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Stories from the Field

Why School-age Children Who Stutter Aren’t Motivated for Therapy


I get queries all the time from clinicians all the time asking me about me about why their school-age children who stutter aren’t motivated for therapy. I typically start by asking them about what their goals are for the child. The answer generally falls along the lines of “helping him learn to use easy starts (or some other technique) across various settings.” That is a reasonable goal, but I’d like to encourage clinicians to think of such a target as a process for achieving a goal rather than as a goal unto itself. For me, the real goals of therapy should have something to do with communication. What is the child having difficulty doing, with respect to communication, because of his stuttering. If we set the goal as helping the child communicate more easily, in whatever situations or tasks are important to him, then we tend to find that they are much more invested in therapy. So, rather than saying “child will use XYZ technique,” clinicians can work with kids to find out if they’re having trouble reading out loud or talking to friends at lunch or telling a joke or talking on the phone or solving problems at the board or giving their book reports. We then take those as the targets of therapy. Say to the child, “Today we will focus on making it easier for you to say what you want to say” and use the specific situations the child highlighted as your examples. Of course, the process for achieving that goal may involve using a technique (and, importantly, it may also involve helping the child learn to come to terms with and accept stuttering, desensitizing the child to stuttering, reducing tension and struggle in the child’s speech mechanism, helping others in the environment learn more about stuttering, etc…)… But, when the child sees that the purpose of therapy is to help him do the things he wants to do, he often becomes much more motivated. An analogy? The purpose of a diet is not to limit calories; it is to lose weight. Nobody would want to go on a diet whose sole goal were to limit calories…we want the product that comes from that process. In my opinion, many speech-language pathologists tend to get too focused on fluency and forget that there is a big picture out there – the child’s communication. If we keep our eyes on the real prize, then we (and the child) will better understand the reasons that we have to do various drills or other activities in order to help us get there.

So, how does this all relate to the OASES? Well, the OASES was specifically developed in order to help clinicians (and our clients – whether they be school-age children, teens, or adults) keep our focus on communication. The OASES is based on a model that puts daily functioning and quality of life at the forefront. Going through the OASES with my clients allows me to talk with them directly about what is affecting their lives, and then I use the results of the test to directly help me plan my treatment goals. We return to the OASES form often, talking about which aspects of communication are affected, and then we plan treatment activities aimed at minimizing the burden of stuttering that the test revealed. As we move through treatment, the OASES also helps me to document my treatment outcomes – what specific changes has the client experienced in terms of his/her perceptions about speaking, reactions to stuttering, ability to manage environmental or situational differences, functional communication skills, and, ultimately, quality of life. These are the things that matter to people (whether they stutter or not), so by addressing these topics, we find that our clients are far more motivated to actively participate in the therapy process.

Back to School!


Speech Language Pathologist
Los Reyes Elementary
San Antonio, Texas

Back to school can mean so many different things to different people. For students it means summer is over and they are no longer able to sleep in, for parents it is finally back to a routine, for classroom teachers it is sleepless nights thinking about what needs to be done to make the first day perfect, but what is it for speech pathologists? The answer is a little bit of everything.

On the surface it looks like the school-based speech language pathologist has it easy for the return of school. The classroom is small so less prep work needs to be done, students don’t typically start speech services until week two of school so naturally SLPs get an extra week “off”, and if the SLP is returning to the same school there is no nervousness about meeting the new “class” because he/she has the same students from year to year. But if you take a deeper look, under all the paperwork, you will find the SLP and it is not as easy as it appears.

As school-based speech pathologists, we look forward to getting to the routine just as much as the next educator. The beginning of school includes more behind the scenes work than can be imagined. One of the top items on the list for back to school is the natural concern for the students. Did they regress over the summer break? Did they continue with the speech homework and drills? Will their new classroom teacher understand them? But it doesn’t stop there. Every year for the past 7 years that I have been in the school-based setting, I return to work with at least one (typically more) email, phone message, or file waiting for me. Someone has requested testing and wants it done ASAP, or a child has transferred into my school and I need to locate the official documentations to determine eligibility, and the number one concern for school based SLPs is, you guessed it, SCHEDULING!! How will I formulate the groups? Will the classroom teachers allow me to remove the students for speech at this time? Will the students get what they need from their speech session?

