Monday, October 10, 2016

Music and Speech-Language Therapy

When I was a much younger SLP, it seems there was more of an emphasis on developing auditory skills with our students. There was a wealth of materials on auditory discrimination skills and discriminating environmental sounds. We spent time teaching students HOW to listen and follow verbal directions explicitly, encouraging eye contact and subvocalization. My articulation therapy training in the early eighties included spending considerable time teaching students to listen for target sounds in my speech, in isolation, syllables, words, then in their own speech (Mysak's Developmental Feedback). We then would work on auditory comparing student productions with therapist productions. Who remembers the games Dig for Gold and Old Itch? Discovery Toys had a great game What's That Sound whereby students listened to sounds on a cassette tape and covered a lotto board in order to identify the sound. I still have all those games and have actually started using them again. It seems our little ones are really having a difficult time sitting still and attending and listening! Hmmmm, I wonder why? I could hypothesize on the myriad reasons (excessive television and electronic media time, little family discourse, etc.), but the bottom line is we are seeing students who struggle with verbal directions, auditory skills, social listening and more.

At the outset of our school year, our school district offered a series of in-services presented by fellow colleagues. I decided to attend a session on Music and Literacy offered by a dynamic and creative music teacher in our SAU, A.J. Coppola. A.J. uses a method of instruction referred to as the Kodály Method. Kodály was a Hungarian composer who was dismayed with the state of music education in Hungary. He felt there needed to be better teacher training, better music curricula, and an increase in the amount of time devoted to music instruction in schools, thus, the Kodály method was born. The framework of his method is solidly based in child development. Students are introduced to skills according to their developmental levels, first being introduced to more simple tasks and progressing to those that are more difficult as they master skills. It is a very linear and sequential method whereby skills are continually reviewed and reinforced through movement, games, and songs. It really sounds a lot like what we as speech-language pathologists do in therapy!

We know melody and rhythm is valuable in increasing fluency in patients with aphasia (Melodic Intonation Therapy) and can be very effective when working with students with ASD.  From a speech-language perceptive, music has many applications including helping students with Central Auditory Processing difficulties detect pitch and stress differences to developing social skills through song. A.J. introduced us to several books I thought would be wonderful to utilize in therapy (the Feierabend Series publishes a book each year using folk songs and the Musicmap Series uses multicultural songs in an illustrated format.)

Songs are a wonderful way to calm anxious students and establish connections. They provide the basis for rhythm, pattern, and pitch which are basics in speech-language therapy. Listening skills are foundational to communication and classroom functioning. Auditory skills, from sound discrimination to figure-ground discrimination to perception, reception, and synthesis, are skills necessary for learning. I, for one, am going to pull out my shaker eggs and maracas, Old Itch and Listening Games books and return to some SLP roots. So grab an echo mic, learn a folk song or two and SING.

Sunday, October 2, 2016

Capitalizing on Trends in Speech Therapy

As many parents do, when our children were younger we made it a point to know what they were watching on television. We sat through countless episodes of Bear in the Big Blue House, Teletubbies, Noddy and more. As they grew up, their tastes changed. We moved on to Pokemon and Avatar. Pokemon was so cheesy, I would have to hold back my laughter. Avatar,  is one of my personal favorites and I will admit to watching it alone even today! I am impressed by the clever writing and the relationships forged between the characters. To see males depicting tender emotions and hugging or crying in a cartoon is generally unheard of. We then moved on to the Disney channel and Good Luck Charlie, The Wizards of Waverly Place, and Lab Rats.  I will also admit to laughing during some of those episodes. As a result of the Pokemon craze of the early 2000s, our children have amassed a lovely collection of Pokemon figurines. Who knew that in 2016 we would see a resurgence of Pokemon? Well, I guess with all good marketing, it was bound to happen. Companies don't want to let go of a good thing.
In speech-language therapy, any SLP will tell you about the importance of capitalizing on a trend. Over the years I have made Strawberry Shortcake games, used pogs and slammers as reinforcers, and played with My Little Ponies. We will do whatever is necessary to motivate our little clients, so why not use what they know and love? Finding the right motivator for each student is a time consuming and sometimes expensive endeavor. Time is a hot commodity and creating activities around Minecraft and minions is not something I am able to do as often as I would like. Additionally, since our children are older, it is not as easy for me to know what's hip. Yes, I am getting older and sometimes feel like a caricature of someone screaming "Look out, old person coming!" 

