Posted by Landria Seals Green, M.A., CCC-SLP on 29 April 2013 | 1 Comments
Tags:
speech language pathology,
career
Speech Language Pathology was recently listed as a top career selection...that's excellent news. We have made it (finally) to career day, top 20 careers, and have the pleasure of being listed amongst engineers (my husband and father are both), physicians, and attorneys. As a seasoned SLP and Executive Director, I am often asked for observation hours and we receive resumes for grads looking for jobs. I have a love and passion for my profession, but I hesitate on the CF, yet I yield to the calling of paying it forward as some wonderful mentors opened doors for me. But after reading some tweets and cover letters this evening, I decided to give some helpful tools that will hopefully shift the thinking or perspective of the new grad.
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Posted by Landria Seals Green,M.A., CCC-SLP on 1 April 2013 | 4 Comments
Tags:
autism
Today is April 1, the beginning of a month long campaign to improve autism awareness. Early in my career the prevalence rate was 1 in 150. I remember distinctly researching this detail as I delivered a speech for the Westchester County-Fairfield chapter of Autism Speaks. The speech was requested to improve the collaboration amongst private providers. In this speech, I discussed Autism as being an Out of the Box disorder requiring every professional to step outside of their box of speech and occupational therapy and actually collaborate well to improve the system and performance of people with autism. Almost 8 years later, the prevalence rate is now suggested to be at 1 in 55. This rate could mean that awareness happened and more children are being diagnosed and/or properly diagnosed.
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Posted by Landria seals Green, CEO on 23 March 2013 | 0 Comments
Tags:
autism,
technology,
iPad,
Android Tablet,
AAC
Maybe you know about this tablet! It's pretty new to me. The Kurio is not only inexpensive, but loaded with reinforcers. What's great is that parents can set the time intervals for play and the allowable sites to visit. This is great and moves the kids from you phones. I often see children transitioning from the waiting room to treatment and face the challenge of leaving their favorite game on their parents phone behind. Or in a behavior assessement, one of the challenges being listed is letting go of the technology. While I think the latter requires a different kind of attention, both challenges can be addressed by having children use something of thier own.
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Posted by Landria Seals Green, CEO on 23 March 2013 | 2 Comments
Tags:
work life balance,
working mother,
ceo mom,
new mom
I have always been the "I am there for you" person. I am the drop anything for you friend, speak to a parent at night (when their children are asleep) therapist to review goals, etc. Stay up until the wee hours of the morning to get ready for the next day's IEP or to write a masterpiece report. I was also frustrated and guilty because I had absolutely no work life balance. The phrasing "Work Hard and Play Even Harder" was meant for other people...I wasn't playing hardly at all. Even on vacations, I was fielding calls from my office, writing emails, reviewing reports, or even writing reports...and that was before cloud computing! I secretly envied friends who could leave their jobs and turn it off. My friends would constantly assure me that as Director and Owner of a private practice, this was my life and comes with the territory. Still frustrated, I felt like I was on a never ending chase of the ellusive work-life balance. And then I had a baby.
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Posted by Landria Seals Green, M.A., CCC-SLP on 12 October 2012 | 1 Comments
Tags:
speech therapy,
oral motor therapy
As a child, I have never ever liked tongue depressors. In fact, I recall as a child the mere presence of them and watching them come towards my mouth would result in severe gagging and occasional regurgitation. Tongue depressors were a norm for me as a child as I was always a casualty of October strep throat. Even as an adult, every September and October...I get a bit of a cold (when I fall off of my healthy eating regime). I did quickly learn, as a youth, to open wider and verbalize to the doctor that I did not require a tongue depressor.
As a speech language pathologist working primarily with children with autism, I get their perspective quite frequently. For those verbal, vocal, and nonverbal...I understand that often times you just don't want to share, you just want to relax and not work, and you just don't want the tongue depressor. I have been fortunate to attend awesome schools and have extraordinary mentor SLPs in my young career. These SLPs pushed me to the limits and today I am forever grateful. One in particular, in the North surburbs of Chicago (Andrea, SLP), taught me how to reduce use of tongue depressors, horns, and the like to elicit speech and use real things. Andrea was the district consultant for Assistive Technology for children with Intensive Learning Needs in this special education school district. First day, I was given assignments and told that my job was to make children better...get going. She did not hold my hand at all (very different from the training and supervision a lot of new SLPs now want...is this generational?!? hmmm)!
