Collaboration Corner: Time to Reflect and Give Thanks

 

 

blog may 16“Though our experience of knowing is individual, knowledge is not.”

(Wenger, E., McDermott, R., & Snyder, W. [2002]. Cultivating communities of practice. Boston, MA: Harvard Business School Press. p. 10)

This time of year is frenzied; closing up the school year, planning for next year. I have students moving up to middle school, and little ones coming up from preschool. When my brain and emotions start to wonder, I make a conscience effort to slow down. Stop. Reflect.

I thought this would be the perfect venue to pay thanks to the professionals whose collaborative efforts made my days a little lighter this year.

So here it goes (in no particular order):

Thanks to my colleagues, the inclusion facilitators,and  special educators who made sure communication goals were an integral part of each student’s IEP, and owned by all staff. Thanks for making me feel a part of your teams, even if I was traveling between buildings.

Thanks to my colleagues, the general education teachers who shared materials gave me curriculum to reinforce key concepts, and implemented language-based strategies that helped not just one child, but an entire classroom with narrative language development. There are many more examples that I could give, but suffice it to say, the art of teaching is alive and well.

Thanks to my BCBA colleagues, who understood how our disciplines can (and should) overlap in all areas of behavior, communication, academics, and even eating.

Thanks to my colleague, an English Language Learner teacher. She helped me support a language-impaired child who moved in late in the year and didn’t speak a word of English. We tag-teamed and figured out the difference between fundamental language skill deficits (word retrieval, vocabulary), and the typical obstacles expected for acquiring English. She outlined a plan and approach sensitive to the family unit and culture, which was invaluable in my decisions around goal-writing and intervention.

Thanks to my colleagues, the paraprofessionals, who sat in on all of their students’ speech and language sessions, translated my words into Spanish,  asked questions, made visuals and PECS books, programmed devices, and worked hard to make sure generalization could happen.

Thanks to my colleagues, the social workers and psychologists, who helped me understand keenly the role of emotional stability, learning readiness, and effects upon communication.

Thanks to my colleagues, the teachers for the visually impaired, who helped me set up a communication book made completely of tactile symbols, and engaged in healthy dialogue on cognition, cortical vision impairment and communication.

Thanks to my OT and PT friends, kindred spirits of the related services world who understand the value of co-treatments and interdisciplinary input for kids with complex medical and physical needs.

Thanks to my SLP colleagues who helped me keep a sense of humor in a way that only another SLP working in a public school can understand.

Finally, thanks to the administrators who continue to believe in inclusion, and supported my time this year in each of their buildings. Leadership doesn’t happen in a bubble, and has transformative affects upon the school culture and inclusion.

So thanks. Happy spring…..fewer than 40 days to go!

 

 

Kerry Davis, Ed.D, CCC-SLP, is a city-wide speech-language pathologist west of Boston. Her areas of interest include working with children with multiple disabilities, inclusion in education and professional development. The views on this blog are my own and do not represent those of my employer. Dr. Davis can be followed on Twitter at @DrKDavisslp.

Collaboration Corner: Finding the Common Core of Social Skills

shutterstock_96126980

 

A few months ago, I wrote a blog about making speech and language goals integrated throughout the IEP. One person commented, “We need to work smarter, not harder.” I completely agree. Our caseloads will continue to increase, and our students will become more and more complex.

Now we have this Common Core thing to worry about, right? Forty-five states have adopted the Common Core Standards related to math, language, science and social studies, all focused on developing a well-rounded student ready to take on the challenges of college and career.  So with that in mind, I took to trip to the website.

I was checking out the speaking and listening, section under English Language Arts, when what to my wandering eyes did appear? First grade standards:

  • CCSS.ELA-Literacy.SL.1.1 Participate in collaborative conversations with diverse partners about grade 1 topics and texts with peers and adults in small and larger groups.
  • CCSS.ELA-Literacy.SL.1.1a Follow agreed-upon rules for discussions (e.g., listening to others with care, speaking one at a time about the topics and texts under discussion).
  • CCSS.ELA-Literacy.SL.1.1b Build on others’ talk in conversations by responding to the comments of others through multiple exchanges.
  • CCSS.ELA-Literacy.SL.1.1c Ask questions to clear up any confusion about the topics and texts under discussion.

