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

Let’s say the quiet part out loud.

If a preschooler is lisping, and we choose to wait, we are not being cautious. We are building the wrong motor plan.

In this episode, I am pushing back on the idea that a frontal lisp is something to “monitor” until school age. Because while we are waiting, that child is producing "TH" for "S" hundreds of times a day, every day, wiring in a pattern that becomes significantly harder to change later.

This is not harmless. This is not neutral. And it is not something most children simply outgrow.

We are talking about what the research and clinical reality both tell us. The S sound is one of the most frequent sounds in the English language, which means errors with it are practiced at a massive scale. Add in what we already know about persistence into adulthood and the window of neuroplasticity in early childhood, and the argument for early intervention becomes very hard to ignore.

Then we get into the part that actually matters.

What do you do differently with a three- or four-year-old?

Because if your approach is telling a preschooler where to put their tongue, you are already losing. They do not have the motor control, the language, or the awareness to make that meaningful. So instead of fighting that, we work around it.

I am walking you through how to go in through the back door using incompatible strategies that make a frontal lisp almost impossible to produce. We are talking about why I do not waste time on isolated S, and how using clusters like SCR, SQU, STR, and SPL leverages assimilation to pull the tongue exactly where it needs to go without over-explaining or over-cueing.

This is where therapy shifts from chasing errors to building a system.

We also address the reality that some cases will take more work, especially when you are dealing with open bite or long-term habits like pacifier use, and what that means for your expectations as a clinician.

If you are ready to stop waiting, stop hoping, and start shaping accurate motor plans early, this episode will change how you approach frontal lisps on Monday morning.

And if you want this exact clinical thinking turned into therapy you can actually use without spending your nights planning, that is what we do inside the SIS Membership.

Inside SIS, you get ready-to-use, literacy-based, movement-driven activities that are built on these principles so you are not guessing what to do next. You are walking in with a plan that targets speech, language, AAC, and literacy all at once and is designed for carryover.

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

Because waiting does not make it easier. It makes it harder.

Wishing you a week of bold clinical decisions and real progress,💚Kelly

If you work with children who have autism, minimal joint attention, and limited expressive language, this episode challenges what you’ve been taught and replaces it with something far more useful.

This is not a “wait and see” conversation. This is a rethink-everything conversation.

Drawing from a powerful systematic review and the lens of dynamic systems theory, this episode breaks down why language development in autism does not follow a predictable path and why that actually changes how we should intervene starting today.

You will walk away with a clearer understanding of how language can emerge in unexpected ways, why inconsistency is often a sign of growth, and how to respond in the moment so you do not accidentally shut down emerging communication.

This is about seeing the child differently and adjusting your intervention accordingly.

What You’ll Learn...

Why joint attention is not a prerequisite for language
The reality that some children develop language without following typical developmental sequences?

How children may learn language visually, through patterns, reading, or AAC rather than through listening?

Why “inconsistency” in communication is often a sign that a new skill is emerging
How dynamic systems theory explains variability in language development?

Because the child in front of you is not broken. They are showing you their pathway. You just have to be willing to take it?

3 Clinical Takeaways You Can Use Immediately

1. There is no single pathway to language
   Children may not follow a linear progression from babbling to words to sentences. Some may start with scripts, reading, or full phrases. Your job is to identify the pathway and build from it.
2. Variability is not a problem
   When a child says a word once and then “loses it,” that is not regression. That is emergence. Do not punish inconsistency. Support it.
3. Be dynamic in your response
   You cannot use a fixed script with a variable system. Adjust moment by moment. Increase support, then fade it. Follow attention, motivation, and engagement in real time.

Referenced in This Episode

Kissine, M., Saint-Denis, A., & Mottron, L. (2023).
Language acquisition can be truly atypical in autism: Beyond joint attention. Neuroscience & Biobehavioral Reviews, 153, 105384.
https://doi.org/10.1016/j.neubiorev.2023.105384

Spencer, J. P., Perone, S., & Buss, A. T. (2011).
Twenty years and going strong: A dynamic systems revolution in motor and cognitive development. Child Development Perspectives, 5(4), 260–266.
https://doi.org/10.1111/j.1750-8606.2011.00194.x

Your Next Step

If this episode is hitting something for you, if you’re realizing that your therapy needs to shift from linear to dynamic, then you need tools that actually match that approach.

Because insight without application does not change outcomes.

Inside the SIS Membership, you get weekly, ready-to-use, literacy-based movement activities that are built for exactly this kind of work.

