providing speech language intervention using teletherapy · 8 tips for easy –fast –free speech...
TRANSCRIPT
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Providing Speech Language Intervention Using TeletherapyProviding Speech Language
Intervention Using Teletherapy
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‐Technology is readily available
‐Controlled Environment
‐Support Personnel
‐By choice
‐Technology isn’t readily available
‐Home environment
‐Parents are not the service providers or the support personnel
‐Because Pandemic
‐Emotional stressors for clinicians and families
‐Economic stressors
‐Shifted Priorities
‐Requires knowledge of video platform (privacy and settings)
‐selecting clients who are appropriate for assessment and intervention services via telepractice
‐Requires understanding of interactive features for student engagement
‐understanding and applying appropriate models of technology used to deliver services;
‐selecting and using assessments and interventions that are appropriate to the technology being used and that take into consideration client and disorder variables
Teletherapy Teletherapy during a Pandemic
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Things have changed. BUT…
There are industries that have successfully transitioned over to remote working.
We just need to learn how they are scheduling, organizing their sessions, using technology, and interacting as new professionals
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Things have changed. BUT…
There are SLPs, albeit, a small number, who have already been doing teletherapy for years.
We just need to get up to speed on how they are effectively evaluating, treating, and achieving balance between work and life.
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Things have changed. BUT…
Early Intervention Specialists have developed Routines‐Based Intervention and interact really well with families and in the home.
We just need to know how to flip the model from teacher‐centered to parent‐centered and form goals around home activities.
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Things have changed. BUT…
Some (not all!) of our tired‐and‐true therapy technigues are still successful when used remotely.
We just need to know which ones, how to share materials digitally, and how to track progress.
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Providing Highly Effective Speech Language Teletherapy
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Improve Your Technology Use6 Tips to Use Zoom/Hangouts /Powerpoint/ Google Slides Effectively
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1. Light source and camera angle Put the light to the side and have your camera up higher.
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2. What to check and uncheck
Check• “Recurring” for Weekly Sessions
• Meeting Password to avoid Zoom Bombing
• Join Before Host
Uncheck• Meeting Required• Waiting Room (Zoom)• Mute Participants Upon Arrival
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3. Test Audio and Video• Don’t take it for granted anyone can
see or hear you.
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3. Test Audio and Video• Zoom “Share computer sound”
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4. Open 3 things: Presentation, Chat, & Participants
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5. Build your materials in PowerPoint or Google Slides
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6. Browse by Individual Window
So how did we do this?
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For PowerPoint:
• Open Powerpoint• Click on SlideShow• Click Browse By Individual Kiosk
• Open the full Powerpoint view
• Shrink down this window
• In Zoom, share the Powerpoint, not your whole screen
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Easier Scheduling and Increasing Show Rates
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Schedule Reminders : Scheduling like a dentist
Use Email
Use Text
Remind at the end of the prior session
Email reminder the day of
Text reminder an hour before
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Email Templates
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Email Scheduling
Bulk write all your emails on Monday and schedule them.
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Email Scheduling
Search: Install Gmail Boomerang or How to Delay Sending an Email Using Lotus Notes
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Bulk schedule texts
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Use Google Translate
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How do we handle texting?
The Problem• We need our phone on to hear from parents but it is distracting during sessions.
• We normally don’t mark texts for “later” to be able to respond by email.
• In terms of the global pandemic, there is a lot more going on.
The Solution
• Set Notification Rules
• Pin Messages
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Pin Messages
• We often feel an immediate need to respond to texting.
• If we don’t the message can get buried by everything else that comes in that day.
• This is unlike email where we can mark things for later.
• Pin messages so that that stay at the top.
• Batch respond to everyone at one time later in the day.
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Set Notification Rules
• Mark certain people or groups to silent or inactive.
• A Case Study:• My family!• I have 6 sisters and 1 brother • They text like crazy at times.• During the global health crisis, one of my sisters is a nurse who contracted Covid. Our 80—year‐old aunt and uncle also got sick.
• So I want to stay tuned in, just not all day.
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Sharing Materials and Giving Instructions
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2 huge hurdles to transitioning over to
teletherapy:
Giving InstructionsSharing Materials
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Make Your Own Website
• Websites are a great – single location – for you to share all of your stuff.
