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Marisha

#093: Considerations for Linguistic Diversity When Assessing Narratives

August 24, 2021 by Marisha Leave a Comment

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This Week’s Episode: Linguistic Diversity and Narrative Assessments

So far in this month’s podcast series, we’ve reviewed a few of our favorite formal assessments and the importance of narratives in everyday life. We dove in and took a closer look at the different language structures with informal assessments.

Last week Monica and I shared tips on how to collect language samples to help minimize your stress levels and collect a valuable language sample!

This week we are moving along to a very important topic: Linguistic Diversity and Narrative Assessments. I have to tell you that part of the reason I’m so grateful to be sharing the mic with Monica is that we have double the experience to draw from. 😍

Especially this week because Monica has a ton of experience with linguistic diversity in the schools — and she generously shared what she’s learned about navigating this with her caseload.

Let’s get to it!

Here’s what we discussed:

– If you don’t speak the student’s language, make sure you have a native speaker to translate for you during the assessments.
– Build rapport with the student.
– Interview the parent/guardian.
– What is the student’s dominant language at home?
– What language do they prefer to use?
– Take a language sample in their native language and their second language and compare the two.
– Is that language sample the language that they are most comfortable with?
– Don’t assume things based on a student’s ethnicity.

Quick Links

– Cornell University: The Multilingual Language Use Questionnaire
– Tips and Tricks for Working with Bilingual Students with Liliana Vasquez (The Bilingual Speechie)
– The Portland State University website
– BiLingustics: What Story-Telling Elements do All Cultures Share?

Subscribe & Review in iTunes

Are you subscribed to the podcast? If you’re not, subscribe today to get the latest episodes sent directly to you! Click here to make your listening experience auto-magic and as easy as possible.

Bonus points if you leave us a review over on iTunes → Those reviews help other SLPs find the podcast, and I love reading your feedback! Just click here to review, select “Ratings and Reviews,” “Write a Review,” and let me know what your favorite part of the podcast is.

Thanks so much!

Transcript

Transcript
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Marisha: Hello there and welcome to the SLP Now Podcast, where we share practical therapy tips and ideas for busy speech-language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode.
Hello there and welcome the SLP Now Podcast. I am your host Marisha and this month we are diving into all things narratives. So if you head back to episode 90, you can hear a little bit about how Monica and I tackle narrative assessment and just kind of our framework for it. Then the rest of the episodes throughout the month for 91, 92, 93, we'll dive into specific aspects of assessment and just things that we want to consider when we're getting ready to target narratives in therapy.
Without further ado, let's dive right in.
Now, let's dive into linguistic diversity. Monica, you've gotten some really great experience with this at your schools, and so I'm going to let you take it away and just kind of tell us a little bit about how you navigate this with your caseload and just some experience shares if you're willing to dive into all that.

Monica: For sure. So I am not bilingual in English or Spanish, so when I'm doing these assessments I make sure that I have a native speaker translator with me. She's a professionally trained translator who is able to help with all of the testing. So beforehand I'll make sure that I kind of give her a heads up, like I want to make sure I do a language sample today. She's got a little reference to look at for maybe, "Oh, I'm looking for past tense, because that's something that I heard in English that they didn't have."
So, we're just doing little things like that. So we do a little kind of catch up before I go get the student, and then I make sure that I've talked to parents about language usage at home. So, what is their dominant language at home that they prefer using? If the student is old enough, I ask them, what language do you like using? Because that's going to be the best indication of what they're comfortable with.
I ask about their siblings in the home, like parents, do you feel like they are at the same level that your other children were at if there are other kids in the home or cousins or their friends that they play with, do you feel like in whichever language, native language or English, how do you feel like they're doing? Just because if the students are only speaking English at school, you're not going to get a measure of that. Especially if that student is shy, they're not going to want to talk to two new adults in the same room. An assessment like that can feel really overwhelming for kids, so is the sample that I got the same as how they talk at home in that language for the translator that I have?
Then Marisha, you sent this cool language use questionnaire from Cornell that I've never seen before that I liked too. So it's information about it, how fluent do the parents feel? What is their education level, language use questions, information about your parents, information about grandparents and then attitudes towards the language. Because that does come up frequently in meetings where parents will say, "Someone told me that they should only be exposed to English." You're like, "Full stop. No."
It's unfortunate that that might be the first time that someone has told them absolutely expose your child, children to your native language. So, that's also something that you can find when you're doing that parent interview or parent questionnaire that you sent home.

Marisha: I have that quick little plug here. So I learned about that resource from Liliana Vazquez from the Bilingual Speechie, and we did a podcast interview, I think it was in July, so almost a year ago. If you guys want to check it out, it's at slpnow.com/54, but she shares a bunch of tips and tricks for working with bilingual students as well. She's the one who shared this language use questionnaire with me. We're just doing a quick little conversation, but that can be a good place to dive in if you want to find more information too.

Monica: Yeah, for sure. It sounds like an awesome resource. So, the other things to take into account are just cultural differences. So I'm Asian American, as a child I was really shy, but even though that's kind of like a stereotype, not all Asian kids are going to be like that, so that's a good place to kind of check where you are. Am I assuming that this child is a certain way because of their ethnicity? Maybe you might have to build more rapport before you dive into an assessment.
You can talk to parents, are they usually comfortable around adults? So if you're thinking about stuff like eye contact or body language, are you taking those different cultural things into consideration and not counting it as something that needs to be worked on? Because it might not be, it's just something that they do with their family. Especially for students who come over here from a different country, and they are dealing with a lot more than just trying to come into a whole new culture.
But yeah, we kind of talked about how to ask parents and teachers if that language sample is representative of how much they speak at home when they're comfortable, but dynamic assessments really are the big thing. So we kind of talked about it a little bit, but it's just like you're not necessarily going to get that type of input with formalized standardized assessments. So, you were looking at the norming population and it's not great for the student that you want to, maybe they have a language that that student wasn't even a part of that norming population. So, that's really where you want to pull in that dynamic assessment to be able to measure their skill for learning things when the language isn't there.
We talked about making sure you use a translator to make sure that you're measuring their skill in their native language, and then being able to compare that. So, if you're comparing two different language samples and you're comparing the language sample in their native language and they're comparing the sample in the English language, you're going to want to account for language differences in your language sample for English. Even if they have a dialect, it's AAE, you're going to want to look up things for that specific language.
So, I don't necessarily have one resource that I go to. I'm in California, so there are lots and lots of languages that could pop up here. We're really diverse in Southern California, so typically whatever language comes up is when I'll go and try and find it. So Marisha, I don't know if you had anything that you usually typically go to for that, or if you just kind of look it up on a case by case basis as well.

Marisha: Yeah, I think there's definitely some case by case research, but Liliana shared about, I believe it was from Portland State University, apparently they have a resource that I personally haven't used, but she talks about it in her podcast episode, slpnow.com/54. So, that would be a great place to go for some additional inspiration and tools that we can use as well.

Monica: Awesome. So yeah, then when I am looking at the two different language samples, I'm accounting for those differences and then I am looking for the same thing that you would look for in each language sample kind of traditionally. The complexity of their language, do they use a lot of vocabulary, the length of their sentences, where their grammar is. Truly when I asked the kids, what do you like using more? Do you like using this one or this one? I would say the majority of time, because they're in school all day and a lot of times their parents will say they end up using English at home, it's something you can keep in the back of your mind that I just need to make sure that I'm not missing something with the native English and just making sure that you're testing it. But that is a good opener for the parents though to be like, "Even though they speak English at home, keep talking to them in your native language."
Then we talked about the LEADERSproject, but Bilinguistics is also a great research kind of based resource. They've got a lot of blog posts on there, a lot of free resources as well. I was trying to look for research articles for the differences between narratives for different cultures. There was one blog post from Bilinguistics about, I think Scott Prath wrote it, and what story grammar parts are consistent across cultures and what's different, I didn't find too much honestly.

Marisha: But even that, when we were talking as we were going through the research together, I thought that was absolutely fascinating. Maybe I should be ashamed, but that wasn't something that I thought of that different cultures would have differences in the story grammar elements, so that's something we should consider when we're writing those goals as well. So we'll definitely link to that article, because I think that's fascinating and really important to consider. It's not just the language structure and vocabulary and grammar, overall structure can be different as well.

Monica: Yeah, and I'm even thinking about when I watch K-dramas or if I watch American TV shows, that the storytelling even in those is really different a lot of times, so it really does become an embedded cultural thing. Then I am Chinese American, but I watch K-dramas all the time and I lived in Japan for a short time, so I watch a lot of Asian films and movies and everything, and it is, it's very different. A lot of times when you're watching the two, to go back and forth between American entertainment and Asian entertainment I feel like.
But back to that Bilinguistics one, they were referencing an article and they said that the things that would be the same across different cultures would be the initiating event, the attempt, the consequence, the resolution, and the setting, and then added onto that there were differences between that. So, I feel like that's at least kind of a good starting point.

Marisha: That is so fascinating. Yeah, I got really excited when you found that, that was really cool. So, just a couple of other thoughts. So, we talked about taking cultural differences into consideration and we talked about building rapport with the student, and then the teacher parent report will really come into play there, especially if we use the language use questionnaire, that can give us some good information.
I referenced Liliana's podcast episode where she talks about a resource to learn more about cultures. Google can be a good resource too, although we want to be critical of what we're reading, so making sure that we're getting good sources. But then I thought it would be interesting to talk about ... So, I loved your idea of showing the language sample and asking parents if that's typical of what they see at home. I think that's a good way to kind of approach that. I'm curious if there's anything else that we can do to be very mindful and sensitive to those differences?
One thing that I was thinking about was observing the interaction between ... I was also required to do classroom observations, so I think it could be interesting to observe the student interacting with peers, with the teacher. If they're all in the IEP meeting, we can see how they interact as well, or hopefully if we have the opportunity to see them before the meeting as well.
But Monica, do you have any other tips? If you feel like you're struggling to find the information online or in a journal article, do you have any other strategies to navigate that? Or how do you approach asking those questions?

Monica: Offhand before I forget, sometimes if I can't get a language sample in their native language, because it's overwhelming, there's two new adults in the room, I'll have the parents record a sample from home and then send it in. But I think that because you're asking parents, it's kind of a way in, like, "I want you to record this sample, because it's been kind of hard to get it while we're here." Then you can ask them, "Do you have these concerns?" In English, they forget this past tense, and then you can ask the parents are they also doing that in the native language? Do you have concerns with that?
So, then that can kind of be an opener to be like, "I want to hear your concerns. Are there other concerns when they are playing with neighborhood kids or their cousins or things like that? What concerns do you have?" Because then it's going to be through their lens and what their concerns are through their different culture or whatever they're doing.
So that can be a natural way, I think, to ask about concerns and ones that you might not consider. Because it might be something that is a big concern for you, but it might not be a big concern for parents. So as long as it's not impeding their ability to participate in school or be successful academically, than it might not be really high on my priority list. So, I think that is kind of an answer to your question.