This year, I opened a brand new school to my district. In doing so everything that is typically weighing on the SLP’s mind at the beginning of school becomes multiplied by 100! I arrived back to work 3 weeks before my contract started and was met with a box of files for students I have never met who are transferring from at least 4 different prior schools. Everything has to start from scratch. Every SLP and school has their own way of writing IEPs, and it is now my job to make sure they all “mesh.” The last month has been spent reading files, understanding goals and objectives written by other SLPs, scheduling ARD/IEP meetings (with a new “district way of doing things”) with parents, and of course scheduling. I have edited and tweaked my schedule at least 50 times in the last week and to top it off, once I thought I had it perfect, technology at its finest LOST my document. Yes, it was technology’s fault because not only is the school new but so are all its computers and printers and there are always things that need to be “tweaked.” Luckily I had a printed copy so I did not have to reinvent the wheel, but you can imagine my frustration. We are now in the second week of school and I couldn’t be happier to start seeing my students. I am a realist and understand that many more changes will be done as the school year continues. Students will be evaluated and qualify while others will be dismissed. But I can say with confidence that as the second week of school begins, I am ready and excited to face the challenges. From here on out everything should begin to become second nature again, I say with hope. Students understand their schedule and speech goals, I have become familiar with the students and their needs, as well as knowing my schedule so well I can recite it in my sleep. Of course I plan on being able to complete the oh-so-loved paperwork as if I have been doing this my whole life and nothing has changed. Here’s to the 2012-2013 school year; bring it on!

SpeechandLanguage.com would like to thank Madeleine for writing her first blog for us! Madeleine is also a member of our Speech and Language Advisory Panel.

Be sure to view the webinar, “Build a Foundation for Treatment in the First Weeks of School” presented by Sarah James here.

Better Hearing and Speech Month-With Donuts On the Side (Revisited 8 Years Later)


It is eight years later at Courtenay Language Arts Center, and I have been preparing for my eleventh annual speech poster contest. I am still a speech-language pathologist at Courtenay, which is a thriving elementary school in Chicago. My 65 speech students are busy working on their speech posters for the contest on Friday, May 6th. I spent the last ten months cutting out pictures of images relating to communication (speech, language, friendship, playing, etc), as well as several hundred words on the same topic. The children selected their own pictures from among these thousands of images and arranged them as collages on poster board. The Courtenay teachers will vote on the three top posters to select the winners in each of two age categories.
Courtenay now has State-Pre-K through eighth grade, and has an enrollment of about two-hundred children. Almost half of these students have special needs, and all of Courtney’s classrooms are now inclusive. Additionally, about 75-80% of Courtenay students speak Spanish, but the remaining students speak about twenty different languages as well. I have been at Courtenay for nearly twenty years now, and have been with the Chicago Public Schools for close to thirty. I organized the poster contest to celebrate May, which is Better Hearing and Speech Month in the United States. This contest shows my students, staff and parents the importance of communication, hearing, speech, and language, and how it impacts our entire lives. Winning students have their picture taken, receive ribbons and prizes, and have their names published in the school newspaper. I really enjoy this time of year and the students seem to as well; they are very excited about the contest, and have done an excellent job in portraying their views on communication.

Are you doing anything to raise awareness about/celebrate Better Hearing and Speech Month? Leave a comment! I’d love to hear from you.

 

-Ellen Lunz, MS, CCC-SLP

 

Weekly Links, November 29, 2010


a 6' tall Mr. Bear (PLS-5)

Some photos from the 2010 ASHA Annual Convention on our Facebook page (if you haven’t already, make sure you click the Facebook "Like" button button.). Ok. Here’s a peek (on the left).

Find out what some of Pearson’s SLPs were up to at the 2010 ASHA Convention

If you’re looking for something to really sink your digital teeth into, check out this Primer on Psychometrics from Pearson VP of Development, Dr. Larry Weiss, and Pearson Sr. Research Director, Pat Zureich, MA, CCC-SLP.

ASHA has a fantastic blog, ASHAsphere. It’s full of great content from a number guest-writers. Check out their posts recapping the 2010 ASHA Annual Convention.

If you haven’t joined (or don’t want to join) the conversation on Twitter, be sure to at least check out this search for #SLPeeps on Twitter every so often. The hashtag #SLPeeps is what SLPs on Twitter use to keep track of professional conversations.

Need some last-minute ASHA CE credit? Dr. Chad Nye will be presenting a free webinar on December 16, titled Evidence-Based Practice: Clinician’s Tutorial for What Works. Space is limited, so register early!

