Marisha

Marisha: Hello there and welcome to the SLP Now podcast. I am so incredibly excited to have Kayla Redden with us today. She is my SLP bestie, but she's also an amazing school-based speech-language pathologist currently working as her sixth year in a rural preschool and elementary setting. She also serves as the secretary of the Kentucky Speech and Language Hearing Association and has participated in KSHA's ICANN Advocacy Network where she learned how to advocate for herself, her students and other SLPs. This is definitely a topic that I'd love to chat with Kayla about, all things advocacy, but today we are focusing on some articulation strategies, and if you're wanting to find out more about Kayla, we'll talk about this more at the end, but she also is ... She creates materials for elementary-age students on her Teachers Pay Teachers store, which is called Kayla SLP and she also blogs about therapy tips at kaylaslp.com. So without further ado, let's jump into today's conversation. But before we get into all of the practical tips and tricks, Kayla, first of all, welcome.

Kayla: Thank you. I'm so excited to be on here.

Marisha: Then, I also would love to hear a little bit about your experience as an SLP, in general, and how you started or how you got started with the service delivery model for articulation.

Kayla: I started working as a preschool and elementary SLP about six years ago. I've worked with preschool through high school, but the last few years I really zoned into the younger students. Something that has always bothered me about articulation therapy is that we so often gravitate towards the two times a week, 30 minutes a session, and it just kind of fits into our schedule and that's what we're so used to doing. But I wasn't seeing the progress that I really wanted to see with my students, and especially some of these younger students with such short attention spans. I was hearing some other students, I'm sorry, some other SLPs talk about five minute speech and I wasn't entirely sure what that was. So I did some Googling, I talked to some other speech therapists and I found out that it's a top of service delivery model.
Now, you can buy a specific product, they have Speedy Speech in Five Minute Kids that lay out the whole program for you, but you not really have to have that necessarily to implement this program. I started thinking about my own students and some of the difficulties I was facing like my students getting bored, or distracted, or me not feeling like I was spending enough time on each individual student in large groups and so I thought I'd try it out to see if it would work for me and my students.

Marisha: That is amazing. I love it. Just solving some problems in your SLP world and now you get to share about it with us. Awesome. So it sounds like you already told us a little bit about what convinced you to give it a try, but were there some aspects that you weren't sure about when you started looking into it and where you found those answers or was it a pretty easy decision? I'd love to hear a little bit more about how that process went.

Kayla: Honestly, I struggled a little bit whenever I started to implement this because I hated to switch all my students over to this model and then find out that it didn't work. And also with it being sort of non-traditional, it made me nervous that maybe my administration wouldn't want me to be doing this specific model or maybe the parents would be cautious about me pulling their students only for five minutes at a time working on them with their speech. But once I figured out a way to make it work with my schedule and talked to my administration and parents about it, I realized that it wasn't too much different than what I was already doing. Just shorter sessions basically.

Marisha: Yeah, and I bet you tried this with a couple of students before making it part of your inventory of strategies to use across your caseload.

Kayla: Yeah. That first year I picked three students, I believe, who only had a few sound errors, maybe one or two just as a test run. And when I saw how it was working for them, I started moving more and more over. But I would definitely recommend starting small with this just to see if it's going to work for you, and your students, and your schedule and just your school as a whole.

Marisha: Yeah, and I think that really helps guide that discussion with administration and parents and teachers, because if you're selling this approach and trying to implement it with everyone on your caseload, but you haven't gotten to use it yet, then it's harder to answer some of those questions and speak from a place of authority or experience maybe would be better. So I love that approach and I think that can apply to any type of change we're wanting to make with our caseload or our service delivery models or anything that. So super helpful.

Kayla: Absolutely.

Marisha: Then I'd love to hear a little bit more about the pros and cons of using this approach. So you talked a little bit about potentially having to modify your schedule, which could be a con initially. What else was on your pros and cons list when you were getting set up and implementing too?

Kayla: I would say some of my cons or initial inconveniences to getting started with this approach was, like you said, changing my schedule to make this model work. I will say that starting small help with that because I could see how much time I would need to block off just for three students. But just changing my schedule little at a time, changing over the IEP service minutes, trial and error with students who are starting out, trying to figure out who you want to use this approach with and who it might not work with and then just educating the parents and staff on what this service delivery method is.
As far as pros, I definitely have more pros. I see more increased attention and engagement within the tasks because there's no time for these students to lose interest. It's very quick and they're engaged the entire time. I've seen a increased ability to recall sounds they're working on whereas previously seeing students once or twice a week, they would sometimes seem to forget the sounds in between sessions. You know, "What sound are we working on?" "Oh, I don't know." And these kind of pick a sound, but when they're working on it almost every day it's really hard for them to forget what they're working on. I see more productions per session, decreased frustration because even if something is hard, I feel a student can do just about anything for five minutes and they're missing less class and they're sooner to be dismissed, honestly.

Marisha: Yeah, I love that. So many pros and it is definitely challenging to switch and try something new, but I think if we can remind ourselves of the impact that it can have on students, we can give it a try too, especially using that approach where we start small. So let in terms of helping SLPs get this set up with our caseloads, I'd love to dive into some of the cons or challenges that you mentioned. So the biggest one I think is getting administration onboard. So how did you go about this and what did that look for you?

Kayla: My best advice is to bring the research to the table when you're talking with your administration. Obviously, it's going to depend on who your administration is and I'm very lucky to have a director who trusts my decisions and what I say I would to try with my students, she's very flexible. But bring their research because they may say, this is something I've heard others say to me, "Well my administration says five minutes isn't going to do anything for these students because they're so used to seeing speech therapists use the traditional 30 minutes at a time approach." I do know that the Speedy Speech and the Five Minute Kids websites have research available that you can print off and bring to your administration, but just be upfront with them so they know exactly what this top of therapy looks. And really the research is just talking about how short, frequent, intensive therapy can lead to greater outcomes. So you don't have to have the program in front of you to bring to your administration. Just talking about how those short sessions with lots and lots of repetitions can make a change with students.

Marisha: Yeah. And especially for something articulation. There's some really cool research out there and I love that we can find we get easy access to summaries and handouts from those sites as well. That makes it even easier.

Kayla: Yes. I love it.

Marisha: So what about communicating with parents and teachers? What has that looked like for you?

Kayla: I feel I've had a very positive response from parents and teachers alike. The teachers really it because the students are missing less class and really they're with me no longer than they would be at a bathroom break, for the most part. So they're not missing all of science or all of social studies when they come with me, they're just missing five minutes. So they've been very on board with that. They to see that these students are really engaged with what I'm working on, because sometimes I'll do this in the classroom and they see what I'm doing and they're like, "Oh my goodness, I can't believe you get so much in just five minutes." And parents like that their kids are getting one-on-one therapy, and that's something that we don't always offer a lot of in schools. We see most of our students in groups, but even if it's just for a short period of time, parents knowing that their students getting all of your attention a few days a week for a short period of time means a lot.

Marisha: Yeah, and did you have any parents or teachers who were resistant to it at first?

Kayla: I personally have not had any. I came fully prepared that I might have some that were upset or worried about just a change in approach and I get it because it seems like five minutes, what can you do in five minutes? But I think if you're just upfront with them, especially after you've tried it a few times with other students and you can say, "Listen, I've seen really great results with this. Your student is missing less class and they're getting dismissed faster." Then that's enough to convince most parents and teachers that we're on the right track.

Marisha: Yeah. It's just a matter of bringing that information to the table and not just saying, "We're switching to five minute sessions." And instead, setting up the conversation and sharing the research and what it would look and just like we would with any other approach. So I love it.

Kayla: Yes, So whenever I had that initial meeting where I switch over, I do go over that with the parents and the teacher as to why I want to switch, what I've seen in the past and I just go over the reasoning. I think it puts everybody at ease.

Marisha: Yeah. Then also just before we dive into the logistics of actually getting it set up with your caseload, I'm wondering too if you can break down from what you've read in the research or what you've seen in your experience, who is a good candidate for this approach and maybe who wouldn't be as good of a fit?

Kayla: So like I said, when I first started out, I wanted to test it with my more mildly impaired articulation students. So I picked some single error or two error students and it worked really well. So over time I've learned that it does not have to be just those students. You can work with R students, and I say R is not a single sound error because there are so many different versions of R and it can take so long to fix an R, but those are great students to work on this with. Multiple sound error students. Phonology, you can use it with your kids who are using cycles because it doesn't have to be five minutes. You can do five, seven, 10 minutes for a child depending on what they need. So you could do three 10 minute days and use a cycles approach with these students. I've used it with kindergarten through elementary. I believe my other SLP at my school has used it with high school and I've used it with isolation through conversation levels. But the one group that I might not use this with will be preschool just because preschool doesn't always respond the best to drill, drill, drill, especially these new three year olds and four year olds. I use more of a play-based therapy approach with those students, but I feel most anybody else you can make five minutes for each work.

Marisha: That is super helpful, and then it's also case by case too. Maybe if we're in the very beginning stages of establishing a sound and it's really tricky, maybe the student would benefit from a longer session but I feel like from my experience that's pretty consistent with what I've seen too. I'm just trying to think if there's any other exceptions, but I think you got it. So I think we're ready to dive into some more of the logistics. What do you think, Kayla?

Kayla: Yeah, let's do it.

Marisha: Okay. So I'd love to dive into how you set this up with your caseload. So do you have any general setup tips or should we dive into the specifics of the IEPs? What do you think makes the most sense here?

Kayla: Just as a general rule, like we already said earlier, I would just start small. That's my best tip because you're going to be so overwhelmed if you start trying to change your entire schedule and all of your IEPs at one time for this. I would say wait until a student's annual rolls around before you change their IEP instead of trying to amend everyone's at one time, but yeah.

Marisha: Yeah, that makes a lot of sense. Then speaking of IEPs, what did that look when you ... So you said to wait until the annual, so you're not amending them, but then what did you write in the IEP or do you have any tips there in terms of how the Five Minute Kids approach, or the Speedy Speech, or just any variation of that would look in the IEP?

Kayla: I know that every IEP program allows you to write different things as far as service delivery times go. For Kentucky, where I work, we have to write how many times we're going to see the student either per day, week, or month and then for how many minutes. So when as soon as annual comes around, I typically write five minutes, 12 times a month and that allows me to see these students three days a week and that can be pretty flexible. You could write maybe nine times a month or 10 times a month if you want to allow some flexibility but I feel like five minutes, 12 times a month has worked well for me.
But let's say that you want to do cycles with a child you may choose the 10 minutes, three times a week or if a student is working on placement still and you still want to try shorter sessions maybe 15 minutes twice a week. Or if you can write ranges, which I think would be great, five to seven minutes, nine to 12 times a month or however you want to write it. It doesn't have to be that five minutes, three times a week. You can be flexible depending on your student and I know the manual, a Five Minute Kids kind of goes over that too, but again, five minutes is not the magic number. It's whatever works for your student. It's really just short, intensive sessions.

Marisha: Yeah, and I think that's a really important point to drive home. I think we get into our templates of once or twice a week for 30 minutes and this could become another template of, "Yeah, I do five minutes three times a week." But it's really like we're expanding into these different service delivery models and exploring them because we want to find the optimal service delivery time for that individual student. So you're absolutely right, it's not a template and we get to consider each student's individual factors as we're setting this up. So that's perfect.

Kayla: Yeah.

Marisha: Okay. Then what about Medicaid billing? I feel like there's a lot of questions about billing with this approach.

Kayla: Yes, lots of questions. Again, I'm very lucky to work in a school who does not force me to write my IEPs based off of Medicaid. I do know that if you want Medicaid to reimburse you can't write five minutes and some administration may want you to write your minutes more than five minutes just so that you can get that reimbursement. And I understand that and that's where I say the eight minutes, the 10 minutes may be just as beneficial for your student. They're getting a few extra minutes with you and it will meet your Medicaid requirements. So that's the discussion that I would suggest having with your administration before getting started just so everybody's on the same page and they know that five minutes will not get you reimbursed, 10 minutes will but still do what's best for your students. So if your students truly need the five minutes, that's a point that you need to really emphasize when you're talking about this approach with your administration.

Marisha: Yeah, and that absolutely makes sense. Putting students first and then advocating for them in that way, and then yeah, just kind of making it work and being a problem solver. We get to be really good at that.

Kayla: Absolutely.

Marisha: Then, what about scheduling? How did you get this set up in your therapy schedule?

Kayla: I set up a block of time for three days a week to see my students. I do allow some time for movement because I am going from classroom to classroom working my way down the halls seeing these students. So for example, if you have four students who are getting five minutes speech and you're seeing them five to seven minutes each, you may want to schedule 30 minutes just so you have enough time to transition between classrooms, make your way down the hall and see everybody. Because if you really only allow yourself five minutes, you will get behind and I have learned that the hard way because at first I set up my schedule five minutes, five minutes, five minutes and there was no way I could see three Five Minute Kids in 15 minutes even if they were in the same classroom together basically.
So always allow a few minutes of movement time. But I do suggest scheduling a block just so you can leave your room, work your way down the halls, and then come back to your room for whatever you have to do for the rest of the day. But there will always be some students who don't fit into that block. So the good thing about five minute speech is you could always say, "Okay. Well, third grade does not fit in this block. I will see them the first 10 minutes of school and I will see everybody in these 40 minutes in the afternoon." There's a way to make it work because it's such a short period of time.

Marisha: Yeah. And I'm curious, what does that block of time look like and how many students are you seeing in that amount of time?

Kayla: I probably see 10 students in about maybe an hour because that gives me about 10 minutes that way to ... Well, I don't know, I'll have my schedule in front of me. I think I see about 10 students maybe in 50 minutes and then that leaves some time for me to move down the hall, but I've fluctuated and I've actually dismissed so many students I'm not entirely sure how many I'm seeing that block of time. Because I've actually got to dismiss two of those students just recently and that helps a little bit. But I say, however many students you're seeing allow about 10 extra minutes of movement time just because you may be walking across the entire school building to see some of these kids or one may be in the bathroom and you have to wait a minute. So just allow some flexibility.

Marisha: Yeah, that makes sense. Then I'm curious too, if you have three students in a class, do you just tell the teacher, "Okay, I'll be here on Mondays, Wednesdays, and Fridays from 3 to 3:30."

Kayla: Yes.

Marisha: Or do you give each student a specific time?

Kayla: I just sort of give the teacher a block of time and then I make my way into their room and just call them over one at a time to see me, and a lot of times they'll even go get the next student. If we're all in the room together they're like, "Oh, do you need so-and-so? Let me go get them." So it flows very fast but the teacher knows within about a 15 minute period that I'll be in their classroom.

Marisha: Yeah, that's awesome. Then of course I bet that some days everything goes super smoothly and then other days it takes a little longer. So having that range I think is helpful.

Kayla: Yes.

Marisha: Awesome. So totally doable. Then that also reminded me of a question that comes up a lot in terms of student privacy because these sessions are typically happening in the hall or the classroom, right?

Kayla: Yes.

Marisha: Yeah.

Kayla: Just to make sure that your students are not ... You're not breaking FERPA because you do want to keep your students' privacy protected and the fact that they are receiving a special education service. Taking students into the hallway may not always work. Now, if you were in a school where you have a ... The end of the hallway where no one's coming down and it's a quiet end of the hall, that may be okay. Or if you have some fold-out barriers, I know that we have some fold-out cardboard barriers we can put up at the end of the hallway to use you can do that. But I also see students in the classroom. I try to go in during a busier time in the classroom, so when they're not doing silent work so that I can just pull them to the back or the side without disturbing the entire classroom for them to work with me.
So I see students at a back table in their classroom, on the rug, I've pulled them into the library before. Just anywhere where I'm not disturbing the rest of the class and the rest of the class isn't disturbing us necessarily. But you don't have to go in the hall, it doesn't work for everybody. I know that you don't want to parade your speech students around. So definitely, if you can find a little corner somewhere to go, just go there.

Marisha: Yeah, that's perfect. Then also I'm curious what the sessions typically look in terms of the structure, the materials, all of the good tips you've got.

Kayla: So this may be my favorite part of five minute speech, besides the fact that so many kids get dismissed. You don't have to plan much for it. You don't have to print off worksheets, or bring a ton to flash cards, or set up a game. Usually, when I go to five minute speech it is me, my clipboard and my iPad and that's about it. So my iPad has all of the apps that I would use for my articulation students for flashcards or reading passages, conversation starters. Most of the apps that I use allow me to track my data on them so I don't really have to bring a data sheet with me most of the time, but I usually keep something just so I can jot notes down for my next session with that student.
I use Articulation Station Pro and it goes from word-level two reading passage level. So that covers most of my caseload. I use Little Stories Pro, which has reading level and conversation level and super-duper story starters, which may be free, I believe and it's conversation level. Just fun little topics for your students to work on conversation carryover. But I love that I don't have to bring a cart full of stuff down the hallway. It's just my iPad and my clipboard and me and I time it on my watch, or you can use a digital timer, but if you have an Apple Watch you can just say, "Five minute timer." And it'll start vibrating whenever time's up.

Marisha: Ooh, that is a fun little hack too. I love that.

Kayla: Yeah, and my students think it's super cool that I talk to my watch so you earned some cool points doing that too.

Marisha: I love it. And it keeps you on track, so win-win-win.

Kayla: Yes. Yeah, It kind of keeps you from going over too much on time because it is easy when you get in that session just to keep going and going. So I do suggest setting a timer so that you and the student know when time's up, next student, but I'll see you tomorrow.

Marisha: Yeah, no that's great. So you grab the student, they sit down with you, you pull up whatever activity they're doing on the iPad, then you drill, drill, drill, drill, drill. Do you have anything that you do when they first sit down or with the wrap-up? Obviously, you say hi and check-in, but do you frequently share their progress or is there any other little elements that you think are helpful that you add in?

Kayla: Usually, when we first sit down, I will ask them, "What did we work on yesterday?" And I mean 95% of the time, even my kindergartners can tell me exactly what we did the day before, which is a huge win in my opinion because with the traditional models, they didn't always remember that we worked on T last time or Ks last time. So just a quick refresh, "What do we work on yesterday?" Then sometimes we'll pull up their scores and we'll say, "Okay, here's how we did yesterday. Let's try to beat that score today." Then we'll do our drills for five minutes and then at the end I'll let them see their data. And the good thing with Articulation Station is that it gives a little checkmark if they've hit 80% or 90% whichever one you set it to. So if they see that checkmark, they know that they're reaching that goal, but even if they don't reach the goal, they can see if their progress went up or stayed the same or went down from the day before and they enjoy that.

Marisha: Yeah, that's super fun. And it's so easy to see progress using this approach because it's super fresh, they're practicing it regularly, all that good stuff. That's awesome. Then do you ever send home homework or anything like that with this approach when you're implementing it?

Kayla: I usually will send home something. Some of these students, if they're having particular difficulty with a certain set of words I will email that word list to their parents, and Articulation Station allows you to do that. You can pick the sounds they're working on and send the email, I believe with the flashcards on it to the parents. And I'll also send home a monthly little checklist thing of, "Okay, if you practice your sounds 15 days out of this month then you get something." Or, "If you practice every day this month you get something." So I do send home a little bit of homework because I feel like if I'm working on it every day, then it should be pretty easy to carry over at home because the students can tell their parents exactly what they're working on and that's one of the biggest barriers I see to homework is that the parents don't understand how to help their child. But when I've seen them almost every single day the student can say, "Well, here's what we're doing and here's how I say that sound." And it just helps with the carryover.

Marisha: Yeah. And I love that tip that because I don't think I've used that feature. I love Articulation Station. I don't think I've used the email feature other than to email myself the report in the evaluation app, but that's so helpful. So cool. Awesome. That's so easy then and you definitely ... It's super relevant and you don't need to do any printing and that's probably easier for parents too because that way if they're waiting, I don't know, if their sibling is in soccer practice and they're just sitting in the car waiting they can just pull that up and run through some words, and it can just very easily become a routine, which is amazing. I love it.

Kayla: And you can also screenshot it, I believe. And if you, if your school uses Remind or ClassDojo, you can send it that way too. So if a parent doesn't have email or doesn't check their email often, most of them will check a text or Remind. So I send it that way too. I just take a screenshot and send it through Remind and it's just they're on their phone at anytime. They can practice anytime.

Marisha: Yeah, I loved using that with my caseload. Then in case listeners aren't familiar, what is Remind and ClassDojo and all those kinds of things?

Kayla: Those are apps for parent communication, and I know that most schools adopt some system of parent communication as a whole. It's basically another way to text parents without giving out your phone number to parents. And we personally use Remind at our school and you can send text messages and photos. You can't send videos, I wish you could. I would love to share my students doing their five minute speech with their parents, but you can share the photos of whatever you're working on or take screenshots and send it to parents that way.

Marisha: Yeah, that's perfect. And I had loved using that with my caseload. It was something that the school was already using and I would just have them ... I did send out emails just in terms of getting it set up, and I'd love to hear how you did this, but I ... Because I was new to this school so I sent out handouts asking the parents to join. I set up a class for my speech students and I set it up so that the other parents couldn't see other students. So they only could see their student. But I sent that invite out and then some parents responded to that. Not everyone did though, but at every IEP meeting I would bring that up and I was at ... What do you call it? A title one school.

Kayla: Yes, right.

Marisha: I think they traditionally get a rap for not having as much communication or less just involvement, but every parent that I talked to about it ended up signing up for it and we were able to communicate. It just makes, this is a little bit of a digression, but it just makes a really huge impact on student progress because we're able to just send super quick notes back and forth. I don't know what it is, but answering the phone or listening to a voicemail or reading an email even sounds like a big chore, but this just feels a super easy little text message and they just respond really quickly. And I've seen it help tremendously with generalization and I love the tips that you shared of sending screenshots and with this approach, it's super easy to implement that because it is one-on-one.

Kayla: Right, and you can even say just a quick text to the parent that says, "Hey, we worked on K this week. Here are some words to practice at home." And like you said, you're way more likely to get this parent engagement I feel like when you send a text style message to the parents because it is, it's so quick for you to send it and it's so quick for them to respond. So if anyone is not using one of these programs I really suggest you look into it, because I think you'll be surprised at what the open lines of communication will do for you and your students.

Marisha: Yeah, I absolutely agree. Then also just a couple other tips. Some school districts or some schools might not be using an app Remind or ClassDojo. I've heard of some SLPs using Google Voice and just setting up a number and then they can ... Because then that way they don't have to share their personal number, but there's a way to communicate and just check with your administration and check with your confidentiality and all of that, but those are things that I've heard of other SLPs doing just as a way to navigate that.

Kayla: I've heard that too and I've actually had that before. So I also recommend Google Voice if no one's used that. Give it a try.

Marisha: Yeah. And I think it's especially helpful for EI or if you're traveling or whatnot because then it's easy, then you don't have to give out your personal number and you can call parents and send them updates just as you're communicating scheduling and all that.

Kayla: Completely agree.

Marisha: So awesome. So thanks for humoring that little digression, but I think that's super important. If we're seeing a student for three times a week for five minutes, and if we can get the parents to help us we could essentially be doubling or tripling the student's practice time, which would result in much more progress. So this is a very important element of it and I'm glad we got to dive in.

Kayla: Me too.

Marisha: Okay, so another question. Do your students get bored? Because it sounds like it's ... Like it's not any fluff. You didn't mention a bunch of reinforcers or gains, you're just running through the articulation apps. Do they get bored?

Kayla: That was a fear of on when I switched over to this method, just because these students that I was using this with were used to getting to leave class, coming in my room, playing a game, getting a reward, and then going back to class. So I was nervous that I might have some pushback from the students themselves because they were no longer getting to come to my room, or get these fun games that we've been playing in my classroom. But I learned that maybe the first couple of times they may say, "Well, why don't I go to your room anymore? I want to go in your room and play a game." But I just tell them, "You're doing so well. This is how we're going to start working on your speech and I want you to be able to get back to your friends as fast as possible." My students really don't get bored. And I think it's just because the sessions are so quick there's no time to get bored. Whereas even in the classroom, when you're doing something super engaging you're going around the table and everybody takes a turn. Student one may be bored by the time you get to student three. Well, in five minutes speech is just you and that student, and there is no time for boredom because they're the only ones doing all the work.
So we still joke around and we still have fun and they love using the iPad. So bringing that, it's just a reinforcer in of itself even if you are practicing flashcards on there, or playing a matching game, or reading a sound loaded story. It's sort of rewarding in and of itself versus having to get a reward in the classroom.

Marisha: Absolutely. And I think if we are having that discussion with our students and they're really clear on what they're working on and if we're seeing them that frequently they're making that progress. So I think being able to see that progress is really rewarding. I know that would get me super excited. It's like, "Last week I was at 60 and I got 80 this time. I'm getting better." So I think just emphasizing that progress and mastery can be a huge win and we need all the extra stuff.

Kayla: Honestly, and sometimes your students are just excited because they're seeing you more. They're seeing you for less time, but they're seeing you almost every day and they love that. They're like, "Oh, I get to see you three days this week, four days this week." Or however often you're seeing them. But that gets them excited too, just you say, "Well, you used to only see me once a week for 30 minutes, but now you get to see me three days a week and I'm bringing the iPad." And yeah, it's a good time.

Marisha: And they get your one-on-one attention. How often does that happen throughout the school day and maybe even at home? That's, pretty special.

Kayla: Yeah, it means a lot to them, I can tell.

Marisha: Yeah. Oh, that's amazing. Have you ever run into behavior issues or do you feel like the length of the session is just so short that it doesn't even come up?

Kayla: Knock on wood, I have yet to have a behavior issue and I have used this with maybe 20 plus students so far. Actually, I'm sure more than that, but I've never had an issue. It's just because the students look forward to working with me one-on-one. Like you said, they love that attention. They don't want to get in trouble. And I tell them, I'm like, "We only have five minutes." That's one thing I do tell them if they start to get off task. You know, "We only have five minutes together today. So let's make the most of it. Let's not be silly, goof around, roll on the floor and I'll see you again tomorrow but we have to work hard today." Then that pretty much nips it in the bud right there.

Marisha: Yeah. Then another thing too, because when I was using Remind to communicate with my parents, they knew that I would be sending a note to their parents at the end. That wasn't something that I said often. Like, "Oh, I'm going to text your mom." But I feel like they just know that I'm going to be having that communication and they know that their teacher is right there too. It is just so incredibly short that I think all of those factors just combined make it really easy to manage that behavior because it just ends up being a non-issue.

Kayla: I agree.

Marisha: Okay, awesome. Then do you reward students at the end of the session or what does that look like?

Kayla: I don't always give rewards during five minute speech just because it's such a short period of time. I feel like they're getting rewarded, I know this sounds ... This is going to be controversial because some people believe in stickers every time or candies every time, but I feel like if I'm seeing a student for five minutes, then maybe not a candy for hanging out with me for five minutes and working hard. I will sometimes bring a smelly, which is what I use for some of my younger kids, a scented chapstick, put it on the back of their hands but that's sort of a rare thing even. It's usually, "High five, great job, look at your progress, see you again tomorrow." And they don't ask for things. It could be partially because even when they were in traditional type therapy with me I didn't really give out a lot of rewards. I was more of a, "Here's a smelly." Or, "You can sit in the teacher's chair for the session." That kind of thing. But they don't really ask for rewards and when they do get one it's super exciting because they don't come around that often.

Marisha: Yeah, I think that makes a lot of sense. And I mean the reward is in being able to spend with you and make progress towards their goals, and they get to do fun stuff during the session. It's not like you're making them pull their teeth out or anything.

Kayla: It is not just straight-faced flashcard drill, and I'm talking even kindergartners. So I'm not just talking older students. Even my kindergartners do not necessarily require a reward at the end. It's literally just, "You did so great today. Look at how much you went up." Maybe you could say, "I'm going to text mom and tell her how great you did today." High five and then we'll do it again the next day.

Marisha: Yeah, that's perfect. Then I loved what you mentioned because I think you ... From what I understand, you don't do a prize box or the stickers or the candy in general, right?

Kayla: Right. I've stayed away from that recently.

Marisha: Awesome. And you have a really great blog post that you wrote. So I'll link to that in the show notes as well as the different apps that you mentioned and any other resources that came up. Like the links to the programs and that'll be slpnow.com/44 but I really loved that blog post because they think if you are struggling with that and your students are always asking for more stuff, or you're not sure if you want to be spending money on that, Kayla has a lot of really great ideas so look for that in the show notes as well. That's a really helpful post.

Kayla: Thank you.

Marisha: And I just love the scented chapstick idea because it costs one or two dollars and it probably lasts you forever. So tell us a little bit about how you do that just in case it's not super clear.

Kayla: I have a box of about 20 different chapsticks that I've bought up throughout the different seasons and at Walmart and on Amazon, and at the end of a session if a student worked hard, was nice to others, did their job, then we get a smelly, that's what we call them. And I close my eyes and make a really big deal out of picking out a chapstick from the box and we talk about what smell it is and then they all get just a little smudge of it on the back of their hands, and they can smell that for the rest of the day or until they wash their hands. But they love it. It's a huge, huge, huge deal.

Marisha: Yeah. And that gets to be a language activity in and of itself because you're working on describing and all of that.

Kayla: Yes.

Marisha: Awesome. I love it. Awesome. And I love the experiential rewards, like getting to sit in a special chair or ...

Kayla: Right, and I tried the treasure box, but it was more of a, "You don't have what I want in there." So I just kind of got rid of that and now it's more of, "No shoes." Or, "Sit in the teacher's chair." Or, "Five minutes of iPad time." Just something that doesn't require physically buying something and stocking a treasure box that may not even suit all of your students' wants and needs.

Marisha: One of the rewards that I would give was to have lunch with me, which was a surprisingly exciting prize. And I think it's cool too, we can get creative with how we implement this. With articulation, we're working through the hierarchy, so we're from isolation to ... Or yeah, isolation to syllables and words, and phrases, and sentences, and maybe we can implement some rewards that way too. Like if you get to the word-level or if you master this level then we'll get to have this celebration thing. And maybe it could be just a scented chapstick depending on how long it takes, but there's fun little things that we can do.

Kayla: The great idea though, I didn't think about that. Yeah. As they master a level then the reward comes. That's a great idea. I love it.

Marisha: Yeah. I have a little ladder that I print out. It's just like ... And all of my students have a little articulation folder, but then we'll use that. We'll get to color in the levels of the ladder as we move through the steps, and I think it helps to educate the students so they know what they're working towards and we'll kind of say ... Not all students are going to go all the way to the top of the ladder right away. Some students take longer than others, but I feel like with this approach it could happen pretty quickly. So we just-

Kayla: Yeah, it moves fast.

Marisha: Yeah.

Kayla: And I love it, but definitely write your goals a little loftier than you normally would I feel like with this approach, because if you write just a word-level goal your students are going to surpass that it seems like in no time. So that's another thing to keep in mind when you're writing your IEPs. Think bigger than what you may be thinking now because the progress is going to come faster than what you think.

Marisha: That is so exciting. I love that. I wish we could ... We need tacs this for all of the different types of goals that we write because it's amazing.

Kayla: Yes.

Marisha: I love it. Okay. So let's just recap real quickly. So in terms of some of the pros to using this approach, so we've got ... Maybe we can round-robin it and see how many we can come up with. So we've got increased engagement because of their short sessions and all of that. Is there anything else?

Kayla: Increased ability to recall those sounds. They know what they're working on.

Marisha: Yeah, goal awareness. And then rapid progress.

Kayla: Yes. Less time missing class.

Marisha: Yes, and less of that educational impact, which is awesome. Then, let's see, what else can we think of?

Kayla: Sooner to be dismissed? That faster progress leads to sooner dismissal.

Marisha: Yeah, and then more impact in the therapy time too.

Kayla: Yes. And the one on one therapy, which a lot of students, like you said, they're not getting that most of the times, that one on one.

Marisha: Yeah. Anything else? Or do you think that covers the essentials?

Kayla: I think that's the biggest part of it.

Marisha: Oh, and then last prep time too.

Kayla: Oh, yeah.
My favorite. I already forgot my favorite. I just love that I don't have to prep for those 10, 12 students or however many you have on it. It cuts your planning time greatly. Greatly, you'll love it.

Marisha: Yeah. And I love when those worlds collide where there's less planning and more impact. It's the like thee ...

Kayla: Could it get any better?

Marisha: Yes. So that's amazing. Then for some of the challenges, we talked about just like getting it ... The setup seems the biggest challenge and we talked about how to communicate with administrators, how to communicate with parents, teachers and then-

Kayla: Just starting small.

Marisha: Yeah.

Kayla: Don't overwhelm yourself, just start small and go from there with your schedule and service minutes and all of that. Because that is the hardest part, is getting everything moved over but give yourself the year. Give yourself that school year to start moving students over and then the next year it'll already be set up for you.

Marisha: Yeah. Perfect. Then I love that tip that you gave too, as you're updating student's IEPs to decide if it would be a good fit for them and then making that change there and then, yeah. We can get creative there if we feel like, "Oh my goodness, this student is not making any progress. We need to make a change ASAP." We can problem solve in those situations, but I think that's a good strategy to make it feasible because rolling it out over the course of a year is better than never rolling it out because it feels too much of a hurdle.
So we can let go of a little bit of our perfectionism because it can be hard to think about, "Oh my goodness, I want to do this and if I'm going to do it, I have to do it all the way." But I think that's something that was helpful for me. At least I'm implementing it with these students and then the rest will come. But that's really the most feasible way to make a change in any area of our practice.

