July 12, 2023 • 13 mins
Do you ever wonder how closely motor and language development are intertwined in children? Discerning the subtle ties between these two fundamental areas can be profoundly insightful, especially for those of us in the field of pediatric speech-language pathology! I am Denise Stratton, bringing you episode 89 of the Speech Umbrella, as we delve deep into this fascinating correlation, especially concerning children with autism. Drawing from a wealth of research, we underscore the reality that language impairment often goes hand-in-hand with motor skill development issues.
Let's dive into how motor skills might actually be the first domain where developmental divergence appears in children diagnosed with autism. We bring light to the valuable resource - the 16 actions with objects by 16 months - developed by the First Words Project. This tool has innovatively changed the game for me in my practice, and I can't wait to share it with you! Understanding and fostering the development of motor skills can lead to future gains in communication. So join me as we celebrate the power of simple therapies and their potential for improving outcomes in our young patients' lives.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
Welcome to the Speech Umbrella, the show that
explores simple but powerfultherapy techniques for optimal
outcomes.
I'm Denise Stratton, apediatric speech-language
pathologist of 30-plus years.
I'm closer to the end of mycareer than the beginning and
along the way I've worked longand hard to become a better
therapist.
Join me as we explore the manytopics that fall under our
umbrellas as SLPs.
(00:27):
I want to make your journeysmoother.
I found the best therapy comesfrom employing simple techniques
with a generous helping ofmindfulness.
Hello everyone, welcome toepisode 89 here on the Speech
Umbrella.
There are a lot of professionalsin our field who work with
children.
Besides SLPs, there are OT's,PT's, developmental specialists
(00:48):
and behavior specialists.
While we each have our area ofspecialty, it's not so easy to
separate these areas in reallife, nor should it be.
There are not clear anddistinct lines between a child's
motor, cognitive, social andcommunication development.
What is particularlyinteresting and concerning to me
is research indicating thatchildren with language
impairments have poor motorskills, and in children with
(01:11):
autism, it may affect as much as80% of the children with that
disorder.
Now, that's probably notgroundbreaking news to us, but
the question is what can we doas SLPs to promote motor
development along withcommunication, but without
getting out of our lane and intothe OT's lane.
I have a great resource thathas helped me a lot and that's
what I'm going to share today,along with some research on
(01:33):
motor development and autism and, as always, some clinical
application.
Today's episode is called ARising Tide Floats All Boats,
The Motor Language Connection.
With this information I'm goingto share today, SLP s can
recognize and celebrate progressthat doesn't seem directly
related to communication.
We know it's a sign of futurecommunication gains and we can
(01:54):
share this exciting news withparents.
First, I'm going to go oversome research facts, then the
motor development research, andwind up with clinical
application.
All the research I'm citingtoday comes from the website
spectrumnews.
org.
I'm quoting from threedifferent articles which I'll
link in the show notes, and theyhave done a great job of
writing these articles for thegeneral public.
I love it when research issummarized so I can understand
(02:16):
it.
Now let's dive into the research.
Do you wonder when autism canfirst be recognized?
I've been around a long timeand it used to be that we
wouldn't spot it until languagedelays made it apparent that
something was not developing aswe expected.
But actually, motor skills maybe the domain in which
developmental divergence appearsfirst.
Infants later diagnosed withautism showed fine and gross
(02:39):
motor differences by just sixmonths of age, and large
differences were observed by 13months of age.
Early motor difficulties couldmake it difficult for babies to
focus their eyes on objects andthat could hinder reaching
movements and that makes itharder to get objects and share
them with people.
And that all cascades intolanguage.
So you get this cascadingeffect across domains.
(02:59):
In fact, some of the firstcommunication skills to emerge;
facial expressions, jointattention and pointing to
requests, are all motorbehaviors.
Rebecca Landa, who is an SLP,and executive director for the
Center for Autism and RelatedDisorders, said this really
makes a difference in the way Idesign early intervention for
autism.
For example, when teachingtoddlers play skills, she says
(03:22):
she focuses specifically onimproving their motor abilities
and some studies show a directlink between communication and
motor development.
There's an interesting studythat showed reaching for and
actively playing with toys canboost young infants' interest in
faces, and there's another onethat shows greater risk for
motor impairment is tied tosocial communication skills and
restricted and repetitivebehaviors.
