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PeterPan

Narrative language in autism

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19 minutes ago, kbutton said:

I am suggesting that if he is doing more complicated sentence structures in PROMPT, but it's divorced from a context where those structures mean something he understands and uses pretty spontaneously (from, say, your work with him), then I think it's essentially possible to make him hyperlexic in a way, but with speech instead of print language. You know for a fact that he memorized long passages that he used in place of his own language. I would think it's possible to keep doing that if the articulation is not paired with meaningful language activity. 

That's the crux of my concern. My son, even when he would sometimes say something in echolalia, refused to say or memorize something he didn't have a pretty good understanding for. He just tended to find it easier to use someone else's turn of a phrase. He will rephrase it if it's not too much effort for him. 

We had a point with our previous SLP where there was not carryover to everyday speech. There was something about how they were doing the PROMPT that was just not clicking. It may have been the rate was too slow or that there wasn't buy-in or something, I don't know. When I watched sessions, it was literally as if he had a falsetto, as if he had PROMPT speech and then the regular way he wanted to speak, and they were segregated in his mind. It was almost like he was going to a dance class and being forced to memorize motor planning patterns he didn't want.

With our current therapist, for whatever reason, we have not had that. His speech jives up and generally improves. She's able to connect with him and engage his cognitive without quite turning it into paranoia. We want him to engage his cognitive a *little* but not so much that his attempts become unnatural. For some kids, more typical kids, you could engage more cognitive and would. For him, it just totally backfires. So they do the motor planning in the PROMPT in a real way, in the way he really wants to talk, and we get carryover.

He has no articulation gap. Like it's not like he's sitting there lisping to get out a /th/ or /TH/ and that's making his sentences effortful. It's not like that. Everything that comes out is straightforward. He just flat fatigues, and I don't really have a solid, solid explanation for that. We could go back to the ADHD thing and say to put him on meds and use something else to counteract whatever goes haywire. We could say it's an expression of severe ADHD. We could say it's processing speed or the wiring of his apraxic brain. It IS a known phenomenon in autism that as people fatigue their speech drops. So for him to say it's HARD it's legit. For him to say he's fatiguing and wants a break is legit. What I don't have is cold hard science to say WHY and help me figure out exactly what to do about it. I have no evidence, no concrete explanation. I don't know if anyone does. It was a psych who told me about the speech dropping, and I dno't know if she has a concrete explanation. I could ask. All I know is our benchmark for successful apraxia intervention is EASE in speech and that we all wish for EASE in speech in our kids. I wish it wasn't hard. But it's not actually the motor planning of the precise sounds. It's some kind of cumulative fatigue effect, and it happens across environments and situations and demand levels. Just the fact that he's on the spot talking is fatiguing to him.

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4 minutes ago, PeterPan said:

I understand your ds can handle cognitive load while he's doing PROMPT. I don't have a great answer for that other than ASD2, kwim? I can tell you that when we were working with the previous SLP they found it was better to remove those elements. With ds, just with the way he responds and how it rolls, they're working on one OR the other. They either work on PROMPT *or* they pause the PROMPT and go work on inferences or something. They never do them together, and it has to be him, not the SLPs. They're reading him. After all, would you feed a cat and wash it at the same time?

I am not saying working on PROMPT and a new concept at all--like that the concept worked on during PROMPT would be automatic before being brought into PROMPT. Does that make more sense? 

You were giving examples of sentence complexity and not knowing words earlier, and then here you switched to things like inference. I was being much more cut and dry about what to bring into PROMPT. I just meant that if he doesn't understand in a very natural way how to use subordinating conjunctions, I would not have him saying sentences during PROMPT that use them. 

But, if your therapists are aware of the issue and seeing it, it will probably be on their radar. Your history of them not realizing that your son could use language he didn't understand is really underlying my concern on that, combined with you mentioning that PROMPT is not primarily about language but articulation.

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I get the fatigue aspect to apraxia. My other son's reason for it is different (connective tissue disorder that messes mightily with jaw stability). I am glad that you had many of the other problems clear up with the change in therapists--I don't always get the follow-up, and then the reasons for concern dangle in the wind. :-)

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27 minutes ago, kbutton said:

The real crux, I think is that kids with autism struggle with parts and pieces, struggle to know which ones they need, and they need these things added to their toolbox slowly because they have to generalize them. So part B has to match up with part A. Add part C, and it has to match up with A and with B, and so on. My son clearly has all or most of these parts, but they were not put into the toolbox in a developmentally typical fashion. He received no therapy for years. We didn't know it was a language thing. You have a chance to see that your son gets these things put into his toolbox in a more typically developing sequence, which might be more powerful than backing up and patching holes. It's very late with my son to do that--we are patching holes, and honestly, it seems like the holes with my son are how to put the pieces together, not the content. If we can make him understand what we want, he can do the parts.

 

I think this central coherence issue is HUGE. I was talking with ds as he watched this ridiculous Nine Lives movie yesterday, and it was so obvious he was seeing lots of parts and not knowing how they fit together. It was still funny to him, but he couldn't answer even BASIC questions because he had NO CLUE how the storylines fit together or even that they SHOULD fit together, lol.

But think about that. We're saying central coherence is an issue and that they need SGM to see the flows, totally agree. But that doesn't mean you have to use the stupid easiest model out there. It would actually be MORE fun to do it on something stupidly complex, like that 9 Lives movie, where there are enough different plot lines going to be interesting. Or, like Nixpix said, do it with Captain America and all this crazy Avengers stuff, lol. That's totally spectrum-friendly. I haven't seen it, but I'm just saying some spectrum people I know are way into it, lol. So you could take all those idiotic plots and intense emotions (hello, Thor, there's gotta be emotions there) and SGM it wacky style in Inspiration.

Obviously you don't start there, but you could. And you could roll your dice on connectors as you build the plot and tell it. Or you could make your whole map and then roll dice and build with conjunctions and just go crazy. Like you roll because and an emotion and you have to find some point in your map and make a because sentence with that emotion. Could be crazy, lol. You'd use the 6 universal emotions for that. I'm crazy for that framework btw. It's very hard, as an adult, to find systems that really make sense. That's just your tip of the day. When you find a really simple, straightforward system that seems based on some research that could actually organize a lot of the world (like all of lit, all of emotions, all of relationships because relationships are all driven by emotions), that's pretty handy. Just my two cents.

