#200: Writing Goals for Stuttering

Marisha (00:01.73)

Hello there and welcome to the SLP Now podcast. I'm really excited to have Nina Reeves on the podcast today to continue our series on goals. And today we are talking about stuttering. and I'm sure you've already heard of Nina Reeves and know all about her, but just in case she is, a board certified specialist in stuttering, cluttering and fluency differences.

And she's also an ASHO ASHA fellow and the co-owner of Stuttering Therapy Resources. And she has over 30 years of experience and just has so many phenomenal resources. This intro does her like zero justice, but yeah, you're going to fall in love with all of her resources and knowledge and expertise as we go through. So hello, Nina.

Nina Reeves (00:59.515)

Hello there, how are you? I'm just glad to see you again and talk to you again. I really love when we have our chats.

Marisha (01:01.676)

Great, how about you?

Marisha (01:08.522)

I know they're the best. So let's dive into all of the content we have planned today. Would you mind first just sharing a little bit about your story? Like how did you end up becoming a board certified specialist in this area and what has your journey looked like?

Nina Reeves (01:28.891)

Well, that's a, I love when people ask me about the history because my history can be sort of anyone's story in many ways. I was a brand new SLP coming out of the university and saying, you know, I'm going to take on the world. I was a CF in the middle of nowhere, Illinois in a cornfield. And I was an itinerant and I was bouncing between school districts.

not even school campuses, but school districts. They were all separate rural school districts and I was their itinerant SLP. And I met my first kiddo who stuttered on my own. And I realized probably, I don't know, less than six months into my career that I really didn't know what I was doing. Like I had so much training.

in stuttering because I was trained by a Van Riperen trained guy who stutters. That was our professor. And I should have known better, but I got to the district and the lady that was there before me had been there 30 years. And she was writing fluency goals and doing all these things about fluency enhancing. And even though I knew better, I let my brain, you know, sort of

go away. And I just knew about six months in, I wasn't doing this kiddo any good. So I just launched myself into self study, you know, and because I knew he needed me almost more than any other child on my caseload, that he was struggling just with communication. And trying to be fluent was actually causing more trouble than it was worth.

And so I embarked and it sucked me in. The big hole that sucked me in and I never came out.

Marisha (03:30.966)

Yeah. So now 30 years later, here we are. I love that. okay. So. But let's dive into, cause we're the title of this episode is stuttering goals. But writing goals is actually like a really tiny part of the puzzle. Right. And we want to make sure that we're doing a high quality assessment and also.

Nina Reeves (03:33.4)

Here we are. Here we are.

Marisha (03:59.722)

incorporating neurodiversity affirming and evidence based practice. what are some, can we have a quick discussion about some of the things that we want to think about before we dive into the goals?

Nina Reeves (04:13.874)

absolutely. It's so fun when people invite me to talk about goals because what everybody would really love me to do, I found out over the years is provide a goal bank, which Scott, Scott nor I will ever do. We have a pact that there will be no goal bank. And here's why. First of all, or well, you'll hear that through the next few minutes as we talk, but

Marisha (04:27.544)

Yeah, where's our gold?

Nina Reeves (04:41.741)

The first thing we have to know before you ever put pen to paper on what am I going to do with this kiddo is finding out where this kiddo is, where they've been, where they are now and where they want to go. And so that's that multi-dimensional assessment. The problem is, is that history in our profession has created a space, especially in the public schools, where there's got to be some kind of fluency count, right? And a lot of people focus on that.

And that becomes problematic right away. So let me tell you why. Okay? You probably already know why people listening know why, but I'm going to say it out loud to confirm your suspicions.

Counting stutters is, as I say, like chasing a greased pig. You're going to get it sometimes. You're going to miss a ton of them because it's when we count stutters in an assessment, we are counting what we can see. And so many of a child's stutters are beneath the surface. We're never going to see them. OK, it's really supposed to be about how stuck

that child is feeling under the surface, on top of the surface. Yes, we can see some of the things, but then we start creating a problem that we're objectifying the listener's experience of that child stuttering, not their experience of it. And we're missing a ton of information if that's primarily what we're looking for or basing our assessments on. Stuttering is at its core variable.

It's going to change from moment to moment, day to day, time to time, situation to situation. And so trying to decide that fluency counts are anything more than just what they make me do every three years is a waste of my time. So I'll do it right now until we find another way to get there. But it won't be something I will base my therapy plan on.

Nina Reeves (06:57.846)

I do think it's worth looking at because I get rich and salient information while I'm doing that. I'm looking at the observables and I'm saying, that's great, whatever, you know, that I'm not going to base anything on that, but I'm getting rich information. Is the child avoiding? Is the child pushing? Are there any kind of struggle behaviors happening? And all of that I'm getting from case history.

and I'm getting from working with the student themselves. So that's fine.

In that, I want to say, if anybody out there has heard me talk before, they know I'm going to bring up the ICF model, the International Classification of Functioning Disability and Health from the World Health Organization, which by the way, is smack dab in the middle of our scope of practice. It's how we are supposed to be working with every kiddo that we work with, every client, every adult, every patient.

we're supposed to be looking at the ICF model for our referral, our assessment, our therapy planning and our documentation. And if the people listening right now have never really gotten into it, I'm going to tell you, we'll put it in the show notes. I'll put the one that's on the ASHA website and then I'll put the one that my co-author Scott Yaros and his colleagues over the years have done a lot with for

how it relates to stuttering. And it's gonna change your world. Because then you look at it and you go, I'm going to assess, okay, I'm going to assess the child's function, okay, how stuck are they getting? What are the differences in how their speech system is functioning? But then also reactions, environment, and impact. Reactions being the thoughts, feelings, and behaviors that happen.

Nina Reeves (08:59.148)

because I'm a person who stutters in a world that doesn't get it. Okay? It's not even always a reaction to the actual stutter. It's a reaction to being and experiencing the world as a person who stutters. And so that's a huge part of what we're supposed to be looking at in an assessment and then writing goals for. And then the environment, how people perceive.

What's going on? What do they know about stuttering? What do they not know? What are the wrong things they've picked up? What are the facts we need to fill in? And then the impact. How is stuttering impacting this child's communication?

I could go into a ton on IDEA with the school base, but I'm just going to say communication, not academics. Don't let any administrator tell you it has to be clouding the academics. It's clouding the communication that invariably leads to adverse impact in education. So we want to look at that ICF model to set us up for success because I'm going to talk about that when we...

you know, when we go into how to write goals.

Marisha (10:19.35)

Yeah, that's perfect. so, cause you said that you still include, you may still include like the language sample kind of stuttering counts in your assessments, but what, and I know we don't have time to fully dive into this, but what types of components would we be including in like a gold star evaluation that address more of that, that I, the complete ICF model.

Nina Reeves (10:49.4)

Great question. Let me tell you, I may include it. I actually haven't, unless I've been forced to by some kind of institutional system that says you have to. I haven't done a fluency count on a kiddo. I can't even tell you the last time. And I literally have, well, we won't get into it. So here's the deal. To get into the ICF model, sure. You've got to...

take a look at how this child is stuttering. Yeah, it's just your observable behaviors. That's fine. We get some information about that as long as we look at it in context. And then we're gonna talk to the child and ask them questions about how their speech is feeling. Not how it sounds to us, but how their speech is feeling. And...

Scott and I have written extensively on this over the years. Many people address this. There's resources out there to help SLPs learn about how to interview kiddos or use questionnaires. Definitely that the history surrounding the kiddo, which means we're going to talk to the people in the child's environment. We're going to have them fill out some case history forms and some checklists and questionnaires.

because we want to know what they've been observing. Many times a caregiver can tell me a lot about whether the child is maybe changing words or, you know, not talking as much as they used to. These are all very big pieces of diagnostic information for me. So we're going to look at the whole child from the child, from other people. And

we're also going to take a look at how they think and how they feel. Okay, so that's going to be things like the OASIS, the behavioral assessment battery. There's many things out there. Stuttering anticipation scales, things that are there in our world that we can locate and use to make sure we're finding out is the child, does the child have any negative

Nina Reeves (13:11.749)

affect, thoughts, I can't talk, people don't want to listen to me. When you're interviewing a child and you're hearing words like, I messed up, I stuttered, that's diagnostically significant. If a stutter is a mess up, then we have some negative affect, thoughts and feelings. So I want to be looking at all of those things. We get the environmental information and the impact from

taking a look at the whole child and the Oasis gives us so much. The overall assessment of the speaker's experience of stuttering. The speaker's experience of stuttering. So that would round us out and give us such great information that a child may never say to us, but it's from seven and up. If you have a kiddo that's in that age range, you can find out.

if there's something there that you'll be addressing and writing goals on.

