Happy Wednesday! Listed below are a few naturalistic strategies to consider. These are also strategies that I religiously implement into my sessions, and are super easy for me to teach and model to parents in order to facilitate sufficient carryover. Enjoy!! :)
*Environmental Arrangement:
-observe your environment upon your arrival at the home
-make yourself apart of the routine
-pick an activity, present choices that are highly motivating, and begin to play, interact, and engage the family
-make sure to provide explanations for techniques and strategies you are using, ways to illicit responses, etc.
*Modeling
-be sure to capture the child's attention, using turn taking, hand over hand, motivating toys/objects & activities
-show the child and parent what you want them to do, allow them to imitate you, and continue to practice throughout the session, providing and fading models when necessary
-provide corrective feedback
-expand on responses; ex: the child makes a word approximation for "bear" you could respond "brown bear", or use other descriptors to increase vocabulary and expand on concept knowledge
*Mand-model
-similar to modeling, however, you are being more insistent about being provided with a response
-provide choices "do you want cereal or fruit?" and model and provide verbal prompts/cues "I want_____" or "______ please"
-be consistent and make sure the child knows your expectations, be sure to explain to the parents how to implement this into their routine, and why it is important for communication skills growth
*Time Delay
-model the sound, word, gesture, phrase, etc. at least 3 times; be sure to wait for a response
-observe the child and ask yourself, "are they engaged?" and "do they understand?"
-when presenting an item, allow the child to make comments or requests, instead of speaking first
***Coaching***
-provide an opportunity for the parent to demonstrate their usual activity and interactions with their child; ask what they would like to see happen
-demonstrate how to make the behavior and/or communication happen & allow them an opportunity to practice
-give direct instruction and feedback
-brainstorm ideas and plan ahead for various trials/test it out
-explain the behaviors, techniques, etc. and how they directly relate to the speech and language goals
-summarize the session, make measurable and reasonable recommendations for the week
-ask for feedback; "was it helpful to you?, what do you need from me?, if you could change something in the therapy session, what would it be?" etc.
-follow up during the next session and be consistent with practice and instruction
Wednesday, January 15, 2014
Monday, January 13, 2014
Noteworthy
Happy Monday!! :) I have been so graciously complimented on my therapy notes in the past few months by a couple of my families. I just wanted to do a short post on how I typically format my speech notes and provide a brief explanation of why I feel these items are important to mention. I try my very best to capture a 60 minute session in 15 minutes or less, including as much as possible for the parents to use as a guide for the week, weekend, and/or month until we meet again, for any other provider working with the child, and for parents to share with their medical team, and/or preschool/daycare teachers if ever necessary. As always, feel free to share your speech note formats and explanations. Thank you in advance!
Family Update: All things new :) In this section, I write a short paragraph about any new news regarding the child and their family, life changes, transitions to preschool, new words, new phrases, new signs, new intervention services, etc. I believe it is imperative to capture the family's full dynamic, and factors that may impact the child's overall communication skills.
What Happened?: This section of the note includes the initial greeting (it's important to know how the child reacted and to track progress of them "coming out of their shell", regression, etc.) activities/routines practiced (this makes it easier to imitate throughout the week, especially if this routine is difficult for the child and/or parent) , therapeutic techniques used: modeling, hand over hand, instruction, verbal cues, etc. (this tells the parent how to do what is needed to assist their child in progressing), what the child enjoyed (it's important to follow the child's lead and continue with preferred activities, as this motivates them to communicate and communicate effectively), & explanations given to the parents about questions asked regarding language development, overall development, etc. (a plethora of information is shared throughout the session and this a good reminder for the parents to refer to, versus trying to remeber it all on top of all of the other things they need/have to remember).
Recommendations: This is where I share one specific recommendation and a few therapeutic techniques and strategies to assist with achieving the short term goal/s. Typically it's the same recommendation for a couple of weeks or until I feel and/or the family feels as though their child has grasped or is close to achieving this goal or concept. When parents/caregivers are actively involved, carrying over the recommendations is generally easy to practice, as the techniques have been previously introduced throughout the session. Also, depending on the family update, I may take a step back, and modify the goal if it appears too difficult or too taxing for the child and their family at that time.