Marisha: No, that was perfect. I haven't done that where I ask the parents to record a sample. That's such a great strategy and that can give us a whole different insight. Even if it's in the other language, we can work with the translator to analyze that as well. So, so many amazing resources, so helpful. Thank you for diving into this with me, Monica. We hope that this was super helpful for anyone listening in well, and we'll see you next time.
Thanks for listening to the SLP Now Podcast. This podcast is part of a course offered for continuing education through Speech Therapy PD, so yes, you can earn inaudible for listening to this podcast. If you enjoyed this episode, please share with your SLP friends and don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.

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Filed Under: Podcast Tagged With: Assessment, Language, Narrative

Teaching How To Follow 2- and 3-Step Sequential Directions

August 23, 2021 by Marisha Leave a Comment

This is a guest blog post by Holly, a school-based SLP, all about teaching how to follow 2 and 3-step sequential directions!

Teaching Sequential Directions

Do you have students on your caseload that can follow one-step directions pretty well, but–as soon as the complexity increases–that accuracy goes out the window?

If that’s the case for you and your students, you’re not alone! There are plenty of factors that influence the ability to follow complex directions: hearing/vision, executive function skills, language comprehension, grammar, student level of interest, task complexity, and sequencing, just to name a few. These areas were reviewed in further depth in a previous post on following simple directions — a lot of that info applies here, too!

Complex instructions are relevant for students across the grade-span. Like many domains of communication, the milestones related to following directions are geared towards younger children:

– Between 1-2 years of age, kids generally follow familiar one-step directions with support (Linguisystem, 2014)
– Between 2-3 years, children can follow two-step commands (Linguisystem, 2014)
– Around 4-5 years old, kids typically understand sequential terms (e.g., first, next, last) and respond to three-step directions at home or school (ASHA)

We know, of course, that the importance and complexity of instructions don’t end at age 5. Whether you work at an elementary, middle, or high school, following instructions serves as a major foundation for learning. These skills are also incredibly valuable for students working on vocational skills and transition plans. (Imagine your first day at a new job! There are countless tutorials to follow and procedures that you’re expected to get the hang of!) So how can we support our students no matter what level they’re working at?

In a previous post on following simple directions, we outlined the process of assessing this skill, selecting meaningful targets, using visuals and strategies, plus designing structured and contextualized intervention.

Now we’re taking it a step further by teaching how to follow multi-step, sequential directions! We’ll review different types of complex directions, plus how to teach and strengthen this skill in therapy.

Types of Complex /  Multi-Step Directions

Not all directions are equally complex — that’s why it’s important to figure out what strengths and challenges are impacting a student’s ability to follow along with instructions. Here are a couple examples:

Conditional Directions: If you ride the bus after school, line up here. 

Spatial Concepts: Take a seat at the nearest table and face your chair towards the front of the room. 

Temporal Concepts: Before you sit down, hang up your bag on the wall.

One Action, Multiple Objects: Grab a packet, glue stick, and a pair of scissors from the table.

Multiple Actions, One Object: With your pen, circle the word you don’t know, then underline any clues that will help you figure out what the word means.

Multiple Actions, Multiple Objects: Pick out a book, bring it to the checkout counter, and present your student ID card to the librarian.

The more concepts embedded into a set of instructions, the higher the demands placed on language and working memory will be.

For a deeper dive into assessing these skills, check out the prequel to this blog post and browse through the assessment materials available through the SLP Now membership! There’s a Smart Deck to quickly probe students’ accuracy in following 1, 2, and 3-step directions.

Quick Probe Smart Deck

Teaching Multi-Step Directions in Therapy

How do you feel about using anchor charts, visuals, and compensatory strategies in therapy? From kindergarten through high school, I’ve found that these kinds of support make a huge difference for students.

Visuals

When teaching a new skill, it can be helpful to use visual aids to represent a concept. This is because many of our students are already challenged by auditory or written comprehension (Law et al., 2017), so we can use this teaching phase as an opportunity to play to any strengths! This might involve using pictures, symbols, photos, or other visual supports when teaching a skill. Here are some of my favorite visuals to use with complex instructions:

Following Directions

Strategies

When helping students strengthen skills in an area, it takes time and practice. Strategies can be taught, practiced, and used the very same day — that kind of success can be really motivating for our students when they’re starting out! Over time, using rehearsal/visualization techniques has also been found to improve students’ abilities to follow directions (Gill et al., 2003).

Teaching Strategies

These handouts (included in the SLP Now membership) are great for partnering with teachers and working on self-advocacy skills for students.

Targeting 2 & 3-Step Sequential Directions (In Therapy & Beyond!)

Once you’ve selected your targets and reviewed the skills and strategies you’ll be working on with your students, now comes the fun part… Practice!

Games

Introduce a new game or tweak a familiar one, emphasizing the importance of listening to the instructions

Recipes

Can you think of a multi-step activity that is more functional than following a recipe? Our speech-language rooms don’t often come equipped with extra space, so your recipe could be as simple as making trail mix. However, if your school has an area dedicated to cooking skills or a kitchen space that you can borrow, try incorporating it into your therapy activities!

Calendars

Try filling out a planner, agenda, or calendar with students. The working memory demands are high here (e.g., note that your spring break is from April 4th-8th, and your book report is due the following Monday), so it emphasizes the importance of using external strategies, such as writing down details!

Vocational Activities

When working with older students and developing transition plans, identify what kind of job skills involve complex directions (e.g., bagging groceries involves sorting items based on weight/shape/temperature, organizing them into a bag, and placing the bags into the cart). This is a great opportunity to incorporate your students’ interests!

Other Curriculum-Based Activities

To support carryover throughout a student’s school day, collaborate with other teachers to see what activities involve complex directions. In a framework developed by Wallach (2014) and Kamhi (2014), we see that a contextualized approach to targeting these skills can be the most effective!

I hope this post has been helpful for you! Do you have any other questions or ideas for targeting multi-step directions? Feel free to comment below — thanks for stopping by!

 

References

American Speech-Language-Hearing Association. (n.d.) What should my child be able to do? Four to Five Years Old. Retrieved from https://www.asha.org/public/speech/development/45/.

Gill, C. B., Klecan-Aker, J., Roberts, T., & Fredenburg, K. A. (2003). Following directions: Rehearsal and visualization strategies for children with specific language impairment. Child Language Teaching and Therapy, 19(1), 85-103.

Kamhi, A. G. (2014). Improving clinical practices for children with language and learning disorders. Language, Speech, and Hearing Services in Schools, 45(2), 92-103.

Law, J., Dennis, J. A., Charlton, J. J. V. (2017). Speech and language therapy interventions for children with primary speech and/or language disorders. Cochrane Database Systematic Review.

Wallach, G. P. (2014). Improving clinical practice: A school-age and school-based perspective. Language, Speech & Hearing Services in Schools, 45, 127–136.

Filed Under: Therapy Ideas Tagged With: Evidence Based Therapy, Therapy Plans

#92: Quick Tips for Language Sample Overwhelm

August 17, 2021 by Marisha Leave a Comment

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This Week’s Episode: How to Get a Language Sample

So far in this month’s podcast series, we’ve reviewed a few of our favorite formal assessments and the importance of narratives in everyday life.

Last week we got a standard score with a normative sample that is appropriate for our students. We dove in and took a closer look at the different language structures with informal assessments.

One of the common things we talked about was collecting a language sample. And that feels super overwhelming when you’ve got a backlog of 5 million evaluations and referrals. I’m exaggerating a bit, but the stress can add up, quick!

So Monica and I thought it would be nice to share some tips on how to collect language samples and hopefully, these quick tips will help minimize your stress levels and how valuable language samples are!

Shall we get to it?

Quick Tips for Language Samples

– Ask yourself, “what do you want from this language sample?”
– Build rapport with the student by asking about their specific interest.
– Are their responses very literal?
– Use a narrative rubric.
– Use a Language Sample Spreadsheet.

Context Samples
– Conversation Sample
– Story Generation
– Story Retell
– Persuasive Sample
– Expository Sample

How to Use the Language Sample Spreadsheet

Click here for your free SLP Now Language Sample Google Spreadsheet

Links Mentioned 

– SLP Toolkit Narrative Rubric
– Check out this blog for my 6-step process to quickly and easily collect a language sample.

Subscribe & Review in iTunes

Are you subscribed to the podcast? If you’re not, subscribe today to get the latest episodes sent directly to you! Click here to make your listening experience auto-magic and as easy as possible.

Bonus points if you leave us a review over on iTunes → Those reviews help other SLPs find the podcast, and I love reading your feedback! Just click here to review, select “Ratings and Reviews,” “Write a Review,” and let me know what your favorite part of the podcast is.

Thanks so much!

Transcript

Transcript
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Monica: Hello there and welcome to the SLP Now podcast, where we share practical therapy, tips and ideas for busy speech-language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode.

Marisha: Hello there and welcome to the SLP Now podcast. I am your host Marisha and this month we are diving into all things narratives. So if you head back to episode 90, you can hear a little bit about how Monica and I tackle narrative assessment and just kind of our framework for it. And then the rest of the episodes throughout the month for 91, 92, 93, we'll dive into specific aspects of assessment and just things that we want to consider when we're getting ready to target narratives in therapy.
And without further ado, let's dive right in. So we talked about all of these different informal language activities or assessments that we can use. But one of the common things, because we talked about this throughout when we were talking about the formal assessment, as well as the informal assessment and we talked about collecting a language sample. And that feels super overwhelming when you've got a backlog of 5 million evaluations and referrals and all of the things. And so in my district, we were required to do a language sample so it was frustrating at first. But I'm really grateful that this is how things were set up because I got to learn how incredibly valuable language samples are and I also figured out ways to make them a lot easier. So I thought it'd be interesting though first because we talked about these different tools that we can use in assessment, but Monica, do you collect a language sample?

Monica: Yeah, usually they're pretty basic. I'll just do the minimum that's required by EDCO. To be completely honest, I'm not capturing a 10 minute language sample from these kids. But I think what helps you, right, is to think about in your mind what I want from this language sample before you start it. What do I want to get from this? Is there something that I'm looking for based on what formal and informal assessments that I've given so far that I really kind of want to narrow down, maybe? So that's kind of how I set it up. But do you want to talk about the different contexts that we can sample from language samples?

