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New Giveaway: Creating a Functional Therapy Plan: Therapy Goals, Objectives & SOAP Note Documentation

slide1Recently I did a series of lectures for a graduate speech language pathology program regarding how to create the most effective therapy plan following the client’s assessment.  The learning objectives for the presentation were as follows:

1. Identify the difference between goal and procedure
2. Describe three phases of intervention planning and the nature of goals and procedures at each phase
3. List differences between LTG’s, STG’s and SG’s
4. Explain how to write brief and functional SOAP notes
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Do Our Therapy Goals Make Sense or How to Create Functional Language Intervention Targets

In the past several years, I wrote a series of posts on the topic of improving clinical practices in speech-language pathology.  Some of these posts were based on my clinical experience as backed by research,  while others summarized key point from articles written by prominent colleagues in our field such as Dr. Alan KamhiDr.  David DeBonnisDr. Andrew Vermiglio, etc.

In the past, I have highlighted several articles from the 2014 LSHSS clinical forum entitled: Improving Clinical Practice. Today I would like to explicitly summarize another relevant article written by Dr. Wallach in 2014, entitled “Improving Clinical Practice: A School-Age and School-Based Perspective“, which discusses how to change the “persistence of traditional practices” in order to make our language interventions more functional and meaningful for students with language learning difficulties. Continue reading Do Our Therapy Goals Make Sense or How to Create Functional Language Intervention Targets

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App Review and Giveaway: Speech Therapy for Apraxia – NACD Home Speech Therapist

Recently I got the opportunity to take a look at the “Speech Therapy for Apraxia – NACD Home Speech Therapist” by Blue Whale Apps.

According to the developer the app is applicable to

• SLPs with individuals with apraxia (both children and adults)
• Parents working with children with apraxia
• Traditional articulation practice (drills)

Developed by the National Association for Child Development (NACD) by an SLP, the Apraxia app provides choices of different phonemes to target and gradually increases the levels  of difficulty to improve motor planning for speech. Continue reading App Review and Giveaway: Speech Therapy for Apraxia – NACD Home Speech Therapist

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Creating a Comprehensive Speech Language Therapy Environment

Image result for comprehensiveSo you’ve completed a thorough evaluation of your student’s speech and language abilities and are in the process of creating goals and objectives to target in sessions. The problem is that many of the students on our caseloads present with pervasive deficits in many areas of language.

While it’s perfectly acceptable to target just a few goals per session in order to collect good data, both research and clinical experience indicate that addressing goals comprehensively and thematically (the whole system or multiple goals at once from the areas of content, form, and use) via contextual language intervention vs. in isolation (small parts such as prepositions, pronouns, etc.) will bring about the quickest change and more permanent results.

So how can that be done? Well, for significantly language impaired students it’s very important to integrate semantic language components as well as verbal reasoning tasks into sessions no matter what type of language activity you are working on (such as listening comprehension, auditory processing, social inferencing and so on). The important part is to make sure that the complexity of the task is commensurate with the student’s level of abilities.

Let’s say you are working on a fall themed lesson plans which include topics such as apples and pumpkins. As you are working on targeting different language goals, just throw in  a few extra components to the session and ask the child to make, produce, explain, list, describe, identify, or interpret:

  • Associations (“We just read a book about pumpkin: What goes with a pumpkin?”)
  • Synonyms (“It said the leaves felt rough, what’s another word for rough?”)
  • Antonyms (“what is the opposite of rough?”)
  • Attributes 5+ (category, function, location, appearance, accessory/necessity, composition) (“Pretend I don’t know what a pumpkin is, tell me everything you can think of about a pumpkin”)
  • Multiple Meaning Words (“The word felt has two meanings, it could mean _____ and it could also mean _______”)
  • Definitions (“what is a pumpkin”)
  • Compare and Contrast (“How are pumpkin and apple alike? How are they different?”)
  • Idiomatic expressions (“Do you know what the phrase turn into a pumpkin means?” )

Ask ‘why’ and ‘how questions in order to start teaching the student how to justify, rationalize, evaluate, and make judgments regarding presented information (“Why do you think we plant pumpkins in the spring and not in the fall?”)

