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tricks of the trade

16 Sep

I just had my 2 year workiversary! (At the end of July.) As such I thought I’d celebrate two months late by sharing some of my early intervention tips!

1. Put it on your head. I don’t know why, but kids think hats are hilarious. Whenever a kid is not looking at me, is about to cry, is crying, is about to bail on a toy, is distracted – whatever – I just put something on my head. 60% of the time this works every time.

2. Bubbles freeze in the winter and crayons melt in the summer. Plan accordingly.

3. Also on bubbles: blow UP not out. When you blow up, you have time to draw attention to the bubbles, talk about the bubbles, sing about the bubbles, and generally enjoy the bubbles. When you blow out they just fall down and suck.

4. Get yourself pants with a strong knee. I’ve gone through three pairs of pants in less than two years. Double duty knees. Support knees. Worker knees.  Utility knees. Or maybe buy one of those gardening squishy rectangles.

5. In addition, get yourself a poker face. You can’t buy this but I highly recommend obtaining one. Poker face has been something I’ve been working on for years, but now that I’ve sort of got my face under control I find my life is a lot easier. When a kid does something that grosses me out, annoys me, makes me mad, makes me laugh (when I shouldn’t), makes me sad, or shocks me – you would never know. I’m like Mona Lisa MS, CCC-SLP over here. You don’t want parents or children feeding into your emotions during therapy sessions so lock it up!

6. Patience is a virtue.  Learn to wait. I always tell the kids, “I know, waiting is so hard!” and I make them wait for everything…but it took me a long time to learn to wait for them. Waiting waiting waiting. I do it all day. Wait for them to reach, wait for them to vocalize, wait for them to calm down, wait for them to notice. Quit anticipating, quit assuming, quit rushing, quit pushing. COOL YOUR JETS.

7.  Embrace the germs. I mean, Clorox wipe everything and wear gloves when needed. Embrace that you are going to get sick a lot when you first start. Like, a LOT. Way more than you can possibly anticipate. Start stocking up now on all your favorite cold and cough meds, you’re gonna need them. I’m here to tell you that there is a light at the end of the tunnel…after two years I have the immune system of a feral mutt. I can withstand anything (A kid sneezed into my open mouth the other day and I lived to tell the tale.) And you will too. But you have to live through the first six months.

8. Get a mentor (or three). I have a lot of mentors. I have my mentor for picture exchange, I have my mentor for feeding, I have my mentor for behavior, I have my mentor for apraxia…the list goes on. I don’t harangue these people endlessly for lunch dates so we can discuss me and my progress in becoming a grown SLP like them. But I do say, “Hey can I pick your brain about this little guy?” when I need back up. Know when you need backup, and find strong resources. It’s okay to ask for help, and it’s okay to have lots of mentors. (I recommend reading Lean In’s chapter “Are You My Mentor?” if you’re looking to develop mentor-mentee relationships…it’s really very enlightening.)

9. Learn about the other disciplines as much as you can. In early intervention it is SO important to look at the whole child. And until you work with OT/PT/ECE regularly you’re going to have a harder time looking at the whole child (because what are you looking for!?) You’ll see so much improvement when you make adjustments based on those other disciplines. You’ll know when to make referrals, and when to just make a suggestion. It’s hard to help the whole child make major improvements when you’re just looking at his mouth. Cotreat. Observe. Ask. 

10. Be flexible. No two kids are alike. Seriously. None. What worked with one, will work again with none. It’s insane. You will see new things every single day. I always say, “Never a dull moment” with EI. It will keep you on your toes and keep you moving and thinking constantly.  As an early interventionist you’ve got to be open to new ideas – whatever you’ve got planned probably isn’t going to go as you imagined 🙂

 

If you’re just starting out in EI I hope some of these help you on your path. If you’re a seasoned EI Vet – share some of your tips and tricks, I’m always looking for new ideas!

NP: Ingrid Michaelson – Home

addendum: my biggest struggle

18 Oct

I wrote post a few weeks ago about my difficulties with children who displayed elopement behaviors in my speech therapy sessions.

A lot of therapists shared a lot of great ideas with me! At that time I had seen a child I was having a good deal of trouble with about four times. I’ve seen him three times since then and I wanted to give a little update.

My supervisor came to observe me at that fourth session (which went horribly), and she came to observe me today, and she said there was a NOTABLE difference. So what happened?

First, I rearranged the setup to reduce the chance of him escaping. (Basically I cornered him.) Secondly, I offered him choices so I could better follow his lead (i.e. – “Do you want crayons or cars?”) Thirdly, I worked really hard at allowing his siblings to be a part of the play rather than trying to prevent them from wanting novel toys. This also allowed me to see what happened when my client had to take turns or share (not pretty.) Not going to lie, the first few sessions after that post were a LIIIIIITTLE wild. A lot of tantrums, a little aggression, and more elopement. But I had to create routine.

