Helping Middle Schoolers With Organization and Time Management

Students often find the transition from primary to secondary school a challenge. Especially those who experience issues with executive-function skills. Many of my students (and even their typically developing peers) particularly struggle with organization and time management. For example, kids spend most of their time in one classroom in elementary school, while from 6th to 12th grade, they move through classes with different teachers and subjects.

I spend a lot of time working with my kids to develop these skills for many reasons. I stress that if they think it’s hard now, it will only get trickier as academic demands increase. Below are just a few ways I work on organization and time management with my students:

1. Folders
Students should use separate folders for each class. Many students already do this, but my kids must work harder to keep them organized. They pile everything into one folder and can never find what they need. Spend a session going through your students’ folders and putting papers where they belong. We also discuss what’s important to keep versus what they should throw out.

2. Planners
I don’t think I could get through life without some kind of planner or organizer. Introduce students to how and why to use a planner. It’s a visual reminder of what they need to do each day and for planning steps for future tasks or assignments. Check if your school has free planners. Also, you can print out weekly planning pages for your kids and make them a planner. If your students are tech savvy, show them how to use a calendar app. Or check out the many downloadable planning apps to see which ones they might like to use.

3. Check-lists/Schedules
Similar to a planner, checklists and schedules provide students with a visual reference of tasks they need to accomplish.

  • Checklists are great to organize all the things needed to get done for the day or week. We feel accomplished when we cross things off. Help students generate a checklist of what they need to get done. It can include homework, projects, reading, chores, etc…. You can also show them how to break down projects into smaller chunks, so they’re not as overwhelmed with assignments. For example, if they have a five-paragraph essay due, they spend each weekday working on just one paragraph, versus facing the WHOLE thing in one day.
  • A student struggling with time management may find a daily schedule helpful. Drafting a schedule together will help you see what the student does or can do with his or her time each day. It’s also a good opportunity to help that particular student come up with a plan.

4. Backpacks
I don’t know if it’s just my kids, but their backpacks are a MESS! Sometimes I take a look inside and wonder how they find anything. I’ve spent entire sessions just organizing and cleaning out bags. The kids are amazed at the things they find—lost homework or projects due months ago, for example. As with folders, this is a good time to discuss what they need to carry with them and what they should leave at home.

I hope these ideas will help your students with executive-function challenges. I like to try different strategies and see what’s successful. If one thing doesn’t work, try something else!

Gabriella Schecter, MS, CCC-SLP, is a full-time SLP working in a grade 6-12 school. She posts regularly on Instagram (@middleschoolSLP), sharing ideas and activities for this age group. Check out her blog or email her at MiddleschoolSLP@gmail.com.

 

When Patients Won’t Practice

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You give 100 percent in each session, but end up repeating last week’s activities because your patient didn’t practice. Who’s at fault?

We all tend to get complacent with the materials and techniques we use. Thankfully, we also take CEU courses to keep ideas and implementations fresh. But what if you try everything in your bag of tricks and your patient still doesn’t improve?

I discussed this exact issue with two of my patients recently. Each one had a different situation, but both were making limited progress. “John,” for example, sought treatment with the hope that others would stop complaining about his voice quality. He says he stopped doing the diaphragmatic breathing exercises I assigned, because his voice wasn’t any better. I replied that it takes more than a week of doing only breathing exercises to make improvement. Breathing is just the first component of coordinating a new voice.

He and I talked about the real reason he was here. I discovered that although he felt his voice sounded disordered, it was really only affecting those around him. It really didn’t bother him that others thought his voice was annoying, so he decided not to continue sessions. Fair enough.

“Sara’s” case was different. She and I worked together for several weeks and ended up going through almost the same session each time. She reported practicing, but I didn’t see evidence of that in her productions. Frustrations arose and she felt like she was getting nowhere.

In our most recent session, we talked at length about life and the projected outcomes of her condition. Her voice issues affect her life, which upsets her. This emotional roadblock gets in the way of her dedicating time to practice outside the treatment room. She also feels guilt and blames herself for the issue, even though it’s not at all her fault. She realizes that these feelings are holding her back, so she’s taking time off from sessions and coming back when she’s ready to commit.

We should try to build up patients when they come to us feeling down on themselves. That might be tricky, however, because we also point out their mistakes in order to correct them. Sometimes sharing personal experiences as encouragement helps. It’s never a bad idea to refer clients to a therapist or counselor as supplemental treatment—it’s even in our code of ethics and scope of practice.

I do this occasionally when sessions frequently turn into “therapy.” If I think a patient would benefit from talking through issues with a trained professional, I always refer out. That way when the patient comes to our sessions, we focus on the voice disorder and I know the other issues are being addressed.

If your patient isn’t practicing, it’s time to find out why. Is it motivation? Is it you? Do your best to figure out what else the patient needs from you to be successful, and offer many options. Sometimes all you have to do is ask.

