Supervisors Frank Bender ALycia CanAvan sara sTarlin Maple Elementary School Katie mason lori Hornfelt Fall 2019 Introductions 1 st Years Name Where you are from ID: 928570
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Slide1
School-Age Speech-Language-Social Skills Center
Supervisors: Frank Bender, ALycia CanAvan, sara sTarlin (Maple Elementary School), Katie mason, lori Hornfelt
Fall 2019
Slide2Introductions
1st Years: NameWhere you are from?
What fears do you have about Graduate School or this clinic?
2
nd
Year:
Name
Where you are from?
What would you like to learn from this clinical experience?
One piece of professional advice would you provide to the 1
st
year graduate students?
Slide3Today’s Schedule
Briefly Review the Clinic Calendar and Group Meeting Schedule & Topics Peer mentor responsibilities Overview of the School-Age Speech, Language, and Social Skills Center and quick review of the content areas that are typically addressed in this clinicAn overview of both formal and informal assessments
Preparing for your 1
st
Session
Second Years Dismissed
Logistics with 1
st
Years
Work on preparing CHARTR & Lesson Plans
Slide4Review the Clinic Calendar and Group Meeting Schedule*
Review the Flow of the TermUse this document as a schedule and checklist Watch for Important Due Dates This is posted on
infoCDS
under the School-Age Specialty Center
Group meeting slides will be posted under the group meeting tab on
infoCDS
Slide5Peer Support Groups and Responsibilities
Kenny O’Dea Isabella Carino
Brandon
Zuel
Katie Coles
Lauren Hudgins
Sofia
Dorantes
Zella
Kourafas
Melissa GaribayCaitlin KuelAlyssa CamposJessica Johns
Provide clinic logistical support when needed.
Be available to answer questions regarding the clinical experience
Be available to answer client specific questions associated with evaluation, goal development, or treatment.
Be available to answer questions regarding clinical documentation (i.e., CHARTR, Lesson Plans, SOAPs, Evaluation Reports, and ITPs
You will not be required to grade or read through all clinic documentation requirements or participate in the clinical session with your assigned partner.
Slide6Purpose of the School age Speech and Language Specialty Clinic
Purpose of services is to facilitate each child’s ability to functionally communicate in all environments and successfully participate in grade level/age-appropriate school and home activities.
Slide7Who We Will Serve:
Population: The clinic will serve children who are kindergarten through 12th grade with communication disorders specific to speech, language, cognition and hearing loss.
Deficits include:
Speech sounds/articulation, language (phonology, morphology, syntax, semantics, pragmatics/social skills) and hearing loss.
Slide8Service delivery models:
In UO Speech Language Hearing Center (UOSLHC) and at Maple Elementary
Individual & group sessions (or a mix) to best support individual needs.
Slide9What is a Communication Disorder?
An impairment in the ability to receive, send, process and comprehend concepts or verbal, nonverbal and graphic symbol systems.It may affect individual’s abilities to speak, read, write, process information or interact socially.
Slide10What do SLPs do who provide service for school-age children?
1. Speech production2. Language3. Cognition – not specific to head injury/TBI4. Feeding and Swallowing5. Fluency6. Voice7. Resonance8.
Auditory habilitation/rehabilitation
Slide11What is a Speech Disorder?An impairment of articulation, speech sounds, fluency, or voice
Slide12What is a Speech Sound/Articulation Disorder?An atypical production of speech sounds characterized by
Substitutions (tool/cool, wash/watch)Omissions (sip/slip, boo/book)Additions/Distortions (lisps, wabbit/rabbit)This disorder may affect intelligibility.Significant speech sound disorders impact a child’s self-esteem, peer relationships and ability to read, spell and write accurately.
Slide13What is a Language Disorder?A language disorder is impaired comprehension, and or use of spoken, written and/or other symbol systems.
The disorder may involve in any combinationthe form of language (phonology, morphology, syntax);the content of language (semantics); and/orthe function of language in communication (pragmatics/social).
Slide14What are the different types of language disorders?
PhonologyMorphologySyntaxSemanticsPragmatics/Social Language
Slide15Phonology
Study and use of individual sound units in a language and the rules by which they are combined and recombined to create larger language units. Phonemes are the unit of sound such as /s/ or /b/ , they do not convey meaning. Phonemes alter meaning of words when combined (e.g., sat to bat).
