What’s Happening?

We’ve been busy busy busy at Skill Builders! There are lots of exciting things happening around here. Here are some highlights!

Skill Builders Del Ray           

 Little Yellow House

In case you missed the big announcement- Skill Builders now has a Del Ray location. You can find us at the “Little Yellow House” right on Mount Vernon Avenue. We are currently only seeing speech therapy clients there, but keep your eyes peeled for updates as we get to know our new neighborhood. We hope to be bringing our full array of services to Del Ray soon!


This month, we say goodbye to two phenomenal therapists. Lauren Mazel is relocating to Massachusetts (But first, she taking time to travel around Southeast Asia!) and Julie Aills is returning back to her home state of Ohio. These two will be sorely missed around here, but we are eager to hear of their successes!

New Faces

We are thrilled to welcome THREE new therapists to the Skill Builders team!


Amanda Biesecker received her BS in Rehab and Disability Studies from Auburn University in 2008, and her Master’s in OT from the University of Alabama Birmingham in 2010. She just moved to Alexandria from Boston with her husband and 3 year old son.


Caitlin Jones (you may remember her as a speech-language pathology intern here last Fall!) received her Bachelor’s Degree in Special Education from Elon University, and taught for one year in North Carolina, before moving to Washington DC to attend the George Washington University.  She received her Master’s Degree from GWU in 2018. She is originally from Pennsylvania.


Aimee Jennings received her Bachelor’s degree from Longwood University in 2014. She also received her Master’s degree from Longwood University in 2016! She is originally from Northern VA.

Internship Program


Did you know that Skill Builders has a new internship program? This is a fabulous opportunity for teens and young adults to work on important vocational skills under the supervision of a skilled therapist, all in the welcoming and inclusive setting of our office! You might see our interns taking care of things in the waiting room or greeting clients at the front desk. If you catch any of them doing a great job…be sure to let them know! 🙂

Fun Summer Offerings


Emily Smolak, MS, OTR/L is offering Aquatic OT sessions! These fun, individualized one-on-one sessions will be held at Audrey Moore RECenter, off of Braddock Road in Annandale. You can contact Emily directly for more info! (Emily@skillbuildersllc.com)

dance class

My popular dance and movement class is back for the summer, and I am offering classes “a la carte” for the first time! If you have ever wanted to try out my dance class, this is a perfect time. You can contact me directly for dates and sign up details. (ElizabethM@skillbuildersllc.com)

Camp SuperNOVA

Camp SuperNOVA Rocket

Our smash-hit summer camp is back and we are excited to say that we are officially full! Each week, 15 lucky campers will join us for exciting activities and fun new experiences. Keep your eyes on our social media pages for photos and updates. Missed out on camp for this year? Sign up for our emails to get priority notification about camp registration for 2019!

PLAY Project


Skill Builders is co-hosting the PLAY Project with our friends at Washington Speech.       This is a fabulous opportunity for parents and professionals who work with children on the Autism Spectrum. Several of our therapists will be attending and we hope to see you there! Click here for registration info.


Do you have any ideas or things you want to see at Skill Builders? We always want to hear from our clients about ways we can better serve the families we work with. Drop us a line and give us your thoughts! (info@skillbuildersllc.com)


We hope your summer is off to a great start! Check back soon for more fun updates about practice.


-Elizabeth Clark McKenzie, MS, CCC-SLP


Summer Therapy



Schools are out and hot weather is here to stay…it is SUMMER TIME! 🙂

Here at Skill Builders, we are gearing up to start our summer schedule next week. The summer can be a really busy time for families between camps and vacations, and it is easy for the weeks to fly by quickly! Now is a great time to shake things up in therapy. Here are 5 tips to help you get the most out of your summer therapy sessions:

1. Schedule a team meeting

– The summer can be a really nice time to schedule a meeting with both parents, the therapist(s) and even nannies or other caregivers.   At our practice, we have both SLPs and OTs on staff, so we try to include both treating therapists when at all possible.  This meeting can be used to talk about progress, share important updates from school and talk about any changes in the routines at home. I also use these meetings as an opportunity to modify or update goal areas.

2. Choose a focus

-Since you often only have about 8 sessions over the summer, it is a great time to select one or two goal areas to intensively focus on. This allows us to really make some progress in one area, and have the satisfaction of checking a goal off our list by the end of the summer. I like to get input from my kids. I will ask them “What is something you really want to work on this summer?“. One year, I worked with a kid on intelligibly saying his sister’s name. It was great to target something so functional and my client was extra motivated to work on this goal. How satisfying!

