Clinical Skills Confidence: Have A Life!

The latest installment of Clinical Skills Confidence doesn't actually focus on anything clinical. We all tend to eat, live, sleep, and breath speech - but it's important to have a life outside speech too! Recently I asked my Facebook followers what they like to do to stay in shape. It got me thinking about how it's important to have work/life balance! 

These are some of the things I like to do to make sure I'm living outside the SLP world:

1. Exercise: I make this a habit 6 days a week. It takes getting out bed early, but I feel so much better afterwards. Recently, I discovered The Gymbox through Amazon Prime. It also gives you access to a lot of Jillian Michaels' workout videos. I usually just run, but I know I need to mix it up with some strength workouts. 

2. Hang out with friends: I'm lucky to have close friends in the school that I work at. We routinely get together outside of school.

3. Get takeout and watch a movie: At least one weekend night, my husband and I get takeout and just watch a movie. It's nice to just relax and spend some time together. 

4. Do seasonal activities: Apple picking, pumpkin picking, ice skating, farmer's markets. Whatever it is, get out of the house and take advantage of the seasons. 

5. Find a hobby: For me, I actually really enjoy blogging and TpT activities, which has turned into my hobby - but that's speech related. Outside of that, I like to cook/bake, read, and do crafts.

What do you do to "have a life"?

Clinical Skills Confidence: Sharing Results At Meetings

I'm not one of the people that really enjoys public speaking. In fact, in high school, I pretty much did anything to avoid it. Then in college, we needed to do presentations. I got more used to it and sometimes (gasp) even sort of enjoyed it! Still, when I know I have to speak in front of people, I get nervous. Those butterflies can dance a mighty jig! 

I'm not sure that grad school really prepared me for sitting in IEP or eligibility meetings. Especially the part where I need to share results. Here are my tips for coasting through it without breaking (too much of) a sweat. 

1. Print and highlight: I print a copy of the result and highlight key points that I want to mention. It makes it easy to relay the important information and not look all over the place for it.

2. Rate: I tend to speak very quickly, so I make a conscious effort before I start talking to remind myself to SLOW DOWN.

3. Pause and ask: After I relay a couple pieces of information, I always try to stop and ask if there are questions. Sometimes it can be a lot for parents to take in and they might have questions right then. I find it easier to address throughout my "speech," rather than at the end. 

4. Offer your contact information: Often parents will think of questions later on, so I always give them my contact information. 

I hope that gives you some ideas and some peace of mind about sharing results! It does get easier!

Clinical Skills Confidence: Staying On Top of IEP Deadlines

Graphics: KG Fonts and 3AM Teacher

Clinical Skills Confidence posts are back! I asked my Facebook fans what kinds of posts they'd like to see. One of the first suggestions that caught my eye was staying on top of IEP deadlines! If you caught my post earlier this month, you'll notice how I set up an Excel sheet that helps me because all information is in one location. 

For a quick refresher, here's a look at part of the Excel sheet before sorting by date:

*names are not real*

 And after sorting by date, using the AZ sort button (oldest to newest):

This is where I start at the beginning of the year. I go through this list and write down due dates for all annual IEPs. This way I can see what IEPs are due each month. If they are speech only and I am the case manager, I generally try to schedule the meeting for a couple weeks before the due date, in case it needs to be rescheduled or there are weather closures. For the ones I serve as a related service provider, I can see when I need to collaborate with the special education teacher for the meeting or go over concerns about a student. 

That takes care of annual IEPs. For new cases that are speech only, I really try hard to evaluate and hold the eligibility and IEP meeting within a month after getting permission. Since it involves coordinating less people, I am usually able to accomplish this. Still, I know it can be hard to keep everything straight, especially when you've got multiple evaluations in progress. 

Post-its to the rescue! Read about how I use those to keep me organized for evaluations here!

It is a lot of information to keep track of. The best thing you can do is find a planner that works for you and write yourself as many notes as you need. Make a checklist, make a to-do list, do whatever it takes to keep yourself organized. You don't want someone looking for you because you missed a deadline!!! Hope this helps!

Clinical Skills Confidence: Banish the "video games" answer!