Okay, back to speech-language therapy. In the past two years I have seen a marked increase in the number of students on my caseload with fluency disorders. In fact, that number has increased from zero to five. This isn't the classic definition of stuttering either. It's more consistent with ASD and is characterized by final part-word repetitions, phrase repetitions, and considerable fillers. Add to that the behavioral challenges associated with ASD and we have a perplexing student profile. Finding the right motivator is crucial with this population. Using both the cognitive techniques for ASD and fluency strategies has been my approach when doing stuttering therapy with these students. Enter Pokemon! When I mentioned to one student in particular that I had two large containers of Pokemon replete with Pokeballs and figurines I saw a notable shift in his demeanor. So I dusted off the bins and carted them into school. It has been an incredible success therapeutically, as a relationship builder, and as a motivator.

I was able to incorporate Pokemon into my student's therapy in this way:

  1. My student selected a Pokemon to research.
  2. I used this website for Pokemon statistics:
  3. Using a write-on die, I colored each side of the cube to correspond to a fluency strategy to practice.
  4. My student rolled the die, matched the color to the corresponding strategy written on the whiteboard and read the statistics using the strategy.
  5. Our daughter gave us permission to give away any Pokemon, so my students can purchase one by saving their "Doyle Dough" earned in therapy. Our son, on the other hand wants his container returned to the safety of our home as soon as possible.

It has been so much fun pulling these toys out of the attic. I have enjoyed seeing the happiness they have brought to a new generation. I have enjoyed how effective they have made therapy. I have enjoyed seeing how my own children are ready to pass them on or guard them dearly.  I would love to know what toys you have dusted off for speech-language therapy? I am always searching for fun, new ideas!

Sunday, September 18, 2016

From Those to Whom Much has Been Given

My Teachers Pay Teachers Store is sort of a snoozer, in large part because it is my red-headed stepchild. Doyle Speech Works, the store has 52 products, some of them lovely little gems, but they are not big sellers. I am not a big materials creator nor am I a stellar marketer. I create things I think my students will enjoy and if the mood hits me, dot my copyright I's and cross my copyright T's and upload them. I don't earn a substantial income from my halfhearted endeavors. I marvel at those who have made Teachers Pay Teachers a successful business, however I choose to spend my time doing other things. This spring I reevaluated my commitment to TpT and decided to un-clutter my life and eliminate thoughts, things and activities that add an element of stress, so I stopped creating altogether.

Fast forward to the weekend of September 10, 2016, when Mother Teresa was canonized. Here is a woman, who amid swirling controversy and negative publicity, devoted herself to helping others. Here is a woman who despite experiencing what is called the "dark night of the soul," (a feeling of spiritual emptiness) still sought God. I am humbled by her selflessness and the selflessness of countless others who give of their time, treasure, and talent.

I used to be one of those people. When my children were younger, I spent a considerable amount of time and energy in volunteerism. I taught faith formation, helped raise money for and build a playground, began a women's retreat (now going on its 16th year), raised money for Bibles for middle school students, and did walks and runs for everything pushing my little ones in a double stroller as I did them.  As my children got older they volunteered on their own and I did less. My volunteerism of late has been paltry. I donate money to causes, but I DO very little.

As I reflected on the life of this diminutive nun with a Texas-sized heart, this verse from Luke echoed in my mind: "From everyone to whom much has been given, much will be required" (12:48). That means me. I have so much to be grateful for, so much. I need to dig back into my heart and find that altruistic nature I once nurtured.