Kayla: Absolutely.

Marisha: So awesome. I love that. Okay, and then I think we are ... I think that covered ... That was a good recap of what we covered. Did you have any other tips for success or strategies that you found to be particularly helpful or just anything else you want to share?

Kayla: Just my biggest tip besides not stressing yourself out trying to get this started is to, when you start to roll it out, like I said, have the research, have those open conversations with the parents, and with the teachers, with your administration. Maybe even talk to the teachers before the meeting and just say, "Hey, there's this service delivery model that I'm really wanting to try out with some students. I think your student would be a great fit." And that way explain it to them first so when you go into the meeting, nobody's caught by surprise and when you talk to the parent about it, the teacher's already on your side. They understand your rationale behind it instead of just saying, " inaudible understand what you can do in five minutes." Talk to the teacher beforehand, talk to administration beforehand, and the parents, I think they will be in agreement with what you want to do for their child because you are doing what's in the best interest for their child.

Marisha: Yeah, and I think that automatically shines through when that's the case. So that is super helpful and I love the tip, particularly if you think it might be a challenge if you let the teacher know upfront. I think that could make a really big difference because the parent will, especially if they have a good relationship with the teacher, they might look towards him or her to kind of see, "Okay, what's her reaction or what's his reaction?" So if she or he is nodding along and they're positive about it then I think that can help, especially for parents who you think might be a little more resistant to change or whatnot.

Kayla: Absolutely.

Marisha: Awesome. Okay, so that was super helpful. I feel like this was jam-packed with practical tips and strategies to get this started. I love all of the suggestions for really easy things that we can do to work through this. So thank you so much for sharing all of this, and I was wondering if you could share where ... If SLPs listening to this want to find out more about you, where can they connect with you and what's a good place to learn more about your therapy strategies, and materials, and all that good stuff?

Kayla: You can find out more information about how I run my therapy and some of the activities that we do in my therapy room on my blog, which is www.kaylaslp.com. You can also find me on Facebook and Instagram, Kayla SLP. And I also sell on Teachers Pay Teachers. Again, Kayla SLP. So you can find me pretty much anywhere just by Googling Kayla SLP. But I talk about a lot of this stuff, the five minute speech, the reward systems, lots of good stuff everywhere. So just find me on social media.

Marisha: Awesome. I just remembered that you wrote that post, so I will link to your ... If SLPs or listeners prefer to get a readout of some of the points that we talked about, Kayla did write a super helpful blog post. So that will also be in the show notes at slpnow.com/44.

Kayla: Sounds great. Thank you for having me.

Marisha: Yeah, thank you so much, Kayla. This was so incredibly helpful and thank you to all of you who made it to the end of this podcast for listening in. I hope you're walking away with tons of practical tips and strategies and that's a wrap. Thank you.

Kayla: Thank you.

Marisha: Hello there and welcome to the SLP Now podcast. I am so incredibly excited to have Amy Chambers with us here today. She has been a long time friend. We met back in the day on Periscope and she is a special education teacher who just shares the most wonderful tips for behavior. She has helped me tremendously with my previous case loads and students and so I'm super excited to be connecting with Amy again to share all of her amazing tips and tricks with you, and just a little bit more about Amy. She is the CEO and founder of lightenupteaching, a business based on helping educators and parents bring mindfulness and social emotional techniques to students.
Amy is also a national board certified educator with over 18 years of experience and I'm super excited to hear more about all of the amazing things that Amy is doing because that's definitely a very, very tiny snippet, but without further ado, let's jump in. Hi Amy.

Amy: Hi Marisha. I'm so glad to be here.

Marisha: Yes, I am so incredibly excited. It's been far too long.

Amy: Yes.

Marisha: Like I gave a little bit of a snippet of what you do, but can you tell us a little bit about your experience as a special education teacher, and kind of your journey there and where you ended up?

Amy: Sure. I actually, went to college a very long time ago to be an art teacher, and kind of as part of my study, I knew that I would be teaching all the kids in a school and so I always kind of sought out experiences to work with kids with special needs and I ended up babysitting a lot in college and I kind of got on the list of moms that had kids with special needs who I was willing to babysit. I ended up working at an autism camp the summer after I graduated and as I was doing my student teaching and art, I was spending a lot of time with the kids with special needs and I ended up starting to take classes in special ed and so I started out in a autism classroom with students who were mostly nonverbal, lots of communication devices and the 2003 version of communication devices which are a lot different than what we have now.
I did a couple of years in that really intense middle school classroom with kids with pretty significant autism or significantly affected by autism I guess, and then I taught art for a little while after that and then I went back into more self-contained classroom in elementary and I've been at the school I'm at now. This is my 14th year and I moved from the self-contained setting to more of a resource classroom and now I kind of have a blend of separate setting resource, mostly second and third graders but I've had experience with pretty much any kind of special education that you could think of at this point, I think.

Marisha: That is so amazing and I'm really excited to be able to learn more about how all of those experiences kind of shaped all of the things behavior for you but I feel like you're kind of recognized as a behavior expert, especially in the teacher groups. How did you come to learn so much about behavior and like what led to you to that?

Amy: Well, as a special educator, and as an art when I taught art, it was actually to center for young people who are detained, so it was like a juvenile detention center. I've pretty much always had caseloads in classes with lots of intense behavioral needs and it's just been very clear to me from the beginning that these were really sweet, wonderful kids who wanted to do well and didn't know how to do well. I really don't believe that kids come to school and want to make you have a hard day as their teacher or therapist and so I've just really... I'm very curious person so I've always done a lot of research and I try things pretty much as soon as I learn about them and so I've just put a lot of things into practice over the years and it's just, I feel like helping kids with behavior is one of the best ways that you can impact them in school and in their life, so it's just something that I feel like I can share with other educators too to kind of help the whole school community be improved.
And so much of it is communication and I think that what you guys as speech therapists do is very important and that's a lot of what I'm doing with behavior, is helping kids communicate more effectively about what they need.

Marisha: Yeah it's so true because behavior is a form of communication and I feel like a lot of times... like a lot of the students on my case load are the ones that teachers like in the teacher's lounge or whatever, those were the students that they'd be pulling their hair out about because they didn't have... they weren't able to communicate what they needed to communicate and so then that manifested in terms of their behavior.

Amy: Absolutely.

Marisha: So yeah, I think it's amazing when teachers and speech therapist can collaborate and work on behavior together because it's such a... yeah so this is a perfect conversation to be happy. And then how would you... like, let's start kind of broad first. I think you started touching on it already, but how would you describe your approach or your philosophy when it comes to behavior?

Amy: Well, yeah, like I said, like I really feel like most people, most kids especially are doing the best that they can and so when a kid is having behavior problems at school that is something that is not just the kid's problem, it's the adult's and the students need to work together to help solve that and I just really like being able to help kids be as successful as they can be at school and also for teachers to be able to do the work that they have gone into education to do and I really like Ross Greene who does proactive and collaborative solutions. He's a behavior expert and he said that all disruptive behavior is a result of either lacking skills or unsolved problems and I really enjoy that challenge of helping to figure out what skills could kids need to help them have more success at school and what problems they're having that we can help solve for them. It's a great challenge and I really enjoy helping kids be more successful.

Marisha: Yeah. I feel like that mindset or that philosophy makes it much easier to start troubleshooting and work towards solutions instead of... because I think it's easy to... I feel like I saw this happening a lot in the schools where children were just labeled as being difficult or having behavior issues and there wasn't as much of that digging to really understand the why behind it and figuring out how we can support but it's totally doable. Like you and I worked together on some of my students who were really challenging, but just after... even the most challenging students after some initial digging and sometimes it did take a little bit more time but it wasn't... like by showing up in that way, I think the students really respond to it and we come up with some pretty amazing solutions. So, yeah.

Amy: Absolutely. Yeah and I think one thing that kind of goes under my philosophy, but I know that sometimes when teachers or therapists or people working in the schools have a student with a behavior problem and the behavior is really causing a lot of issues for them in a classroom, they don't see it as fixed unless the behavior totally goes away. Whereas we know if we're teaching a kid sound or we're teaching them a new skill, we measure progress and we take those small steps and see that as progress and one of my philosophies with behaviors that help teachers notice progress with behavior and not just when the kid is no longer disrupting class at all because that might not even be a reasonable goal, but helping kids learn how to manage their own behavior and how to make those little steps and improvements I think is another really important part of my philosophy, is looking at it just like you would a therapy goal for a sound.
You wouldn't expect a kid to master it in one session. I don't know that much about speech therapy, but I would think normally it's not just a one and done situation, so helping to come up with ways to measure that progress and celebrate that I think is really important.

Marisha: I totally agree and I think that like speech therapist experience with writing those goals does give us a little bit of an advantage when it comes to... because we're already in that mindset and we're looking-

Amy: Absolutely.

Marisha: ...for crosstalk progress. I love that you mentioned that because we conduct... like especially if a student is struggling, we should be able to celebrate the small wins and progress because we're heading in the right direction and that's amazing.

Amy: And I think that's an important part of our role with the regular education teachers is to help them recognize that progress too, because we do get that smaller group setting or that more intensive look at just one or two kids and so that's a really important thing that the SLPs can bring back to the other teachers in the building. As you know at the beginning of the year this was happening X amount of times during our group and now it's happening 50% fewer times or whatever because I think you're right. I do think the therapists are much more ready to recognize that and that is a good thing that we can do for the kids, is to point that out to others around us.

Marisha: Yeah. And are you ready to dive into some of your favorite strategies and tool?

Amy: Absolutely, yes.

Marisha: And is there one that is absolute favorite that you'd want to start with?

Amy: Well, I think the overall umbrella that I kind of work everything into now is mindfulness and just using trauma informed practices because I think we're learning more and more about a lot of the persistent behavior problems we're having at school are having to do with things that are not just related to school. Just really incorporating mindfulness in my classroom at all times so things like having an agenda to check off, like a schedule or just an agenda for what you're going to do in that session for the day is really helpful for kids who don't always know what to expect in their lives or have had unpredictable situations in the past. I find that to be a really easy thing that helps me stay on track and it also helps the kids feel more calm and relaxed in our time together.
That's one of my favorite things that works for all kinds of different situations. It never hurts to have an agenda to check off for your group and that's a really great mindfulness strategy. That's not too wuwu that pretty much anyone can get behind so I also think that that is a really good thing to just start out with and to implement off the bat, and I really like using growth mindset language. I assume most people are probably familiar with that at this point but there's a book called Growth Mindsets by Carol Dweck and she's done a lot of research on praising effort rather than smartness or ability and that's just such an important thing in the work that we do because we are working with kids that have skill deficits and so a lot of the times they're comparing themselves to others in their classrooms and so really using a lot of growth mindset language and teaching kids to say yet, like I can't do this yet or I haven't mastered that yet and really praising effort and growth is such an important thing and that has really changed my teaching.
I know, you had mentioned I like to really celebrate mistakes in my classroom and this is a really fun thing to do. I read a book a few years ago called The Art of Possibility and it was all about growth mindset and different practices to use when working with people and one of the authors was a conductor and he taught the people in his orchestra to celebrate their mistakes by throwing their hands in the air and saying how fascinating every time that they hit a wrong note or something because mistakes are how we learn and learning from our mistakes helps our brain grow. All these kinds of things I say all the time in my classroom now.
A lot of years I'll train my groups to notice when they make a mistake and to say how fascinating and it's really great when a kid really latches onto that and really does start to get excited about their mistakes. One of the things, I've done, like if we're doing writing together, I have lots of washi tape. I really like to do crafts so I have an overflow of craft supplies so I take them to school, and I had some glittery washi tape that will cover up our mistakes with a magic tape and so it's something that they can literally see and get excited about when they make a mistake to help them learn to find that process exciting, that process of making mistakes and learning from it.
That is something that I think works really well and could be easily incorporated, especially with younger kids. I think you can get older kids behind it but I've worked with elementary for so long. My husband actually teaches middle school, so I started to test things out through him to see what still tracks with seventh graders.

Marisha: That's amazing. Like what have you found that you... were there things that you think wouldn't work or that did work or that were surprising-

Amy: With the older kids?

Marisha: Yeah.

Amy: Well, he had a mindfulness club last year where he did different meditations and everything, different kind of mindfulness practices and he had several kids sign them because they really liked it. He uses GoNoodle a lot in his classroom, with the movement brain breaks and I definitely feel like GoNoodle is geared toward younger students, but his kids love it when they use GoNoodle in his class. I think that's really fun that that works for them. He uses the professionals in training a lot with middle school and what that is is instead of teaching kids to have respectful behavior since respectful is kind of a subjective term and people may have a completely different type of meaning of respect in their home than what we might think of as respectful, but everyone can kind of get onboard with the idea of we're learning how to be professionals, we're learning how to have a job one day when we're not in school.
Instead of saying that behavior's rude or bad or wrong or disrespectful, that's not professional. He uses that a lot with his seventh graders and I think it helps him feel a lot more like he's not just making arbitrary rules and just... I think it helps them be a lot more consistent to just say that behavior is not professional. We are working towards getting a job one day and we need to learn how to have professional behavior when we're in the school setting.
What I do when I do that with my kids is I really talk to them about what they think they would like to do when they grow up or what they could see themselves doing as a job one day and so I'll even have them like draw a picture or write it down and keep it on their desk so that... actually had a student today and we had clubs at school and he really wants to be a chef and we were baking and he spilled the sugar on the table while he was measuring it out and he picked it up with a singer and put it in his mouth. I was like, well, you have to go wash your hands and he got really upset with me and I said, I understand like if you're at home and you're baking, it's one thing, but when you're baking for other people, like different people in the school are going to eat this. You have to wash your hands. That's professional behavior.
It's not that I think it's right or just something that I made up but you have to learn if you want to be a chef at your own place or in a restaurant, you have to wash your hands. That's a really important rule and he's really upset with me at the outset, but he did come back around and understand what I was saying and that was a really good framework for us to work in later on when we discuss the behavior, and kind of debriefed and learned from our mistake because growth mindset really applies to behavior just as much as learning an academic skill. I try to apply that growth mindset with our behavior talks too and not just that I know the rules and you don't and I'm right and you're wrong. I really try to kind of meet the kids on a, we both have something important to say and so I really try to meet them where they are and not just act like I'm the teacher and my way or the highway kind of thing.

Marisha: Yeah, that makes sense and I love that you mentioned professionals in training. That's one thing that I learned from you and that I've used a lot over the years because I think it's so incredibly helpful. Like especially with students who are getting older and who are a little bit over speech in the context of being a speech therapist, like-

Amy: Absolutely.

Marisha: ...crosstalk get tired of their goals, like they're tired of coming. That we can talk about how it relates to how their goals will help them and it's even better if we can involve them in the discussion from the beginning and if they can be involved in like picking their goal but when I first started using it, like the students already had their goals and so we got to have the discussion about what do they want to be when they grow up, and then we got to map their goals on to that so that they have like that motivation behind it too. I think it's like a little bit different from what you described but I latched onto that and have definitely been able to use it with my students inaudible so far.

Amy: Well, and that's the thing about it, it's so applicable in all kinds of different ways. It also, I feel like just being at school in general or yeah, going to speech outside of school or whatever, we know that it's the law that kids have to go to school and most people that end up working in these types of fields really valued school when they were kids and their families really valued education but a lot of the students that we're teaching don't really know why they're there. They just kind of think that's what you have to do. They're not necessarily motivated to do well just because someone told them they had to go.
I feel like when you put it in that lens of we're here to learn how to be grownups one day, then it really... and when they're thinking about what they want to do as a professional, you can help hook them in and make everything more meaningful to them which is how you get kids motivated to work hard and do their best and all of that, so the professionals in training is definitely something that applies to all ages and to all different types of situations at school.

Marisha: Yeah, I completely agree. And then is there anything else that you wanted to add in terms of the middle school pieces that your husband is doing or should we jump onto some other...

Amy: I think the professionals in training is the biggest thing he uses and he also uses a Two-by-Ten strategy a lot, which is a behavior strategy where basically every day for 10 days in a row of when you're in the same place as the kids. If you see them at school they come to you every day. You spend two minutes talking about things that aren't related to school or behavior or anything to do with your school goals, but just talking to them about their life or their favorite football team or their best friend or just connecting with that kid as a person outside of whatever our agendas are in terms of school.
I mean, I feel like that one is a biggie. Like if you can just take some time to check in with the kid and show that you care about them not just because it's your job to teach them something. I think that's been really useful and it also works for the adults. If you're having difficulty professionally with someone else in your building, just kind of taking some time for a few in a row, finding out about their life or asking them how they're doing, that can be really useful across ages.

Marisha: I've definitely seen that work too. I love that that strategy inaudible the Two-by-Ten.

Amy: Yes.

Marisha: It's perfect.

Amy: So yeah, two minutes a day or 10 days in a row.

Marisha: 10 business days, I guess. inaudible. No, we're going to go call up these students on Sundays. Okay, awesome and then... okay, and do you mind if we circle back to the mindfulness piece, because I know... like I love the agenda checkoff thing. I think that's something that a lot of SLPs can get on board with that. I'm curious like what else that looks like in your classroom and whether it's wuwu or not. I'd love to hear what that looks like for you.

Amy: What mindfulness really means is just paying attention to what's happening right now, being present in this moment. That can look a lot of different ways and I've done some training with compassionate schools, which is a lot about trauma. There is a great TED talk by Naomi Burke Harris about the adverse childhood experience survey, which I would really recommend that people that want to know more about trauma informed practices. Watch that TED talk it's about 15 minutes, but there's so much that affects the way kids learn that has to do with their home environment or what kind of background they've come from and it's actually been shown that trauma can make a kid look like they have ADHD when really it's the result of these traumatic experiences that they have gone through.
I do a lot related to that of just like really asking the kids what's going on, setting up things like temperature checks, which is where I have like a thermometer in my room and it'll either go from zero to five or zero to 10. I usually do zero to 10, but for some kids it's kind of hard to, that's maybe too many choices, but zero is like the worst day of your life and 10 is like the best day of your life like you went to Disney World and I just kind of have them stop and think about how they're feeling and what their temperature is and they can just hold up their fingers so it's not really public and I just notice if someone's five or below, I know that I need to kind of circle back and check in with them.
And even in one class we had the kids write their number on a sticky note and just stick it on their desk if they wanted us to know what their number was so that, that way I knew if a kid had taken the time to put that on their desk, that I might need to check in and see what's going on. I did talk to a middle school teacher who does this temperature check as like a check in on a computer. She has a Google form and she asked the kids like a couple of questions like, how are you doing? Have you eaten today? They rate their mood from one to five or one to 10 or whatever and she has the form set up so she gets an alert if they're below a certain number so she doesn't necessarily read all 100 of her forms every day since she has so many students but she's alerted to the kids who have said there's a problem or is there anything you want me to know?
That is a really useful mindful strategy. I also have these little trash cans that are really cute, they're like pencil boxes. I got them at the Dollar Tree and I just kind of have one up in my classroom and that's where our worries go. Anything that a kid's perseverate about or worried about or just really excited about and they can't calm down, I teach them to kind of put that in the trash can.
It's not that we're getting rid of it, we're just going to hold it safe there so that we can move on with whatever we need to do in our time together and that is really helpful to a lot of kids and I have a few of them so if like I have a kid who's having a lot of emotional trouble and they need to take a trash can with them to keep in their classroom, I have enough where they can do that. That's been really helpful for some kids and it helps them stay mindful in this moment at school and not have all that anxiety of all the other things going on. They're not carrying that around with them all day.

Marisha: So much good staff.

Amy: Yes. That's been really useful and I could really see that being useful in a situation where you only have the kids once or twice a week and you really only have 30 minutes to get done what you need to do. You need to have some kind of way to honor their experience without having to sidetrack your whole group. The little trash cans are great and you could draw one or whatever but the little ones from the Dollar Tree are really cute. It's okay since the kids love them.

Marisha: Yeah, if it's cute, it makes it that much more fun I think-

Amy: Absolutely. For sure.

Marisha: I hadn't used the trash can idea yet, but I definitely use the thermometer check and I think that was super helpful for me. It's like an integral part of my therapy routine, like the students walk in and just check in to see how they're doing and I think that really helps set us up for success because then I know if a student is that a two, they're not going to participate in the session so just taking... or they're not going to benefit or get the most out of it.
Just knowing that right up front and being able to do... like a lot of times it's just a quick fix. Like what are some things... so like when you circle back, can you give us a couple of examples of like when you circle back to the student, like what do they tell you and what do you do to help them? What does that process look like?

Amy: Sure. Like for example, sometimes I'll ask the kid did you get good sleep last night? And sometimes they haven't gotten good sleep and then they're worried that they're going to get in trouble in their classroom. I used to have a morning mindfulness club where the kids would come to me before they went to class, which was great and I would help them maybe like I'd say, is there anything I can do to help you with that? And I would help them like write a note to their teacher to say, dear so and so, I had a really hard time sleeping today and I'm kind of grouchy and I don't want it to affect me in class. Is there anything you could do to help me with this? Or just that like process of writing that out I think helps the kids notice what's really going on with them but then I think it's such a valuable skill to teach them how to communicate with the people that they're working with that I'm not at my best today and I realized that and I could use your help with it.
I model that with my students a lot too when we do temperature checks. I give them my temperature too and every once in a while I'll tell them I didn't sleep well last night. I'm feeling kind of grouchy and I don't want to be a mean grouchy teacher. Is there anything you guys can do to help me with that? And they're they're usually extra nice or they'll give me a compliment or do something to help us have a better day and they're really sweet about it but I also just think that modeling that is really important because there's days sometimes where it's really hard to be patient with kids when other things are going on in our lives. It doesn't happen very often, but I do try to model that with the kids when I have a day like that.
I'm trying to think what I have. These pictures is just like a profile outline of a head and it says what's going on in your head? And I'll laminate those sheets and just the kids can just write out at the beginning of a group what's going on and one day a kid was really sad because he lost his iPad at home then he was sad that he lost his iPad. Sometimes it's just acknowledging, oh that's really hard. I'm sorry to hear that and sometimes they're hungry and I can give them a snack or... yeah, it's usually things like that or something really sad has happened and I can help them write a note with the counselor to the counselor to help the counselor check in on them.
There's all kinds of different things that you can learn from kids, but often I just want to know that you care about them as a person and a lot of times just that process builds your relationship to a point where you can get a lot more accomplished.

Marisha: Yeah and I feel like that works with adults too. Like if I'm having a bad day and someone takes a second to like check in with me and just ask how things are going or offer support makes that a huge difference.

Amy: Yeah. And that reminds me one thing I've really tried to do, especially in the past couple of years, is to not ask a kid how they're doing unless I actually have time to listen to their answer. I went through a divorce a few years back and it was really painful and one person at school asked me how I was doing and I said something like, or not great and he said, great and he just kept walking and I thought, I don't ever want to do that to a kid. I don't want to ask them how they're doing when I don't actually have the time to listen to what they're saying so I try to say things like, good morning or it's good to see you or I'm glad you're here and I try to save the how are you doing for a time when I can really listen to them because they usually just say fine, but sometimes they have things going on that they want to share and I want to be present for them if that is something that they need to talk about.

Marisha: Yeah, that's a really good point.

Amy: It's very hard to not say how are you? It's like so ingrained.

Marisha: Yeah. I love the others options that were like, I'm glad you're here. It's good to see you, or giving them a compliment or whatever it may be. I feel like that's almost more meaningful because how are you just gets thrown around so much that it's just like fine, fine. No one really... it's just kind of noise.

Amy: Absolutely.

Marisha: crosstalk breaking that. I think it's super interesting. I love that. Okay. Man, we talked about a lot of things and like when I didn't... I just did another podcast about mindfulness and it was very different and so when I was thinking, when you started talking about mindfulness, I thought it would be more like that, but there's some like really simple things that we can do, like having that agenda, the thermometer check and I think like teaching kids to identify how they're feeling is huge. Like I feel like as an adult I struggle with that so that absolutely makes sense and like many trash cans and what's going on in your head.
I love all of those strategies and those are all really simple things that we can implement to help students develop that mindfulness about anything.

Amy: Another thing that we have as part of our compassionate schools project is every classroom in our school has a calm spot and it doesn't have to be a huge... I tend to have a couple in my room because I tend to have kids with lots of emotional challenges but every teacher has a calm spot and it could be just a chair or a spot in the corner and just a little place where kids know they're safe to go for a couple of minutes if they need to regroup.
This is our third or fourth year with the school inaudible calm spots and it's so cool now to see the different kids that use it and how they use that spot. It's not a timeout and it's not a punishment but it is a place where I can invite the kids too if they're having a hard day. Do you need a couple minutes in the calm spot? Would that be useful? Do you need me to find someone to take a walk with you? That kind of thing and that I feel like in most therapy rooms, so it would be easy to set up a spot where the kids can go and kind of regroup.
I use a calm spot sometimes in my classroom. Again, it's kind of that modeling, we're never going to get this all figured out like we've got to be gentle with ourselves too. The calm spot is a really great thing to use. And I also... we have class mission statement school wide and for me what I found at works with the resource groups where they're coming in and out is to have each group write a mission statement at the beginning of the year and that's really helpful when we start to get off topic or if kids are kind of not in control of their bodies, I can just say what's our mission? And we can use that mission statement as the redirection instead of that mission statement that we wrote together.
I would think for SLPs that would be really useful, like it's our mission to learn to speak like professionals so we can be better readers and writers or whatever it is that you're working on because sometimes I think the kids don't know, but we're working on in my groups and... so the mission statement has been really useful and it's a good way to set the tone for the group. Like we say the mission statement together before we get started. That's been a really good mindfulness-

Marisha: crosstalk.

Amy: ...in our class and it's really fun to write it together.

Marisha: Yeah and do you do like display it in the classroom or what does that look like?

Amy: Yeah. I have them like outside of my door for each different group and when we get to the room, I don't have an actual door so when we get to the opening we like stand on the line and the carpet and say it together and I'm not the most structured regimented person and once I do this for a couple of weeks, the kids will remind me if I'm kind of getting harried and forget to do it, the kids will remind me to read the mission statement and it's a really great thing to do to regroup if we're getting really off track or the kids are being super silly, is to go back and regroup and read the mission statement and then you don't have to be like, hey, we're not doing... we're supposed to be doing and be all angsty. You can just redirect to the mission statement.

Marisha: Yeah, that's perfect and do you have anything else that you'd want to share under the mindfulness umbrella?

Amy: I just think it's really good to remember that mindfulness doesn't necessarily mean doing yoga or breathing all the time, although those can definitely be parts of it and I think movement and breathing techniques are really helpful but I think just anything you do where you're keeping the kids present and you're honoring their experience is using mindfulness in your classroom. One thing that I have done in the past couple of years is kind of remind kids that they're the person that's going to be with them all the time so they're kind of their own best friend and helping them learn how to like live with that best friend and advocate for that best friend and just be their own bestie, I say.
I'm their advocate at school but I want them ultimately to learn how to be that advocate for themselves, so all these things that we're learning are things that we can take out into the world and help us all have a better experience.

Marisha: Yeah. That's so amazing and I love... because you've given so many examples of how you model that for the student and how you scaffold that so that they are learning those skills and are able to achieve that. I love that. Okay. So a couple more questions. I'm trying to just inaudible to start. Because we touched on growth mindset and you mentioned that Carol Dweck book which is inaudible thinking and talking about like celebrating mistakes and I love your literary washi tape idea. I had so much fun using that when you taught me that several years ago but what about... because the MindUP curriculum is part of that too, right?

Amy: Yes.

Marisha: Can you tell us a little bit about that and what that looks like or how you like incorporate more elements into the growth mindset?

Amy: Yeah, the MindUP curriculum, it was actually developed by the Goldie Hawn Foundation several years ago and there are three volumes. There's a K-2 curriculum, a 3-5 curriculum and then a middle school curriculum. It's just probably 20 bucks on Scholastic. They have all kinds of mindfulness lessons, like mindful eating, mindful walking. It has book recommendations and all kinds of great lessons and it's really nice if you like more of a step by step curriculum and they're short lessons, most of them are 15 to 20 minutes so there's definitely things you could implement into any type of setting at school and that as another one of those things that kind of crosses the age ranges.
I've really enjoyed using that a lot. There's a lot of great ideas in there. I also really like the zones of regulation, which was developed by an occupational therapist. I can't remember her name at this moment. It's Leah and it starts with a K. But it teaches kids how to kind of classify different feelings they are having into different zones, different colors and we use that a ton in my classroom and it's really helpful and we can apply that when we're reading books and talking about feelings of a character. Oh it looks like they're in the blue zone. Just really helps the kids kind of classify what they're feeling and what type of strategy might help them the most. Like different things work when you're feeling low or sad or when you're feeling excited and restless, so that's been really useful.

Marisha: Ooh, that is so good. Yeah, because I know a lot of SLPs have heard of the zones of regulation, that's something that is used pretty frequently, but I love that idea of incorporating... like identifying it that in book characters and modeling it that way because like if a student is having a meltdown and we're like, you're in this zone, they're going to... they won't, but they won't have it.

Amy: It's not the best time.

Marisha: Yeah, I love that idea to model it in that way and that's something that... like I love using books in therapy and I think that is something a lot of speech therapists do, so awesome strategy there. This was one of my... jumping back to the MindUP curriculum too, because this was one of my favorite things that you talked about but well first of all, you get like a giant brain poster crosstalk right?

Amy: Yes. I love my brain poster. Yes. That's worth the 24 bucks right there.

Marisha: Yeah. And so how do you use that brain poster?

Amy: One of the main things about MindUP is it teaches the kids about the three part... I mean, there's more than three parts of your brain, but it teaches the kids about the hippocampus which that cause the scrapbook where you store your memories and your learning that you've mastered and then the amygdala is like your security guard and then the prefrontal cortex is the part that helps you make good decisions and kind of keeps you following the guidelines of good social skills and all that and it really helps teach the kids about how when you flip your lid and you start acting out of control or even just getting really wiggly and unfocused, that's your security guard acting up, or being overactive.
I always tell them if a bear walked in the classroom, our security guard would take over and we would get away as fast as we can without thinking about how we're supposed to behave or any of that but most of the time we're safe and so we need to help our PFC or the prefrontal cortex keep us safe and making good decisions and helping us have that good social behavior. I really teach the kids a lot about their brain and which parts of the brain are working for different things that we're doing and it's so fun to teach the kids words like amygdala and prefrontal cortex.

Marisha: And then they will go into the other classrooms or they go home and like my amygdala is crosstalk.

Amy: Right. Exactly. Yeah.

Marisha: Oh I love it.

Amy: Amygdala is probably a good speech challenge word too.

Marisha: Yeah. No, those are awesome. I love that. Okay, cool and then I think we're... One thing that you also talked a lot about was alternative seating. Can you tell us a little bit about how you set that up and how you navigate that and use it as a strategy?

Amy: Yeah. I kind of view my resource classroom as like a lab. I try things in my classroom to see if it will help the kids in regular ed or in their classes that they spend more of their time in but I have... I don't love for me yoga balls for the kids to sit on because I find those to just fly across the room a lot of the time but I have some yoga ball chairs that have like solid metal legs and those have been great and the kids... it's like an experiment for the kids to figure out which seating really helps them the most and I have some standing desks that a lot of the kids really enjoy and some of my kids really prefer regular chairs and the rule is that they have to keep at least one foot on the floor.
I got some gardening stools at Lowes that rock really nicely that were very inexpensive and the kids pick their seat when they get there. That's good for their learning and as long as they're showing that they're using it well, that is the seat that they get to use. I use a tally system for the groups, so if the group earns five or gets five tallies, I should put a tally up if the kids are not using the chairs appropriately. If like there's unsafe behavior, I don't really call people out. I just put a tally on the board and when there's five tallies, we take a vacation from the chairs. I let kids sit in the floor with clipboards but it really helps the kids feel like they have some ownership of the classroom and I'm not just directing all of that.
When I need to do a lot of work, I don't sit in a hard chair with a straight back. I usually go to Starbucks or sit on the couch. It's just another way of helping the kids learn what works best for them and how to use something different in a responsible way.

Marisha: Yeah, it makes a lot of sense and I love all of the different ideas that you gave, like the yoga ball chairs with solid legs. You are right that they just fly everywhere. Standing desks, sitting on the floor, like the gardening stool and I've seen... like if you Google an alternative seating, there's lots and lots of crosstalk-

Amy: Yeah, it's definitely taken off in the last several years. Bouncy bands are pretty inexpensive and you can just hook those to the chair or the table and then kids can kind of bounce their leg while they're sitting in a regular chair. My students tend to like those too.

Marisha: Yeah. Okay, that's a good one.

Amy: And with all of this I teach them it's a tool not a toy, we're using to help grow our brain, to help our learning and not just to play.

Marisha: Yeah, that's perfect and then I'm curious too, like we're almost at the end of our time so we can start wrapping up. What would you recommend to a speech therapist who like... because they obviously listened to 50 minutes of this podcast already, so they're definitely wanting... they might be struggling with some behavior issues in their speech room or wanting to implement some of this... because you could just threw out a lot of different things. What would you tell an SLP in that situation? Like what advice would you give him or her or where would you suggest that they start?

