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

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 

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

Keywords: executive function, speech language pathology, developmental language disorder, speech sound disorders, apraxia of speech, stuttering, verbal working memory, UDL, SLP caseload, 2025 research

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.

This episode is a message on humanism, mission, and showing up fully for every child.

It's not a question of whether the child can do it. Of course they can. It's only a question of how.

This week's episode is deeply personal. After losing a close friend and being present with him in his final moments, a powerful message surfaced: when someone is suffering, don't look away. Go toward them. For SLPs working with challenging children (kids who bite, scratch, have hours-long tantrums, or hurt themselves) this message is everything. The children on your caseload who are hardest to reach are the ones who need you most. And you have what it takes to show up for them. In this episode, let's discuss...

Why a humanistic lens, not just a clinical one, is the foundation of meaningful work with children

Why a narrow approach with kids with autism will leave you stuck, and what a truly holistic approach looks like

How to take what's working in one area of your practice and bridge it to the gaps without reinventing the wheel

Why this work is a mission and why giving all of yourself mentally, emotionally, and physically is worth it

This episode is for you if....

You work with children who are challenging to reach and sometimes wonder if you're making a difference

You feel the physical, emotional, and mental weight of this work

You want to be reminded that you are capable and that there's always a "how"

You're looking for the motivation to roll up your sleeves and keep going

READY TO MAKE THE WORLD A BETTER PLACE ONE CHILD AT A TIME?

You bring the mission. We bring the materials. The SIS Membership gives preschool SLPs instant access to ready-to-use, effective, and engaging resources, so you can spend less time prepping and more time doing what you do best: showing up for your kids.

✔ Therapist-designed materials built for real preschool caseloads

✔ Strategies that support a holistic, whole-child approach

✔ Tools that work even with your most challenging kids

You don't have to do this alone. Join the SIS Membership today and change lives faster. https://www.kellyvess.com/sis

See you there,💚Kelly

End-of-Year Reflect & Recap:

The 3 Questions Every SLP Needs to Ask Right Now

Whether you're a seasoned SLP or fresh out of grad school, the most powerful professional development you'll do this summer won't come from a CEU course. It's this.

In this episode, Kelly walks you through her end-of-year Google Doc ritual: three simple but mighty questions that help you close out the school year with intention and walk into fall with clarity and confidence.

In this episode, you'll learn:

🔥 What Was FIRE? Identify what worked in your therapy room this year, including the techniques, materials, and strategies that produced real, measurable gains. These are your non-negotiables. Where there's fire, you add gasoline.

🧀 Where Are the Holes? Channel your inner Swiss cheese and honestly audit your practice. From streamlining parent communication with copy-paste swipe emails to strengthening your high-tech AAC implementation at home and in the classroom, this is where your growth lives.

🩹 How Will You Fill Them? Use the triangle of evidence-based practice, combining your clinical expertise, the research, and family and child feedback, to build a specific, actionable plan for the 2026–2027 school year. The more specific, the better.

Why do this NOW? It's all fresh. The wins, the frustrations, the "why didn't I think of that sooner" moments are all right there. Write it down today, and you're 42% more likely to actually follow through.

🎒 Ready to walk into next school year with engaging, evidence-based materials already in hand?

Don't spend September scrambling.

Spend your summer building and let the SIS Membership do the heavy lifting with you. SIS gives SLP students and professionals access to a growing library of evidence-based therapy materials, strategies, and resources designed to move the needle for the children and families you serve.

👉 Join SIS today at https://www.kellyvess.com/sis and head back to school this fall feeling more prepared, more confident, and ready to make this your best year yet.

This episode is perfect for: school-based SLPs, SLP-Assistants, SLP graduate students, pediatric SLPs, AAC specialists, and anyone who believes the details are what move the needle.

Are you winging it when it comes to picking consonant clusters?

If you're spending more time hunting for the right targets than actually running therapy, this episode is your reset button.

In today's episode, we're diving deep into selecting consonant clusters.

We're breaking down how to select targets strategically, sequence them with intention, and finally see the carryover you've been waiting for.

Whether you're a seasoned SLP or new to building your clinical confidence, you'll walk away with a clearer framework and a fresh perspective on why some clients plateau and exactly how to get them moving again.

In this episode, we cover:

1) Why random target selection is quietly sabotaging your data

2) The developmental and phonological principles that should be driving your cluster choices

3) How to align targets with your client's unique error patterns for faster progress

4) What the research actually says about cluster intervention sequences

Ready to stop searching and start treating?

Join the SIS Membership and get done-for-you consonant cluster targets you can put to use today.

No more building from scratch, no more second-guessing, just clinically sound, ready-to-use materials designed specifically for SLPs and SLPAs.