I was taught to reimagine how I could elicit the target sounds and integrate Anatomy, Nerve Function, Physiology with Real food/real objects. Real: items that are part of the child's everyday world or exposure and accessible to families. I quickly learned that the Twizzler wrapped in gauze (for weight) and dipped in applesauce (or any other flavor) can give a wonderful impact for placement cues for lingual back sounds (k, g). I utilize P.R.O.M.P.T. and other tactile cues to support...but let's face it, food is much more appealing and welcoming when we think of objects that should come towards our face and mouth.
This week I have been working with a youngster trying to achieve bilabial placement for the production to [m]. We have some real coordination and placement issues. I pulled out a trusty cracker. and we held it with both lips at the place where the lips should be meeting for the production of the sound. We did not over place this food item, but quickly transferred that placement cue to the production of the sound. And he's got it.
Social Emotional Learning is important when it comes to supporting motor speech disorders. He likes crackers. From a behavior analysis standpoint, I paired the "like" with the goal I am trying to achieve, and now I am shaping speech. Communication connects people. The tools we use to elicit these motor patterns, oral motor placement cues, must also support the transference of the connection to the desired movement. Yes it takes thought and a great deal of time, especially if the youngster has aversions to textures, tastes, and the like.
For those that are more Finicky Eaters, it is a wonderfully messy task to play with food from the feet up. In Speech Therapy, Occupational Therapy, and ABA Therapy we are rolling our car toys over crackers and pudding, playing in foam, steping on fruit snacks and then moving up to the mouth. Motor begats motor. Sensory Motor processing supports speech therapy. Both are important. This week I have worked more than a sweat in treating children and loving every minute of it. I just wanted to thank a school SLP who was my graduate mentor for a full semester while at Northwestern because I went back to the basics.
Enjoy and Be Empowered
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Posted by Landria Seals Green, M.A., CCC-SLP on 24 July 2012 | 4 Comments
Tags:
speech therapy,
ABA Therapy,
Occupational Therapy
Effective September 1, 2012, SLC Therapy will be an in-network provider for ABA Therapy, Occupational Therapy, and Speech Therapy services for Cofinity/Aetna plans. This will better serve our Michigan families and help support the financial impact of a diagnosis of autism. SLC Therapy provides a center based ABA program along with Occupational Therapy (including Sensory Integration Therapy), Feeding Therapy, Speech Therapy, and Augmentative Communication Therapy. Home based ABA programs are also provided and based upon availability of staff, scheduling, and best treatment environment for clients.
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Posted by Landria Seals Green, M.A., CCC-SLP on 20 July 2012 | 1 Comments
Tags:
Michgian,
speech therapy in michigan,
southeast michigan speech therapy,
connecticut speech therapy,
fairfield coutny speech therapy,
apraxia
I am always looking to improve quality and create a consistent and excellent standard of care for clients. In looking at speech sound production and shaping vocal behavior especially in clients that are nonverbal, it is essential that the speech language pathologist identifies and distinguishes themselves from the ABA therapist providing a Verbal Behavior program. While there is much overlap, the speech language pathologist is uniquely trained and positioned to provide intensity in verbal and vocal shaping programs.
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Posted by Landria Seals Green, M.A., CCC-SLP on 20 July 2012 | 1 Comments
Tags:
autism,
specific language impairments,
ADHD,
michigan ABA,
Connecticut ABA,
speech therapy,
Landria Seals Green
I have long maintained that paraprofessionals are individuals who are on the front line with children with disabilities. They are part of the teaching, nursing, social work, behavior intervention support team rolled into one. We wont discuss their compensation or any other societal -economic imbalances...we can stick to and maybe agree with the statement that training may not always be given to this professional as a priority. Training not dictatorship, shaming, reprimanding, but true teaching and modeling of how. Training also means that these professionals should have knowledge of and read the child's IEP and at minimum the PLAAFP form. Quite frankly, it is a great suggestion that the child's goals, strategies, and reinforcers are posted throughout the classroom.
A few years ago, I was asked to train paras before the beginning of school for 1 hour. In one hour, I gave them tools for communicating with students with language based disabilities inclusive of autism, dyslexia, apraxia, specific language impairments and other disabiltiies.
Enjoy and Be Empowered.
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Posted by Landria Seals Green, M.A., CCC-SLP on 20 July 2012 | 0 Comments
Tags:
speech therapy,
autism therapy,
speech therapy michigan,
speech therapy connecticut,
aba therapy,
behavior therapy,
speech language pathologist,
Landria Seals,
Landria Seals Green,
slc therapy
Teaching people with communication impairments to respond to Yes/No questions requires a level of knowledge and understanding from the person(s) posing the question. The person being a family member, a therapist, relevant person, or community provider. Therapists' working on Yes/No with clients, should understand that there are different levels of comprehension and thinking from clients that require increased levels of cognitive and language processing.
