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Getting Started: Non-English EI Referrals

12 Oct

Hey ya’ll.

If you were an early intervention speech therapist, and you got a referral for a child who does not speak a language that you speak – what would you do?

@liselschwartz and I discussed the other day and I wanted to share some of our ideas. I see a lot of Spanish-speaking children, but I don’t get too many referrals for other languages. Even though I speak some Spanish, my sessions can be a little disjointed. Early intervention is about coaching and guiding parents so they can provide therapy services all week long when you aren’t there. If you can’t talk to them during your sessions how can you make this happen? Here are some ideas!

Figure out how to get an interpreter in there. Our child-find program typically schedules an interpreter for at the least the first session, and then once a month following for non-English speaking families. If you don’t get an interpreter scheduled off the bat, ask your supervisor about what the protocol is for requesting one. When/if you get someone who can interpret for you, try to get some basic vocab words  in THEIR language written down for your knowledge and use. For early intervention my top ten in no particular order are usually:

1. More (some therapists aren’t into this being a first word but it’s quick and easy so I’m sticking with it)
2. Give me/my turn
3. All done
4. Open
5. Help
6. Eat
7. Drink
8. Cookie – or cracker, or apple, or whatever the child eats a lot of
9. Milk – or water, or juice, or whatever the child drinks a lot of
10. Play

– If you can’t get a list from someone who can interpret, trying Googling the words you want – if it’s the wrong word the family will likely know what you MEANT and will tell you the correct word (for example, I didn’t know the Spanish word for “marble” so I just called it “pelota” until a Mom told me “canica.”) If you put into Google “German for ball” it will give you several options, so I just pick the one that sounds closest and the families correct me if I picked the wrong concept. I also LOVE wordreference.com for colloquial definitions.

Put those words to signs for the family. In our center we even make a little sign language book with a picture of the sign and the word below. I know each language has its own corresponding sign language – but this is hard enough without adding extra sign languages to the picture so I just stick with ASL.

mas

de plusmehr

And so on and so forth.

– Do what you can to provide services in their native language. This can hard for a number of reasons (the main being that YOU do not speak Twi or Cantonese or Hmong or whatever). But also sometimes families know that the child is going to be exposed to English in the school system, and so they just want you to speak English to the child. But the two year old should really keep being exposed to their native language so they can communicate with their family members when you aren’t there. This is why it’s vital to get the family playing and doing the therapy, while you coach.

– If caregiver knows someone who can read English, who isn’t there at the time of your sessions, see if you can write down ideas to have translated later. Sometimes Dad or cousin or sister reads English, and so I’ll write down my “ideas” for the week, and then they’ll have that person read later. If you can find something like “Handy Handouts” from SuperDuper (which is in both English and Spanish) that’s ever better – you want to provide resources as much in the native language as you can. As the languages get more “obscure,” the harder this becomes.

– Sometimes families will have a little English in the home, or siblings will speak English, so families will ask, “If the English word is easier to say, can I just model the English word?” (think “ball” instead of “pelota” or “shoe” instead of “zapato.”) I usually try to steer clear of this unless that really is their preferred word that they’d typically use (I see a lot of Spanglish so some families really do just say “apple” instead of “manzana.”) I typically recommend in this circumstance to model approximations of the native language word, rather than modeling the English.

– If there are older siblings in the home who speak English try getting them involved, they can be a huge help for you, and they always love teaching the “teacher” their language and words. 🙂

 

Any other ideas out there? What do you do with kiddos and parents who don’t share your language? What if you can’t get an interpreter, or the family resists an interpreter? Please share!

NP: Florence + the Machine – Blinding

 

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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