 

 

Kristie Knickerbocker, MS, CCC-SLP, is a speech-language pathologist and singing voice specialist in Fort Worth, Texas. She provides voice, swallowing and speech-language treatment in her private practice, a tempo Voice Center, LLC, and lectures on the singing voice to area choirs and students. She is an affiliate of ASHA Special Interest Group 3, Voice and Voice Disorders. Knickerbocker blogs on her website at www.atempovoicecenter.com. Follow her on Twitter @atempovoice or like her on Facebook at www.facebook.com/atempovoicecenter.

 

Collaboration Corner: Knowing the Big Picture and Little Details of Autism

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As Autism Awareness month wraps up, I thought I‘d share my learning moments from working 15-plus years with my students on the spectrum, their families and my dedicated co-workers who support them:

  • Autism is a spectrum. There’s not a cure or a fix, but there are evidence-based interventions and nuances for each child that will help him or her succeed. My job (and yours) is to recognize those little details and shine a light on them.
  • I’ve developed a super appreciation for things that spin, shake, light up and squish. I also appreciate when these features suddenly become appalling and over-stimulating.
  • Sometimes the best way to get a child’s attention is to speak just above a whisper or not talk at all. Less is more and often things don’t just sound loud, they feel loud to a person with autism.
  • Sand and water play are seriously awesome.
  • Regardless of where a child is on the spectrum, you can find an activity that feels like fun and learning at the same time.
  • Candy doesn’t always taste or feel good, but hot sauce tastes delicious on French fries.
  • Take the short and long view on augmentative and alternative communication. Work on the here and now to make your clients efficient communicators, then model your expectations to bring them to the next level. Make them life-long communicators.
  • Students and families will show you when they are ready—ready to try something new, ready to accept who they are. You just have to listen, be patient and push. But not too hard.
  • Finally, having co-workers who are cued in and can step in and help at a moment’s notice is invaluable and—when in action—nothing less than a work of art.

What lessons have you learned from working with clients on the spectrum?

 

Kerry Davis EdD, CCC-SLP, is a speech-language pathologist in the Boston area, working with children who have significant communication challenges. She conducts trainings and workshops, and serves as a volunteer clinician and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this blog are her own, and not those of her employer. kerrydav@gmail.com

 

 

 

 

Social Mediating: Using Telepractice for Clients With Autism

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I think most of us agree that technology changes our social interactions. The daily flurry of “tweets,” “likes” and “snaps” can make us feel more engaged with our world than ever. At the same time, we probably feel isolated sitting next to a person who has their face buried in a smartphone.

So what does a highly technological exchange like telepractice mean for individuals with autism spectrum disorder (ASD) who typically require social interaction guidance and have restricted behaviors?

The core characteristics of ASD include “deficits in social communication and social interaction and the presence of restricted, repetitive behaviors.” As a result, people with ASD struggle with a variety of behaviors like joint attention, verbal and nonverbal communication, restricted interests and routines, and high sensitivity to sensory input. That’s a wide range of things to cover in treatment.

In addition, speech-language pathologists use many different treatment methods with these clients. The National Professional Development Center identified 27 evidence-based interventions for ASD. Some of these approaches require physical assistance. Others focus on a client’s environment. Treatment might also target subtle skills such as interpreting a partner’s eye gaze and tone of voice.

The remote nature of telepractice versus the “hands-on” nature of some tools means that SLPs must evaluate each client’s needs, treatments already in use, and ways to modify treatments for telepractice, and look at options better suited for telepractice. Be aware and ready for potential obstacles—how to address eye contact when you’re using a webcam, for instance, or if the equipment accurately conveys subtle changes in body language and tone of voice—ahead of time.

However, there are also advantages.  Telepractice interaction may be less overwhelming to a client with ASD, for example, or using technology may hold his interest more so than an in-person session.


April is Autism Awareness Month and our entire April issue focuses on related issues.


Obviously, autism and its treatments require flexibility. Fortunately, telepractice offers just that. Researchers at the University of Pittsburgh outlined various technologies and clinical applications for telerehabilitation. These include more-direct “teletherapy,” to less-direct “teleconsultation,” “telecoaching,” and “teleplay.”

You can use some techniques—like social narratives, technology-aided instruction and video modeling—through telepractice without many extra steps. Interventions including peer-mediated instruction, parent-implemented intervention and pivotal response training already require indirect approaches, so modifying them for telelpractice won’t take much more effort than applying them for a specific client in face-to-face sessions.

Emerging research in telepractice treatment for ASD clients already shows success in both direct and indirect interactions. One case study gives positive results for two clients with ASD. One subject received services through “active consult,” in which a student clinician was coached  and monitored by a remote supervising clinician using Bluetooth technology. The other client received telepractice services and responded more favorably to those than he did to onsite intervention.

Another study compared traditional onsite intervention to a hybrid model of direct onsite and indirect telecoaching services. They found that gains made through traditional therapy could be maintained as well or better in a model that also incorporated telepractice.

