Progress monitoring is a scientifically based practice that is used to assess students' academic performance and evaluate the effectiveness of instruction. Progress monitoring can be implemented with individual students or an entire class.

What is progress monitoring?

Progress monitoring is a scientifically based practice that is used to assess students’ academic performance and evaluate the effectiveness of instruction. Progress monitoring can be implemented with individual students or an entire class.

How does progress monitoring work?

To implement progress monitoring, the student’s current levels of performance are determined and goals are identified for learning that will take place over time. The student’s academic performance is measured on a regular basis (weekly or monthly). Progress toward meeting the student’s goals is measured by comparing expected and actual rates of learning. Based on these measurements, teaching is adjusted as needed. Thus, the student’s progression of achievement is monitored and instructional techniques are adjusted to meet the individual students learning needs.

What are the benefits of progress monitoring?

When progress monitoring is implemented correctly, the benefits are great for everyone involved. Some benefits include:

• accelerated learning because students are receiving more appropriate instruction;
• more informed instructional decisions; documentation of student progress for accountability purposes; 
• more efficient communication with families and other professionals about students’ progress; 
• higher expectations for students by teachers; and fewer Special Education referrals

Overall, the use of progress monitoring results in more efficient and appropriately targeted instructional techniques and goals, which together, move all students to faster attainment of important state standards of achievement.

Who should be practicing progress monitoring?

Anyone who is interested in improving results for children should be implementing progress monitoring. Whether you are a regular educator, special educator, related service provider, administrator, or family member, you should be interested in implementing research-based progress monitoring practices. It's always a good idea for teachers and special education teachers to have it ready to show to parents or other stake holder. It's great to show parents and students.

What are the challenges of progress monitoring?

• Educators and families need information about the effectiveness of progress monitoring that would encourage them to adopt the practice.
• Teachers and other practitioners need support in translating progress monitoring research into easily implemented, usable strategies.
• Technical assistance on progress monitoring must transfer knowledge in ways that accommodate differences in background, training, and beliefs, as well as differences in the nature and philosophy of the instructional programs and practices already in place.
• This information dissemination must take place in a variety of formats, in usable forms, and at different levels of specificity.

It’s also call:

Progress monitoring is a relatively new term. Some other terms you may be more familiar with are Curriculum-Based Measurement and Curriculum-Based Assessment. Whatever method you decide to use, it is most important that you ensure it is a scientifically based practice that is supported by significant research.

A year never goes by when I have to explain to a teacher what motor planning is what they can do in class to support students. I hope this information helps you find something you can use in your classroom.

WHAT IS MOTOR PLANNING?
Motor planning is the ability to conceive, plan, and carry out a skilled, non-habitual motor act in the correct sequence from beginning to end. Incoming sensory stimuli must be correctly integrated in order to form the basis for appropriate, coordinated motor responses. The ability to motor plan is a learned ability which is generalized to all unfamiliar tasks so a child does not need to consciously figure out each new task he or she faces. The child with motor planning difficulties may be slow in carrying out verbal instructions and often appears clumsy in new tasks.

WHAT CAUSES MOTOR PLANNING DIFFICULTIES?
Motor planning difficulties are caused by problems processing sensory information and poor neural connections in the brain. In order to have efficient motor planning, an individual must be able to organize sensory input from his body, have adequate body perception and be able to move around his environment. Difficulty with sensory processing can lead to poor motor planning for fine, gross, and oral motor tasks (such as handwriting, jumping, and forming words, respectively).

HOW CAN I HELP TREAT MY CHILD’S MOTOR PLANNING DIFFICULTIES?
A sensory integrative approach is often used when treating a child with motor planning difficulties. Children rely on adequately interpreting sensory information from the tactile, proprioceptive, vestibular, visual, and auditory systems, in order to develop body awareness. Children with motor planning difficulties often have a poor body scheme. By providing your child with sensory information to help organize the information he receive form his environment, he can develop a better body scheme and his motor planning can improve as a result.

WHAT YOU CAN DO IN CLASS:

• Before doing a task encourage the child to:
• Visualize the task;
• Verbalize before doing the task or repeat instruction;
• Verbalize end result;
• Assess whether plan worked- if not work out why not for next time.  

