Collaboration Corner: Must-Have Books for Building Language and Literacy

1book

I can’t believe it’s September! For those of us in public schools, that means re-organizing and replenishing our bag of tricks. Books of course, are an easy and engaging way to expand language.

If parents are looking for some ideas on stocking up their bookshelves (or yours) this list may help.

I also rely upon my librarian colleagues for other ideas. If I can find the board book version of anything, I usually opt for that version; board books are durable and allow you to do things like add pictures with a little bit of Velcro for matching, like this:

1horsepic

For very young children, or children with language delays, I generally use a couple (or five) quick pointers when perusing the bookstore:

  • Engaging pictures that aren’t too visually complicated but have a clear character and setting.
    • Targets: Who, what, where, when questions, descriptive language.
  • Books with repetitive words and phrases.
    • Targets: Oral/expressive language and literacy skills through  predictable text patterns and repetitive lines.
  • Books that aren’t too long, maybe 10-12 pages.
    • Target: Maximize engagement for short attention spans.
  • Books that can allow the adult to target core language concepts, either through text or illustrations.
    • Target: Syntax, vocabulary.
  • Books that enable the adult to expand beyond the text.
    • Targets: Commenting, labeling how a character feels or what they are thinking.

There are many books from which to choose, but here are some good starters for your collection:

  • Good Night Gorilla: Peggy Rathmann
  • The Very Hungry Caterpillar: Eric Carle
  • Have You Seen My Cat?:  Eric Carle
  • Good Night Moon: Margaret Wise Brown
  • Blue Hat, Green Hat: Sandra Boynton
  • Where’s Spot?: Eric Hill
  • Go Away Big Green Monster: Ed Emberley
  • Big Red Barn: Margaret Wise Brown
  • Good Dog, Carl: Alexandra Day

Not every book on this list follows every guideline perfectly,  but all allow for a positive learning experience that supports child language and preliteracy development.

Have an inspired school year colleagues!

 

Kerry Davis EdD, CCC-SLP, is a speech-language pathologist in the Boston area, working with children who have significant communication challenges. She conducts trainings and workshops, and serves as a volunteer speech-language pathologist and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this post are her own, and not those of her employer.

 

Finding the Right Fit: Social Pragmatics Groups in Middle School

1kidgroupThe recent explosion of social pragmatics curricula and materials for students with social challenges like autism spectrum disorder is both a blessing and a curse to those of us SLPs who work in private practice or outpatient settings. On the one hand, I am grateful for the selection of topics and target goals. On the other hand, how can we best weed through it all and offer a group curriculum that is the most functional and change-inspiring for this tricky but very deserving population of pre-adolescents?

There are many benefits of conducting groups outside the school environment in an outpatient setting, including more time spent on concepts, practice in a “safe” and diverse environment (participants may not have to see each other again), making new friends (participants may like to see each other again), parent/caregiver education and training, and parent/caregiver networking opportunities.

Along with the benefits, there are challenges that are unique for private practice and outpatient SLPs as we try to help these children and their families. These challenges can be grouped into two categories: logistical and content-related.

Logistics are tricky, but are definitely the easiest barriers to overcome. A typical group series for outpatient settings lasts 8 weeks. Group sessions range from 1-2 hours, depending on the number of participants. Costs to families for each session can be substantial, despite the Health Care Affordability Act, whether it be insurance co-pays or out-of-pocket. And there are also transportation costs and challenges for families who live in rural areas. These barriers mostly belong to the families of our group participants, but SLPs can help reduce their impact by strategies such as offering the group at “family-friendly” times (evenings or Saturdays), as well as choosing a central location for the meetings.

Once logistics are met, the real work begins. This brings me to the content of this post: content-related challenges. As a former instructional designer and journalist, my foremost consideration is “know my audience.” It may be a funny way to initially think about a therapy group, but it’s a basic tenant that I find critical.

Unlike the school setting where therapists can get to know the child in their “natural environment,” outpatient SLPs must somehow determine which kids can best go together in groups. Finding the right fit may sound like a logistical challenge, but is actually content-based.

