Service Delivery Models

I just read a great article called Different Service Delivery Models for Different Communication Disorders. It can be found in the most recent issue of Language, Speech, and Hearing Services in Schools Vol.43 117-120 April 2012. It is a really well written article from the editor that discusses the need to individualize our service delivery models for each child. She discusses the fact that a pull-out model, though great for some individual situations, is less than ideal for many of our students. This has bothered me for years, but honestly with our ridiculously high caseloads (I had 87 last year) is there another way? She alludes to the fact that we, as school based SLPs, are being stretched very thin. We are expected to be experts in such a broad range of disabilities it is so hard to address each one individually as it should be done. She discussed the possibility of  SLPs in the schools beginning to specialize in certain areas such as autism, language disorders, articulation disorders, stuttering, and so on. The idea has good merit but I am not sure it is likely to happen. Making changes within the public school systems takes years if not decades, especially if it means the schools paying more money for more specialized professionals. I see the need for change. And the need for different service delivery models. But how are we supposed to address these needs while we can barely give our students the 30-60 minutes on their IEP each week? If our caseloads were more manageable, I have no doubt there would be so many incredible programs that would truly change the lives of our students for the better. Has anyone tried or heard of different service delivery models other than pull-out? I would love to hear about them. 
 

CLICK HERE to share your ideas on service delivery models

picture found at http://www.news.wisc.edu/13955

Homework Survery Results

Thank you to everyone who participated in the homework programs survey! I wasn't expecting such a GREAT response. It turns out that the free version of survey monkey caps the number of surveys at 100 and we quickly hit that cap. I am sorry to those SLPs who did not get to take the survey. If you have any input you'd like to share about successes or failures in speech homework programs please share!

I have to admit, I am rather grateful that there was a cap on the number of surveys that could be submitted. For the past two weeks I have been trying to organize and analyze the data from these 100 surveys. I was feeling slightly overwhelmed by the avalanche of information but it is pretty exciting stuff! (and this is the point where my husband would say "nerd-alert!")

I have to make a disclaimer that I am not a statistician so I haven't run any regression tests on the data. I thought about it, but for now I am rather busy with my cute husband, our insanely adorable 6 month old baby, and my high caseload at work. Also I don't really feel like delving into my old Research Statistics notes from grad school to figure out how to properly analyze the data. I am only reporting raw data with basic percentages for each variable. Someday I'd love to go back and get a Ph.D. and maybe do some more focused research but this is not that day. So without further ado, here are the most interesting raw data results of this survey filled out by 100 speech language pathologists across the country.

I'm going to add some opinions in here that should be separated from the facts of the survey. My opinions will be in italics, like this.

One of the major points the survey confirmed is that a majority of SLPs report that their homework programs are unsuccessful. So if you are feeling frustrated and discouraged with your homework programs YOU ARE NOT ALONE! The criteria for the categories was determined as follows 0-20% homework returned was defined as unsuccessful, 40-60% of homework returned was defined as less successful, 60-80% of homework returned was defined as more successful, and 80-100% of homework returned was defined as most successful.

 Here is a quick comparison of variables between the most successful group (those reporting 80-100% homework returned) and the least successful group (those reporting 0-20% homework returned).

Though I haven't run any statistics besides calculating simple percentages, the comparisons between the two groups seem to be pointing to some key elements. 

CONSISTENCY in assigning homework seems to be playing a major role in the success of our homework programs. If we are consistently giving homework, the students are more likely to be consistently doing it. Successful homework programs sent homework at least one time each week. Interestingly, it appears that assigning homework every other week or once per month is not effective. Being assigned homework one week and not the next week might be confusing the students and their parents. It is easier for them to remember if it is a consistent expectation.

The Use of CONSEQUENCES when homework is not returned was another big variable between successful and unsuccessful homework programs. Successful homework programs had a set consequence. Here's an interesting note: the type and severity of the consequence did not appear to make a difference. Most of the consequences were a simple withholding of the child's homework sticker, prize or game. As long as the consequence was well defined and consistently enforced it seemed to do it's job. Another very interesting note was that withholding "extra" prizes did not appear to be very motivating to students. For example, many SLPs report that they give their students prizes (or stickers, or other reinforcements) just for coming to speech or behaving well during speech sessions. Then on top of those rewards the student can earn even more rewards for doing their homework. While these systems may help control behavior during the speech sessions, they do not appear to be very effective in encouraging completion of homework. Try to think like your students, if you know that you'll get a prize no matter what, why do your homework?

Many SLPs left comments that said "if I gave a consequence for not doing homework, my students would hate coming to speech."  I feel like this is an unfortunate attitude among SLPs in general that may getting in the way of success with our speech homework programs. Many SLPs do not believe students are responsible enough to do it, and it may be creating a bit of a self-fulfilling prophecy. If you don't believe in them, or don't expect them to do it, then why would they do it? I loved a comment from one SLP that said "homework and good behavior are just expected of my students, they know what I expect of them and they expect things of me as well."

