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Back to School SLP Efficiency Bundles™

September is practically here and many speech language pathologists (SLPs) are looking to efficiently prepare for assessing and treating a variety of clients on their caseloads.

With that in mind, a few years ago I created SLP Efficiency Bundles™, which are materials highly useful for SLPs working with pediatric clients. These materials are organized by areas of focus for efficient and effective screening, assessment, and treatment of speech and language disorders.

A.  General Assessment and Treatment Start-Up Bundle contains 5 downloads for general speech language assessment and treatment planning and includes:

  1. Speech Language Assessment Checklist for a Preschool Child
  2. Speech Language Assessment Checklist for a School-Aged Child
  3. Creating a Functional Therapy Plan: Therapy Goals & SOAP Note Documentation
  4. Selecting Clinical Materials for Pediatric Therapy
  5. Types and Levels of Cues and Prompts in  Speech Language Therapy

B. The Checklists Bundle contains 7 checklists relevant to screening and assessment in speech language pathology

  1. Speech Language Assessment Checklist for a Preschool Child 3:00-6:11 years of age
  2. Speech Language Assessment Checklist for a School-Aged Child 7:00-11:11 years of age
  3. Speech Language Assessment Checklist for Adolescents 12-18 years of age
  4. Language Processing Deficits (LPD) Checklist for School Aged Children 7:00-11:11 years of age
  5. Language Processing Deficits (LPD) Checklist for Preschool Children 3:00-6:11 years of age
  6. Social Pragmatic Deficits Checklist for School Aged Children 7:00-11:11 years of age
  7. Social Pragmatic Deficits Checklist for Preschool Children 3:00-6:11 years of age

C. Social Pragmatic Assessment and Treatment Bundle  contains 6 downloads for social pragmatic assessment and treatment planning (from 18 months through school age) and includes:

  1. Recognizing the Warning Signs of Social Emotional Difficulties in Language Impaired Toddlers and Preschoolers
  2. Behavior Management Strategies for Speech Language Pathologists
  3. Social Pragmatic Deficits Checklist for School Aged Children
  4. Social Pragmatic Deficits Checklist for Preschool Children
  5. Assessing Social Pragmatic Skills of School Aged Children
  6. Treatment of Social Pragmatic Deficits in School Aged Children

D. Multicultural Assessment and Treatment Bundle contains 2 downloads relevant to assessment and treatment of bilingual/multicultural children

  1. Language Difference vs. Language Disorder:  Assessment  & Intervention Strategies for SLPs Working with Bilingual Children
  2. Impact of Cultural and Linguistic Variables On Speech-Language Services

E. Narrative Assessment Bundle contains 3 downloads relevant to narrative assessment

  1. Narrative Assessments of Preschool and School Aged Children
  2. Understanding Complex Sentences
  3. Vocabulary Development: Working with Disadvantaged Populations

F. Fetal Alcohol Spectrum Disorders Assessment and Treatment Bundle contains 3 downloads relevant to FASD assessment  and treatment

  1. Orofacial Observations of At-Risk Children
  2. Fetal Alcohol Spectrum Disorder: An Overview of Deficits
  3. Speech Language Assessment and Treatment of Children With Alcohol Related Disorders

G. Psychiatric Disorders Bundle contains 7 downloads relevant to language  assessment  and treatment in psychiatrically impaired children

  1. Recognizing the Warning Signs of Social Emotional Difficulties in Language Impaired Toddlers and Preschoolers
  2. Social Pragmatic Deficits Checklist for School Aged Children
  3. Social Pragmatic Deficits Checklist for Preschool Children
  4. Assessing Social Skills in Children with Psychiatric Disturbances
  5. Improving Social Skills of Children with Psychiatric Disturbances
  6. Behavior Management Strategies for Speech Language Pathologists
  7. Differential Diagnosis Of ADHD In Speech Language Pathology

You can find these bundles on SALE in my online store by clicking on the individual bundle links above. You can also purchase these products individually in my online store by clicking HERE.

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Review of the Test of Integrated Language and Literacy (TILLS)

The Test of Integrated Language & Literacy Skills (TILLS) is an assessment of oral and written language abilities in students 6–18 years of age. Published in the Fall 2015, it is  unique in the way that it is aimed to thoroughly assess skills  such as reading fluency, reading comprehension, phonological awareness,  spelling, as well as writing  in school age children.   As I have been using this test since the time it was published,  I wanted to take an opportunity today to share just a few of my impressions of this assessment.

               

First, a little background on why I chose to purchase this test  so shortly after I had purchased the Clinical Evaluation of Language Fundamentals – 5 (CELF-5).   Soon after I started using the CELF-5  I noticed that  it tended to considerably overinflate my students’ scores  on a variety of its subtests.  In fact,  I noticed that unless a student had a fairly severe degree of impairment,  the majority of his/her scores  came out either low/slightly below average (click for more info on why this was happening HERE, HEREor HERE). Consequently,  I was excited to hear regarding TILLS development, almost simultaneously through ASHA as well as SPELL-Links ListServe.   I was particularly happy  because I knew some of this test’s developers (e.g., Dr. Elena Plante, Dr. Nickola Nelson) have published solid research in the areas of  psychometrics and literacy respectively.

According to the TILLS developers it has been standardized for 3 purposes:

  • to identify language and literacy disorders
  • to document patterns of relative strengths and weaknesses
  • to track changes in language and literacy skills over time

The testing subtests can be administered in isolation (with the exception of a few) or in its entirety.  The administration of all the 15 subtests may take approximately an hour and a half, while the administration of the core subtests typically takes ~45 mins).

