Jake's Journey with Apraxia

And the Friends We Met Along the Way

by Katie, SLP and Contributing Writer

Do you ever feel like there is a missing piece in your child’s language development, especially in the areas of reading and listening comprehension? Can you just not find the key to unlock the mystery of why he continues to experience difficulty despite therapy, extra help, and tutoring? Please keep reading! Perhaps what I describe below is the missing link!

Ever since I heard Ellen Brigger, MEd, Lead Teacher for the Apraxia Academic Program at St. Rita School for the Deaf and a presenter at CASANA’s 2014 10th Annual National Conference on Childhood Apraxia of Speech in Nashville, TN suggest using Nanci Bell’s Visualizing and Verbalizing program, I knew I had found my next continuing education pursuit!

This past July, I had the privilege of attending a Visualizing and Verbalizing training in Asheville, NC. I have also now been able to utilize the first steps of the program with several of my students. What a super neat experience to watch children learn to make detailed pictures in their minds and then express what they are seeing back to me!

I have found this program to be an excellent tool for helping children meaningfully fill existing holes in their expressive vocabulary. Additionally, the structure words within this program provide a concrete starting place for eliciting verbalizations in children who have difficulty expressing their thoughts and ideas. It has also been particularly enlightening to learn that a child can be more successful at performing higher order thinking tasks (e.g., main idea, conclusion, prediction, inference) when he can clearly picture what the words he is reading are depicting.


So, what is Visualizing and Verbalizing? It is a program “specifically designed to develop language comprehension and thinking” which is based on the connection between imagery (nonverbal) and language (verbal). A “sequence for imagery stimulation” is presented very clearly and systematically and is suggested to produce “remarkable results.” Though designed to be administered individually, Visualizing and Verbalizing can be adapted for groups. There are no proposed age or ability limitations for its use.

Nanci Bell provides insight into the many symptoms a child may exhibit which may, at least in part, have their root in weak concept imagery. Some of these symptoms, in addition to difficulty comprehending and expressing oral and written language, include difficulty following directions, difficulty grasping humor, difficulty interpreting social situations, difficulty with cause and effect, and difficulty with attention and focus.

While instructing a child through the Visualizing and Verbalizing program, consistent use of words such as picture, see, and imagine drive each lesson. The principle of questioning rather than telling is another primary component of this program. Repetitive, daily stimulation is recommended for success. Kids learn that “words turn into pictures and pictures turn into words.” How simple, yet BRILLIANT!

After “The Climate” for this new way of thinking is set for a child (Step 1), the Visualizing and Verbalizing steps begin with removing the visualizing piece and walking the child through the verbalizing piece (Step 2). At this point, the structure words I mentioned previously are introduced. Examples of the structure words include color, movement, background, and perspective. Here, a child learns to describe a given picture in a way that creates the same picture in his teacher’s mind.

The visualizing piece is added within Step 3 during which the child learns to make pictures in his mind of single words and clearly express these pictures. The child is then taught to visualize and verbalize with increasing complexity through progressive steps (Steps 4 through 10) involving single sentences, sets of sentences, whole paragraphs, and whole pages. As the text length increases, higher order language tasks are incorporated into the lessons.

A child’s independence, automaticity, and speed at which he processes spoken and written language steadily increases across the program. I love that there is a relationship built and trust developed between the teacher and the child which facilitates his growth and learning. Rewards and praise are ever present throughout each step.

As a Visualizing and Verbalizing provider, I am learning to improve my ability to ask relevant and appropriate questions to guide my students’ imagery skills. I am also learning to change my teaching vocabulary which in essence changes the process by which my students think. Nanci points out in the manual that we often assume everyone creates pictures for words in his mind. As you begin to question your children/students, you may find this simply is not the case. How encouraging to know there is a tool available to support our efforts to help our children think differently, in pictures!

Going through the Visualizing and Verbalizing steps with one student in particular has truly opened my eyes and taught me a little more about how he thinks. Part of putting the puzzle together, finding the right keys to unlock a student’s mind, is gaining understanding. I am grateful to have found a well-established program which enables me to do just this, and I am excited to see what doors the Visualizing and Verbalizing key opens on my quest to helping children develop their language skills.

For more information on Nanci Bell’s Visualizing and Verbalizing Program, please click here.

Bio: Katie is a speech-language pathologist who has been serving children of all ages for 15 years in home, daycare/preschool, school, and clinic settings. She earned her Bachelor of Science degree in Psychology from Presbyterian College in Clinton, SC, in 1996 and her Master of Education degree in Communication Sciences and Disorders from the University of Georgia in Athens, GA, in 1999. In her free time, she enjoys working out and running.

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