Curriculum in Therapy

I was recently asked by a new therapist, working at the middle school level, if I was able to use curriculum material in therapy.  Over the years I found that it was very difficult to incorporate curriculum into therapy.  So I guess my answer is no but with some clarifications and of course exceptions. 

Speech therapists generally don’t see the kids often enough to keep up with the curriculum.  Most of my students in middle school also work with a special education teacher that services them much more often both in and out of the classroom.  The special education teachers are or at least should be connected to the regular education teachers.

Therapy groups are often made up of students from several different classes (sometimes even different grades) rarely are they working on the same thing at the same time.  I’ve occasionally been able to organize a session around a specific  book a grade might be reading.  Talking about higher level language, underlying meaning setting or conflict.

If planning time with teachers isn’t built in clearly you will not know what is specifically going on in the classroom.  One thing that you can always ask teachers for is curriculum vocabulary.  It never hurts to preview, review or introduce a knowledge connection to new vocabulary.

Occasionally when I’ve consulted or observed a classroom where I noticed a skill or concept introduced that looks challenging.  I can usually assume that my students might need simplification, clarification, reinforcement, relevant examples or a knowledge connection.  I’ll start out by asking them about what was covered in therapy to see what they retained.  Then adjust the therapy session accordingly.

Even though many would disagree with me, the speech pathologist is not there to teach academics.  We are there to fill gaps.  The SLP needs to focus on teaching underlying skills that aid independent learning and life skills.  It is difficult to work on remediating language disabilities if we also have to address academics.
Last thoughts......It is important to have an idea of the basic curriculum.  If a student asks for help with academics, try to drop everything, find out what they need and help them out.  I know that if a student comes to me with an academic questions they are either struggling, confused or overwhelmed.

Teresa
From my newest blog The School Speech Therapist  for more information on Speech and Language development.

Therapist to Therapist: Why Am I Hearing More Older Student With Articulation Errors?

     I’ve recently received several advertisements for a new Articulation Test put out by LinguiSystems referred to as the LAT (Linguisystem Articulation Test).  I haven’t reviewed the test but one of their advertising selling points is updated norms, “why use 10 year old norms.”  Initially I had to chuckle at that one because it’s only and articulation test and how much could norms for an articulation test actually change over 10 years or even 50 years.  Despite theories of some researchers, I don’t think child development has changed that much but experiences and exposure has.  

     Then I started thinking about recent observations I’ve made at the middle school level.  Going into the classrooms more often, I’m hearing more and more older children with significant articulation issues.  The errors noted are usually distortions (not substitutions) of later developing sounds /s/, /l/, /r/, /w/, open vowel sounds and even some difficulty coordinating oral motor movements (making their speech look and sound awkward).  

     The older students demonstrating these articulation errors are not children with a history of special needs or developmental disability.  These are not students who might be considered uncoordinated.  Most of these kids are average to above average students, coordinated, relatively mature and social.

     Now my observations were very unscientific but I starting asking myself why are there more older kids with articulation errors.  Of course I’ve developed some theories on this

1. I feel the biggest reason for increased articulation difficulties in older children is because there is a lack of phonics instruction and drill during the early years.  Most of the children I observed were exposed to a whole language approach to reading without consistent phonics supplement across all classrooms.  Without a strong phonics background the ability to identify and discriminate between similar sounds may be lacking.  Phonics helps to develop auditory awareness which is key to many language skills.
2. Schools often do not allow or encourage the necessary intensive therapy needed to remediate articulation issues.  Some school systems are insisting that all therapy (articulation and language) take place in a classroom setting.  That works for some kids, not all.  Sometimes iii a budget issue disguised as a “new articulation therapy approach.”  These schools might have very large group articulation therapy.  The “new therapy approaches” are usually not designed by Speech Language Pathologists either.  Some schools have made mandates not to work on articulation in the older grades at all.  It’s my opinion that  articulation therapy is very individual and private matter, especially with older students.
3. These kids are not already on the special education rolls so most of the time we are not going to pick them up for an articulation errors unless they are clearly dyspraxic or have parents who are insistent.  For some schools it is the whole thing about articulation being a medical issue rather than an educational issue.  
4. As therapists we often hesitate to pick up kid with later developing sound errors either through an IEP or 504.  Later developing sounds are more difficult to remediate.  By the time students are developmentally ready to work on and remediate later developing sounds they don’t want to, parents don’t push it, schools don’t push it and it takes a lot of practice.  However, the process is always made easier if the kids have a good background in auditory perception and discrimination.  Again this is what develops when students are exposed to a strong phonics approach.
5. School schedules at the middle and high school level often cannot accommodate individual or pull out therapy for either articulation or language.  To rule out pull out therapies for all kids based on the idea of total inclusion, takes the “individual” out of the individual educational plan.  Some therapy issues are just so private or need to be addressed so intensively that it just can’t happen in a classroom setting.  School schedules must offer flexibility for students in need (addressing language, articulation issues or other learning needs).  One therapy model that is working well for some therapists is intensive sessions for a shorter duration.  For some older kids it isn’t appropriate to address articulation at school and an outside therapist would be a better choice.