• Help the child identify steps needed to begin and accomplish the task.  Have the child repeat directions and, if possible, write down the steps.  
• Timing and sequencing are important to introduce into activities.  Sequencing may include getting from one position to another or remembering which movement comes after which. 
• Giving a short assignment so that the child can feel instant success in completing a task. 
• Giving one direction at a time.  After one action is successfully completed, add another direction. 
• Helping the child physically move through the action.
• Minimizing visual distractions.  Check for clutter in classroom environment. 
• Reviewing how to play a game before actually playing it.  Demonstrate and verbalize actions.
• Review what has been taught on a regular basis. 

Ideas to assist organizational skills:

• Ensure a clutter free environment.
• Have instructions written down in simple sentences.
• Ask child to repeat instructions- gradually increasing the number and complexity of instructions.
• Discuss with your child their time plan for the day, e.g.: ‘What will you do this morning?’ ‘What will you do after lunch?’  A daily planner on the wall at home will prompt items required for the day. 
• Gradually withdraw the amount of help you are giving your child and encourage them to develop their own strategies for planning and organizing e.g. making a list, putting out reminders.  

Motor Planning Activities:

• General tactile (touch) and vestibular (movement) stimulation are important for motor planning.   Include regular visits to play parks with rides on swings and slides. 
• Brain Breaks
• Activities involving sequences of movement are particularly useful in developing motor planning. Start with simple sequences, gradually make them more complex.  Where possible involve the child in making up patterns.  

For me mental math plays a huge part of building number sense and a students ability to work math in their heads. Some days most of my math block is spent doing mental math and other days it may only be 3 minutes of an activity. I have listed some for my students favorite. They work great for interventions and RTI.

Mental math is the main form of calculation used by most people and the simplest way of doing many calculations. Research has shown that in daily life at least 75% of all calculations are done mentally by adults. However, unfortunately due to the emphasis on written computation in many classrooms, many children believe that the correct way to calculate a simple subtraction fact such as 200-3 is to do it in the written form.

Through regular experiences with mental math children come to realize that many calculations are in fact easier to perform mentally. In addition, when using mental math children almost always use a method which they understand (unlike with written computation) and are encouraged to think actively about relationships involving the particular numbers they are dealing with.

In order to be effective Mental Math sessions should:

• occur on a daily basis (5-10 minutes per day)
• encourage ‘having a go’ on the part of all students
• emphasize how answers were arrived at rather than only whether they are correct
• Promote oral discussion
• allow students to see that there are many ways to arrive at a correct answer rather than one correct way
• build up a dense web of connections between numbers and number facts
• emphasize active understanding and use of place value

Following are some possible activities for K-5 classrooms:

Fill the Hundreds Chart:

On day one display a Hundreds Pocket Chart with only 5-6 pockets filled with the correct numerals. Leave all other pockets blank. Select 3 numerals and 3 students. Ask each student to place his/her numeral in its correct pocket and to explain the strategy they used to help them complete this task. Repeat the above with 3 numbers and 3 students per day until all pockets are filled. Take note of students who use a count by one strategy and those who demonstrate an awareness of the base ten patterns underlying the chart. Select numbers based on your knowledge of individual student’s number sense (e.g. you may select a number immediately before or after a number that is already on the board for one child and a number that is 10 or 11 more than a placed number for another child who you feel has a good understanding of the base ten pattern).

Possible questions to involve other students:

Yesterday we had __ numbers on our number chart and today we added 3 more. How many numbers do we now have on our number chart? How do you know?
If there are __ numbers on our number chart how many more numbers do we need to add to fill our chart? Ask several students to explain the strategy used to solve this problem.
We now have ____ numbers on our number chart. If we continue to add 3 numbers every day how many more days/weeks will it take to fill our number chart? Explain your thinking.

Today’s Number is… 

Select a number for the day (e.g. 8) and write it on the board or chart paper. Ask students to suggest calculations for which the number is the answer. Write students' suggestions in 4 columns (addition examples, subtraction, multiplication and division). After 8 or 10 responses, focus in on particular columns or types of responses that you would like more of. For example,"Give me some more addition examples", "Give me some ways which use three numbers", "Give me an example using parentheses" etc.

What's My Number

Select a number between 1 and 100 and write it down without revealing it to your students. Have students take turns to ask questions to which you can only answer ‘yes’ or ‘no’. Record each question and answer on chart paper. For example:

Is it greater than 30? No
Is it an even number? Yes
Is it a multiple of 3? No
Does it have a 4 in the ones place?...

