Seven Lessons for Newly-Minted SLPs

graduation

It’s graduation season and I can’t help but notice all of the brand new speech-language pathologists coming out of graduate programs across the country. What’s more is that I can’t help but be so happy for them! Here’s why: It seems as if it was just yesterday that I was a free spirited sophomore who decided to take a random class in phonetics. Little did I know this class would influence my life’s work. The class was taught by a young Ph.D., Gloria Weddington, who helped to focus me and, much to my mother’s delight, give me a purpose.

As a senior, Dr. Weddington took me to my first ASHA Convention where she introduced me to all the leaders in our profession.  What impressed me most was how well liked and respected she was by everyone. She would introduce me to her colleagues  as her “little student”  who was going to be a great addition to our profession.  She believed in me and I believed in myself. Once I received my master’s degree, I was ready to set the world on fire!

I vividly remember my first experience as an itinerant SLP in Los Angeles Unified School District. I was so eager and excited to have my first real job with my first real paycheck. I loved my schools and my kids and had a great master teacher who served as my CF supervisor.  I enjoyed my work and continued to grow seizing every new opportunity that came my way.  I absolutely loved my job! A few years later I left my very secure job to strike out on my own and opened a small private practice. I was the secretary, the receptionist, and the SLP,  but most importantly, I was happy again.  That was 35 years ago and I have never looked back.  In fact, I discovered another side of myself, that as an entrepreneur who was able to develop and sustain a thriving private practice in Los Angeles.

Today, many of my friends and colleagues are happily retiring. I have to admit, I feel a little conflicted when I think of what it must be like to wake up each morning and to not having any professional responsibilities.  However, I also can’t imagine life without my professional responsibilities, especially since there is so much more for me to do. The truth of the matter is that I feel as passionate today about our esteemed profession as I did when I was 24.

Young staff often ask me what’s my secret?  It’s no secret–it’s living and learning from life’s experiences. I am approaching 40 years “young” in our great profession and here are seven lessons learned along the way that continue to feed my spirit and nourish my soul:

  1.  Find a role model, a hero whom you admire, respect and trust. Listen, watch, and learn from him or her. If you are lucky they will be your mentor.
  2. Make your CF year count. Get the clinical supervision and support that you need to grow strong and healthy in our profession.
  3.  Be willing to rebuild your dreams.  Protect the joy and excitement that you experienced upon entering the profession. Remember there are no victims, just volunteers.
  4. Continue to grow, learn, and maintain high standards.  Make it a priority to attend ASHA conventions or at the very least your state conferences.  Learning is critical in our ever-changing profession
  5. Keep plenty of mirrors around.  Look closely at whether the person you see is the person you really want to see.  And, when in doubt refer to our ASHA Code of Ethics.
  6. Don’t burn bridges. You never know who you will need to give you that last cup of water.
  7. Have fun.  There is always work to be done!

Congratulations and welcome to our great profession!

Pamela Wiley-Wells, Ph.D., CCC-SLP, is the president of the Los Angeles Speech and Language Therapy Center, Inc. and the founder of The Wiley Center, a 501 (c)(3) organization dedicated to providing direct services and support to children with autism spectrum disorders or other developmental disabilities. The practice includes early intervention programs located in South Gate, Lawndale, Los Angeles, and Culver City as well as two satellite speech therapy clinics in Studio City and Downey. Wiley is a frequent lecturer on how to effectively deliver services to the increasing number of children diagnosed with ASDs who have social cognitive deficits.  She has written several professional articles and has co-authored two therapy workbooks; Autism: Attacking Social Interaction Problems for children 4-9 and 10-12 years of age as well as a separate parent resource guide available in English and Spanish. You can follow her private practice on Facebook.

 

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.

Aural Rehab: Getting an “A” in Listening

listening

There is no denying that aural rehab is critical for patient success with amplification. Unfortunately, most hearing care professionals do not implement a structured, patient-focused aural rehab program. They report lack of time, lack of patient compliance, and lack of reimbursement as the common challenges. As a practicing audiologist, I face these challenges on a daily basis, which prompted me to develop the 5 Keys to Communication Success and the Cut to the Chase Counseling program. The 5 Keys to Communication Success are:

dusty graphic

Educating our patients about these five simple keys to successful communication will help them to understand a few important points:

  • Communication is like a puzzle that requires several pieces to work properly.
  • Hearing aids are only one piece of this communication puzzle.
  • Involvement of family members, friends, and caregivers is essential.

