What School SLPs Want to Know

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If you want to know what the real talk is at an ASHA Schools Conference, you need to pull up a chair at the lunch tables. That’s where you’ll hear chatter about the most top-of-mind topics for the speech-language pathologists and audiologists who attend.

So it was that this roving blogger sat down to share a sandwich and some conversation with this year’s attendees. Here’s what a sampling of them report are the most burning issues that brought them to Schools 2014 in Steel City: Pittsburgh.

Brianne Young, SLP, Renfrew, Pennsylvania
I want to know how we’ll use the Common Core State Standards. We’re switching to the Common Core totally but we haven’t yet transitioned the speech-language piece of it 100 percent. We started adapting the reading and language standards last year, and nobody’s sure how this will all work. I also want to know more about incorporating Common Core with RTI.

Amy Shaver, SLP, Hamden, Connecticut
As a former stay-at-home mom just getting back into it—I just got hired fulltime by a school for next year—I want to learn more about iPad apps for speech. The technology has changed so dramatically and rapidly in eight years. It’s kind of an odd place to be because as a mom, technology can seem like a big negative. I’m always limiting my kids’ screen time. So it’s an interesting shift to think of it as an educational tool.

Sabrina Hosmer, SLP, Manchester Public Schools, Connecticut
As a bilingual evaluator, I’m here to find out how other SLPs have made systemic changes to their school districts. In our district we have problems of overidentification of speech-language disorders among bilingual children. The children are tested in English, and they’re not supposed to be, but we don’t have enough bilingual SLPs to do appropriate assessments or to serve the bilingual kids who really do have speech-language disorders.

India Parson, SLP, Prince Georges County, Maryland
What’s on my mind? The Common Core—how do we use the literacy standards with children with severe disabilities? And what’s going to happen with tying them to performance evaluations of SLPs, which they’re doing with teachers and are talking about doing with us? The other issue is the shortage of bilingual therapists. We have a big problem of overidentification of disabilities in the bilingual population. We need folks making better diagnostic decisions up front.

Christine Bainbridge, SLP, Ithaca, New York
What’s burning for me is wanting to learn more about central auditory processing disorder—what is the research evidence base on CAPD, how does it truly change children’s functioning in the classroom, and how do we intervene with it in an evidence-based way?

Audrey Webb, SLP, Charlotte, North Carolina
I’m just coming into the K-12 schools this year after working as a preschool SLP for many years, so what’s going on with the Common Core will be big. Of course, a lot of that’s up in the air now because our state legislature just repealed it, but we’ll still be using it for the time being. I’m also big on RTI. I’m a fan of it, and always interested in ways to get teachers on board with it.

Mary Pat McCarthy, SLP, Clarion, Pennsylvania
My reason for going to Schools every year is always to see what the current buzz is. It’s no one thing I want to know. It’s everything, really. I know if I go, I’ll get what I need for the coming school year. This year I’m especially interested in hearing about working with teachers on improving our work on phonology and articulation with kids. But this conference is always a great professional recharge during the summer.

 

Bridget Murray Law is managing editor of  The ASHA Leader.

SLPs in the Home: What’s Pot Got to Do with It?

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I never thought I’d be writing an article for ASHA about marijuana, but because I live in Colorado, I’ve got the latest news on weed to pass along to my fellow SLPs. In fact, if you were sitting here with me in the privacy of my own home (and you were over 21), we could chat about it while lawfully smoking a joint, munching on an edible cannabis-laced cookie, sucking on a marijuana lollipop or even, inhaling the vapors from an e-cigarette packed with marijuana oil. That’s just a sampling of the options we have to get high in the “mile high city.” Before you shout “I’m coming over!” I should probably disclose that I’m not a marijuana user, medical or recreational. If your next thought is “But I DON’T live in Colorado (or Washington) so this doesn’t apply to me – at least professionally” please read this entire article. Colorado law is considered a “springboard for other states” to legalize marijuana soon. Plus, illegal shipping to other states, often discovered during a routine traffic violation committed by the average Joe next door, has increased significantly. According to the El Paso Intelligence Center & National Seizure System, the mini-vans and SUVs bringing home “souvenirs” from Colorado aren’t just from the states bordering the Rocky Mountains. New York, Florida, Illinois and Wisconsin were some of the most popular destinations and consequently, you may experience some unexpected safety issues if you are providing home-based care for children and adults.

In an effort to educate therapists on the new laws and our responsibility to inform our families of issues that may arise with recreational marijuana use, Jane Woodard, the executive director of Colorado Drug Endangered Children, is traveling the state providing health care professionals the necessary information to keep ourselves and the families we serve safe. SLPs are required by law to report suspected conditions that would result in neglect/safety issues or abuse of children and adults. However, many of our families are simply not aware of the safety concerns and home based therapists are often the first resource for educating those families who choose to partake in using, growing or processing recreational marijuana.