     Should we be addressing articulation with older students in school?  Should schools be advocating for this?  I guess that depends on the what you want for students.  Do we just want kids just to be able to get by and pass state mandated testing or do we also want kids to grow up to be articulate adults who can express themselves?  Do we want kids to be able to present themselves as confident well spoken adults?  If we do, articulation therapy is very important.  

     Most older students with articulation distortions have little or no awareness of how they pronounce their sounds.  Even if their speech is accepted by peers, teachers and parents for now, someday they will have to go on a job interview, interact with clients, interact with customers and make important phone calls.

     I am very interested in comparing the norms from the old moldy Goldman Fristoe.  Which in all honesty I would be more than happy to replace since the pictures are so dated, the stories are babyish and I never found it easy to track when giving it.  I would love to see where students stand in terms of articulation development (even though it is only normed from ages 3-8).  I curious to see if there are any changes in articulation development in younger children.

     Do Speech Language Pathologists really even need to use an articulation test?  Yes, of course if we want to prove to administrators that articulation needs to be address.  However, most experienced speech language pathologists know articulation development guidelines and can differentiate between a developmental delay, out of range distortions and apraxia just by looking, listening and observing.  

    I think it is really sad that so many “typical” older kids are affected by articulation difficulties.  What have we done wrong?  Most people in this country think our primary job is working on articulation errors in children.  Historically we’re known for fixing “speech” as opposed to working on “language.”  This is an issue which needs further investigation. 

Let me know what you think.

10 Ways to Enhance That Summer Reading

When your kids were small, you read to them. That’s just something parents do. At first, it’s a good bonding experience. Then you begin to really understand what a good learning experience it is. Reading to a child clearly helps with language development, phonemic awareness, listening skills, comprehension skills, general learning and obviously learning to read.

So why should this stop just because they are older? OK so maybe they don’t want to curl up on the couch with you to read anymore but there are ways to enhance the reading skills of older children.

1. Show interest in what they’re reading. Make sure you know the types of book they like, subjects that interest them. Ask questions and encourage discussion.

2. Every once in awhile read the same book as your child. That way you can talk with your child about the book. Expand your questions to include character, setting, plot, conflict, climax and ending. Don’t read every book they read because they will see that as an invasion. Summer reading is perfect for this because during the school year, teachers guide them through books (almost too much sometimes to the point where they end up hating the book, another subject for another time) so some kids might need a little extra help or encouragement to get through a book on their own. Summer reading book are usually books they are not their choice therefore not real personal to them.

3. If the summer reading book is on audio, get it. Fill those long car rides to and from summer activities listening to something productive. Make sure is it the unabridged edition. And check out the library. That way is doesn’t cost you and arm and a leg.

4. Just like homework, you have to provide an atmosphere that is conducive to reading. If you have a child who is obsessed with video games, computers or TV, cut them off. Put limits on those things. Kids need structure just as much in the summer. However, don’t make reading time too formal or they might balk at it. The idea is to make reading more natural rather than forced.

5. Encourage fun summer reading. This includes magazines, newspapers, comics and internet articles. All reading has value even some of the most questionable material such has Mad (which I personally love for older middle schoolers) or superman comics. You want to child to read challenging material that will improve their vocabulary but reading mindless material is ok too. We all pick up People Magazine in the doctors office every so often, it’s a quick easy read.

6. Set a good example. Let your child see you reading.

7. Drag them to the library or bookstore several times over the summer. Encourage them to pick out something that they are interested in. At the very least, you are exposing them to a library/study/research atmosphere. Knowing how to behave in and use a library properly is a skill they will need for success in high school and college.

8. Have your child bring books with them so whenever there is down time they're able to read and get something productive done. Some suggestions are: car/plane/train rides, trips to the beach, while waiting to pick up your other children at activities, rainy days

9. Try to get through the assigned reading early in the summer so they have time to make some fun summer reading choices. This also alleviates stress at the end of August when the reading/projects are not complete.

10. Hit the used book stores, used book sales and even garage sales, looking for used books. Sometimes you can pick up a bag of books for a buck. Even if your child only looks at on book in the bag, you’ve gotten your money’s worth. It can actually be a lot of fun perusing old books. This also adds a nice variety to your library.