(Core standards, 2012)

Why doesn’t that look just like … wait a minute, something familiar … social pragmatics! In my district our schools are busting at the seams with kids needing social pragmatics skills. We even have city-wide social thinking educators that run groups all focused on social skill development.

Here is how we are going to work smarter—by haring our expertise with others. It is fantastic that the need for social skill development has hit the national education scene, this gives some street cred to our social skills groups and lunch bunches. Now we need to bring it to the next level: get it out of the speech office, and back into the classroom.

Some things to consider:

1) Make your consult time be staff development time: Train your teachers, paraprofessionals, whoever will listen to use social skill strategies you are using with students.

2) Set a reasonable goal for adoption: Maybe it’s visuals for the first grade classroom one year, or key words and phrases for whole class lessons and expectations using the social thinking curriculum by Michelle Garcia-Winner.

3) Use the Common Core to guide IEP objectives: Look at the standards, and then simply make them achievable and measurable, and hold everyone accountable for following them.

4) Market your tools as “good teaching” rather than “special education” tools: A total pet-peeve of mine … there are no “special education” tools to learning—there are just tools.

5) Run a couple of whole group lessons, model for the teachers, and gauge what is doable.

Your presence in the target classroom reminds teachers to use you as their point person, their resource. They won’t know you’re there unless you make yourself present, and that’s when the good stuff, the collaborating, starts.

 

Kerry Davis, Ed.D, CCC-SLP, is a city-wide speech-language pathologist west of Boston. Her areas of interest include working with children with multiple disabilities, inclusion in education and professional development. The views on this blog are my own and do not represent those of my employer. Davis can be followed on Twitter at @DrKDavisslp.

Put ABA to Work: Tie Behavior to Language Goals for Kids on the Spectrum

Photo of marshmallows

(photo credit)

When I was in graduate school in the mid-90s, a family hired me to take care of their two-year old son, Jayden. He did not imitate or make any sounds. Jayden was an adorable toddler with autism who preferred to stare at the patterns on his kitchen floor or the spinning fan in his living room. His loving family flew halfway across the country several times a month to learn about the Lovaas method of applied behavioral analysis (ABA).

To get their son to speak, they flew in ABA-trained specialists, who wrote a binder of lesson plans and left them for graduate students like me to carry out. There were four fairly clueless graduate students who implemented the lessons in four-hour shifts. From our combined efforts, their little boy received eight hours of ABA services a day—every day—focused on communication and play.

Our lessons would go something like this: First, I would show Jayden a picture of an ordinary item, such as an apple. Then I would say, “Apple.” If the toddler made an approximated sound, I gave him a mini-marshmallow. We repeated this exercise in succession dozens of times. My novice grad-school self would wonder, “Does this kid understand the experience of an apple? Or does he now think an apple is a marshmallow?”

Twenty years later, I am a school-based practitioner. Eighty percent of my kids are children with autism, a majority with severe communication challenges. I work closely with several board-certified behavioral analysts, and many behaviorally trained paraprofessionals. I’ve developed an understanding of ABA principles, and the realization that reinforcement compels behaviors to continue or change. We all abide by these principles: You go to work, you get money and derive some job satisfaction. Because your duties are reinforcing (some days more than others), you continue to come into work. It is the same with language and ABA: I show you something is worth requesting, and you start to learn to ask for it by whatever means—pictures, signs, gestures—you need to.

