Am I an SLP With a Social Communication Problem?

shutterstock_225655450

 

Have you ever pondered your social relevance, like an iPhone 5 right after the iPhone 6 comes out? Sure, you still look pretty good and have barely been used, so why is everyone already lining up to trade you in for a newer model? As a 28-year-old SLP working with junior high kids, I think about this a lot. I’m not that old and, therefore, relatively “cool” and in tune with what kids like … right?

The other day, during one of my many social skills groups, it hit me. I just might be an SLP with a social communication problem. My second realization was that I hadn’t been using the same advice I give my students. Like a broken record, I instruct my students on the rules of making and keeping friends. Week after week I serve up the same social strategies, such as find common topics of interest, initiate small talk and add relevant information.

However, the awkward social elephant in the room was me! I knew relatively little about the topics my students enjoyed.

Kids communicate in ways that we, as SLPs, and most adults don’t even understand. Surely it’s not for us to keep up with the five-second attention spans of adolescents and their never-ending pop culture nonsense. But, on the other hand, how can we teach social communication skills if we don’t know how kids are communicating or what’s important to them?

If a student asks me for help on inviting other kids over for a party, I advise to shoot a quick text. Email is considered far too formal and they’d laugh at the idea of a thoughtful handwritten note on engraved cardstock. So I do need to keep up with the times. I help kids talk and socialize for a living. But I need to do that using things from their world, not mine. Also, many of my students already struggle to know what’s socially important or appropriate, so it’s up to me to fill in the blanks.

I had some homework to do. That evening, I spent a hot second on Google and ended up learning way more about One Direction, Ariana Grande and CW series than I ever cared to. Talk about an unnecessary wake-up call!

As an SLP, however, I use the socially relevant information to relate to my students. The difference between good and great treatment comes down to preparation and knowledge. The more I learned, the better my sessions and conversations with my kids became. It will for you as well.

On a side note, did you know that there’s a Wikipedia knockoff site called Wookieepedia? As the name might imply, the information covers all things Star Wars. Trust me, your kids with autism spectrum disorder sure know about it.

Since making it a priority to spend a few minutes here and there searching celebrity gossip or other trends, my social groups changed for the better. My kids find it incredibly cool that I actively participate in conversations about the newest apps, superhero movies and hot video games.

I’m not suggesting anyone run out to buy the newest gaming system. I’m just saying that as we teach students to communicate in the world, let’s participate in the conversation ourselves.

#foodforthought #pragmatics #speechtherapy

 

Ken Anderson, MS, CCC-SLP, is a school-based SLP in Los Angeles. Follow him on Instagram @slpken or email kenwanderson87@gmail.com.

10 Low-Cost, Low-Tech Tools for SLPs Treating Teens and Adults

shutterstock_38185804

With summer—and client travel—around the corner, I’m sharing ideas for non-electronic treatment activities that are low-cost, portable and ideal for adults with developmental disabilities. Use these activities in the treatment room and for families who want to work on speech, language and communication goals between sessions. Encourage clients to take these materials along during summer travel, on the beach or on a short trip in the community.

Whenever I work with older teenagers and adults with developmental disabilities, I focus on finding age-appropriate activities. An older client might feel disempowered by a childlike activity.

Most people also already own these materials!