• There are several places you can go to build your own site quickly.
• This article has all you need to pick a site and get up and running quickly:
• https://www.websitetooltester.com/en/blog/best‐free‐website‐builders/
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How do we share instructions?
Parents need a way to remember what to do or how to intervene between sessions.
Teachers would benefit from seeing examples or knowing how to improve communication in the classroom.
The fastest and most impactful way to share instructions is with videos.
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The Speech Therapy Blog:
Easily Make SLP Videos
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8Tips for Easy – Fast –Free Speech Pathology Video Creation
1. Use the Free Software your computer has:PC = Windows Movie MakerMac = / Quick Time / iMovie / Photo booth
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8 Tips for Easy – Fast – Free Speech Pathology Video Creation2. Clap Your Hands After You Mess UpClapping your hands causes the audio to spike so that you can see where your mistake was. It makes it really easy to edit those parts out.
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8 Tips for Easy – Fast – Free Speech Pathology Video Creation3. Don’t Turn Your Camera OffIf you make mistakes, keep rolling! Turning your camera off and on takes up a lot of time and can make you more‐and‐more nervous. Just roll with it and cut out the bad stuff later.
4. Add a Title Slide or Beginning StatementLet’s face it, we really don’t want to invest our time into a video if we don’t know what it is about. While it breaks our story‐telling hearts, we need to begin by saying EXACTLY what the video is about.
“This is a two‐minute video that will show you how X, Y, & Z.”
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8 Tips for Easy – Fast – Free Speech Pathology Video Creation5. Smile for a Few Seconds Before You Start TalkingIf you smile and hold your smile for two seconds before you begin to talk, it is easier to find a frame you like to begin with.
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8 Tips for Easy – Fast – Free Speech Pathology Video Creation6. Use Transition Slides to Cover‐Up Bad TransitionsIf you cut out a section you don’t want. You can spend hours trying to make the pieces fit together or make your face not look weird. Throw a transition action life Fading or a screen with a title between the breaks: “Next, How to Teach Following Directions”
7. Keep them short!Research from Vimeo, Youtube, and Facebook indicates that there is a big drop‐off in watching after three minutes. This is permission for us to keep it short!
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8 Tips for Easy – Fast – Free Speech Pathology Video Creation8. Shrink your videos using HandbrakeHandbrake is a free program that you can download to your computer to reduce the size of the video.
https://handbrake.fr/
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Telepractice Work‐Life “Balance” :Unblurring the Lines in the Age of Overlap
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11 Tips for Working
Remotely and Maintaining a
Sense of Harmony
Gathered from Industries Who Have Made the Transition to Remote Working
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Be careful how you define yourself"We tend to form our identity around what we do as a job. Part of the point of work‐life balance is recognizing that there's more to you than being a therapist. Work‐life balance helps practitioners to avoid over‐identifying with one role."
Roberta L. Nutt, PhD, chair of the APA Board of Professional Affairs' Advisory Committee on Colleague Assistance (ACCA)
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Start with making some small changes
You don’t need dramatic upheaval, you just need to set your priorities and build up some small wins.
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Have a clear endpoint to your work day
Have a set time when you’re done for the day, and allow yourself to recharge and engage in non‐work activities after that point.
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Be unavailable
Unplug your devices and step away from the outside world.
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Have a strong non‐work, non‐household social support network
Research shows a correlation between social support and lower levels of work‐family conflict
(Quick & Tetrick, 2002, p. 151).
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Have fun after work during the weekDon’t save all of your fun activities for the weekend. What are you doing during the weeknight after work?
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Know your limitations"Nowadays with the information age it feels as if there is always more to do than one can truly accomplish in
one day.
Accept that you're not going to be able to do everything that you want
to do.”
Learn how to say “no”Learn how to say “later”
Jonathan Huppert, PhD, assistant professor of clinical psychology in psychiatry at the University of Pennsylvania
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Deliberately and intentionally take time off
Don’t forget about your vacation days!
Devote periods of time to personal interests outside of the workplace.
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Develop outside interestsPsychology research indicates that having an outside interest improves mental health.
HobbiesVolunteeringRecreational activitiesExercise
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Embrace flexibility
My daughter’s math teacher during the pandemic:
Hi all,All of my lessons are now up online. I set up my office and classroom hours so that I can also help get my three kids set up during their classes. I will have office hours from 9‐10 am and 5‐7 pm. And of course we will meet for class at 11am.