Amy: I think using the agenda is an easy thing to start and just maybe doing a mission statement if not with every group with those groups that they are kind of keeping them up at night, wondering how they're going to get them to behave, I guess for lack of a better word. If I'm having more of a difficulty with just one student, I really like to do contracts and we call them win-win agreements, where I talk to the kid about what's going on and I ask them what they need from me and so we kind of each say my goal is to help you with in this way or like I'm not going to say your name in front of the group.
Like it's kind of the teacher will do something and the kid will do something and then it's a good way to kind of take data and I also really like doing the love languages for kids survey which... it's like The Five Love Languages. Gary Chapman I believe is the author. There's a kids survey and so you can give the students that survey and then you really have a good idea if a good incentive would be to eat lunch with you or to have some sort of tangible prize or if they would love like a note home with positive feedback about their behavior because each kid really is motivated by different things.
I really find that like finding what motivates a student, especially if you're kind of having, you need to zero in on one student that's not being as successful as you want and if it's more of a overall management I think mission statements and agendas and just finding some way that feels good to you for measuring progress and tracking is really helpful.

Marisha: Yeah. And then what would you suggest, so like an SLP is doing the agenda and mission statement inaudible working while, in terms of the other strategies, I assume that you approached like any new strategy as a little bit of an experiment.

Amy: Absolutely.

Marisha: Like how long would you recommend trying a strategy before deciding it's not a good fit and like how do you navigate that decision making process?

Amy: Yes. Well, it normally takes about two weeks to tell if something is working or not. If it's something that I just thought might be fun and I'm finding it cumbersome then I don't usually stick with it because I know there's no point in finding out that if it's not working great for the kids right away, then it's just kind of taking up valuable time for me. I can usually tell pretty quickly if something is just not working with my style because it's really important that you match the strategies that you're using with your personal style as an educator. I like to have fun in class but I'm not a goofball telling jokes all the time. If using humor was my strategy, that would be really challenging for me every day on top of just having a challenging job anyway.
It's really important to try to fit something that matches your style. Like if you're more of a old school, really all about structure and having like a really calm classroom, doing a lot of dancing and wiggling and all that kind of stuff all the time just isn't going to sit well with you. I think it's important to go outside of your comfort zone a little bit, but not so far that you're just stretching your limits too much if that makes sense.

Marisha: Yeah, that does make sense and I love that suggestion to try something for two weeks, then it doesn't work on day one and we still don't have a true answer.

Amy: Absolutely.

Marisha: ...crosstalk that's helpful but then also we get to use our clinical judgment and just like personal values and style to kind of guide those decisions too. So awesome. Well, I feel like... I hope everyone walks away with a lot of new ideas and things that they can try and just feeling motivated and re-inspired to tackle some of these challenges potentially or just have things ran a little bit more smoothly in the speech room. Thank you so much Amy for sharing all of this inaudible was done and can you let us know where people can find you if they want to learn more?

Amy: Absolutely. You can go to lightenupteaching.com. So L-I-G-H-T-E-N-U-Pteaching.com. That's my website and there you can sign up for my newsletter, which is going up about every other Tuesday. I am at lighteupteaching on Instagram. I have a mindfulness in the making course that launches about once a month that I would love to have some of your SLPs be a part of and you can email me at [email protected]. If you have any questions about anything that I've shared, I would love to hear from you guys and I really appreciate you having me, Marisha. This is so much fun.

Marisha: Yeah, so much fun. Yeah, and you can find all of the links that we mentioned today. Like I'll get links to all of the different books and resources as well as Amy's contact information in the show notes and you can find that at slpnow.com/44 and thank you again, Amy. You are so amazing.

Amy: Thank you.

Marisha: We will see you next time.

Amy: All right, thanks.

Marisha: Hello there and welcome to The SLP Now Podcast. I am so excited to be introducing Kristin Bowers today. She is an ASHA certified speech language pathologist, she graduated from the University of Pittsburgh in 2007, and she graduated in 2010 with a master's in speech language pathology as well. So Kristin has utilized her skills as a speech language pathologist abroad, including her participation in the Bosnia autism project in 2012. I wish we had time to dive into this more, because that sounds super interesting. But she is here today to talk about data collection. We've been getting a lot of questions on this topic lately, and I thought she would be the perfect person to break this down with us.
Just a little bit more background, she has experience in early intervention, working with three through five-year-olds, she's also worked in private practice, and she currently works in the schools, and she serves kindergarten through fifth grade students. She's also the owner of Kiwi Speech, and she creates amazing materials for speech language pathologist, and she also has some amazing resources for clinicians in private practice. But without further ado, let's dive into all things data collection. Hi Kristin.

Kristin: Hi, how are you?

Marisha: Amazing. We were talking about this before we went live, but I feel like such a nerd when it comes to this topic, and I'm like genuinely excited.

Kristin: I totally agree. I definitely geek out over the data helping people do it more effectively, because I just think it's... No, it doesn't need to be as complicated as we all make it. So hopefully we can simplify it a little bit.

Marisha: Yeah, I totally agree. I wish I had you to talk to when I was first starting out, because I felt like I tried about 5 million different tools and strategies and just all the things to try and get a hold of my data collection. I had these super elaborate systems with like labels and I was printing things all the time and it was just kind of messy, and so I'm really excited to hear... Maybe you have had some of that experience too. crosstalk.

Kristin: Are you even an SLP if you have not already tried all the things? No. Of course, I have. I wish I had had the things I knew now when I was... Even if you years ago, I wish I had it figured out. Not that I have it figured out now, but I think I have a much clearer picture for myself now and I found a system that has worked for me consistently. Over the last probably three years, I've used the exact same system. That's when you've figured it out for yourself, because usually at the end of every year you think, "Oh, next year... This is okay, but next year I'm going to do like that a little bit differently or that a little differently." And when you come back and you're like, "Nope, I'm going to stick with it. Okay, I'm onto something."

Marisha: That is amazing. I used to switch things like on a monthly basis. I had a caseload in the triple digits at one point, and I was just drowning and I felt like it was so hard and that there had to be an easier way. So yeah, I was... I probably made it much harder for myself. crosstalk. But can you give us a little bit of a tour in terms of the different systems that you have tried and maybe just tell us a little bit about kind of why you switched? If your list is as long as mine, just highlighting like a few potential.

Kristin: I think more than anything, when I... Before I did data the way I do it now, I think I just really didn't have a consistent system, and it just made it really hard to write a progress report and compare apples to apples, because you'd collect data on something one day, and you'd collect data on something on another day and you just really want to write that progress report and you're like, "All right, well, I can see that they're doing R in the initial position of words independently at 20%. Oh wait, that was back in November. Let me see where they're at now. Oh, I haven't collected data on that recently."
So you didn't really feel like you had anything to report on your progress reports or whatever was current inaudible. It was just all over the place, and I felt like I was just mentally trying to pull all this information together, and I knew I needed it to be laid out for me. I had tried collecting data. Even just with my data sheets, I'd have a data sheet per kid or I'd have a data sheet per day or... I had data sheets changing every year. So now, I do my data logistically, I collect daily data and I have data sheets that are by group. So I just pull out the group's data sheet and I collect daily data on that.
And then three times a year, I collect more what I consider my progress monitoring data. So I kind of have my daily data, and then I have these three overarching data collection systems. Between the two of them, I find it really easy to write a progress report. All the data is like right in front of me now. Hopefully, I never go back, because it's working out much better.

Marisha: Yeah. No, that makes a lot of sense. I definitely went through all the different types of data collection sheets too, like by individual student and by day and by group.

Kristin: And by post-eds, like I did the post-ed system for a little while, or the labels, that was a good one for a while. Yeah, I've tried them all.

Marisha: Yeah, I did. I tried setting up Google Forms, and I printed like QR codes for-

Kristin: Yeah. God.

Marisha: ... then their links won't-

Kristin: Marisha, why am I not surprised that you made QR codes?

Marisha: Yes. It was super exciting. I thought it would work really well and I thought it would be fun to involve kids in their process, but it's just like Google Forms wasn't meant to help us manage our caseload. There's definitely issues with using Google Forms as well. So yeah, it just gets messy.

Kristin: Yep. I totally agree.

Marisha: Okay. But if you are listening and you are an SLP who has tried a lot of different things, you're definitely not alone. So hopefully that helps you feel that way. Kristin, you told us a little bit about how you currently use group data sheets and you do daily data and then you do your... you said it three times a year?

Kristin: Yeah. crosstalk. We send out progress reports just in my district. We send them out mid year and then at the end of the year. So I try to do a big data collection probe in one of my first sessions for all my kids. And then again, I do it in the middle of the year and then at the end of the year. So if nothing else... like if all my data through the rest of the year turned out really poorly or I wasn't... whatever, I always have these like three really excellent data points to run back on. So I tend to use those for... We use rubric based progress report, so we can check kind of zero to 50%, 50 to 75%, that kind of thing. I use the progress monitoring data to do those, but then I tend to use the daily data to do more anecdotal stuff or make more subjective comments.
So I might be able to say, they produced R in the initial position of words completely independently 30% of the time. However, when they're in a session with me and I'm giving them feedback on productions or some visual cues, they're actually able to do it 80% of the time, that sort of thing. So I usually read through those progress reports to give that kind of more subjective descriptive data that I think resonates with the parents when they're reading the reports.

Marisha: Yeah, that's super helpful. So we're definitely going to dive into more of the logistics for both of those in just a little bit. But I'm curious if you have any suggestions for SLPs who are struggling with data collection, like they're hopping from system to system. What suggestions would you give them to work a system that is sustainable and that you can stick with for three years and not have to change?

Kristin: I think there's probably a million systems out there that could work for you, depending on your style. But if I could give one bit of advice, it would be to separate your therapy from your data collection. So if you're collecting data and you're finding that you are playing a large role in that moment and you really have your therapist hat on, then to me that is just not the greatest time to be collecting data. So I think it's really important to conceptualize, you're either giving therapy or you're measuring progress. Because you're not supposed to be measuring yourself. We're not there to collect data on how great of a therapist you are in that moment, we want to know how the child's performing.
So, when I do my data, whether it's the daily data or the more progress monitoring data that's intermittent throughout the year, and like you said, we'll go into that, but in both situations, I'm really never collecting data at the same time that I'm giving therapy. I'm either doing one or the other. Just conceptually separating out those two things, to me, will change the way you collect data, no matter how you record it or what sheet. If you use the labels or you use the post-it's, it really doesn't matter. But being able to separate those out would be like my number one takeaway from this podcast or from when I presented. That to me is like the one point, is just really learned to think it's okay that you're not collecting data in a moment if you're giving therapy, and it's okay to not give therapy in a moment when you're collecting data.

Marisha: Yeah, that's perfect. Is there anything else that you want to share before we dive into more of the logistics in terms of broad suggestions?

Kristin: Maybe just that sitting down and coming up with a plan can really make a difference. It doesn't mean you have to sit down for a whole day and come up with an elaborate plan, but just taking a minute before a session to think, "Okay, what am I going to collect data on today?" For me, at the beginning of the year, taking a moment to say, "All right, what am I going to work on probably in this whole semester? I need to make sure I collect date on that now so I can show their progress." So little bit of planning goes a long way. Again, just keep it simple. It doesn't need to be super complicated, I promise.

Marisha: Ooh, I love that. Have a plan and keep it simple. Because you probably don't want to be like me during my CF where I was juggling all of these QR codes, making it way, way, way too complicated. And then I would also... I love how you said that we want to know what we're going to measure. I think this is one that... I definitely agree with what you said about separating therapy from data collection. That's what I've landed on as well. And then the next important thing is knowing how we're going to measure what we need to measure. So whenever I write a goal for a student, like when we update an IEP, I make sure that I have... that I really know how I'm going to measure that goal and I have... I just make sure I have a sheet, like, this is the probe that I'm going to use for that goal. It makes it really easy because then all you need to do is have time to collect that.

Kristin: Absolutely.

Marisha: So I think those are... like, if you only listen to a part of the podcast, hopefully that helps get you started. But let's talk a little bit more about your daily data collection. What does that look like today?

Kristin: So when I say daily data collection, I mean I collect data on most days. There are definitely days that I'm so involved with what we're doing that I maybe don't. But most days I collect data. To me, the main thing is that more data points doesn't mean better therapy or better data for that... Oh gosh, I just inaudible. Anyway. More data points doesn't mean better therapy, and it definitely doesn't mean better data either. So if you think about if you were to collect data on the first 10 productions a child makes and they were 50%, if you were to continue to collect data over 20 data points or 50 data points or 100 or 1,000, the more data you're getting over a session, you're really just diluting that and that initial number.
Because assuming you're a good SLP and you're helping them improve their production of their sound over the course of the session, the longer you collect data, the closer it's going to get to 80, 90%. So all you're doing is taking out the sensitivity of that number you're recording, and it's going to be really difficult for you to show progress or change over time. So I really just stick with 10 data points typically. So kids will come in, I might have a therapy activity ready to go, and my therapy activity does not necessarily... it's not necessarily the exact same thing I'm collecting data on. It's okay to collect data on a skill in a slightly different way than you're teaching it.
I always think about teachers who give a spelling test. They do a pre-test at the beginning of the week, and they have the kids spell the words. And they don't help them or give them clues, they just say the words and kids write them down. And then they probably do the same thing at the end of the week. They say the words, they're not giving clues are not helping them, they're not giving feedback, they're just measuring. But in between, they're using all sorts of brilliant strategies to teach those spelling words. They don't just continue to administer that same test over and over and over. So that's how I like to think of my daily data, is I this little probe at the beginning to see how they are, to see what they remembered from last time and then I can spend the rest of the session teaching it in whatever way that I feel is best, and that's where our professional expertise comes in. Anyone can collect data, but only... we are the people who are trained to get the therapy.
So they come in, I pluck 10 data points, and it's usually as independent as possible. I might flip them 10 flashcards, I might run through... Like we're doing some sort of worksheet, I might run through the words on there, I really don't give them any feedback about it, I'm just measuring, and then we jump into the therapy. But that data takes me 30 seconds per kid at the beginning of a session. So it really doesn't suck up a lot of time, and it's a really nice data that I can compare from one day to another.

Marisha: Awesome. I have a couple of questions that always come up when I talk about this too. But why do you choose to take data at the beginning of a session?

Kristin: It's really funny, that question. When I was in grad school, we did like a big project, and part of it was asking us to look at a case and ask how we would ideally collect data or how we would turn it into almost like a single case study. I had given an example which was similar to this. Now that I think about it, it kind of came full circle. But they asked me the same question, why are you collecting data in the beginning? My answer inaudible. I don't think it really matters if you collect it at the beginning or at the end as long as you're being consistent with it. Because obviously, how a child is performing when they walk out of my speech room is very different than how they perform when they walk in, and we all know that's the case. We've all got kids that walk in, aren't using their sound, by the end of your session, they use it 100% of the time and then they walk out into the hallway and don't use it again.
So I think as long as you're consistent, it really doesn't matter. I collect it at the beginning because I think that that's a better representation of probably how they're using it outside my speech room. At the end of the day, that's what I care about. There are definitely kids who walk through that threshold and see me and turn on those sounds, but a lot of them are not necessarily thinking about it until we kind of get into our direct activity. So I collect it at the beginning because I just think it's more representative of what they're doing independently. But I think if you're consistent, you could make either one work.

Marisha: I agree that consistency, and you get to use your clinical judgment, you get to decide how to inaudible your caseload and your data and all of that. But I think starting at the beginning makes sense because it also... I also think about it as... Because if it's at the end, I feel like it's a measure of how well I'm doing-

Kristin: Absolutely.

Marisha: ... versus inaudible in fresh. And then it's also helpful me to know where they're starting because I feel like if we're working on K and I give a student 10 initial K words and they're at 20% accuracy, that's going to... I will prepare and make sure I do some initial teaching or just make sure I cue up my visual strategies or whatever type of queuing I want to use with that student, versus if they get 80% accuracy, I would approach things a lot differently, like I might jump to the next level. That would drastically change what that therapy session looks like. Granted, we can get that information as we dive into the therapy activity too, but I think this just helps me be more prepared and just use my time a little bit more efficiently.

Kristin: No, I totally agree. I supervise some grad students for one of the local universities, and that's one of the things that comes up that we score them on, is, are they using session data to guide clinical decisions? That's exactly it. If we collect data at that first session and they're at 90%, I want to see my students changing the complexity of what they're giving them or making it a little bit harder somehow and challenging them versus if they come in and they're at 0% in that initial data probe. I want to see it, like you said, doing some initial teaching or using some new strategies or prefacing the lesson with something that's going to help them. So I totally agree.

Marisha: I love that you have that experience too. Because you work at... Is it a university too?

Kristin: No. I supervise students from the University of Pittsburgh. That is really local.

Marisha: It's amazing.

Kristin: So one of the schools I work at is on a university campus, but no, I don't work at a university.

Marisha: But you get to supervise-

Kristin: Yes, I do.

Marisha: ... students.

Kristin: So yeah, it's nice. They send the students out, so all their placements are out in the community, they don't have an in house clinic. So they're there with us getting really hands-on knowledge and skills and being taught by a variety of people out in the field. So I think that's a real strength to the program.

Marisha: Yeah. That's amazing. I love that. Oh, I was going to ask something else about data at the beginning of the session, but it's escaping me, so we'll just have to come back to it.

Kristin: That's fine.

Marisha: Another question that comes up a lot is how you get through your probes quickly. Because you said it takes you 30 seconds. Because I talk about this strategy too, about just collecting those quick probes at the beginning, and every time I talk about it, people ask like, "How do you get through it quickly?" So I'm curious what you say to that.

Kristin: Yeah, I don't know. I guess part of me is... you just keep it simple. Like I said, I try to keep these probes as independent as possible. So with some of the younger students, I may be giving them a model. And this isn't an exaggerated model that has sort of built in cues to help them, it's literally just, I'm providing them with the stimulus. But I don't give them... During this data collection, I really don't often give them feedback, even, I just want to know how they're doing on those words. So it's just a quick Amandy from hand to speech, it's just quick data sampling. That's what she calls it, data sampling. That's what it is. Boom, boom, boom, I go through 10 words. I often don't tell them, yes, no. Oh, can you fix that, or try it this way. I'm literally just measuring. So it takes them exactly as long as it takes them to say 10 words and really not a lot more.
I also save time just by sticking... Typically, I use whatever we're going to do for that activity that day. I use the stimulus items straight from there. So I'm not shuffling around other things. When all else fails, I have a word list, and I just go down a word list. So I keep it really, really simple, and I keep myself out of it a lot, which saves a lot of time. When I'm not talking, it saves everybody a lot of time.

Marisha: I love that. And then if you have your... Because you use the strategy of using the treatment activity. So you have that on the table already, so you can just run through it-

Kristin: Exactly.

Marisha: ... super quickly, and that makes sense. I think this is where our approach is just a little bit different. It's like, that's a cool part of this, because like you said, there's not one... There're so many ways we could set this up, and it really just depends on our style and our caseload and just all the millions of factors that play into all of that. But I like to use like a set probe for the different goals, and so I just have those ready to go. Like I have a really simple but like very intentional system on how I keep those organized so I can quickly pull up whichever probe I need. So that's been super fun too. But whether you're using the therapy activity or some probe that you already have prepped, just being prepared for the session makes it really, really simple to run through that.

Kristin: Yeah, totally I agree, and I love that idea. I do have a set of probes I use for the interim progress monitoring that I'm doing a little bit less frequently. Those are always the same words, and they're ready to go. But I do mix it up throughout the week. I like it, because you know how every now and then you come across a word that for whatever reason is really tricky for them? I feel like sometimes when you're mixing up the stimuli between sessions, you come across this little subset of words and you're like, "Wow, they really struggle with that context for some reason." So I do love that about it. As you said, either way works, and I love your organization.

Marisha: I am definitely an organization nerd, so we can talk about that all day long. I remembered what I wanted to circle back to. I use this especially as a newer clinician when I wasn't feeling as confident in terms of taking data at the beginning of the session, because I feel like data is power, and if we know exactly where the student is, it sets us up to be that much more successful, and I feel like it helps us... we can approach the session just a little bit more confidently.

Kristin: Absolutely. Absolutely.

Marisha: Even if you end up taking data at the end of the session, having that information is... it's what enables us to provide amazing therapy because we are able to adjust and all of that. So I think it's a great confidence tool.

Kristin: Absolutely.

Marisha: So I just wanted to inaudible. It's funny, I definitely took more data on the weeks where I was feeling like I don't know what I'm doing, and then I have the data and be like, crosstalk.

Kristin: Yup, I totally agree. Every now and then, it's really nice. Especially if we've had a week off where I haven't seen a child and I am lesson planning in the morning and running through my lessons and I'm like, "Man." Sometimes I'm able to just look back at the last session, and it's just like given to me. Even with very few notes from a quantity standpoint, I'm able to look at it and be like, "Oh, I know exactly what we're doing today." It's just really nice.

Marisha: Yeah. That's amazing. So speaking of that, how do you keep it organized? How do you organize all that data so that it is easy to go back to? You mentioned the group data sheets.

Kristin: Yeah. So it takes a little bit of work, and this would be the one thing I don't like about it, but to me it's well worth it. Again, knowing that I've stuck with the system now for a few years, tells me it is. During the first few sessions of the year, I actually do just collecting on like a blank piece of paper and save it because I like my data organized by group. So each group has like a packet of data sheets, and I can usually fit... I don't know, depending on the size of the group, like if it's a three child group, I can usually fit like three weeks on one side of the paper, and it literally just has the date on the left side for that day and then it has each child's name and then each child has two lines. The first has one line that's split into a 10 boxes for my 10 data points, and then there's a blank line where I could write some notes and then there's a little space down the bottom where I could write additional notes.
So we're talking like a three inch section for an entire group for the week. So the reason I said, in the beginning, I collect on a blank sheet of paper is, at the beginning of the year, it just takes you a while to get those groups ironed out, and kids are moving from this group to that and the times they're changing. But once I feel like I've got them, I do sit down, I take a day to make these data sheets. I make them on my computer, so all their names are typed on there. And then I just use that same sheet throughout the year. So like I said, I can probably get three weeks on a page, so it's not a ton of papers.
During a single session, I'm never flipping between pages, all the kids are there in one section on one page. I absolutely loved... I resisted doing that for a while because I didn't want to take the time up front to set it up. And then they also had this thought that I needed all these data sheets filed in each kid's individual file, but when it came down to it, like I just don't think I need that. So like no one ever said I did, and I finally just did it. I said, "If I absolutely needed it, I could copy them and blackout the other kids or something." But that has never happened, and having them organized by group to me is 100% the way to go. Flipping through pages is definitely not me. So that's what I do for my daily data.
And then for my progress monitoring, I have these big data sheets, it is one like eight and a half by 11 page. Now, it is jam packed with a grid, but I use that one side of one sheet for an entire year for one sound. So it typically has, I think, 10 words for each. So say I'm inaudible, those will all be on one page and it'll have 10 words for each of those sounds in the initial, medial and final positions and enough space for me to collect it three times. So I can use literally one side of one piece of paper for my entire year for my progress monitoring that I just do the three times. So I am not a paper flipper, I just want everything on one page. I feel like we just use so much paper. I'd like to be better, and I'm no environmentalist, but come on, the amount of paper we waste just kills me. So I'm trying to keep it down to one page, it is the least I can do.

Marisha: Yeah, that's super helpful. Because you have those data sheets in your teachers pay teachers store? Right?

Kristin: I do. So I have them in my store and then they come with printable stimuli, so you can put a page in front of the child and they can just read through the words and look at the pictures. But I also made it as like an interactive PDF, so you can pull it up on your iPad and they just... I've kept it real simple, there's not a ton of buttons or anything, but they can just swipe through the pictures, and it has the picture real big in a work. They like it because it's on the iPad, so that means apparently it's a game, even though they're literally just swiping pictures. But Hey, whatever works. It moves really quickly because I don't have to facilitate it. I typically let them swipe through themselves. If they're moving too fast, I just let them know to slow down, and I can get through... I can easily do an entire group of four kids working on R in an under a session if they're all pretty on track.
I tell them, "Hey, this is not going to be the world's most thrilling therapy session, but it has to be done. We only do this three times a year, so we can get through this in one session, we're done." So most of them buy into that and we get it done and move on with therapy.

Marisha: I have that articulation, I forget what it's called. But I have that progress-

Kristin: Yeah. I think it's literally called-

Marisha: It's beautiful.

Kristin: ... the ultimate Progress Monitoring Kit. I can't remember exactly what I've labeled it, but it's pretty self explanatory.

Marisha: You definitely have a knack for design, and so it's just like... I don't know. I feel like especially when it comes to... Well, I kind of enjoy progress monitoring because I geek out about the data. But it makes it even that much more exciting when it's just something that's beautiful to look at. crosstalk.

Kristin: I geek out about it now that I have a good system. Whereas before, it just overwhelmed me. But now it's like, yeah, you go back to something exactly four months later and you're seeing little check or a little pluses where before there were little minuses, and it's just so nice to see it because you're... it's so easy to see. You're comparing apples to apples. With some of my older kids, I have them charted and... No, I totally agree. I geek out over it too. When you keep it simple like that, oh, it just makes your life so much better.

Marisha: Yeah. There's nothing like seeing those minuses turn into the classes over the year.

Kristin: Totally agree.

Marisha: So I do like that one sheet for the year idea. That makes a lot of sense. And then since I love organization, I feel like I have to jump into... I assume you just keep the sheets just in a binder and then you would just flip through those. Or do you keep them in individual folders-

Kristin: I have actually... It's funny, this is one thing I switched this year. I used to just file them after I collected it at those times back in their folders, but then I was like, "Why am I continuing to file these just to pull them out again in four months?" So now I have a folder in my filing cabinet right at the front of all the kids' folders and it just says progress monitoring. So all their data sheets are in there, and they'll stay there until the end of the year and then I'll put them in their folders. But no, it was like three times a year, I was pulling them out and putting them back in, and I was like, "Wait a second, this doesn't make any sense." Actually, I think this is the first semester I had this like, aha moment and thought, "Wait a second." So now I just throw them in a folder. Like I said, they'll all be there ready for me in May or June.

Marisha: What about your data sheet?

Kristin: The data sheets, so I don't have like daily folders for my kids or anything, so I just have one of the hanging file folders and they... I make a real quick kind of cover sheets, so to speak, that has each of the kids and their goals on it that came straight from their progress reports just to make sure that I'm always reminding myself what ultimate goal we're working on, and then the data sheets are just stapled. So each group has a packet, and then if I have materials or something I'm using for them, I will just paperclip them to the back of that and they just get filed.

Marisha: Perfect.

Kristin: I'm pretty minimalist as far as keeping papers around for data collection and stuff. If you can't tell, I just can't stand it.

Marisha: Yeah, it definitely adds a lot of clutter, because we have like all the data sheets and all the paperwork that we have pending, plus the therapy papers, and it's just... it's a lot. So anything to minimize that is-

Kristin: crosstalk. I would obviously keep all the sheets I needed to if felt like having the meetup better, but I honestly think it makes it worse for me when I'm trying to write those progress reports and I have to flip through so many things. It's just so much harder. Now, I can usually just look at one side of my daily data notes and one page of my progress monitoring, and I can very quickly and easily write up a progress note that has a lot of great information in it. More is not always better.

Marisha: Oh, and then I meant to ask too, with your data, at the very beginning of each session, do you pick one goal, or how do you decide what you're taking data on?

Kristin: I typically pick one goal per session. I have a lot of articulation kids on my caseload more so than language. So yeah, we're typically only working on one speech sound in a session, so that part's easy. For language, it depends on honestly what I have planned that day as far as activities. So if I'm going to do, I don't know, some irregular plurals and I don't know, some pronouns, I might collect data on both. Or I might collect data on one, see how we go time wise and then do the data probe on the other one as we move into that. But I typically only do one per session. You know how it is, we only have 30 minutes, so depending on what I'm targeting, that's usually what I collect data on.

Marisha: Yeah, that makes a lot of sense. And then another question that always comes up is, how do you manage data collection with mixed groups? So if you have like three or four kids sitting in front of you, like you're obviously collecting data on one student at a time. Do you have any strategies to help that run smoothly? What do the kids do while they're waiting?

Kristin: For me, so much of that comes in the planning for the session anyway. Like I said, I collect that data on... Well, if you're talking about the daily data I often am using stimuli straight from the activity, so I've picked whatever stimuli it is or whatever activity, and I'll go through that. As I said, I keep it so quick that it's not even a question of what the other kids do during that time. They all know they've got... If there's four kids in the group, they've got one minute and 30 seconds. They just have to sit there and be quiet while I do the data and then we'll move on to our fun activity. They learn pretty quickly. If we can't get through it, then they have less time in their game. So there's that.
For the progress monitoring at the session or that I do intermittently, now, that one sometimes does take a little bit longer. If I have... this is going to sound complicated, it's one of those things, verbally, I feel like it's going to sound confusing. But if I am using my progress monitoring kit with the stimuli on the iPad, if I've got say like two R kids and to S kids in our group, I will try to get my hands on two iPads and I'll have one pair switching one iPad and one pair switching the other, and I'll have them do 20 at a time. So they do 20 words, and then I move on to the next 10 and do 20 words, and then once they get to the end, we start over, but start at the other person. So they're like alternating which stimuli they do.
I know it sounds super complicated, but it's really not. So basically, by the end of it, they've all done all the words with their sounds in them and they've only had to sit quietly for maybe a minute at a time. Again, I know I said before, it's just one of those days that's not super fun. It is what it is. There's no gains, there's no antic, but I think most of them at the expectations there can handle it for one day. They know typically in the next session we'll do something a little bit more interactive and fun. But hey, it's three times a year, it's got to be done, and if we can get through it in one session, then so be it.

Marisha: I think that's a good skill to work on too.

Kristin: Yeah. Totally.

Marisha: It's an important life skill to be able to sit and be quiet and wait patiently. So we get to practice that in speech too.

Kristin: I agree. But I also think from the standpoint of the SLP acknowledging to them, like, "I know that this session is going to suck a little bit. Sorry about that." I recognize that. I think that that goes a long way, rather than having them come in and you pretending like this is the most thrilling thing ever and being frustrated that they are bored. So we all know it's boring, but it has to be done, and I think if we can all get on the same page with that, the kids and I, then we kind of just have this mutual understanding. It's not all that thrilling for me either.

Marisha: I think just being able to crosstalk is... that goes a very long way.

Kristin: Exactly.

Marisha: So that's perfect. So you've told us a little bit about this already. In terms of the articulation, you have your set stimulus items that you use three times a year, and if you're working on... like in the daily data you use just whatever you're using in the session. Do you have any favorite tools that you like to use for the language goals when it comes to that three times a year progress monitoring?

Kristin: I don't. It's been on my list of something to do, is to create some similar types of things for language. But I do have so many fewer language kids on my caseload, and I also just find... For me at least, their goals are also vastly different. So that one I do honestly on a really case by case basis, and I don't have as well set up of a system as far as what probes I'm using. I do try to keep the same theoretical plan about it, where I think in September, what can I use right now that's really going to measure their progress in this? So if that is... I'm just thinking of one example. So I have like an irregular plurals puzzle, and it's just a simple puzzle, I think it came probably from some old reading curriculum and it just happened to be at one of my schools when I got there. But it's great, because it has a whole bunch of irregular plural words. So that may be the task I use as my progress monitoring, and I may not use that same task again until I progress monitor again in January.
So I do really collect data for my language kids on a case by case basis, but I try to keep that same idea of keep being consistent with whatever I used to measure in September is the same thing I used to measure in January is the same thing I used to measure in June and then that way I can really see their progress. And then that thing, whatever it may be that I use to measure, is typically almost completely excluded from materials I use to teach throughout the rest of the time.

Marisha: Yeah, that makes sense. Like I said before too, when you're setting up your caseload at the beginning of the year or when you're writing an IEP, it's really helpful to be able to identify what you're going to use-

Kristin: Absolutely.

Marisha: ... and just make a note of that or attach it, like add it to that folder with all the other progress monitoring stuff, because then it's not even a question, you're just ready to go. I agree that language is a little... Because the goals can vary so much, it's not as easy as the articulation. It would be lovely if it all fit crosstalk into a nice little box like that.

Kristin: Even kids with "the same goal", they're all kind of... sometimes they struggle with it in a different way or have difficulty with different examples of that. So yeah, I definitely... Language is a little bit harder, and I have few enough on my caseload that inaudible on a really case by case basis isn't too big of a deal for me. I'm also reporting on progress reports, those things, a little bit differently. To me, they take just a little bit more. Not that they can't be reported in numbers, because they can, but to me, they take just that little bit more explanation of exactly what they're doing and what this looks like when they're speaking more so than like, they say S about 50% of the time and words independently. That's relatively self-explanatory.