Join now at kellyvess.com/sis

Don't delay and have a summer of reorganizing the brain today. 

You're welcome. Because today, we're digging into something I bet you're seeing on your back porch right now, and nobody is talking about it. Asthma and speech sound disorders. If you have a child on your caseload with significant asthma, this episode is the one you need tomorrow. Roll up your sleeves with me. We're going to get our hands really, really dirty, and we're going to talk about where the research stops and where the practitioner begins. Because this is where you have to have skin in the game. This is where it matters that you know your little professors closely, that you study what's happening under your own magnifying glass. Here's what we cover: What the research tells us. A Northwestern-led study of 337,285 children found that asthma, hay fever, and food allergy are significantly associated with speech disorders, and the more severe the disease, the greater the risk (Strom & Silverberg, 2016, Pediatric Allergy and Immunology). A 2006 population-based study of 7,389 eight-year-old children identified asthma as one of the factors associated with voice disorders (Carding et al., 2006, Journal of Voice). So we know there is a connection. And that is where the research stops. What I'm seeing on my back porch. This is where things get gnarly. The children with significant asthma are breaking the rules of speech development. They're stopping fricatives, they're fronting velars, they're voicing voiceless sounds, and they're deleting the /h/. Looks like phonological processes, right? Except phonological processes happen across positions of words. What I'm seeing with these kiddos is 0% accuracy in the initial position of words and 100% accuracy in the medial and final positions. That is not linguistic. Do you dare disturb the universe? Yes, you do. That's physiology. Why this is happening. My hypothesis, and this is practitioner experience, not research on large populations, is that these children have insufficient subglottal air pressure. Continuant sounds need continuous airflow from the respiratory system. After the vowel gets going, the vocal folds are doing the work and producing those sounds becomes easy. But in the initial position of words, when you're starting cold, you don't have that help. So fricatives stop, velars front, voiceless sounds get voiced, and the /h/ gets deleted. What the child is telling you. Mouth breathing at rest. Chin jutting. Head forward to get more air in. Tense neck and visible effort while speaking, like they're yelling at conversational volume. Fluctuating accuracy that tracks with allergy season and asthma flare-ups. The clear boogers come out and suddenly the phonological processes you thought were suppressed come right back. That is not a child regressing. That is a child without the respiratory support to do the work in initial position. What to do differently (DSD). You've been doing best practice. You're doing the complexity approach, you're doing DTTC, you're doing multimodal cueing, you're holding the 80% challenge point. And you're still at 0% in initial position. So we're going to do something different. We're going to capitalize on what the child can do. They can produce these sounds after a vowel, so we anchor with a vowel. We say "a sun, a sun." Or we use the end of one word to start the next, "yes sun, yes sun." And then over time, we stretch the pause longer and longer until that target is sitting in the initial position of the word on its own. That is how we DSD. This is one to take notes on. And if you have one of these kiddos on your back porch right now, shoot me an email. This is exactly the kind of clinical pattern I want to research next. 🌟 Join the SIS Membership Today If you learn from doing, and you want highly effective, engaging therapy materials ready to go without the prep, the Sparkle in School Membership was built for you. Educationally rich activities, 100% planned, prepped, and delivered to your inbox every Friday. So your energy goes into cueing the child in front of you, not building materials at midnight. 👉 Join today at kellyvess.com/sis 📘 For the deeper dive, grab Speech Sound Disorders: Comprehensive Evaluation and Treatment on Amazon, with 100+ video clips of best practices illustrated. 📧 Got a kiddo with asthma who's daring to disturb the universe on your back porch? Email me at [email protected]. I want to hear about it. Be better. Do better. Create better. Make the world a better place, one child at a time. You will always be first. 📚 Research Cited Strom, M. A., & Silverberg, J. I. (2016). Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children. Pediatric Allergy and Immunology, 27(6), 604–611. doi:10.1111/pai.12580. Pooled analysis of 337,285 U.S. children from 19 population-based cohorts (NHIS 1997–2013 and NSCH 2003/4 and 2007/8). Carding, P. N., Roulstone, S., Northstone, K., & ALSPAC Study Team. (2006). The prevalence of childhood dysphonia: A cross-sectional study. Journal of Voice, 20(4), 623–630. Cohort of 7,389 eight-year-old British children, with asthma identified among the factors associated with increased risk of voice disorders. Tags: speech sound disorders SSD pediatric speech therapy preschool SLP asthma and speech respiratory support subglottal pressure phonological processes stopping fronting voicing errors glottal fricative initial position of words articulation therapy evidence-based practice DTTC complexity approach multimodal cueing physiological speech disorders differential diagnosis do something different DSD Kelly Vess KellyVessSLP The Preschool SLP SIS Membership Sparkle in School SLP podcast speech-language pathology early intervention school SLP