(03:43):
And that makes me wonder ifdifficulty playing with toys can
contribute to always playingwith them the same way and that
contributes to repetitivebehaviors.
That's just the thought of myown.
That was not in the research.
How can SLPs incorporate motorskills into therapy And where do
we even start?
I love looking at the sequenceof development when I'm
wondering where to start intherapy.
(04:04):
And that's what this resourcecalled 16 actions with objects
by 16 months does.
It lays out the orderdevelopment of key motor skills
from 9 to 16 months.
It was developed by the FirstWords Project at Florida State
University.
They also developed 16 gesturesby 16 months.
That's another fantasticresource.
If you want to hear more aboutthat, hop on over to episode 33,
(04:25):
challenges in earlyintervention.
Now back to 16 actions onobjects.
Here's an overview of all theactions that they have detailed
from 9 months to 16 months, andyo u'll be able to see how these
skills build on each other andalso how communication starts to
come in.
At nine months is all aboutmouthing, banging and dropping.
Babies use mouths to explorefeatures, they bang objects with
(04:49):
their hand and they also bangobjects together.
They drop objects by chance andsometimes they drop them on
purpose.
By the way, dropping objectshas a direct connection to
developing the gesture of giving, which in turn is connected to
back and forth play with objects.
At 10 months, babies grab andpull and take things off Like
they'll take their socks andshoes off.
They grab and pull to take ablanket off their head and play
(05:09):
peek-a-boo with you.
They explore objects in an opendrawer and they take things out
of the drawer Everything out ofthe drawer.
At 11 months, babies learn topush.
Think of squishing a stuffedanimal, pushing buttons on
pop-up toys, pushing a towerover.
They also learn to turn thingslike pages in a book, a toy
steering wheel or turn a faucet,or they might turn a basket
(05:30):
over their head to make youlaugh at them.
At 12 months, patting andputting in comes along.
They can pat themselves offwith a towel or they can pat
their teddy bear, and patsdevelop into hugs.
When they learn put in, theylearn a lot of functional
actions.
They put a sippy cup in theirmouth to drink, they put a spoon
in a bowl to scoop and they putthe spoon in the mouth to eat.
(05:50):
By the way, put is one of myall-time favorite words and
actions in therapy.
It's just so functional I useit all the time.
When 13 months rolls around,they begin to learn by observing
others and copying what they doand say.
They start to pretend, which isso important to language
development.
Think of feeding mom with a cupor pretending to feed teddy
bear with a bottle.
(06:11):
They also open and closeobjects as they learn to use
objects as tools.
So toddlers can open and closecupboards and oven doors.
It's interesting to me thatopening and closing and copying
others emerge together.
I do a lot of pretend play withkitchen play and we open and
close doors with the pretendoven and we pretend to make food
at the same time.
So I'm incorporating those twothemes when I'm doing kitchen
(06:33):
play without even thinking,because we're imitating what
their parents do by cooking andwe're opening and closing a lot
of things.
And open is another one of myall-time favorite words in
therapy.
At 14 months, toddlers learn tomove objects back and forth and
up and down.
I can really see how thesemovements contribute to symbolic
play, for example, pretendingto vacuum and cutting play food,
using a rolling pin and cookiecutters.
(06:55):
Now Play Doh, rolling pins, andcookie cutters are always
within arm's reach in my therapyroom.
They are just so awesome.
At 15 months, they're learningto use two objects together with
a plan in mind.
They can pour from one objectto another, such as a liquid
from a bottle into a cup.
They can pour from a shovelinto a bucket and from a
watering can onto plants.
Playing with two objectstogether is also a step in
(07:16):
symbolic play.
At 16 months, we have stacking,cutting out, scribbling and
drawing.
Now kids are able to make andcreate things; stacking blocks,
creating with Play Doh, drawing,and painting.
They are making things thatrepresent other things, which is
also critical to languagedevelopment.
This understanding thatsomething can represent another
thing is really what verbal andwritten language is.
(07:38):
The actions a child learns varydepending on their family and
culture, of course, but having16 actions with objects by 16
months is a critical milestonefor all children because it
launches imagination and thatfuels language and learning.
Now, no doubt you're alreadythinking of ways to apply this
in your practice if you workwith toddlers and preschoolers.
I want to share a particularcase history of how I used 16
(08:01):
actions with objects to sparkturn taking.
