Ten Speech and Language Goals to Target during Food/Drink Preparation

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Food and/or drink preparation can be an excellent way to help facilitate speech and language goals with a variety of clients that span different ages and disabilities.

Below are 10 speech and language goals that you can target during food or drink preparation:

  1. Sequencing: Because recipes follow steps, sequencing can be an ideal goal. If there are too many steps in a recipe then break them up into smaller steps. Take pictures of each step and create a sequencing activity using an app such as Making Sequences or CanPlan.
  2. Literacy: If a recipe has complex language that your client has difficulty reading and processing, modify it. I often rewrite recipes with my clients or use a symbol based writing program like the SymbolSupport app.
  3. Expanding vocabulary: Recipes often contain unfamiliar words. When beginning a recipe, target new vocabulary. If your client is an emergent reader, create visuals for the vocabulary words and use aided language stimulation as you prepare the food and/or drink with her.
  4. Articulation: Target specific sounds during food preparation. Are you targeting /r/ during sessions? Prepare foods that begin with r like raspberries, radishes and rice, or even a color like red!
  5. Describing and Commenting: Food/drink preparation can be an excellent time to describe and comment. Model language and use descriptive words such as gooey, sticky, wet, sweet, etc. Encourage your client to use all five senses during the activity (e.g. It smells like ____, It feels like ______).
  6. Actions: Actions can be an excellent goal during food and/or drink preparation. For example, when baking a simple muffin recipe, the actions such as measure, pour, fill, mix, bake, eat, can be targeted.
  7. Answering “wh” questions: As you are preparing food, ask your client open ended “wh” questions, such as “What are we baking?” or “Why are we adding this sugar to our recipe?” and more.
  8. Problem Solving: Forget the eggs? Hmm, what should we do? How about forgetting the chocolate in chocolate milk? Ask your client different ways of resolving specific problems with food preparation, such as: “What do you do if you are missing an ingredient?” or “What do you do if we add too much of one ingredient?”
  9. Turn Taking: Whether you are working with one or two people, turn taking occurs naturally during baking and/or food preparation. If you are working in a group, make assignments before beginning.
  10. Recalling Information: As you prepare the food/drink, ask your client to recall specific After you are done with the recipe, model language and then ask your client to recall the steps of the recipe.

Preparing even a simple beverage such as chocolate milk can be an excellent activity to engage in during a session. Although it’s made up of only two ingredients, you can still work on a variety of speech and language goals including sequencing, describing, problem solving (e.g. what to do if you put in too much chocolate), actions, turn taking and recalling information.

Here are some helpful apps to use during or after food/drink preparation:

I Get Cooking and Create Recipe Photo Sequence Books

Making Sequences

CanPlan

Kid In Story

SymbolSupport App

For more suggestions, check out my post here on getting a child with special needs involved in the kitchen.

 

Rebecca Eisenberg, MS, CCC-SLP, is a speech-language pathologist, author, instructor, and parent of two young children, who 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 both children and adults with developmental disabilities in a variety of settings including schools, day habilitation programs, home care and clinics. She can be reached at becca@gravitybread.com, or you can follow her on Facebook; on Twitter; or on Pinterest.

Picky Eaters in the Preschool Classroom: 7 Tips for Teachers

Two scoop sizes allow children to select a smaller portion for unfamiliar foods.

Two scoop sizes allow children to select a smaller portion of unfamiliar foods.

As a pediatric feeding therapist, part of working in the child’s natural environment is making regular preschool visits to offer teachers and staff guidance when a child is not eagerly participating in mealtimes. Whether a child is a selective eater or the more common picky-eater, here are seven tips for teachers that focus on the seven senses involved in food exploration and eating:

