225. Under the Iceberg: Why Isn't Speech Developing in Autism, with Dr. Karen Chenausky

225. Under the Iceberg: Why Isn't Speech Developing in Autism, with Dr. Karen Chenausky

We learned in grad school that working on joint attention and language will lead to speech development. But for the estimated 30% of autistic children who never develop functional, fluent speech, that's not the whole story. Dr. Karen Chenausky, PhD, CCC-SLP, is a speech scientist, SLP, and director of the SPAN Lab at the MGH Institute of Health Professions. She takes us beneath the iceberg to explore the hidden contributors to speech development in autism, including the motor-speech disorder component our field rarely talks about. In this episode, you'll learn: -Challenges that can limit spoken language in autism include joint attention, receptive language, speech perception, sensory differences, fine/gross motor cascades, and motor speech challenges -Minimally speaking vs. minimally verbal vs. pre-verbal: what each term really means, and why we wait until about age 5 to classify a child as 'minimally verbal' -How Dr. Chenausky identifies suspected Childhood Apraxia of Speech (CAS) in minimally speaking children using Iuzzini-Siegel's (2015) criteria, plus the catch-22 when a child doesn't produce enough speech to diagnose speech motor disorders -What to evaluate in a minimally speaking preschooler: the motor component of speech, language comprehension and expression, nonverbal IQ, and gross/fine motor skills -An invaluable assessment tool you may not know SLPs can use: the Vineland Adaptive Behavior Scales for capturing fine and gross motor performance -Auditory-Motor Mapping Training (AMMT), the intonation-based treatment inspired by Melodic Intonation Therapy, and the promising findings on who benefits most (hint: phonemic repertoire and readiness-to-learn skills mattered) -JASPER (Joint Attention, Symbolic Play, Engagement, and Regulation), Connie Kasari's play-based intervention that builds the prerequisite skills for language -A Monday-morning session framework: three-tiered tasks (mastered, on-the-cusp, challenge) that keep the child at a 70-80% success point in their zone of proximal development -Writing pivotal speech goals that expand the phonemic repertoire while diversifying language expression -When to prioritize robust AAC, because every child deserves access to all the ways of communicating -Dr. Chenausky's call to the field to develop more reliable methods to assess nonverbal IQ and receptive language in children with motor praxis and visual processing/visualmotor challenges Research referenced in this episode Chenausky, K., Norton, A., Tager-Flusberg, H., & Schlaug, G. (2018). Behavioral predictors of improved speech output in minimally verbal children with autism. Autism Research, 11(10), 1356-1365. Free link: https://pubmed.ncbi.nlm.nih.gov/30230700/ Chenausky, K., Brignell, A., Morgan, A., & Tager-Flusberg, H. (2019). Motor speech impairment predicts expressive language in minimally verbal, but not low verbal, individuals with autism spectrum disorder. Autism & Developmental Language Impairments, 4. Free link: https://pubmed.ncbi.nlm.nih.gov/35155816/ *To connect with Dr. Chenausky, Google search "Karen Chenausky SPAN Lab"

224. Rate Your Own Speech Therapy: 5 Questions That Separate Good Sessions From Life-Changing Ones

Would your therapy sessions pass a research review? 🔬 In this episode, I'm pulling back the curtain on my experience as a proposal reviewer for the Council for Exceptional Children, and I'm handing you the exact 5 criteria reviewers use, reframed as a self-evaluation for YOUR therapy sessions. Rate yourself 1 to 5 in each area and find out exactly where to grow this summer. In this episode, you'll learn: 🎯 Relevance. Is the skill you're targeting truly essential? I'll share why storytelling may be the single most pivotal skill for children with developmental language disorder, and why a year spent on one grammatical morpheme probably isn't changing anyone's life. 📐 Alignment. Do your objectives actually build toward the big skill, or are they busywork dressed up as goals? ⚡ Functionality TODAY. I'll tell you why I target "non-functional" words like scrape on purpose, how one complex SKR blend can unlock F, V, S, Z, SH, CH and more for free, and why the higher you aim, the higher the gains. 📊 Evidence. You need numbers for every single detail of your practice. I'll show you how to vet those $400 boxed programs before they waste your 30 minutes a week, and what to do when the research just hasn't been done yet. 👀 Active Participation. This is the one criterion that exposes wasted therapy time (looking at you, auditory bombardment). I'll describe what true engagement looks like, even with sensitive, reluctant, or freeze-response kiddos. Grab your scorecard, be honest, and build your plan to turn every 3 into a 5. ⭐ Ready to stop guessing and start moving the needle? Join my SIS Membership today and get needle-moving treatment targets and done-for-you speech therapy activities delivered to you weekly, so every minute of your limited therapy time counts. Join now: kellyvess.com/sis If this episode helped you, follow the show and leave a 5-star review. It helps more SLPs find their way to life-changing therapy.

223. 5 Powerhouse Strategies to Improve Executive Function in Speech Therapy

Nearly every child on your caseload is at greater risk for executive function challenges. What do you do about it? In this episode, I'm sharing the 5 powerhouse strategies I use every single day to build executive function directly into speech and language therapy. No extra sessions, no separate goals — just smarter treatment that changes lives. You'll learn: The Problem, Plan, Action, Check process that teaches children to identify a problem, make a plan, take action, and finish the job How multi-step, task-oriented movement activities build working memory, sustained attention, and cognitive flexibility. Why first, next, then, lastly, and because are billion-dollar words for verbal working memory and emotional regulation How to move children from scaffolded scripts to spontaneous complex sentences How complex speech targets in paragraph form improve speech, language, and executive function all at once Ready to put these strategies to work in your next session? Join the SIS Membership at www.kellyvess.com/sis and receive powerful speech and language treatment targets aimed at improving executive function plus ready-to-use activities delivered straight to your inbox every Friday. Join today at www.kellyvess.com/sis