A Message from Our ASHA 2006 Annual Convention Scholarship Recipient


Another successful professional conference. Kudos to all convention/conference personnel who work so diligently to provide workshops, sessions, exhibits and accommodations that make our annual event a worthwhile investment.

Although I look forward to attending sessions related to my work setting, because they often provide practical information that can be taken back and implemented with the clients on my workload, I also look forward to sessions that keep me abreast of research in areas of Speech, Language and Hearing which are not the focus my daily practice. It’s part of lifelong learning. I always come away from these conventions feeling very proud to be part of a profession that offers so many opportunities for delivering services that make such positive change in a clients life. The exhibitors keep us abreast of the latest and greatest materials in our profession. Their generosity in sponsoring events, giveaways, little treats that sometimes have substituted for a missed breakfast or lunch (I believe that chocolate is part of the new government nutrition pyramid), conference discounts and overall congeniality is a proven hit with conference attendees as witnessed by the constant buzz on the busy floor.

Not to forget the all important networking with friends and colleagues. It’s not often that we get the chance to just sit and visit and what a setting! Cool patio breezes, clear warm weather, dining experiences and tropical refreshments…for a moment I was back there!

Thank you, Pearson for being an important contributor to the professions of Speech/Language Pathology and Audiology.

Photos from Pearson’s booth:

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Photos from the PPVT-4/EVT-2/The Bridging of Vocabulary Launch Party!

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Summary of 2006 Schools ASHA Schools Conference


My trip to Phoenix for the 2006 Schools ASHA Conference was a blast. I have never been to a national conference so I was really excited to learn that I had been selected as the winner of the scholarship. I traveled alone for the first 10 minutes of my trip. I met another speech path from a neighboring district in the airport before boarding the plane. We became traveling buddies and friends before the quick weekend was over. I heard many great and motivating speakers during the course of two and a half days.

The workshops that I attended covered teaching language through written context, using RtI to serve those simple articulation cases, and managing unmanageable caseloads. A roundtable discussion was held one afternoon and there I learned that my challenges are not unique to me or to my way of thinking. It was both reassuring and encouraging to discover that others encounter the same issues I do on a daily basis. Last, but not least, the exhibitor’s hall was a lot of fun. Vendors lined this huge room and I was able to see, touch and play with all kinds of speech pathology materials. Discounts were offered on all products as well.

The hotel was beautiful, the food was good and the company was great. I came home extremely relaxed and refreshed, but motivated and eager for the upcoming school year. I would recommend the ASHA schools conference to anyone contemplating attending. It was a definite energizer.

Clark County, Nevada Case Study


Clark County, NV, May, 2006 – In Nevada’s Clark County School District, the New Year brought new opportunities for speech-language professionals to expand their access to intervention materials. In January, the district adopted TheraSimplicity, an online subscription service that offers over 1,800 precreated worksheets, activities, flash cards, handouts, slide shows, and games.

District Speech-Language Director Judy Moseley is behind the effort to introduce the program to Clark County, the fifth biggest school district in the country. She explained that each year the district identifies funding for SLP resources. As part of their search effort for effective materials,TheraSimplicity Marketing Director Joe Eral was invited to make a presentation to district representatives.

“We gave him six ‘r’ words,” Judy said, “and in just seconds he made worksheets, practice sheets and a word-search activity. We were really impressed. He also showed us how they planned to expand the program and even solicited input from us on how to change and grow the service.

“Another thing we liked is that the program is Web based. That means you can really use it anywhere, even at home. Just put in your password and you can get to work wherever you are.”

TheraSimplicity uses the latest Internet technology to deliver resources. The application is seamless and always accessible. There’s never a worry about installation, upgrades, or patches. The program includes a multitude of pictures. In fact, subscribers get unlimited access to over 11,000 images that include color illustrations, line art, and photographs. And content is never static—it’s continuously growing.

Judy said, “In the past, we purchased prepackaged items. Some fit our needs and some did not. Because TheraSimplicity lets us customize materials—and because we felt it would save us money in the long run—we decided to use part of our resource funding to provide the program to anyone who wanted it. About 170 people took advantage of the offer. We’re going to test it for a year, but in the few months we’ve had it, I’ve gotten positive feedback.

“For example, I recently observed a lesson where the SLP was using the book Brown Bear, Brown Bear. She extended the activity to real live animals and line drawings from TheraSimplicity.”