  1. Sight: New foods are better accepted when the sight of them is underwhelming. When serving foods family style, include TWO utensils for scooping from the main bowl or platter [see above]. Present each food with one larger scoop and a standard spoon. The kids at the table can choose which scoop/spoon they would like to use, which allows the more hesitant eater to choose a small sample instead of what might feel like an overwhelming shovel-full. If meals are served pre-plated, offer smaller portions (1 tablespoon) of new foods and allow the kids to request more after their first taste.
  2. Smell: Warm foods often have a stronger aroma and for some kids, this can be a quick turn-off before the food ventures toward their lips. In regards to the hesitant eater, begin passing the bowl of warm foods so that it ends up at his seat last, when it will be less aromatic. For meals that are pre-plated, simply dish up his first but place it in front of him last, so that the food has time to cool a bit. Straws are an excellent option for soups, because they allow the child to sample by sipping. The longer the straw, the farther away they are from the smell. The shorter the straw, the less distance the soup needs to travel to reach the tongue, but the closer the nose is to the aroma. Consider what suits each child best and adjust accordingly. Thinner straws allow for a smaller amount of soup to land on the tongue, but if the soup is thick, you may need a slightly wider straw. Keeping the portion as small as possible also keeps the aroma to a “just right” amount for little noses. Try tiny espresso cups, often under $2, for serving any new beverage, soup or sauce.
    espresso cups
  3. Taste: Experiencing food doesn’t always mean we taste it every time. If the best a hesitant eater can do that day is help dish up the plates or lick a new food, that’s a good start! But when it comes to chewing, encourage kids to taste a new food with their “dinosaur teeth.” A fun option are these inexpensive tasting spoons commonly found in ice cream shops. Keep a small container in the center of the table for kids to take tiny sample tastes direct from their plates.
    tasting spoons
  4. Touch: Like any new tactile sensation, few of us place our entire hand into a new substance with gusto. It’s more likely that we’ll interact with a new tactile sensation by first using the tip of one finger or the side of our thumb. Take it slow – and remember that touch doesn’t just involve fingers and hands. The inside of the mouth has more nerve endings than many parts of our bodies, so it may be the last place that the hesitant eater wants to experience a new texture, temperature or other type of sensation. Start with where he can interact and build from there.
  5. Sound: The preschool classroom is abuzz with activity and thus, noise. Beginning each snack or mealtime with a song or a ritual, such as gently ringing some wind chimes to signal “it’s time to be together with our food” is a routine that centers both teachers and children. Whatever the ritual, involve the most hesitant eaters in the process and encourage their parents to follow the same routine at home if possible. Kids do best with when routines are consistent across environments.
  6. Proprioceptive Input: The sense of proprioception has a lot to do with adventurous eating. One fun routine that provides the proprioceptive input to help us focus is marching! In one preschool classroom, we implemented a daily routine where the kids picked a food and marched around the table with it as a way to mark the beginning of a meal and provide that much-needed stomping that is calming and organizing for our bodies. Download the song “The Food Goes Marching” here (free till February 1, 2015) as the perfect accompaniment!
  7. Vestibular Sense: While we all know the importance of a balanced diet, you may not be aware that a child’s sense of balance has a lot to do with trying new foods! Our sense of balance and movement, originating in the inner ear and known as the vestibular system, is the foundation for allfine motor skills. In order to feel grounded and stable, kids need a solid foundation under the “feet and seat.” Many classroom chairs leave preschoolers with little support and feet dangling. Create a footrest by duct taping old text or phone books together or if you’re extra handy, create a step stool that allows the chair legs to sit inside the stool itself.
    footrest
    An inexpensive version can be made with a box of canned baked beans from COSTCO, like this one. Carefully open the box because you’ll be using it again to create the footrest. Simply remove the cans, empty just two, then rinse thoroughly and discard the lids. Now place the cans back in the box with the two empty cans facing up, so that the legs of the chair will poke through the box and into those two cans. Reinforce with duct tape. Instant footrest!

Melanie Potock, MA, CCC-SLP, treats children birth to teens who have difficulty eating.  She is the co-author of Parenting in the Kitchen: How to Raise Happy and Healthy Eaters in Our Chicken Nugget World (Aug. 2015), the author of Happy Mealtimes with Happy Kids and the producer of the award-winning kids’ CD Dancing in the Kitchen: Songs that Celebrate the Joy of Food!  Melanie’s two-day course on pediatric feeding is  offered for ASHA CEUs.  She can be reached at Melanie@mymunchbug.com.  