3. Pick a project

-For many kids, it can be fun to pick a project that will be worked on every week. I like to pick a project that is tailored to the child’s personal interests. Doing this can make the summer feel more like a special camp that is separate from the rest of the school year. At the end of the summer, the child has a finished project to show off all of his hard work! One of my kiddos wrote his own comic book over the course of 8 weeks, and we surprised his parents with it at the last session.

4. Change it up

-I have been seeing some of my kids for years! Even the hardest little workers can get demotivated by the same old routine over and over again. Try changing rooms, starting a new type of schedule, or playing music during the session. The summer is also a great time to try having the child work with another therapist once or twice. A new set of eyes can be really helpful in setting new goals, and it allows the child to practice generalizing skills with a whole new person. Shaking things up in the summer can help you start the new school year off with a fresh attitude.

5. Do the homework

-I get it…the word homework does not scream “summer fun!” but the summer is a really great time to prioritize home practice because you don’t have other school assignments to do.  I love it when parents ask me for ideas for home because it increases the carry-over from session to session! There are lots of ways to make homework a bit more fun, like earning stickers towards a fun reward or creating assignments that can be done outside or better yet, in the swimming pool!

Looking forward to a fun and productive summer here at Skill Builders! Check out our Instagram feed for fun pictures of all the fun things happening in therapy this summer!


-Elizabeth Clark McKenzie, MS, CCC-SLP



The Theory of Loose Parts

‘In any environment, both the degree of inventiveness and creativity and the possibility of discovery are directly proportional to the number and kind of variables in it.’

~ Simon Nicholson, Architect




In 1971, architect Simon Nicholson wrote a groundbreaking paper in an architecture journal titled “How Not To Cheat Children- The Theory of Loose Parts“.  Nicholson proposed that it is loose parts in our environment that empower creativity.

Loose parts refer to objects that have no predetermined purpose or set of directions and can be used alone or with other objects. Loose parts can be moved, carried, combined, redesigned, lined up, assembled, taken apart and put back together. The best example of loose parts is a set of wooden blocks. Think of all the possibilities beyond just building a tower- making a train, tossing blocks into a bucket, filling a toy truck, pretending to cook/eat the blocks, etc etc etc. There is no wrong answer!

Nicholson’s theory is based on the idea that all children are creative beings- not just a gifted few- and by giving children “open-ended” play materials, we are giving them endless opportunities to create. Over the years, this concept has completely changed the play landscape of preschools, childcare centers, and toy design. Experts love loose parts because they can be used in any way the child chooses, encourage mastery and generalization of multiple skills, and promote individuality. Parents love loose parts because you don’t have to invest in expensive, fancy toys!

I have been thinking a lot about this recently with many of my little friends who struggle with creativity in play. I have been trying to be more mindful of what materials I am offering, as well as what recommendations I am making for home. Children don’t always use materials the way us adults expect them to. Just the other day, I pulled out a bin of plastic balls, in all different sizes and colors. I was planning to show the 20-month old that I was working with how to roll these balls down a ramp. Before I knew it, the little guy had hidden 3 of the balls in his shoe and was covering his eyes saying “Ball….where are you?“. Why didn’t I think of that?!


For more ideas of materials to keep on hand, check out our previous post on non-toys.

-Elizabeth Clark McKenzie, MS, CCC-SLP


Useful Apps

In this day and age of technology, there are many useful apps out there that can make the jobs of parents, caregivers and therapists just a little bit easier! Here are 7 fantastic apps to check out:

Tantrum Tracker   Tantrum Tracker App 1Tantrum Tacker App 2This app is great! It allows you to track locations, triggers, take photos and videos, and write up to 25,000 characters of notes related to the event. It also consolidates the data and looks for any patterns or commonalities for you. You can easily share the information with teachers, therapists, and other caregivers.

Time Timer time timer 2Time Timer 3The Time Timer app is SO useful for therapists and parents alike! You can adjust the timer to any increment that you like, and you can have multiple timers going at once. Children can easily see how much time is left. You can also save your timers to reuse for future!