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Adopt a long‐range perspective
"We all have different needs to balance during different stages of our careers…Keeping things in perspective and creating a long‐term balance is important. We may not be able to keep every day balanced, but we can work to keep the week or the month balanced. We all need to find the steps that work for us.“Roberta L. Nutt, PhD, chair of the APA Board of Professional Affairs' Advisory Committee on Colleague Assistance (ACCA)
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Providing Speech Language Intervention Using Teletherapy
Region 6 ESC Online
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About Me
2
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3
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Laura Finkel MS-SLP-CCC
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Major Transformations in my Practice
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YES and No……
• Agree or Disagree??
• Both….
BLEEP
6
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“The ability to shift quickly to virtual learning and learning-at-home models, with increased accountability for student engagement.”
7
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Reflecting on Practice: a Discussion on Equity in
Teletherapy
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Routine
• I work..I work…
• How do you feel?
• Song or Picture of the Day
• Story Grammar Review
• Intervention
• Wrap-Up Activity
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Acknowledge the Difference
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Google slides or Powerpoint
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I work!I work!
I work on…telling a story!my sounds!R, S, SH
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Welcome to Finkel Friday Speech
• I work..I work..I work on telling
stories.
• Check-In
• Song (or picture of the day)
• Story Grammar Rap
• Literacy-Based Intervention
• Game
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Welcome to Finkel Friday Speech
• I work..I work..I work on telling
stories.
• Check-In
• Song
• Story Grammar Rap
• Literacy-Based Intervention
• Game
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• I work..I work..I work on telling
stories.
• Check-In
• Picture of The Day
• Story Grammar Rap
• Literacy-Based Intervention
• Game
What’s Going On in This Picture? | May 18, 2020
Look closely at this image, stripped of its caption, and join the
moderated conversation about what you and other students
see.
May 21, 2020 By THE LEARNING NETWORK
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• https://www.archives.gov/education
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Speech
• I work..I work..I work on telling stories.
• Check-In
• Picture of The Day or Song
• Story Grammar Rap
• Literacy-Based Intervention
• Game
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Characters are the people in a story.Setting is when and where.Problem, hey what’s wrong?Solution, let’s solve it!
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What’s the Plan?
• I work..I work..I work on telling
stories.
• Check-In
• Picture of The Day
• Story Grammar Rap
• Literacy-Based Intervention
• Game/Show and Tell
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How important are narratives?
• We ask children to tell us about events, retell
stories, write about events in their journals, and
answer questions about stories.
• We analyze and judge the grammar and content
of their stories, the order of events, the semantic
complexity, and the narrative elements.
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Why Use storybooks in speech and language therapy?
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� Shared reading activities • Increase development in multiple areas (Doyle & Bramwell, 2006; Debaryshe, 1993; Burner, 1978)
• Promote language development in children with typical development (Teale & Sulzby, 1986; Westby, 1985) and with language impairments (Gillam & Ukrainetz, 2006)
• Promote a greater desire to read (Mason & Blanton, 1971)
• Exposes student to printed materials and positive reading models (Teal, 1984)
WHY USE STORYBOOKS?
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Language disabilities and reading disabilities:
• 40% of preschool children with language disorders develop significant literacy learning difficulties (Aram & Nation, 1980; Rescorla, 2003) even if their delays appear to have been resolved by age 5 (Scarborough, 1990; 2002)
• Approximately 90% of individuals with severe communication disorders experience significant literacy learning difficulties (Koppenhaver & Yoder, 1992).
• Children with oral language disorders are at great risk for reading disabilities (Schuele, 2004)
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IDEA
2004
•Free and Appropriate Public Education
IEP
•Access to the General Curriculum
SLP
Services
•Least Restrictive Environment
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Working Across All Levels
Serving a Range of Disorders
Ensuring Educational Relevance
Providing Unique Contributions to Curriculum
Highlighting Language/Literacy
Demonstrating Cultural Humility
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@theconsciouskid
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• • Follow and learn:
@theconsciouskid
@iamrachelricketts
@diversereads
@britthawthorne
@thetututeacher
@apron_education
@readlikearockstar
@blackandembodied
Elementary Level
A Kids Book about Racism by Jelani Memory
Last stop on Market Street by Matt de la Peňa
The New Small Person by Lauren Child
Look Up by Nathan Bryon and Dapo Adeola
Please Baby Please Spike Lee and Tonya Lewis Lee
Dancing in the Wings by Debbie Allen
Baby Dance by Ann Taylor
Peekaboo Morning by Rachel Isadora
I Can Do it Too by Karen Baicker
Lola at the Library by Anna Mcquinn
When Grandma Gives you a Lemon Tree by Jamie L.B.