Marisha: Yeah, that definitely makes sense. Because I feel like that's the more subjective aspect of what we do, and it's just like really being able to describe things. Do you have any strategies that you like to use when tackling that in progress reports? I guess you would just be looking back at your data sheets to see-

Kristin: Yeah, and that's why I think I... When I presented on this topic at The Flash at a CEU on the cruise, I really talked about these two methods of data collection, and there's daily data collection and then intermittent progress monitoring. But one thing I probably at that point didn't make as good of a point is that I combine the two. I do both, and they both can serve a purpose. So they're not mutually exclusive. I think depending on what your data requirements are from your district, you may be able to use just one. But for me, it's a really good fit to use both. I typically keep that progress monitoring that happens infrequently really, really independent. If that means there is 0% to measuring periods in a row, I'm okay with that.
So think about those kids who just started R. Some of them take well more than four months to get a true R. So if I got them for the first time in September and I collected data on their initial R, it's 0%. I either just literally looking at a picture and saying these R words, if they're still at 0% independently in January, that doesn't concern me. But what I want is some daily data that shows how they performed with support or with feedback or with cues or with prompts. Because I don't want to just say they went from zero to zero independently, I want to say, "Right. So they still can't say it independently, and that's okay, but look what they can do now."
Now, if I give them a model and I remind them about their tongue placement and I give them a visual cue, they're at 70% in the initial position of single words. So being able to use both the internet and progress monitoring and then that daily data collection, that really helps with some of those more subjective things. Plus, I often just make notes on my daily things. Oh, I tried the L to R slide, that was really effective, or today they did a really nice job not rounding their lips, those kinds of things. So I do make notes like that outside of just my numerical data, and those often make it into progress reports just to be supportive of the families and the kids and the progress they are making even when the numbers don't always show it, as you know is the case, unfortunately.

Marisha: I'm so glad that you broke that down and talked about why you include both types of data, because I think that's incredibly important. I feel like that... It definitely applies to R and some of the... that can happen with some of the other articulation sounds, but I feel like it's especially applicable when it comes to some of the language aspects too. When you were describing that, I kept thinking back to like when I was in the autism preschool, that was something that would happen a lot. Like, they wouldn't be doing things independently, but at the beginning of the year, they would need a tremendous amount of support, and then by the second reporting period, they could do all these things with just a verbal-

Kristin: Absolutely. Absolutely.

Marisha: ... versus hand over hand to all of those things. That is still indicative of progress, and I'm so glad that you broke that down.

Kristin: Yeah, absolutely. crosstalk. Right. There are so many increments to progress. I know, I always refer to R, but I feel like it's... First of all, I think it's one of those things that almost all SLPs are struggling with, but you can also tell what a large majority of my caseload is working on. But I do think R in particular has so many steps when you're shaping from, just say W to the actual R, more so than I feel like these other sounds do. I don't feel like there are as many incremental steps between FNTH, as one example. But R, there are just so many little steps along the way, and I want to be able to report that progress.
For some of the kids that are really struggling with it, I will make it a short term goal. This isn't an official short term goal, but I'll kind of write it in my notes that I'm accepting any production, any production that is not a W, and I do not care if it sounds like an L. I do not care what it sounds like, but if it is not a W, they are getting cheers and claps and applause, because that is the first step, for me, getting away from that W. So in the same thing, when I'm using some strategies, if they produce an R that sounds more like an L, I tell them what a great job they did because at least that means they're finally moving their tongue instead of it sitting on the bottom of their mouth. If they made an L, that means they're moving their tongue, they're getting towards the roof of their mouth and you're in the right direction. So Hey, they get praised, for that, and I'm calling that a win for the day.
But again, that goes back to deciding what you're going to collect data on at the beginning of your session. So it's okay to collect data, for me, on anything that's not a W, but I have to define that and I have to write it down so that when I refer back to it, I know that yeah, they were 90% on anything that wasn't a W. It doesn't mean they got 90% Rs, that just means only 10% of them were Ws. So that's something I definitely work with my students on, is just taking that moment to define what you're working on and what you're measuring. Within reason, I think measuring almost anything within the course of one day is fine, and that's where we're going to get that subjective data that's going in that progress report.

Marisha: And then a followup question to... Because I feel like I've read a lot of notes where it'll just say, gave mean cues or a mean support or a mean mod or... and I feel like that's not incredibly transparent in terms of what actually happened in the session. So do you have a strategy or any kind of system in terms of how you're describing what you're doing in this session? One example you said was the L, like the slide, that that was like a helpful strategy. I think getting super specific like that makes sense. But do you have any other strategies? How do you typically approach-

Kristin: That's one of the reasons that I try to keep, in many cases, those daily data probes as independent as possible, because you take that gray area out of, exactly how did you obtain that data, or what was that data really showing? So that's one reason I just tried to keep it as minimal as possible as far as my input is concerned.

Marisha: So I think that's a question that comes up a lot too. But id write support and crosstalk, but how do I do that? So I think that we should... I think it makes sense to write a goal without support because it's really clear how that's going to be measured. Any SLP could measure it, and there's ways to adjust the goal so that it's still achievable. It might just be at a simpler level like saying R in isolation versus R in sentences-

Kristin: Absolutely.

Marisha: ... for example. But then I was curious about just the data in... When you're taking your subjective notes in the session, do you have any tips or strategies for how you're describing your support?

Kristin: Absolutely so. I do still keep it as simple as possible. So I consider, did I give them a model? Yes or no? And then the other thing I consider, and I think that gets forgotten a lot... So like you said, some people are writing mean cues or maybe even writing independently. But the question I always have is, if someone's writing independently, so say they're giving words, with or without a model, and the child is supposedly producing them independently. The question I always have is, did you give them feedback? So I think sometimes people write independently, but they're telling the child after each production, "Yeah, you've got that one," or, "Oh, can you fix it?" Whether or not they mark that one that was corrected as correct or not, feedback is a type of cue that you're giving, it impacts their performance on any production that comes after it.
So to me, there's a huge difference between giving 10 productions with no feedback and giving 10 productions where you're telling them after each or after some whether or not they got it correct. So sometimes I know I've seen people write, Oh, they did it with a model independently, but they gave feedback, and they're calling it independent because they didn't give a cue before they elicited each response. But giving a feedback after where response is really the same thing. So that's the one thing I always want to point out, is that feedback really is a type of input that you're giving them, even though it comes after the stimulus.
But going back to the question, I think I try to keep it simple. Did I give them a model? Did I give them feedback? And then did I give them some sort of verbal cue? Most of my kids are responsive to a pretty simple verbal cue. I only have kindergarten through fifth grade. I don't have a lot of preschoolers. I'm not doing a lot of like tactile queuing, that kind of thing. So all that other stuff really is coming during that teaching period where I'm not heavily collecting the data. So when I am collecting data, yeah, I just try to keep it kind of those three things, model, yes or no, feedback, yes or no, verbal cue, yes or no. So a verbal cue might literally look like, "Okay, we're going to do this. Don't forget to get your tongue back, rabbit." And that would be it. So yeah, I do avoid use of minimal, moderate or max queuing. Because as you said, it's really open to interpretation.

Marisha: I like how you said it before, like the student benefits from this type of cue or this specific verbal prompt, because different students will respond to different ones differently. Or if they respond to like you making a gesture at how their tongue is supposed to move, that's helpful for the next SLP to know or for us to remember when we're jumping into the next session to set them up for success. So I think that's a very useful and meaningful way to set that up, and it's incredibly transparent. Because yeah, it's super clear what that-

Kristin: Oh yeah. You've got to write down those little tricks that did or didn't help because as you know, we're trying... In some of the cases, we're trying so many of them, so it's like, did that L to R slide work? So sometimes telling the kids to smile works like a charm and sometimes it makes it worse. So yeah, writing down those little notes, they do a ton of time in your next session trying to figure the same thing out again.

Marisha: Ooh yeah. I like the point of writing what didn't work too. That can be helpful-

Kristin: I probably have some session notes that they're like, "Do not bother trying eggs."

Marisha: Well, it does save time. You got to work smarter. Okay. Awesome. So I think that was a super helpful overview of how you set things up and just some really actionable, just really simple tips that I think can make a really big difference. Is there anything that you wanted to close with or anything you wanted to emphasize before we wrap up?

Kristin: Nothing we haven't talked about. But I would say that... If I could emphasize one thing, it would just be that more data points does not mean better data. It certainly doesn't mean better therapy. But it doesn't mean better data, so just really give yourself permission to take less data, but take that moment to think about it so it's more meaningful and useful to you. Because having 200 data points that mean nothing probably means you weren't as present as you could have been during that session, and you still don't have data to help you write your progress reports or all the other things that data is great for. So yeah, give yourself permission to collect a little bit less data. That would be my one takeaway.

Marisha: I love it, and that definitely makes a ton of sense, like everything else that you said during this podcast. So thank you so much for sharing all of your tips and tricks with us today. I definitely walked away with some new ones myself. So I so appreciate you. If SLPs are interested in checking out any of the things that we talked about during the podcast, they can head to slpnow.com/43. I'll also include some links in case SLPs want to connect with you. So where are your favorite places to hang out in the online world?

Kristin: So Instagram, I am reasonably active on. I would say that's probably the best place. Best place to reach out to me would be on Instagram, that's just at Kiwi Speech. I do also have a Facebook page, I'm just not there as much.

Marisha: You have super helpful content-

Kristin: Thank you.

Marisha: ... on there. If you liked what Kristin shared today and if you are as obsessed with her materials and design as I am, you definitely want to hang out with her on Instagram. But yeah, thank you so much, Kristin.

Kristin: Thank you so much. crosstalk. I appreciate. Thank for having me.

Marisha: Yeah. And we'll-

Kristin: Bye.

Marisha: ... see you next time.

Marisha: Hello there and welcome to the SLP Now podcast. I am so excited to introduce today's guest, Venita Litvack. She is a speech language pathologist currently serving as a full-time augmentative and alternative communication and assistive technology consultant for public schools in Florida. So, she has a passion for using AAC, AT and literacy to support individuals with complex communication needs, autism and other disabilities. Venita has also just delivered poster presentations in several topics related to AAC at ASHA. She also coauthored two articles published in the ASHA Leader as well as the Lou Knows What To Do book series published by Boys Town Press. She's also an amazing fellow podcaster and blogger at Speechie Side Up and just an all-around rock star, SLP and person.
So, today we're going to be breaking down all things AAC and literacy. And then before we dive in to all of the things, I just wanted to, because we're kind of taking ... This is like AAC 102, maybe 201. And so, before we dive into all of the things, I just wanted to give a really quick recap of some other amazing resources that Venita has shared.
Her Speechie Side Up podcast is amazing first of all. If you haven't subscribed yet, definitely do that. She has several episodes on AAC, so I will link to those in the show notes at slpnow.com/42. And then she also did a podcast interview with my colleague and fellow podcaster in the speech therapy PT network for Michelle Dawson's First Bite and she has a really great crash course on AAC there as well. And then she has an absolutely amazing blog post with some tips to help you start navigating AAC if it's new to you. So, it's called 10 Ways to Boost Your Knowledge in the Area of AAC. And so, I'll link to all of those resources in the show notes in case you're just trying to start navigating AAC because I think that would be an amazing supplement to all of the tips and tricks that we're sharing here today. But that was a little bit of a longer intro, but hello Venita.

Venita: Hi Marisha. Thank you so much. That was such a nice intro and I think you covered a big part of where I would recommend people get started before they dive into a topic like this with AAC literacy because this is definitely going to be a very comprehensive and dense topic, but I'm really excited to chat with you about it.

Marisha: Yeah. I have been nerding out, like we've been going back and forth and I cannot wait to hear from you on this topic. Like as you guys know, I am a huge advocate of using literacy in therapy and a lot of you have been asking about how to use this with students who use AAC. So, I just cannot wait for us to break this down and you're the perfect person for it.

Venita: Oh yay. Well, I'm excited that we were able to kind of combine both of our interests.

Marisha: No, that is so amazing. And I think we're going to have a blast or I know we are. And then I'm curious, is there anything else that you'd like to highlight in terms of places to get started? Like if there's anything in particular that really stands out to you like from your blog posts or do you think that's a good enough place to start at this point?

Venita: I think you've mentioned some really great resources. One other one that I might recommend is the Core Calendar Club Group on Facebook that I am doing with and page from Beautiful Speech Life and Kristen Bell from the Daily Dose of Speech. It's a year-long AAC challenge where we provide you with weekly resources for a specific core word. And then we also present discussion topics weekly where people share their favorite AAC tradings, the troubles that they have with AAC and how they're addressing them. So, we have about 1100 people in that group and it's just a really great supportive group. We have a goal in mind, which is to increase your AAC knowledge. So, it's not just going in there and asking questions whenever they come up, but kind of structured format for learning more about AAC across the school year.

Marisha: That is so amazing. And that's a free group?

Venita: It's free. Yup.

Marisha: Oh my gosh. I feel like that would be worth ... Ugh, that's so valuable. That is amazing. Especially if you're really wanting to tackle AAC in your practice, like as a listener and just like having these resources plus the Facebook group to just get like continued inspiration, I mean that's amazing. I'm so glad that you guys are doing that. So, helpful.

Venita: Thanks. It's a lot of fun.

Marisha: Oh yeah. And I will definitely link to that group as well in the show notes if you can't find it with a quick search. But okay, so, I think we are ready to dive in. So, let's just get straight to the strategies. And so, let's start with some evidence-based strategies for teaching literacy to children who use AAC. I've heard you talk about, and it's RAAP/ I forget how you like how you say that acronym. Is it RAAP?

Venita: It is. Yup.

Marisha: I know you've shared a lot of other strategies as well, but it'd be amazing just to get an overview of some of the ones that you found in your research and just help break that down for us a little more.

Venita: Sure. Yeah. I think this is a really important topic and a great starting point. I will definitely reference the RAAP strategy as we get into specific activities that you can use. So, in the timeframe from when you first asked to an interview and we decided that the topic would be literacy, this amazing book came out and as soon as I saw it I was like, "Oh, I have to get that." And this book is kind of taken the AAC world by storm. Everybody's getting it. And it's called comprehensive literacy for all teaching students with significant disabilities to read and write by Karen Erickson and David Copenhager. I hope I'm saying that right. And it's amazing.
I mean, they have just synthesized all of the research on teaching individuals with significant disabilities to read and write. And their basic premise is that all students, no matter how severe their disabilities, can learn to read and write, and they provide a framework for that. So, I'd like to start with providing the Literacy Bill of Rights because I think that that's really important for people to keep in mind when they're working with students who use AAC and keeping in the back of their mind. Like maybe it doesn't seem like they could learn to read and write at this point, but here are their rights that they're entitled to. So, I'll briefly summarize these. And these were outlined by Yoder, Erickson and Copenhager back in 1997.
So, number one is that all students have the right to the opportunity to learn to read and write. All students have the right to accessible, clear, meaningful, culturally and linguistically appropriate texts at all time. All students have the right to interact with others while reading, writing, or listening to texts. All students have the right to life choices made available through reading and writing competencies. All students have the right to lifelong educational opportunities incorporating literacy instruction in use.
All students have the right to teachers and other service providers who are knowledgeable about literacy instruction, methods and principles. I think that's really important for us to keep in mind. And there's two more. All students have the right to learn in environments that provide varied models of print use, which we're going to outline later today. And then all students have the right to learn in environments that maintain the expectations and attitudes that all individuals are literacy learners. And I love that last, right? Because I think it's so important that attitude makes a huge difference. And when we presume or assume that the child has the ability to grow and has the ability to learn and read and write, then we're already setting them up for success.
I know that was a lot and I definitely encourage anybody who has not seen that Literacy Bill of Rights to go look at the full version because that was an overview even though it might've not seem like it, but I like starting there because I think it's important. Then the next thing, this book, the Comprehensive Literacy for All that I told you about earlier, they share in there that when you are starting with literacy instruction for students who use AAC or any individual who uses AAC, you need to determine where are you going to start and what the student needs. Do they need comprehensive emergent literacy instruction only? Do they need conventional instruction only or do they need a combination of both and that's really for like a group-based setting.
And the way that they tell you to determine that is by asking four questions. The first question is, does the student identify most of the letters of the alphabet most of the time? The second question is, does the student engage and interact during shared reading? The third question is, does a student have a means of communication and interaction? And then number four, does the student understand that print has meaning.
So, if you answered no to just one or any more of those questions, then you should start with comprehensive emergent interventions. If you're able to answer yes to all four of those questions, then you would start with comprehensive conventional interventions. So, for today's purpose, I'm going to be sharing mostly about emergent interventions because according to Janice Light, she said currently the majority of individuals who require AAC do not have functional literacy skills. And I heard a quote recently where something around 80% of individuals who use AAC or who are nonspeaking verbally are at the emergent literacy level. I tried looking for the research reference prior to this interview, but I wasn't able to find it. So, I did quote Janice Light instead. But I think that's really important and I'll kind of stop here in case there's anything you wanted to say about those.

Marisha: That is such a helpful overview. I'm just so excited to keep diving into all the other things. But just a quick recap. So, we've got three main types. So, immersion, conventional or both in terms of the intervention that we can use. And that really just depends on where the student is that, like are they identifying letters of the alphabet, are they engaging in shared reading? Do they have the method of interaction and do they understand that print has meaning? Did I get that?

Venita: Yeah. Thank you for summarizing that. And they're set up differently, the type of instruction. So, it's nice to have a framework and know where we should start with the student rather than just saying, "Okay, they need literacy. Let's read books." Because we know literacy is so much more than that. And we're going to talk about the five different areas that encompass comprehensive emergent literacy instruction.

Marisha: Okay, let's do it. I can't wait.

Venita: Great. So, I'll briefly share those. The first area of comprehensive emergent literacy instruction is shared reading. Then you have shared writing. Then you have alphabet and phonological awareness, independent writing with full access to the alphabet and self-directed reading. And all of these were outlined in that book. So, when we start to talk about the different activities that I would recommend when teaching literacy to students who use AAC, I will break them down by those five different areas.

Marisha: Perfect. Let's do it.

Venita: In terms of shared reading, Erickson and Copenhager recommend that you do this activity at least two times a day for 10 to 15 minutes a day. Now, I know SLPs, we have different schedules, different settings, so you have to do what you're able to do. When I worked in a school for children with autism, I actually got to go into the classrooms every day for about an hour, but I know that looks drastically different in other types of school settings. Maybe you're only seeing the student one time a week, two times a week.
So, kind of take this with a grain of salt or what you can do and we'll actually talk about some ways that you can incorporate these strategies in group lessons. And I am sensitive to the fact that you might not see the child every day of the week, so we'll talk about that later. But in terms of shared reading, Marisha, you brought this up earlier. One of the strategies that I really like and talk about is the RAAP strategy. And I like it, one, because I actually studied under one of the researchers, Dr. Kent-Walsh, and got to see the impacts of that research, got to help present at the actual convention, but it was developed by Dr. Cathy Binger and Dr. Jennifer Kent-Walsh. And it's not rap music, but it actually stands for read, ask, answer and prompt.
And it is an interactive reading strategy for improving literacy experiences for individuals who use AAC. It encourages aided-language input, so a form of modeling on the AAC system, which is really critical for our emergent communicators. And it gets the communication partner to slow down and allow the AAC user more processing time. And along with that processing time, I do like to highlight what the research tells us in terms of the amount of time it takes students to process questions or information that we present to them. So, there was a study by Hilary Johanna Mathis entitled, the effect of pause time upon the communicative interactions of young people who use augmentative and alternative communication. And in that, they suggest that we provide a wait time of up to 45 seconds and that would support AAC users to claim more conversational turns and use more words.
Now, I know 45 seconds seems like a really long time. So, I think on average, the research says that between 10 to 20. That was the only reference I was able to find though, and that's why I brought it up. But it just illustrates the importance of how much time we need to be giving. And in reality, we're probably getting closer to like two to three seconds.
So, the framework for the RAAP strategy, when you're reading a book together with a child is on every single page, you're going to do the RAAP. So, the first step is to read the book or read the page and model two symbols on the device. Then you pause for five seconds by maintaining eye contact and looking at the AAC learner expectantly. Then you're going to ask the WH question and model two symbols on the device. And again, you're waiting for five seconds.
The reason you're waiting for five seconds is because you're allowing the child to comment to answer the WH question, whatever they want to do in order to be an active reader along with you. And then the third step is if they didn't answer the WH question, you'll answer it for them and model two more symbols on the device and then pause again. And then if they don't say anything or if they do say something, you're going to provide a two to three-word response using the AAC system and verbally. So, you might say something like, your turn or show me the, if there's something on the page like a caterpillar, show me the caterpillar and you actually repeat this process for every single page of the book. And it really helps the reader or the student who uses AAC to be more active in the reading and less passive, less of a passive listener. So, that's my shared reading activity that I wanted to share. Do you have anything you want to add to that before I move on to the next area?

Marisha: No, that was perfect. And do you know if they have ... I'd be super curious to see this in action. Like do they have examples of this like on YouTube or anything?

Venita: That's a great question. They definitely have videos. I'm not sure if they're sharing it on YouTube, but there's a name of the lab and I'll try to get that for you. What I'll do is I'll share that in an email with you and you can put that in the show notes, but they have a lab and I would assume they put the videos on there, but I'll do my best to get those for you.

Marisha: Amazing. Thank you so much.

Venita: No problem. In terms of shared writing, again, Erickson and Copenhager recommended to do this again for 20 to 30 minutes a day and this doesn't have to be done just by the SLP. This can be done by the classroom teacher as well. So, you're finding this information helpful. You can share this framework with the teachers that you collaborate with, but predictable chart writing has been found to be really helpful for these shared writing activities. So, I'm going to talk about the framework that was outlined by Hanser Cunningham Hall and Williams. Separately, of course, they had different research studies looking at predictable chart writing.
But in summary, predictable chart writing is a fun and easy shared writing activity that supports emergent and conventional writers and readers. It's a way of providing some structure while allowing students to generate their own ideas. And it provides many different activities that occur around the predictable chart over a five-day period.
So, this is going to look very different depending on whether you are in the classroom every day doing collaborative teaching or if you see the student one to two times a week. But again, the classroom teacher can definitely implement this. So, I'm going to discuss all five days, the activities across all five days with you. So, on day one, you are going to write a chart. So, for that, you're going to need chart paper or you could use a big dry erase board on the front of the classroom and a single message device.
So, what happens is that you're going to pick a phrase that's repetitive. So, let's say we're going to use the phrase, "I like to." If you're working in a group, every student who uses AAC in the group or every student in your group, they're going to tell you something that they like to do. So, the phrase is repeated for each student. So, let's say you have five students. Maybe student one says, "I like to swim." The next student may say, "I like to sleep." The next one might say, "I like to eat." And the only word that changes is the last word. But they get to kind of write their own sentence or finish their own sentence by providing something that relates to them.
And then on day two, you are going to reread the sentences as a group and you're going to put them on individual sentence strips. So, you're going to together as a group, reread the chart while pointing to each word. You can clap out the words. You can rap the words. You can sign the words. But it's just getting them to recognize that those words have individual units of meaning as you're rereading them.
And then on day three, you're going to cut up the sentences. So, you want to make sure that you have the students sentence their own sentence on two separate sheets of paper because they need one as the model and the other one you're going to cut up and they're going to rearrange the words to remake the sentence and play with the words. Maybe they can even make a new sentence. So, goal of this step is to help support students in understanding that sentences are made from left to right. And that students don't have to create a perfect sentence. They just have to get comfortable with using these words, manipulating these words and the process of writing.
And then on day four, they get to act out the sentence, which is fun. So, you would give each student their AAC system or a single message device with the word of the sentence programmed into it. So, let's say you have five students in the group. One student would be I. The other student would be like. Another student would be to. And then it can be like one of the words that the students had said, maybe I like to swim. So, they're going to read the sentence together. So, the person that says I is going to do I, and then the next one's like, and the next one's to, and the last person would say swim. So, they're acting out the sentence by saying their individual words. And you can actually have them if possible, depending on like their physical limitations, line up in the order of this sentence too. And that gets them to understand like the structure of a sentence.
And then on day five, the last day of the week, you would make a book with all of the students' sentences. So, one-on-one, you're going to support the students in making their page, which will be part of a class book. So, if the first student said I like to swim, you would help them find a picture to go along with that to support the text. And then they get to make one page of the class book. Then the next student might have, I like to eat and they'll find a picture for that and they get to make the second page of the class book. And at the end, you can print it out and add it to your class library.
And it's really nice because it's a book that they created together as a group and can reference and get to know each other a little bit better. And one resource for making the book, which I really like is called Tar Heel Reader, which I'm going to talk more about later.

Marisha: That is so amazing. Like I'm just imagining this happening in a classroom and oh my goodness, I love it. Because I talk a lot about creating like parallel stories in my literacy-based therapy framework and like the students, they just love that and they get so much out of it. And I feel like for this population, like making that book and having it be a shared experience and something that they can all take is absolutely amazing. And I love my structure, so I am so appreciative of this framework that you're sharing. So, thank you so much.

Venita: No problem. Well, thanks to Erickson and Copenhager and all the other researchers that developed it. But I'm like you, I love frameworks. I love structure and I love that it's evidence-based. Like we know what literacy is comprised of. We know what makes up literacy instruction, but it's important to know what the evidence says in terms of this population, what works, you know?

Marisha: Yeah. That is so helpful. We could make up our own little frameworks and everything, but it's that much better when we do feel confident about it being evidence-based as well.

Venita: Exactly.

Marisha: Especially for the specific populations. But I feel like this is amazing that you've been able to pull together all of these different strategies to use. So, you're amazing.

Venita: Well, it's a passion of mine, but I am a good synthesizer. I'll say that.

Marisha: I agree. Okay. So, are we ready to do the third?

Venita: Yeah. Yeah. So, the third area is alphabet and phonological awareness. So, we're going to be talking about different activities to use for that area, but I think when we talk about the terms phonological and alphabet knowledge, it kind of brings back nightmares from grad school. So, I'll just provide some brief definitions for both of those because if you're anything like me, it was definitely crossed over the two definitions.
So, phonological awareness is the ability to identify and manipulate sounds and spoken language. And then alphabet knowledge includes the ability to distinguish letters, shapes, name them, write them, and identify the sounds they represent. So, now that we've talked about both of those, let's get into the activities that we can address for both.
So, interestingly, what I read in that book that I referenced in the beginning is that Treiman, Levine and Kessler in 2007 found that teaching a letter of the week or month is not the appropriate amount of time to learn each letter. And I thought that was so fascinating and super applicable to even like a core word of the week approach, that's a whole another topic. But they found that this is the case because if they're doing a letter of the week, it's going to take 26 weeks for that letter to be revisited again, unless it's being embedded in daily routines. But really to be specifically targeted, it's going to be another 26 weeks before it's reintroduced. It's almost the entire school year. And it just is not enough time for students to embed that letter, use it in functional ways.
So, instead what they recommend is that use a letter of the day approach so that letters are retaught every 26 days using the following routine. They want you to identify the letter, identify the sound of the letter, find the letter in text and write the letter. So, those four components are really important for teaching a letter. Any questions about that, because I know that was a lot of information.

Marisha: No, I think that that makes sense. I really appreciated the just defining what we're talking about with phonological awareness and alphabet knowledge and I think that's a really great tip of like focusing on using the letter of the day approach versus the week or the month. And yeah, I love the four strategies that you shared too. Because I feel like this is so incredibly actionable. Yeah. And I'm curious to hear if you have any other tips for this area.

Venita: Okay, perfect. So, we'll move on to our ideas for phonological awareness instruction. So, these are fun. And I'm sure that a lot of these you've heard of, you can go on Pinterest for some ideas on addressing phonological awareness, but things like clapping out syllables, listening to nursery rhymes, even raps for your older students, poetry and playing alliteration games. And like I said, Pinterest has so many different activities that you can do to address those areas.
And then in terms of alphabet instruction, same thing. You can use alphabet books, alphabet puzzles, games, student names, environmental print. There's so many different ways that you can address that just by looking at ideas on Pinterest. And if I didn't say this already, Erickson and Copenhager recommend doing this for about 20 to 30 minutes a day. So, the explicit alphabet and phonological awareness instruction.

Marisha: Perfect. I think that's a really great overview and starting point. And I feel like we could dive into each of these areas could potentially be a whole podcast. So, I think we'll leave it at this and maybe we can revisit if we have time at the end just to kind of like break it down a little bit more. But I think this is a really awesome place to start.

Venita: Okay, perfect.

Marisha: Yeah, so what's the next one?

Venita: So, the next two areas, they're much shorter. They're not as dense. So, we'll go through those pretty quick. The last two areas were independent writing and self-directed reading. So, some ideas for promoting independent writing, 20 to 30 minutes a day, is to provide access to a variety of writing materials such as crayons, pencils, dry erase markers, alphabet letters, computers, AAC device.
So, the idea here is to provide access to a ton of different writing materials, not just a pen and paper or pencil and paper. And then make sure to ask the student to read aloud what they have written and write it down for them. So, a training that I just attended, it was so fascinating because she had us go through different writing examples and we know that emergent writing is not letter based. It's forming circles, forming lines, kind of doing little drawings that communicate a message.
So, she had us look at these drawings and then she told her what the child explained the story behind the picture was and then she would ask us as a student and emergent writer or a conventional writer. And I just thought that was so fun. So, if your students are not writing conventionally like with letters, you can definitely have them tell you the story behind their drawing or their writing and summarize it for them on like another page by writing it down so they can see what that looks like.
And then one really special thing is like you know when your parents would put up your writing on your refrigerator or like a board, it's really special for kids to be motivated to keep writing more by publishing their writing that way. So, if you can put it up in your speech room or in the classroom, maybe you have like a writing corner or like a board, that would be really helpful as well.

Marisha: Those are such great ideas. And I'm curious too like I assume that a lot of the same strategies ... Because you could potentially use some of the like RAAP strategies that you talked about here too. Like with some of these students, if we ask them and they don't respond within a couple of seconds, we probably want to wait a little bit longer. Do you have any additional strategies when it comes to like talking to students or asking students about what they wrote?

Venita: That's a really, really good question and I would assume that they dive into that in the book that I presented in the beginning. So, I would recommend looking at that. On the top of my head, I don't have like a framework for writing like I do with the shared reading. But it's a really good thought because if it hasn't been developed then, that might be a nice thing for somebody to look into.

Marisha: Yeah. And if they don't have well-researched answers for us, I think we can definitely pull from some of the other strategies you've shared to make that happen.

Venita: Yeah.

Marisha: Yeah. I love that. I'm loving these tips so far. So, what about self-directed reading?

Venita: Yeah, self-directed reading. So, that was the last area of comprehensive emergent literacy instruction. And some ideas that are recommended to promote independent reading include building a library of reading materials. And it's important to note that this should be done about 10 to 15 minutes a day. So, depending on the time that you see this child or time that you see the group, that might not be feasible for your group if you're only seeing them for 30 minutes.
But again, working with the teacher to provide that additional time for self-directed reading but providing access to magazines, newspapers, song lyrics, reading apps, comic books, audible, all of those different ways that they can access reading. Because believe it or not, audible reading, like read alouds is reading and there's tons of research to support that. I just heard it recently and it kind of reaffirmed that because it's definitely questionable but it is still considered reading. So, it's important for people to keep that in mind and provide access to that for students.
And then you want to provide a variety of materials so that all the students have access to something they want to read, so not necessarily materials but maybe you genres. So, some students might like to read comic. Some students might like to read like fantasy, fiction, sports. So, it's important to provide a variety of reading materials to them.
And then at the end of the self-directed reading, this is really important, have the students share out what they read about.

Marisha: That is perfect. Yeah. And so, I'm really curious, how do you work towards like implementing, because you just shared a ton of different strategies, lots of different resources and things that we can use, but there's a lot, definitely way more than can fit in one session. So, how do you go about like planning your group lessons to incorporate these strategies and just tips for making this happen in general?

Venita: That's such a good question and I think it's so important because looking at the research is one thing, but putting it into practice is a totally different thing. So, you explain what my role is now and I'll just be very transparent here. I am an assisted technology specialist, so now I support teachers and SLPs in the middle school. But I did work in a charter school for children with autism when I first got started.
And so, I'll kind of explain what that looked like when I was doing a AAC and literacy in group lessons when I was doing collaborative lessons with the teacher. So, it's going to look a little bit different than what I described and I think you do what you can until you know better. And I'll explain what I did and then maybe some things I might change knowing what I know now.
So, one of the things that I did in terms of shared reading is that I would put pick a book or theme of the week, which I know you're really passionate about and that's great. So, I pick a book or theme of the week and if it could go along with the academic lesson, all the better. So, I would talk with the teachers about what they were working on and try to pick a book that went along with that. And then I would identify core and French vocabulary that can be modeled while reading, which is important when you're doing that RAAP strategy.
And then I provide access to AAC so students could use their personal AAC systems or BIGmacks. And on the BIGmack, I might put like a repetitive phrase that I want the student to say. So, if we're reading a book like Brown Bear, Brown Bear, What Do You See? I might have that whole phrase or I might have, what do you see on the BIGmack and the students that don't have an AAC system, they can push the button, take turns pushing the buttons so they feel like they're helping me read. And then, I don't know Marisha, are you familiar with story grammar marker? I feel like you would be,

Marisha: Yes.

Venita: Okay. I love story grammar marker. And I would use the Braidy doll to discuss story element after the reading. So, we would talk about the character or the setting and the story sequence using the story grammar marker doll.
And then in order to address shared writing, I would pick a phrase that relates to the book such as, say we're reading Brown Bear again, maybe I see a, and then the students, we could do that predictable chart writing with them filling out what they see. So, each student would say, "I see a teacher. I see a chair," whatever they see at the moment that they want to say for their little phrase.
And then I like to reiterate this, depending on how often you go into the classroom, you can do each step of the predictable chart writing or some steps and help the teacher or even assign homework to the parent.
And then in order to address alphabet knowledge and phonological awareness, every day I would sing a letter song with my groups. So, you can find these on Pinterest or TPT. Mine were cards. And so, for each letter, it had like a sound that went with the letter and we would sing it out as a group. This was really for my like younger elementary school age kiddos.
And then in order to also address the phonological and alphabet knowledge, we would incorporate the academic words. So, the programs that the teachers that I worked with provided like words of the month, and these tended to be a lot of sight words. So, there's a lot of crossover between sight words and core words. So, we put it up on a word wall or they might already have it up on a word wall and we would try to read the words, clap them out, spell them out. And there's other research out there or other strategies that are pretty well known at least in the education field on how to target those words as a group and do phonological awareness instruction with those words.

