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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 EBP's, are important in maintaining the fidelity of our practice as SLP's. 



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 SLP's 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 it's 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 FBA's 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 SLP's 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 SLP's 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 SLP's train parents in language facilitation techniques. 

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

How do you incorporate EBP's into your practice? 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!


Wednesday, August 26, 2015

Top Tools for the Preschool SLP


#1 Magic Wand!


No speech therapist should be without a magic wand! This immediately captures my preschoolers' attention as we review our daily schedule and rules. I use the wand to point to each visual, then push a button which makes it light up with a fun “whoosh!” sound. As the year progresses my students enjoy taking on the responsibility of being my “magic wand helper,” using it to review our daily activities (e.g. “First we will say hello” – whoosh!, “Then we will do sound cards” –whoosh! . . ). I target a ton of speech language objectives during this time including: increasing sentence length, sequencing, using the future tense, as well as articulation and fluency.   

#2 Hand Stamps


What would I do without my hand stamps?? I picked these up at Lakeshore and always carry some with me at all times. Not only are hand stamps great for reinforcing positive behavior, but they can be also be used to encourage children to request, make a choice, increase sentence length, build vocabulary, improve articulation, and answer yes/no & where questions.

This is how we use them: I ask each child if they would like a stamp, then give them a choice (e.g. Do you want a butterfly or a ladybug?) encouraging them to respond with a sentence ("I want a ladybug"). After they have requested I ask where they'd like it and prompt them to respond with a sentence such as “on my hand.” Even my students with extremely limited language have picked up this simple phrase because we’ve made it part of our routine. Some of my older students have fun requesting the stamps be placed on their fingers, thumb, wrist, elbow, and shoulders, so there’s the added benefit of increasing vocabulary of body parts as well. I couldn't survive without at least one of these in my back pocket;)

#3 Mini-boxes
The mini-boxes quickly became a favorite in my preschool speech sessions last year. These pill boxes can be picked up inexpensively up at any drug store (or check the dollar bin at Target!). I place a small piece of velcro on the top of each box to which I attach various small pictures. I generally choose pictures which correspond to the vocabulary of our current theme, but have some which target actions and specific phonologic processes. The mini-boxes may be used receptively (Find the tiger) or expressively (“I want to open the giraffe”). After selecting the box, my students then push the button to open the box, not only gaining practice using both these verbs, but building fine motor skills as well. The boxes are the perfect size to fit a goldfish cracker, cereal, popcorn, M&M, or small sticker.   




This small file has been perfect for keeping all my icons organized:


I’ve used Boardmaker to create many of my pictures, but if you do not have access to this program at your school, I’ve created a collection of small pictures which are available for free in my store:


Any favorite tools that keep you and your students fired up? Love to hear from you!


Wednesday, July 29, 2015

The Best Thing I Learned this Summer


Hi friends!

This week I'm thrilled to be teaming up with the Frenzied SLP's for my very first linky party - #SLP Strong! 


The best thing I learned this summer was that working with older students was not nearly as intimidating as I thought it would be and actually ended up being pretty fun. 

Working exclusively with preschoolers during the school year, I was a little anxious to learn I would be working with middle and (gulp) high school students this summer. 


It's been a long time since I've worked with students that age. Could I help them meet their goals? What materials was I going to use? I mean they're just so  . . . big! This definitely required me to step outside my comfort zone. But I'm always up for a challenge and in the end I'm grateful I embraced it.

I've grown to expect ESY (Extended School Year, aka "summer school") to be chaotic the first few days with learning students' names, getting familiar with their goals, and just finding a time to fit everyone in. Add to that an unfamiliar population of students with an extremely wide range of needs and I was starting to feel in over my head. 

As educators we're often perfectionists by nature and can have a tendency to be too hard on ourselves. I recall one session in particular in which I attempted to play the game "Scattegories." As I watched the sand in the little plastic hourglass drain, my students sitting motionless, pencils poised, expressions perplexed, I realized it was a complete flop. Even I was having difficulty coming up with a U.S. city that started with the letter "K."   

Instead of pushing it I admitted defeat, but as I dejectedly began putting the dice and blank pads of paper back in the box, the topic of the Gold Cup Soccer play-offs came up. Intrigued I inquired further and listened as my students excitedly retold details of the match the night before, expressing opinions of their favorite players, and which team they hoped would win it all. They were developing arguments and backing them up! Comparing and contrasting teams! Listening, responding, and practicing interpersonal communication skills! Most importantly they were having fun. Hey maybe this session wasn't such a disaster after all.  

This was a great lesson for me that with any population, from preschool to high school, it pays to be flexible, interested, and engaged.

                           

And yes maybe I did luck out with an incredibly kind, courageous, not to mention hilarious group of young people this summer, but as ESY drew to a close I was definitely feeling a little more confident working with older students, a feeling I'm hoping to carry with me as I transition from early intervention to a K-8 school this fall. 

Don't get me wrong, I'm sure it's still going to be a huge learning curve, but naturally I'm up for the challenge. Because after all we're #SLP Strong right? ;)

             
 

Secret Word ***FLICKER***




Sunday, July 26, 2015

Rediscovering The Three Billy Goats Gruff


Some stories are just timeless. The Three Billy Goats Gruff, a Norwegian fairy tale, dates all the way back to the 1840's! And we're still enjoying it today. I mean how cool is that?! 

The inspiration to try a Billy Goat theme with my speech students came after hearing this song/story by Heather Forest. My kids have been enthralled by it and love participating by making the fun sound effects along with the music. 



  


I was even more inspired when I stumbled on this adorable clip art from Susana at Whimsy Workshop Teaching. These have been the perfect visuals to support the story and song. 






Now there are so many versions of The Three Billy Goats Gruff that choosing which book to go with was a little overwhelming  After pouring over several copies, I settled on Stephen Carpenter's adaptation for it's simple language and appealing illustrations. It's also the ideal length to hold the attention of preschoolers. 





As a Speech Language Pathologist I always have an eye towards how I can use a book to address the goals of my students. This story's been great for building understanding of size, sequence, and feelings/motivations. To address even more speech and language goals, I created a book companion designed to naturally target:

   -Third person singular  
   -Conjunctions (but, and)
   -Contractions (I'm, he's, don't)
   -Sequence (first, second, third)
   -Comparative (bigger)
   -Adjectives (mean, ugly)
   -Future tense (going to)
   -Vocabulary (bridge, troll, gobble, horns)
   -Narrative skills


       





My students have been picking up quickly on the repetitive language of this simplified story. After listening to it a few times they begin to finish the sentences themselves, building grammar, sentence structure, articulation, and narrative skills. (And it's been so much more fun than drills and flashcards!) 

If you've never read The Three Billy Goats Gruff with your students I encourage you to give it a shot. If you have, I'd love to hear what you liked about it. Any other classics you're looking forward to reinvigorating this year? 

Thanks for checking out my blog:)

Stay fired up!