Marisha (14:17.708)

Yeah, I love that. And so, and we'll have a recap in the show notes too, to like the specific assessments that you mentioned, but I think a helpful framework is getting like interviewing the student, getting their questionnaires, reading skills, whatever that might look like, talking to other people in the environment, like parents or teachers. And we have different ways that we can do that as well. And then,

I'll see if we can gather some additional resources too, because you've written so much on all of these topics and we don't have time to do them all justice, but there's a lot of rabbit holes that we can go through to learn more about how to structure those interviews and which tools to use. So we will share that in the show notes as well. Okay. Anything you wanted to add along that train of thought?

Nina Reeves (15:00.957)

Yes.

Nina Reeves (15:04.403)

Great.

Nina Reeves (15:10.601)

Yes, in the assessment and all through therapy, I would love to watch us all as a profession consider ourselves detectives. I call it the SLP stutter detective, which means when we get a kiddo, let's just say even, okay, you get an initially value detecting. We already know that. I want us to look at any child that comes in and even ones we've been working with, sometimes step back and go, let me find out.

what this child has learned, has learned that's wrong, has to unlearn, or doesn't remember. Because we rely on reports. Well, that may be what they worked on, does the child, did the child understand it? Do they remember it at all? So I want us to, in those ongoing assessments, is to find out where are the gaps? What is this child not learned? Or what is

what is therapy not addressed for this kiddo or their family in the past? Because then I can go fill those gaps before I try to move on to anything else.

Marisha (16:22.2)

Perfect. then, so let's say we had like a gold star assessment and we incorporated all of that information. How do we use that to then transition? how do we approach writing goals and what's a effective way to navigate that?

Nina Reeves (16:40.585)

Well, you know, it's so fraught with nuances, but I'm going to try to boil it down.

Nina Reeves (16:52.135)

Some of the most important considerations that I keep in the back of my mind while I'm considering, as Scott and I call it, goal choice, not just the writing, but the choosing of what we're going to try to tackle, first, second, third, and then sometimes you have to sort of regroup and try different things. besides the fact that the ICF model

is going to now lead you into goal writing. You you're going to say, okay, where are our areas of strengths and challenges in the areas of function, reaction, environment, impact? And how am I going to address them? And which ones will be the most, I call it bang for your buck, you know, like what's going to get us the most movement right away? And the problem is, is that people

Imagine they go referral assessment tools, speech tools, strategies, skills. And I want to tell you neurodiversity affirming therapy practices do not do that. We are stepping back a whole lot from that idea that that's all SLPs do is teach kids strategies.

And I'll address that in a moment. But when I think about it, I want to look at, is this child, is this student, is this client involved in setting out what Ali Burke has from England, from the Palin Center calls best hopes? I have now decided that I'm not going to talk too much about goals anymore. I'm going to talk about best hopes because you know, goals like either get it or you don't. It's like a...

too contrasting. I love the idea of what are your best hopes for your communication this year? And I want my students when they're ready to be able to get into that with me. And so is that team, is that student involved in sort of being involved in their own therapy or we just writing goals for them? I think that's an important aspect. The second thing is I always ask myself, why am I doing what I'm doing? Okay.

Nina Reeves (19:19.643)

I'm writing this goal. Is there a principle behind this? Is there a reason? Is there evidence base?

I want to make certain I understand why I'm writing that down before I write it down. And then number three would be how do we get there? Because it doesn't matter what words you write. That's why Scott and I are like no gold banks, because you can write as many things from our gold bank as you want, but you may not have any idea why it's there and what to do with it. So the

what prerequisites are needed before we get into these kinds of activities that align with this goal. So there's a lot of thinking about this and not just about what can I put on the page. Unpopular opinion, but I have big shoulders, I'll take it. And then thinking, there's a couple more things. I would absolutely wanna know what is the intent

of the goal. Okay, so even if I know why I'm doing what I'm doing and how I'm going to get there, what is the overall intent of this goal that's going to take me into therapy practice? Okay, and if I move into practicing therapy or doing therapy practice with this student, does the student know why I'm doing what I'm doing, why we're working on what we're working on, and what the intent is? And here's where we get

into neurodiversity affirming, know, solidly. Because we have to be thinking, are we stepping back out of that medical pathology? Okay, where the intent of stuttering therapy was to make kids fluent. Stop their stuttering, make them stutter less, make their stutter. I've even heard SLPs say, we're just trying to make their stutter less noticeable.

Nina Reeves (21:23.13)

which is total masking. If we stop, step back and say stuttering is natural for people who stutter. my gosh, wait, what? You know, it's verbal diversity as we say, okay? And you were with me when we talked about verbal diversity the first time and blew up the summit on that one. It was like,

people went crazy because all of a sudden everybody had that mindset shift or the beginning of it or the validation of it that these kiddos have a different way of talking sometimes. Okay, they're all different from each other. But why is it okay to be everything in the world but it's not okay to stutter? What is that? It's, well, it's ableism.

You know, it's honoring quote unquote fluency above anything else. And we really have to think about that. It doesn't make us bad people, but we have to be thinking about what the unintended message is. If these kiddos only hear, yay, you did that fluently. You didn't stutter once. Then the opposite of that is make sure that you don't stutter because stuttering is bad. So what's the intent?

If I'm doing any kind of anything, is that to help this child communicate easier, more joyfully, more spontaneously, to become authentic instead of worrying about how they're talking. Okay? If I'm presenting anything that ends up being, so you don't stutter as much or even the unintended message of that.

then I'm off away from a goal that would be neurodiversity aligning.

Nina Reeves (23:29.143)

And number five is the most important thing is the goals that I'm writing, are they meaningful? Do they help this student have a feeling of successful communication that is not defined by how many stutters they had? It's successful communication where they just, they say what they want to say, when they want to say it, to whom they want to say it. Stutter and all.

Because if we take off this idea of fluency and look at what we are, we're communication specialists. I may not be passionate about this. We're communication specialists. So why aren't we focusing on whether this child is accessing the curriculum, saying what they want to say, going out for the extracurriculars that they want, making friends, connecting with other people?

rather than focusing on are they using their tools. That's a fixing message. And kids who stutter don't need fixing. need support and allies and they need to know, number one, it's not only okay to stutter, but it's okay to stutter. Not it's okay to stutter, but go back and make that one smooth. What? Wait.

That's totally opposite.

Yes, we are going to help them. If they're struggling with stuttering and if they're pushing their words out, yes, we're going to find ways to help them ease up that struggle. But it's not going to be focused on a bunch of strategies. They're still there in the background, but the fluency stuff that we have been focusing on for decades is taking a backseat. And sometimes it's not even there.

Nina Reeves (25:28.397)

I know that sounds unpopular opinion again, but it's really true that when a child starts to understand that they're okay exactly how they are, they stop fighting with their stutter, which makes struggle less, it happens less, and nervousness and worry and all the reactions.

It's a big switch for us, but it is the way in which we see stuttering in a social relational model rather than a medical model.

Marisha (26:09.11)

Yeah. I love that. I love how you explained that too. have like, I bookmarked a bunch of stuff as we were recording. was like, I need to write that down in that, that one in that. so many good things. yeah. Thank you so much for breaking that down. And like you said, we've been doing things. Well, a lot of us have been doing things very differently for like, you said decades. And so.

what resources would you recommend for SLPs who are like, okay, this explanation makes sense to me and I'd like to try to implement this and learn those strategies or not strategies, like understand the approach and how to navigate that in my therapy sessions or in our therapy sessions. How would you recommend that they start that journey? Like what resources would be helpful?

Nina Reeves (26:52.441)

Yes, I get you.

Nina Reeves (27:08.865)

Okay, so many. The good news is that there's so many, right? Don't overwhelm yourself. Number one, take small steps. The first thing is what you just said. I recognize that I have to make some shifts. Everybody's in a different place. Some people listening to this are going, yay, I've been doing that for years, right? Other people are going, uh-oh, I just came out of...

university and my professor said, we are going to use timed syllable speech. And they're looking at what I'm saying and going, this is so opposite. Now we won't panic. We can be neurodiversity affirming stuttering therapists by looking at the idea that

strategies and skills are less as less part of the puzzle as we thought and we're going to have to get some centering ideas about what's in our scope of practice but may not have been trained for us counseling in communication disorders and differences now the minute i say that we're counseling everybody's like they get all scared

Okay, if you haven't had a lot of this, that's okay. I never had a counseling course. Everything that I've learned over the years has been from other people, self-taught, diving into the literature, finding the resources that I'm going to put in the show notes. There's this idea that you don't have to be a counselor to have some skills of how to, it's really relational.