After 3 or 4 questions ask, “What is the smallest number it could still be? What is the largest? Discuss why it is better to ask a question such as "Is it an odd number?" than "Is it 34?" early in the game. To ensure that all students are involved have them use individual laminated 100 charts with dry erase markers to mark off numbers after each question is asked. Keep going until the number has been named correctly. During the game you may also want to keep track of how many questions are asked before the number is named. Next time you play challenge students to guess the number with fewer questions.

'Friendly' number activities
Give a number less than 10. Students must respond with an addition fact that will make the number up to 10. For example, if today's target number is 10 and you say 6 the student must respond with "6 + 4 = 10". Vary the target number e.g. 20, 50, 100, 200, 1000 etc. to suit students' ability level.

Working in a small district, my Speech-Language Pathologist is only in the building a couple days a week. Which makes collaboration with her very hard. I have a couple of students who have significant expressive language delays that make learning and making progress in reading very difficult for them.

I have used some of these activities to build both background knowledge and vocabulary to help with their comprehension of what they are reading. I have found that their first reads or cold reads of an instructional level text are at a frustrational read but by the second read its an instructional level. My SLP believes that this is because of their language delays.

I have decided to make a point at the beginning of each book to focus on their expressive language as part of their pre-reading. My hope is that by the end of the month these students have moved up a reading level.

Strategies to Develop Expressive Language Skills in the Classroom

• Opportunities to speak and time to rehearse before speaking
• Visual clues to help children order ideas effectively before expressing them
• Vocabulary lists to help with word finding difficulties. Use appropriate and consistent vocabulary
• Color coding different groups of words/sets of pictures
• Giving correct models of language structures
• Repetition and reinforcement of correct language structures
• Small group work to give children confidence to express themselves
• Appropriate questioning to give children the opportunity to reply
• Self-questioning and the development of learning scripts (e.g. What do I know already? What do I do next?)
• Rhymes
• Word play
• Restrict your language to short unambiguous language
• Story telling – cutting up picture segments and retelling stories
• Try and keep children ‘on topic’. Be specific, remind children e.g. ‘We are talking about…’
• Discussing what they have seen or done with an adult or more verbally able peer
• Puppet play/drama etc.
• Sharing books
• Revise links and associations between ideas and vocabulary – categorization/function/
• context/similarity/association
• As part of the partnership approach, it is important to detail which of these strategies have been most effective.

Barrier games

• This can be used for both talking and listening. The child or children either side of the barrier have identical sets of equipment.
• One child has a picture or constructs an assembly of objects and then gives instructions to the other to enable him/her to duplicate the picture or assembly.

How do I feel?

• In a small group imagine a situation and talk about how you would each feel and what you might say (speech bubbles resource is good here).

Silly Stories

• Collection of objects/pictures, e.g., horse, lady, man, child, dog, ball, pirate, dinosaur.  Adult starts story “Once upon a time there was a dinosaur”. Next child (house) continues the story “He lived in a house made of chocolate”.  Next child (ball) “One day he found a ball under his bed” …..

Narrative

• Color Coding approach.  Children take one color question ‘Who, What, Where, When’ and sequence a story using their own ideas.
• Mind Map Activities: An excellent way for supporting new vocabulary and talking.

Defining and describing

• Have a range of objects in a bag or a range of pictures. One child takes an object or picture and is allowed to give 3 pieces of information to describe their item. The rest guess.

Question Question

• Barrier game. Once child has an object or picture and the rest ask questions to find out what it is. You cannot say the name of the item.
• A good resource is Clowning Around or Guess Who?

What do you know?

• Use a composite picture and take turns in the group (mini circle time). Each child giving a new piece of information about the picture. Extend by talking about a particular object or event in which everyone has been involved.
• Tell me how to do it
• Use a classroom activity or event which has already been experienced and get a child to re-tell the event in his/her own words.
• Allow a child to explain to the others how to play a particular game.

Conversation

• In a small group it is possible to think about how we behave during a conversation and make explicit the skills we need. There are a couple of good resources for this.

