School-age Speech and Language Center - PowerPoint Presentation

Slide1

School-age Speech and Language Center

Supervisors: Frank Bender, Alison Hentz & Katie Mason

Summer 2018

Today’s Schedule

Complete Clinical Survey Briefly Review the Clinic Calendar and Group Meeting Schedule & Topics

Overview of the School-Age Speech, Language, and Social Skills Center and quick review of the content areas that are typically addressed in this clinic

An overview of both formal and informal assessments

Overview of Formal Assessment Experience

Anatomy of a Client File and Using RDS

Preparing for your 1

st

Session

Review Files, Contact Parents, Work on Lesson Plans for 1

st

Session

Complete the Clinic Survey

Please complete the provided clinical survey We will complete the same survey at the end of the

term.

This will help us plan for future clinics.

Thank you for assisting us.

Review 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 will be posted on

infoCDS

under the School-Age

Specialty Center

Summer Dress Code and Use of Outdoors

Medical Dress Model – be aware of parent camera angle from viewing room.

If going outside, make sure parents know and if your client might be one that could wander, I would have the parent go outside with you.

Group Meeting Weekly Topics

Week 1

: Clinic Overview & Discuss Informal Assessment Approaches, Work on Client Lesson Plans

Week 2

: Developing LTGs and STOs, Formal Assessment Update, Review Intervention Resources on

infoCDS

Week 3

: Grand Rounds - Client Share Week 4: Intervention strategies, supports, and use of materials

Week 5

: Connecting LTGs/STOs to the Common Core Standards

Week 6

: Client Video Recording Activity

Week 7

: Term Overview and Wrap-Up

Week 8

: No Meeting – IPPE Meeting

Purpose 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.

Who We Will Serve:

Population

: The clinic will serve children who are kindergarten through 12

th

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.

Service delivery models:

In UO Speech Language Hearing Center (UOSLHC) and at Maple Elementary

Individual & group sessions (or a mix) to best support individual needs.

Summer Social Skills Camp: This will be covered during Thursday’s Meeting

What 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.

What do SLPs do who provide service for school-age children?

1. Speech production2. Language (Morphonology, Syntax, Vocabulary, Semantic

Relationships, Literacy, and Social Skills)

3.

Cognition – not specific to head injury/TBI

4. Feeding and Swallowing

5. Fluency

6. Voice

7. Resonance

8.

Auditory habilitation/rehabilitation

What is a Speech Disorder?

An impairment of articulation, speech sounds, fluency, or voice

What is a Speech Sound/Articulation Disorder?

An atypical production of speech sounds characterized bySubstitutions (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.

What 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/or

the

function

of language in communication (pragmatics/social).

What are the different types of language disorders?

PhonologyMorphology

Syntax

Semantics

Pragmatics/Social Language

Phonology

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. Individual Phonemes are the unit of sound such as /s/ or /b/ , they

do not convey meaning. However, combined phonemes do alter the

meaning of words when combined (e.g., sat to bat).

Phonological Deficits

Frequently appear as articulation disorders.Child omits a consonant:

“

oo

”

for you

Child substitutes one consonant:

“

wabbit

”

for rabbitDiscrimination: child hears “go get the nail” instead of mail

Morphology

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)

Morphological 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”

Syntax

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.

Syntactic 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.

Semantics

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.

Semantic 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.

Figurative language problems.

Pragmatics

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.

Pragmatic 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.

What are Cognitive Disorders?

Cognitive disorders refers to difficulties with:AttentionMemoryProblem solving

Executive functioning

These 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.

What is Auditory Habilitation/Rehabilitation?

Working on speech, language, listening and communication skills that are affected by hearing loss, deafness.

Assessment and Data Collection

Informal vs. Formal Speech, Language, Social Skills

Baseline Assessment Probe Data v. Norm Referenced

Standardized Methods.

Data Collection for Both Approaches

See slides on

infoCDS

and information on data collection methods.

A handout overview will be provided and discussed.

Evaluations & Assessments

Formal or Standardized Norm-Referenced Assessments

Typically completed with a new intake – but this could be used to obtain updated information on a client’s abilities.

Typically a New or a Re-Evaluation after At least 1 Year from Previous Formal Evaluation

Done 1:1 in a 1-2 hour appointment (90 Min for Us)

Review Intake Materials, Possibly Phone Interview Parent/caregiver

Determine Assessments to Administer

Components of Assessment

Parent / Client Interview

Standardized Norm-Referenced Testing (Language, Speech, or Social Skills)

Language / Conversational SamplingOral Mechanism EvaluationHearing ScreeningComplete Formal Evaluation with RecommendationsUsing template on infoCDS

Determine if client meets criteria for clinical services

Informal or Criterion-Referenced Assessments

Are not comparing client’s performance to other like populations

Identifying what the client can and cannot do compared to a predefined criterion.

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)

May have only done baseline on some of the goals

Completed at the end of the term to show progress

Will compare to baseline

Where should we go next?

Continue or discharge?

All Returning Clients: Components of an Informal Assessment

Parent Interview: Identify any updated information, any changes, observing any transfer and generalization, current concerns and priorities.