This client was two and on theautism spectrum, and this took
place over five months fromApril to August.
I had this plan of how to usethe motor skills he had and
bring him along in this languagewith developing motor skills he
had yet to develop, and it wasso textbook perfect.
I mean, he just followed myplan perfectly.
I know that doesn't alwayshappen, but this was awesome.
(08:22):
These are my notes.
In April, with his mom, Ireviewed the 16 actions with
objects and we determined thathe was functioning around 13 to
15 months, so not too far behind.
We brainstormed ideas forincorporating turn taking with
actions at that level he was atand things that would be a high
interest to him, but nothingreally worked for encouraging
turn-taking.
We brainstormed ideas for howshe could incorporate
(08:45):
turn-taking with actions for thethings he did at home and using
things that would be highinterest for him, but she
reported back to me that nothingwas really working for
encouraging turn-taking.
So, in May I was thinking ofhow to take putting in and
pouring, those actions that hehad that are around 15 months,
and more of it into ball play,and so this is what I did.
We took Play Doh and made aball and rolled it across the
(09:07):
table.
And I introduced rolling theballs into cups.
So I put my cup down on thetable so it was really easy that
the opening was laying on thetable and all he had to do was
give it a little push and itrolled into my cup and then I
would roll into his.
And he wasn't quite sure whatto do, but he went along with it
.
And the next session he wasreally engaged.
We started tipping the Play Dohballs back and forth between
(09:27):
his cup and mine.
So now we're using that pouringin and out, and this was the
first sustained back and forthactivity he engaged in.
Now the next session he againparticipated in tipping the Play
Doh ball back and forth from mycup to his, and then he
continued to do it when wechanged containers, and he
caught the ball and by caught itI mean I loved it to him really
(09:47):
soft.
I was like two inches away fromhis hands and kind of threw it.
But he caught it.
So that was cool.
And in June he said I want aball when he had a toy orange.
And so we pretended that theorange was a ball and he rolled
it and threw it back and forth.
And at the end of June he waspassing the ball to his mom and
to me.
In July, he was rolling backand forth with eye contact and
(10:09):
starting to engage in other turntaking activities.
And in August, he threw a ballback and forth through a
basketball hoop, playingbasketball just like a typically
developing toddler.
And it all started with theidea of using pouring back and
forth motor movement asdescribed at 15 months.
In closing I want to hark backto what I said earlier about
recognizing and celebratingskills that don't seem directly
(10:32):
related to communication.
They don't seem to be, but theyare.
When a little client of mine onthe spectrum said put in, as he
was dropping balls into a tube,it was really exciting.
But equally exciting to me waswhen he calmly and purposefully
reached for each piece in ashape sorter toy and worked
diligently at fitting the shapestogether.
It's exciting because reachingfor and actively playing with
(10:54):
toys can boost young infant'sinterest in faces, as I cited
earlier.
He's not an infant now but hestill needs to develop that
interest in faces.
And what he just did with theshape sorter toy is going to
support that interest and that'sjust as important in my book as
him saying put in.
I called this episode A RisingTide Floats All Boats for a
reason.
That's one of my favoritephrases, because when a child's
(11:16):
motor skills develop and rise,everything else rises too, and
we've just seen howcommunication is so tied to how
their motor skills develop andhow, as SLPs, we can use this
resource, this 16 actions withobjects by 16 months, to really
examine where a child is and tobring them along, following the
sequence of development, tobuild their communication.
(11:37):
So here's a few things to keepin mind from this podcast.
Number one motor skills may bethe first indication of autism.
Number two remember thisawesome resource by the first
words project, 16 actions withobjects by 16 months, it's
fantastic.
It's awesome.
Share it with your parents.
And number three think abouthow you can use this resource to
(12:01):
look at a child's motor stageand think about how you can tie
language into where they are atand bring them along in their
language skills.
That wraps things up for today.
If you want a transcript or thelinks for today's and every
other episode, you can find themat thespeechumbrella.
com/blog.
Take a minute to browse aroundmy store and sign up for the
free resource library.
(12:21):
I know you'll find somethingthat will help you with your
kiddos.
Tell your fellow therapistabout the podcast, leave me a
review and let's connect onsocial media.
I'm dStratten SLP on Instagramand The Speech Umbrella on
Facebook.
Check out my videos on YouTubetoo.