Family Update: All things new :) In this section, I write a short paragraph about any new news regarding the child and their family, life changes, transitions to preschool, new words, new phrases, new signs, new intervention services, etc. I believe it is imperative to capture the family's full dynamic, and factors that may impact the child's overall communication skills.
What Happened?: This section of the note includes the initial greeting (it's important to know how the child reacted and to track progress of them "coming out of their shell", regression, etc.) activities/routines practiced (this makes it easier to imitate throughout the week, especially if this routine is difficult for the child and/or parent) , therapeutic techniques used: modeling, hand over hand, instruction, verbal cues, etc. (this tells the parent how to do what is needed to assist their child in progressing), what the child enjoyed (it's important to follow the child's lead and continue with preferred activities, as this motivates them to communicate and communicate effectively), & explanations given to the parents about questions asked regarding language development, overall development, etc. (a plethora of information is shared throughout the session and this a good reminder for the parents to refer to, versus trying to remeber it all on top of all of the other things they need/have to remember).
Recommendations: This is where I share one specific recommendation and a few therapeutic techniques and strategies to assist with achieving the short term goal/s. Typically it's the same recommendation for a couple of weeks or until I feel and/or the family feels as though their child has grasped or is close to achieving this goal or concept. When parents/caregivers are actively involved, carrying over the recommendations is generally easy to practice, as the techniques have been previously introduced throughout the session. Also, depending on the family update, I may take a step back, and modify the goal if it appears too difficult or too taxing for the child and their family at that time.
Saturday, January 11, 2014
Budget Friendly Language & Play!
As a community based early intervention speech-language pathologist, I am always thinking of various ideas and ways to promote imaginary play and continuous language stimulation for the children I work with in the most natural way possible (using materials/objects in their home). In addition, I continue to share my ideas and brainstorm with families to compile lists of favorite books, songs, observe play skills, etc. In the list below, you will find some creative play ideas, using materials that are right under your nose at home/in your kiddos' homes, or can be purchased for a small price.
Providers: Try suggesting some of these play ideas to your families. Reiterate that the activities costs little to no money, and will help their child expand on their play skills, while intensely stimulating growth in their communications skills.
Caregivers: Try creating your own game using materials from your home. If you believe, your children will believe and enjoy this, and you may even find them beginning to create their own game using objects you never imagined. Use your imagination, it can be a magical and heavily stimulating language learning experience if you only believe.
1. Music
Imagine this:
Have a concert, clap hands, stomp feet; choose interactive songs that require imitating gestures and or making faces, sing to your baby etc.
Keywords: music, sing, clap hands, wave hands, stomp feet, jump, touch head, tap legs, etc.
Some of my favorite children's music artists include Laurie Berkner & Raffi.
Music is a universal language that can be used with all ages :)
2. Books/Reading
Imagine this:
Photo Album/Book: make a photo album using construction paper and gluing and/or taping pictures of family member, objects in the home, American Sign Language
(ASL) baby signs, favorite toys, categorical items (bathroom toys/objects, clothes, foods, transition times, etc.)
***Pictures can be cut from child friendly/parenting magazines to glue on to construction or printer paper as well.
Sticker books: Have the child place their favorite character stickers, shapes, colors, animals, cars/trains, etc. on paper and staple together, hole punch and tie with yarn to make a book, etc.
Keywords: book, paper, glue, sticker, etc.
3. Boxes
Imagine this:
Pretend the box is a car, grocery cart, and/or house: push the box around, place items from around the house into the box, decorate the box with stickers and coloring, place a blanket and pillow in the box, etc.
Keywords: night night, box, vroom, beep, window, house, car, in, out, open, close, etc.
