Getting Mad at the Zoo

Zoo Miami July 2, 2011

Photo by osseous

In our graduate level communication studies language class we studied narratives and how we use these in everyday conversations. We often narrate when we don’t realize we are doing so. One way to think of it is storytelling and some of us have better skills than others. It depends really on the ‘language’ we use — words that describe, words that put us in a different time, place, experience. Here is an example that will put a smile on your face:

The link was posted by one of my friends on facebook. I decided to use this link as a post this week, allowing me to practice the structures of a narrative. It is of a child who narrates his day at the zoo. His use of language — description, sequence, feelings — allow us to empathize with him in his angry situation. Better than me and than most adults, this child, despite his very young age, also managed to create narrative that is complex, using all of the following structures of a narrative:

1. Abstract: Summary of story

Example: He basically tells us his trip didn’t go well

2. Orientation: Time, place, persons, activity, situation

Example: It’s his daily trip to the zoo with friends but they only saw the gentle

animals

3. Complicating action: Found in Temporally sequenced clauses

Example: See what he says about Harmony (and what dad writes…)

4. Evaluation: The point of the narrative

Example: He really wanted it to be a terrific day. He wanted to see the otters.

5. Result or resolution: Termination of temporarily sequenced clauses

Example: Dad offers a revisit another day to which he agrees.

6. Coda: Found at the end of the narrative

Example: His final comment “I don’t like it. Let’s go.”

Perhaps we can learn something from this child and his parent’s prompts for information. These prompts shaped the perfect narrative, and allowed for a two-way communication between adult and child that honors affect from start to finish. Not only is this the type of parent I want to develop into — but it’s the type of therapist I hope to be one day.

 

Liz Guerrini has been a K-12 and college teacher for the past 18 years and is entering her final graduate year in Communicative Disorders at CSUN. She’s an Olympian who finds many applications of her sport world to the teaching and therapy worlds. She home-schools her bright and beautiful son who lives with trisomy 2, severe dysarthria, severe CAS, hearing loss, ASD and hypotonia. She is a member of ASHA’s Minority Student Leadership Program. Liz blogs at  Christopher DaysSLP to-Be and the Signing Time Academy.

 

Apps and EBP

Stream of Apps

Photo by Phil Aaronson

When I review apps, my years of experience play a significant role in my assessments of their usefulness. I rarely base my reviews on research to determine if the app is evidence based.  This is because research is time-consuming and the reviews of apps already takes a considerable amount of my time. However, I do check suspicious claims. A claim will strike me as suspicious if I suspect that the citation of research has been done to sell the app. Those of you who have read my earlier posts know that I have shown where a claim of an app being based on research is not supported by the research cited.

In this month’s ASHA Leader, Lara Wakefield and Teresa Shaber, in their article, “APP-titude: Use the Evidence to Choose a Treatment App,” noted, “App developers’ descriptions and customers’ reviews, however, may lack discussions of evidence and contain inherent biases. SLPs who use only this information may be relying solely on opinions and advertisements to make decisions.”  Wakefield and Shaber then discuss a five step process for determining if an app is evidence based. These steps are:

Step 1: Frame your clinical question using PICO (Population, Intervention, Comparison, and Outcome).
Step 2: Find the evidence.
Step 3: Assess the evidence.
Step 4: Search the app store and consult the evidence.
Step 5: Make a clinical decision and integrate the different types of evidence to determine your choices.

It is quite easy to do the research. Some app developers cite research in their app descriptions. Follow their lead and make sure the research does support the developers’ claims. ASHA has a database of thousands of articles. Do a search using a few key words and a screen will appear with various articles to peruse.

If one wants to be certain that a particular app meets evidence based standards, one needs to go that extra mile.

 

(This post originally appeared on Apps for Speech Therapy)

 

Mirla Raz, CCC-SLP, is a speech pathologist in private practice (Communication Skills Center) and the author of the Help Me Talk Book: How to Teach a Child to Say the “R” Sound in 15 Easy Lessons, How to Teach a Child to Say the “S” Sound in 15 Easy Lessons, and How to Teach a Child to Say the “L” Sound in 15 Easy Lessons (also available in Kindle). Her latest endeavor is her blog Apps for Speech Therapy.