From experience, placing the right kids together can make or break the success of the group, particularly at the tween/middle school age. Knowing this however, is only the beginning of the solution. My colleagues and I have whittled out three main areas of need for this age group:

  • Basic Social Rules—skills associated with being with another or group, such as eye contact, body language, expected behaviors, thinking about others.
  • Conversation Rules—skills associated with communication with another or group, such as establishing a topic, asking and answering questions, staying on or switching topics, social wondering.
  • Higher-level Social Skills—skills associated with making others comfortable and making/keeping friends, such as social problem-solving and perspective-taking.

Regardless of diagnosis or age, these three areas seem to be a good way to group kids so that behaviors can be managed equally and everyone learns. I have tried pragmatic assessments such as the CELF-5 Pragmatics subtest. I have given self-made parent/caregiver surveys of functional skills that coincide with the teaching concepts of the group. I have given their referring SLPs surveys of functional skills. Sometimes I have used all three methods. So far, I have not found a combination that can qualify everyone accurately. In every group, there always seems to be at least one kid whose skills are significantly more advanced or significantly more impaired than the rest.

The question is this: How can we most effectively figure out where each child fits? How do we qualify a child for the right group when the reality is that most of our candidates demonstrate a constellation of challenges across two or all of these areas?

That is the question I am posing to this ASHAsphere community. Thank you in advance for your responses as we problem-solve together.

Lisa Lucas, MA, CCC-SLP, is a speech-language pathologist in Cincinnati, Ohio. She practices as an outpatient SLP for Cincinnati Children’s Hospital and as a telepractice SLP for Presence Learning. She is an affiliate of ASHA Special Interest Group 18, Telepractice.

Fulltime Evaluator: An Effective New Role for the Speech-Language Pathologist  

blogevaluator

You’re an SLP at an elementary school who sees 42 students each week (most of them twice), attends individual education program meetings that are often scheduled back to back, reports for recess duty three times a week, and writes daily therapy notes and Medicaid reports, all while trying to squeeze in materials preparation for the next therapy unit. Now, how can you possibly find time for a two- to three-hour autism evaluation?

Sound familiar?

This was a typical week for the SLPs in the Albuquerque Public Schools until they created a new role group—”the SLP evaluator.”

APS is the 28th largest urban school district in the country, with over 90,000 students and approximately 10 percent of them receiving speech-language services in 143 different educational sites. The district employs 200 SLPs, but, due to a budget shortfall the past few years, faces challenges updating and replacing all the SLPs’ testing materials, such as the newly revised Clinical Evaluation of Language Fundamentals-5 or Oral and Written Language Scales-2. In addition, the New Mexico Public Education Department redesigned educational disabilities (such as specific language impairment, specific learning disability and autism spectrum disorder) in 2011 to standardize initial and reevaluation criteria. This required more training for those working in special education.

With these obstacles in mind, APS created a new SLP role—that of evaluator—to reduce caseloads, provide consistent eligibility criteria, and save some money in materials and training.

The evaluator group is made up of 22 SLPs (several of whom are bilingual) and is divided into one of three diagnostic centers across the city. We work side by side with educational diagnosticians, psychologists and others assessing students for all initial evaluations. We test students at the centers or at the schools, write reports and share the results with the diagnosticians, interpret test results with the parents, and attend the Educational Determination meetings at the school. We also collaborate with the SLP at the school who writes goals based on the findings of the assessments.

In addition, we conduct reevaluations when a change in eligibility is being considered, and for some schools we do all the reevaluations. Schools that have high caseloads, multiple district programs, or employ SLPs who are clinical fellows or who work part time may be designated a “Full Reevaluation” school. When a student is due for a reevaluation, we review past test results and current information and decide if the student needs another formal assessment. If one is needed, the SLP evaluator administers it. If a performance evaluation is appropriate, then the school-based SLP conducts it.

Last year, the evaluator role group performed over 1,900 evaluations; that’s 1,900 evaluations that the school- based SLPs did not have to do, which gave them the time they needed to focus on their therapy. And by using standard eligibility criteria, students in each school were correctly identified, which reduced the number of students with speech or language needs. The district was also able to save over $100,000 by not having to order the new CELF-5 for all 200 SLPs.  Now in its sixth year, the evaluator role group not only has been cost effective, but has proven to be an effective use of SLPs.

