206. Why Traditional Speech Therapy Misses Drooling: What Works Instead

If you work with children who drool, this episode is for you. I’m pulling back the curtain on an approach I’ve used for over 15 years that has consistently reduced—and often eliminated—drooling in preschoolers. Not in theory. Not in a lab. In real therapy rooms, with real kids, on real caseloads. Here’s the uncomfortable truth: There is very little direct research on speech intervention and drooling. And instead of grappling with that complexity, our field often defaults to dogmatic thinking—blindly applying principles from other populations and calling it “evidence-based.” In this episode, I challenge that thinking. You’ll hear why: Motor learning principles do not transfer cleanly to preschoolers Bottom-up oral motor logic fails when the task is speech Single sounds don’t recruit the same neuromuscular systems as 3-element consonant clusters Then I walk you through four precise reasons why targeting three-element clusters (like /spr/, /skr/, /skw/) uniquely impacts drooling: Jaw stability driven by sustained /s/ with a closed mandibular posture Differentiation of tongue and lips from the jaw, mirroring swallowing mechanics Enhanced proprioceptive feedback through Dynamic Temporal Tactile Cueing Endurance and motor control built through slow, continuous, high-load speech tasks I also share a practical “back-porch” way to test this yourself—no fancy equipment, no new evals, just systematic observation and honest comparison. This isn’t about abandoning evidence-based practice. It’s about doing it better—with nuance, skepticism, and attention to detail. Because real progress doesn’t come from swinging between extremes. It comes from asking better questions and working at the right level of complexity. What You’ll Learn Why drooling is a neuromuscular control issue—not a hygiene issue How 3-element clusters recruit swallowing-relevant motor systems Why preschoolers need more, not less, feedback How to get speech gains and drool reduction at the same time Where the limits of this approach actually are (and why that matters) Call to Action If you want to apply this Monday morning, don’t guess. When you join the SIS Membership, you’ll immediately receive: Ready-to-use 3-element cluster treatment targets Weekly task-oriented movement activities that support posture, endurance, and executive function Research-to-practice tools designed for real caseloads—not perfect conditions You don’t need more time. You need higher-yield targets. 👉 Join here: https://www.kellyvess.com/sis Because when you work at the right level of complexity, the easier skills take care of themselves.

If you work with preschoolers with autism and you care about spoken language outcomes, this episode matters. A lot. In today’s episode of The Preschool SLP Podcast, we unpack the largest study to date examining why some autistic children do not develop spoken language, even after receiving high-quality, evidence-based early intervention. The takeaway is blunt: Motor imitation doesn’t matter a little. It matters a lot. Inside this episode, we cover: Why one-third of autistic preschoolers in a large, multi-site study did not advance in spoken language despite receiving ~10 hours/week of evidence-based intervention How motor imitation emerged as a key distinguishing factor between children who advanced in speech and those who did not What neuroscience tells us about mirror neurons, empathy, perspective-taking, and speech development Why speech develops from the inside out: core → proximal → distal → speech. And, what happens when we skip the body and go straight to the mouth How motor imitation supports: Entry into peer play Social communication Speech motor planning and execution Prefrontal–cerebellar connectivity Why this research gives us a “crystal ball”—not to maintain the status quo, but to do something different earlier  You can’t build speech on a system that can’t yet support posture, movement, imitation, and motor planning. If motor imitation is weak, speech outcomes are at risk, pretending otherwise doesn’t help children. Clinical bottom line: If a child presents with: Severe autism presentation Limited or absent spoken language Poor motor imitation Then motor imitation must be intentionally built into intervention, alongside AAC, multimodal cueing, movement-based learning, and robust communication supports. This episode challenges us to stop treating mouths—and start treating children. 🎧 Want practical ways to integrate motor imitation, movement, AAC, and literacy? Join the SIS Membership for ready-to-use, movement-based, evidence-informed activities designed for real preschoolers in real settings: 👉 https://www.kellyvess.com/sis Vivanti, G.L, et al. (2025). Proportion and profile of autistic children not acquiring spoken language despite receiving evidence-based early interventions. Journal of Clinical Child & Adolescent Psychology. https://doi.org/10.1080/15374416.2025.2579286      