Learny Food Food App1Food App 2I like this app to use for my picky eaters. It provides visual prompts and rewards for trying new foods, allows children to earn tokens and prizes, and keeps track of progress. My favorite feature is that you can offer the child visual choices, and he can rate the food right within the app!

iPrompts First Then AppFirstThen 2I just recently discovered this app and it has been a game changer for one of my clients! The app allows you to create and save visual schedules that are completely customized to the child, complete with real photos!

First Then Visual Schedule iPrompts AppiPromptsApp2Similar to the iPrompts app, this app creates visual schedules but in a much more simplistic way. I love this app for earlier language learners. It also comes with a timer that can be paired with each task. I also love the “make a choice” feature, which provides visual choices to the user.

DreamyKidDreamyKid1DreamyKid2 Mindfulness is all the rage these days, and for good reason! I have been trying to work some calming strategies into all of my sessions, and this app is super helpful! It has fun graphics that guide children through meditations, as well as ideas for activities, inspirational quotes, and yoga poses. You can also access calming background music or nature sounds to use while completing other tasks.

ArtKiveArtKive1ArtKive2This is a little bit of a bonus, but I love this app! It is designed to store and organize photos of children’s artwork, but could also be used by therapists to keep track of drawing, handwriting, and other visual-motor tasks. The files are easily accessible and you can create profiles for multiple children.

I am always looking for ones to recommend to parents. What are some of your favorite apps?

Elizabeth Clark McKenzie, MS, CCC-SLP

Time to Play


Play. This word might seem inconsequential to some, but for the developing child, play is absolutely essential.

For many adults, we equate play with relaxing. As in, “First we do our work, and then we get to play.“, or “I don’t understand how he can be so tired- we did nothing but play all day!“.  What many don’t realize is that play IS the work.  Play is how children experience the world around them, master new concepts, utilize their sensory systems, and socialize with others. Research shows that children learn best through discovery and exploration using all of their senses. When young children are playing, they are actually learning to learn. So what you see your 18 month old doing with a bin of blocks is way more than just having fun. She is building the foundation to be a life-long learner!

Just like gross motor skills or language skills, play skills develop in phases. According to Cari Ebert, MS, CCC-SLP, we see play skills develop in this order:

1.Random and Exploratory Play 

In this phase, kids are picking up objects, banging them, mouthing them, holding them, and throwing them. This phase is all about taking in how things feel, and how objects relate to your body in space.

2. Cause and Effect Play

Now, children start to figure out that their actions can lead to an outcome. If I press the button, a light turns on. If I say “ba”, my mommy blows bubbles. If I push the block tower, all the blocks fall down. Cause and effect is the foundation of all other play, because it is the beginning of playing with a plan.

3. Functional Play

In this stage, children begin to play with the functions of objects. They are able to think about the concept of an object, and this directs their play. Children will start to push cars along a road or stir with a spoon which shows that they are applying previously learned knowledge into their play. How cool is that?!

4. Symbolic Play

Once functional play is mastered, a child is now able to think about objects that are not in the room. A plain wooden block can turn into a helicopter and a throw pillow can be a dog to take on a walk. This phase is so fun because the sky is the limit! Your child can now pull any fun idea into his play schema.

5. Constructive Play

At this point, kids will start to use their imagination and previous experiences to create. You might catch your kiddo building houses, skyscrapers, castles or even whole cities! Constructive play also involves building a play space, so you might see your child designate different materials to represent parts of an idea. For example, this pile of leaves is my bed and this pine cone is my alarm clock, and that tree over there is my mom’s bedroom. Kids in this phase may spend just as much time setting up their play as they actually do playing!

6. Dramatic Play

This is where the fun really begins! This is the phase in which they put it all together. Kids use their experiences, imaginations, fears, daydreams and emotions to orchestrate elaborate play schemas that may involve many different toys and materials, or no materials at all. This is the phase where collaborative play with friends really takes off too. Kids in this phase create their own storyline, and use their play as an avenue to explore all kinds of concepts and ideas. As their language skills expand, their dramatic play will too.



It is really important to consider the play phase that a child is in, rather than his chronological age. I advise parents to ignore that recommended ages on toys, and to focus more what what skills their child currently has. There is no need to rush the developmental process because we want a solid, strong foundation to build upon later.

Don’t succumb to the notion that young children need heavy academics and a rigorous schedule of extra-curricular activities to thrive! I’d actually argue just the opposite- kids need ample time carved out in each day that is dedicated completely to “just playing”. The most powerful learning experiences can come wrapped up in the simplest of packages.

