Six Steps to Improve Communications—Listening and Talking—with Parents

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This year’s Better Hearing and Speech Month theme—”Early Intervention Counts”—made me wonder what more I could do to connect with moms and offer families early intervention services. I asked myself a key question:

Am I getting inside the mind of moms whose children I could help?

Throughout May, I communicated with moms everywhere I possibly could. I mean everywhere!

I spoke with moms I knew personally or professionally. I visited online speech-language groups, I peeked at comments on speech-language blogs popular with moms, and I learned what questions moms ask on forums and social media groups.

I noticed a strong trend that moms tend to ask other moms for advice about their children’s communication skills before going to a speech-language pathologist. I asked numerous moms: “Why would you reach out to other moms to share your concerns and/or ask questions about your child’s speech-language development over seeing a speech-language pathologist?”

Let’s look at the most common responses:

  • It’s faster and convenient to ask other moms their opinion or a question, especially online and during evenings.
  • It takes commitment to make a potentially unnecessary appointment with an SLP plus extra commitment for follow-up appointments.
  • I know and trust moms but I don’t know any SLPs.
  • Other trustworthy moms have a wealth of knowledge, especially if they have been through the process with an SLP. These moms give you an idea of what warrants a visit to a professional.
  • Fellow moms share my perspective. They show compassion and understand what I’m going through with my child.
  • I’m not intimidated by “parent friendly” messages that don’t use confusing or technical jargon.
  • Advice from other moms comes free.
  • I’m nervous an SLP will tell me my child needs help or diagnose my child with a disorder.

Based on responses, I’m taking six steps to improve my communication approach, the language I use and how I connect with parents:

  • I’m communicating with moms on my own social media sites and within online groups and forums.
  • I’m being vulnerable by sharing relatable facts about myself personally and my core values for my business.
  • I’m using parent-friendly language and avoiding acronyms and negative terms, such as “disorder,” during our conversations.
  • I’m asking moms more questions about their perceived needs and concerns for their child so I have more opportunities to listen actively and empathize about what they are going through.
  • I’m focusing on and talking about children’s strengths as a way to build a rapport with parents.
  • I’m also acknowledging my appreciation to parents for taking the time and effort to access my services.

If you wonder what types of questions parents ask, here are three valuable online resources:

  1. www.circleofmoms.com
  2. www.mamapedia.com
  3. Search for speech-language support groups for moms and moms on Facebook

Boost the value you get from online communities by reading through the group descriptions, rules, policies and other posts before posting in the group. Contact the group administrator(s) before posting for their best tips on joining.

What have you learned from listening to parents? Please share in the comments!

 

 

Keri Vandongen, aka “Speech Keri,” provides speech-language services for families with young children through her private practice in Alberta, Canada. She also offers online video training and techniques to enhance speech-language practice and carryover. Keri@myspeechparty.com

Hey, I’ve Got a Voice Box and This is Crazy…Singing—Speaking—Similar Maybe?

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If you see clients who complain of voice problems, it’s important to know if they sing in any context. Patients don’t have to be professional singers to be “rockstars” in the car or shower, so make sure you investigate all ways or places voice damage might occur.

We don’t switch out our speaking vocal folds for singing ones, but some folks speak much differently than they sing. Billy Corgan, for example, speaks in a low vocal fry and sings in a high-pitched nasal way. Here are a few pointers to aid in helping speakers who are also singers get the most out of each session.

1) Treat your diaphragm like a well-oiled machine. Whether you’re singing or speaking, you must have air flow through the vocal folds to achieve oscillations. If you force too much air out at one time, you sound breathy. If air is extremely rationed, you sound strained and strangled. If you treat a classically trained singer, chances are he/she knows proper breath technique for singing, but there’s always a chance that breath for speaking was never addressed in any teaching. Knowing your vocal dynamic science helps your treatment approach. We all breathe with the same organs, and voice disorders caused by poor breath support can be easily corrected with proper breath training. Remind your clients and yourself that the best breathing for both speaking and singing is with the powerhouse muscle that is your diaphragm.

2) Speaking or singing both cause tension in muscles surrounding your vocal folds. The larynx/voice-box hangs in muscles and ligaments from one bone: the hyoid. It does not have a strict skeletal frame to keep it in place, so tension can very easily impact the vocal fold movements during sound production. If singing or speaking fatigues your patient, laryngeal tension can reduce that sore, tired feeling. For singers, try singing through a straw to facilitate proper production and throat alignment, then immediately sing a line of a song to practice maintaining that decrease in vocal fold collision forces. For speakers, use straw phonation to speak a sentence or paragraph then immediately speak the same thing normally with no straw. The patient will feel the freedom of decreased glottal impact and can learn to recognize this and aim for it in normal speech.

3) Hone Your Cavity!! Resonance modifications to the oral cavity during singing and speaking, instead of recruiting excess muscular effort, can increase intensity. Opera singers have a distinct, but loud sound. Megaphones help cheerleaders project over the roar of the crowd. Each uses time and space to amplify sound to keep from overworking the delicate vocal systems. With the operatic style of singing, the soft palate and oral cavity raise and open in the back, similar to a yawn. Vowels are modified to sound similar to the word being sung, and volume’s achieved with this mouth position. Megaphones and wide-mouthed singing (belting) use very little muscular effort, but singers and speakers must also create the right space with their mouth. With each type of oral cavity construction, the larger amount of space created equals high volume as the sound bounces off the walls before leaving the mouth. (Source-Filter Theory anyone?) Use the diaphragm for this in speaking and singing to avoid strain in the throat.

The vocal subsystems of breath control, vocal fold vibrations and resonance work simultaneously in a delicate balance for us to speak and to sing efficiently. We are communicating when we do both, so let’s learn to speak the language of coordination.

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.

Am I an SLP With a Social Communication Problem?

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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

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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?

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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