When I saw an increase in behaviors I got a chance to do some functional behavior assessment. Turn taking and sharing lead to the aggressive behaviors (pushing, hitting) and tantrums. I saw the elopement during transition between toys and tasks, and when he was told no, or that he had to wait (especially in regards to turning on the TV.)

So, to decrease the aggression and tantrums, I really encouraged mom to make turn taking and sharing a major part of play and home routine. If he only has to share once a week of course he’s going to be upset. It needed to be established that this was an expected behavior.

In terms of elopement I had to improve my transitioning. I realized what I was doing was letting him play with a toy, then saying “ALL DONE” and putting it away. That means all of the sudden his object of desire has been removed and he’s got nothing new to entertain him – OF COURSE he’s gonna run! So now I preface the transition “In a minute new toy. Soon it’s time to clean up.” Etc and I bring out the new toy before I take away the old one.

Also I’m increasing my affect, I’m working REALLY hard at taking center stage, and trying to make kids WANT to pay attention to me. It feels really stupid sometimes but that’s what these kids need! You need to be better than the toy they have.

Another factor in this kiddo’s behavior SEEMS to be sensory related. I noticed when he was eloping he was crashing, jumping, throwing himself around – more so than your average 2 year old boy. He’s a rough player. I spoke to one of our OTs and she gave me the run down on sensory processing and integration and he seemed to fit the profile. So the last few sessions I’ve been LETTING him take some sensory breaks, and I’ve been providing some sensory input. Deep pressure, squishes, squeezes etc. At first he did NOT like it and resisted, but today he allowed it for a few minutes and seemed to be seeking continuation of the deep pressure.

What it is really coming down to following the child’s lead and PLAYING. Watch behaviors and do your ABCs (antecedent, behavior, consequence.) Make changes as needed. Really look at what you’re doing and analyze how the kid is reacting to your actions. There is a reason for behaviors, you can figure it out!

NP: Mumford and Sons – I Will Wait

PS – when it comes to the TV, sometimes I let him turn it on and I’ll kind of narrate what he sees for a minute. Then I transition him back to play. If he continuously tries to turn it on I have to say “I’m sorry, not TV time” and prevent him from turning it on. Sometimes he’s okay with that and sometimes he does NOT like that and I see some elopement or tantrums, but I just say “I’m so sorry that you’re angry – let’s do XYZ.” He recovers either way. I play it by ear and how easy he is to redirect that day. The TV is a hard one when you’re in people’s homes, but it is OKAY to ask to turn it off or lower the volume.

PPS – I did all of the above in SPANISH. Booyeah.

Don’t be alarmed, we’re taking over the ship.

17 Sep

Whoa! Speechie off the port bow!

This post is in dedication to Talk like a Pirate Day (September 19th…of course.) The fine folks over at LessonPix asked the #slpeeps for some pirate-y themed therapy and we obliged (because we’re da bomb dot com.)

First let’s start by saying: LessonPix is AWESOME. I’m not just saying that because they asked me nicely to write this post and be part of their blogging hearties. I’m saying it because I DO WHAT I WANT, YO. What is LessonPix you ask, Dear Reader?

Well, “LessonPix is an easy-to-use online resource that allows users to create various customized learning materials.”

For serious – you can make SO MANY THINGS. It’s $36 a year, and in comparison to something similar (think in the ballpark of $400) I think it is WELL worth it. Especially since I can login on any computer – I don’t need a disk. For $36/yr I’m getting what – 11 years to the $400 one time price. (Obviously prices change and products change and therapy changes so don’t come crying to me in eleven years, that’s just a way to think of it if you’re having trouble with the cost in your brain.)

 What sorts of things can you make? I’ll tell you. Picture cards such as THESE:

Seriously. Do Not Copy. Or I will hunt you down.

Or you can create about a zillion other things. You pick the PIX you want, and the website creates PDFs with your material.

Materials Frankenstein

You can search what you need, upload personal images – it pretty much does all of the things. Which is awesome because I’ve got things to do, I can’t be hanging out in Paint all day trying to draw with my arrow mouse. I couldn’t do that in fourth grade and I can’t do it today.

Self Portrait

Anyway back to the pirates. I’m working for the MOST part as an Early Intervention Therapist. My caseload is composed primarily of two year olds (Yeah I didn’t know I had patience either, you aren’t the only one who is surprised.)

