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Monday, September 4, 2017

Taming the Data Monster

I guess I have a love/hate relationship with data. The former behavior therapist in me relishes the idea of quantifying a goal and measuring progress. 

But the reality of attempting to record responses in a group looks more like this:
Between trying to keep students engaged, facilitating language activities, and managing behaviors, data collection can definitely take a back seat. 

And has this ever happened to you? At the time you totally think you'll remember that awesome utterance your student just articulated, only to completely draw a blank by the end of the day? 
Well I've been there too. So I get how valuable having something discrete and tangible to look back on can be. Not to mention it makes progress report writing SO much easier. But I've struggled with a way to consistently take data in my speech groups. 

And guess what, I still don't have it all figured out. It's a constant challenge striking that balance between recording responses and staying present with my kiddos. Over the years I've tried keeping data in binders (too cumbersome), notebooks (too much flipping), even sticky notes (pretty much a disaster).  

Last year was the first time I picked a method that actually stuck. It's not revolutionary. In fact it's super simple. But it worked for me so I thought I'd share.

Here's what you'll need to create a "working file":

I hole-punch and attach my goal sheet to the right hand side of the folder with a prong fastener like this: 

In my district I can print a "Goal Summary" from our online IEP system with all my student's speech goals all on one page. I attach this to the left side: 

See I told you it was simple.
I have each working file organized by group and this year I'm even experimenting with color coding by grade so they'll be easier to spot and grab. 

Starting in a new district, I've been spending the week getting to know my students. These Get to Know You worksheets from Speech Room News are awesome for gathering info about what my students are into. I'm keeping these in the working files too, along with other activities we complete throughout the year. Parents and teachers are always interested in work samples, so it's nice to have these at my fingertips.

I love having all the information I need in one place! 

Will I be able to take data on every student's goal, every time? No. But I can make an effort to focus on one or two goals, for one or two students, each session. Having a game plan and a systematic way to record responses will help me stay on track this year and not get devoured by the data monster.  

Interested in using this data sheet too? It's free for email subscribers along with other monthly speech goodies. If you're not already a subscriber, join us here!



Sunday, August 6, 2017

EBP - Part 2


Welcome to Part 2 of EBPs for SLPs! In case you missed it, EBP stands for Evidence-Based Practices. As Speech Language Pathologists, EBPs are an integral and natural part of what we do everyday. Part 1 introduced 15 of these 27 EBPs, established by the National Professional Development Center on Autism Research as being effective for students on the Autism Spectrum. Let's dive in to the final 12. 
16. Reinforcement (R+): A response occurring after a behavior resulting in an increased likelihood of future recurrence of that behavior. While it would be nice if all our students were intrinsically motivated to work on their speech goals all the time, the truth is this stuff is hard for them! That's why "great jobs," high fives, and stickers are a regular occurrence in our speech rooms. Social, tangible, maybe even edible, I think we can safely say positive reinforcement is a regular part of our practice. 

17. Response Interruption/Redirection (RIR): Use of prompts or distractors during an interfering behavior that diverts attention and reduces behavior. Now I'm super careful to not REINFORCE a disruptive behavior, but ignoring and moving forward with an engaging activity, letting a child take a turn when he's calm, can be very effective. SLPs working in early intervention are masters at this. I mean it's pretty hard to cry and blow bubbles at the same time right? Music is another great distractor and my personal favorite when my little ones are upset. We SLPs always have a few RIRs tucked away to pull out in case of a meltdown. Because hey, it's what we do. And guess what? It's Evidence-Based. 
18. Scripting (SC): A verbal or written model of a skill or situation that is practiced before use or in context. As SLPs we understand first-hand how powerful visual support and repetition are for our students, especially those on the spectrum. We use scripting all the time when role-playing social scenarios, scaffolding sentences, and summarizing texts. 