Given the various populations that we serve, here is an overview of some of the safety issues:

Infants: As a pediatric feeding therapist, just one of the populations in my care are babies who require support for breast and bottle feeding. In this Colorado culture of embracing our new freedom, mothers are commenting to me without restraint that they’re using marijuana to combat nausea during pregnancy or enjoy “a little pot now and then” while breastfeeding.Studies indicate that by age four alarming changes occur in children that have had prenatal exposure. It’s noteworthy that the studies focused on a much lower amounts of delta-9-tetrhydrocannibinol (THC: the chemical that produces the psychoactive effect) than what is present in today’s super-charged marijuana products. The children demonstrated “increased behavioral problems and decreased performance on visual perceptual tasks, language comprehension, sustained attention and memory.” Marijuana use while breastfeeding is contraindicated because the THC is excreted into breast milk and stored in fat and is suspected to impact a baby’s motor development. There are no established “pump and dump” guidelines for THC and it stays in the bloodstream for much longer than other drugs. Consider the increased risks from both second-hand smoke and third-hand smoke or the “contamination that lingers” after smoking, including an increased risk for SIDS and more. For the home-based SLP, exposure to second and third-hand smoke or residue means that I will likely carry that aroma with me to the next home. I am responsible for the safety of all of the children I treat, and many are medically fragile and/or have sensory challenges and would be impacted by these odors. Today, I am faced with difficult conversations with parents that I never imagined I would have.

Children: In four short months, from January to April 2014, Colorado’s Poison Control Center has reported 11 children who ingested edibles, one as young as five months old. Over half of those children had to be hospitalized and two were admitted to the ICU. Consider that those are the reported cases – and what goes unreported is difficult to ascertain. While the law requires that the packaging cannot be designed to appeal to kids, current practices are questionable. Some argue that edibles are packaged too much like junk food, with boxes of “Pot-tarts” similar to the popular toaster pastry, bottles of fizzy “soda-pot” and candy bars with labels that rival Mars® and Hershey’s®.  In April 2014, Karma-Candy was the marijuana candy that a father in Denver consumed just before hallucinating and killing his wife, who was on the phone with 911 dispatchers at the time. She could be heard yelling to her kids to go downstairs as she desperately tried to get help for her family.

Packaging of certain products must also be in an opaque and re-sealable container, but that law only applies to the time of purchase. Plus, most edibles contain multiple servings and it’s not unusual for one cookie to serve six people. Even adults are mistakenly eating whole cookies and in April 2014, one visiting college student consequently jumped to his death from a hotel balcony after eating too much of an edible. A New York Times columnist visiting Colorado ate a whole candy bar labeled as 16 servings, and “laid in a hallucinatory state for 8 hours.” Home baked marijuana options are equally confusing. As a feeding therapist, I used to be comfortable offering foods to a child from a family’s pantry. But now, a tempting plate of brownies may be more than just a plate of brownies. By law, edibles, like any marijuana product (even plants), must be in an “enclosed, locked space.” However, it is not unusual for Colorado therapists to arrive for their home visit and find a bong, topical lotions or a half-eaten edible on the living room coffee table. Early intervention and home health care agencies are considering how to educate families on the first day of contact, during the intake process. Susan Elling, MA, CCC-SLP, who treats both children and adults in the home, notes that “It will be very important to have an open and honest conversation with a patient (and their family) regarding marijuana use as part of taking the medical history – just as we do for alcohol and smoking.”

Adults: Ms. Elling reported that “the population in need of homecare services may be more likely to use marijuana to control pain and nausea” because family members are more likely to suggest it and there will no longer be a need to obtain a medical marijuana card. Ms. Elling also notes that marijuana “affects sleep, balance, coordination, and cognition.  This may be amplifying the conditions a patient is already dealing with related to medical issues.  It can also significantly raise anxiety.  These are all factors that increase fall risk, confusion, lead to poor judgment, and can setback a patient’s recovery. It may be very difficult to determine what issues are related to the patient’s medical condition and which are related to the marijuana use.  Interventions, progress and prognosis may be affected.” Edibles in particular are a safety hazard for this population, because of the inability to self-regulate. There is no predicting how an edible will effect one person or another.

“It’s not your grandmother’s marijuana,” reported Dr. Richard Zane, who is the head of the Department of Emergency Medicine at the University of Colorado Hospital. Well-meaning family members, hoping to control their loved one’s discomfort, may not realize that the strength of today’s marijuana is significantly higher than the pot your cool grandma smoked in the 60’s. In fact, THC levels represent a 121% increase just from 1999 to 2010. Family members may not understand that the strength and effect of the drug varies from product to product. For example, compare two hits on today’s joint and an individual will ingest approximately five mg of the chemicals that produce the psychoactive and/or sedative effects compared to up to 100 mg in one packaged edible. Plus, even using the exact same method of ingestion does not guarantee the exact same dosage every time. Zane reported in this interview with Colorado Public Radio that the “drug isn’t always spread evenly through food or candy, so several people eating the same amounts can be ingesting different quantities of marijuana.”

The uncertainty of dosage and effects has Elling on guard: “I am concerned that the high potency, unpredictable effect, easy availability, and unclear dosage information of edibles may have serious consequences for homecare patients with already fragile health. It is also misleadingly considered quite “benign” and safe compared to alcohol consumption and smoking.  I feel the need to know the signs and symptoms of a marijuana overdose and know the contraindications with any other prescription or OTC drugs they may be taking and be able to educate my patients and their caregivers regarding this issue.”