Counseling is relational, right? It's listening and discovering and being curious so that people that you're working with actually find these things on their own over time. And so there's a lot of things out there for, especially in the world of stuttering, how we bring those skills of acceptance and commitment therapy, cognitive and behavioral therapy. I love...

Nina Reeves (29:36.19)

avoidance reduction therapy. Some of the things coming out as a solution focused therapy from the Michael Palin Center in England. There are many things that we'll put in the notes to help people know that you can find this information out there and bring it bit by bit into your mindset shift that then shifts your practices.

First thing always, shift the mindset. If you're sitting here and going, this makes sense to me, I just don't know how to do it, you're gonna find ways to do it because now it makes sense to you. And when I say stuttering is verbal diversity, so many of my colleagues and other, and people who stutter just have this big sigh of relief. Like, I always sort of figured that.

I never felt like a fluency strategy was the way I was supposed to be going or trying to make them be fluent because I could never make them all fluent anyway. So I was just doing things over and over and I was frustrated and they were frustrated and the caregivers and the teachers, everyone was frustrated because I wasn't making them fluent. And you're validating. I am, me. And now you and I together are validating.

That was never really the point. It's what society thinks is the point. Because listeners have to take a chill pill. They have to get into the idea that people who stutter do not need to change themselves so that we feel more comfortable. Like, let's get desensitized to hearing different ways of people talking. And that's what stuttering is. It's like accents, it's like different languages, it's like whatever.

People speak differently. Stuttering is one of those things.

Nina Reeves (31:34.486)

Let's get on board.

Nina Reeves (31:39.755)

So that's part of the resources, is the counseling resources. There's a lot of CEs out there, people are doing a lot of articles. I'll put a couple of articles. One whole entire forum from language, speech and hearing services in the schools, January, 2023 issue was ableism and school therapy for stuttering and autism.

You want to talk? Well, that's where we got the neurodiversity movement was the autistic population said, wait, why do we have to look and sound and be like you when that's not how our neurology works? Same with stuttering.

Marisha (32:29.334)

Yeah. Okay. Amazing. and yeah, so there's a lot more to dive into. I feel like that's the trend with all of these episodes. It's like, it's just the beginning, just the tip. but hopefully this, I hope that people listening, are like, whether you're already implementing like this and it helps you, it's a feel good episode. or if you're kind of in the process of like,

Nina Reeves (32:30.41)

Yeah.

Marisha (32:58.05)

figuring this out and exploring that mindset. I hope that this was a great overview for you too. And like we said, we'll have lots and lots of resources in the show notes if you're interested in learning more. But did you have any final thoughts before we close out, Nina?

Nina Reeves (33:18.112)

I think I have one that I can't believe I didn't say at the beginning is that if you want to understand the experience of people who stutter, listen to people who stutter. I'm not the expert in this. I got the speechy stuff background and the experience background because I have thrown myself into the world of stuttering and the support and self-help communities.

I have both of those parts of me where I have realized just because I know it from a book doesn't mean that's what this person needs. So listen to people who stutter. Now everybody's going to have a different experience. So it's not like this person who stutter says I should do this. Wait, stop. Okay, that's great. Bring it in and put it through the idea of evidence base and then try to find ways

to see if that works for this particular child. It's really more about experiential learning than book learning. It's about relating to people and listening to their stories, their experiences. Because once you hear people who stutter, who have been around the block for a while, you will say, I will not try to make people fluent anymore.

that can do more harm in the end. And I have been listening to society say that's what they want from me, even if it didn't resonate with me in the time. So I'm going to get with the facts that I can't cure stuttering, but I'm also going to say that doesn't mean I don't.

that people who stutter are not eligible for therapy and need support and understanding and guidance as a team, as a relational team, you know, navigating my favorite new word. It's not really new. I've been saying it a lot, but I'm really bringing it up a lot. You're helping.

Nina Reeves (35:34.033)

and being an ally and a supporter for people who stutter to learn to navigate stuttering in a world, in societies that don't understand it. And they're going to show up as themselves and learn how to navigate this. Whether somebody accepts it or doesn't, they're going to learn to accept it in themselves. And that's our thought. It's our role.

Marisha (36:06.582)

Yeah. And I feel like I've been pausing after everything you said, because I just want to let that sink in. But yeah, no, this is great. Thank you so much for being so generous with your time and expertise today. And then, yeah, the show notes will be chock full of resources to continue exploring. And man, I wish we had.

Nina Reeves (36:13.714)

Hahaha

Marisha (36:34.188)

way more time to dive in because there's so many more questions, but I think this will be a good starting point and yeah, thank you again.

Nina Reeves (36:43.584)

I appreciate you giving me the opportunity. It's a very obviously passionate topic. And I hope that the listeners can find nuggets in there that help and then resources in the show notes that keep them on their journey.

Marisha (37:04.332)

Yeah, I agree. Well, thank you so much to all of you who tuned in too, and we'll see you in the next episode.

Marisha (00:00)

Hey, it's Marisha and I cannot wait to continue our goal series. This is the last solo episode that I'll be recording for a little while. And we are going to dive into syntax. So here we go. And I know a lot of you might be thinking, don't hit pause just yet. If you're working with preschool, early elementary,

This might still be an impactful area to work on with some students. It's not just an area for older students. And we'll talk a little bit about kind of the norms and what this would look like. And I have come to really, really love this area as like an intervention. And I hope you enjoy it as much as I do. So like we've done in previous episodes,

I wanna chat a little bit about why we might even target syntax. And like I said, this is relevant even with preschool, kindergarten, early elementary kiddos. So I love this quote from Balthazar and Scott, 2023. Again, I'll link to the articles and citations in the show notes. You can find the syntax.

the resources for this episode at slpnow.com slash 199. But again, the quote from Balthazar and Scott, 2023. So they say, inability to comprehend key sentences in a text will undermine finding the main idea, drawing conclusions, making inferences, or answering many comprehension questions. So, whoa, okay, let's break that down. So syntax, if teachers are,

reporting that students are having difficulty identifying the main idea, like summarizing, making inferences, answering comprehension questions. Those could all be related to syntax. Well, OK. And this could also be true. Like if we're hearing that students are struggling with following directions, syntax could also be an issue. And then Balthazar and Scott also say,

Students are expected to engage in oral discussion of topics and issues where complex ideas require complex sentences to explain, elaborate, and debate. producing compound complex sentences is necessary to express those complex ideas and to understand complex ideas too. So the name of this article is Sentences Are Key.

And sentences really are key. Syntax is a huge component of a lot of the skills in areas that we might see students struggling with. So it might look like they're having difficulty summarizing or making inferences or with comprehension, but maybe syntax is really like that core component that they need support with. I just.

Love that kind of stuff. some skills that we might target include compound and complex sentences, comprehension of clauses, like relative clauses, adverbial clauses, et cetera, et cetera, or production of those clauses. And then we might also look at passive voice. So.

Whew, those are a lot of things. And I will link to some different resources about compound and complex sentences and clauses and passive voice because we don't have time to break those all down in this episode. But I wanted to touch on just some of the developmental expectations because I know that I presented on

Syntax at the summit and I heard a lot of chatter about well, that's a course for older students It doesn't apply to me But it's it's you'll see when we go through the research. It's really interesting to see At what ages these skills start to come into play? so Let's look at some of that data. So when it comes to production of compound or complex sentences and clauses

So Owens et al. 2024 looked at conversational language samples for 196 children ages 5 through 10, and they found that five-year-olds used an average of 1.25 subordinate clauses and 2.05 coordinate clauses. So even five-year-olds are starting to produce clauses in compound and complex sentences.

this number continues to increase with age. then page seven of their article has a really nice table. So again, this is Owens et al 2024. And I'll link to it in the show notes at slpnow.com slash 199. But if we are, even when we're working with five year olds, if we see that they're not using any compound sentences, if they're only speaking in simple sentences,

that might be an indicator that we want to target syntax with those students. And that could look like producing, we could write a goal around producing compound or complex sentences. And again, if we think back to what Balthazar and Scott said, the quotations I shared at the beginning, like this is a key skill. Like this will impact.