Graphics: My Cute Graphics

I don't know about you, but my sessions frequently begin like this:

Me: "Hi XXX, how are you?"

Student: "Fine."

Me: "What did you do over the weekend/last night?"

Student: "Played video games."

Sigh.

This seems to be a highly popular response. Everyone's entitled to their own opinion about technology, particularly video games. However, I got tired of hearing this response. So I decided it was time to do something about it. I'm ok with getting that response, but if this is what interests my students, then I should use it to my advantage!

What does that get you? A freebie! And maybe you'll be saved from that same response too!

I put each of the circles on a popsicle stick and put them circle side down in a cup. Students are warned as we are walking into the room that if they answer my question about their weekend with "I played video games," they will be required to pluck out the sticks and complete the corresponding language task (I decided beforehand how many I wanted them to complete). To grab your copy, click here.

I also had the students write down some of the video games they play, so I could find out more and maybe know what they were talking about for the next time. I'd love to know if you plan on trying this!

Clinical Skills Confidence: Keeping Tabs on E.I.P.

At this time, I'm currently treading water in a sea of evaluations. Sometimes, I'm floating on my back just to get a little break. This is when keeping tabs on E.I.P. becomes crucial for me and if I don't have all my ducks in a row, something can easily slip through the cracks. 

What's E.I.P.? Evaluations In Progress! 

Here's how I do it:

After the meeting where we learn about the student, I compile all notes that I took in a file folder with the student's name and date of birth. I put 2 sticky notes on each file: one with chronological age for easy reference and one with all the steps that I need to take to finish the evaluation, so that I can check it off as I go. As anal as it sounds, it keeps me organized. I also put test forms for the tests I plan to give in the folder, so they're ready to go. These are the steps I usually take:

-evaluation: names of all tests I plan to give since I usually don't finish in one session

-oral motor exam (that can easily be forgotten)

-observation (not always done, but I try to do it)
-language sample: I have my checklist handy for this and I record it

-teacher questionnaire (I give the CELF one)

-write report 

-make copies for cumulative file, my working file, and parent

I usually also have the sticky app on my laptop with who I'm currently evaluating so I can reference it when I'm at home. I try to finish up evaluating and write the report as soon as humanly possible, especially when I'm doing a bunch at a time. Otherwise, I'm liable to forget which kid did what! 

That's my system! How do you keep track of evaluations? 

Clinical Skills Confidence: Classroom Observation [freebie]

Graphics: My Cute Graphics

Font: http://teachesthirdingeorgia.blogspot.com

SLPs in the schools need to have an understanding of how students are functioning in the classroom environment. In order for a student to qualify for speech/language services in the schools, there needs to be an impact in the classroom. 

How can you determine if there is an adverse impact? 

We can use standardized tests of course. But they often are not enough. I also like to use a teacher questionnaire and do a classroom observation. I decided to create a short form that you can grab and use during an observation rather than furiously scribbling down notes about what you're seeing. Grab the freebie here! [don't forget feedback]

This article from ASHA highlights what elements are important for a comprehensive speech/language assessment. 

Check out Speechie Freebies for more awesome SLP freebies!

Do you do a classroom observation? What do you look for? 

Clinical Skills Confidence: Social Story Resources

SLPs use social stories all the time! The term "Social Stories" is trademarked by Carol Gray and more information can be found on her website. In a nutshell, they are stories that are designed to help a student understand a situation or skill.

There is a wealth of resources available out there. Why reinvent the wheel? If you're looking for a general social story, you can usually find one with a little searching. If not, never fear, I'll let you know how I have customized ones when I couldn't find what I needed!

First, the ready-made ones:

• Speaking of Speech has some social stories that have been posted by other SLPs. 
• One Place for Special Needs has several social stories available
• Positively Autism is a blog that has some social stories for holidays and feelings
• Supporting Autism Spectum has a listing of some available social stories

Sometimes I am unable to find what I need, so I'll create one using Custom Boards by Smarty Ears. Among other wonderful things that this app can do, one of the options is to create a mini-book. Open the app, click "new," then "worksheets" and "My Book." You can add pages as needed to fully customize it for your needs. You're free to email the pdf to print and go!