Being mid-year, I find that I'm explaining why I'm selecting the text that I am. I walked into out book room and someone asked what I was looking for and I said no more than 2 words on a page with strong (if not in your face) picture support. I have a student that I've been working with on not adding to the text (she loves adding extra words to the story). The teacher in the book room pointed my to the a shelf on Level As. Knowing what text looks like at each level helps me find the right text for each group. I hope this helps you out or something you can share with parents.

Early Emergent Readers (Levels aa-C)

·         increasingly more lines of print per page
·         more complex sentence structure
·         less dependency on repetitive pattern and pictures
·         familiar topics but greater depth
·         beginning to use knowledge of letter sounds to solve unknown words
·         uses language, memory, pictures, and print as major cues to read and understand text
·         is able to predict what comes next

Early Fluent Readers (Levels K-P)

·         More pages
·         Longer sentences
·         More text per page
·         Richer vocabulary
·         Greater variation in sentence pattern
·         Less reliance on pictures
·         More formal and descriptive language
·         Analyzes new words and checks them against what makes sense and sounds right
·         Uses meaning to begin to self-correct
·         Uses known words and word parts to figure out unknown words
·         Begins to retell the major points of the text
·         Decreases the use of finger pointing as fluency and phrasing increase
·         Uses prior knowledge and own experience to make meaning

Fluent Readers (Levels Q-Z)

·         More text
·         Less familiar, more varied topics
·         Challenging vocabulary
·         More complex sentences
·         Varied writing styles
·         More description
·         Reads silently; reads fluently when reading aloud
·         Initiates topics for discussion about books
·         Begins to use comprehension strategies (retelling, monitoring for meaning, making connections, making mental images, making/revising/confirming predictions, questioning, determining importance, inferring, summarizing, synthesizing, critically evaluating) across genre and subjects
·         Consistently develops new strategies and new knowledge of texts as he/she encounters greater
variety of texts
·         Is in a continuous process of building background knowledge and realizes that he/she needs to
bring his/her knowledge to his/her reading
·         Sustains interest and understanding over long texts and reads over extended periods of time
·         Notices and comments on aspects of the writer’s craft

I hope everyone has a great week going into Christmas Break. Have a great holiday break and enjoy the Sight Word freebie below.

What do the tiers mean?

Description of Critical Elements in a 3-Tier RtI Model The following table outlines the essential features of a three-tier model of RtI including suggested ranges of frequency and duration of screening, interventions and progress monitoring. This is intended as guidance as they determine the various components of their RtI model.
Elements	Tier 1 Core Curriculum and Instruction	Tier 2 Supplemental Instruction	Tier 3 Increased Levels of Supplemental Instruction
Size of instructional group	Whole class grouping	Small group instruction (3-5 students)	Individualized or small group instruction (1-2 students)
Mastery requirements of content	Relative to the cut points identified on criterion screening measures and continued growth as demonstrated by progress monitoring	Relative to the cut points identified on criterion screening measures and continued growth as demonstrated by progress monitoring	Relative to the student’s level of performance and continued growth as demonstrated by progress monitoring
Frequency of progress monitoring	Screening measures three times per year  (DIBELS, AIMSWeb, iReady)	Varies, but no less than once every two weeks	Varies, but more continuous and no less than once a week
Frequency of intervention provided	Per school schedule	Varies, but no less than three times per week for a minimum of 20-30 minutes per session	Varies, but more frequently than Tier 2 for a minimum of 30 minutes per session
Duration of intervention	School year	9-30 weeks	A minimum of 15-20 weeks

What are the Benefits of RtI?

• RtI ensures a shared approach is used in addressing students’ diverse needs.
• Parents are a very important part of the process.
• RtI eliminates the “wait to fail” situation, because students get help promptly within the general education setting.
• The RtI approach may help reduce the number of students referred for special education services while increasing the number of students who are successful within regular education.
• RtI helps to identify the root cause of achievement problems.
• RtI’s use of progress monitoring provides more instructionally relevant information than traditional assessments

How Parents/Guardians can support at Home:

• Reading is Fundamental (These tips have been adapted from Reading is Fundamental (www.rif.org)
• Invite your child to read with you every day.
• When reading a book where the print is large, point word by word as you read.
• Read your child’s favorite book over and over again.
• Read many stories with rhyming words and repeated lines.
• Discuss new words and ideas.
• Stop and ask about the pictures and what is happening in the story. Encourage your child to predict.
• Read from a variety of materials including fairy tales, poems, informational books, magazines and even comic strips.
• Let your children see you reading for pleasure in your spare time.
• Take your child to the library. Explore an area of interest together
• Scout for things your child might like to read. Use your child’s interests and hobbies as starting points.