Deenihan
I Got the Rhythm by Connie Schofield-Morrison
Jabari Jumps by Gaia Cornwall
Ron’s Big Mission by Rose Blue and Corinne Naden
Those Shoes by Maribeth Boelts
Martin’s Big Words by Doreen Rappaport
Henry’s Freedom Box by Ellen Levine
Snowy Day by Ezra Jack Keats Hair Love by Matthew A. Cherry
I am Enough by Grace Byers
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For Literacy-Based Teletherapy
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For Literacy-Based Teletherapy
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Immigrant Stories
• Islandborn By Junot Díaz
• My name is Yoon By Helen Recorvits
• Name Jar By Yangsook Choi
• One Green Apple by Eve Bunting
• Angel Child Dragon Child By Michele
Maria Surat
• Grandfather’s Journey By Allen Say
• The Memory Coat By Elvira Woodruff
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Read-Aloud Pre-recorded Example
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Problem: I cannot stand
the sound of chickens.
Characters: Claire Rose,
Ms. Phuong, chickens
Setting: At the speech
clinic
Solution: We close the
windows!
Telling: “Claire Rose and Ms. Phuong. We at speech, and we hear chickens.
And and we close the door and and work on on stories. “
Retelling (after Ms. Phuong’s) 1: “ We going in speech, and the windows are
window. And, I hear a chicken. Annoying! And, we close the door, and we end
speech.“
Retelling 2: Claire and Ms. Phuong in speech. I am not in school. I’m sitting
down at Ms. Phuong’s desk. I am angry about these chickens, and we are
working on stories and sounds. So, Ms. Phuong closed the windows! And,
Claire is sitting down in the chair.
X Characters?
X Setting?
X Problem?
X Solution?
X Feelings?
Dialogue?
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16-Part Narratives
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TheInformedSLP.com
TheInformedSLP.com
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Outside of the box pre and post-reading ideas
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4 Week Literacy-Based Intervention Plan
Building Background information and intro to Story-Tell by SLP
Round Robin Story Re-tell of “MATS”+ Song
Progress monitor by language sampling story re-tell for each
student
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Middle School Book Club
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This Photo by Unknown Author is licensed under CC BY-NC-ND
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Build Background Knowledge
• What are Fables?
• Watch a video
• Pre-teaching vocabulary
This Photo by Unknown Author is licensed under CC BY-ND
Language Sampling With Adolescents: Building a Normative Database With Fables, Marilyn A. Nippold , Laura M. Vigeland , Megan W. Frantz-Kaspar , and Jeannene M. Ward-Lonergan, Aug 2017
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Questions:
1. Do you agree with the moral of this story, “It
is better to bend than to break”?
2. Why or why not (do you agree or disagree)?
3. Can you think of a situation in real life
where that moral would apply?
4. Can you tell me anything more about the
moral or the situation?
Language Sampling With Adolescents: Building a Normative Database With Fables, Marilyn A. Nippold , Laura M. Vigeland , Megan W. Frantz-Kaspar , and Jeannene M. Ward-Lonergan, Aug 2017
The Oak and the Reed Adapted from Aesop’s Fables,
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Questions:
1. Do you agree with the moral of this story, “What is truly most valuable is often underrated”?
2. Why or why not (do you agree or disagree)?
3. Can you think of a situation in real life where that moral would apply?
4. Can you tell me anything more about the moral or the situation?
Language Sampling With Adolescents: Building a Normative Database With Fables, Marilyn A. Nippold , Laura M. Vigeland , Megan W. Frantz-Kaspar , and Jeannene M. Ward-Lonergan, Aug 2017
The Stag at the Pool
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Questions:
1. Do you agree with the moral of this story, “Beware of flatterers”?
2. Why or why not (do you agree or disagree)?
3. Can you think of a situation in real life where that moral would apply?
4. Can you tell me anything more about the moral or the situation?
Language Sampling With Adolescents: Building a Normative Database With Fables, Marilyn A. Nippold , Laura M. Vigeland , Megan W. Frantz-Kaspar , and Jeannene M. Ward-Lonergan, Aug 2017
The Fox and the Crow
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Questions:
1. Do you agree with the moral of this
story, “If you grasp at the shadow, you
will lose the substance?”