If you don’t think the books are appropriate for your child in terms of reading level or topic, speak up. Talk to the teachers about alternatives immediately. However, if teacher’s choices are just books that you or your child don’t like, do your best to help them get through the books (and follow up paper or project “aggggg” if there is one). Do not put down the teachers choices in front of your middle schooler (or even younger child). In high school and college they will have to read a lot of things that are not of interest but important. Reading challenging and varied material is how children continue to develop their adult vocabulary.

Summer reading should be enjoyable, relaxing and somewhat natural. Some kids will just not want to read. Try to find out why reading isn’t coming easy for them and see what you can do about it. However, make your expectations clear. Summer reading is important and it is their responsibility.

Here Come The High School Years

Even though we are still in the dead of winter most middle schools around the country have already began preparing their 8th grade students and their parents for High School. In my district, they have already hosted a parent information night and visited the High School. Next week our students take their placement test. Most private High School and alternative High School applications were due in December and students are anxiously waiting to see if they get in. Moving on to high school is a big deal for these kids and most are ready to move on. However, I guarantee that most kids are thinking about what their social status will be in High School, not “am I going to be able to do the work or will I be successful?”

Students will enter high schools at a variety of different academic and maturity levels. High School placement tests are fairly good at placing students in the proper academic level. Public Schools will usually offer 2-3 different academic levels for students to enter. Private Schools will often offer 4-5 different academic levels. Parents need to understand that just because their middle schooler was an honor roll or even high honor roll student that does not automatically mean that the student is placed in the highest academic level. “A” work in middle school is very different than “A” work in high school. So don’t be too concerned about your child’s initial placement but do keep an eye on your student’s progress. You and your child will realize quickly if the work is too easy or too difficult. At that point, your child can speak to their teacher or guidance counselor about moving levels. Always let your child try to work things out on their own before intervening, it is high school after all.

By the end of 8th grade, kids are starting to feel really grown up. Parents occasionally seem to think it is the right time to back off completely. Don’t think they don’t need you because they do. They still need guidance, support and supervision in High School. What they don’t need is hovering. It is a fine line but you still need to know what your child is doing in school and how they are doing in school. Supervision after hours is just as important. They are experimenting with new friendships. Keep tabs on who their new friends are and don’t assume every parent has the same rules and values you do.

Homework becomes more important in high school. Usually a good percentage of a student’s grade is based on homework completion. If your school keeps grades on line, continue to check assignment completion, often. Your child should be doing some homework at home if they are not I would check in with teachers or review teacher expectations (usually provided as an outline). Some district might even have a homework policy. There is some controversy among teachers and administrators around homework. Let’s face it not all parents can do calculus or even algebra for that matter. We are probably all a little rusty on our French or Spanish. The controversy is that students do not go home on an even playing field where homework is concerned. However, by High School shouldn’t expectations be raised and shouldn’t students be more independent around homework? If your child is having difficulty academically in high school, encourage them to get help from their teachers before you step in. At the same time make sure they are doing the work.

I think it is important for all parents to have a basic idea of the school curriculum. You need to make sure of what they are taking and when they are taking it. If you have a child who receives special needs services it is a lot more important for you to be involved. You need to know exactly what your child is suppose to get, when the services take place, who will be providing the services and a direct contact person for any special needs concerns. Most schools will go out of their way to review programs and educational plans with parents of special needs students. If your child’s high school balks at this, pay even closer attention to their services. Any school I have ever been involved with as a Speech Language Therapist or as a parent has tried their best to design appropriate service plans, listen to students and parents and respond appropriately. Schools are not always perfect but remember you also have to work at developing a good working relationship with them. Education plans should be ammended or updated to dovetail with the high school schedule.

Don’t be too worried about your baby going off to high school. They will probably be ok. It’s scary for us parents and I know I’ve been on pins and needles those first few days of high school…..just worrying and wondering if everything is ok. Rather glad I don’t have to go through that again. Try to know what is going on with your child. Keep talking to your high schooler even if they don’t want to. Find something you can both feel comfortable talking about or do together, and then sneak some serious discussions when you can. Let your child know your expectations for their academic performance and behavior in general. You don’t have to set expectations at an impossible or stress inducing level but set some expectations. I’ve seen one child through high school and off to college and enjoyed almost every minute of it.

The picture above is of my son's 8th grade graduation last June. I no longer have a middle school student. A little sad I have to admit.

Pressure vs. Expectations

Over the past several years, many books have been written about how we as parents and we as a society put too much pressure on kids. I’ve purchased several, read a couple and scanned a few. The world is different these days and kids are under a lot more pressure to perform earlier than we ever were. Pressure to perform at school, on the athletic field and with peers have lead to anxiety, acting out and even suicide. Obviously, too much continuous pressure is not a good thing for anyone.