To begin, I have decided to donate any monies earned in my Teachers Pay Teachers store through December 31, 2016. If I don't earn much I will supplement the amount, so as to provide a donation that is helpful. My goal is to help 3 different charities, one per month. I have selected the Captain Douglas DiCenzo Camp Fund, the Jim Kelly Memorial Fund for the PRHS Music and Theater Department, and CADY. The Camp Fund provides children, who would otherwise be unable to attend, an opportunity to go to summer camp. Jim Kelly is a recent graduate of our high school and a dear friend to my children and many others. Sadly, Jim is no longer with us, but his music and theater legacy will live on with this memorial fund and I will do what ever I can to sustain it. CADY is a nonprofit organization dedicated to promoting alcohol and drug-free youth in our community and beyond.

I have to spend more time discerning where to give my time and talent. I have some thoughts and will fill you in when I have made a decision. I would like to enlist my husband to work with me as we move forward in our lives. It will be nice to work together.

You never know this might motivate me to create more materials! Meanwhile, take a gander at my store. If there is something that piques your interest, buy it! I hope it makes you happy to know all proceeds will go to to those who need it. Praise God, I don't!

Tuesday, September 6, 2016

Progress Monitoring-Baselines and Beyond: A Frenzied SLP Linky

Labor Day brings the unofficial close to the summer season and with it an end to the lazy, hazy days of relaxation. Don't dismay, though, because with the return to schedules and school come the Frenzied SLP posts chock full of ideas, materials, and suggestions for the busy SLP. Thank you Sparklle SLP, Lisette Edgar, and Kelly Woodford-Hungaski for coordinating our first frenzied linky!

To start things off, we thought we would share how we do progress monitoring, establishing baselines and more. I understand there are a plethora of products available for progress monitoring, however, I have streamlined my process. I purchased MANY products for monitoring progress and what I found was that, while, they were fantastic products, they weren't aligned with the goals I had established for my students. I created a couple of my own progress monitoring tools, but still, I didn't feel I was capturing the information I needed (You can access my elementary and middle school progress monitoring tools for free). Additionally, trying to find the extra time to administer the progress monitoring tool added needless stress to an already stressful day.

I take detailed data for every session. I write an anecdotal and document percentage accuracy for every objective. What I realized was my documentation was, in fact, all I needed for progress monitoring that specifically targets my students goals and objectives. When it is time for an annual review or progress reports I collate all the data for a specific time span and find the median percentage accuracy.  Using the median rather than mean eliminates the outliers. I also have a baseline if I need to continue addressing a certain area. This streamlined approach has saved me considerable time and, I believe, paints the most accurate picture of a student's progress as it relates to their individual goals.

Sample data collection sheet
You can access my data collection sheet here. Everyone does things differently, however, I have found that keeping accurate and current data is the best method for me to assess progress without having to pull out an additional tool or schedule time for dedicated progress monitoring. 

How do you monitor progress? The Frenzied SLPs are eager to hear your thoughts and/or check out your methods. Link up with us!!

Friday, August 19, 2016

Thoughts From the Back Porch: My Visit with Small Talk, SLP

I know how busy people are these days and catching up on the blogs can be a task. This post will likely be lengthy, however to truly do it justice, it has to be told in full. This is a story of friendship, so I'll spare no words. 

It all started several years ago, when my soul sister and I started sharing photos and quips on social media. We had been liking and commenting on each other's SLP-based photos back and forth for a while, when one day I posted an activity using some winter themed stampers. My social media and SLP compatriot "hearted" the photo and expressed how she liked the stamps. I had ordered them from Oriental Trading and received triple of each stamp, I think, so, I asked her if she wanted a set. She was thrilled and I was happy to send them across the country to brighten her day. The rest, as they say, is history. A cross-country friendship between Small Talk, SLP and Doyle Speech Works was born, moreover the relationship between Pam and Annie has flourished ever since. 