CSD Students Use Their Skills in Ethiopia This Month

   

The CSD program at Teachers College Columbia University is in Ethiopia this month visiting schools for students with autism and a center for adults with intellectual disabilities. The TC Team—nine master’s students and three ASHA-certified SLPs: Lisa Edmonds, Jayne Miranda and I—used our experiences in Ghana and Bolivia to prepare for the trip.

At a vocational center for adults with intellectual disabilities the TC Team created “Seller’s Market Cards,” so the adults can independently sell their products. These low-tech Augmentative and Alternative Communication cards, laminated with packing tape, introduce the seller and list products for sale with their prices. We worked with the sellers to create the cards and then immediately tried them out at an impromptu market at the center!

At the Nehemiah Autism School, 20 teachers and our team spent the day collaborating to identify ways to bring more communication opportunities into an otherwise excellent school. We made 70 flash cards for weather, a large calendar, practiced social stories, and talked about ways to introduce literacy and math.

Right now, we’re presenting a five-day cleft palate speech institute at Yekatit 12 Hospital. Smile Train and Transforming Faces supported 14 cleft palate team professionals who attended from East and West Africa.

Please follow our adventures on the blog.  We love to see comments and are just halfway through our trip.

 

Catherine J. Crowley, CCC-SLP, JD, PhD, Distinguished Senior Lecturer in speech-language pathology at Teachers College Columbia University, founded and directs the bilingual/multicultural program focus, the Bilingual Extension Institute, and the Bolivia and Ghana programs. An experienced attorney, Crowley is working with NYCDOE on a multi-year project to improve the accuracy of disability evaluations. 

Our Profession’s Biggest Open Secret

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What’s the biggest open secret in our field? Each of us might have slightly different answers. Here’s mine: the reason so many students are blocked from receiving needed services is because their home states have not updated their Medicaid telepractice policies.

Children who qualify for Medicaid coverage, by definition, are from low-income families. My experience is that these children are disproportionately affected by the shortage of SLPs and could therefore benefit a great deal from access to treatments delivered via telepractice.

In addition, many schools, when faced with tight budgets, simply do not have the money to hire additional SLPs–telepractice or not–without Medicaid funds.

This places an unfair burden on the rural and urban schools that need telepractice the most. They struggle more than their affluent peers to find qualified SLPs. One reason is that those wealthier districts can pay substantially more for treatment delivered via telepractice if state Medicaid policies haven’t been updated to reimburse for online services.

This isn’t the most surprising part of the secret, however. That honor goes to how easily states can make the change. Consider this:

  • The federal government, which partners with each state on its Medicaid plan, has already approved billing for telepractice. That’s right, the Centers for Medicare & Medicaid Services already has an approved billing treatment for treatment delivered via telepractice.
  • All reimbursements for telepractice are paid for entirely by the federal government. This means that states don’t pay for additional reimbursements out of pocket. Let me repeat that one more time: allowing reimbursement for telepractice increases access to services without requiring additional funds from your state’s Medicaid program.
  • For all states that PresenceLearning has researched—aside from Indiana—allowing reimbursement for telepractice is as simple as publishing a clarifying policy memo. The memo should say that online services can be billed with the same codes as traditional sessions as long as a “GT” telepractice modifier is included for tracking purposes.

It is important to keep in mind that telepractice is just a different delivery method for services already approved by CMS and reimbursed by Medicaid in schools.  SLPs provide online services using the same approaches and materials they would use if they were physically at the school site. 

What can you do to help students get the treatment they need by motivating your state to write that memo?

  • Speak to stakeholders to build a consensus. Stakeholders include: ASHA, state licensing boards, special education directors, state departments of special education and directors of child health programs for your schools.
  • Consult state-level billing agents on the best way to document services to ensure program integrity.
  • Network with colleagues using telepractice to find out which states currently approve Medicaid funding for telepractice.

