1. Speech-Language Impairments
Tricia Hansen
Oklahoma State Department of Education
Instruction and Related Services Specialist
For the next few minutes, we will be talking about Speech and Language Impairments. Part of my responsibilities at the OSDE is supporting Related Services Providers, which include Speech Pathologists. Although I am not one myself, I have had many opportunities to work closely with them thorough out my years of teaching. Back when I was a school-aged student, I remember not ever truly understanding what a Speech Pathologist’s role was. I knew they took kids into their room, played a game, and practiced pronunciation. It wasn’t until I started as a paraprofessional that I had the opportunity to go into one of those sessions and see what they do and why they do it.

2. Introduction to Speech Or Language Impairments
The King's Speech
Marshmallow Activity
Sentence Activity
Grocery List Activity
To give you a small taste of what a Speech Pathologist’s role is, let’s take a moment to watch the movie trailer for The King’s Speech. Although this only a version of the true story of King George VI, his story causes chills to run through my entire body. His story is just one of many lives that have been touched by the work of speech pathologists.
Before we begin, let’s try a couple of activities to give you all a first-hand look into the lives of someone with a Speech or Language Disorder.
In front of you, you should each have some items on your desk. In groups of 2, you will each take a turn telling your partner what you need them to buy at the grocery store. As you read off your list, there is no cheating! You can’t show your partner your list and can’t write it down for them. Partner A will be the Reader and Partner B will be the Writer. Before we begin, Partner A must place the marshmallows in his or her mouth (please be careful). This is an easy task, so it shouldn’t take any more than about 30 seconds. (Let partners change roles and begin activity again).
Let’s reflect on this activity for a moment. Turn to your partner and answer these three questions. (about 2 minutes)
How did you feel as Partner A and B?
What was the most difficult part of this activity for you?
Did you find this activity frustrating? Why?
How might this affect a child?

3. Incidence
More than one million students who receive special education services under IDEA in public schools are served under that category of speech or language impairments.
Because many disabilities do impact the individuals ability to communicate, the actual incidence of children with SLI is much higher.
Research shows that more than one million students who receive special education services under the Individuals with Disabilities Act in public schools are served under the category of speech or language impairments.
In reality, because many disabilities do impact the individuals ability to communicate, and receive speech or language related services, the actual number of children served is much higher.

4. Causes for Speech Or Language Impairments (SLI)
Hearing Loss
Neurological Disorders
Muscular Disorders
Developmental Delays
Brain Injury
Mental Retardation
Autism
Cerebral Palsy
Drug Abuse
Vocal Abuse or Misuse
Physical Impairments (ex. Cleft Palate)
It is important to understand what causes speech or language impairments. Unfortunately, there are many different reasons. Some of these include those listed above.
Hearing loss
Neurological Disorders
Muscular Disorders
Developmental Delays
Brain Injury
Mental Retardation
Autism
Cerebral Palsy
Drug Abuse
Vocal Abuse
Physical Impairments such as Cleft Palate

5. Symptoms and Signs of SLI
Interruptions in the flow or rhythm of speech such as stuttering
Articulation or phonological disorders
Improper use of words and their meanings
Inability to express idea
Reduced vocabulary
Inadequate social skills
Difficulties with vocabulary, site words, decoding, and comprehension
Difficulty writing down thoughts
Difficulties with abstract ideas
Fluency impairments
So what might be some symptoms or signs of someone with a Speech or Language Impairment? These signs or symptoms may include:
Interruptions in the flow or rhythm of speech such as stuttering (just like King George VI).
Articulation or phonological disorders (such as a child saying “wabbit” for “rabbit”)
Improper use of words and their meanings
Having the inability to express an idea clearly (can’t get their full sentence out, and can’t get their needs met)
Having a reduced vocabulary (using the words “this” or “that”)
Having poor social skills (personal space issues, interrupting conversations, dominating conversations, etc)
Having difficulties with learning new vocabulary, reading site words, decoding, and reading comprehension
Other symptoms might include difficulties with abstract ideas or fluency impairments.

6. Signs of SLI Signs of SLI
Here is a video that describes ways teachers can recognize signs of SLI in their students.

7. Definition of Speech or Language Impairment (SLI)
The Individuals with Disabilities Education Act defines an SLI:
As a communication disorder, such as stuttering, impaired articulation, language impairments, or a voice impairment, that adversely affects a child’s educational performance.
Let’s take a closer look at the actual definition of a Speech and Language Impairment. The IDEA defines and SLI “as a communication disorder, such as stuttering, impaired articulation, language impairments, or a voice impairments, that adversely affects a child’s education performance.”