There's a lot of great stuffunder The Speech Umbrella.
Thanks for listening.
Speaker 2 (12:40):
Thanks for listening to The Speech Umbrella.
We invite you to sign up forthe free resource library at
thespeechumbrellacom.
You'll get access to some ofDenise's best tracking tools,
mindfulness activities and othergreat resources to take your
therapy to the next level.
All this is for free atthespeechumbrella.
com.
If you've enjoyed this podcast,subscribe and please leave us a
(13:03):
review on Apple Podcasts andother podcast directories.
Welcome to the Speech Umbrella, the show that
explores simple but powerfultherapy techniques for optimal
outcomes.
I'm Denise Stratton, apediatric speech-language
pathologist of 30-plus years.
I'm closer to the end of mycareer than the beginning and
along the way I've worked longand hard to become a better
therapist.
Join me as we explore the manytopics that fall under our
umbrellas as SLPs.
(00:27):
I want to make your journeysmoother.
I found the best therapy comesfrom employing simple techniques
with a generous helping ofmindfulness.
Hello everyone, welcome toepisode 89 here on the Speech
Umbrella.
There are a lot of professionalsin our field who work with
children.
Besides SLPs, there are OT's,PT's, developmental specialists
(00:48):
and behavior specialists.
While we each have our area ofspecialty, it's not so easy to
separate these areas in reallife, nor should it be.
There are not clear anddistinct lines between a child's
motor, cognitive, social andcommunication development.
What is particularlyinteresting and concerning to me
is research indicating thatchildren with language
impairments have poor motorskills, and in children with
(01:11):
autism, it may affect as much as80% of the children with that
disorder.
Now, that's probably notgroundbreaking news to us, but
the question is what can we doas SLPs to promote motor
development along withcommunication, but without
getting out of our lane and intothe OT's lane.
I have a great resource thathas helped me a lot and that's
what I'm going to share today,along with some research on
(01:33):
motor development and autism and, as always, some clinical
application.
Today's episode is called ARising Tide Floats All Boats,
The Motor Language Connection.
With this information I'm goingto share today, SLP s can
recognize and celebrate progressthat doesn't seem directly
related to communication.
We know it's a sign of futurecommunication gains and we can
(01:54):
share this exciting news withparents.
First, I'm going to go oversome research facts, then the
motor development research, andwind up with clinical
application.
All the research I'm citingtoday comes from the website
spectrumnews.
org.
I'm quoting from threedifferent articles which I'll
link in the show notes, and theyhave done a great job of
writing these articles for thegeneral public.
I love it when research issummarized so I can understand
(02:16):
it.
Now let's dive into the research.
Do you wonder when autism canfirst be recognized?
I've been around a long timeand it used to be that we
wouldn't spot it until languagedelays made it apparent that
something was not developing aswe expected.
But actually, motor skills maybe the domain in which
developmental divergence appearsfirst.
Infants later diagnosed withautism showed fine and gross
(02:39):
motor differences by just sixmonths of age, and large
differences were observed by 13months of age.
Early motor difficulties couldmake it difficult for babies to
focus their eyes on objects andthat could hinder reaching
movements and that makes itharder to get objects and share
them with people.
And that all cascades intolanguage.
So you get this cascadingeffect across domains.
(02:59):
In fact, some of the firstcommunication skills to emerge;
facial expressions, jointattention and pointing to
requests, are all motorbehaviors.
Rebecca Landa, who is an SLP,and executive director for the
Center for Autism and RelatedDisorders, said this really
makes a difference in the way Idesign early intervention for
autism.
For example, when teachingtoddlers play skills, she says
(03:22):
she focuses specifically onimproving their motor abilities
and some studies show a directlink between communication and
motor development.
There's an interesting studythat showed reaching for and
actively playing with toys canboost young infants' interest in
faces, and there's another onethat shows greater risk for
motor impairment is tied tosocial communication skills and
restricted and repetitivebehaviors.
(03:43):
And that makes me wonder ifdifficulty playing with toys can
contribute to always playingwith them the same way and that
contributes to repetitivebehaviors.
That's just the thought of myown.
That was not in the research.
How can SLPs incorporate motorskills into therapy And where do
we even start?
I love looking at the sequenceof development when I'm
wondering where to start intherapy.
(04:04):
And that's what this resourcecalled 16 actions with objects
by 16 months does.