So many of the discussions happening in the classroom and the stories that kiddos are telling, they require a lot of complex ideas and students really need those to be able to express themselves, but also to understand all of these concepts that are being taught. And so it is a really integral component even from the early school age years. And like I said, I consider this as a goal if I'm not seeing any compound or complex sentences, they're not using.

any types of clauses and I would see that in a language sample. So this is why it's important to grab a good language sample. And then some other things we might see if students are struggling to express themselves in the classroom. So this might be like they're only writing simple sentences or they're only communicating in simple sentences in the classroom. If they're having difficulty with

classroom discussions or math word problems. Like these are all types of things that we might see. And that's why it's important to use classroom observation, parent teacher report or examples, et cetera, et to get that full picture and not just maybe a subtest of a formal assessment to help us decide our goals. Something else we can do or something, another area we can look at.

is comprehension of clauses. So students might be using simpler sentences, but they might also struggle to comprehend different types of clauses. So when we are looking at narratives and expository texts, we see a lot of temporal and causal, or causal conjunctions and

a lot of adverbial clauses to this is how we connect ideas and we'll see those a lot in directions as well. And so looking at those types of clauses and looking at the comprehension of those types of clauses can be really impactful, especially if we're seeing students struggle in those types of areas. And just another quote from Scott and Balthazar 2010.

They state that relative clauses occur regularly in narrative and expository text throughout the school years. And so again, just more rationale for why we might want to look at that. And if you're like, okay, so how am I going to look at comprehension of clauses? We have some activities in SLP Now membership. If you're a member, you can just search for, we have a syntax section that

has all of the clause resources. But if you're not a member, you can sign up for a trial. I'll include a link in the show notes as well. Or you can just go to slpnow.com. But your trial includes some free downloads if you want to check out some of those resources too. then so we want to look at comprehension of clauses if we're hearing about any of those types of.

challenges in our parent teacher report or in our observations during assessment, etc. The last area that I wanted to touch on was comprehension of passive voice and

They found, so Owens 2016 found that approximately half of five year old children accurately comprehend reversible passive sentences and 90 % of children between the ages of seven and a half. So this is a skill that many like kindergartners are coming in with. And especially as we get into like second and third grade, the majority of vast majority of children.

should be comprehending those reversible passes. And it's a skill that develops early in the school-age years. And it might be worth targeting if students are really struggling with comprehension or following directions because those, yeah, that is coming up. That might be part of the element because there is quite a bit of

passive voice in the books and the articles that students are encountering throughout the school day. And again, if I'm noticing in parent-teacher report, classroom observations, work samples, if I'm noticing that difficulty with comprehension, I might do a quick probe or dynamic assessment to look at comprehension of clauses and or passive voice.

to decide if that might be a worthwhile area to target. And again, we have resources for, we also have resources for passive voice inside the SLP Now membership if you're looking for a quick way to start looking at some of this. so given that information, some goals that we could write are like if we're looking at the comprehension side of things, students will answer questions about

sentences or paragraphs that have those target skills, whether it's passive voice, temporal conjunctions, causal conjunctions, relative clauses, three or more clauses. There's a lot of different ways that we can set that up. and again, check out the show notes, slpnow.com slash one 89 for a written overview of this. And so we just touch on comprehension.

We can also write goals for production where students will produce sentences using passive voice, temporal, causal conjunctions, relative clauses. And we can write goals for, like if they produce, if we collect a language sample and they produce like zero subordinate clauses and zero coordinate clauses, we could write a goal for that as well. That's a little bit higher level.

So we can have like, when given a picture, student will produce a compound sentence. Or we can look at the language sample and see if they're using compound or complex sentences in their spoken language. So there's different ways to piece that up. And it really depends on the student.

what we think is achievable within the goal period and or the IEP and just what would be the most impactful for them as well. So I hope this was a helpful overview. We'll have Mina Reeves on the podcast next week to talk about stuttering and really excited for that conversation. And I hope you have a great rest of your week.

Marisha (00:00)

Hey there, SLP. I'm excited that you're joining me for another episode in the goals series that we're doing here on the podcast. Today we are diving into grammar goals and we're focusing on more foundational grammar skills today. And then next week we'll chat about syntax, which I think that might be a goal area that I'm most excited about!

But I love a good grammar goal too. So let's go ahead and dive right in. As always, I'd like to start off with a little bit of a rationale in terms of why we might want to target grammar with our students and what we want to be thinking about. So Fey et al have a beautiful, beautiful article. It was published in 2003. I'll include a link in the show notes at slpnow.com/198.

But it's, and they have some follow-up articles too, but the 2003 article include, is titled 10 principles of grammar facilitation for children with SLI, specific language impairment. And they have some really great strategies. They've written some follow-up articles with even more strategies. So if you're wanting to step up your grammar intervention, do check out those articles, they're phenomenal. But Fey et al. say that the basic goal of all grammatical intervention should be to help the child achieve greater facility in the comprehension and use of syntax and morphology in the service of conversation, narration, exposition, and other textual genres in both written and oral modalities. So that was a long quote.

It can be easy to get bogged down and nitpick at all the grammar and to get overwhelmed. But our ultimate goal is for students to be able to comprehend sentences and understand sentences and then be able to use grammar to communicate their thoughts and ideas. And so that is the ultimate goal behind all of any goal that we might write. And we're really wanting to help students access their curriculum.

To be able to understand and communicate effectively. And that is the ultimate goal. So let's have that as our lens as we start thinking about goals. And I love this quote by Eisenberg. She says that, is crucial. Students must have a reason for doing the things that lead them to learn and use grammar so they can read, write, and speak better. So I love getting to, because grammar is one of those areas where it isn't a lot of SLP's favorites and not a lot of students' favorites either. But it can be so impactful. And if we can talk to students about why it matters, how it can help them, and we'll get some examples as we go through, especially when it comes to syntax. my goodness, it's so cool.

But if we talk about how it'll impact them, how it can help them and then embed the practice in really meaningful context. We've got some beautiful intervention going on. So some things that we might think about when we're writing grammar goals, we might be looking at like MLU, main clause structure, objective and possessive pronouns, regular and irregular plural nouns, subject verb agreement, regular and irregular past tense verbs, negation, question formulation, all of those types of things. And then, like I said, we'll talk about syntax in the next episode. So those are all of the types of things that we might be looking at and thinking about as we're considering grammar goals. as always, we often are required to administer formal assessments.

And we might have some subtests telling us that students need help with grammar, but we want to look at multiple data sources. So we want to look at that formal assessment data. Yes, we want to look at parent and teacher report, work samples, classroom observations, language samples. We want to take multiple pieces of data to really understand. What are the students strengths and what are their needs?

Because they might have performed poorly on a grammar subtest, not because of grammar skills, but because of executive function, for example. Or maybe it was more of a vocabulary issue or comprehension. So we don't want to just take one piece of data and use that to determine our goals. We want to look at the whole picture and use that to decide what makes the most sense.

That's what we've got there. then in terms of developmental expectations, Guo et al in 2016, again, I'll put the citation in the show notes at slpnow.com/198. But they, Guo et al, looked at language samples for 300 typically developing children.

Check out the article for specific numbers for different age ranges. But for example, six-year-olds produced an average of 90.64% of grammatically correct utterances. So they call that PGU. So 90% on average, I believe the standard deviation was like six. So the majority of kiddos were producing sentences with 80 to 96-ish or 84 to 96-ish percent accuracy, roughly. Check out the article for the specific numbers. That gives us an idea for how many errors we're expecting at that age for six-year-olds, for example.

And the number continues to increase as students get older. So that's just something to keep in mind. That gives us kind of a frame for reference if we're looking at a language sample and deciding if there might be a need for grammatical intervention, for example, especially if parent-teacher report, we're seeing this in their work samples, et cetera. So one goal or a couple avenues for goals, we could keep it very, very general. Going along with the Guo et al study, we can have a goal around students producing X percentage of grammatically correct sentences.

and using that PGU measure using a language sample, which again, check out the Guo et al article. Another way that we can approach this is the percent of grammatical responses. So PGU uses a language sample, and PGR (percentage of grammatical responses) uses pictures and prompts. And then they measure the percentage of grammatically correct responses. And again, this is Eisenberg and Guo 2017. They did the study with three year olds, but they give you the pictures and the prompts. And so that could be an interesting measure to use.

That can be like a really general goal, but we likely want to select specific targets that the students demonstrate needs for. And we like, in order to make progress towards that goal, we would have to target specific structures anyway. But that is one option in approaching our goal of writing.

Another goal would be to identify the specific targets. Whether we're working on comprehension or production. And we can decide what would be most impactful for our students. But.

We would select a target that we want the student to demonstrate comprehension or production of. So, for example, for comprehension of plural nouns, we might give the students some sentences and they have to identify the correct picture. So whether it's singular versus plural. So we might have the doc, the girl is walking the dogs. And then we have a picture of a girl walking one dog versus two dogs. And then they have to identify the correct picture.