Additional Safety Concerns: In the course of this short article, it’s impossible to cover all of the safety issues, including those related to growing and processing marijuana in the home. These concerns include electrical hazards from impromptu wiring (not to code); cultivation hazards such a mold and poor air quality for medically fragile patients;  increased carbon dioxide and carbon monoxide necessary for growing; chemical exposures and improper storage of pesticides and poisonous fertilizers; THC on household surfaces and airborne exposure; and exploding hash oil labs. From January to April 2014, hash oil explosions occurred on a weekly basis in Colorado, some triggered just by turning on a nearby light switch.

Consider Family Functioning: The impact on safety is the tip of the iceberg. Woodard explained that home health professionals must consider a parent’s behavior when using marijuana, the impact on a child’s behavior and family functioning overall. Difficult but often necessary questions to ask include: What steps have you taken to protect your children and family members? How do you store your marijuana and paraphernalia? What are you like when you use? Most importantly, she recommended asking yourself “Do I believe that the conditions in this home could reasonably result in harm” to anyone in this household? If so, educate the family and be mindful of mandatory reporting laws.

 

Melanie Potock, MA, CCC-SLP, treats children birth to teens who have difficulty eating.  She is 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 and includes both her book and CD for each attendee.  She can be reached at Melanie@mymunchbug.com.

Kid Confidential: Parent Education and Training, Part 1

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This is part 1 of a three part blog series on the topic of parent education and training.  Look for part 2 and part 3 coming up over the next two months.

Parent education and training is not only an important part of our job as SLPs it is an essential part of our job.  Still, I’ve spoken to many SLPs over social media who still feel like they are lacking this particular skill for a number of reasons. For SLPs in the schools, their caseloads are so high and paperwork demands so daunting, they are left with little time to collaborate with school staff let alone contact parents on a regular basis. For private practitioners, speaking from experience, I think we are so focused on targeting the necessary skills and making gains with our clients, that we forget how important parent education can really be.

We know that parent involvement in general education is certainly beneficial. Children whose parents are involved in their school tend to have better academic performance and fewer behavior problems. It makes sense that parental involvement in speech services also would result in positive effects such as increased home practice of target skills and generalization of learned skills to the home environment.  In fact, there are whole therapy models (i.e. DIR/Floortime, Hanen, etc.) that incorporate parent education and involvement as key factors in their models and have the research to back it up.  The DIR/Floortime model’s portion of parent education and training has been tested and retested among various populations all resulting in positive effects, faster progress and improved generalization of social skills for children with ASD (see list of additional resources below).

So the question we need to ask ourselves is why we aren’t tapping into this wonderful resource and effectively educating and training parents of our clients?  For myself, I can tell you that it took some time to become effective in this manner. Initially it seemed as if I was more of a teacher explaining the rationale for various techniques however I was missing some very important steps. Over time, I have improved upon my ability to educate and train parents and I will share with you my tips for effective parent training:

  1.  Trial techniques:  The first thing I usually do is trial various techniques to determine which techniques the child responds successfully.
  2. Explain rationale:  Once I determine the most effect speech therapy techniques for the child (which we have to accept will change over time, maybe even at each session depending on the child’s ability and behavior), I will explain the rationale behind the techniques to the parent(s) present (either in my therapy room or in their homes when providing therapy).
  3. Model technique(s):  Modeling the technique(s) immediately after explaining the rationale will demonstrate the effectiveness of the technique(s) and make more sense to the parent(s).
  4. Parent’s turn: Allowing the parent(s) to take turns trying to eliciting the communication skill via the use of determined techniques will give them much needed practice in the safety of the therapy session.
  5. Give Feedback: Giving feedback is necessary to training.  It allows parents to feel successful with the skills they currently exhibit and provides additional ideas for the areas in which they are weaker.
  6. Follow up: I think it is so important to follow up with parents session to session to determine how well the techniques are working at home, how comfortable they feel using the techniques and if there are adjustments that need to be made for more effective use.

These are my basic tips for effective parent education and training.  Next time I’ll be talking about how I realistically incorporate parent education and training in my speech therapy sessions.

DIR/Floortime Resources:

  • Casenhiser, D., Shanker, S., & Stieben, J. (2011). Learning Through Interaction in Children with Autism: Preliminary Data from a Social-Communication-Based Intervention. Autism, 17 (2), 220-241.
  • Pajareya, K., & Nopmaneejumruslers, K. (2011). A pilot randomized controlled trial of DIR/Floortime™ parent training intervention for pre-school children with autistic spectrum disorders. Autism15 (5), 563-577. doi: DOI: 10.1177/1362361310386502
  • Solomon, R., J. Necheles, C. Ferch, and D. Bruckman. “Pilot study of a parent training program for young children with autism: The P.L.A.Y. Project Home Consultation program.” Autism, 2007, Vol 11 ( 3) 205-224.