Again, there are specific guidelines to writing Social Stories. You should write them from the perspective of the student. Carol Gray suggests a ratio of 2-5 descriptive sentences for each directive sentence. Feel free to learn more here.

A descriptive sentence gives information about a situation (who is there, events that occur). Example: When it is time to work, students sit at their desk and pay attention to the teacher. 

A directive sentence gives information about what the student should do in that situation. Example: I should stay in my seat and look at my teacher. 

A perspective sentence gives information about what others feel. Example: My teacher likes when I stay seated and listen to her. 

*This information was summarized from Child-Autism-Parent-Cafe.com*

Do you use Social Stories? Do you find that they work well for your students?

Clinical Skills Confidence: Speech Note [freebie]

Some of my parents like to have more back and forth contact than just a quarterly progress report. Usually the requests are few and far between, so I'm happy to oblige if they want more routine updates. I decided that I wanted to create a simple one that I could just copy and write on. So that's what I created! You can grab a copy for free too - just click on the image below:

I included 2 different versions. One has a notes/homework section, the other includes a strength and weakness area. I think it's important to highlight strengths whenever possible (not just at progress report time). On the 2nd version: exciting = something great that the student did during the session, keep fighting = something the student still needs to work on. 

I hope you find this useful! 

Clinical Skills Confidence: Progress Reports

It's almost that time again for me. End of the quarter = progress reports. This is when I'm glad I do my best to keep my data binder organized, because I usually can grab this and start the daunting task of inputting all my progress reports. Here are my tips:

1. Don't wait until the last minute! This probably doesn't need to be said, who needs the extra stress of knowing you are quickly running out of time? I start thinking about them a few weeks before the quarter ends so I can make sure I grab data on all the goals/objectives. I take data on at least one objective every single session, so that's not too much more work. 

2. Make a list and check it off. I make an excel list of my kids at the beginning of the year with pertinent information like name, DOB, IEP date, disability category, and IEP goals/objectives. It's a lot of work in the beginning of the year, but it saves me time later. I copy and paste the names and print it out. As I'm going through the kids, I check off each name when I do his/her progress report.

3. Try to spread it out over a few days. If I get "in the zone" I can crank out 20 at a time. I try to tell myself "get through X number today and do the rest tomorrow." It's more manageable, plus we all know how tired our eyes get after several hours of staring at the computer screen.

4. Check in with teachers (if possible). They're busy putting in grades too! Most of the time, I'm in contact with teachers at least weekly, but if I've been wondering/concerned about how they're doing in the classroom, it's worth the extra 10 minutes to seek out the teacher to ask. We're coming up on the end of the 2nd quarter, so academic concerns are usually cropping up about this time. 

How do you efficiently manage progress report time? 

Clinical Skills Confidence: Speech Therapy Materials That Won't Break The Bank

Graphics: Lovin Lit

Disclaimer: Affiliate links are included for your convenience.

I'm fairly certain that most SLPs have very little (if any) money to spend when it comes to therapy materials. During the jobs that I've had since graduating, I got used to purchasing or making my own materials. I don't necessarily see this as a bad thing - mainly because if I leave the job, I get to take whatever I bought with me. 

But I don't have endless funds of my own to spend, so recently I've taken a trip off the beaten path to find some other low cost options for materials. Confession: I get bored with the same materials over and over, so I like to change it up just as much as the kids do!

Don't get me wrong: I frequent Super Duper and Linguisystems often. I REALLY miss Super Duper's 50% off weekly sales - as that was my go-to pretty much every week. There has been one weekly deal lately that is usually 50% off. Oh, and obviously TpT!!!

I thought I'd share some other websites that I have found some pretty awesome deals on (I was not provided any compensation for mentioning these sites and I have not personally ordered from all of them, they are simply ones that I've found on my own):

1. Educational Insights: Their $10 and below section currently has things like Hot Dots, Make Your Own Hot Dots set ($5.49), and phonics books. 

2. Speaking Of Speech Swap Meet: This website, created by Pat Mervine, allows SLPs to post materials for sale. All arrangements must be made by the individuals. 

3. Really Good Stuff: The Outlet section has tons of items, separated by category (under $1.00, under $2.00, language arts, etc). You might need to do a little more digging, but finding a deal makes it worthwhile!