There are eight states that reimburse for telepractice services. They include: Colorado, Maine, Minnesota, North Dakota, New Mexico, Ohio, Oregon and Virginia. In addition, reimbursement for telepractice services are pending in California and Michigan.[Note from ASHA editors: This list was published in July 2013, so it may have changed. Our December issue focused on telepractice and has a slightly different list of states offering reimbursement.] 

Contact state speech and hearing associations or state-level Medicaid directors to find out how you can assist in getting Medicaid reimbursement for telepractice services. Let’s work together to ensure students who need our services receive them and schools receive the appropriate funding from Medicaid.

Melissa Jakubowitz M.A. CCC-SLP, vice president of clinical services at PresenceLearning, is an SLP with more than 20 years of clinical and managerial experience, Melissa is a Board Recognized Specialist in Child Language. She is a past-president of the California Speech-Language-Hearing Association and is also active in ASHA, serving as a Legislative Counselor for 12 years. Melissa began her career working in the public schools and can be reached at melissa@presencelearning.com

“Use Your Speech Tools!” Why Your Child Who Stutters May Not Be Using His Strategies

Stuttering Tools

When a child who stutters demonstrates the ability to change his speech during a treatment session, it seems obvious that he’d want to use the same strategies to improve speech outside the session as well.  Children, especially teenagers, rarely want to stand out in a way that stigmatizes them, provokes questions or increases the chances of teasing.   So the question arises, “Why aren’t they using their tools?!”

Speech and stuttering modification techniques are often learned quickly and easily within the treatment setting.  However, SLPs and parents often feel discouraged when these tools seem to disappear as soon as the client gets to his car.  Is it laziness on the part of the child?  Is it the fault of the family for not following through with home assignments?  Is the SLP not teaching the best strategies?

Instead of placing blame, consider the following three reasons a child may have difficulty generalizing his skills:

Reason # 1: These Techniques Are Too Hard! 

Making changes to one’s speech becomes exponentially harder when you introduce factors that often are not present in the session, such as interruptions, time pressure and feelings of embarrassment or shame associated with stuttering. Learned escape/avoidance behaviors and increased language demands may make it very difficult to use these tools.  Suddenly, what felt like an easy decision to use a new technique, becomes complicated by the person’s desire to be heard in a large group of chatty peers or by the need to formulate an excuse about why he doesn’t have his homework.

How Can I Help?

Children will be more likely to use speech/stuttering strategies if they are first introduced in safe and supportive environments (i.e. home, session room).  To help with this, create a hierarchy of speaking situations and use it to guide where the client practices the strategies.  If a child who stutters is not yet using speech tools in certain situations such as the classroom, it is probably because of where that situation is on his hierarchy. Work with your clients to determine where they would like to use their strategies , while also identifying those situations where they would prefer to concentrate on things other than using their tools.

Reason #2: These Techniques Make Me Sound Weird! 

There are several techniques that may be taught to a child who stutters. Some strategies involve prolonging the initial sound to ease into or out of a word with less physical tension or struggle.  Other techniques include inserting more pauses into speech.   All speech tools require a child to alter their speech in a way that is still different from how his friends sound.  Children may report that they have similar negative thoughts and feelings about using these strategies as they do about their stuttering.  This may play a role in why they are choosing not to use speech strategies outside their sessions.

How Can I Help?

Just as you might spend time trying to help reduce negative reactions to stuttering, you might also spend time desensitizing clients to hearing themselves use strategies through voluntary stuttering assignments.  Children can also benefit from improving their ability to handle listener reactions. This can be addressed by participating in role-playing activities that help the child create “scripts” for responding to curiosity/teasing.  For example: “Why do you sound like that?” “Sometimes I stretch my sounds like that to help me get out of a stutter.”  The more comfortable the child feels with his strategies and ability to respond to questions about his speech, the more prepared he will be to use these techniques outside the session.

Reason #3: These Techniques Aren’t Worth it!  