Slide16Phonological Deficits
Frequently appear as articulation disorders.Child omits a consonant: “oo” for “too”Child substitutes one consonant:
“
wabbit
”
for rabbit
Discrimination: child hears
“
go get the nail
”
instead of “mail”
Slide17Morphology
Study and use of morphemes, the smallest units of language that have meaning.A morpheme is a group of sounds that refers to a particular object, idea, or action.Roots can stand alone (e.g., car, teach, tall)Affixes are bound such as prefixes and suffixes and when attached to root words change the meaning of the words (e.g., cars, teacher, tallest)
Slide18Morphological Deficits
Elementary aged: may not use appropriate inflectional endings in their speech (e.g.,“He walk” or “Mommy coat
”
).
Middle school: lack irregular past tense or irregular plurals (e.g.,
drived
for drove or mans for men).
Be aware of
“
cultural dialects
”: “John cousin
”
, “I have two book”
Slide19Syntax
Study of the rules by which words are organized into phrases or sentences in a particular language. Referred to as the grammar of the language and allows for more complex expression of thoughts and ideas by making references to past and future events (This is extensively covered in Dr. Nippold’s class).
Slide20Syntactic Deficits
Lack the length or syntactic complexity (e.g., “Where Daddy go?”). Problems comprehending sentences that express relationship between direct or indirect objects. Difficulty with wh questions.
Slide21Semantics
The larger meaning component of language. More than single words, includes complex use of vocabulary, including structures such as word categories, word relationships, synonyms, antonyms, figurative language, ambiguities, and absurdities. Classes of words (e.g., pronouns, nouns, verbs, adjectives, adverbs, prepositions, articles, conjunctions, etc.) Struggle with understanding or using temporal or spatial prepositions (impact on following directions or impacting reading comprehension)
Slide22Semantic Deficits
Limited vocabulary especially in adjectives, adverbs, prepositions, or pronouns. Longer response time in selecting vocabulary words. Fail to perceive subtle changes in word meaning: incomplete understanding and misinterpretations. Struggle with interpreting comments or written language that uses inferencing and figurative language.
Slide23Pragmatics
Knowledge and ability to use language functionally in social or interactive situations. Integrates all the other language skills, but also requires knowledge and use of rule governing the use of language in social context.
Slide24Pragmatic Deficits
Problems understanding indirect requests (e.g., may say yes when asked “Must you play the piano?”). May enter conversations in a socially unacceptable fashion or fail to take turns talking. Difficulty staying on topic.
Slide25What are Cognitive Disorders?Cognitive disorders refers to difficulties with:
AttentionMemoryProblem solvingExecutive functioningThese may be due to a syndrome, birth defect or traumatic brain injury (TBI),The TBI may be the result of concussions or other head injuries.
Slide26What is Auditory Habilitation/Rehabilitation?Working on speech, language, listening and communication skills that are affected by hearing loss, deafness.
Slide27Assessment and Data Collection
Informal vs. Formal Speech, Language, & Social Skills Baseline Assessment Criterion-Based Assessment v. Norm-Referenced Standardized Assessments.
Data Collection for Both Approaches
See slides on
infoCDS
and information on data collection methods.
Slide28Formal Norm-Referenced Standardized Assessment
Typically administered for a new client or a client who has not been formally evaluated over the last 1.5-2 years OR…. If there is another concern that you are exploring.
Parent / Client Interview
Include all HEDCO documents if they have not been completed (Permission to Evaluate & Serve and Release of Information).
See example documents on
infoCDS
Standardized Norm-Referenced Testing
Speech Sounds, Language, and Social Communication
Discuss New Tests Ordered
Additional Dynamic Assessment to identify stimulability or levels of cuing support
Language / Conversational Sampling
Oral Mechanism Evaluation
Hearing Screening
Complete an Evaluation Report (Template and Example on
infoCDS
)
Determine if the client meets criteria for a diagnosis (ICD-10 Code), requires services, and the focus of service.
Slide29Where to Start and What to Focus On Using a Criterion-Based Assessment
For returning clients, it’s recommended to use the previous ITPs and the noted recommendations as a guide to where to begin developing your clinical question, which will direct your focus for developing a criterion-based assessment.
