Author Archives: ARobinsonSLP

10 Tips for the New School Based SLP

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With the start of school rapidly approaching, I’ve seen several tips for the newly minted clinical fellows out there. I’m going to jump on this band wagon and offer some nuggets of information that I learned along the way.

1. YOU ARE GOING TO MESS UP!!!! It’s just a matter of when. We are all human and we all make mistakes. When the inevitable happens, take responsibility, work to make it right, and MOVE ON! Believe me when I say, “It will be ok.”

2. If you are working in the school system, make friends with the front office staff and custodians. They run the school and can basically address any issue you will ever have.

3. Ask for HELP. Even if you are the only SLP on site, bring difficult clinical cases to your supervisor or fellow co-workers. Asking questions does not make you look like you don’t know what you’re doing. Take every opportunity you have to learn from your coworkers.

4. It’s ok to procrastinate… a little bit… My first year of work, I would rush to complete any paperwork/task that was given to me (e.g. completing annual professional development plans) well before the due date. Inevitably something changed (“Hey Ashley we gave you the wrong form”) and I ended up doing the work twice. It’s important to meet deadlines, but you don’t need to complete things months in advance. Wait and see how it’s all going to shake out.

5. Your relationships matter more than the amazing activities you plan. I spent a ridiculous amount of time my first year finding and making in depth materials for my students. Pinterest has helped immensely with that (definitely get into Pinterest if you haven’t already), but I also quit worrying about finding the perfect activity and focused on establishing connections with my students. I’m not saying, don’t have a plan – but really think about what the goal is for that student. Then think about how you can address this goal using what’s in front of you and what the student cares about. Check out my post on inclusive practices here. I doubt my students will remember the awesome board game I invented, but I hope they will remember that I listened to what they had to say and advocated for them.

6. Stretch out activities. Again, when I was planning these elaborate activities I found that students couldn’t always complete the task(s) I prepared in one session. I found myself rushing through sessions to get everything checked off the list. Remember – it’s not about the final product, it’s how you get there. I see this a lot when working on written expression. Many times my students were just worried about getting the assignment done, and negate the entire process of writing. My greatest success last year was when one of my high schoolers was given a writing prompt and asked, “Can I preplan first?”

7. Ask “Why?” and don’t be offended when someone asks you “Why?” Basically, if you don’t know why you’re doing something, nobody else will either. Keep asking yourself, “Why am I using this evaluation tool?” or “Why am I asking this student to complete this task?” If you can answer this question, you will be fine. It’s not a bad idea to state the reasons up front to avoid any confusion down the road. It’s also ok to ask others “Why did you do that?” You can learn a whole lot by doing this.

8. Smile – even when you don’t feel like it. When you walk down the hallways, smile big and say hello. Even if you aren’t in the building that much, people will at least know you as the nice, happy person that walks around.

9. When you feel overwhelmed, repeat this mantra “This is the last first time I will start at this school” or “That was the last first IEP meeting I will ever have.” You will never ever ever ever start a new job as a clinical fellow again. You’ve done it!

10. Try to leave work at work! I still struggle with this as I tend to take things too personally and carry a lot of baggage home with me (both emotional and work to be done). I have never met one person who worked in the schools that felt like they had everything checked off his/her To Do list. You know that feeling of wrapping up a semester and feeling accomplished? Yah- that’s over. There’s always going to be more to do. Really prioritize what needs to happen and what would be nice to happen. Focus on what needs to happen.

Good luck to all of those new SLPs out there. You are entering crazy, fulfilling, and awesome profession.

Does anybody else have some recommendations for recent graduates?

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Thank You New Voices Foundation!!!!

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Whew…it’s been awhile since my last post. Since I’ve last written, another school year has wrapped up and I kicked off the summer with an amazing professional development opportunity. Thanks to the genorosity of the folks at the New Voices Foundation, I was able to attend a PODD 2 day workshop led by Gayle Porter. To be in the same room with one of my idols was awesome in itself, but I learned so much. Seriously – Gayle Porter has this wealth of knowledge about people with complex communication needs and has dedicated her career (and what seems like her life) to enhancing communication for those who require augmentative and alternative forms of communication.

For the first day and a half of the training, I had this nagging feeling in the back of my mind. The one I get at all conferences, “How am I going to find time to get this started in the real wold?” But as the afternoon of the final conference day wrapped up, Gayle talked about the importance of creating an environment to support aided language development. This was my AHA! moment. This is where I need to start. I can’t throw tools at teachers and expect them to just implement them in the classroom with no background knowledge. We need to first focus on building foundations that support the aided language. Here are some key points:

* We need to model, model, model  (in NATURAL, everyday contexts) the language we want the child to produce (including augmentative and alternative communication). Aided language input (ALI) is an evidence based practice!

