Getting Warmer at the ATIA Conference

florida2

Looking for a way to get warmer and up your assistive technology know-how? Well, sadly, you missed it– for this year, anyway. The Assistive Technology Industry Association, a non-profit organization that represents manufacturers and vendors of assistive technology solutions,  held its 15th annual conference in Orlando, Fla., during the last week of January (right about when half the country was under a winter advisory). But it wasn’t all about the weather; there was plenty of good information to be found. Two days were set aside for a selection of one- and two-day workshops, with topics such as Universal Design for Web Design and Digital Media and Technology Supported Evidence-Based PracticesThe Changing Role of AT Teams and an iPad Boot Camp.

From Thursday morning to Saturday, shorter presentations ran concurrently, providing the more than 2,600 attendees with an overwhelming set of choices. For many, the problem wasn’t which sessions to go to but which to miss due to clashes! Fortunately the handouts for all the sessions were available at the conference website so it was possible to ensure you took home all the information you came to collect.

Additionally there were more than 100 vendor booths showing the latest in software, hardware, and services available to the AT community. People tried out eye-gaze systems, tested screen-readers and magnifiers, saw hundreds of apps and software packages, met with people who use AAC devices, and  generally had lots of hands-on experiences with a broad range of technological solutions.

ATIA conference

And don’t forget about social media. Attendee Karen Janowski (@KarenJan) is an occupational therapist and assistive technology specialist with Newton Public Schools in Boston, and is a regular at the ATIA conferences. This year she was instrumental in organizing a now familiar event at many events – the conference Tweet-up. As an advocate of leveraging new social media technologies, she says that, “The Tweet-up was a great success and provided an opportunity for people to connect with their Twitter colleagues. Meeting each other face-to-face helps to strengthen those connections that have been made virtually. People on Twitter seem to be on the cutting edge and always willing to share ideas and information. In fact, Twitter has become one of the best professional development tools out there, with hashtags being central to the power of tweeting.”

As the host of a regular Twitter event, the #ATChat discussion group, Karen understands the growing role tweeting has in supplementing learning and interaction among the AT community. “In fact,” she says, “Twitter can get your reputation ‘out there’ beyond the AT community, and this facility to reach outside of your field is important.”

This was also the first year that an app was available on both on iOS and Android platforms to help people check on session and exhibitor information. The ATIA conference team estimated that over 2,000 copies of the app were downloaded, suggesting this will become a regular feature of future events.

The next conference is already scheduled to take place again in Orlando from January 27th-31st, 2015, (probably right about the time the second Nor’easter of the winter is bearing down) with the call for papers taking place between April 21st and June 20th this year. If you are interested in attending a great AT and AAC conference, put this on your radar. And for those of us living in the north, a week in Orlando in January is never a bad idea!

Russell Cross, MS, CCC-SLP,  is the Director of Clinical Applications for the Prentke Romich Company, a developer of AAC solutions. He is a member of ASHA SIG 12 and writer for the Speech Dudes blog.

Collaboration Corner: Love Your Librarians!

librarian

One of the best resources in my school is my librarian. I have an amazingly knowledgeable colleague who knows top to bottom, every resource on the shelf or online. Here are some things (online and off-line) that she taught me about my school library:

  • Libraries are an excellent resource for wordless picture books: I can never have enough wordless picture book resources to target narrative language, my kind librarian researched wordless picture books, and printed out a list of titles available throughout the district. The best part is I can check out books as I need to, which saves me from out-of-pocket costs for materials.
  • Libraries are a great place for pre-voc skills: One year I had a minimally verbal student with ASD who was so great when it came to sorting and shelving books in alphabetical order. I’ve had other students help with book check-in or check-out.
  • I have access to so many subscriptions purchased by my schools district, including curriculum-aligned resources, which includes my most recent favorite place, PebbleGo.
  • As we continue to help our students understand fact, fiction and other online places, there are a ton of resources for digital literacy and education, including cyber-bullying.

 

Finally, the library is a welcoming place for all kinds of learners. My generous colleague purchased multi-sensory books and curriculum which help my students connect with literacy in a way that is enjoyable. Whenever a student of mine is having a tough time, we can come to a place for quiet and a little bit of sunshine…there’s a spot right by the window whenever we need to beat a little bit of those winter blues!