What should parents do if they believe their child is struggling?

• Contact your child’s teacher
• Request a parent/teacher conference
• Access the parent portal and other daily means of communication
• Review your child’s work to see if there is progress
• Talk with your child to ensure they know you are supporting them at home as well as in school

Be sure to stop by my Teachers pay Teacher store for great RtI progress monitoring tools during the 2-day Cyber Sale all items 28% off. My students love  my RTI: Nonsense Word Fluency Activities. Its a great way to open guided reading so students to practice going from the individual sounds to the whole word. 

What Are the Essential Components of RTI?

• ·         High quality, research-based instruction and behavioral support in general education.
• ·         Universal (school-wide or district-wide) screening of academics and behavior in order to determine which students need closer monitoring or additional interventions.
• ·         Multiple tiers of increasingly intense scientific, research-based interventions that are matched to student need.
• ·         Use of a collaborative approach by school staff for development, implementation, and monitoring of the intervention process.
• ·         Continuous monitoring of student progress during the interventions, using objective information to determine if students are meeting goals. (Progress monitoring like DIBELS Next)
• ·         Follow-up measures providing information that the intervention was implemented as intended and with appropriate consistency.
• ·         Documentation of parent involvement throughout the process.
• ·         Documentation that the special education evaluation timelines specified in IDEA 2004 and in the state regulations are followed unless both the parents and the school team agree to an extension.
• 
  
• What Are the Key Terms?

• Response to Intervention (RTI) is an array of procedures that can be used to determine if and how students respond to specific changes in instruction. RTI provides an improved process and structure for school teams in designing, implementing, and evaluating educational interventions.
• Universal Screening is a step taken by school personnel early in the school year to determine which students are “at risk” for not meeting grade level standards. Universal screening can be accomplished by reviewing recent results of state tests, or by administering an academic screening test to all children in a given grade level. Those students whose test scores fall below a certain cut-off are identified as needing more specialized academic interventions.
• Student Progress Monitoring is a scientifically based practice that is used to frequently assess students' academic performance and evaluate the effectiveness of instruction. Progress monitoring procedures can be used with individual students or an entire class.
• Scientific, Research-Based Instruction refers to specific curriculum and educational interventions that have been proven to be effective –that is, the research has been reported in scientific, peer-reviewed journals.

What Role Does RTI Play in Special Education Eligibility?

How Can Parents Be Involved in the RTI Process?

• ·         Does our school use an RTI process? (Be aware that your child's school may call their procedures a “problem solving process,” or may have a unique title for their procedures, e.g., Instructional Support Team, and not use the specific RTI terminology.)
• ·         Are there written materials for parents explaining the RTI process? How can parents be involved in the various phases of the RTI process?
• ·         What interventions are being used, and are these scientifically based as supported by research?
• ·         What length of time is recommended for an intervention before determining if the student is making adequate progress?
• ·         How do school personnel check to be sure that the interventions were carried out as planned?
• ·         What techniques are being used to monitor student progress and the effectiveness of the interventions? Does the school provide parents with regular progress monitoring reports?
• ·         At what point in the RTI process are parents informed of their due process rights under IDEA 2004, including the right to request an evaluation for special education eligibility?
• ·         When is informed parental consent obtained and when do the special education evaluation timelines officially commence under the district's RTI plan?

What Are the Potential Benefits of RTI?

Phonological and Phonemic Awareness

Phonological awareness is a broad skill that includes identifying and manipulating units of oral language – parts such as words, syllables, and onsets and rimes. Children who have phonological awareness are able to identify and make oral rhymes, can clap out the number of syllables in a word, and can recognize words with the same initial sounds like 'money' and 'mother.'

Phonemic awareness refers to the specific ability to focus on and manipulate individual sounds (phonemes) in spoken words. Phonemes are the smallest units comprising spoken language. Phon
emes combine to form syllables and words. For example, the word 'mat' has three phonemes: /m/ /a/ /t/. There are 44 phonemes in the English language, including sounds represented by letter combinations such as /th/. Acquiring phonemic awareness is important because it is
the foundation for spelling and word recognition skills. Phonemic awareness is one of the best predictors of how well children will learn to read during the first two years of school instruction.