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36 minutes ago, kbutton said:

You KNOW your son has issues that we didn't know about with my son, and I think that you might solve them with or without SGM, but I strongly suggest that you won't solve it until you've matched all the parts and pieces pretty systematically with all of the other parts and pieces, and possibly not until you match it up (eventually) with PROMPT. How you go about doing it is your business. I am just suggesting that SGM might be a good overarching way to be sure you're actually matching it up in a more typically developed sequence. Your son is at a more sensitive period than mine for therapy, so maybe you are getting lucky or maybe you are matching up parts and pieces in a more wholistic and systematic way that you are able to articulate. But from where I sit, it's possible to have all the parts and not have them integrated, and it sounds like when people suggest something that could integrate those things, you minimize the tool. If you are integrating them, great. It's just kind of hard to tell. For those of us who are worried about the integration, the tool seems like a really promising way to integrate it all.

I keep going back to the idea that the sum of all the parts is greater than the parts individually with language. The reason this problem is so hard to state is because it's a very hard thing to pinpoint and give a name, and not every child is entering with all the same parts and pieces missing, integrated, not integrated, etc. When you say that they want to rub the tool on a kid like garlic, that's very dismissive. The tool might be ten times more brilliant than you realize if it actually succeeds in teaching what you don't have a name for without naming it. Whether it does or not remains to be seen--I am not an apologist for SGM. 

It sounds (to me) like you are saying that if I fill holes with my son, then all will be well, but you are missing that activities designed to fill holes show that he can pretty much do them, if he gets that's what we're driving at. It sounds like you are aiming to fill holes with your son, and I really don't want you to find out that filling holes leads to...the situation my son is in. 

 

I deleted a bunch here that was agreeing with you, because I do agree with you. I want to explain the garlic thing. I went to an SLP who specializes in expressive language (and probably apraxia, if you ask her) who was like oh he clearly needs story grammar elements, that's why he can't narrate. This girl had NO CLUE about VBA, and VBA clearly, clearly tells us that a kid has to be able to tact actions and then a sequence of actions before they're ready to narrate. Hello, it's OBVIOUS. So when I get really pissy about SLPs, it's because they're buying SGM and wanting to use it without building any foundation or without even realizing what's missing. She didn't have a CLUE. She wasn't offering to go back through and build up FFC like I've done. She wasn't skillful to help him be able to tact a sequence of pics, which is what he desperately needed. He's got that NOW because I did it. So he can go into something like SGM NOW because I was building it up.

And these people want $135 an hour from me. Seriously. And if they are wrong, I lose months, semesters, YEARS listening to them. And you can put in hours with a therapist and not get as much as you had hoped. That's what bugs me. 

Clearly I think SGM is worthwhile, or I wouldn't be spending hours making my own braidy doll. I mean, you do realize I've got kelp balls and squid legs and it's just all ridiculous all over my dining table. Ds is totally enchanted that I'm making him something and excited to know what in the world it is. I'm going to tell him it's a squid with a starfish and kelp rings. He's like kelp rings, what are those? Well they don't really grow that way, but they got wrapped around the squid.

So yeah, I'm in deep and I'll be doing it. It's just a matter of what and when. I've got a bunch of storytelling kits coming, and I really liked my idea for an Our Wacky Day journal using SGM icons. It could really work.

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I want to say something here that I sorta know and let slip from my mind. My hindsight from how many years of teaching dd was that any time I was making excuses or diverging widely from what a typical child was doing, that was a red flag. Like take coloring. We might want to say it's busy work, blah blah, but there are reasons it's done, even if we don't realize them. So I think you're saying SGM, reading discussion groups, etc. are maybe the same gig, that it's stuff that should work and be in reach and that NOT having them be in-reach is significant and something to be cautious about blowing off.

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39 minutes ago, kbutton said:

I think that we all have these areas in math, science, or whatever. But this is so much broader, and I think that you might be surprised--if someone did teach these things to your son, maybe those things would actually eventually make a difference to you.

There are things I have no use for that my kids need and vice versa. But, my son's ASD is less severe, and people are really going to expect things from him that they might not expect from your DS. We have friends whose son does better with certain kinds of academics, but he can't make a sandwich without assistance. If it were up to me, there are entire realms of information that I wouldn't bother to expose them to or teach them, and it would be very hampering. None of them have anything to do with areas of neurotypicalness--they are more cultural or personality-based. But my kids aren't me even when they have things in common with me. 

It's why I haven't decided what to do with our increase in funding, because I haven't found the person that seems right to do that. I've actually been looking across domains and labels. I'm just looking for the person with those strengths, someone who enriches ds when he has time with them. I think it's less about what specifically they're doing. Just haven't found that person yet. I have a BCBA practice I talked with that keeps like 10 on staff and has RBTs. I've got ideas floating around like that. There are other services. 

We've floated some other ideas too, like one day a week in a Montessori school that is good with SN around here. I haven't been to visit. They're sorta different, and it might or might not be a good thing. But we're floating all kinds of ideas. When I found the therapy place we're using now for social skills groups, I knew I had found something really special. I just figured I'll float ideas for a bit, let it all fluff up and settle, see what sticks in my mind as being most important. The behaviorist feels like we're doing so much right now that we just dno't know where he'll be in July. She wants to kind of watch and let it unfold. So I could get really impatient, but on the other hand she's right that we need to let it unfold.

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30 minutes ago, kbutton said:

I get the fatigue aspect to apraxia. My other son's reason for it is different (connective tissue disorder that messes mightily with jaw stability). I am glad that you had many of the other problems clear up with the change in therapists--I don't always get the follow-up, and then the reasons for concern dangle in the wind. :-)

Ahh. Nope, we're totally good with this therapist. I'm at ease and she handles behaviors adequately. I don't think it's perfect, but I also think he's not perfect. One of the SLPs we tried for expressive was a really hard cookie, laying down the law, and all it did was exacerbate things with him. So I look for calm going in, calm going out, and compliance. As long as we're getting that and his speech is improving, we're taking it. 