It lays out the orderdevelopment of key motor skills
from 9 to 16 months.
It was developed by the FirstWords Project at Florida State
University.
They also developed 16 gesturesby 16 months.
That's another fantasticresource.
If you want to hear more aboutthat, hop on over to episode 33,
(04:25):
challenges in earlyintervention.
Now back to 16 actions onobjects.
Here's an overview of all theactions that they have detailed
from 9 months to 16 months, andyo u'll be able to see how these
skills build on each other andalso how communication starts to
come in.
At nine months is all aboutmouthing, banging and dropping.
Babies use mouths to explorefeatures, they bang objects with
(04:49):
their hand and they also bangobjects together.
They drop objects by chance andsometimes they drop them on
purpose.
By the way, dropping objectshas a direct connection to
developing the gesture of giving, which in turn is connected to
back and forth play with objects.
At 10 months, babies grab andpull and take things off Like
they'll take their socks andshoes off.
They grab and pull to take ablanket off their head and play
(05:09):
peek-a-boo with you.
They explore objects in an opendrawer and they take things out
of the drawer Everything out ofthe drawer.
At 11 months, babies learn topush.
Think of squishing a stuffedanimal, pushing buttons on
pop-up toys, pushing a towerover.
They also learn to turn thingslike pages in a book, a toy
steering wheel or turn a faucet,or they might turn a basket
(05:30):
over their head to make youlaugh at them.
At 12 months, patting andputting in comes along.
They can pat themselves offwith a towel or they can pat
their teddy bear, and patsdevelop into hugs.
When they learn put in, theylearn a lot of functional
actions.
They put a sippy cup in theirmouth to drink, they put a spoon
in a bowl to scoop and they putthe spoon in the mouth to eat.
(05:50):
By the way, put is one of myall-time favorite words and
actions in therapy.
It's just so functional I useit all the time.
When 13 months rolls around,they begin to learn by observing
others and copying what they doand say.
They start to pretend, which isso important to language
development.
Think of feeding mom with a cupor pretending to feed teddy
bear with a bottle.
(06:11):
They also open and closeobjects as they learn to use
objects as tools.
So toddlers can open and closecupboards and oven doors.
It's interesting to me thatopening and closing and copying
others emerge together.
I do a lot of pretend play withkitchen play and we open and
close doors with the pretendoven and we pretend to make food
at the same time.
So I'm incorporating those twothemes when I'm doing kitchen
(06:33):
play without even thinking,because we're imitating what
their parents do by cooking andwe're opening and closing a lot
of things.
And open is another one of myall-time favorite words in
therapy.
At 14 months, toddlers learn tomove objects back and forth and
up and down.
I can really see how thesemovements contribute to symbolic
play, for example, pretendingto vacuum and cutting play food,
using a rolling pin and cookiecutters.
(06:55):
Now Play Doh, rolling pins, andcookie cutters are always
within arm's reach in my therapyroom.
They are just so awesome.
At 15 months, they're learningto use two objects together with
a plan in mind.
They can pour from one objectto another, such as a liquid
from a bottle into a cup.
They can pour from a shovelinto a bucket and from a
watering can onto plants.
Playing with two objectstogether is also a step in
(07:16):
symbolic play.
At 16 months, we have stacking,cutting out, scribbling and
drawing.
Now kids are able to make andcreate things; stacking blocks,
creating with Play Doh, drawing,and painting.
They are making things thatrepresent other things, which is
also critical to languagedevelopment.
This understanding thatsomething can represent another
thing is really what verbal andwritten language is.
(07:38):
The actions a child learns varydepending on their family and
culture, of course, but having16 actions with objects by 16
months is a critical milestonefor all children because it
launches imagination and thatfuels language and learning.
Now, no doubt you're alreadythinking of ways to apply this
in your practice if you workwith toddlers and preschoolers.
I want to share a particularcase history of how I used 16
(08:01):
actions with objects to sparkturn taking.
This client was two and on theautism spectrum, and this took
place over five months fromApril to August.
I had this plan of how to usethe motor skills he had and
bring him along in this languagewith developing motor skills he
had yet to develop, and it wasso textbook perfect.
I mean, he just followed myplan perfectly.
I know that doesn't alwayshappen, but this was awesome.
(08:22):
These are my notes.