*  NO PRESSURE!!!! One of my favorite Gayle Porter quotes was, “Nobody has ever died from using pictographs to communicate. So go ahead and do it.” Basically, there is nothing that an individual has to do to show that he/she is “ready” to communicate.

* Likewise, don’t put demands on individuals to use the communication system. You don’t want to the person to see the communication system as work. Unfortunately, this is not what has happened to many of our older students. You need to overcome the idea that the communication system means they have to do something (and they may be unsure of what to do). This can be a slow process, but DON’T GIVE UP!!!!

* Which leads to the next point. What if the behaviors we sometimes see in individuals who are nonverbal are NOT because they can’t adequately express themselves? What if those behaviors are the result of individuals NOT understanding what is being asked of them? Food for thought….

* EVERYONE has the right to communicate. We know that. But I’m going to take it one step further. Everyone has the right to be an environment that supports their language development – no matter what the system may be.

So…. I am excited to get started in the fall. I hope to be able to educate other professionals in my district on these key principals and give them a strong foundation to implement augmentative and alternative forms of communication.

Again, I cannot thank the New Voices Foundation enough for providing me with this wonderful opportunity. I look forward to future collaborations and growing our AAC program in the public schools of NC!

Feeling Happy…

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This evening, I had the honor of watching my mentor (Ruth Morgan of Chapel Hill Snippets) receive an award for her many contributions to the practice of serving students who need alternative or augmentative communication. It was a much deserved award and her passion for her work was evident.

A WONDERFUL organization called the New Voices Foundation sponsored the event in honor of an amazing individual who used AAC – Laura Jane Parker. They awarded four individuals who have dedicated their careers to serving students with physical and communication needs. Check out their website to see more of the awesome work that they do – I could go on all day!

It was a true honor to be in this room, surrounded by some amazing professionals, celebrating the work of our peers. I will admit that prior to this event, I was feeling kind of low. Political agendas (both state and local) had gotten me down. But sitting in that room – I felt the love.

The folks behind New Voices truly care about individuals with communication needs and for the professionals that are working to serve those individuals. That’s something I haven’t felt in a while. I left with a renewed spirit.

The field of AAC is dynamic. This is the time to be innovative and to collaborative! Tthings aren’t great in the NC public school systems, but there are people out there fighting for us to get the tools and support we need. I hope to work with New Voices in the future.

It’s time to get out of my funk and focus on the good – believe me there’s a lot of good. It’s an exciting time to work in AAC!

What do others do when you start feeling low about your work?

 

Tis the Season…for Job Interviews

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As many of you know, I have the privilege of working with an enthusiastic and hard working graduate clinician this semester. It’s been a true pleasure to work with her and I know she will go on to be a great speech language pathologist. In a few short weeks she will be graduating and looking for her clinical fellowship position. I remember these days, and how nerve wracking the job interview process can be. Luckily for me, a fellow speech language pathologist – TJ Ragan from “The Gladdest Thing Under the Sun” wrote this AMAZING blog post with job interview questions to practice. Click HERE to find the link to those questions.

This was my bible when I was interviewing, so I asked if I could share this on my blog. I hope others find it as useful as I did. Good luck!

Does anyone else have any interesting job interview questions to share?

 

 

Components of my AAC Evaluation

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Spring is here!!!!! Well… spring break that is. This winter was a busy one, but it’s time to get back on the blogging wagon. I have a deep respect for those professionals who are working full time and keeping up these blogs as a “hobby.”

I’m looking at you praacticalaac.org

I recently finished a comprehensive AAC evaluation. As I made my recommendations, I kept asking myself “Why?” I think that if I can convey why I’m recommending a certain device or accommodation, then I’ve done my job.

AAC assessment is an iterative process. I’ve found that it takes me a great deal of time and gathering information from multiple sources.

Here are the components of my AAC assessment:

1. File Review – Gather all information you can. Check IEPs, progress reports, notes/data from therapists, and TALK TO MEMBERS OF THE TEAM! I’ve found in some cases, the buck stops here. Often I have quick recommendations that the team can put in place, but if more information is needed – we proceed with the assessment.

2. Observations – In MULTIPLE settings. I sit as unobtrusively as possible in classrooms, therapy sessions, or anywhere else that will wield good information. Not only does this provide information on how the student is functioning within the typical day, but I can analyze the environment as well.