Please note that there are 5 subtests that should not be administered to students 6;0-6;5 years of age because many typically developing students are still mastering the required skills.

  • Subtest 5 – Nonword Spelling
  • Subtest 7 – Reading Comprehension
  • Subtest 10 – Nonword Reading
  • Subtest 11 – Reading Fluency
  • Subtest 12 – Written Expression

However,  if needed, there are several tests of early reading and writing abilities which are available for assessment of children under 6:5 years of age with suspected literacy deficits (e.g., TERA-3: Test of Early Reading Ability–Third Edition; Test of Early Written Language, Third Edition-TEWL-3, etc.).

Let’s move on to take a deeper look at its subtests. Please note that for the purposes of this review all images came directly from and are the property of Brookes Publishing Co (clicking on each of the below images will take you directly to their source).

TILLS-subtest-1-vocabulary-awareness1. Vocabulary Awareness (VA) (description above) requires students to display considerable linguistic and cognitive flexibility in order to earn an average score.    It works great in teasing out students with weak vocabulary knowledge and use,   as well as students who are unable to  quickly and effectively analyze  words  for deeper meaning and come up with effective definitions of all possible word associations. Be mindful of the fact that  even though the words are presented to the students in written format in the stimulus book, the examiner is still expected to read  all the words to the students. Consequently,  students with good vocabulary knowledge  and strong oral language abilities  can still pass this subtest  despite the presence of significant reading weaknesses. Recommendation:  I suggest informally  checking the student’s  word reading abilities  by asking them to read of all the words, before reading all the word choices to them.   This way  you can informally document any word misreadings  made by the student even in the presence of an average subtest score.

TIILLS-subtest-2-phonemic-awareness

2. The Phonemic Awareness (PA) subtest (description above) requires students to  isolate and delete initial sounds in words of increasing complexity.  While this subtest does not require sound isolation and deletion in various word positions, similar to tests such as the CTOPP-2: Comprehensive Test of Phonological Processing–Second Edition  or the The Phonological Awareness Test 2 (PAT 2)  it is still a highly useful and reliable measure of  phonemic awareness (as one of many precursors to reading fluency success).  This is especially because after the initial directions are given, the student is expected to remember to isolate the initial sounds in words without any prompting from the examiner.  Thus,  this task also  indirectly tests the students’ executive function abilities in addition to their phonemic awareness skills.

TILLS-subtest-3-story-retelling

3. The Story Retelling (SR) subtest (description above) requires students to do just that retell a story. Be mindful of the fact that the presented stories have reduced complexity. Thus, unless the students possess  significant retelling deficits, the above subtest  may not capture their true retelling abilities. Recommendation:  Consider supplementing this subtest  with informal narrative measures. For younger children (kindergarten and first grade) I recommend using wordless picture books to perform a dynamic assessment of their retelling abilities following a clinician’s narrative model (e.g., HERE).  For early elementary aged children (grades 2 and up), I recommend using picture books, which are first read to and then retold by the students with the benefit of pictorial but not written support. Finally, for upper elementary aged children (grades 4 and up), it may be helpful for the students to retell a book or a movie seen recently (or liked significantly) by them without the benefit of visual support all together (e.g., HERE).

TILLS-subtest-4-nonword-repetition

4. The Nonword Repetition (NR) subtest (description above) requires students to repeat nonsense words of increasing length and complexity. Weaknesses in the area of nonword repetition have consistently been associated with language impairments and learning disabilities due to the task’s heavy reliance on phonological segmentation as well as phonological and lexical knowledge (Leclercq, Maillart, Majerus, 2013). Thus, both monolingual and simultaneously bilingual children with language and literacy impairments will be observed to present with patterns of segment substitutions (subtle substitutions of sounds and syllables in presented nonsense words) as well as segment deletions of nonword sequences more than 2-3 or 3-4 syllables in length (depending on the child’s age).

TILLS-subtest-5-nonword-spelling

5. The Nonword Spelling (NS) subtest (description above) requires the students to spell nonwords from the Nonword Repetition (NR) subtest. Consequently, the Nonword Repetition (NR) subtest needs to be administered prior to the administration of this subtest in the same assessment session.  In contrast to the real-word spelling tasks,  students cannot memorize the spelling  of the presented words,  which are still bound by  orthographic and phonotactic constraints of the English language.   While this is a highly useful subtest,  is important to note that simultaneously bilingual children may present with decreased scores due to vowel errors.   Consequently,  it is important to analyze subtest results in order to determine whether dialectal differences rather than a presence of an actual disorder is responsible for the error patterns.

TILLS-subtest-6-listening-comprehension

6. The  Listening Comprehension (LC) subtest (description above) requires the students to listen to short stories  and then definitively answer story questions via available answer choices, which include: “Yes”, “No’, and “Maybe”. This subtest also indirectly measures the students’ metalinguistic awareness skills as they are needed to detect when the text does not provide sufficient information to answer a particular question definitively (e.g., “Maybe” response may be called for).  Be mindful of the fact that because the students are not expected to provide sentential responses  to questions it may be important to supplement subtest administration with another listening comprehension assessment. Tests such as the Listening Comprehension Test-2 (LCT-2), the Listening Comprehension Test-Adolescent (LCT-A),  or the Executive Function Test-Elementary (EFT-E)  may be useful  if  language processing and listening comprehension deficits are suspected or reported by parents or teachers. This is particularly important  to do with students who may be ‘good guessers’ but who are also reported to present with word-finding difficulties at sentence and discourse levels. 