A cost-benefit analysis can be useful when trying to understand why a child may choose not to use speech/stuttering strategies.  At the surface, it may appear that there are many benefits of using strategies which include increased fluency and improved overall communication. However, SLPs and parents must be careful to consider the costs, as well.  Costs may include increased effort, difficulty concentrating on the content of message, the risk of showing more stuttering and the potential that the strategy doesn’t work.

How Can I Help?

Have discussions with clients about what they perceive as potential costs versus benefits of using strategies in a variety of different speaking situations.  As the child becomes more accepting of stuttering and is better able to tolerate both his feelings about stuttering and listener reactions, physical tension and struggles associated with speaking will decrease.  As this happens, tools become easier to use and costs may not feel so high.

The bottom line 

There are several strategies that may help reduce stuttering frequency and severity.  However, you often can’t offer these tools without first considering and incorporating goals that target how the client thinks and feels about his speech both while stuttering and while using tools.

Brooke Leiman, MA, CCC-SLP, is the Director of the Stuttering Clinic at the National Speech/Language Therapy Center in Bethesda, Md. She is an affiliate of ASHA Special Interest Group 4, Fluency and Fluency Disorders. This blog post is adapted from a post on her blog, www.stutteringsource.com, which focuses on fluency disorders and their treatment.

 

 

A Student Information Tool to Help Itinerant Evaluators in Schools

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I remember attending a presentation by Dr. Wayne Secord at a conference at Stockton State College in New Jersey, back in the late 1980s or early 1990s. I couldn’t tell you the topic, however, I recall Dr. Secord saying something along the lines of “today ‘multidisciplinary’ means come together-go apart when it should mean come together-stay together.” That sentiment has remained with me all these years.

At the time the truth of this struck me like a lightening bolt. Twenty-five or so years later, this idea, by and large, still rings true. But despite our best efforts, the time we need for collaboration is sadly limited. We are overwhelmed by staggering caseload numbers, case management responsibilities, massive paperwork requirements, meetings, playground duty and more. In concert with our general duties come more and more highly involved students presenting with academic and medical challenges that require the need for continuing education and research. Never has the need for consistent collaboration been more crucial.

I am fortunate in that I work in one building. I have the luxury of having a quick conversation on the run. I also have the benefit of knowing the students in my building. However, the itinerant speech-language pathologist or evaluator does not have such luxuries of interprofessional access. Recently, several of my colleagues expressed concern that itinerant evaluators may not have the inside scoop on students, potentially posing challenges to testing accuracy.

As a result, I decided to create a document that could be completed by a classroom teacher or case manager and given to an evaluator to provide a better understanding of a student’s dynamics. I based some of the criteria on James Anderson’s Habits of Mind (HoM), but also included general information such as the types of prompting the student responds to best, preferred reinforcement, response speed, signs of fatigue or frustration, ways to redirect the student, whether breaks are needed and the preferred type of break. The document also includes demographic information and opportunities to incorporate work samples and class schedule.

The Habits of Mind present a way to think about the way students learn and are, to a large extent, a determinant in academic success or failure. The HoM include persistence, managing impulsivity, listening with understanding and empathy, thinking flexibly, metacognition, striving for accuracy, questioning, applying past knowledge, thinking and communicating with clarity, gathering data through the senses, creating and imagining, responding with wonderment and awe, taking responsible risks, finding humor, thinking interdependently, and remaining open to continuous learning.

Having an understanding of a child’s ability to manage impulsivity perhaps, or task persistence paints a more complete picture for an evaluator. Such knowledge would allow an evaluator to say, schedule movement breaks or encourage a child to take risks when responding. The upshot is, the information obtained could yield more accurate test results. I am hoping that this document provides evaluators with greater insight when administering tests and interpreting test results.

Anne Doyle, MA, CCC-SLP, is a speech-language pathologist in Bridgewater, New Hampshire, who is in her 31st year of practice in the schools. She is a graduate of ASHA’s Leadership Development Program and is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education, and 16, School-Based Issues. This post is adapted from  the post “Help for Itinerant Evaluators” on her blog “Doyle Speech Works.”