Stay tuned to our blog for more tips on how to play with your child! To check out previous posts on play, click here, here or here.


Elizabeth Clark McKenzie, MS, CCC-SLP

Bubbles Bubbles Bubbles


If I could have one item in my therapy room, I would hands down choose bubbles.  You might be thinking “What is so great about bubbles?!“. Let me tell ya…I can target dozens of goals with one little container. Here is a list of my 10 favorite ways to use bubbles in therapy:

  1. Anticipation – For those early language learners, I hold the bubble wand up to my mouth, draw in my breath and round my lips. Then, I wait for the child to make eye contact, gesture or vocalize before I blow a bubble.
  2. Bilabial Sounds – Think of all the bilabial targets that you can hit! BUBBLE, MORE, POP, etc.
  3. Oral- Nasal Contrasts – For children who have difficulty keeping sounds out of their nose, I like to use bubble blowing as a way to demonstrate control of air flow.
  4. Lip Rounding –  Especially with little ones, learning to blow bubbles can be a fun way to model lip rounding! Sometimes, I even add a vocalization of a round vowel before blowing the bubble. (ex: “OO”)
  5. Breath Support– It takes a lot of control to blow a really big bubble! Practicing blowing one big bubble vs. many small bubbles is a great way to develop breath support.
  6. Requesting – Think of all the core words that you can utilize to request bubbles: MORE, AGAIN, GO, UP, DOWN, IN, OUT, PULL, WANT, HELP,etc.
  7. Turn Taking– If your child can blow bubbles himself, practice taking turns. Layer expressive language goals on there by adding “my turn”/”your turn“, or asking a question: “Do you want to try?
  8. Following Directions – My kids love playing the “Bubble Pop” game! We take turns giving each other directions on which parts of our body to use to pop the bubbles- thumbs, pinky fingers, elbows, knees, and even tummies! Social skills groups particularly get a kick out of this one.
  9. Impulse Control – I ask my child to strike a pose and hold it like a statue. I blow a bunch of bubbles around her, and she has to hold the pose without giving into the temptation to pop the bubbles!
  10. Regulation- In my therapeutic dance class, we like to end our class with a little something called “Bubble Yoga”. The children find a comfortable position on their backs or seated, and I blow bubbles all around them. The goal is for the children to watch the bubbles float and pop as their body relaxes into a calmer state. It works like a charm!


So the next time you need some inspiration, or you are running short on time to plan an elaborate therapy lesson, look no further than your trusty tumbler of bubbles! (I like this non-toxic and spill proof variety) Kids can’t get enough of them, and the possibilities are endless.

Have fun!


-Elizabeth Clark McKenzie, MS, CCC-SLP


Executive Functions


I recently attended a continuing education conference that was all about Executive Functioning. It was very eye-opening to think through how much executive functioning skills impact our ability to do just about everything! So what exactly are executive functioning skills? Here is the nitty gritty:

Executive Functioning skills are defined as “higher order cognitive skills that serve  on-going goal directed behavior”. (Meltzer, 2007). You might think of the executive skills as the conductor of a brain’s orchestra, telling us which skills to use when.  Here are the main executive skills according to Peg Dawson, Ed. D, NCSP:

  1. Response Inhibitionthe ability to think before you act.
  2. Working Memorythe ability to hold information in memory while performing other tasks.
  3. Emotional Controlthe ability to manage emotions in order to achieve goals or complete tasks.
  4. Flexibilitythe ability to revise plans in the face of obstacles.
  5. Sustained Attentionthe ability to maintain attention despite distraction, fatigue or boredom.
  6. Task Initiationthe ability to begin projects in an efficient and timely manner.
  7. Planning/Prioritization– the ability to create a roadmap to reach a goal, as well as to make decisions about what is important vs what is not important.
  8. Organization – the ability to create an maintain systems to keep track of information or materials.
  9. Time Management – the ability to gauge how much time a task will take, as well as to work within those time limits to meet deadlines.
  10. Goal Directed Persistence – the ability to set a goal and complete it without getting sidetracked by other interests. 
  11. Metacognition – The ability to self-monitor and self-evaluate, as well as look at yourself from another perspective. 