In April, with his mom, Ireviewed the 16 actions with
objects and we determined thathe was functioning around 13 to
15 months, so not too far behind.
We brainstormed ideas forincorporating turn taking with
actions at that level he was atand things that would be a high
interest to him, but nothingreally worked for encouraging
turn-taking.
We brainstormed ideas for howshe could incorporate
(08:45):
turn-taking with actions for thethings he did at home and using
things that would be highinterest for him, but she
reported back to me that nothingwas really working for
encouraging turn-taking.
So, in May I was thinking ofhow to take putting in and
pouring, those actions that hehad that are around 15 months,
and more of it into ball play,and so this is what I did.
We took Play Doh and made aball and rolled it across the
(09:07):
table.
And I introduced rolling theballs into cups.
So I put my cup down on thetable so it was really easy that
the opening was laying on thetable and all he had to do was
give it a little push and itrolled into my cup and then I
would roll into his.
And he wasn't quite sure whatto do, but he went along with it
.
And the next session he wasreally engaged.
We started tipping the Play Dohballs back and forth between
(09:27):
his cup and mine.
So now we're using that pouringin and out, and this was the
first sustained back and forthactivity he engaged in.
Now the next session he againparticipated in tipping the Play
Doh ball back and forth from mycup to his, and then he
continued to do it when wechanged containers, and he
caught the ball and by caught itI mean I loved it to him really
(09:47):
soft.
I was like two inches away fromhis hands and kind of threw it.
But he caught it.
So that was cool.
And in June he said I want aball when he had a toy orange.
And so we pretended that theorange was a ball and he rolled
it and threw it back and forth.
And at the end of June he waspassing the ball to his mom and
to me.
In July, he was rolling backand forth with eye contact and
(10:09):
starting to engage in other turntaking activities.
And in August, he threw a ballback and forth through a
basketball hoop, playingbasketball just like a typically
developing toddler.
And it all started with theidea of using pouring back and
forth motor movement asdescribed at 15 months.
In closing I want to hark backto what I said earlier about
recognizing and celebratingskills that don't seem directly
(10:32):
related to communication.
They don't seem to be, but theyare.
When a little client of mine onthe spectrum said put in, as he
was dropping balls into a tube,it was really exciting.
But equally exciting to me waswhen he calmly and purposefully
reached for each piece in ashape sorter toy and worked
diligently at fitting the shapestogether.
It's exciting because reachingfor and actively playing with
(10:54):
toys can boost young infant'sinterest in faces, as I cited
earlier.
He's not an infant now but hestill needs to develop that
interest in faces.
And what he just did with theshape sorter toy is going to
support that interest and that'sjust as important in my book as
him saying put in.
I called this episode A RisingTide Floats All Boats for a
reason.
That's one of my favoritephrases, because when a child's
(11:16):
motor skills develop and rise,everything else rises too, and
we've just seen howcommunication is so tied to how
their motor skills develop andhow, as SLPs, we can use this
resource, this 16 actions withobjects by 16 months, to really
examine where a child is and tobring them along, following the
sequence of development, tobuild their communication.
(11:37):
So here's a few things to keepin mind from this podcast.
Number one motor skills may bethe first indication of autism.
Number two remember thisawesome resource by the first
words project, 16 actions withobjects by 16 months, it's
fantastic.
It's awesome.
Share it with your parents.
And number three think abouthow you can use this resource to
(12:01):
look at a child's motor stageand think about how you can tie
language into where they are atand bring them along in their
language skills.
That wraps things up for today.
If you want a transcript or thelinks for today's and every
other episode, you can find themat thespeechumbrella.
com/blog.
Take a minute to browse aroundmy store and sign up for the
free resource library.
(12:21):
I know you'll find somethingthat will help you with your
kiddos.
Tell your fellow therapistabout the podcast, leave me a
review and let's connect onsocial media.
I'm dStratten SLP on Instagramand The Speech Umbrella on
Facebook.
Check out my videos on YouTubetoo.
There's a lot of great stuffunder The Speech Umbrella.
Thanks for listening.
Speaker 2 (12:40):
Thanks for listening to The Speech Umbrella.
We invite you to sign up forthe free resource library at
thespeechumbrellacom.
You'll get access to some ofDenise's best tracking tools,
mindfulness activities and othergreat resources to take your
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com.
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(13:03):
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