That could be one example of a comprehension goal that we set up or for production, we just give the student those pictures and they have to produce a sentence. And that can be one level of it, or we can ask, we can expect them to produce those targets in structured activities and spontaneous speech. There's lots of ways to write these goals, but the basic formula is having a specific skill.

And then deciding how you want to measure it and describing that in the goal. And then these sample goals that I'm giving don't include, again, duration, accuracy, criterion, level of support, baseline setting, et cetera, et So we obviously want to add in elements that are required and that make for a clear, smart goal.

And like I was saying, it makes it a lot easier to write and measure the goal throughout the IEP if we're able to figure out how we want to assess this goal. So whether you're using like a rubric or a probe, just make sure that you have that ready to go to make sure that you're writing a goal that is actually measurable. And then it'll make your progress monitoring and progress reporting a million times easier if you have that ready to go. And then if you can attach anything, any of those types of resources to the IEP, that makes it even more impactful. If the student were to transfer or if they moved to a different SLP for whatever reason, then we'll have that continuity in our intervention and it'll be just beautiful stuff.

Okay, so we're wanting to think about, I'll link to the episodes on grammar intervention and how to embed that in case that makes it easier to think about goal writing too, because that context is important. But in the show notes, I'm also going to list a guide created by the Informed SLP.

It gives a suggested sequence for grammar intervention. There are a lot of skills on this list. But if we are, let's say we collect, so we have formal assessment data. We have our parent and teacher report. We observe in the classroom, we have work samples. We've done some informal assessmentm have that language sample. We have a lot of pieces of data.

And across those pieces of data, we've likely identified targets that the student seems to struggle with, whether they haven't been able to produce them or they've produced them incorrectly. So we can have a working list of targets. And then you can look at the Informed SLP's guide. "OK, I have a list of 10 things, 10 grammar targets."

"How do I decide how to tackle this? Which one do I want to target first? In what sequence do I do this in?" The Informed SLP guide will walk you through that. It's a really nice resource. But I think it is a little overwhelming to look at all those skills. If you don't have any of that data going in, then it might be like, my goodness. But it can also be helpful if you're wanting to do some.

It could guide your assessment too. "I feel like the student is around this level." You can probe some of those skills to decide what you might want to target as well. So there's a couple of different ways to use that. but the main thing that we're looking at are like, what are the common threads across all of these sources of data? What are the parents, teachers saying? What am I observing in the classroom? What do the work samples show?

And really thinking about what's impacting the student's ability to access the curriculum and participate in the classroom. So yes, the suggested sequence is really helpful. But if there's a skill a little bit further down the list that are really, really impacting the student in the classroom, we might want to prioritize that.

Obviously want to think about the whole scope of that and looking at the whole child as we're deciding. which goals we want to write and how we want to tackle all of the different skills. So that's what we've got for our grammar goals. Again, head to slpnow.com/198 for quick links to the articles that I mentioned and also some example goals written out. And then I'll also link to the Informed SLP's guide for the suggested sequence of different grammar targets. And yeah, I'll see you next week where we'll continue the conversation on syntax. Hope you have a good one.

Marisha (00:00)

Hey, it's Marisha and we are continuing our series on vocabulary. I'm really excited. So last week we talked about earlier, more foundational vocabulary goals. And today we're continuing the conversation and talking about more complex vocabulary goals and I'm really excited. So let's go ahead and dive right in. So this is, and we talked about this

last week, but students' comprehension improves if they are taught keywords prior to reading, especially when it comes to like tier two words. I've read research and in my personal experience, I found that this doesn't apply as much to like basic concepts and categories, object functions, more of that foundational vocabulary because they kind of, if they don't have that very base vocabulary,

We don't really have words to define it for them and it just, it works out better if they can experience it. but with tier two words, when we're working on those skills, students already have that foundational vocabulary and they have words to understand other words. So I think to me, that's how I rationalize why that makes sense. so yes, we found that comprehension improves if we pre-teach vocabulary words.

And I have an experience when I was a few years into being at an SLP, I was using a reading passage with some of my sixth graders. And it was a passage that we pulled from the classroom. It was a forensic science article. And I was really excited that I was just using anything from the curriculum. And we did.

We just dove in, we read the article, and then we did some comprehension activities. And this article included a lot of really great vocabulary words like suspect and investigate and evidence. And I didn't think to check to make sure that students understood these key words. And there, you might not be surprised.

but they didn't have, like their comprehension was not great. And when I was like, hmm, I wonder what happened. Cause they were super engaged in the reading. Like, why don't they comprehend this? When I did a probe to see if they understood the vocabulary, they didn't. And that was the missing component. And that really impacted their comprehension. And so that was a learning experience for me.

as a younger SLP, and that might have been obvious to you from the start, but that experience really stuck with me and I was like, okay, let's pre-teach our vocabulary before we dive into an article. And it's just as a really nice strategy. And if we are, so for using the approach where we pre-teach vocabulary words that are, and we select, like we identify the words that we want to target from a text.

We pre-teach them, and then we read the text. Students have multiple, like they are seeing those words in context multiple times. And last week we talked about how many meaningful exposures students need to master a vocabulary word and add it to their mental dictionary, so to speak. this is a really nice strategy that we can use when targeting.

This is jumping ahead because today we're talking about goals. But this information, this context is really important when we think about how we're writing goals. And there have been multiple studies where children have been able to learn and retain new vocabulary when we give them direct explanation, which we're doing when we're pre-teaching. And doing that,

increases, they're like they're more likely to actually learn those words if we pre-teach and give that direct explanation versus just giving them the opportunity to read those words in text. And last week we talked about how important that direct instruction of target vocabulary words is for our students because they struggle to learn those words indirectly and they really, really benefit from that direct exp-

exposure like that direct teaching and then they also need a larger number of exposures meaningful exposures than maybe their peers. So given that context and thinking about okay, so how do we use this to decide what types of goals we're targeting with our students or how we're writing and structuring our goals? We do want to look at

multiple data sources, and I say this multiple times every episode because it is so important. So we are often required to administer formal assessments and we have subtests that look at vocabulary skills and it's really easy to just look at those vocabulary subtests and write goals based on that. But we want to look at more than just that. We want to consider parent and teacher report.

Like, are they, are parents or teachers reporting difficulty with vocabulary or comprehension? Like, what are their types of, what concerns do they have? And could that be related to vocabulary? We might want to also implement some criterion referenced assessments, or we might want to do some probes or dynamic assessment based on the concerns that parents or teachers are bringing up.

and do some kind of sleuthing and investigating as to what could be the root cause to help us get like determine the most meaningful goal. And dynamic assessment can be particularly helpful because maybe vocabulary isn't the thing that students need. Like if they struggle with comprehension, maybe it's something different. So if we could do a comprehension activity,

without pre-teaching the vocabulary and see if teaching the vocabulary improves their performance. But maybe it's something else. Maybe it's like executive function, attention type of thing. But that dynamic assessment will give us some of that data in helping to determine the best course of action. And so that's why we want to collect those multiple sources of data. And of course, we want to be writing goals that

will actually help our students access their curriculum. So if it's not, if parents and teachers aren't reporting it as an area of concern, if their work samples look beautiful and they're doing really well on classroom-based activities and we observe them in the classroom and they seem to be doing really well, then maybe it doesn't.

Like we'd obviously want to consider it, but maybe the formal assessment results aren't very helpful. And maybe it's an indicator of something else, for example. So that's why we want to take those multiple pieces of data and kind of put it on our investigative hats to determine what the students actually need. So that's kind of our foundational discussion and some potential goal areas.

our affixes and I'm including, we're going to just touch on affixes really quickly and then we're going to spend the majority, like the rest of our time chatting about tier two words. Mostly because I've just found a lot more research around interventions for tier two words and it can be really impactful for our students. But.

We have.

So with affixes, so those are prefixes and suffixes. And this can be, and it might not work for every student, which is why we might want to do a little bit of dynamic assessment and consider other factors, whether this would be a good approach for students or not. I feel like this is a little bit more of a higher level goal. And we,

might want to start with two tier two words potentially. But I wanted to include this because there's apparently there are four prefixes and four suffixes that account for 90 % of affixed words. So we could in theory teach four prefixes and four suffixes

And that would help students break down like 97 % of the affixed words that they encounter like in the curriculum in their daily life. So for example, pre is one of those prefixes. And so if we can teach students, okay, pre means before. And this is how you identify

as a prefix in words, and this is how you can use it to determine what the word means, that can be a really powerful and impactful strategy. But it might require a little bit too much for some of our students, and it might be really difficult for them to actually use this, which is why I'm sometimes hesitant, but I've seen it be

really impactful and work really well for some students, which is why I want to share it. But if that is approach that we want to look at, like it makes a lot of sense and it's a little bit more concrete than like it's a little bit more of a helpful strategy potentially than like just using context clues. Although context clues might include looking at the word parts.