Holistic learning

As practitioners, we must re-examine skill mastery. Mastery is beyond 4/5 opportunities in my speech session, or 8/10 trials with a paraprofessional in a cubicle. Skill mastery demands holistic consideration. We learn through schemas—that is, our experiences shape our understanding of the world. If we have no prior knowledge, then our ability to retain that information is reduced dramatically. If I talk about my vacation to the beach, we all produce a somewhat similar multi-sensory image in our head: There’s an ocean or a lake, sand and the various sounds and smells of a beach. Now imagine if you have never been to the beach (or heard of one) and someone shows you a picture. Then they hand you a marshmallow … do you think marshmallow is another word for beach? Have you really learned about a beach?

On occasion, I will inherit an individualized education program chock-full of language objectives written by someone other than an SLP. However, some of the most effective IEPs I have seen have been created through the coordinated efforts of SLPs collaborating with board-certified behavioral analysts.

Here are some good ways to keep meaningful language consideration alive and well when thinking about IEPs, communication, language and ABA principles:

Tease out language versus behavior.

Although language may provide a function, it does not always reduce behavior. This is why it is important for the team to use tools like preference assessments and functional behavior analyses. Little Susie may be pulling your hair because she wants your attention, or perhaps she is pulling your hair because she doesn’t want to wait. In the first example, the SLP could teach the language (e.g., “I want to talk to you.”). But in the second example, teaching the language “I don’t want to wait” may not be sufficient, because the child may act out anyway (picture a two-year-old being told to wait). In this case, a behavioral intervention with something other than words may be more appropriate.

Examine the language-behavior plan connection.

Behavioral support plans are a great way for the team to address behavior in a consistent way. Many behavior plans that come my way are language-laden. This is a great opportunity to work with board-certified behavioral analysts and other team members in refining what language to use with the child at his or her developmental level, while also refining functional communication.

Combine ABA with language and academic goals.

For my students whose IEPs include ABA, one great way to work on generalization through immersion is having the paraprofessional run programs that address “speech and language” goals. For many of my students who have a board-certified behavioral analyst, each goal area on the IEP has an ABA program that corresponds to each objective. I collaborate with the board-certified behavioral analyst on presentation and prompt hierarchies so that we can all agree on the student’s current performance and level of independence. Paraprofessionals take data for each program. Come progress report time, I consult the data collected from staff and combine it with my own. This allows the team to identify discrepancies in how content is delivered, and provides a great opportunity for the team to troubleshoot any issues in terms of skill mastery or curriculum modifications.

Final thoughts.

The overlap between language, communication and behavior is undeniable. Keeping language separate from behavior can ultimately compromise your teaching process’s efficiency. Schools and special education teams need to carve out opportunities for behavioral specialists and speech-language pathologists to collaborate, and think beyond the “reward” of the mini-marshmallow.

Dr. Kerry Davis is a city-wide speech-language pathologist in the Boston area. Her areas of interest include working with children with multiple disabilities, inclusion in education and professional development. The views on this blog are my own and do not represent those of my employer. Dr. Davis can be followed on Twitter at @DrKDavisslp.

Collaboration Corner: Surviving Dysphagia in Schools

4948663060_d03422c6d5_z

(photo credit)

According to ASHA (2006), 1 in 10 public school speech-language pathologists have a student with dysphagia. I have to be honest; this is a struggle for me. Here’s why: while I have extensive dysphagia experience in medical and private home-based settings, I have difficulty defining my role as an SLP who provides dysphagia therapy in school.

Identifying the obstacles

ASHA has a fairly clear document describing the role of the school-based SLP in schools. However, the perceived obstacles can be daunting (Miller, 2008). The top 4 obstacles consistently come across are: Scheduling and environment, training staff, keeping the lines of communication open between family, staff and outside therapists, and getting student buy-in.

Removing the obstacles

Miller (2008) urges collaboration in treating students with dysphagia. I have the good fortune to work with many talented special educators, nurses, behavior specialists. While I bring the knowledge of dysphagia to the table (bad pun), recognizing the daily demands upon the child requires team-based attention. The following strategies may help balance your student’s dysphagia issues within the context of the school day:

Examine/modify the child’s schedule. Students have very little time to eat. Snack is usually 15 minutes (if at all) and lunch is about the same with recess either before or after. This means students risk missing academic time, social time, recess. Suddenly speech is the no fun allowed zone; staff/students become worried that therapy cuts into these activities.