Finding Strength in Vulnerability

Teacup!

Photo by pheezy

Perfectionism has a strong allure. At one time I thought it was an admirable vice, demonstrating a drive for excellence, but in the past decade I’ve realized that perfectionism is much less about Olympic-like performance and much more about guarding your vulnerabilities.

Like many women, once I had children, I had a good hard lesson in our inability to exert control over our lives. Oh, sure you can pack hand sanitizer in your purse, stick an umbrella in the car, keep chicken tenders in the freezer, but you’ll always miss something. Maybe you’ll send your son in to school with shaggy hair and an old tshirt on picture day, or suddenly realize that not only was your child due at a birthday party 30 min ago, but you don’t even have a gift.  So, now I’m a recovering perfectionist, looking to treat myself with the same compassion I would a friend and practicing taking bumps in the road in stride.

One of my summer reads was The Gifts of Imperfection by Berne Brown. Truth be told, it was on last summer’s reading list.  See how I’m making progress?  Brown spent years researching shame before turning to her own journey of wholehearted living and I liked her idea that imperfections are not inadequacies but “reminders that we are all in this together.”  Their gifts are courage, compassion and connection.

This particularly resonated with me in light of the welcome session at ASHA Schools 2012.  Jennifer Abrams presented “Hard Conversations” the practice of which does require a dose of courage. She doesn’t advocate confrontation for the sake of confrontation, but does encourage us to speak our minds, advocate for what needs to be accomplished, risk being outspoken and opinionated.

I think this is a particularly tough role for a school therapist. Frequently we feel a bit outside the usual school hierarchy, not quite as entrenched or comfortable as we would want to be, especially if we were going to make waves. Yet, sometimes this outsider status might give us a better perspective on changes that need to be made, or to advocate for students or families that aren’t getting the services they deserve.

Other times, this might mean advocating for ourselves, whether that means defining our role or (as recent #slpeeps conversations and other blogs have covered) asserting our “speech-language pathologist” title. It’s less important to be well liked and a perfect employee than it is to live up to the values that brought you to the profession in the first place.

At my house we have exceedingly hard glazed dinnerware that I specifically chose for its durability. A few years ago, one of the mugs was thwacked solidly against granite and suffered a chip on its lip. I moved it to the back of the cabinet and it was almost never used. Last winter, I purposely pulled it out as my afternoon tea mug and I use it most days. It’s a good reminder to me that even with a vulnerability the main purpose is still maintained. And as far as a gift of imperfection?  I can always tell which tea is mine.

Care to share? Let us know if you struggle with perfectionism or enjoy a more carefree attitude.

 

(This post originally appeared on Activity Tailor.)

 

Kim Lewis M.Ed, CCC-SLP has a private practice for pediatrics in Greensboro, NC. She is the blogger at www.activitytailor.com, providing creative ideas for speech therapy, and the author of the Artic Attack workbook series.

Tips for Parents Raising Bilingual Children: When the Home Language Differs From the Community Language

quantos mundos cabem num potinho de areia?

Photo by agreste3000

Be Intentional

  • Realize that everyday activities such as mealtimes, getting dressed, bath time, and playtime are all opportunities for talking, teaching, and providing quality language exposure. Be intentional about ongoing verbal interactions about things, routines and events in your child’s life.
  • Arrange for varied opportunities for your child to have diverse contexts for engaging in the minority language such as book sharing and reading experiences, singing, educational videos, children’s shows, play groups, family visits and trips. It is important for your child to have access to other speakers of the minority language as much as possible.
  • When your child uses incorrect words or grammar, simply model the correct vocabulary and/or sentence structure in response to the child’s utterance.
  • When appropriate, expand your child’s utterances by first affirming what he/she said and then by adding to what was said if the vocabulary or grammar usage was lacking.
  • Even if your child is tending to speak more in the majority language, continue speaking to him/her in the minority language. When appropriate, recast the utterance, or present it in a different or changed structure while maintaining its meaning. For example, if your child utters a phrase or sentence partly or entirely in the majority language, recast the utterance in the minority language, modeling correct usage where any vocabulary or grammatical gaps were noted.
  • Instill in your child a sense of pride and “need” for the minority language by keeping it relevant and constant in his/her everyday life. Children will inevitably discard a language they do not feel they need.
  • Consider teaching your child to read and write in the minority language. The more competencies your child develops in the minority language, the more internally relevant and important that language will become.

