Wednesday, April 30, 2014

Transition Time! Tips for the SLP

Now is the time for transition meetings!  These are for preschoolers with IEPs who will be attending our school in the fall.  Each case is different, each student is unique.  All students have someone who loves them--this may be two parents, one parent, guardians, grandparents, mentors. They come from all walks of life.  I see anxiety in the grownups' faces, unanswered questions, trepidation, sometimes tears.

After attending these transition meetings year after year, here are my tips for speech pathologists to help ease those fears, allay anxiety, and yet advocate for students......

  • Look friendly---sometimes this is hard to do after back-to-back meetings in a hot room; however, try to use those megacognitive skills and force your lips in an upward curved position.  Look at people eagerly, like you believe this new child will be the best adventure ever!
  • Try to have some information about the child in advance.  A transition meeting may  not be as in depth as an annual review IEP meeting, but it's helpful to know some of the child's strengths and needs.
  • I personally don't stress over recommendations about service delivery and times.  My feeling is that I don't know the child, so it's not my place to pre-determine.  If speech delivery times seem inappropriate, however, I will speak up, but only if speech times are out of sight (e.g. I have had requests for twice a day speech, every day).  For the past 5 years, time for speech service has been reasonable in my school and I've found that times of service can be changed later once everyone sees that the child also needs to access the classroom curriculum. I realize, though, that this can be a battleground.  The preschool transition meeting, however, is not the place to have the battle.
  • Be helpful!   I have made picture books for new kids which have teachers and rooms clearly displayed.  I have greeted new children when they visit the school before the beginning of the year.  I've gathered emails from new parents.  All of this helps!  
  • Be an advocate for the child.  This is perhaps the most important, yet most difficult task. Most of the time, the team who is handing off the child has not observed the setting they are recommending.  Occasionally, the setting may not be in the best interest of the child.  Who will speak up?  Sometimes, the speech pathologist!!! Don't be afraid---part of an IEP meeting is to consider more than one setting. Is the child in need of a restrictive setting when the only issue is behavior?  Does the child need typical peer role models?  Does the child require complete one-on-one assistance all day and would function more independently in a self-contained classroom?  Does the child need an assistive technology evaluation?  Speech-language pathologists are often a source of wisdom, so say what you think, but don't demand.  Use questions---and the process will work.  An IEP team should act as a problem-solving team, even during transition meetings.

How does your school system handle preschool transitions?  I'm curious.

 I apologize for not posting any new printables this week.  Life calls---I spent the past many days helping my wonderful inlaws move to a retirement community.  They are going though a transition also, as are we.  Will our Christmas celebration ever be the same?


Wednesday, April 16, 2014

Supervision of Graduate Interns---I never had a class in this!

I've had oodles of graduate interns working with me over the years.  They come, they go, they graduate, and often they land higher paying jobs than what I have.  I love interns! 
  • They bring fresh ideas
  • They are enthusiastic
  • They are up-to-date on current research
  • They are young (now they are the age of my own children)
  • They work tirelessly and are high-achievers
  • They are articulate

This list can go on.

 Although I do enjoy having them, sometimes minor issues arise and my big problem is that I have never been trained to supervise an intern.  I've developed my own homemade style (after careful thought) year after year, but each new intern brings a different set of prior experiences and skills.  Often interns have had a prior career; and just as often, they have recently graduated from an undergraduate program.  Sometimes, English for the intern is actually not the primary language. Sometimes, an intern is challenged in some area.  The point is that even if I had training in supervision, the students themselves are so diverse, it's hard to apply a 'one size fits all' approach.

After a lot of discussion and thought with my newest intern, I finally went back to the ASHA standards which are pictured below.  The ultimate goals for an intern are independence and an ability for self-evaluation, with consultation and occasional assistance from a supervising clinician. The student should strive for 'Level 3' in a practicum setting. 

I'm obviously in the 'trenches' and haven't blogged about scholarly research here, but with my role as a supervisor, and my lack of training in this role, I have begun to scout out Special Interest Group 11--Administration and Supervision.  I'm not a member of this group, but since I joined a different Special Interest Group, I do have access to the publications of group 11.  I found an article written by Dr. Corey Cassidy, who is affiliated with the Department of Communication Sciences and Disorders at Radford University in Virginia.

 "The Relationship Between Perceived Supervisory Roles, Working Alliances, and Students’ Self-Efficacy in Speech-Language Pathology Practicum Experiences"  Corey Cassidy, SIG 11 Perspectives on Administration and Supervision, October 2013.

 Dr. Cassidy clearly explained the three main types of clinical supervision roles:

Weekly evaluation form

The Teacher Role: In the teacher role, a supervisor may focus on evaluating therapy session interventions, modeling, and demonstrating for the student.

The Counselor Role:  The goal of supervision in the counselor role is to promote students’ self-growth, and the supervisor tends to be more open and to exert little control.

