Review of the book, Speech Language Pathology & Related Professions in the Schools By

This book was published in 1993, It was written to support new SLP grads in their role as part of

a multidisciplinary team in the school setting. The book has 13 chapters, each addressing a

component of providing speech therapy services in the school setting. Topics covered included:

● Integrating speech language programs into the school curriculum.

● The law and the school professional

● Audiology

● Education of deaf/hard of hearing

● Special education teachers

● Psychological assessment

● Learning disabilities

● PT and OT in the schools

● The multidisciplinary team

● Common health problems in the school

● Communicating with parents and teachers

Each chapter was written by a relevant professional, ie. the Audiology chapter was written by an

audiologist. The chapters gave a broad overview of the topic and it’s role in the student’s school

plan.

In reviewing this book, I found the following components of this book advantageous:

● Some chapters discussed specific disabling conditions and characteristics that may

impact the communication skills.

● Suggestion lists for working with different populations.

● Tips on how and why to communicate with parents/teachers.

● It’s a handy resource with brief overviews of MANY issues one may encounter as a new

SLP.

The concept of this book is excellent. A resource for new SLP’s as they begin providing services

as part of multidisciplinary team is a valuable tool to aid in developing a gestalt for the school

setting.

That being said, this book is older than some of our current SLP’s. Not only is there outdated

terminology (mentally retarded?!), the scope of services described for some disciplines are not

as broad as they currently are, and some of the medical information (regarding common health

problems….the biggest section was on AIDS).

And for the part everyone has been waiting for…..application. Is there a takeaway for the

current SLP in 2018? I will share the timeless information that resonated most with me is

regarding open communication with parents. Tips shared included:

1. Utilize effective helping. In a nutshell – it’s the old saying, teach a man to fish and he’ll

eat for life.

2. Assume a positive and proactive stance or belief in the strengths of the parents. ***This

one is a biggie y’all.**** Read this one again. Chew on it for a minute.

3. Respect and honor the cultural diversity of families. Wowza – this is a huge focus for our

district this year. Let’s be less judgey as SLP’s when we talk about our students names

and nicknames. Those are cultural things. Let’s not be judgey about some families who

wean their children later as part of a cultural practice.

4. Be an active listener. If you can do this, then you won’t have to try as hard for #2.

5. Make your meeting locations a comfortable environment. We don’t have a ton of control

here….but we can make sure the parents get the comfortable chairs. We can have

tissues, pens and notepaper available.

6. Avoid professional distancing. This is something we all slide into….stop using so much

jargon. Stop speeding through reading reports and goals….this educational language is

like a foreign dialect to parents. We, as SLP’s, can and should model effective

communication during IEP’s AND advocate for parents when it appears they are lost.

7. Use positive non-verbal communication. Enough said.

8. Use open-ended questions. Tell me about…..Explain how…..Tell me more….

9. Provide appropriate written materials. Written in parent friendly terms

10. Prepare systematically for meetings with parents. Plan what you will say, the data you

will share.

11. Develop methods to communicate with families based on their preferences. E-mail?

Communication notebook? Texting?

–Chelsea Graham

 

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Chapters 109 and 111

Chapter 109

 

Finally we have a clue to who the famous Siobhan is!  This whole time I have not been able to figure out how to pronounce her name and everytime I read it I would say it differently in my mind.  It’s pretty ironic because she has been a mystery in the book until now…is she a student (no Ms. or Miss)…. an adult friend…SLP maybe…who is she?  The first real clue of her real identity comes when the author writes about her having a cup of coffee (ok…I assume an adult) and sitting at the playground “with the other teachers.”  Bingo! She’s a teacher at his school who seems to understand and relate to Christopher in ways others do not. He feels comfortable enough to talk to her about his personal life and intimate details such as his conversation with Mrs. Alexander in which he felt close enough to share with her.  She asks him questions to see what he will do and how he feels about finding out about his mother and Mr. Shear’s affair. He says he is not upset and always tell the truth. Siobhan then kind of educates Christopher on sad feelings and what others may feel or do to mask their sadness. She also tells him that he can always come and talk to her about it. He is lucky to have someone that has knowlwdge about Spectrum Disorders and can talk with him where he is.  Christopher thinks it’s stupid to feel sad about it because his mom is dead and Mr. Shears is gone…so it isn’t real and doesn’t exist in his mind.