4. Etsy: If you search "speech therapy," you can order from a shop called SENtoys or Felt Resources that have some items that I think would be great for therapy. I have lost countless hours of time just searching all the other great stuff on Etsy, like Dean Trout's Little Shop of SLP for totes that will hold all your materials! SLPMomma takes care of SLPs around the world!

5. MpM School Supplies: Their clearance section is amazing! Some things that caught my eye were Memory Boosting Mnemonic Songs for Grammar, Storytelling with Puppets, Props, and Patterns, and several books.

These are just a few websites that you might want to check out. I always like Oriental Trading, local consignment and thrift stores, Dollar Tree, and the Dollar Spot at Target. What is your favorite place to score a deal?

Clinical Skills Confidence: Dear SLP...Love, Yourself

Graphics: http://www.teacherspayteachers.com/Store/Lovin-Lit

Dear SLP:

I know you are feeling tired, overworked, slightly crazed, and maybe a little disheartened. You sometimes feel that you start the day with a million things to accomplish. While you may accomplish a few tasks, different things are added or shifted and everything just piles up. Like the mountains of paperwork on your desk. Or the things in that corner that "you'll get to when you have a free moment." 

You want the best for those on your caseload. You want to see them succeed and feel a sense of pride in themselves. But sometimes you feel that you aren't doing enough.

You did not plan as thoroughly as you'd hoped for the week.

You couldn't find the pin that you KNOW you pinned a few days ago for your craft of the week.

You forgot your planner at home, which leaves you feeling completely off.

You meant to print and laminate and cut all those awesome TpT activities.

You plan your sessions, only to have it not go the way you saw it going.

You show up at a classroom, only to find there was an activity that you can't pull the students out of. 

You forgot all that Medicaid billing and now it's due tomorrow.

You have to go to meeting after meeting and some days, lunch just doesn't happen. 

It's ok. 

Stop for a minute and really think. You feel this way because YOU CARE. You push yourself to put in 120% every single day, so those days that you might only be able to give 98% feel like a failure. But it's not. 

Think about the times you showed up at a classroom and your students jumped up and said "yay, speech!"

Think about the times a parent told you how much his or her child LOVES speech.

Think about the first time a student achieved placement for the sound you've been working on forever.

Think about other therapists or teachers coming to ask your advice on something.

Think about the first time a student used their AAC device to request something.

Your job is hard. But you love it. Rest assured, you are making a difference, even if you sometimes don't see it.

Love,

Yourself

Clinical Skills Confidence: 14 Early Developing Morphemes

Let's take a short trip back to graduate school and discuss Brown's Morphemes. These were identified by Roger Brown and detail morphological and syntactical elements of expressive language. Caroline Bowen has more details on her website, which can be found here.

There are 5 stages to Brown's Morphemes. Mean Length of Utterance (MLU) is expected to increase as a child's age increases. I frequently refer to these morphemes, especially with younger students. For whatever reason, I will always remember the difference between auxiliary and copula. Side note: you may receive puzzled looks if you throw these terms into everyday conversation! It's ok, fellow SLPs understand. Auxiliary means supplementary so there is always another verb, which means it's a copula if there is no other verb. Remember, these all refer to the "to be" verb. Contractible means it can be shortened (ex. he is swimming --> he's swimming), while uncontractible means it can't be shortened (ex. he was mad). 

I have created an informal screener for these 14 morphemes. It's been on my to-do list for awhile and I finally got around to it! Please note that this is not a standardized tool, it is simply meant to provide a baseline when looking at the expressive language of a child. Click the picture below to be taken to the link to download your screen (it's FREE):

A tracking form is included:

 An answer key for the screener is also included:

 Each page looks at one morpheme. The box on the left contains a target visual and verbal example to read to the child. The boxes on the right are for the child to respond to. There are different formats for this, depending on what the morpheme is. 

I truly hope this is something you can use! Feedback is always appreciated!! 

Clinical Skills Confidence: Websites To Use In Therapy

Disclaimer: This post contains links to the websites mentioned for your convenience.