***A family I work with did this, and I commended them for being creative and resourceful, as well as thanked them for allowing me to share their idea
4. Toilet paper rolls/Pringles Container/Biscuit Container
Imagine this:
Binoculars/Telescope: pretend to look outside, play "I Spy", look for items in books, out of the window at home, when driving, etc.
Speaker phone/Telephone: pretend to make a phone call, call upstairs/downstairs and/or around the house to the family pet or family members, use this to make requests, label picture/objects, etc.
Keywords: I see, wow, look, come please, help please, more juice, hi, bye bye, all done, etc.
5. Tupperware
Imagine this:
Talk about the various shapes and sizes of the tupperware, place objects in, out, on top, under, etc.
Keywords: circle, square, big, little, in, out, on top, under, etc.
Pretend to drive with the circular shaped tops or bottoms, making it your steering wheel
Keywords/Sounds: beep beep, car, drive, vroom, fast, slow, go, etc.
Make a train by lining up the tupperware and pushing them like a train
Keywords/Sounds: choo-choo, go, fast, slow, chug-a-chug, track, etc.
Have a concert; bang on the tupperware and sing songs, pretend they're instruments, etc.
Keywords/Sounds: drum, sing, music, bang, boom, la la la, etc.
Play Peek-a-boo: hide behind the tupperware and call the child's name or say "boo" or "I see you"
Keywords: I see you, boo, etc.
Feel free to leave more creative play ideas in the comments section or email me. Have a great weekend!!! :)
Providers: Try suggesting some of these play ideas to your families. Reiterate that the activities costs little to no money, and will help their child expand on their play skills, while intensely stimulating growth in their communications skills.
Caregivers: Try creating your own game using materials from your home. If you believe, your children will believe and enjoy this, and you may even find them beginning to create their own game using objects you never imagined. Use your imagination, it can be a magical and heavily stimulating language learning experience if you only believe.
1. Music
Imagine this:
Have a concert, clap hands, stomp feet; choose interactive songs that require imitating gestures and or making faces, sing to your baby etc.
Keywords: music, sing, clap hands, wave hands, stomp feet, jump, touch head, tap legs, etc.
Some of my favorite children's music artists include Laurie Berkner & Raffi.
Music is a universal language that can be used with all ages :)
2. Books/Reading
Imagine this:
Photo Album/Book: make a photo album using construction paper and gluing and/or taping pictures of family member, objects in the home, American Sign Language
(ASL) baby signs, favorite toys, categorical items (bathroom toys/objects, clothes, foods, transition times, etc.)
***Pictures can be cut from child friendly/parenting magazines to glue on to construction or printer paper as well.
Sticker books: Have the child place their favorite character stickers, shapes, colors, animals, cars/trains, etc. on paper and staple together, hole punch and tie with yarn to make a book, etc.
Keywords: book, paper, glue, sticker, etc.
3. Boxes
Imagine this:
Pretend the box is a car, grocery cart, and/or house: push the box around, place items from around the house into the box, decorate the box with stickers and coloring, place a blanket and pillow in the box, etc.
Keywords: night night, box, vroom, beep, window, house, car, in, out, open, close, etc.
***A family I work with did this, and I commended them for being creative and resourceful, as well as thanked them for allowing me to share their idea
4. Toilet paper rolls/Pringles Container/Biscuit Container
Imagine this:
Binoculars/Telescope: pretend to look outside, play "I Spy", look for items in books, out of the window at home, when driving, etc.
Speaker phone/Telephone: pretend to make a phone call, call upstairs/downstairs and/or around the house to the family pet or family members, use this to make requests, label picture/objects, etc.
Keywords: I see, wow, look, come please, help please, more juice, hi, bye bye, all done, etc.
5. Tupperware
Imagine this:
Talk about the various shapes and sizes of the tupperware, place objects in, out, on top, under, etc.
Keywords: circle, square, big, little, in, out, on top, under, etc.
Pretend to drive with the circular shaped tops or bottoms, making it your steering wheelKeywords/Sounds: beep beep, car, drive, vroom, fast, slow, go, etc.