There are five levels of yes/no question comprehension and cognitive thinking. To be clear, each level should have a mastery of 90% inclusive of fluency. Fluency is the response rate the client must answer the question. Fluency is important because typical brain developer communication is rapid and requires answers rapidly. While situational patience is provided sometimes, therapists' should not depend on this when pushing our clients toward Independence. As a therapist, my benchmark is the typical developer and typical peer social communciation, cognitive, and language skills. After all, inclusion is real and in order to prepare our clients, we must teach them the knowledge along with the verbal fluency the world requires.
So again, 90% mastery inclusive of fluency to increase levels of learning of the concept of Yes/No.
The first level of Yes/No is the Mand, Choice making level: The Sd or prompt is typically 'Do you want ____".
In level one the clinician is asking the question plainly. There is no addition of the word "or". You are not saying Do you want the ____ or the ___? The reason is for clean data and clean teaching. So often, I meet children who have splinter skills. This does not mean that the teaching was totally in error, but the science behind the teaching was not present. The one thing I can attribute to my learning and knowledge in applied behavior analysis, is the scientifically segment the actual skill so that the skill is learned. My influence as a speech-language pathologist has allowed me to always make sure that programs have included reasoning, thinking, and social connectedness. In the first level of Yes/No, the client is learning to answer a simple yes/no question related to something that he wants. When teaching the concept of yes and no, the client is tasked to learn to give an answer...then we work on fluency (Fast and Accurate). The actual stimuli should be visually present. Another challenge level to expose the client to answering the question without the presence of the visual stimuli. This is real life in the treatment room. Parents ask their children "Do you want McDondalds" before arriving to the restaurant just to name a few scenarios. Here is what your data sheet should look like
The second level of Yes/No is the Mand, Choice making with "or". The Sd or prompt is now " Do you want the ____ or the ____?"
Or is a different concept to learn. We wait to include this exclusionary concept because the comprehension or lack of comprehension of this one word "or", can disrupt the clients acquisiton of the concept. By completing the first level with 90% accuracy, your are ensuring that concept of answering Yes/No for manding is present. The clients performance here shows that as a therapist we need to be teaching the understandign of "or", not the comprehension of yes/no.
The third level is Knowledge based Yes/No- item Name. The Sd is now "Is this a _(item name___?"
In this skill set, its not really yes/no that the clinician is after. Here we are asking clients to cognitively refer to their knowledge bank to answer questions. This level of teaching should be reflective of the known knowledge. The collaboration with other professionals who may also be working with your client is necessary especially here. This program setlist should be reflective of the mastered receptive ID programs. For example, if a child can identify "dog", then I can now add to his Yes/No program by asking "Is this a dog?" But he must already know the concept of the tact-label of the item before I add this to my new level of Yes/No programming.
The fourth level of Yes/No is Knowledge Based- Category Label. The Sd is now "Is this a _(item label)___?"
In the fourth level. The client must have knowledge of labels. Their receptive language programs should now be moving to " A dog is an animal, A dog barks. A dog has four legs. A dog is a pet". Only when data shows clients firmly have this information, do we add this level to the Yes/No programming. Yes no is still relevant here because classroom teachers, community, and typical developers ask questions like this all the time.
The fifth level of Yes No is Knowledge and Reasoning. The concepts can be related to safety, daily living, and reasoning about general knowledge. The Sd will vary, but should be documented so that identification of difficult question forms and concepts can be tracked and taught. An example here is "Do you touch a hot stove? Is fire hot? "
Based upon where I am going with this, readers can probably guess that I have had or overheard one too many conversations about a child's inability to answer "yes/no" questions. And quite frankly, that's not enough information. As clinicians we should be framing statements about what our clients are not able to do at the present moment with specific statements rather than generalities. When the statements are general, I can assure you that the data collection and teaching are not specific enough. Further, each teaching should have an error correction procedure that outlines how the clinican is correcting the error AFTER each trial. This necessary, because we do not want clients to attend therapy getting many many trials and opportunities to NOT LEARN. Therapy is an unplanned expense for families, yet they come with copays, coinsurance, and private fees. We must SLPs, ABA therapist, and all those in between (with a license :-)....should be providing specific data collection and correction procedures.
Enjoy and Be Empowered.
Landria Seals Green, M.A., CCC-SLP/L
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