3. Data – I like to have some objective information to support those gut feelings. This can be done through trials. There are more and more tools coming out. Here are a few that I’ve been using recently:
– AAC Evaluation Genie App (I especially like the visual discrimination subtest)
– AAC Profile from Linguisystems (This follows the format from Janice Light’s research. You can find more information on that in this previous post
– TASP (Created by the Joan Bruno – creator of Camp Chatterbox)

4. Feature Matching – Once I have identified the needs and areas of strength, then I can try to match the best technology for that student.

5. Summary and Recommendations – I like to use simple tables in this section to bring it all together. In my first table, I summarize areas of strength and areas that were identified as challenging. Next I make recommendations. It is important to clarify that I only make recommendations. It is up to the IEP team to meet and decide what, if any, of my recommendations should be implemented in the IEP. My recommendation table includes three columns: AT currently in place, AT tools to consider, and AT recommendations.

What are you using for AAC assessment?

Inclusive Practices

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In a recent post I wrote about my work as a secondary SLP (check it out here). In that post I talked about how I primarily serve students through inclusive services. I do this for a variety of reasons that I won’t get into now, but here is some information I stumbled upon this past week that talks more about what inclusive practices look like (found in the ASHA Leader February 2014):

http://leader.pubs.asha.org/Article.aspx?articleid=1830636#.Uw0k-NbehWA.email

I really can’t say it better than Ms. Dixon does in this article. Basically, it’s not a one size fits all approach. Personally, I’ve had the most success using the supplemental teaching method working in conjunction with resource teachers – but I’ve been heavily advocating to my principal that we need time to collaborate together so we can deliver some team teaching lessons.

If you want more info on this topic, I found this Considerations Packet that has lots of good info and resources for implementing inclusive practices. As a school based speech language pathologist, I feel like I am uniquely set up to deliver inclusive services within the classroom (the place where kids spend the vast majority of their day).

Some of the benefits I see everyday include:

– increased student motivation (once students hit middle school, they hate anything that might mark them as “Different” so pull out is a no go)

– increased teacher carry over of what I’m doing: I LOVE when teachers ask me for my materials OR when they hand me materials they know I will be interested in

– teachers in my schools KNOW WHAT I DO!!!!!

– goal writing has become so much more collaborative between myself and teachers  (with a focus on goals that address the curriculum)

– students are making progress (even students that aren’t on my caseload)

 

Is anyone else using inclusive practices? How’s it going?

Communication

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How many of our daily problems could be solved with better communication?

This week I have had several reminders about how important it is to communicate with other team members – and I mean ALL team members.  Communication is the foundation of trust.

One thing I  love about working in the schools, is how many team members I easily have at my disposable. Just start typing their names into my school email account and BAM! – quick email sent to the OT/teacher/behavior therapist/autism specialist…

However, the communication needs to extend beyond the school’s four walls – especially when you are dealing with implementing AAC. Many students with complex communication needs have teams that extend beyond the school based personnel.  When you combine all of the people who are working with this student, we end up with some REALLY big teams!  Team members usually  come from multiple agencies and backgrounds.

Here are some important tips to keep in mind when communicating with other team members:

It’s always safe to assume that everyone on the team is there to help the student and doing the best he/she can; so, keep an open mind when you enter into courageous conversations.

Just because someone is doing something different from you – do not assume that it is wrong.

On the same note – DO NOT get offended when someone asks you, “Why did you think/do/choose that?”  We all bring unique talents to the table and we aren’t going to agree on everything, but if you have information to back up what you are doing/recommending – it’s much easier to get others on board.

If you find yourself thinking, “I should call/email _____, but I don’t have time,” then make time. It’s so difficult to carve out times in our jam packed schedules to make the time to communicate with each other – but it’s so critical to building trust. Keep on keeping on!

I’ve made communication mistakes, and I’m sure I will continue to do so; but, I’ll keep trying.

Here are some quick(ish) ways to communicate among team members (with parent permission of course):

– emails

– shared google docs/forms

– video taping what you are doing

– sharing of evaluations/progress notes

– private blogs to provide quick updates

 

How do you communicate amongst team members?