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

 

Just Breathe. Really?

breathing

Easy for you and me to say.  But for 7.1 million U.S. school children it’s not. Childhood asthma rates continue to rise and from 2001 through 2009 those rates were the highest for African American children, almost a 50 percent increase. Asthma accounts for 10.5 million school absences each year. The main trigger of asthma in school children are the same contributors to poor indoor air quality. Yeah, that’s right … open a window.

Air is mostly composed of nitrogen (78 percent) and oxygen (20 percent), air also has about 1 percent of water vapor and tiny amounts of argon and other gases.  For most of us, air quietly passes through our nasal passages into our lungs and out again; taking in the oxygen needed for our blood supply during inhalation and disposing the carbon dioxide by-product during exhalation.  We do this without thought, without effort–unless you are a child with asthma.

Asthma is a chronic lung disease characterized by inflammation of the airways. Recurring symptoms include wheezing, shortness of breath, chest tightness, and coughing.  Asthma develops in childhood as early as 6 months of age and lasts a lifetime.  About one in 12 Americans are living with asthma and over one third of them are children. In adults women are more likely than men to have asthma and more boys than girls among children. Those with asthma pay a huge price, about $3,000 per year per person to be exact. This figure includes medical care, medications, lost work/school days and deaths.

Various triggers not easily controlled can cause an asthma attack such as changes in weather. However, there are other triggers that can be controlled such as the presence of dust mites, roaches, pets, and mold affecting indoor air quality.  Asthma is particularly more prevalent to those living in poor neighborhoods.  A recent episode of NBC Dateline revealed that the childhood asthma rates in East Harlem run at 19 percent compared to the adjoining Upper East Side neighborhood at 7 percent.  They breathe the same New York City air, so what accounts for the difference?

Water leaks, pest infestation and general contract repairs are the responsibility of a rental unit’s landlord. As economically disadvantaged families tend to reside in these units, they are at the mercy of their landlord. Water damage leads to mold; pest infestation carries allergens; both of these conditions create a significant trigger for asthma in children. Even a child without an asthma history may become asthmatic as a result of repeated and chronic exposure to such poor indoor air quality.

School absences are of particular concern; children who miss more than 18 school days are year are more likely to drop out of school. Children with asthma miss more days of school due to their disease compared to children without asthma.  The number of missed days rises with severity—on average a child with severe and persistent symptoms misses 11.5 days of school in a year.  That’s a lot of missed homework and make up speech sessions. Asthma also affects a child’s sleep quality, which in turn affects a child’s ability to pay attention in class and lowers their quality school work.

 What can you do? 

  • Know which children on your caseload have asthma and know how to deal with an asthma emergency, including the location of the child’s inhaler.
  • Take a look at your therapy treatment room or classroom. Are the floors hard wood or are they carpeted?  If hard wood, hooray! If carpeted, make sure they get vacuumed every day and shampooed at the end of the school week.
  • Got pets? If there are in your classroom, better to send them to another home. Animals carry dander that can trigger asthma. If you have a pet at home, make sure your work wardrobe is free of pet hair.
  • Are you working out of a trailer or portable classroom?  These type of environments generally trap moisture than can turn into nasty mold. Make sure spills and leaks are taken care of quickly.
  • Skip the perfume spritz and after shave before leaving the house for work. Fragrances can trigger an asthma episode.
  •  Refrain from fuzzy or scented materials, pillows or upholstered furniture; these can collect dust mites, which are (surprise!) asthma triggers. If the furniture must stay, vacuum it frequently.
  • No clutter!  Cockroaches and dust mites love clutter … and produce more asthma triggers.
  • If your room has a window that faces high volume vehicular traffic, keep it closed during the vulnerable morning hours and cold temperatures.
  • Stay away from phthalate-based toys  as phthalates are known triggers for asthma.
  • Don’t use pesticide sprays in your room.  Go for integrated pest management strategies instead.
  • Like team work?  Collaborate with your school nurse and district’s administration to develop an asthma management plan at your school if one does not exist.  Another excellent resource is to adopt ideas from the IAQ Tools for Schools Action Kit.  Work with your district’s transportation department to monitor school bus engine exhaust near open windows.

 

Although asthma is prevalent, with some forethought and preventive measures, it can be controlled. Now breathe a sigh of relief!

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. 

 

 

 

Top Ten Apps for Adolescents and Adults with Developmental Disabilities

10 apps

Have you ever downloaded apps that you weren’t satisfied with? Here’s some help  if you work with older adolescents and adults with developmental disabilities.