Students at risk for reading difficulty often have lower levels of phonological awareness and phonemic awareness than do their classmates. The good news is that phonemic awareness and phonological awareness can be developed through a number of activities.

What the problem looks like:

A kid's perspective: What this feels like to me

• Children will usually express their frustration and difficulties in a general way, with statements like "I hate reading!" or "This is stupid!". But if they could, this is how kids might describe how difficulties with phonological or phonemic awareness affect their reading:
• I don't know any words that rhyme with cat.
• What do you mean when you say, "What sounds are in the word brush?"
• I'm not sure how many syllables are in my name.
• I don't know what sounds are the same in bit and hit.

A parent's perspective: What I see at home

Here are some clues for parents that a child may have problems with phonological or phonemic awareness:

• She has difficulty thinking of rhyming words for a simple word like cat (such as rat or bat).
• She doesn't show interest in language play, word games, or rhyming.
• Click here to find out what parents can do to help a child at home.
• A teacher's perspective: What I see in the classroom
• Here are some clues for teachers that a student may have problems with phonological or phonemic awareness:
• She doesn't correctly complete blending activities; for example, put together sounds /k/ /i/ /ck/ to make the word kick.
• He doesn't correctly complete phoneme substitution activities; for example, change the /m/ in mate to /cr/ in order to make crate.
• He has a hard time telling how many syllables there are in the word paper.
• He has difficulty with rhyming, syllabication, or spelling a new word by its sound.

How to help

With the help of parents and teachers, kids can learn strategies to cope with phonological and/or phonemic awareness problems that affect his or her reading. Below are some tips and specific things to do.

What kids can do to help themselves

• Be willing to play word and sounds games with parents or teachers.
• Be patient with learning new information related to words and sounds. Giving the ears a workout is difficult!
• Practice hearing the individual sounds in words. It may help to use a plastic chip as a counter for each sound you hear in a word.
• Be willing to practice writing. This will give you a chance to match sounds with letters.
• What parents can do to help at home
• Check with your child's teacher or principal to make sure the school's reading program teaches phonological, phonemic awareness, and phonics skills.
• If your child is past the ages at which phonemic awareness and phonological skills are taught class-wide (usually kindergarten to first or second grade), make sure he or she is receiving one-on-one or small group instruction in these skills.
• Do activities to help your child build sound skills (make sure they are short and fun; avoid allowing your child to get frustrated):
• Help your child think of a number of words that start with the /m/ or /ch/ sound, or other beginning sounds.
• Make up silly sentences with words that begin with the same sound, such as "Nobody was nice to Nancy's neighbor".
• Play simple rhyming or blending games with your child, such as taking turns coming up with words that rhyme (go – no) or blending simple words (/d/, /o/, /g/ = dog).
• Read books with rhymes. Teach your child rhymes, short poems, and songs.
• Practice the alphabet by pointing out letters wherever you see them and by reading alphabet books.
• Consider using computer software that focuses on developing phonological and phonemic awareness skills. Many of these programs use colorful graphics and animation that keep young children engaged and motivated.

What teachers or parents can do to help at school?

• Learn all about phonemes (there are more than 40 speech sounds that may not be obvious to fluent readers and speakers).
• Make sure the school's reading program and other materials include skill-building in phonemes, especially in kindergarten and first grade (these skills do not come naturally, but must be taught).
• If children are past the age at which phonemic awareness and phonological skill-building are addressed (typically kindergarten through first or second grade), attend to these skills one-on-one or in a small group. Ask your school's reading specialist for help finding a research-based supplemental or intervention program for students in need.
• Identify the precise phoneme awareness task on which you wish to focus and select developmentally appropriate activities for engaging children in the task. Activities should be fun and exciting – play with sounds, don't drill them.
• Make sure your school's reading program and other materials include systematic instruction in phonics.
• Consider teaching phonological and phonemic skills in small groups since students will likely be at different levels of expertise. Remember that some students may need more reinforcement or instruction if they are past the grades at which phonics is addressed by a reading program (first through third grade).

I hope these ideas help and answer some questions for parents. Have a great week.

What Do Speech Therapists Help With?