TILLS-subtest-7-reading-comprehension

7. The Reading Comprehension (RC) subtest (description above) requires the students to  read short story and answer story questions in “Yes”, “No’, and “Maybe”  format.   This subtest is not stand alone and must be administered immediately following the administration the Listening Comprehension subtest. The student is asked to read the first story out loud in order to determine whether s/he can proceed with taking this subtest or discontinue due to being an emergent reader. The criterion for administration of the subtest is making 7 errors during the reading of the first story and its accompanying questions. Unfortunately,  in my clinical experience this subtest  is not always accurate at identifying children with reading-based deficits.

While I find it terrific for students with severe-profound reading deficits and/or below average IQ, a number of my students with average IQ and moderately impaired reading skills managed to pass it via a combination of guessing and luck despite being observed to misread aloud between 40-60% of the presented words. Be mindful of the fact that typically  such students may have up to 5-6  errors during the reading of the first story. Thus, according to administration guidelines these students will be allowed to proceed and take this subtest.  They will then continue to make text misreadings  during each story presentation (you will know that by asking them to read each story aloud vs. silently).   However,  because the response mode is in definitive (“Yes”, “No’, and “Maybe”) vs. open ended question format,  a number of these students  will earn average scores by being successful guessers. Recommendation:  I highly recommend supplementing the administration of this subtest with grade level (or below grade level) texts (see HERE and/or HERE),  to assess the student’s reading comprehension informally.

I present a full  one page text to the students and ask them to read it to me in its entirety.   I audio/video record  the student’s reading for further analysis (see Reading Fluency section below).   After the  completion of the story I ask  the student questions with a focus on main idea comprehension and vocabulary definitions.   I also ask questions pertaining to story details.   Depending on the student’s age  I may ask them  abstract/ factual text questions with and without text access.  Overall, I find that informal administration of grade level (or even below grade-level) texts coupled with the administration of standardized reading tests provides me with a significantly better understanding of the student’s reading comprehension abilities rather than administration of standardized reading tests alone.

TILLS-subtest-8-following-directions

8. The Following Directions (FD) subtest (description above) measures the student’s ability to execute directions of increasing length and complexity.  It measures the student’s short-term, immediate and working memory, as well as their language comprehension.  What is interesting about the administration of this subtest is that the graphic symbols (e.g., objects, shapes, letter and numbers etc.) the student is asked to modify remain covered as the instructions are given (to prevent visual rehearsal). After being presented with the oral instruction the students are expected to move the card covering the stimuli and then to executive the visual-spatial, directional, sequential, and logical if–then the instructions  by marking them on the response form.  The fact that the visual stimuli remains covered until the last moment increases the demands on the student’s memory and comprehension.  The subtest was created to simulate teacher’s use of procedural language (giving directions) in classroom setting (as per developers).

TILLS-subtest-9-delayed-story-retelling

9. The Delayed Story Retelling (DSR) subtest (description above) needs to be administered to the students during the same session as the Story Retelling (SR) subtest, approximately 20 minutes after the SR subtest administration.  Despite the relatively short passage of time between both subtests, it is considered to be a measure of long-term memory as related to narrative retelling of reduced complexity. Here, the examiner can compare student’s performance to determine whether the student did better or worse on either of these measures (e.g., recalled more information after a period of time passed vs. immediately after being read the story).  However, as mentioned previously, some students may recall this previously presented story fairly accurately and as a result may obtain an average score despite a history of teacher/parent reported  long-term memory limitations.  Consequently, it may be important for the examiner to supplement the administration of this subtest with a recall of a movie/book recently seen/read by the student (a few days ago) in order to compare both performances and note any weaknesses/limitations.

TILLS-subtest-10-nonword-reading

10. The Nonword Reading (NR) subtest (description above) requires students to decode nonsense words of increasing length and complexity. What I love about this subtest is that the students are unable to effectively guess words (as many tend to routinely do when presented with real words). Consequently, the presentation of this subtest will tease out which students have good letter/sound correspondence abilities as well as solid orthographic, morphological and phonological awareness skills and which ones only memorized sight words and are now having difficulty decoding unfamiliar words as a result.      TILLS-subtest-11-reading-fluency

11. The Reading Fluency (RF) subtest (description above) requires students to efficiently read facts which make up simple stories fluently and correctly.  Here are the key to attaining an average score is accuracy and automaticity.  In contrast to the previous subtest, the words are now presented in meaningful simple syntactic contexts.

It is important to note that the Reading Fluency subtest of the TILLS has a negatively skewed distribution. As per authors, “a large number of typically developing students do extremely well on this subtest and a much smaller number of students do quite poorly.”

Thus, “the mean is to the left of the mode” (see publisher’s image below). This is why a student could earn an average standard score (near the mean) and a low percentile rank when true percentiles are used rather than NCE percentiles (Normal Curve Equivalent). Tills Q&A – Negative Skew

Consequently under certain conditions (See HERE) the percentile rank (vs. the NCE percentile) will be a more accurate representation of the student’s ability on this subtest.

Indeed, due to the reduced complexity of the presented words some students (especially younger elementary aged) may obtain average scores and still present with serious reading fluency deficits.  

I frequently see that in students with average IQ and go to long-term memory, who by second and third grades have managed to memorize an admirable number of sight words due to which their deficits in the areas of reading appeared to be minimized.  Recommendation: If you suspect that your student belongs to the above category I highly recommend supplementing this subtest with an informal measure of reading fluency.  This can be done by presenting to the student a grade level text (I find science and social studies texts particularly useful for this purpose) and asking them to read several paragraphs from it (see HERE and/or HERE).

