Disconnect de comunicacion

3 Mar

Currently in my caseload, I am working with approximately 13 Spanish-speaking families. Communication at times can be very tricky – not between the child and I, but rather between parents and me! I have enough Spanish to interact with a toddler, and I can generally express myself to parents, but when they ask me a question or tell me a story – not a chance. My receptive Spanish skills are pretty limited (in classes when a Spanish professor asked me a question I was always a deer in the headlights.) Oftentimes I’m working with a child in a daycare, so I’ve never even met the parents, or spoken to them on the phone. In this case I leave a carryover note in Spanish, but I’m constantly using wordrerefence.com (they need an app) to look up phrases and words.

I don’t love the disconnect, and I never know what the parents have questions about or concerns until their service coordinator comes to me after months of therapy and says, “Oh Mom thinks they aren’t making progress” or “Dad is worried about XYZ” and then I have to do this crazy tango between the coordinator and the parents. Plus I have no idea about what suggestions or techniques are being carried over.

I do get an interpreter once a month, when I specifically request one, but that’s pretty useless when I’m in a daycare since I don’t need an interpreter to play. We have a receptionist at work who speaks Spanish, so I can potentially use her to call families though scheduling this with the receptionist and the working parents and my schedule isn’t necessarily going smoothly.  For one child I’m developing a communication notebook to stay in the daycare cubby so Mom can ask questions and let me know her concerns, or tell me what is working at home and what isn’t. But I have no idea if Mom will actually use it or if I’m just going to be writing note after note with no sign of life on the other side.

I’m wondering what other strategies clinicians are using for parents interaction. I’m sure this happens in the schools frequently. How do you find out what is going on at home? Have you learned any tricks for communicating when the parents aren’t sitting inches away from you every week?

Ayudeme!

OH and does anyone happen to know student-friendly Spanish musical artists? I have a client who is highly motivated by Latino tunes but I don’t wanna download the Latino equivalent of Lil Wayne by accident.

Okay now this is too funny

1 Mar

I had NO idea that this blog was being pinned on Pinterest (it’s all good, I’m glad not mad…I just didn’t think about it.)

So I was looking at the site stats and referral sites etc and I click on Pinterest. And this is what I see:

 

AHHHH oh my God. I cannot stop laughing. It's just too funny.

AHHHH oh my God. I cannot stop laughing. It’s just too funny.

 

Thank you all for reading and making me laugh. This is way awesome.

The Special Mother and Ginny

1 Mar

Erma Bombeck is absolutely one of my most favorite authors. I’m not a mom so it doesn’t make a whole ton of sense that I’m obsessed with her. But her writing is funny and honest, and one day I’ll probably reproduce so she’ll come in handy.

I was reading her book Motherhood: The Second Oldest Profession and she touched on the subject of mothers of children with special needs. I’ve read a lot of her books and I haven’t seen this topic before so I was surprised. The first of these stories was: The Special Mother.

The Special Mother

I think this was beautifully written and touching. But when put in the perspective of the second story, I came to love Erma even more. It’s a little darker, but also just as beautifully written and touching as the first. The chapter is entitled, Ginny. You’re able to read it here as a GoogleBook (if you can’t find it, it is Chapter 17 – you should be able to just search it.)

Sometimes at work we have to have the conversation – while we think that as therapists we’re fun, and we play, and the children are happy (sometimes) –  it isn’t necessarily “fun” for families to come to us. If a family is coming to us, there may be something “wrong.” The story of Ginny reminded me that our families love their children and want the best, but also life (and therapy) can be hard. A reminder that those of us who work predominantly with families need sometimes.

I think Ginny also serves as a nice reminder (copywrite 1983) that because of Early Intervention, families don’t necessarily have to feel as though their children will never accomplish things. We’ve come a long way, and we’ve still got a long way to go.

NP: Santigold – Riots gone

Measuring vocabulary development in bilingual children

10 Feb

The topic of my first Research Tuesday Blog is (drumroll please): “Total and Conceptual Vocabulary in Spanish–English Bilinguals From 22 to 30 Months: Implications for Assessment.”

This is all there is to see folks

This is all there is to see, folks

To understand the purpose and findings of this article it is beneficial to know the difference between total and conceptual vocabulary.