To help with this let the child start eating in the cafeteria before everyone else arrives, use calming strategies such as music with headphones, or a favorite book for the child to read while he/she is eating. Bring a lunch buddy if it helps. Gradually set limits around how much music she/he can listen to. If a child is too overstimulated during lunch time (elementary cafeterias are quite an experience), have the student eat early and let them read a book or chat with friends. This allows mealtimes to be associated with positive feelings.

Training staff. Many students have a paraprofessional, who also needs to eat their lunch, but guess when their student may need the most support? During lunch, of course. Keep clear instructions and provide hands-on training for staff, give a copy to the school nurse. If there is a change in staffing, make sure the change is with a familiar person who also has training. I have staff sit in on times that are not during their break or lunch. I also encourage the student’s paraprofessional to eat with the student as to “normalize” the experience and to provide role-modeling around food. We have Fun Friday where everyone eats together and we do a fun food play activity. Again, create positive associations with eating (for staff and students!). Staff need consistent access to strategies that will keep the student calm, like this cue card, created by my colleague and co-author of The Behavior Code:

Untitled

Communicate closely with families. Eating is a cultural and emotional experience. Ongoing communication with family members provides insight as to when everyone is ready to move to the next step. Clearly communicate that safety is the most important factor in the decisions related to their child’s eating. Encourage parents to come in, or take pictures and video. Use a home-communication journal so notes can go between school and home, highlighting what they ate, how much they ate, and any events that may have affected their eating.

Communicating with outside SLPs. OK, so here’s the deal. Expertise exists across settings. If I don’t do VFSS  on a daily basis, I recognize that I am not an expert in that assessment tool. But if I have a background in dysphagia, have worked in schools for 11 years, have seen this student 3 times a week in their school setting for three years, guess what? I have expertise as well. I can (and should) make a referral for a VFSS by an SLP who has the skill and equipment. Likewise, private SLPs should confer with the school-based SLPs perspectives on eating. Speech-language pathologists need to reach out to one another and value these differences. These differences are a good thing (stepping off of my soapbox now….).

Make the child a part of the process. Keep it low pressure, and rewarding. Take picture of their successes and make a book about it together.  Have them review the book before they eat, so they remember their successes and eating strategies. Here’s a rather crude (but effective) example of a page I wrote with my student:

Untitled

Last but not least, set aside your own assumptions of what tastes/feels/smells good….these kids experience food much differently than you do. Remember, eating involves developing trust; it is not a forced process. The end goal is to make eating pleasurable and safe so that mealtime becomes enjoyable for everyone.

Dr. Kerry Davis is a city-wide speech-language pathologist in the Boston area. Her areas of interest include working with children with multiple disabilities, inclusion in education and professional development. The views on this blog are my own and do not represent those of my employer. Dr. Davis can be followed on Twitter at @DrKDavisslp.

Collaboration Corner: Rethinking the IEP: Making Language the Foundation of Academics

2417451770_01b2948c73_z

Collaboration Corner is a new monthly column written for ASHAsphere by Kerry J. Davis, E.d.D, CCC/SLP.  Kerry will focus on different themes that involve collaborating with colleagues and other disciplines. Thank you Kerry for sharing your ideas with the ASHA community!

We welcome guest bloggers and columnists; if you’d like to write for ASHAsphere, please fill out a blogger application here.

I work in a totally inclusive school district as an inclusion speech-language pathologist. My caseload consists of the neediest students in the district. Those kids are simply fascinating to me. I work with the soup-to-nuts kids; kids with severe learning challenges, kids with social-emotional disabilities, kids who are nonverbal. You know the kids where you try and crawl inside their neurology and figure out how they perceive the world? These students push me to be a better clinician. More importantly, they make me want to think creatively on how to make public school and inclusion work for them.