Beyond Articulation: Don’t Forget Reading

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I have sometimes felt overwhelmed with the number of children on my caseload who struggle with reading.  It shouldn’t surprise me, as spoken language and hearing speech sounds is the foundation for reading text. We know that children with speech and language delays are at risk for reading failure. It’s important for the speech-language pathologist to understand how delays in early sound productions interfere with the process of reading and learn simple interventions to remediate both articulation and early literacy skills at the same time.

It is common to see many children in preschool, kindergarten and first grade struggling with articulation of sounds. Underneath that struggle is a child whose sound/symbol system is weak. That means this system may also be weak in hearing sounds, learning to read sounds and in learning to write sounds. This is the perfect time to get involved with the classroom teacher and use your skills to help all children make sense of sounds and print.  I have found it essential to teach an overlap of skills to the students on my caseload who present with moderate to severe articulation errors.

Reading and speech tips

Here are some general pointers on working on both speech and reading:

  • Review with the kindergarten staff how to teach all students how sounds are made, feel, look and touch as they are introducing alphabet sounds.
  • Talk about where the sounds are made in their mouths. Do they make the sound in the front of their mouth? Do they use airflow? Did their voice turn on or was it off? Was the sound made with their lips or their tongue? This practice helps students connect hearing the sounds to what their mouths are doing when saying them.
  • Teach children the correct way to produce sounds, making sure they don’t begin to add a “schwa” sound like ‘uh” onto the end of their productions. For example, the “f” says /f/ not /fuh/, the “h” says a silent /huh/ not a voiced /huh/, the “t” says /t/ not a voiced /tuh/, the “p” says /p/ not a voiced /puh/ and the “k” says /k/ not a voiced /kuh/. When children learn to produce sounds with the added schwa they may have trouble when they are sounding out words.
  • Be an active participant with the classroom teacher when they begin to assess the letters and sounds a child knows. Offer to help give the assessments and take a close look at the results. It’s amazing what you can learn about a child’s speech sound productions and early reading skills just by a simple sound assessment.
  • Consider an initial sound DVD that is very visual, repetitive and kinesthetically rich. Children can solidify alphabet sounds very quickly when given access to repetitive song-type DVD’s.
  • Phonemic awareness skills taught in the early grades are extremely important for children with speech articulation difficulties. Children need to be able to hear and play with sounds in words. Work with the child on the skills of blending and segmenting simple CVC words using sounds they are working on.
  • Teach classroom teachers and children about voiceless and voiced sound pairs. Make a chart and post it in the classrooms. When children understand how these sounds are related, spelling skills improve.

 

Voice Off Voice On
       f      v
       p      b
       s      z
       t      d
       k      g

 

When a child is reading text

Here are specific things you to can do to help when children read:

  • Use visual reminder cards with children to remind them to use certain reading strategies. A simple strategy card may include strategies such as “Get your mouth ready” or “Say what you see.”
  • “Say what you see” is helpful to say to children when they make an error when reading an initial sound in a word. So when a child is trying to read the word “dog” and he says “fat”, explain that if he sees a “d” in the beginning of the word his mouth has to make that sound.
  • Make simple books with beginning sight words tied to words with the sounds the child is working on. Books like “I see____” or “I like____”. Use blank page books or take a simple book that you own and replace the text with your own, targeting the sounds a child is working on.
  • Every time a child reads out loud they are practicing oral speech sounds.
  • Use highlighter tape to visually highlight the sounds a student is working on. Use the tape in books they are reading or in their writing to draw attention to sounds. Students love to use the tape to cover their sounds while another student in a group is reading.

Sue Lease is a speech-language pathologist at Glacier Edge Elementary School in Verona, Wisconsin. She has a particular interest in emergent literacy in young children.

Collaboration Corner: Must-Have Books for Building Language and Literacy

1book

I can’t believe it’s September! For those of us in public schools, that means re-organizing and replenishing our bag of tricks. Books of course, are an easy and engaging way to expand language.

If parents are looking for some ideas on stocking up their bookshelves (or yours) this list may help.