When LessonPix asked if I’d use their pirate materials to do therapy I was all about it. Here are some things I made:

Shapes treasure map

These are GREAT, because obviously I can put anything I need to in there. For a lot of my kiddos we’re working on receptive language – specifically identification of familiar objects/toys and following directions. So in the case of the treasure map up there, I put in images that correspond to a puzzle I was using in therapy. Then I can provide not only a verbal cue, but I can point to an image. Many of my clients require an extra prompt or two so adding a visual component is a great way to supplement cues I’m already providing. And since it’s on a treasure map, I can use these little guys to hop along to the next piece:

Me crew

If I wanted to do a themed therapy session with pirates, I could use the game board and a corresponding toy for a scavenger hunt type of activity. I found this in our therapy cabinet and it worked great for such a task:

Tis me ship

You can see that this toy has many components, such as cannon, helm, mast, spyglass, ladder, etc. While playing we could go over these vocabulary terms and then use the gameboard to prompt “giving” specific items or identifying by pointing. In early childhood therapy themes are often used so even if there was an ocean or beach unit, this type of toy could fit in nicely. And having engaging, novel materials to use with little ones is pretty much key to your survival so LessonPix really helps out with that!

I will absolutely be using LessonPix materials again, I think their product is amazing! My brain can’t even understand how the picture gets to the TV Screen so I have no idea how they’re making customizable materials out of thin air that make my life so easy.  Now all I need is a real pirate to help me cotreat…

NP: The Little Mermaid – Part of your World

I have things to say again!

4 Aug

My laptop won’t connect to wireless and I’m tired of blogging from my phone so I’m sitting in the library right now just for you!

I started my first ever big girl speech language pathologist job on Tuesday. As I stated previously, since getting your license in the state of Delaware is apparently near impossible, I’m starting as an “aide” rather than an SLP. This week I just did some observing, orientation, and training types of things.

2 days this week I spent out in the community with my CF supervisors. I have two supervisors because I’m working half the time with peds and half adults so it makes sense. Both days I observed peds home health and community services. I love it! I think I’ll really learn a lot and get to experience a really wide range insofar as disorders and cultural diversity. I’m living in Wilmington, DE which apparently contains 30% of the nation’s population in a 100 mile radius – so that’s a lot of different kinds of people all squashed together.

One thing I found interesting was that in some cases my employer uses a “trans-disciplinary” approach. They say I won’t be doing it right away and I gotta say, “WHEW.” For those of you who don’t know what I trans-disciplinary approach is, let me explain:

What happens is, that for whatever reason, it is determined that the patient you’re seeing NEEDS treatment from multiple disciplines but can’t see multiple disciplines. This could be due to time, parent desires, behavior etc. So the treatment team picks a main therapist who delivers multiple types of therapy. So not only is the speech therapist there for speech, but they might also be working on the child’s ability to hold a crayon or jump. The therapists all work together to help the main therapist think of strategies and techniques. Everyone makes goals for the child during a transdisciplinary assessment.

You may now understand why this seems overwhelming to me. Since I’m not an OT or a PT, I don’t know their technical jargon or their techniques! But one day, I may be the lead therapist. And I find this scary. Probably by the time it rolls around I’ll have worked and co-treated enough that it isn’t so scary, but the idea right now of providing OT/PT services as an SLP makes me want to run and hide! What do you guys think? Have any of you encountered this in your jobs or training? How’s it going for you?

In related news, I really need to step up my toddler-Spanish and my sign. I took Spanish for eight years but never really functionally used it, but with a population that is so diverse I will very likely encounter clients and families who speak Spanish (among other languages – Spanish is just the one that I know). I only took sign for one semester, I could definitely use a refresher.

Sometime I need to join ASHA but right now I genuinely have no money. I want to take advantage of the gift to the grad program and my NSSLHA membership, but I can hardly make ends meet. I reaaaally need a paycheck. Ah the perils of unpaid internships. Get excited folks, it’s really fun.

(The man sitting next to me just put his hands all the way into his pants and adjusted himself. I’m judging.)

And my fourth post on the Hearing Journal is up so check it out!

it’s all happening!

13 Jan

I’ve applied to two jobs so far (one school, one hospital) and the school emailed me and invited me to a 30 minute interview in February!

Also, this week a child escaped from my grasp and yesterday the same child hit me in the face with this duck:

quack quack

i can’t sleeeeep

8 Jan

I have tried. No dice. What to DO?! Blog. Duh.

Life update: I’m living in the finished attic of friends KG and DH. They are super lovely and accomodating and without them I’d be living…no where. So basically I’m indebted to them for the rest of time. On Saturday the boyf is moving my storage unit crap to STL. Then I’m here for another two weeks!

This will be week four of the externship with my little bitties. Technically supposed to be my last week but I’m asking for more time because I AM NOT READY.