Here is my personal thought on consequences. They do not have to be "terrible" but they need to be strong enough that the child is at least aware that it's a consequence. Give the consequence but continue to be a happy and encouraging therapist during your sessions. I have my students call home and ask their parents to help them remember to do their homework. I don't get mad, or give them a lecture I just point to the phone. It's just something that they know they have to do. If they forget their homework one week, I don't give them a hard time the whole session, but I also don't feel like I need to let my students get away with things just so they will like coming to speech. I try to make it enjoyable and productive. 

 If you are using rewards to encourage good behavior in speech I would suggest trying to keep your behavior reinforcement system completely separate from your speech homework reinforcement system. Maybe if they behave well or come on time they will be able to participate in the therapy game, but if they forget to do their homework they do not get their homework sticker.

The SLP's Belief in the Importance of Homework also appears to be a key player in success of homework programs. 100% of the SLPs who had successful homework programs said homework is important for their students' progression. Whereas, only 58% of those with unsuccessful programs said homework is important.

SLPs with successful homework programs often had a set system to keep track of homework they had sent in the past. These SLPs in general reported more organized homework systems. Some of the great suggestions for keeping track of previous homework included writing it down in your data logs, using a homework tracker, leaving all previous homework pages in the child's homework folder (which is awesome because the student can review it at a later date and you do not have to reprint it) and other similar suggestions.

The TYPE of Reinforcement does not appear to make much of a difference in success of homework programs. Most of the reinforcements reported for both successful and unsuccessful homework programs were exactly the same and often included small stickers, prizes, candy, or steps toward a prize. There did not appear to be any "super rewards" that the kids were just dying to get. However, a good percentage of the unsuccessful homework programs reported that they did not have a DEFINED reinforcement for homework.

The Socioeconomic Status of the area did not appear to effect success of homework programs. The distribution of SES for the surveys is shown in the graph below. It was interesting to me that some of the most successful programs were in areas where the majority of the families were very poor, while other very successful programs were in areas where families were average middle class to very well off.

The TYPE of homework assigned did not appear to significantly effect the success of homework programs. The most commonly reported types of homework included: worksheets, suggested activities, suggested books to read with parents, and packets. Some of the least successful types of homework were websites and packets given over breaks.

Other interesting notes from the survey..... 

• almost all people surveyed reported a significantly faster rate of progress for students who practice homework versus those who don't.
• notebooks with secured papers appear to be more successfully transported from school to home and back again compared to loose leaf papers and packets.
• an open communication relationship with the parents seems to play an important role in the parent's willingness to help their student with speech homework. There were a lot of great ideas to keep good communication with the parents including: a communication log in the student's homework folder, email correspondence, phone calls, a good clear homework description page in the student's homework folder, attending parent-teacher conferences and others. Any communication with the parents, no matter how small or big, seems to help.
• homework assignments that were only 5 to 15 minutes were the most likely to be completed.
• elaborate and overly creative homework is time consuming and draining. Conserve your creative energy for your therapy sessions. Have a simple, but consistent homework program and I think you will be so much happier with your homework outcomes.

There are a few specific notes from this survey that I would like to discuss more in future posts. But for now my bed is calling my name and I've already spent too much time away from my family tonight writing this post. I really hope these results help someone. Have a wonderful night!

Parent Homework Survey

Thank you to all of the speech language pathologists who participated in the survey about speech homework programs. If you have not yet filled it out please go ahead and do it. So far the results are intriguing. I am noticing definite patterns that lead to success or failure. I am excited to share with everyone as soon as I am done with the analysis.

While I was reading all of your input I realized that I was only hearing a part of the story. We need to get input from the parents and students. This week let's focus on parent input. If there is any way you can get your parents to fill out this survey about their attitudes and feelings toward speech homework it would really help us understand both perspectives. I'm guessing the easiest way to get participation would be to copy the link into an email and send the email to all of the parents of your students. Or you could send a note home asking parents to go to the link. Or you could send it in the mail if you think it wouldn't get home. Please please please, we need as much parent participation as possible. Thank you.

The link is

http://www.surveymonkey.com/s/C2M7VY2

I think this is a VERY important key to figuring out what we can do to make our homework programs more successful.

Why is it so hard to get speech homework back?

Getting homework back from students is HARD! Especially in speech! I think it'd be awesome to hear from everybody what works and doesn't work with their homework programs. Please, please, please, click on the link below and fill out this survey on homework programs. It's only ten questions long and your answers do not have to be anything profound or life-altering. We just want as much input as possible so we can get a good representation of what is happening with other SLPs out there. Let's problem solve together!

Click HERE for the Survey

Homework Packets for Articulation Students

I have had a lot of people ask me what I send home as homework. For my articulation kids it is pretty cut and dry. I have 3 go-to books for my articulation kids.

• Webber's Jumbo Articulation Drill Book 
• No Glamour Articulation
• 40,000 Selected Words Organized by letter, sound, and syllable

I usually use the Webber's Jumbo Artic Book to make homework packets for my kids. I just copy the whole section for the target sound which includes pictures, lists, and sentences with the target sound in all positions of words.