But it's a little bit less for students to manage because with context clues, we're thinking about a lot of different things. So yeah, but some goal areas that we might include are just being able to identify the parts of a word. So identifying prefixes and suffixes in a word, being able to state the meaning of a prefix and suffix, and maybe we would include the list of like, they can state the meaning of these eight.

prefixes and suffixes, although that is not super functional. That might be more of like a benchmark kind of thing. But then the more meaningful goal would be to state the meaning of an unknown word by using word parts. So students would learn to identify the prefix and the suffix potentially, and then use that to guess the meaning of the word.

could be a strategy that we look at. again, these are just goal stems. We would obviously want to add the baseline and the criterion and the duration and level of support and all of those types of things to make it an actually good goal. But that is something that we can do. And it might be helpful to identify the specific prefixes and or suffixes that we want to use.

just to have it be a little bit more of a specific goal. And then, so that's, I just wanted to touch on affixes briefly, but like I said, there's a lot more research around tier two words. And there's a lot of ways that we can approach this. And I, over the years, I've kind of become

a fan of really, really specific goals because our students don't always, like especially with vocabulary, it's difficult to see generalization. And so like in the previous episode, I talked about basic concepts and having a specific list of concepts that I want to target throughout the year. I feel like it makes my intervention more focused and intentional.

And then maybe we can have a list of generalization concepts too. But I feel like...

We just don't see a lot of generalization, especially with our students, because of all of the effects that we talked about. Like our students need direct exposure to words. They need that direct instruction, multiple, like 20, 30 plus meaningful exposures before they add that. So we have to be really, really intentional. And so I think selecting specific words.

is a really great strategy. And that's what they've been doing in the research as well. So I'm going to share two examples. So there was a study by Lohmann et al in 2018. And again, I'll share the link to the actual article in the show notes. You can find that at slpnow.com slash 197. And those are the digits. So 197.

They selected, so this was cool. Five kindergarten teachers selected 12 instructional verbs that they believe that students should know by the end of kindergarten. So some of those words were identify, predict, match, sort, illustrate. So these are the types of words that are coming up all of the time in directions. And the authors.

Like the researchers created four stories and each of the stories were intended to teach three of those instructional verbs. And they recruited preschoolers for a summer program. And then they did a book reading group versus their control group. And the book reading group had interactive reading experiences. They included

explicit instruction of the vocabulary words. They did definitions, all of that. And it was only three weeks of intervention. And the students in the book reading group learned significantly more verbs than the control group. And they maintained this advantage when they started school two months later. So this is a...

I thought this was really creative because they worked with the teachers to identify meaningful words and then they had really structured activities to teach those target words. And then, so that could just be a beautiful goal. Like if this were during summer school, like student will, whether like define 12 instructional verbs selected by the curriculum team or whatever.

And then you would attach a list of those words. You would get your baseline and then you would measure your progress by the end. throughout summer school or throughout your IEP year, you would target those words and make sure that students learn them. And then, I don't know, I just think that's so cool. So, it just makes a lot of sense for intervention and it's very intentional and very impactful because these words were selected by the teachers.

And if you're working with kindergartners, this would be a great list of words to use. Like I said, some examples were identify, predict, match, sort. Even with first graders and second graders, that could be a really helpful list of vocabulary words to target. But you can mimic this model.

whether you're working with kindergartners or 12th graders and use a similar approach where you select the words that are going to be really important in the curriculum and then teach them. And as we're doing that, because it can be a little bit, I've struggled because it sounds really nice to, like we want to teach students to fish and I want to teach them like,

big skills that will impact them and that they can use across all the things. But the vocabulary research is telling us that our students need that direct instruction and we need to teach them words directly. And so we might as well just be picking, selecting words that are going to have an impact and be meaningful. And that's, there's tons of research that can still be done to

can really determine what those words are. But if we can be really thoughtful about the words that we're targeting, and we can target them in a really strategic way, I think that's really, I don't know, it's just a really nice way to structure intervention. And then, okay, one more example. This is from Spencer et al. 2023, but they did something similar.

If you've probably heard of Story Champs, but it's a narrative intervention program. They developed 24 new stories. The stories were each about 100 words long. They included all of the central story grammar elements. And then they each story included two intentionally woven in academic vocabulary words. And there are lists out there of tier two vocabulary words by grade.

So if you're considering writing a goal in this way, you could just search for a list and pick the words that you think make sense. But I think it is really meaningful if you can do it like the Lohman et al article and work with the teachers to select those words. But this could be really cool. I was working with a group of second grade teachers, and they had a professional

like their yearly professional goal was to really improve math board problems. And there's common words that continue to come up in those activities. And that would have been so meaningful if I had come up with a list of words and wrote a goal to teach the students those words. But we can get strategic in how we select the words, whether it's super easy or collaborating with the team. Anyway, back to the study.

So they included two target words in each story. And they did this with first graders, but they had structured discussions about the words. And then they had at least eight opportunities to practice each word. And they did this by describing pictures, retelling the story, telling a personal story, using the new words. And they included, the article goes into a lot more detail on the prompting and support.

But they found that all students who participated in the intervention improved measures of immediate word learning as well as retention of those words. So again, these are just some studies to look at for inspiration if you're thinking about writing goals in this way. But there's some really compelling data and yeah, I think it's a really, especially for picking tier two vocabulary words.

These are words that are going to come up through the student's entire school experience. And we can continue to add on more and more words. And by teaching them these words, hopefully they're able to master more complex words as we go. And as we're teaching them these words, there are some incidental learning, there are learning strategies and all of that. It's not, we're not.

just teaching those words. They are learning strategies as we go along. yeah, hopefully that helps a little bit if you're feeling overwhelmed by the goal setting process. But just a quick recap. we, an example of a goal could be to define X number of words and include a list, like attach it to the IEP. And if you

Like if you're working with kindergartners, borrow that, those 12 instructional verbs. That's beautiful and that's perfect. And then just target those goals throughout the year or target those words. and that would be beautiful, but you can do that with math vocabulary words, or maybe you're partnering with the social studies or science or whatever the using that to determine those word lists and then

strategically targeting them throughout your units. And then you're off to the races. then, yeah. So that's, I'll include a written version of this again in the show notes at slpnow.com slash 197. I hope you enjoyed this episode and I'll see you next week as we dive into grammar.

Hello there and welcome to the SLP Now podcast. I will be your host and presenter today. We're continuing the goal series and today we are going to chat about vocabulary goals, starting with kind of more of the foundational skills. And then next week we're going to dive into more complex vocabulary goals.

Before we dive into the goals that we're writing, I want to take a quick moment to think about the importance of these goals and why we might want to include vocabulary goals because we do have very limited time in our sessions and we only get to write a handful of goals for our students. And we want to be selecting the goals that are going to make a meaningful impact and allow them to access the curriculum and just make their lives a little bit better. So I want to start off by revisiting the Matthew Effect. This was shared by Stanovich in 1986. The Matthew Effect is the effect where students who read more tend to learn more words, which results in improved comprehension.

If we're trying to read a passage and we don't understand the words, then that is going to significantly impact our comprehension. But on the other hand, if students struggle with reading, they are reading less, they're learning fewer words, and they're having poor comprehension as a result because they aren't able to read as much, they're not getting as much exposure, they're not learning as many words, and because they have a smaller vocabulary, they've struggled with their comprehension. And so it's just this not so fun effect where a lot of our students continue to fall behind because they have that initial struggle to be able to read and then they're reading less and learning less words, which then impacts their comprehension.

That is some of the rationale behind targeting vocabulary is just helping our students catch up in that way. And of course, targeting reading and improving their ability to read would make a big impact as well. But today we're focusing on vocabulary. And then another compounding effect here is that a lot of the students that we work with often don't learn words indirectly. And they struggle to learn words directly and they need to be taught words in a more direct way. And this is, this was discussed by Pence and Justice in 2004. I'll share the research citation in the show notes, which you can find at slpnow.com/196.