• articulation disorders: This when a kid has trouble saying certain sounds or saying words correctly. "Run" might come out as "won." Or "say" may sound like "thay." Lisps are considered articulation disorders.
• fluency disorders: If a kid repeats certain sounds and has trouble saying the complete word, he or she may have fluency disorder. For example, a kid trying to say "story" might get stuck on the "st" and say "st-st-st-story." Or he or she might draw out certain sounds and say "ssssssstory." A stutter is a fluency disorder
• voice disorders: A kid might have a voice disorder if people have trouble understanding him or her. The kids might start a sentence loud and clear, but it's quiet and mumbling by the end. Sometimes these kids sound like they have a cold or like they're talking through their noses.
• language disorders: A kid who has trouble understanding people or has trouble putting words together to express thoughts might have a language disorder.

Who Needs Speech Therapy?

• hearing impairment
• weak muscles around the mouth
• cleft lip or palate
• vocal nodules/ hoarseness
• autism
• breathing disorder
• swallowing disorder

What's It Like?

How Long Will Treatment Last?

What are Gross motor skills?

Gross motor skills are the abilities required in order to control the large muscles of the body for walking, running, sitting, crawling, and other activities.

Motor skills are actions that involve the movement of muscles in the body. They are divided into two groups: gross motor skills, which are the larger movements of arms, legs, feet, or the entire body (crawling, running, and jumping); and fine motor skills , which are smaller actions, such as grasping an object between the thumb and a finger or using the lips and tongue to taste objects. Motor skills usually develop together since many activities depend on the coordination of gross and fine motor skills. Gross motor skills develop over a relatively short period of time. Most development occurs during childhood. However, soldiers, some athletes, and others who engage in activities requiring high degrees of endurance may spend years improving their level of muscle and body coordination and gross motor skills.

Encouraging gross motor skills requires a safe, open play space, peers to interact with, and some adult supervision. Promoting the development of gross motor abilities is considerably less complicated than developing fine motor skills. Helping a child succeed in gross motor tasks requires patience and opportunities for a child to practice desired skills. Children reach developmental milestones at different rates. Pushing a child to perform a task that is impossible due to development status promotes frustration and disappointment. Children should be allowed to acquire motor skills at their own paces.

There are a number of activities parents can have children do to help develop gross motor skills. These include:
• playing hopscotch and jumping rope; activities that help children learn balance
• hitting, catching, kicking, or throwing a ball, such as a baseball, football, or soccer ball; activities that help develop hand-eye or foot-eye coordination
• kangaroo hop, in which children hold something, such as a small ball or orange, between their knees and then jump with their feet together frontward, backwards, and sideways
• playing wheelbarrow, in which someone holds the children's legs while they walk on their hands along a specific route
• walking on a narrow bar or curb, while holding a bulky object in one hand, then the other hand, and then repeating the activity walking backwards and sideways
• toss and catch, in which children toss an object, such as a baseball, in the air and then catch it, while sitting or lying down and also while using alternate hands

Infancy
The first gross motor skill infants learn usually is to lift their heads and shoulders before they can sit up, which, in turn, precedes standing and walking. Lifting the head is usually followed by head control. Although they are born with virtually no head or neck control, most infants can lift their heads to a 45-degree angle by the age of four to six weeks, and they can lift both their head and chest at an average age of eight weeks. Most infants can turn their heads to both sides within 16 to 20 weeks and lift their heads while lying on their backs within 24 to 28 weeks. By about nine to 10 months, most infants can sit up unassisted for substantial periods of time with both hands free for playing.

One of the major tasks in gross motor development is locomotion, the ability to move from one place to another. Infants progress gradually from rolling (eight to 10 weeks) to creeping on their stomachs and dragging their legs behind them (six to nine months) to actual crawling (seven to 12 months). While infants are learning these temporary means of locomotion, they are gradually becoming able to support increasing amounts of weight while in a standing position. In the second half-year of life, babies begin pulling themselves up on furniture and other stationary objects. By the ages of 28 to 54 weeks, on average, they begin navigating a room in an upright position by holding on to the furniture to keep their balance. Eventually, they are able to walk while holding on to an adult with both hands and then with only one. They usually take their first uncertain steps alone between the ages of 36 and 64 weeks and are competent walkers by the ages of 12 to 18 months.