 

Maria Del Duca, M.S. CCC-SLP, is a pediatric speech-language pathologist in southern, Arizona.  She owns a private practice, Communication Station: Speech Therapy, PLLC, and has a speech and language blog under the same name.  Maria received her master’s degree from Bloomsburg University of Pennsylvania.  She has been practicing as an ASHA certified member since 2003 and is an affiliate of Special Interest Group 16, School-Based Issues.  She has experience in various settings such as private practice, hospital and school environments and has practiced speech pathology in NJ, MD, KS and now AZ.  Maria has a passion for early childhood, autism spectrum disorders, rare syndromes, and childhood Apraxia of speech.  For more information, visit her blog or find her on Facebook.

Collaboration Corner: 10 Easy Tips for Parents to Support Language

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As we make our way through the lazy days of summer, schedules change, and things relax. My usual theme is collaboration; parents can be one of our biggest assets in promoting language development. Parents of young children usually want to know what they can do to support their child’s language development in the absence of a structured day. Though I teach children with disabilities, I find I continually revisit the following tips with parents of young children regardless of whether a child is typically developing or needs a little more support. Here they are in no particular order of importance:

  1. Pay attention to body language, when a child is looking toward or reaching for something, they are communicating. Talk about what they are reaching for, “Oh, you want the bubbles!”
  2. Avoid the “say this” tendency. Don’t pressure the child to speak; keeping the experience positive is important. Instead, model what the child might say when he/she is ready.
  3. Take time to sit and read with your child every day. Label everything you see, and encourage them to point to the words and pictures as you talk about them. Books with repetitive lines are great.
  4. Be playful. Sing songs. Use lots of inflection. With familiar songs, leave some of the words out and see if your child will hum or sing the words.
  5. Provide limited choices when you aren’t sure what your child wants. Holding out 2 items, lessens the stress of having too many choices.
  6. Talk with your child about what you are doing, then provide the opportunity for your child to reciprocate. “I’m making some cookies, do you want to help?”
  7. Use first/then language to guide behavior, and then be consistent, “First you need to eat, then you can read.” Use this language even when moving between activities that are preferred or less preferred.
  8. Use pictures: Take pictures of your child’s day and talk about what is coming up next, or make a photo album of fun activities (vacation, going out for ice cream) to talk about.
  9. Remember language is everywhere, even if you child doesn’t understand everything you are saying, he or she needs the exposure. Car rides, walks outside, blowing bubbles are just a few examples. Describe what you see, and ask questions, e.g, “I see a cow. What does a cow say?”
  10. Simplify your props. Sometimes the simplest toys can bring out the best language. Summer is full of such opportunities: A spinning toy, taking a turn kicking a ball, bubbles…all can support your child’s development, simply by talking to them.

Kerry Davis Ed.D., 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 pathologist and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this blog are her own, and not those of her employer.

Favorite Resources: Fiction and Non-Fiction Texts

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School based SLPs often look to align their intervention goals with academic content standards to increase student success in the classroom. Many of these goals align with English Language Arts standards. Goals for vocabulary, comprehension, and articulation can be targeted easily using fiction and non-fiction texts. Using reading passages is a perfect way to support reading skills and curriculum. It’s also an easy way to incorporate current events or seasonal information as well. I wanted to share four different resources I used for my caseload this year.

The

1. Newsela.com
Newsela is a site that takes regular news articles and changes the lexile level for a variety of readers. You can select the article, then pull it up on your screen. On the right side of the screen you can select a variety of lexile levels from 3rd grade up to the regular adult version.This is perfect for mixed groups.
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I love to use it for middle schoolers reading at lower lexile levels.
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We also use these in my articulation groups. This 7th grade student went through and highlighted each /r/ word.
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As he reads the page, I marked each sound with a +/-. Then we go back and work on the words he missed. This resource is free.
2. ReadWorks.org
ReadWorks is another fantastic free resource. I love their units for seasonal reading. Sign up for a free membership. You can search using the calendar at the bottom of the home page. There are resources for Kindergarten and up.
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They even have whole units for free for common books you already have on the shelf! Take time to search through and find units that are made to teach specific skills.
3. ReadingA-Z.com 
Many  districts pay for teachers and SLPs to have access to ReadingA-Z.com. I use it a lot and would recommend it to any SLP working with school aged students. I also have access to VocabularyA-Z. Let me show you some favorite resources within it.
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Leveled books used to be the meat of ReadingAZ. Lately they have added a whole lot more, but these are still my Go-To!
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Once you open a leveled book, you have many options. Print the book, share on a Smartboard, or print additional worksheets.
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I love the vocabulary connections most of all.  Since we have a subscription to VocabularyA-Z there are sets of  vocabulary lessons for EVERY BOOK!
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This is such a huge time saver for me. It takes the planning out of vocabulary practice!
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There are special lessons for ELL/ESL. These are great for language learners and for daily living skills units.  There are printable books that focus on feelings, vocabulary (vegetables, money, etc.), and places (neighborhood, school).
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The website also includes decodable books.  They are divided by sounds and even blends. These are  great for articulation practice.
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One section of ReadingAZ features comic books. Lots of my reluctant readers /language delayed  kids love comic books.
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The last feature I frequently use is the write your own story books. Most of the lower leveled books are available in the ‘write your own’ format. You can either print the regular book or print the wordless book. This is an easy way to progress monitor a variety of grammar and narrative skills. Of course it’s great for direct instruction, too! If you’re working on retell you can read the story with the words first and then use the ‘write your own’ version to support retell.
ReadingAZ is a paid subscription. Look into the free trial if you haven’t used it before.
4. N2Y.com
News-2-You is a symbol based weekly newspaper. It’s my ‘go-to’ for daily living skills classes and autism classrooms. I love the predictability and the symbol support. You can also download many levels of  instruction.
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This is the ‘regular version.
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The simplified version has less text.
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This is the ‘higher’ version (but still not the highest offered.)
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Did you know they have a spanish edition?
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I love the pre-made communication boards and the recipes included. I use the app frequently with my students.N2Y is a subscription based program. You would not be disappointed if you purchased it. I promise!
Those four resources are websites I use every week to support my instruction.  SLPs can use them as part of their instruction or as a way to provide homework, align their intervention goals with academic content standards in order to increase student success in the classroom.