  1. Newspapers. A newspaper—which may cost less than $5, depending on the paper—serves as a multipurpose treatment tool. Even better—some papers are free! Target literacy, answering and asking questions about current events, searching for a movie time and location, and social skills or abstract language in the comics section. Check out how to use comics to meet speech and language goals.
  2. Magazines. I love using magazines as a treatment tool with adults. Age-appropriate and interesting, magazines contain a variety of articles, pictures, advertisements and more. Also, the magazines your clients choose may give you insights into their interests and motivations. I recently asked one of my clients to choose a magazine at the local convenience store. I expected him to choose a food or car magazine, but he gleefully went straight for the gossip rag. We had a productive session afterward discussing various sections in the magazine via his communication device.
  3. Grocery circulars. Use free circulars to learn money management, categories (such as food groups) and new food vocabulary. Other goals include facilitating commenting and describing. Circulars also act as conversation starters: “What would you buy at the grocery store?” “I want to make steak and eggs for breakfast. What do I need to buy?”
  4. Brochures/catalogs. Brochures and catalogs—another free option—motivate and engage clients depending on their interests. If your client likes electronics, bring an electronics catalog, for example. Discuss prices, various types of equipment and what they like versus dislike. The same approach works for clothing, gardening or home décor catalogs.
  5. Subway/bus maps. Also free and functional! Work on travel training, literacy and map reading with these resources. Language concepts include problem-solving, sequencing and answering “wh” questions.
  6. Menus. I’m sticking with the free theme, here! And what’s more functional than being able to read a menu and make a choice? Check out my previous article on using menus as a treatment tool.
  7. Employment applications. Stop into any fast-food establishment, restaurant, movie theater or retail store and ask for an application. Filling out an application facilitates improved literacy, answering “wh” questions, recalling information, expanding vocabulary, and sequencing by writing the order of educational or work history.
  8. Dominoes. A set of dominoes offers an inexpensive, portable, age-appropriate and fun developmental activity for adults. Practice matching, taking turns, solving problems and following directions.
  9. Playing cards. Ideas for card games include Uno, Go Fish and War. Again, thiese low-cost games double as age-appropriate, accessible, portable and functional treatments. Examples of targeted goals include matching, solving problems, taking turns and prediction.
  10. Board games/bingo. How about a game of Sorry or Connect Four? These games are less than $10 each and teach taking turns, learning colors, following directions and solving problems. A generic bingo game or a customized bingo set also works well. If you have clients who need work on specific vocabulary related to actions, send them home with an action bingo board. Instruct them to use it with family or friends to build vocabulary, practice taking turns and forming complete sentences.

 

Rebecca Eisenberg, MS, CCC-SLP, is a speech-language pathologist, author, instructor and parent of two young children. She began her website, www.gravitybread.com, to create a resource for parents to help make mealtime an enriched learning experience. She has worked for many years with children and adults with developmental disabilities in a variety of settings, including schools, day habilitation programs, home care and clinics. Contact her at becca@gravitybread.com or follow her on FacebookTwitter or Pinterest.

What Language Do You Speak to Patients and Families?

shutterstock_124922828

What is health literacy? It is the ability to understand and communicate information about health. Your ability to clearly communicate that information using plain language helps clients and their families make appropriate decisions about health.

Imagine taking a trip to a foreign country where people speak an unknown language. Translation services aren’t available. No Rosetta Stone software. No interpreter. No translation app on your phone. How much can you understand? You’re frustrated, overwhelmed and frightened. Anyone would feel bewildered by this inability to understand critical information.

For families of patients with communication disorders, our professional language sounds foreign to them. Our world of common professional jargon includes: auditory, aural, cochlear, apraxia, pharyngeal, acoustic, receptive, expressive, hierarchy, audiogram, speech perception, otoclearance, OAE, ABR, air-bone gap, frequency, decibels, dysphagia, articulation, disfluency, air conduction, bone conduction, aphonia, assessment, congenital, nonverbal, multi-disciplinary, IEP and many more.

We discuss these topics throughout our day. Those words roll off our tongues fluently. To people without our background—most of our clients’ families—these are foreign terms. Most families—let alone anyone who speaks English as a second language—struggle to understand our explanations. A family might find it difficult to help their child or loved one if they’re focusing on understanding what these professional terms mean.

Our profession is about clear communication for everyone, so becoming health literate by knowing how to use plain language is crucial. Plain language includes clear, concise and easy-to-read terms and explanations. Avoid anti-intellectual, unsophisticated or dumbed-down vocabulary.