Marisha: Yeah, of course. And so it's super interesting because I did a lot of conversation samples when I started out and I maybe did some story generation. There's a lot of different types of samples that we can get. So of course, conversation samples. So just having a conversation with the student and then transcribing what they say. Which I guess is optional, there are some nice checklists out there that we can use without having to record the language sample, but we'll get to that later.
So we've got conversation sample, we can have them retell a story, we can have them generate a story. It's super interesting. If you ever have the opportunity to collect multiple samples from the same student, it's really interesting to see how they vary and it can make a huge difference if they're given visuals or not. It's dramatic the difference in language that we can see if they're talking about something that's immediate, something that they can see versus something that they're just asked to retain. Fascinating, fascinating stuff. And I think that could give us a lot of insight if we're comparing, having an immediate reference versus not, that can give us a lot of information.
And if they're really struggling in the classroom with narratives, that can give us a lot of information. So we talked about conversation, story generation, story retell. For older students, I think it's helpful to switch things up too. We can collect a persuasive language sample where they're trying to convince us of something or pretending like they're convincing their parents to let them watch a certain movie or convincing the principal to shorten the school day or to shorten the school week. And that requires some very different language structure than just retelling a story or engaging in conversation. And then expository language samples, they elicit very different types of language as well. So like, how to do something or summarizing a text or whatever it may be.
So those are some things to think about and I've collected lots and lots of different types of language samples just based on the feedback, like the parent and teacher report give us a lot of information, also the assessment results if there's something that I want to look into a little bit more closely, that can be helpful. And then, yeah, just trying to collect the data like Monica said to help kind of answer our questions. So yeah, that's a recap of the context that we'd like to sample. And then Monica, do you want to talk a little bit about how you tackle your language samples and how you make it doable given all of the workload and all of that?

Monica: For sure. I think that kind of talking about that like double duty thing again. I work a lot with the autistic population, so a lot of times if it's their initial or maybe like shy, I can use it as a rapport builder too. So you can ask parents or teachers, what is their special interest? And then you can get them talking about that and they're going to generate a far better language sample than me asking conversational questions.
So then I can kind of see with kind of like memorized things, especially if they're a Gestalt language processor, where is it with that? Again, that's a strength of theirs. That's where we can start off with, I can see where that's at. Because a lot of times for those kids, if they have to do something, they have no picture, no information about it, no prior knowledge, you're not going to get anything. You might get one to two word sentences because they're just trying to give you an answer. But if they talk about their special interests, whoa, that language sample is always amazing. But also I can make note of different things. So, if we're doing a conversational one, are they talking about other people? Are they talking about emotions?
Do they have that language in their vocabulary? So you can connect that back to what teachers or parents might be saying, where they have a really hard time with moments of frustration. And it might be because they don't have that language to express their emotions. So that's something that you can do with the sample. Are they able to work through that? If you ask them about something that they did over the weekend and they talk about a brother or sister and they talked about something that happened that they didn't like, you can get those sort of emotion words, which I think is always super functional. Are they showing perspective taking skills with characters, if you're doing like a wordless picture booking, you're doing a word retell? Are they just doing exactly what's on the page and nothing beyond? Is it very literal?
So those are definitely some of the things that I look for kind of off the top of my head that can be really useful then for thinking about what goals you're going to do and making it something very functional across contexts so then that's generalizing. You're always talking about decontextualized versus contextualized and this is definitely a way to make sure that everything is going to be embedded and to really make sure that you're making a good use of your time.

Marisha: Absolutely. And then in terms of how I tackle a language sample, I like my numbers and my data. And so I get a little bit nerdy with this, but it's totally doable. And it's so impressive to an administrator or even a parent because it's something like when we're describing the things that we're seeing in a narrative, it can feel a little bit fluffy and if we can assign a number to it and then we can see progress over time, I think that's incredibly powerful.
So there's some really great rubrics out there. And I typically use those when I write goals, SLP Toolkit has some amazing narrative rubrics and they also have a language sample checklist too in their tool, I believe. But in terms of getting the numbers, I made a little Google spreadsheet, I'll link to it in the show notes. It has boxes to transcribe the language sample. So as we're having the conversation, as I'm listening to their story, whatever it may be, I try and type it in real time if I can. If I can't, then I'll just record it on my school iPad or whatever, and then just listen back to it later. But then I just type in what the student is saying. And then I use one line per utterance. It has all these smart pieces in it where it automatically counts the words or morphemes if you add spaces between the morpheme.
So just make sure you're being consistent with how you're reporting that. It calculates the total words or morphemes in the language sample. It tells me how many utterances there were. So that gives me the MLU. And then it also has a space to look at the number of clauses that are in there and then whether they're grammatically correct and then there's room to leave notes. So if I'm seeing pronoun errors or if I'm noticing a lack of story grammar structure. Or if I do notice something that they're doing well, I can just jot that down in the notes. And then I just print out that spreadsheet and I can just attach it to the evaluation. We can go over it. Then the parent gets a concrete look at the language sample. Like I said, sometimes I do this with the language sample from the TNL, or I do like the conversation sample or a combination of the above.
It makes it really easy to compare the different samples and it gives us some really good information and it can be helpful for goal setting too. So we probably don't want to do the language sample every week. I've never done that. But it can be helpful to do on a quarterly or semester or maybe even a yearly basis just to see how they're progressing and just having a concrete way to see that progress. And it's really interesting to compare the samples year over year, especially if we use the same type. Like if we use the slam cards in year one and year two, and just being able to see that is really cool. That's how I tackle that. And I'll link to that spreadsheet with a quick little tutorial video if you're interested in trying to use that as well. Monica, anything you'd like to add or any other tips?

Monica: No, I would say same, definitely. I do the same thing and compare the MLU and kind of where their general grammar is at. But I totally agree about having that little record of their language samples. Because for a couple years I would actually have students from preschool up to maybe second grade and so I would end up doing their try and I would remember back, and it was such a great moment in the meeting to be like, this was their language sample from preschool. And this is where they're at now and just have a really concrete record of their progress. And for us to just all celebrate that growth in the meeting was always really fun.

Marisha: Yeah. It's awesome for all the progress monitoring and celebrating and also it gives us really great information. Like with the language sample that I use, if the student is only using simple sentences, maybe we need a goal to write compound or complex sentences. If they are always making verb errors or pronoun errors, we can write a goal to target that. Yeah, it's great all around, especially if we get to attach it to the evaluation for future reference.
Okay. So I think that's a wrap with our language sample tips and tricks. Thanks for listening to the SLP Now podcast. This podcast is part of a course offered for continuing education through speech therapy PD. So yes, you can earn ASHA CEs for listening to this podcast. If you enjoyed this episode, please share with your SLP friends and don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.

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How to Target Sequencing Goals

August 10, 2021 by Marisha 1 Comment

This is a guest blog post by Monica, a school-based SLP, she reviews the importance of targeting sequencing and shares tips and therapy ideas. 

Why do we target sequencing?

It is important to target sequencing because it is involved with so many daily tasks and is a foundation to academic success.

We want our students to be able to listen to a sequence of directions and be able to follow them, to retell stories, and answer WH questions. The question really is, how do we target sequencing in a way that will generalize into these skills? 

Kamhi (2014) states that sequencing is not a process that should be targeted in isolation. The article goes on to review how working memory, attention, and conceptual knowledge are at the core of this challenge, and that targeting sequencing with contextualized narrative intervention is the path to generalization.

What do students need to be able to sequence?

Students need to hold that information as a visual representation in their head to use later (Barkley, 2012; Ward & Jacobsen, 2014).

Students then need to use self speech which uses verbal working memory (Ward & Jacobsen).

With this in mind, would your sessions targeting sequencing stay the same or would they change? 

What if we thought about some of our students that we know may already struggle with executive functioning skills, like our students with ADHD or our autistic students? Same or different?

Universal supports in our sessions to support executive functioning makes a lot of sense!

The Challange

Research has shown that contextualized language intervention is where the magic happens. Contextualized language intervention effect sizes were three times larger on average than effect sizes for decontextualized language intervention (Gilliam, Gilliam & Reese 2012). 

Move away from sequencing tasks like brushing your teeth and how to make a peanut butter sandwich. Start to incorporate narrative retells as a more functional target that will help build communication and academic skills (Kamhi, 2014).

Use transitional words like first, next, then, and last to help students become familiar with the vocabulary for when they are self-generating retells. 

The next step is story grammar, which has been shown to help with comprehension (Stetter & Tejero Hughes, 2010).  We should always be keeping the next steps in mind when planning for a student’s success. 

Now that we see the flow and how it builds to working on comprehension, we can see the importance of targeting sequencing in the framework of narratives instead of by themselves. 

The challenge then becomes…

What do these supports look like?

How do we fade those supports? 

And how do we incorporate them into our goals and therapy sessions?

Session Solutions

An article by Dempsey (2021), showed that strong story comprehension skills were best predicted by a child being able to use a verbal account of a story (without pictures), followed by enactment (acting it out with prompts), then sequencing (retelling a story with pictures). This sets up a natural progression for fading support.

Preschool

Supports: I do a book walk and use parts of the story for a simplified retell. Videos that tell a story are another fun way to work on sequencing. You can use a graphic organizer with sticky notes or props if needed. Remember to use transitional words like first, next, then, and last when talking about the story to model the language.

Early Elementary

Supports: Use a first, next, then, last template (link below) and sticky notes while you are reading a story to mark what happens. You can adapt it to a three-part story if needed. This is the build-up to using story grammar and later generating stories of their own. Fade visuals as needed.

Tip: I use lots of narrative-based language during the session so that it’s familiar by the time we get to it.

> Point out that the bear is a character. When we answer WHO questions, we’re talking about the characters.
> Talk about the problem. If a question asks WHAT HAPPENED, we can think back to the problem.

That way by the time we have a WH question goal, we’ve been working on these language strategies and the student has had many many exposures to the language. We all know it takes repetition!

Additional Blog Posts for Narrative Therapy

Targeting Narratives with Literacy-Based Therapy: Preschool

Targeting Narratives with Literacy-Based Therapy: Early Elementary

Targeting Narratives with Literacy-Based Therapy: Later Elementary

Using Books to Target Sequencing (Scroll to the bottom of this post for a freebie!)

Additional Supports

Check for understanding by having students repeat the directions in their own words.

Have additional visuals available as needed. 

Check for emotional and sensory regulation before you start your session. 

Fahy (2014) states that there are six components to executive functioning: attention, working memory, inhibitory control, flexibility of thought and effort, initiation and persistence, and self-monitoring and regulation. Ensuring that your students are able to have “sustained attention over time” and are regulated prior to the sessions will be critical for student success.

A Sample Sequencing Goal

Goal: By XX/XX/XX, (in setting), after being read a story, Student will independently use self-generated language to retell a story on first trial data using at least 3 utterances, as measured by SLP observation and data.

Objective 1: By XX/XX/XX, (in setting), after being read a story, Student will sequence pictures in the correct order and repeat a 3-part story on first trial data, given picture prompts, as measured by SLP observation and data.

Objective 2: By XX/XX/XX,(in setting), after being read a story, Student will act out and verbalize a 3-part story on first trial data, given props, as measured by SLP observation and data.

Examples of Collaborating with Teachers

Push-in lessons (Brandal, 2014) are also a great way to make sure that the teacher is using the same language to talk about sequencing. Talk to the teacher ahead of time to see where they’re at with talking about stories. Taking a look at Common Core Standards is a great place to start to know what to ask the teacher. I usually talk about story grammar because it’s easily adaptable to different grade levels. This is also a great way to fade support so that the support is being provided inside the classroom.