Total vocabulary is the sum of the words a child knows across two languages.

Conceptual vocabulary gives the child credit for knowing concepts rather than words, and concepts that are represented in both languages are counted only once.

So basically, when looking at a bilingual child’s total vocabulary you would count both the word perro and the word dog. If you were looking at conceptual vocabulary you would only give the child credit for knowing one concept: the furry, four-legged creature in my house which barks and eats kibble is a dog/perro.

The bottom line about this article? The researchers found that when assessing bilingual children, it is most appropriate and beneficial to look at total vocabulary (total vocab FTW!) A clinician is able to look at total vocabulary in a bilingual child by providing the MacArthur Bates Communicative Development Inventory (CDI; Fenson et al.,1993) in English as well as in the family’s home language.

What happened in this research project? Cynthia Core, Erika Hoff, Rosario Rumiche, and Melissa Señor provided families of 47 bilingual families with the CDI and the Inventario del Desarrollo de Habilidades Comunicativas (IDHC; Jackson-Maldonado et al., 2003.) This was a longitudinal study; the children were assessed at 22, 25, and 30 months-of-age.  The children were age and socioeconomically matched with 56 monolingual (English-speaking) children who were assessed with only the CDI.

At the initial 22 month trial, all parents completed the Ages and Stages Questionaire (Squires et al., 1999). The parents of monolingual children completed the CDI, and the parents of bilingual children completed both the CDI and IDHC, at the 22, 25, and 30 month session. The CDI and IDHC provide parents with a checklist of words they have heard their child produce and yields raw vocabulary scores based on this checklist. Both tests provide a percentile based on monolingual norms.

Then the researchers ran all sorts of crazy ANOVAs and t-tests and z-ratios which were totally over my head so I skipped ahead to the conclusion.

Researchers found:

The Spanish-English bilingual children showed a mean conceptual vocabulary which was significantly lower than their total vocabulary.

Total vocabulary in the bilingual children was not different from the monolingual children at any of the three sessions.

Conceptual vocabulary in the bilingWual children was considerably lower than the monolingual children at the 30 month visit.

Total vocabulary assessment did not identify any more/less at-risk bilingual children than bilingual children. Conceptual vocabulary assessment identified a higher number of bilingual children who appeared to have vocab development in the low-average range.

When one compares a bilingual child’s vocabulary to monolingual norms it underestimates the child’s expressive language and over-identifies at-risk children.

Using the CDI (and the home-language counterpart) clinicians can get a clear picture of a bilingual child’s total vocabulary without being responsible for considering the child’s language experiences, and language dominance, and language overlap, and the “balance” in their bilingualism. Clinicians are able to see clear change using these protocols (which we all love).

The authors caution us to remember to take socioeconomic status and receptive language into account. They also suggest that monolingual testing may be appropriate in the event that a clinician wants to know about English proficiency (or the proficiency of the home language.) They also pointed out that similar studies have been done previously with mixed results. ALSO the researchers did a really nice literature review to give you more background on bilingualism, total and conceptual vocab etc., so please read that if you desire.

Direct Link (you will need your ASHA login): http://jslhr.pubs.asha.org/article.aspx?articleid=1797298&resultClick=1

Citations:

Cynthia Core, Erika Hoff, Rosario Rumiche, Melissa Señor; Total and Conceptual Vocabulary in Spanish–English Bilinguals From 22 to 30 Months: Implications for Assessment. J Speech Lang Hear Res 2013;56(5):1637-1649. doi: 10.1044/1092-4388(2013/11-0044).

Fenson, L., Dale, P. S., Reznick, J. S., Thal, D., Bates, E., Hartung, J. P., … Reilly, J. S. (1993). The MacArthur Communicative Development Inventories: User’s guide and technical manual. San Diego, CA: Singular.

Jackson-Maldonado, D., Thal, D. J., Fenson, L., Marchman, V., Newton, T., Conboy, B. (2003). El Inventario del Desarrollo de Habilidades Comunicativas: User’s guide and technical manual. Baltimore, MD: Brookes.

Squires, J., Potter, L., Bricker, D. (1999). Ages and Stages Questionnaire: Parent-Completed Child Monitoring System (2nd ed.). Baltimore, MD: Brookes.

Coming Soon: Research Tuesday!