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36 minutes ago, kbutton said:

I am not saying working on PROMPT and a new concept at all--like that the concept worked on during PROMPT would be automatic before being brought into PROMPT. Does that make more sense? 

You were giving examples of sentence complexity and not knowing words earlier, and then here you switched to things like inference. I was being much more cut and dry about what to bring into PROMPT. I just meant that if he doesn't understand in a very natural way how to use subordinating conjunctions, I would not have him saying sentences during PROMPT that use them. 

But, if your therapists are aware of the issue and seeing it, it will probably be on their radar. Your history of them not realizing that your son could use language he didn't understand is really underlying my concern on that, combined with you mentioning that PROMPT is not primarily about language but articulation.

Yeah, then we're probably saying the same thing. They can't work on formative grammar for him AND work on PROMPT at the same time. Too hard, too much. 

I had a point where I wasn't happy with the previous SLP, and it was a combo of things. The results weren't there and it was hard to pinpoint why. Now we have results and collaboration and everyone is happy. And people can 2nd guess, but reality is ds has severe apraxia. Reality is we've worked a lot of years and have more to go. And when you meet the next person who has severe apraxia who's doing this well, let's just have a little chat and say what I did wasn't good enough. What we've got is a MIRACLE. My issue is always wanting MORE. I want the apraxia to go away. I want the speech to be easy for him. I want it not to wear him out just to say "A hammer and pliers are alike because they both have handles." That isn't FAIR and that it's like that, and life is not fair. And it sucks. And I wish my ds' behavior was perfect and speech was perfect and articulation was perfect and that he could narrate beautifully and get it all out. And I can't make it happen, no matter how hard I try. And it SUCKS. I've driven myself to the bone, making things, driving hours and hours to therapy sessions. I had pneumonia twice and bronchitis once in the last 6 months. I've tried. And I can't stop trying, but I can't make it all better. Nobody can. And it SUCKS.

That's a rant, that's all. I could enroll him in a school I found and he'd be happy. He wouldn't get any more speech therapy or language development, wouldn't be able to get thoughts out to write, wouldn't be able to do ANY of the things, I'm giving him, but they could make him HAPPY. And it SUCKS that that's my choice. Giving him all the therapy he needs would cost an astronomical amount, and no one is dedicated to doing it. Just walking in the door would cost his entire scholarship. But he'd be happy. Is that really a great choice? It's not the choice I'm making for him, but I think it SUCKS that I can't give it all to him.

So I'll do the best I can. I hope we can finish PROMPT in a year and maybe have some flexibility. I don't know. I don't even know if we're that close. And really, I don't know that he'd like that school, lol. It's just a yucky stage I think. And I'm just ranting. I need to step up my game, make a new plan for summer, bring in some more pairing and fun things. Being sick for weeks has really killed that. I've gotta find my zip and get us into a good summer routine. It sorta crept up on me and I haven't figured out what it will be. Some of the things I thought we were going to do fell through. The social skills group I was most psyched about fell through, like literally no one else enrolled, lol. It was supposed to be celebrations (I was calling it party club!), which is why I was looking at that East Meets West. I was thinking we could use those books to do a holiday a week and have weekly parties for the summer. They're also doing an SGM writing group this summer, and ds is on the list. Guess I never told you that, lol. I was just undecided, because where ds was a month ago it would have frustrated him. Now, with his improved ability to use active verbs and describe things, it might actually be in-reach. It's being taught by 2 SLPs. I haven't canceled. I was just watching it to see, as we got closer, whether it would be a good fit. I'm just really, really cautious because I've had people SCREW UP good things that I wanted my dc to like. So if they're not going to do a good job, I don't want them doing it. But if he's ready, he might have fun. I thought it would be good for him to see how his peers handled the tasks. That alone would be enlightening to him. And we have our travel club for social skills. And we'll be able to swim every day. They actually opened the pool today because it was 90, oy.

Well that's a good point about the SGM group. Yeah, I have him signed up for one, lol. And if I leave him in that, I just need to keep working toward what will get him ready for that. The emotions work, the perspective taking, and the journaling about our day. That would be enough. If he has those pieces, he'd be ready to go into that club. More work with Talkies and description. Yeah, he's actually pretty close now. I could almost see us getting there. It's good to be on the cusp, not necessarily doing the skills. That way he's not bored. So then if he's going into that, do I need to buy stuff? Goes back to my infatuation with expository, lol. They'll probably nail the basics of narrative elements in the club. Maybe my brain or God had already fit it together and I didn't even realize it?

The other thing about our coming summer and school year, which goes back to what Lecka was trying to address, is that I want to have more things that he can do independently. I want us to get this year to where he can wake up, go to his office, do some things on his list and know he's free then till I work with him. He needs that sorta can do, get in and do it, kinda thing going. It's responsibility and structure and I think the independence would empower him. So I just haven't figured out a list for that. We've worked on independent work, but not quite to that extent. So I don't know how reading say a lit book to discuss fits in with that, but in theory it could. Something ike a BJU 2 or Mosdos or something might work for him, dunno. Lit guides were also so unnecessary with my dd, so tedious. They're most useful when they're actually getting the person to think in a way that pleasantly stretches them. It would be interesting and it could fit in with that idea of independent work and discussion. It's a challenge though because I can't just ramp up a zillion hours with good things. It has to be targeted and a manageable total amount. But there are things I'd like to nurture (that independent work thing) that are more important even than the whats.

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I've been thinking to have him do some prompt-writing this year. I think he's really ready to have an opinion, lol. I haven't totally figured out how I'm going to do that (dictation software, whatever), but it's my plan. I thought it could go in that independent work time. I think he could have more things like that.

Oh, the prompts would be from the JumpIn manual. I need to look at them and see if what I'm remembering is how they are, lol. They seemed to be concrete, not too creative. I think creative ones we'd need to do together. They'd be fun too. It's stuff I want to grow him into doing because I think he's finally ready. 