Within the past 15 years, I have worked with a variety of populations, including adults with developmental disabilities.  In the past, I have used predominately workbooks, adapted books, social stories, and age appropriate therapy materials during my sessions. Within the past five years, the use of the iPad has changed my therapy sessions dramatically.

Within the past couple of years, I have found excellent age appropriate apps that are motivating for my clients and help meet their goals with regard to their social skills, literacy, life skills, language, and increasing independence in the community. I use these apps listed below on a regular basis and find them functional and useful during my therapy sessions. I have received promo codes for a couple of apps listed below but all of my recommendations are solely based on my own personal experience as a speech language pathologist and do not reflect the views of anyone else.

These apps are best used when combined with other therapy materials and real life situations. For example, if I am working with a client who is going to be visiting the library, I would work on that specific topic using Community Success by Attainment Company. I also like that many of these apps can be trialed before purchasing them.

Apps Adults DD 2

Please comment if you have any app recommendations of your own!

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.

 

Kid Confidential: Using Thematic Therapy to Write Goals

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Last month I discussed the benefits of using thematic lessons in speech therapy.  Today I will discuss how I write goals using this type of therapy.  Please understand the following information is based solely on my own clinical experience and information shared with me from other licensed speech-language pathologists.

Taking data for thematic therapy does not differ as compared to taking data for non-theme based therapy activities in general.  However, it does depend on the specific goal for each student and the sources from which you are planning on collecting data.

In the school setting, working as a multidisciplinary team, there are a number of different ways goals can be targeted: in the speech room, in the classroom, in particular academic exercises, in small groups, in large groups, in functional language opportunities, conversation, play, etc.  I also have used data collected by a number of different individuals in the school setting to determine generalization of skills: the SLPA, the reading specialist, the classroom teacher, the special educator, the classroom paraprofessional, etc.  The key to determining effective data collection is to know what you want to target and who will be taking the data.

Goal Writing

First let’s discuss how goal writing can affect data collection.  Goals should always be objective and measurable in nature targeting the individualized needs of each student. However, we must guard against writing goals that are too specific, such as naming particular intervention programs, school curriculum, or technological devices that will be used in therapy.  The problem with writing goals that are too specific is that they are not always able to translate from one school district to another, especially if a new district lacks the same access to such named programs, have different school curriculum or different technological devices.  Therefore, I always like to say my goals must be objective, measurable, individualized and transferable (meaning no matter where this child may move, any SLP can work on each goal as it is written).

Goals to Be Used With Any Thematic Activity

How can an SLP write specific goals with the plan of using thematic therapy in mind?  I tend to write my goals using a particular percentage of accuracy as the measurement, however I base it on the number of opportunities per session.  For example, I may write something like:

“Johnny will receptively and/or expressively label subjective (he, she, they) and objective pronouns (him, her, them) during thematic therapy activities independently (or types of cues-verbal, nonverbal, visual, written, phonemic, semantic, etc., and level of prompting required-minimal, moderate, maximum) with 80 percent accuracy of total opportunities per session, across three consecutive data collection days.”

The reason I write my goals in this manner is because in natural conversation or in the classroom, there may not be an exact number of trials/opportunities to demonstrate a skill.  So functionally, if my student begins to demonstrate that skill successfully at 80 percent accuracy, regardless of the number of opportunities across three consecutive data collection days, then I feel I can confidently say this student has learned this skill.  Writing goals this way also allows me to easily take data throughout an entire session regardless of the number or types of thematic activities my student participates in that day.

Writing Thematic Vocabulary Goals

Thematic therapy is such a great way to improve semantic skills!  One way to do this is to use academic vocabulary within thematic therapy activities and keep a running record of the targeted and learned vocabulary words.  It is believed that the average child can learn approximately 10 new vocabulary words every day (from approximately 3 years old on through elementary school), setting a total number of vocabulary words a child would typically learn in a week at approximately 70, and the total number of words per school year (36 week) at approximately 2,520. Not all of these words will be useful in the academic environment; therefore, when working on vocabulary goals for school age children, I tend to rely on academic vocabulary to guide my therapy as I know giving a child words they can use in the classroom will translate into improved academic performance.  As some children who are receiving speech and language services may not be able to learn 10 academic vocabulary words a day, due to cognitive delays or other reasons, I prefer to write a goal of learning new academic vocabulary words over the course of a marking period (9 weeks) based on teacher input.  I may write goals that target learning anywhere from 10-20 new academic vocabulary words a week, depending on the number of new vocabulary words the teacher will present to the student in the classroom on a weekly basis, as well as the student’s learning ability.  A simple example of this type of goal would be:

“Over a nine week period, Johnny will increase his understanding and use of academic vocabulary as determined via the academic curriculum and classroom teacher by demonstrating improvement in defining vocabulary, correctly using vocabulary in sentences, and/or labeling synonyms and antonyms of vocabulary for at least 90 new words during thematic therapy activities in small group speech therapy sessions.”

