Kid Confidential: Data Collection Using Thematic Therapy

data collection

In December’s Kid Confidential column, I discussed the advantage to using thematic lessons in speech therapy.  Last month, I explained how I write goals when using thematic lessons in therapy and the need for additional sources of data throughout the academic environment.  Today, I’m going to discuss how I record data during thematic therapy sessions as well as how I have gotten other school staff members on board to collect data.  Please note that the below information is based solely on my clinical experience.

Data Collection of SLP in Thematic Therapy Sessions

There are three main ways I can think of to collect data using thematic therapy.  The first of which is to do so throughout the entire therapy session.  The second way is to collect data for certain activities during each session.  The third option is to use periodic data collection among several therapy sessions.

Target goals throughout the entire session

Once you know exactly what skills you are targeting with each student you can determine how you will do this in thematic lessons.  One way to do this is to simply target at least one skill for each student in every thematic therapy activity.  I tend to use this technique most often when working with small groups of students who demonstrate emerging skills.  I will choose language rich thematic activities and incorporate ways to target at least one goal/objective for each student during each activity.  For example, if I have a student who is struggling with pronouns, I will be sure to ask questions during every activity that would require that student to label or expressively use pronouns in order to answer my questions.  This way I am targeting that one specific goal for the entire session for that student. This technique allows me to continue to take data throughout the session for each student and performance in this way tends to demonstrate generalization of skills to other activities as well.

Multiple Short Activities Targeting Different Goals

Now there are times when it is necessary to “drill and kill” a skill for students who have yet to demonstrate emergence of skills and who seem to require multiple trials in one session to facilitate learning.  When this is needed, I will choose to have my students participate in several different short thematic activities where each student is given time to repeatedly target an individual skill within an activity I created just for them centered on the theme and interest of their choosing.  In that manner, all students participate in each activity however data may not necessarily be collected for each student during every activity.  Time for each activity should be flexible depending on your goals, the time it takes to complete the activity and students’ interest.

For example, let’s use the recent holiday season as a possible theme for therapy.  In a small group of 5 students, I may have one that is working on understanding and using prepositions, another student working on increasing overall vocabulary skills, two students working on auditory comprehension skills and recalling details of a story and one student working on articulation skills.  What can I do?  Well I can have a quick craft in which my student working on articulation skills can read directions with different prepositional phrases.  This activity will allow me to collect data on the student who requires assistance in learning prepositions, the students who are working on improving auditory comprehension skills, as well as allowing me to tackle articulation skills of my fourth student.  The next activity could be a thematic book in which my students take turns reading the pages (or if I want to save some time, I may read the book).  Of course this allows me to ask WH questions about the book, possibly ask for synonyms, antonyms or even definitions of words within the book and finally have the students attempt to use a graphic organizer to “map the story” thus requiring them to recall details in sequential order.  Now I have targeted at least one goal for each of my students.  As the book activity would most likely take longer than the craft, this is an instance where my second thematic activity may have a longer duration as compared to my first activity.  By the end of the session, I should have data on at least one goal/objective for each student from at least one activity.

Periodic Data Collection Across Therapy Sessions

The third main option, I believe we have as SLPs is to periodically record data.  This may mean, as an SLP, data is not collected every session but periodically among a number of sessions.  Some colleagues prefer this method of data collection for a number of reasons explained to me previously such as periodic data collection allows for a therapist to focus on the therapy itself without the additional distraction of data collection.  Periodic data can aid in time-management skills particularly for those with extremely high caseloads.  Some therapists feel this is a better indicator of a student’s skills over time without needing to filter out the variability of performance on a daily basis.  Additionally, some therapists believe using the “pre- and post-teach/testing” method of collecting data reflects the academic environment more accurately than daily data.  With all that said, I do want to share a word of caution to those thinking about using periodic data.  The most important thing to remember is to be consistent in taking that data.  Know ahead of time when you are planning on data collection and ensure that you have enough data collection days within each marking period to target goals effectively.  Meaning, if you write your goals for a skill to be performed with a certain amount of accuracy across three data collections days, then you must at least have three data collection days to determine if the skills has been achieved.  Also be diligent.  If a student is absent during those days, be sure to take data regarding that student’s skills the next therapy session.  Periodic data can be helpful in looking at a child’s performance over time if collected consistently.

Data From Other Sources

There will be times when we write goals and target skills in therapy but would like to determine generalization to the academic environment as previously mentioned in last month’s column.  In an instance such as this, data may be collected in a different way and from a different source. Periodic data can be just as effective as daily data collection, as mentioned above, if done with consistency.