Marisha: Yeah. I love the practical examples here and just like what this could look like in practice. And then I have just a quick experience share too. I worked in an autism preschool and this was my first job that I had. So, I didn't know all of this research yet. And I totally resonate with what you said about you do what you can until you know better. Because there's definitely no way to know it all when we first start out. But I feel like I was able to use a lot of these strategies when I went into the classroom.
For me, circle time was a really good time to make that happen because the teacher was already using like we did songs so we could work on like we had an alphabet song and we would show the letters and we would work on clapping. We had a lot of that alphabet, phonological awareness kind of aspects built into that routine. And then I would always bring in a book and do some different activities around that. And at this level a lot of us or a lot of the students were just using like a single switch, a button like the BIGmack or whatnot. And we included some of those different activities.
We identified like the core vocabulary that we wanted to target during that. But I wish I had known, like if I were going back, I think I would have done like the RAAP strategy. I don't know, did they say in the book which ages you would start this with? Would you do the sentence activity with preschool too?

Venita: That's a really good question. They did say that you can start pretty young. I haven't gotten to a point where they said there's like a specific age limit. They give ideas for targeting these areas with different age groups, but they didn't say that like a child is too young, but I haven't completely finished it so I don't want to say that they do or they don't.

Marisha: Yeah, that's amazing. And I feel like in terms of like as I was in a typical preschool to where they definitely did activities. In the autism preschool, they also did activities with their names and letters and all of that. But I know in the general preschool, they cut up sentences and things like that. So, I've seen it in practice and I've seen little kiddos do it. So, yeah, I am definitely going to check out this book because it sounds like an amazing resource for this population. I'm so grateful you shared that.
But yeah, I think it's just really helpful because I think a lot of us are like we might be able to as we're listening to this, like we're able to identify strategies that we've used in our practice and this is just a way to celebrate what we're doing and reinforce those activities that we are using and then maybe think some things to add to our own session or to work with the teachers on like, "Hey, I heard that this was really great."
Oh, the reason that I wanted to share my preschool experience was because I would go in on Monday with the book and I would model all of that and then the teacher and the paraeducators would be in the classroom with me too. And it's the best thing when you walk into a classroom and they're using those strategies that you modeled the day or earlier in the week. So, I definitely led it a couple of times, but it was just really cool to see them reinforcing that throughout the day too. So, we definitely get to use a team approach to make this happen. So, it's not all us.

Venita: Yeah, I love that. Yeah, and like you, I've done both sides. Recently I had to help cover for SLP services and I got to work with the gen ed population in the schools and I could see why that collaborative teaching wouldn't work because their goals are very different. Maybe we're working on sound specific goals, but even in your group settings, you can definitely address those areas of literacy at the same time that you're targeting those other goals.

Marisha: Yeah. So amazing. And then we've got one more question. What are your go-to resources when you're implementing these strategies and just incorporating AAC and literacy in your sessions?

Venita: This is probably my favorite question because there's so many great resources out there and I don't know that everybody knows that they're available and you kind of wonder like where are these resources? But they're so disseminated. So, I like to summarize them all here.
In terms of AAC and literacy or just literacy in general, Tar Heel Reader is like an amazing resource. It was developed by the University of North Carolina's Center for Literacy and Disability Studies. And what you can do on Tar Heel reader is you can create your own books or you can look for books and you can look for books based on keywords. So, if let's say are doing like a core word of the week or the month or the day, then you can look up books that have that core word in it. So, that's a really great resource that you can use online. You can pull up on a projector or a smartboard and implement it within a group setting.
And then Epic books, which I'm sure you probably mentioned. I know that's a hot one in our field, but Epic books is great and you can access it for free if you have an educator's email or a school email. And then Overdrive is also great. You can access thousands, tens of thousands of books that are available at your local library for free. Just have to put in your library card information.
And then this one's not as well known, but I've spoken about it in other trainings that I've done. It's called the Novel Effect app. And the reason I like that one is because it provides sound effects for like popular books and they're building their library all the time. So, if you're reading Brown Bear Brown Bear, it's crazy. It knows when you are on to the next page without you even clicking anything on the app just based on like your reading of the book. So, if you say like "Brown bear, brown bear, what do you see?" And then you pause, it'll play music just for that page and sound effects just for that page. So, I think that's a really great way to get, especially younger kids engaged in the reading.
And then PRC or the Prentke-Romich Company, the creators of LAMP Words For Life and Unity and other AAC language systems and devices has a resource called Literacy Through Unity on the AAC Language Lab, which is a phenomenal program that's online that you can go to and they have free resources on the AAC Language Lab and they also have a paid subscription, but it's very little for the year. I want to say it's like 20 bucks for the year, maybe even less. But they have a literacy through Unity program that actually Karen Erickson helped develop. So, if you have a student who uses Unity or LAMP, then I would check that out.
And then Saltillo, if you have a student who uses like a NovaChat or the TouchChat app, they have these calendar supports. So, like for the month of January, they give you a book and then the words that you can target with that book and some other like literacy-based suggestions for that month. So, I love that resource and it's free.
And then the Tell Me curriculum, I just want to mention it here. I, full disclosure, don't have a lot of experience with that book just because I think it's primarily geared towards the preschool population and that's not a population that I work with, that I support at this time. I would love to learn more about it, but in my department, we kind of provide resources and trainings to the areas that you work in. So, at some point, I'm looking forward to diving into that curriculum a little bit more, but I just don't know a lot about it. But if you work with that population or like the elementary population, then I would really encourage you to look into that curriculum.
And then any of the resources from UNC Center for Literacy and Disability Studies is phenomenal. They have like trainings on there and modules. So, check that out. And then now we have this resource and I'll just say the name one more time because I think it's worth noting. A lot of the information I spoke about today is from this book and it's just a really helpful book. I will forewarn you though that it is like a textbook, which I wasn't really expecting because it has this like beautiful cover. It's very dense and it is bringing me back to grad school days. But you know what, it is just so amazing and every page is like a mic drop, so I really encourage you to check it out. It's called again, Comprehensive Literacy for All Teaching Students with Significant Disabilities to Read and Write by Karen Erickson and David Copenhager.

Marisha: Oh, I love books like that where there's just so many mic drops and knowledge bombs. I feel like it can be hard to find those types of answers. So, when you find a resource that really breaks it down and you just kind of hone in on that.

Venita: Definitely.

Marisha: And those were so many amazing resources. If you're listening and you had a hard time keeping up with all the amazing ideas, I'll list and link to everything that I can at slpnow.com/42, so you can kind of start checking those out. And then is it okay if I add one more that came up for me too.

Venita: Sure.

Marisha: So, I just discovered this maybe a few months ago. It's called Vooks, so V-O-O-K-S. But it they make animated videos for a lot of popular books. So, I think it could be a great activity for that independent or self-directed reading time because it really draws students in and I think they even animate the words in some or all of them. So, it's just a great way to draw attention to the literacy piece but it supports the students in reading that too and just keeping them engaged. Like the students I've used it with have loved it. So, I really like that one too.

Venita: I love that. I've heard about that resource. I haven't actually had the opportunity to look at it, but I think it is a great idea for that self-directed reading. So, thank you for sharing that.

Marisha: Yeah. And then I also just want to emphasize because I feel like one of the biggest barriers is getting access to books because you feel like in some SLPs aren't able to go to the library or they don't want to use library books in therapy because things happen. And so, I just think like the resources that you mentioned to get books for free, like Epic and Overdrive are so incredibly helpful because you don't even have to go anywhere. You have instant access to these digital books for free. So, I don't think that budget or time to drive and get physical books should be a barrier here.
And if those options don't work, YouTube has books as well. They have lovely like grandmothers who record themselves reading books. And definitely check out the video first. But there's lots of ways to make this happen. And I feel like after listening to this episode, you are equipped with so many strategies to use literacy in therapy. And so, I feel like that's just the last step to start practicing and working on implementing this.

Venita: Yeah, absolutely.

Marisha: And then Venita, is there anything that you would add or that you just really wanted to emphasize?

Venita: No. I think that you as an SLP already have a lot of these tools and knowledge in place and now you have a framework for implementing them for students who use AAC, so you're doing an amazing job and I hope that this information will help. It certainly has helped me as I'm reading through that book because it was just really nice to see like, okay, we're doing the right thing, but this is how we can do it even better. So, I encourage you to just keep doing what you're doing and you are going to do amazing things to help support your students who use AAC to learn to read and write.

Marisha: I love ending on that note. Thank you so much for sharing your time and wisdom with us. And if people want to find out more about you, where are the best places for them to connect?

Venita: Good question. I tend to hang out on Instagram @speechysideup. And then my website is also speechiesideup.com. And if you want to come join us on that Facebook group called the Core Calendar Club, we would love to have you. We do ask two questions in the beginning and one includes taking a quiz. The reason that we have you take the quiz is because we're gathering data that we are hopefully going to present at a conference in the near future. And we also want to see if the group is helping you from the start to finish. So, you'll take the quiz at the beginning and you'll take a quiz at the end. But it's a fun quiz. It has like maybe 5 to 10 questions and then you find out if you're like more like Ariana Grande, Lady Gaga or Beyoncé. So, we make it fun for you.

Marisha: Oh, I love that. Definitely something fun to check out. Okay, so I think that's a wrap. Thank you so much, Venita. You are amazing and such an inspiration and I definitely appreciated all of the information that you shared and thank you to the listeners for tuning in.

Venita: Thank you so much for having me, Marisha. When you asked, it was like such an honor and I think you are so inspiring too. And again, I love that we were able to combine both of our passions into this episode today.

Marisha: Yeah, this was definitely a highlight, so thank you.

Venita: Thank you.

Marisha: Hello there, and welcome to the SLP Now podcast. I am so excited to introduce our guest today, Angie Merced. Angie is a Certified Life Coach by the Life Coach School, and a school based SLP. She lives with her husband and two little girls in Rochester, New York, and her passion is to rescue SLPs who are feeling overwhelmed, overworked, and trapped in a career that they're "supposed to love." If you don't relate to that, then I don't know.
I've just been consuming some of Angie's content, and it's been so incredibly helpful, and I can see how she shows her clients how to reclaim their energy, create more time, and generate resources. She's just on a mission to help whip-smart SLPs do less, be more, and thrive with joy in the one life they have. I cannot wait to dive into a discussion all about burnout today, with Angie.
So, without further ado, hello, Angie.

Angie: Hello! So excited, thank you for having me.

Marisha: Yeah. I cannot wait to dive into the questions that we have for today's podcast, because I feel like this is something that all of us struggle with, at least at some point in our career, if not frequently.

Angie: Yeah.

Marisha: ... throughout our career.

Angie: Yeah.

Marisha: I cannot wait. But, before we dive into the burnout discussion, I'm so incredibly curious to hear about, first, just your experience as an SLP? Then, also, about how you became a Life Coach, and that journey as well?

Angie: Yes! So, I graduated with my undergraduate degree, back in 2001. I started working with preschoolers, and right out the gate, I was pretty burned out, three or four months in. That was my first round of burnout that I had, and that place was coming from a severe anxiety, and lack of confidence, and that ... What do they call it? I'm trying to think. Impersonator syndrome? Imposter syndrome, that's what I'm thinking of. That was my first round of burnout.
Back then, I didn't have the life coaching tools that I have now, but I was able to use enough resources that I was able to come out of it. I worked for two years, that was back when you could work without undergraduate degree. In New York State, I don't think you can do that anymore. Then, I went back to graduate school, and graduated from graduate school in 2004. And I went back to working with preschoolers, which was fun because I had done that before, it was at a different agency.
After a couple years there, I started realizing I'm going to work, and I'm coming home, and I'm putting my pajamas on, and going to bed. That's all I had energy for. That was another round of burnout that I had. I was looking at my options, and I thought, well, maybe I need to change my setting, go into a different job. I did find a job in a school district, back in 2007. I thought it was great, because there was going to have a planning period, and I got some other perks of working in the school. But, there again, within that first year of that job, I found myself in burnout again.
I was learning all new processes, working with a different population. Again, that lack of confidence. For me, that lack of confidence was coming up. At that point ... Let's see, by about 2010, 2011, I said, well, I'm going to quit being an SLP, and I'm going to become a life coach. Ever since I was a teenager, probably, I've just been obsessed with reading self-help books, and watching Oprah, and things like that, I was just so interested in mental health, and becoming a life coach.
So, I decided that. I thought I'm going to quit my job, then I'm going to be come a life coach, and I did. The amazing miracle, awesome thing that happened was, in the process of becoming a life coach, I learned the skills of managing my mental and emotional world, and I learned how to ... I just learned the skill, the literal skill, of loving my job. Then, I found myself in a place where I didn't have to quit my job, I didn't have to escape my job anymore, which was fun. So, I stayed, and I'm still there, I'm still at the same district.

Marisha: Oh, wow. I'm glad that there's no video here, because I was like, nodding my head like a bobble head, because there's so much in your story that I can relate to. I just love that you were able to learn the skills that you needed to, to not need to escape. Then, you're also able to help other SLPs figure that out for themselves.

Angie: Yes! Yes.

Marisha: That is so cool.

Angie: I hear about ... We're struggling, they're struggling, and I just want to do everything I can to get people some tips, and just help people take some agency over their career, and over their life.

Marisha: Yeah, that is so amazing. I am even more excited to dive in, because I frequently talk with SLPs who are in my membership, or just in my community in general, like on Instagram, and one of the biggest things that comes up is, they don't feel confident, and they are just really struggling, and don't feel great about much of anything that they're doing. You're the expert here, but I think that definitely contributes to the burnout, and you just kept mentioning that confidence. That's something that I've heard from hundreds, and thousands of SLPs, even, that's a real struggle.

Angie: Yeah. I mean, it really is. It's not the case for everyone who's struggling, but yes, that is a huge piece of it.

Marisha: I think it's just the broad scope of practice, especially in the schools, we can ... There's so much paperwork on our plate, and the caseloads, and all of those things. I'm excited to hear your perspective, but I think that makes sense.
So, the first question is, can you tell us just a little bit about what you've seen with SLPs and burnout? Do you have any information about how many SLPs struggle with it, or what the patterns are?

Angie: Yes.

Marisha: Kind of, what you're seeing there?

Angie: We are givers, right? We're teachers, and we're guiders, and we're healers, and we serve, and we help, and that's what we do. A lot of us struggle from burnout. I've done a lot of searching for stats on what percentage, and there are some studies that are definitely relatable to our field.
About 20 to 30 percent of teachers in America have moderate to high levels of burnout, about 52% of medical professionals, so we're thinking doctors, nurses, have moderate to high levels of burnout. So, those fields are pretty relatable to our field. There's a study, out of Canada, that said that 76% of SLPs were experiencing mild to moderate signs of burnout. Now, when I read that study, a quarter of the SLPs that were given the questionnaire survey, didn't fill out the survey. My guess is that most of those that didn't fill out the survey were also burned out, because they couldn't be bothered with the survey.
Yeah, if I were to hypothesize how many SLPs struggle with burnout, at some point, I would say it's really because ... Although burnout is becoming more recognized, and more understood, it's highly under reported. I think that it would be closer to 80%, if I was going to hypothesize about how many SLPs suffer from burnout.

Marisha: Yeah, that definitely makes sense. If you're looking over the course of a career, I feel the estimate could be-

Angie: Yeah, like 99.

Marisha: ... even higher.

Angie: Right?

Marisha: Or, 100.2.
Yeah, that really makes a lot of sense to me, I think it's helpful just to get a little bit of the numbers behind it. I'm curious, what are the symptoms of burnout? I'll let you decide what makes the most sense, but I'm curious, how do we know if we're burned out? Then, what do you think about the causes of it? Like, it might make more sense to start there.

Angie: What's kind of cool is that it is being recognized more and more, it's actually ... Burnout is in the ICD 11. What it's defined as is "burnout is a syndrome, conceptualized as resulting from chronic workplace stress that has not been managed." There's three components, they define three components of burnout.
Now, the first one is ... I always talk about, if you picture your spaghetti strainer, if you're a bowl, normally, when you're in burnout, you're a strainer. It goes along with that first component of burnout, which is energy depletion. You're physically, mentally, and emotionally exhausted. That's the first, and these do occur in progression, that's the first part.
The second part that I see is what I call brain fogs, so there's a mental distance. Your brain actually becomes pretty cynical, pretty critical, very negative. That's a tough place to be, because once you're there, it's really hard for your brain to see any kind of solution.
Then, the third component is reduced professional efficacy. So, you're just not as effective, which makes sense.
Some other things that I see, on top of this definition, is a lot of scatteredness, confusion, over analyzing, over questioning, lack of confidence. Something I call compare and despair, so you're comparing yourself to other people, and you're in a lot of despair about that. I see difficulty making decisions, and I see defensiveness.
Another thing that I want to say about burnout, and this is what happened to me, is what I call perfectly hidden burnout. Like, really, there probably was some reduced professional efficacy on my part, when I was in burnout, but really, no one would have ever known it. I was still going to work, I was still turning in my reports, and everything that I needed to do, it's just when I was getting home, I was overeating, watching Netflix, staying in my pajamas all weekend. Not because I wanted to, but because that was all the energy I had. I was just going through the motions of my life.
Then, the other thing I see is, I like to see your body's response to chronic stress. Your body gives you whispers, what I call whispers. So, you'll get a headache, you'll get a kink in your neck, you'll have some stomach issues, you might get a sore throat. For me, now that I've been doing this work for quite a while, my jaw is my stress management barometer. If my jaw and shoulders are tense, I know that I need to go back and manage my stress. So, your body gives you those little whispers, and most people, most of us don't really listen to those, we don't really connect that it has an underlying stress-based cause.
The thing is, when you start living from that place, you're very dependent on the world cooperating with you. It's like, you're constantly living from an anxious place of, I hope nothing happens, because I can't handle one more thing. But, we're humans, and we live in a world, and one more thing always happens. It's just a crappy place to be.

Marisha: That is definitely a crappy place to be, and I ... Oh, I just love your analogies. I take some notes during these, and my pages are already full, so much good stuff. I love the bowl versus the spaghetti strainer analogy, that makes so much sense. Yeah, I think I can definitely relate to what you call the perfectly hidden burnout, because I was just picturing myself with the overeating, Netflix, pajamas all weekend. That was definitely part of my life for a while, there, too.
I just love what you said about the whispers, because a lot of that stuff is happening for a reason. So, so incredibly helpful.

Angie: Yeah.

Marisha: I think that's a great breakdown, and a great way of checking for other SLPs to ... The first step is being able to recognize what's happening, because then we can take some next steps.

Angie: Yeah. That's the tough thing about burnout, when your brain is cynical and negative, it's actually hard to recognize it, it's hard to have some openness and curiosity about yourself.

Marisha: Yeah.

Angie: That's the inaudible part. That's why I think education is huge here.

Marisha: Yeah, I agree, and you are the profit person to break this down, so I am very excited. I think, based on what you were saying, burnout comes from chronic workplace stress that hasn't been managed. Was there anything else that you wanted to say about the cause, there?

Angie: Oh.

Marisha: Okay.

Angie: Yes, there is more I wanted to say. I've got a few things, here. Yes.
Nobody teaches us how to manage stress. Most people, we really don't know how to manage stress. We have these clues, like do yoga, and drink a green smoothie, and take a bath, but that doesn't really teach us how to manage stress. We don't learn it, we certainly don't learn it in our training, we don't learn it in grade school, most of our parents don't teach us that.
For me, it's something I learned in becoming a life coach. There're things that happen in our world, we do have stressors, and we do have triggers. I know that's a word nowadays, like trigger warning, but my thing is, let's not have a life where we have to avoid every single trigger, because triggers are going to happen in our world. That's just part of being a human. Things like, you get three new avails, or you have some new students, or you've got a student with some specific behaviors, or you're asked to, I don't know, write another report. Just all those things come up, and those definitely might be triggers. How do you manage those triggers? Not being able to manage them is one of the big causes.
The other thing that I like to think about is, we don't know how to say no. I feel like part of this comes from our grad school training, because you think about grad school, I know for me, it was pretty intense. It would be like, you have to push yourself through, and take this test. Push yourself through, and write that lesson plan, and do your practicum. Push yourself through, and jump through another hoop. We condition ourselves to live our lives that way, but it's not sustainable.
When I talk about people don't know how to ... Saying yes, and saying no, people have just said yes to too many things. They need to say no more, and create good boundaries. Good, healthy boundaries. Specifically like time boundaries, right? Making sure you have a time to work, and a time to rest, and a time to be with your family, and your loved ones, and making sure your time is organized in that way.
Now, something I continue to work on is when I have a coach ... I am a life coach, and I have a life coach. One of the things I continue to work on is a massive resistance to rest and relaxation. So, a lot of us, we're watching Netflix but the whole time, in the back of our mind, we're saying, I should do this, and I should do that, so we're not truly resting.

Marisha: Yeah, I totally can see that. I'm thinking back to the weekends when all I did was watch Netflix, and I definitely didn't feel rested after doing that. I think part of it is because, yeah I was just lounging in my pajamas watching Netflix, but I was also constantly scrolling through my phone, and thinking about Johnny, and Alice, and thinking about what I was going to do for my therapy plans, and all of that. I think there's really an art to true relaxation, I think.

Angie: Yes. I think part of is just, like I said, we have to undo that tendency that we have to push through, and just realize that it's not sustainable. Yeah, just getting into that wholehearted rest. Well, I'll get into my tips in a little bit, I'm going to get into that.
Putting those time boundaries for your rest, and putting your relaxation in your schedule first. If you're not rested, if you have no energy, you're not effective, right? We have to work at undoing those tendencies, though.

Marisha: Yeah, that definitely makes sense. It's like trying to pour from an empty cup. It might feel selfish, or, I don't have time to rest, what are you talking about? I have my job, and my three kids, and all of this stuff happening. If we don't take that time, then we're not able to show up, and be our best selves for our students, and our families, and just for ourself, too.

Angie: Yes, yes. I'm so glad you said that. The thing is, once you actually practice it, and learn how to wholeheartedly rest and relax, it doesn't actually take as much time as you think it would.
Like you said, a whole weekend of having that brain spin, of all the things you should be doing, but on the surface it looks like you're resting, but you're really not, in your mind. All that time isn't restful. Whereas if you actually just wholeheartedly rest, for an amount of time, it really is rejuvenating.

Marisha: So helpful. I am super excited to dive into some tips and tricks that you might have for us.
Let's say that an SLP is beginning to experience the signs of burnout, or they're deep in it, what would you tell us, if that's where we are?

Angie: Yes. I have so much for you.
Fundamentally, the first thing is giving yourself the gift of openness, and just giving yourself the gift of curiosity about what's going on, what do I need. There's a meme ... A meme. There's a graphic out there somewhere, that it says, "Our students must Maslow before we can Bloom." I love it, it's referring to Maslow's hierarchy of human needs versus Bloom's taxonomy of the educational objectives. Basically, we have to take care of our human needs before we can learn, and apply things, and self actualize.
Just on a very basic level, when you're in burnout, taking care of your physical needs actually starts to slip. Like, make sure you're getting at least ... What is it? Half your body weight, in ounces, of water a day. Make sure you're at least moving your body in some way, every day, make sure you're eating nourishing foods that physically feel good in your body. It doesn't have to be complicated, but just taking care of your physical needs, that's a place to start. Just being very gentle with yourself, and being curious.
I like to use powerful questions with myself and with my clients. One of the questions that I ask myself, and I have my clients ask themselves is, what's the matter, love? What's up? We ask our students, "What's going on, baby?" Just asking yourself, and opening yourself up to just being curious about what's going on with you. I think that helps to crack that cynical, defensive, critical mindset that happens when you're in burnout.
The other thing that I touched on before, is really creating clear time boundaries for yourself. Sometimes we get to a place and we realize that we've given too many yeses, and not quite enough nos. Making sure there's that time for you to rest, and time for you to connect with your loved ones, and definitely time to work.
I have a five-part series, on my website, Five Effective Ways to Get Your Time and Energy Back. I'll just go through the list, but then I'll go in depth in each one. Does that sound okay?

Marisha: That would be perfect.

Angie: Okay. Now, stay with me, here, because I'm going to explain everything. The first one is Front Loading, the second one is Zap the Time Suckers. Then, Reclaim In Between Time, Prioritize Work, and then the fifth one is Use Constraint.
Talking about Front Loading. I'll ask you a question. If I told you, okay Marisha, you give me $100 on Monday, and if you do that, on Friday, I'm going to give you $500, would you take that deal?

Marisha: Of course.

Angie: Right? You would take that deal. That's what front loading is, but most of us are really afraid to give that $100 up front. That's what front loading is, it's really just planning ahead. But, we have to really make the case for it, in our mind. When I work with my clients individually, we look at, what is going to give them the most bang for their buck?
One thing that I recommend ... There's a thing that's called decision fatigue. When you're going throughout your day, we make a lot of decisions throughout our day. The more decisions you make ... We make a lot of decisions as clinicians, right? That takes brain energy, that takes a lot of brain energy. I like to use the strategy of front loading to reduce the amount of decisions that you have to make throughout your day.
Some things that I've done ... I'm not saying these are the right things for everyone, but just idea-wise. I eat the same thing for lunch, ever day, and I pack my lunches on the weekend, I prepare my lunch on the weekend, and I eat the same thing, every day, five days a week. So, I don't have to think about what I'm doing for lunch. I recommend, also, eating the same thing for breakfast. I've been doing, for about a year now, intermittent fasting, so as far as that, I don't even have to make a decision about breakfast anymore. Now, I'm not saying everyone should do that, by any means, it's just an example of how you can reduce your decisions.
I plan my outfits ahead of time. This is your expertise, here, work in themes. I use a lot of literature, as well. Using materials that can be adapted for lots of different groups. One thing that I've decided, too, is when I take my daily notes, I write one to two sentences, no more than two sentences, with one piece of data, then period. I don't do anymore than that, that decision has already been made, I don't spend a lot of time deciding what I'm going to include in my daily note for my sessions.
Then, a new thing that I've started is I'm doing for dinners, I'm making a monthly meal plan for my family and I. I'm making a ... writing out all the dinners that I'm going to make. Not that I cook every night or anything like that, but what we're going to eat, every night. Then, I basically repeat it, every month. I already know what I need from the grocery store, there's not a lot of decisions that have to be made on a daily basis.
When I work one-on-one with people, we take an in depth look about what kind of front loading might work for them, so we can stop up those energy leaks.

Marisha: Oh, I love that, stopping the energy leaks. I really appreciate all the specific examples that you gave, and I definitely agree with what you said. Each person will need their ... everyone has their own energy leaks, and there's definitely different areas that we could work on reducing the decisions, but I really appreciate those examples, because I think that really helps.

Angie: Yeah, yeah.
The next one is, Zap the Time Suckers, which is kind of a funny name that I call it, but they really are time suckers. To give it a definition, it's those activities, little things that we do, that aren't quite aligned with our goals, and what we want for our future self, or even just our daily goals. Like, if your daily goal is to get your session notes in, but at the end of the day, you pick up your phone and you're scrolling on Facebook, or whatever it is that you do, that would be considered a time sucker.
Now, let me be clear, and give this a little caveat. There's nothing wrong with doing things to kick back, like we talked about before, like watching Netflix, there's nothing wrong with getting on social media, and relaxing, there's nothing wrong with having a beautiful meal and a glass of wine, or whatever it is that you do to relax. The caveat, here, is when we do it as an escape, or when we do it more to avoid the things that we really, actually want to get done. I also call it those numbing out behaviors that we do. Yes, we do need self soothing, and we do need relaxation, but I like it to be purposeful.
So, those times when you're engaging in those types of things as an escape, couple tips. The thing is when you have ... For me, when I have a report to write, especially getting started, I don't want to do it, I just don't want to do it. My tendency is, if I let myself just go, I'll go and scroll Facebook for 10 minutes, or I'll go and commiserate with my coworkers for half an hour about how much work I have to do, or ... This is kind of a joke with my coworkers, but Mrs. Merced will get into the prize box, and it just takes me away from my bigger intention, and what I want to create. I like to leave work at work, because I do have a husband and two little girls at home, and I want to spend that quality time with them when I get home.
We are doing those things to avoid a negative emotion. I want to get into, just a little bit, let's touch on emotion. In life, we experience positive emotion and negative emotion, right? That's just normal, that's a part of life. You're going to have positive things, and you're going to have negative things, that cause you to think negative thoughts, and feel negative emotion. But, I think there is useful negative emotion, versus useless negative emotion.
Some examples of negative emotion that's really not useful for us would be regret, feeling regret, feeling guilt, which I know a lot of us SLPs feel that way, especially Mama SLPs, too. We feel the guilt. Confusion, worry, compare and despair, those really aren't useful emotions, negative emotions.
Whereas, the feeling of discomfort could be useful. When I say that I mean, when I go to write that report, it's uncomfortable, I don't want to do it, it's uncomfortable. This is a really fun tip, wait for it. It's feel the discomfort, just let yourself be a little uncomfortable in the beginning. Now, you might not love that discomfort, but discomfort is better than what you might feel on the back end, if you don't start the project, and that's where the regret, and the confusion, and the guilt, and the overwhelmed, that's where all those emotions start to come in, that feel even worse than that initial discomfort. Does that make sense?

Marisha: Yeah, that does make sense. If we walk through an example, let's say, where we have this report to write, but we're avoiding the discomfort, so we scroll on Facebook, and talk to our coworkers, we don't get it done that day, and maybe we do the same thing a couple days in a row. Then, the report is due on Thursday, so on Wednesday night we're writing the report from home, and missing out on time with our kids, our families. We've got the discomfort still, of writing the report, but then there's also regret for doing the things that we did. And guilt, I'm supposed to be helping my daughter with her homework, or whatever it may be.

Angie: Yes.

Marisha: Is that right, is that how that would show up?

Angie: Yes. Then, I'm so glad you brought that up, because then our brain has a tendency to be mean to ourselves. Like, why didn't you do that? Why can you get this stuff done? Then, we get into that, it's really unuseful. Our brains do that, they beat up on us.
But, I have some more, I have some more tips for this, too, though.

Marisha: I love it.

Angie: To get you through that discomfort, though.
Yes, maybe be willing to be feel that initial discomfort. The next tip is, reclaim the in between times. I know a lot of us ... A lot of times, in my schedule, there'll be an assembly or something, or a student will get picked up, or something happens where 15 minutes opens up in my schedule, or I'll get a little extra time, that I didn't expect. Actually, let me back up a little bit.
When I work with my clients, I have them actually do, most of them actually do a time journal, so we see exactly where their time is going. I do it in 15-minute increments, so that's something you can do. You can really get real about where your time is going, throughout your day, your entire day. The reason I have them do that is because I like to have people get rid of their to-do lists, and put everything on their schedule instead. Endless to-do lists are overwhelming, and it doesn't really give you a good, clear picture of time boundaries, which we talked about before. That's part of reclaiming those in between times.
It's like, when everything is on a schedule, you can see when some time opens up for yourself, and you're like, oh my gosh, I don't have anything scheduled right now. Do I want to take this time for some purposeful rest and relaxation, do I want to start this report that I have, that I have scheduled later?
One of the other tips that I had, I highly recommend using a timer. Now, in college I always called it interval tasking, thinking I invented it. It turns out, it's called the Pondoro Technique. What I do is I use a timer, I try to chunk ... We do this for our students, right? We chunk things, into little mini steps. Use a timer, I work pedal to the metal for 20 minutes, and then I give myself 10 minutes to goof off. Then, I give myself another 20 minute interval, where it's pedal to the metal, and then 10 minutes to goof off.
Now, when I do that, it really, actually, energizes my brain, and gives me just some real focus. That's one of the things that really helps me get over that initial discomfort, that negative emotion that I was talking about. I've just found that to help, really help me be very productive throughout my day. I know it seems like a lot of time of goofing off, but when you have that uber, like I said, petal to the metal focus, you're really getting a lot done.
The other tip I have, this is a strategy for overcoming ... Raise your hand if you're a perfectionist, or a procrastinator, or you're anxious, which, isn't that most SLPs? I know, I raise my hand to all of those.

Marisha: I'm raising my hand, too.

Angie: The tip is, think of it this way. When you get the first 80% of a project done, as fast as possible ... So, those quick, massive bursts, it's going to help you with your focus, stamina, and the other thing it's going to help with, is help you hack your perfectionist fantasies.
Now, today, I was looking at my notes and what I was going to talk about today, and prepare, and I caught myself fantasizing about how I wanted to prepare, to talk with you. I pictured myself going downstairs in my office, and laying out all my articles, and reviewing them. I caught myself actually using a lot of time fantasizing about how I was going to prepare, rather than just preparing, and I think a lot of us do that. There's that over-researching. Do speech pathologists tend to over complicate things? Probably. So, I think just focusing on getting that 80% of the project done, as fast as you can, will really help you get through that initial discomfort of starting a project.
I mean, thinking about putting time boundaries on things, now, most reports I can write in an hour or less. That's my reports, I work with third through fifth graders, so the reports that I'm used to writing, I can write them in an hour or less. What I used to do is get super complicated, and take a report home, and literally, probably spend 12 plus hours writing the report, simply because I had no time boundaries for myself. I would say, well, I'm going to write this report on the weekend, so it would take all weekend.

