Tuesday, September 6, 2016

Progress Monitoring: Baselines and Beyond

The Frenzied SLPs are discussing data collection now that school is back in full swing!  Today I'll be sharing one way I like to take daily data quickly when I have a client with several goals in a 1:1 therapy setting.  If you'd like to see how I took data in the school setting click here.

Firstly, when working in private practice, I like to create a basic treatment plan, a course of action in which I would like to see progress.  Below is an example of a basic treatment plan.

Then I take the goal sheet and create a daily data sheet:
1.  I align the goal #s from the treatment plan to the goal sheet so I know which goals I am targeting without having to re-write them for each session.
2.  I can simply take data only on the goals I target each session.
3.  I also add a place for additional notes.
4.  I would typically hand write on this form, rather than type.  So if I would need additional lines for notes, I would simply continue to the next like and so on until I finished the note.  Then simply add the date of the next session on the next fully clear line.

And that's it!  I can use one sheet of paper for numerous therapy sessions without having to write re-write goals or other excessive information.

How about you?  Do you have a quick data collection system too?  Feel free to share!

Happy Talking!

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Friday, June 3, 2016

Colleague Question #1: ASD client swallows pool water. What do I do?

Often times, I will receive questions from colleagues via email or FB private messages regarding specific cases they are dealing with.  I tend to shoot back an email but I have been thinking lately that it might help to share these responses with you too.  Maybe they will help or maybe they will spurn a few additional great ideas from you that you can share with your fellow colleagues.  So here is the first post in this "Colleague Question" series.

A fellow colleague writes:

"I have a client with ASD and SPD...he loves swimming but can't stop swallowing the pool water. He also struggles with swallowing instead of spitting during teeth brushing.  His parents have suspended his swimming lessons even though he so enjoys them because he can become ill from all the water he takes in...Any suggestions?"

Some of you reading this question may be asking yourselves "What does this have to do with speech therapy or communication?", yet, the reality is, as SLPs, we may be the only service provider for some children and therefore, the only source of guidance and education for parents.  It's important for us to fully understand sensory needs in our ASD population and how we can assist parents in providing effectively for those needs.

For this particular case, let me first say that it is important to keep safety at the forefront of decision making for our clients so I can understand why the child's parents would suspend swimming lessons at this time. However, for children who have sensory needs it is almost painful for me to hear a child not being able to participate in such an enjoyed activity.  I'm sure swimming provides some wonderful sensory input as well as a wonderful social opportunity for this child and my hope would be to find a way to get this child back to swimming lessons as soon as possible.  As this is a safety issue, we cannot encourage this behavior even if it provides some sensory feedback for the child.  What I would suggest is possibly finding a way to appropriately replace this behavior with something safer that the child can do in the water while still providing some type of sensory input.

An acceptable compromise would be to try and replace drinking the pool water with blowing bubbles with lip trill (sounding like a "motor boat") or humming with child's lips sealed while in the water (nose and eyes above water).   Either of these options will still provide sensory input to the child's face but will encourage water to be blown away from lips, or in the case of "humming", total lip closure.  These activities can be practiced at home during bath time so that the child can master one or both of these replacement behaviors initially, then transferred to practicing them in the pool during non-lesson times first, following by adding them during swimming lessons.

To aid in decreasing swallowing of saliva during teeth brushing, it might help child to have a visual goal to encourage a replacement behavior.  Possibly parents can teach the child to spit often (every few brush strokes) into a small disposable bathroom cup.  They could make a game out of it by brushing their teeth together with the child, modeling how to brush and spit often.  Parents and child can each have their own cup in which they draw a large line on the outside of cup indicating a stopping point.  Whomever fills up the cup to that line first wins the game.  This encourages spitting often while making this activity, hopefully a bit reinforcing, creating excitement and fun!  Of course it doesn't sound very appealing to be spitting into a cup and having to look at it for us as adults, but the visual may provide the child with a concrete goal so that he can learn how to spit rather than swallow during teeth brushing.  Over time this activity can be modified to see who can spit in the sink a certain number of times, and so on, so that the cup gets faded out and typical teeth brushing remains.

I hope these suggestions help.  Have any suggestions of your own you'd like to add?  Feel free to comment below.

Look for more posts in this new series to come over the next few weeks.  If you have a specific question you'd like answered feel free to email me at communicationstationspeechtx@gmail.com.  You just might see your question pop up in this series.  (Note: all identifiable information will remain confidential.)

Happy talking and swimming this summer!
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Tuesday, April 5, 2016

Facilitation Generalization: #5 Be Realistic!

One aspect of a speech language pathologist's job that is imperative to successful communication is facilitating generalization as many of our students/clients struggle with showing their classroom teachers or parents all the skills they have mastered for us in the therapy room.  This series of posts will focus on tips, that have worked for me, which can help you facilitate generalization of learned skills to new environments.

