Sunday, November 20, 2016

My SLP Story

A little over one year ago, I published a post entitled What's the Story, Annie?  I encouraged other SLPs to link up and share their stories as our experiences influence what we think, feel and do. At the time no one linked up. Perhaps my timing was off. No, let me reframe that, perhaps I was ahead of my time. One year later the Frenzied SLPs are sharing their SLP stories and are eager to have others join in the collective story telling. I am republishing my original post (with a little updating) and am grateful for the opportunity to share it again. Thank you as usual to Sparklle SLP, Kelly Woodford-Hungaski (Speech2U,) and Lisette Edgar (Speech Sprouts) for their grit in getting us organized. 

If you lived in New York, New Jersey or Connecticut in the 70s you remember a commercial for an appliance store that used the tag line, "What's the story, Jerry?" I am eleven weeks into my 34th year as an SLP! I've been thinking quite a lot about how I got here. What is my SLP story? What makes me the SLP into which I have evolved? It comes as no surprise that my experiences uniquely prepared me for my future, but how I used those experiences to become the woman, the professional I am is worth considering. Here is my SLP story.

My childhood was complex. My parents were loving, but had significant baggage of their own. After their divorce my poor Mother struggled with finances, teenage sons, and her difficulty caring for her sixth and and seventh children while getting a graduate degree and working. We weren't lacking in love, just having our lives organized. I most definitely learned love and compassion from my Mother. After losing my Mother when I was fifteen, my anxiety was tremendous and I had virtually no confidence in my abilities nor my potential. My 27 year brother and his 26 year old wife moved in with my younger brother and me. We worked hard to forge a stable family relationship. My grades in high school were good, but I never pushed myself. I did what I had to do and no more. I didn't participate in any extracurricular activities, no sports, no theater, no clubs, nothing. I wanted to take risks, but was afraid to do so. As a senior in high school there were no college visits, no aspirations, no desire to go away. I applied to two colleges, was wait listed for one and accepted into the other. When completing the applications I suspected I could learn how to do most anything, so I closed my eyes and pointed to the page listing majors. My finger landed on speech-language pathology. I suspect divine intervention! I chose to attend William Paterson College and majored in Speech Path. In May of my freshman year of college my Father died. I was eighteen. Still reeling from my losses, I commuted for four years dividing my time between classes, working at a drug store, and partying with my friends. I did work harder in college than high school and was consistently on the Dean's List, but as a commuter, I still didn't gravitate toward campus life. I was, nevertheless, the VP of the speech pathology club and the Secretary for Kappa Delta Pi, the International Honor Society in Education, but what I really excelled in was playing quarters.

I graduated in 1983 and my first year as an SLP was spent working part-time in four schools in four towns. In those days a master's degree was not yet mandatory to work as an SLP. It is hard to believe; I was 22 years old and worked in two high schools and two elementary schools. Three of my students at the high school were eighteen year old boys! I often think about that year and wish I could go back and do a better job! I was so young and had so much to learn. I remained positive despite grasping at straws at how to motivate kids who were only slightly younger than I was.

Really, during that period I wasn't sure if I was going to continue in the field, but as luck would have it, a position for a graduate assistant at Montclair State College was advertised in the paper and my brother suggested I apply. I called the number listed and waited for a response. The following day I received a call, not exactly the call I wanted, however. Evidently, I dialed the number inadvertently using MY telephone exchange and not the exchange of the graduate office. I had left a detailed message and the kind soul I contacted was thoughtful enough to return my call and tell me I had the wrong number! I remember her saying, "This sounded like an important call, so I wanted to be sure to tell you, you had the wrong number." I went on the interview and was accepted into the communication sciences and disorders program as a graduate assistant! Interestingly, my graduate assistant supervisor and I are both currently presidents of our state speech, language, hearing associations! Isn't is crazy how life unfolds?

I continued my part-time SLP work and my job as a cashier as well as completing the responsibilities of a graduate assistant for the first year of the program. I then found a full-time school position during my second year of graduate studies. This was the period I found my passion for speech-language therapy. As you know graduate school is tough. I think it is tougher now than when I went, but it still kept me crazy busy and crazy stressed. I passed the "ASHA exam," as we then called it, and completed my CFY. I began to realize I was competent, creative, and smart. I took risks. I found my voice. I found my heart. I found my passion and like a butterfly from a chrysalis, I found my wings and I soared!