8. Types of Speech-Language Disorders
Types of Speech Disorders: Refers to difficulties producing speech sounds or problems with voice quality.
Articulation
Speech impairments where the child produces sounds incorrectly (ex. Lisp, difficulty with “l” or “r.”)
Fluency
Speech impairment where a child’s flow of speech is disrupted by sounds, syllables, and words that are repeated, prolonged, or avoided and where there may be silent blocks or inappropriate inhalation, exhalation, or phonation patterns.
Voice
Speech impairment where the child’s voice has an abnormal quality to its pitch, resonance, or loudness.
One of the important things to understand that there are multiple types of Speech Disorders and multiple types of Language Disorders and they affect individuals in many different ways.
When talking about Speech Disorders, we are referring to difficulties producing speech sounds or with voice quality.
Some of these difficulties may include:
Trouble with Articulation. This is where the child produces sounds incorrectly. They may have a lisp and have a hard time pronouncing certain sounds.
They may have a fluency impairment where the child’s flow of speech is disrupted by sounds, syllables, and words that are repeated, prolonged, or avoided.
And finally, they may have a voice disorder where the child’s voice has an abnormal quality to its pitch, resonance, or loudness.

9. Speech Disorders sessions
Here is a quick example of some of the activities you might see an Speech or Language Pathologist do during a session.

10. Types of Language Disorders
Types of Language Disorders: Refer to impairments in the ability to understand and/or use words in context, both verbally, and nonverbally.
Expressive: Difficulty in expressing ideas or needs.
Receptive: Difficulty in understanding what others are saying.
Mixed: Involves a mix of expressive and receptive difficulties.
Next, lets discuss they different types of Language Disorders. Language Disorders refer to impairments in the ability to understand and/or use words in context, both verbally and nonverbally.
They are classified in three areas.
Expressive Disorders include having difficulty in expressing ideas or needs. This can present a huge problem when a child is trying to get his or her basic needs met. If they can’t tell you that they are hungry, wet, cold, or feeling sick, they are going to display other unfavorable behaviors until you are able to identify what they need.
Receptive Disorders include having difficulty in understanding what others are saying. They may have difficulties, following directions or understanding what is expected of them.
Sometimes, individuals may have a mixed Language Disorder which involves a mix of expressive and receptive difficulties.

11. Expressive Sarah Scott Sariah
We’ll take a moment to watch an example of two different girls with expressive language disorders. Sometimes they are born with the condition, while other acquire it after a traumatic event such as a stroke. In the case of the first video, Sarah will try to explain what happened to her. In the second video, a young elementary age student will try to summarize one of her favorite stories.

12. Real Life Application: Expressive
Fourth-grader Elliott stays in his school’s Extended Day program after school. When his mother picked him up one afternoon, he told her, “I’m glad you finally came. I was the last one here.” Elliott’s mother looked around the room and counted ten other children. Eventually, after much questioning, she ascertained that Elliott meant, “I was the last of the fourth-graders here.”
The next day, Elliott’s class was excited because the school’s principal promised to visit them with an undisclosed treat from having the best attendance in the building. Elliott’s teacher sent him to the office with this message, “Ask the principal when she is coming to our classroom.” Elliot went to the office but conveyed the slightly altered message, “My teacher wants to know if you can come to our classroom.” Based on his message, the principal thought that there was a problem and hurried to the classroom, only to find that a miscommunication had occurred.
Let’s read this story about a boy named Elliott and how his Expressive Language Disorder affects him.

13. Elliott
Elliott’s scenario included two examples of consistent expressive-language mistakes.
What were they?
Have you ever known someone with similar expressive-language challenges?
Is there anything you could recommend to his teacher or mother to help prevent similar communication breakdowns in the future?
Elliott’s scenario included two examples of consistent expressive-language mistakes.
What were they?
1) Telling his mom he was the last child there, when he meant he was the last 4th grader there.
2) Making the principal think there was a problem in the class, when he meant to ask “When” she was coming.
Have you ever know someone with similar expressive-language challenges?
Is there anything you could recommend to his teacher or mother to help prevent similar communication breakdowns in the future?
1) Send a note
2) Have him repeat the question or steps to you to ensure he knows what to say.