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24 minutes ago, Moved On said:

The role of declarative and procedural memory in disorders of language

https://pdfs.semanticscholar.org/4a68/c5ee4d60e329ebf460a03702a56bb8a4867c.pdf

 

The sentence structure book is customizable and includes suggestions at the beginning of the book. 

So are you saying you used the No Glamour sentence structure book I was referring to? Yes, I had noticed their suggestions at the beginning on ways to use it. That was actually part of my pause, because I didn't want to use it and not use it well, lol. But yeah, if you used it I'd be interested in hearing how you used it. 

I'm missing the point then on the declarative and procedural memory. You're saying it explains why language is hard, because he's going at it other ways? Is there a take-away or something you DID with this juicy bit of info?

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Wishing you all the best,

M

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16 hours ago, PeterPan said:

 

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Ok, now for your laugh of the morning. http://www.linguisystems.com/sample1/31171.pdf First picture on the first page of this sample workbook for teaching problem solving shows a boy with a birthday cake and the boy has taken a nice swipe of the frosting and has a grin on his face. The book asks what the problem is, and I'm looking at this thinking what is the problem, there IS NO problem! The boy is happy, he got frosting. LOL :biggrin:

Apparently I have a little ways to go in my thinking, lol. My dd says the behavior was unexpected (a social thinking term), so fine but unexpected doesn't mean it's a PROBLEM. LOL 

And the way all that connected? CT is saying to state the problem, how you feel, and the plan. So that's problem solving, which means we have workbooks on problem solving, which means we can work on that issue across a wider range of facets and get carryover to lit. Or working on the lit builds the capability to work across more facets. Either way, there are workbooks for problem solving that might be complementary to CTT work. 

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25 minutes ago, PeterPan said:

Ok, now for your laugh of the morning. http://www.linguisystems.com/sample1/31171.pdf First picture on the first page of this sample workbook for teaching problem solving shows a boy with a birthday cake and the boy has taken a nice swipe of the frosting and has a grin on his face. The book asks what the problem is, and I'm looking at this thinking what is the problem, there IS NO problem! The boy is happy, he got frosting. LOL :biggrin:

Apparently I have a little ways to go in my thinking, lol. My dd says the behavior was unexpected (a social thinking term), so fine but unexpected doesn't mean it's a PROBLEM. LOL 

And the way all that connected? CT is saying to state the problem, how you feel, and the plan. So that's problem solving, which means we have workbooks on problem solving, which means we can work on that issue across a wider range of facets and get carryover to lit. Or working on the lit builds the capability to work across more facets. Either way, there are workbooks for problem solving that might be complementary to CTT work. 

Yep, those workbooks are completely correlated to the TOPS testing, I believe!

I think it's not just that it is unexpected, at least from real life experience. I think that the remediation might be to talk about and explain expected and unexpected behaviors, but I think that there could be numerous problems with the behavior that go beyond the obvious.

So, I'll be clear I'm really jumping the shark about your telling on yourself, and I am not picking on you! I promise!

I mention this because I've seen some of these kinds of things IRL and have heard some sad stories about behaviors like this that persisted and caused major issues--this list might be tailored to the picture, but the stuff I'm mentioning is not in the realm of made up. I've heard other parents pulling their hair out about stuff like this:

  • Possible ADHD impulsivity--restraint is like a muscle, and you gotta use it to get better at it, and we have to use it across settings to exercise it. 
  • Maybe it's not his cake! 
  • Maybe he rushed up to the table and had been playing in the mud (or had just used the bathroom and didn't wash his hands).
  • Maybe the cake was really important to someone--another child in the family was learning how to decorate cakes, and this was a HUGE project.
  • Maybe he went out of his way to find the cake and do this, and he does this for ALL special cakes.

Are the publishers trying to cover all those scenarios? No. But I think the idea that there is no problem could unintentionally send mixed signals to a child that is already having trouble generalizing rules. I will be the first to raise my hand and say that we had issues with some compulsive behavior in my son that my MIL instilled in him and encouraged to blossom. Other people did similar things even after I would explain what was going to happen if they did x or y and let him have carte blanche to do what he wanted. People who got it drew a line with him, and it went well. People who did not (like MIL) refused to make connections to their encouragement of certain behaviors and often blamed it on me. In our son's case, we were fortunate that our son generalized, "This behavior is okay with Grandma" vs. "This behavior is okay all the time." It could've gone the other way and been super, super problematic, and potentially dangerous.

It sounds overblown to be so picky when there was "no harm done" (I know it does because even other NT think so, lol!), but one of my son's intervention specialists told me a story once about a young woman who couldn't keep a job she was super qualified for and that she was super suited to because of how she behaved around CHEESE in the employee cafeteria. She had some serious compulsions around cheese. When she would do lifeskills work at the grocery store, some of her workers would humor her cheese compulsions (but not this intervention specialist). This intervention specialist really thought it was a problem but was ignored, and she turned out to be right in a very sad way. She did try to break this strange compulsion with cheese, but since no other people worked on it (and even actively encouraged it), she was not successful.

We just never know what "benign" thing our SN kids are going to generalize and how it might play out downstream.

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Oh I'm totally with you that my natural, ornery, reaction ISN'T what I'd teach to him, lol. I was just surprised to find the resource even. I've been pouring through the Linguisystems/ProEd stuff, and somehow I had missed it. When I searched for problem solving, thinking it might enhance or pair well with the CTT, tons popped up. Like literally the whole list is good, every single thing. 

And yeah, ds' would be in that camp. Not only would he not know why it was a problem, but he really, really wouldn't take any perspective to think through anyone else's position or even care if they had a position. Like I at least know it was unexpected. He'd be more like the cake exists, therefore it's for me, therefore I can do what I want, therefore my behavior was the expected behavior, end of discussion, lol. And yes, he has that way of doing things EVERY TIME. 