I remember the first time we chatted in real time via instant messenger. I was cooking dinner and we started getting to know each other outside of the public eye. The times we chatted became more and more frequent and open, sharing bits of our lives, our joys, and our frustrations. Now barely a day goes by where we don't touch base, even if it's brief. After a particularly grueling day for one of us, we wished we were sitting on the sofa together with a glass of wine. I remarked that one day that dream would become a reality. Time passed, as it does, and Pam sent me a message asking if I really meant it, would I really come to Oregon and visit? I did get a little nervous, not about the visit (well maybe a little), but about time and money, kids and work. I thought April 2016 would work, alas, no such luck. June arrived and I thought it was high time for an adventure! Now I was waiting on my husband, could he get the time off after recently starting a new job? No he couldn't, but I could! The time was right and on June 30, 2016, I found myself on a plane Oregon bound! YEEHAW!!! When I arrived in Portland I headed to retrieve my baggage and I heard, "Annie?" I turned and saw Pam! We embraced and held each other and were both filled with such emotion! I cannot even describe it adequately. We hopped in her car, started talking and never once did we run out of things to talk about. There was never an uncomfortable moment. Why would there be, we had already bared our souls for years. Now our families? Our families trust our judgment, yet there were a few comments from both sides (What if she's nuts? You're going to let her stay here?). We already knew, though. We were connected.

Our adventures began with what all SLPs do when they visit each other from across the country, a children's book and toy store!! Yes, we both walked out with items for therapy. 

We proceeded to Industry Restaurant for happy hour, a well earned margarita, salsa and guacamole! Simply ambrosia after a day of travel from the east coast to the west. Pam's husband met us there and I loved him the moment we met! We returned to their lovely home and shared our love of fine food by cooking dinner together. It was early to bed for me still not having adjusted to the time differential. I slept comfortably and happily, blissfully exhausted.

The next day began with a lovely 2 mile walk and face to face conversation! Pam invited me to observe her therapy session (with parental permission of course) which was a real treat. What a wonderful experience seeing an incredibly gifted SLP at work. I loved it and wish we had more opportunity to observe each other and collaborate not just with materials and ideas, but practice. Following therapy we headed to Portland for some sightseeing. Portland is bustling and everyone appeared so healthy and active. I love a city. There is just so much to do. We began at the International Rose Test Garden and then headed into the city proper for a visit to Powell's Books, the Food trucks (we went to the grilled cheese truck. Oh My!), and a walk across Tilikum Crossing for a view of Oregon's Bridge City. Naturally, no trip to Oregon is complete without a stop at a brew pub. I can't remember the name of the one we visited in Portland, but while I was there I didn't meet a brew I didn't like. Yummy!!
International Rose Test Garden
Bridge City, Portland, Oregon
Powell's Books: So many books, miles of books, so little time!
Saturday was reserved for hiking. I love to hike and so do Pam and her husband. In fact, we talked frequently about hiking together (I wish Jim had been able to join me). We live in NH, and the hiking is wonderful, but nothing had prepared me for the Pacific Northwest. It was like hiking in Middle Earth, lush and green and majestic. It is beyond compare and beyond words. The day was absolutely perfect and the hiking sometimes steep, yet manageable. I did almost fall backwards down a mountain, when I looked up at a view and stepped back! Gave us all a scare and Pam was grateful she didn't have to call my husband to tell him she lost me down a cliff! We had worked up quite an appetite (and thirst) after hiking, so we went to McMenamin's in Edgefield for a burger and, you guessed it, a cold brew! The focal point of McMenamin's, aside from the spectacular gardens, artisans, and outbuildings, is a hotel that is a restored county poor house built in 1911. The history, architecture, and artwork is remarkable.
Hiking the splendor that is the Pacific Northwest
Sunday morning brought church. To share this moment with my friend and her husband after all we had shared over the years is beyond description. Suffice it to say, I was overwhelmed. Following church was another delicious brewery and restaurant, Ancestry. The gustatory memory of my chicken sandwich and brew is still vivid. I am going to try and replicate that sandwich at home.  My amazing hosts then shepherded me off to the Anne Amie Vineyard in the Willamette Valley. Wine, oh sweet, wine, and vistas like no other. I left with a bottle of Prismé we still haven't opened. I'm waiting for just the right moment. 