As the students are reading  I calculate their reading fluency by counting the number of words they read per minute.  I find it very useful as it allows me to better understand their reading profile (e.g, fast/inaccurate reader, slow/inaccurate reader, slow accurate reader, fast/accurate reader).   As the student is reading I note their pauses, misreadings, word-attack skills and the like. Then, I write a summary comparing the students reading fluency on both standardized and informal assessment measures in order to document students strengths and limitations.

TILLS-subtest-12-written-expression

12. The Written Expression (WE) subtest (description above) needs to be administered to the students immediately after the administration of the Reading Fluency (RF) subtest because the student is expected to integrate a series of facts presented in the RF subtest into their writing sample. There are 4 stories in total for the 4 different age groups.

The examiner needs to show the student a different story which integrates simple facts into a coherent narrative. After the examiner reads that simple story to the students s/he is expected to tell the students that the story is  okay, but “sounds kind of “choppy.” They then need to show the student an example of how they could put the facts together in a way that sounds more interesting and less choppy  by combining sentences (see below). Finally, the examiner will ask the students to rewrite the story presented to them in a similar manner (e.g, “less choppy and more interesting.”)

tills

After the student finishes his/her story, the examiner will analyze it and generate the following scores: a discourse score, a sentence score, and a word score. Detailed instructions as well as the Examiner’s Practice Workbook are provided to assist with scoring as it takes a bit of training as well as trial and error to complete it, especially if the examiners are not familiar with certain procedures (e.g., calculating T-units).

Full disclosure: Because the above subtest is still essentially sentence combining, I have only used this subtest a handful of times with my students. Typically when I’ve used it in the past, most of my students fell in two categories: those who failed it completely by either copying text word  for word, failing to generate any written output etc. or those who passed it with flying colors but still presented with notable written output deficits. Consequently, I’ve replaced Written Expression subtest administration with the administration of written standardized tests, which I supplement with an informal grade level expository, persuasive, or narrative writing samples.

Having said that many clinicians may not have the access to other standardized written assessments, or lack the time to administer entire standardized written measures (which may frequently take between 60 to 90 minutes of administration time). Consequently, in the absence of other standardized writing assessments, this subtest can be effectively used to gauge the student’s basic writing abilities, and if needed effectively supplemented by informal writing measures (mentioned above).

TILLS-subtest-13-social-communication

13. The Social Communication (SC) subtest (description above) assesses the students’ ability to understand vocabulary associated with communicative intentions in social situations. It requires students to comprehend how people with certain characteristics might respond in social situations by formulating responses which fit the social contexts of those situations. Essentially students become actors who need to act out particular scenes while viewing select words presented to them.

Full disclosure: Similar to my infrequent administration of the Written Expression subtest, I have also administered this subtest very infrequently to students.  Here is why.

I am an SLP who works full-time in a psychiatric hospital with children diagnosed with significant psychiatric impairments and concomitant language and literacy deficits.  As a result, a significant portion of my job involves comprehensive social communication assessments to catalog my students’ significant deficits in this area. Yet, past administration of this subtest showed me that number of my students can pass this subtest quite easily despite presenting with notable and easily evidenced social communication deficits. Consequently, I prefer the administration of comprehensive social communication testing when working with children in my hospital based program or in my private practice, where I perform independent comprehensive evaluations of language and literacy (IEEs).

Again, as I’ve previously mentioned many clinicians may not have the access to other standardized social communication assessments, or lack the time to administer entire standardized written measures. Consequently, in the absence of other social communication assessments, this subtest can be used to get a baseline of the student’s basic social communication abilities, and then be supplemented with informal social communication measures such as the Informal Social Thinking Dynamic Assessment Protocol (ISTDAP) or observational social pragmatic checklists

TILLS-subtest-14-digit-span-forward

14.  The Digit Span Forward (DSF) subtest (description above) is a relatively isolated  measure  of short term and verbal working memory ( it minimizes demands on other aspects of language such as syntax or vocabulary).

TILLS-subtest-15-digit-span-backward

15.  The Digit Span Backward (DSB) subtest (description above) assesses the student’s working memory and requires the student to mentally manipulate the presented stimuli in reverse order. It allows examiner to observe the strategies (e.g. verbal rehearsal, visual imagery, etc.) the students are using to aid themselves in the process.  Please note that the Digit Span Forward subtest must be administered immediately before the administration of this subtest.

SLPs who have used tests such as the Clinical Evaluation of Language Fundamentals – 5 (CELF-5) or the Test of Auditory Processing Skills – Third Edition (TAPS-3) should be highly familiar with both subtests as they are fairly standard measures of certain aspects of memory across the board.

To continue, in addition to the presence of subtests which assess the students literacy abilities, the TILLS also possesses a number of interesting features.

For starters, the TILLS Easy Score, which allows the examiners to use their scoring online. It is incredibly easy and effective. After clicking on the link and filling out the preliminary demographic information, all the examiner needs to do is to plug in this subtest raw scores, the system does the rest. After the raw scores are plugged in, the system will generate a PDF document with all the data which includes (but is not limited to) standard scores, percentile ranks, as well as a variety of composite and core scores. The examiner can then save the PDF on their device (laptop, PC, tablet etc.) for further analysis.