So our students are reading less, they're learning fewer words and they're just getting less exposure. And with the exposure that they're getting, they're not learning words. They're learning fewer words indirectly as well. And they need to be taught words directly. So you can see how that continues to compound and compound and compound. And it's interesting too, there's a lot of research around how many exposures a student needs to a word for it to become a part of their vocabulary. And Marzano in 2004 said that the average child needs 15 meaningful exposures for a word to become automation.

And then Pence and Justice in 2004, again, shared that children with language impairments need more exposures than the average child. We need to be thinking about that when we're writing goals in terms of, OK, so what is realistic for our students and how do we want to tackle this? And we'll revisit that in just a little bit.

But some other things that I wanted to share. So Snell et al. in 2015 talked about vocabulary being identified as a key factor in the achievement gap. Children from low income families know significantly fewer words when they enter school. And if we go back to that Matthew effect, because they know fewer words, that results in poorer comprehension.

And then they struggle with reading more and it's just this cyclical cycle. And the number of words in a child's vocabulary is an indicator of their linguistic health and it's a factor in their ability to use language in varied context. So we have a lot of rationale behind why we might want to target vocabulary for our students.

But how do we know if this is an area that we want to target? So one huge red flag for me, and of course, we have our formal assessment data and there is going to be, there will be vocabulary subtests that, and if they score below, like if they score lower in those areas, that might be an indicator that we want to look at vocabulary.

But we also want to be looking at parent and teacher report. Are parents and teachers reporting that these students struggle with comprehension? Are they struggling readers? Are they falling behind on the measures that teachers are collecting in terms of reading progress? And when we're observing them in the classroom, do we see anything that might be indicative of challenges or difficulty with vocabulary or less less linguistically healthy kiddo in terms of their ability to use vocabulary in a number of contexts, whether it's comprehension or production.

And so there's a lot of things to think about, and that's why we want to collect different data in addition to that formal assessment so we can look at the parent teacher report, work samples, classroom observation, maybe some curriculum-based assessments or criterion reference test just to help us get a better idea of where they're at with their vocabulary. I've broken this down into different areas. So today I want to focus on more foundational skills.

Basic concepts and categories and object functions. I think these are a precursor skill for students. So if they don't have those basic concepts, they're really going to struggle with following directions. And they really need that basic vocabulary, whether it is those basic concepts or the categories and object functions and describing words.

If they are going to giving definitions, one of the, or like defining new words and defining unknown words and learning to understand them, if they don't have that foundational vocabulary, that's going to be really challenging because that gives us that many more hurdles. Because when we are introducing unknown words.

If we're looking at tier two words, for example, the student has to understand the definition to be able to add that vocabulary word to their mental dictionary, so to speak. So we wanna give them some of those words because it'll be really important for things like following directions and that initial comprehension, but they'll need it as a foundational skill as we start targeting more complex vocabulary. So that's where we're starting today.

And then next week we'll dive into more of the tier two words and affixes and all of that good stuff. But starting with basic concepts, basic concepts have been demonstrated to be incredibly important for future academic achievement. And if we are, if we observe in the classroom, we can see that kindergarten teachers and early elementary students teachers use basic concepts with intense frequency when they're giving directions and giving instruction. So this is very, very relevant as a foundational skill because it's a building block to be able to access more complex vocabulary. But it is also very relevant to the curriculum at this age and being able to access the curriculum and following directions.

Again, I'm going to be a broken record throughout this series, but that's why it's so important to get teacher and parent report and to get work samples and to do a classroom observation to see how these things are coming up. I'm going to share two formal assessments that we can use to look at basic concepts.

We likely won't be administering these tests to every single student. So it might be helpful to look at the parent and teacher report and those work samples and observations to see if this might be an area of need. Like is the student demonstrating that they're having difficulty following directions or do they seem to be struggling with comprehension?

If so, it might be worth assessing this a little bit further with a formal assessment or just some informal assessments too. But two formal assessments that we have are the Boehm Test of Basic Concepts. And I don't know if I pronounced that correctly, but it's B-O-E-H-M. And again, I'll link to these tests in the show notes, which you can find at slpnow.com/196.

So those are some options. And of course, again, again reiterating that we want to use multiple pieces of data to help decide what we want to do. And I want to share some really cool things. hopefully we're convinced how important basic concepts are for our students. And then there's some cool studies and like inspiration for how we might tackle this. So a study by Lund et al in 2019, there were three conditions. So the SLP only, the adapted PE teacher only, or the third condition was where the SLP and the PE teacher co-treated. And every week they selected five concept words.

They did this co-treating in 30 minute large group lessons and there was a more significant effect. They found a more significant effect when the PE teacher and the SLP were co-treating, which was really interesting to see. And so that can be a fun strategy or idea if you are writing a basic concepts goal.

Although the purpose of this episode isn't to start diving into treatment, but that could give you some ideas on maybe what types of goals you want to write. So they identified five words each time. And so that could be something that we do. Where we work with the teacher to select X number of basic concepts, maybe the basic concepts that occur most frequently or seem to be the most impactful, and then use that to write a goal. And then there was a follow-up study by Schmidt et al in 2023, and they found that teachers were able to effectively adapt the intervention that we just talked about, and they used it with autistic preschoolers.

So if you're looking for some activity ideas, jumping head to intervention, Lund et al. 2019 and Schmidt et al. 2023 might be some good resources to look into. So in terms of the goals for basic concepts, we can look at comprehension or production. So whether we have students identify basic concepts, like show me the one that is big.

Given a field of choices, for example, or we can have students name them. So there's different ways that we can tackle those goals and we can identify specific concepts that we want students to use. One way that I've done this in the past is I've administered like an informal basic concept assessment and I've identified the number of concepts that a student has mastered and I

Sometimes have written a broader goal of like they'll increase their score on this informal assessment from like 20 out of 50 to 30 out of 50, for example. And then I would just select the words that I want to, or the concepts that I want to target. Or you can get more specific and identify the concepts that you want the student to master by the end of the year.

Attach a list of those to the IEP, and then that would guide your intervention. And you would know, OK, I'm going to cycle through these words and target them until we master them. And I've done other podcast episodes about how to structure that intervention as well. that could be, those are some strategies to set up your goals, whether it's increasing the score on an informal assessment.

Or building a list of specific concepts that you want to target and using that to guide intervention. I think the latter might be a little bit more impactful and effective. then now that brings us to the second section, which is categories and object functions. So again, I'm writing goals for categories and object functions based on multiple data points. So maybe there's something in a formal assessment that indicates students could use support with like categories, object functions, describing words.

I would also consider teacher and parent report and look at work samples and classroom observations and maybe a language sample and see like, do they seem to have difficulty following those directions that incorporate those types of words, do they have vocabulary, describing vocabulary? And again, those will all be critical foundational skills when it comes to advancing their vocabulary as well. So some things that we might, some goals that we might write is like naming X number of items when given a category or an object function.

And then the reverse is naming a category or object function when given some exemplars. And then of course, we want to get as specific as possible. If we can attach a specific probe, that can be really impactful. And if we can identify the types of like categories and object functions that we want to target throughout the year, that can be effective again for guiding intervention and measuring progress too.

And then another goal could be to describe a picture or a word using X number of descriptors. And so those descriptors can include category, object function, appearance, parts, location, color, et cetera, et cetera. So we can write goals around that and helping them use their words to describe items.

or using their vocabulary to describe items or other words. So those are some ideas on how we can tackle some of those foundational vocabulary goals. And again, I'll link to additional, because these quick episodes don't do the topic justice, but I will share links to some other episodes if you want to continue diving in and getting some ideas for.

intervention and exactly narrowing down exactly how you might want to structure this for your students. So that is a wrap on part one of vocabulary and I'll see you next week for continuation on the vocabulary topic.

Marisha (00:00)

Hey there, it's Marisha and welcome to the SLP Now podcast. We are continuing our series on goals and for the next several episodes, it'll be just me on the podcast and we are going to chat about some of my favorite areas to research and target in therapy. And today we are starting off with narratives. So before we dive into the types of goals that we might be writing when it comes to narratives. I wanna touch a little bit on why we might even write a goal to target narratives. So I'm going to share some research that I've come across over the years that kind of has boosted my rationale for targeting these goals. And we'll start off with...

There's lot of research showing that when students develop written and or oral narrative skills. It improves students ability to connect with peers and participate in and benefit from classroom activities, which is huge. That's what, especially if you're working in the schools, we have to document that we are helping students access their curriculum and participate in the classroom. So narratives are a really great thing to target and a way to kind of help students with that generalization and also just being able to help them access their curriculum. And there's a lot of research around teaching story grammar and how it's been found to improve comprehension.