Marisha: Yeah. I know that, especially for newer SLPs, it's like, I don't know how long it's going to take me. How do I put a time boundary, or whatever? I think we might not know, but we can just pick a time. I think this is jumping ahead to one of your future points, I think we just have to take a guess, and just go for it. It's surprising how that actually ends up working out.

Angie: Yes, yes. Yes, because at least you have that mental expectation for yourself, initially. Yes, I'll get to a little more on that later on.
The next one is just prioritizing. That's just thinking about your why's, thinking about your why's. My priority, in the past, I would say five years, I've realized how much my mental health is the most important thing for me, because that creates everything. That is my number one priority, but do I spend the majority of my time on that? No. Your priority doesn't necessarily have to be the thing you spend the most time on. I mean, the next priority is my family, but we spend a lot of time at work, we spend a lot of time sleeping, too. Those are priorities, too. Those priorities might not always align with time, so it's good to just know that.
The other little point I like to bring up is Stephen Covey has this concept of urgent versus important. Just thinking about the things that come up ... When I have my clients do their time journal, it's interesting, we go over what urgent things come up. The urgent things are like, the example I'm thinking of now, you go grocery shopping and a day later, you get home and you realize you forgot to buy milk. Then, you've got to go back to the grocery store, and spend all that time getting the milk, bringing it back home, doing what you were going to do with it. Or, ... I just had another idea, and I lost it. Basically, when you're having a lot of urgent, unexpected things coming up, that is a lack of front loading.
It's that, you've got to pay that $100 on Monday, so you can get that $500 back on Friday, so the urgent, versus the important things. So, thinking about spending your time on those important things, rather than the urgent things coming up. The other thing is, some of us overcheck our emails. I really try to only check my emails once or twice a day, because it's really just not that important. There's nothing that urgent that I need to be checking my email more than that. So, clarifying in your mind, what are the urgent things that are coming up, and what is truly important?
The other part is clarifying for yourself your have tos, versus your want tos. Now, most of my clients, including ... I've had this, too. They'll tell me, "I have to work, I have to pay my bills, that's obvious." But, something I tell them is, you actually don't have to work, and you don't have to pay your bills, it's just if you're honest, you don't want to experience the consequences of not paying your bills. Maybe you don't want to be homeless, right? Or, another example is paying your taxes, people will say, "Well, I have to pay my taxes. I don't want to, but I have to." You really don't have to pay your taxes, it's just that you choose you don't want to go to jail, or pay penalties, or whatever it is that you have to do.
I would clarify for yourself, and give yourself that subtle but important distinction of, you really want to work, because you do want to pay your bills, because you don't want to be a bag lady, or you don't want to be homeless. Just giving yourself, it is true, you do want to do these things. I think that part is important.
The last tip that I have, let me give this to you, I want to give you as many tips as possible, is to use constraint. That's like, minimalism for your life and your career. The problem with that is, most people when we hear, the definition of constraint is limiting, and constricting yourself. When we hear that, what happens? If you're going to limit yourself and restrict yourself, I know for me, the rebellious, inner emotional child comes out and says, "No, I'm not doing that." Or, we have that fear of missing out, we get the FOMO, or our perfectionist fantasies start coming out. Like, I have to get this right, we have to make it overcomplicated, we have to do more, and research more.
All of those things that our brain does, so that rebellion, and the FOMO, and the perfectionism, creates a lot of indecision, and non-committal, scattered energy in our life, that's that huge energy, and time drain that happens. I do recommend that you constrain your time. If you've ever heard of Parkinson's Law, it's "work expands to the time available." Who decides what time you have available? You are actually the one that gets to decide that. Going back to that, when I said the report would take me a whole weekend to write, versus one to two hours to write. So, constrain your time, give yourself time limits to work on things, and use that timer to help you. The other thing is just constrain your materials, and the things that you do. I like to work, do literacy based lessons, and that just constrains my materials, so that I can use them in so many different ways.
The last thing I want to leave people with, I know I've given you a lot, is just remembering that when you show up with your clients ... There's been lots of studies in education, with counselors, life coaching, although that's a newer field, so it's less studied ... there's been a lot of studies that say, your relationship with your client is the biggest predictor of your effectiveness. So, just show up as a loving human being, and just ask yourself, can I be a human being today, with my students, with my clients? I think we can all answer yes to that. Hopefully, that will just take a little bit of the pressure off.
Hopefully I've given you a lot of tips, and things you can try, like tomorrow. Don't get overwhelmed with it, just try one thing.

Marisha: Oh, I love that. I love when episodes are packed with practical tips, and this one is overflowing with them, so much good stuff. I definitely agree, we've got 100 things that we could do, based on what you shared, and that's definitely not the goal. This episode will be available for, at least for the foreseeable future, I don't think it's coming down any time, so just pick one of the things you want to try next, and see how that goes. Then, if that's going well, you can revisit it, and pick some more things, or you can connect with Angie.
Where would be a good place for people to read more, or connect with you and just learn more, if they're wanting to work on this?

Angie: Yeah, you can go to my website, SLPBurnoutCoach.com, or you can email at [email protected], or you can see my Facebook page, SLPBurnoutcoach.com.

Marisha: Got it.

Angie: Connect with me, ask me questions, I would be more than happy to answer questions. Email me, reach out, I love talking burnout, I love it.

Marisha: Well, thank you so much for sharing your time and expertise with us. Yeah, I think this was a really helpful conversation, and you definitely gave lots and lots of tips for us to start implementing.

Marisha: Hi there and welcome to the SLP Now Podcast. I am so excited to be introducing Caitlin Lopez today. We are going to be diving into all things mindfulness after a lot of you asked questions about it with Kristin Comella's interview. There was a huge interest in all things mindfulness, and I found the perfect person to help break this down for us. Just a little bit of background, Caitlin received her master's degree from Loma Linda University in communication sciences and disorders in 2012, and she has worked for the last eight years serving preschool and elementary students in the California school system.

Marisha: She also began practicing yoga in 2018, and it was love at first [inaudible 00:00:53]. She completed her 200 hour teaching training in 2013 and has completed 20 hours of trainings in yoga for autism, yoga for children, trauma-informed yoga, all the things, and she teaches adults and kids in studio classes, community centers and schools. She's passionate about helping others find their inner power through using their voices and living intentionally. So I cannot wait to dive into all of the tips and tricks that Caitlin has for us today. But before we get into all of that good stuff, Caitlin, I... Well, first of all, welcome to the podcast.

Caitlin Lopez: Thank you. I'm excited to be sharing.

Marisha: Like I said, before we dive into all the tips and tricks, I'm really curious... I got to hear a little bit of your story already, but I'd love if you could share a little bit more of your story, like how you got started on this journey and what that looks like for you.

Caitlin Lopez: Absolutely. Back in 2008, I started practicing yoga just kind of as something fun to do while I was in school. I think I was doing my undergrad about that time. So I just hopped into classes as something new to do, like a new hobby or whatever and I absolutely fell in love with it. I noticed right away that it was something a little bit more than your average exercise class. So I have been practicing yoga for about four years or so.

Caitlin Lopez: My first year as a speech therapist in the school system, I remember this one day walking into grad students, and I had three kids and they were just like off the walls but on very different pages. One little girl was just like, word salad, telling me some story that made no sense, and another little boy was... he was like bouncing off the walls, just like high energy and then another kid was just like not engaging whatsoever. I was trying all the teacher tricks, like those things that they tell you to try for behavior management to get the two kids calm down and then maybe bring up that other kid, and nothing was working. I was just feeling my energy level kind of rise, my stress level rise, and I was like, "Oh, what am I going to do with these two kids that are bouncing off the walls and then this kid who's like, not interested in anything?"

Caitlin Lopez: I realized like, "Okay, well what works for me? Breath." So I thought, "Okay, I'm going to get them breathing." But in the past, I had tried breathing with kids before, and they just end up hyperventilating. You ask them to take a deep breath and to let it go and it's like... and it's like, wait, wait, that's counterproductive. So I got them grounded first. I have no idea where this idea came from, but I was like, "Okay, I need to get them grounded."

Caitlin Lopez: So I had them elephant walk around the table, because if I thought like, "Okay, if they can feel the ground beneath them, maybe that will give them a little bit of sensory input to bring themselves down." And then they did... they walked around the table a couple times, and I started to feel their energy level drop a little bit. And then I had them do a couple of deep breathing, breathing with their arms up and then exhaling with their arms down. And then once they were on the same page, the three of them, I had them do, like... I think I had them do chair pose or something and I was like, "Oh, we're going to do yoga." And they were like, "What's that?"

Caitlin Lopez: I had them do chair pose and then we did Bakasana or Crow pose, it's kind of like a fun balancing pose that kids are really good at; adults, maybe not so much. So we did that and then we sat down and we went through the rest of the speech session, and the kids were so engaged, I was like, "What is going on? Oh my goodness. I found the answer to all of my problems." So I thought, "Yeah, there must be something here." So as soon as I got home from my day, I Googled yoga for autism. One of the kids... Well, actually, two of the kids were on the spectrum, that were in the class or in the speech session. I found a training that was happening... I think this was about April, May and there was a training that was the weekend, right after school got out in June, and I signed up for it right then in there. The studio that I was attending at the time, they also were offering a 200 hour certification training that summer, that started weekend directly after that autism training.

Caitlin Lopez: So I signed up for that one about a week later after that one. So it was just kind of a summer of yoga training, and that's how I got into it. And then I did a couple of other courses, like the children's yoga, just to add to my tool belt, because children's yoga looks a lot different than adult yoga. Kids relax way different than adults relax. And then through some other experiences that I've had, I was asked to teach for women that were rehabbing out of human trafficking, and so I took a trauma-informed yoga course to give me some more tools to work with that population as well. So that's a little bit about my background.

Caitlin Lopez: Let's see, I started to... When I first started using yoga in my speech session, it was mainly for behavior management, so it didn't really become powerful, or I didn't really see how it could be powerful for kids to take on for themselves until a little bit more recently within the last few years. But yeah, that's my background in how I do what I do.

Marisha: I love that story. It's amazing how that one session catapulted and all of these amazing things that you did and you immediately took action, which is amazing. I love it. So, I'm curious. You shared a little bit of your first experience with this, but I'm curious how... Can you give us a couple more examples of how you incorporate mindfulness into your therapy sessions and what you use them for and what that ends up looking like?

Caitlin Lopez: Yeah, absolutely. So like I said, at first, it was behavior management. So what it has evolved into... Like, I used to... I would feel like kids would act out or they would come in and they would be upset or whatever have you, so I would do a lot of breath practices with them. But what I've learned is that... and as I've kind of evolved into it, is that if we give kids the tools for self-regulation or helping put the responsibility on them and giving them the tools, they can be really powerful. So there's a couple of different things that I do now. I know Marisha, you talk about using a routine in... I learned that from you a little while back through your SLP Now stuff. I really find it powerful with incorporating mindfulness, because it can... I don't want to... It's a fine balance between doing these things that aren't necessarily goal related and then also making sure that you're targeting speech and language goals within your session. Because we do have limited time in the school system.

Caitlin Lopez: So a couple of things that I do is I like to keep to that routine. We usually start out with some sort of mindfulness activity. It can be very brief, it doesn't need to be super intense, and I kind of let the kids pick. Once I teach them the different types of that of activities that they can do, they can pick as a group what they want to do. So I walk to and from my speech sessions with my students. The older ones, I let them go back on their own, but I always walk and get my students. Not only does it kind of break up my day and get me out of the therapy room, but... The particular schools that I have been at, for whatever reason, they don't have an IEP schedule, and so then this way, I know that the kids aren't waiting outside of my room or lollygagging in the hallway on their way to speech.

Caitlin Lopez: So there's a couple of different things that I do on the walk back to the speech room. One of the things that I like to do is a noticing walk where sometimes we walk quietly and we notice all the different things that we can hear on the way to the speech session. And then they have to, if they can, remind... if they can remember, they have to tell me what it was that they heard, whether it was a bird or the crinkling of leaves or footsteps or a bell ringing or a helicopter. So we do noticing walks. We'll do like a gratitude list. Gratitude can be something that's a little hard for kids to wrap their heads around, like that concept, especially the little ones, and so we talk about things that make us happy and then like... They'll say, "I..."

Caitlin Lopez: Once they know that that's the routine of what gratitude is, noticing what makes you happy, then we'll add in the language of like, "I'm thankful for playing with my friends at recess or my mom's hugs." And we'll do like a gratitude list on the way to speech sometimes. Something else that I like to do is a personal weather report. I give them the language of like, am I sunny inside, am I my cloudy, am I thunder, am I... I'm trying to think of other. Like, is it a tornado inside, is it a hurricane, is it sprinkling inside, is it windy inside? So we talk about what those... how the different weather might relate to how their emotions are on the inside.

Caitlin Lopez: Sometimes we'll do the personal weather report and they'll say, "I am cloudy inside." I always just let it be. I don't necessarily try to explain it. A lot of times I don't even ask them why, I just let them like... If they're thunder, "Oh yeah." Like, "Oh, I know how that feels sometimes." Or I usually say something that validates that and then we move on. It's not something that I totally like engage them in, it's just something to help give them power to recognize it's okay to feel these things.

Caitlin Lopez: And then if we do the personal weather report on the check in... Once at the beginning of the session, I always like to do one at the end to show them too that things can change. Maybe we started out in a thunder mood and then after playing a couple rounds of like pop the pig or something, or after a success in speech, then they can maybe be windy or slightly cloudy instead of like a huge thunderstorm. Again, I don't draw a ton of attention to these things, just kind of allowing them to own how they feel and then own that it can change.

Caitlin Lopez: So some other things that I like to do is like rounds of breath. We'll do like only three to five rounds of breath. Sometimes I'll have them just sit like... We'll usually do the breath when they're sitting. So once we get into the speech room, if they decide that they also want to do breath, then they can sit in their chair, and I'll usually ask them to feel like the chair against the back of their legs or against their back, that way... so they're a little bit grounded. And then couple of different breathing practices that we can do is like, I'll just say, equal breath, and I usually have them breathe in for a count of three, hold for a count of three and then breathe out for a count of three. So we can do that one.

Caitlin Lopez: Something else that kids like to do, there's like that game, Johnny whoop, Johnny whoop, I don't know. It's something that I remember playing as a kid. But usually you take like the left hand and you place the palm, or you look at your palm and then you take your pointer finger of your opposite hand and you start at the base of the pinky, and then every time your finger goes up, you breathe in and then you breathe out. When your finger goes down the pinky and then up the ring finger, you breathe in and then exhale as the finger goes down, and you follow that motion. We'll do that usually once you get to the thumb, then we'll go back the other side. I call that one Johnny breath only because of that game, Johnny whoop. I don't know if my students know what I'm talking about, but they sometimes ask for that one. So we do that.

Caitlin Lopez: And then sometimes I'll use yoga as a reward at the end. The yoga for autism training that I did, it was really awesome. They gave us yoga pictures that were on... kind of like a picture exchange card. So I will let them choose one or two poses. I'll only have them choose out of five. It's not like they go through all three of the pictures, because that would take too much time. But if they want to do like yoga poses at the end, I'll let them choose some. Sometimes they take turns teaching each other, but that's like a reward at the end that some of the kids like to do.

Caitlin Lopez: Sometimes we'll do like a sound game where I'll play like a bell at the end of the session and they have to close their eyes and then just listen. They'll raise their hand as they're listening for the bell and then once they don't hear the bell anymore, they just bring their hand down to the table or to their lap and we wait till everybody has heard the bell or has done hearing the bell. So that's one thing that I'll do with them. So I keep it short and sweet. But usually, when I introduce all of the games or the different ideas behind things, it's kind of... I'll spend a little bit more time explaining, this is why we do what we do. The reason why we notice things is it keeps our brains sharp. Something I'll talk about with the inaudible is like we're using our spidey senses, we want to keep our brain sharp, we want to notice everything that happens around us.

Caitlin Lopez: And then with the gratitude list, when we talk about things that make us happy, I'll also have them notice like, "Oh, did you notice that you feel happy when you think about your mom's hugs or when you think about playing games with your friends?" And that I can all remind them too like, "Anytime you need to think about things to make you happy, feel free to do that again." So like I said, it'll be a brief thing. It's not something super intense that we'll do. The same with the personal weather report. Usually at the end, I'll draw a little bit more attention, especially if somebody's weather has changed, like, "Oh wow, how awesome. You felt this way, and now you feel this way. Whether it can change, and we know that. Sometimes it's sunny in the morning and then it rains in the afternoon."

Caitlin Lopez: That's about all I say. That's how I usually use these things within speech sessions. When I work with kids, like in a kid's yoga class, I'll usually be a little bit more intentional. Or maybe not intentional is the right word, a little bit more like spend a little bit more time on these things, because we also have to do speech and language goals too.

Marisha: Thank you so much for all of these ideas. I love a lot of... Well, I love all of the ones that you brought up. I've only used a couple personally, so lots of new things for me. I love what you said about... Because this is... You have separate classes where you dive into these things specifically with students, but I love just the little things that we can use to help set up our students for success in the session. I think these are skills that can be very helpful for them as they go about their day. So it does... I think this is the perfect thing to use as you're transitioning into the speech room and just...

Marisha: Because yeah, it might take one or two minutes out of our very few minutes, but if the student is having like a thundery weather day, if we can do just... if we can teach them some of these strategies, I think the student can get that much more out of this session and then they also have that skill to bring with them to the other parts of the day as well. Yeah, I love that. You gave us so many strategies that we could actually use, which is awesome. And then I'm curious too, what kinds of changes have you seen with your students, or do you have any... I don't know, what got you to be so consistent with using this in your sessions? What were the... Whether it's research or personal experience, I'm curious what you've seen.

Caitlin Lopez: A little bit of both. I think the research, I know like in Oakland they have started... Instead of doing detention, they have meditation for kids. There's a school district up there that does that, or at least a school within the district that has tried that and they've seen really positive results. And then I know for me personally, when I am consistent with things, it starts to take hold and you start to see things. A couple of years ago, there was a school that... Well, actually, it was a little bit more than a couple of years ago. I don't know if you guys remember it, was a inaudible San Bernardino.

Caitlin Lopez: But the December 2 shooting that happened, when it happened, we were actually a couple of miles away from where it happened, like six miles or something. But when the news broke, nobody knew what was going on or what was happening. I remember like... So anyway, we went on lockdown and we didn't... we knew that there was a shooting, we knew it was somewhere in San Bernardino, but we didn't know where it was happening or what was going on. I was out to get a group of students, and the principal walked out of the office and I was walking right by her and she said, "We're going on lockdown." And I said, "Okay, do you need help?" And she said, "Yeah, just help me sweep the campus."

Caitlin Lopez: So the fourth graders, or third and fourth graders were out at lunch and we were sweeping the campus, and one of the third grade teachers... This was not appropriate, but he was probably really scared. Our field was very far away from the classrooms and the bells, so kids could easily say that they didn't hear the bell, which happened regularly. So this teacher went out and was yelling at the students like, "Hey, you guys go in, go in." And the kids weren't listening to him, so he said, "There's an active shooter," which is probably not the right thing to say to children.

Caitlin Lopez: So kids were running into the classrooms, and as we were kind of sweeping the campus, there was a bunch of kids that were outside of the fourth grade classroom, and they had a substitute and it was lunchtime. So she had every right to not be on campus and getting herself lunch. So I ended up being in their classroom with them during lockdown. So the principal opened up the door and we went inside, and two kids were fighting. I just remember walking up and getting the kids into the class, and all of a sudden, one kid was in a headlock that another kid had him in, and it was just pure chaos. So I was like, "We're supposed to be quiet, it's lockdown."

Caitlin Lopez: So I just said, "Okay, who wants to play a game?" And the kids were like, "Uh." And they didn't really know who I was, because I was brand new to that school and it was December. So some of them hadn't really even seen me on campus yet. So they were like, "Uh." So anyway, I asked the kids, "Do you want to play a game?" And they all just looked at me. I said, "If you want to play the game, go ahead and sit at your desks. If you don't want to play the game, you guys can look at these books up here." They had some picture books or something in like a class library at the front of the class.

Caitlin Lopez: So the two boys who were fighting, they pulled their heads up over their heads and they kind of sat on opposite ends of that little library and they just started looking at books. But at least they were quiet, so I was like, "You know what, that's fine." So I did that check in. Instead of calling it a weather report, I just wanted them to say one word that they felt and... Or I should back up. I got them grounded, I got them sitting in their seats, kind of did like, notice if your feet are touching the ground, notice what that feels like. Can you feel the backs of your legs against your chair? Can you feel the chair against your back? And then I had them...

Caitlin Lopez: We went one by one through the class, and I just said, "How do you... One word to describe how you feel." And then some kids, I asked them where they felt it. I started off first. I said that I was hungry because I didn't have a chance to eat lunch yet. I felt that like... I was like, "And I feel that in my stomach. It's growing, and I feel it." So some kids, I asked them where they felt things, some kids, I didn't. So like one little girl, I remember she said she was angry, and I asked her where she was angry and she said her hands, which I thought was really interesting. You could see how kids like, they had never really been asked how do they feel, where do they feel it, and they... some of them I could tell they'd never really been validated in how they felt.

Caitlin Lopez: So I started to see the energy in the room just kind of equalize a little bit. Kids were starting to feel okay. Kids were scared, and they were scared in their heads, they were scared and their stomachs. So then after that, we did a couple of yoga poses by... I had them stand up and we did like one-legged chair and that kind of thing. There wasn't a ton of room in the classroom for them to move around a ton. And then I had them like... Then I think we did some more breath and then we transitioned... I think we started playing Heads Up 7 Up or something in the class that was quiet.

Caitlin Lopez: We were in the class for a couple of hours before they lifted the lockdown. So we also did like a... I did a checkout before it was time to go and kids had calmed down. It wasn't until a couple of days later when I saw one of the kids who was fighting... By the way, the kids who were fighting, they never once participated, but they sat there and they watched, and that was enough for me as long as they weren't putting each other in headlocks. A couple of days later, I was out grabbing students, and one of the kids who is fighting, he said, "Hey." Then they said, "Hi." At the time I wasn't married, so I said, "Hi, I'm Ms. Mack." Then he goes, "Oh, Ms. Mack." And I said, "Yes?" And he said, "Do you think you could come breathe with us more often?" And I said, "Oh. Well, will you breathe? Next time I come into the class, will you participate?" And he said, "Yeah, I think I will."

Caitlin Lopez: So I did it a couple more times with class, and the teacher said she noticed a huge difference just in the way the class interacted with each other, and that she noticed a huge difference. So she started doing it with the kids once she it modeled for her. So they would do it in the mornings, and she noticed a huge difference. So that, to me, is when it started to switch from this behavior management... because I had been using it for behavior management up until then, to this like, "Oh, kids enjoy this, they need a reprieve." The school districts that I have worked for in the past have been kids that have a lot going on at home. So I think for ways for them to have some control over their bodies, over their minds has been really powerful for some of them. So that's when I started to really use it just as part of the day, part of my speech sessions.

Caitlin Lopez: Of course, there are times where they might need a little bit more instruction or I might... If I noticed that a kid is having a thundery day, I spend a lot more and it drops down. I spend a lot more attention encouraging them to try this on their own or to try it when things are not going well for them or if they get stressed out with homework or mom and dad are fighting at home or something like that. Like, "Hey, you can always come back and do the breath yourself. You don't need me to do it for you." So I have noticed a change with some of my students, that they find like... especially the ones that grab ahold of it and they find reprieve or they find success with it and they see the need to do it.

Caitlin Lopez: So that has been... It's not all students. I have several students who... they don't really care about it, but we still do it, because you never know when it might click for them. It took me like... Let's see, I think I did... I did my teacher's training in 2013, and it like... I didn't start using it as like a... just part of my session until 2016, really 2017, because it was January, 2016. So you never know when something will actually click for somebody. I think we can say that too with our speech therapy. We work and work and work on goals and we're like, "Oh my gosh, is this kid ever going to get it? Are they ever going to see the need for why they should get it?" And then it's like, oh, all of a sudden they do it, or all of a sudden they see the importance of it. That's when I started to really use it more regularly.

Marisha: That is so helpful. I love your stories and everything. I can just like visualize it, and I think that's really powerful and helpful. I love what you said about it, taking time to place or to come... like, to really see a difference. For some, it'll be fairly quick and some it takes a little bit longer. For myself, I took a whole seminar, it was like a whole semester long seminar on mindfulness in college, and there was so much research around this approach. I know Caitlin, you have some articles, and then I'll pull together some of the articles that I've come across over the time too. You can find... If you're listening, you can find that in the show notes at SLPNow.com/39. But there's like...

Marisha: I took the seminar, I read like thousands and thousands of pages of research, I got to practice it in the seminar with this master. I don't know what he was actually called, but he was definitely very into mindfulness and meditation and all of that. I did it, but I didn't really feel it click. It took me... I think like 10 years later is when I started actually using it myself too. I love this metaphor. It was in a book that I read called Atomic Habits by James Clear. It's such a good book. But he talks about an ice cube. I think this is... Like you were saying, it's true with what we can do with mindfulness or just speech therapy in general.

Marisha: But if an ice cube is at negative 100 degrees, if we... we can do a lot of work to increase that temperature, but we're not going to see a difference in the ice cube until it hits that melting point. So like we might have gone up by 60 degrees, but we're still not seeing that difference. So I think that's so powerful to keep in mind with ourselves because... I've talked to a lot of SLPs who said like, "I really want to try this, but it's challenging. I don't see it making a difference." So we can use that ice cube reminder for ourselves and also our students. So I love just the examples that you shared because I think it just helps emphasize that point as well.

Marisha: And then along that line too, I want to start with students. But what tips do you have? You shared lots of examples of things that we can do, but what tips do you have for SLPs who are interested-

Caitlin Lopez: Oh, great question.

Marisha: ... in using mindfulness with their students?

Caitlin Lopez: The thing that has been, for me, the most powerful is when... Like you were saying, you've been... it took 10 years for you to really dive into it, and I would say it's about the same for me too. Yeah, I was doing yoga, but did it ever leap off the mat? It took several years for that to happen. I think the biggest tip or the biggest piece of advice that I can give is that mindfulness really should be modeled. It's hard to teach something that you haven't necessarily bought into for yourself that you haven't necessarily practiced yourself. I think it can be done, but I think it is a lot more powerful when you are doing it yourself. It's really hard to teach somebody how to do something that you yourself are not using or that you haven't necessarily done yourself, which is why we go to... we get these master's degrees and continue with CEUs and reading all the research to make sure that we are teaching our students well when it comes to speech and language. But I think the same goes for mindfulness as well.

Caitlin Lopez: So I would really, really recommend developing your own mindfulness practice. That doesn't necessarily mean that you have to be sitting in a 60 minute meditation every single morning. But what can you do to live a little bit more intentionally? Maybe it's taking 12 breaths before you get out of bed in the morning, maybe it's breathing on your way to work in the morning, maybe it's something that's like taking your own noticing walk or your own mindful meditation walk. It doesn't have to be something super intense, but I think any little bit is helpful.

Caitlin Lopez: There was a podcast that I listened to recently, and I completely forget... I think it was Sally Kempton that was being interviewed, but I could be wrong. It was a live forum, and one of the attenders had asked the meditation expert, "What is the bare minimum that I can... What is the least amount of meditation that I can do and still receive the benefits? We talked about all this research about 20 minutes is... it drops your blood pressure and it reduces your stress levels. But what if somebody like me can't sit for 20 minutes and actually ends up like raising our blood pressure because we get so stressed out that we can't sit there for 20 minutes? What can I do?"

Caitlin Lopez: The meditation expert basically just said, "You're looking for the bare minimum that you can do, and really, the best thing you can do is is just a little bit every day. A little bit is better than nothing. A little bit of exercise is better than no exercise, a little bit of eating healthy is better than not eating healthy at all. And then from there you start to build." So that is kind of the best advice that I can give, is to start your own mindfulness practice and come up with a definition of mindfulness that makes sense for you because that's what you are going to be able to relate to your students. If mindfulness is like this really strict, rigid thing, then that's probably what you will do with your students.

Caitlin Lopez: And that's fine, there are people that have very strict, rigid practices. But evaluate your relationship with mindfulness and what is it that you're looking for? Are you just looking for a little bit of peace in your day or a little bit of intentional action in your day? And then that will be related to your students. So evaluate your relationship with it. Is it something that you feel like you should do, versus something that you want to do, or... And that can really change as well. When it's something that you look forward to doing versus something you have to do, it becomes a little bit easier to do, which I know we all knew that. So that's the first tip that I have, is to develop your own practice.

Caitlin Lopez: And then with that, once you kind of develop your own practice, or something that I think is really valuable and can show change in students is when it becomes consistent. It's really hard to get students to breathe when they are like a level 10 and they've never breathed before. But the more that they are able to do it when they're calm, then the more able they're able to help themselves when they are at that high energy level. That's something that I've had to learn the hard way in terms of trying to use it only for behavior management just kind of as that way of life. I think the same goes for all of us. When we're really stressed out and we're really in the heat of the moment, it's really hard to calm ourselves down. But if it's something that we've been practicing and we know how to drop down and take a couple of deep breaths and regroup, then that's something that is a lot easier to do.

Marisha: Thank you again, such helpful information. I'm also really curious like, how has your mindfulness practice changed over the years? Just-

Caitlin Lopez: Yeah, great question. [crosstalk 00:39:21]. A lot of people just kind of like... yoga as a way of like, I wanted that yoga body, to be completely honest. Like, "Oh yeah, hot yoga. Sure, let's do that. That'll get me fit, that'll get me feeling good." And then the more that... I think I had started a class at 24 Hour Fitness or something and I did that for a little while and then I decided to try out a studio. Just the way that the studio teachers taught was very different, and the things that they would mention in class about like intentionally putting your foot where you want it to go or whatever.

Caitlin Lopez: So it started very physical for me. That wanting to be healthy and then moving my body intentionally and being mindful about the... What's the word I'm looking for? Like, the anatomy, making sure that my body was in the right place and that hip goes there and lift your pelvis here, and that kind of thing. And then it didn't really become more... And with that, linking the breath, your spirits kind of starts to come online a little bit more, or maybe that idea of like... that Zen mindfulness starts to come on a little bit more.

Caitlin Lopez: But I had never really been introduced to meditation. I had heard about it and I knew it was good for me or whatever, but I had never really tried it until I did my teacher training actually. I used to journal a lot. The cool thing about my yoga teachers was they were like, "What do you do to process? And then how... Can you think of that as being mindful?" That it's all a part of it. It all works together. So learning a couple of different meditations through my teacher training was really powerful, and that's when I started to meditate.

Caitlin Lopez: But again, still at that point, because they wanted us to meditate... That teacher training was pretty intense. They wanted us to meditate every single day, do a breath practice, which in yoga we call pranayama. We were supposed to do that alongside the meditation and the [inaudible 00:41:51]. We were supposed to do that every single day. So it became something that I had to do, not necessarily something that I looked forward to doing. But it was still like that was... It's only been within the last few years, I would say, that I would... I look forward to my meditation practice. And then like, even the last year or so, and especially the last six months, I've really dived in deep to it.

Caitlin Lopez: What that looks like is... So I started doing this... During the teacher training, we had... our teacher would always say, RPM. "Did you guys RPM? Did you guys RPM?" RPM was rise, pee, meditate. They believed that the best time to meditate was in the morning because your mind is a little bit more... it's a little bit more empty, if you will. You haven't necessarily gone about your day and thought about all the problems, all the things that have happened, all of the interactions that you replay in your head that have happened throughout the day, whether good or bad. So that was something that I gravitated towards, was the RPM method during teacher training.

Caitlin Lopez: Now, I would say when I'm on routine in the school year, I still RPM- rise, pee, meditate. And then I journal after that. I'll do a little bit of reading. I take a couple hours before I go to work. I just like to... For me, that's what works best, to kind of be in that routine. Sometimes I meditate for... Oh, sorry, let me back up. I use Insight Timer, which is a meditation app. I think it's 10 bucks for the initial app, at least it used to be. I've had it for a couple of years now. So I like it because you can put different interval bells on it. They have guided meditations as well, but I usually just do my own thing and use the timer.

Caitlin Lopez: So I will breathe, I'll do a breath practice for the first 10 minutes and then the last 10 to 15 minutes I will just do like a mantra meditation, if you will. Like I'll focus on a thought or a phrase and I'll focus on that for the remaining 10 to 15 minutes. But I do a couple of different breath practices before I get going just because it not only helps wake me up, especially since I rise, pee, meditate, but it also helps center my brain a little bit, gets me focused on the breath, which kind of gets me in a good space. Whereas if I'm just supposed to sit and think about a word or a phrase, I usually think about a lot more other things. So that has been really helpful.

Caitlin Lopez: And then something else that I've really... I tend to be a little bit on the type A side of things, so in years past, and I would say especially this last year, I've been able to lean into this. So in years past, I used to like really beat myself up if my meditation wasn't like inaudible place. But I've been reading a lot of books recently. This last year, I was like, "You know what, I'm going to get into this even more." So yeah, it's a part of my daily routine, but I want two lean into the meditation side of things a little bit more heavily.