Rachel Hawkins, MA, CCC-SLP, is a speech language evaluator with the Albuquerque Public Schools.  She has worked in the public schools since 1993 in New Mexico and Colorado.  She can be reached at hawkins_r@aps.edu.  

As Adults With Intellectual Disabilities Live Longer, They Need More AAC Support

AACpic

Communication for adults with intellectual disabilities and complex communication disorders is a team effort. People with these disorders are living longer, higher quality, independent, and more productive lives thanks, in part, to alternative and augmentative communication technology.

Speech-language pathologists need to understand the settings in which these adults live. No longer do they live in large institutions but in more intimate and natural independent or small group homes.

A crisis may also be at hand as aging caregivers, whose adult children with intellectual disabilities and complex communication disorders live at home, can no longer care for them. According to The State of the States in Developmental Disabilities (2013), in 2011, 71.5 percent of people with these disabilities lived with family caregivers. Over the next few decades this group will flood the group home system as their parents age.

Communication is always important and critical for a person’s independence. Family caregivers may tend to speak for the adult with a disability and anticipate needs more than staff at a group home. Independent means of communication becomes that much more important once that adult moves into a new environment. This is where the SLP has a major responsibility in finding the most appropriate, functional evidence-based AAC intervention.

Many factors exist beyond the skills of the adult with intellectual disabilities and our AAC recommendations, however. Future AAC success is a team effort between the SLP, families and paid caregivers/group home staff. Some staff members are highly supportive; some are not. Informal assessment of the environment in which the affected adult lives is crucial. It can be a delicate process to help the staff member see the purpose of AAC. If the group home staff does not “buy in” to the AAC device recommendation and plan, there is a high risk of abandonment.

Group homes, although typically a better solution than nursing homes for those without complex medical conditions, have their own challenges. Moving to a group home is a major life change for people who have typically lived their whole life with their families and who often have a significant difficulty adjusting to change. In the state of Pennsylvania, where I practice, I have been encouraged to see that the group home system has placed a high level of priority on communication over the past few years. As a result, I have been seeing more adults with intellectual disabilities and complex communication disorders in my practice.

Another challenge in group homes is staff turnover. The State of the States in Developmental Disabilities (2013), reports that hourly wages for workers in community intellectual/developmental programs averaged only $10.14 per hour. A report published by the Paraprofessional Healthcare Institute in 2011 noted that almost half of direct care workers (including group home staff) live below the federal poverty level. Meanwhile, their work can be rewarding but is often psychologically and physically challenging, so it is clear why staff turnover is high. And, unfortunately, frequent staff turnover is confusing, frightening and can lead to a lower quality of life for these adults.

I have seen many adults with intellectual disabilities and complex communication disorders go years if not decades without AAC intervention. It is especially painful when, as children, they used AAC in school and transition into the adult world with no reliable means of expression because either the device was returned to school or the device had become obsolete. There is also a high level of abandonment of AAC devices once the school support is gone. In nursing homes, there can be speech therapy support available. In group homes residents must be seen for therapy as outpatients. Once the resident is back home, it becomes the responsibility of the group home staff to ensure the AAC device use is supported and maintained.

As part of the intervention plan, we must assist the group home staff to add communication goals to their mandated plan of care. We must also train the staff members in the care, maintenance and programming of the recommended device. Adults with ID are living longer, and, as technology has become an accepted part of all of our lives life, AAC interventions will continue to be a necessity. We should remember that an AAC device recommendation is not a once and done process. An adult with ID may need numerous device upgrades throughout their lives. Determining the best AAC device is not the end of the process, it is only the beginning.

Carrie Kane, a speech language pathologist at the Good Shepherd Rehabilitation Network in Allentown, Pennsylvania,  specializes in AAC assessment and treatment for adults with communication disabilities. She developed and is the coordinator of the adult outpatient AAC program in Good Shepherd’s Assistive Technology Center.

She Didn’t Eat a Thing at School Today!

school lunch
It’s that time of year again and little kids are climbing onto big yellow buses, tiny hands clutching lunch boxes that are packed full with a variety of choices, with their wishful parents praying that they will “just eat something!”  But at the end of the day, especially if the child is a picky eater, parents sigh as they open the lunch box latch and see that lunch has barely been touched.