The there is the quadrant model. According to the TILLS sampler (HERE)  “it allows the examiners to assess and compare students’ language-literacy skills at the sound/word level and the sentence/ discourse level across the four oral and written modalities—listening, speaking, reading, and writing” and then create “meaningful profiles of oral and written language skills that will help you understand the strengths and needs of individual students and communicate about them in a meaningful way with teachers, parents, and students. (pg. 21)”

tills quadrant model

Then there is the Student Language Scale (SLS) which is a one page checklist parents,  teachers (and even students) can fill out to informally identify language and literacy based strengths and weaknesses. It  allows for meaningful input from multiple sources regarding the students performance (as per IDEA 2004) and can be used not just with TILLS but with other tests or in even isolation (as per developers).

Furthermore according to the developers, because the normative sample included several special needs populations, the TILLS can be used with students diagnosed with ASD,  deaf or hard of hearing (see caveat), as well as intellectual disabilities (as long as they are functioning age 6 and above developmentally).

According to the developers the TILLS is aligned with Common Core Standards and can be administered as frequently as two times a year for progress monitoring (min of 6 mos post 1st administration).

With respect to bilingualism examiners can use it with caution with simultaneous English learners but not with sequential English learners (see further explanations HERE).   Translations of TILLS are definitely not allowed as they will undermine test validity and reliability.

So there you have it these are just some of my very few impressions regarding this test.  Now to some of you may notice that I spend a significant amount of time pointing out some of the tests limitations. However, it is very important to note that we have research that indicates that there is no such thing as a “perfect standardized test” (see HERE for more information).   All standardized tests have their limitations

Having said that, I think that TILLS is a PHENOMENAL addition to the standardized testing market, as it TRULY appears to assess not just language but also literacy abilities of the students on our caseloads.

That’s all from me; however, before signing off I’d like to provide you with more resources and information, which can be reviewed in reference to TILLS.  For starters, take a look at Brookes Publishing TILLS resources.  These include (but are not limited to) TILLS FAQ, TILLS Easy-Score, TILLS Correction Document, as well as 3 FREE TILLS Webinars.   There’s also a Facebook Page dedicated exclusively to TILLS updates (HERE).

But that’s not all. Dr. Nelson and her colleagues have been tirelessly lecturing about the TILLS for a number of years, and many of their past lectures and presentations are available on the ASHA website as well as on the web (e.g., HERE, HERE, HERE, etc). Take a look at them as they contain far more in-depth information regarding the development and implementation of this groundbreaking assessment.

To access TILLS fully-editable template, click HERE

Disclaimer:  I did not receive a complimentary copy of this assessment for review nor have I received any encouragement or compensation from either Brookes Publishing  or any of the TILLS developers to write it.  All images of this test are direct property of Brookes Publishing (when clicked on all the images direct the user to the Brookes Publishing website) and were used in this post for illustrative purposes only.

References: 

Leclercq A, Maillart C, Majerus S. (2013) Nonword repetition problems in children with SLI: A deficit in accessing long-term linguistic representations? Topics in Language Disorders. 33 (3) 238-254.

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Teaching “Insight” to students with language, social communication, and executive functions impairments

One common difficulty our “higher functioning” (refers to subjective notion of ‘perceived’ functioning in school setting only) language impaired students with social communication and executive function difficulties present with – is lack of insight into own strengths and weaknesses.

Yet insight is a very important skill, which most typically developing students exhibit without consciously thinking about it. Having insight allows students to review work for errors, compensate for any perceived weaknesses effectively, and succeed with efficient juggling of academic workload.

In contrast, lack of insight in students with language deficits further compounds their difficulties, as they lack realization into own weaknesses and as a result are unable to effectively compensate for them.

That is why I started to explicitly teach the students on my caseload in both psychiatric hospital and private practice the concept of insight.

Now some of you may have some legitimate concerns. You may ask: “How can one teach such an abstract concept to students who are already impaired in their comprehension of language?” The answer to that is – I teach this concept through a series of concrete steps as well as through the introduction of abstract definitions, simplified for the purpose of my sessions into concrete terms.

Furthermore, it is important to understand that the acquisition of “insight” cannot be accomplished in one or even several sessions. Rather after this concept is introduced and the related vocabulary has been ‘internalized’ by the student,  thematic therapy sessions can be used to continue the acquisition of “insight” for months and even years to come.

"The Beginning" Road Sign with dramatic blue sky and clouds.

How do we begin? 

When I first started teaching this concept I used to explain the terminology related to “insight” verbally to students. However, as my own ‘insight’ developed in response to the students’ performance, I created a product to assist them with the acquisition of insight (See HERE).

Intended Audiences:

  • Clients with Language Impairments
  • Clients with Social Pragmatic Language Difficulties
  • Clients with Executive Function Difficulties
  • Clients with Psychiatric Impairments
    • ODD, ADHD, MD, Anxiety, Depression, etc.
  • Clients with Autism Spectrum Disorders
  • Clients with Nonverbal Learning Disability
  • Clients with Fetal Alcohol Spectrum Disorders
  • Adult and pediatric post-Traumatic Brain Injury (TBI) clients
  • Clients with right-side CVA Damage

kid-lightbulb-shutterstock_166297358-300×198

This thematic 10 page packet targets the development of “insight” in students with average IQ, 8+ years of age, presenting with social pragmatic and executive function difficulties.

The packet contains 1 page text explaining the concept of insight to students.

It also contains 11 Tier II vocabulary words relevant to the discussion of insight and their simplified definitions. The words were selected based on course curriculum standards for several grade levels (fourth through seventh) due to their wide usage in a variety of subjects (social studies, science, math, etc.)