Do you use computers in therapy? I definitely don't use mine all the time (I have a laptop, so it's a little more difficult with groups), but sometimes it's a nice change of pace. These are some of the websites I really enjoy using:

1. Watch Know Learn: I wrote briefly about this one in Peek At My Week this week. It's a great website with free educational videos for K-12. This week, I used a couple mystery ones (Lochness Monster and Bermuda Triangle) with my older students. We made predictions about what we thought was the truth and answering listening comprehension questions. 

2. Time For Kids: The students get copies of this magazine, so using the website is a great way to incorporate curriculum vocabulary. What's great about this site is that there are Common Core lessons that include worksheets and articles - a ready to go lesson plan!

3. Readworks: You can search grade level reading passages. Reading comprehension is a skill that so many of my students need help with that this has become a go-to resource for me.

4. Social Skills Videos on YouTube: This link takes you to some cute videos for a wide range of social skills like honesty, politeness, etc. This one features cartoon like animals. If you'd prefer videos with people, this one has a few.

5. MrNussbaum: This website has a range of free, educational games. I believe the games can even be played on the iPad, which is great. This website also has a ton of other resources to check out, like printable reading comprehension sheets, Mad Lib type activities, and scavenger hunts. 

I'd love to hear what you're using in your therapy room! 

Clinical Skills Confidence: Baselines

I have all new students this year, so I knew that I wanted something that would be quick and easy to get some baselines. I find it easy to obtain baselines for articulation students, but it's somewhat more difficult to get them for language students. I decided to make my life a little easier and make something that some of you might get some use out of as well! Click the picture to grab your copy!

Note: I see students in preschool-6th grade. I realize not all of these areas are appropriate for all grades, but I just chose sections that were appropriate for each student to get a general idea of where everyone was functioning. 

How do you go about getting baselines for your students?

Clinical Skills Confidence: Norm Referenced Assessments

Next up in the Clinical Skills Confidence lineup: Norm Referenced Assessments

We all use them! In general, they are our "go-to" methods in order to formally assess our clients. What are they? They are tests that compare your client's performance to that of a norming group. You generally are provided with a standard score that falls somewhere on the bell curve. From these scores, you are able to derive a descriptive rating such as "mild, average, severe, etc."

I'm sure we all have our preferred tests for language, fluency, articulation, social skills, etc. This post will focus on what I do when you're not as familiar with a specific test. There are always new editions of tests coming out with slightly different guidelines and/or stimuli, so it's important that we stay up-to-date on the differences!

1. Read the manual: Things to look for - basal/ceiling (if they are used), entry points for different ages, if and when you can repeat, where to look for percentile ratings and standard scores.

2. Grab a test form and write yourself notes/add post-its: I always use pencil when I'm testing. It makes me feel better to be able to erase if I need to. If necessary, I can go back over it with pen later. I highlight or add a post-it to the subtests I plan to give. This makes it easier for me during the actual testing process.

3. Practice administering the test: Sometimes if it's a new test, I will practice saying the directions out loud, along with the first few stimuli.

4. Plan for the unexpected: That doesn't seem to make sense, right? Testing doesn't always go as planned. There can be a fire drill, your student may be inattentive, you run out of time, etc. It's ok. Usually, you are able to administer a test over several testing sessions. If attention is an issue, check out this post for tips related to how to improve a student's attention. 

What do I have for you? A FREE "quick look" sheet for tests. Print off several copies and make yourself a quick reference folder! You can then grab it for a "refresher" prior to giving the test if it's not one you use all the time. Click the picture below to get your copy!

Of course, these types of tests are not the only tests that we used to assess client performance, but we'll save those for another post!

Clinical Skills Confidence: Articulation Carryover

EEEKKK...carryover. I think it might be the most difficult aspect of articulation therapy. Why?! It requires students to take responsibility for their speech and self-monitor, which can be very difficult for some of our kids. I posted back in February about an idea for carryover that is loosely based on the game Red Rover, Red Rover. Check that out (and grab your freebie) HERE!

I've approached this skill in many a different way in the hopes of finding something that works more often than not. Alas, all kids are different; therefore, not all of them respond to the same things! Some ways that I have tried include:

1. When we first start this skill, I take a session to teach students to be aware of my speech and listening for errors. I purposely make errors to see if they can catch me. 