For children in feeding therapy, treatment doesn’t stop when a child is eating well in the clinic setting.  Once a child has begun to eat even a limited variety of foods, I prefer to generalize new skills to the community environments as soon as possible, even as clinical treatment continues.  The school cafeteria in the one hot spot in the community that most kids visit five times a week.  It can be a chaotic setting, as described in one of my first blog posts for ASHA, which offered some tips on how to help kids eat in the Café-FEARia.  But what can a parent do at home to encourage kids to bring a healthy lunch, even when they only eat only five to 15 foods?  Here are six tips to encourage even the most hesitant eaters to not only eat preferred foods, but phase-in eating those new options showing up in their lunchboxes:

  1. Begin with Exposure: Kids may need to see a new food multiple times before they may even consider trying it.  That means they need to see it at school too.  If you’re thinking, “But he won’t eat it, so why pack it?” remember that the first step is helping your  hesitant eater get used to the presence of that food in his lunch box again and again.  The link to this ASHAsphere post will explain more, including why food doesn’t have to be eaten to serve a purpose in food education.
  2. Pack All the Choices under One Easy-Open Lid: For my school age clients, I use a compartment or bento-style lunchbox, such as EasyLunchboxes® or Yumbox®.  Even little fingers can open the lids quickly to reveal their entire lunch, so no time is wasted when most kids in the public school system have about 20 minutes to enter, eat and exit the cafeteria.
  3. Give them Ownership in the Lunch Packing Process. Kids like predictability and need to feel a part of the process, especially when it comes to food exploration.  For my clients in feeding therapy, once they have the oral motor and sensory skills to eat a few foods, those foods get packed along with other safe choices in their lunchbox.  A child who is receiving tube feedings may still take a lunchbox if he or she is able to eat even a few foods orally.  To make them the Lunchbox Leader, we create a poster board together that has a photo of the inside of their bento box, essentially creating a “packing map.”
    Packing Map #2
    Using colored markers, I help the child list the foods they can eat with arrows pointing to where the foods go in the box. For example, the Yumbox® has compartments with fun graphics representing dairy, grains, proteins, fruit and veggies. If the child is limited to purees, we write “applesauce” next to the fruit compartment on the poster. But we also write a few more future purees that he/she just needs to be exposed to, and those show up too. Parents and kids pack the lunchbox together the night before, and the kids choose from their short lists what goes in each compartment.  If they have exactly five preferred foods and there are five compartments, then we create a rule that they need to pick a new food for at least one of the compartments.
  4. Include a Favorite, But Just Enough:  Selective eaters always eat their favorite foods first, so be sure to include their preferred food, but not too much.  Provide just enough so that you won’t be worried that they are starving, but not so much that the other less-preferred choices don’t stand a chance.  That’s why the bento boxes work so beautifully, because the individualized compartments, along with the “map” to fill them, guide the packing process.
  5. No Comments Please!  When the lunchbox comes home, resist the urge to unpack it immediately. Give everyone a chance to breathe, especially those kids with sensory challenges who have difficulty with transitions from one environment to another. When you eventually open it, no comments about the contents please!  Nothing, not positive or negative. For many kids, it creates too much focus on whether they ate or not.  That’s addressed in feeding therapy. For now, just wash it out and set it on the counter for your child to pack again later that evening.
  6. Keep Up with Other Strategies: Parents who have kids in feeding therapy understand that it’s a steady, step by step process.  Keep  up with strategies listed in this ASHAsphere post or this one and/or those recommended by your child’s therapist.

Whether you have a child in feeding therapy or a “foodie” with a palate that rivals a Top Chef, I encourage you to have all the kids in your family create a packing map and be responsible for their own lunch packing, with the kids choosing from each category while the parent provides the healthy food options and keeps the kitchen stocked.  You might be surprised to see some of your young foodie’s choices shift to the more hesitant sibling’s packing map over time!  Remember, it starts with exposure and builds from there.

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.

What It Takes to Get SLPs and Teachers Working Hand-in-Hand

SLPscollaborate
Lately, I feel there is a division between classroom teachers and speech-language pathologists in the schools: an “us” and “them” mentality. Working parallel to one another hoping to reach the same goal is not what is best for our students. While it is true that the professions are separate, they do share a goal—student progress. I believe collaboration is the key to achieving that mutual goal.

