End of School Year Reflections

June 2021…we made it!! It is incredible to look back on all of the conversations we were having back in early September. So much planning, anguish, worry, stress and debate went into making this school year happen. Perhaps your child did school on the computer. Perhaps you gave homeschooling a go. Or perhaps you found a new school to meet your child’s needs. Whatever you did…you did it.

As we all head into summer, I encourage you to take a few minutes to reflect upon this past year. Here at Skill Builders, we are celebrating all of our clients’ victories- big and small. We hope you are finding ways to celebrate too!

Happy Summer!

Elizabeth Clark McKenzie, MS, CCC-SLP

Using Books for Language Expansion: Six Simple Tricks

Books are one of the most versatile, universal, powerful tools one can use with a child. Amanda Wittman, MS, CCC-SLP is one of our Lead Speech-Language Pathologists, and she is sharing some of her insightful tips for using books as a way to expand language!

Every parent knows that books can be an incredible resource for their child-and they are already in your home! Books are wonderful for connecting with your child and can enhance early literacy skills.  Additionally, books can prime language growth and expansion in your child. Try utilizing the following tips and tricks when reading with your child to increase opportunities for your child to communicate:

  1. Go on a “Picture Walk”-Children’s books are rich with beautiful illustrations.  Use the pictures to point out various objects or scenes that you see to your child.  Early childhood educators even recommend going on a “picture walk”: instead of reading the written words on the page to your child, take turns describing what you see on each page.  This can help your child take ownership of how they interact with the book and help them to feel like they are really “reading” with you!
  2. Cultivate Connection-Does your child like to hear every single word on every single page? Does your child enjoy pointing to details on each page to hear you name the items? Or does your child simply like to turn the pages of a book? Follow your child’s lead!  Reading together does not have to look like a structured “story time”-enjoying a book in the same way that your child is enjoying the book increases the engagement between you and your child.  Increasing engagement increases connectivity-which increases opportunities to communicate!
  3. Practice Phonological Awareness Skills-Do you notice that many children’s books include rhyming prose and alliteration? This is done for a reason!  Highlighting when words sound the same at the end (such as in Chicka Chicka Boom Boom, The Pout Pout Fish, Madeline, or Brown Bear, Brown Bear, What Do You See?) helps your child “tune in” to these early phonological awareness skills.
  4. Pause To Let Your Child Fill in the Blank-Have you heard about the power of using “wait time” to increase opportunities for your child to communicate?  The same tool can be used when reading books!  If you are reading a favorite book to your child, you can begin to pause in the middle of a sentence and wait for your child to “fill in the blank”.  Children love to help when reading and will happily finish their parent’s sentence for them, especially during a silly read aloud, such as “A told B, and B told C, I’ll meet you at the top of the….” COCONUT TREE!
  5. Make Predictions-As you read books together, take a moment to ask your child what they think may happen next.  Your child will benefit from hearing you model and think aloud as you make predictions, too!  For example, while reading The Little Blue Truck, you could say, “All the animals are stuck…but here comes toad to help push! I think they will get out of the mud. What do you think?”  
  6. Expand Social Emotional Learning-Taking note of how a character is feeling and why they are feeling a certain way can increase your child’s social emotional awareness and ability to empathize.  Ask your child to make inferences as to how a character may be feeling, such as, “The pout pout fish was sad before.  Now his lips are smiling and his eyes are bright.  How is he feeling now?”  Help your child make connections by asking, “Why is he happy? Because his friend was kind to him! I feel better when I see my friends, too.”

There are a million and one ways to use books to increase interaction and language expression with your child. During your next story time with your little one, try one or more of these tricks!

Keep on Moving!

With dropping temperatures, wintery weather and lots of time spent on our devices, our days can feel rather stationary. Our OT team wants to remind you of the importance of movement for our attention, sensory regulation and mental health. (Breaking News: this applies to us adults too!!)

Betsy Meyers, MS, OTR/L and Prerna Basnet, MS, OTR/L sat down with me to chat about what they recommend to their clients. Here are their tips:

  1. Start your day with movement! Rather than waiting for a child to start showing signs of boredom or fatigue, go ahead and give them some nice sensory input BEFORE sitting down for a task. Prerna recommends aiming to do two minutes of movement followed by two minutes of a calming activity. For example, jumping on a trampoline followed by blowing some bubbles. This gets all systems up and running, and gets the brain nice and organized before tackling a seated, structured task.