With the implementation of RTI, I have found teachers are much more willing and confident in their own ability to take data within the classroom setting, if I take time to train them on how to collect data and express realistic expectations that data will only be recorded at specific times during the day/week or during specific assignments.  This way, I have gotten reliable data collection from teachers regarding a child’s articulation skills for specific sounds during small reading groups, qualitative data on social skills in cooperative learning situations among classroom peers, data on a student’s ability to expressively answer WH’s in the classroom, information on a child’s ability to recall details of a story, and data on the accuracy of a student’s ability to follow classroom directions.

How can all of this work when the goal is to use thematic lessons in therapy?  Well, here is an example for you.  Remember my student working on vocabulary skills?  Well it would behoove me to target academic vocabulary in the school setting as a means to hopefully translate to improved classroom function.  Therefore, I may be given a list of vocabulary words from my students’ teachers and incorporate those words into stories I create using the theme on which we are currently focusing.  I may pre-teach the vocabulary, use context clues to have my students’ define the same vocabulary in my created story, then I may have my students participate in a vocabulary definitions match-up page post story.  This may occur over the span of several sessions.  Once this is completed and I have my data as to how my students performed with this particular list of vocabulary words, I can then compare their performance in my speech room to that of their classroom performance to determine if carryover has occurred.  This way, I am actually using teacher data (e.g. score on the students’ vocabulary sections of their language arts assignments each week) to determine generalization all while still using themes in therapy.

How do I get teachers on board and how can I ensure data collection is occurring?  Here are few tips:

  1. Keep things a simple as possible by providing all materials needed for tracking data.
  2. Let the staff member choose when to take data:  I ask the teacher/staff member what time of day or which classroom activity would be easiest for them to track a student’s performance.  Teachers are more likely to take data during activities or times of day which are easiest for them.
  3. Training goes a long way: Once a specific classroom activity or time of day is identified by the teacher, I will be sure to go to the classroom during that time and train the teacher on how to take data for the specific skill being targeted.  I keep it as simple as possible and very rarely do I have to do this more than once.
  4. Accountability:  I randomly check the data sheets during class time and ask the teacher every few days how my students are doing in the classroom.
  5. Show gratitude:  When teachers and staff members understand how genuinely grateful I am to them for taking time out of their day to help one of our students by recording data, they are much more willing and likely to continue to take data.

What does the data collection form look like for the school staff?  Here’s an example of what I have used in the school setting.

data collection

I usually provide a folder for the data collection sheets for students so the staff member can pull out the data collection sheet, re-read the goal being targeted, and simply take data on the student during the agreed upon time/activity.

For more functional goals that require data collection in real-time during the classroom, such as using appropriate pragmatic skills or using age-appropriate receptive and expressive skills for functional conversational, I will provide teachers with the data collection sheets as well as a page of blank labels.  The teacher can simply take data on the labels in real-time and stick them onto the data collection sheet later.  This way, he/she does not have to stop the lesson to take data.

The possible ways to record data by ourselves as SLPs or collect data from other school professionals is numerous if we are creative and work collaboratively with others.  I’m sure there are a number of school speech-language pathologists using the above techniques as well as a number of others not mentioned today.  As long as we remain flexible, open-minded and always focus on improving functional skills of our students, I believe the ways in which we can do this are infinite.

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: 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. 

 

 

 

Baby Led Weaning: A Developmental Perspective

blw

One of the things I like best about teaching courses on feeding to parents and professionals around the United States is learning what new trends are evolving around family mealtimes. Over the past year,  one of the common questions I’m asked is, “What about Baby Led Weaning?”

Baby Led Weaning (BLW) is a term coined by Ms. Gill Rapley, co-author of “Baby-led Weaning: The Essential Guide to Introducing Solid Foods.”  Rapley graciously chatted with me about her philosophy and explained that although she did not invent BLW, she found the method to be successful in her work as a former health visitor and midwife in the United Kingdom and continues to study the topic today while earning her PhD.

In a nutshell, BLW centers on the philosophy that babies are developmentally capable of reaching for food and putting it in their mouths at about 6 months of age. As stated on the BLW website “You just hand them the food in a suitably-sized piece and if they like it they eat it and if they don’t they won’t.”  Please note that the word “wean” is not referring to weaning from breast or bottle, but instead refers to a term commonly used in the United Kingdom for adding complementary foods to the baby’s current diet of breast milk or formula.  According to the BLW website, ideas for first foods include “chip size” steamed vegetables such as a broccoli spear with the stem as a handle, roasted potato wedges, meat in large enough pieces for the baby to grasp and chew, rice cakes, cucumber, celery and dried apricots.