Here are a few of the most common situations in which SLPs and teachers have opportunities to collaborate for the benefit of students, and some tips for those situations.

When a student begins to receive speech-language treatment.

The SLP can:

  • Offer a few minutes to sit down with teachers and walk them through the student’s IEP. Explain the terminology, how speech-language treatment goals will be addressed in the therapy room, and how the classroom teacher can help to target those same goals when the student is in his or her room.
  • Encourage teachers to speak candidly with speech students. The students are in the classroom more than the therapy room. They will progress further when they are supported and encouraged to use speech-language skills and techniques in all environments.

The teacher can:

  • Ask for an opportunity to view a therapy session in person or via a recording. Note hand signals and specific wording the therapist employs. Carefully listen for the correct speech sound productions. Witnessing some of the successful techniques will help when targeting these same needs in the classroom.
  • Support the SLP’s work in the classroom. Students will be motivated to use good speech and language skills when they are aware of shared expectations between the teacher and the SLP.

When the team is gathered for an IEP meeting.

The SLP can:

  • Provide teachers with a short list of items to think about prior to the meeting.
  • Encourage teachers to list areas of observed improvement or areas of need, and reference this list during the meeting.

The teacher can:

  • Speak out about concerns. Some classroom teachers seem to feel they do not know enough about speech-language treatment to comment on progress during IEP meetings. Teacher input contains vital information. Students do not always present speech-language issues in small-group settings.
  • Share in the ownership of the student’s speech/language success. The teacher is an integral part of the IEP team.

When students miss curriculum content because of pull-out services.

The SLP can:

  • Involve teachers as much as possible when creating a speech schedule. A little flexibility here can go a very long way. Be willing to adjust the schedule as needed. For example, push into the classroom for speech one week instead of pulling out, if appropriate.
  • Provide a full (HIPPA-compliant) schedule to teachers highlighting openings for make-up sessions. Keep this schedule updated as the year progresses. You can access a copy of what I use here.

The teacher can:

  • Ask the SLP if having access to lesson plans might be beneficial. Make the lesson plans available to the SLP in advance of the speech sessions.
  • Send classroom materials to be used in treatment sessions. Have a new unit in science? Send vocabulary words with your student to speech. Need help with an oral presentation for English? Send the rough draft to speech. Having trouble with basic concepts or following directions in math class? Let the SLP know. All of these things can be worked into a speech session.

Teachers and SLPs serve the needs of students in different ways, but we are all working on expanding children’s knowledge and skills. When we are cognizant of our colleagues’ needs and comfortable in our roles on the team, collaboration will be the start of something amazing: tremendous student progress.

 

Ashley G. Bonkofsky, MS, CCC-SLP, is a private-practice and school-based SLP in Utah, where her husband is stationed with the U.S. Air Force. She enjoys creating materials for teachers and SLPs and is the author of the blog Sweet Speech (sweetspeech.org). She is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education; and 16, School-Based Issues.

Kid Confidential: Parent Education and Training, Part 2

dadandkid

Last month I discussed why parent education and training is important and offered tips to effectively train and educate parents.  Today I’ll be discussing how I realistically implement parent training and education.

There are two main ways in which I incorporate parent training and education: at the end of a therapy session and during real-time.

End-of-therapy session Education/Training

I typically use this type of parent education and training for older children (school-age and up) who are working on specific speech and language goals that require some traditional “drill and kill” therapy.  I will also use this type of training for young children who have been receiving speech therapy from myself for some time, long enough that parents are already familiar with implementing techniques at home.

Tips for effectively implementing end-of-session training and education:

  1.  Time management:  I ensure that I end the speech session with adequate time left (usually 10-15 minutes) to effectively educate and train parents (following the tips I shared in part one of this series).  If I feel rushed, due to numerous parent questions, parents requiring more assistance when demonstrating skills, etc. I take a mental note and end my therapy activities a bit earlier the next session so I can provide appropriate training and education.
  2. Review the session:  I then quickly review the session’s activities.  As parents are usually in the room/area where therapy is being provided they are already familiar with the activities I have provided and will quickly know and understand the goal of therapy that session.
  3. Technique(s)—Explain, Model, Take Turn, Feedback: Then, as in last month’s column, I will follow the same steps: explaining the rationale for the technique(s) used, model the technique(s), have parent(s) take their turn and provide feedback.
  4. Follow up:  I always begin the next session with follow up on how implementing the previous week’s techniques are going.