Discuss some examples including clients who met their objective criteria last term.
Once you identify a target to probe, your first attempt to elicit a client’s ability to complete a task should be done without cues or prompting. This provides you data regarding a client’s “Zone of Actual Development”.
If the client does not perform well without cuing, it is then appropriate to continue exploring this target using more of a Dynamic Assessment approach to identify the levels of cuing the client requires (or the level of stimulability) to identify their “Zone of Proximal Development”.
Use enough opportunities to allow you to identify a pattern of productions that can be ruled out as random guessing. Obtaining a count of 5-10 productions should provide you with enough data (depending on the target).
What are you tracking? Correct v. Incorrect productions, levels of cuing, automaticity, distractibility, etc.
Slide30Criterion-Based Assessment
A formative assessment approach typically used during intermittent time frames to gauge changes in treatment progress (e.g., returning clients following a break, post assessment at the end of a term).
Identifying what the client can and cannot do compared to a predefined criterion (Not comparing to a sample of the population).
These tests help answer the question, “How does my client’s performance compare to an expected level of performance?”
They can be used to establish a baseline
May continue as needed throughout the term to determine progress/assess effectiveness/look for new goal(s)
Completed at the end of the term to show progress
Slide31All Returning Clients: Components of an Informal Assessment
Parent Interview: Identify any updated information, any changes, observing any transfer and generalization, current concerns and priorities.Updated HEDCO documentsUpdated information on Family, Home, Medical, and School
Identify previous targets that have not not been met (or just recently met criteria)
Use a an informal criterion-based developed assessment to establish current baseline and/or progress or regression
Conduct a qualitative language / conversational sample
If you need hearing screening hours, all of your clients will get a hearing screening
Track your data
Identify the priority for the term (based upon your data and parent’s request)
Target 2
–
3 long-term goals for the term
* Don’t reinvent the wheel. Use the recommendations by the previous clinician and the previous ITPs to help you prioritize.
Slide32Parent Interviews
Mock parent interview: https://www.youtube.com/watch?v=iYZkDVijFKc Why the parent interview is so important: https://www.youtube.com/watch?v=dAjtKxy0U00
Slide33Informal Tests of Phonology
Analyze student’s production of phonemes in single words and/or phrases or sentences Choose target sounds based upon previous reports, observations, or parent report. Probe target sounds in different positions (e.g., initial, medial, final, blends). When considering the target word, think about the complexity (e.g., cognates, target sound in multiple positions, syllabication)
Provide prompts –
“
Tell me about your weekend for 3-minute sample, count correct and incorrect phonemes.
Following the informal assessment, you can then conduct a stimulability test (i.e., a form of Dynamic Assessment)
Slide34Informal Test of Morphology
Determine mastery level of each morpheme in a hierarchy (Brown, 1973).ing: present a picture of girls playing and say “The girls like to play. Here they are ________.”
Student adds missing word.
Show a series of 20 action pictures and ask student what they are doing.
Accuracy below 90% - morpheme has not been mastered
Slide35Informal Tests of Syntax
Expressive Syntax: Engage in a conversation or have the student provide a narrative about a topic: Analyzing student’s spontaneous speech and note the syntactical errors. Sentence Repetition: Clinician states a sentence with a certain syntactical structure and the student repeats it. Note any errors.
Slide36Informal Tests of Semantics
Logical relationships: Cause-and-effect, and verbal problem solving: Structured picture cards or literature-basedVerbal opposites: Picture cards of 40 pairs of opposites. Student sorts them into opposites.Word categories: Clinician says a word and student says as many words in the same category. Clinician provides picture cards and student puts them into proper categories
Semantic relationships
: Asking client questions or using picture cards to elicit complex language relationships: Synonyms, antonyms, figurative language, ambiguities, absurdities.
Slide37Informal Test of Pragmatics
Analyze spontaneous speech and behavior (use of reviewing a videotape tape can be helpful) Classify pragmatic functions Measure for appropriate loudness, talking at inappropriate times, interrupting the speaker, and using indirect requests, topic maintenance, conversational skills, perseverative behaviors, time-on- task, etc.