You are not guessing what to do next
You are not piecing together random strategies
You are walking into your sessions with a clear, research-informed plan that supports real language growth

This is where theory meets practice in a way that actually works.

👉 Join today: https://www.kellyvess.com/sis

Roll up your sleeves and meet me at the intervention drawing board.

If you work with four, five, or six-year-olds with speech sound disorders, this episode was made for you — and this research will change how you document, advocate, and make eligibility decisions for your students.

In this episode, we break down a brand-new 2026 open-access study that every school-based SLP, early childhood SLP, and preschool speech-language pathologist needs to save, cite, and have ready to go. Whether you're navigating a negative 2.0 standard deviation eligibility criteria, writing IEP goals for preschoolers with speech sound disorders, or advocating for a child who doesn't yet "qualify" on paper, this research is your clinical ammunition.

This landmark study examined peer perceptions of children with speech sound disorders across ages four, five, and six:

• At age 4: Neurotypical peers already rate children with severe speech sound disorders lower across domains of intelligence, friendliness, and likability compared to typically developing talkers.
• At age 5: Children with moderate-to-severe speech sound disorders are rated lower across all social domains by their neurotypical peers.
• At age 6: Even children with mild speech sound disorders are rated lower and are seen as less desirable friendship candidates compared to neurotypical peers.

The bottom line? Severity matters. Age matters. And the social stakes get higher every single year.

• Use this research to support eligibility decisions when standardized scores alone don't tell the full story
• Cite it alongside teacher observations, parent input, direct observation of socialization, and connected speech samples
• Document the educational and social impact of the speech sound disorder, not just the score
• Know your state's eligibility criteria: some states require -2.0 SD, others -1.0 SD, and others rely on professional judgment of adverse educational impact
• Advocate proactively: a wait-and-see approach has real social consequences for your students

Henry, M., & Bent, T. (2026). Let's be friends: Peer perceptions of disordered speech in preschool and early school-aged children. American Journal of Speech-Language Pathology, 35(1).

🔓 FREE Open Access Article: https://pubs.asha.org/doi/10.1044/2025_AJSLP-25-00093

Download it. Save it. Cite it. Your students are counting on you.

📖 RECOMMENDED RESOURCE:

Speech Sound Disorders: A Comprehensive Evaluation and Treatment Guide by Kelly Vess. This is written to support SLPs at every level, from graduate students to seasoned clinicians.

👉 Grab your copy on Amazon

🚀 MAXIMIZE NEUROPLASTICITY — JOIN THE SIS MEMBERSHIP TODAY

Here's what we know: earlier is better. Neuroplasticity is at its highest level in the preschool years. Are you using the most effective treatment targets to capitalize on that window?

The SIS Membership gives you access to complex treatment targets — the evidence-based approach that leverages the power of neuroplasticity to drive maximum speech sound gains in minimal time. If you are working with preschoolers and early elementary students, complex targets are the clinical game-changer you need in your toolkit right now.

This episode just showed you the social urgency. The SIS Membership gives you the clinical tools to act on it.

👉 Join the SIS Membership today and start using complex treatment targets with your students. Because we're not treating a mouth. We're treating a child — and every session counts.

If you work with children with autism, developmental delays, or complex communication needs, this episode is a must-listen.

Today, we’re talking about cerebral visual impairment, or CVI, and why it may be one of the most overlooked reasons children struggle with communication, attention, social interaction, AAC use, and motor-based learning.

This episode is not about whether a child can see an item on an eye chart. It is about how the brain processes visual information and how that affects language, participation, and learning.

In this episode, I share 10 practical strategies from the literature that speech-language pathologists and speech-language pathology assistants can use right now to better support children with visual processing challenges. We discuss why reducing clutter matters, how to make materials more visually accessible, why movement activates learning, and how active task-based therapy can improve visual-motor integration.

You’ll learn:

• Why is cortical visual impairment increasingly referred to as cerebral visual impairment
• How CVI affects communication and social development
• What visual complexity does to learning
• Why movement is critical for visual engagement
• How to adjust therapy and AAC supports for better outcomes

Join the SIS Membership for ready-to-use literacy-based, movement-based activities that help you put these ideas into practice right away:
https://www.kellyvess.com/sis

Featured article:
Wilkinson, K. M., Elko, L. R., Elko, E., McCarty, T. V., Sowers, D. J., Blackstone, S., & Roman-Lantzy, C. (2023). An evidence-based approach to augmentative and alternative communication design for individuals with cortical visual impairment. American Journal of Speech-Language Pathology, 32, 1939–1960. https://doi.org/10.1044/2023_AJSLP-22-00397

Thank you for being with me at today’s intervention drawing board for a better tomorrow,💚Kelly

Many clinicians are told there is a right way to prompt AAC users.

