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Speech and Occupational Therapy Collaboration

3 Nov

My school has a wonderful occupational therapist (OT) who brings in loads of great sensory and fine motor activities to our preschool classrooms. We always say to each other that we should collaborate more but we never get around to doing truly joint speech therapy/occupational therapy sessions for our kids. What I have realized recently though is that our OT is including much more language stimulation in her activities that she ever knew!

The past few weeks I have made a point to stop in a preschool classroom during her OT group time and have realized that many of her activities are a gold mine of language. This week I got put in charge of an activity where the kids had to pick up a small fall themed object (learning fall vocabulary!), scoot across the floor on their tummy on a scooter board ( learning verbs!), and then put the object in a bean bag game board that looked like a jack-o-lantern (learning body part vocabulary!). Next, I was in charge of a game of hitting a balloon with a paddle up in the air back and forth (turn taking, verbs, and prepositions!). I was amazed at how much language is involved in all the OT activities.

In order to add a speech therapy component to these activities is really just a matter of making sure to add language to all the activities by narrating what the kids are doing and picking a language concept or two to emphasize during each activity.

Here are just a few of the language concepts that can be a part of OT activities:

  • Action words: many OT activities involve actions – coloring, cutting, jumping, pulling, pushing, digging
  • Prepositions: when working on fine motor skills while coloring, writing, digging, etc. there are many opportunities to demonstrate under, on top, around
  • Descriptive concepts: our OT has a wealth of sensory objects that are bumpy, soft, rough, wet, and even slimy!

I could go on and on because the possibilities for language stimulation during OT is endless! Keep it up awesome OTs of the world!


To mainstream or to not mainstream…

23 Sep

Earlier this week an episode of  NBC’s Parenthood focused on Max, who has Asperger’s, and his first time mainstreaming into a general ed classroom. In my opinion, Parenthood continued to do a great job depicting another issue that many parents of children with special needs will probably face during their child’s school age years. The question of whether to mainstream or not is a complex one and one that I believe truly needs to be dealt with on a child by child basis. Mainstreaming can undoubtedly be beneficial for the development of  a child but it also needs to be approached cautiously.

There are many philosophies on mainstreaming varying from full inclusion of children with special needs into the general education environment to virtually no mainstreaming with children with special needs being isolated to their own classrooms or campuses. In my caseload of preschoolers, I have children who run the whole spectrum of mainstreaming options and it seems to work fairly well. Our most impacted preschoolers with autism are in classrooms specifically for children with autism that are set up in a reverse mainstreaming system. Reverse mainstreaming means that while the classroom is set up for the students with autism, peers without special needs also attend the class with the goal of them providing good models of language, behavior, etc. We also have preschoolers that attend special day classes that consist of students with a variety of special needs. These students mainstream daily on the playground and for varying amounts of time in the general education preschool classrooms based on their needs. We also have student’s with autism who are fully included in the general education preschool classrooms with some extra supports like behavior specialists and speech therapists supporting them. I may be biased (I am) but I think we do a fairly good job of matching a student’s needs and learning styles with the amount of mainstreaming they receive. Of course we are not perfect but we are always trying to provide more and more mainstreaming for our students under the restraints of what we can do in a public school system in this day and age with budget cuts restricting some flexibility.

The aspect of Max’s mainstreaming experience that struck me the most was the lack of support for both Max and his teacher. A child with special needs should never be dropped in a classroom without loads of support that can be backed off when the time is right. Modifications and accommodations can be made to help a child navigate the classroom and his school work successfully. While I am generally not a fan of providing a “shadow” or “one on one” aide to a student, providing some classroom support in the form of an extra adult in the room trained to work with the student can be very helpful to both the student and teacher. I also feel that one of the aspects that is most lacking is training for general education teachers on strategies for working with student’s with autism. Even some basic training on behavioral strategies can go a long way with helping a general education teacher provide the best learning environment for a child who is mainstreaming in her classroom.

I look forward to future episodes of Parenthood to see how Max’s first year of mainstreaming progresses! Just like with my students I hope that the right mainstreaming setup for Max will be found and that he will have the best school year possible!


Back to School Speech Therapy Tips

31 Aug

Well summer is ending and tomorrow I head back to school for the new school year! Of course I am sad to see summer vacation end but I always get filled with anticipation for what a new school year holds. I know I will be working with several new teachers in our autism specific preschool classrooms so one of my first goals for the year is to establish good collaborative relationships with them.

If you have a child who will be receiving speech therapy this year here are a few tips to get the school year off to a good start:

  • Contact your child’s teacher and ask them for contact info for the speech pathologist (SLP).
  • After a few weeks of school, contact the SLP. Ask he/she what your child’s schedule is for speech therapy and what is the easiest way to contact him/her. I much prefer email but that may differ from SLP to SLP.
  • Pull out your child’s IEP and look over the goals. Make sure that they are still appropriate for your child. Many children make great developmental jumps over the summer break so they may have surpassed their goals.
  • If you feel changes need to be made to the IEP, contact your child’s teacher or SLP to schedule an IEP.

Have a great start to the new school year!

Innocent Until Proven Guilty – Putting the Team in IEP Team

11 Mar

Today at the monthly meeting of all the speech pathologists in my school district the Alternative Dispute Resolution (ADR) specialist for our district came to give us information about the process. Basically, the ADR process kicks in whenever an IEP team and a student’s parents have come to a standstill and cannot agree on some aspect of the IEP. Then the ADR team reviews all the information and meets with the parents to try to resolve any issues. Not every district has this type of a process and those that do probably have different methods so I won’t go into detail but the topic made me think of how to avoid the need for an ADR in the first place!