How have my experiences prepared me for my profession as an SLP? I am able to view each child as worthy, even the ones with dirty clothes. I am able to see the smile in every child, even the ones with downcast eyes. I am able to see the leader in every unmotivated middle school student, even the ones who don't play sports or get the lead in the play. I am able to advocate for each student, especially the ones who feel silenced. I am able to ease the sadness of every child, even for merely thirty minutes, especially the ones who have little hope. I am able to state with conviction to every child that you are good at something, even if you don't believe that today. I am able to listen with a compassionate ear to the child who believes "nobody likes them" and to reply with certainty, "I do." I am able to gently encourage those students who are fearful to take a risk. I am able to explain to every child that this place is the beginning of their story, not the end.

It's always a good practice to reflect. If you would like to share your story link up. What is your SLP story? How have your life experiences primed you for your career?

Write it! Dream it! Love it! Share it! Live it! Be it!

Saturday, November 12, 2016

Supporting One Another: The Power of Encouragement

This post has been on my mind since July. I have hemmed and hawed about writing it, and then thought, "It's time." I've been contemplating what support looks like in our profession. As speech-language pathologists we are 100% behind our students. We go the extra mile, we devote our time, energy and talents to helping our students/clients achieve. We spend our own hard earned cash. We create, remediate and advocate! All this for our students and clients. We would never consider suggesting our students can't or shouldn't try something new or hard. We would never suggest they not try something innovative or daring. Would we? I think not.

This summer while at ASHA Connect I was enjoying some social time with friends, old and new. We were a mixed group, ranging in age from 30s to 50s. Some of us worked in the schools, some in SNFs, some in private practice and some who even are COOs of health care organizations. Our common thread, speech-language pathology.  The conversation moved to our college days, as some of our group were reunited with college professors while at ASHA Connect. One would think the reunions were happy, not so.  I was shocked to hear from these accomplished and successful individuals that while they were in undergraduate or graduate school they were DISCOURAGED from continuing in the field, despite high marks. One was told she wasn't a "good representation of the profession." Another was told her voice was "too harsh." I recall a professor in graduate school posing to our class, "How many of you might pursue a PH.D? None I presume, you are not good graduate students." I felt flattened.  I was a great student with a 3.87 G.P.A., a graduate assistant in the department, and I was looking forward to a long and successful career. Clearly, however, I was NOT Ph.D. material. I have carried that with me my whole career.

Fast forward to today's internet driven world. We have SLP blogs and TeachersPayTeachers. We have Twitter, Snapchat, Facebook and Instagram. We have SLP glitterati and followers. Just the term followers makes me cringe! And yet, we all have the same goals, to help those who need it. For some reason a strata has emerged that breaks my heart. Sellers versus buyers. Posters versus likers. Names versus followers. Groups versus individuals. Who's in versus who's not.

Our field is fueled by advocacy and support and yet, it seems we have forgotten how to support each other. It isn't always outright, sometimes it's more subtle, like ignoring the efforts of groups/individuals viewed as rivals. Rivals for what? Followers? Likes? Sales? While at ASHA this summer I was flat out, face to face ignored by a "friend" who only chooses to speak to me when others aren't around! Of course, I know my value. I was initially hurt by the dismissal, then quickly realized it had nothing to do with me. On the contrary.

I may not be a big TpT seller (by choice, I have decided to focus on my practice and create when I have a need) but I have a lifetime of experience. I did therapy before lesson plans could be downloaded for $5.00. I was creating goals for diverse populations before goal banks. I was writing evaluations by hand before spellcheck. I was using ditto masters and thermofax machines before some SLPs were born. My hope for this community is that at some point we all realize the contributions we can offer to each other. Not just those in our niche.