14. Real Life Application
Twelve-year-old Briana was excited about the swimming pool that her grandparents were putting in their backyard. As she began to explain to her friends what it would look like, she said, “ It’s shaped like a ….” and then paused, unable to recall the word that described its shape.
After a few seconds, she continued, “It’s shaped like a circle, but the sides are longer.”
“You mean an oval?” teased one of her friends.
Briana laughed, embarrassed, and replied “Yep, that’s exactly what I mean.”
Later that day, Briana found out that she’d failed a science test made up of twenty fill-in-the blank questions. Briana was frustrated because she knew the content well. Her teacher decided to give her an alternate test-- one in which Briana could use a Word Bank to answer the same twenty questions. Because she was able to recognize and select the correct answer, rather than recall the word herself, Briana got an A on the test.
Let’s try another example….

15. Briana
Briana’s scenario included two examples of a consistent expressive-language disorder. What is it? How was she able to work around her inability to recall the word oval?
What ideas or suggestions can you suggest that Briana’s teacher implement to support her during class discussions? During test-taking?
I laugh at this one, because this is me sometimes. I know what I want to say and I can see it, but my lips and brain don’t want to coordinate with each other. So, I have just learned to laugh at myself and move on. However for individuals with a severe expressive disorder, this happens all the time and gets in the way of her everyday life and educational success.
Let’s answer these questions:
Briana’s scenario included two examples of a consistent expressive-language disorder. What is it? How was she able to work around her inability to recall the word oval?
What ideas or suggestions can you suggest that Briana’s teacher implement to support her during class discussions?
Have a vocabulary wall using relevant words related to the theme or topic.
Include pictures with words
Repetition of vocabulary; draw it, say it
Multiple exposures to words
What ideas or suggestions can you suggest that Briana’s teacher implement to support her during test taking?
Test in a quiet area
Additional time
Read questions out loud

16. Expressive Language Strategies
Create opportunities for the child to interact with peers.
Pair children to share stories of what they did on the weekend and have them report it to the class (accept all child responses).
Model full sentence responses when 1:1.
Create a safe environment for all students.
Build a word wall.
Allow time for the child to process the question and formulate an answer.
Ask questions beginning with wh-words (who, when, why) rather than yes/no questions.
Model sentences by repeating the child’s message in a correct form
Prompt the child to use expressive language strategies and skills following the specific recommendations of the Speech Language Pathologist (SLP).
Prompt answers by giving choices (what it x or was it y?)
Add to the child’s message by paraphrasing and expanding on it. (ex. “It’s cold,” or “Cold air is coming in because the window is open.”)
Although many of these are great teaching strategies to use for all children, these are specifically geared toward students with Expressive Language Disorders.
These strategies include:
1) Create opportunities for the child to interact with peers.
2) Pair children to share stories of what they did on the weekend and have them report it to the class (accept all child responses).
3) Model full sentence responses when 1:1.
4) Create a safe environment for all students.
5) Build a word wall.
6) Allow time for the child to process the question and formulate an answer.
7) Ask questions beginning with wh-words (who, when, why) rather than yes/no questions.
8) Model sentences by repeating the child’s message in a correct form
9) Prompt the child to use expressive language strategies and skills following the specific recommendations of the Speech Language Pathologist (SLP).
10) Prompt answers by giving choices (what it x or was it y?)
11) Add to the child’s message by paraphrasing and expanding on it. (ex. “It’s cold,” or “Cold air is coming in because the window is open.”)

17. Receptive Language
Receptive Language: refers to our ability to receive information. This may cause great frustration.
Students with language disorders may struggle with:
Understanding what is spoken to them
Comprehending what they read
May have difficulty with:
Complicated sentence structure (simple v. complex)
Unfamiliar vocabulary
Next, lets look at Receptive Language Disorders. Receptive Language refers to our ability to receive information. This may cause great frustration and cause students to struggle with:
1) Understanding what is spoken to them
2) Comprehending what they read
3) Complicated sentence structures (simple vs. complex)
4) New vocabulary or vocabulary they don’t regularly use