So yeah, I just thought this was a really good find, another strand to go down. I just find I really like the structure of the workbooks. They fit my seeming need to be hyper-thorough. They're structured and lead you into things. I'm finding that a fair chunk of what SGM is trying to do for analysis can also be done if you're willing to buy enough of these materials from Linguisystems/ProEd. It was all there. It's just that it costs money, is scattered, and takes time. And I don't think it's either/or. I think ds' deficits are deep enough that we could do it LOTS of ways and not have it be overkill. We could talk about problem solving with the No Glamour cards AND do problem solving with lit via SGM AND do it more ways and it just would not be overkill for him. It would be more repetition, more raising it as a thing to have on his radar.

I've also been thinking I should pursue the concept of right/wrong with him. I haven't done that, other than reading him the 10 Commandments (which modestly helped but didn't totally sink in). Like he really doesn't have some hard lines in his soul of this is right, this is wrong, this crosses moral/spiritual/legal lines, that lines even exist. He's just his own moral universe and compass of wants. Somewhere in there, as you start to problem solve, is the potential to address the idea that there would be not only expected and unexpected ways, but ways that cross the laws of God, ways that cross the laws of man, etc. I don't know how those overlap and how far they take expected/unexpected. At some point that's not enough, because it's not really producing moral clarity. People EXPECT us to follow the laws. People EXPECT you to care about laws and that they exist and that they define to some degree what is expected/unexpected. My ds is internally lawless, and I haven't quite found a way to remediate that, lol. It's a severe deficit in social thinking in a way, a being really wrapped up in your own world.

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I think our mutual speech therapy place has at least one of the TOPS remediation books. If you don't want them to tackle it, perhaps you can ask to see it, or work it into "homework." 

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Added the Practical Theory of Mind Games into our mix today, and it's pretty cute. We did the first 3 lessons, and I think we'll continue to chunk it like that. The sheets are adorable and it gave us good conversations.

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Ok! Finally felt well enough to call MW today and talk to MaryEllen. So wonderful. She said I'm on-track, to keep going at it the way I'm going, and that I need to keep it very real-life right now. She said I was RIGHT thinking that he'd be ready to do expository before narrative and helped me connect the stage of narrative he's at with which expository structures he could do. We talked through maps and graphic organizers, but basically she thinks he needs custom organizers that fit what he's ready to analyze so it can be right in the moment. So she was saying to make lists of steps for tasks, talk about cause/effect with the weather or things we're seeing, that kind of thing, and use the stamps and make the organizer on blank paper right there, boom. I've been doing this to talk about our day, and she REALLY liked that.

So her basic advice was keep going the way I'm going, buy just a few things (stamps, magnets, first book of the autism sequence), and then get more when my gut says he's ready for more. 

She said that having the expository/narrative flip is common and that I was on track there. She said with trauma kids in schools that's what they're having to do. They keep working on the emotions separately, knowing the personal narrratives and lit narratives will take longer and be held back, and they go forward with the expository. So I wasn't crazy. She really was not advising any kind of rush, like put him in xyz level. It was more like you're going to have to go exactly where he is, get out what he's ready to get out, focus on the icons so he can realize what he's getting out. 

Well off for a few errands. My energy is slipping, but it's my b-day. Gonna go get my hair cut. Ds' map for his day was so cute. His kickoff/problem was that it's my b-day and he has no present and needs to plan a party. His plan was go to his aunt's to get a present and plan a party. :biggrin:

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That sounds awesome!!!!!!!!  I’m glad you could talk to her!

I think the samples for the 1st autism book look amazing.  They look really good and also really clear for parents.  I would love to hear how you like it.  

His kickoff/problem for today sounds so sweet :)

Happy Birthday :)

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I did finally order my SGM stuff. I went with the autism book trio, the stamps, the Braidy interactive poster (faces, connector words), the mini magnets, and the My Fantastic Words junior thesaurus. I didn't think the larger ASD kit would be useful to us, because the games are really too much language and too mature for ds. I liked the Braidy interactive poster for the faces. The thesaurus we can use with emotions, etc. 

So now I just need to get my doll and braid thing done. I have scads of books coming from the library. I thought about getting Core of the Core too, but really she was saying our expository needs are limited enough now that I can just make custom organizers with the stamps and be done with it. But she was really up on doing expository while working on the emotions and founds for narratives. She was definitely good with that. So I didn't blow the bank too much, lol. Making the doll is crazy though. It takes a lot of time and would have been better to buy.

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If your son is excited about you making the doll, that could make him a lot more interested in using it, though.  That could go a long way!

That sounds great ?

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I think he's a little old for the doll and that if I had just bought it he would have poo-pooed it. But by making it myself, it's kind of curious and personal and something he's interested in, yes. He asks about it every day, wanting to know when it will be ready, lol. So I figure I'm letting the dramatic tension mount by taking my time. :biggrin: Well that and I'm not looking forward to hand-sewing the rings the last bit. Maybe I'll find a way, but I've been putting it off. I need to hit the stick or my enthusiasm will leave as my energy returns. I woke up at only 35% fatigue today. I'm finally improving a bit. I've been at 70-80% fatigue for weeks now. At that level all I can do is sit. I can work with him, but i'm not very peppy. I bought us an inflatable kayak on a deal on amazon, and every day he asks if we can go, lol. The SLP offered us twice a week sessions, thinking summer was a good time to do more, and I'm like no, I think we should go kayak. :biggrin:

Oh, this was funny. So for his plan yesterday, he said he needed to go to his aunt's to buy me a b-day present. When he brought it to me, I asked if he had gotten me something *I* wanted or something *he* wanted. He said both! He got us both life jackets with the $20 I had gotten him. LOL What a smart boy! I thought for sure he'd get me a nerf gun or something HE wanted, lol.

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I think you should go kayak, too.  It can give so much to talk about, more than being in a speech office.  It’s good to have balance!

That is so nice he got you a thoughtful gift for something you can do together.  That is so sweet and it is really appropriate too in so many ways!  

It sound fun!!!!!