What if the problem with treating the R sound isn’t the child—but the way we train it? In today’s episode, we step outside the field of speech-language pathology and borrow powerful, evidence-based principles from exercise science and kinesiology to rethink how we treat speech sound disorders. Why? Because exercise science has done what our field largely hasn’t: isolated what actually works using controlled trials, precision, and specificity. Speech is a complex neuromuscular skill. Treating it like flashcards and passive listening don’t make sense—and they don’t produce durable change. In this episode, you’ll learn how five core principles from exercise science directly apply to improving the R sound efficiently: • Why “practice makes permanent” and how the 80% challenge point prevents habituating errors • How progressive overload explains why complex clusters outperform isolated sounds • Why auditory bombardment is passive and inefficient when therapy time is limited • How compound training (paragraphs, clusters, movement, literacy) creates system-wide linguistic change • Why specificity matters—and why speech therapy must look like real speech to generalize This episode challenges the status quo in therapy and makes the case for treating speech as the neuromuscular endurance task it actually is. If you’re tired of plateaus, endless cueing, and R programs that don’t generalize, this conversation will change how you think about treatment starting Monday morning. 👉 Ready to treat the R sound more efficiently—without guessing? Inside the SIS Membership, you’ll find high-impact treatment targets, complex R clusters, and ready-to-use paragraphs designed to apply these principles immediately—so you can stop planning and start seeing change. Get access to efficient, evidence-informed R targets at https://www.kellyvess.com/sis Train smarter. Challenge appropriately. Create real change.

Are consonant clusters really “too complex” for kids with severe speech sound disorders—or have we been aiming too low? This episode tackles one of the most persistent myths in speech therapy: that children with childhood apraxia of speech, autism, or severe speech delay aren’t ready for clusters. I’m unpacking the real science behind complexity, coarticulation, and system-wide change—and why waiting for “readiness” often slows progress rather than supporting it. Let's break down three common myths that are not evidence-based: • Myth 1: Children must master single sounds before clusters • Myth 2: Clusters should always come later in treatment • Myth 3: Consonant deletion must be fixed first You’ll hear why speech doesn’t develop like a geyser, how the waterfall effect actually works, and why starting with complex targets can accelerate gains across the entire sound system—even in preschoolers. This episode also walks through how to do this in therapy: using dynamic tactile-temporal cueing, maintaining an 80% challenge point, and choosing treatment targets that improve motor planning, programming, and verbal working memory simultaneously. If clusters feel uncomfortable, slow, or messy—that’s the point. Challenge creates change. Want treatment targets that already do this work for you—without reinventing the wheel every week? Join the SIS Membership for ready-to-use, research-informed activities designed to create real speech change while protecting your time and energy. https://www.kellyvess.com/sis

If you work with children who are minimally speaking with autism or you love a child who is minimally speaking, today’s episode matters. Over the past year, I’ve been doing something deeply intentional. I’ve been having long, honest conversations with speech pathologists and special education teachers who are truly effective with high-tech AAC. These weren’t quick chats. Each interview ran over an hour. I asked open-ended questions. I pushed for specifics. I wanted to know what is actually working for robust AAC systems with thousands of words. What I found surprised me. There was no magic training. No perfect certification. No secret setting hidden inside the device. What these highly effective professionals shared was something much more human. They believed in themselves enough to try. To fail. To troubleshoot. To look clumsy. To learn alongside the child. In this episode, I talk about why vulnerability is the real needle mover in AAC implementation. I share why modeling uncertainty, curiosity, and joy matters more than appearing fluent. Showing a child how you search for a word, celebrate finding it, or flexibly choose an alternative builds far more communication power than perfection ever could. We discuss treating AAC as play, not performance. About using devices the way we use books with young children as interactive tools meant to spark connection, not test correctness. I also connect what I’m seeing in my dissertation research to real-life practice. Across hours of transcripts and coding, the same theme kept surfacing. Fluency doesn’t come from training. It comes from hands-on experience. Repetition. Messy, imperfect action. This episode will challenge you to rethink comfort zones, to stop waiting until you feel ready, and to remember that communication growth begins when adults are willing to learn out loud. If AAC has ever felt overwhelming, intimidating, or like something you were supposed to already have mastered, this conversation is for you. And if you want ready-to-use, engaging, and effective activities that make AAC implementation doable in real sessions, join the SIS Membership. Weekly resources arrive in your inbox so you can spend less time prepping and more time modeling, exploring, and connecting with your kids. You can learn more and join at https://www.kellyvess.com/sis Thank you for being part of this work. Roll up your sleeves. Be vulnerable. And keep changing lives one child at a time.