Plain language means clients and their families understand information the first time. When sharing information about communication disorders, assume that everyone’s unfamiliar with our jargon. When writing materials for patients and families, a target a comprehension level of fourth to sixth grade to make the information understandable to most people. When our patients and families have a clear understanding of diagnosis, treatment plan, equipment and home programming, they’re more likely follow through with your recommendations.

This example of plain language explains a complicated audiology test:

Cortical Auditory Evoked Potentials (CAEP): A nerve carries sound signals from the ear to the brain. Problems with this nerve can cause problems with hearing. A CAEP test shows what the hearing nerve does when it receives sound. It can tell us if your child needs hearing aids or a cochlear implant. It can tell us if your child’s hearing aids or cochlear implants are set correctly (fifth-grade reading level explanation of CAEP).

These quick tips help for incorporating plain language:

  • Assume information is challenging for everyone to comprehend.
  • Explain a maximum of three concepts or details at once. Three pieces of information is the most people retain in one setting.
  • Provide paper and pen for families or patients to take notes about the information.
  • When developing patient and family education materials, write the material at a fourth- to sixth-grade reading level. By doing so, the information will be accessible for all.
  • Take time to make sure that you have explained the information clearly. Verify with families or patients that they can share this information with other family members.
  • Have the family or patient demonstrate what you’ve taught.
  • Check for questions by stating or asking, “Tell me what questions you have” or “What can I better explain?”

The next time you meet with a family or patient, think about how you can clearly communicate—using plain language—about their assessment, equipment and/or treatment plan. Take complex information and make it accessible to people of all backgrounds, education levels and cultures. Clear communication equals elevated understanding. When we teach patients and families about speech and hearing disorders, we shouldn’t evaluate how much information they know. We should evaluate how well we teach it.

 

 

Becky Clem, MA, CCC-SLP, a listening-spoken language specialist (LSLS) with auditory-verbal certification, is the education coordinator for rehab services at Cook Children’s Medical Center in Fort Worth, Texas. Her experience includes patient and family education, health literacy, working with families of babies and children with hearing loss, and mentoring professionals for LSLS. Becky.clem@cookchildrens.org

Five Easy Activities to Prevent Summer Brain Drain

shutterstock_111842108

Over the summer, children lose months of reading and math skills, according to several studies. When they return to school in the fall, teachers dedicate five or six weeks to review, rather than pushing students to explore new challenges. Luckily, we can encourage parents to help! In addition to reading, exploring museums and just playing at the park, check out five easy activities to help parents and clients prevent summertime brain drain.

Going on a picnic

  • How to play: The starting player sets up a pattern of what can or can’t be brought on a picnic and doesn’t tell the other players. For example, if only food starting with the letter “s” can be brought, the starting player would say: “I’m going on a picnic and I’m bringing sandwiches.” Then the other players try to figure out the pattern by guessing words or items that might match the starting word and then listening to what other items are approved.
  • Why it works: This classic game targets memory, word retrieval and vocabulary. Additionally, this is a great game for listening skills!
  • Extra language twist: Work in categories. For example, you must bring fruits, vegetables, clothing items or words that start with a certain letter or sound.

Alphabet game

  • How to play: Start by looking for a word on a sign or billboard that starts with “A”… Once you find a word that starts with “A,” look for one that starts with “B”—go through the entire alphabet! Warning: This game can become quite competitive if you have a “race” to the end of the alphabet.
  • Extra challenge: To make it even harder, make a rule that all players must use an original word—no repeats!
  • Why it works: It’s not an overwhelming amount to read and it still targets articulation sounds and letter identification. It really is so much fun!

I spy

  • How to play: Players describe an item they see.
  • Why it works: Through this game you can work on describing, word-retrieval strategies and listening skills while still having a stress-free, enjoyable time!
  • Extra language twist: Work on “wh-questions” by encouraging players to ask questions to get more information about the object. Also, you may want to limit the objects to certain categories to target categorical thinking. For added structure, remind your child to describe by category, how you use it, what it looks like and where you find it.