Meetings

In meetings, it’s important to talk about targeting sequencing skills as a foundation for later narrative and retell skills by building on the student’s strengths. It’s also a great way to talk about something that can be practiced at home without adding too much to a family’s already busy schedule. Talking about supporting the student’s executive functioning skills can also lead to a great discussion with the team about other areas of need besides sequencing. 

Sometimes I’ll recommend that families print out daily activities onto a sticker magnet page and cut it out to put on the fridge. It can help children sequence the dreaded “How was your day at school” question. Children can see what they might have done that day that they want to talk about and then be able to sequence and verbally describe it.

 

References

Barkley, R. A. (2012). Executive functions: What they are, how they work, and why they evolved (pp. xi, 244). The Guilford Press.

Brandel, J. (2014). Making Evidence-Based Decisions Regarding Service Delivery for School-Age Students Participating in Narrative Intervention. 13.

Dempsey, L. (2021). Examining the validity of three methods of measuring pre-readers’ knowledge of storybook events. Child Language Teaching and Therapy, 37(2), 137–148.

Fahy, J. K. (2014). Assessment of Executive Functions in School-Aged Children: Challenges and Solutions for the SLP. Perspectives on School-Based Issues, 15(4), 151–163.

Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: Results of an early efficacy study. Language, Speech, and Hearing Services in Schools, 43(3), 276–291.

Kamhi, A. G. (2014). Improving Clinical Practices for Children With Language and Learning Disorders. Language, Speech, and Hearing Services in Schools, 45(2), 92–103.

Stetter, M., & Tejero Hughes, M. (2010). Using Story Grammar to Assist Students with Learning Disabilities and Reading Difficulties Improve their Comprehension. Education and Treatment of Children, 33, 115–151.

Ward, S., & Jacobsen, K. (2014). A Clinical Model for Developing Executive Function Skills. Perspectives on Language Learning and Education, 21(2), 72–84.

Filed Under: Therapy Ideas Tagged With: Evidence Based Therapy, Literacy-Based Therapy, Narrative, Sequencing

#91: A Quick Review of Informal Assessments for Narratives

August 10, 2021 by Marisha 2 Comments

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This Week’s Episode: Informal Assessments for Narratives

So far in this month’s podcast series, we’ve reviewed a few of our favorite formal assessments and the importance of narratives in everyday life.

So, we’ve got a standard score potentially with a normative sample that is appropriate for our students and all the other factors we want to consider. This week we get to dive in and take a closer look at the different language structures with informal assessments.

Let’s get to it!

Informal Assessment Options for Narratives

– The Index of Narrative Microstructure (INMIS, Justice et al 2006): This study investigated measures and developed a tool for analyzing narrative microstructure.
– SLAM Cards: These language elicitation cards and questions are designed as a tool to be used in assessing language for mid-elementary and high school-aged students.
– DYMOND (Peterson & Spencer, 2021): This is a dynamic assessment for narratives, grades one through six. It’s currently in a pilot version to get normed. This is really great for all age groups.
–Dynamic Assessment: This is used when we are trying to determine a language difference or language disorder. By having a measure from the pretest and the post-test, you’re measuring the skill that they have to learn new information as well as learning what types of supports they benefit from.
– Parent and Teacher Report

Links Mentioned 

– Leaders Project Website
– Matt and Molly
– Check out our other blog posts on Parent/Teacher Communication!

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Transcript

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Marisha: Hello there and welcome to the SLP Now podcast, where we share practical therapy, tips and ideas for busy speech-language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode.

Marisha: Hello there, and welcome come to the SLP Now podcast. I am your host Marisha and this month we are diving into all things narratives. So if you head back to episode 90, you can hear a little bit about how Monica and I tackle narrative assessment and just our framework for it. And then the rest of the episodes throughout the month for 91, 92, 93, we'll dive into specific aspects of assessment and just things that we want to consider when we're getting ready to target narratives in therapy. And without further ado, let's dive right in.

Marisha: So now let's dive into some informal assessments. We've got a standard score potentially with a normative sample that is appropriate for our students and all the other factors we want to consider. And now we get to dive in and take a closer look at the different language structures. So one of the tools that we can use is the Index of Narrative Microstructure. So the INMIS, I-N-M-I-S, developed by Justice et al in 2006. And this is a tool that helps us break down language samples, and I'll include a link to one of the articles that breaks it down even more. And it just helps us look at, they look at all of the T-units and all of that. They have some really great resources on their site as well that helps break it down as well. But that's just one to look into. One that I have more experience with myself is the School-age Language Assessment Measures.

Marisha: They're also called SLAM cards and they were developed by Crowley in 2014. But I found this on her Leaders Project website. And again, we'll link to this in the show notes as well. It's right at the top of the site though. So it's easy to find. I really like these cards. They even have some Japanese ones, which is really cool and they have guidelines for analysis. They give you lots of resources and they've got them in different languages and all of that. They have a couple of series. So one of them is a set of cards about a bunny going to school. And then there's another one about a dog coming home, a dog that got lost. And it ranges because there's one about losing a cell phone and there's a variety of sets of cards that we can use for a variety of students.

Marisha: And they're very colorful and just really nicely done. When I started working in the schools, I just printed these out and had them laminated and I would just pull them whenever I needed a good language sample. And I could use that across my caseload. Yeah, they're just really easy to use. And like I said, the site has different resources to help us break that down. So that is one of my favorites when it comes to collecting language samples.

Marisha: Monica.

Monica: Yeah. And those are free, right?

Marisha: Yeah, they're totally free. The Leaders Project website, if you haven't heard of it, or if you haven't been on there, they have test reviews. They probably have a test review of inaudible I haven't looked at that in a while, but they have disability modules for preschool and school-aged children. It's a wealth of knowledge. They do a really great job and it's all free.

Monica: Yeah. And inaudible too. I was like, "I totally forgot to mention that." So the ones that I like, again, from Peterson and Spencer is called The DYMOND, which I was like, "I don't know if there's a longer name for these. I should look that up." This one came out in 2017. So this is kind of similar. This actually looks pretty similar to the cards that they have. So it's the same illustration, but it's a dynamic assessment for narratives. So it's for grades one through six. It's currently in a pilot to get inaudible. So if you want to be part of that, I can get on that and you can send in your data for that and be part of that. So that's kind of cool. So since it's a dynamic assessment, if you're not familiar with what that means is you give a pretest. So you have a retell and you do that and then there is a portion in between where you teach them about story grammar. It's all laid out on the test and then you give a post-test and you compare those scores.

Monica: And it's fantastic for all populations, especially for bilingual populations or those diverse populations where you need something that's a little more dynamic. So that's super awesome for that. And this one, you can do that just for the retell~ and language complexity compared to the cubed, which has the comprehension and personal generation inaudible. So if you're trying to decide between the cubed and the diamond, those are the differences besides the age groups.

Marisha: And can you tell us a little bit more about dynamic assessment and why we might want to use that or how that could be helpful?

Monica: For sure. So I think dynamic assessment, when we think about it the most it's when we are trying to determine a language difference or language disorder.

Monica: So by having a measure of how they're doing from the pre-test, and then after teaching and the post test, you're really measuring that skill that they have. So you're not necessarily measuring their understanding of all of the vocabulary in that, especially if they're a second language learner. You're measuring that skill that they have to learn new information when it's taught and then to be able to use that new information. So you're measuring that skill of learning, So it's like relating back to the classroom. If their teacher is going to give them instructions and then they have an assignment, you're kind of that transference measuring that skill. So it's really a fantastic thing to do for that.

Marisha: Yeah. So it's helping us get at that difference versus disorder. It also gives us information about what types of support do they benefit from what helps them, which can be really helpful when we get into treatment.

Marisha: And also, just thinking if we even need treatment, if just after a little bit of teaching they're good to go, then maybe they don't need it. So it's really helpful. And it would be a shame to put them in that least restrictive environment, like go through the whole IEP process to find out that they don't really have a disability.

Monica: That's such a great way for you to be able to tell their teacher, "I just added this, this and this port and then they did so much better." Where a teacher in a classroom of 30 might not have the time to sit there and go through different supports and see what that student needs. So you're absolutely right. You could be that bridge right there.

Marisha: Awesome. Anything else on the diamond?

Monica: Nothing else on the DYMOND, but that does kind of make me think about other ways that I do informal assessments.

Monica: So if some of these tests, the language is going to be a barrier for me to assess those skills. Like maybe the vocabulary isn't in that child's vocabulary skills, then I'll use something that I have. So I have like Matt and Molly stories that I always have around that have simple pictures and then I can put the sentences that I want to test with and bring it down to their level to really, really look at what level they need support with. And kind of like we talked about like what supports I can add, because it's informal testing. You can add as many visuals as you want. You can add as many verbal prompts as you want. A lot of times I'll put that in my report, like, the student benefited from this, this and this, and then you have your baseline for goals and you're making your goals while you're doing assessments and rolling it all into one.

Monica: So I think that also makes it a lot easier. For my district, we have to do benchmarks under our goals. So if I can test a student and the first benchmark has this many visuals and this many prompts, and then the next one maybe I add another part of a story and I take away the support, I can test it while I'm doing the assessment and it saves me a little bit of time later because it's all kind of a bundled together thing. That's usually how I do it.

Marisha: No, that makes a lot of sense. That's perfect. Then it looks like you got one other resource for us.

Monica: My favorite. Yes. So the other one, which might be one of the most important things, which I know it's hard to squeeze in there, but it's parent and teacher reports. So when you're asking the teacher, you're really looking at common core standards and how they're functioning in the classroom. So some things that I asked teachers are like, "Can they put together a couple of sentences when they have a picture prompt?" Kind of like thinking about how much they support they need there. And also thinking about initiation, do they need a graphic organizer to get started? Do they need directions repeated a lot? Do they need a full example? That gets into executive functioning which is a whole nother conversation, but it's a good measure because when you're working on narratives, you're working on a lot of that executive functioning and students have that structure of what the story is in their mind.

Monica: So you're able to get out where they're at. They may not even have a schema. Do they have a little bit of it? And that kind of helps you with the levels of support because especially if it's an initial and you will only have that kid in your room for testing the one time, it's important to talk to the teacher to see what their real functioning levels are at. The other one is parents. I feel like one of the most frequent questions I get is, "When they come back from recess or lunch at school, can they tell you what happened? Because when they get home from school, they can't tell me what's happened." And so that's a great indication because that's retell too. So sometimes what I'll do is I'll send home a little visual schedule thing, just like pictures that they can cut out.

Monica: And I have them put it on adhesive magnet things that they can put on the fridge. So then when they get home, they can take the pictures from what they didn't at school and then be able to retell their day. So if that helps, then that also gives me a clue of where that student is at and what level of support they need. So it only takes 5 or 10 minutes and I feel like when parents have that little bit of input, it just makes everything go a lot smoother too.

Marisha: It helps with that generalization, if they understand what they're working on, if they're buying in, then the student will make that much more progress just by the fact that they're getting a little bit of extra practice. And parents are so busy, everyone's busy, but maybe they only do it once a week, but if they know their strategies, if they're in the car on the way to soccer practice, then they'll find themselves just using those types of strategies and supporting narratives, which I think is super powerful.