You opened your caseload. Another Spanish-speaking kiddo. You don't speak Spanish. There's no translator. No bilingual SLP down the hall. Now what? You don't freeze. You don't refer out. You don't waste a single therapy minute. You use the 5-step Good Enough Practice plan, built on the complexity approach research, to drive real, generalizable gains in both languages, even when you're only treating in one. In this follow-up to Episode 215 (assessment), we roll up our sleeves and walk through exactly what to do Monday morning. 🔥 What You'll Walk Away With ✅ Why "good enough practice" beats "no practice," and how to defend your why on every clinical decision ✅ The exact target selection sequence that gets you the most generalization per minute of therapy ✅ Why FR will get you FL "for free," and why SKR might out-perform both ✅ How to coach caregivers in 5 minutes a day (and why frequency beats duration at the preschool level) ✅ The single word probe strategy that tells you whether gains are generalizing, not just memorized ✅ The one thing more important than language matching: multimodal, dynamic cueing at the 80% challenge point 🎯 The 5-Step "Good Enough" Framework Step 1. Find an error that occurs in BOTH languages. Use IPA to compare error sounds across the child's L1 and English. Pick a sound that's broken in both phonological systems so any gain transfers across languages. The research on shared targets supports this. When shared sounds are treated, cross-linguistic generalization happens, even when treatment is delivered in only one language (Barlow et al., 2024; Gildersleeve-Neumann & Goldstein, 2015). Step 2. Pick a COMPLEX target, not a singleton. Skip /f/ alone. Skip /r/ alone. Go for the cluster. Complex targets create system-wide change because clusters imply singletons, meaning treating the harder thing makes the easier things come along for the ride (Gierut, 2007; Storkel, 2018). Higher aim, higher gains. Cirque du Soleil in the mouth. Step 3. Treat in the language YOU are fluent in (English). You cannot deliver therapy with fidelity in a language you don't speak. A ChatGPT word list doesn't fix your inability to model a Spanish trill. Stick with English, and select complex targets that share sounds with the child's L1 so the gains cross over. Pilot data on Spanish/English bilinguals show medium effect sizes for system-wide generalization in both the treated and untreated language when complex cluster targets are used (Combiths et al., 2023). Step 4. Train caregivers with daily home practice in the child's L1. Build a short core vocabulary list, sentence, or paragraph that contains the target and hand it to the family in their language. Embed it into an existing routine like toothbrushing, bedtime, or snack. Frequency over duration: 5 minutes every day beats 2 hours once a week at the preschool level. Step 5. Probe progress in BOTH languages every quarter. Skip the practice-effect probes for the same 5 words. Re-administer a single-word, phonetically balanced picture test in each language every 2 months and track the number of errors, not the standard scores. That's how you know gains are generalizing rather than rehearsed. 👉 Ready to Stop Hunting for Materials and Start Driving Real Gains? Here's the secret the 5-step plan can't give you on its own: the materials. Inside the SIS Membership, you get the done-for-you complex cluster paragraphs, phonetically loaded sentences. These are the exact materials I hand to caregivers to embed into toothbrushing, bedtime, and snack routines. No more scrambling. No more wondering if your target is complex enough. Join SIS and work smarter, not harder: https://kellyvess.com/sis