As Judy continues to conduct performance evaluations throughout the year, she said she’d see how other people use the program. “I think it will be especially nice for those interested in making their own materials.”

Darcie Osgood, Clark County SLP agrees. “I use it a lot—in fact every day—because I can make my own worksheets, for instance, when teaching certain sounds. As the program expands, it will only be better.”

Darci says TheraSimplicy also helps keep her organized. “Once I have created worksheets, I can save them by ‘artic’ or language goal, such as ‘pronoun,’ and go back to them for use with another child. I can also make worksheets ahead of time for homework.

Darci’s coworker SLP Greg Staley says he uses the program more for phonological and articulation therapy than for language. “I have a lot of experience using the Internet. In my opinion TheraSimplicityis a robust, quick, and easy tool. For the first rollout of a program like this, I feel it constitutes a pretty good base.

Dona Rogner, another Clark County SLP, works in a school with special education and kindergarten students and also with a group of preschoolers in another location. She finds that TheraSimplicity is valuable for students with a wide range of needs. “For instance I work with an apraxic student, and for him, I like to use the section with games. Starting with the blank game board, I write in the words I want him to say. This way he can practice sounds and I can give the game to his mom for homework.

“With other students, I make worksheets for reinforcing specific sounds. I also like that the program includes black and white pictures. This saves on ink, and after we’re done with the exercise, the kids can color the worksheet.”

Dona mentioned she also appreciates being able to get immediate answers when a question arises. “For example, I could not find a specific topic after searching through all my options on the site. I made a phone call to TheraSimplicity, which was answered immediately from the time zone 3 hours away! I was very impressed with the speedy service. [The person who answered the phone] walked right through the site while I sat at my computer. I am having so much fun coming up with a variety of ways to enhance my lessons! My compliments to the creators!”

Later in the year, the SLP Forum will check again on Clark County speech-language professionals’ progress with TheraSimplicity. For additional information on this program, click onwww.therasimplicity.com.

Letter from LuAnn Dukes, ASHA national conference scholarship winner


December 15, 2005

Dear AGS staff,

I was extremely surprised when I received the telephone call that announced that I had won the the AGS Publishing scholarship to attend the national ASHA convention in San Diego this past November—I truly didn’t believe I had won until I received my plane tickets!

I have attended ASHA conferences in the past, but this trip was very special due to the wonderful AGS Publishing staff. I want to thank all of you for allowing me to attend this year. Even with my special needs, you made arrangements for me to be able to fully enjoy the convention. This has been an experience that I will always remember.

The poster sessions and short courses were excellent. The sessions concerning school based practices for stuttering and dysphagia were especially helpful in giving practical ways to show progress and involving other school staff in the therapy process.

Thanks again and bless all of you.

Sincerely,

LuAnn Dukes, MEd, CCC-SLP

Speech-Language Pathologist, Jesup, GA

A Letter from Pearson 2005 ASHA Schools Scholarship Winner


August 22, 2005

Dear AGS Publishing,

I wanted to thank you again for the wonderful opportunity to attend the ASHA Schools conference this summer. Although I have attended the National ASHA conference many times, I have never been able to attend the Schools Conference. I would not have been able to attend this year, had it not been for your award scholarship.

My experience at the conference was wonderful. I was pleased that all the sessions I attended were so relevant to working in the schools. The speakers were all so engaging-they were very knowledgeable, and were able to provide real life suggestions I could immediately apply in my work.

It was also nice to be around other speech-language pathologists who work in public schools to bounce ideas off them, and find out what works for them in their practice. Being able to interact with professionals who knew where I was coming from was one of the best “take aways” I got from the conference.

Overall, I felt the quality of speakers, the relevancy of topics, and the opportunity to interact with colleagues from similar areas of the field made the ASHA Schools Conference in Indianapolis a truly invaluable experience.

Thank you for your continued commitment to the SLP community!

Sincerely,

Anida J. Gonzales Levesque, MA, CCC-SLP

Speech-Language Pathologist
Fairfax County Public Schools, Fairfax County, Virginia

A Winner In Every Way


If you happened to stop by the AGS Publishing booth at the ASHA conference in Philadelphia, you might have met Clarice Karam-Polston, M.S., CCC-SLP. She was the vivacious speech-language pathologist who spent an hour each day in the booth encouraging visitors to fill out drawing forms for the travel case on wheels.