19. Self-Management (SM): Instruction on discrimination between appropriate and inappropriate behaviors and accurate self-monitoring and rewarding of behaviors. Again if you're familiar with Michelle Garcia Winner's Social Thinking curriculum and the concepts of "Expected" and "Unexpected" behaviors, then you're familiar with this EBP. Working with children with pragmatic language challenges, this one's right up our alley too. 

20. Social Narratives (SN): Descriptions of social situations with examples of appropriate responding. Carol Gray's Social Stories provide a great framework, but sometimes the best narratives are the ones we create spontaneously in the moment, to help an anxious student deal with a fire alarm or a young child learn to share. We may not all be amazing artists, but we've seen how a few sketches paired with simple explanations can go a long way in helping our students understand social expectations. So keep it up! It's Evidence-Based!

21. Social Skills Training (SST): Direct instruction on social skills with rehearsal and feedback to increase positive peer interaction. Check! As SLPs we're bound to have at least a few students on our caseloads working on social skills. And I'm not going to lie, breaking these skills down to explicitly teach can be TOUGH. I don't get it right every time, but with our natural empathy and commitment to our students we're perfectly suited to the task. This Conversation Tracker has also been huge for me in simplifying these complex skills. 
22. Structured Play Group (SPG): Adult led small group activities that include typically developing peers and use prompting to support performance. Any decent special education program will provide time for mainstreaming. But proximity to typical peers is not enough. Research suggests our students learn best from their peers in a structured environment with adult support. Offering a "lunch bunch" with peers is one idea for a SPG, or consider a reverse mainstreaming model by volunteering to run a small speech center in the general education classroom. 

23. Task Analysis (TA): The process of breaking a skill into small steps that are systematically chained together. For some of our students, even simple tasks can seem overwhelming. That's where TA comes in. Anytime we break a task down into a sequence of steps we're using this EBP (think functional motor activities like washing hands, tying shoes, or making a sandwich). We can also coach teachers in this powerful EBP to help our students be more successful in their general education environment. For example instead of saying, "Everyone get ready for the spelling test" our students may need to be told, "First take out a piece of paper and a pencil, then fold the paper in half lengthwise, and last write your name in the top right hand corner." 
24. Technology-Aided Instruction and Intervention (TAII): Intervention using technology as a critical feature. Nothing will ever take the place of face to face social interaction but SLPs understand that technology absolutely has its place in speech language therapy, either as speech generating device such as Proloquo2Go or tool to build listening comprehension and language concepts like syntax, vocabulary, grammar, and pragmatics. Each student's individualized goals will always guide the programs we use, but a couple of my favorites for school-age and middle school students include Auditory WorkoutRainbow Sentences, and Between the LinesMany of these track data as well, so it's no surprise they're evidence based.  

25. Time Delay (TD): Delaying a prompt during a practice opportunity in order to fade the use of prompts. Another EBP we use intuitively. Giving our students the opportunity to respond on their own, prompting only when necessary, is how we move them toward the ultimate goal of independence. 

26. Video Modeling (VM): A video recording of a targeted skill that is viewed to assist in learning. The interactive iPad app, Social Expressmodels a variety of social behaviors and has been a hit in my speech room. And having students analyze videos of their own interactions can increase self-awareness of eye contact, facial expressions, body position, and proximity. Admittedly this is one I'm trying to incorporate more.  

27. Visual Support (VS): Visual display that supports independent skill usage. Research suggests that visual supports can help students on the spectrum process information easier and more quickly. It can also reduce reliance on verbal prompts, increasing  independence. Using a Picture Exchange Communication System (PECS) for functional communication, referencing a list of expected behaviors, or checking a visual schedule, I can think of so many examples of how SLPs use this EBP. 

Well there you have it. See? EBPs are a huge part of our therapy practice everyday!

So the next time someone asks you . . . 
You can respond with confidence. Because as SLPs we've got this EBP thing on lock.   

I know I'm just scratching the surface here. I'd love to hear more examples of the EBPs you use in therapy. I'm always fired up to hear new ideas so drop me a line in the comments below!