Marisha: What about Matt and Molly? Should we talk about that?

Monica: Sure, sure. So Matt and Molly, if you are listening and you don't know what that is, it's not a curriculum, but it's like a material bundle and they are stick figures just to be really simple. And it comes in four parts stories, like really simple four part stories and you get a little booklet. And each four part story has a story already written. But I don't always use it, I'll modify it. And then it has a set of questions that you can ask with it, but it's just to have something quick and easy, and that's always really similar each time. So the students then know what to expect. So what I'll do too, is sometimes I'll put the four and I'll mix them up and see if they can unmix them. Are they able to do that?

Monica: That might be where I start. And then I might tell them a simple three part story. I might take one out to make it more simple and then see if they can retell that. And if they can't, then I might try it where they repeat after the first one. So I'll do a sentence for the first one and then they'll repeat it. And then I'll repeat for the second and the third one, and then see if that extra modeling helps. That way I am able to listen to their sentences after I model, because I can tell you a lot about where they are with grammar and syntax as well, because they're not going to repeat something that they don't have super solid.

Monica: So it's like you're getting all of these super natural things from their language while you're doing narratives. And it's so quick, it's so quick. You just put out three pictures and you do it and you've got an informal assessment that you can do in eight minutes. If you're worried that this sounds super overwhelming to do informal assessment on top of your formal assessment, it doesn't have to take a lot of time and you get so much information out of it I feel like.

Marisha: Yeah, I couldn't agree more. And I love the ideas that you shared because sometimes we might try and administer the TNL. It's a high level language assessment and a lot of these require a lot of language. And I've had students maybe say one word. In retrospect, maybe I shouldn't have even administered the TNL in those cases, but you live and learn and we figure things out.

Marisha: But I especially love these because the pictures are super simple. Monica shared amazing ideas to adjust the task so that it works well. We can modify it. And just the nature of how it's set up. It has four simple pictures. We can decrease inaudible simplify the story if we need to. It has the sentence strips that can support some students if they are readers. I typically don't use these when I'm using it for assessment. I laminated my picture cards and then we can write on them and give visual supports and just try all sorts of different things and just really see what helps the student and what level of support helps us to get a narrative.

Marisha: And I left her idea for the sequencing activity too. That can be really helpful as well. So good step. So I think that's a wrap for our informal assessment, like blitz of different assessment tools that we can use. You can access the SLAM cards for free, and then the diamond is free as well. So there's something that you can use. If you don't have a printer, you can pull this up on your computer, or if you're lucky enough to have an iPad. So it's totally accessible. There's something in here that you can use. And even if you're not able to do any of that, you could just draw up some pictures and make a story about it. And this fancy set of Matt and Molly materials uses stick figures. So we can draw stick figures too. Just go for it. Yeah. We got this.

Marisha: Thanks for listening to the SLP Now podcast, this podcast is part of a course offered for continuing education through SpeechTherapyPD. So yes, you can earn ASHA CEUs for listening to this podcast. If you enjoyed this episode, please share with your SLP friends and don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.

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Filed Under: Podcast Tagged With: Assessment, Parent Communication, Teacher Communication

#090: A Quick Review of Formal Assessments for Narratives

August 3, 2021 by Marisha Leave a Comment

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This Week’s Episode: Formal Assessment Options

I am so excited to introduce Monica Lind! She is the newest addition to the SLP Now team! She is a lead SLP in Southern California, and she is just as nerdy about evidence as I am. She has a broad range of experience as an elementary school SLP and loves literacy-based therapy.

For this month’s podcast series we’re focusing on all things narratives!

Narratives are so functional and so important when it comes to success in the classroom. Not only are they closely connected with academic achievement but they and allow students to connect socially.

We discuss how narratives are a great way to naturally measure where a student’s skills are at while also encompassing multiple different goals. We will break down 3 of our favorite formal assessment options and how to choose which assessment to use.

Grab your favorite beverage and let’s dive into discussing formal narrative assessments! 🤓

Formal Assessment Options:

– Test of Narrative Language (TNL, Gillam & Pearson, 2004)
– Edmonton Narrative Norms Instrument (ENNI, Scheider et al., 2005)
– CUBED: Narrative Language Measures (Peterson & Spencer, 2016)

Cheat Sheet

Formal Narrative Assessment Cheat Sheet
Click here to access our free cheat sheet!

Links Mentioned

– CUBED Free Webinars
– CUBED Free Tests and Norms
– ENNI Free Tests and Norms

Subscribe & Review in iTunes

Are you subscribed to the podcast? If you’re not, subscribe today to get the latest episodes sent directly to you! Click here to make your listening experience auto-magic and as easy as possible.

Bonus points if you leave us a review over on iTunes → Those reviews help other SLPs find the podcast, and I love reading your feedback! Just click here to review, select “Ratings and Reviews,” “Write a Review,” and let me know what your favorite part of the podcast is.

Thanks so much!

Transcript

Transcript
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Speaker 1: Hello there. Welcome to the SLP Now podcast, where we share practical therapy, tips, and ideas for busy speech language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode. Hello.

Marisha: Hello there. Welcome to the SLP Now podcast. I am super excited today because we have Monica Lynn joining us. She's the newest addition to the SLP Now team. We'll hopefully be recording many more podcasts together, but just a little bit of background on Monica since you may or may not have met her yet. She is a lead SLP for a school district in Southern California, and she is just as nerdy and all about the research as I am. She has a broad range of experience as an elementary school SLP. She's focused a lot on literacy based therapy, which we talk a lot about here, speech sound disorders, and then also functional social and language therapy, and so she's been a blast to work with.

Marisha: I hope that you enjoy getting to meet her too. Our goal for today is to dive into all things narratives. We'll start out just with quick introduction of why we're even talking about narratives this month. Monica, do you want to jump in first and share a little bit of your experience?

Monica: Yeah. Sure. I think that I really just love narratives because they're so closely connected with academic achievement. It's so functional. It's just like... When you're at a meeting and you're talking about goals and the teacher's like, "No. That's perfect. That's exactly what we work on." I feel like that's always what I'm going for, so definitely for that. I also just love the complexity of it because it's just such a good functional, natural measure of where their language skills are at. I feel like it also is a great way to add strengths in a report when you want to do that. Sometimes when you have all those formal standardized scores, it's hard. It can be tough for some of those parents to read that. But then if you do narratives, you can really highlight where their skills are at.

Marisha: Yeah. You can always find something that they're doing well with when it comes to narratives and communication and all of that. Yeah, I totally agree. I think it's cool to... Just piggybacking off of what you said, it is incredibly educationally relevant just across the curriculum, whether that's in the classroom, retelling a story that they read or on the playground, telling their friends what they did over the weekend. If they can't structure a narrative to tell that funny story or talk about what they did with their friends over the weekend, then they're really going to struggle with those social connections. Or if there's an incident on the playground and they can't tell their side of the story, that can be really frustrating for the student as well. Empowering to build those skills that they can use educationally as well as socially is incredibly rewarding. I love targeting narratives because I think we've established that it's a very meaningful context, but it also integrates a lot of different skills because we're producing sentences, which requires grammatically correct constructions and the use of vocabulary. There's also social language aspects.

Marisha: It's a really nice way to encompass a lot of different goals and we can do some really discreet practice on the different sub skills that the students need support with and then build that into similarly cool final products. Hopefully, you're on board with us too.

Monica: Yeah. You can't see because it's a podcast. I'm just sitting here nodding my head. It is. As school SLPs, we're always thinking about where can we get that big bang for your buck in narratives and putting that in part of your assessment. inaudible.

Marisha: Absolutely. Today, we are focusing a lot on assessment because we talked about why we want to target narratives in the first place, but how do we get started with them? What data do we want to collect? The first thing that we'll be diving into are some formal assessment options. I have used the Test of Narrative Language quite a bit, the TNL. The TNL is a test developed by Gillam and Pearson. It's in the second edition now. When I first started using it, it was in the first. This is a formal assessment. It's a norm-referenced test and it measures children's narrative language abilities. In other words, their ability to understand and tell stories. There's a series of stories with a series of different tasks. There are some retell involved, there's an opportunity for story generation, there's also some comprehension activities. I really liked this too. I will piggyback the assessment.

Marisha: I'll administer it as indicated by the manual and then get the standard score, but then I'll also record one or all of the retells and generations and all of that and I'll do some additional analysis on that, which we'll talk about when we get to the informal assessment option. A lot of what we'll talk about is informal assessment. This is a nice way to get some of those numbers, although we don't want to base all of our decisions off of a number. But that's a discussion for another day. Then another tool that I've learned about is the Edmonton Narrative Norms Instrument. This is the ENNI, E-N-N-I. It's another assessment tool and it's normed on children four to nine years old. It also uses a similar structure where they have illustrated pictures and then there's protocol to follow in terms of how we administer that. It's similar to the TNL, but it only has local norms.

Marisha: It was collected from 377 children in Edmonton, Canada. If you don't have access to the TNL, that can be a good option. Then if the normative sample doesn't match your students, it can also be a great additional tool to collect additional data. It's all free to access. They have some really cool demos and all of that on their site.

Monica: Then the next one is the Cubed. That's by Peterson and Spencer. They, I think relatively recently, have the norms for that. The cube has two parts. One is the narrative language measures and the other one is the dynamic decoding measures, and so I do the narrative language measures one. That one is preschool to third grade. You can use it as a progress monitoring one, so it has fall and winter. It has listening retell, comprehension, and personal generation. I really like it because it has norms. You can do it either for the entire normative sample or you can do it just for bilingual English-Spanish only. The school that I work at has a really large English-Spanish bilingual population, so I can make sure that I'm comparing the norms to that. It can also be used to do a dynamic assessment if you want to do that.

Monica: You can do the first benchmark one and then you can do a teaching part, and then you can do the second one because... We'll talk about one in a little bit that's called The Diamond. That one's grades one through six. If you have preschool through third grade, that works really well for that. They also have free recorded webinars on their website, not for CES, but it's just cool to be able to have those webinars so you can see it and you can see how the assessment is done. Sometimes it's overwhelming to think about learning a new test to give, but it's got the videos there so you can see how that's done.

Marisha: That's awesome. We'll link to more details for all of these assessments in the show notes, so you can take a closer look. We'll make sure to make it super easy for you to find those free recorded webinars. I think it'd be interesting to chat a little bit about how do we decide which formula assessment we want to use. We're going to dive into the informal assessments in the next segment here, but do you have any tips on how you decide Monica?

Monica: I think about the language that's used in the testing since I usually have younger kids. If the language used in the testing, they're not even going to be able to understand that, they won't understand what the story means, they won't understand what the directions are necessarily, I'm thinking about, is that actually going to test what I want, first of all. Then if it's appropriate for them... The Cubed has a lot more they're skateboarding or they're going to the park. It's a lot more relevant, so I like it. I Usually have younger students, so that's first how I'll do it. Then second, I'll look at the normed population. Is that relevant to my population? Do I feel like it's representative of them, so it'll be a really accurate score for me to compare to them? I think that's where I start off.