Clarice also helped pass out bottles of lavender, cucumber melon, and cherry vanilla lotion—gifts for conference goers—that represented the beneficial “hand-in-hand” partnership between ASHA and AGS Publishing.

“It was like being on stage again. I loved it,” recalled Clarice.

In disbelief

Surprised and elated, Clarice was chosen from a pool of over 7,000 entrants to receive a free scholarship to the 2004 ASHA conference. “I had never won anything before,” she said. “I was thrilled. It was also the first time I attended this conference.” She received an all-expense paid trip from her home in Tucson, Arizona, which included airfare and accommodations, courtesy of AGS Publishing.

Clarice had signed up for the contest on SpeechandLanguage.com. A couple of months later when she got the call about winning the scholarship, she was shocked. Clarice explained, “I really thought the call was a solicitation. I said, ‘You’re kidding me, right?’ I did not believe I had won until the winner was posted on the Web.”

At home in a school setting

Although the contest was based on chance, Clarice definitely deserved the prize. After having raised three children and moving from coast to coast because of her husband’s business, she went back to college. She chose the field of speech-language pathology because it involved the study of the brain and all of its related parts (motor abilities, voice, cognitive abilities, and more). Clarice received her bachelor’s degree from the University of Arizona and her Master’s of Clinical Speech and Language Pathology from Northern Arizona University. In addition, she obtained her Clinical Certification Certificate (CCC) from ASHA and holds a permanent Speech and Language License in the State of Arizona.

Since graduation, Clarice has worked as a speech-language pathologist for the Sunnyside Unified School District in Tucson. She serves 52 children and youth in kindergarten through grade 8, spending four days a week at an elementary school in the district and one day a week at a middle school. Clarice thrives in this multicultural environment, in which 90 percent of her students speak Spanish.

“I regularly use PPVT-III (Peabody Picture Vocabulary Test, Third Edition) to test my students’ receptive vocabulary and language processing abilities. For more detailed articulation assessment, I administer GFTA-2 (Goldman-Fristoe Test of Articulation, Second Edition),” added Clarice.

Advocating for children with brain injuries

In addition to her therapy responsibilities, Clarice serves as a consultant on the Support Cadre for the Arizona Dept of Education in Southern Arizona for traumatic brain injury (TBI). She is also a member of the Arizona Governor’s Council on Spinal and Head Injuries. Clarice spoke about the work of the Support Cadre: “We are very involved with the process of getting information about TBI into the schools, medical facilities, and other professional areas, so that awareness and knowledge are enhanced and individuals who experience TBI are identified and treated accordingly.” She and other members of the team are revising TBI documents for medical and education staff in Arizona.

Highly interested in the subject, Clarice has attended seminars on brain injury for the purpose of sharing information with others. She has presented to other speech-language pathologists, psychologists, and nurses. Clarice aims to “basically make people aware of what happens when a child hits his or her head.”

“Sometimes,” Clarice explained, “we see medical patients with brain injuries being released into the school setting who still display significant symptoms. These children may require additional rehabilitation. We need to be prepared to provide the best strategies that will help them. By building on the child’s strengths, we assist in the progress of the child’s successes.”

Finding a community of peers

Coming to the ASHA conference nourished Clarice’s spirit. “In the speech-language pathology profession, we’re pretty much loners. We’re hardly ever together,” she reflected.

At the ASHA conference, she felt totally immersed in a warm community of peers. “It was incredible meeting professionals who were doing the same thing I was. Just sitting in a room together was exciting,” Clarice said. She enjoyed the “face-to-face” contact and the ability to brainstorm with others. “This is the perfect place to generate ideas.”

Clarice mentioned one of the many ASHA seminars she found interesting. Led by a voice teacher/SLP/singer, the presentation covered combinations of vocal behaviors that can impact voice problems. She reported learning “basic assessment and treatment protocols applicable to the professional singer. These included the importance of taking the history, administering a vocal capabilities battery, and developing a comprehensive treatment plan.”

Final note

All in all, the ASHA conference was rewarding for Clarice. She hopes to come back again. “I want to thank Tina, Deb, Patrick, and all the other staff at AGS Publishing. They were wonderful. I had a very comfortable and peaceful stay. The accommodations were fabulous! I would never have had this powerful experience, had I not put my name into the drawing on the AGS Publishing Web site. I hope that others take advantage of this resource. It offers a myriad of ideas and a plethora of opportunities,” she said.