Caitlin Lopez: So I've really come to just accept my meditation practice for what it is. I was recently on vacation and I... Before the holidays I was like, "Okay, I want to do 30 days of meditation." So I have just committed to that, whether it's five minutes or 10 minute, and sometimes when you're on vacation and you're out of routine. It's been sometimes in the morning, sometimes in the evening before I go to bed. So I've just let things be, and I've just noticed like, "Oh wow, my brain was really busy today. Huh, I didn't really settle down, did I?" I've just let it be, versus like beat myself up of, "Oh, you're a terrible yoga teacher. You're a terrible meditation teacher. You can't do this."

Caitlin Lopez: I had a lot of grace for myself in that, and that has really helped kind of catapult me towards having a better... It's catapulted my thinking towards my meditation practice of, "I get to do this, and I look forward to doing this," versus like, "Ah, it's just a part of my day that I have to do." I know it's good for me. Like eating kale, I am somebody who doesn't like to eat kale, but I do because it's supposed to be good for us. So that is a little bit of how my meditation practice has evolved through the years.

Caitlin Lopez: Something else that I really enjoy doing that has become a mindful activity for me as well is cooking. I really, really, really love to play with flavors, and I think cooking and food is such a great mindfulness activity because you use all five senses. So whether... My husband knows. Like I'm in the kitchen, I'm doing my own thing, he'll sometimes come and play his guitar next to me or whatever. But I am like in the zone in the kitchen, whether it's chopping, and like it's just kind of... All I'm doing is focusing on that. My phone is nowhere near, the TV is not on, and I really enjoy just kind of diving in and watching how he changes the food or how chopping kind of releases the smells of the food and then also the eating aspect of the food and taking it all the flavors as far as that goes too.

Caitlin Lopez: So really, mindfulness can be any activity you want it to be. My definition of it is just kind of that one pointed focus. So if you're cooking, you're focused on just that one point of preparing the food. So that has been something that has been helpful for me. Walks can be really great. You're focused on your walk, you're focused on your surroundings. So those are the things that I dive into. My inaudible practice, it used to be really strong. So the yoga poses, it used to be really strong. And then over the last couple of years, I have definitely not had... Like, I would say my practice is stronger in terms of like, I'm doing what I need to do, not necessarily like all the hand stands, all the arm balances, all the strong...

Caitlin Lopez: So when I like... It used to be really strong in terms of like the poses, very intense poses, and now it's become just kind of this retreat for me where sometimes I will do a handstand or some arm balances if I have the energy. But a lot of times, I'm just kind of moving and breathing through my body and stretching what needs to be stretched and working what needs to be worked, but then also finding that rest in whatever it needs to be rested too. I don't think there's any right or wrong way to that. There are definitely days where you need to work hard and do that, and there's definitely days where you need to be in Shavasana or child's pose the whole time. So finding that balance, I think, is really powerful. So that's where I'm at with all of it. I'm definitely a lot... How do I say this? It's funny, I feel a lot stronger in my mindfulness practice, but I would say from the outside looking in, it probably looks a lot more type B, even though I feel like now it's all encompassing, if that makes sense.

Marisha: Okay. That does make sense. I so appreciate all of the examples. Like, we talked about before, a lot of SLPs are feeling like well... I don't know, they've probably tried like one of the meditation apps and they were like... I don't know, that can be hard to... For some people, that's easy to just jump in and they are able to get through that, but like for me, I tried starting with the meditation app and it was just like... it was just too much to start with. So I love that you shared different ideas, whether it's taking a walk before you go into work or going for a walk during your lunch time and just doing that. Because you called it the noticing walk, so just taking like a five minute walk as a way to start, or having a gratitude list or taking a couple of breaths before you walk into school. There's just a lot of little things that we can do to get started, it doesn't have to be, like you said, a 30 minute meditation or going to yoga every day.

Caitlin Lopez: Absolutely.

Marisha: Just kind of exploring and seeing what makes sense for you and something that is approachable.

Caitlin Lopez: Absolutely. [crosstalk 00:51:32].

Marisha: Because it's supposed to help you crosstalk and not make you feel more stressed up.

Caitlin Lopez: crosstalk teachers that I really, really love, Jackie crosstalk and Mary Beth LaRue. In their teaching, they talk about this concept of trying on. So they have a podcast called Rock Your Bliss, and it's more on this... Excuse me. It's more on this mindfulness journey. But I love the idea of trying on. There's something really valuable in finding community and talking about these things with your friends or... whether you join some sort of online community or something, because what might work for one person will not work for the other person. But then when we all share, it's like, "Oh yeah, I hate sitting quietly and meditating, but I can totally cook dinner and be focused on that."

Caitlin Lopez: So it's this idea of trying on different practices and seeing what works for us and what doesn't. There have been lots of things that I've tried that I've been like, "No." A guided meditation is not my jam at all. I am like, "Well, why are you talking so much? I just want to chill." But then there are times where a guided meditation is exactly what I need because my brain can't chill. So yeah, I like that idea of trying on different things and seeing what works for you and then being okay if something doesn't work for you and just letting that go.

Marisha: I love what you said about... because this has definitely been the case. When I first started exploring, meditation just felt like excruciating. Sometimes it works, sometimes it... Sometimes it feels great, sometimes it doesn't feel so great, and just meeting ourselves where we are and going from there, I think, is incredibly powerful. So yeah, I love this. And then you already mentioned the Insight Timer. I'll share links to these different resources in the show notes as well at SLPNow.com/39. So you mentioned Insight Timer, which is an-

Caitlin Lopez: Absolutely.

Marisha: ... app.

Caitlin Lopez: So if you-

Marisha: Do you have other-

Caitlin Lopez: ... are a teacher-

Marisha: ... meditation apps crosstalk that you would recommend in case people are interested in that?

Caitlin Lopez: ... I would definitely check them out. They are a favorite. I have lots of friends that are not teachers that pay for it. They are guided meditations and they're relatively short. But if you're a teacher, you just use your school email to sign up. They even have some for kids, which is really awesome. I haven't used them in therapy simply because they are a little bit longer than... You try it on if you think that works for you. I haven't tried it on yet. So that's a really good one. And then if you are interested, miniyogis.com is the kid's website or the kid's yoga website. YouTube is also really great. There are meditations on YouTube, there are tons of great yoga classes on YouTube, and that's free and so I would recommend that.

Caitlin Lopez: Another really popular meditation timer or meditation app is Headspace. Andy Puddicombe, I think, is the one who does that one. He has a really great accent and so that can be fun to listen to if you haven't done that already. I think they have like a 10 day free trial, which is like an intro to meditation that is pretty decent. I've done that one before, but I hadn't paid for it. They have a bunch of like class packs that you can pay for and get if you're interested in that. That's something that you try on and you like. Another website that has online yoga... it's an online yoga studio, it's glow.com. I think it's only 18 bucks a month, and they have tons of different world-class teachers that I have really enjoyed studying with, whether in person or through the website, tons and tons.

Caitlin Lopez: The cool thing about glow.com is that they also have different class times. So I know a lot of us are busy and we can't commit to the commute time to a yoga studio and then taking the full hour and a half class or whatever your local studio offers and then the commute time home. What's great about Glow is they have like five minute classes, 15 minute classes, an hour and a half classes. They have a lot of different class times that I have found really fun to do, and they have a bunch of different programs. Like I said, some of the teachers on there are amazing, amazing teachers. Like, Annie Carpenter is probably my all time favorite teacher and she has classes on there. So I would definitely check that out.

Caitlin Lopez: Again, you can try on... They have teachers from all different lineages and so it's kind of fun to try on some of those things and see what... the style you resonate with, if that's something you're interested in. And then I also have a blog at radiatekind.com, where I talk about a lot of different mindfulness activities and journal prompts and I put up affirmations and things like that that you can check out, and again, just simply try on and see what works for you and what doesn't. I'm looking to start some kind of conversation there as far as others helping each other out. I find community to be really, really helpful in this mindfulness journey. I've learned some things through friends who do different practices, some of them I don't necessarily resonate with, but then others are kind of fun to try on and see like, "Oh, that did work, or maybe if I tweak it this way, it works for me." So going to your local yoga studio is a really great way to build that community and to make friends who are in that same journey.

Marisha: Awesome. Thank you for all of those amazing resources. And then you're also putting together-

Caitlin Lopez: Yes, yes.

Marisha: ... a little-

Caitlin Lopez: I will put together-

Marisha: ... like a sheet with some ideas-

Caitlin Lopez: ... a bunch of different-

Marisha: ... for activities that we can use with kids too.

Caitlin Lopez: ... I recommend... With the list, I know that we talk about this a lot whenever you take CEUs is like you can't implement everything all right away. Sorry, excuse me. But maybe you try one thing a week or you try one thing with one group and you know that that absolutely won't work with another group. It's something simply to try on. It's not like they have to or you get like you have to do them all or whatever. It's just simply ideas that you can try and see what works for you, or maybe you tweak them and you make them work for you.

Marisha: Awesome. I'll link to all of those resources, again, at SLPNow.com/39, in case you want to check them out. Definitely keep us posted on what you end up trying and how it goes. We'd love to hear from you. And then Caitlin, thank you so much for sharing your stories-

Caitlin Lopez: Thank you.

Marisha: ... and amazing knowledge with us. I so appreciate you and thank you for your time.

Here we go. Hello there and welcome to The SLP Now Podcast. I am so incredibly excited to have Allison Cloutier here with us today. We've been getting some questions about therapy ideas for the younger students on our caseload and she is an amazing resource and before we dive into all of her questions, I just wanted to share a little bit of her experience.

So she has worked in a pediatric private practice setting since 2011 and she graduated from the University of New Hampshire with her Masters Degree in Speech Language Pathology and she also concentrated in early childhood and augmentative and alternative communication and she has some amazing resources.

She does a lot of education for parents and for people growing their private practice and childcare centers, all of the good stuff and she'll be able to do that description much more justice, but I'm really excited to talk to her today just to hear a little bit more about her experience and she is going to be sharing so many practical therapy ideas that we can use with the younger students on our caseload. So without further ado, here is Allison.

Thank you for having me here today.

Yeah. I am really excited to dive into this topic, but before we go into all of the amazing therapy tips and ideas, I'm really curious just to hear a little bit more about your background and just how you decided to focus working up with the younger population and just where you're at now and what you're up to.

Yeah, I think really looking back at just kind of who I am as a person, I have always been really interested in working with kids. I know I've spent most of my teenage years either babysitting or working in afterschool programs.

It's just really a population that I love to work with. I love their energy and just having fun and they're just so involved in everything that you're doing. It's just really a place that I love to be and when I was doing my graduate clinical placements, I was in all the different settings they have as try and when I was in the pediatric private practice setting, I also had the opportunity in that clinic placement to co-treat with an OT and I just found that I just loved the environment of having some more of that flexibility and I really loved the connection I was able to make with the parents in addition to the children being in that setting.

And I'm always has been ... I've always been very drawn to that play-based family-centered format and that setting really allowed me to do that. So I also found that when you're in that private practice setting, it kind of caters logistically to that younger population.

You have your early intervention kiddos and then you have kiddos who get picked up from the school district and then there's somewhere that in between where they've aged out of early intervention, but they might still be in like a daycare setting or parents haven't pursued the school district for services and so we kind of have that age in between where sometimes they're looking for supports without those resources.

So just logistically, I found that that age has fallen onto my caseload a lot. So other than that, it's really just my comfort level and I love playing with them and figuring out a way to take their goals in their knees and integrate it into a format that is really meaningful for them.

Yeah. I can totally relate. I'm definitely a school-based SLP at heart, but I did get to work in some clinics and grad school and I love the ... Because it's like a different level of collaboration when ... Because in the schools, we can collaborate with other professionals, but I don't know about you, but when I was in the clinic, I shared an office with several other physical therapists and occupational therapists like we had lunch together all the time.

And we saw our clients together sometimes. So it was just really cool, just an awesome opportunity to really collaborate and then I definitely saw that too in the ... The transition between early intervention and the schools and getting to work with those kids and they are definitely so much fun and I'm especially excited to talk to you about it today because I feel like for a lot of us, it's not our natural area of strength.

We feel a little bit overwhelmed with what to do and especially if we are in the schools and we're ... We primarily work with older students. I'm really excited for you to share your tried and true tips and tricks to help us gain a little bit of confidence.

Yeah, and I think as I've done a lot more education with parents or early childhood providers or even other speech pathologists, it's ... I wasn't as aware of how easy that play-based and that connecting comes to me and it's something I've had to remind myself that this is easy for me and it's a comfort level, but it's not for everyone else.

So I really had to take another perspective on that and that's really what's led me down the path of doing more education for other professionals as well is being able to take my knowledge and share that information in a way that's helpful in the same way that when I was asked to consult with a high school student, I was like, "Okay I can do that, but let me tap into some of my resources first." Just being able to share that expertise is really helpful within our field.

Yeah, I love that and because I know you've had a lot of experience with like connecting to and creating relationships with local daycares and preschools and doing that education with those providers and parents and everything. Can you tell us a little bit more about what that looks like and what you're doing there? Because I think that's a huge component of it too.

Yeah. I think one of the places we would start with there is that the private practice I work for is actually in the same plaza as a daycare. So we first built a relationship just with them and a lot of that was mostly for ease of the parents.

So we do either bill insurance or have cash pay. So we have a little bit of flexibility with the location of where we provide those services and what we found was for the parents whose children are in those daycare settings, they're usually full-time working parents.

So it was very helpful for us to be either onsite or be able to take that child. We would just walk across the sidewalk into our office. So we did one or the other. It was really helpful for those families to have that as a resource and then what we also found was that those teachers were so ... What's the word I'm looking for?

They so were, had such a desire to help those children that it was ... It created some really great conversations between myself in those childcare providers of how they could support that child within that setting.

So I would also then start to do some of my sessions in their daycare classrooms. So similar to what a push-in session would be and I was able to then be in their environment, their teachers could see how I was working with the child and then their peers also started to understand a little bit more as well.

If it was a child who had more significant needs, we could do a little bit of educating with the peers and so overall, I just found it was ... Became a really valuable resource to everybody that was involved and then of course, the parents, we would keep them updated.

I would write a note every day and if it was a parent that I didn't get to see face to face very often, we would have regularly scheduled phone calls just to kind of give them an update and answer any questions they would have and then I also found that as I worked with this age population that the parents were looking for the same thing at their centers.

So when I first started creating relationships with other centers in our area, a lot of it came from my client connections. So their parents would ask for either giving their teachers some tips or being able to provide services on site wherever their child was attending.

So I started to build a relationship by seeing certain children on site. I then became a familiar face. The teachers were familiar with me and the work that I did and I slowly started getting referrals from them and thus far, I would say that most of the majority of my referrals either come from word of mouth from an existing client or they come from those daycare centers where I have built a relationship with them.

And then another part that I found was as those teachers were trying to learn a little bit more about that child's specific needs, that I was giving a lot of education to them and so then by necessity and some need, I actually started creating workshops for those teachers and that then allowed me to share more in depth information, allow for asking and answering questions.

And then I was able to take that information and outreach to other daycares and preschools and then from there, it just kind of snowballed into just creating more relationships which helps them, it helps me, it helps the client and it's actually been a really wonderful thing.

Yeah, and that's so cool and I love ... One of the things that I struggled with a little bit working in private practice was that it felt like it was disconnected from the child's context because I just saw them 30 minutes twice a week or whatever it was [crosstalk 00:10:29] and I would like try and ... I would teach the parents strategies and they'd sit on the sessions and we do all that, but I love that you are working in those childcare centers or preschools, whatever they, whatever contexts those are and like that's their environment for a huge component of their young lives. So that's amazing. I love that you were able to find a way to get that context.

Yeah, and I found that I ... As I went in and I was just doing I called it speech and language therapy basics and I would talk about what was typical for each age as far as speech and language development goes, when you should refer a child, talking to parents about it, collaborating with other professionals, how do you know who to refer to based on what you're seeing.

And I would get so many questions from the childcare providers that they really are looking for what's best for those children and then it gave them really a gateway to talk to the parents with confidence as well and then sends them to someone who could then really do the evaluation and take on that information. So it does, it's been a way that's really created a great collaboration between everyone.

Yeah, I love that. That makes a lot of sense and thanks for giving us a little bit of insight there and then I'd love to get into the therapy side of things. So in your Biodynamic, you mentioned play-based approached for therapy and I think that's what we hear a lot of when we're talking about intervention for those younger students and I'm curious if you could share a little bit of what that looks like for you and any tips that you'd be willing to share just to like help us kind of ... If we are feeling like we're struggling with that, what could we do to set us, set ourselves up for success?

Yeah, I have a few kind of different thoughts and tips here. So the first I tend to do is just really figure out what motivates that child and typically at the onset for me it's ... Well, I mean, I guess it would be for most therapies, but really for those younger ones is really building that rapport with them.

So I often ask parents or teachers if that child has a specific topic or interest or characters or things that they like and I will try to integrate that into our initial session.

Just really trying to create that positive environment for them and one thing too. It takes a lot of self-awareness which I think is a little bit tricky sometimes is really when you're building that rapport to get to that Playbase level is really gauging where the child's at in their energy levels.

So I always like to have some kind of movement with my younger kiddos, but some kids, if they're a little bit anxious, if I'm super excited, it might be a little intimidating to them or if they're a child who moves around a lot and needs a lot of input and I am really quiet, then sometimes, they don't connect to me as well.

So it's kind of having to morph a little bit more into their comfort zone just so you can get into a place that the work that you're doing will be really receptive from them. So one of the first suggestions to beyond that is definitely that movement piece I found for this age.

It's just so important for them to be learning through movement and I do some really simple things just like ... Even just crawling through a tunnel. In my office, I do a lot of hide and seek, so whether it be little figurines or puzzle pieces or pictures or cards and I'll place them around my room and of course when they're younger, I don't really hide them necessarily, but they're just placed in different areas and they get to go collect them and bring them back to me. I have a lot of things with sensory input. I don't know if you've ever ... Have you ever heard of a Yogibo before?

I haven't.

Okay. It's like a massive beanbag basically and they're a little pricey, but in my book, I use it almost every single day, so it's been well worth it. They're kind of like a massive beanbag, but they have little tiny beads inside and you can take that outside zipper off to wash it when you need to which is wonderful, but I use it for letting kids run and jump on top of it.

I might squish them up inside of it. I do a lot of singing songs where I like will rock the Yogibo back and forth. So they're getting some movement and some input, but they're in a safe space as well.

So I guess those would be my first points would be that find out what motivates them and really get on their level to build that rapport, gauge where your energy level is compared to the child and then adding in a lot of movement for them if that's what works well for them.

Yeah, that's perfect and I definitely want to check out a Yogibo now. That sounds amazing.

They're really comfortable to sit on yourself if you're writing reports too when children aren't in your office.

Oh, I love it. Yeah, I used to have a, just a cheap beanbag. I don't even remember. I might've gotten it from a teacher or something, but it was super fun to use in therapy, but the massive beanbag seems even more amazing and you can wash it.

Yes.

And I know that wasn't the highlight, but ...

It is [crosstalk 00:16:13] actually for most therapists and parents and we'll even do like I'll have them sit in a cube chair or on a circle square so they know their space and I'll even sometimes take like a Buffalo drum and as they run, I go like do, do, do, do, do, do boom and as they jump and they just think it's absolutely hilarious. So I do have some more tips there too, but I just didn't want to get too far ahead of myself in answering your question, so.

No, this is perfect. Keep on rolling.

Okay. So another thing I do a lot of is that imaginative play. So I will have a lot of materials and have them more like acting out and playing with figurines and moving the pieces around because of course, if you're looking at or like three and four year olds specifically, some kids will sit and do more drill work with you, but a lot of them, we'll do that just for a moment and then it's not meaningful to them.

So I'll find ways, I actually have little bags that I call sound bags and I'll have them labeled with ... I have all the vowels and I have like beginning constant sounds and just as I'm going to little thrift stores or things that my own daughter has, if I see like a little figurine that has that sound in it somewhere, I'll add it into my sound bag.

And then I'll use those either for the hide and seek or digging in a bean bucket or sticking them into Play-Doh and we pull them out and then I use that to address the sounds and it's great because then you don't have to be constantly brainstorming for a session.

Does this game, does this activity actually target what we need? But it is a way that you can easily integrate those into play-based therapy. So then you can use them in multiple context as well.

And then another thing I do a lot of is books of course. So I have an endless supply of books for kiddos and we do different sounds or whether it just be engagement or we talk about the pictures, having them do repetition and I think there's just so many different ways that I can use those books in therapy with those kiddos as well.

Yeah, that sounds great and I'm a huge fan of using books in therapy. We could go on and on about that. Awesome. So just a quick recap, finding out what motivates a student and you can, or the child and parents and daycare providers and all that are a great resource for that.

Gauging the child's energy and matching that, like getting on their level, incorporating movement, imaginative play, using books, is there anything else that you would add or like any favorite therapy materials along those lines?

Yeah, I would also say anything that adds that element of surprise is typically highly motivating at this age. So I do a lot of really simple like hiding something under a little blanket and we do either the peekaboo or we're trying to say like, "Oh, what is it? Oh, look what we found inside."

A lot of element of surprise. I do a lot too of having like a box or a bag where I put something inside and just try to get their engagement that way and then also really getting comfortable with being a little bit silly because that's how really to get some of these kiddos to be engaged especially if we're looking for already three or four or even five, but we're on a developmental delayed pattern of some sort.

We sometimes are needing to backtrack really that engagement piece so that element of surprise typically keeps them engaged much more. I also have this little pig puppet, but he eats different things.

So I'll do a lot of the pig puppet will hide and we have to ask for him and then when he eats something, he does a little bit of tickling. So using that same sensory piece to engage them as well and if you have a space that allows you to explore different sensory experiences without making too much of a mess, I would say that that's another way I often engage these younger kiddos as well.

I do also have access to a swing in my office, so that typically has been a really great resource for me as well adding in that movement, that engagement piece. It's really easy to do when you have access to something like a swing.

As far as some of my specific favorite like actual activities that you could or gains you could buy for this age, I really love, if you haven't heard of the company that they're called Fat Brain Toys.

They create a lot of really ... They're simple, well, the younger ones, they're very simple like cause and effect, but they're not all musical and lights and everything. So one I really love is called the SpinAgain and it's kind of like plastic gears that you put one on top of like a plastic pole and it just spins all the way down.

So it's a really quick cause and effect, but kids really seem to love watching the spinning. They also make one called Dimpl Duo and it's like silicone poppers so you'd have like a tray. It's kind of hard to explain without seeing it, but it has like a tray with six different colored like silicone ovals, but when you push it, it pops through and then you can just flip the board over and you can pop them back through the other way.

So my kids really enjoy that one. I love another company I really enjoy is they're called Blue Orange. I'm not sure if you've heard of them. They have like the Spot It Jr. and Telltale. Those are two of my favorite.

They're just a little round tin and they have picture cards inside of them and this would be for the older end of that young population or into early elementary. Spot It Jr. is where you have animals and there's a match.

So every card has one animal that matches on the other card. So you can flip them over and then they're scanning. They have to find the match and then they name it and then typically, I expand on that and we either talk about that and well, depending on what their goals are, we either describe the animal, we talk about what it does, or I'll be like, "Oh, that's a fish. It swims. What's another animal that swims?"

So we're able to expand on that language with those games. I wrote down some notes for myself and I had mentioned the Yogibo, but we already talked about that and then one that I have to mention I really love it is again for a little bit older because it has some small parts, but it's called Enchanted Cupcake Party and it's like little ... They're all princess themed, but they're little cupcakes and there's a cup, a cake, a frosting, and a topper.

And I've used it for working on lots of different sounds. I most often do it for sequencing for kids. So whether they are receptively listening to my directions as I'm describing or I have them expressively described to me when it is that I'm supposed to be making.

And then once we're done, we like go through the whole sequence again. Then we do a little bit of pretend play, putting it in an oven, taking it out. Sometimes we'll make like a little shock with it. So that's like one activity that you can do a lot of different levels of play with and then one thing, whenever I have a graduate student with me who's learning, I give them this very specific challenge.

So it's something I think that would be fun for your listeners to try as well. So I challenge them to take like one theme box. So I have a lot of plastic boxes that I put like a bunch of materials that are under one specific theme and I tell them that they have to use that box for all of the clients that we're seeing.

So it really makes you try to take like one group of materials and figure out how would this target receptive language, expressive language, speech sounds, engagement, social pragmatics and it's really getting ... You're used to looking at materials in a different way. So that's a fun way to kind of take what you have in thinking about how you could use it in different ways.

Ooh, I love that idea and we're going to ... We are going to get to do a little bit of that in just a moment ...

Yes.

Which is super exciting.

So I think, I'm sure once we're off, I will probably think about all kinds of other ones that are my favorite for this age, but I was really trying to think about ones that were a little different.

Of course, I always have like a baby doll and stuffed animals in the typical toys you would think for that age, but those are a few that are a little less common that I thought listeners would enjoy to have as resources.

Yeah, and I always use ... A lot of the ones you listed are new to me. I don't think I've used Fat Brain Toys. I have used the Blue Orange like Spot it Jr. and Telltale, the Enchanted Cupcake Party sounds amazing.

It is and it's hard because it does have ... The pieces are fairly small so it's not really for super young kiddos, but the kids, I can tell you, they just ... They love building them. They love talking about them, they love telling stories to pretend play.

It's definitely a very versatile toy at my office and that one actually stays. It doesn't leave because it can be used in so many different ways.

Yeah, I love that. And I definitely use lots of baby dolls, stuffed animals, the play house and the play farm are big ones, all the Fisher-Price stuff.

Yes.

And then I can't remember what it's called but I love the, I don't even know ... I know it's at Target but it's like a ... I don't know, it's kind of like a jail.

Oh, the one with the keys?

Yeah, it has all the different doors and then they have to match the keys with the shape and the color and you can put ... I think it probably ... Yeah.

I think it's like an animal hospital or like animal critter hospital.

Yeah. I think critter is the name.

Critter, yes because I use that one too.

I think it's amazing for ... To target so many of the goals that we talked about like describing, following directions. You can use it for articulation. If you have your little small figurines, you could put ... You could just pick whatever or categories and just grabbing whatever items we have, but that was one that was huge.

Yeah, I have that one too and what's great about it is that's one where like the product itself is just one thing, but you can always change what's inside to match the season or match a theme so kids continually enjoy.

One thing my kids, my younger ones that they really love in that one is putting a lot of windup toys so they get to open it and then we have a windup toy. I actually thought of two more too.

So another Fat Brain Toy is called Squigz. They are, picture like little builders that would have a suction cup on them. So my daughter right now, she's 20 months old and she'll take it and she'll like push it on the table and then when you pull it up, it makes like a pop sound.

And there's another one I'll put around the room, I'll go stick it on different surfaces and they'll get to go and kind of pull them off and pop them and then another great activity for this age and of course, I love like a lot of the themes are really great, but it's also fun to have those open-ended toys. So similar to the critter. There's one called Tot Tube. Have you ever heard of a Tot Tube before?

I haven't.

okay. So it's basically like a long plastic tube, but what's nice about it is it breaks into three separate parts. So you can put it in a box that comes in and store it away when you don't need it and so it's kind of ... It's like three plastic pieces and you put them together, but the middle is clear, you can see through it.

So I've used this for kids if we're just putting cars or balls that roll like down them and we do ready, set, go, car in, blue car, car go, all those simple combinations, but I've also found that since it's a really smooth plastic, if I have any kind of plastic figurines, recently, I was just doing an Arctic animal theme so I had little plastic Arctic animals and if you put that in the top, it slid right down.

So it went, it doesn't have to be something that rolls or has wheels. A lot of things would get sent down there. I've also used the Tot Tube with a little bit older kiddos where I have ping pong balls and I draw either letters or words on them so we get to send something down and then either name the letter, tell me what sound it makes, give me a rhyming word or reading like all of those things.

So it's a fun way just to add another element of movement and engagement with those different goals and then what I like about the middle part being clear plastic is when I've had really younger ones where we're really just working on initiating or basic signing or basic speech.

I will put something in there and then I'll hold it so they can like see it kind of floating in the middle and then I wait for whatever word it is that we're using, whether it just be vocalizing or out or please or ball or my turn or whatever it is that I'm using as a target. I'll wait for that and then I can dump it out and then they get to receive whatever it was that was inside.

Yeah, I love that. Yeah, I've never had the Tot Tube, but I used, I mean this sounds way better because you can manipulate it a little more to have more control over the ... Just set up opportunities, maybe manipulate a negative connotation, but we ... We're very strategic in how we set things up.

Some of our kids aren't super excited to communicate so we're setting up those opportunities, but I always use a ball track.

Yes.

And that was, I would use it for that purpose too and that was super fun, but the Tot Tube we can use all different figurines and have five bazillion more options which is ...

Yes, and that's what ... So as a product, but it does leave, it has a specified use, but it leaves a little bit more open-ended flexibility depending on what you want to use with it.

Yeah, and those like especially with limited budgets, we want those kinds of choice where we can get lots and lots of bang for our buck and use them over and over and still have it be like fun and engaging and all that.

I think the Tot Tube, I haven't listed on my website with a link to Amazon, but I'm trying to ... I think it's around $30 I think which ... I had someone that was like, "Oh, but you can buy a plastic tube for a lot cheaper."

I was like, "Yes, but this one has the clear middle and it packs in a box nice and neat." So those two to me are worth spending the money on.

I just looked at that, then it's like 19.95.

Okay. [crosstalk 00:32:40]

Right now, so it could definitely change, but yeah, it looks so fun.

It is.

I'll also link to it in the show notes, but yeah, I love it. I want to go work in with these kiddos again.

Yeah, I know [crosstalk 00:32:58]

This is so fun.

It is a lot of fun, but it sometimes, I work with middle schoolers right now, two days a week too and I'm like, "Oh my energy level is a lot different at the end of the day when I'm not trying to run around and play too."

Yeah, play is tiring sometimes.

Yeah, [crosstalk 00:33:17]

But it's a whole different challenge with the older [crosstalk 00:33:21].

Yes, it is, but I think it's more like because you're taking their, what their needs are and trying to integrate it, that's really how Playbase therapy becomes the most effective. So you have to be a little bit on top of your game while you're playing with them.

Mm-hmm (affirmative). And you never know how a kid is going to show up.

Correct.

[crosstalk 00:33:43] activity and then they show up in a mood and then it's like, "Oh wait, nope, let's rethink this whole thing." So you're making teeny-tiny decisions like all day long every minute of your session."

Yeah, I have a ...

Which is [crosstalk 00:33:58]

I have a two year old right now who has very minimal words and I'm like, "Oh yes, he's going to love this." And then I show up and he's like, "No." And I'm like, "Oh man, I was, I thought for sure I had a home run."

So yeah, that would be another suggestion I get, I guess is really having some backups too and being flexible because like you said, they could show up in a mood or they might not be interested.

So really playing with that flexibility because if you're just trying to push the same thing like then you're just going to likely frustrate them and then that gets nobody anywhere, so.

Yeah, we don't want to end up in a battle with a three year old.

You do not because you will most likely lose it.

They are very determined. I love this. And then so our plan is to go through a specific theme and just talk about how we can use different materials, but I'm curious too, because I know when I was first starting out with this population, I was like, "I don't even know what's appropriate to target."

Could you throw out just a handful of goals that you find yourself ... Goals or areas that you find yourself targeting a lot? What are or maybe we can start with, well, articulation I think is pretty simple, right?

Straightforward.

We can easily determine that and not simple, straightforward is a better word. Thank you. But what types of like for receptive language skills are you often working on?

Yeah, as far as receptive language, it's a lot of I would say identifying vocabulary which is another reason why to have a lot of those figurines as you can, and I have a lot of them, but it's taken me time, overtime to kind of build up that.

I don't suggest necessarily going out and spending a ton of money because we have so many resources in our world of kiddos who no longer play with things and they get sold at yard sales and now I guess on online avenues fairly easily.

But yeah, I would say it's a lot of basic identifying, but I prefer to have that be for actual items versus necessarily like pictures and then a lot of really simple following directions and a lot of those will be for routines versus novel.

So I would say at this age, there's not a ton of novel directions. It's more basic routine-based directions. So like put on our shoes, where's your coat? Be kind to the doggy, working on all of those things within our session as far as receptively goes and then also a lot of responding to their name and joint attention.

So joint attention kind of crosses that receptive, expressive boundary, but usually at this age when I have kiddos coming to me with more receptive things, we really have to work on that joint attention and being engaged and a lot of imitation as well too.

So imitation really is our foundation for learning, right? If you're typically developing children or children who are in speech therapy, a lot of the ways they learn both speech and language is that I say or do something you say or do something.

So there's that imitation piece. I once had a little one, I think he came to me at 19 months old and he had no words and he actually even had very minimal babbling and as I evaluated him, what one of our goals ended up being was just play imitation because I said we have our gross motor and then our fine motor and speech is really ... It's a finally complex fine motor task, but he wasn't even imitating like gross motor play.

So we had to go backtrack a little bit and if I would build up some blocks and knock them down, he wouldn't try to not ... He wouldn't try to do the same. So we really had to integrate imitation in there.