Slide38Assessment and Intervention Approaches
Resources on infoCDS: https://coe.uoregon.edu/cds/
Slide39Resources to Assist with Your 1st
Session Review information on infoCDS regarding assessment and intervention. Review sections in your textbooks for language disorders and speech sound disorders.
I also have many additional books.
Review posted materials on
infoCDS
regarding data collection strategies.
Review posted materials on
infoCDS
regarding behavior management techniques.
Slide40Preparing for 1st Session
If you haven’t contacted your client to confirm clinic sessions, please do that ASAP If you have a returning client, I would encourage you to reach out to the previous clinician (if they are on campus) and to review previous video. If you have questions about this, please let me know. Have your lesson plan reviewed by your supervisor and bring with you during your session
Collect and practice with any informal assessment material
Create any needed visual schedules for your lesson
Bring a back-up activity
–
Jut in case
Know how to record your session & maybe have a separate your recorder
Have your data collection system developed
Have all documents for parent to sign - this can be done while you are working with the client. Use the File Review Checklist to help you organize the documents.
Client Cancellations or Need to Reschedule Days and Times: What to do !
Slide41Supervision and Feedback
Supervisors are required to supervise 50% of your evaluation time and 25% of your treatment time. You will likely receive written feedback following each clinical session with the amount of time that was observed by your supervisor. These are typically emailed to you following a session (or within 24 hours). I use the supervisor feedback form posted on infoCDS. However, your supervisor may have a different format. I would recommend checking with them to identify how clinical feedback will be provided.
Slide42Session Feedback from Supervisor
Written Verbal* This may look different for different supervisors, so please talk with them regarding their approach.
Slide43When reviewing your client files, see if there are any updated forms that may need to be collected during your first parent meeting. This information can be identified within the
File Review Checklist and the documents that follow.
Slide44RDS File Conventions
Slide45What’s Up Next
You will complete your CHARTR and lesson plans and have it posted on RDS by 7pm on Friday. Myself, or the other supervisors, will be available to answer Qs. Again, contact our families and confirm dates and times.
Check Titanium Schedule for your room assignments for your client
Review and practice the video recording technology for your session.
Continue to review the clinic calendar as your operating checklist
Review previous video sessions of your client for ideas and support
Use
infoCDS
to leverage resources, documents, and examples
I will have a schedule posted outside of my door to schedule individual
Hearing Screenings Training and Schedule.
The schedule may fluid during start up based upon the OSHA conference and school schedules.
Be prepared to discuss your client and your initial plan during the next group meeting. An outline will be posted
Slide462nd Years Excused ~ 1
st Years StayDocumentation Logistics CHARTR QuestionsLesson Plans SOAP Notes
ITPs
Clinical Feedback
Slide47Lesson Plan Draft
This will be your plan that goes into your clinical session To be posted in RDS at least 24 hours before your sessionSee RDS for blank copies and examples listed in previous client RDS files.
Slide48Slide49CHARTR Questions
You only need to complete sections 1-3 for this Friday. Sections 4-5 will be completed by the end of week 3.
Slide50SOAP Notes
* To be completed and posted at least 24 hours following your session What is a SOAP Note? A form of documentation, typically used in the medical field, as a form of communication and summary of any form of evaluation or treatment performed with a client. SOAP Stands For:Subjective: Subjective and non-measurable information that may come from the client or caregiver’s point of view. However, it could also explain certain behaviors observed during a session
–
which will be addressed in the “A” section.
Objective:
This section contains measurable finding
–
Your raw data. For your first assessment session, you may note that you performed a certain assessment, and whether it was completed, and refer to the ITP for specific results.
Assessment (analysis):
This is a synthesis of your information from your “S” and “O” section. You do not reiterate the raw data. Here you would note what might have influenced the data and student performance (e.g., fatigued, level of cuing, etc.)
Plan: Note your recommended plan of action for your next session (bullet points are fine). This will direct you in crafting your next lesson plan* See Slides Posted on infoCDS
under Group Meetings
Slide51ITPs
Individual Treatment Plans Use the most recent ITP for your client located in RDS as a possible template and then make updated changes See the example posted on infoCDS that will reflect the information that you should include in your ITP. Your draft is due week 3 – primarily so you have your LTGs and STOs mapped out.
The final draft will go to the parents at the end of the term.
Slide52THANK YOU!QUESTIONS / COMMENTS / CONCERNS?