Keeping a simple running record of the academic vocabulary presented and learned during each nine week period serves as a simple way to collect data during therapy sessions.

When working in early childhood, I wrote goals specifically for thematic vocabulary that aligned with the weekly classroom themes for my preschool students.  An example would be:

“Johnny will demonstrate an increase in thematic vocabulary repertoire, by receptively and/or expressively labeling objects related to various developmental themes as determined by the classroom teacher (e.g. transportation, clothing, seasons, foods, etc.) via structured thematic therapy activities given phonemic and semantic cues with minimal assistance (cuing less than 25 percent of the time) with 80 percent accuracy of total opportunities, per theme presented.”

As preschool classrooms are based on thematic education, this particular goal could transfer to any preschool classroom.  Also adding in that this goal would be targeted for each theme presented throughout the academic year, helped to ensure that this goal would continue for each classroom thematic lesson.

Writing Goals to Accept Data From Other Sources

As I briefly mentioned above, another affective way to demonstrate if speech services are having a positive effect on a student in other settings is to accept data recorded from other sources within the academic setting–classroom teacher, classroom paraprofessional/aide, special education teacher, reading specialist, etc.  To do this, it should be identified within a goal that certain sources will be used for data collection.  For example:

“Johnny will demonstrate generalization of understanding and use of subjective pronouns (he, she, they) and objective pronouns (him, her, them) to the general education classroom by verbally expressing and/or writing the correct pronouns during class participation (e.g. responding to teacher questions, reading group discussions, etc.) or in classroom assignments (e.g. classroom journal, worksheets, homework, etc.) with 80 percent accuracy of total opportunities as per teacher report and graded classroom assignments, across 3 separate data collection dates.”

In this particular example, the goal here is to demonstrate generalization of a language skill to another environment. Therefore, as an SLP, I may continue to target this specific skill through various thematic therapy activities, however I will use teacher report and classroom assignments to determine if generalization has occurred.

Help from Other Colleagues

Some of the best goals I have found come from other speech-language pathologists.  Tatyana Elleseff, a colleague and owner of Smart Speech Therapy, LLC, has shared some of her preferences in writing goals with the use of thematic lessons in mind, which I very much like.  The following are examples simple skills one can target using thematic therapy.  Adding your own measurements systems and identifying ways in which data will be collected are necessary to complete these particular goals to create something objective, measurable, individualized and transferable.

Short-term Vocabulary and/or Grammar Skills:

  1. Child will be able to appropriately label 150 functional objects (nouns) related to his academic and home environment.
  2. Child will be able to appropriately label 70 functional actions (verbs) related to his academic and home environment.
  3. Child will be able to appropriately label 35 functional descriptors (adjectives) related to his academic and home environment.
  4. Child will define and use curriculum/related vocabulary words in discourse and narratives.
  5. Child will improve his ability to formulate semantically and grammatically correct sentences of increased length and complexity.

These particular skills lend themselves very nicely to SLP data collection simply by keeping running records or recording performance during therapy sessions.

Story Telling/Narrative Skills:

  1. Child will increase ability to produce cohesive age-level narratives containing 5+ story grammar elements
  2. Child will identify main ideas in presented text.
  3. Child will identify details in presented text.
  4. Child will answer simple inferencing and predicting questions (e.g., “How did this happen?”/ “What would happen…?”) based on presented text.

The above skills can be measured either in the therapy room by the SLP during specific language tasks, within classroom assignments and teacher report, or a combination of both depending on how many sources of data collection you would like to use.

Other Long-Term Language Skills

Receptive Language: Client will demonstrate age-level receptive language ability (listening comprehension, auditory processing of information) in order to effectively communicate with a variety of listeners/speakers in all conversational and academic contexts.