Be Consistent

  • If you are the primary source of language input for your child in the minority language, consistently speak to your child in that language whether at home or out in the community.
  • Though code mixing, or alternating between two languages while speaking, is completely normal and appropriate for bilinguals, in order to clearly draw a line between the two languages in your child’s linguistic environment, limit code mixing as much as possible at least at the beginning stages.

Be Persistent

  • Don’t lose heart or give up even if your child’s language proficiency or skills seem to fluctuate over time in his/her two languages. Some fluctuation is normal as children learn to navigate between both languages.
  • Don’t allow for interruptions or long periods of little or no exposure to the minority language. • When it seems hard and laborious, remember the long-term benefits and rewards you are bestowing upon your child by raising him/her to be bilingual.
  • Relatives, friends, and community members may misunderstand or even disagree with your decision to raise your child bilingually for various reasons. If you can, kindly educate them about your decision, but if not, politely stand your ground based on what’s best for your child. Your dedication, consistency and persistence will pay off in the end!

“The bilingualism of children should be a source of joy, both for parents and children, even if there are occasional moments of difficulties.” François Grosjean

(This post originally appeared on The Speech Stop)

 

Ana Paula G. Mumy, MS, CCC-SLP,  is a trilingual speech-language pathologist and the author of various continuing education eCourses, leveled storybooks, and instructional therapy materials for speech/language intervention, as well as the co-author of her latest eSongbook which features songs for speech, language and hearing goals.  She has provided school-based and pediatric home health care services for nearly 12 years and thoroughly enjoys providing resources for SLPs, educators and parents on her website The Speech Stop.

Adventures in Word Finding or is Their Language Comprehension Really THAT Bad?

One Word IV

Photo by LauraLewis23

This summer I am taking an online course on word finding with Dr. Diane German, and I must say, in addition to all the valuable information I have learned so far, this course has given me a brand new outlook on how to judge the language comprehension abilities of my clients with word finding difficulties.  It all started with a simple task, to determine the language comprehension abilities of my client with word finding deficits.  Based on available evidence I’ve collected over the period of time I’ve been working with him, I had determined that his comprehension was moderately impaired. I was then asked by Dr. German what language tasks I had used to make that determination.  She also pointed out that many of the formal language comprehension tasks I’ve listed in my report required an oral response.

That question really got me thinking. The truth of the matter is that many formal tests and informal assessments that probe language comprehension abilities rely on learners oral responses. But as it had been pointed out to me, what of our clients with impaired oral skills or significant word retrieval deficits? Most of the time we judge their language comprehension based on the quality of the oral responses they produce, and if their answers are not to our satisfaction, we make sweeping judgments regarding their comprehension abilities, which as Dr. German rightfully pointed out “is the kiss of death” for learners with word finding difficulties and could potentially result in “a spiral of failure”.

Now, in the case of this particular client in question, his language comprehension abilities were truly moderately impaired. I knew that because I tested him by showing him pictures of situations and asked him questions, which did not rely on oral responses but on him selecting the correct answer from a series of pictures and written sentences.

However, had I not performed the above tasks and simply relied on the “language comprehension” subtests from popular standardized tests alone, I would not have had a defensible answer and would have had to admit that I had no clue whether his language comprehension was truly as impaired as I had described.

Following that discussion I decided to take a “fresh look” at the other expressively impaired clients on my caseload but first I needed to figure out which tasks truly assessed my clients’ language comprehension abilities. I didn’t just want to assess their listening skills and vocabulary knowledge (some of the more “easily” assessed non-verbal skills). I wanted to know whether their memory, problem solving skills, figurative language, perspective taking abilities or knowledge of multiple meaning words were actually better than I had originally judged.