3 Feb

As some of you may know, many of the SLP Bloggers of the World (official title) have been participating in an undertaking known as Research Tuesday.

The purpose of Research Tuesday is to encourage awareness of current professional research! I know that for me since graduating, I haven’t put much oomph into reading research articles. Which is silly because access to ASHA Journals is part of what I pay ASHA for every year. But there you have it. Unless someone forces me to read an article I am probably not going to. If say, research articles weren’t a thousand years long and full of jargon-y jargon, maybe it wouldn’t be so painful!

SO, as a result of this being the case for everybody in the club, Research Tuesday was founded. “The goal is to increase accountability for reading the research, advocate for reading the research, and improving exposure to research.”

Since my blog is in a current state of transition and lackluster blandness, I decided I would participate. I’m hoping that (a) I’ll learn (and you! You’ll learn!) more about professional topics that I like and (b) I’ll be encouraged to blog more because I’m slacking.

Keep your eyes peeled boys and girls!

Clinical self-discovery. It’s okay!

21 Jan

Hey 2014, great to see ya!

It’s been two (TWO!) years since I started my internships and I’ve been thinking quite a bit on the narrowing of my clinical interests.

When I started my internships, I had no idea what I liked and didn’t like. I mean, I THOUGHT I knew (but we all know that’s silly…you have no clue until you get experience under that very cute belt you’re wearing.) I THOUGHT I wanted adult and hospitals. I THOUGHT I hated AAC (now we have a love-hate relationship.) I THOUGHT I wanted middle school students with diagnoses of ED/BD.

Hahaha. Thoughts.

I knew after my first internship that I loved working with the little children – you know, the weensy ones with the munchkin voices. I knew after my second internship that I did not want to focus on ED/BD. I knew after my third internship that hospitals are not my scene. Even after that, we still have quite an elaborate scope of practice to choose from.

So I got my first job and started my CF with a great, big, wide open caseload. Early intervention, bilingual early intervention, adult dysphagia, adult AAC and cognitive communicative therapy, peds feeding. Behavior, family coaching, communication strategies, group homes, ASL. Lions, tigers, and bears, OH MY!

When I started I was all, “Ohmygod I loooove it allllllll.” Now, a year and a half in, I’m seeing that I have clientele that I get excited about and things I look forward to and enjoy learning about. In turn, there are clinical things I don’t get super thrilled to death about. (Don’t get me wrong. I love all of my patients, but as far as clinical interests go there are things that I just professionally am more intrigued by.) (Was that a fragmented sentence?)(Sorry.) Since I would like to pursue the Ph.D. at some point, figuring out those clinical interests is a really important thing! I can’t stroll into a Ph.D. program and say, “Hey ya’ll – I like everything!” I need to find out what I love so that I won’t mind studying it for the rest of the foreseeable future.

So what do I enjoy? I love working with my Latino babies and families for language therapy. I love working with adults with developmental disabilities. I love adult dysphagia. I just wanna do those things all day.  Is there some communicative disorder where all three happen at once? Oh and I weirdly enjoy evaluations. Can’t really explain that one.

What do I sorta enjoy-ish? AAC. But not high-tech. I enjoy helping families use no-tech, low-tech strategies for targeting critical communication acts. (High-tech AAC makes me want to crawl in a hole. My brain rejects it. And the process for obtaining any device is the worst thing that ever happened. And it is just getting harder. And it is terrible. Run away!)

What am I unsure about? Peds feeding. It makes me so nervous. I don’t have a lot of practical experience and my book-knowledge is useless because it’s book-knowledge. Observation is an option, but frankly every child is so different there isn’t a ton I can take away from watching someone else do it. I’m learning as I go. Progress is slow (for me, not the kids.)

What am I pretty certain I don’t find particularly intriguing? High tech AAC! Adult acquired communicative-cognitive deficits pooooooooost-onset. School aged ANYTHING.

Part of me feels bad, about not loving it all. I have to remember that we ALL have clinical interests. That’s how we grow and develop specified skill sets. I can’t, mentally, love it all and I can’t know it all. I do truly enjoy interacting with and getting to know all of my clients. However, when faced with a puzzle, some situations get me all excited and riled up and I want to learn more. And I’m finding out what those exciting things are! Woo woo! Self-discovery!