222. The Executive Function Research That Changes How SLPs See Every Client

If you think executive function challenges only affect your ADHD and autism clients, this episode will change how you see your entire caseload. In this episode, we break down the latest 2025 research, revealing that executive function difficulties are far more widespread than previously recognized, including in populations SLPs have historically underestimated. You'll learn: Adele Diamond's 3-part framework for understanding executive function (attention and inhibitory control, verbal working memory, and cognitive flexibility) Why do children with developmental language disorder almost universally show verbal working memory deficits across all ages and native languages The surprising finding that even children with mild articulation errors, like distorted R's and S's, show statistically significant executive function risk New 2025 data linking stuttering to verbal and visual working memory difficulties How Universal Design for Learning (UDL) principles can help you build one powerful, inclusive activity that targets executive function across your whole caseload The bottom line: We need to stop treating a mouth and start treating the whole child. Next week: Part 2 covers what the research says actually works to improve executive function and how to bring it into your sessions starting Monday. References: Afshar, M., Zarifian, T., Khorrami Banaraki, A., & Noroozi, M. (2022). Executive functions in Persian-speaking preschool children with speech sound disorders and comparison with their typically developing peers. Applied Neuropsychology: Child, 11(4), 702–712. https://doi.org/10.1080/21622965.2021.1937169 [https://doi.org/10.1080/216229%EE%80%8065.2021.1937169] Kakuta, K., et al. (2025). Executive function in preschool children who stutter: A behavioral assessment study. Scientific Reports, 15(1), Article 16159. https://doi.org/10.1038/s41598-025-00981-9 [https://doi.org/10.1038/s41598-025-00981-9]  [https://doi.org/10.1044/2025_LSHSS-24-00142]   Lee, D., Boulton, K. A., Sun, C., Phillips, N. L., Munro, M., Kumfor, F., Demetriou, E. A., & Guastella, A. J. (2024). Attention and executive delays in early childhood: A meta-analysis of neurodevelopmental conditions. Molecular Psychiatry. Advance online publication.  Niu, T., Wang, S., Ma, J., Zeng, X., & Xue, R. (2024). Executive functions in children with developmental language disorder: A systematic review and meta-analysis. Frontiers in Neuroscience, 18, Article 1390987. https://doi.org/10.3389/fnins.2024.1390987 [https://doi.org/10.3389/fnins.2024.1390987] Keywords: executive function, speech language pathology, developmental language disorder, speech sound disorders, apraxia of speech, stuttering, verbal working memory, UDL, SLP caseload, 2025 research

221. The ABCs of Picking Books That Ignite a Love for Learning

Ever wonder why some books become instant hits with your students while others fall flat? In this episode, we go behind the scenes on a real-life book hunt and walk away with a practical framework you can use every time you pick up a new children's book. Using the principles of Universal Design for Learning (UDL), we break down exactly what makes a book "sticky" for diverse learners, including kids who struggle with attention, visual processing, auditory processing, or language itself. The UDL Book Selection Framework: The ABCs Before adding any book to your therapy toolkit, run it through these three filters: A — Connection: Does this book connect to the child's world? Think about interests, home routines, prior knowledge, and personal experiences. If a child can see themselves in the pages, engagement follows. B — Multimodal Presentation: Can you bring this book to life? Look for opportunities to use vocal animation, movement, emotion, rhyme, sound effects, and gesture as you read. The best books practically beg to be performed. C — Active Child Participation: Can the child do something with this book? Movement, facial expressions, sound-making, turn-taking, and storytelling from personal experience all count. The goal is for a child to be participating with the book, not just listening to it. The 6 Books Featured in This Episode How Do Dinosaurs Say Good Night? (board book version) — Realistic, emotionally expressive dinosaur illustrations paired with a bedtime routine kids know well. Rich with rhyme, emotion, and movement opportunities. Perfect for diverse learners with its short, one-sentence-per-page format. That's Not Funny, David! by David Shannon — A step up from No, David!, this one is heavy on inferential thinking. Kids identify what David is doing wrong from indirect cues rather than direct ones — a powerful tool for building higher-level language skills. Everyday scenarios spark personal storytelling and connection. Llama Llama Feelings — Pairs a familiar, beloved character with a known routine (the bedtime sequence) to introduce nuanced emotions like joy, worry, and excitement in rich context. Far superior to decontextualized feelings cards. Rhyme throughout keeps engagement high. Mr. Brown Can Moo, Can You? (beginner book version) — A goldmine for non-speaking and emerging communicators. Onomatopoeia, animal sounds, environmental sounds, and the "cloze" technique (pause before the last word) let every child participate meaningfully. Connects print to sound in a playful, low-pressure way. Night Night Farm — Interactive lift-the-flap format with repetitive, predictable language. Farm animals + glow-in-the-dark stars on the final page = irresistible engagement, especially for younger learners. A perfect wind-down book that ends with a singalong. In My Heart — The standout of the bunch. Maps complex emotional concepts onto simple, concrete nouns (a star for happiness, an elephant for sadness). Moves emotional vocabulary well beyond basic happy/sad/mad into nuanced, embodied feeling language. Highly recommended for children working on emotional regulation and self-expression. If you're tired of starting from scratch every week, the SIS Membership gives you a library of research-informed, engagement-tested materials so you can walk into every session confident and prepared. 👉 Join the SIS Membership and get access to activities for these books and dozens more — plus new materials added regularly throughout the school year: https://www.kellyvess.com/sis Drop a comment or send a message letting us know: what's a book you swear by in your therapy room? We're always on the hunt for the next great find.