2. Aim for breaks that are quick and frequent. Betsy points out that only one or two breaks in full day of virtual schooling is not enough maintain regulation and attention. Instead of waiting for recess or lunch, try incorporating a 2-3 minute break every 45 minutes. These breaks are perfect for running up and down the stairs, doing some animal walks or bouncing on an exercise ball.

4. Use what is around you! Betsy warns against overthinking movement breaks. Activities don’t have to be complicated or utilize a bunch of expensive equipment. Use the space and objects that you have! Try making an obstacle course out of couch cushions. Ask your child to help with some household chores like spraying and wiping or sweeping. Stairs can be a fabulous way to sneak some movement in! No equipment necessary.

3. Incorporate heavy work. We know that “heavy work” provides important input to the nervous system which can be essential for executive functioning, sensory processing and attention. Think about activities that really make your child work with their whole body: carrying books, pushing a basket of laundry, unloading groceries, wiping down the tables, etc.

5. Think outside the box. Betsy and Prerna both emphasized that many fun activities are actually filled with opportunities for sensory input and movement! It doesn’t have to look like an OT session to be effective. Try a scavenger hunt, freeze dance, hide and seek, charades, Simon Says or do the Hokey Pokey! Keeping things fun and playful will also serve as a major mood booster during these long days at home.

-Elizabeth Clark McKenzie, MS, CCC-SLP

How are you moving at home? We want to see! Snap a photo and tag us on Instagram or Facebook.

One Toy- 10 Ways to Play!

As an early interventionist, I am often helping parents to figure out ways to support their child’s speech and language goals through play. Many parents ask for toy recommendations and it can be easy to fall into the trap of loading up your Amazon cart with a million dollars worth of new toys. But you do not have to do that!! Take it from an expert – all you need is a few open-ended toys and the possibilities are endless.

Here is a great example- the classic barn and animal set. Most people have this toy, yet so many parents feel stumped by how to really play with it. What else can you really do besides label the animals and put them in the barn? Well let me tell ya!

  1. Night Night, Animals! Tuck each animal into bed and tackle some two-word phrases! “Night Night, Cow. Night Night, Pig. Night Night, Night, Night Chicken.”.
  2. Vet Clinic. Grab a few tools from your doctor kit and give each animal a check up. This is a great way to work on possessives and body parts! “Cow head. Chicken mouth. Pig foot.”
  3. Throw a Birthday Party! Give each animal on the farm a chance to have a birthday. “Happy Birthday” is a great song for filling in the blanks. “Happy Birthday, Dear Chicken….Happy Birthday to _____”
  4. Take a splash! Grab a tub of water (or throw your barn in the bathtub) and give each animal a dip in the pool. Work on some action words: jump, splash, kick, swim, go, stop, up, down, in, out, dry, etc.
  5. Hide and Seek. Hide the animals around the room and take turns finding them to return to the barn!
  6. Knock Knock Who’s There? Give each animal to knock on the barn door. Use their names or their animal sounds.
  7. Mommies and Babies. Match up baby animals with mommy animals as you put them in the barn.
  8. Animal Hayride. Grab a truck or wagon and take each of the animals on a truck ride!
  9. Feed the Animals. Pull out your pretend food and give each animal a special snack.
  10. Connect to a Book. There are several books that feature farm animals. Act out the story or match toys to the pictures.

Expanding play ideas doesn’t just make toys last longer. It also provides SO many more opportunities to practice language and vocabulary!

Elizabeth Clark McKenzie, MS, CCC-SLP

Teletherapy for Tiny Ones

We’ve been delivering virtufal therapy services since March, and as our therapists have gotten more comfortable with the technology, the sessions have been getting better and better! When we first went virtual, we were unsure how therapy with toddlers and preschoolers would translate to Zoom. While it does take some creativity and patience, we’ve found that we are still able to deliver effective and fun therapy sessions virtually. Here are what our sessions can offer:

Expert Ears and Eyes

A trained clinician is better able to make observations surrounding your child’s development.