Jenna Rayburn, MA, CCC-SLP. is a school based speech-language pathologist from Columbus, Ohio. She writes at her blog, Speech Room News. You can follow her on facebooktwitter, instragram and pinterest.

How to Make Social Skills Stick

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At Communication Works, a private practice in Oakland, California, we’re passionate about partnering with parents and caregivers in the treatment process. When it comes to social learning, many children struggle to carry over learned skills from the therapy setting or school to their home environment. Parents are in a perfect position to help practice and facilitate those skills and help make them stick! As professionals, we can give parents the awareness and knowledge as well as the tools and strategies to help them embrace teachable moments and guide their children. Even though parents are busy and sometimes overwhelmed, we can enlist their help without making stressful demands on their time. Parents are usually eager to help as long as we offer specific, easy activities that fit within the family’s natural routines.

Whenever possible, try to support the things parents are already doing and to piggyback onto those activities, such as reading bedtime stories, doing chores, or eating dinner. As an example, if a child is working on conversational turn taking in therapy, families can pass a “talking stick” (a spoon or spatula) at the dinner table to signify whose turn it is to talk and facilitate taking turns when describing each person’s day. If the child is working on “wh” or “wonder” questions (who, what, when, where, etc.) and you are using a visual prompt to facilitate this in therapy, make a copy of that visual and send it home for parents to use with their children during meal times or when having conversations in the car..

If you’ve created a roadmap or social story for an event at school, share a copy with parents. If the child has an event coming up (a graduation, birthday party, holiday, etc.), offer examples of details the parent can share with the child about what is expected during that event. For example, if a child is planning to attend a graduation for the first time, the parent can explain about caps, gowns, and diplomas (and why students toss the caps into the air) as well as how much sitting still and listening time the child can expect. If the child hasn’t yet attended a July 4th celebration, the parent can prepare the child for a big crowd and loud noises. They can discuss the type of behavior expected in a crowd and how to make the event more enjoyable and comfortable for the child, perhaps by bringing earplugs or asking for a break when feeling overwhelmed.

Parents also appreciate simple suggestions for teachable moments that may occur during part of the family routine or in the community. For example, if you’ve worked on increasing observational skills and understanding nonverbal language, talk to the parents about setting up a time for them, to take their child out for a snack and do some “people watching.” This can not only be an excellent opportunity to generalize a skill learned in the therapy setting, but can be a great bonding experience for parents and children. Teach the parents how to play “social detective” with their child and identify how the other people in the coffee shop are related, how they are feeling, and possibly what they are talking about. If you’re teaching sequencing during a therapy session, show parents how to practice this skill by sequencing out the steps for baking cupcakes or making a birthday card. If you’re focusing on self-regulation strategies like calm breathing, show the parent how to practice by placing a teddy bear or book on the child’s belly and watching it go up and down. As you develop new lessons, think about how parents could easily adapt them for home use. Be sure to provide handouts or information for them to share with other family members, and keep activities “no fuss” for busy parents.

Therapists working in schools will have limited time with parents, but can communicate through notes, logs, or a binder that goes back and forth from home to school. If you work in a private setting, consider bringing parents into group or individual sessions for a portion of the time, and have the child(ren) show what they have learned. Take a few minutes to brainstorm with the parent about ways to practice at home. Parents appreciate knowing the why’s as well as the how-to’s. Without overwhelming them with pages of information, provide the reasoning behind a particular activity as well as specifics about how to carry it out at home.

Social learning is a 24/7 process, and kids need support to be able to bring learned skills into the home and community. If professionals don’t collaborate with parents, the child misses countless opportunities for practicing essential social skills. When we do engage parents in the process, they can serve as both coaches and cheerleaders for their children. If we give parents the right tools, knowledge, and encouragement, they can feel confident and inspired to play an essential role in bridging the gap between therapy and real life.

Elizabeth Sautter, M.A. CCC-SLP is co-director and co-owner of Communication Works, a private practice in Oakland, California, offering speech, language, social, and occupational therapy. She is the co-author of the Whole Body Listening Larry books. Her most recent book is Make Social Learning Stick! How to Guide and Nurture Social Competence Through Everyday Routines and Activities. She can be reached at makesociallearningstick@gmail.com or follow her: website; Facebook; Pinterest; Twitter.