Expressive Language: Client will demonstrate age-level expressive language ability in order to effectively communicate with a variety of listeners/speakers in all conversational and academic contexts.

Pragmatic Language: Client will demonstrate age appropriate pragmatic skills in all conversational contexts.

As you can tell from the particular skills targeted above, data collection from an SLP alone is not going to be enough to demonstration functional skills throughout the academic environment or in all conversational contexts.  Therefore, using a number of data sources within the academic environment is necessary to accurately measure these particular skills.

In general, data collection does not change drastically when using thematic therapy lessons versus the “drill and kill” concept.  However, when planning to use thematic therapy, you may notice the way you write your goals and the sources from which you collect data can differ slightly from when skills are traditionally targeted by the SLP alone.

Next month, I will discuss how I collect data during thematic therapy and how I get teachers on board to become an additional data source as well.

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: Developing an IEP with C.A.R.E.

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How can we make goal-writing and individualized education programs less daunting?  Recently I wrote an article for the upcoming March volume of SIG 16 Perspectives. I took the literature and combined it with what, in my experience working in public schools, makes the process collaborative.  Since I’m a visual person, I drew a model:

 

visual

 

So as you sit down as a team to write your next IEP, you may want to consider these four parts:

Context:

I apologize to those of you who have heard this from me before, but I can’t stress enough how important it is to remember that language is everywhere. Aside from basic artic goals, we really can embed our goals under most curriculum areas. Look to see how your speech and language targets may actually fit across other areas such as math (descriptive/comparative language), history (explain/describe/narrate), and science (using temporal language to order steps in a process, vocabulary).  If our ultimate goal is generalization, then it is logical to think broadly, holistically.

 

Assessment

Assessment doesn’t happen just at IEP time, it should be ongoing. If an IEP is collaborative, then data can be collected from a variety of general education activities and speech and language activities. Don’t reinvent the wheel; look at the assessments the general education teacher is giving your students and either analyze their findings or offer to provide the assessment. This is not extra work; it helps to inform your intervention. Recently I helped a Kindergarten teacher with a dictation assessment, and was it ever so enlightening!

Review & Reflect

Review your approach honestly; reflection is how we, as practitioners, learn and grow (Tagg, 2007). Since we have very little time in our crazy professional lives, this often falls by the wayside. As related service providers, we need to find time to discuss what we are seeing, and consult with teachers on how this can translate academically. In some cases, this may mean including in the IEP that the team will meet every certain number of weeks, to discuss and update one another on the student’s current performance.

Extend

Think about how to create goals that can extend beyond the immediate environment. For the majority of the students who I see, I am constantly looking for ways to connect academics with independence. A student learning math and money, for example, may need a trip to the store. A student working on following directions may bring a list to the store and come back to follow a recipe. These kinds of experiences make the abstract become concrete.

C.A.R.E is about creating a smooth, efficient and collaborative IEP process. This way we can move on from the paperwork part, and get back to the business of intervention and academic success. For more detailed information, please keep an eye out for my article entitled, “Autism in the schools: IEP best practices at work,” coming out in the next SIG 16 Perspectives issue.

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

NIMTR: Not In My Treatment Room!

poison

You’ve heard of NIMBY, “not-in-my-backyard” haven’t you?  Well there’s a new acronym, NIMTR or “not-in-my-therapy-treatment-room!”  Speech-language pathologists are inundated by catalogs filled with wonderful colorful, fragrant, pliable toys as treatment materials.  We use these every day with our students, our clients in clinics, our bedside patients.  But how much do we really know about the safety and makeup of those therapy materials your shrinking budget dollars are purchasing every year?

Some interesting facts about toys.

Toys are BIG business. Just visit any mall in America or website such as Amazon.com.  Worldwide, over 80 billion dollars were spent on toys in 2009, with more than a quarter of that money consumed in the United States. The latest figures by the Toy Industry Association Inc., places the annual U.S. domestic toy market at $22 billion in 2012.  Of this, $6.63 billion covers toys and articles for infants and toddlers, puzzles and games, and arts and crafts.  I mention these specific categories because they are materials most likely to be used by SLPs working with young children in early intervention, preschool, or school settings.

So many toys … but are they safe?