Identify previous targets that have not not been met (or just recently met criteria): Use

recommendations from spring clinicians

Use a an informal criterion-based developed assessment to establish current baseline and/or progress or regression

Conduct a qualitative language / conversational sample

Track your data

Identify the priority for the term (based upon your data and parent’s request)

Summer Term

: Target 1-2 long-term goals for the term and no more than 2-3 STOs

Informal Assessment Approach for New Clients ~ Due to Formal Assessment Day

Contact parents and conduct a phone interview to identify communication concerns

Speech Sounds

Language

Social Skills

Find out if your client has a current IEP

Find out if your client has academic difficulties and find out what that looks like

Ask the parent if there were 1 or 2 areas to address over the 6 weeks of treatment, what would those be?

With this information, set up an informal probe for these areas for your first session.

For these clients, your final assessment report will outline comprehensive recommendations – which will include data from your intervention sessions (i.e., a version of Dynamic Assessment)

Parent Interviews

Why the parent interview is so important: https://www.youtube.com/watch?v=dAjtKxy0U00

Example Parent Interview (Module 1)

https://www.youtube.com/watch?v=FWWAzuHgAco

* Note: All YouTube videos have captioning capabilities

Informal 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)

Informal 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

Informal 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.

Informal Tests of Semantics

Logical relationships: Cause-and-effect, and verbal problem solving: Structured picture cards or literature-based

Verbal 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.

Informal 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.

Assessment and Intervention Approaches

Resources on

infoCDS

:

https://coe.uoregon.edu/cds/specialty-clinics/school-age-speech-and-language/treatment-approached-and-intervention-materials/

Assessment Days for New & Potential Clients

We have 6 clients where full assessments need to be completed by the end of the term.

Client Codes

DINA: Date TBA / Clinician: Rachel

COET: Date TBA / Clinician: Sarah

HEJO: Date TBA / Clinician: Joan

SAKA: Date TBA / Clinician: Bridget

LEJA: To be rescheduled. / Clinician: Maureen

STKE: Date TBA / Clinician: Abby

* Note: If any of this these clients are being served this summer and are receiving services for 2 days, incorporate your assessment into your sessions over the course of your sessions during this summer. However, be thoughtful of timing.

Assessment Day Framework: Weeks 3-5

For a complete assessment (Use example Report and Assessment Documents found in the School-Age Section of Assessment on

infoCDS

)

Parent interview

Communication Checklist

Medical and Educational Overview

If there is an IEP, summarize current goals/objectives

Speech Sound Norm-Referenced Test (if appropriate)

If not, provide the GFTA-3 for experience.

DDK if there is a concern for CASLanguage Test (if appropriate)If not, administer the PPVT-4 for experienceSpeech and language conversational sampleInformal analysis

Oral mechanism evaluation

Hearing screening and tympanometry

Any potential Dynamic Assessment or Stimulability Testing

Complete Assessment Report by Week 7

Preparing for 1st Session

If you haven’t contacted your client to confirm clinic sessions, please do that ASAP

Review client information on RDS or the main file to complete sections 1-3 of your CHARTR or lesson plans

Use additional Group meeting time today (2-5pm) to ask Frank specific questions.

Collect and practice with any informal assessment material

Create any needed visual schedules for your lesson (which may be recommended from previous documentation.

Think about your activities during parent interview and 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. (Don’t forget to Include Fee Schedule for Scottish Rite Scholarship possibility or fee adjustment and new HIPPA document).

What’s Up Next

Your finalized complete lesson plans should be posted on RDS by Saturday at 5pm – following any changes that need to be made from individual meeting with Frank.

Check Titanium Schedule for your room assignments with 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 info CDS to leverage resources, documents, and examples

I will have an office hour schedule posted outside of my door for individual client questions to be addressed. I will have this posted each week.

Clinic Documentation

Anatomy of a File

New File Review Checklist

Scholarship and Financial Information

RDS Folders and Posting Conventions

Lesson Plans (Use CHARTR Flow Chart if Needed as a Decision

Tree Model)

SOAP Notes

Assessment Reports, LTGs and STOs, and ITPs (Pre and Final)

Anatomy of a Client File

Name the documents that are listed on the client review checklist that need to be completed and renewed each year?

In what section could you find information about a client’s clinic

Hx

?

Which documents could tell you about treatment approaches and targets?

Which documents could tell you about intervention strategies that could support the client?

When 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.* May need to add a line for new HIPPA form

RDS File Conventions

Lesson Plan Draft

This will be your plan that goes into your clinical session

Your final draft of your first lesson for each client will be due by 5:00pm on

Saturday, June 30th. This will allow me to review your approach and make any final comments before your first session.

Future lesson plans should be posted to RDS at least 24 hours before your

session

If you have a client that you see 2 x per week, you may combine your

lessons into one lesson plan.

See RDS for blank copies and examples listed in previous client RDS files.

SOAP Notes

* To be completed and posted at least 24 hours following your session* For clients being seen 2 times per week, you may combine your SOAP. However, please break out

information my dates.

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

ITPs

Individual Treatment Plans for each client

For returning clients, use the most recent ITP for your client located in

RDS as a possible template and then make updated changes

See the example ITP report posted on

infoCDS

that will reflect the information that you should include in your ITP.

Summer: Your LTGs and STOs should be mapped out after your first

clinic week and posted in the ITP file on RDS (email Frank when done).

A draft of the final ITP should be posted for review by week 5 or before. Again, use the previous ITP as your template. Your final draft with post-test data, comments, and recommendations should be posted by week 6 for review and your final to be shared with parents during week 7.

Supervision 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

.

Note: The Social Skills camp will have a different format.

THANK YOU!

QUESTIONS / COMMENTS / CONCERNS?