Have zero dollars in your therapy closet for bilingual Spanish assessments? You are not alone — and you are not stuck. In this episode, I walk you through the 8-step gold-standard process for assessing bilingual Spanish-English preschoolers for speech sound disorders, every single step backed by free, vetted, research-supported tools. This is the same framework recommended by Sharynne McLeod, Sarah Verdon, and the International Expert Panel on Multilingual Children's Speech (McLeod, Verdon, & IEPMCS, 2017, AJSLP) — taught to you in plain English with direct links you can click today. You'll learn how to: Capture a true language profile Sample BOTH languages without overdiagnosing dialect features Use narrow IPA transcription so you don't mislabel allophones as errors Distinguish a transfer error from a true speech sound disorder Free Resources Mentioned Step 1 — Language Profile Alberta Language Environment Questionnaire (ALEQ/ALDeQ) + Intelligibility in Context Scale: https://www.ualberta.ca/en/linguistics/cheslcentre/questionnaires.html Intelligibility in Context Scale: https://www.csu.edu.au/research/multilingual-speech/speech-assessments/ics Step 2 — Sampling Both Languages UBC Cross-Linguistic Phonological Development Project (single-word probes in many languages): https://phonodevelopment.sites.olt.ubc.ca/ Frog, Where Are You: https://www.iifilologicas.unam.mx/uploads/IL-2-Lecturas/050-Frog_Story_all_as_pdf_image_300.pdf Step 3 — Narrow IPA Transcription ASHA Spanish Phonemic Inventory: https://www.asha.org/siteassets/uploadedfiles/spanish-phonemic-inventory.pdf Step 4 — Parent Baseline Recording Speech Accent Archive (cross-dialect reference recordings): https://accent.gmu.edu/ Step 5 — Independent Then Relational Analysis Phon software (open-source phonological analysis): https://www.phon.ca/ Step 6 — Rule Out Transfer & Dialect Bilinguistics Spanish-English Articulation Norms Chart: https://bilinguistics.com/articulation-norms-for-spanish-and-english/ Step 7 — Diagnose Only If Errors Appear in BOTH Languages Goldstein & Fabiano (2007) ASHA Leader: https://leader.pubs.asha.org/doi/10.1044/leader.FTR2.12022007.6 Step 8 — Treat with Complex Targets UBC Fun-ology Activities: https://phonodevelopment.sites.olt.ubc.ca/activities-2/activities/ Reference: McLeod, S., Verdon, S., & International Expert Panel on Multilingual Children's Speech (2017). Tutorial: Speech assessment for multilingual children who do not speak the same language(s) as the speech-language pathologist. American Journal of Speech-Language Pathology, 26(3), 691–708. Ready to Optimize Change with Complex Targets? Join the SIS (Speech It Smarter) Membership to learn how to select, sequence, and track complex treatment targets — including three-element /s/ clusters, /fr/ and /fl/ clusters. Join the SIS Membership: https://www.kellyvess.com/sis

If you’re feeling like your therapy sessions are “working” but chugging along at a slow pace, this episode is going to hit a nerve in the best way. Because here’s the truth that most of us weren’t trained to see clearly: When a child has anxiety or ADHD, you are not just treating speech and language. You are working against a nervous system that is dysregulated, overloaded, and constantly scanning for what feels safe, predictable, and doable. And if your therapy doesn’t account for that, it won’t stick. Not because the child can’t learn, but because the system isn’t ready to hold onto what you’re teaching. In this episode, we break down what is actually happening underneath the surface with anxiety and ADHD, and why traditional, sit-and-work therapy models often fall apart with these learners. We walk through what to look for, what to shift immediately, and how to build sessions that regulate first so language, speech, and AAC can actually follow. We’re talking about real, Monday-morning changes that increase engagement, reduce shutdown behaviors, and create the kind of momentum that leads to true generalization. If you’ve ever thought, “They can do it with me, but nowhere else,” this episode is for you. Because that gap is not a mystery. It’s a systems problem, and you can fix it. And when you do, everything changes. If you are ready for therapy that actually works for children with anxiety and ADHD, where movement, regulation, literacy, and communication are all working together instead of competing, then it’s time to step into a model that was built for exactly that. Inside the SIS Membership, you get ready-to-use, literacy-based, movement-rich therapy activities designed to support regulation, attention, and engagement first, so that speech, language, and AAC gains can finally stick and generalize across settings. No more piecing things together. No more guessing what will work. Just open, implement, and watch the shift. Join the SIS Membership here: https://www.kellyvess.com/sis Roll up your sleeves and meet me at the intervention drawing board.💚KellyVessSLP

When it comes to making real, measurable change in therapy, we have to stop thinking small.

In this episode, we are digging into what actually moves the needle for our preschoolers and early learners, and it is not isolated drill, disconnected targets, or hoping repetition alone will generalize. The research is clear. When we aim higher with more complex targets, we create system-wide change across speech, language, and literacy.

We are talking about why those tough targets like three-element blends are worth your time, how continuous motor planning changes everything, and what it really looks like to cue in a way that leads to spontaneous carryover. This is where therapy either clicks or falls apart, and I want it clicking for you on Monday morning.

If you have ever felt like you are working hard but not seeing the generalization you expected, this episode is going to challenge your thinking in the best way and give you a more efficient path forward. Because here is the truth. Our students do not need more activities. They need better designed ones.

Inside the SIS Membership, I take everything we know from research and translate it into ready-to-use, literacy-based, movement-driven activities that target multiple domains at once. You are not planning from scratch. You are walking into your sessions with a system that is built for generalization. Each week, you get themed, engaging activities that integrate speech, language, AAC, and literacy with built-in movement so your students are not just participating, they are learning in a way that sticks.

If you are ready to stop second guessing your therapy and start seeing meaningful progress across domains, it is time to join us.

👉 Join the SIS Membership here: https://www.kellyvess.com/sis

Wishing you a week of efficient, effective therapy that carries over far beyond your session walls,💚Kelly