Make a train by lining up the tupperware and pushing them like a train
Keywords/Sounds: choo-choo, go, fast, slow, chug-a-chug, track, etc.
Have a concert; bang on the tupperware and sing songs, pretend they're instruments, etc.
Keywords/Sounds: drum, sing, music, bang, boom, la la la, etc.
Play Peek-a-boo: hide behind the tupperware and call the child's name or say "boo" or "I see you"
Keywords: I see you, boo, etc.
Feel free to leave more creative play ideas in the comments section or email me. Have a great weekend!!! :)
Tuesday, January 7, 2014
Organized State of Mind
So…if you don’t know by now, I am a self-proclaimed
organization freak. I have provided the chart that I use daily to keep track of
all of my visits and clients, as scheduling in early intervention can overwhelm
you if you do not plan ahead and maintain organization. I have a pretty
consistent schedule each week, however, life happens and it may vary from time
to time. I also use a weekly/monthly planner, to write down the child’s name
and their scheduled sessions, as well as keeping a caseload sheet (child’s name,
address, caregiver phone number, etc.) paperclipped to the inside front flap of my planner.
Early intervention providers, please feel free to use this chart or share your
own chart. Thank you and have a beautiful day J
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IFSP Date
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# of Visits
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Notes
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Frequency
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Birthdates
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Monday, January 6, 2014
Consistency is Key!
Happy Monday!! In addition to the strategies used during therapy, I also am always sure to reiterate consistency with all of the families. I attended a session on early intervention at a conference that broke down the significance of consistency like this:
*There are 84 hours in a week
*Children are typically awake for 12 hours a day
*There are 360 hours in a month
*There are 4,380 hours in a year
and your EI provider is only with your children for 1-2 hours a week, every other week, twice a month, and/or one time per month. Parent/Family involvement and active participation during the sessions are IMPERATIVE, so that the strategies and techniques used can be used in the daily routines when the therapist is not present. I also encourage parents to keep a developmental and/or communication journal so that they are able to write down new words and phrases, experiences, observations and progress and we can exchange feedback about strategies and techniques used, what worked/didn't work, etc.
EI Providers: As you conduct your sessions this week, stress consistency, and leave the family with one strategy to try during the most challenging daily routine.
Caregivers: Be sure to observe the strategy, attempt, and give feedback to your therapist.
Consistency is KEY!
*There are 84 hours in a week
*Children are typically awake for 12 hours a day
*There are 360 hours in a month
*There are 4,380 hours in a year
and your EI provider is only with your children for 1-2 hours a week, every other week, twice a month, and/or one time per month. Parent/Family involvement and active participation during the sessions are IMPERATIVE, so that the strategies and techniques used can be used in the daily routines when the therapist is not present. I also encourage parents to keep a developmental and/or communication journal so that they are able to write down new words and phrases, experiences, observations and progress and we can exchange feedback about strategies and techniques used, what worked/didn't work, etc.
EI Providers: As you conduct your sessions this week, stress consistency, and leave the family with one strategy to try during the most challenging daily routine.
Caregivers: Be sure to observe the strategy, attempt, and give feedback to your therapist.
Consistency is KEY!
Saturday, January 4, 2014
Health & Wellness Tips for EI Providers and Infants & Toddlers
It has been my experience that October through March most of my kiddos' health are compromised. I am just getting over a cold, and was quickly reminded of how easy it is to get sick especially during one of my busiest times of the year (winter). I have listed a few tips that help to keep me healthy as well as those that I see used in the homes of the children I visit, daycares & preschools. Have a healthy & happy winter!!
1. Wash hands often with warm soap and water- I wash my hands before and after each visit and incorporate this into my sessions (singing songs about washing hands, narrating actions, & discussing all the materials being used or that are needed such as water, soap, towel, etc.). I also keep hand sanitizer in my car and in my bag, and use it as often as possible.
2. Sneezing and coughing in your arm instead of in your hands- This way you are not contaminating others and/or objects.
3. Take your vitamins consistently- If you are unsure of which vitamins are best, consult with your doctor or child's pediatrician.