When patients fully grasp the complexity of communication, and understand that each piece of the puzzle is critical for communication success, they are much more likely to be satisfied with their hearing aids and to comply with our recommendations.
My previous blog went into detail about the first key, The Speaker.
Today I’ll dive deeper into the second Key to Communication Success: The Listener. Most of the listener strategies we attempt to teach our patients are critical for all listeners, including those with perfect hearing. However, the importance increases exponentially when the listener is challenged by hearing loss. We must impress upon our patients that implementing these strategies is just as important as wearing their hearing aids.
Listener strategies revolve around the concept of active listening. The listener is no longer allowed to sit back and passively expect communication to happen effortlessly. Even with new hearing aids, this is an unrealistic expectation. I encourage my patients to earn an “A” in listening. To accomplish this, they must:

  • Be aware of their surroundings.
  • Anticipate what might be said.
  • Take action to make sure they can clearly see the speaker’s face.

As with all of the communication keys, I find it works best to classify the listener strategies by environment. For example, in a restaurant environment I instruct the listeners to read and discuss the menu ahead of time, to focus on the facial expressions and lip movements of the speaker, and to actively “tune out” the noises that aren’t helpful for communication. We also discuss listener strategies for the following environments: around the house, in the car, dining out, on the phone, and public events. While repetition of strategies is common between environments, I find that patients are more likely to retain and implement the information when it is applied to a specific situation where they experience listening challenges. It is also easier for patients to grasp the importance of these strategies when they see them repeated across environments.
The ultimate goal is to equip and empower our patients with a multitude of tools that will facilitate successful communication. The simple structure of the 5 Keys to Communication Success makes this easier and more efficient for both clinicians and patients alike. Next month I’ll discuss the third key: Environment.

 

Dr. Dusty Ann Jessen, AuDis a practicing audiologist in a busy ENT clinic in Littleton, Colo. She is the founder of Cut to the Chase Communication, LLC, a company dedicated to providing “fun, easy, and effective” counseling tools for busy hearing care professionals. She is also the author of Frustrated by Hearing Loss? 5 Keys to Communication Success. Dr. Jessen can be contacted at info@CutToTheChaseCommunication.com.

 

Learning About New Foods Without Eating: 5 Surprising Tips for Parents

new food

Wait … isn’t the idea to get the kid to eat Brussels sprouts?  Yes, ultimately.  But exploring food with all of our senses is often the first step to eventually, tasting new foods.  Whether your child is in feeding therapy or you’re just trying to raise a more adventurous eater, here are 5 strategies for encouraging kids to discover various sensory aspects of new foods before they muster the courage to take that very  first taste:

  1. Still Got Easter Eggs?  The plastic ones, that is.    Take the 2 halves and line an egg carton with red, yellow, green and/or orange eggs.  Cut up fruits and vegetables into dime-sized pieces and practice matching colors.  Each time your child picks up the new food, tell him “Red tomato with Red Egg!” and help him find the red egg so he can drop in the tomato.  Now you have a kiddo who is picking up all kinds of fruits and veggies, even the slightly wet, cut-up pieces, which many kids hesitate to touch.
  2. Pop in a DVDCopy-Kids created a DVD of adorable kids eating fruits and vegetables, “because children learn best from other children.”  Sit down and watch it with your child, along with a colorful snack tray of bell peppers, broccoli, avocado, blueberries…you get the idea.  Keep it positive and don’t emphasize the eating part.  Just pick up the same food you see on the TV and say something silly about it.  Roll it down your cheeks and talk about how it feels.  Give it a big kiss and proclaim your love for orange, red, yellow and green peppers!  It’s not always about biting into a new food – that comes later.  But, if taking a bite happens in the course of playing and watching a silly DVD, then that’s terrific!
  3. Create Your Own Food Network Show with your kid as the host!  If the best he can do is direct the show behind the camera while you cook, that’s still a great start.  At least he’s in the kitchen, interacting with the food (albeit from a distance)  in a positive, fun way.  Later that evening, invite the whole family to watch his creation together and serve the food you made on film.  Soon, he’ll be hosting the show and cooking new dishes while you operate the camera.
  4. Watch More TV.  Before you think I’m obsessed with television, let me share 2 terrific resources that will help your kids explore new cuisine.  The Good Food Factory is the Emmy award-winning kids’ cooking show televised in California.  But, you can still watch vintage episodes as well as 2 newer episodes on line.   Or, check out the tiny tasters on the Doctor Yum videos.  Created by a pediatrician, the website includes lots of how-to videos featuring kids doing the cooking.  Using videos to introduce the joy of food to your kids is just that – an introduction.  Afterward,  head to the grocery store.  Pick out that new produce you saw on a Doctor Yum video – like a prickly pear or a lychee or a dragon fruit.  Cut it open…take a lick…one thing might just lead to another!
  5. Make Handprint Pictures Using Purees.  First, include your child in the process of making the edible “paint” puree.  Anything will do: yogurt, pudding or even cauliflower blended to a smooth paste.  Add a touch of color to the cauliflower by using natural food dyes or blending in real food, such as carrot juice or spinach leaves, letting your child pick up the spinach and add it through the safety top of the blender.  Spread the puree onto a cookie sheet or flat plate.  For the child who is tactilely defensive, you may notice that he will touch the puree with either just the side of his thumb or the tip of one finger.  That’s a fine place to start!  Over time, he’ll progress to tolerating his entire hand flattened into the plate of puree and then, pressing  his messy little hand onto paper to make a handprint.  For ideas on various animals you can create with hand or even footprints, click here.

Egg Carton Color Matching

What do all of these strategies have in common?  They’re fun and they involve YOU – the most important person in your child’s life!  Be silly, be positive and join in!  Get your hands messy,  model healthy eating and praise what your kiddo can do on that day.  Learning to try new foods involves all of our senses and remember,  tasting  often takes time.

 

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.

Mission Impossible: Collaboration (Are We Succeeding?)

collaboration

 

Ellie’s parents were optimistic about her transition from her private preschool for children with hearing loss to her neighborhood public school kindergarten.  After all, Ellie’s speech and language skills had improved greatly since enrolling her in the preschool. Ellie’s previous school had an audiologist who came to the school daily to check all the children’s equipment and interacted easily with Ellie’s speech-language pathologist and teachers of the deaf.  However, only a few weeks into kindergarten, Ellie’s mother was already concerned that the new speech-language pathologist was not checking Ellie’s cochlear implant on a regular basis.  The audiologist for the school district was responsible for 250 children at multiple schools throughout the county so how attentive could she be to Ellie’s needs?  Would Ellie tell her teacher if her implant wasn’t working, or if her battery was dead?  Would Ellie’s implant audiologist at the hospital share her test results with the speech-language pathologist, as Ellie’s mother had requested?

Scenarios such as this one are familiar to those of us who work with children with hearing loss.  Children are being identified and treated for hearing loss earlier than ever thanks to universal newborn hearing screenings and enhanced technologies.  The same children who 30 years ago would have been in specialized educational settings are now entering mainstream classrooms across the nation.  Clearly this was our goal, and we are excited to see the progress that has been made on this front.  However, when a child is in a general education classroom, sees her audiologist twice a year for programming at a hospital 50 miles from home, gets private speech therapy one hour a week at ABC Therapy, and sees the school SLP for 30 minutes twice a week, coordination of care can fall through the cracks.  It was this disconnect between the professions of speech-language pathology and audiology that first drove me to pursue both my Au.D. and SLP degrees and become dually certified.  I wanted to be able to treat the whole patient, from diagnosing the hearing loss to helping them achieve listening and spoken language outcomes.

In 2011-2012, I conducted a survey under the direction of Anne Marie Tharpe, Ph.D. examining this issue.  We wanted to know whether or not audiologists and speech-language pathologists believed they were collaborating effectively, and we wanted to see if the parents of children with significant (moderate-profound) hearing loss agreed.  We surveyed 189 individuals, essentially evenly divided between parents, audiologists, and speech-language pathologists.  Almost all respondents to the survey felt that collaboration between the two professions was important.  “Collaboration” meant everything from sharing test results to attending IEP meetings.  The take-home message from the survey results was that about 1/3 of the parents and audiologists, and 1/4 of SLPs surveyed did not agree that professionals were working collaboratively.  So one out of every three parents with whom you interact may feel there is something more we could be doing to work better as a team.