18. Real Life Application: Receptive
Maddie reads the following passage from The Witch of Blackbird Pond (8th Grade)
Sailors began vigorously to roll out the great casks of molasses and pile them along the wharf. Two of the men lowered over the side the seven small leather trunks that held all of Kit’s belongings and piled them, one beside the other on the wet planking. Kit clambered down the ladder and stood for the second time on the alien shore that was to be her home.
Her heart sank. This was Wethersfield! Just a narrow sandy stretch of shoreline, a few piles sunk in the river with rough planking for a platform. Out of the mist jutted a row of cavernous wooden structures that must be warehouses, and beyond that the dense, dripping green of fields and woods. No town, not a house, only a few men and boys and two yapping dogs who had come to meet the boat. With something like panic Kit watched Goodwife Cruff descent the ladder and stride ahead of her husband along the wharf. Prudence, dragging at her mother’s hand, gazed back imploringly as they passed.
Let’s look at an 8th grader Maddie. Maddie and her class have been asked to read an excerpt from The Witch of Blackbird Pond. It reads,
Sailors began vigorously to roll out the great casks of molasses and pile them along the wharf. Two of the men lowered over the side the seven small leather trunks that held all of Kit’s belongings and piled them, one beside the other on the wet planking. Kit clambered down the ladder and stood for the second time on the alien shore that was to be her home.
Her heart sank. This was Wethersfield! Just a narrow sandy stretch of shoreline, a few piles sunk in the river with rough planking for a platform. Out of the mist jutted a row of cavernous wooden structures that must be warehouses, and beyond that the dense, dripping green of fields and woods. No town, not a house, only a few men and boys and two yapping dogs who had come to meet the boat. With something like panic Kit watched Goodwife Cruff descent the ladder and stride ahead of her husband along the wharf. Prudence, dragging at her mother’s hand, gazed back imploringly as they passed.

19. Maddie This passage is confusing to Maddie for several reasons:
She doesn’t know what the bolded words mean, decreasing her reading comprehension.
She mistakes the word piles in the second paragraph for the word piled in the first, and imagines something being piled in the river, but wonders, “Piles of what?”
She associates the term alien with science fiction and beings from outer space, resulting in a misinterpretation of that sentence.
Some of the phrasing confuses her.
Example: She thought the phrase, “Two of the men lowered over the side” means that two men were lowered over the side.
This passage is confusing to Maddie for several reasons:
She doesn’t know what the bolded words mean, decreasing her reading comprehension.
2. She mistakes the word piles in the second paragraph for the word piled in the first, and imagines something being piled in the river, but wonders, “Piles of what?”
3. She associates the term alien with science fiction and beings from outer space, resulting in a misinterpretation of that sentence.
4. Some of the phrasing confuses her.
Example: She thought the phrase, “Two of the men lowered over the side” means that two men were lowered over the side.

20. Maddie
What can you do as a teacher to help students with language disorders comprehend the material and avoid confusion?
What can you do as a teacher to help students with language disorders comprehend the material and avoid confusion?
Preview the vocabulary (Define it, use it in a sentence, draw a picture)
Build a Word Wall for the Story or Unit
Make Predictions
Stop and Talk with a Partner about what happen. Think/Pair/Share activities

21. Practical Life Application
Myron’s teacher asks him to help her put some photographs of leaves on a bulletin board. The pictures are part of a learning center in which the students will have to look at the photos and identify key characteristics. Myron’s teacher tells him, “I wouldn’t put the photos up so high that students can’t view them easily.” He teacher’s choice of words confuses Myron; he isn’t sure whether he is or is not supposed to put the photos up high, and whether the students should or should not be able to view them easily.
Let’s try another one….
Myron’s teacher asks him to help her put some photographs of leaves on a bulletin board. The pictures are part of a learning center in which the students will have to look at the photos and identify key characteristics. Myron’s teacher tells him, “I wouldn’t put the photos up so high that students can’t view them easily.” He teacher’s choice of words confuses Myron; he isn’t sure whether he is or is not supposed to put the photos up high, and whether the students should or should not be able to view them easily.

22. Myron
Why do you think Myron was confused by his teacher’s instructions?
Can you come up with 2-3 instructions that would be similarly confusing?
Restate those 2-3 statements, as well as that of Myron’s teacher, to be more easily understood.
Why do you think Myron was confused by his teacher’s instructions?
Because he has a Receptive Language Disorder, he already has difficulty understanding what people mean by what they say.
It wasn’t a direct instruction. He wasn’t sure what he should do.
2. Can you come up with 2-3 instructions that would be similarly confusing? (Think/Pair/Share)
1. I think it cold in here. (It means, “Please turn on the heater!” or Please get my jacket!)
3. Restate those 2-3 statements, as well as that of Myron’s teacher, to be more easily understood.