4. Stay hydrated & Eat Properly- I try to eat at least one fruit and one vegetable a day, as well as drinking at least 8 ounces of water a day. Make sure your child has a properly balanced diet, so they are receiving all of the nutrients needed to have energy, stay healthy, etc.
5. Proper Rest- The amount of sleep needed varies depending on age groups. Most doctors recommend at least 8 hours of sleep for adults and between 12-18 hours from the newborn to toddler stage. Having your child on a consistent schedule, does wonders for their sleeping habits, and in my experience can be the deciding factor of your child's behavior and potential throughout the day.
6. Rescheduling- I DO NOT make home/daycare/preschool visits when I have a fever or if I feel like I am catching a cold, especially after possibly being exposed to a highly contagious virus such as the flu or strep throat. I also encourage parents to reschedule the visit prior to the scheduled visit if the child has a fever or if the entire family is experiencing a virus, as I do not want to be exposed to illnesses and contaminate other children and their families. Do not send your children to preschool/daycare if they have a fever, diarrhea, vomiting etc. as it only spreads more germs, (you would be surprised how many parents do this). I also always stress that rescheduling is the best option when you or your child are sick, as your child will not perform to their best abilities during the session if they are not feeling well, and you as the parent will not be able to participate (which reduces carryover consistency). Your therapist and child will be healthy and happy if you call ahead and reschedule :).
Friday, January 3, 2014
Advocating for Early Intervention Services
As we begin the new year, I would like to reiterate to all of my families and fellow early intervention service providers, how critical early intervention services are. Early intervention services provide an opportunity for maximum developmental potential in infants and toddlers with disabilities within their natural environments. Early intervention service providers hold the responsibility of supporting and providing therapy and rehabilitation within the child's daily routine and activities. The federal Individuals with Disabilities Education Act (IDEA) Part C, mandate that infants and toddlers with disabilities and their families receive coordinated services in the natural environment. The services MUST be flexible, culturally responsive, and meet the needs of the child and their family. I am making advocacy for EI services a personal career goal, and encouraging other providers to advocate for your kiddos and their families, and to continue creating awareness of their rights and the rights for their children. I have provided a list of several agencies in the DC Metropolitan area that help to advocate for these services and more. For my subscribers who do not reside in this area, please visit your state government website, child and family services agencies, department of human services, local department of health, etc. to find out how to get involved. Also, please feel free to visit my FAV Links tab to browse a plethora of resources regarding this topic and beyond!
1. DC Action for Children
1432 K Street, NW, Suite 1050
Washington, DC 20005
202 234-9404
info@dckids.org
2. Community Health Administration
DC Department of Health
825 North Capitol St. NE
Washington, DC 20002
202 442-5955 (phone)
202 442-4947 (fax)
www.doh.dc.gov
3. Department of Human Services
64 New York Ave. NE (6th floor)
Washington, DC 20002
202 671-4200
www.answerspleasedc.gov
4. The Arc of Virginia
2147 Staples Mill Road
Richmond, VA 23230
804 649-8481
thearcofva.org
5. Advocates for Children & Youth
34 Market Place, 5th Floor
Baltimore, MD 21202-4034
410-547-9200 (phone)
410-547-8690 (fax)
director@acy.org
6. Maryland Association of of Resources for Families & Youth
P.O. Box 220
1517 South Ritchie Highway, Suite 102
Arnold, MD 21012
410-974-4901
410-757-9530 (fax)
Be Active in Early Intervention in 2014! :)
1. DC Action for Children
1432 K Street, NW, Suite 1050
Washington, DC 20005
202 234-9404
info@dckids.org
2. Community Health Administration
DC Department of Health
825 North Capitol St. NE
Washington, DC 20002
202 442-5955 (phone)
202 442-4947 (fax)
www.doh.dc.gov
3. Department of Human Services
64 New York Ave. NE (6th floor)
Washington, DC 20002
202 671-4200
www.answerspleasedc.gov
4. The Arc of Virginia
2147 Staples Mill Road
Richmond, VA 23230
804 649-8481
thearcofva.org
5. Advocates for Children & Youth
34 Market Place, 5th Floor
Baltimore, MD 21202-4034
410-547-9200 (phone)