Robot Turtles: A Fun Way to Target Social Communication and Coding Skills

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If you are looking for a fun way to target social communication skills, as well as beginning computer programming, Robot Turtles is a great new board game you can play with your students (with or without autism). Robot Turtles requires players to use simple commands to move their turtles to capture a jewel on the game board. When students give commands, they are replicating the process computer programmers use to give instructions for a computer to execute. Games, in general, provide opportunities for social communication; Robot Turtles in particular involves specific interactions between the game players that enable more opportunities for social communication. For students who show an interest in games and computers, playing Robot Turtles can be a highly engaging way to practice social communication. Check out this video.

During game play, it is easy to provide students with opportunities to practice five different social communication skills:

1) Perspective taking: As turtle masters, students take the perspective of their turtles on the game board in order to decide which way to move. If they were to take their own perspectives, players may not move in the intended direction; success in the game depends on the ability to make decisions based on a different perspective.
2) Turn taking: Students also actively take turns throughout the game. Not only do they have to wait for the other turtle masters to complete their turns, but students do not actually move their own game pieces. The adult overseeing the game, otherwise known as the turtle mover, is in charge of executing the moves on the game board based on student commands.
3) Eye contact and body language: Since turtle masters don’t move their own pieces, they must clearly communicate their commands to the turtle mover. This offers a good opportunity to practice politely giving directions, as well as utilizing eye contact and body language to effectively communicate and acknowledge the turtle mover.
4) Following directions: In return, the turtle mover may communicate directions for the turtle masters to follow. The turtle mover also ensure players are aware of and adhere to the rules of the game.
5) Making comments: Throughout game play, students can be encouraged to make positive comments directed specifically to other turtle masters. For example, a student could say, “Nice move. I like how you did that!” when another player makes a good move in the game. In Robot Turtles, the goal is not to have one winner; all students keep playing until they achieve the goal for that specific level. Establishing a positive atmosphere where everyone is encouraged to be successful creates a great opportunity for modeling and practicing comments.

Robot Turtles can be played with children as young as four, all the way up to middle or high school. The game has several levels so it is easy to adapt game play based on student age and experience with the game. The upper levels of the game require sophisticated logic and analytical skills to complete the challenges, while the simple levels introduce children to basic logic. Either way, social communication skills can be targeted in various ways throughout the game.

Eric Sailers, MA, CCC-SLP, is a speech-language pathologist with eight years of experience who currently works with high school students. He has an assistive technology certificate and a mobile programming certificate specializing in iOS. When he is not providing speech-language services in schools, he is creating iOS apps and delivering presentations.

Why Growing a Healthy Green School is Golden

green school

Remember dioramas from first and second grade? Last fall I was invited to attend the opening of the U.S. Environmental Protection Agency’s “Lessons for a Green and Healthy School” exhibit, a giant, life-sized, walk through diorama on how to create a green environment in schools. Located at the Public Information Center of US EPA’s Region 3 offices in Philadelphia, what I learned there about sustaining a healthy school for students, teachers, and community was exciting…and I heard it from the students themselves. [How to Build A Healthy School]

The Green Ribbon Schools Program is a joint endeavor between the U.S. EPA and U.S. Department of Education. The program honors schools and districts across the nation that are exemplary in reducing environmental impact and costs; improves the health and wellness of students and staff; and provides effective environmental and sustainability education, which incorporates STEM (science, technology, engineering, mathematics), civic skills and green career pathways.

A healthy green school is toxic free, uses sustainable resources, creates green healthy spaces for students and faculty, and engages students through a “teach-learn-engage” model. Examples of greening techniques include the using building materials for improved acoustics; installing utility meters inside the classroom as a concrete aid for teaching abstract concepts in math; and incorporating storm water drainage systems within a school’s landscape design to teach and practice water conservation. What are some environmental concerns to address when you are growing a healthy school?

  • Asthma and asthma triggers (indoor air quality)
  • Asbestos and lead (especially in older buildings)
  • Carbon monoxide (from old furnaces, auto exhaust)
  • Water fountains
  • Chemicals in the science lab (think mercury)
  • Art and educational supplies
  • Managing extreme heat
  • Upkeep of athletic grounds
  • Mold, lighting fixtures
  • Waste and recycling

Now more than ever, we must educate new generations of citizens with the skills to solve the global environmental problems we face. How can we have a green future or a green economy without green schools?

Benefits of green schools

1. Cost/Energy Savings:Daylighting” or daylit schools achieve energy cost reductions from 22 percent to 64 percent over typical schools. For example in North Carolina, a 125,000 square foot middle school that incorporates a well-integrated daylighting scheme is likely to save $40,000 per year compared to other schools not using daylighting. Studies on daylighting conclude that even excluding all of the productivity and health benefits, this makes sense from a financial investment standpoint. Daylighting also has a positive impact on student performance. One study of 2000 school buildings demonstrated a 20 percent faster learning rate in math and 25 percent faster learning rate in reading for students who attended school with increased daylight in the classroom.

2. Effects on Students: Students who attended the diorama presentation in Philadelphia expressed a number of ways how their green school changed personal behavior and attitudes. One young lady spoke of how a green classroom helped her focus and stay awake. Another student said being in a green school made them happier. There was more interest in keeping their school environment cleaner by monitoring trash disposal, saving water by not allowing faucets to run unnecessarily, picking up street trash outside the school, sorting paper for recycling, and turning off lights when room were no longer in use. Some students went so far as to carry out their green behaviors at home. Small changes in behavior and attitude such as these are the foundation for a future citizenry who will be better stewards of the environment.