Real-Time Education/Training

This type of education and training is so effective for my very young clients (birth-5 years) as parents are such an integral part of language development at this stage, that it is necessary they are involved the entire therapy session.  This can sometimes propose a problem with there are numerous siblings present, however I tend to incorporate siblings into therapy in order to save time as well as train siblings how to use communication techniques as well.  My motto in this instance is “if you can’t beat ‘em, join ‘em!”.

Tips for effectively using Real-Time Education/Training:

  1. Techniques—Trial, Explain, Model:  The first thing I do with these young kiddos via play therapy is to trial a number of techniques.  Then I determine the most effective techniques and explain to the parent(s) the rationale for using them.  I then model the use of each technique, one by one, and demonstrate the positive effects of its use several times in a row (I strive for 5-10xs in a row to demonstrate the effectiveness to parents).
  2. Questions: I then ask the child’s parent(s) if they have any specific questions before they trial the technique. Usually they do once they realize they will be asked to perform the same technique.  If I need to provide specific step by step instructions, this is the time.
  3. Parent Model:  Then I have the parent’s take a turn using each technique a number of times (again I strive for several in a row-5 to 10xs-to build confidence).
  4. Feedback:  I provide feedback on each use of the technique.  I share the strengths that I see, I note the positive child responses, and of course address any weaknesses or modifications as needed.
  5. Make a list: For parents new to using therapy techniques, I will sometimes write a list of the techniques or the process of implementing a technique so they can refer to it between therapy sessions.  For my most basic language facilitation strategies/techniques I have created my own parent training/education handouts which you can find here.
  6. Follow up: I always begin the next session with follow up on how implementing the previous week’s techniques are going.

Yes, real-time education/training can eat up a lot of your therapy time.  However, it is time well spent as long as the training is effective and parents can demonstrate independence with the use of the chosen techniques.  In my experience, using real-time parent education/training actually brings up several questions and concerns parents either do not think of prior to our discussions or are reminded of during therapy.  It’s a wonderful way to make the connection between the parent’s ability to change their communication approach and their child’s improved language development.  The goal of course with any parent education/training is to leave the parent feeling empowered in their ability to help their child.  A small amount of training can go a long way!

Next month, I will be sharing how I use digital recording to support parent education and training.

Maria Del Duca, MS, 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.

Bringing Speech-Language Services to Taiwan and Beyond

1lights
As far back as I can remember, I was always very curious about speech, language and communication. When I was a little girl I noticed some people could not talk fluently and I wondered why. I also noticed that some people spoke with a lisp and I wondered why.

In our neighborhood , there was a beautiful young girl who simply could not add five and five and I also wondered why. One of my cousins kept running around and around and he never stop running—and I also wondered why.

A friend’s older sister went to her first day of school, and she came home crying because she lost her hair ribbons, notebook, pencils and her school bag. The kids in her school were laughing at her. She never went back to school and she looked a little different. (She was a child with Down syndrome.) The father of my classmate never talked when we went to visit her home. During dinner he never uttered a sound and was hiding behind a newspaper—and I wondered why.

I have devoted the last 45 years of my life doing exactly what I love: speech-language pathology.

I began returning to Taiwan, the place where I grew up, beginning in 1980. I returned to Taiwan every summer for five years, teaching the various subjects of speech and language pathology. I helped to organize many symposia on human communication disorders in Taiwan. Over the last 30 years, many speech-language pathologists and audiologists have been trained there, and there are now five programs of speech language pathology and audiology in Taiwan.

In 1984, former ASHA President David Yoder took a group of us to Taiwan to attend and speak at the first Sino-American symposium on speech language pathology and audiology. In 1986, former ASHA presidents Kay Butler and David Yoder went to Taiwan and attended the third symposium on speech language pathology and audiology. 30 years later, in April of 2014, I again organized a symposium to advance the knowledge about our understanding of human communication. This was held in Taipei, and colleagues Barbara Hodson, Carol Westby, Kathee Christiansen and Kenneth Tom also went to Taiwan to support this symposium on child language development and disorders. The symposium was well attended, and we celebrated 30 years of work in the development of programs and services for Taiwan.