Thus, I set out to compile language comprehension materials (formal or informal), which could be used to assess various aspects of language comprehension (multiple meaning words, problem solving abilities, etc) without relying on the child’s ability to produce verbal responses.  However, this task turned out to be far more difficult than I had originally anticipated. For example, when I took a closer look at one of the more popular standardized tests available to me, such as the CELF-4, I realized that there were only two subtests on the first record form 5-8 years (“Concepts and Following Directions” and “Sentence Structure”) and 3 subtests on the second form 9-21 years (“Concepts & Following Directions”, “Sentence Assembly”, and “Semantic Relationships”) that relied on the listener’s ability to point to pictures or use written visuals to answer questions. Moreover, two of the subtests on the second record form (Sentence Assembly”, and “Semantic Relationships”) still required verbal responses.  All other subtests testing “listening comprehension abilities” relied purely on oral responses for correct score determination.

As I reviewed other popular tests (TOLD, CASL, OWLS, etc) I quickly realized that few of these tests’ subtests actually satisfied the above requirement.  Moreover, tests that actually did considerably rely on nonverbal responses (e.g., pointing) such as the Test for Auditory Comprehension of Language-3 (TACL-3) or the Test of Language Competence- Expanded Ed (TLC-Expanded Ed), were unfortunately not accessible to me at my place of work (although I did manage briefly to borrow both tests to assess some clients).

So, I decided to adapt some of the existing tests as well as create a few of my own materials to target language comprehension abilities in various areas.  Surprisingly, it wasn’t as difficult as I imagined it to be, though some tasks did require more creativity than others.

The easiest of course were the assessment of receptive vocabulary for nouns, verbs, and adjectives which was accomplished via standardized testing and story comprehension for which I created picture answers for the younger children and written multiple choice responses for the older children. Assessment of synonyms and antonyms was also doable. I again printed out the relevant pictures and then presented them students.  For example, to assess synonym knowledge the student was shown a relevant picture and asked to match it with another similar meaning word:  “show me another word for “trail” (requires the student to point to a picture depicting “path”) or “show me another word for “flame” (requires the student to point to a picture depicting “fire”). For recognition of antonyms, the student was presented with pictures of both synonyms and antonyms and told: “show me the opposite of child” or “show me the opposite of happy” and so on.

To assess the student’s understanding of “Multiple Meanings” I borrowed the sentences from the Language Processing Test-3 Elementary (LPT-3E), and printed out a few pictures from the internet. So instead of asking the student to explain what “Rose” means in the following sentences:  “Ask Rose to call me”, or “The sun rose over the mountains”, I asked the student to select and point to a corresponding picture from a group of visually related multiple meaning items.  For some children, I also increased the complexity by presenting to them pictures which required attention to details in order to answer the question correctly (e.g., differentiating between boy and girl for the first picture or between actual sunrise and sun peeking through the clouds for the second picture).   Similarly, to assess their problem solving abilities I again printed out pictures to go with select verbal reasoning questions: “Point to what you would do if …”; “Point to how you would solve the following situation…?”

I do have to admit that one of the more challenging subtests to adapt was the “Recalling Sentences” task.  For that I ended up creating similar sounding sentences and asked the child to select the appropriate response given visual multiple choice answers (e.g., point to which sentence did I just say? “The tractor was followed by the bus?” “The bus was followed by the tractor?” “The tractor was followed by the bicycle.”

Again, the point of this exercise was not to prove that the learners’ comprehension skills were indeed impaired but rather to assess whether their comprehension was as significantly impaired as was originally judged. Well the truth of the matter was that most of the children I’ve reassessed using the “pure” auditory comprehension tasks ended up doing much better on these tasks than on those which required verbal responses.