In my career, I have been involved in many IEP meetings with the vast majority being very positive and constructive. I think there are a few keys to setting the stage for positive IEPs where both parents and educators feel like equal members of the team.

  • Remember you are all on the same team – opinions and ideas may differ but everyone’s goal should be what is best for the student, do not get caught up in personal agendas
  • Maintain open communication about the student all year long – springing surprises on teachers or parents about a student’s progress or possible changes is never a good idea
  • Remain open to ideas and solutions – both sides need to maintain an open mind and be flexible, one of the best thing about having multiple IEP team members (including parents) is that they can all bring their own knowledge of the child to the table to help come up with the best plan
  • Solicit input on possible IEP goals prior to the meeting – educators and parents can both provide ideas for areas of priority or concern so that the most important areas are sure to be addressed
  • Educators provide reports to parents ahead of the meeting and parents take the time to review reports prior to the meeting – this allows for parents to identify questions they may have and soak in some of the information instead of having oodles of jargon and numbers thrown at them in the meeting
  • Do not wait until the annual or triennial IEP date to address problems (or positives!) – if something is not working do not wait months and months to address it; in the same vein if things are going really well don’t wait until the next IEP date, meet again to make new goals or make changes (and celebrate!)

Unfortunately, these ideas are often much easier to say than do. As educators, we have to walk a fine line between what our compliance departments require (shouldn’t be the case but that’s how things are in public education these days) and what we might do outside the constraints of public education. Despite that I feel that it is a very realistic expectation to have the IEP process be a positive experience for both educators and parents if both sides work together as a TEAM!

Making The Kindergarten Jump

2 Feb

Around this time of year the big question on the minds of the parents of my preschoolers who will be moving to kindergarten next school year is “Will my child be ready for general ed kindergarten?” Fortunately, I work with a great preschool special day class team so many of our students do move on to general ed kindergarten and are very successful in that placement. However, some students may not be ready to move to general ed kindergarten. We have IEP meetings, usually in April or May, to discuss the pros and cons with parents and usually come to a consensus on what we think is the best plan for the individual student.

Many parents are afraid that if their child doesn’t move to a regular education classroom in kindergarten they will be stuck in a special ed classroom for the rest of their schooling. That should never be the primary reason for moving a child to general ed kindergarten. While kindergarten is a big milestone, I like to remind parents that it is not necessarily the best time to make the jump from a special ed classroom to a general ed classroom. I cannot speak for all school districts but in my school district our special day preschool classes are generally between 8-12 students while a general ed kindergarten class will usually have around 34 students. For a student with social/emotional or language delays, being moved into a large general ed classroom before they are ready can be a nightmare. In my experience, a special day class kindergarten with mainstreaming as appropriate can be a much more successful environment for students that still need support with language and/or social skills. In many school districts, including mine, the classroom numbers are lower for first grade and it is also a more structured environment than kindergarten so it can be a better time for making the transition from a special ed classroom to a general ed classroom.

If your child is moving to kindergarten next year I recommend asking your IEP team for an observation of the special day kindergarten class that your child may attend. Many of the parents that go observe the special day class that their child may attend are relieved to see that the academics are still very rigorous while having a smaller classroom where their child can get more attention. Of course, classrooms vary quite a bit from district to district and even within districts so that is why I recommend observing the potential classroom and doing whatever research you can so you can make an educated decision about what is right for your soon-to-be kindergartner!

Hi Speech!

29 Jan

It has happened more than once that I have walked into a classroom containing students with autism to be greeted by one of my students as, “Hi Speech!” Everyone (including me) gets a good laugh that a student thinks my name is “Speech” (there are surely worse things to be called!) and I am happy that a student gave me a spontaneous greeting.

One lesson that I have taken away from this though is that we need to be very careful of the language we are using with our students. In this case, the students have probably heard “Are you ready to go to speech?” or “time for speech” from one of their teachers when I come into the room to pick up a student and the student has learned that “speech” surely must be my name since they hear it every time I am around.

While a typical child may be able to decifer that “speech” is not a name, children with autism generally learn language in more of a gestalt manner (learning language in chunks instead of the individual meaning of each word) which makes it more difficult for them to learn and generalize words. A typical child may easily learn that the word “bug” does not just mean the first type of bug they ever saw and another person labeled for them. They soon learn that a “bug” can mean many different kinds of insects and it can also mean “go away” in the context of being told “don’t bug me.” A child with autism will often need to be taught specifically what belongs in the category “bugs” and will be confused by the phrase “don’t bug me” until it has been explicitly taught and demonstrated to them.

Thinking about being called “Speech” reminded me was that we need to inundate children with autism with many models for the words and word combinations that we want them to learn as well as opportunities to use them. We shortchange them if we make the assumption that they will make their best progress learning words and language skills if given the same input a typical child is given.

I am happy to say that I haven’t been called “Speech” in a while, but I wouldn’t mind it every once in a while!

She Said No!

27 Jan

As I walked by one of the preschool structured autism classrooms at my school I heard someone yell my direction, “She said no!”  Confused, I backed up and peeked into the classroom wondering what that could be about and one of the classroom aides was looking my way with a big smile repeating, “She said no!, Sarah* said no!”

The casual observer probably would have found the interaction strange but it made my day.  Here was a classroom aide who is in a classroom that is bursting at the seams with students who all have very significant needs and she took the time to recognize a major communication breakthrough for one of her students. I felt like throwing a party!

I give the teachers and aides I work with lots of tips on eliciting communication and noticing subtle communication improvements but it’s hard to tell if I am having a positive effect or just adding one more thing to their already full plates. It turns out I should have given them more credit!