410-547-8690 (fax)
director@acy.org
6. Maryland Association of of Resources for Families & Youth
P.O. Box 220
1517 South Ritchie Highway, Suite 102
Arnold, MD 21012
410-974-4901
410-757-9530 (fax)
Be Active in Early Intervention in 2014! :)
Wednesday, January 1, 2014
Early Intervention & Safety
As an early intervention (EI) speech-language pathologist, I provide services in the community, which is one of the BEST parts of my job. I have the awesome opportunity to nurture and facilitate a understanding and language learning experience for children and their families in their natural environments... their homes... using their toys and their daily routines as a baseline and resource for treatment plans. The communities I serve are diverse and unique, and often provide insight to the culture and community resources and activities available to the child and their family. In addition to this, it also reminds me to remain aware of my surroundings no matter how safe the neighborhood appears to be or how comfortable I am in the neighborhood. I have listed 5 safety tips that I abide by daily to help keep me safe as an EI provider. Stay safe :)
1. Don't go in your trunk: If someone sees you going into your trunk, they may get the impression that you have several items of value, monetary or otherwise. Try to remember to retrieve all materials necessary for your sessions prior to leaving your home or arriving at your destination. I personally hardly ever use toys of my own, due to trying to implement and imbed strict naturalistic routines and environmental objects into my session.
2. Blend in: Make sure not to wear flashy jewelry or clothing. Wearing inconspicuous clothing, makes it appear as though you are apart of the community and not an outsider.
3. Be aware of your surroundings: Always look up the address prior to your initial visit and do research on the neighborhood before going. Make sure to review parking rules, crimes in the area, school dismissal times (as this can sometimes add chaos), hospitals nearby, etc. Try not to walk and talk on the phone or text while walking or talking. Do not sit in your car to do paperwork, make phone calls, etc. in a neighborhood where you feel unsafe. Schedule your appointments accordingly (try not to schedule appointments after 4:30 PM in the winter months and after 8:00 PM in summer months)
4. Trust your instincts: If you pull up to the home or get into the home, and feel unsafe or uneasy, trust your instincts and do not get out of the car and/or reschedule the appointment. For example, if an argument ensues while your are in the home between the family members...reschedule!
5. Keep your car clean & clear: Do not under any circumstances leave any items on the seats of your car or in plain view. Always lock your doors and windows, even when sitting idle to work on paperwork and/or make phone calls.
1. Don't go in your trunk: If someone sees you going into your trunk, they may get the impression that you have several items of value, monetary or otherwise. Try to remember to retrieve all materials necessary for your sessions prior to leaving your home or arriving at your destination. I personally hardly ever use toys of my own, due to trying to implement and imbed strict naturalistic routines and environmental objects into my session.
2. Blend in: Make sure not to wear flashy jewelry or clothing. Wearing inconspicuous clothing, makes it appear as though you are apart of the community and not an outsider.
3. Be aware of your surroundings: Always look up the address prior to your initial visit and do research on the neighborhood before going. Make sure to review parking rules, crimes in the area, school dismissal times (as this can sometimes add chaos), hospitals nearby, etc. Try not to walk and talk on the phone or text while walking or talking. Do not sit in your car to do paperwork, make phone calls, etc. in a neighborhood where you feel unsafe. Schedule your appointments accordingly (try not to schedule appointments after 4:30 PM in the winter months and after 8:00 PM in summer months)
4. Trust your instincts: If you pull up to the home or get into the home, and feel unsafe or uneasy, trust your instincts and do not get out of the car and/or reschedule the appointment. For example, if an argument ensues while your are in the home between the family members...reschedule!
5. Keep your car clean & clear: Do not under any circumstances leave any items on the seats of your car or in plain view. Always lock your doors and windows, even when sitting idle to work on paperwork and/or make phone calls.
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