And for your viewing pleasure, here is a picture of Simon snuggling with his own tail:

He is sooooo cute

He is sooooo cute

further details regarding my BAG

11 Nov

I was having mall and lunch time with MsSohanSLP on Sunday and she asked when the last time I blogged was.

Shame. I AM ASHAMED. It’s been a stupid long time. I have a wide variety of things I could blog about, and I choose not to because I’m a lazy, lazy SLP.

I thought the easiest way to return to the blogging was to segue from the previous post!

(lazy. i’m so lazy.)

As we know, I do home health with 0-3 about half my work week. As we also know, I have raging ADHD and can’t play with the same toys week after week after week like some kind of therapy zombie. So I *try* to change what I bring to homes each week. It can be a challenge and it requires some creativity, but it can be done, and if you’re a home therapist I encourage you to change it up when you can!

Anyway, since this “school” year started in September, I have been attempting to do THEMES! Yes, my bag is now themed! We do group therapy in my center and we do monthly themes so I thought, why not translate themes to home therapy as well?

So far I’ve done: farm animals, zoo animals, transportation, body parts, food, shapes/colors, letters/numbers, actions, and this week is SENSORY.

Since it’s sensory week I’ve got playdough, paint, shaving cream, crazy textured balls, a small bean box, touch and feel books, and so on and so forth. Also I have wipes and a table cloth because…I’m not dumb.

I’m kind of running out of ideas. I’ll probably do “home” as a theme, and “school” as a theme. Any suggestions are welcome! What are some concepts that you think 0-3 year olds should have under their belt by preschool?

Okay, that’s all for now. I’m going to be better, I swear! Well, I don’t swear but I’m making a sort of promise to be a better blogger. And give me theme ideas please and thank you!

 

NP: Lady Antebellum – Get to Me (this song gets me right in the feels).

What’s in my bag?

28 May

I’m sorry but I just have to say that writing about “my bag” makes me think of Austin Powers. (Warning: that link is NSFW).

Now that we’ve got that out of the way: my therapy bag. What is in it? How do I decide? As many of you know, I’m doing some home health for kids 0-3 (mostly in the two-three range). My car and home are filled with toys, but I abhor taking the same toys into homes every week – I get bored, the kids are bored, the parents are bored. It’s like “Yeah, we know, you knock the blocks down and say, ‘UH OH’ – message and vocabulary received.” I like to keep things fresh and exciting. However, I also have to be realistic regarding my time and energy, and the children’s…everything.

When I’m considering what toys are going into my bag, I have to think about my kids. Some kids are age-level in terms of play. They have strong fine motor skills, strong attention, strong cognition: everything is age appropriate with the exception of their language. The toys I take into these houses are a little more complex and require more imagination: baby dolls with food and cups and plates, Little People paraphernalia, high-level puzzles, high level books.

On the other hand, I have some kiddos who do not yet shake musical toys or bang two objects together. Some of my kids have rather limited attention. Some need a lot of sensory breaks. The toys I take into these houses are more cause-and-effect, texture-based,  noisy, etc.

As a result of all of these factors, I keep some good ol’ stand-bys in the trunk of my car. My employer has a few cabinets of “Community Materials” so those, combined with my own toys, give me enough material to change it up once a week. That doesn’t mean that kids don’t frequently play with the same toys, it just means that something new or something they haven’t seen in awhile gets thrown in the mix pretty regularly.

When I pack my bag to go into a house I try to ensure I have: one book, one fine motor oriented toy, one sensory-something, something with pieces for receptive language,   something for turn-taking and social games, and my phone so I have some language-apps as back up.  Some therapists may think this is a lot but frankly, my sessions are one hour long with two year olds. Five or six toys doesn’t seem like that much to me.

Toys from my personal collection that I have a lot of success with? I share them with you now:

BOOKS!

I like books that have manipulative features for the EI population.

I like books that have manipulative features for the EI population.

 

Puzzles!

Think of the different skill sets required to complete each of these puzzles. Something as simple as taking a puzzle to a kid's house takes a lot more thought than you would ever think.

Think of the different skill sets required to complete each of these puzzles. Something as simple as taking a puzzle to a kid’s house takes a lot more thought than you would ever think.

Sensory!

Bean Box! I like these but holy smokes get ready for a mess.