Saturday, July 22, 2017

EBP - Part 1

EBP stands for Evidence-Based Practices. The National Professional Development Center on Autism Research  has identified 27 Evidence-Based Practices which have been shown through scientific research to be effective for students on the Autism Spectrum. By law, teaching practices must be based on evidence of effectiveness. So Evidence Based Practices, or "EBPs," are important in maintaining the fidelity of our practice as Speech-Language Pathologists. 



But no need to be intimidated by the technical names - most of these are things we do everyday! Check out how many we are ALREADY using:

1. Antecedent Based Intervention (ABI): An arrangement of events preceding an interfering behavior to prevent or reduce the occurrence. So you know that kindergartener who just can't help but touch ALL of your materials? You make sure he's seated out of arms reach right? Or those temptations are out of sight. Well that's ABI. See? You've been using it all along!

2. Cognitive Behavior Intervention (CBI): Instruction on cognitive processes leading to changes in behavior. If you've ever used Michelle Garcia Winner's Social Thinking curriculum, then you've used CBI. Helping students be aware of their own thoughts and behaviors, and how they effect the thoughts and behaviors of those around them, is the foundation of any good pragmatics program.

3. Differential Reinforcement of Alternative, Incompatible, or Other Behavior (DRA/I/O): Consequences provided for desired behaviors that reduce the occurrence of interfering behaviors. In other words. . . Positive Reinforcement. As SLPs we know how powerful this can be. Ignore the things you can ignore, and reinforce the heck out of the behaviors you want to increase. Punch cards, mini-boxes, and hand stamps have worked great for me this year for reinforcing positive behaviors in speech. 

4. Discrete Trial Teaching (DDT): Instructional process of repeated trials, consisting of instruction, response, and consequence. Articulation drills anyone? Or targeting and tracking comprehension of directions, Wh-quesions, or specific grammar forms perhaps? I fully support a play based approach to learning but believe DTT definitely has its place. 



5. Exercise (ECE): Antecedent based physical exertion to reduce interfering behaviors or increase appropriate behaviors. Making an exuberant student your "helper" in order to get him up and moving just kinda seems intuitive doesn't it? Holding open the door, handing out materials, and removing visual icons from our felt board are all activities which have worked for me. 

6. Extinction (EXT): Removal of existing reinforcement in order to reduce an interfering behavior. Ok, full disclosure. I'm all about positive reinforcement but for a behavior which CANNOT be ignored I have been known to remove punch cards for the remainder of the session or withhold hand stamps (gasp!) A few minutes away from a reinforcing activity is another behavior management tool I keep in my back pocket when necessary. 

7. Functional Behavior Analysis (FBA): Systematic protocol designed to identify contingencies that maintain an interfering behavior. In my district true FBAs are performed by a behaviorist, but we can help by observing and taking note of what happens immediately before a behavior in order to understand the function it is trying to communicate (e.g., attention, obtaining a desired item, protesting, escape).

8. Functional Communication Training (FCT): Replacement of an interfering behavior with communication that accomplishes the same function. Helping a child make this connection might be the most gratifying experience for an SLP. I mean this is what it's all about! Especially with our little ones, I think we can safely say FCT is our JAM! 

9. Modeling (MD): Demonstration of a desired behavior that results in acquisition through learned imitationAnother one we use MANY times a day. And I'm not just talking giving an example before an activity. As SLPs we understand how powerful peer modeling can be. This is one of the benefits of mixed therapy groups. One child's area of difficulty may be another's strength, creating opportunities for them to learn from each other. 




10. Naturalistic Intervention (NI): Intervention strategies that occur with the learner's typical settings and routines. In other words . . . Push-In. Another EBP we SLPs utilize on a regular basis. 