As a SLP who focuses on pediatric feeding, I view feeding as a developmental process.  Whether I’m working with a child experiencing delays in development or offering advice to a parent whose child is meeting milestones with ease, I always ask myself “How can I respect and support this family’s mealtime culture while guiding this child safely through the developmental course of learning to eat?”  Thus, for families who are interested in following the BLW method, whether their child is in feeding therapy or not, I try to support their wishes if the child is capable,  while offering the following BLW points to consider:

BLW encourages parents to eat with their children, since everyone is eating the same food. 

In today’s busy culture, it feels easier to many parents to feed the baby prior to the adult or family meal, and in BLW the thought is that jarred purees contribute to this habit and it’s important to include baby at the table at an early age.  Even in feeding therapy,  the ultimate goal is for families to be able to gather around the table at mealtimes with everyone enjoying the same foods.  Plus, Columbia University reports that consistent family dinners are an integral and valuable part of raising children.

BLW emphasizes that babies must be the ones to put the food in their mouths.

Feeding therapists encourage self-feeding  for all kids because it allows them to get messy.  Babies are programmed to explore the world with all of their senses, especially their hands and mouths, and often the two together!  BLW notes that the time to begin self-feeding is at 6 months when baby can sit upright on his/her own. I explain to parents that first, every child must have the gross motor stability to support fine motor skills, including reaching and raking for food and controlling their grasp to bring the food to the mouth to be chewed.  For children who have this capability, I feel comfortable with large pieces of food that will not snap off (or allow a solid chunk to fall into the mouth) in addition to short spoons and chewable toys for practicing the skills that will eventually lead to self-feeding.

BLW follows the baby’s cues rather than the parent controlling the feeding via the spoon.

I explain that whether presenting food to your child by placing it on the high chair tray in front of them, directly on a spoon or even mouth to mouth as done in some cultures, reading baby’s cues for readiness is crucial.  Like a beautiful, flowing conversation, feeding children is a reciprocal experience.

According to the BLW blog, BLW introduces chip-size foods (rather than purees or mashed foods) so that baby learns to chew first and then spit out if unable to swallow, noting that with purees on a spoon, babies learn to swallow first and then chew.

From a developmental perspective,  this doesn’t quite fit with my understanding of how infant reflexes integrate  and babies acquire oral motor skills. Babies can begin the process of BOTH spoon and finger feeding between the ages of 5 and 6 months using both purees and soft, safe foods.  Why?  Because this is when babies acquire better lip control and movement as they suck the puree off of a parent’s finger, their own hands or a spoon.  As noted in Diane Bahr’s book “Nobody Ever Told Me (or My Mother) That!” this is when babies use their rhythmic bite reflex to bite off soft pieces of safe, soft or meltable foods that they can hold in their tiny fists or when presented by a parent to their open mouths. If the food is placed onto the gums where we will one day see molars, a rotary chew pattern will begin to emerge over time, thanks to reflexive patterns that soon become purposeful movements.  It’s a developmental process and BOTH purees and finger feeding facilitate the progression of skills. It makes sense to me to transition gradually from thinner  liquids (breast milk/formula) to thicker (thus, a smooth puree) to consistently mashed or chopped  while introducing soft meltables over time.  Keep in mind that I also encounter families who are moving too slowly through graduation of textures, as noted in this article by Bahr.  But, jumping straight to only large pieces of foods to be chewed and then either swallowed or spit out feels like skipping crucial steps in the developmental process.  “Feels like” is the key phrase here: We need research to determine if children who follow this model eventually acquire skills traditionally learned prior to chewing chunks of food as listed in this article found in ASHA Perspectives.  Unlike my previous post on sippy cups, where therapists have raised concerns based on their professional experience over several years and observation of prolonged sippy cup use,  consistent BLW practices are a relatively new phenomenon in the United States.  So, when any parent asks “What about Baby Led Weaning?” I try to integrate my own practitioner expertise and knowledge of feeding development while honoring the family’s preferences and mealtime culture.  Still,  my biggest concern for any 6 month old child is choking.

BLW encourages parents to become comfortable with gagging episodes and understand the difference between gagging and choking. 

Gagging versus choking are two different experiences.  Typically, an infant’s gag reflex is triggered when the back three quarters of the tongue is stimulated, but by the time a child reaches  9 months of age, the reflex covers less area, lying on the back third of the tongue. Eventually, the gag reflex shifts posteriorly even more as the child learns to tolerate the stimulation. Gagging is nature’s way of protecting the airway, where true choking occurs.  Choking happens when food (or other substances) obstruct the airway and thus, often has no sound or intermittent, odd sounds.  Other signs of choking include but are not limited to: gasping for breath, turning blue around the lips and beneath the eyes and/or staring with an open mouth while drooling.