Bean Box! I like these but holy smokes get ready for a mess.

 

This stuff is called "Gazz it" - it's 99 cents at Walgreens and it's a weird alternative if you're sick of play-doh

This stuff is called “Gazz it” – it’s 99 cents at Walgreens and it’s a weird alternative if you’re sick of play-doh

 

Fine motor!

Kids love to bang on things.

Kids love to bang on things.

Shape sorter ball is always a hit. Wooden stacker is a personal fave. And that ball thing is just something different.

Shape sorter ball is always a hit. Wooden stacker is a personal fave. And that other ball thing is just something different.

Social fun times

I just want to bang on my drum all day. And shake shake shake. And pat. And tap. And clap. And imitate motor movement. And sing songs using baby signs. Yay!

I just want to bang on my drum all day.
And shake shake shake. And pat. And tap. And clap. And imitate motor movement. And sing songs using baby signs. Yay!

Cause-and-effect

These poppers are always fun. For early players you can do a simple "POP" and for more advanced kids you can do some receptive "Who is in the trash can? Push the boat. Where'd he go?" games

These poppers are always fun. For early players you can do a simple “POP” and for more advanced kids you can do some receptive “Who is in the trash can? Push the boat. Where’d he go?” prompts.

 

These are just some of my favorites right now, DEFINITELY not a be-all-end-all list. And as an FYI – I get nearly all of my toys at Goodwill. Don’t feel like you have to spend a fortune to get some nice materials. And if you don’t have a lot that is okay, my supervisor always says you should be more interesting than the toy. If you can get a kid engaged and playing with YOU then you are all good in the hood.

NP: Love Somebody – Maroon 5

The NSSLHA discount brain explosion!

21 May

I’m writing this because I was misinformed and I want to make sure new SLP students get the correct info!

When I was in undergrad, my CMDS program encouraged us to join NSSLHA – for the support, for the resources, and because of this great program: 2 years in NSSLHA and you get a discount for your first ASHA membership. It’s that simple! Join NSSLHA – it’s $60 a year and it is TOTALLY worth it. I joined (I think) my junior year and continued to renew my membership through my first year of grad school. By my second year of grad school I thought, “I got no money and I’ve met my ‘Two Years’ so it will be okay for my membership to lapse.”

Fast forward to my application for my CCCs: I call ASHA’s Action Center to get my NSSLHA number and was told to not expect my discount because too much time had elapsed between my last year in NSSLHA and my ASHA membership.

And I was like, “UHHH HUH? WHAT?”

As far as I knew – there was no expiration date on my two+ years in NSSLHA. No one ever mentioned that I basically had to be in NSSLHA at the time I graduated from grad school in order to get my discount. When I was in grad school no one ever even talked about NSSLHA – it was what the undergrads did. Right? Right.

HOWEVER, I was wrong! (As were a majority of my peers it turns out.) Everyone I’ve talked to thought you just had to be in NSSLHA for two years…at SOME point. After talking to an Exec NSSLHA member I was told that INDEED: you are SUPPOSED to be a NSSLHA member for the two years directly prior to applying for your CCCs!

Who knew?! Not me. I mean it says it directly on the website but I never even looked because why would I? Professors are never wrong! (Right? Hahaha.) (Also I’m not the brightest crayon in the box.)

So grad students – JOIN UP (like, yesterday). And grad schools – TELL YOUR STUDENTS. Encourage your students! Don’t just make NSSLHA about undergrads! This is important, yo.

And don’t forget about Gift to the Grad!

NP: Lisa Loeb – Stay

Learning about Deaf culture

10 Mar

I owe Liza a post!

To start at the beginning, I took “sign language” as an undergrad. It was pretty much a VERY BASIC sign course where we talked a little about grammar and Deaf culture and learned a lot of nouns. I never used it functionally and lost most of it pretty quickly. As of July I had retained toddler signs, and that was about it.  I’m currently enrolled in a legit ASL course taught by a Deaf woman and it’s bad ass. But still, I’m learning a lot and by no means think that I can “sign.”

Anyway, things got interesting as my caseload expanded and I started seeing adults for AAC. A majority of my adults have developmental disabilities and three of them are Deaf. They had sign language interpreters attend evaluations as well as therapy
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