So that's something I definitely look for and when I'm working with younger kiddos and that becomes almost like a precursor goal that I work on a lot before we're actually saying like, "Oh I say ball, I expect you to say ball." Does that answer most of your question there as far as some of that receptive piece?

Yeah, and that just sparked a memory that I have. I haven't looked into the research on this in a while so definitely check it first, but because I love how you mentioned that you're using like the play imitation gross motor actions to be able to roll that into the speech kind of sound imitation pieces.

There's actually like a manual that breaks that process down and I think it's based ... It comes from the ABA world, but it's rapid motor imitation antecedent training. I just dabbled using that with some of my ... I worked in a autism preschool for a couple of years and that was something that I started trying towards the end of my time and it was just really cool to see because the concept is like you kind of build that behavioral progression and do like a bunch of more gross motor kind of imitations and then it was amazing how it actually works. So you got them falling that pattern and then they ... It was easier for them to imitate some of the [crosstalk 00:39:53].

Yeah, and I see that too in my ... Yeah, I see too in my conversation with an occupational therapist that I often we refer clients back and forth is she'll do the same, but like from a motor planning perspective.

So for her, it's building like motor sequences in a way that kind of sets the stage for creating more motor sequences. So that starts getting out of my realm of expertise as far as where that ... Actually, the precursor and the foundations behind that where her and I kind of cross paths with a lot of those kiddos who aren't talking at all like for questioning some motor planning where she works on it from one perspective and I work on it from another perspective and it seems to help them.

Yeah, and I think it's just that momentum plays a role too. I even had that, I'm thinking back because I worked in a clinic, I don't even ... It wasn't that long ago. I am the worst historian though, but I ended up using that strategy with some of my students who were just, I guess maybe resistant.

I felt like they were just kind of shy and they were really ... They knew that communication was hard so I think they just tried to avoid it, but if I combine those motor actions with it, then they just ... If we make our arms super big or we jump and we do all these things, then they're like having fun and we're doing it and then if I do the movement and pair it with a sound, then they [crosstalk 00:41:38] beautifully, but if I just have them say like, even just like ooh, if I just say ooh, and then they say nothing, but if I move my arms and do it, then they do it. It's so funny.

[crosstalk 00:41:49] there's a lot of research about motor and speech together and we obviously, won't get into all of that now, but even for adults they talk about when you're learning, if you're doing some kind of movement like either walking on a treadmill or something that it actually stores the information further. So in a place where the younger kiddos do, but we would have to find the specific research and steps to do that effectively.

Brush that part of our brain.

Yeah, and then I think that expressively is pretty simple. A lot of my kiddos at that age, they have some kind of delayed language or delayed speech. So most common in that preschool age I get initiating and then if we're supposed to be doing two word utterances and we're only doing one, building the length of utterance or if we're at a two word stage and we're supposed to be talking in three to four.

So really building the utterance length. I do a lot of social stuff with kids this age from an expressive standpoint because like you said, if there's a barrier to language or speech, we see a lot of them kind of shut down a little bit.

So getting them to learn how to effectively communicate. I teach a lot of sign language at this age. We're kind of talking about the more involved kiddos. I do have some preschool kids where that stuff is fairly intact and we're working on a lot of sequencing, storytelling, seeing the beginning of some executive function stuff, but at an earlier level. I would say the majority of them though would cover those basis when I'm working with them.

Yeah, that's super helpful and it just kind of helps kind of frame our reference point as we start diving into the theme-based ideas. So do you think we're ready for that or is there something else? Okay.

So we talked about, we chatted a little before we went live, but we decided to go through a zoo theme. So I'm curious, let's say that you're planning to use the zoo theme next week, what would you do to set that up and kind of prepare?

Yes, so I have ... I found these plastic storage boxes that have handles on them and they are like the best thing ever. Maybe that's even a resource, I could send you that would be helpful to speech pathologist because then I can carry them around to different places, but what I do for my zoo theme, my zoo-like Safari theme, another actually great thing for this age are the poker dot books.

So again, that same physical, that pop, that cause and effect. So I grab, I have a polka dot Safari and then I grab some of my more classic books like Goodnight Gorilla, Dear Zoo, Polar Bear, Polar Bear, all of those and then I gather any of figurines I have.

So I have little people zoo animals. I have a couple of puppets, an old Beanie Babies stuffed animals and then any dress up that I have so right now in my Safari zoo box I have like a vest and binoculars.

Binoculars, they love to do the pretend play with binoculars and like a flashlight that they can shine on the animals and then I always have just some songs I tucked away that I enjoy. For this one, I specifically like ... There's a song, oh, I changed it to Down in the Jungle. I forget ... Actually, Down in the Jungle might be the original version.

I can't remember, but you can look up lots of songs, of course, but I like Down in the Jungle and then there is one that just talks about all different animals that are in the jungle and does some describing for them.

So I typically gather all those materials. Now, I've been working for so many years. I don't even really think about each child. I just bring the box with me and then I kind of ... When we start a session, I'm able to open it up and pull out the different things and use things like blankets or the hiding or the Tot Tube or surprise boxes that I just use those materials within those types of settings.

Yeah, I love that and then I think ... So we've got our materials organized and I love that you mentioned a specific storage box because that's definitely my thing. So we have this zoo like Safari theme box, we've got all of our materials.

Let's talk a little bit about maybe like some hypothetical therapy plans. So maybe we can pick like a couple of different types of students and how we could use the different materials. Do you have a student in mind that would be a good one to start with?

Let me think. Yes. Maybe if we had a child who was even ... Okay, so say we talk about some basic signing or one word utterances with our beginning sounds so more, please, all done, pop, boo, et cetera.

So these would be I would have singing songs with the puppets and then hiding them or doing the peekaboo with the different animals. Like I mentioned earlier, having the figurines and putting them in a bean bucket. So I sometimes will put like the cover on top of the bucket and wait for them to sign more or please or play and then we open it up and then when we find the animals, I do a lot of animal sounds so that like you've mentioned, that imitation and there's a lot of vowel sound, a lot of beginning sounds in there and I will simplify a lot of those too to just the vowel versus like the whole word if it's needed.

So basically, just using those themes more as like the motivators I guess for those simple structures for the kiddos we're working on really basic language and then I'm trying to think if we get to more preschool age.

I do a lot of taking turns, following directions like describing the animals, like what do they like to eat, what parts do they have? We go through a lot like that ... I forgot the name of it. There's like a visual checklist of like who, what, where parts name.

You go through all the different things like the different language to describe them and then that's another thing where the hide and seek comes into play because sometimes I actually will hide it and I'll say, "Oh, it's somewhere under a blue chair." And give them those prepositions, those items around the room for some following directions.

And then the opposite, I'll let them hide it and have to give me the direction of where to find it. Giving clues. If they have something hidden in a box or a bag, they can describe it to you.

If you have to guess it. I'm trying to think. I kind of jumped from your younger age to the preschool age there and then any of the stories. So you can always do a story retell. I do a lot of fill in the blank with stories so if it's repetitive, I will read the beginning of the phrase and leave off the end and have them do some of those closed phrases, those fill in the blanks.

And then a lot of those books like with the animals are so engaging so like Polar Bear, Polar Bear. I do a lot of like, "What does he hear?" And then we turn it and we say the animal and like it makes them all excited.

And then also for that preschool age, as I mentioned earlier, the flashlight or the binoculars, kids absolutely love to do this. So if you put the animals either around your room or like in a make a zoo, like a pretend zoo where they're in like their cages or whatever, having them either search through the binoculars to see what they can find or shining a flashlight on them before they tell you the animal's name and describe what it looks like to them. To cover it all, I [inaudible 00:49:56] get off on a little bit of a tangent there.

I love those ideas. No, that's perfect and I think it's ... I know it's so hard. I always travel with, because I love to give like concrete examples, but if ... It's so much easier to think of activities when you know like, "Okay, I'm seeing Johnny. This is what we did last time, this is what he's working on." You can really see that child and it's harder to come up with these [crosstalk 00:50:23]

... I do for this age like you mentioned earlier, a lot of naming, describing propositional phrases like following basic directions. So even though it's not really a here's the child, here's what we worked on. I feel like most of them would cover those bases somewhere. So hopefully, that would be some helpful information to just spark some ideas.

Yeah, and for the earlier communicators. There won't be as much of that, as much of the talking, but all if these things can be turned into a game and like play is that ... Those students or it is still for preschool too, but that's how they learn and so there's ... Yeah, we can totally set up the activity to elicit the signs or the one word phrases or whatever we're trying to target.

We can just be like you said, the bean bucket and the binoculars could be fun too or like even, I don't know if you ever do this, but when I was in the preschool, we had a lot of songs and the teacher just had the CD, but I found them on YouTube too.

So maybe it's not like perfect for like we want to limit screen time, but that can be like a fun occasional activity because they'll definitely request more and like [crosstalk 00:51:54]

Yeah, and music is so motivating for this [crosstalk 00:51:57] even more into the session is another way just to reinforce what you're working on.

Mm-hmm (affirmative). Yeah. And then so I think a huge component of like what we're doing with these ... Well, in any type of therapy is being able to have the students continue like practicing the skills when they get home.

So I'm curious if we're using the zoo theme example, what would you, and maybe we can focus on the early communicator and the preschooler and kind of brainstorm a couple of quick ideas on how we would communicate what we did to parents and how we might be able to encourage them to carry some of that into ...

Yeah. I do, of course in private practice, I have access to speak to those parents so a lot of them will sit in on my sessions or I'll give them a very specific task of like, "Oh, they really loved playing ... Putting the monkeys and elephants and snakes down a slide or something."

And encourage that they take the one piece that was really motivating. When it's at school, you don't have that direct access, but sometimes, I'll write notes home to the parents or send a quick email.

So one of the biggest things I would say too is just really to start with those books and it's easy to get books from the library if we don't own the one that we're using and really just pointing out to them that, "Oh, I use the ..." "Oh, oh, oh on every single page."

Or really, I was just looking for them to like I would hold it until they gave me eye contact and then I would turn it. So really just picking one piece that targets that goal, but that would be easy for parents to carry over.

I think when you give them too much information, it's a little overwhelming and also encouraging them to do that pretend play, but I found that a lot of parents have a ... Not a lot of them, but when they aren't being models what I'm doing, they have a harder time kind of conceptualizing that.

So just really being as detailed as you can for them to take what you're doing and really encouraging them that here's the simplified version. We're not going, "I'm a monkey." We're just saying, "Ooh, ooh."

Encouraging them the simplified version is a step in the direction that we want to go, but at that child's level and kind of giving them the confidence to just start with something small based on what you're doing.

Yeah. I love that and that's so much more feasible and like they're more likely to remember that. I sometimes go ... This is a little tangent, but sometimes I'll go to physical therapy and she'll give me like five exercises to do and it's like, "Oh." Especially as ... Yeah, if you're a parent and you have a kid with special needs, plus probably multiple kids and a job and all these things going on, I think like really small specific things are so incredibly helpful [crosstalk 00:55:13]

... And then more likely to carry over one small task than to disregard five of them so I would rather they have one tangible piece of information that's actually going to be implemented than being overwhelmed.

Yeah, I love that and the examples you gave were perfect. Yeah, I love that, like if the child is working on drawing attention, maybe we can work on making eye contact or a precursor skill. We'll work on eye contact [crosstalk 00:55:45]

... rather than doing the whole book and then be like, "So what is it about?" Breaking it down for them. Yeah.

yeah. It's so good. I love it and that's totally doable. It's easy for us to ... We can easily think of one activity, especially if it's something that the student was especially engaged in.

That easily stands out and it's easy for the parents to implement too. I love those tips. So helpful. Okay, so I feel like we've got some good ideas going on here. [crosstalk 00:56:25]

Yeah, I mean, I'm just really hoping that [crosstalk 00:56:23] information just to even inspire people to kind of think a little differently about the materials they have and as I mentioned before, I can send you over my website where I have actually some Amazon links to a lot of the games and activities I mentioned and then also, there's a whole bunch on there that I didn't necessarily mention specifically, but are definitely some of my favorite. So maybe I can send that over to you so your listeners can browse through if it's something that they're interested in looking at.

Yeah, I would love that. That is perfect. So I'll put that link in the show notes. So that will be at slpnow.com/38 and then Allison, what would be ... If SLPs are wanting to learn more about working with early childhood or just [crosstalk 00:57:22]

Yeah, I do have my website which is allisonpcloutier.com and actually, you can probably link that as well so I won't have to spell my whole name there and I do have some trainings for speech pathologists.

They're up on there and now, I'm working on creating a more streamlined process for those, but people could certainly reach out to me and we could talk about it and that actually is including a lot of the content from my presentations that I give and encouraging everyone how to build those relationships with daycares and preschools.

So there's information on running the therapy, but also how to do that if it's something you're interested in and I also have a little bit of one-on-one coaching too that if someone feels like they want some specific feedback and ideas, they could do that.

And then you and I together have been working on some of those themes, ideas where people would have access to using those themes and kind of have it all compiled for them together. So I'm happy to have people send me emails to ask questions, to check out those as resources or within your system to take kind of that knowledge of the thematic units and apply them as needed.

I love it and amazing resources, so excited that people will get to find out more about you and what you do and I so appreciate your time [crosstalk 00:58:58]

Thank you for having me.

Thank you so much for sharing all of these amazing tips and tricks. I'm definitely super grateful. So thank you.

Hi there, and welcome to the SLP now podcast. Today we are diving into all things literacy based therapy, with a focus on older students. So, in episode four, I talked about how to use books in therapy. I talked about the five step therapy framework that I use, and we did include some ideas for older students in that episode. But we've gotten several requests to really dive into how to use this with older students, so that's what we're doing. It's still the same model. I'll still be going over that, but I'll be focusing exclusively on ideas for older students. And when I think of older students, we move away from picture books, which was a large focus of the episode for presentation. But once students start to get a little bit older, we'll move to texts that are not picture books. They're typically articles.

ReadWorks is my favorite source for those articles. But we'll talk more about that in just a moment. But the literacy based therapy model works best with fiction texts, because then those are an actual story. So, I will use that until my students have a really strong grasp on story grammar. There are so many benefits. Check out my narrative presentation if you want to know more about that, I'll link that in the show notes. So, there are some amazing benefits to teaching story grammar, which is why I use the fiction articles as long as I do. We definitely want to target nonfiction, and I will make that clinical judgment in deciding what is most appropriate for my students, and you'll be able to do the same.

But I really like to use those fiction articles as long as students don't have a very strong grasp on their narrative skills, just because of the broad impact that that has. Once they're doing well with that, I do want to move on. I'm not just going to stick with story grammar, fiction texts, just because I like them. I feel like nonfiction texts are a step up. The syntax is more complex, and the students will really need to be able to read to learn, and a lot of the things that they're learning are nonfiction concepts in social studies and science and all those different subjects. So, that's what we want to jump to once they have the prerequisite skills. And this definitely is not set in stone. That's just what I've seen from my clinical experience. So, that's what we've got.

So, with older students, we're focusing on articles. I'll tell you how to select those articles in just a moment. And then I typically like to start with fiction articles and then move to nonfiction as they demonstrate those skills. So, that's what we've got. And then just taking a step back to, why even use literacy-based therapy. Studies document improved outcomes compared to other approaches. Though, there's receptive vocabulary, expressive vocabulary, narratives, so many different benefits. I'll share some of the citations, and you can definitely email me if you'd like more. And then there was a really cool study by Gillam, Gillam, and Reece in 2012. They provided small group interventions three times a week over six weeks, which is probably a little bit more intensive than we typically do with our students, but it's not so far off. But the purpose of the study was to evaluate narrative intervention that's contextualized or literacy based, versus decontextualized, like using games, drill cards, those kinds of things. And they looked at vocabulary, sentence complexity, social language.

So, these are a lot of the goals that we're working on with our older students. So, they found that students' comprehension and story retell generation skills improve more with that contextualized intervention. And so, contextualized intervention is what this whole approach is about. The framework includes some decontextualized practice. There are some things that are a little more drill based, but they're still based overall on a more meaningful context than just rehearsing those past tense verbs. We are going to do some of that, but we're using targets that are relevant and applicable and that will be used in different steps. So, we'll dive into more of the nitty gritty behind that. But I just wanted to put this out there, because I know we are short on time;we are overwhelmed; there's a lot going on. Why would you invest in trying a new approach if what you're doing feels like it's working?

And so, I just wanted to share that study because it shows the potential benefits that we can see by implementing that kind of approach. So, it could benefit our students, and I'm willing to try anything that will benefit my students. And there's also some other benefits to this as well. Over the years I've built my framework, and I have some really simple materials that I have set up, and I'm able to tackle pretty much any text that comes my way. And I can make it work really well. Having that framework and just that structure to a unit makes it really easy to plan for therapy. It makes it predictable for our students. It gives our students enough exposure to a target in a variety of meaningful ways, whether we're looking at vocabulary, or grammar, or comprehension. It just is set up in a very strategic way that allows our students to make some really nice progress in a meaningful context, which can help with that generalization.

We could potentially make this work if we grab a deck of verbs to work on irregular past tense verbs, I guess we could shape that into the larger context by creating a story using those cards. But it's not as meaningful as pulling the verbs from a story and practicing those targets and then using those verbs to retell the story and then creating a parallel story. And we'll dive into all of the specifics of that in just a moment too. I'm alluding to a lot here. But we can work on past tense verbs and sentence construction and specific vocabulary words and all of that, and then we can shape that into retelling a story, and using those targets in a very meaningful way. And I don't know about you, but my ultimate goal is to be therapeutic in a functional context. I want to be able to teach students the language that they need to participate in the classroom and be successful. And yes, that's the ultimate goal. There's a quote by Gillam and Ukrainetz, 2006, that's a really helpful, and I'm just going to read this off for a second.

So our primary goal with literature based language intervention is not to teach students to read. So, we're not doing literacy, we're doing literature based language intervention. Sorry, that was unquoted there, but quote, “Our goal is to improve the many aspects of language, vocabulary, knowledge, grammatical acceptability, grammatical complexity, pragmatic awareness, phonological awareness, conversation, narration.” That's a lot of skills. That quote influenced the ability to participate in and profit from instruction in the general education classrooms. So, I know that was a lot, but we are giving this really meaningful context to target all of those different skills. I really feel, and I'm not the only one, but we can target pretty much any goal. And if you have any questions, if you're like, “I don't think I can target this goal using literacy based therapy unit,” send me a message, and definitely let me know. Because I'd love to brainstorm with you, because it's just such a meaningful context.

I haven't come across a goal that I can't target in that way. And articulation, when we're at the beginning levels, I want to target that separately if at all possible. But we can still make it work if we need to. And there are different goal areas like that where we just want to get some really structured practice just based on the research. But for all the vocabulary, grammar, pragmatics, social language, phonological awareness, all of those different things, we can really target those very, very effectively using narratives. And this is totally possible. It doesn't have to be a huge headache. It doesn't have to be a huge overwhelm. We're going to break this down in a way that makes a lot of sense. And I've talked to so many SLPs who have started implementing this, and so I've gotten a lot of their questions and their feedback. And so, I've heard a lot, and hopefully I'll be able to share all the different tips and strategies that will help set you up for success.

And I talk about this all the time. So, if there are certain areas that you're not sure about, I'm sure I have blog posts and other podcasts episodes and additional courses that can help break this down even more. But my goal is for this to be a really good starting point. And then I know, if you're feeling like, “Okay, well I read the book, and I don't know what else there is to do,” or, “I spend one session on the unit, and we're good to go,” for me, and we'll talk more about timing as we go through, but these units can last a month. You can spend several therapy sessions really diving into all of these elements and still be fun, and engaging, and have your students experience success and progress and all of those great elements.

So, well we've got this. We can do this, and let's just dive on in. So, before we go into the specifics of the actual framework, I want to share one other framework. Because this is a question that comes up a lot in addition to the, “Okay, I read the book. Now what else do I do?” The other element is, “Okay, I feel like if I'm pulling a tax based on what they're doing in the classroom, or if I'm pulling an actual text from the classroom, I feel like a tutor. I feel like I'm not doing anything.” And that's a common comment or question that I get. And so, Dr. Ukrainetz, who also, if you're wanting to read more about this, her textbook called Contextualized Language Intervention is incredibly helpful. That's where this framework came from. I learned all of the things from her when I was struggling as a CF. So, that's definitely an amazing resource if you want to dive into any of these elements in more detail.

But she has this helpful framework called RISE. And so, they're the four elements that we want to include in our therapy to make sure that we're being therapeutic. And it's just when I'm feeling like a tutor in a session, I go through the RISE framework and I ask myself, am I doing R-I-S-E, and often times if I'm not feeling therapeutic, there's one of these elements that are missing. And it just breaks it down in a way where I can be like, “Oh, okay. So, I need to make sure that I'm doing this.” And then I implement that, and then I feel great. And sometimes it takes a little bit of troubleshooting, but then at least I know where to start. So, RISE stands for R, repeated opportunities; I, intensity; S, systematic support; and E, explicit skill focus.

So, R, repeated opportunities: if a student is going to master past tense verbs, or a vocabulary word, or whatever it may be, they need to have repeated opportunities. A tutor might just say something once or twice if they're going through a vocabulary activity, but as a speech language pathologist, we know that our students need a lot more exposure. That's why they're getting speech and language therapy and they're not seeing a tutor. Your tutor just gives a little bit extra support. We really break things down, and we're very strategic with the number of opportunities that we give.

We also look at I, which is intensity. So, this is typically what we think about when we're writing the student's IEP. We are strategic with how often we see a student and what that looks like. And so, if we have a student who isn't making progress, we might want to look at the intensity. Do they need to be seen more times a week for shorter sessions, or do they need a longer session, one time a week, or do we just need to increase the frequency of sessions overall while keeping the same duration? What will help the student be successful? And where we definitely are careful about, and we're conscious of this decision, we make our best guess when we're writing the IEP, but that's something that we can check in on and do a pulse check if we're not seeing the progress that we want.

Then S stands for systematic support, and this has something that we're really good at. We are always providing scaffolds and cues and all that good stuff. And then E stands for explicit skill target. So, with my older students, I definitely want them to know what we're working on. And Ukrainetz adds, she calls it RISE plus. So, the plus is a student factor. So, with older students this is incredibly important, we want them to be aware of their goals, and we want them to be able to reflect on their progress. So, when I'm setting up an activity, I make sure that I have that explicit skill focus. I show the student the visual; I tell them what we're working on, and they know that's what we're doing. If we're working on complex sentences, I say, “Okay, the goal is to make these complex sentences. That's what our focus is,” and that visual makes that super clear.

Then in addition to that, I want the students to know the why behind their goal. And the way that I do that is anytime I write new goals for an IEP, I have the students fill out goal cards, and then they write their goal in their own words. And then on the back I like to have them write why that goal matters, and why it's important to them. And it's incredibly helpful if it can relate to any of like their personal or career goals. If they want to be a professional football player, or if they want to be a YouTuber. One of my students, one of my third graders, really wanted to be an amazing Dad, which is so sweet. But we can really connect with the students and find out what motivates them, what their goals are, how we can connect with that. And we're working on communication, so it's not hard to make that connection. And that just helps so much with the buy-in, especially if we can involve them in the goal setting process, and think about that ahead of time. It's such a game changer.

But even if you're just trying to implement this now, we can always find a way to connect our goals to what they want to do in the longterm, and if not, we might want to check on our goals. And sometimes it can be super far out, like their career goals, what they want to be in 10 years from now. Or it can also relate to, “I want to be able to pass this class,” or just whatever is meaningful to them. Or I want to be able to talk to my friends and have them understand me. Or I want to be able to ask a girl to the prom and not the plum. Whatever their goal is, whatever their motivation is, we want to have that be at the forefront ideally every session, so we can just keep reminding of that.

So, off that soapbox and onto the steps of the framework. So, we have five steps here. We start with pre-story knowledge activation. Then step two is shared reading. Step three is post-story comprehension. Step four is focus scale activities, and five is a parallel story. And so, before we dive into the framework though, we need to pick the vehicle for this session. What are we going to be talking about? And with older students, this is typically an article. So, I really liked to use readworks.org. It's a free site. It has tons, and tons, and tons of articles. I can always find something that is relevant to what they're working on in the classroom, and a lot of times teachers are using these articles in the classroom as well. You can pull anything from the classroom. If you're working on fiction articles, you obviously want to pick something that's fiction or nonfiction; pick something from a social studies book, or a science book, or whatever it may be.

I personally haven't had as much success pulling from books, because I could spend a whole month on just one little tiny section of a chapter. And I think it's frustrating to the students if the class is going ahead on this whole text, and they're making a ton of progress, and we just keep revisiting this tiny little section. It doesn't feel as redundant and frustrating if it's an article, because we're doing so many things within the article. But I think just the reminder that we're working on that very specific section of the book, it's a little frustrating. If it's a really meaningful section of a chapter in their social studies book, if we want to focus on learning about a specific battle or, I don't know, whatever it may be, I've had a lot of success with that, or any types of articles that they're reading. And so, that's my personal preference. I like to pick something that I can read in 10 minutes or less. So, if I pick something from a book, I pick a small snippet, and I want to make sure that the text has multiple demonstrations of their targets.

And with older students, we're going to be looking at things like compound complex sentences, adverbial clauses, relative clauses, prefixes, suffixes, all of those components. So, I want to be able to see at a glance that the article has the targets that I want. If I really want to work on passive voice, I'm going to pick an article that has some passive voice in it so that it has some demonstrations there. And of course we can create our own targets by manipulating the text. But it's really nice if it is already there. It's just a little bit more authentic and relevant, I suppose.

And so, I personally make cheat sheets for the articles that I use in therapy. So, it just really helps me structure my sessions. I can at a glance see, “Okay. These are all the grammar targets. Here are all the vocabulary.” I can decide within seconds if that's an article that I want to use with that group. And I just end up keeping these cheat sheets and they're easy to access. And then it just makes it super simple when it comes to planning and putting all the elements together. You can totally make your own too, and that's how that works.

So, let's dive into the framework. So, the first step is pre-story knowledge activation. And I think just to illustrate this a little bit more clearly, I'm going to pick an article that I have used in my therapy sessions. So, this is from the March SLP Now bundle, and this is the hiking trip. You can access the article for free on readworks.org. And then I just create companion materials, but you can totally just access the article and use it based on what we talk about today.

So, for pre-story knowledge act fashion, just backing up a second, the hiking trip is an article about. So Devin, the main character, had been waiting all winter to be able to go hiking, because it was snowing and she wasn't able to go. It's finally spring, sorry, he, Devin he, he begged his dad to take him on a hike. And then his dad didn't want to go hiking, because he usually goes with his mom. And so, they encountered some interesting things along the way. So, it's just a story about that experience. So, with pre-story knowledge activation, the unit includes a sheet with some different discussion questions that we can dive into. So, we can talk about, if they've ever been hiking, have they ever gotten lost? Where do they go hiking; what happens in the winter and the spring; why couldn't they go in the winter; all these different types of questions. And I cater this, because I get to know my students, and so I have an idea of what their experiences are, and so I will cater the questions that way.

But it's always surprising what they do and don't know. So, it's a good experience. And I like diving into these types of questions. And this just helps set us up for success. It gives me an idea of what they know and don't know yet. It gives me a pulse on how much exposure they'll need to the vocabulary concepts, because if they don't understand, if they've never been in a forest, and they've never been lost, I don't know. There's just so many different elements that will come into really understanding the story, and building that vocabulary, and all of those different elements. So, that's what we've got there. Some other fun ideas are to watch a video, so about hiking in the forest, or whatever it may be. And I like to call it a virtual field trip, because then it just helps us imagine what that would actually look like. So, we could look at a snowy forest, and we could look out of forest in the spring, and just to build that background knowledge to help understand what happens in the story and why.

And then another thing that I like to do in this pre-story knowledge activation section is take an article tour. So, a lot of the ReadWorks articles have a photo; they have a nice big title. Some of them have a headings. And so, we'll just look at the overall structure of the article and take a guess what it'll be about. And this is a strategy that some of my teachers taught me in high school too. It's a great comprehension strategy to just scope out the article and see what we can find, and just teaching those strategies, to set them up for success when they're tackling different texts, and just helping them to be able to do that on their own.

So, that is step one, pre-story knowledge activation. With older students, I don't do this as much with younger students, but with an older student, it might make sense to pre-teach some of the vocabulary, because I've had a couple of just super salient examples of how important this is. I always tell the story of when I was working with sixth graders and we read a forensic science article. And the first time we read through it, I thought it was super interesting, and they were excited about the concept. But after we just did a rough read through, this was before I used literacy based therapy units and this framework; but I asked them comprehension questions and they had no clue. I just did a little bit of teaching of the vocabulary in the story, like victim, suspect, all of that, and just teaching them a handful of words, their comprehension just skyrocketed. It was amazing.

So, I think using that as a strategy is incredibly helpful, and pre-story knowledge activation, before we dive into the story, is a helpful time to look into those words. And when you're doing the article tour, you can even have the students, you can have them spot-check the article and see if they can identify words that they don't know. Or if we're working on prefixes and suffixes, the cheat sheet that I use has the list of the prefixes and suffixes in the article, so it can just help me, we can start to look at that and notice those as well. So, alluding to what we're going to be doing and step four of the framework. So, that is step one.

Then we have step two, which is shared reading. And with older students, I might have the students read it themselves, read it out loud. I might read it, and we might round-robin read, whatever makes sense. ReadWorks also has recordings for some of the articles. So, sometimes we play that. There's tons of options there. But it's pretty simple. We just read through it. I just make sure that the students are staying engaged. I'll pull out whatever tricks I can to keep them engaged, and it really depends on the group. So, that's why I mentioned maybe there'll be excited about listening to her recording, or maybe they need to round-robin to stay engaged, or maybe I need to read it and continue asking them questions. So, that really depends on the group and the factors there. But it's just a pretty quick read through, not a whole lot going on there.

And then I also want to say, throughout all of these steps, I planned this around my students' goals and I'm very strategic about how I show what I'm doing throughout the unit. I highly recommend checking out the vocabulary and the grammar podcast episodes, because those give a lot of specific strategies that we can use throughout the unit. But for example, just with grammar, I'm being really strategic. I'm recasting the structures that I want the students to use. So, if they give me a simple sentence and I want them to start using more compound sentences, I recast that into a complex sentence, or I'll throw in a relative class, or an embedded clause, or whatever we want to work on. I'll start making those things happen, so that when we get to step four where we're doing some super focused skill activities, then there'll be ready for that.

And, like I said, we might want to pre-teach the vocabulary in step one. We might want to teach just a grammar concept in step one before we dive in. It depends on the group and where the students are. It's not just a, do this then this, then this and this. This is a general framework, and then we get to apply it to our students. So, step one pre-story knowledge activation, potentially adding in a pre-teaching vocabulary, some grammar reviews, whatever it may be. Then two is shared reading.

Three is post-story comprehension discussions. So, with this, the cheat sheets include literal and inferential questions that we can ask. There's also different activity pages with more comprehension activities. And then again, I'm thinking about the student's goals, always recasting, always embedding that vocabulary, asking questions to try and elicit vocabulary, whatever it may be, or asking questions to elicit specific grammar structures. I'll do it all. I'm being very strategic throughout this whole thing. This isn't fluff. This is very intentional use of time, working through skills in a meaningful, embedded way.

So, that's what we do for post-story comprehension discussion. If we're reading a fiction text, I always make a little interactive, story-grammar activity. So, if we are working on a story retell, then I'll ask questions like who has a story about; where did this story happened; when did the story happen. And then, there's different levels of complexity across the story grammar framework. But that's a really great starting place to see how well the students understood the story, versus just asking questions about different details. You think it's a nice way, and then it sets us up for success for the subsequent steps of the framework, which is super helpful.

So, that's what we've got here. And I think having those visuals is incredibly helpful. I put my story-grammar organizers inside the SLP Now membership, but you can easily create your own, make a graphic organizer with the different story-grammar elements. There's tons of research studies that give you ideas for different icons to use. It's a really nice framework that has a lot of evidence behind it. I used to use sticky notes. I would just pull from Google images, all sorts of things, so many options there. And then I think incorporating technology too helps keep our students more engaged. So, that's always a fun thing.

Now the meat of the literacy based therapy unit is step four, which is the focus skill activities. And this is where we dive into all of the different skills. And we can spend quite a bit of time here. So, we work on comprehension in step three. We started working on vocabulary and grammar in step one. If you're looking for ideas for step four, definitely look back at the grammar and the vocabulary episodes. I'll link those in the show notes, which you can find at slpnow.com/37. But there are tons of different ideas and activities in there. So, we start with structure drill practice if that's needed, and then we'll work towards more embedded practice within the step four.

So, for example, if we are working on prefixes, we might do some activities first, and this might have started in step one, but I might have introduced the prefix a little bit. We might've worked looked at identifying the prefix in the text, because that's a really important strategy. If we want them to be able to use prefixes as a strategy to break down unknown vocabulary words, then we definitely want them to be able to identify. Because if we're working on the prefix re, like R-E, read starts with R-E, but d is not a word, or ad. So, we have to work on being able to identify that and actually identify the prefix.

So, we might go through and find some of the examples, then we might pull out some of the words and define them using the skill pack on prefixes and adding them to our vocabulary journal. And then we would start using them in sentences, and just embedding the words that we pulled in a number of different ways, using different activities. And then when we get to step five, then we would continue to use those words as well. Another exam.