3. Faculty Retention: Who wouldn’t want to be a speech-language pathologist in a green school? Besides, there would be so many opportunities for a therapist to embed environmental concepts in to their session activities. Think how a quieter environment would foster increased student attention. How about having the choice of conducting a small group session in the pest-free landscape of the school yard? Research supports improved quality of a school environment as an important predictor of the decision of staff to leave their current position, even after controlling for other contributing factors.

How to make your school green

  • Have a vision for your school environment. You can start small at the classroom level or go district wide. Focus on one area or many (healthier cafeteria choices, integrated pest management, purchase ordering options, safer chemistry lab) Maybe you already know what environmental hazards affect your school – if you do then start there.
  • Get a committee going. It helps to have friends. Is there someone you can partner with? School nurse, building facilities manager, classroom teacher, PTA, students?
  • Conduct a school environmental survey. This doesn’t have to be complicated, you can poll your colleagues, or discuss at the next department meeting, or over lunch. If you like, check out EPA’s “Healthy SEAT – Healthy School Environments Assessment Tool” for ideas.
  • Have a plan. Select a time frame, short term first and use it as a pilot to evaluate whether a green school is possible. Pick something small to work on.
  • Monitor and evaluation your progress. It’s always a good idea to collect data but it doesn’t have to be too sophisticated. Use “before and after “ photos or video student testimonials.
  • Embed the green environment into the student curriculum and activities. Create speech lesson plans with green materials or photos of your green school project. Growing Up Wild is an excellent curriculum for early childhood educators.

Anastasia Antoniadis is with the Tuscarora (PA) Intermediate Unit and works as a state consultant for Early Intervention Technical Assistance through the Pennsylvania Training and Technical Assistance Network. She earned a Master of Arts degree in speech pathology from City College of the City University of New York and a Master’s degree in public health from Temple University. She was a practicing pediatric SLP for 14 years before becoming an early childhood consultant for Pennsylvania’s early intervention system. Her public health studies have been in the area of environmental health and data mapping using geographic information system technology.  You can follow her on Twitter @SLPS4HlthySchools. 

 

 

 

Language Time with Curious George

 

banana

I can’t remember a time in my life that I didn’t love the character Curious George. He is a cute, sweet and lovable character with a curiosity that most children and adults can appreciate. Curious George books were originally written by Margret Elizabeth and her husband Hans Augusto “H.A.” Rey. They were first published in 1941 by Houghton Mifflin.

Curious George books are generally predictable, which can be an advantage for those children struggling with speech and language disorders including issues with narratives and sequencing. Already knowing and understanding the characters and the mischievous ways of George can help a child engage in each individual story and increase motivation.  In the more recently published books, there also includes a carryover lesson and activity. With so many Curious George books published (hundreds but I haven’t counted), it is easy to find a book for younger and older children depending on particular interests. There also are some e-books available, as well. I recently wrote an article on comparing e-books and print books.

Growing up with such a fondness for Curious George naturally led me to reading this series of books to my own kids and clients. I wanted to share some language tips in this article to use for the Curious George series. Language tips include:

  1. Expanding vocabulary: Within each book you will find new vocabulary to work on and define. For example in “Curious George Goes to the Chocolate Factory” discuss and define vocabulary such as “chocolate”, “treat”, “sale”, “factory”, “store”, etc. Words that many children do not know may include “truffle,” “caramel,” and “tour guide”.
  2.  Sequencing: Within each story, there are basic events that occur in a specific order. For example in Curious George Makes Maple Syrup, there are clear and concrete steps to make the maple syrup.  In order to work on sequencing, take some photos and upload them to sequencing app, such as Making Sequences.  With this app, a child can put the story in order and then retell you the story in their own words. Another way I work on sequencing is to use blank comic strips.
  3. Recalling information: Throughout the story, ask simple questions and help your child recall specific information about the story. For example, during Curious George Makes Pancakes, encourage conversation about George and his involvement in making pancakes. Why does everyone love George’s pancakes? Why is he running away from the chef?
  4. Describing: Encourage your client to explain what is occurring in the story. For example, in Curious George Makes Maple Syrup, encourage your client to explain to you how the maple syrup might taste and what a maple tree looks and feels like. If possible, bring in some maple syrup and a piece of a tree bark and ask your client to describe the feel and smell of the syrup and bark.  If you don’t have the manipulatives, search for videos or pictures describing what is in the book. For example, with the book, Curious George and the Plumber, I found a photo online to show my client what an “auger” was and other equipment that the plumber used in the book. It helped connect specific ideas with the book and make it more concrete and engaging for the child.
  5. Answering “wh” questions: Throughout the book, ask “wh” questions and encourage your own client to ask specific questions about the story. Work on pragmatics by staying on topic and taking turns within a discussion.
  6. Problem solving: There are many opportunities to problem solve during any story with Curious George because he is always getting into trouble due to his curiosity. Discuss the problem and ask your client to figure out what he might have done differently to deal with a problem. For example, in Curious George and the Puppies, George decides to let all of the puppies out because he wanted to hold them. All of the puppies ran out and now George had a big problem. Before you move onto the next page, discuss what George should do, etc.
  7. Pragmatics: George and his friend, the Man with the Yellow Hat, have a wonderful relationship. Although George is always finding himself in trouble, it is obvious that both characters love and care about each other. They have a mutual respect for each other which can be a great model for children. Also, the Man with the Yellow Hat always forgives George for his mischievous ways which can be great discussion for many children.
  8. Literacy and Reading Comprehension: Work on improving your client’s ability to read the words in the story and comprehend what they are reading. Another way to work on literacy is having your client draw a scene from the story and then have them write a sentence about it.
  9. Emotions: George and the Man with the Yellow Hat have many emotions throughout each story. Both characters are often happy and then sometimes sad, scared, confused and regretful. Describe these emotions and begin a discussion about them.
  10. Narratives: use a story map such as this one with the story. This story map was created by Layers of Learning. There are many other story maps available, but I liked this one….