 

Chapter 113

 

Christopher tells us his memory is like a film.  I started to think of the movie “Rainman” and Jeopardy being on at 7:30 and having to buy underwear at KMART…well we know what his brother thinks of KMART!  Back to Christopher…he says that he can “press” Rewind, Fast Forward, and Pause like a DVD player when people ask him to remember something. There are no buttons like a DVD player, but all memorized in his head.  He talks about an example of a holiday he took in 1992. He gives details of his mom. He can go into his DVR and remember what she was wearing, what she said, and even what book she was reading at the time. This memory leads into where the “hand thing” came from to connect and calm him down without too much human physical contact.  When his mom jumped backwards and disappeared into the ocean, Christopher started screaming thinking she was eaten by a shark. His mom stood back up, walked toward Christopher and held up her right hand up with her fingers spread like a fan. His mom asked him to listen to her, stop screaming, and touch her hand. After awhile, Christopher trusted her and touched her hand as his mom comforted him with words like, “It’s OK, Christopher.”  Here is the important part- he then felt better!

 

He then talks about how he does a “Search” through his memories to remember people and figure out how he is supposed to react in a certain situation based on past memories.  When figurative language is used or confusing situations happen, he goes back into his DVR and tries to figure out what that means or how he should react. He also talks of other people having pictures in their head as well, but these pictures aren’t real and didn’t happen.  Like when his mom was day dreaming aloud about if she didn’t marry his father and would be living in France in a farmhouse sipping red wine. That made no sense to him…it wasn’t real. Siobhan also shared what she does to calm herself when depressed to feel peaceful. Again…wasn’t real so what is the point.  The chapter ends with Chistopher talking about his Grandmother having pictures in her head, but they were confused, not in sequence, and did not make sense which leads me to think she has Dementia.

 

-Kim Raho

 

Chapter 127

In chapter 127, Christopher has just come home from school. He sets his belonging down in the kitchen, including his “detective book”, and continues on to watch some non-fiction TV. He remarks that he likes this particular show because he likes to imagine living in these deserted places, all alone. When Christopher’s father comes home, he says “howdy, partner”, trying to be funny, but Christopher simply responds with “Hello,” clearly not comprehending that his father’s attempt at humor should encourage him to be humorous in return. After this point, the crap hits the fan, so to speak (not that Christopher would understand that particular figurative language).

 

Christopher’s father goes into the kitchen and discovers the detective book, in which Christopher has documented all his conversations with neighbors and his work in trying to discover the dog’s killer. When Christopher’s dad comes in the room, he asks quietly (albeit with pretty harsh and vulgar language), what the book was. As Christopher states, his father was not yelling, so Christopher did not interpret his words as being angry. This is another instance where Christopher’s lack of social awareness and theory of mind have had a negative impact on his comprehension of conversations. Christopher answers his father’s questions truthfully and very “matter-of-fact” as he does not notice his father’s anger. It is not until his father raises his voice and grabs Christopher’s arm that Christopher realizes how his father is feeling. The more emotional Christopher becomes, the less he is able to answer his father’s questions and to understand the conversation. He does not like to be touched and does not like surprises, so he reacts almost instinctively and hits his father. The situation escalates and Christopher “blacks out” and does not remember much. He just knows time has passed by looking at his watch. Christopher likens his “blacking out” to being “switched off and switched back on”. After Christopher is “switched back on”, he analyzes the scene. Again, he is very descriptive about what he sees: his father breathing slowly and deeply, the book being bent and the edges torn, blood on his own hands, and a scratch on his father’s neck. His father leaves the room, throws the book in the trash (or so Christopher assumes), and returns into the room and states he needs a drink and gets a beer. Christopher can see all of this, but still does not seem to interpret the meaning behind his father’s reactions. He does not seem to understand that what occurred was volatile and emotionally and physically exhausting to his father. He makes no move to try to talk to his father or to even understand what happened when he was “switched off”. I see similar events happen very often with my students on the spectrum. They often times only hear the words, and lose the emotional meanings behind them. I see this a lot in their lack of understanding with sarcasm. I also have had students who have become physical when angry and after the incident, they say they cannot remember what happened.

