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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!