Marisha: Yeah, absolutely. Especially with your population because it sounds like you use the Cubed most often because that normative sample, the other assessments, you wouldn't be able to use the scores because they don't match up. That's one thing that we mentioned about the ENNE. If we want to use the norms, we do have to consider that population. It still can give us really great information. I think all of these assessments, there's definitely quite a bit of overlap in how they're gathering samples and having us take a look at it. Just the different samples and slightly different setup as tasks. I think if you're wondering which one to use with your caseload, do consider the normative samples and then take a look at the assessment and see which one you think would give you the most helpful information.

Monica: Then of course, if you really wanted to nerd out all of the sensitivities, inaudible in there in the technical manuals, they're there for us.

Marisha: I was looking through some journal articles and one of those came up talking about how a lot of us, we don't look at those metrics as well. It'd be cool if we made the little cheat sheet, just so it's easy to compare these three assessments. We should totally do that.

Monica: We should. We definitely should.

Marisha: We're going to do that. That'll be in the show notes as well, just to give you one additional resource to make it a little easier. Maybe we can just have a little breakdown table that makes it even easier to compare. Anything else that we need to think about for the formal assessments?

Monica: Probably just a general note, especially for all those new clinicians out there, that your assessment should not stop at formal assessments. Especially in school, if your district requires that you have a score, some districts do have a little more give, but just think that more and more people are realizing that there's a wealth of information in informal assessments and it is well worth your time. Formal assessment's definitely important. It's important to get that number and have that score, but just know that it shouldn't stop there.

Marisha: I could not agree more, which is why we are going to talk about informal assessments and give you lots and lots of options to gather additional information to make that decision in the next segment.

Speaker 1: Thanks for listening to the SLP Now podcast. This podcast is part of a course offered for continuing education through speech therapy PD, so yes, you can earn extra CEUs for listening to this podcast. If you enjoyed this episode, please share with your SLP friends and don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.

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Filed Under: Podcast Tagged With: Assessment, Evidence Based Therapy, Therapy Plans

5 Tips to Write Speech Therapy Goals for IEPs

July 30, 2021 by Marisha 1 Comment

We’ve all been there. Blankly staring at a screen hoping that your speech therapy goals would write themselves, and the IEP would be complete. After the long process of an assessment, it feels like you’re at the summit only to find there’s another mountain to climb. 🏔

We’ve got you! Keep reading if you want tips on how to create smart goals!

How to Write SMART Goals to Help Your Students and Make your IEP Goals as Clear as Possible

This post will help guide you on a path to write SMART goals that really help your students. My goal is to help make your goal writing a little easier. The decision process is hard to nail down and something you learn on the job, but I’m hoping this guide will give you some good ideas!

Getting Started with Speech Therapy Goals

Let’s start at the beginning with a little review of what can prepare you for writing really solid speech therapy goals.

1. A complete assessment that included formal and informal testing 

2. Input from the student, teachers, staff members, and family members

3. Data from your sessions (if applicable)

4. Your student’s strengths and the foundation you’re going to build on

5. An understanding of your student’s challenges and where they are struggling in the school environment

If you’re an SLP Now member, you have access to the paperwork binder that includes assessment, treatment plan ideas, and factors to consider that can help shape your speech therapy goals. There are also lots of quick informal assessments to use for baseline and probe data! 

S.M.A.R.T. Goals

We all know our speech therapy goals need to be SMART, but how do you get from your assessment results to goal areas to target? We’ll go through a couple of different treatment areas to cover our bases.

S – Specific: Is your goal specific? Did you talk about the setting? Are you putting too many things in one goal?

M – Measurable: Can you measure this goal with data? Consider a rubric for some of those harder-to-measure speech therapy goals.

A – Attainable: Is this goal attainable in a year for this particular student? Goals are individual, make sure it’s feasible for this student.

R – Realistic: Is this goal something that will generalize to the classroom/school environment and help the student succeed at school? Have you considered the whole EBP triangle with research, clinical judgment, and information from the student and their family?

T- Timely: Can the student achieve the speech therapy goal in the amount of service time you are recommending for the IEP?

Start with our Speech Therapy IEP Goal Bank

If you’re wondering where you should start, the SLP Now Goal Bank is full of speech therapy goal ideas that can help you create individualized speech therapy goals based on your students’ speech and language strengths and needs.

The goal bank includes AAC goals, fluency goals, social language goals, receptive language goals, expressive language goals, articulation goals, and more! Definitely head to the SLP Now Goal Bank to brainstorm IEP goals and objectives for your speech therapy IEP goals.

Tips for Speech Therapy Goals

1. Goals must be educationally relevant in the school setting.

Goals do not have to be based on developmental norms. To be aligned with IDEA, you have to find out the educational impact of the child’s speech errors and select your goals after that process (Ireland & Conrad, 2016).

Perry Flynn

2. Look for patterns.

Do you see articulation errors, phonological patterns, apraxia, inconsistent speech disorder? If your student is bilingual, don’t forget to cross-check the student’s native language!

3. Select a treatment plan.

Sometimes it’s easier to select your treatment plan before you write your goals. That way your goals and treatment plan are nicely aligned. I’m a big fan of the complexity approach!

Possible Treatment Plan

4. Keep phonological awareness in mind.

Make sure you think about phonological awareness skills as well, especially if the student is writing their error the way they say it. Students with speech sound errors are more likely to have difficulty reading and writing (Cabbage et. al., 2018).

5. Vary your target selection and individualize.

Map out the student’s pattern of errors on a place, manner, voice chart. Make sure that your targets are varied. You might pick one marked sound, one early developing sound, one sound that is relevant to the child’s life, and one sound that is frequently occurring. Choosing targets from different classes is also a good way to make sure you have well-rounded goals.

6. For childhood apraxia of speech.

We love Edyth Strand as a resource. Treatment for childhood apraxia of speech focuses on movement, not specific sounds. Goals should allow for use of an EBP based treatment plan like (Dynamic Temporal and Tactile Cueing) DTTC (Strand, 2020). A goal for syllable shapes (e.g., CV, CVC, CVCV) is one example of a goal that is appropriate for apraxia. Don’t forget to consider AAC!

Whew! That was a lot. Thanks for hanging in there. Check out these related posts on speech sound disorder treatment if that’s your next step in the process!

– A Review of Articulation Approaches
– Tips for Treatment of Childhood Apraxia of Speech
– Where to Start with Phonological Awareness
– How to Implement the Complexity Approac
– How to Implement the Cylces Approach
– Target Selection Considerations for Speech Sound Disorder Intervention in Schools

Tips for Language Goals for Speech Therapy IEPs

Zeroing in on your student’s strengths and challenges can really narrow down where to go with language goals. Look for patterns and what the ROOT of the challenge is. In order to be educationally relevant, your goals need to target skills that will help the child’s ability to access curriculum and participate in the school environment. If your goals aren’t generalizing outside of the speech room, we’ve got some ideas to help! 

Make sure to take baseline/probe data in order to be in the student’s sweet spot for learning. Including visuals and varying your prompting can also give you clues about a student’s learning potential. A goal that is either too hard or too easy will not lead to the optimal amount of progress for a student.

1. Work on executive functioning. 

Consult with other IEP team members (like the psychologist and special education teacher). Talk about executive functioning challenges you both see. You want to be working on strategies that will generalize into the classroom (Kamhi 2014). For example: Work on using describing words to talk about new concepts instead of memorizing a set of new words, or work on embedded narrative skills like story grammar rather than working on sequencing separately. Working on these types of skills will help executive functioning skills like working memory and planning. It is within your scope of practice to work on executive functioning in the school setting (Ward & Jacobsen, 2014), you probably do already!

2. Consider social-emotional needs. 

Consider any factors related to social-emotional aspects (Kirch et. al., 2020).

Are they able to get their daily needs met? Can they talk about how they are feeling? Can they tell a peer a story or joke?

If this is a need, it needs to be a goal.

3. Consider the Common Core.

Look through Common Core State Standards and find where your student isn’t able to participate in the classroom or access academics. I usually start by looking at the speaking and listening and language sections. What sticks out as an area to target? 

Some Ideas

– Vocabulary
– Grammar
– Language skills like narratives
– Functional Communication

4. Build on student’s strengths. 

Focus on what they were able to do and what the next attainable steps are. (Example: they can describe different things that happened in a story but can’t sequence them correctly in their working memory, so you target story grammar to improve working memory and their ability to tell a story. This helps with both academics and with their social relationships).

5. Consider the educational impact.

Prioritize what will help your students succeed academically and participate in the school environment. This puts you in the right mindset to pick their goals as well. Collaboration is always encouraged. I check in with teachers to make sure that the goals make sense for their classroom and would help them. Make sure there is educational impact in order to justify services!

6. Provide additional speech therapy supports.

Do they need other supports for sensory processing during the session and/or are they a gestalt language processor? This may affect the amount of trials, visuals, prompts/cues, the environment, et cetera as you’re formulating your goals.

Tips for Fluency Goals

For fluency and social goals, a great mindset to have is to think of the social model of disability. We aren’t trying to change the person, we’re thinking of ways to support the student and change the environment in order for them to succeed.

I am absolving you from the idea that you have to get gets fluent.

Yes, you read that right! Check out this post by Nina Reeves about why we shouldn’t be writing goals for a percentage of fluency. She links to a handout about writing goals for fluency. 

First and foremost, we are going to consider the student and what their communication goals are. We want to focus on creating an environment through education/training and levels of support that encourage the student to be confident and comfortable speaking.

Areas to Target

1. Change the environment.
– Education about stuttering (journals)

2. Support the student.
– Thoughts and feelings about stuttering (including acceptance)
– Demonstrate fluency strategies
– Demonstrate awareness of dysfluencies
– Self-advocacy (e.g., decrease avoidance)

Tips for Social Language Goals

Goals for social language/pragmatics are going through quite the shift lately. In following the social model of disability, our thinking has to shift to what WE can change to accommodate the student, not what they can change about themselves. Research points to masking (an autistic person having to change who they are to blend into a neurotypical world) as being very detrimental to their mental health (Beck et. al., 2020). So what can we do about it? Listening to autistic voices is one way of making sure that you are targeting goals that are supporting the student’s environment and their needs, rather than forcing them to mask.

Check out this website made by an autistic SLP/SLT in the UK!

Goals should not be compliance-based.

Goals should support the needs of the student.

Goals should not support masking, unless requested by the student!

Example Goal Areas

1. Student Supports
Support for gestalt language processing
AAC/any form of communication student is comfortable with
Self-advocacy (e.g., for sensory breaks)
Self-regulation skills (e.g., recognizing when they need a break)
Daily living skills (e.g., job training)
Recognizing emotions in themselves and others

2. Supporting the Student in Interactions
Problem-solving
Self-advocacy (e.g.,  tell the teacher they are listening so they don’t have to make eye contact)

When working on these goals, push-in lessons are ideal to talk to both neurotypical and neurodiverse students. It’s a great way to promote understanding and to talk about the double empathy problem (Mitchell et. al., 2021). Neurodiverse students don’t have difficulty communicating with each other, but neurotypical and neurodiverse relationships can have difficulty understanding each other.