Don’t forget the inferencing and predicting questions in order to further develop the client’s verbal reasoning abilities (“What do you think will happen if no one picks up the apples from the ground?)

If possible attempt to integrate components of social language into the session such as ask client to relate to a character in a story, interpret the character’s feelings (“How do you think the girl felt when her sisters made fun of her pumpkin?”), ideas and thoughts, or just read nonverbal social cues such as body language or facial expressions of characters in pictures.

Select materials which are both multipurpose and reusable as well as applicable to a variety of therapy goals. For example, let’s take a simple seasonal word wall such as the (free) —Fall Word Wall  from TPT by Pocketful of Centers. Print it out in color, cut out the word strips and note how many therapy activities you can target for articulation, language, fluency, literacy and phonological awareness, etc.

fall word wall

Language:

Practice Categorization skills via convergent and divergent naming activities: Name Fall words, Name Halloween/Thanksgiving Words, How many trees  whose leaves change color can you name?, how many vegetables and fruits do we harvest in the fall? etc.

Practice naming Associations: what goes with a witch (broom), what goes with a squirrel (acorn), etc

Practice providing Attributes via naming category, function, location, parts, size, shape, color, composition, as well as accessory/necessity.  For example, (I see a pumpkin. It’s a fruit/vegetable that you can plant, grow and eat. You find it on a farm. It’s round and orange and is the size of a ball. Inside the pumpkin are seeds. You can carve it and make a jack o lantern out of it).

Practice providing Definitions: Tell me what a skeleton is. Tell me what a scarecrow is.

Practice naming Similarities and Differences among semantically related items: How are pumpkin and apple alike? How are they different?

Practice explaining Multiple Meaning words:   What are some meanings of the word bat, witch, clown, etc?

Practice Complex Sentence Formulation: what happens in the fall? Make up a sentence with the words scarecrow and unless, make up a sentence with the words skeleton and however, etc

Phonological Awareness:

Practice Rhyming words (you can do discrimination and production activities): cat/bat/ trick/leaf/ rake/moon

Practice Syllable and Phoneme Segmentation  (I am going to say a word (e.g., leaf, corn, scarecrow, etc) and I want you to clap one time for each syllable or sound I say)

Practice Isolation of initial, medial, and final phonemes in words ( e.g., What is the beginning/final  sound in apple, hay, pumpkin etc?) What is the middle sound in rake etc?

Practice Initial and Final Syllable and Phoneme Deletion in Words  (Say spider! Now say it without the der, what do you have left? Say witch, now say it without the /ch/ what is left; say corn, now say it without the /n/, what is left?)

Articulation/Fluency:

Practice production of select sounds/consonant clusters that you are working on or just production at word or sentence levels with those clients who just need a little bit more work in therapy increasing their intelligibility or sentence fluency.

So next time you are targeting your goals, see how you can integrate some of these suggestions into your data collection and let me know whether or not you’ve felt that it has enhanced your therapy sessions.

Happy Speeching! Thankful Clip Art Printable owl card

Helpful Resources:

 

 

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Help, My Child is Receiving All These Therapies But It’s NOT Helping

On a daily basis I receive emails and messages from concerned parents and professionals, which read along these lines: “My child/student has been diagnosed with: dyslexia, ADHD, APD etc., s/he has been receiving speech, OT, vision, biofeedback, music therapies, etc. but nothing seems to be working.”

Up until now, I have been providing individualized responses to such queries, however, given the unnerving similarity of all the received messages, today I decided to write this post, so other individuals with similar concerns can see my response. Continue reading Help, My Child is Receiving All These Therapies But It’s NOT Helping