In addition, I also began to work with the Education Bureau of Guangzhou in China with a proposal to provide training in speech-language pathology for special-needs populations by organizing professionals from Taiwan, Hong Kong and the United States. Colleagues Geraldine Wallach and Vicki Reed also participated in this program. More than two thousand teachers and special education teachers attended these training programs.

Over the last 30 years, I have traveled to many parts of the world with a focus on the Chinese-speaking populations in China, Hong Kong, Taiwan, Thailand and Singapore. The need for quality services for individuals with communication challenges is urgent. I feel blessed to be part of the development of many programs and many seminars. I know that there is so much more work to do. Over the last 30 years I have had the privilege to serve on the Multicultural Issues Board of ASHA, the Board of IALP, the Taiwan Speech and Hearing Association and many other organizations.

Growing up in a multilingual environment, I was very much aware of the many languages people speak. Thanks to ASHA for giving me the opportunity to continue to serve in the area of multilingualism and multiculturalism. I hope that there will be many more opportunities for my colleagues from ASHA and around the world to continue to advocate for the human right to communication and to improve the quality of life so many through our relentless effort to excel. Global civic engagement is a lifelong learning process.

I wish the best of luck to all my colleagues and happy journeys.

 

Lilly (Li-Rong) Cheng is professor in the School of Speech, Language, and Hearing Sciences and director of the Chinese Studies Institute at San Diego State University. She is the past chair of ASHA’s Multicultural Issues Board.

Using Comic Strips in Speech Intervention

comic

For the past couple of years, I have used Carol Gray’s materials extensively during my work with adults with developmental disabilities. Creating comic strip conversations has been extremely helpful in facilitating conversation, resolving social issues between peers, taking turns in conversation and providing different social scenarios within various contexts.

Since I have worked in creating my own comic strip conversations with my clients for some time now, I decided to experiment using the comics section in the newspaper. My clients are motivated by the local newspaper for many reasons. They enjoy browsing through current events, looking at the pictures in the sports section and reading the comics.

The comics within a local paper are inexpensive (in my area it is just $1.00 for the local newspaper), easily accessible and age appropriate for older children, teenagers and adults. Therapy using comic strips has been surprisingly motivating and beneficial to my clients. I never realized how effective using the comics section could be!

I like to keep my favorite comics and laminate them for future use. I have also created a game around using the comics section. My clients take turns choosing from a pile of comic cards and then have a discussion about each particular card. When one client doesn’t understand a particular comic and why it’s funny, I have him ask his peer for assistance. As a group, we have had many extensive and interesting conversations related to the comics. Here are some speech and language goals that can be facilitated with the comics:

1. Expanding vocabulary: The comics are full of language, which make it an ideal time to discuss and define new vocabulary. It will be difficult for a client to understand a particular comic without understanding the actual definition of some of the words. For example in a recent Garfield comic, Garfield thinks “This is a perfect day to stay in bed and contemplate life’s truths.” Discuss what “life’s truths” means with your client. Defining the “contemplate” can help build vocabulary and build in conversation. Ask your client, “What do you contemplate about?”

2. Abstract Language/Humor: The comics are excellent in discussing abstract language and humor. In many comic strips, there are often multiple meanings of words. In a recent comic, the discussion between the characters was about “trail mix.” To one character trail mix was the snack, to the other character trail mix was a bunch of items that you picked up along a trail in the woods (e.g. dirt, sand, rocks). This comic began a conversation about the multiple meanings of words and how they had a miscommunication. Discuss the humor in the comic and why it may be funny to the reader. This can be a tricky exercise for many clients especially with autism, but it can be extremely useful as well. Helping a client recognize humor can help build friendships and improve conversational skills.

3. Taking Turns in Conversation: Between characters, there are natural turns in conversation. This can be a great model for conversation. As a carry-over activity continue the comic with an extra blank comic strips. This can help your clients create their own conversations.