Therapy Activities Disguised as Play

Believe it or not, we are finding that most of our little ones WILL in fact do a lot over the screen. We use a combination of interactive and appealing graphics, real toys and our own personalities to engage your child. Our therapists have gotten quite creative with this- from building forts to playing hide and seek to even having a costume party!

Parent Coaching

Even if your child isn’t easily engaged via Zoom, our clinicians are able to teach you strategies and tips so that you can implement the treatment yourself. We collaborate with you to find tools that are the most effective for your child, and the best fit for your family’s routine. We can also help you problem-solve or pivot if something is not working well.

Fresh Ideas

With so much time at home, it is easily to get stuck in a rut. Our therapists can take a peek at the toys and materials you already have, and give you new ideas of how to use them in a way that will support your child’s goal areas.

Progress Monitoring

Even a bi-weekly or monthly check-in is a great way for our team to keep tabs on your child’s development to make sure we aren’t losing ground while stuck at home.

A Space for YOU

Life is so upside-down right now. Having a chunk of time carved out each week for you to ask questions, talk through frustrations, make observations and share success stories can be invaluable. We want you to feel supported and confident in your ability to work on this stuff at home. Many of our families use their weekly session as an anchor for the week. We are in this together!

Amanda Wittman, one of the therapists on our early intervention team, suggests these helpful tips for smooth zooming!


-Don’t worry about your child being “on” for every minute of every session.  It is just as valuable for the clinician to coach you through moments where attention is waning or your child is acting out, as it is to see your child playing “perfectly”.

 -Consider putting the iPad or computer up high with the screen angled down towards you and your child to limit visual distractions. Also-this prevents the child from turning the computer off, or ending the session by accidentally pushing random buttons!

-If you are open to direct parent-coaching, consider using headphones so that the clinician isn’t seen or heard-this really ups the child’s engagement, believe or not!

-If you are interested in having the child interact directly with the clinician, set up the child in a high chair or at a table so that they are moving and walking around less.  This can help the child focus, but don’t worry about bringing them to the table or high chair until the session begins. 

-Come with lots of questions! But, prepare to ask them towards the ends of the session.  Little ones tend to have their best attention at the beginning of the session, so once their attention begins to peter out after 20 minutes or so, this can be a good time for the clinician and parent to talk directly without the child’s direct engagement.  I use this time to ask the parent how they could take some of what we did in the session and practice it with other toys or during other times of the day throughout the week.  Giving parents 2-3 things to practice really empowers them at the end of the session-it’s a nice way to wrap up our time together.

-Try tag-teaming with caregivers: if mom or dad has a meeting during your regular session time-that’s okay! Ask the other child’s parent or au pair or grandmother to come to the teletherapy session instead.  It takes a village with our little ones, and coaching other caregivers can be very, very valuable!

Even though we are offering in-person therapy, many of our clients are electing to stay virtual because it is going well! If you think your family might benefit from teletherapy, give us a call! Our team is ready to help.

Elizabeth Clark McKenzie, MS, CCC-SLP

Back to “School”

2020 will go down as the year we learned to live life virtually! If your child is gearing up for distance learning, you might be feeling overwhelmed. Virtual learning can be really tough for our kids with sensory and communication challenges. Here are 5 tips to help things go more smoothly:

creative desk pens school

  1. Create a routine of “going to school.”. Daily routines give us cues to get in the right mindset for our day.  Have breakfast, brush teeth, get dressed and be ready for school- even though you might just be walking 5 feet to your dining room table. Similarly, when learning is over, create a routine of putting materials away to help shift gears into down time.
  2. Organize materials in one place. Keep devices, chargers, writing utensils, paper and school materials all in one place. At the end of each day, charge the devices and replenish materials so everything is ready to go for the next day. I like using a cart like this one that can be moved from room to room. This way, it is easy to quickly change scenery if your child is getting bored or distracted.
  3. Keep sensory strategies handy. Keep a box of fidget toys near your child’s school station. Have a weighted blanket or bumpy cushion available to use. Keep a water bottle filled. Offer chewing gum or chewy snacks. You might find some strategies work better depending on the day. Be prepared!
  4. Reduce distraction. It is hard to control the environment completely but reducing auditory and visual distraction is important, especially if your kiddo has any attention or processing deficits. Noise cancelling headphones can be a great solution to a busy household. Minimizing clutter can also be really helpful.
  5. Reward effort instead of performance! Managing expectations is the name of the game, especially in the beginning. Pull out any reinforcement systems that you know are effective and use them liberally. We want our kids to feel confident and successful in this very unfamiliar, less-than-ideal set up. Praise your child for attending and participating. Take note of which times of day seem more challenging, and be more generous with your positive reinforcements during those times.