If the child is working on 2 or 3 sounds I put packets for each sound in their folder, with colored paper in front of each new packet to make them more easily separated. Make sure that the copies are 2 sided or else their homework folder will be huge. I know it's A LOT of worksheets and not very specific or individual, this is why I created the homework tracker.

With the homework tracker I can write down what specific page the child needs to work on for the upcoming week. Please note, if you 3 hole punch the worksheets and secure them in the folder, they are MUCH more likely to stay in the folder. If you have them loose in the folder they are likely to fall out and get lost in transit. Make sure your homework tracker is secured in the folder at the very front.

Here are some advantages to keeping a whole packet in your child's homework folder...

• It can be used as a coloring book. I like to encourage this with my students because it makes their speech folder more fun, they also keep track of it better when they like it, and they have more exposure to words with their target sound. And when I do my quarterly probes (words the child has not practiced) to check for progress, I let the child who is not being tested color in their book while I test the other(s).
• You don't have to make a copy every session for every child. Just write in their homework tracker which sound and position they need to work on. (I also add a small sticky note on the page so they can just flip open to the page with the sticky).
• You can have the student practice certain pages again if they need more work on it. (and you don't have to copy it again cause it's still there).
• You always know what you gave as homework the week before. 
• There are weeks when I am not perfect and forget or run out of time to write in their homework tracker. I tell my students at the first of the year that if I do this they need to choose a page to work on and write down which page they worked on in their homework tracker. If they are younger, I make sure the parents know to pick a new page if I forget.

At the first of the year I run off 5 packets for each sound (well I do 10 for the most worked on sounds like R, S, L, and "th"). I have the copier automatically staple the packets so I don't get them mixed up. Then I use the schools awesome 3 hole punch machine to make sure the packets are all ready to go in the folders.

I put all the ready made homework packets in my file cabinet. It will take a lot of file cabinet space for the first week. My first sessions are always dedicated to putting together our homework folders, reviewing rules, expectations and routines and getting to know the child. Once the homework packets are distributed they will be in the student's hands instead of in your office. I keep all the leftover packets filed, in case I get new referrals or transfer students. That way I can just whip together a homework folder really quickly.

I know there are probably better ways, but I have found this a great, efficient solution to creating consistent homework that is easily individualized.

Creating a Happy Learning Environment

One of the most important things for speech-language therapists is building great relationships with our clients/students. In my experience, kids tend to learn better when they are in a happy environment. They work harder when they like you and trust you. Our profession can be so fulfilling. Or it can be a pain in the butt. It all has to do with attitude.

My first year as an SLP was a great learning experience. But looking back I was very overstressed. I had a high caseload, was trying to figure out all the required paperwork and documentation, scheduling, homework, meetings, and not to mention planning therapy sessions for each individual kid. I'm sure you all know what I'm talking about.

One particularly stressful day one of my kids actually said to me "Miss Annie what's the deal? You are usually all smiley and stuff and right now your are just blah. Are you okay?" Oh, Hello, reality check! I realized that day that my therapy is probably not very effective when my students can sense my own stress. That day it was time to "take a chill pill" as some of my kiddos would advise. I sat back and thought about how I could make things better and here are a few conclusions I came to.

1. Be a friend. Let your student's talk, and listen to them. I'm not saying spend the whole therapy session chatting, but building that therapist/client trust is really important. If they really want to tell you a story, but you don't have time, acknowledge it and tell them you want to hear about it later. My students tend to want to tell me all about their week. I LOVE this, but I need them to work. Often their story can be used in the session somehow. With a lot of my articulation groups I let them each have 10 seconds at a time to tell me whatever they want to, but they HAVE to use their good sounds and once their time is up it's the next kid's turn. I like the ten seconds things because I can just hold up my fingers and they know when their time is up. I always try to really listen and comment on their story just like I do when talking with my best friends. With my language kids I have them think about what they want to tell me until the end of the session and sometimes I give them a good couple minutes. It's a good time to reinforce good sentence structure or have them describe things in more detail. Give them time. They can tell if you like them, and you can tell if they like you.
2. Be the "teacher". Just because your students like you doesn't mean that you can't expect them to work hard. From the beginning let them know what you expect and what they can expect from you.
3. Be consistent. If you have rules, use them. If you have a schedule, stick to it. If you require homework, keep track of it. Kids thrive on routine. If you expect them to do something, let them know, and most importantly follow through with your expectations. Make visuals rules. It's so great to blame the "rules poster" instead of saying "because I said so".
4. ORGANIZE! Organizing your paperwork, schedules, routines, etc is like making a good strong foundation on a building. If you have strong organization and routine you spend less time dealing with behavior problems with the kids, you won't be as stressed and your therapy will be more effective. It takes a lot of leg work at first but once your organized you will have more time to really focus on the child's needs.
5. Make your room a happy place. I realized the day that my student mentioned my "blah-ness" that I kinda hated being in my tiny 8 by 10 foot "room" (that was really a storage closet with a whiteboard). I decided I needed to make it a happy place for my sake and my student's. A week later "The Parrot Perch" was born. I decorated and organized my stacks of paper and suddenly I felt super giddy when I walked into the room, instead of feeling stuck in a cave and the speech kids were "cool" cause they got to go to speech.