Language activities in this packet include:

  • Explaining definitions
  • Answering open-ended comprehension questions
  • Sentence construction activity
  • Crossword puzzle
  • Two morphological awareness activities
    • Define prefixes and suffixes
    • Change word meanings by adding prefixes and suffixes to words
  • Self-reflection page in written format contains questions for students to assist them with judging their own strengths and weaknesses related to academic performance

And now a few words regarding the lesson structure

I introduce the concept of “insight” to clients by writing down the word and asking them to identify its parts: ‘in‘ and ‘sight‘. Depending on the student’s level of abilities I either get to the students to explain it to me or explain it myself that it is a compound word made up of two other words.

I then ask the students to interpret what the word could potentially mean. After I hear their responses I either confirm the correct one or end up explaining that this word refers to “looking into one’s brain” for answers related to how well someone understands information.

I have the students read the text located on the first page of my packet going over the concept of insight and some of its associated vocabulary words.  I ask the students to tell me the main idea of each paragraph as well as answer questions regarding supporting text details.

Once I am confident that the students have a fairly good grasp of the presented text I move on to the definitions page. There are actually two definition pages in the lesson: one at the beginning and one at the end of the packet. The first definitions page also contains word meaning and what parts of speech the definitions belong to.  The definition page at the end of the packet contains only the targeted words. It is now the students responsibility to write down the definition of all the vocabulary words and phrases in order for me to see how well they remember the meanings of pertinent words.

The packet also includes comprehension questions, a section on sentence construction several morphological awareness activities, a crossword puzzle and a self-reflection page.

The final activity in the packet requires the student to judge their own work performance during this activity.  I ask students questions such as:

  • How do you think you did on this task?
  • How do you know you did ________?
  • How can you prove to me you understood ________?

If a student responds “I know I did well because I understood everything”, I typically ask them to prove their comprehension to me, verbally. Here the goal is to have the student provide concrete verbal examples supporting their insight of their performance.

 This may include statements such as:

  • I know I did well because you said: “Nice Work!”
  • I know I did well because you didn’t correct me too much
  • I know I did well because you  kept smiling and showed me thumbs up as I was talking

As mentioned above this activity is only the beginning. After I ensure that the students have a decent grasp of this concept I continue working on it indirectly by having the students continuously judge their own performance on a variety of other therapy related activities and assignments.

You can find the complete packet on teaching “insight” in my online store (HERE).  Also, stay tuned for Part II of this series, which will describe how to continue solidifying the concept of “insight” in the context of therapy sessions for students with social pragmatic and executive function deficits.

Helpful Smart Speech Resources:

 

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#BHSM – School Based Innovation and RtI FREEBIE Blog Hop

Art by Margaret Warner mwa2808@gmail.com

To celebrate the 2015 ASHA Better Hearing and Speech Month in May, Speech Language Literacy Lab has organized an RtI Blog Hop. During the hop Smart Speech Therapy LLC along with 29 other professional bloggers from a variety of ancillary fields (e.g., OT, special education, etc.) will be sharing FREE materials and resources on the subject of School Based Innovation and RtI.

Each day, readers will have an access to a new blog post to have access to new freebies and resources. Our organizer Sl3l lab will also be linking these blog posts to their site daily.

Blog Posting Schedule:

5/1/2015 Kick Off to Better Hearing and Speech Month!

5/2/2015 RTI for the R sound! Badger State Speechy

5/3/2015 An effective RTI program Stephen Charlton Guest blogs on Speech Language Literacy Lab

5/4/2015 Technology and RTI  Building Successful Lives Speech & Language

5/5/2015 Starfish Therapies

5/6/2015 Orton Gillingham Approach & RTI  Orton Gillingham Online Academy

5/7/2015 Evidenced-based writing that works for RTI & SPED SQWrite

5/8/2015 RTI/MTSS/SBLT…OMG!  Let’s Talk! with Whitneyslp

5/9/2015 RtI, but why?  Attitudes are everything!  Crazy Speech World

5/10/2015      Consonantly Speaking

5/11/2015 Universal benchmarking for language to guide the RTI process in Pre-K and Kindergarten     Speech Language Literacy Lab

5/12/2015 Movement Breaks in the Classroom (Brain Breaks)   Your Therapy Source

5/13/2015 How to Write a Social Story   Blue Mango LLC

5/14/2015 Some Ideas on Objective Language Therapy    Language Fix

5/15/2015 Assistive Technology in the Classroom  OTMommy Needs Her Coffee

5/16/2015 Effective Tiered Early Literacy Instruction for Spanish-Speakers Bilingual Solutions Guest blog on Speech Language Literacy Lab

5/17/2015 Helping with Attention and Focus in the Classroom   The Pocket OT

5/18/2015 Tips on Effective Vocabulary Instruction  Smart Speech Therapy, LLC

5/19/2015 An SLP’s Role in RtI: My Story Communication Station: Speech Therapy, PLLC

5/20/2015 Incorporating Motor Skills into Literacy Centers   MissJaimeOT

5/21/2015 The QUAD Profile: A Language Checklist  The Speech Dudes

5/22/2015 Resources on Culturally Relevant Interventions  Tier 1 Educational Coaching and Consulting

5/23/2015 Language Goals Galore: Converting Real Pictures to Coloring Pages  Really Color guest blog on Speech Language Literacy Lab

5/24/2015 Lesson Pix: The Newest Must-Have Resource in your Tx Toolbox Speech Language Literacy Lab

5/25/2015 AAC & core vocabulary instruction Kidz Learn Language

5/26/2015 An RtI Alternative Old School Speech

5/27/2015 Intensive Service Delivery Model for Pre-Schoolers   Speech Sprouts

5/28/2015 RTI Success with Spanish-speakers     Speech is Beautiful

5/30/2015 The Importance of Social Language (pragmatic) Skills Linda Silver guest post on Speech Sprouts

5/31/2015 Sarah Warchol guest posts on Speech Language Literacy Lab

Hope to see you all hoping during #BHSM!

