The Tough Decision to Move Our Son to a Residential Community

Kevin at the beach

My husband and I had an “Aha!” moment right before our niece’s wedding. As our niece was moving to a new chapter in her adult life, it occurred to us that we had no idea what our son’s life apart from us might look like. We always included Kevin—our 31 year-old son with cerebral palsy and a severe communication disorder—in extended family get-togethers. So, we didn’t hesitate to call for a family meeting after the wedding to talk about our thoughts and concerns for his future. My husband and I wanted to keep Kevin at home until we could no longer care for him. Both having been diagnosed with cancer—although successfully treated—we recognized the need to plan for Kevin’s future without us.

We began to search for a residential community with a secure financial base that offered Kevin a safe, homelike setting. An only child, he appreciated not sharing a bedroom. His private space is important to him. Kevin works with a job coach and has since high school. He enjoys workplace interactions, so the provision of scheduled work activities was also vital in our decision.

KevinDivingKevin loves being “on the go” and participates regularly in church services and a variety of recreational activities. We identified a community with a new church home and leisure activities in addition to all of the other criteria we expected for our son. In our small rural community, Kevin developed relationships with the same therapists and caregivers for most of his life. We realized that any change would cause issues for him, so positive interactions with caregivers remained another non-negotiable feature. Finding a facility able to maintain his level of physical strength and flexibility for walking presented another challenge. That created another requirement—access to quality health care, various therapy services and fitness programs.

Communicating with unfamiliar listeners posed his greatest challenge. Kevin uses oral speech, gestures and some idiosyncratic signs to communicate. His love of his smart phones and technology drove his increasing use of oral and written language since high school. Any time a new communication app became available, a speech-language pathologist and an occupational therapist provided treatment to help Kevin use it. Kevin learned word prediction, which greatly expanded his ability to discuss topics or clarify his comments via text. Therefore, we insisted the community we selected would need to embrace technology and facilitate his use of it.

When we found the place that met all of ours and Kevin’s needs—Innisfree Village—executive director Carolyn Ohle asked us why we wanted to wait to move Kevin. She explained that younger residents adjust more easily when family members actively support the resident through the transition. This also allows parents or caregivers to visit frequently and take their child home for vacations and holidays.

Her words made sense and, once our emotions caught up with our reasoning, we decided that moving him sooner was better for Kevin even if it was more difficult for us. Kevin has now been at Innisfree Village for almost two years. He works in the bakery, vegetable garden, community kitchen and on the farm. He receives physical therapy and exercises regularly in a fully equipped gym. Kevin especially enjoys going to the local coffee house and attending sporting events in Charlottesville. His life is rich and full.

My husband and I continue to grieve the loss of Kevin’s presence in our daily lives. But we made the right decision for his present and future, and that gives us peace.  Whatever happens to us and no matter when it does, he’s in a comfortable and caring community, which won’t change with our passing.

 

The Unexpected Empty Nest,” in Exceptional Parent’s December 2013 issue shares more about Kevin’s life and transition to Innisfree. A condensed version appears on the Innisfree Village website, which CSD students can explore for volunteer opportunities.

Ann M. Darby, MA, CCC-SLP, Kevin’s Mom, retired SLP, spent her career working in the public school system as an ASHA certified SLP, preschool special needs teacher and preschool specialist. amdarby70@gmail.com

Five Tips to Help Students Review Skills Over Summer Break

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According to the website of the National Summer Learning Association, “all young people experience learning losses when they do not engage in educational activities during the summer.” I want to help support my middle-schoolers’ language skills during this time. This year, I put together a handout with suggestions on what families can do over the break:

1. Visit a Museum

  • While at the museum, go on a scavenger hunt. There are plenty of pre-made hunts online. Some scavenger hunts ask simple “wh” questions and others may require critical thinking. The best part is that the students are learning without even realizing it!
  • Ask students to come home with three facts they learned. They can take pictures (if allowed) as a reminder and/or jot down details.
  • On the way to museum, review common museum terms such as exhibit, ancient, extinct, era, discovery and more.

2. Write a journal

For students who need to work on writing skills, suggest journaling. Ask them to create a summer writing journal and decorate it. Students can write what they do day-to-day, or print a list of pre-made writing prompts. I found a sample list of writing prompts online.