Step #5:  Be Realistic:

My final tip to facilitating generalization is to be realistic when you are asking staff or parents to use various techniques or cues to target speech and language goals.  Keep it simple.  Write down exactly what you want behavior you want them to encourage and be sure to have them focus on one task at a time.  It can be overwhelming for parents and nearly impossible for teachers to try to facilitate generalization for numerous skills but tackling one skill at a time is much easier and you have a great chance of parents or teachers having some time during their day to do so.

Provide visuals as needed.  For busy teachers or forgetful parents, try writing down the strategy or use a picture to visually remind them of the strategy they are using or the skill they are trying to facilitate.

Remember, if you are willing to help teachers with their goals, they will be willing to help you with yours.  So be a team player an ask them how you can help too!

Also remember to thank parents and staff members for their work in helping facilitate these skills to new environments.  A little acknowledgement can go a long way.

And that's it!  My five simple Steps to facilitating generalization.  If you've missed them you can begin here with Step #1.
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Tuesday, March 29, 2016

Facilitating Generalization: #4 Be Specific!

One aspect of a speech language pathologist's job that is imperative to successful communication is facilitating generalization as many of our students/clients struggle with showing their classroom teachers or parents all the skills they have mastered for us in the therapy room.  This series of posts will focus on tips, that have worked for me, which can help you facilitate generalization of learned skills to new environments.

Step #4: Be Specific:

Praise and accolades can be as good as empty promises if we do not express the exact behaviors or skills we are positively reinforcing.  Sometimes we may need to rely on teacher or parent report to support various behaviors.  We are part of a team to support this child as a whole.  It doesn't matter if we are reinforcing a speech or language skill or another important life skill, our students must learn.  It's just important that we make our students feel supported, proud of their own actions and able to attempt to continue exhibiting them.

Remember to be very specific when giving feedback during therapy or when providing positive reinforcement.  The following are all statements I have actually used for students in the past (to honor confidentiality, names used are fictitious).  Sometimes you will have some great speech and language skills to support and sometimes, you just need to take what you can get.  See the silver lining and make your students' see it too!

For the student who is working on social skills:
"Johnny, I really like how you looked toward me and answered my question before you introduced a new topic!"

For the classic articulation case:
"Susan, I love to hear that /k/ sound at the ends of your words!  I can really understand what you are saying.  Thank you for helping me understand you."

For the student who needs some help controlling his own behavior:
"Mark, I know how hard it is for you to stay in math class.  But today, you made it through the whole class with only one break to the water fountain.  Boy your brain must have been working overtime!  I love your desire to learn!"

Remember always be supportive and be specific!  What confidence and pride we can give our students with a few simple words!

Click here is you missed Step #1, Step #2, Step #3.  Next week, I'll share my 5th and final tip!
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Tuesday, March 22, 2016

Facilitating Generalization: #3 Using Positive Reinforcement!

One aspect of a speech language pathologist's job that is imperative to successful communication is facilitating generalization as many of our students/clients struggle with showing their classroom teachers or parents all the skills they have mastered for us in the therapy room.  This series of posts will focus on tips, that have worked for me, which can help you facilitate generalization of learned skills to new environments.

Step #3:  Use Positive Reinforcement: 

You know the saying "You catch more flies with honey".  So be sure to distribute your honey!

Once staff members were aware of their student's goals and progress, I would enlist them to help me out in providing some positive reinforcement.  Have you seen those "caught being good" tickets or other positive reinforcement measures?  The reason I like something external, such as this, is because it provides something concrete for the student to receive, see, feel, and have.  Also they can then share this with their parents, teachers, and friends their accomplishment and for some younger elementary students this is sometimes a reinforcement of it's own.

A word of caution:  Some students must first be motivated by positive reinforcement before you ever see change as they tend to doubt their own abilities to improve.  So be sure to give ALL of your students positive reinforcement (not at the same time) at various times regardless of their sole improvement on a specific speech or language goal or skill.  There are a number of things everyday each of our students do to make us proud, smile or laugh.  Be sure to capitalize on those moments, especially for the emotionally damaged child!  Children who know they are valued, will be more confident and will work harder.

So don't underestimate the power of positive reinforcement!

If you missed Step #1 or Step #2 click on these links.  Stay tuned for Step #4 next week.

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Tuesday, March 15, 2016

6 Home Hacks for the Busy SLP: A Link Up

Today I am linking up with Doyle Speech Works, to share with you some of my life hacks.  Well some of these are more survival tips when you have an 18 month old on the prowl for anything and everything he can get into.  And some of these are just organizational things I do to make my life easier. So, let's begin!