11. Parent-Implemented Intervention (PII): Parent delivered intervention learned through a structured parent training program. The Hanen model for early intervention is an excellent example of this. Based on the idea that young children learn best through everyday routines and interactions with caregivers, Hanen-certified SLPs train parents in language facilitation techniques they can implement at home. 

12. Peer-Mediated Instruction (PMI): Typically developing peers are taught strategies that increase social learning opportunities in natural environments. Working with typical peers to increase awareness and understanding of individuals with autism and other disabilities is the first step in PMI. From there, strategies such as initiation and persistence can be taught to increase opportunities for our students to interact meaningfully with their peers. 

13. Picture Exchange Communication System (PECS): Systematic 6 phase teaching the exchange of pictures between communicative partners. Loads of evidence for this one when implemented correctly. 

14. Pivotal Response Training (PRT): Pivotal learning variables guide intervention implemented in settings that build on learner interests and initiative. A fancy way of saying, "follow the child's lead." If you work with the 0-5 population, you've no doubt used this powerful EBP. 



15. Prompting (PP): Verbal, Gestural, or physical assistance that support skill acquisition.  Prompting (and prompt fading) is how we as SLPs target goals and systematically move our students toward the ultimate goal of independence. Yep we've got this one down too.   

So I'd say as SLPs our EBP game is strong! And that's just the beginning. Stay tuned for part 2 where I'll get into more EBPs (and more ways we rock!) 

How do you incorporate EBPs into your therapy? Leave me a message in the comments section. I'd love to hear from you!


Stay fired up!



Monday, November 21, 2016

My SLP Story



Looking back I there’s no doubt I was meant to be a Speech Language Pathologist.

It just took me a little while to realize it.

As a child, when my younger brother had difficulty communicating due to recurring ear infections, I’m told I was the only one who could understand him, often serving as his translator (“He wants a tissue!”)

But when I had the opportunity to observe the speech therapist at my mother’s school I was less than enthralled. Little did I know just how much more to our field there was than articulation drills.

So for a while I entertained I the idea of being a nurse. But when I got to college and saw the amount of calculus involved (yikes!) I promptly switched my major to psychology and upon graduation happily stumbled into the growing field of behavior therapy. 

Working with young children recently diagnosed with autism fascinated me.  I spent the next three years doing in-home Applied Behavior Analysis including serving as a shadow aide in classrooms, facilitating play dates, training families, and collaborating with other professionals, including SLPs.

And man, the SLP’s had hands down the best gig.

Watching a child’s frustration fade as he finally got his message across, witnessing the joy of her family as she spoke a new word – it was thrilling!

I mean seriously what could be cooler than helping a child communicate?

I applied and was fortunate to accepted to a program in my home of San Francisco. Although at the time the 3 and ½  years of grad school seemed daunting, it went by in a flash and I’ve never looked back. To this day I’m still thrilled with each new skill acquired, no matter how small, enjoy collaborating with parents, teachers, and other professionals and love that our field gives us the opportunity to never stop learning. Transitioning from early intervention to working with school-age and middle school students last year was a huge learning curve but as SLP’s we thrive on those challenges, don’t we?


So that’s pretty much why I became an SLP. Well that and the hugs. You can’t beat the hugs;)




Thanks to Kristen Immicke of Talkin with Twang and The Frenzied SLP's for letting me link up! Looking forward to checking out more SLP stories!





Tuesday, November 24, 2015

5 Things You Didn't Know About This SLP




I'm thrilled to be participating in this Linky Party and sharing 5 things you may not know about me. Huge thanks to Jessica Cassidy from The Speech Space for hosting! I'm looking forward to hopping around and discovering a few new things about some of my favorite SLP bloggers too. 

As for me here goes:


1. Before I was a Speech Language Pathologist, I was an ABA therapist. For 3 years I served families of young children newly diagnosed with autism through in-home behavior therapy. I enjoyed finding ways to incorporate play into my sessions and collaborating with parents and other professionals. And of course nothing beat the acquisition of those first words! To this day I'm still passionate about early intervention and still elated watching one of my students master a new concept. Isn't this just the best?    