If you work with children who have complex communication needs, you already know this truth: You cannot pour from an empty cup. In this episode, I share six realistic self-care swaps I use from morning to night to support energy, focus, and emotional regulation in the work we do. These are not trends. They are practical, research-informed adjustments that help me show up fully present in therapy sessions, even during long, demanding days. As winter approaches and energy dips, comfort-food cravings rise. Instead of relying on willpower, I build better systems. In this episode, I walk you through: • A caffeine swap that supports focus without crashes • A protein-rich breakfast that stabilizes blood sugar • A comfort-food lunch that doesn’t derail energy • A 4 p.m. strategy for end-of-day slumps • A clean popcorn hack that actually works • A dessert and sleep routine that supports recovery, not burnout Self-care isn’t indulgence. It’s infrastructure. When your body and brain are supported, you can stay responsive, regulated, and fully present with the children and families you serve. A note for SIS Members and those considering joining Inside the SIS Membership, I design therapy the same way I design my self-care: with systems that remove friction. Members receive weekly, done-for-you, research-informed activities so they can spend their energy where it matters most: interaction, responsiveness, and connection. No scrambling. No reinventing the wheel. Just showing up ready. If you are ready to reduce decision fatigue, protect your energy, and innovate your practice alongside a community of practitioners doing the work in real classrooms and therapy rooms, you can join us here: 👉 https://www.kellyvess.com/sis You deserve support that actually supports you. Thank you for joining me at today’s drawing board for a better tomorrow, 💚 Kelly

If you work with parents of children with special needs, this episode is non-negotiable. Instead of diving into research, we’re heading straight into a film that delivers the kind of uncomfortable clarity our field rarely gets. Today, we break down If I Had Legs, I’d Kick You—Mary Bronstein’s raw, emotionally accurate look into the lived experience of parenting a neurodivergent child—and why every SLP, special educator, and early-intervention professional needs to watch it. This movie exposes a blind spot in our practice: how we show up for families. And more importantly, how often we get it wrong. In this episode, you’ll learn: • Why judging parents instantly destroys trust • How our “professional persona” blocks genuine connection • The simple shift that makes parents feel heard instead of dismissed • When your “support” becomes a burden—and how to stop doing it • Why burnout in families is invisible until it explodes • How to rebuild capacity for parents and for yourself This is not a feel-good conversation. It’s a necessary recalibration for anyone who works with families navigating neurodivergence, chronic medical needs, and overwhelming daily demands. If you want to do better for the families you serve, start here. Feeling your own burnout creeping in? Stop white-knuckling it. The SIS Membership provides weekly, ready-to-use, universally designed literacy-movement activities that dramatically reduce your planning time while increasing engagement for every child on your caseload. Protect your capacity. Strengthen your practice. Join today at https://www.kellyvess.com/sis