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Review and Giveaway: Healthy Heart & Language Mart Tier II Vocabulary Words

frenzy pictLast February I did a product swap and giveaway with the fabulous Rose Kesting of Speech Snacks. It was entitledWintertime Wellness:Language Building, Problem Solving & Reading Comprehensionand was aimed teaching students aspects of health and wellness as pertaining to the cold and flu season.

This February, I am at it again, reviewing her “Healthy Heart & Language Mart” companion for middle and high school students.  As I’ve mentioned in the past Rose runs a fun and unique blog. In her posts she combines her interest in nutrition and healthy cooking with her professional knowledge as a speech-language pathologist.  

Rose created the “Healthy Heart” packet as a way to help create a greater awareness of good health, nutrition and fitness while improving language skills during American Heart Month in February. Now I know what you are thinking, Tatyana its February 24th, why are you giving away this packet when there are only 4 days left in February?

Simple really! It may be the end of February but the topics of “good health, nutrition and fitness” do not end there and are just as important during the cold month of March.  Furthermore, many of our students are limited in their choices of physical activity during the winter months due to lack of opportunities or resources, which is why this packet continues to be relevant and useful vocabulary-wise long past the month of February.

Main Packet Contents:

Vocabulary Cards, Definition Cards, Synonym Cards, Question Cards, Sentence Writing Page, Sentence Writing Worksheets, Grammar Correction Worksheets,  Figurative Language Cards, Problem Solving Photos, Reading/Listening Comprehension Cards as well as Shopping Cart Game Mat/Grocery Bags Game.

Packet Overview:

One of the most hugely impressive parts of this packet are the diverse types of Tier II vocabulary words pertaining to health, wellness, and fitness.

Rose created 24 vocabulary cards to match the 24 definition cards to introduce the vocabulary for the students. She placed the key words or context clues in BOLD font to assist students in determining the correct answer. Similarly, she created 24 synonym cards with matching definitions to further improve the student’s knowledge and use of health-related vocabulary words.

LM 1

After that to reinforce the students’ knowledge Rose created comprehension questions cards (Beating Heart Bonus) pertaining to the above vocabulary words to ensure understanding of presented information.

I also like to pair the above comprehension question cards with pages 28-31 from Rose’s packet which contain 8 health-themed passages. These passages contains 2 sets of questions: factual and inferential to differentiate the question complexity. While many students are able to easily answer factual text-based questions they may  present with significant difficulty producing responses to inferential questions, so this may be an area on which SLPs can spend additional time working on in sessions.

Once that knowledge is solidified, students get an opportunity to write sentences with the presented vocabulary words.

LM 4

 

Finished writing? How about some good old-fashioned grammar work? Students can work on identifying run-on and simple/compound sentences as well as work on expanding sentences to increase their written output.

Then have some fun with figurative language by identifying idioms and applying them in action.

LM 3

Then move on to Problem Solving activity by answering questions based on real-life photos that involve real-life scenarios. I love the fact that besides identifying the problem the student must provide two possible solutions  to the problem. Here I also asked my students to provide justification for their solutions in order to solidify their knowledge as well as to make sure that they are producing coherent responses. 

Finally, finish up with the Shopping Cart Game Mat/Grocery Bags Game, which my students love. We play it as a game of chance. I distribute the definitions cards (face down) and mats to the students and then draw a vocabulary card from the pile, which I then read to them. The student who has the correct definition gets a ‘grocery bag’ to put on their mat. The first player to collect all six grocery bag categories is the winner! (Don’t forget to make copies of one shopping cart and one set of grocery bags per player).

Also don’t just use this packet for one or two sessions. Research indicates that students with language impairments need much more exposure to new and challenging vocabulary words in order to be able to use them in a proficients manner. So I’ve been actually using portions of this packet (which I had since last year’s FB Frenzy) with my students for WEEKS.

Again as with all of Rose’s products, I found this packet to be incredibly useful because of how multifaceted it is.  It is connected to the common core with respect to topic (health and wellness) and content areas (vocabulary, comprehensions, figurative language, etc).

The information it has is timely and relevant and is useful not just to address language goals in academic setting but also contains real life application (students need to know this information in order to engage in healthy lifestyles).

But what I really like about her product is that she uses research recommended evidence based strategies to teach students with language impairment new vocabulary words.

My students really enjoyed working with this packet and didn’t feel like it was a chore because of all the new words they learned in an interactive format.

You can find this packet in Rose’s TPT store HERE for $7.00 or you can enter my Rafflecopter giveaway for a chance of winning your own copy.

But wait there’s more!!! Rose is doing a review of my product “Treatment of Social Pragmatic Deficits in School Aged Children“, so if you head on over to her BLOG and read her review you’ll be able to enter both giveaways!

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Review: Kindergarten Language Benchmark Assessment (KLBA)

Recently I had an opportunity to use the Kindergarten Language Benchmark Assessment published by Speech Language Literacy Lab with a classroom of kindergarten students 5-6 years of age.  The KLBA is the screening and progress monitoring tool which tracks the development of appropriate early language skills and helps support the RTI model.

KLBA+test

This tool is comprised of four sections: auditory comprehension, following directions, categories and  narrative language, which are correlated to future reading success and academic competence. It is intended for monolingual and bilingual kindergarten children 5 to 6 years of age. It yields a raw score for each skill area and requires a very short administration time (around 5-7 minutes) .