 

NC Paperwork for the New Clinician

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I have the distinct pleasure of working with a graduate student clinician this semester. I am so excited to have her and she is doing great. I look forward to seeing her implement her ideas and I know our students will benefit from working with her. This is her last semester in grad school and she is looking for jobs (hopefully in the schools…)

During the hustle and bustle of the day, I don’t always get to sit with her and talk her through all of the paperwork. When I first started my job at the schools, I did not realize how much my supervisor was doing behind the scenes (e.g. many forms exist other than the IEP). So, I’ve created a graphic to help explain what paperwork needs to be completed (in NC) for initial evaluations and for re-evals. I’ve highlighted paperwork the SLP is responsible for completing in green. Hopefully these are helpful!

Initial Evaluation: (find the form Initial Evaluation Paperwork)

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Re-Evaluation: (find the form Reevaluation Paperwork)

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In my district we are so fortunate to have Program Facilitators, who facilitate (go figure) much of this process. These wonderful individuals handle forms like the Dec 5  (Prior Written Notice) and Dec 6 (Informed Consent for Initial Provision of Services). The link to all of the forms can be found here. Many districts are moving to web based platforms to complete these forms – which comes with it’s own set of pros and cons.

In any case, paperwork is a necessary part of our job. I like to think of it as a system of checks and balances to ensure that proper steps are followed for all.

My last piece of advice: It’s so easy to use acronyms and technical jargon when completing these forms. Remember: these should be accessible to all – event those who are not familiar with school based terminology. When in doubt, explain everything.

Did I miss any steps? How does your district handle paperwork?

Secondary SLP Service Delivery

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Snow day in NC!!!! Thanks Leon!

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Today I thought I would take a detour from my typical blog posting about AAC and talk about the other part of my job (SLP for middle and high schoolers). Never in a million years did I imagine myself working at the secondary level – but now I can’t imagine a world in which I don’t work with adolescents! (at least some of the time)

Working at the secondary level has it’s unique challenges to service delivery. Here are two of the biggest challenges that I have come across, and how I’ve addressed those:

1. Secondary students have limited time. Once students hit middle school, they have classes that they are required to take. Often times, students spend a limited amount of time with each teacher, so teachers are not usually willing to let students miss a class period once/twice per week (not to mention time lost due to testing, assemblies, field trips and required remedial programs). How can you provide service delivery when students only have a limited amount of time in the day?

a. Schedule students in sessions per quarter (rather than sessions once/twice per week). Unlike many of my peers, my schedule is a fluid, ever changing thing. So when a teacher says, “Johnny can’t come to see you today because he failed his science test and needs to retake it.” I can say, “OK, I will catch him twice next week” to make up for the lost session. FLEXIBILITY is key! Scheduling times per quarter is also helpful when state mandated testing rolls around. In my experience, this is a horrible time for students and speech language therapy is the last thing on their minds. If I can avoid it, I do not schedule therapy on days students are testing. Remember though – you should not schedule students based on your convenience! The team decides what level of support the student needs to access his/her IEP goals – which you can translate into times per quarter.

b. Parent and elementary SLP education. The other secondary SLPs and I have done some brief inservices for our elementary counterparts to inform them of the unique scheduling demands of middle and high school. One of the biggest differences is that students are not with one teacher throughout the day – so if they miss that day’s lesson, there’s no making it up that day and the class will move forward without them. In my district, students at the resource level may get one small group resource class with a resource teacher per day. THAT’S IT! Student’s may get put into collaborative classes (resource teacher or teaching assistant in the class with the gen ed teacher) as needed. This means that the resource teacher has one period per day to preteach/reteach concepts, provide opportunities for test retakes, and help students complete assignments (not to mention any required remedial programs that must be provided). Once we lay this out for parents and SLPs, we can talk about ways the SLP can support the student within the secondary environment. Which brings me to my next point…

c. CONSIDER OTHER MODELS OF SERVICE DELIVERY. I think the biggest problem that I see is the Related Service Support Description (e.g. support plan) is considered a means to exit students from speech and language supports, or provide less supports. THIS IS NOT TRUE!!!! 

Let me explain: Sally is a 6th grader with a significant learning disability. She is reading independently at a mid 3rd grade level and writing is below grade level. She works hard and is turning in most of her homework (which she completes in her resource class with the resource teacher). Her homework completion is saving her grade, because she is failing tests (as you would imagine since her skills are not at the 6th grade level). Classroom instruction is moving much too fast and the gap is growing.

An 8th grade general education teacher asked me, “When students come to my class, I expect to lay the 8th grade set of bricks. What do I do when I have a student who does not have the 7th grade (or even the 3rd grade) bricks?”