The most often-cited barriers by clinicians to collaboration included time constraints and large caseloads.  One of the most rewarding findings in the survey was that 100 percent of parents of children ages birth-3 years felt that professionals were working collaboratively.  This tells us that we have indeed done a good job in improving our service delivery to this population with a focus on family-centered care.  However, we are still challenged by how to provide collaborative hearing care to children and their families when they reach school.

So what are your thoughts? Do you feel you work well as part of the parent-audiologist-speech-language pathologist team?  What are your biggest frustrations? How might we improve our collaborations with other professionals – perhaps by embracing new technology that allows us to communicate and collaborate in a more timely manner? As we think about Better Speech and Hearing Month this May, let’s focus on working toward better collaboration with one another so that children such as Ellie have the best chance to succeed.

 

Adrian Taylor, Au.D., M.S., CCC-A/SLP is an audiologist and speech-language pathologist at the Vanderbilt Bill Wilkerson Center in Nashville, Tenn.  She works primarily in the area of cochlear implants and aural (re)habilitation in both the pediatric and adult populations. Adrian may be contacted at Adrian.l.taylor@Vanderbilt.edu.  

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.

Pragmatic Language Intervention for Adults with Autism

autism

 

A man enters the room, apparently comfortable with his surroundings and with those around him. Despite his large physique, he exudes a gentle demeanor and a genuine kindness as he approaches the other adults in the room. He curtly nods to a few people in the room, and then takes a seat in his usual spot. As he scans the papers in front of him, his face lights up and he points to a picture representing the day’s refreshments. He smiles at the woman sitting next to him and carefully produces the words, “Want…snack.” He nods again and smiles with noticeable satisfaction.

This man’s name is Jim, and he is an adult with autism. Jim attends one of the two Adult Language and Pragmatics Skills (ALPS) programs offered at Towson University’s Hussman Center for Adults with Autism. Like many other individuals on the autism spectrum, Jim struggles to communicate verbally and to engage in meaningful social relationships. These difficulties represent unique challenges for Jim and other adults on the spectrum. To address these challenges, Jim attends the ALPS group each week and participates in meaningful activities designed to explicitly address areas of need. The activities target communication in a variety of social contexts, and participants show subsequent improvements areas of need.

In addition to the positive changes observed with group participants, the ALPS programs also are gaining positive attention from families in the greater Baltimore community. Jim’s mother recently expressed her appreciation for the ALPS group and for the noticeable improvements she sees in her son’s communication. She wrote, “There are not enough words to express my gratitude to you and your team. Jim’s communication did significantly increase with the Fall session. I know that your program is critical to Jim’s continued progress.”

So what makes the ALPS programs at Towson University effective and attractive? Some would say the impressive amenities available at Towson University’s Institute for Well Being facilitate the programs’ success. Admittedly, the rooms equipped with multi-media technology and the fully furnished apartment in which adults can practice skills are indeed helpful. But the ALPS groups also offer experiences purposefully designed to incorporate evidence-based practice techniques for optimal success:

  1. Mentor/Peer Role Models – The use of peer role models is well-supported in the literature as an evidence-based practice intervention (Llaneza, DeLuke, Batista, Crawley & Frye, 2010; McGee, Almeida, Sulzer-Azaroff & Feldman, 1992; Orsmond, Krauss & Seltzer, 2004). Mentors from the ALPS groups include graduate student clinicians earning clinical hours in the speech-language pathology program, as well as undergraduate mentors earning service learning hours. Mentors plan the group sessions as well as individualized activities to target specific goals agreed upon by mentors and participants. The mentor-participant relationship emerges as a mutually-beneficial partnership in which each party experiences growth and personal satisfaction. Participants learn from the mentors through direct modeling experiences, and the mentors gain invaluable experience with adults on the spectrum. Often, the student mentors indicate that their perceptions of autism significantly change as a result.
  1. Relevant Topics – To foster meaningful learning experiences relevant to the unique challenges that adults with autism face, topics are selected that directly relate to participants’ everyday lives. Topics vary from semester to semester, but generally include practical themes such as nonverbal communication, managing emotions in moments of conflict, dating and relationships, self-advocacy, communication in the workplace, and increasing independence. Many participants suggest ideas for topics, and sessions are planned with the participants’ specific needs in mind.
  1. Universal Design for Learning Standards – To target specific strengths and needs of participants in the group and to incorporate learning style preferences, sessions are planned utilizing Universal Design for Learning (UDL) guidelines. The UDL approach asserts that to best meet the individual needs of diverse groups of learners, clinicians should offer (a) multiple means of presentation, (b) multiple means of response and (c) multiple means of engagement (Rose & Gravel, 2010). The ALPS groups at Towson University incorporate UDL standards in several specific ways:
    • Technology Tools – to increase engagement and to provide additional visual representation, ALPS groups routinely incorporate multi-media videos, interactive whiteboard activities, iPads, smartphones, and personal communication devices into learning experiences.
    • Response systems – to facilitate and maintain engagement of the group and to include nonverbal responders, discussions are often supplemented with systems that allow all participants to answer questions and express opinions simultaneously. Pinch cards, signs, color-coded paddles and gestures are all used to facilitate each participant’s communication of ideas and opinions.
    • Kinesthetic and tactile experiences – to include kinesthetic/tactile learning styles and to address participants’ need for movement for regulating sensory input, all sessions include activities requiring the participants to move. Sometimes the movement also serves as a mode of response (e.g., moving to a designated location in the room to indicate a choice), further integrating UDL guidelines.
    • Differentiated supports – to meet the needs of individual learners in a diverse group, activities are adapted specifically for each participant. Student mentors often create and implement visual supports, and provide hierarchical prompts to promote the highest levels of success and independence.
  1. Experiential Learning Opportunities – to address multiple learning styles and to provide hands-on practice, sessions often include functional activities that utilize social communication skills. Group members participate in role play activities, everything from acting out scripted dyadic communication to real-world experiences like ordering food in a restaurant. Participants do not simply listen to an instructor talking about strategies for successful communication; rather, participants engage in direct and relevant experiences that target effective communication and self-advocacy.
  1. Social Connection Opportunities – ALPS sessions are comprised of a variety of social experiences, encouraging participants to connect with others through structured practice. Whole group, small group and individual experiences are offered weekly as group members discuss ideas and opinions relevant to the session topic. Activities that foster partnership and cooperation are also utilized, encouraging participants to step out of their comfort zone as they practice social skills.
  1. Reflection and Review Experiences – All participants are encouraged to reflect on their experiences and to review important strategies. Each week, participants and mentors discuss progress and identify goals for the participant to consider in the week ahead.
  1. FUN – As one participant freely offered, “I don’t learn much when I’m bored. But I always remember the fun parts!” A preference for fun is certainly not unique to the autism population. Don’t we all remember the fun parts? To maintain an enjoyable and social atmosphere, sessions are planned using central themes. Activities, snacks, and even attire may revolve around the designated theme. Past selections include favorite movie, sport, travel and holiday themes. To further the fun, ALPS groups end each semester with a celebration party in which each group member is recognized for personal achievements.

All of these techniques are integrated into meaningful ALPS sessions for the advancement of pragmatic language and social skills. Future projects at the center include studies to objectively evaluate treatment efficacy and functional outcomes of the participants and mentors. While the ALPS groups continue to adapt and improve, the current success of the programs remains readily apparent. As we work to document improvements and successes, we are continually inspired by the adults who come to our center. Adults like Jim, entering our rooms with nods and smiles, looking for fun and friendly faces. Our hope is that these special adults feel equally inspired, and that they leave our rooms feeling successfully connected.

 

Lisa Geary, M.S., CCC-SLP, serves as Clinical Assistant Professor in the Department of Audiology, Speech-Language Pathology and Deaf Studies at Towson University. In addition to teaching and supervising graduate students in the on-campus Speech-Language Center, Lisa serves as program facilitator for the Adult Language and Pragmatic Skills Groups at Towson’s Hussman Center for Adults with Autism. Her teaching and research interests include Universal Design for Learning, Autism through the Lifespan, Augmentative and Alternative Communication (AAC), and Instructional Technology. Lisa can be reached at lgeary@towson.edu

 

References

Orsmond GI, Krauss MW, Seltzer MM. Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of Autism Dev elopmental Disorders, 2004; 34:245–256.