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Couple small updates. By working in small chunks at a therapeutic level the way we are, ds has been getting lots of opportunities to ask for breaks. Now I've gotten some room to extend that, so instead of just saying "I want a break," which is what we finally got him saying, now I've been able to push into "I want a break because I'm hungry" or "I want a break because I want to go back to my apps" or whatever. That's really good stuff!

And I realized too that he hasn't connected any of his body awareness scales (which I want to work on more) with adjectives. So the next thing we could do is make that explicit with charts and language. Like after lunch I asked him where his hunger was on a scale of 1-10 and where it had been before lunch. Well before lunch it was a 10, so I pointed out he could have said "I'm STARVED!" That would fit with a 10. 

That's actually two separate wins or ideas there, because one is making body scan check-in forms. I haven't done it yet, but it's my plan. He doesn't really understand enough to do his own body scan and he doesn't slow down and listen to anything So I'm thinking a check-in form using 1-10 for each part would work. It's probably in the interoception book, lol. I finally dug out my copy and need to go through it. So much seemed inaccessible or impractical or not well thought out. The concept was right but the methodologies were all worthless. So we need to do check-ins with numbers and then we need to make gradation charts where we go 1-10 and put that to language. The Int book wants you to put language to the feelings, and that I guess is what is not getting us anywhere. Who gives a rip how your knee feels? Nobody. But to put a number and translate it into something you WANT to say, that's actually useful. And we could do that for all the systems, all the numbers, and laminate onto cards on a ring. Then he could point and explain himself or use language. It would be more nuanced. Kbutton is always warning about a lack of nuance...

The other update? We're FINALLY getting ready to finish the never-ending SPARC Attributes book. My lands that thing has gone on FOREVER. It's been good, but what an enduring slog. Ok, I have bronchitis. But even at 1-2 a day, the book has just been hard, a lot of work, very challenging. WORTH it, absolutely! But a lot. So, of course, we'll keep going with more SPARC books. :biggrin: Gluttons for punishment we are. LOL I think we're going into SPARC for Grammar next. I sorta thought maybe it was simplistic, but then as I was looking at the samples I realized it's exactly what he needs. I think he doesn't UNDERSTAND "I". Like something so foundational. I don't think he gets it. I think that alone could be revolutionary. I think it's maybe why he uses lots of things in his speech but doesn't use them right, doesn't say things the way we would. So we'll see. It can't hurt and it might be miraculous. Hopefully it will be easier, since it builds on methodology we've learned in the SPARC Attributes book. 

My other realization in this is that we've been doing an astonishing amount of reading. He's basically reading 15 plus pages to me a day. So like if someone else had their kids reading chapter books or something, he is reading a lot. Some of the pages (another 5-6 a day) are pictures and talking about pictures, but a LOT of what we're doing requires him to read. And I have him doing all that reading OUT LOUD to make sure that motor planning is getting there. I think it may have really stepped up the expectations for what is normal to read, what is ok to read, because he's banging out so much, page after page. And when you consider a year ago we were doing and cheering about Fountas & Pinnell readers, that's pretty cool! But it also means he couldn't have done this work a year ago. We would have had to do it lots of other ways, because he couldn't have accessed it this way. It might also be why he's fatiguing, hmm. I definitely don't regret it. Reading aloud all these speech therapy pages has pumped tons of age-appropriate, useful language into him.

I'm still working on my list of what I'll order/use next, and I'm still researching spelling.

 

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https://nj01000539.schoolwires.net/cms/lib/NJ01000539/Centricity/Domain/27/Lang_Speech_Curriculum_2012.pdf

This pdf is an outline from a school district for their language intervention for each area. It shows what the SLP would use for APD, for grammar issues, etc. etc. A lot of it is stuff we're discussing here, but it has some ideas I hadn't seen and organizes it all really nicely if someone is overwhelmed and just wants to know where to start.

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I think if one book in a series worked well, it makes sense to look for books from the same series.  I think that is a good idea.

That is awesome about asking for breaks and giving reasons.  It is so functional and it’s on a top ten list for reducing problem behavior.  That has always stuck with me because it doesn’t seem like it would be that helpful, but then it is!

I think the self-monitoring forms sound good too.  I have never done it but self-monitoring is an evidence-based practice.  You can do it on a schedule or with timers if you want.  To be more independent (when that is appropriate, but I like all the language when there is discussion about it together), there are things where kids do self-monitoring checks with a timer or as an item on a list.  I hear good things about all kinds of self-monitoring forms.  I think that is a great idea and nice to be able to do it through the day.  

 

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36 minutes ago, Lecka said:

...That is awesome about asking for breaks and giving reasons.  It is so functional and it’s on a top ten list for reducing problem behavior...  

Oh yes, it's just so obvious it's like this huge relief to him. It's almost like he's trying it now to see if it's the real deal, if he really can just say that and have the words mean something and have them be powerful and get him a break if he makes the effort. So much better to be able to get out something he is feeling than just to be frustrated and trapped. And look how long it took us to get anybody to acknowledge the language issues. An SLP we tried this spring ACTUALLY TOLD ME that I had TOO HIGH of expectations, that he talked like her son!!!!!!!!!!!!!!!!!!!  For real. That's literally what she said. 

Yup, the bummer is I'm realizing that eventually he's going to need to go through the level 2 books of the series. I'm skunked about that, sigh. But at least we have them and  know what works now.

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That sounds great ?

Something to keep in mind, I looked at the sparc sample and I think it looks really good.  However anything with a picture is a tact.  You may need an additional step doing the same skills as intraverbals (oral only with no picture).  My son had to learn everything first as a tact and then transfer to intraverbal, and it is hard for him.  

It’s a reason with him we see him talk much more easily about everyday life things, because it is more like a tact with an object present, and then conversational language is often not about something we currently see, and that is an intraverbal.  

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That was the next thing I was pondering, how to tell or be certain I'm getting the skills to carry over. I HAVE to use the visuals right now, because I have to make sure that he really gets the meaning of the individual parts. He has chunked meaning, but his SPELT testing shows the breakdown in comprehension at the word production level. He doesn't actually understand the meaning to rearrange them.