I also rely upon my librarian colleagues for other ideas. If I can find the board book version of anything, I usually opt for that version; board books are durable and allow you to do things like add pictures with a little bit of Velcro for matching, like this:

1horsepic

For very young children, or children with language delays, I generally use a couple (or five) quick pointers when perusing the bookstore:

  • Engaging pictures that aren’t too visually complicated but have a clear character and setting.
    • Targets: Who, what, where, when questions, descriptive language.
  • Books with repetitive words and phrases.
    • Targets: Oral/expressive language and literacy skills through  predictable text patterns and repetitive lines.
  • Books that aren’t too long, maybe 10-12 pages.
    • Target: Maximize engagement for short attention spans.
  • Books that can allow the adult to target core language concepts, either through text or illustrations.
    • Target: Syntax, vocabulary.
  • Books that enable the adult to expand beyond the text.
    • Targets: Commenting, labeling how a character feels or what they are thinking.

There are many books from which to choose, but here are some good starters for your collection:

  • Good Night Gorilla: Peggy Rathmann
  • The Very Hungry Caterpillar: Eric Carle
  • Have You Seen My Cat?:  Eric Carle
  • Good Night Moon: Margaret Wise Brown
  • Blue Hat, Green Hat: Sandra Boynton
  • Where’s Spot?: Eric Hill
  • Go Away Big Green Monster: Ed Emberley
  • Big Red Barn: Margaret Wise Brown
  • Good Dog, Carl: Alexandra Day

Not every book on this list follows every guideline perfectly,  but all allow for a positive learning experience that supports child language and preliteracy development.

Have an inspired school year colleagues!

 

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 speech-language pathologist and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this post are her own, and not those of her employer.

 

Fulltime Evaluator: An Effective New Role for the Speech-Language Pathologist  

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You’re an SLP at an elementary school who sees 42 students each week (most of them twice), attends individual education program meetings that are often scheduled back to back, reports for recess duty three times a week, and writes daily therapy notes and Medicaid reports, all while trying to squeeze in materials preparation for the next therapy unit. Now, how can you possibly find time for a two- to three-hour autism evaluation?

Sound familiar?

This was a typical week for the SLPs in the Albuquerque Public Schools until they created a new role group—”the SLP evaluator.”

APS is the 28th largest urban school district in the country, with over 90,000 students and approximately 10 percent of them receiving speech-language services in 143 different educational sites. The district employs 200 SLPs, but, due to a budget shortfall the past few years, faces challenges updating and replacing all the SLPs’ testing materials, such as the newly revised Clinical Evaluation of Language Fundamentals-5 or Oral and Written Language Scales-2. In addition, the New Mexico Public Education Department redesigned educational disabilities (such as specific language impairment, specific learning disability and autism spectrum disorder) in 2011 to standardize initial and reevaluation criteria. This required more training for those working in special education.

With these obstacles in mind, APS created a new SLP role—that of evaluator—to reduce caseloads, provide consistent eligibility criteria, and save some money in materials and training.

The evaluator group is made up of 22 SLPs (several of whom are bilingual) and is divided into one of three diagnostic centers across the city. We work side by side with educational diagnosticians, psychologists and others assessing students for all initial evaluations. We test students at the centers or at the schools, write reports and share the results with the diagnosticians, interpret test results with the parents, and attend the Educational Determination meetings at the school. We also collaborate with the SLP at the school who writes goals based on the findings of the assessments.

In addition, we conduct reevaluations when a change in eligibility is being considered, and for some schools we do all the reevaluations. Schools that have high caseloads, multiple district programs, or employ SLPs who are clinical fellows or who work part time may be designated a “Full Reevaluation” school. When a student is due for a reevaluation, we review past test results and current information and decide if the student needs another formal assessment. If one is needed, the SLP evaluator administers it. If a performance evaluation is appropriate, then the school-based SLP conducts it.

Last year, the evaluator role group performed over 1,900 evaluations; that’s 1,900 evaluations that the school- based SLPs did not have to do, which gave them the time they needed to focus on their therapy. And by using standard eligibility criteria, students in each school were correctly identified, which reduced the number of students with speech or language needs. The district was also able to save over $100,000 by not having to order the new CELF-5 for all 200 SLPs.  Now in its sixth year, the evaluator role group not only has been cost effective, but has proven to be an effective use of SLPs.