These days children grow up quicker, they are left alone more often and participate in organized activities sooner. So many kids are in divorce situations, splitting time between two busy and sometimes angry parents. If you think that does not cause pressure think again. My own theory is we expose kids to a lot of different experiences earlier than we ever were. Many of these experiences they are not ready for from a developmental standpoint. In these experiences, I include academics, family problems, dance, music, athletics, competitions, daycare till 5 or 6, organized everything. ( I posted earlier a lot of free play is missing). So typical little Billy, who is having trouble with in full day academic kindergarten (which I strongly oppose as a standard for all), may not be developmentally ready for a full day or even some academics in kindergarten, is now sent for special education testing when probably half the class is not developmentally ready to take on the academic challenges or the stress of a full day away from home.

I am saying earlier experiences have changed but child development has not evolved any differently. So right from the start we put too much pressure on them. I am not convinced that full day kindergarten makes your kid smarter or helps them to read that much earlier. By the way, most kid’s skills tend to catch up with each other by about 4th grade. So even if little Sally’s parents bragged about her reading at 4 she will probably turn out to be just an average student. Her experiences were different, exposed to pre-reading skills earlier and it worked for her. Perhaps, she was even pressured into reading so her parents could brag. I believe a lot of the pressure (but not all) emerges when children are expected to do things they are not developmentally ready to do.

So with pressure to succeed and to fit in especially at the middle school and high school level identified as a problem, the trend has been to decrease the pressure and to get help for kids if needed. Most parents have become aware of creating too much pressure and I think have backed off. However, in the quest to decrease the pressure many parents and teachers have also decreased or eliminated common sense expectations.

So what is the difference between putting on too much pressure on a child and having expectations especially high ones. Pressure, I feel, is pointing your child toward an almost impossible goal. Talking about that goal 27/7 and having their life revolve around that goal. The goal becomes so much of a focus that the kid ends up hating the goal and only does it to please their parents. Kids will also self induce pressure so a parent must keep a close watch on high achievers and intervene when the pressure looks like it’s too much.

Expectations are the day to day rules and the life goals kids are suppose to follow whether a parent or teacher is reminding them or not. At home some expectations might be certain chores, doing homework without being told, going to bed at the proper time, preparing your self for school or other activities, doing your best at school, being kind to others, not bullying, speaking politely to adults, following the rules at school and other activities, telling parents important information, behaving yourself in public especially when unsupervised……the list of common sense expectations go on an on. Some of the expectations at school include being respectful to others, listening to adults, coming prepared to class, not throwing trash on the floor, following school routines without always having to be told to get moving, doing your work, working cooperatively, controlling anger, no bullying…..again the list is endless.

As my own children have gotten older, our expectations have changed and increased. We expect them to perform to the best of their ability at school. We expect them to put effort into extracurricular activities, volunteer activities and work. Our biggest expectation is that they will not drink especially if they are driving our car. Does that assure me they won’t? Of course not. But, they also know we do everything in our power to make sure that does not happen. They know we call parents to see if anyone is going to be home and we check their breath when they come in. They know there will be consequences at home for inappropriate behavior. They’ve missed a lot of parties because of our actions and I might add missed the near-death experience of a friend from too much alcohol.

I worked with a middle school teacher once, Mary we’ll call her. Mary called me naive to think my own middle school kids were not exposed to sex, drugs and alcohol. Mary implied that my kids probably were experimenting with all three. It is not that I don’t know those thing are out there but my expectations to my own children is that we do not want you around that kind of stuff or indulging in it. Needless to say, while Mary was spouting this to me, I knew that she had a couple of very wild teenage daughters at home. I assume she thought that because her girls indulged that that had to be the norm. See she was willing to accept their behavior as normal teenage behavior rather than tell them her expectations for behavior.

Kids with no expectations flounder, both at school and in their social lives. They tend to also grow up with an inappropriate sense of entitlement…. The ”I don’t have to do that” attitude. They goof around in school and disrupt things for others. Most of them know that their parents will not do anything if the teacher calls home. Parents seem to be too busy sticking up for their child’s bad behavior rather than giving them clear expectations for conduct. Some parents clearly do not care and I have to wonder about that. I see so many kids without clear life expectations and wonder what they will be doing in 10 years.

Teachers can provide clear expectations at school. However, if the parental expectations and follow up is not there it is almost impossible for the child to succeed to their potential. It is the rare student that can see school as their ticket to success and that can generate self expectations.

So parents, talk to your child. Let them know your expectations for them at home, at school and out in public . Be the parent you need to be and don’t let them run the house or make up the rules. Point out inappropriate behavior even if it is just little etiquette things. If there is a problem don’t make excuses for them, follow up with appropriate consequences. Basic expectations are life long lessons that will serve them well long after they leave the classroom.