Interestingly enough, these skills develop in approximately that order, so when looking at what to work on in therapy, it may be helpful to work sequentially. I also learned that it takes about 25 years for these skills to fully mature! This means that even though we are legally adults at age 18, we very well might not possess all the executive functioning skills we need to be fully successful.

As we know, certain diagnoses come with an implication of executive functioning deficits, including ADHD and Autism. However, I think it is important for us to recognize that all people have executive functioning strengths and weaknesses.  Here is a quick survey for adults that will rank your executive functioning skills from strongest to weakest. I did this with my husband, and it was rather enlightening! 😉


I’ve pulled together a list of some fun games that help build executive functioning skills:

And a few other fun, therapeutic activity ideas:

  • Designing, building and executing an obstacle course.
  • 20 Questions
  • I Spy
  • Simon Says
  • Building with Legos or blocks
  • Journaling
  • Playing “Restaurant”
  • The Alphabet or Picnic Game

I’ve found that tackling some of these underlying executive functioning skills has really helped support progress in other goal areas. Parents also really appreciate folding these goals into sessions because executive functioning skills are so directly related to home and classroom routines. It’s a great way to make sure you are providing a robust and well-balanced treatment plan.

For more information, you can check out www.SmartbutScatteredkids.com.

-Elizabeth Clark McKenzie, MS, CCC-SLP

Heavy Work


I don’t know about you, but whenever the seasons change, I notice most of my kiddos have a harder time focusing and self-regulating. They seem to be bouncing off the walls! My super smart OT friends have clued me in on the benefits of heavy work. Heavy work refers to tasks that provide the body with proprioceptive input to the muscles and joints. This can have a calming effect, but also provides increased awareness of where the body is in space. For many children, these tasks can help support focus and attention. (Not to mention all the benefits of physical activity in general!) Here are some ideas:

  • Pushing someone else on a swing
  • Building an obstacle course
  • Climbing up a slide
  • Playing tug of war
  • Animal walks
  • Carrying heavy bags
  • Pushing a cart
  • Pulling or pushing a heavy door
  • Hanging on monkey bars
  • Wheelbarrow walking
  • Playing catch with a heavy ball or beanbag
  • Push-ups
  • Carrying a stack of books
  • Dragging a heavy pillow or beanbag
  • Scrubbing dry erase marker off of a mirror

Bonus- I have been trying many of these with my rambunctious “threenager” at home, and it works like a charm for her! I have her help me carry in groceries or load wet clothes into the dryer, and we’ve noticed a big difference in her mood and behavior. When I really think about it, I tend to be more focused after working out or doing household chores.  It seems like we all can benefit from adding more heavy work to our daily routine! For other strategies for improving attention, check out our previous post on fidgeting.  Got any other inventive ideas? Post them in the comments below!


Better get to work! 🙂

-Elizabeth Clark McKenzie, MS, CCC-SLP

Stories for Social Skills

I know…I know… ANOTHER book post but I just can’t help it! I love using books in therapy because they are so portable, easily adaptable, and easy for parents to use at home. I enjoy using books with all of my kids, but particularly with my social skills groups. We can tackle all kinds of important topics while reading a fun, entertaining story! Self-regulation, making inferences, predicting, perspective taking, problem solving… I could go on! Here are is a list of my favorite books (with links!) to use for pragmatic therapy:

SHH We have a plan

Clark the Shark

Pete the Cat

Chester's Way

Mean Jean the Recess Queen

The Invisible Boy

The Nuts Keep Rolling.jpg

Still Stuck.jpg

The Bad Mood and The Stick.jpg


I like choosing a book to base my whole session off of. I will create 2-3 expansion activities based on the book, which helps bring the story to life. I have also found great “already made” materials on Teachers Pay Teachers , as well as several fun ideas for crafts and games on Pinterest ! (Psst…did you know that Skill Builders has our own Pinterest page?! Lots of awesome pins up there!)

I also recently discovered Storyline Online , which is run by the SAG-AFTRA Foundation. This site has oodles of videos of celebrities reading story books. They do a really nice job bringing the story to life with fun animation and exceptional story telling. Several of the books listed above are on the site! Sometimes, I find that my students enjoy watching a video of someone else reading the story, rather than just hearing my voice for the whole session. It breaks things up a bit!

Got any other recommendations? I am always on the lookout for new books to add to our library.  Post your suggestions in the comments below! For more great book suggestions, you can check out my other book posts here and here.


-Elizabeth Clark McKenzie, MS, CCC-SLP