All of my students participate in a general education classroom. Students attend their neighborhood schools and access their day with a host of academic supports. All of my students have goals that allow meaningful access to math, language arts, science and social studies. And here’s the funny part, while all of my students have communication disorders, I am working to eliminate the designated “speech and language” section of many students’ IEPs.

Imagine taking the speech and language section off of the IEP! I can sense the collective raising of eyebrows….

But here’s the deal. I believe that one of the best parts of being a speech-language pathologist is that opportunities for learning are never-ending. Language is everywhere. Bruner (1996) discussed the need to connect learning through meaningful interaction. People learn when they can relate new information with old information. Semantic-connections allow for learning. Language is the vehicle for that connection.

So let’s back up to the IEP. Why do we tend to compartmentalize language and communication to a single goal area? It is unnecessary, and dare I say…inappropriate.

Collaborative goal-writing

So perhaps we should rethink our approach. A student’s IEP is based upon the team’s recommendations.

Integrating language-based goals throughout the IEP also encourages team ownership. Distributing language-based objectives throughout the IEP underscores the connection between language and academics. For students who need extra repetition and meaningful practice across contexts, these collaborative efforts foster skill generalization. So how does that look in an IEP? Here are some ideas my school-based teams have used (as a part of measurable objectives of course):

Math:

  • Develop the concepts of less, more, some
  • Answering wh-questions related to quantity
  • Following directions in a recipe, including gathering appropriate tools and materials

Science:

  • Provide similarities and differences(feature/function/class) between target vocabulary words
    • simple machines
    • animals and habitats
    • weather
    • states of matter
  • Using temporal markers, will demonstrate understanding of  a plant/animal life cycle
  • Answering wh-questions related to non-fiction text and picture books

Social studies/geography:

  • Matching clothing with seasons
  • Using attributes to describe the weather
  • Identifying and answering personal and biographical information (town, street, school)
  • From a book or activity, answer who, where, what doing, and when questions related to other countries and communities

English Language Arts:

  • Answering wh-questions related to character, setting and supporting events
  • Using temporal markers to create a personal narrative from a photograph
  • Use a home journal template to retell a two activities of the day
  • From a photo, use adjectives to describe an event or activity
  • Sequence pictures representing events from a picture book

Independence:

  • Communicating self-advocacy,
  • Asking clarifying questions,
  • Following checklists related to daily routines,
  • Following 2-step group directions

Some words of advice

I’ve used these ideas with children who have a variety of skill abilities. I use these ideas with children who have moderate to severe cognitive and communication challenges. Many use high-tech assistive technology tools, to accomplish these goals. Others use fill-in-the-blank cut and paste activities. The key is to scaffold the concepts in a way that will be meaningful. This does not mean lowering the bar for learning, these means thinking about how to embed naturalistically these ideas throughout the school day. Checklists can be used as part of getting ready in the morning. Narrative writing may include templates and photographs, or writing a letter home at the end of the day. Sequencing can be used in “how-to” books, or describing the life cycle of a frog. Comparisons can be drawn between a student’s home, and the Native American Wetu. All of these examples connect language concepts and learning in a meaningful way.

Gather the expertise in your team members and make the IEP work for those students that challenge you; you will be better practitioner for it. Not every team will be ready for this change. Through thoughtful discussion, creative planning and patience, the shift may not be as hard as you think.

References:

Bruner, J. (1996). The culture of education. Cambridge, MA: Harvard University Press.

Dr. Kerry Davis is a city-wide speech-language pathologist in the Boston area. Her area of interest includes augmentative alternative communication, and working with children with multiple disabilities and learning challenges. I welcome various perspectives and lively dialogue. The views on this blog are my own and do not represent those of my employer. Dr. Davis can be followed on Twitter at @DrKDavisslp.