4. Improving Literacy/Punctuation: Having your client read the comics can help improve literacy and reading comprehension. Point out different punctuation markers within the comic such as exclamation marks, periods, question marks, etc. Also, discuss the difference between the characters thinking a particular thought versus actually speaking it.

5. Interpreting Facial Expressions and Feelings/Emotions: In many comic strips the characters have extreme emotions. In other comics, the feeling and emotions of a character can be a little tricky due to the high levels of sarcasm. Read the specific comic strip together, discuss the language and then ask your client how the character is most likely feeling.

Rebecca Eisenberg, MS, CCC-SLP, is a speech-language pathologist, author, instructor, and parent of two young children, who began her website www.gravitybread.com to create a resource for parents to help make mealtime an enriched learning experience . She discusses the benefits of reading to young children during mealtime, shares recipes with language tips and carryover activities, reviews children’s books for typical children and those with special needs as well as educational apps. She has worked for many years with both children and adults with developmental disabilities in a variety of settings including schools, day habilitation programs, home care and clinics. She can be reached at becca@gravitybread.com, or you can follow her on Facebook; on Twitter; or on Pinterest.

 

Three Easy Ways to Collaborate with Teachers

teach

 

Like many of you, as a school speech-language pathologist, I left graduate school ready and excited to jump into classrooms. I realized the benefits of reaching my students in their own environment and so I set out to reach them there by “educating” teachers on speech and language. And then… reality hit. With all the added responsibilities, how do I go about adding one more task to my ever-growing list and collaborate with teachers?

Are you like me? Often, school SLPs feel lost when it comes to reaching their students in the classroom. Typically, we fall into one of two camps. Either we feel the need to completely take over the classroom lesson to “teach” the teacher something about language or we become too afraid of looking like a “know-it-all” and so do not offer any suggestions. Neither of these offers a solution. Here are three easy ways to collaborate with teachers that provide a balance between the two:

1. Provide a monthly newsletter. This is one of the easiest ways to stay in touch with teachers. If you have monthly themes, give them an idea of what you’re working on. Provide a “vocabulary word of the month,” a tip on how to serve students in their classrooms, a good resource or website, or even a practice sheet stapled to your newsletter for teachers to provide to students. Teachers will appreciate the time you took to reach out to them and will also gain information on both their students and how we service them.

2. Give a student snapshot to your teachers. This is most beneficial at the start of the school year. Unfortunately, with all of our responsibilities, important information is often not communicated and students’ services often suffer as a result. Relay any accommodations on students’ Individual Education Program (IEP) that the teacher is responsible for providing in the classroom and make sure they understand what each one means. It is also helpful to provide an overview of the goals you are working on with their students. For example, a simple statement such as “During Johnny’s speech and language session, he is working on increasing his vocabulary and reading comprehension,” would give the teacher an idea of what he works on with you.

3. Hop into the classroom during independent reading. Many classrooms now schedule a chunk of time devoted to practicing independent reading and writing skills. My district uses a structure for this called “The Daily 5” created by Gail Boushey and Joan Moser. When I walk into a classroom during Daily 5, I can immediately sit with students and listen to reading, ask questions about what they are reading, teach vocabulary and assess and monitor articulation skills while reading. What does this type of intervention mean for us as SLPs? We can easily monitor and work on skills within the classroom setting all while requiring minimal if any planning time. This type of intervention also sets the tone for easily working with the teacher on their turf without taking over the entire classroom.

I hope this next school year finds you rested and ready to try new ideas. Reaching out to teachers often feels like one more to-do, and can fall to the bottom of our priorities. By making a goal each year of trying just one new idea, it can seem less overwhelming. I guarantee it: by reaching out to our students in their environment, we will be making a huge impact on their lives.

Nicole Allison, MA, CCC-SLP, has a passion for creating materials that benefit the school SLP, especially when it comes to data collection and the Common Core State Standards. She currently works in a public school as the only SLP (yes, that’s right, all 13 grades and loving them) and is the author of the blog Allison’s Speech Peeps (speechpeeps.com). She also serves on The Ohio School Speech Pathology Educational Audiology Coalition as secretary. Her and her husband recently had a baby and are loving parenthood. She can be reached at nrallison@gmail.com.