The United States imports many more toys from foreign countries compared to its exports. China, Japan, Mexico, Canada and Denmark lead the way in toy imports.  Since other countries do not implement the same environmental protections in manufacturing as we do in the states, the question of safety looms large.  The Consumer Product Safety Commission (CPSC) is the main body responsible for overseeing the safety and recall of unsafe toys and products manufactured in or imported into the United States.  In 2012, the CPSC released a new risk assessment tool to help improve the screening of imported products. About 5 percent of the total number of these screenings identified children’s products.  One example: a shipment of 28,000 baby bottles imported by Dollar Tree was seized after determining they were defective and unsafe using the new risk assessment tool. You can read more about the successes of CPSC online.

The Consumer Product Safety Improvement Act of 2008 made it mandatory for all toys aimed at children under the age of 14 to meet new federal safety standards.  Some of these include testing lead content and concentration of phthalates (DEHP, DBP and BBP* in particular). Here is a video to see how CPSC works collaboratively with other government agencies to seize toy imports that are unsafe for children.

Even though we have protections, toys of questionable safety continue to enter the consumer market.  Recently DNAinfo in New York released this alarming report, which shows many toys in stores tested positive for elevated levels of toxic substances, including phthalates, which have been found to be associated with asthma, birth defects and hormone disruption, among other health problems. One item on the list, a Teenage Mutant Ninja Turtles pencil case manufactured by Innovative Design was found to contain 150 times the legal phthalate limit for toys. But alas, currently, it does not qualify as a toy under federal regulations.

What if it is not a toy?

And that’s a good point: Sometimes SLPs use materials in their practice that are not toys. Like the pencil case mentioned above or what about commonly used rubber tubing that a speech-language pathologist may use during treatment for oral exercises?  Would such rubber tubing be considered a toy, a medical device, or something else?  Who oversees the safety of products such as these?

Two organizations responsible for developing standards of safety are the International Organization for Standardization (ISO) in Switzerland and the American Society for Testing and Materials International  based in Pennsylvania.  Both provide standards to industries that produce just about everything, from iron bolts to bathmats.  Each provides standards for purchase to companies, who in turn use the standards to manufacture and distribute their product to specification.  I contacted both these organizations to find what standards exist for the rubber tubing example.  As of this writing, no responses to my request have been received.

What is an SLP to do?

So what can you do to ensure that the materials you use with your students and clients are safe?  Here are a few suggestions:

  1. If you are purchasing from a distributor online, check their website for more information. For example, SuperDuper Publications places a Product Safety statement on their website and invites customers to email them for more information.  Companies who openly provide statements such as these make it easier for the consumer to trust the safety of their purchases.  If you cannot find information on product safety or product testing, email the company and ask for it.
  2. Check the CPSC’s website for toy and product recalls. You can find the latest recalls, search for recalls by product name or by country of manufacture, and also report an unsafe product.
  3. Read the manual! Electronics such as iPads and tablets come with a manual that will often provide the ISO or ASTM Int’l standard used to insure safety and will list potential hazards.
  4. Contact the manufacturer of the product and ask for the MSDS – materials safety data sheet.  This would be a good choice if the product you have or consider purchasing lacks a manual or an information sheet on standards testing.  You also can look up a product by name and manufacturer on the MSDS website. On this site a search for “rubber tube” gave me 34 hits.  While searches can be daunting and time consuming, the insurance of safety provides peace of mind to you and the clients on your caseload.
  5. Avoid buying inexpensive toys or materials from questionable sources such as street vendors.

Informed SLPs can now approach their materials purchases with a new savvy.  Next time you are tempted to buy inexpensive therapy materials composed of questionable ingredients, just say “NIMTR”!!!!

 

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.

Collaboration Corner: “Out of my Mind” Speaks Volumes

ccorner

This year, I worked with a fifth grade class who was reading “Out of my Mind” by Sharon Draper. The story is about a nonspeaking 11- year-old girl with cerebral palsy. Her classmates, teachers, and even  her doctors underestimate her abilities. Little do they know she has a photographic memory. One day after months of fighting with insurance, Melody (the protagonist) is given the gift of voice through an AAC device; the drama unfolds from there.

The teachers read a little of this book every day to the class, but wanted the students to get a better understanding of Melody’s struggles. They asked me to come in and show students various kinds of AAC devices.

This was the perfect launching point for a lesson on inclusion and AAC. This was one of the most effective ways I’ve worked with teachers and students regarding the challenges AAC users face everyday.