Heads up

  • How to play: This is both an app and a board game. In this game, a player has a word on his or her head, and other players describe it. The players continue to describe the word until it is guessed correctly.
  • Why it works: This game targets describing, which helps children express their ideas in a specific, clear and effective way. Additionally, this is a great game for listening skills and gathering information!

Twister

  • How to play: This classic board game has a large “game board” with different colored spots. A player spins the spinner and depending on the color it lands on, each player has to put a hand or foot on the designated color.
  • Why it works – You can help your child work on sounds by writing letters on the Twister board, or work on sight words by writing words on the Twister board. Additionally, this is a great game for listening skills and following directions!
  • Extra language twist: If you use a marker to write words instead on the colored dots, you can work on identifying sight words. You can also use words with target sounds for articulation!

 
Emily Jupiter, MS, CCC-SLP, is a speech-language pathologist at Alphabet Aerobics Speech and Language Education (www.alphabetaerobicsspeech.com) in Manhattan and Southampton, New York. She works primarily with children ages 6 to 14 who have been diagnosed with ADD/ADHD, dyslexia, and expressive and receptive language disorders. emily@alphabetaerobicsspeech.com.

 

 

 

 

 

5 Things You Need to Know About Working in the Neonatal Intensive Care Unit

shutterstock_45678268

If you answered yes to any of the questions in my first post about wanting to work with acute care infants, then read this follow-up!

  1. The NICU is an intensive care unit: Infants in the NICU are critically ill or were in the recent past. These most fragile patients can become physiologically unstable at any time—and it might happen during your therapy. The emotional roller coaster of NICU leaves families fragile, too.
  2. It’s not easy to practice in the NICU environment: Quick and constant losses and triumphs cause emotions to run high. An infant’s status can change at any time. Caregivers are highly skilled and passionate, which sometimes leads to strong opinions and respectful disagreements. The SLP needs to thoughtfully collaborate, yet at times take a stand.
  3. The NICU SLP requires advanced practice skills: It’s not just knowing what to do, but what not to do. We often support feeding/swallowing, so the risk for compromising an infant’s airway is significant. Essential skills include solid critical reflective thinking, the ability to complete a differential, and broad, multi-system knowledge about preterm development and swallowing/feeding. Your preparation should include solid experience with the birth-to-3 patients, as well as continuing education, mentorship and guided participation with many infants in both the newborn nursery and the NICU. The NICU is too demanding to be an initial independent placement after graduate school.
  4. The NICU evidence base is rapidly evolving: Read, read, read as much professional neonatal literature as possible. Sources are not just within our field but also in medical, nursing and OT/PT journals. Our role is not only to understand the evidence base, but to bring it to the NICU team. Neonatologists and neonatal nurses will ask “why?” and we must be able to discuss the research-based evidence along with our clinical wisdom: For example, if you recommend changing from “volume-driven” to “infant-guided” feeding.
  5. The NICU is rewarding: After almost 30 years working full time in the NICU, not a day goes by that I don’t learn something, make a difference in an infant’s life or experience the joy of a grateful “thank you!” from a family. The appreciation from nurses and neonatologists when an infant can now feed safely and, therefore, go home, makes your day. With such rewards, however, comes great responsibility. In our hands lies the potential to influence parent-infant relationships through positive neuro-protective feeding experiences that wire the brain toward feeding and build future connections.

If you are thinking about moving into NICU practice, you will find lots of information on my website. Stay tuned for more tips to guide your journey!

 

Catherine S. Shaker, MS, CCC-SLP, BCS-S, works in acute care/inpatient pediatrics at Florida Hospital for Children in Orlando. She specializes in NICU services and has published in this practice area. She offers seminars on a variety of neonatal/pediatric swallowing/feeding topics across the country. Follow her at www.Shaker4SwallowingandFeeding.com or email her at pediatricseminars@gmail.com.