Gagging is an uncomfortable sensation where the soft palate suddenly elevates, the jaw thrusts forward and down, and the back of the tongue lifts up and forward.  It is not unusual for a child to vomit after gagging.  In between the gags, the child is still able to breathe, cry and make vocal noises.  The occasional gag is an important built-in safety mechanism, but frequent gags and/or vomiting can lead to an aversion to food.

In summary, when asked for advice from any family that would like to follow Baby Led Weaning principles, I stress the importance of reading baby’s cues and monitoring them closely for safe feeding while supporting them through the developmental process of learning to eat, no matter what age.  This includes proper positioning in the feeding chair for optimal stability and presenting only manageable pieces of safe, meltable and/or solid foods that do not pose a choking hazard.  For children in feeding therapy, incorporating some aspects of BLW is dependent on that child’s individual delays or challenges and where they are in the developmental process, regardless of chronological age.  My primary concern for any child is safety – be aware and be informed, while respecting each family’s mealtime culture.

Melanie Potock, MA, CCC-SLP, treats children birth to teens who have difficulty eating.  She is the author of Happy Mealtimes with Happy Kids and the producer of the award-winning kids’ CD Dancing in the Kitchen: Songs that Celebrate the Joy of Food!  Melanie’s two-day course on pediatric feeding is  offered for ASHA CEUs and includes both her book and CD for each attendee.  She can be reached at Melanie@mymunchbug.com.

Kid Confidential: Using Thematic Therapy to Write Goals

creative 

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.

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.

Kid Confidential: Using Thematic Instruction in Speech Therapy

pirate

I have seen many speech and language activities labeled as “themed” therapy activities just by the mere coincidence that they may sport graphics or clip art associated with a particular theme or holiday.  However, simply pasting an associated picture on a stimulus card while asking a student to perform a generic speech or language task is the not the same thing as participating in a themed activity.  Until I learned from my educator colleagues what it truly meant to teach via themes, I made this same mistake, too.  Regular and special educators are taught to understand the importance of themes and how they relate to child development and learning.  However, at least based on my own personal experience, newly graduated speech-language pathologists lack the instruction needed to fully understand what thematic teaching is really all about.

I see myself as an educator first and foremost.  Therefore, I learned many valuable things about education through colleagues and by reading educational research and textbooks.  This particular topic has been no exception.  Marjorie Kostelnik, Anne Soderman and Alice Phipps Whiren, spend an entire chapter explaining what thematic units really are and how they can effectively be used within the academic environment in their book titled, Best Practices in Early Childhood Education.  The following information is adapted from this source.

What is a theme and why would we use them in speech interventions?  A theme can be defined as the creation of various meaningful activities planned around a central topic or idea. The activities are then integrated into all aspects of the curriculum (i.e. language arts, reading, math, science, social studies, etc.).  Thematic instruction has been researched and observed to help children learn about concepts (i.e. ideas about objects and events in a child’s world) and facilitates in connecting various concepts together cognitively. In SLP lingo, this means thematic instruction helps to teach our children about categories. Through first-hand experience and additional learning activities, our students are improving their semantic mapping/networking skills thus improving receptive and expressive vocabulary, understanding and using synonyms and antonyms, word retrieval skills, story comprehension and story retelling skills, answering “WH” questions, as well as improving their ability to make inferences and predictions, thus resulting in improvements in overall language skills.

How do we create effective thematic lessons for our speech sessions?  According to Kostelnik, et al., there are five necessary components to creating an effective theme:

  1. Relevance: The theme must be relevant to your student’s real-life experiences and timely in that themes should be targeted based on your students’ current interests.  For example, a field trip to the pumpkin patch may be planned in the fall. Creating a theme-centered around fall harvest/fruits and vegetables, around this time would be an appropriate time to maximize your students’ interest in learning about this topic.
  2. Hands on activities: Concepts whose informational content can be accessed through hands on activities are appropriate for students 3-8 years of age.  These activities can be offered via exploratory activities, guided discovery, problem-solving activities, group discussions, cooperative learning, demonstrations or direct instruction.  I think as SLPs we tend to be very good with demonstrations and direct instruction (i.e. speech/language activities, what I like to call “drill and kill” activities) as well as guided discovery (particularly in book reading when asking student’s to infer or make predictions), however we miss opportunities for students to use self-talk to problem solve or use cooperative learning to have a discussion with peers.  These are important executive function and social skills that should be trained at an early age so as to generalize to other environments as our students mature.  If, during our group therapy sessions, we step out of the equation as facilitators, will our students educate each other on the necessary skills for continued development (e.g. teaching each other to self-monitor speech production or how to use appropriate social skills in real-time, or even help each other use correct grammar in sentence formulation)?  We must create opportunities for our students to use what they learn independently to help themselves and their peers.
  3. Diversity and balance across the curriculum:  Many of you might be reading this and think, well this doesn’t apply to me because I teach speech and language skills.  However, the truth is, you are already doing this!  Through your planning of speech therapy activities you are incorporating science (e.g. matching pictures of clothing to correct seasons, mixing red and blue paint to make purple, etc.), social studies (e.g. discussing community helpers and matching up the helpers to the objects/tools they use), math (e.g. counting and sorting animals into correct categories), and language arts (e.g. recalling details of a story or retelling a story in correct sequence).  Therefore, the use of “academic” or “curriculum-based” materials in the upper elementary grades, middle school and high school is, more than likely, what most of you have been doing for years!
  4. Primary and secondary sources of information must be available:  When planning a theme, thought must be given to the primary and secondary sources of information.  Primary sources of information are seen as what the child already knows (background knowledge) or can determine via concrete information present.  Secondary sources of information are sources that provide students with additional information they had not known nor can determine via concrete information present.  For example, when focusing on “farm animals” as a theme, a child may already know that a pig says “oink” and can see from a picture that it has four legs.  This is known as primary information.  An example of secondary information would be using books, pictures or other additional resources or materials to explain the role of pigs on a farm or the types of pigs and where they live.  So in a nutshell, a good theme uses the background knowledge your students already have and builds on that by providing additional new information.  Doesn’t this sound a lot like reading comprehension strategies (background knowledge, pre-teaching vocabulary, introducing new information, recalling information, etc.)?
  5. Potential for projects/“discovery learning”:  A good theme must lend itself to discovery learning. Discovery learning simply means you present your students with opportunities to problem solve and/or reason information not factually presented to them.  These projects are child-centered and/or child directed.  This piece is very important in planning themes because as you introduce information to your students you want to follow their lead and listen to the questions they have about the information presented.  Then you want to create a “project” that addresses the student’s questions or concerns.  For example, if when discussing farm animals a child asks have you (as the SLP) ever been to a farm? Your student is expressing the interest to learn more about others personal experiences about farms.  So you guide a “project” where your student asks the other students in your therapy group (language practice in formulating appropriate questions) or classroom if providing in class therapy, and you graph their responses.  Now you’ve just incorporated math (graphing, counting, adding, concepts of more/less) into a “project” your student directed and by the end your student has problem solved a way to survey his/her peers to find out more information about themselves.

I can hear the collective frustrated sigh from many of you out there reading this. “I have my students for 30 minutes, two days a week.  How am I supposed to use thematic units to teach them what they need to learn in that time?”  The first thing I would suggest to do is to start small.  Focus on the use of thematic teaching for a small portion of your language delayed students. Listen to what they are interested about learning and begin to create activities based around those topics. Remember you need to know what your students already know (primary source) so you can provide appropriate expansion materials/activities (secondary source).  Then compare your results.  See how the use of themes aid in learning and language development for this group as compared to the therapy groups for which you do not provide thematic lessons.

Another important key to successful themes is the stay flexible.  Follow your students’ lead.  Remain on one theme only as long as your students’ interest in the topic lasts.  This means, you don’t have to perform five or six thematic activities within your two therapy sessions a week. You can take as long or short a time as needed.  You might even take two sessions to participate in one activity.  I used to work with a colleague who used two or three sessions of repeated book reading as part of thematic teaching and it was amazing to see the improvements in numerous linguistic skills of her students after these sessions.  It just depends on your students’ current level of skills and interest.

So the next time International Pirate Day rolls around on the calendar throw out those multi-step direction cards that have nothing remotely related to learning about pirates. Rather, spend a week or two reading pirate stories while increasing the use and understanding of pirate-associated vocabulary (e.g. treasure, map, spyglass/telescope, etc.), and pirate lingo (e.g. “Shiver me timbers!” “Matey” and “Land ho!”), recalling details and or retelling the stories read (language arts), discussing famous historical pirates and from where they originated (history, geography), creating a “treasure hunt” for your students to cooperatively complete (following directions with pirate lingo, problem solving and reasoning, use of appropriate social skills), and spend time creating a pretend play scenario about pirates (hands-on, expansion activity) using all the information your students’ learned throughout your therapy sessions.  I promise you that your students will have just as much fun learning from you as you will have teaching them.

 

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.