Enter specialized instruction team! Wouldn’t it make more sense for the EC teacher to be able to spend more time with the general education teacher to adapt assignments to ensure that they are on Sally’s level (IN ALL CLASSES), so Sally can benefit from the instruction and learn? It also stands to reason that the speech and language pathologist could provide input as well to address language needs in the classroom. This way, Sally is getting that support throughout the day (not just in speech and language therapy sessions). Unfortunately, there is limited or no time for this collaboration throughout the day. Everyone’s schedule (including the kids’) is so jam packed, that we are relying on our predetermined times set on the IEP instead of looking at the bigger picture here. It’s like putting band-aids on a broken bone.

 

2. Student Motivation – As students enter adolescence, they worry about “being cool,” yet strive to fit in with their peers. In my experience, pulling students out of class to work with me is the worst thing I could possibly do for their self esteem.  No amount of prize boxes or bribery can make up for that. I see VERY few students 1:1 for this reason. Over the last 2.5 years, I’ve worked very hard to build  positive relationships with my students and have done so with many of them. It has become clear that INCLUSION YIELDS THE BEST RESULTS.

a. INCLUSION. So there are many levels of inclusion (more on this later), but I hate going into the classroom and acting as support staff for a teacher’s lesson. I do not want to go into the classroom and walk around keeping students on task and “getting them through” the assignment. For me the best place to do this inclusion is by “pushing in” to student’s small group resource classes. Over the last couple of years, I have slowly built relationships with resource teachers, and they allow me to come into their classrooms once or twice per week to delver a lesson to the whole class (usually 5-6 students). We give it a jazzy name like “Writer’s Workshop” (haha). I create lessons that are targeting the language based needs of a couple of students in the class; however, the entire group benefits from the instruction. This set up gives me the best chances at student participation and allows the resource teacher to see what I’m doing so he/she can carry that skill over into other lessons. For example, I have been working on teaching my 6th graders how to write a paragraph using a 4 square graphic organizer. Now, when the student is asked to write a paragraph in Language Arts, the resource teacher in that collaborative class can refer back to the graphic organizer that students used in Writer’s Workshop (disclaimer: we call it Writer’s Workshop, but reading comprehension or other language based objectives can easily be addressed).

A good resource for this is Western Michigan’s (Go Broncos!) Writing Lab Outreach Project – found here.

 

All of this makes me wonder, what if we changed the traditional views of speech therapy? What if I primarily served as a consultant for teachers (both EC and gen ed) to address language based needs in the classroom? Would I still lead Writer’s Workshops and drive instruction through student data? – ABSOLUTELY!

 

How are others serving their students?

 

Rolling Out the PODD: STEP 1

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Oh PODD… how I love you. You are a wonderful language based, low tech system that grows with students (check out my Pillars of PODD post to get the scoop). My dream is to have a lending library of PODD books in my district to use for assessment purposes – just another tool in the toolbox.

Yet, PODD is providing to be a good bit of work. Anyone who has spent hours trimming those tabs knows what I’m talking about… But there’s more to it than just getting the books made and distributing them throughout the district to all of the little boys and girls. In order to ensure that devices are used in the classroom, it is important to make sure that the classroom staff understand and feel comfortable with devices. Here’s where we are so far in the PODD roll out in my school district:

STEP 1

Student identified as possible candidate for PODD system – After a brief training for our district SLPs and EC teachers, many approached me asking if they could try PODD with a specific student.

Introduction of PODD to Classroom – Once a student was identified as a possible candidate, I brought the appropriate level of PODD over to the classroom. I did a quick “Pillars of PODD” training. DON’T FORGET TEACHING ASSISTANTS IN THIS TRAINING!

Full disclosure: Initially, I sat down with teachers and therapists in initial training thinking they would relay the information to the TAs. While intentions are good, in the hustle and bustle of the day, the information wasn’t always transmitted. TAs have asked to be included right from the get go. LESSON LEARNED!

Identifying Targets – I asked staff to think about the curriculum and the student’s communication needs to determine our first vocabulary targets. In order to keep it doable, I’ve asked staff to pick 3-5 to start with. This vocabulary can be from the core word vocabulary and/or “fringe” vocabulary deeper in the book. I always make sure that I am not dictating to the team what vocabulary to use. I am not an expert in the curriculum and the team knows the child much better than I.

Now what?

Next Steps:

Once the team has identified the first targets, I will come back for an additional training. This training will focus more specifically on teaching the targets the team has identified and integrating the PODD across the day – not just within specific activities. Data collection will be another story….

 

Is anyone else out there rolling out the PODD? How’s it going?