I succeeded in getting out of bed and going to collect thesis data, for anyone who doubted me. The best part of my project is asking people to “write a sentence” for the MMSE. I get the best sentences and people always look at me like I’m a weirdo at this request (I get the same look when I ask them to count backwards from 100, by seven. Dear Folstein and Folstein, NO ONE CAN DO THAT. Love, Sam). So far the sentences (or fragments of sentences) are,

1. I think this crazy.

2. I would like to make my way to Mountain Grove. (WHAT??)

3. I am going today.

4. The leaves are now all gone.

5. It’s not so bad here.

6. This is a beautiful day.

It’s like a MMSE poem.

I’ve been analyzing the data I’ve got. Nothing to write home about yet, but this weekend I plan to finish data collection and stats so I’ll letcha know what we’ve got going on.

My clinical director said to not start applying to jobs until March or April. However, two women I work with at my site heard this and were completely aghast. Apparently I should start like…NOW. I started fixing up my resume and would LOVE some input. Like, I have a LOT of stuff to put on a resume but my work experience and extra curriculars are basically irrelevant. Do I put those on there? I like to keep my resume to a page so I want to make the most of that page.

I’m putting my resume here so you can judge it:

Seriously, TELL ME WHAT TO DO.

 

I’m all about the constructive criticism. Please tell me what I can do to make this resume beautiful and miraculous. I want a JOOOOB. I also sent this to an SLP who I sort of know in Kansas City so hopefully she’ll have the hook up.

In unrelated news, I got a hamster. His name is Mr. Stoli Socks. He is a Russian dwarf. And he was a Christmas orphan. And he has a nibbled ear. And he is super cute and kind of mean. I think he is misunderstood.

"Oh hey guys. I am super cute. LOVE ME"

I couldn’t stop myself. HE WAS ABANDONED. Also, Monty needed a friend. He was getting tired of my shenanigans. Like I tried putting him in this hanging tunnel thing and his back legs and balls were hanging out because he is SO LAZY he couldn’t get the gumption to pull those body parts into the tunnel. Needless to say, he was none too pleased. The animals on the package looked so happy! But this is what he looked like:

From experience, I can tell you, this is an unhappy pig

This is apparently what should have happened if Monty wasn’t so lackadaisical.

You may be thinking, "That pig doesn't look more or less happy than Monty" and my answer to that is,"This pig's testes are INSIDE the tunnel"

I don’t put Monty and Mr. Socks in the same cage, but piggies and hammies are social critters. So when I put Mr. Socks in the ball and set Monty on the floor they engage. It is QUITE adorable.

In related news, I’m clearly insane.

While I’m an attic troll, my parental units are watching my creatures. Obviously my charms are many.

Since I’ve been back in Springfield, I’ve done the following: gone to hot yoga, gotten a spray tan, and attended a black tie wedding. Life keeps getting weirder and weirder. And awesomer. Also, I’m up to 252 clinic hours and 35 externship hours! Woop woop! 400 here I come!

I hope everyone taking the Praxis next week is having good luck studying! I know a lot of comps are going on as well. Keep your head up! We’re almost there!

I’m going to sleep.

Winter clothing core curriculum vocab

27 Dec

At my externship site we use the district’s recommended core vocabulary and follow the curriculum. As such we spend a lot of time doing activities that last a week or two that teach the same words over and over and over. Last week I made this snowman to work on Winter Clothing Vocab. The snowman is laminated and the clothing velcros on to facilitate turn taking and active learning.

In the mind of preschoolers, every snowman is named Frosty

Loves it

24 Dec

Pete the Cat: I love my white shoes by Eric Litwin. Free story:

http://www.harpercollinschildrens.com/feature/petethecat/

Here’s the book done with music:

someone cure me!

19 Dec

I keep thinking I’m recovering from the creeping crud and then I try to go out in the world and I have no success. I went to my externship this morning and I was so miserable and yucky that my supervisor sent me home. IF I’M NOT BETTER BY TOMORROW I DON’T CARE I’M SUCKING IT UP. I’ve got crap to do man.

Everyone keeps saying, “Oh with ECSE just Clorox everything and Germ-X every five minutes and you’ll be fine”

OH OKAY. TELL ME WHAT TO DO WHEN A KID SNEEZES DIRECTLY INTO MY FACE. Nowhere is safe.

I miss the teensy ones, I wanna go back!

 

some new grad school images

17 Dec

Using an eye gaze system Cadabbey and I wrote "I ZAPPED A MAN"

Your brain on grad school: I left the house wearing these penguin slippers

Last day of clinic - contents of my lab coat pockets

She kept every single client billing log and every single corresponding supervisor comment.

Last day pictures (there are more of these but JENNI WON'T UPLOAD THEM)

feeling unhappy about returning the lab coat

super unhappy

 

I made this to work on holiday core curric vocab at ECSE

Things I won't miss at the clinic: THIS PRINTER. GAAH.