2. I love learning new sports. From horse back riding to pole vault, I've always embraced the challenge of a new physical endeavor. When I was eleven I even decided to teach myself the very useful skill of unicycle riding. Mountain biking is my latest obsession. My brother took me on my first ride and I'm hooked. 



3. The Star Spangled Banner makes me cry. Growing up in a military family has made me unusually patriotic. The service men and women who risk their lives to protect our freedom will always be my heroes. Hearing the national anthem before a race or Giants game is a reminder to me of all the hard fought liberties I take for granted and it just gets me. 

4. I can think of no better job than helping a child communicate. Even though I'm finding this year extremely stressful, I still couldn't imagine doing anything else. Working with a variety of populations and wide a range of needs keeps me on my toes! I could do without the paperwork but otherwise relish every aspect of our field from assessment to treatment to collaborating with teachers (my other heroes). 


5. I recently became an aunt! I can't wait to spend the week of Thanksgiving getting to know this little one:



Thanks for checking out my blog! Wishing everyone a wonderful holiday:)




Thursday, October 8, 2015

Why I love the BIG GREEN MONSTER

I just adore Halloween. Not sure why. Maybe because I'm really just a giant child. The excitement is palpable around school these days and its not hard to engage my students in conversation; They are more than willing chat about what costume they plan on wearing and what candy they hope to receive. So as an SLP I'm naturally taking full advantage of the language opportunities:)

One of my favorite preschool themes this time of year is Monsters! And the book I find myself returning to year after year is:



For those not familiar with this one, Go Away Big Green Monster is a picture book on which each page a piece of a monster's face is creatively added, from his "two big yellow eyes" to his "scraggly purple hair." When the monster is complete, it is determined "You don't scare me!" and page by page each body part disappears with an emphatic "Go Away!" 

I make this book interactive with free visuals from KizClub which I laminate and attach with velcro to a felt board. 


Before diving into the story, I first introduce the vocabulary by taking out each item and setting it on the table (e.g., This is the monster's long blue nose, These are the monster's little squiggly ears. . .) As we read the story, each child then has the opportunity to place each body part on the monster's face (after requesting of course:) At the climax there's a third opportunity to practice the vocabulary as each body part is taken off and thrown down with an energetic "Go Away!" This part's a hit. Every. Single. Time. 

Go Away Big Green Monster is short, simple but still effective in targeting:
  • Body parts
  • S-blends (Scraggly, Squiggly, Scare, Monster)
  • Emotion words (Scared, Brave)
  • Comparative words (We talk about the monster getting "scarier" as each body part is added)
  • Negation (You don't scare me!)

But I think my #1 favorite thing about monsters is the opportunity to build understanding and use of:

    ATTRIBUTES 

Big, Little, Long, Short, Tall, Scary, Mean, Silly, Round, Sharp, Bumpy, Smooth, Fat, Skinny . . . 

These concepts are easy to reinforce. All you need is some play-doh and a few Mr. Potato Head pieces and you're got . . .  MONSTERS!



Instead of giving my students free access to the pieces, I lay them out and require them to request. If they ask for a nose, I show them their options (e.g., I have a big orange nose or a small red nose) and prompt them to use an attribute to describe which one they want (e.g., I want the big orange nose.) I always love how the play-doh monsters turn out - each one so cute and different!

And of course when we're ready to clean up, each piece gets put back with a "Go Away!"

If you're a music fan like me, this app puts the book to music with great visuals and an extremely catchy song (Although be warned - This song will be in your head ALL day.)  But if you've got an iPad and your students respond to this story as much as mine have, I've found it's been well worth it as just one more way to reinforce the language and concepts.



These are a few of the ways we stayed fired up. Have you used Big Green Monster in speech therapy before? Leave me a comment - I'd love to hear how!

Thanks so much for checking out my blog!