One of the options I have with my funding is to bring in a BCBA from a practice that has a lot of them where they have RBTs. It's a large practice (10 BCBAs) and I could use my funding. That would be a way to be organized and work on language, non-verbals, etc. However I got word on the street (and it's something you've said before but this person said it like she's heard stories) to be absolutely certain the BCBA has significant experience with ODD and not just let them go bringing any old person in. They did say they'd only bring in veteran RBTs for him, not novices. I won't let in novices anymore.

Anyways, I started that discussion with them and didn't finish because at the time I wasn't certain of my funding. Now it's just one of those things where I don't know what could happen. In my mind, it could be really good. However bringing people into my home means compliance issues. He's used to running his world, and I feel like when they try to connect by pairing he just runs them all over the planet and never transitions. Then he starts treating ME the way he treats them, which I won't allow. 

So I don't know if that would work or make more problems than it's worth. It gets sticky when you're saying your behaviorist (not BCBA, old school, before that) is running things but that you're bringing in someone else to do language and maybe non-verbals. That's really sticky. If someone was good with RDI or would have goals to work on some of the RDI skills the RDI person assigns, I'd love that. I'd like someone to play with him more. The behaviorist is working on language with play, but he could really use more time. It wouldn't even have to be a ton to make a difference. I could see if the behaviorist could come out more hours. I don't know. The RBTs are more cost effective than an SLP or behaviorist, but that doesn't mean they're the same caliber. It would have to be a high quality person.

So anyways, that's why I haven't called back, because I was worried about provider conflicts, sigh. But the idea and potential is there. The RBT could also go to church and help us problem solve there. Our church has been utterly, utterly unhelpful. I'm basically on my own to make supports happen, which I guess means I need to call. In a month I'll have the higher funding, so it's probably time.

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This is sort of a rabbit trail, but Lecka ages ago had mentioned the idea of auditory processing and had differentiated it from APD, saying there was an expected component of issues with how they process auditory with ASD. Well as I've been going through these lists of workbooks in the Spotlight series (Linguisystems, Pro-Ed Inc), what I'm finding is that ds *needs* to do the listening comprehension books but that they're the most challenging. And it finally hit me, duh, if you're working on understanding the language, you're not really ready to work on it with that higher level focusing on listening comprehension. But maybe in a way that is part of the answer on moving from tact to intraverbal? The speech therapy materials are putting it under listening comprehension, where they remove the visual and do it all orally, boom. 

So it was just my realization, sometime between last night and today, lol., that we're going to need to go through all that but that we need to focus on doing this stuff with the visual supports first.

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If he's making the sentence from words on a page (text) but NOT with pictures, is that still a tact? A lot of his worksheets have words that you combine or written questions you answer or have you form sentences to justify your answer.

So with the words, he can do it but it's fatiguing. I would say with the pictures what we're doing is getting into his brain. I'm trying to get in there and make lexical organization and get it down to the BITS, the teeny tiny bits. So that ability to overlay a conjunction and have him SEE what it means I think will be good. I have him doing them now, but I don't think he really gets them. He will benefit from the visual step.

I think it will probably be that progression in the materials from very visual with language to text with language to listening to use language. The SPARC books are expensive, but they're super fab awesome for bringing in the visual. They seem to be making concepts click in his brain. Yesterday he used a definition, like totally made his own, following the pattern of what we've been doing with SPARC. Blew my mind. He was joking with dh and said he was going to get up and go get "something with two cookies and ice cream in between." That's pretty amazing!! (He wanted an ice cream sandwich, lol.) 

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The reality too is I don't think we've accounted for the effect of the severe apraxia here. By the numbers, that's where he's at. (where he was at a year or two ago, I forget) It's why he's needed therapy so long and will continue to, because it was really significant apraxia. By having him *read aloud* everything, he's just getting massive practice in actually using his language. He's saying things, working through the motor planning, practicing to automaticity, over and over and over and over. To me, what I'm listening for and looking for is how that gets easier. Like where maybe at the beginning he was reading the instructions silently and now he's reading them aloud a little more willingly. I'm tracking his fatigue.

This idea of just bulk practice, like just plain talking more, seems to be really useful to him. I almost think maybe we should have a read aloud hour where we take turns reading pages in a book to each other or something. I think it could almost work. I think he may need to read aloud and get massive amounts of practice using more complex language, just by reading it aloud, before that motor planning will be there and be easy for him. Like maybe not too difficult a book, but something engaging and descriptive, something with adventure. I think reading aloud those sentence structures could be that middle step leading to getting it out yourself. 

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What that tells me too is I should find some things that are written in narrative, things written in sort of a daily journal style, and have him read those aloud. They would give him more automaticity in that type of language I think. I don't know, I've never heard anyone say that. He just seems to be eating up language now. I think he would benefit from ANY language I brought in. I'll have to think about that more. Like if he listened to that journal/diary style book on audio, I'm not sure it would have the same effect.

Just to answer my own question, I think the logical way to do that is with reading aloud the pictures books for our narrative work.

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I think it's still tacting.  I'm not sure.  

You are separating out coming up with the response, from the sentence formation.  Those are two pretty big things happening, one, coming up with the response, and two, forming the sentence.  

So -- I always get confused on this, but sometimes the same thing can be a tact, or an intraverbal with a prompt.  So -- I get confused on that, but to some extent, if you have that prompt then it is a tact.  But for an intraverbal it would have a prompt.  So that is still good and everything, it is just with a prompt, and then you just have to see if he can do the same thing if you ask him without the prompt.  And then if you have supplied the language of the responses recently, that could be a prompt.   

Because it is a difference if you have just been talking about that concept or words, or if it is more out-of-the-blue.  It is harder when it is more out-of-the-blue.  

If you don't see any hang-ups then you don't need to worry about it.  It matters more if you see a lot of things like "he did it when we were practicing, but why can't he do it now?"  

It also matters if it is a mand or an intraverbal..... for the ice cream sandwich, if he manded with that (made a request) then that can be different from if he had to respond to a question, without any visual prompts.  