23. Receptive Language Strategies
Signal the teacher when directions have not been understood
Ask for Repetition of directions
Ask for clarification of directions
Sit close to the teacher and white board
Sit in a quiet place
Pre-teach specific vocabulary
Build a word wall
Review previously learned material
Connect new vocabulary or information with that previously learned
Use direct requests (“Please close the window”, instead of “It’s cold in here”)
Give directions in a time-ordered sequence (first, then, etc)
Pair directions with gestures or visual cues
Reduce visual distractions
Gain student’s attention before giving directions or instructions
Use a phrase or visual prompt before giving directions or instruction
Speak clearly
Stress key words in a sentence
Provide additional response time
Avoid asking the child to listen and write simultaneously
Use visual aids, such as pictures, diagrams, graphs, or written key words
Again, all student benefit from good learning strategies, but these strategies are geared toward students with Receptive Language Disorders. Some of these strategies include:
Teaching the student how to:
1. Signal the teacher when directions have not been understood
2. Ask for Repetition of directions
3. Ask for clarification of directions
4. Sit close to the teacher and white board
5. Sit in a quiet place
Good Teaching Strategies include:
1.Pre-teach specific vocabulary
2. Build a word wall
3. Review previously learned material
4. Connect new vocabulary or information with that previously learned
5. Use direct requests (“Please close the window”, instead of “It’s cold in here”)
6. Give directions in a time-ordered sequence (first, then, etc)
7. Pair directions with gestures or visual cues
8. Reduce visual distractions
9. Gain student’s attention before giving directions or instructions
10. Use a phrase or visual prompt before giving directions or instruction
11. Speak clearly
12. Stress key words in a sentence
13. Provide additional response time
14. Avoid asking the child to listen and write simultaneously
15. Use visual aids, such as pictures, diagrams, graphs, or written key words

24. Pragmatic Language Disorders
Pragmatic Language: refers to the appropriate use of language in social contexts.
Students with language disorders may have trouble with language-based social interactions.
Characteristics may include:
Difficulty interacting with peers and/or adults
Violates conversational rules
Has limited eye contact
Interrupts frequently
Makes odd, irrelevant comments
Violates personal space
Inability to interpret and use non-verbal cues
Dominates conversation
Has poor topic maintenance
Another area to focus on is Pragmatic Language Disorders. Pragmatic language refers to the appropriate use of language in social contexts. More often than not, our students, especially students on the Autism Spectrum have difficulty in this area. Some of the characteristics may include:
1. Difficulty interacting with peers and/or adults
2. Violates conversational rules
3. Has limited eye contact
4. Interrupts frequently
5.Makes odd, irrelevant comments
6. Violates personal space
7. Inability to interpret and use non-verbal cues
8. Dominates conversation
9. Has poor topic maintenance

25. Pragmatic Language Strategies
Practice appropriate body language.
Make facial expressions and ask students to tell you how they think you feel (mad, happy)
Teach conversational skills in the classroom
Components of conversational skills:
Turn-taking
Recognizing and responding to a topic
Ensuring clarity of your part of the conversation
Requesting clarification
Topic transitions and time factors
Terminating a topic
Students must be explicitly taught these skills. The things they need to learn include:
Practicing appropriate body language
Understanding facial expressions
Practicing taking turns, etc.

26. Pragmatic Language Strategies
Strategies for Teaching Conversational Skills
Start with short conversations on one topic.
Provide additional cues if the student does not respond (gestures, clarification)
Provide the student with time to process information when beginning a conversation.
Keep the conversation going by asking questions.
Keep from asking yes/no questions.
Encourage the student to listen to others as they speak.
Some strategies for teaching conversational skills include:

27. Real Life Application
Two six-year-olds are playing a game on the playground when a third child approaches them and says, “That looks fun!” and is invited to join the game. A fourth child also asks, “Can I play?” and, once given approval, joins the game. However, through six-year-old Lela likewise wants to join the game, she is uncertain how to approach the others to initiate an interaction. She wanders around the general vicinity where the children are playing, approaches them several times, but walks away without saying anything. Finally, she joins in the game without asking. Although the others let her play, they are uncomfortable because she did not follow the normal social conventions.
Two six-year-olds are playing a game on the playground when a third child approaches them and says, “That looks fun!” and is invited to join the game. A fourth child also asks, “Can I play?” and, once given approval, joins the game. However, through six-year-old Lela likewise wants to join the game, she is uncertain how to approach the others to initiate an interaction. She wanders around the general vicinity where the children are playing, approaches them several times, but walks away without saying anything. Finally, she joins in the game without asking. Although the others let her play, they are uncomfortable because she did not follow the normal social conventions.

28. Lela What should Lela have done in order to join the girls’ game?
What pragmatics skills does she need to develop?
What should Lela have done in order to join the girls’ game?
1. Asked if she could join in and play with the rest of the group.
What pragmatics skills does she need to develop?
1. Eye contact
2. Asking to play

29. Real Life Application
Eleven-year-old Libby has trouble following conversational rules. She approaches a group of classmates in the hallways and says, “Hey Abigail, guess what?” Abigail, who was already in a conversation with someone else, does not hear her and continues talking with her friend. Libby does not pick up on this social cue and instead proceeds to tell Abigail about her weekend, even though Abigail is still talking. When Abigail does acknowledge Libby and starts talking to her, the conversation breaks down further.
Eleven-year-old Libby has trouble following conversational rules. She approaches a group of classmates in the hallways and says, “Hey Abigail, guess what?” Abigail, who was already in a conversation with someone else, does not hear her and continues talking with her friend. Libby does not pick up on this social cue and instead proceeds to tell Abigail about her weekend, even though Abigail is still talking. When Abigail does acknowledge Libby and starts talking to her, the conversation breaks down further.

30. Real Life Application
Libby responds to some of Abigail’s comments with remarks that are not relevant to the conversation. She doesn’t allow the usual give-and-take, instead taking longer conversational turns, and often talks at the same time Abigail does. In frustration, Abigail finally says, “Libby, you never listen to anything I say!” and walks away. Other girls who witness the scene agree that Libby is frustrating to talk to and decide amongst themselves that she is “weird.”

31. Libby What social cues did Libby fail to recognize?
How did this affect her conversation with Abigail?
How do you think her peers’ perceptions of them could be negatively affected because of their language disorder.
What social cues did Libby fail to recognize? (Think/Pair/Share)
1) Ignoring...means wait
How did this affect her conversation with Abigail?
How do you think her peers’ perceptions of them could be negatively affected because of their language disorder.
1) People think they’re weird, or rude.

32. The Role of the Special Education Teacher
Consult or collaborate with the Speech-Language Pathologist on specific needs and helpful strategies for the individual child.
The Special Education Teacher may work on child’s goals throughout the week in addition to the child meeting with the SLP.
Ensure classroom accommodations are being followed.
All additional responsibilities of a classroom teacher.
As I said before, I am not a Speech Pathologist….in fact none of us are. However, we are going to be working with them. Some of you, depending on the type of program you are in will work with them very closely. It is important to build an effective collaborative relationship with your SLP. Talk about how you can help practice the skills they are learning during therapy sessions.

33. Instructional Strategies
Powerful strategies to support the learning of students with SLI impairments:
Always assume competence.
Incorporate Literacy
Provide Visual Input
Model Fluent Reading (choral reading, paired reading, etc.)
Use multiple types of Reading Strategies (prediction, reader’s theatre, etc.)
Divide academic goals into smaller units
Present only one concept at a time
Use tactile and visual cues
Offer Maximal social interaction opportunities
I think it is important no matter which child you are working with or what type of disability they have, it is imperative that you always assume competence. Even when they can’t get a single word out, our their behavior is at its worst, they have potential to do amazing things. We, as teachers, must act as investigators to identify the way they learn best so that we can support them and help them reach their full ability.
One of strategies I want you to remember when it comes to reading, is that for our children with Speech or Language Disorders, literacy is vital. They need hear and practice what fluent reading and speaking sounds like. Model it daily through choral or paired reading, through reader’s theatre. Give them the opportunity to be exposed to it in a safe, fun, and engaging way.

34. A Story of Hope Hope Hope 2
Finally, I want you share with a story of hope and one mother’s journey to help her son learn to talk.