–Rachel Lacap

Tech Tuesday

Michelle Hughes shares:

I have many apps that I have gotten over the years. Many of them were purchased when they were on sale. Many app companies, such as Smarty Ears, will have a selection of apps on sale for parts of May. Here are a few of my favorites that I use in therapy:

 

Articulate it by Smarty Ears

I like this app because it can record a student’s response and also accesses the video function so the students’ can get visual feedback. It will track data and send you a report. I use this feature for my student’s to take their own data and then compare their data to mine. My kids like that you can change the background theme by month or holiday.   Dislikes—the program gives each student only 1 turn before moving on to the next student. I wish you could adjust the number of pictures a student can receive on each turn. Overall it is a great program. Cost: $47

Expressive Builder by Mobile Education Store

This is a simple app that has many bright and active pictures. It records the student for feedback and allows you to save the recordings. It has 3 levels of “hints” for students having difficulty with sentence formulation. You can also import your own photographs into the program easily. Cost: 9.99

Asperger Syndrome: A Social Skill Curriculum

My first thought about the title was that the term Asperger is now outdated but professionals continue to understand that the term typical means the person has significant deficits in social language and that their intelligence is usually average to above average.  The first part of my blog post includes the vocabulary and review of terms and deficits that author presents.  Much of this will be review for most therapists but I found it helpful to review the terms and see the areas of difficulty highlighted.  I could possibly refer back when developing goals.  The middle part involves ideas with how to structure group intervention.  The last part of the post will be activities suggested.  There were A LOT, so I just picked several from each area for each age group, along with the page number if you wanted to look up that particular activity.  Many are self explanatory and most involve students being in charge of part of the supplies needed so that there is opportunity to practice asking for supplies, turn taking, problem solving, etc.

 

DEFINITIONS

The book begins by providing definitions for common terms when working with people with autism.  Theory of mind is the understanding of others perspective.  The book gives the example of a man walking out of a shop, runs back, comes out slowly searching the ground.  If you use theory of mind, you can make an inference that the man has likely lost something.  Our students who are working on developing this many be confused as to what is going on.

The next term is epistemic words, which are words that reflect internal knowledge or action.  Some examples of words include think, feel, hope (verbs), thoughtful, happy (adjectives), sadly, wishfully (adverbs).  The author referred back to the man in the shop example.  The author states “actions would seem unusual if lacked ability to understand mental state words.”  Therefore, if a child has no understanding of epistemic words, then they will likely have difficulty understanding story plots and character perspectives.

Basically, if you have an underdeveloped theory of mind, you will interpret messages literally.  This made me think about the impact it would have on a student for reading, interpreting vocabulary, multiple meaning words, and anything with a figurative or literal meaning.  According to the author, effective communication is achieved when speakers and the listener use theory of mind to structure the conversation.  Additionally, when you use pragmatic skills, you know to organize information to communicate more effectively.

MY THOUGHTS: After reviewing all of this information (I’ve heard it many times over the years) it reminded me how much difficulties with social skills can impact reading and class discussions.  It almost made me feel a little overwhelmed at all the ways the students with Autism need to be explicitly taught things that many of us acquire through observation and experience.

The author then discusses the challenges for children with Asperger (and I feel like it applies to all children with autism).  The areas are social competence, executive function, friendship, nonverbal communication, academic achievements, self-management, sensory perceptions and motor skills.