To illustrate, here is a recent case example. I was working with one student on strengthening his knowledge of geography related core vocabulary words (names of the continents and the major bodies of water surrounding them).  This boy had profound difficulty recalling the words even with maximal phonemic cues, after multiple sessions of drill instruction.   Typically after he was shown a specific continent and asked to name it he produced a semantically related response (“South America” for “North America”, “Arctic” for “Antarctica”, etc), which appeared to indicate that his “knowledge” of the words was impaired or at least highly inconsistent.  However, when the verbal naming task was completely eliminated and he was asked to show the examiner specifically named continents and bodies of water on a map (e.g., “Show me Europe”; “Show me Atlantic Ocean”, etc) he was able to do so with 90% accuracy over 3 trials indicating that he did have fairly solid knowledge of where each continent was located visually on a map.

Consequently, as Dr. German has rightly pointed out, when making judgment calls regarding language comprehension abilities of complex clients with severe or at least fairly involved expressive language difficulties, it is very important that SLP’s use tasks that require non verbal responses to questions (e.g., pointing, selecting a picture out of a group, etc), in order not to underestimate these children’s “true” comprehension abilities.

 

References and Resources:

German, D. J. (2009, Feb. 10). Child Word Finding: Student Voices Enlighten Us. The ASHA Leader, 14 (2), 10-13.

German, D.J. (2005) Word-Finding Intervention Program, Second Edition (WFIP-2)  Austin Texas: Pro.Ed

German, D.J. (2001) It’s on the Tip of My Tongue, Word Finding Strategies to Remember Names and Words You Often Forget.  Word Finding Materials, Inc.

Dr. German’s Word Finding Website: http://www.wordfinding.com/

 

This post originally appeared on www.smartspeechtherapy.com/blog/)

 

Tatyana Elleseff MA CCC-SLP, is a bilingual speech language pathologist with a full-time hospital affiliation (UMDNJ) and a private practice (Smart Speech Therapy LLC) in Central, NJ. She received her MA from NYU and her Bilingual Extension Certification from Columbia University. She specializes in working with bilingual, multicultural, internationally and domestically adopted at risk children with complex medical, developmental, neurogenic, psychogenic, and acquired communication disorders.

 

iPad Essentials: Sharing your iPad screen as a Visual/Interactive Context with a Group

I wanted to address a very frequently asked question about connecting iPad to LCD projectors, interactive whiteboards such as a Smartboard, TVs, and laptops. SLPs and special educators may be interested in displaying an iPad to a group in order to present info visually, or allow the group to experience an app; the iPad is an amazing teaching tool!

This is such a divergent process (you can do it so many ways!) that I thought it would be best to make a video.  This video goes through 6 different ways to share your iPad on a bigger screen, and they are all a lot easier than you think.  Because we are talking about 6 different ways, the vid is a tad long.  Feel free to skip to what you want to see and ignore my babbling.  Also, keep in mind I am not a videographer or producer, so I did the best I could shooting and editing this (with iMovie) on my iPad, and I don’t know why I didn’t get rid of the pen behind my ear, haha.  You may want to watch the video on a computer rather than iPad or mobile device, as I added annotations via YouTube that are only visible on the full web.

Note: Since I made this video, I learned about AirServer- an app for PC that reportedly serves the same purpose as Reflection for Mac, i.e. it allows you to mirror or show your iPad on your PC screen.

Here are some supporting links that are also in the annotations:
Apple iPad to VGA Converter
MacReach Episode on using Apple TV in Educational Settings
How to Activate AirPlay on iPad to stream to Apple TV connected to HDTV or LCD Projector
Adapter Required to connect Apple TV to LCD Projector
A Helpful Video on iPad and Apple TV in the Classroom (with SmartBoard)
Reflection App used to Mirror iPad on Mac Screen

Overall, this was fun to make and taught me about video editing on iPad and YouTube annotations…always good to have a context to learn!

(This post originally appeared on SpeechTechie)

 

Sean J. Sweeney, M.S., M.Ed., CCC-SLP, an SLP, instructional technology specialist and consultant, works in private practice at The Ely Center in Newton, Massachusetts. He is the author of the blog SpeechTechie, a contributor to the ASHA Leader, and recently took on a role as Product Development Manager for Smarty Ears Apps.