You may have heard that you should always use least-to-most prompting. Others insist most-to-least prompting is best.

But what does the research actually say?

In this episode, we look at findings from a scoping review of 29 AAC intervention studies examining the prompting strategies used with children with autism who use speech-generating devices.

Here’s the surprising truth:

The research does not show that one prompting hierarchy is universally superior.

Instead, effective AAC intervention is multimodal, flexible, and individualized. Successful clinicians use a toolbox approach, drawing from multiple evidence-based strategies depending on the child in front of them.

In this episode, I walk you through a DTTC-inspired prompting hierarchy adapted for AAC that moves children from high levels of support toward full independence.

I also share a real therapy example from this week using a St. Patrick’s Day literacy activity with a puppet and AAC device, so you can see exactly how this process works in practice.

This is not a theory. This is something you can try tomorrow. Why This Matters for AAC Intervention?

Children with autism are developing across multiple domains simultaneously:

• language
• motor planning
• executive function
• symbolic representation
• social interaction

Because autism is multifaceted, intervention cannot rely on a single rigid strategy.

The most effective clinicians adopt an “all of the above” mindset and use prompting dynamically depending on:

• the child
• the task
• the novelty of vocabulary
• the motor planning demands
• the learning context

This episode will show you how to do exactly that.

Want Ready-to-Use Activities That Apply This Framework?

Inside the SIS Membership, I provide ready-to-use activities designed specifically for:

• AAC users
• speech sound disorders
• language development
• motor planning
• executive function

Every week, you receive literacy-based movement activities that allow you to apply frameworks like the DTTC-for-AAC hierarchy immediately with the children on your caseload.

These activities are designed to address multiple developmental domains simultaneously while keeping therapy engaging and efficient.

You also get access to the Speech-Language Treatment Target Library, giving you structured targets across speech, language, AAC, and literacy.

Instead of spending hours planning therapy, you can walk into your session with activities that are already designed to produce meaningful communication gains.

Start Using DTTC for AAC Today

If you want structured activities that help you implement these strategies immediately:

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

You’ll receive:

• weekly ready-to-use therapy activities
• weekly Google Slides Deck
• treatment target library
• practical strategies you can implement tomorrow

Because when we reduce clinician workload and increase engagement, every child wins.

Feeling overwhelmed by a caseload that includes autism, childhood apraxia of speech, developmental language disorder, articulation, fluency, and AAC users… all back-to-back?

You are not alone.

Many speech-language pathologists walk into therapy sessions with a stack of different activities for every child. One game for articulation. Another for language. Another for fluency. Another for AAC.

Before long, therapy starts to feel like running a fast-food counter.

Quick activities. Separate goals. Limited impact.

But what if you could run one powerful therapy routine that works for every child on your caseload?

In this episode of The Preschool SLP Podcast, Kelly Vess shares the five-step therapy routine she uses every single day to deliver educationally rich, engaging sessions that treat the whole child while producing powerful gains across:

• Speech sound production
• Language development
• Literacy skills
• AAC use
• Executive function
• Motor planning and coordination

Instead of pulling ten different activities from behind the therapy table, this routine uses one structured activity and simply changes the treatment target to match each child’s goals.

Built on principles from Universal Design for Learning, motor learning, and executive function research, this approach allows clinicians to work smarter, not harder.

You will learn:

• The five predictable therapy steps Kelly uses with every child
• How to use one activity to treat speech, language, AAC, literacy, and fluency
• Why predictable routines help children feel safe, regulated, and ready to learn
• How task-oriented movement improves executive function and engagement
• Why treating the whole child instead of just the mouth produces stronger outcomes

When therapy is predictable, engaging, and multimodal, both the clinician and the child can be fully present.

And that is when the magic happens.

Join the SIS Membership

If you love practical therapy frameworks like this, the SIS Membership was built for you.

Each week inside SIS you receive:

• Ready-to-use movement-based therapy activities
• Powerful complex speech and language treatment targets
• A growing treatment target library you can use with any caseload
• A full literacy, language, and movement Google Slides deck for therapy, classrooms, or teletherapy

Everything is designed to help busy SLPs deliver high-impact therapy without spending hours planning.

Many members prep their entire week of therapy in less than one hour.

Join today and receive the entire Treatment Target Library immediately.

Visit:
https://www.kellyvess.com/sis

Work smarter.
Treat the whole child.
Create meaningful gains.

💚 Kelly Vess
The Preschool SLP Podcast