I've only been an official speech language pathologist for 3 years and there is so much more to learn! But when I started realizing these things, my life as a therapist got even better than it already was.

What do you do to help keep a happy environment in your therapy sessions?

Organizing Web Searches with Pinterest

Have you heard of the pinterest craze? Maybe you thought it wasn't for you because you don't plan on making wreaths out of all your old newspapers and headbands with all your old tee shirts. But lest you thought pinterest was only for those who reek of the craft store, let me enlighten you. This site is an AMAZING way to organize your web searches. You can use the site to "pin" pictures of anything that you find useful. You can follow people and see what they are pinning as well. It's basically twitter for visual people.

Above is a screen shot of my computer when I'm logged into pinterest. The red arrow is pointing to the most useful tool that pinterest gives you, the "Pin It" button. This button allows you to save any web search and put it in organized categories on your pinterest site. Below is a screen shot of my speech and language therapy board. When you pin something, you have to select a picture from the website to pin, then you have the option of typing notes to yourself to remember why you pinned that thing. Once it has been pinned, every time you click on that picture or "pin" it will take you directly to the website where the picture was found.

I have just started using pinterest but the possibilities blow me away! I am LOVING it! You can organize and save your internet research instead of saying, "I remember seeing that somewhere on the internet" or "I found it on some website".

On top of being able to organize your own web searches, you have the option to see what your friends or other people are "pinning". You can also search the pinterest site for pins on specific things like "language" or "articulation" and it will pull up all the pins that have those key words (just like twitter, except you aren't limited to things people have #hashtagged).

*note: if you pin something and don't provide an adequate description it will not be a useful and searchable pin to the public. if you do provide adequate descriptions it helps other who are searching pinterest find your awesome pins.

It would be so great if the SLP community could start pinning more. It would provide such a wonderful variety of therapy ideas. Pinterest is open to the public so you can roam the site and see how you like it before you sign up for an account. I would recommend going to the site and browsing by clicking HERE

On the top left hand corner of the screen there will be a search box where you can search anything and everything. You can even look me up by typing annie_slp in the search box and then clicking on "people" (under the search box there is an option for pins, boards, or people). An AMAZING pinner is PediaStaff. They have soooooo many awesome pins and boards for SLPs and OTs. Here's a glimpse of their pinboards.

Happy Pinning Everyone!

Articulation Therapy Apps: Articulate It versus ArtikPix

I've tried two articulation therapy apps recently, Artik Pix and Articulate It. Both of them are decent apps. Here's a brief list of pros and cons to both. I put a * next to a point that I think is a particularly important difference between the two apps. I'll put a brief description of how I use articulation apps like these in therapy at the end of this post. So without further ado, here is my comparison.

Artik Pix Full Version: $29

Pros:
-has pictures for all English phonemes and ability to select position in words (initial, medial or final)
-*has target sentences
-can keep data for up to 4 kids at a time
-has great feedback sounds ("yea!" when they get it right and "aw" when they get it wrong)
-has good sound models
-*ability to take data on multiple attempts of the same word
-cute kid friendly interface. note: all stimuli are simple drawings (not the best if you prefer real pictures)
-recorder built into program to allow child to hear themselves say the word
-ability to set up a matching game with goal sound
-gives percentages for each child at the end of the session
Cons:
-*can only work on ONE GOAL sound at a time
-does not keep audio recordings of student attempts

an example of the ArtikPix screen during therapy

Articulate It: $38

Pros:
-*can work with multiple students with multiple goal sounds at the same time
has pictures for all English Phonemes and ability to select position in words (initial, medial or final)
-has ability to choose target words based on manner of articulation
-has ability to choose phonological processing targets (not ideal for phonological processing therapy though)
-can review list of words before the session and deselect words that you feel are too difficult or inappropriate for certain students
-recorder built into program to allow child to hear themselves say the word.
-*recorder saves audio files for individual students. Can be emailed or listened to anytime during or after the session. I LOVE this feature!
-provides list of words that were scored correct and incorrect
-gives percentages for each child at the end of the session
Cons:
-*scoring feature does not allow for multiple attempts of the same word (can only score once for each word)
-*does not provide target sentences (can be remedied by just having your student make up their own sentences)
-some of the sound models have distorted vowels and a few are even articulated wrong! (for example the audio says "box" for a picture of a "fox")

an example of the Articulate It screen during therapy

How I use articulation apps in therapy:

• Use app as target stimuli
• Have student practice the word or put it in a sentence or story.
• Record it every few turns
• Let the student judge how they did (they get to take the data on the iPad, they think this is the bee's knees!)
• Take data on usual paper data logs. Even though there is the option to keep data using the iPad, I still much prefer taking notes on paper data logs for a number of important reasons including...having a paper record is important, it is not prone to technological error, the kids can't mess it up, it can be hidden (for those kids who are overly sensitive to getting it wrong), I can take notes easily without having to take the iPad away from the kids, I trust myself more than the machine.
• Incorporate games and/or rewards after a number of attempts or a given time period (if you just use the app it can get pretty bland)

Notes:

• The apps are great, but they are limited. If you used these as your only articulation therapy targets your kids will quickly get sick of the 60 or so words on the target lists. It is important to keep a big articulation book around like Webber's Jumbo Articulation or No Glamour Articulation since they have hundreds and hundreds of words for each sound in each position.
• I think if I had to choose between the two apps I would choose the Articulate It app because I love the option of working on different goal sounds at the same time and the ability to save audio recordings for each individual student is amazing!
• The Articulate It app would be ideal for probes to measure baselines and quarterly progress. Keep in mind that if you are using this app as a progress probe, you should not use it in your weekly therapy.
• I have heard of a few other apps like these (for example, PocketSLP) but since articulation apps are relatively expensive I decided I would just try the two for now. Have any of you tried pocketSLP or other articulation apps?  Which ones are your favorite?

Using the iPad as a speech & language therapy tool

Well it's been 3 weeks back at work and I tell you what, speech language pathology is a mighty fun job! If I'm gonna leave my cute baby it sure as heck better be for a job that I love. Lucky for me, I'm an SLP! Thanks to everyone who reads the blog! You're emails and comments are awesome! I'm glad to say I'm back in the blogging world.

The newest development for my speech room this year is that our school district got a grant that bought iPads for all of the SLPs. Isn't that awesome! I've been trying it out in my therapy sessions this week. I have to admit it hasn't "rocked my world" like I thought it would but there are some serious advantages to having an iPad as a tool in therapy. Here is a brief list of pros and cons after this test-run week. Keep in mind I'm new to the iPad. But it's a pretty intuitive device, even for people who are not technologically savvy.

Pros:

• Storage solution! The IPAD is a great way to store an incredible amount of therapy stimuli in a small portable device. It's an unfortunate but true fact that most speech pathologists work in tight quarters. That is, if they are lucky enough to even have a room. For example, if you looked at the master map of my school last year, my speech room was labeled as a "closet". I know many SLPs across the country don't even have a room to do therapy in. The ability to carry around a huge variety of material on one small device is a serious advantage that can't be overlooked.
• Access to A LOT of Materials: There are so many apps out there it can be overwhelming! But it is nice to avoid buying tons of books from Super Duper or Linguisystems or other publications, then wait for them to be shipped to you, then find a place to store them.
• Easy simple data tracking. Most IPAD apps for SLPs have built in data tracking and a lot of them have the ability to track data for multiple kids at a time. Very cool.
• Voice Recording and Video Capabilities. We all know self-monitoring is absolutely necessary if the student is going to use targeted skills in their every day life. Voice recordings are among my favorite tools to help a student develop their self-monitoring skills. A lot of the articulation apps have recording features that I really love. I'm also loving the video feature with my language students. I can give them a scenario to role play or record them in actual interactions with friends. It's fun for the kids to see themselves and we can pause and discuss what they did great and what they could do better next time.
• Conversation Starters at your Fingertips: You can use the iPad for some pretty sweet conversation starters. Just look up kid friendly websites with articles about things they're interested in. Pull up some funny pictures and have your kids describe them. Watch a short video clip and have your students try to role-play it.
• Motivation: Come on, don't tell me you haven't heard of the game Angry Birds! And if you have been living in denial of the days current obsession with "Apps" believe me, your students haven't. Sure, it's slightly terrifying how "hooked on devices" the world is becoming, but why not use it to your advantage to get some good quality work out of your students. 28 minutes of hard work for a 2 minute game at the end is a pretty good compromise.

Cons:

•  Data Holes: This may be my lame, old-fashioned dependence on paper and pens but there are some "holes" in relying on the IPAD to track your data. Sure it is nice to say "yea" or "nay" just by the click of a button and then have that fancy device ring up the percentage as you go. But hopefully nobody depends completely on these cut and dry data trackers. Technology can't take the place of a good speech therapist. One of the things I love most about our profession is that it requires us to always be on our toes, actively thinking about what will benefit our students/clients the most. Adapting our therapy to the needs of the individual kiddo. Listening for patterns, identifying appropriate future goals, etc. For me, it's a lot easier to keep notes on how little Johnny is responding to certain techniques or write a reminder to work on a different goal when I have a piece of paper in front of me. Instead of taking the IPAD from him in the middle of it all and saying, "hold up! I gotta type in a note on this thing." I do have to say, there are some promising data apps out there and I might eat my words as I try them out. But from this week of working with the IPAD I find that either you use the IPAD as your stimuli and take your data on your usual paper logs, or you use the IPAD as your data tracker and have flashcards, games, other things as your therapy stimuli.
• The "EASY" Planning Trap: SLPs are genius' at "winging it", right? With 80 plus students on your caseload per week there is no way you will plan out every minute of every session with every kid. I sincerely hope that these ready made apps do not encourage any SLPs to become lazy about analyzing their students and adapting to their needs. I guess what I'm really saying is, it is best used as a supplement to therapy, not a replacement. However, I find SLPs as a whole to be a very unlikely group to be lazy.
• It's Not "Natural": Remember sitting in your graduate courses and hearing your professor emphasize the importance of a "naturalistic" setting. I'm pretty sure the IPAD is the opposite of that "natural" setting your professor was talking about (though it can be used to encourage some great conversation as noted above). It'd be fancy if your student could perfectly repeat a sentence that the IPAD chanted to her but it's useless unless she is talking appropriately with her teachers and friends. 
• It's Expensive: Remember how we all had to shell out the big money to get our master's degrees but most of us make less than someone with the average 4 year degree? Yeah, we're not made of money. So, if I hadn't been given an iPad to try out I probably wouldn't have the iPad leap right away. The iPad itself would take a large chunk of my monthly paycheck and the cost of the applications can add up quickly. So even though it's pretty neat, I would probably use the money to pay off my student loan instead.

These are just a few of my thoughts on the iPad. It's great, but it didn't change my life. Overall, I'm liking it as a supplement to therapy. I'll write a post on some of my favorite apps soon.

What are you thoughts on the iPad? Do you love it? Do you hate it? Please share!

Rules are IMPORTANT!

Wouldn't it be awesome if all of our clients came with little halos and had perfectly angelic behavior? Well we all know that is not the case. Honestly, their little quirky personalities and hyperactive smiles make my day, so I'm glad they aren't drone-like. However, sometimes it is necessary to bottle up their overflowing enthusiasm. I quickly found out my first year that it was absolutely 100% necessary to have rules in the speech room. Having them posted with visuals (for those who can't read yet) and using them consistently is also key.

I have this thought that it would be awesome next year to start the year off making a "behavior contract" with my students. We would have a discussion the first day about their goals in speech and what they hope to accomplish. Then we would write a goals sheet and keep it in the front of their speech homework folder. Then maybe we'll have a discussion about why how we speak matters, why we need to work hard and why messing around during speech would get in the way of those goals. Then we will make the "behavior contract" and both sign it. Good idea, right? Well I'll let you know how it goes this fall when I try implementing that with my students.

What rules/behavior systems have you found to work best for you with your speech kids?

These are my rules from this year. It's been good to have a visual and I love that whenever I need to help a kid remember that being on top of the desk is not really where they are supposed to be I can just say "Hey Drake, Remember Rule #4" and then point to the picture. Then Drake says "oh yeah, vats da one I always foget!" Gotta love that kid!

Building Routines in Therapy

This year I did a little experiment with having a set routine for my articulation groups. The reason behind this was a ridiculously large caseload and the need to make the most efficient use of my 30 minutes with each student. I decided to email all of the 76 SLPs in our school district and ask them what they did as part of their therapy routines. Still being relatively new to the field I love to hear how other people do their therapy. Here is the little routine I came up with for my 30 minute articulation groups.

WHAT I DO WHEN I COME TO SPEECH

1.       Turn in my HOMEWORK!

a.       1 sticker for any homework done this week

b.      Homework Heroes ticket for 5 days of homework (yippee!)

2.       Get SOUND CARD and start practicing (out loud!) to see what the sound cards are like click HERE

a.       Get the sound I am working on this week

b.      Put sound card in return box when I am done

3.       CHECK FOR PROGRESS on homework to see some progress charts click HERE and HERE

a.       Update progress chart! (I hope I got better!)

4.       PRACTICE, PRACTICE, PRACTICE my speech sounds (that’s why I am here!)

a.       I can play a game if I did my homework 

b.      I cannot play a game if I did not do my homework 

c.       5-10 practice sounds/words/sentences = 1 turn at the game

5.       REVIEW HOMEWORK for next week (so I know how and what to practice at home)

a.       Make sure it is written in my homework tracker

6.       WRAP IT UP! It’s almost time to go!

a.       Put sound cards back on the wall

b.      Update progress charts

c.       Push in my chair

d.      Go back to class

PUT MY HOMEWORK IN MY BACKPACK so I can practice every day!

The routine is posted where every student can see it and it has pictures to help them remember. It has made my therapy a lot more effective this year. I might have to make some adjustments. 

 

Here's the small handout I made for our speech department meeting.

What are some things that you find effective in your therapy routines?

Scheduling Tips for Elementary School Speech Language Pathologists

Scheduling is one of the more difficult aspects of a school speech language pathologist's job. Teachers and parents are rightfully unwilling to let their students be pulled out of class during important class lessons and activities. On top of that there are recesses, lunches, and prep times (art, computers, dance, etc) to work around for 50-80 individual speech students.