We still have a lot to learn about how to use telepractice to serve clients with ASD. However, developing evidence reinforces something we know from other settings: We are most successful when we analyze and individualize our services to fit a specific client.

 

Nate Cornish, MS, CCC-SLP, is a bilingual (English/Spanish) clinician and clinical director for VocoVision and Bilingual Therapies.  He is the professional development manager for ASHA Special Interest Group 18, Telepractice; a member of ASHA’s Multicultural Issues Board; and a past president and vice president of ASHA’s Hispanic Caucus. Cornish provides clinical support to monolingual and bilingual telepractitioners around the country. He also organizes and presents at various continuing education events, including an annual symposium on bilingualism.  

nate.cornish@vocovision.com.

Interprofessional Pre-screening Shortens the Wait for Autism Diagnoses

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Editor’s Note: In recognition of Autism Awareness Month, we have several posts addressing autism-related issues throughout April. The screening program described here is one of several ASD initiatives at Wichita State University; another that eases children’s visits to the dentist is explored in this month’s April ASHA Leader issue.

 

Recently, I became passionate about expediting identification and diagnosis for young children who show signs and symptoms of autism spectrum disorder (ASD). This desire was fueled by a research project I conducted with Douglas F. Parham and Jagadeesh Rajagopalan; the results revealed that pediatricians and family physicians have not been screening young children for ASD as recommended by the American Academy of Pediatrics (regularly conducting ASD-specific screenings for children two times prior to their second birthday) in Kansas, Iowa and Oklahoma.

Based on these results, I determined that one way I could help advance the identification of these young children would be to develop an authentic interprofessional education opportunity for students in the allied-health and education programs at my university: Wichita State University in Kansas. In the spring of 2012, WSU students, faculty and community professionals agreed to form the Wichita State University-Community Partners: Autism Interdisciplinary Diagnostic Team (AIDT).

The team aims to:

  1. Educate undergraduate and graduate students to better recognize the characteristics of ASD and to be able to participate in screening, assessment and referral of children who demonstrate early signs.
  2. Provide a highly needed service to children and families throughout south-central Kansas.

Since the initiation of this team, faculty, clinical educators and students from eight departments—communication sciences and disorders (audiology and speech-language pathology), early childhood unified special education, clinical psychology, physical therapy, dental hygiene, physician assistant, nursing and public health—have participated. Additionally, the University of Kansas School of Medicine–Wichita (represented by a developmental pediatrician and an advanced practice registered nurse) has been a valued partner and referral source.

Faculty and clinical educators recruit and select students to participate in our screening program. Student participants must enroll in a field-based experience and/or an appropriate class within their respective programs. All stakeholders then do a one-day training prior to the start of each semester on identifying the characteristics of ASD, to screen, to participate in the assessment process and to identify appropriate referrals for children and families. The educators agree to participate in at least four diagnostic sessions each semester, ensuring that students from various professions have multiple opportunities to work together, while observing interprofessional collaboration among university and community professionals.

The partnering developmental pediatrician and the advanced practice registered nurse refer children and families to the screening program based on the “red flag” characteristics parents report on the pediatrician’s developmental history form. The program’s coordinator (that’s me) contacts the family via phone to gather additional developmental information, and then the team meets to discuss that information and other relevant documents.

The team conducts the evaluation over two days. The first day, we assess the child’s communication, play and cognitive abilities, using selected tools and strategies based on the child’s strengths and needs. The second day, we administer the Autism Diagnostic Observation Schedule-2 and the Childhood Autism Rating Scale-Second Edition, Standard Version, to provide the developmental pediatrician with diagnosis-relevant information. We also conduct hearing, motor and oral health screenings. The team then meets to discuss the aggregated assessment results, which, in addition to appropriate recommendations and resources, are shared with the family.

We schedule an appointment for the child and family with the developmental pediatrician approximately one week following our assessment. Someone from our team accompanies the family to the appointment to act as a liaison and assist with the examination.

Since the introduction of the AIDT, 133 students, clinical educators, faculty and community professionals across 10 disciplines have come together via this individualized education program field-based experience. Our students and professionals have assessed 24 young children who present with characteristics of ASD, and approximately 85 percent of these children have received a confirming medical diagnosis.

Participants and families alike gain from this experience. Students learn from, with and among others who are committed to interprofessional practice. Families voice their appreciation for receiving diagnostic information from multiple disciplines all at once, so they don’t have to run from place to place to receive it.

Mostly, they value how quickly the AIDT’s work enables them to get their child needed help.

 

Trisha Self, PhD, CCC-SLP, is an associate professor in the Department of Communication Sciences and Disorders at Wichita State University and coordinator of the school’s Community Partners: Autism Interdisciplinary Diagnostic Team. She is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education; and 10, Issues in Higher Education.
Trisha.Self@wichita.edu