Rachel Hawkins, MA, CCC-SLP, is a speech language evaluator with the Albuquerque Public Schools.  She has worked in the public schools since 1993 in New Mexico and Colorado.  She can be reached at hawkins_r@aps.edu.  

Using Comic Strips in Speech Intervention

comic

For the past couple of years, I have used Carol Gray’s materials extensively during my work with adults with developmental disabilities. Creating comic strip conversations has been extremely helpful in facilitating conversation, resolving social issues between peers, taking turns in conversation and providing different social scenarios within various contexts.

Since I have worked in creating my own comic strip conversations with my clients for some time now, I decided to experiment using the comics section in the newspaper. My clients are motivated by the local newspaper for many reasons. They enjoy browsing through current events, looking at the pictures in the sports section and reading the comics.

The comics within a local paper are inexpensive (in my area it is just $1.00 for the local newspaper), easily accessible and age appropriate for older children, teenagers and adults. Therapy using comic strips has been surprisingly motivating and beneficial to my clients. I never realized how effective using the comics section could be!

I like to keep my favorite comics and laminate them for future use. I have also created a game around using the comics section. My clients take turns choosing from a pile of comic cards and then have a discussion about each particular card. When one client doesn’t understand a particular comic and why it’s funny, I have him ask his peer for assistance. As a group, we have had many extensive and interesting conversations related to the comics. Here are some speech and language goals that can be facilitated with the comics:

1. Expanding vocabulary: The comics are full of language, which make it an ideal time to discuss and define new vocabulary. It will be difficult for a client to understand a particular comic without understanding the actual definition of some of the words. For example in a recent Garfield comic, Garfield thinks “This is a perfect day to stay in bed and contemplate life’s truths.” Discuss what “life’s truths” means with your client. Defining the “contemplate” can help build vocabulary and build in conversation. Ask your client, “What do you contemplate about?”

2. Abstract Language/Humor: The comics are excellent in discussing abstract language and humor. In many comic strips, there are often multiple meanings of words. In a recent comic, the discussion between the characters was about “trail mix.” To one character trail mix was the snack, to the other character trail mix was a bunch of items that you picked up along a trail in the woods (e.g. dirt, sand, rocks). This comic began a conversation about the multiple meanings of words and how they had a miscommunication. Discuss the humor in the comic and why it may be funny to the reader. This can be a tricky exercise for many clients especially with autism, but it can be extremely useful as well. Helping a client recognize humor can help build friendships and improve conversational skills.

3. Taking Turns in Conversation: Between characters, there are natural turns in conversation. This can be a great model for conversation. As a carry-over activity continue the comic with an extra blank comic strips. This can help your clients create their own conversations.

4. Improving Literacy/Punctuation: Having your client read the comics can help improve literacy and reading comprehension. Point out different punctuation markers within the comic such as exclamation marks, periods, question marks, etc. Also, discuss the difference between the characters thinking a particular thought versus actually speaking it.

5. Interpreting Facial Expressions and Feelings/Emotions: In many comic strips the characters have extreme emotions. In other comics, the feeling and emotions of a character can be a little tricky due to the high levels of sarcasm. Read the specific comic strip together, discuss the language and then ask your client how the character is most likely feeling.

Rebecca Eisenberg, MS, CCC-SLP, is a speech-language pathologist, author, instructor, and parent of two young children, who began her website www.gravitybread.com to create a resource for parents to help make mealtime an enriched learning experience . She discusses the benefits of reading to young children during mealtime, shares recipes with language tips and carryover activities, reviews children’s books for typical children and those with special needs as well as educational apps. She has worked for many years with both children and adults with developmental disabilities in a variety of settings including schools, day habilitation programs, home care and clinics. She can be reached at becca@gravitybread.com, or you can follow her on Facebook; on Twitter; or on Pinterest.