Being present in the classroom is also a great way to know what supports the student needs in that setting and an easy way to model it for classroom teachers. 

3. Supporting the Student Academically
Figurative Language
Narrative Language
Story Grammar
Perspectives in books (e.g., character’s perspectives)

Adjust the Setting and Supports

After your goals are set, you can adjust the setting and any types of supports either with the goal (visuals and prompts) or in the school setting with accommodations/supports sections of the IEP. You’ll also make final adjustments to your service delivery model and service minute recommendations. 

I hope this post has given you some confidence to justify your goal areas as treatment targets. It takes a lot of time and practice to go from assessment to goals easily. I still call my SLP friends to bounce ideas off of (following FERPA guidelines, of course!).

Give yourself the space to learn and grow.

 

References

American Speech-Language-Hearing Association. (n.d.). Speech sound disorders: Articulation and phonology. https://www.asha.org/practice-portal/clinical-topics/articulation-and-phonology/#collapse_6.

Barlow, J. A., & Gierut, J. A. (2002). Minimal pair approaches to phonological remediation. Seminars in Speech and Language, 23(1), 57–68.

Beck, J. S., Lundwall, R. A., Gabrielsen, T., Cox, J. C., & South, M. (2020). Looking good but feeling bad: “Camouflaging” behaviors and mental health in women with autistic traits. Autism, 24(4), 809–821.

Beukelman, D. & Mirenda, P. (2013). Augmentative and Alternative Communication: Supporting Children & Adults with Complex Communication Needs 4th Edition. Baltimore: Paul H. Brookes Publishing.

Cabbage, K. L., Farquharson, K., Iuzzini, -Seigel Jenya, Zuk, J., & Hogan, T. P. (2018). Exploring the Overlap Between Dyslexia and Speech Sound Production Deficits. Language, Speech, and Hearing Services in Schools, 49(4), 774–786.

Crosbie, S., Holm, A., & Dodd, B. (2005). Intervention for children with severe speech disorder: A comparison of two approaches. International Journal of Language & Communication Disorders, 40(4), 467–491.

DeVeney, S. L., Cabbage, K., & Mourey, T. (2020). Target Selection Considerations for Speech Sound Disorder Intervention in Schools. Perspectives of the ASHA Special Interest Groups, 5(6), 1722–1734.

Dodd, B., Crosbie, S., Mcintosh, B., Holm, A., Harvey, C., Liddy, M., Fontyne, K., Pinchin, B., & Rigby, H. (2008). The impact of selecting different contrasts in phonological therapy. International Journal of Speech-Language Pathology, 10, 334–345.

Dodd, B., Holm, A., Crosbie, S., & McIntosh, B. (2006). A core vocabulary approach for management of inconsistent speech disorder. Advances in Speech-Language Pathology, 8(3), 220–230.

Gierut, J. A. (1989). Maximal Opposition Approach to Phonological Treatment. Journal of Speech and Hearing Disorders, 54(1), 9–19.

Hodson, B. W. (2018, March 12). Enhancing Phonological Patterns of Young Children With Highly Unintelligible Speech (world) [Review-article]. The ASHA Leader; American Speech-Language-Hearing Association.

Julien, H. M., Finestack, L. H., & Reichle, J. (2019). Requests for Communication Repair Produced by Typically Developing Preschool-Age Children. Journal of Speech, Language, and Hearing Research, 62(6), 1823–1838.

Justice, L. M., & Fey, M. E. (2018, December 31). Evidence-Based Practice in Schools (world) [Review-article]. The ASHA Leader; American Speech-Language-Hearing Association.

Kamhi, A. G. (2014). Improving Clinical Practices for Children With Language and Learning Disorders. Language, Speech, and Hearing Services in Schools, 45(2), 92–103.

Kerch, C. J., Donovan, C. A., Ernest, J. M., Strichik, T., & Winchester, J. (2020). An Exploration of Language and Social-Emotional Development of Children with and without Disabilities in a Statewide Pre-Kindergarten Program. Education and Treatment of Children, 43(1), 7–19.

Levy, E. S. (2014). Implementing two treatment approaches to childhood dysarthria. International Journal of Speech-Language Pathology, 16(4), 344–354.

Maas, E., Robin, D. A., Austermann, H. S. N., Freedman, S. E., Wulf, G., Ballard, K. J., & Schmidt, R. A. (2008). Principles of Motor Learning in Treatment of Motor Speech Disorders. American Journal of Speech-Language Pathology, 17(3), 277–298.

McLeod, S., & Crowe, K. (2018). Children’s Consonant Acquisition in 27 Languages: A Cross-Linguistic Review. American Journal of Speech-Language Pathology, 27(4), 1546–1571.

Miccio, A. W., & Elbert, M. (1996). Enhancing stimulability: A treatment program. Journal of Communication Disorders, 29(4), 335–351.

Mitchell, P., Sheppard, E., & Cassidy, S. (2021). Autism and the double empathy problem: Implications for development and mental health. British Journal of Developmental Psychology, 39(1), 1–18.

Smith, A. L., & Hustad, K. C. (2015). AAC and Early Intervention for Children with Cerebral Palsy: Parent Perceptions and Child Risk Factors. Augmentative and Alternative Communication (Baltimore, Md. : 1985), 31(4), 336–350.

Filed Under: Therapy Ideas Tagged With: Fluency, Goals, Language, Productivity, Speech Sound

SLP Summit Q&A: Strategies for Narrative Intervention

July 30, 2021 by Marisha Leave a Comment

I presented at the SLP Summit earlier this week, and it was so fun! We got to spend an hour talking about narrative intervention. 🤓

As promised, here is a roundup of your questions!

Strategies

What is story grammar?

Story grammar helps students learn the parts or elements of a story. Different programs/protocols will include different elements, but character, setting, problem, and solution are common elements.

What is recasting?

A recast is when we correct what the child says or modify the modality (e.g., turn a statement into a question).

What strategies did you recommend for students with autism?

This is a quote from Spencer & Petersen’s (2020) article:

For children with autism and other developmental disabilities, this may involve providing longer wait times, limiting verbal prompts, and strategically fading visual prompts (Favot et al., 2018; Garcia et al., 2019; S. L. Gillam et al., 2015; Petersen et al., 2014).

Check out the article for all of the citations!

Embedding Skills

How do you embed vocabulary instruction with narrative instruction?

I share tons of strategies in the Vocabulary Bootcamp course in the SLP Now Academy. (This is included with all SLP Now memberships!)

A few of my favorites are to…

– strategically select target words from the text/story
– pre-teach vocabulary words in the text/story (when working with older students)
– support students in incorporating the target words in their narratives

How do you get a child to tell a story in a specific verb tense (especially if they mix tenses)?

It’s difficult to give specific recommendations without knowing more about the child/target, but here are some general suggestions:

Assuming the child has had enough exposure to the target verb tense, I would do a structured drill activity (e.g., contrastive imitation).

After completing the drill, we could jump into the story retell. I would consider using a visual to remind the student of the target tense. I would also provide visual/verbal prompts to support the child during their retell of the story.

If you want more detail, check out the Grammar Bootcamp course in the SLP Now Academy.

Goals

Do you have any recommendations for writing goals for narrative retell?

When we’re using a narrative-based approach, we don’t have to change our goals! We can target all of the same skills. We’re just using a slightly different approach/context.

If your students are working on narrative goals, I typically write goals that measure how many story grammar elements that the student can identify and/or include in their retell.

Timing

How long you do stay on a literacy unit? Will you use a book for a week, two weeks, a month?

It depends on the group, but we typically run with one book/article for a month. I see students with increased needs multiple times a week, so all groups typically end a book/article around the same time!

How many times would you read a specific story during a unit?

It depends on the group! I tend to read the book once (or twice) in therapy so that we have plenty of time to dive into all of the targets. I love to share the YouTube link to a book with parents/teachers so the students get additional exposure to the story. (The research supports multiple readings, but we just don’t always have time for it in therapy!)

This could be a good “warm up” activity though! You could give each student the opportunity to listen to the book while you collect your probe data. (More on that below!)

Data Collection

How do you take data?

I like to take data at the beginning of each session. I use a probe (which is basically a mini assessment with 5-10 items). I don’t provide any support so I get a really good read on how the student is doing. This helps me determine how much support I’ll need to provide during the session (or how much teaching I need to do before we dive in). It gives me clean data and allows me to focus on being the best therapist I can during the bulk of the session. I simply document the level of support I provided in my “real therapy” at the end of the session. I have a rubric that helps me consistently report the level of support. Click here to read more about my system and access the free rubric (at the bottom of the post).

How do you address reliable data collection with a group? I feel that I can take reliable data on the first student that retells the story but everyone else has had more time to listen to the story repeated before they do their turn.

If all students have a goal to retell stories independently, there are a few different options!

– You can pull the students from class individually to do a quick progress check.
– During your therapy session, you can pull one student to the side while the other students do a different activity.
– You can assess story retell for one student each week. (You can probe the students’ other goals during their “off” weeks.)

We can get creative in overcoming these types of hurdles!

When working with groups of 3-4 students with multiple goals each, how do you suggest getting enough targets/data for each student for the session?

I run through my probes at the beginning of the session to make sure I have “clean” data to report. I collect data for one goal per student to make this more manageable. It only takes a few minutes once the routine is established.

Then I focus on being the best therapist that I can be!

If it’s overwhelming to keep track of your students’ goals, have them each focus on one goal. (It would make sense to target the goal you probed at the beginning!) Set up each student for success by giving them a visual for each skill. This will make it easier to prompt them, but it’ll also remind you of which goals you need to target.

I don’t tally up data during this phase of the session. I find it more helpful to pay attention to the type of supports that a student benefits from. (I document this and always refer back to it, so I don’t have to reinvent the wheel each time.)

I’m curious what your daily note for Medicaid billing would look like when you are doing this?

Each state/district will require different elements, but here’s one possibility (if we’re using narratives as a context for embedded practice):

STUDENT participated in a book activity (Giraffes Can’t Dance) on DATE. STUDENT worked on using past tense verbs. They achieved 50% accuracy. After completing a contrastive imitation drill, they achieved 70% accuracy when using past tense verbs in a contextualized story retell activity. They self-corrected all verb errors when the SLP provided a recast for any verb errors (e.g., “The giraffe goed to the dance.” “Yes, the giraffe went to the dance.”).

The Curriculum

Do you ever use stories from the curriculum that students are reading in the classroom?

Absolutely! That is such a smart strategy and can facilitate generalization for our students.

How can we apply this to classroom reading activities?

All of the same strategies apply! Literature is literature, and it all works!