Here’s all I used:

  • A PECS book;
  • Two iPads with two different communication apps;
  • An alphabet board;
  • Low-tech battery operated voice output device;
  • A sheet with a picture of two “thought bubbles” and two hearts (see below);
  • Index cards with written scenarios; and
  • A sheet of emotion cartoons.

First, the class gathered together, and I gave them an overview of how people might communicate. Most understood body language, words, and some mentioned sign language. Then I brought out the different systems. Their eyes lit up. Then they started to make connections to other children in the building who used these systems. They were hooked.

Next, the children broke up into groups of four or five. Each table had two AAC systems. Within each group, students paired off. One student had a “speaker” card, and the other a “listener” card. Speaker cards had clues like, “you can’t speak, but you can point and read. You really want to tell your friend about the movie you saw last night.” The partner’s card (“listener”) read, “Your friend can’t speak, but she can point and read. She really wants to tell you something, find out what it is.”

I wish I had taken a video. The interactions were amazing, and the students really dove into the activity. Each group got a turn with a different kind of system. A nice, unexpected experience: Teachers went by and facilitated interactions with tips like being closer to the speaker, or waiting and not interrupting.

Finally, I collected the devices. Each group received a copy of a words related to emotions and a worksheet, which they worked on individually. This gave them a chance to reflect.

On the worksheet were only two fill-in the blanks on top:

When-I-was-the-speaker

On the bottom were two more:

When-I-was-the-listener

And then the teaching part happened! Here were some of the responses:

  • I was thinking, why can’t he understand me!!! I was outraged!
  • This is so hard! I felt like giving up.
  • I don’t have enough words. I felt like oh, well, never mind.
  • I wanted to help you, I’m sad and frustrated for you
  • I can’t understand you, I felt impatient.
  • Keep trying! I felt helpless.
  • I can’t spell, this takes too long! I felt annoyed.

I kept copies of every single sheet, I’m not exactly sure what I’m going to do with them, though I’m fighting the urge to wallpaper my office with them.

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

 

 

 

 

How to Provide Bilingual Services (Even When You’re Monolingual)

vogl

Evaluation is one huge hurdle to working with English Language Learners (ELL). The second is providing therapy. Once you’ve determined there is a disorder, what do you do? Do you provide treatment in English? What goals do you target? Can you provide competent treatment in English only?
It may be easier to address some of these ideas for specific age ranges. For the children under 3 years of age, working with an interpreter in the primary language with the family on how to talk with toddlers and babies is your best friend. It is important to be mindful of possible cultural differences in how adults and children relate to each other. Not every culture values parent-child verbal interactions as the stereotypical white middle class family might. How to address these differences is like a dance. If one person is too powerful of a leader the other cannot follow, might stumble, and ultimately will quit dancing. A parent/caretaker who does not share the value we place on parent-child interactions will most likely not follow through on our recommendations. In which case it may be better to train a sibling how to model language for a younger sibling. Make sure you understand the family and/or cultural relationships as much as possible first.
For preschool age children (depending on family views of preschool) your efforts should go toward encouraging the family to enroll the child in Head Start, preschool, daycare, or even scheduling consistent “play dates” to expose the child to typical language development. If possible, encourage both languages (primary language and English). What about therapy? Targeting social language, the Basic Interpersonal Communication Skills, in English is essential. Children will need these skills to be successful in the academic world.
For school age children, research suggest that there is a strong correlation between ELL students with a language learning disorder and poor and/or inappropriate social skills and therefore, have fewer friends when compared to other students who are ELL. Social skills groups are very important for these students. Simultaneously, targeting Basic Interpersonal Communication Skills and Cognitive Academic Language Proficiency will help close the language gap these students have. One approach to do that is by teaching root words, suffixes, and prefixes (morphology). As we learn in linguistics, they are like puzzle pieces. For example, you can take the root word “view” and the prefix “re-“ and teach students that the view means “to look” and re- means “again.” When added together form “review” or “to look at again.” Then applying context, “The teacher tells you to review your work,” what does she want you to do? Helping students understand contexts for which they might hear the word and then additional contexts for when they might use the word is important. How does your work in English translate over to the primary language? Here is where parents come into play. Most parents I’ve worked with prefer you send the list of “academic” words (from curriculum and/or state standards) home in English. They can then use their personal dictionary to look up the correct correlating word in their home language, versus us guessing on a translation website. Have the parents talk with the child about these words in their home language. This builds the foundation for carryover from primary language to English. When using root words you can also can help students make educated guessed on definitions for words. Once students have a decent grasp on root words, some great games to play are Scrabble, Boggle, or Balderdash. An added benefit for teaching root words, is it’s included in the Common Core State Standards.
Here is some personal evidence. Last school year I had a 5th grade student who scored Level 1 (Beginning) on an English Language Proficiency Assessment for all of his academic years, Kindergarten through 4th grade. His 5th grade year we implemented a social skills group and taught root words from the curriculum. With the entire team’s support (student, parents, teacher, SLP) this student scored a Level 3 (Intermediate) on the same assessment. Some beliefs for such success was that our intervention targets were meaningful to him. Social skills helped his friendships and the root words helped him understand and communicate in the academic setting, which is the majority of his day Monday through Friday.
I am sure that there are other evidence-based therapy approaches to working with this population and they should all be founded on the same principals. 1) It is better to target both BICS and CALPs together that waiting for BICS to be mastered well enough to move to CALPs. Reason being, the language gap will only increase exponentially. 2) It is also better to work with the family.
I’d love to hear about other approaches. How do you address therapy for children and families who are not fluent in English?