And of course, don’t forget that we are here to help! Our team is ready to help support you. We can do this!

Stay safe and be well. Happy School Year!

photo of child sitting by the table while looking at the imac

-Elizabeth Clark McKenzie, MS, CCC-SLP

Skill Builders Superstars!

The past 3 months of quarantine have posed a lot of unexpected challenges and really pushed us to act quickly, get creative and be flexible.  Our team has worked hard and we are proud of that! But we would be remiss if we didn’t acknowledge and celebrate our amazing clients who have also risen to the occasion! Overall, our clients have embraced teletherapy and the kids have been incredible. We are impressed!



One of our SB Superstars is Leah. Leah is seen by Amy Bereiter. Leah’s mother had this to say about teletherapy:

“My daughter Leah, does teletherapy with Ms. Amy and has been excited for every single session. Ms. Amy is very responsive to Leah’s needs and treats her with the highest dignity and respect that is unparalleled by anyone we have ever worked with. 

Leah is eager to see her therapist, chat and see what exciting games and lesson that she has for her, she even takes initiative in setting things up for her session. 

I feel that this virtual experience has been exceptionally valuable for her development. I say that because she is extremely motivated to use her communication device and continues to stay engaged and focused throughout the session.  

The prepared lessons are extremely well thought out, they build on her knowledge and skills and are interactive and captivating. My daughter has benefited from these sessions so much that sessions have been increased in duration and quantity of sessions a week. She is currently doing sessions twice a week for 1 hour and 45 minutes. 

I have seen a significant improvements in Leah’s communication, language and speech production since starting teletherapy in March. She is enjoying communication and sharing more of her thoughts and ideas with ease.

Watching and learning from Ms. Amy has increased my own knowledge and confidence in the implementation of the communication device into our daily lives and in teaching Leah grammar. She has taught me to encourage communication with positivity and with fun. 

I am encouraged by Leah’s progress and know the value of increasing her knowledge of language… it is an investment into Leah’s future. Together as a family, with Ms. Amy’s support and guidance, Leah will have a voice to create a life of choices, friendships and community. 

Thank you Skill Builders for not only providing an extraordinary learning experience that she looks forward to but you provided this option in lightening speed ahead of other companies that we work with. “


When I asked Ms. Amy about her experience in working with Leah, she replied:

What a rockstar! This lively and fun girl has rocked teletherapy! Leah has increased frequency and duration of sessions since switching to tele-therapy and has made quick and steady progress with this service delivery model. Most importantly, we have had fun while doing so! We have done activities such as making smoothies with a peer and myself, doing ‘show and tell’ with home items, looking at and describing family photos (old and new!) via google slideshows, playing games, and all things in between. The key is finding activities that don’t feel like work, but allow us to make progress towards our goals!  I find tremendous joy in working with Leah and her family. They are so invested in her progress and future, and celebrate all successes. They have jumped in 100% with implementation of her communication device at home and that has been the key to her success.  It has been a team effort of planning ahead with her family, sending/locating materials they can have at the ready on their end, and consistent implementation of strategies/suggestions/activities across the week, not just therapy session days. In a few short months, Leah’s spontaneous use of her communication device to tell me her thoughts, opinions, and ideas has increased so much she now tells me to ‘wait’ (don’t interrupt) because she has more to say! She now asks me questions about myself, and is using far more grammatical structures than 2 months ago. Her length and complexity of language has dramatically increased. She has applied this to other tele-meetings she has with her various community groups and is now using her communication device to interact with peers, which she was not doing a few short months ago. While I am very proud of the communication and language progress we have made, I am most proud to be part of Leah’s journey to show the world her ideas and amazing personality; this is why I became a speech-language pathologist.  “


Leah and Amy- the entire SB team is proud to celebrate your hard work. Keep it up!