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.

Dynamic Assessment: How Does it Work in the Real World of Preschool Evaluations?

dynamic evaluation

 

In a disability evaluation, we ask a child to point “to the triangle” or “to the author” as part of test developed to identify disorder.  An evaluator who uses this kind of test to identify disability must assume that all children being evaluated have had similar exposure to “triangle” and “author” including similar family, cultural, and educational experiences. It follows then, that if a child cannot identify “triangle” or “author” it is because that child has some kind of learning problem. But what if a child does not have a disability but simply did not have the same exposure to “triangle” or books as the majority of children his age? Dynamic assessment offers evaluators an approach to see whether a child can acquire new linguistic information from the environment. Here are some clinicians examples of how to translate the dynamic assessment research into their own disability evaluations, including some “dynamic” approaches to increase the accuracy of our preschool disability evaluations.

First, Let us consider nonword repetition tasks, one type of dynamic assessment. Nonword repetition tasks assess whether a child can hear, retain briefly, and then repeat nonsense syllables of varying lengths. Nonword repetition tasks give us insight into why a child may have a weak vocabulary. If the child has difficulty with nonword repetition tasks it may indicate a disordered ability to learn new words from the environment and will also affect the child’s ability to understand directors and spoken stories. Here are two modules analyzing videos of several children, both with and without language impairments, doing the same nonword repetition task. By seeing how different children of different abilities perform as they acquire the new words, clinicians acquire clinical judgment. Nonword repetition tasks are not classic dynamic assessment because there is no pre and post-test. But because we watch the child learning new syllables in front of us, it is dynamic rather than static.

Another dynamic approach is fast word mapping. In fast word mapping we evaluate whether a child can learn new words. Because the words are completely made up, no child has more or less experience with these words. In these videos of 4-year-olds, one child is typically developing, one child has low average to mildly delayed skills, and one child has mild to moderate delays. What is especially helpful with more dynamic approaches to assessment, we see a much greater range of information about a child’s skills, rather than simply did he identify the “triangle” or not?

A child’s cognitive skills, including the ability of children to describe cognitively challenging tasks, can also be seen through dynamic assessment. Here is an example of how a psychologist used dynamic assessment to evaluate the nonverbal cognitive skills of a 2 year 10 month old boy with Autism Spectrum Disorder (See 8:25 to 10:50). The psychologist described in his report what he saw as: Dynamic assessment demonstrated that George is intelligent and learns quickly. The evaluator showed George how to make a rubber duck fly into the air by placing the duck on the flat end of a spoon placed on the table and hitting the round end. George smiled and laughed and searched for the duck, although he did not make eye contact with the evaluator. George tried and had difficulty the first time, but after a second demonstration George was able to make the duck fly and seemed happy he made it happen.”

David’s dynamic assessment task reminds me of one that a great trilingual SLP, Barbara Dittman, showed me. She used the disappearing egg in the cup trick. Barbara would show the trick to the student and tell him how to do it. Then she would bring another person–a parent, teacher, or peer—and have the student do the trick and then explain to the person how to do it. Barbara learned about cognition and also about the student’s ability to explain a somewhat challenging task.

Recent articles demonstrate similar effectiveness of dynamic assessment in distinguishing bilingual preschoolers with and without disabilities. These dynamic assessment tasks for bilingual preschoolers include fast word mapping and a graduated prompting task with a novel word learning, semantic, and phonological awareness component.

Based on research going back several decades, the importance of dynamic assessment in accurate identifying a language disorder is well established. New studies continue to support its value. In addition to the videos on dynamic assessment and preschool assessment in general, the LEADERSproject.org has many resources available to anyone looking to sharpen their disability evaluation skills including test reviews, discussion of current law, regulations, and policies, and model evaluations.

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, Cate is working with NYCDOE on a multi-year project to improve the accuracy of disability evaluations. The LEADERSproject.org is a website dedicated to supporting quality clinical services and is funded by the Provost’s Office and several foundations.  Cate, an ASHA fellow, received the “2012 Humanitarian Award” from the National Council of Ghanaian Associations, and ASHA’s certificates for Contributions to Multicultural Affairs and for International Achievement.