There was a really cool study, it's a little bit older, but it was Gurney et al. 1990. But they worked with high schoolers who had learning disabilities and taught them, they taught them story grammar elements and they found that it even improved the comprehension of a social studies lecture. So that was really interesting to me that these targeting narratives and teaching these skills can have a really profound impact on students' ability to tell stories and connect with peers and participate in the classroom activities because so much of it is narrative-based throughout the day, whether it is in a more curriculum, like hard curriculum, versus connecting with peers. So yeah, that's part of why I love working on narratives. And there's also research that school-aged children with language disorders, if they present or if they demonstrate poor narrative skills, they're disadvantaged during a large portion of the school day because so much of that classroom instruction does incorporate at least some degree of narrative discourse, whether it's in how the teacher is presenting the lesson or how they're interacting.

It's just a really key part of that. And Gillam et al. 2018, go into that in a little bit more detail. So hopefully we're all on the same page now that it is worth our time to target narratives. We can get lot of bang for our buck by targeting these types of goals. It's very relevant to the curriculum and it can have a huge impact on our students, just quality of life in general too.

So in terms of kind of what we expect, I found this, like I think it's interesting to see like what we might see in our students versus other students in the general education classroom. So they have found that students with specific language impairment tend to produce narratives that have fewer total words. They use fewer different words. They have more syntactic errors. They have poorer use of cohesive devices like conjunctions and adverbials. They incorporate less story grammar. So these are the types of things that we might be looking at. So if we collect a language sample for a student's narrative generation or narrative retell, those are some of the types of things that we might see. And we have some normative resources that we can use to determine whether our students are on track or not. And I'll share some of those.

But it can also be helpful if we get into the habit of collecting language samples as part of the process for an IEP, for example, then we can get change over time. And that can give us some good indicators on whether students are, whether they would benefit from targeting narratives and having some goals around those different areas, or if they're progressing, how we would expect them to. But in terms of some of the narrative resources or normative resources. The test of narrative language is a formal assessment and it has norms because that's what formal assessments have. And so in the test of narrative language, students are asked to retell stories. They generate a story. They answer comprehension questions. And there's little rating scales for the narratives. There's a scoring rubric that can give us some data whether students are performing similar to similar age periods. And we of course want to consider the normative sample and all of that when we're analyzing those results and making sure it's appropriate for the student that we're working with. Some other options, if you're like, I'm not sure if this narrative is typical or not, or if it warrants intervention.

Some other norms that we can use are the Edmonton Narrative Norms Instrument, the ENNI. And I will add links and citations to all of these in the show notes. But you can access that at slpnow.com/195. And then the last formal normed assessment that I wanted to share was the CUBED narrative language measure.

This is by Peterson and Spencer. And again, I'll link to that in the show notes as well. So that can give you some data that you can pull from. And then we, of course, we won't just write a goal for narratives just because the students fall at a certain percentile or whatnot. We want to look at the impact in the classroom as well.

We'll be looking at teacher and parent report and work samples and classroom observations and all of those different pieces of data to really decide if this is an appropriate Avenue for goal writing for our particular students And there are like I mentioned the parent teacher report, classroom observations, work samples all of that. We can also collect informal language samples and analyze them for some of the things that I mentioned, like narratives, like how many total words, how many different words they're using, their syntactic errors, whether they're using cohesive devices, and whether they're including story grammar elements. Some other informal assessment tools are the dynamic assessment, the DYMOND by Peterson et al. is really great.

The school-age language assessment measures, the SLAM cards by Dr. Crowley are great too. And then there's the, we can use SALT to analyze our language samples too. And then there's the the MISL (Monitoring Indicators of Scholarly Language) by Gillam and Gillam. And again, I'll link to all of these, but these are just some extra resources that you can use in determining if this is a good goal area for your students.

And then as we will obviously be looking at the all of the assessment data, whether it's formal assessment, informal assessment, parent/teacher report, classroom observation, work samples, maybe we'll do little probes or whatnot, language samples. We'll look at all of those pieces of data to decide what types of goals we might want to write for students.

But I wanted to share just a handful of ideas to get us started. So we might write a goal for more related to comprehension. So maybe we could write a goal around answering questions about story grammar elements. So if I were creating a probe for this goal, which is how I like to do my progress monitoring, and I'll share linked to some other relevant episodes in the show notes as well. One article or one other episode that might be helpful is just how I structure my data collection because when we're writing goals, we want to think about how are we going to monitor progress and take data towards this goal. So that's something really helpful to think about. So I'll share a link to that episode and then I'll also share some other episodes that we've done related to narratives if you're wanting to dive in a little bit more because this is a super quick peek at some things that we might be thinking about and some goals, a quick overview of some goals that we could be writing. But we could have comprehension goal, answering questions about story grammar elements. like some common story grammar elements are character setting, problem, feelings, plan, et cetera, et cetera.

So we could ask for character, we would be asking like who was in the story setting, where did the story happen? When did it happen? And so we could develop a probe where we have a short reading passage and then answer, have some questions related to the targeted story grammar elements. And then we can get a baseline and see where students are starting and then measure their progress. And of course these goals that I'm listing off don't include all of the goal elements that are often required by school districts or that are elements of like smart goals. They are, especially for creating a probe and attaching it, the goals are specific. But we might want to also include like duration, accuracy, criteria, and level of support, the setting, and all of that kind of stuff too.

So these are just quick ideas and then hopefully you've got the skills to fill that out. I'll also link to a blog post about goal writing that goes into more detail there. So that's one goal, like comprehension, answering questions about story grammar elements. Another goal might be more of a narrative production goal where we're retelling a story, including X number of story grammar elements. And we would list the elements that we expect the student to include.

So whether it's character, setting, problems, feelings, plan, action, solution. So maybe we could say if those are the ones that we want them to include, that those, I just listed seven story grammar elements. If that's what we're considering, like our complete episode, then maybe we expect a realistic goal would be for them to retell a story, including five out of seven of those.

And that could be just a quick goal that we include. So that was story retell. We can also have a goal to generate a narrative, like a personal narrative, including however many story grammar elements. And then I think it would be helpful to list them out. And I'll put examples of these goals written out in the show notes as well.

Those are some basic goals, looking at comprehension of narratives, as well as the retell and generation. And we can look at the number of story grammar elements included. You can also create a rubric that looks at more than just story grammar elements. And for some students, we might want to do that.

We might want to have a rubric that includes the level of support that they're receiving and the number of elements that they've included, like the number of story grammar elements. And maybe a one is equivalent to having like being given a direct model and lots of prompts and cues, whereas a five on the rubric for level of support is whether they tell it independently without any support. So we can write a goal like to retell a story scoring five out of nine on the story retail rubric. However, you end up setting it up, but that rubrics are a nice way to look at multiple components. So you can look at like level of support, number of story grammar elements included. You can look at grammar, cohesive devices, and whatever is relevant for the student.

And it's a way to track progress on multiple areas. Or you can create multiple goals for those different elements. So another example would be to generate or retell a narrative using X number of cohesive devices. Because if you remember, that's something that we see when compared to typically developing peer students with specific language impairment produce narratives with less cohesive devices or incorrect use of those. And those are like conjunctions and adverbials to help kind of string the story together and make it make sense and to communicate more complex ideas in the story as well. So that could be a type of goal that we could write.

We could also write a goal for number of syntactic or grammatical errors. So those are all different types of things that we can look at. again, in the show notes, I'll give a quick recap of the goals in written format. And then you can access that at slpnow.com/195. But just a super quick recap.

Some potential goal areas that we talked about were answering questions about story grammar elements when given a short story. So that's more of the receptive part. And then when it comes to expression, we can write goals for retelling or generating narratives. And I think some helpful things that we could look at are the number of story grammar elements that are produced, the level of support required, the number of cohesive devices used.

And you can roll in other grammar goals as well, like whether they're using like pronouns and reference. Do they use the characters names and all sorts of things like that. So again, your assessment data will give you a lot more direction in terms of the specific things that you might want to add in. And again, just to recap, we talked about some different formal assessment options as well as informal.

And we, again, wanna take those multiple pieces of data when we're writing goals. We don't want to just administer the test of narrative language and write goals based on how they're scoring on those elements. We wanna look at the whole picture and consider parent teacher report and looking at work samples and classroom observations so that we're writing goals that are really meeting students where they're at and helping them access the curriculum.

Supporting our students the best that we can. So that is a wrap on narrative goals. Don't hesitate to reach out if you have any questions or feedback or ideas. Instagram is a great place to find us @slpnow. And I hope this was helpful and I'll see you next week where we're going to start diving into vocabulary goals.

Thanks!