Kid, you’ll move mountains! Today is your day! Your mountain is waiting. So get on your way!” -Dr Seuss 


Do you want to see your child featured on our blog? Send us your story and photos! We want to celebrate you too!

-Elizabeth Clark McKenzie, MS, CCC-SLP


Adventures in Teletherapy!

It is hard to believe that we are 7 weeks into quarantine. Our team has been getting into a good groove with teletherapy, and we are starting to appreciate how fun it can be! Here is a glimpse into what some of our talented therapists have been doing virtually:

We can do a virtual dance party….

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Climb up a building with Spiderman…

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Take a tour of the United States…

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Plan an elaborate Teddy Bear Picnic…


Practice conversation skills…


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Crack a secret code…


Make cards for a local senior center…


Practice handwriting and erasing…


Play board games…


or card games…


Discover fun new apps…


Solve a puzzle…


…and sometimes, we even get a little silly…


Pets and siblings can also join the fun!

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As you can see, we are having a ball! Our team is dedicated to continuing to find fresh, creative and innovative ways to keep teletherapy exciting for our clients.

If you haven’t given virtual therapy a try yet, give us a call! We’d love to work with you. To initiate services, contact Cari Syron at cari@skillbuildersllc.com.


-Elizabeth Clark McKenzie, MS, CCC-SLP





What a wild, historic, unprecedented time that we are living in. Here at Skill Builders, we’ve been rolling with the punches as best we can, and working around the clock to accommodate and adjust as the pandemic has unfolded. Teletherapy is new to us, but it is actually not a new service-delivery model. Many practices all over the country use teletherapy, and there are mountains of materials and resources out there to help make virtual therapy sessions effective and fun.

As a practice, we are dedicated to making sure our clients continue to get services. With the sudden changes in routine and lack of structure, we know that many of our kids are struggling. We want to provide continuity, support, and a familiar face to help them through this time. 

You might be wondering if your child is a good candidate for teletherapy. To be honest, we were concerned about that too. Guess what! We’ve found that nearly ALL of our clients are good candidates for teletherapy! It is amazing at how much we are able to do virtually! Here are some teletherapy myths debunked:

“My child is really young so he won’t be able to do teletherapy”

Our therapists have techniques and tricks up their sleeves to capture your little guy’s attention. We use songs, toys, interactive graphics and more to engage the kids. For many young clients, we spend short bursts of time directly interacting with the child, and the rest of the session is focused on generating ideas for home or coaching the parent. For younger children, we often offer two 30-minute sessions, in lieu of the hour long session. This helps with continuity and decreases the demand. 

“My child’s goals can’t be targeted virtually.”

You’d be surprised at what we are able to do from afar! As we’ve gotten into therapy, we’ve used AAC devices, targeted feeding goals, worked on handwriting, built obstacle courses, and even hosted a birthday party for our social skills group! Our therapists are committed to thinking outside the box and working with parents to make sure that sessions are productive and effective. If you are having a hard time picturing a teletherapy session, talk it out with your child’s therapist. We will work with you to come up with the best fit for you and your child.

“Teletherapy won’t be as fun.”

Teletherapy has opened up a whole new word of apps, materials, web content and technology to us! We are having fun using fresh, new materials, and we have a hunch that your child will too. After our first month of therapy, the feedback we have gotten from the kids has been great. They think it’s novel and exciting to see their therapist in a whole different context. Our kiddos have also really loved getting to show us their houses, toys and pets over video chat!  A fun opportunity for connection that we would not normally get to have. 

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We encourage you to come give teletherapy a try! Our team will continue to work on perfecting the art of virtual therapy, as delivering high-quality, personalized, effective services remains our number one goal. 

If you have questions about our current offerings, or want to explore what services might work best for your family, check out our website or contact our director- Cari Syron at cari@skillbuildersllc.com. 

Stay tuned for future posts with teletherapy activity ideas and personal stories from some of our current clients. 

Stay safe and be well.


-Elizabeth Clark McKenzie, MS, CCC-SLP