However, I would recommend picking something that takes ~5 minutes to read. Anything longer that than will be harder to target and really dive into. If they’re using a longer text in the classroom that makes a lot of sense for therapy, I pick an excerpt!

In general, do you target narratives as a retell of a simple story that was presented in class or in your therapy session?

It depends! Story retell is a great strategy, but we can also target story generation. It depends on what makes the most sense for the student!

At Home Practice

What resources do you give parents to help them work on these skills at home?

I share a copy of whatever visuals/graphics organizers are most helpful for the student in therapy. If I have the opportunity to see the parent/guardian, I will share a few strategies and/or demonstrate how to support their student’s narrative. If not, I try to send a quick video! Each child benefits from different supports, and taking a few minutes to put something together specifically for the students seems to be most helpful.

Book/Text Recommendations

Do you have some suggestions for great culturally diverse books that lend themselves well to story elements?

Chrysanthemum, I Like Myself, Allie’s Basketball Dream, and The Storm are some of the most popular diverse books in the SLP Now Membership.

If you’re a member, you can see the full list of diverse books here. We hired an amazing team of diverse SLPs to help us build out our library, and I’m so proud of what they put together!

Do you have any suggestions on finding lists of stories that can be used for the types of language targets you are describing?

Yes! I did a roundup of books for vocabulary, early language, later language, and grammar.

I also did a similar roundup of articles.

I also analyzed 190+ books and included “at a glance” target sheets for each book in the SLP Now membership!

What stories do you recommend for upper elementary self-contained classrooms of students?

I would recommend matching what they read in the classroom. Are they reading and books or articles? If so, I would use that to set up the students for maximal success.

What do you suggest for middle school students? Do you have books or stories that are age-appropriate but able to read in a short period of time?

I love using fiction articles with middle school students! They are more age-appropriate and relevant to the curriculum. ReadWorks is my favorite source! They have a large selection of articles, so it’s easy to find something that connects with what they’re learning in the classroom. (SLP Now also has article companions to make your prep even easier!)

Can you talk about retelling expository/informational texts?

I talk all about summarizing in the Language Bootcamp course in the SLP Now Academy. (This is included with all SLP Now memberships!)

SLP Now Materials

Do you sell these materials?

Yes! You can find out all of the details at slpnow.com/summit!

Do you have these visuals available in a format that can be uploaded for teletherapy, like PDFs?

Absolutely! They are all available for download in the membership.

Does the membership include materials for upper elementary and middle schoolers?

Yes! We hired a secondary SLP to build out our materials for older students. The fiction articles, nonfiction articles, and video units are some of the most popular materials for that age group.

Where can you obtain the sentence pack?

We offer the sentence pack to current SLP Now members! You can download it digitally from the membership or contact us ([email protected]) to purchase a prepped version!

Are the additional courses included in the membership or is it separate?

The courses are included in the membership!

Can you post the link to the backpack?

Here’s a link to my yellow backpack (affiliate link).

Filed Under: Therapy Ideas

Tips for Back to School Letters for SLPs

July 21, 2021 by Marisha Leave a Comment

So you’ve got pretty much everything set and organized and now you need to reach out to all of your students’ families! Congrats! 🎉

The first week can be a whirlwind and super overwhelming. As this is your first contact with your students’ parents/guardians, you’re probably worried about making a good first impression. We’ve got you covered!💪 

Start with an Introduction Letter

An introduction letter is a great way to reach out to families. Keep it short and sweet but make sure your letter has your contact information and a short introduction about yourself and how you’re looking forward to working with their child. We’ll include an example one and a blank one for you to customize. 🙌

How to Send a Letter

Try to communicate in some form with your families during the first week of school. Here are a list of ways to try and communicate!

Email: I typically email my letter to students’ parents/guardians. (That way I know if I have the right email address too!)

Paper Letter: If I don’t get an email back, I’ll put a paper version in the student’s backpack. Some will also request a paper version so they can put it on their fridge.

Phone call/text message: Depending on your caseload, you may be able to have a quick phone call or send a text message. I use Google Voice or Seesaw. What you use will depend on your district. I use Google Voice because it keeps a log of my communication. Seesaw messages get archived every year.

If you use a different method, you may want to start a communication log. Make sure it’s FERPA compliant!

If you need some inspiration, click here for a free template!

Follow Up Communication

I also send a follow-up after I have my schedule with the tentative day and time of their child’s session. I’m also able to make a note of the best way to contact that family. It comes in handy later! I promise!

Check-In

Throughout the year, I do try to check in a couple of times with parents/guardians just to drop a quick note about how a session went well and right before an IEP. It’s a great way to connect with parents/guardians so that meetings aren’t the only time you’re talking to them.

I’ve found that all of my meetings go a lot smoother when I’ve checked in with them before a meeting and a couple of times a year on a good note. My students also LOVE when they get to take that note home! 😍

Good luck and I hope that you have a great year!

Filed Under: CFY Resources Tagged With: CFY, CFY Resources, Parent Communication

How to Cut Down Spending on Therapy Materials

July 9, 2021 by Marisha Leave a Comment

We can end up spending a lot of our own money as SLPs. Here are some ways to get creative and save money!

Use the School’s Curriculum

Accessing existing materials can help cut down on costs. It also makes it easy to implement curriculum-based therapy.

Access Other District Resources

Does your district provide a materials budget? If so, use it!

If you don’t have a budget allocated to you, you can always try to request materials. If you present a good rationale, they likely will approve the request!

If the district says “no,” there are other options! For instance, are there district SLPs that can donate therapy materials to you?

Invest in a Subscription

Your caseload needs can shift drastically as you get to know your students and get new ones throughout the year. Having access to a library can be really helpful. By purchasing a subscription, you’ll have access to thousands of materials at once! This will help you avoid spending way too much on individual materials that you haven’t (and may never) use!

Avoid a spending spree as soon as you get your caseload!

Get to know your students first and what type of support they need.  The materials that you will need will change. Books, songs, videos, and bubbles will take you a long way!

Other Free Resources for Educators

The public library (A great source of physical books and e-books)

Free Books for Literacy-Based Therapy

Libby

37 Amazing Sources for Free Teacher Resources

Remember, you are your best therapy tool.

You don’t need tons of materials to provide amazing therapy.

The best thing you can do is invest time (not money!) in keeping up with the latest research.

We know that this can be really daunting!

The Informed SLP is a great account to follow to help you stay up to date on the latest research.

We recommend taking the information they share (on Instragram and on their blog). Then, think about new ways to use your existing materials!

You can also our free challenge to learn how to do literacy-based therapy! (You don’t need tons of materials to implement this approach, and you can always access free books!)

Remember that old saying in grad school about how we should be able to do therapy with a post-it note? (Or paperclip or whatever they joked about!)

Well, it’s halfway true! As SLPs we are what drives the therapy, along with our relationship with our students. How we use our materials and shape them to provide therapy is up to us and our knowledge.

Filed Under: CFY Resources Tagged With: CFY, CFY Resources, Freebies

How to Set Boundaries as a CF

July 9, 2021 by Marisha Leave a Comment

Sometimes setting boundaries is a struggle and not having dedicated time to work or wind down is a fast road to burnout. We’ve put our heads together and come up with some tips on how to set boundaries early while being friendly but consistent.

Be intentional about your time.

You’ll have to weigh being a social butterfly with your workload. I’m an introvert and I need downtime. If someone comes into the room to talk but I’m finishing a report, I will tell them I’ll pop into their classroom when I’m done in 30 minutes.

Set boundaries early.

Be friendly but consistent. Not having dedicated time to work or wind down is a fast road to burnout.

If someone asks you to do a task that is not in your job description, be honest about your workload and ask them if it is a priority over XYZ. 

If you’re looking for additional resources, Nerdra Glover Tawwab has a fantastic book on setting boundaries. Here’s a link to her book, Set Boundaries, Find Peace.

I really love her Instagram account for bite-size pieces on improving relationships.

Set yourself up for success.

Introduce yourself to the team and becoming a resource. If teachers/staff know what the criteria are for referral and how your RtI system works, you can streamline your referral process. This may be new information or a review. You can ask what the old referral process was and gradually change it to one more efficient.

Your first year is for observing and learning!

Some Resources on Missed Sessions and Makeups

ASHA’s stance is that there should not be a blanket policy from districts. Decisions should be made on an individual basis if missed sessions are a denial of FAPE for that particular student.

ASHA Leader Article: Missed Session … What’s Really Missing?

ASHA IDEA Part B Issue Brief: Missed Sessions

Don’t be afraid to ask for help!

If you are unsure of how to respond to something at work, you can ask your supervisor.

I also loved collaborating and learning from others!

Here are some people you can build relationships with:

Psychologist
Counselor
Occupational Therapist
Physical Therapist
Teachers

Knowing what other members of the team do can be really helpful for when parents ask for help and you feel like you need to do and know everything.

Be careful about referring for services, and align yourself with your district’s policies. You can always ask other team members for their advice on what to tell parents.

Setting Boundaries to Avoid Burnout

Burnout is a big problem in the education field, as well as speech-language pathology as a whole. Setting boundaries for yourself is important too!

Here are some boundaries to think about:

How much time will you spend at work? How early will you come in? How late are you willing to stay?

How much of your personal time will you devote to SLP-related activities?

How much time will you spend answering emails? Will you answer e-mails outside of work?

Filed Under: CFY Resources Tagged With: CFY, CFY Resources

CF Supervision: How to Build Independence

July 6, 2021 by Marisha Leave a Comment

Your supervisor is an amazing resource, but it’ll go a long way if you do some of the leg work before you ask a question.

Here are some strategies to consider:

Processes

1. Create a cheat sheet for your state’s eligibility guidelines.

2. Create a cheat sheet for legal timelines.

3. Create a cheat sheet for your school/district’s RtI process and referral process.

4. Use a planner or task management system to keep track of deadlines.
If you’re looking for a planner, Rifle Paper Co, Erin Condren, and the Happy Planner are popular options.
You can also use our free CF Binder to keep track of your dates!

Learning

5. You don’t need CEUs during your CF year, but it’s your responsibility to be knowledgeable enough to serve your caseload. Once you get to know your caseload, look into what you need to learn more about.

6. Look through ASHA’s evidence maps and practice portal.

7. Search the SLP Now blog. There’s a search bar towards the bottom of the page (in the light blue box)!

Report Writing

8. Look for (or request) report templates.

9. Look for (or request) goal banks.

10. Collaborate with other team members (e.g., teachers, parents) to write reports and decide on goals.

11. Learn how to align goals with Common Core State Standards.

IEP Meetings

12. Create an IEP meeting outline for yourself.

13. Write down commonly used explanations for your IEP meetings. Practice them (out loud!) to get comfortable.

14. Gather parent handouts that will be used frequently.

Now what?

Share anything that you create or learn with your supervisor! They can provide feedback and answer any questions that you might have. They might also take this into consideration when completing your Speech-Language Pathology Clinical Fellowship (SLPCF) Rating Form.

Filed Under: CFY Resources Tagged With: CFY, CFY Resources, Productivity

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