Toddlerhood
Toddlers are usually very active physically. By the age of two years, children have begun to develop a variety of gross motor skills. They can run fairly well and negotiate stairs holding on to a banister with one hand and putting both feet on each step before going on to the next one. Most infants this age climb (some very actively) and have a rudimentary ability to kick and throw a ball. By the age of three, children walk with good posture and without watching their feet. They can also walk backwards and run with enough control for sudden stops or changes of direction. They can hop, stand on one foot, and negotiate the rungs of a jungle gym. They can walk up stairs alternating feet but usually still walk down putting both feet on each step. Other achievements include riding a tricycle and throwing a ball, although they have trouble catching it because they hold their arms out in front of their bodies no matter what direction the ball comes from.

Preschool
Four-year-olds can typically balance or hop on one foot, jump forward and backward over objects, and climb and descend stairs alternating feet. They can bounce and catch balls and throw accurately. Some four-year-olds can also skip. Children this age have gained an increased degree of self-consciousness about their motor activities that leads to increased feelings of pride and success when they master a new skill. However, it can also create feelings of inadequacy when they think they have failed. This concern with success can also lead them to try daring activities beyond their abilities, so they need to be monitored especially carefully.

School age
School-age children, who are not going through the rapid, unsettling growth spurts of early childhood or adolescence , are quite skilled at controlling their bodies and are generally good at a wide variety of physical activities, although the ability varies according to the level of maturation and the physique of a child. Motor skills are mostly equal in boys and girls at this stage, except that boys have more forearm strength and girls have greater flexibility. Five-year-olds can skip, jump rope, catch a bounced ball, walk on their tiptoes, balance on one foot for over eight seconds, and engage in beginning acrobatics. Many can even ride a small two-wheel bicycle. Eight- and nine-year-olds typically can ride a bicycle, swim, roller skate, ice skate, jump rope, scale fences, use a saw, hammer, and garden tools, and play a variety of sports . However, many of the sports prized by adults, often scaled down for play by children, require higher levels of distance judgment and hand-eye coordination , as well as quicker reaction times, than are reasonable for middle childhood. Games that are well suited to the motor skills of elementary school-age children include kick ball, dodge ball, and team relay races.

In adolescence, children develop increasing coordination and motor ability. They also gain greater physical strength and prolonged endurance. Adolescents are able to develop better distance judgment and hand-eye coordination than their younger counterparts. With practice, they can master the skills necessary for adult sports.

Common problems

There are a range of diseases and disorders that affect gross motor skill development and skills. Among young persons, developmental problems such as genetic disorders, muscular dystrophy , cerebral palsy , and some neurological conditions adversely impact gross motor skill development.

Gross motor skills can become impaired in a variety of ways, including injury, illness, stroke , and congenital deformities. Developmental coordination disorder affects motor skills. A person with this disorder has a hard time with skills such as riding a bike, holding a pencil, and throwing a ball. People with this disorder are often called clumsy. Their movements are slow and awkward. People with developmental coordination disorder may also have a hard time completing tasks that involve movement of muscle groups in sequence. For example, such a person might be unable to do the following in order: open a closet door, get out a jacket, and put it on. It is thought that up to 6 percent of children may have developmental coordination disorder, according to the 2002 issue of the annual journal Clinical Reference Systems . The symptoms usually go unnoticed until the early years of elementary school; the disorder is usually diagnosed in children who are between five and 11 years old.

Children with any one or combination of developmental coordination disorder symptoms should be seen by a pediatrician who specializes in motor skills development delays. There are many ways to address gross motor skills impairment, such as physical therapy. This type of therapy can include treating the underlying cause, strengthening muscles, and teaching ways to compensate for impaired movements.

When to Worry?
Parents, teachers, and primary caregivers need to have a clear understanding of how young children develop gross motor skills and the timetable for development of the skills. The Lincoln-Oseretsky Motor Development Scale is an individually administered test that assesses the development of motor skills in children and adults. Areas covered include fine and gross motor skills, finger dexterity and speed, and hand-eye coordination. The test consists of 36 tasks arranged in order of increasing difficulty. These include walking backwards, standing on one foot, touching one's nose, jumping over a rope, throwing and catching a ball, putting coins in a box, jumping and clapping, balancing on tiptoe while opening and closing one's hands, and balancing a rod vertically. Norms have been established for each part of the test for children aged six to 14. When in doubt ask. There is never anything worry in asking questions.

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