5 Ways to Involve Parents More in Their Kids’ Treatment

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As a speech-language pathologist, I know how much successful treatment relies on parent involvement and home practice. We might work miracles during our treatment sessions, but we  have only  a couple hours with our clients each week. If a child spends one hour per week with us, they spend 167 hours per week OUT of treatment. Typically, the majority of this non-session time gets spent with mom and dad.

Think about it in terms of a jar full of jelly beans (we can all relate to candy, right?). Fill a jar with 168 jelly beans—one for every hour in a week. Now remove one jelly bean to symbolize the hour you as a clinician spend addressing your client’s communication goals. Look at the alarming amount of jelly beans left. In fact, it’s safe to say, the lay person might not even notice the single missing bean!

Getting parents or caregivers involved in the treatment process and designing home programs they can manage in their typically busy schedules is critical for successful carryover. We know this.

Before my children were born, I subscribed to the “more equals better” mentality and absolutely loaded my families down with speech-language assignments. Now I realize families simply can’t spare much time. So how can we create programs that families can weave into their already hectic schedules?

  • First things first: Involve parents in sessions. Sometimes they prefer a waiting room to settling into teeny tiny chairs, but try to persuade them to join you. And I mean join you at the table. Talk to them about the activity and why you chose it. Deal them into the Go Fish game. Involving caregivers in your sessions and establishing a comfortable, open line of communication leads a solid rapport. Assure them your treatment room offers a safe environment where learning is your number-one goal for clients and caregivers.
  • Start every session with some version of “tell me something new you’ve noticed this week.” This open-ended question affords caregivers the chance to tell you about specific situations related to communication. Remember to check periodically with caregivers about how they feel their child progressed and if they want to work on new or additional goals.
  • Ask caregivers to bring a list of the toys and books the child enjoys. Knowing what your families work with at home helps you provide activities that address the child’s goals and assimilate easily into their routines. For example, my daughter’s current favorite activity is splashing around in her baby pool. This gives me ample opportunity to address spatial concepts (in, out, under), comprehension and use of present progressive verbs (swimming, floating, kicking, dripping, splashing), increasing use of descriptive terms (cold, wet, slippery), and following directions. Or if you really need your client to work on medial /p/, encourage an extra reading or two per day of “Hippos Go Berserk.”
  • Ask caregivers when they can set aside time for communication activities. Share ideas or strategies to maximize speech and language practice during these times. If mom feels she can only devote the 20-minute morning commute to addressing communication skills, don’t despair. Toss out worksheets and sit down with her to create a list of activities they can safely complete in the car. Suggest categorization—“name all the animals you can!”—or expansion techniques to increase length of utterance, or acoustic highlighting and auditory bombardment. Create a speech book with target-sounds pictures to place in those handy-dandy seat-back pockets, so her child can talk about the pictures while practicing her sounds. Coach mom to elicit multiple productions when her little superstar gets it just right and to model and correct if her child struggles.
  • Involve the whole family. It’s no secret older siblings motivate little ones. Encourage parents to recruit their big kids to play the role of “speech assistant” and turn speech and language homework into family play time.

Amanda Rhodes Fyfe, MS, CCC-SLP, works for the Mansfield Independent School District. amandafyfe@misdmail.org 

3 Ways to Incorporate Literacy Into Treatment

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To address literacy skills or to not address literacy skills? That is often the question facing the public school speech-language pathologist. And before you start secretly thinking angry thoughts about me and my caseload, I’ll stop and agree with you right here: No, we cannot add another job to our workload. With the education changes we have seen in the last few years, we need to work smarter, not harder. We can, however, incorporate literacy into the language, articulation, fluency and voice treatment sessions we already do.

These three techniques work for me:

  1. CVC/Words with blends. Write consonant-vowel-consonant words or words containing consonant blends on paint cards. Students tap each sound and blend them together to read the word. Associating letters with sounds and blending them is great practice for our students having articulation and phonological disorders. For a little simultaneous language practice, ask the student what the word means after she reads it. If a student doesn’t understand what he’s reading, he’s not really reading, no matter what his fluency score might look like.Often, I’ll ask my students to blend and read words such as “dog,” “cat,” “big,” “hat” and then ask them what it is. If they don’t know, they didn’t truly read the word. When we do it again, I can see the exact moment the light comes on and they read the word. It usually goes something like this: “Oh yeah, that’s something that says bark!” or “At home, my dog’s name is Buddy!”
  1. Use Reader’s Theatre in your articulation, voice and fluency groups. This research-based intervention doesn’t only increase reading fluency, it also promotes intonation, prosody, comprehension and overall reading enjoyment. Print pages of plays and ask your articulation students to highlight sounds they’re covering before they practice. My guess is that you’ll target various goals in one session and the students will enjoy doing it!
  2. No reading materials? No problem! Use materials from the regular classroom. Have students bring books that they’re reading in class to your sessions. It’s often eye-opening to see what our students do in class. Recently, a group of my students brought the book “Tuck Everlasting.” I made copies for my articulation students to highlight their target sounds and read to the rest of us. My language students then retold the story and discussed the book.

The thought of incorporating literacy into our sessions might overwhelm us. It doesn’t need to, however, if we connect literacy to what we already do during treatment.

 

Nicole Allison, MA, CCC-SLP, serves as media chair on the Ohio School Speech Pathology Educational Audiology Coalition and blogs at Allison’s Speech Peeps. She also creates materials to benefit school SLPs, especially on data collection and the Common Core State Standards. nrallison@gmail.com

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 three 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