LLaneza DC, DeLuke SV, Batista M, Crawley JN, Christodulu KV, Frye CA. Communications, interventions and scientific advances in autism: a commentary. Physiol Behav. 2010;100:268–276.

McGee, G. G., Almeida, M. C., Sulzer-Azaroff, B., Feldman, R. S. (1992). Promoting reciprocal interactions via peer incidental teaching. Journal of Applied Behavioral Analysis. 25 117–126.

Rose, D.H. & Gravel, J.W. (2010). Universal design for learning. In E. Baker, P. Peterson, & B. McGaw (Eds.). International Encyclopedia of Education, 3rd Ed. Oxford: Elsevier.

 

 

 

Are You Ready for Better Speech and Hearing Month?

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Better Hearing and Speech Month is a mere week away, and ASHA is gearing up for an exciting month! By now, we hope you’ve seen some of the resources we developed specifically for members—press release and media advisory templates, our 2014 poster, a Facebook cover photo, a letter to parents, our 2014 product line, and much more. We also encourage members to utilize the Identify the Signs member toolkit during May, as the campaign will be front and center for this year’s BHSM. The campaign’s message of early detection is a great tie-in to the 2014 BHSM theme of “Communication disorders are treatable.”

If you’re still looking for ideas on ways to celebrate, it’s not too late to plan something. We’ve got a list of suggestions here, and you can check out our new interactive map featuring stories of how your fellow ASHA members have recognized the month.

If you do have a fabulous event or activity in store, we want to see it! Take a photo and post to Instagram with the hashtag #BHSM. One winner will be randomly selected to receive a package of 2014 BHSM products. More details can be found on the BHSM member resource page. The contest will run from May 1st – 12th.

In addition to member resources and contests, ASHA will be conducting a lot of public outreach during the month to raise the profile of communication disorders and the role of ASHA members in treating them. Some highlights this May include:

  • Google Hangout—A live, online Google Hangout to mark BHSM will be held on May 6th from 1:30 – 2:30 p.m. ET. Moderated by ASHA CEO Arlene Pietranton, the event will convene experts from a wide range of backgrounds to discuss the critical role that communication plays in daily life—and the importance of early detection of any speech, language, or hearing difficulties in children to allow them to reach their full potential academically and socially. Guests will include Elizabeth McCrea, ASHA’s 2014 President; Libby Doggett, deputy assistant secretary for policy and early learning at the U.S. Department of Education; Sara Weinkauf, an autism expert from Easter Seals North Texas; Patti Martin, an ASHA-certified audiologist from Arkansas Children Hospital; and Perry Flynn, an ASHA-certified speech-language pathologist at the University of North Carolina – Greensboro. The panel will take questions from the public, and members are encouraged to participate. Questions can be posted to ASHA’s Google+ page, or use the hashtag #BHSM on Twitter. You can RSVP for the event here.
  • Twitter Party—A Twitter party hosted by lifestyle technology and parenting blogger Michele McGraw (@scrappinmichele), and co-hosted by five other leading parenting bloggers, will be held on May 20th from 12 – 1 p.m. ET. During the party, parents and other interested parties will have the opportunity to learn, and ask and answer questions, about speech, language, and hearing disorders. No RSVP is required; members who are interested in joining in should just follow the hashtag #BHSMChat at that time.
  • New Infographic—A new infographic illustrating the prevalence and cost of communication disorders, as well as the benefits of early intervention, will be posted online at www.asha.org/bhsm and http://IdentifytheSigns.org, and distributed widely to traditional and new media.
  • Podcast Series—Four new topical podcasts featuring ASHA members will be rolled out weekly during the month. These are: Newborn Hearing Screening—In the Hospital and Beyond (May 1); Noise-Induced Hearing Loss in Children: A Preventable Problem (May 12); Autism Diagnosis and Treatment of Today and Tomorrow (May 19); and Building Language and Literacy Skills During the Lazy Days of Summer (May 27). These will be available at http://IdentifytheSigns.org.
  • International Communication Project 2014—During May, ASHA is going to be disseminating digital messaging that relates to the International Communication Project 2014 that was launched earlier this year—and promoting signatories to the Universal Declaration of Communication Rights. Members are encouraged to sign the Declaration and invite others to do so to show their support for people with communication disorders. Watch the February Google Hangout to learn more and hear from the participating countries.