3. Play language games

SLPs often collect and hoard board games that we use to reinforce target goals. Why not share some of these with parents? Common games played in my room appropriate for middle school include:

  • Apples to Apples
  • You’ve Been Sentenced
  • Trigger
  • Baffle Gab

4. Read, read, read.

I know this seems obvious, but it’s so important for kids to continue reading over the summer. In my school, we charge kids with reading every day for at least an hour. Send home a list of books that kids in your caseload may enjoy reading. Also, encourage parents to ask their kids questions about characters, problems, solutions, settings and other story details.

5. Cook

Why not try a new hobby while home for the summer? Older students can make many yummy dishes and cooking offers another fun way for parents to engage with their kids. You can find plenty of no-bake recipes online for kids who stay home alone during the day. Reading a recipe teaches following directions, comprehension and vocabulary. It’s also a pretty important life skill (in my opinion).

These are just some ideas to help your kids get going and keep busy this summer! What summer activities do you suggest for your older kids?

Gabriella Schecter, MS, CCC-SLP, is a full-time SLP working in a grade 6-12 school. She posts regularly on Instagram (@middleschoolSLP), sharing ideas and activities for this age group. Check out her blog or contact her at MiddleschoolSLP@gmail.com.

Summer Postcards for Social and Language Skills

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As the school year winds down, parents often ask me for easy summer activities to support goals we’ve been addressing all year. Some of my favorite tips involve postcards.

Dear Me

Writing a daily postcard each night of vacation builds sequencing skills (or grammar or vocab or any expressive language skill). I ask families to come up with three to four activities they did that day or three to four elements from a big event. Parents may take (verbatim) dictation, but I always ask that the child sign off. I often suggest doing this in a restaurant while waiting for food to arrive, because family meals are a typical time to discuss what happened that day.

If it’s feasible, I ask parents to mail the postcard home each day. If not, they act as postmaster once home by mailing one a day.

This mail generates a lot of post-vacation excitement. The little one gets mail several days in a row and hears or reads activity sequences again. Kiddos love stories they star in! They are also a great keepsake and less arduous than keeping a travel journal.

I ask parents to bring the postcards in for a couple of sessions once school starts again. They give me and my students something tangible to review and I have a reference point for topics and questioning. They also provide a great starting point for class projects on “what I did on my summer vacation.” Our students appreciate the memory boost for generating detailed, sequential information about events that happened several weeks earlier.

Goal Nudging

I also use postcards to push goals along during the break from our sessions, which is especially important for fluency students.

My student and I come up with five to seven summer goals (with a variety of difficulty). Each goal gets written individually on a postcard (hometown or generic), stamped and addressed to me. As the student completes the goal, they simply sign their name and drop it in the mail. I encourage a sentence or two of feedback, particularly from older students, but I don’t insist. If I don’t receive a postcard within the first month or so of summer break, I send a postcard reminder of my own!

I use these activities with K-12 students, but I think they would adapt easily to adult populations as well.

Kimberly Swon Lewis, ME, CCC-SLP, is a pediatric speech-language pathologist in Greensboro, North Carolina, and the author of the ActivityTailor.com blog. kim.lewis@activity.tailor.com

 

 

10 Low-Cost, Low-Tech Tools for SLPs Treating Teens and Adults

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With summer—and client travel—around the corner, I’m sharing ideas for non-electronic treatment activities that are low-cost, portable and ideal for adults with developmental disabilities. Use these activities in the treatment room and for families who want to work on speech, language and communication goals between sessions. Encourage clients to take these materials along during summer travel, on the beach or on a short trip in the community.

Whenever I work with older teenagers and adults with developmental disabilities, I focus on finding age-appropriate activities. An older client might feel disempowered by a childlike activity.

Most people also already own these materials!