Like -- if you were in the car and asked him "what do you want for dessert," and he says "an ice cream sandwich," that is harder than if you are picking things from the freezer.  And, it's harder than if you have listed off some things he likes to give him ideas.  

I think it sounds really good, but mastery criteria is often going to try to be that something can be used in conversation.  Conversation is going to require listening, responding quickly, and responding appropriately based on what the other person said.  That is a pretty high bar, but you don't have to do everything all at once.  It's just something to keep in mind depending on what you see with his language use.  If you see he doesn't use new constructions or come up with responses, in some circumstances, then it's something to consider.  If you see it does then it is not an issue.  

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On the listening comprehension, it does tie in with intraverbals and it gets pretty similar.

When you have worked on wh questions, have you worked on wh questions where he just listens to something and answers a wh question?  Because that is more advanced than what you are doing right now, so he may be able to do more there.  Answering "general knowledge" wh questions with no visual is also more advanced than what you are doing right now, I think. 

There are so many levels to wh questions.  They can keep getting harder and harder.  

So your listening comprehension materials you are looking at might be on the harder side, maybe you could use easier listening comprehension materials.  I don't think it's too soon, but I don't think you have to rush and do it now, when what you are doing now is good.  

Plus there are listening comprehension demands in every day life, so in a way he is going to do it every day anyways.  You can see what you see in every day life, if there are things he gets and then things he misses, and that might help you find a good level.  

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2 hours ago, Lecka said:

It also matters if it is a mand or an intraverbal..... for the ice cream sandwich, if he manded with that (made a request) then that can be different from if he had to respond to a question, without any visual prompts.  

Like -- if you were in the car and asked him "what do you want for dessert," and he says "an ice cream sandwich," that is harder than if you are picking things from the freezer.  And, it's harder than if you have listed off some things he likes to give him ideas.  

Yeah, with the ice cream sandwich thing, that was totally out of the blue, totally him. He had the idea in his head and was telling us what he was going to do. Actually he was asking dh if he wanted one, which is even funnier. 

So yes, that's what I've been watching for is carryover. We're seeing it. We're not in the range of NO carryover. It's more like slow, fledgling carryover. I think working on it could get it stronger just by giving more occasions. But yes, we're starting to see carryover. Like when he's playing, he's using the language more. That's a pretty natural time to be using your language, when you're narrating play, and he's both saying more AND doing more with the play, which I thought was interesting.

Well he went to work today at our business. We'll see how that went. He was nervous about it.

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2 hours ago, Lecka said:

When you have worked on wh questions, have you worked on wh questions where he just listens to something and answers a wh question?

Oh mercy yes. We've been working through a whole book on that, but it was more just the most basic/obvious (form questions, answer questions). A lot of our materials now are working wh-questions and coming at it from more ways, with more complexity. I see it coming in some of the other books too. Even working at the pretty brisk pace we're doing now (20 pages a day, which is basically half of one of those Spotlight books a day but with us spreading them over lots of different books), it's still just going to take time. 

It also finally gelled in my pea brain that you aren't trying to spell things you aren't using. Like when I was saying he *could* spell the things but it was pointless, that was what was really happening. So it's more important to continue to work on his language than it is to spell. OR we can use spelling as a way to work on language. That works too. But just to work on isolated spelling, that's why it didn't feel right.

I could probably get really smart about this and make up lists that follow patterns he should be working on that use words he'd actually find interesting. I was finding some things in that vein. I don't know, it's just a convergence of language issues and the rest of haha language arts that I hadn't really thought through. I'm not sure I'll make lists like that. I finally found something I think I might like. I'm just not sure if he's ready for it, but I think he might be. I'm kinda just looking and pondering. I'm also looking into a prosody program. Now that we're doing a lot more reading aloud, it's obvious he needs one. He can't even turn it on or fake it. The prosody work would merge well with the conversation program and the reading aloud of the picture books. The skills would go naturally together.

That's what I've been trying to do is find things that go well together. Clearly I can't do it ALL, not all at the same time. So we'll just take a couple things, do 'em hard, get 'em rolling in real life, then move on to more things. Like right now, the work we've done with active verbs (being able to state use/functions) and descriptions (attributes, features, class), is actually showing up in his speech and being used by him and being useful to him. So now I'm moving on to feelings and beginning problem solving, because then he can say basic things like he feels such and such because of this or that and wants to do something about it. That cause/effect and the feelings work go naturally together. I'm bringing the sentence structure alongside. So then, as that gets in order (which I haven't counted out, but I'm hoping 10-20 days), then we can bring in the picture books, the prosody, the conversation, the narrative work. That's sorta my plan. 

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I am trying to combine prosody and reading fluency, and I have to use a low reading level.  Right now my son does Peppa Pig, Little Critter, and some level 1 Lego books.  There are some more he has done.  But it has to be low for him to sound good, but then I think it is great practice for him.  These are all books he likes, too.  

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I’m just going to add, I know nothing about prosody programs, but there is overlap with fluency and I spent a year on reading fluency with my older son, and it went a long way with him.  There is definitely stuff in reading fluency materials about where to pause, how to read with expression, paying attention to punctuation, and things like that.  He read in a monotone and didn’t pay attention to punctuation.  

He also prior to that could not follow dialogue with listening to read-aloud, even in very basic books, because he would get lost with who was talking, especially anything where people went back and forth talking.  It did not click with him at all, and reading fluency helped with that.

I am curious what is out there for prosody.  

Oh, there’s also a lot of tie in with reading comprehension, because you have to understand what you are reading really well to read it and sound good, have good phrasing, etc.  It is harder with longer sentences for sure.  

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http://www.linguisystems.com/products/product/display?itemid=10888 This is the prosody program, and some of the stuff it mentions is stuff we did in music therapy.

Some of the Spotlight on Social Skills workbooks are also going to hit verbal stuff http://www.linguisystems.com/sample1/31843.pdf

I thought I had one more program, and I don't know what it was. I'll try to find it again.

This is not what I was looking for, but it's informative. https://web.archive.org/web/20110205232123/http://www.cambridge.org/other_files/downloads/esl/booklets/Gilbert-Teaching-Pronunciation.pdf

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