2. I give a number of coins (usually 10 to start with) and taking one if I hear a mistake. Usually, I start this by reaching slooooooowly towards the coin, giving the student ample time to correctly produce the word. After we've been doing it awhile, I'm less forgiving and also provide them with less coins to start with.

3. We record a narrative sample and then listen to it. I have the student count how many errors he/she made. This is more difficult to do in group sessions though.

4. The student and I agree on a nonverbal cue that I will use if I hear a mistake. Some have included tapping the table or touching my ear. I find this often works well at the beginning stages. I like that it is nonverbal, because a parent/teacher can incorporate this into daily interactions when they hear mistakes. Older children get tired of hearing someone verbally correct them all the time, so they like that this involves no talking! 

How do you work on carryover for articulation?

Clinical Skills Confidence: Language Samples Part 2

Time for Language Samples Part 2!

If you missed Part 1, check it out HERE. 

I made a language sample checklist that can be used when taking language samples. It is not exhaustive, but should give you a good idea of a student's strengths and weaknesses. Grab it HERE!

While taking a language sample, I am looking for the following:

• Does the student speak in complete sentences?
• Are there a lot of grammatical errors?
• Can I follow what the student is saying?
• Does the student use age appropriate vocabulary?
• Are there any stuttering like behaviors?

This is where we have to quiet our SLP tendencies to talk too much! I find it hard sometimes too, especially with a student who is shy or not really saying much more than 1-2 words. Resist the urge to ask too many questions. If you do speak, use open ended comments or questions, such as "I really like to go to amusement parks. I don't like going on roller coasters though." This way, the student will hopefully open up and start a dialogue, rather than just answering your questions with 1 or 2 words. 

What do you use when taking language samples? Tell me below!

Clinical Skills Confidence: Language Samples

Time to talk about language samples! 

I like to make sure I take a language sample when I do an assessment. Of course, this is not the ONLY time I take one, but it gives a good representation of a student's strengths and weaknesses, grammar skills, narrative skills, and overall language skills. 

This is where I'm eternally grateful to have an iPad. I can easily grab it to take a recording and go back to it later on. In a pinch, I can use my digital recorder. 

Sometimes, I have students who are not as easily engaged in a conversation. In these cases, I may pull out a book to have him/her narrate a story or watch a short video to help the student start. In an effort to save you some time, I created some language sample prompt cards that you can whip out instead of having to come up with a topic! Grab your free sample HERE. I also have the full product on sale in my TPT store, which you can grab HERE!

Stay tuned for a future Clinical Skills Confidence post where I will write about what I look for in a student's language sample! Let me know what YOU use to get a language sample from your students!

Clinical Skills Confidence: Preschool Party!

Disclaimer: Pictures link to Amazon where you can purchase the described item. I am an Amazon affiliate. 

Who loves working with preschoolers? I generally consider preschoolers to be 3-5 year olds. I love working with children of all ages, but I find children this age to be pretty entertaining and fun to work with. These little ones are starting to exert their independence (and boy do they sometimes) and figuring out the world around them. 

Though not exclusively, I've worked with this age group since I graduated. Here are my favorite, inexpensive things to use with this age group: 

1. Balloons: Oh, the fun you can have! I like to blow up a balloon, hold it up and say, "ready, set, go" before letting it fly all around the room. The look of delight on their faces is priceless. Fair warning: they always want one to try blowing it up themselves, so I have extras on hand. If I have a child who is working on expanding utterance length, I will often prompt him/her to say "blow...blow bigger...blow more..."

2. Pill boxes: These little compartments are great for lots of different things. I sometimes put buttons or other little things inside and prompt the kids to say things like, "open, shut, I see ____, I found ____." I put velcro or something over the day/time. 

3. Stretchy book covers: Small confession - I like back to school time when all sorts of school supplies are in stores. I found these soft book covers on clearance once and have used them for different things. I purchased a bunch in different colors. If you invert one of the sides, they can be hung over the backs of chairs. You can have the kids do sorting, vocabulary, WH questions, or other activities this way. They are really soft too, so I've had kids who just like putting their hands in them and twisting for a mini-sensory break.

What are your favorite inexpensive things to use with this age group?