2. Why or why not (do you agree or
disagree)?
3. Can you think of a situation in real life
where that moral would apply?
4. Can you tell me anything more about
the moral or the situation?
Language Sampling With Adolescents: Building a Normative Database With Fables, Marilyn A. Nippold , Laura M. Vigeland , Megan W. Frantz-Kaspar , and Jeannene M. Ward-Lonergan, Aug 2017
The Dog and His Shadow
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The Hungry Caterpillar
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Toy Story 4
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Measuring Progress
•Macrostructure
•Story Grammar
•Rubrics
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Goals+Therapy=Outcomes
• Student will receive 22/35 points on the narrative scoring scheme by including character development (including character dialogue), setting, problem and solution given a graphic organizer and recasted language models.
• Student will score a 3 out of 5 on character development on the narrative scoring scheme by retelling a story with character dialogue and by including main and supporting characters given, “who question prompts” as needed.
Narrative Scoring Scheme
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Assessment of Fictional Narratives
www.Bilinguistics.com
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Articulation
• Student will produce
/target sounds/ with 80%
accuracy independently
at the word level.
• Student will produce
/target sounds/ with 80%
accuracy given models,
visual/verbal reminders,
recasted productions of
target words as needed
at the story re-tell level.
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Articulation In-Person
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Articulation Distance Learning
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Interactive Features for Articulation
Video Example
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Annotate
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The Cat who Climbed a tree (and got stuck)
By Santiago
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Articulation Create a story with target words and sounds
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Technology vs. Traditional Toys
This Photo by Unknown Author is licensed under CC BY-SA-NC This Photo by Unknown Author is licensed under CC BY-NC-ND
Auditory Bombardment, Discrimination, Phonemic Awareness Tasks
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Jesus, L. M. T., Martinez, J., Santos, J., Hall, A., & Joffe, V. (2019). Comparing Traditional and Tablet-Based Intervention for Children With Speech Sound Disorders: A Randomized Controlled Trial. Journal of Speech, Language, and Hearing Research. doi: 10.1044/2019_JSLHR-S-18-0301.
-The Informed SLP
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AAC and Core Vocabulary via Teletherapy Video Example
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Pre-recorded examples of Core Board
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Changing Virtual Background
Settings Virtual Background Choose new background
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Follow on YouTube
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Surprise Bags
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Social Skills
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• I work..I work..I work on telling
stories.
• Check-In
• Picture of The Day
• Story Grammar Rap
• Literacy-Based Intervention
• Game
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www.boomlearning.com/decklibrary
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Show and Tell
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SA Case Study 1st grade
• Selective-Communication Like Behavior
• Recently started communicating with me after 3 months of knowing him.
• Presents with phonological processes stopping and fronting
• Language Disorder
• Currently being evaluated for other dx besides SLI
• Difficulties with Reading, Writing, and Math.
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Scavenger Hunt
Expanding Expressions Tool
ExpandingExpression.com
Increasing Vocabulary Diversity
Bilinguistics.com
Hadley, E. B., Dickinson, D. K., Hirsch-Pasek, K., & Golinkoff, R. M. (2018). Building semantic networks: The impact of a vocabulary intervention on preschoolers’ depth of word knowledge.
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Informed SLP
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Parent Coaching
• “I wonder if…”
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The family’s perspective
• The therapist just plays with my child.
• They just sit and talk with me and do nothing with my child.
• This is all too overwhelming.
• I don’t have time in my day to do this.
• I forget what to do after the therapist leaves.
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The SLP’s perspective
Families don’t always follow through with suggestions.
I can’t get families to incorporate ideas into
daily routines.
Many times families don’t
make appointments.
I don’t have easily
accessible resources to share with families.
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Not on the same page
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Buy In
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Rationale
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Maslow’s Hierarchy
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Getting Families Involved
We know it’s important, how do we do it?