 

Leisha Vogl, MS, CCC-SLP, is a speech-language pathologist with Sensible Speech-Language Pathology, LLC, in Salem, Oregon. She can be reached at leisha@sensiblespeech.com.

 

How to Navigate the Profession One Binder at a Time

Binders

 

My entire professional career can be summarized by what binder I was holding, and where I was while holding it. I waltzed into my interview for graduate school with a small binder, and a ton of nerves; I entered the current school I’m working in (my first job, ever!) holding my giant binder containing my portfolio. However, the most important binder in my very “speechy” timeline is the one I took to my school practicum.

Many departments offer different variations of clinical experience, whether they’re in a clinic, school, or hospital setting. Everyone gets their hours, but sadly to say, some either have poor experiences or don’t make the best use of their time. When I entered into the first day of my school practicum, I was chock-full of bulletin board ideas, and holiday-themed crafts. I almost exploded with Velcro and stickers! Then it hit me–I was going to have five faces staring at me every day as I navigated teaching them everything they needed to know. All while attempting to be as entertaining as their Xbox or iPhones. I began to panic.

That’s when I recalled the power of supervision. I had almost forgotten the wonderful woman who showed me around the building on my first day. Oh yeah–that nice lady is going to hold my hand through the first few weeks of this! Thank the Speechy Powers That Be!

Not only did my supervisor support me through my practicum, but she let me fly. Our first sessions with the students from the self-contained classroom left my head spinning. Were we shaking maracas and throwing scarves? Did I need to invest in Velcro’s stock? How many times can we sing that song? Oh, and when will this song leave my brain!? By the third week, I was singing, shaking, and velcroing with the best of them. We had an intense caseload with fantastic kids. Everything my supervisor uttered, handed me, sent me, all went in my binder. I knew I only had this window of opportunity for so long and I had to keep it all. binder1 I left my cozy clinical experience and now have embarked upon my Clinical Fellowship Year. I went to pick up one of my first students, and was met with a non-verbal child with autism spectrum disorder. He, of course, did not have his AAC device. I grabbed his hand, said a small prayer to the Speech Gods, and we went to the classroom. It was scary, sure, but I had this; I knew what to do. Not only did I have the materials from my binder, but I had the training to go with them. Skills I learned in a classroom are necessary and invaluable (especially when I pull out those technical words in a meeting to prove a very Speechy point!). However, the knowledge I gained from my supervisor, and my school practicum, is what makes me a good speech-language pathologist.

So my advice is this: Take the time to cherish, learn from, and stumble during your school practicum. Rewrite things, ask questions, and most importantly, make sure you’re in the placement where you will learn best. I’m now navigating my CF in a new building, with new students, new faculty, and a new non-graduate student version of myself. I’m surviving and, even better, also learning something every second (or so it seems). However, I always say that if I had not had the practicum experience that I did, or my handy binder that absorbed it all, I most likely would be crying in a corner hugging my Praxis book!  

Alexis Gaines, MA, CF, is a speech-language pathologist for the New York City Department of Education. She is using Instagram to document her clinical fellowship and you can follow her @practicallyspeeching and #instacfy! You also can follow her blog “Practically Speeching.” She can be reached at practicallyspeeching@gmail.com.