My hope is that collectively SLPs learn to view each other as assets, not rivals. That we move forward as a group with each person sharing their vision, so that collectively we support those who need our support. Support doesn't necessarily mean advice, either. It may just mean encouragement. It means a professor encouraging the graduate student who needs to take a risk or make a change. It means offering encouragement to the person who thinks they can't to, "Yes, start a blog." It means encouraging a creative SLP to author products. It means encouraging the seller who just posted a picture of her new creation by commenting. It means encouraging the author who is successful and not begrudging them their success. It means so many things that are kind and loving and inclusive.

Imagine then a field where we all use growth mindset thinking and encourage each other to work hard and strive to be the best version of ourselves we can be.  How would that then trickle down into our own lives, our interactions with our families, colleagues and students? It may just be a dream, but it's a good one and it IS POSSIBLE. "Therefore encourage one another and build one another up, just as you are doing." 1 Thessalonians 5:11

Sunday, October 23, 2016

Working as a Team: Supporting Rehabilitative Assistants

The Frenzied SLPs are back this month with posts about working as a team, and we are truly a team, working together to bring you materials, ideas, and inspiration. Teamwork takes many forms with many different people and I am very excited to hear the different perspectives that will be shared! Thank you to Sparklle SLP, Kelly of Speech2U, and Lisette of Speech Sprouts for once again keeping the Frenzied SLP team organized!  

It seems counter intuitive sometimes. Special education is founded on a multidisciplinary teamwork model and yet it how it unfolds in schools is often the complete opposite. The reasons are many: lack of team time, huge caseloads, minimal/no administrative support, paperwork burdens, pride, you name it. Despite this, the fact remains, effective programs have effective teams, who know how to work together and respect each member's unique talents and contributions.

A frequently overlooked member of highly effective special education teams is the paraprofessional also known as a rehabilitative assistant. These bastions of support and patience are integral for SLPs and OTs. Rehab. assistants spend all day with our most highly involved students supporting them in the classroom, supporting hygiene needs, helping with transitions, lunchtime, and offsetting behavioral difficulties. In order for the work rehab. assistants do, to be eligible for medicaid reimbursement in our state, they must be supervised by a "licensed practitioner of the healing arts." It must also be very clear that the work they do with our students NOT be academic in nature. In fact, when I post those sessions I sign that "I certify that activities being billed under rehabilitative assistance for the above student(s) (...) on the dates specified (...), for which I am knowledgeable of the service provision, and provide weekly consultation to the aide, are not classroom instruction or academic tutoring, but are therapeutic in nature and are necessary for the maximum reduction of each student’s physical/mental disabilities." 

For many years the rehab. assistants, case managers, and special education administrators in our district balked at this supervisory piece. SLPs were even told that there aren't any "medicaid police." Well, we know that is not the case and I for one, finally decided I had worked too hard to earn my degree, Cs and license to lose it to egos. I now insist on weekly consultation where the rehab. assistant and I discuss how they can support student goals in the classroom. In order to document consult times I created a log sheet that allows for entering the date of the consult, comments, and initials. Having written proof certainly eases my anxiety around signing off on rehab. assistant support in the classroom. You can get it here for free! 

This takes care of the consult documentation, but the larger issue is how to utilize rehab. assistants in the most effective way possible. During my initial conversations with rehab. assistants, it became abundantly clear that the majority of support being offered to our students was academic. This was a huge concern. As a result, I enlisted the support of one of our paraprofessionals extraordinaire in order to create a planner for rehab. assistants. I am really happy with the result! So now during our consult time rehab. assistants share concerns, ask questions, and describe how students are functioning in the classroom and are able to keep it all organized between meetings. In this way, I am able to provide suggestions, strategies, and supports for students. The Paraprofessional Paperwork Planner has forms for notes, communication, a to-do sheet, strategy form, a calendar, planning sheet, glossary of common SLP and OT terms, and more. The best part? It contains several editable pages! You can find this planner here in my TpT store, Doyle Speech Works 

It appears that the rehab. assistants I supervise are receptive to this more structured consult and are appreciative of the planner. I am hoping this allows us to truly support our students in the most effective way possible using common language and consistent supports.

How do you team? Link up with the Frenzied SLPs and share your successes or struggles. We are after all, a team!

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!!