The kit was created by Naomi R. Konikoff, MS, CCC-SLP and Jennifer Preschern, MA, CCC-SLP. It includes an administration manual, testing book, and 25 protocols.  Each protocol allows for 3 administrations (Winter, Spring, Fall) to monitor language growth in kindergarten students over a period of a school year.

Subtest description:

Auditory Comprehension subtest assesses the students’ ability to respond to -wh-questions based on short stories 3-4 sentences in length

Following Directions subtest assesses the students’ ability to follow 1-2 step directions.

Categories subtest assesses the student’s ability to receptively identify the similarities between 2 out of 3 presented items and then coherently verbalize their connection

Narrative Language subtest assesses the students’s ability to produce simple stories in order to determine their use of relevant story grammar elements.

KLBA 1

While there are a number of uses for this tool (RTI, to reduce over-identification of Limited English Proficiency students, evaluation of effectiveness of early language instruction, etc.),  since I’ve had it for a fairly limited time I used it as a screening instrument in order to determine whether a full comprehensive language testing was needed for the kindergarten children who were currently not mandated language services.

To confirm its reliability I also used it with children with known language impairment on my caseload, to determine how sensitive it was to detecting already existing language impairments.

The KLBA had indeed proven to be a reliable screening tool with the children I had tested. It cleared the children with typically developing language abilities (as per teachers reports and personal observations). In contrast when used with language impaired students on my caseload, KLBA had reliably identified their areas of weaknesses.  Children with language impairments were able to do quite well on several KLBA subtests due to the fact that they had already been receiving language therapy services. However, they invariably did poorly on the following subtests: expressive categorization and narrative production, which research has identified as being most sensitive to language impairment.

KLBA 2

Given the research behind the KLBA I find it to be another useful tool in my material repertoire. For more information on KLBA check out Speech Language Literacy LabTo purchase KLBA from their site click HERE. 

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Birthday Giveaway Day Twenty One: First Grade Common Core Daily Language Workout

Wrapping up third week of my Birthday Month Extravaganza is a giveaway from Speech Universe called First Grade Common Core Daily Language Workout.

This product was designed to track progress using an RTI approach. It spans about 10 weeks and include the following 18 First Grade Common Core State Standards :

Phonological Awareness

  •  RF.1.2b Orally produce single-syllable words by blending sounds, including consonant blends.
  •  RF.1.2c Isolate and produce initial, medial vowel, and final sounds in single syllable words.
  •  RF.1.2d Segment spoken single syllable words into their complete sequence of individual sounds.

Conventions of Standard English

  • L.1.1b Use common, proper, and possessive nouns.
  • L.1.1c Use singular and plural nouns with matching verbs in basic sentences.
  • L.1.1d Use personal possessive and indefinite pronouns.
  • L.1.1e Use verbs to convey a sense of past, present, and future.
  • L.1.1i Use frequently occurring prepositions.

Vocabulary Acquisition and Use

  • L.1.4a Use sentence level context as a clue to the meaning of a word or phrase.
  • L.1.5a Sort words into categories to gain a sense of the concepts the categories represent.
  • L.1.5b Define words by category and by one or more key attributes.
  • L.1.5c Identify real-life connections between words and their use.
  • L.1.5d Use synonyms of verbs and adjectives.

Speaking and Listening

  • SL.1.1 Participate in collaborative conversations with diverse partners about first grade topics and texts with peers and adults in small and large groups.
  • SL.1.4 Describe people, places, things, and events with relevant details, expressing ideas and feelings clearly.

Key Ideas and Details

  • RL.1.1 Ask and answer questions about key details in a text.
  • RL.1.2 Retell stories, including key details, and demonstrate understanding of their central message or lesson.
  • RL.1.3 Describe characters, settings, and major events in a story, using key details.

Packet Contents:

  • State Standard Checklist
  • Pre/Post Test
  • Daily Workout Sheets
  • Note Sheet

You can find this product in Speech Universe’ TPT store by clicking HERE or you can enter my one day giveaway for a chance to win.
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Gotta Love the RtI: Teacher Edition

RTI Language, Listening, and SpeakingI have written about Response to Intervention (RTI) to intervention before (HERE),  bemoaning the fact that it’s not currently utilized in my setting (outpatient specialized school in a psychiatric hospital) and how I was hoping to gradually incorporate it at work.

To summarize it briefly RtI is a 3 tiered approach to intervention that identifies children at risk for learning deficits and provides them with high quality instruction in order to separate the ones who just need a little extra help from children with true learning/language deficits. So you can tell that i am always on the looking for more RtI materials which is why I was very excited to come across Ms. Jocelyn’s RTI: Language, Listening & Speaking Packet. Continue reading Gotta Love the RtI: Teacher Edition

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It’s all about RtI!

Today I am excited to review one of the latest products from Busy Bee Speech “Common Core Standards-Based RtI Packet for Language“.

So what is RtI or Response to Intervention?

Developed as an alternative to the ability–achievement “discrepancy model,” which requires children to show a discrepancy between their IQ and standardized tests/grades, RtI is a method of academic intervention aimed to provide early, systematic assistance to children who are having difficulty learning in order to prevent academic failure via the provision of early school based intervention, frequent progress measurement, and increasingly intensive research-based instructional interventions for children who continue to have difficulty learning.

In contrast to a number of schools in my state (New Jersey), RTI or Response to Intervention is currently not utilized in my unique setting (outpatient specialized school in a psychiatric hospital). Continue reading It’s all about RtI!