Social competence: ability to accomodate and adapt ongoing social skills by rapidly reading social cues

Executive function: higher cognitive abilities to plan long term, choosing/initiating multi tasking, organizing.  Can also be perceiving emotions/recognizing facial expressions.  May exhibit difficulty with pretend play and planning as well as stopping a task.

Friendship: follows sequence of development.  Start playing next to a child, then with a child along with sharing and turn taking.

Then reciprocity (friends help and support each other to facilitate friendship.  THEY MAY NEED ASSISTANCE UNDERSTANDING THIS ASPECT SO PRACTICE GIVING COMPLIMENTS, SHOWING CARE AND COMPASSION AND HELPING OUT WHEN NECESSARY

Nonverbal: facial expressions, sarcasm.  May misunderstand jokes or conversations.  This can lead to social ridicule or isolation.

Verbal communication: Children diagnosed with what was previously referred to as Asperger typically have normal early language development with syntactic, semantic  relatively normal and pragmatics impaired.  Difficulties typically with conversational turns, eye contact, initiating and maintaining a topic not of their choosing.

Academic: difficulty with central coherence, combine diverse information to construct higher level meaning and make sense of situations and events.

Self Management: Includes 4 categories and typically need to give direct instruction in these areas

  1. Self-monitoring
  2. Self-assessment
  3. Self-instruction
  4. Self-reinforcement

Sensory Perception: difficulty with sensory domains (visual, auditory, gustatory, olfactory, somatosensory, vestibular, proprioceptive)  If not effectively perceived, organized and processed, may result in the unusual behaviors we see in kids with AS.

MOTOR: often described as clumsy.  They can have difficulty with movement, balance, handwriting, scissor use, rhythm and hand-eye coordination  Possible accommodations could be keyboard or pairing a highly desired activity with a motor activity.

 

GROUP INTERVENTION

Rules must be established.  The author mentions that it is very important to include the student  with establishing the rules but monitor.  The author used the example thatt one student said “no wigs.”  The author talked to the student and asked if wigs had ever been a problem.  WHen the response was no, they decided that wasn’t a necessary rule.

Themes:   allow for consistency session to session and increase redundancy of concepts being addressed.  THEY ABSOLUTELY NEED REPETITION AND REDUNDANCY TO FACILITATE THEIR LEARNING.

The author provides some theme examples: trip around the world. Problem solving olympics, science, history, holidays, secret garden, a day at the beach, books to read, community helpers.

Conversational skills:   These must be actively incorporated, greetings explicitly targeted (often fail to greet and close during social communicative exchanges.  Be sure to take baseline so can target appropriate number of conversational turns.  Lunchtime groups are becoming popular.

Problem Solving:  In every treatment sessions, all participants needs to be included with role for ultimate end product.

Games: The author suggests repeating the mantra “Sometimes we win, sometimes we lose.  It’s just fun to play the game.”      Help the students to win and lose graciously to foster friendships.

Role Play:  helps view situations from perspective of others.  The author suggests the following activities, writing a play (playwright), acting it out (actor), present book reports (book reviewer), etc.  You should consider each child’s unique talents and interests.

Reward system:   This is something that should be agreed on by group and should be simple.  Have them vote and that’s important because the author says that it lets them know they don’t always get what they want and typically majority decides in real world.

 

Principles of Group Intervention

Participants: grouped according to individual needs, deficits and developmental/age level

And structure session.  The author stresses always starting with sharing personal information and all other things can go in any order.  They provide the following example order:

  1. Sharing personal information-monitor share time
  2. Group problem solving
  3. Group game playing
  4. Scripting and role playing

REFLECTING ON OUR SESSIONS, WE MAY NEED TO EITHER CUT OUT A STEP OR 2 OR REDUCE TIME OF EACH STEP.

 

ACTIVITY IDEAS

The author breaks activities down in 3 group

3-5

6-9

10-12

I found that almost every activity could be adapted to increase or decrease complexity.  I also found that they could work for almost anyone with some modifications.  Within the age groups, they break down the activities for specific skills.  I will highlight some I thought were most practical for us to do and the ones most easily adaptable.  They were many I did like but could not include because the time it would take to type it all out.  If you have groups that would benefit, I highly recommend borrowing the book from the speech office.  It’s a quick read and there are so many ideas.

