selector, and 2) Tap Roulette.

Create a Code of Conduct for Game Playing.  Supplemental to therapy, let them know your game-playing expectations, a type of Code of Conduct:  Like parenting, give them the rules first.  It gives you a fall back, a reminder for them, in the heat of the moment.  Review your Code of Conduct every month so it remains fresh in their mind.

  • Games are fun, but learning is even more fun.  And besides, learning helps you live a better life, games don’t.
  • When it’s your turn to listen, listen.  “Look at the person that’s speaking, and listen with your ears, eyes, and mind.  Think about and be interested in what they’re saying.  Learn from them (not just you).  When possible, think ahead and be ready.”
  • When it’s your turn to talk, talk.  “Talk clearly, and in a way that we can all hear and understand you.  We’re all interested in what you have to say.  If you talk too loudly, that takes away from your meaning.  Use good grammar.  If I hear a word that isn’t correct, it’s my job to let you know and give you a chance to change it.” 
  • Everybody supports everybody.  Competition can be motivating, and it feels good when we win.   However, during the game, when ugly, unfriendly sportsmanship happens, remind them that everybody supports everybody.  No criticism or putting down others.  Only supportive words are to be used during our time together (good job, nice try, you’ll do better next time, etc.).  “Only say things to other people that you would want to hear from them.”

Targets in Games Must be at Their Capability Level and Relevant.  I love the book, How the Brain Learns, by David Sousa.  In it, he boils down what we need to do to generate long-term memory in our kids.  Two things:  1) Make sure they understand the material, and that the sounds or words or information, etc. is at their capability level, and, 2) The material must be relevant and meaningful to them. 

Repetition: “Children with language impairments need many learning episodes clustered together within the sessions but spread out over time across sessions.”  (Eisenberg, 2014) 

Some thoughts and suggestions on how to do, what I call, repetitions-with-a-twist.  The following can also be done with young children; just simplify the tasks and use pictures.

  1. Select a few appropriate target speech words, or high value language words (this is great for vocabulary).  Select nine (for example) relevant-to-their-needs words.
  2. Go through the nine target words identifying and saying the words.  Ask them to think about each word and share their PRIOR KNOWLEDGE about the meaning of the word.  Prior knowledge is anything they know or have experienced concerning the meaning of the word; it establishes associations for new learning connections.
  3. For the remainder of the activity, expand on those nine targets in a variety of ways that’s at their capability level; drill-down vertically (milk the meaning), rather than horizontally (adding more words).  Choose from:
  • Read it out loud
  • Sound it out, i.e., segment, then blend
  • Count the number of syllables
  • Come up with a child-friendly definition
  • Compare and look up the formal definition in the dictionary
  • List rhyming words
  • Determine if it’s a noun, verb, adverb, or adjective
  • Name as many synonyms as you can and write them down
  • Name as many antonyms as you can and write them down
  • Provide association words (go-togethers)
  • How could the word be used in an idiom?
  • Create a 3-word sentence; then a 5-word sentence; then a 7-word sentence. (note the differences in words used and differences in the process of creating longer sentences)
  • Put several of the target words together and make a sentence.
  • Put several of the target words together a make a short story

4. Toward the end of your time together, see how many of the nine words they each can remember.  Either individually, or go around the circle, each person siting a word.  Or, you say a definition of one the words and they tell you the appropriate word.  This type of activity can be done over several sessions.

Char Boshart, MA, CCC-SLP, has been a proud speech speech-language pathologist (SLP) for more years than she can count, in several cities and states.  Each year, she conducts seminars and speaks with numerous highly-qualified, highly-caring school SLPs. It is totally fun. She also writes practical books and blogs about life in the schools, and artic and language therapy. If you would like to hear more from Char, be sure to visit her website.

Eisenberg, S.  (2014) What works in therapy: Further thoughts on improving clinical practice for children with language disorders. LSHSS, Clinical Forum, Vol. 45, p117-126.

Eboatu, VN, Omenji, AS.  (2015) The impact of class repetition on students’ academic achievement: implications for educational policy making.  European Scientific Journal, Vol. 11, No. 19, p. 259-267.

Sousa, DA. (2006) How the Brain Learns, third edition. Corwin Press, Thousand Oaks, CA.