Then there is the style of your therapy to consider. Some SLPs prefer to do their interventions within the classroom and others prefer to do their lessons in a pull-out format where the student participates in speech therapy in a separate room. I think in-class and pull-out both have good and bad aspects. But I have had a lot of good success with weekly half-hour pull-out therapy sessions with groups of one, two or three students at a time (depending on severity and goals) so I generally stick to that format. However, I reserve the right to change my philosophy on service model in the future if research suggests one is better than the other.

Here are the steps I like to take each year in setting up my schedule.

• Make an accurate, up-to-date caseload list including full name, grade, teacher, area of treatment (articulation, language, functional communication, fluency, AAC, etc.), and service time.
• Organize the list by grade.
• Split into groups of 2 or 3 students, ideally a group of 2 from the same teacher's class and with the same area of treatment. Believe me, I know it doesn't always work out perfectly. Try to keep the student's in groups with similar goals and ages.
• Inform all general education teachers which students in their classes have speech/language services. 
• Ask the administration if they have particular days and times for regularly scheduled assemblies. If there are, try to avoid scheduling any students during those times (hard learned lesson this year with my Thursday afternoon groups!)
• Write down any weekly meetings you are required to attend (faculty meetings, special education team meetings, ect.)
• Be aware that Mondays and Fridays tend to have a lot of holidays when you work in a school so you may miss students scheduled on those days more than others (these are pretty good days to schedule your testing times).
• Make a rough outline of how you want your weekly schedule to be. Make sure to include a consistent lunch break of at least 30 minutes, some amount of planning time each day, any required meetings, and at least one morning and one afternoon testing/evaluation slot (to evaluate new referrals or observe students in class).

Now, you have a lot of options of how to actually set up your schedule once you have all of this information. The first year I set up my schedule I tried to figure out the recess, lunch and prep time schedules for each kid and work my schedule around that. It was a NIGHTMARE!  and I ended up sacrificing my lunch break, which was no good.

Last year I tried a new scheduling technique and it was soooo much faster. You can do the same idea without sticky notes but I found the sticky notes helped move the process along pretty quickly.

Sticky Note Scheduling Strategy:

• Get your group list you made earlier.
• Write the names of each student in the group on the same sticky note (each sticky note represents 30 minutes, so if you have a student/group who needs to come 60 minutes weekly make sure they have 2 sticky notes)
• Write your rough schedule on a large poster board, or on a whiteboard with time slots big enough for the sticky note to fit in (use wet erase marker if you do this)
• Send an email to the teachers informing them that you will be requesting their input for when to take their students for speech services. Let them know how many speech groups from their class you will be pulling out (e.g if there are four speech students in their class, there will probably be two groups and the teacher will need to think of 2 time slots during the week). Make sure the teachers know that they need to double check all recess, prep, and lunch times for their class.
• Tell all teachers the day and time you will have them come sign up for times.
• Tell the teachers that your schedule fills up on a first-come-first-serve basis (this is such an awesome motivator for them to look at their schedules right away).
• Give the sticky note with student names to the teachers prior to sign up day. (if there are multiple teachers make sure they know they need to get together to decide on a time)
• On the day of the schedule sign up have the principal or secretary announce over the intercom that all teachers with speech students need to go to the speech room to sign up for a therapy time. Make sure  the announcement is clear that it is first-come-first-serve.
• Wait for the stampede of teachers (they literally ran to my room last year! Hillarious!) 
• Have the teachers place their sticky notes in the half hour slots on your big schedule. Once the slot has a sticky note it is gone. 

This gives the teachers a say in when their student is pulled out and gives them the task of checking their own class schedule to make sure it does not conflict with any recesses, lunches or prep times. This saved me HOURS of work and was relatively easy for the teacher since they usually know their schedules well.

I copied this blank schedule onto a clear transparency paper. I use wet erase marker to write in my groups. This is great because as a school SLP my schedule changes so often with graduations and new referrals and if I need to make a change all I have to do is erase the one slot instead of printing a whole new schedule.

*I just got a comment from an amazing SLP blogger and I think the sticky notes idea may have originated from her blog. Here is the link to her blog post about it. It shows an awesome picture of how she did it. http://ifonlyihadsuperpowers.blogspot.com/2010/10/scheduing-for-speech.html

Charting Progress for Articulation Therapy

Progress charts are an amazing visual tool to use in your therapy. It helps the child understand and see their progress and gives them motivation for improvement. I am a HUGE believer in homework and daily drill with my speech clients. Usually the weeks where my students have a lower score than the previous week it is because they have not practiced their homework. Using a progress chart helps my clients feel more accountable for their improvement. We always celebrate any improvements and discuss all the possible reasons for regression. It is important that you let the client try to figure out why they didn't improve instead of pointing your finger at them and making them feel terrible. When they realize for themselves that they are in control of their improvements they always work harder and have a better attitude. I have made a number of different progress charts over the years. Last year I used this one. It is good, but it was hard for some of my clients to understand why we were charting the different positions (initial, medial, and final) on the same chart. So I decided to make a new one to help them better visualize which positions were easier and harder for them. Here it is. I am having a lot of success with it this term but I'm sure I'll be tweaking things like I always do.