(Although some of my students have needed counseling, I try not to take on this role.  Occasionally, a student will want to talk about personal issues, diverting attention from the tasks at hand. It's best to not take on this role unless truly necessary.)

The Consultant Role: "Within the consultant role, a supervisor focuses on the content brought to the session by the student with the goal of promoting control by the student ( Stenack & Dye, 1983). The supervisor is likely to discuss options of techniques or models based on the initiation of the student ( Bernard & Goodyear, 1998). These supervisors using the consultant role emphasize student control, initiation of direction, and problem-solving processes."  This is directly quoted from the above mentioned article by Dr. Cassidy.

Dr. Cassidy doesn't claim to have the answers as to what is the most effective supervisory role (although he seems to encourage movement towards a consultant role as the intern gains experience).  Since the goal is to increase graduate student self-efficacy,  I'm personally trying to be less directive as a semester wears on.   I usually begin  supervising in the teacher role with new graduate interns.  My goal is to gradually allow more autonomy, and consult on lesson planning and implementation.  I've discovered that self-reflection is a skill that needs taught with some students.   Although I am often physically in the room, I don't feel that intervening frequently is best for building problem-solving skills; but time for discussion afterwards is helpful. 

     What is the best way to promote self-efficacy?  A few ideas here....

  • Students can record their own therapy sessions and watch.  Perhaps the SLP can consult about what to look for (e.g. intern's own language levels, intern's eliciting skills, etc..)
  • After a session, the student can read the ASHA skill set and rate their performance based on the rating scale.
  • Students can focus on one or two of their own skills and rate them after the session.
  • Supervisors can play a role by highlight areas of strength as well as weakness giving the interns a direction when self-monitoring improvements.
Dr. Cassidy concludes with the following:   The supervisor role has an effect on students’ self-efficacy in the course of their clinical education. Many supervisors, however, habitually use a more directive style of supervision with all students, regardless of students’ prior experience or competence in the clinic, and overlook the critical process of rapport within the supervisor-student dyad. Students should take an active role in the supervisory process in order to encourage and improve their working relationships with supervisors, and aim for clinical independence at a pace that is most comfortable and appropriate for them.

"The Relationship Between Perceived Supervisory Roles, Working Alliances, and Students’ Self-Efficacy in Speech-Language Pathology Practicum Experiences"  Corey Cassidy, SIG 11 Perspectives on Administration and Supervision, October 2013.

 Stenack, R. J., Dye, H. A. ( 1983). Practicum supervision roles: Effects on supervisee statements. Counselor Education and Supervision, 22, 157– 168.

 Bernard, J. M., Goodyear, R. K. ( 1998). Fundamentals of clinical supervision ( 2nd ed.). Needham Heights: Allyn & Bacon.

Wednesday, April 9, 2014

AAC adult modeling (and graduate intern mentoring)

Example of AAC modeling
I take things for granted these days.  I forget easily that I've worked with kids for 35 (gasp) years and have an intuitive sense about things.  (Yes, my first teaching job was in 1979, hard to believe!)  When I work with young graduate interns, however, it's hard for me to see things from their perspective and lack of experience, so I become impatient.  Why are they not doing therapy techniques that seem so common-sense to me?  Then I reflect---duh! Some direct instruction to the intern (from me) might help!

One such concept that bubbled to the surface today was adult modeling the use of an AAC device.  I personally know that most young AAC users don't know how to use much of the core vocabulary on even a simple device, or even simpler--a communication board.  These concepts need modeled by the adult using the same device in structured therapy.  With any language or communication system, a client needs to see the use in action.  

 I'm certainly not the first to blog about AAC modeling.  One of my very favorite blogs (Praactical AAC) has a collection of insights and tips about this.  I sent my graduate intern to this site, and hopefully he will look at this and then do a little further research.  A good supervisor is often a teacher, and a facilitator...... a guide to an intern so that he or she can then find their own answers.  I don't have all the answers, and I'll be the first to admit that.

Anyway, here is a a great blog entry by Praactical AAC with links to examples and research.


 It's a good starting point, and interested SLPs or teachers can then go further to explore evidence-based practice on using augmentative communication in the classroom.   

My parting question is:  Let's pretend you were teaching a child to learn a different language (e.g. Japanese).  Most teachers would model the Japanese language in some type of functional context.  Wouldn't you do the same modeling if a child was learning to use an augmentative communication system? 

Sunday, April 6, 2014

Modest Collection of Easter Materials

I'm back from a wonderful London vacation, and thought I would get this out to you all.  It's my Easter collection---things I've made or adapted over the past few years.   I'll add to it in the next week.

Easter Eggs Adapted Book

Easter Bingo

Eggs Everywhere---printable adapted book

Bunnies Everywhere--printable adapted book

Taken from the London Eye