1.  Water Cooler Spout with Child-Lock:

If you are anything like my family, we drink TONS of water so we use a cold water cooler dispenser.  It became a problem with my then, 12 month old, was sticking his finger in the faucet and letting water spill all over the floor.  Goodbye water cooler?  Oh no!  My wonderful hubby found this awesome water cooler spout with a child-lock for a few bucks online!  Simply press the back button then push down and voila', water flows.  Luckily for me, my little guy has not figured out how to get this one to work...yet! ;)

2.  Upcycle a Vase:

I DETEST having to try and find my cooking utensils hidden away in drawers while I am cooking.  And I MUST have them to the left of my stove as I am left handed.  So this year, I decided to reuse this beautiful vase, I was given as a present, from my wonderful hubby to hold all the necessary utensils I use on a daily basis when cooking dinner.  No mess, no fuss, and it looks pretty too!

3.  Weekly Cleaning Schedule:

I have shared this before, but this is something that really helps streamline the housework for me.  I like to follow my weekly cleaning schedule so I only have to focus on one thing each day which is quick and easy.  Of course, a daily cleaning up of toys each night is a must or my house would look like a tornado hit it! Ha!

4.  Magnetic clip for Take-Out Menus:

I can't stand finding take-out menus everwhere and I do not want them taking up my precious kitchen drawers, so I use a magnetic clip to put them all together and hang them on the side of my refrigerator.  This way they don't clutter the front of my fridge and can free that space up for some amazing kid art! Proud mamas have to display the fridge art! Am I right?

5.  Monthly Meal Plan:

Ok I know what you are thinking.  What?  You plan out what you are eating for a month at a time?  The answer is YES!  I started this a few years ago, b/c I hate asking myself the daily question we all dread "What's for dinner?".  I would forget to pull out meat to defrost and would end up eating something unhealthy or nothing at all.  This way, I plan and use what I have in my house, saving time and money (and who doesn't want to save money?).  Therefore, I purchased this dry erase board and began planning.  I like to begin mid-month to mid-month, this way I can actually plan for 5 full weeks at once!  I keep a running list of dinners my family enjoys and intersperse new recipes to try a few times a month.  I also use pictures to remind me of what's going on certain days.  As you can see, a baseball is on Monday's b/c my son has baseball practice at right at dinner time each week.  I reserve Monday's for easy meals (sandwiches) and crock pot meals. Saturdays are baseball game days and Thursdays are MY FAVORITE DAY of the week, b/c it's LEFTOVERS night and this mama does not have to cook!  

You want to try and meal plan but think you can't do it for a month? No worries.  I have several friends who plan for two weeks and repeat those weeks to make a full month's worth of meals.  Might be worth a try! 

6.  Metal Ring for Hair Ties:

So somewhere along the way, this small metal ring was found in my house at some point.  I don't recall where it came from.  Maybe a child's toy, maybe it has some other function, but for me, I now use it as a way to hold all my hair ties.  I slide them one to metal ring and hang the ring on my hand towel rack next to my sink in the bathroom.  This way when the towel is on it, my hair ties are hidden behind it.  I'm never without a hair tie anymore b/c I keep them all in one place. Finally!

And that's it.  Those are 6 of my life hacks that I use on a daily basis to survive this very busy life of ours!

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Facilitating Generalization: #2 Share Goals AND Progress with Others!

One aspect of a speech language pathologist's job that is imperative to successful communication is facilitating generalization as many of our students/clients struggle with showing their classroom teachers or parents all the skills they have mastered for us in the therapy room.  This series of posts will focus on tips, that have worked for me, which can help you facilitate generalization of learned skills to new environments.

Step #2: Share goals and progress with others!

I know this tip also sounds obvious, yet I've been shocked over and over with the number of times I've participated in a transition meeting for an incoming preschooler whose SLPs, classroom teachers or special educators could not explain what the student was working on in speech.  I also am aware of the fact that many school districts require a snapshot IEP to be presented to classroom teachers at the beginning of the school year, but it has been my experience that the beginning of the school year is overwhelming for everyone and those snapshots go by the wayside often without a glance.  So a simple email or written reminder of the basic goals your student is working on with you will go a long way in helping the classroom teacher.

Remember your student's success is not placed solely on his/her shoulders but should be the shared responsibility of all staff and guardians involved.  So remember to share the students goals AND progress with classroom teachers, special educators, academic coaches, school social workers or psychologists and of course parents.  A simple email or paper reminder will do the trick.  When I worked in the schools, I would update teachers weekly on students progress mostly through quick classroom visits (a "drive by" so to speak) or emails.  However, there are times I needed to have something in writing for parents or other staff and a very basic update.  Some of the things I was sure to share were not just overall IEP goals but, if I needed to back track and create a short term goal to reach those IEP goals, I would be sure to share those and the techniques and methods that work best for this student. Very rarely did I have to ask a teacher or parent to follow through with using the techniques as just sharing them seemed to be enough of an invitation to support them using them.

Tip:  I also would ask teachers how I could help them reach their goals for students.  This is the best way I have found to collaborate (especially for older elementary and middle school students).  Once teachers knew I wanted to support them, they were also willing to support me!

That's Step #2 in a nutshell.  If you missed Step #1 click here.  Stay tuned for Step #3 next week.
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