You can get a copy of this progress chart by going to my Teachers Pay Teachers website (seller name annieSLP) or copy and paste this link into your URL for the direct link to the artic progress chart:
http://www.teacherspayteachers.com/Product/Articulation-Progress-Chart

working file binders

Working files are a work in progress for me. Read this post for ideas on organization of working files.

Everyone does there working files differently and that is good because everyone thinks, organizes and plans differently. I am still trying to find the best system for me. Last year I had separate manila file folders in alphabetical order in a file drawer in my desk. It worked but it wasn't the most efficient to have to pull out the file every time the kids came and then refile it every time they left. It just took time. and time I did not have. This year I decided to try to rework my working file system to be more efficient. I am putting working files in the order that I service each child and separating them by service days.
Now I can just pull out the binder I need for that day. A colleague of mine showed me these wonderful binder inserts with tabs and pockets on both sides that I now use as my working files.

The student's name obviously goes on the tab. The front pocket of the insert has the student's current data and IEP goals. Behind the current data are any baselines and target probes done throughout the year. In the back pocket is the attendance log, treatment cycle, and treatment data log all stapled together. So far this is working out pretty well. But I'm sure I'll be tweaking things next year too.

One of the things I love best about our profession is the flexibility of how to structure and set up your own therapy. There is not set way to do things. You are free to do what you feel is best according to your professional judgment. The tricky part is figuring out what works best for you and your clients/students.

How do you do your working files? What have you found to be the best and most efficient ways?

Organized Paperwork = Easier, More Effective Treatment

Data logs don't necessarily have to be meticulously organized. They just need data, right? However, there are some visual tools you can put in your data logs that can make it easier to check up on your students' with just a glance. My goal with this new school year is to have more organized data in my working files. Here are some forms that I will include with each file this year to hopefully simplify the process of searching through my data logs. I have put examples of how to use them on the blog but you can get a copy of the forms on my teachers pay teachers website. Click HERE for the link to my little TPT store.

Forms include:

• Speech Language Therapy Attendance Log (I use this as a cover sheet to my data)
• Speech Language Treatment Cycle (I put this on the back side of the cover sheet, it serves as a visual to see if I am spending appropriate amount of time on each goal)
• Articulation Therapy Data Sheet
• Articulation and Language Therapy Data Sheet
• Language Therapy Data Sheet

Schedule Boards

Holy Smokes have you ever used a schedule board? They are the best! This is my schedule board that I used this year for about a hundred-million different things. It was so useful in so many ways. I know I know it's just a black poster with a bunch of numbers velcroed on but seriously this beauty rocks my world! Read more of this post to find 6 ways to use a schedule board in your therapy.

Here are a number of uses for this fabulous therapy tool

Evaluation Count Down. When evaluating a kiddo I usually put up a number for each subtest that we need to do. After each subtest they get to take the number off the schedule board and put it in the "all done" pile. It helps them feel a sense of accomplishment and know how much more is ahead.

Incentive to work! I use it all the time to help little munchkins who have short attention spans. It is a visual that helps them know that they have to get so many "things" done before they get a break. Example of use with animal artculation cards below. Make sure that the child knows what they get when they complete the work and provide that reinforcement immediately. This kid LOVES bubbles so I always use the bubbles. Please observe the fabulous butterfly bubble bottle that I got at some wedding four years ago and is now an essential part of my therapy. One of my professors once said that bubbles were like crack for kids. He was right!

Picture Schedule. I use this with a few of my autistic clients. Autistic children are very visual and really crave routine. The schedule board shows them what they can expect to do in a session and what happens at the end.

Sequencing. The numbers are great to help children organize sequences of events.

Sentence Pacing Board. If you are working toward a longer MLU and the child needs a more structured approach you can use the numbers to make a pacing board. Put out 4 numbers if you want the child to use a four word sentence. Put your hand on the numbers as you say the words (e.g. for the phrase "the ball went down" touch 1 for "the", 2 for "ball", 3 for "went", and 4 for "down"). To fade this cue out try clapping instead of pointing to the numbers and then just doing it with a melody and then without any cues at all.

Multisyllabic Words Pacing Board. For kids who struggle articulating multisylabic words try breaking them up into the number of syllables. (e.g.watermelon can be broken up into 4 parts wa-ter-me-lon)

The possibilities are ENDLESS!

Time Timer

During therapy sessions sometimes it is best for the client and the clinician to have a visual reference to let them know how much time is left in the session. The Time Timer is my favorite for this. It is a timer that SHOWS you how much time is left. It is particularly great for young kids and low functioning clients but so fabulous for everyone. The smaller amount of red...the less time. It helps me to not go over time with my kids and it helps my kids pace themselves. It's a great therapy tool!