 

Many of these resources won’t be available until May 1 or later, when they are debuted to the public. We encourage you to visit our member resource page www.asha.org/bhsm frequently to see the latest, and hope you can share the information with your networks. These resources will also be posted to http://ldentifytheSigns.org, the home of the Identify the Signs campaign and a site designed for consumers to easily find information tailored to them.

We hope this year’s BHSM will be one of the best yet, and look forward to hearing how you’re celebrating the month. Send us any stories, questions, or comments to bhsm@asha.org.

 

Francine Pierson is the public relations manager at ASHA. She can be reached at fpierson@asha.org.

Rockin’ the ASHA Health Care & Business Institute

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Where the heck is everyone? Oh. I get it.

So…here’s a tale to share, OK? Yours truly, this intrepid, Down Easterner editor-in-chief for the ASHA Leader news magazine, is attending his first ASHA Health Care & Business Institute. It’s Vegas (baby!), glistening with probabilities and paradox: palm-tree-lined streets press against yellow-brown desert; a chiming, smoke-filled casino perches an escalator-ride above a bustling, professional conference. And there’s me, all nimble-like, sprinting the gauntlet of one-armed bandits, dashing down the escalator, caught up in a dizzying quest to nab an interview or two. It’s the perfect time, ay-uh. Sessions are running now, but—if my experience at hundreds of other professional conferences holds true—there’ll also be a fair number of folks milling and networking outside the meeting rooms or chatting up the exhibitors.

Nope. The hallway stands silent. I duck into the exhibit hall.

Nada. There be tumbleweeds a’ blowin’. Heck, even a fair number of exhibitors are nowhere to be found.

My goodness—everyone’s in the meeting rooms. Yes, folks, the sessions at the ASHA Health Care & Business Institute are that darn good.

Packed with more sessions and CEU opportunities than ever (hey, check out the awesomely convenient and affordable PLUS Package recorded courses CE option), the 11th ASHA Health Care & Business Institute attracted a near-record-breaking crowd from April 11—13. It’s not difficult to understand why.

  • Tons and tons of practical advice. Interested in the most effective strategies for contracting with employees and third parties? How about the six principles of influence to best leverage yourself and your brand? The impact of using mainstream versus less mainstream speech on your career? Tips for reading the body language of your clients and colleagues? Want candid advice from an entrepreneur on how to build your own practice? The sessions on business management and strategies were packed!
  • Up-to-the-minute coverage and tips. Want to learn the best way that your program or practice can thrive under the Affordable Care Act? What about the latest, greatest apps for pediatric populations and adults? Need to know about Medicaid for children in 2014 or this year’s billing procedures and codes for SLPs? What about the newest requirements for securing health information? Attendees had at their fingertips the most recent goings on affecting communication sciences and disorders at these popular sessions!
  • The latest advances from the frontlines of treatment. Session after session, many featuring legendary CSD researchers and clinicians, showcased the latest approaches to assessment and treatment for clients affected by a wide range of communication disorders—aphasia, dementia, dysphagia, childhood apraxia of speech, and autism spectrum disorder, among others. Some of these sessions were so well attended that folks were sitting in the aisles and on the floor in the hallway outside—I gave up my chair many times…

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So, with such a gang buster conference going on, what was this editor-in-chief supposed to do? When in Rome….I immediately jettisoned the interview-heavy approach to coverage and swore a courageous but ultimately foolhardy vow to cover the sessions as completely as possible through the Leader’s social media channels.

Picture this: It’s early Friday morning, and I begin hopping like a killer rabbit (beloved Holy Grail reference required) from one session to another, tweeting and posting photos at #ashaigers on Instagram. Listen, snap and tweet; listen, snap and tweet. Whew! By lunch I was stretched rather thin, and then I had to do it all again that afternoon, the next day, and the morning of the third day. I didn’t waver. My grandmother was right—when a notion takes my noggin’, I get as set and fixed-purposed as an old New England stone wall.

And now it’s time for a slice of humble pie. In the end, I must admit that the Great Social Media Effort was nobly conceived but executed imperfectly, because 1.) there were so many wonderful sessions going on that I simply could not do justice to all of them; and 2.) in many cases, I found myself so drawn in by a presenter, subject, and/or an audience’s enthusiasm and engagement that it was very difficult to leave the room. Grrrr. I. Just. Couldn’t. Cover. It. All.