If you love weaving books into speech and language therapy, this episode is absolutely your lane. In this conversation, Kelly breaks down a 2025 scoping review on early language development and reading aloud, then translates it into five practical literacy “hacks” you can use with preschool and early elementary students starting tomorrow. She pulls zero punches about the study design: you’ll hear exactly what a scoping review is (and isn’t), why it doesn’t carry the same weight as a systematic review or meta-analysis, and how to use it wisely as an “idea generator” rather than gospel. From there, she layers in two decades of clinical experience and walks through the habits that actually move the needle in real therapy rooms. You’ll hear about: Why this 2025 scoping review on reading aloud and early language is best viewed as an “idea article” How the authors used PCC (Population, Context, Concept) to narrow 1,000+ studies down to 106 Why repetitive, predictable books (like The Gingerbread Man or Brown Bear, Brown Bear) allow diverse learners to participate at a higher level How to rethink “social stories” using a Brown Bear-style repetitive frame and a child’s favorite characters for more powerful behavior change What Universal Design for Learning actually looks like in speech therapy when you go all-in on multimodal cueing How multisensory, multimodal activities (print, props, movement, AAC, writing) especially support autistic students and kids with attention and motor planning challenges Why connecting books to real-world roles and prior knowledge (“You’re the zookeeper…”) drives deeper language and thinking than fact-based WH questions Simple language shifts that move you away from quizzing (“What color is…?”) toward higher-level thinking (“I wonder why…”, “Tell me about a time…”) How predictable literacy routines reduce cognitive load and move kids out of fight/flight and into learning Why the interaction itself matters more than any single treatment target or book choice How prepping rich, ready-to-go materials frees you to be fully present in the interaction (where the real “magic” happens) By the end, you’ll walk away with five concrete literacy routines you can plug into your week and a much clearer lens for judging research quality while still using it creatively. Want these literacy hacks done for you every week? If you’re ready to stop reinventing the wheel and want literacy-based, movement-rich activities that already embed these principles, join the SIS Membership. Inside SIS, you get: Weekly Google Slides decks built around repetitive, predictable books Multimodal, multisensory activities (movement, props, print, AAC, writing) you can use with your entire caseload Treatment targets that are already leveled and ready to go, so you can focus on the interaction instead of scrambling for materials Join SIS here and grab everything instantly: 👉 https://www.kellyvess.com/sis   Annika, A., & Johanna, L. (2025). Early language development and reading aloud with children: A scoping review and content analysis. International Journal of Educational Research Open, 9, 100508.

Children who speak freely at home but shut down in public aren’t being stubborn. Their capacity is getting crushed by the demands of new people, new settings, and unpredictable routines. In this episode, we break down how to build capacity using the PRIDE approach—adapted specifically for reluctant speakers and children with selective mutism. You’ll hear how to shift out of “thermostat mode” and into “mime mode,” using 10 minutes a day of pure responsiveness to lower pressure, increase connection, and support communication in high-stress seasons like the holidays. We walk through exactly how to use each part of PRIDE—objective encouragement, reflection, imitation, description, and enjoyment—without adding demands, without pushing speech, and without triggering shutdown. This is the blueprint for helping sensitive, cautious, or selectively mute children communicate more confidently when the world gets loud. In this episode, you’ll learn: • How the Demands–Capacity Model explains shutdowns in public or group settings • Why holiday routines, unfamiliar people, and novel activities increase mutism • How to adapt each PRIDE element for reluctant speakers (no expansions, no recasts) • What 10 minutes of daily “mime time” does to build capacity fast • The specific social and communication behaviors that improve when capacity increases • How SLPs can coach families through this process during high-stress seasons If you work with children who freeze, whisper, avoid, or stop speaking outside the home, this episode gives you a concrete plan you can use immediately. Want ready-to-use activities that make your therapy educationally rich without adding demands? Join the SIS Membership and get weekly materials designed to support speech, language, and social-emotional foundations—especially for sensitive and reluctant communicators. 👉 https://www.kellyvess.com/sis

If you serve young children with behavior challenges, this episode delivers a framework you can put to work immediately. Today, we break down the PRIDE skills: five evidence-based behavior strategies drawn from Parent-Child Interaction Therapy (PCIT) and Teacher-Child Interaction Training (TCIT). These methods have more than 50 years of empirical support and consistently improve behavior, engagement, emotional regulation, and communication across diverse populations. You’ll learn how to use objective praise, reflection, imitation, description, and genuine enjoyment to build connection—not compliance. This child-directed interaction approach has been shown to make meaningful gains for children with autism, ADHD, selective mutism, developmental language disorders, trauma histories, hearing differences, anxiety, and disruptive or externalizing behaviors. The research is broad. The effect sizes are large. And the application is simple. We dig into how PRIDE skills strengthen executive function, expressive language, joint attention, and emotional resilience—and why these strategies are essential for SLPs, early childhood educators, and anyone working in preschool or early elementary settings. When you have educationally rich activities prepared, you can stay fully present and implement PRIDE with intention, clarity, and consistency. If you want treatment plans that allow you to focus on relationships, responsiveness, and evidence-based connection strategies that actually change behavior, the SIS Membership is designed for you. Each week, you receive educationally rich activities that treat the whole child—speech, language, literacy, executive function, and motor foundations—so you can implement PRIDE seamlessly without scrambling for materials. Join the SIS Membership and make your therapy easier, richer, and more effective: https://www.kellyvess.com/sis Let’s build capacity, connection, and better outcomes—one child at a time.💚Kelly