{No! No! No! ~ Dealing with Challenging Behaviors: SLP Hacks}



{No! No! No! ~ Dealing with Challenging Behaviors: SLP Hacks} I work in a setting where a large percentage of the patients have challenging behaviors. It’s often a huge undertaking just to get them to engage in any meaningful way. I have lots of strategies in my speechie toolbox including visual schedules, various methods of reinforcement, using techniques from the Hanen & DIR Floortime programs, etc.

I currently have one particular kiddo whose favorite word is “no” and is very tough to engage. Seriously…. as in having whole sessions initially where he would hide like a turtle in his hoodie or plop to the ground and refuse to move. Fast forward several months and he’s a little more willing but still very challenging. Elmo is his BFF who comes to every session. We are usually okay long as the primary focus is on helping Elmo learn to say his speech sounds more clearly (not a lie right? Elmo definitely could use some therapy… lol). What’s funny is that this kiddo almost always answers on behalf of Elmo.

Yesterday in a blended Hanen / DIR Floortime focused session I discovered that this patient thought it was hilarious to take turns playing hide and seek with Elmo & me. I usually alternate sessions between his goals targeting play skills and those focusing on articulation. The problem is even with Elmo incorporated into the artic therapy this patient often immediately responds with a very melodramatic “no! no! no”. But I was prepared for that today. I had the Speech Stickers app ready to work on some CV combinations with him. I quickly changed the target to “no”. Every time he said “no” (to refuse to participate) I added a speech sticker to the screen and imitated his melodramatic production. He immediately was caught off guard, started to giggle and we were eventually able to move on to some other CV combinations. He was highly motivated to finish the stickers to get to the reward animation at the end but to keep him producing the sounds to get there I had to convince him that the characters in the iPad had to “hear” him before they would appear on the screen (had to be sneaky in tapping the scoring at the top so he didn’t catch on that I was actually in charge of it). We ended the session with a highly reinforcing game of Elmo hide and seek.

The reason I share this is that they don’t typically teach SLP students hacks/creative strategies like this in grad school. When you get out in the real world and especially if you work in a setting that has kids with challenging behaviors you will need to develop some creative SLP hacks to engage these kiddos in therapy.


What are some of your most creative hacks / strategies to keep kids engaged? Join the conversation over on the OMazing Kids Facebook page (https://www.facebook.com/OMazingKidsAAC/). Unfortunately I had to toggle off commenting here on my blog a couple of years ago due to huge amounts of spam.


In case you don’t have the SpeechStickers app by Seriously Sticky LLC, I highly recommend it (https://itunes.apple.com/us/app/speechstickers/id436101181?mt=8, iPad only, iOS 7.0 or later)!

FYI… They have a second app, Sticky Words, in the works (https://www.facebook.com/OMazingKidsYoga/photos/a.1039368119447526.1073741892.174264525957894/1187059944678342/?type=3&theater)…. can’t wait 🙂


Angela Moorad, MS, CCC-SLP
Speech-Language Pathologist
Founder of OMazing Kids, LLC – inclusive wellness & educational activities for kids of all abilities
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Angela Moorad is the founder of OMazing Kids, LLC and is an ASHA certified & licensed pediatric Speech-Language Pathologist and Kids Yoga Teacher with over 26 years experience working in a variety of settings (early intervention, schools, teletherapy & a nonprofit pediatric rehab hospital for children with developmental disabilities). She is an app beta tester for educational & therapeutic app developers and loves sharing info about great apps, products, books & toys to use with kids of all abilities.
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