• Provide specific instructions
• Provide a rationale
• Keep it simple and consistent
• Have it pertain to a family event or routine
• Set expectations
• Follow through
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The Informed SLP
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Shared-Reading
Switching mindset from “education” to gaining insight into the child’s thoughts
No such thing as right or wrong
Increasing use of wait time
Increasing conversational turns
Making phonemic awareness fun and silly (like making up nonsense words by taking words in the text and changing one phoneme)
Using open ended prompts: “I wish…” “I think…” “I wonder…” “What do you think?”
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Interacting with Teachers and Parents
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Creating a website
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How to use your website during therapy
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https://youtu.be/s-P_WdQWPc8
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BitmojiClassrooms
ToyaNicol3 on Teachers Pay Teachers and YouTube
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Technology as a Social Engagement
Tool
What if the students didn’t touch
the iPad even when you’re doing
in-person learning. It’s a barrier
activity that can be used in-
person and through distance
learning.
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Using Technology: Sentence Combining as Evidenced-Based Practice
This Photo by Unknown Author is licensed under CC BY-SA-NC
It CAN be FUN!
Lynne Telesca (2018).
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Sentence Combining
• Student will increase sentence
complexity from an average of 1
clause per utterance to 1.2
clauses per utterance during a
story retell, given a word bank of
subordinating conjunctions.
1. The boy ran quickly.
2. The bees were chasing him.
Subordinating Conjunction
Because
Lynne Telesca (2018). Supporting Adolescent Writing Manipulating Complex Syntax Across Disciplines. ASHA Connect Summer 2018.
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TinyBop Apps
• Creature Garden
• Weather
• Space
• The Robot Factory
• Plants
• The earth
• Coral Reef
• States of Matter
Target word:
Because
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Group vs Individual Teletherapy
This Photo by Unknown Author is licensed under CC BY-NC
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Considerations for Teletherapy
• There’s not a one-size fits all with families and speech-language pathologists.
• When you enjoy what you’re doing, you’ll be more effective.
• Technology vs traditional toys….it doesn’t matter. It’s the approach that matters.
• Find your groove within tele-therapy while keeping yourself rooted in evidenced-based practice.
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Follow on YouTube
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Resourceshttps://www.theconsciouskid.org/books
https://www.theinformedslp.com/
Hessling, A., & Schuele, C.M. (2020). Individualized narrative intervention for school-age children with specific language impairment.
Language, Speech, and Hearing Services in Schools. https://doi.org/10.1044/2019_LSHSS-19-00082 [available to ASHA members].
Curran, M., & Van Horne, A. O. (2019). Use of Recast Intervention to Teach Causal Adverbials to Young Children With Developmental
Language Disorder Within a Science Curriculum: A Single Case Design Study. American Journal of Speech-Language Pathology.
doi:10.1044/2018_AJSLP-17-0164
Language Sampling With Adolescents: Building a Normative Database With Fables, Marilyn A. Nippold , Laura M. Vigeland , Megan W.
Frantz-Kaspar , and Jeannene M. Ward-Lonergan, Aug 2017
Jesus, L. M. T., Martinez, J., Santos, J., Hall, A., & Joffe, V. (2019). Comparing Traditional and Tablet-Based Intervention for Children With
Speech Sound Disorders: A Randomized Controlled Trial. Journal of Speech, Language, and Hearing Research. doi:
10.1044/2019_JSLHR-S-18-0301.
Hadley, E. B., Dickinson, D. K., Hirsch-Pasek, K., & Golinkoff, R. M. (2018). Building semantic networks: The impact of a vocabulary
intervention on preschoolers’ depth of word knowledge.
Nelson, L. H., Stoddard, S. M., Fryer, S. L., & Muñoz, K. (2019). Increasing Engagement of Children Who Are DHH During Parent–Child
Storybook Reading. Communication Disorders Quarterly. doi:10.1177/1525740118819662
Lynne Telesca (2018). Supporting Adolescent Writing Manipulating Complex Syntax Across Disciplines. ASHA Connect Summer 2018.
Jissel B. Anaya , Elizabeth D. Peña , and Lisa M. Bedore. (2018). Conceptual Scoring and Classification Accuracy of Vocabulary Testing in Bilingual
Children.
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