  1. Newspapers. A newspaper—which may cost less than $5, depending on the paper—serves as a multipurpose treatment tool. Even better—some papers are free! Target literacy, answering and asking questions about current events, searching for a movie time and location, and social skills or abstract language in the comics section. Check out how to use comics to meet speech and language goals.
  2. Magazines. I love using magazines as a treatment tool with adults. Age-appropriate and interesting, magazines contain a variety of articles, pictures, advertisements and more. Also, the magazines your clients choose may give you insights into their interests and motivations. I recently asked one of my clients to choose a magazine at the local convenience store. I expected him to choose a food or car magazine, but he gleefully went straight for the gossip rag. We had a productive session afterward discussing various sections in the magazine via his communication device.
  3. Grocery circulars. Use free circulars to learn money management, categories (such as food groups) and new food vocabulary. Other goals include facilitating commenting and describing. Circulars also act as conversation starters: “What would you buy at the grocery store?” “I want to make steak and eggs for breakfast. What do I need to buy?”
  4. Brochures/catalogs. Brochures and catalogs—another free option—motivate and engage clients depending on their interests. If your client likes electronics, bring an electronics catalog, for example. Discuss prices, various types of equipment and what they like versus dislike. The same approach works for clothing, gardening or home décor catalogs.
  5. Subway/bus maps. Also free and functional! Work on travel training, literacy and map reading with these resources. Language concepts include problem-solving, sequencing and answering “wh” questions.
  6. Menus. I’m sticking with the free theme, here! And what’s more functional than being able to read a menu and make a choice? Check out my previous article on using menus as a treatment tool.
  7. Employment applications. Stop into any fast-food establishment, restaurant, movie theater or retail store and ask for an application. Filling out an application facilitates improved literacy, answering “wh” questions, recalling information, expanding vocabulary, and sequencing by writing the order of educational or work history.
  8. Dominoes. A set of dominoes offers an inexpensive, portable, age-appropriate and fun developmental activity for adults. Practice matching, taking turns, solving problems and following directions.
  9. Playing cards. Ideas for card games include Uno, Go Fish and War. Again, thiese low-cost games double as age-appropriate, accessible, portable and functional treatments. Examples of targeted goals include matching, solving problems, taking turns and prediction.
  10. Board games/bingo. How about a game of Sorry or Connect Four? These games are less than $10 each and teach taking turns, learning colors, following directions and solving problems. A generic bingo game or a customized bingo set also works well. If you have clients who need work on specific vocabulary related to actions, send them home with an action bingo board. Instruct them to use it with family or friends to build vocabulary, practice taking turns and forming complete sentences.

 

Rebecca Eisenberg, MS, CCC-SLP, is a speech-language pathologist, author, instructor and parent of two young children. She began her website, www.gravitybread.com, to create a resource for parents to help make mealtime an enriched learning experience. She has worked for many years with children and adults with developmental disabilities in a variety of settings, including schools, day habilitation programs, home care and clinics. Contact her at becca@gravitybread.com or follow her on FacebookTwitter or Pinterest.

How Do You Know When it’s a Language Delay Versus a Disorder?

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Editor’s Note: This is an excerpt from a blog post that originally appeared on Special Education Guide. 

How do you know when it’s a language delay versus a disorder?

Unfortunately, there is not always a straightforward answer to this question. A language delay is just that—a delay in acquisition of language skills compared to one’s chronological and cognitive/intellectual age-peers. A young child with a language delay may exhibit a slower onset of a language skill, rate of progression through the acquisition process, sequence in which the language skills are learned, or all of the above.

However, there is a subset of children who continue to demonstrate persistent difficulties acquiring and using language skills below chronological age expectations (by preschool or school age) that cannot be explained by other factors (for example, low nonverbal intelligence, sensory impairments or autism spectrum disorder) and may be identified as having a specific language impairment (language disorder).

In contrast to a delay or a disorder is a language difference. With a language difference, communication behaviors meet the norms of the primary speech community but do not meet the norms of Standard English. This difference can exist whether the person in question is a child from a different country or simply from a different neighborhood in the same city.

So, what are some options for addressing language delays and disorders?

Intervention for a delay may take on several forms:

  • Indirect treatment and monitoring
    • Provide activities for parents and caregivers to engage in with the child, such as book-sharing and parent-child interaction groups.
    • Check in with the family periodically to monitor language development.
  • Direct intervention, including techniques such as:
    • Expansions—repeating the child’s utterance and adding grammatical and semantic detail.
    • Recasts—changing the mode or voice of the child’s original utterance (for example, declarative to interrogative).
    • Build-ups and breakdowns—the child’s utterance is expanded (built up) and then broken down into grammatical components (break down) and then built up again into its expanded form.

Intervention for a language disorder is child specific and based on that child’s current level of language functioning, profile of strengths and weaknesses, and functioning in related areas, including hearing, cognitive level and speech production skills. The overall goal of intervention is to stimulate language development and teach skills to enhance communication and access academic content. The developmental appropriateness and potential effectiveness on communication and academic and social success should be considered when developing treatment goals.

 

Aruna Hari Prasad, MA, CCC-SLP, is ASHA associate director of school services.  ahariprasad@asha.org