Monday was July 4th and Pam and Dan were prepping a barbecue for their children. It was another picture perfect Oregon day, with wonderful weather and even better company. I went to bed fairly early knowing my adventure was coming to a close. I had to leave at 3:30 in the morning to get to the airport and Pam was gracious enough to drive me. 
Red, white, and blue!
Frequently, social media is viewed as a black mark, and it can be, but it's a tool. If it's used in the way it was intended it affords us the opportunity to find information and establish meaningful relationships. I think of my experiences as the modern day version of writing pen pal letters. Many a relationship was forged via pen and paper and the relationships I have made are truly no different. Perhaps the chance to talk daily vs. weeks or months even enhances those relationships. I have spent many a summer morning on this very porch enjoying coffee with my girls. Some may view my trip to Oregon (and my trip last year to Ohio) as a leap of faith. When Pam and I discussed this possibility we agreed; nah, it wasn't a leap of faith, it was meant to be and the natural next step in our story. Our story. To be continued...

Friday, July 29, 2016

Thoughts from the Back Porch: Summer Post 4

Work. Often, during my workaday life as a school-based SLP, I think of work as a four-letter word. There are days and weeks I think will never end. There are days and weeks that go by at the speed of light, leaving me little time to complete all my tasks. It can be an endless cycle of do, complete, redo, restart, test and retest. It can be exhausting. It's the type of exhausting that renders me prone on the couch and ordering pizza for dinner. The type of exhausting that when Saturday rolls around, the thought of cleaning can bring me to tears. While, the physical aspect of SLP life is limited to trips up and down the hallway and in and out of chairs, the mental piece is substantial and exacts a toll both emotionally and physically.

Fast forward to summer. My summer is work is different; it is generally pure physical. I don't shy away from hard physical labor. In fact, during the summer I relish it. I like to sweat. I like to get dirty. I like planning and planting and mowing and weeding yard work. At the end of the day when I'm grubby and tired I can look at the fruits of my labor and get deep satisfaction. I can see what my toils have produced and I love it. Summer is good for my soul.
I mentioned to some SLP friends recently as we were sharing photos of our gardens, that if I were a rock farmer, I'd be a millionaire. NH is rife with rock. Our landscape is crisscrossed with picturesque rock walls and many towns have ordinances that prohibit their dismantling, as they are inherent to our New England character. As beautiful as these rocky scenes are, they are a bane to gardeners. So what do we New Englanders do? Use the rocks. Over the years I have built a number of rock garden beds. I have single handedly, hunted, harvested, hauled and built these beds. 
This week I wanted to further fortify our fire pit (yes, I am in an alliterative mood). For roughly three hours I scoured the woods for rocks and dug them out.
I piled them into the wheelbarrow.
I pushed that wheelbarrow UP the hill that is our driveway.
I hoisted them out and carried them to their final resting place.
I strategically placed them one on another.
I put my feet up and felt a sense of pride in my strength and my work.
Now, I know that my efforts at my day job yield results. I see the student who has made some measure of progress and I receive the rare note from a grateful parent or student. More often than not, though, we are unsung heroes and we miss the end result of our labors. I want to reframe my vision of my daily work as an SLP. I don't want work to be just a four-letter word. Perhaps, in the spirit of growth mindset, I can envision my task as building a rock garden. Each and every day, I search for a beautiful rock. I carefully extract it from the earth, that has a firm hold on it. With strength I carry it to the place where it will shine. When my work is done, I look at the end result and I am grateful for the toil because it has yielded a purpose, it has touched a child. Isn't that why I do what I do?

Monday, July 18, 2016

I'm Visiting the Speech Bubble

I am so happy to helping Maureen, a.k.a. The Speech Bubble, with her blog as she prepares for her little baby! Expecting your first baby is such a special time filled with joy, happiness and a healthy dose of nerves. As many of you already know, my first baby is preparing to go off to college. I too am filled with many of the same feelings as Maureen! I wish her all the best as she readies herself for this next big time in her life.

It is always exciting to do a guest post and I am happy to share what I consider to be the highlights of ASHA Connect 2016. So head on over to The Speech Bubble and enjoy!  <3 Annie