At long last, with the Luxor and its Strip kin fading behind, I had time on the flight back to reflect on an outstanding conference. The attendees LOVED it and learned much. Those I spoke with were uniformly excited about the sessions; many pronounced the meeting as the best yet. They’ll be back next year, I reckon. Come hell or high water, I’ll be there, too. Perhaps leading an army of Leader editors to help cover it ALL next time. Ay-uh.

Gary Dunham, PhD, is ASHA publications director and editor-in-chief of The ASHA Leader.

 

How to Begin or Reignite Your Career in Schools

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One of the best things about being a speech-language pathologist is the variety of work settings to choose from. Holding the CCC affords SLPs the flexibility to carve out a niche many settings such as schools, hospitals, skilled nursing facilities; private practice, academia and corporate.  You can reinvent yourself just by changing where you work.

As an SLP who has worked in many settings.  I can attest to the value of change and honing new skills. However, change is always easier when you’re equipped with the right information.

If you’re making a change to schools, here are ten things to know to help you get started:

  1. The federal IDEA law and regulations governs special education and related services to all children with disabilities. This includes children with speech and communication disorders. It is important to understand the law and regulations in order to follow the special education process in schools.
  2. IDEA requires that all students who receive special education have an Individual Education Program or IEP. The IEP is the blueprint for the services that each child receives and should include a statement of the child’s present level of performance, measurable annual goals, including academic and functional goals that will help the child to benefit from the educational curriculum.
  3. It’s important to know that there are qualifications for eligibility for speech language services in schools. Check with your local district or state for guidelines outlining eligibility criteria for speech-language services.
  4. Service delivery in schools is typically conducted through individual or small group sessions, and/or  in collaboration with teachers and other education professionals. Tracking goals and collecting data for multiple students in one session is accomplished with preplanning and organization. It is important to develop a method of tracking data for each student goal in order to report progress throughout the year.
  5. The average student Caseload  across the country is 47 according the 2012 Schools Survey. That number will fluctuate throughout the school year. Scheduling and service delivery are key to managing your caseload.
  6. Response to Intervention (RTI) is a process in which struggling students are provided with alternative interventions in areas of need to determine if their performance is due learning difficulties or faulty instruction. Some schools fully embrace the RTI model while others do not. IDEA allows for RTI but does not require it.  SLPs often play a role in the RTI process in their schools.
  7. The Common Core State Standards have been adopted by 45 states thus far and is an initiative to prepare students for college programs or to enter the workforce.  The standards include the areas of reading, writing, speaking and listening, language and mathematics. SLPs should be familiar with the standards in their state to develop IEP goals that complement and integrate the Common Core curriculum for the students they serve.
  8. Speech-language pathology assistants (SLPAs) typically work in the school setting under the supervision of an SLP. The scope of practice for an SLPA is narrower than that of an SLP and is designed to support, not supplant the work of the SLP. ASHA recommends that SLPs supervise no more than 2 SLPAs at a time.
  9. SLPs in schools may be subject to state teacher requirements. ASHA’s state by state webpage outlines teaching requirements from each state across the country. Learn in advance what you’ll need to work in the public schools in your state.
  10. Salaries in schools vary widely across the country. ASHA’s 2012 School Survey provides salary data for public school SLPs in every state. Opportunities to earn additional income may be available by working in after school and summer school programs. Salary supplements may be available to SLPs who hold CCC credential.  Schools also offer excellent retirement plans, health benefits and favorable schedules.  Read more about the rewards of working in schools.

Of course, there’s much more to school based practice than just these ten points, but it’s a start.  ASHA is committed to serving school based SLPs by offering clinical and professional resources as well as professional development opportunities. One of the most popular professional development events is ASHA’s annual  Schools Conference. The Conference features the best speakers in the field on a variety of topics.  In fact, early bird registration is open now!
These resources and opportunities for learning will help to make your transition to schools a smooth one.  If you’d like to connect with us about school based practice, please contact us: schools@asha.org. We’d love to hear from you.

 

Lisa Rai Mabry-Price M.S. CCC-SLP, is the associate director of School Services for ASHA. She can be reached at lmabry-price@asha.org.