I include the page number so if you want the entire activity with materials listed, you can reference it easily.

 

AGES 3-5

Activities that target cooperative skills: indoor fall hike (p.20), plate faces (24), seasons book (25), favorite things collages (26)

Activities that target eye contact: guess who (31), dice talk (32), obstacle course (51)

Activities that target turn taking: farm song and play (43), animal imitation (44)

Activities that target pretend play: zookeeper (53), I am a pet, who am I? (55), what’s for dinner (57), car wash (59)

 

AGES 6-9

Activities that target cooperative skills: house collage (69), sponge painting an ocean (71), making trail mix (73)

Activities that target eye contact while speaking and listening: red light, green light (82)

Activities that target using facial expressions to convey feelings: expressions charade (87), track meet (90)

Activities that target turn taking in a group: pumpkin decorating (95–could possibly do a contest for each group so they work as a team), floor puzzles (96), watch the leader (97), Fly, Mr.Bird (99), snack with feeling–texture, taste, etc (106)

Activities that target role play: safety at home (111), community helpers (113)

AGES 10-12

Activities that target cooperative skills: name the border (117), power tower (118), unusual card game (122), no cook oatmeal cookies (123)

Activities that target eye contact when speaking and listening: partner interview (127), I’ll be your server (129), Name game–alliteration (130), Get off my back (134), Here’s looking at you (135)

Activities that target facial expressions to depict emotions: facial expression collage (137),  alphabet expressions (138), what to do it… (143), take a deep breath (146)

Activities that target turn taking: treasure hunting puzzle (147), build a robot (148), magnet play (151

Activities that target topic maintenance: outside invitations (157), story creation (158), spinner talk (160), occupation collage (161)

 

 

In summary, I liked that this book was an easy read but gave me a good review of information that is helpful when designing groups and working with student with Asperger.  The activities offer a great variety of (mostly) easy activities to gather the supplies and execute well in a group.  I like how most were easily adaptable and how they list skills the activity can target.  I’ve worked with students with Autism for years but sometimes it still can be a challenge to figure out what to focus on and activities that may facilitate growth with the goals.

–Sarah Coty

Chapter 107

In this chapter, Christopher discusses aspects of The Hound of the Baskervilles, which is his favorite book. He describes an event in the book where Sherlock Holmes and Doctor Watson are visited by James Mortimer. Mr. Mortimer’s friend, Sir Charles Baskerville, has died and has family history which may explain his death. Doctor Watson, Sir Henry Baskerville (Sir Charles Baskerville’s son), James Mortimer, and secretly Sherlock Holmes travel to investigate. Christopher describes Sherlock Holmes secret travels and investigation, which is much like his own investigation of the dog killer. In fact, in this investigation a dog is killed. Christopher shares, “which is not nice because it is not the dog’s fault.” Christopher shares the parts of the story he doesn’t like, specific quotes. He doesn’t like the use of old language, which he finds difficult to understand. He does like the clues and Red Herrings of the story. Christopher describes his love and application of clues and how these bits make it all true. He also described how much he likes Sherlock Holmes as a detective. He states that Holmes is a proper detective, intelligent and solves the mystery. He compares himself to Holmes by stating they both get interested in things and are hard to distract when they are in study mode. That is why Christopher is writing this book, “to frame some scheme into which all these strange and apparently disconnected episodes could be fitted.” Finally, Christopher shares that he and Sherlock Holmes agree on their thoughts about the supernatural and interesting facts about misconceptions of Sherlock Holmes.

I like the parallels that Christopher noted between these two investigations. That there were parts he loved (the facts) and parts he hated (things he had to interpret, but didn’t understand). A person who is great at the little details does make a great detective. This chapter gives some more information as to why finding the dog killer and being a detective is important to Christopher.

–Amanda Piekarski