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Could you give therapy with a penny?

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

Spending time abroad must be about the best educational experience there is. I am fortunate that I have been traveling to different countries since I was sixteen. Even now, many (okay, many, many, many) years later, I value the experience just as much, perhaps even more.

This summer, I had the fabulous experience of spending a month with a host family in a small city in Costa Rica. As you probably already know, the country is stunningly beautiful, rich green, so plush. Of course, we went on many excursions, hiking to waterfalls and volcanoes, enjoying the beach, horseback riding, rappelling, zip-lining (my younger son’s favorite), and walking across hanging bridges (my older son’s favorite). We all had an amazing time.

No matter where I go, however, I cannot help but want to do something related to the profession. There seemed to be very few speech-language pathologists in Costa Rica, from what I could find. So, while my kids took classes in the mornings, I explored places where I could volunteer. I found a retirement home in a beautiful spot on the outskirts of the city. There, I worked with several wonderful individuals who had suffered strokes and with a dear woman diagnosed with Alzheimer’s. They received physical therapy from a lovely and loving therapist, but speech-language therapy was simply not available there. My mornings there were a truly incredible part of the trip. I did not come prepared to give speech-language therapy, so it was a really neat experience finding creative ways and materials to use. And I made a lot of improvement in playing dominoes – what an excellent memory game!

Here, back home, it is incredible how many speech-language resources are available to clinicians. We are very fortunate. Even so, I’d have to agree with one of my professors from graduate school who used to say, “A good clinician could give good therapy with just a penny.” I loved the challenge to think outside the box.
The life-long learning and diversity in experiences are two of my favorite things about speech-language pathology. I cannot wait to go back to Costa Rica, and hopefully, with students in speech-language pathology!

 

 

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Standardized Test Scores — How Should They Be Reported?

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

“For every complex problem there is an answer that is clear, simple, and wrong”  –Henry Louis Mencken

 

This quote reminds me very much of speech and language assessment practices for linguistically diverse children. SLPs may look for simple solutions to complex problems, such as relying primarily on standardized tests to evaluate the skills of English language learners. However, oversimplification of the process is likely to yield an inaccurate diagnosis.

In the 2004 Individuals with Disabilities Education Act, an important procedural safeguard indicates that testing and evaluation materials “will be selected and administered so as not to be racially or culturally discriminatory. Such materials or procedures shall be provided and administered in the child’s native language or mode of communication, unless it clearly is not feasible to do so. In 2006, regulations further specified that evaluation materials should be administered “in the form most likely to yield accurate information on what the child knows and can do academically, developmentally, and functionally.”

Despite these safeguards, we are still seeing an over reliance on standardized assessments in English, even when test norms are not adequately representative of children’s cultural and linguistic background. Years ago, I remember evaluating an English speaking child from the Virgin Islands. The only English measures to which I had access were normed predominately on English speakers from the U.S. According to the test manual, a minuscule number of children in the normative sample lived outside the U.S. Therefore, I could not consider the norms adequately representative of my student.

What I would like to see in all reports is a description of the assessment measure that the clinician used with a statement about the normative sample.

For example, if I have a bilingual student and choose to administer the Expressive One-Word Picture Vocabulary Test-Spanish Bilingual version, I provide a statement indicating that the test was normed on children growing up in bilingual (Spanish/English) environments in the U.S.

Likewise, is an SLP is conducting an assessment of an English language learner and finds benefit to administering an English assessment that was normed predominately on monolingualEnglish speakers, the SLP should be clear about this in their report. Such specification helps clinicians explain why it is not always appropriate to report the standardized scores. In the report for this English language learner, the evaluator could write “This test was normed primarily on monolingual English speakers; therefore, in accordance with IDEA’s policy on appropriate testing, results are discussed in descriptive format.

Again, I would like to see a description of the normative sample in all reports. Many clinicians are already doing this. I think this is a critical piece of our reporting practices.

 

 

Posted in ASHA, CF, clinical practicum, clinical writing, Communication Disorders Graduate Programs, early intervention, english language learners, family intervention, Individuals with Disabilities Education Act, language development, language impairment, literacy, RTI, SLP Advice, SLP Therapy Ideas, standardized testing, Uncategorized | Tagged , , , , , , , , , , , , | Leave a comment

Intervention Ideas during African American History Month

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

Speech-language pathologists are increasingly designing their language interventions to align with school curricula.  Of course, this is easier for school-based clinicians who have more communication with classroom teachers and easier access to classroom goals and lesson plans.  For clinic-based clinicians, it may be somewhat more challenging to find out what their young clients are learning in the classroom, although parents often have access to this information which they can share with clinicians.

I am a strong supporter of language intervention that expands children’s language skills while also supporting their world and background knowledge.  February is African American History Month during which the country celebrates the innumerable contributions that African Americans have made to the economic, cultural, social, and political developmental of the United States.  If you are looking for ideas for language intervention themes this month, African American history is the perfect topic for clients of all ages.  Think of all the rich content knowledge and vocabulary related to social studies and social language that you can incorporate: historical figures, government, geography, maps, cultures, timelines, feelings, and so many more.

For example, one of the common core standards for second graders (CCSS.ELA-Literacy.RI.2.3 ) indicates that children will describe the connection between a series of historical events, scientific ideas or concepts, or steps in technical procedures in a text.  For third graders (CCSS.ELA-Literacy.RI.3.3), it states that children that children will describe the relationship between a series of historical events, scientific ideas or concepts, or steps in technical procedures in a text, using language that pertains to time, sequence, and cause/effect.  According to one standard for sixth through eighth graders (CCSS.ELA-Literacy.RH.6-8.10), students will read and comprehend history/social studies texts complexity band proficiently.  

There are excellent resources available on the web, including children’s books and lesson plans, to help you plan intervention this month.  Just a few are listed below.  Enjoy African American History!

africanamericanhistorymonth.gov
africanamericanhistorymonth.gov/teachers.html
readingrockets.org/calendar/blackhistory
teachervision.com/black-history-month/lesson-plan/48600.html

 

 

Posted in african american history month, family intervention, literacy, SLP Advice, SLP Therapy Ideas, Speech-Language Pathology Careers, Speech-Language Pathology Graduate Programs, Uncategorized | Tagged , , , , , , , , , | Leave a comment

Improving services for English Language Learners (ELLs)

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

There is so much to look forward to in 2014! For one, Alejandro Brice (University of Florida at St. Petersburg), Caitlin Panke (Madison Metropolitan School District), and I are collaborating to create a new website titled Training to Enhance Services for ELLs (TESELL). This project is supported by a grant from American Speech-Language-Hearing Association, Office of Multicultural Affairs.

The purpose of our project is to help our fellow SLPs transfer knowledge and train other professionals in best service practices for ELLs. We are developing and will be posting a series of training modules that SLPs and presenters may use (at no cost) when training other professionals who work with ELLs. In a nutshell, we want to create a site where we can pool and share our training resources to make it easier for SLPs who present on the topic of ELLs, thereby reducing their need to reinvent the wheel.

Current training modules under development include:
• Normal stages of stages of second language development and how bilingualism influences language, literacy, and cognitive development

• Promoting high quality teacher-child interaction and language facilitation strategies appropriate at each second language stage to promote achievement of Common Core State Standards

• Strategies to facilitate and enhance peer-interactions in the classroom

• Monitoring and evaluating children’s progress and achievement

• Providing inclusive classroom interventions/differentiated instruction to meet the needs of struggling learners

As we share the common goal of enhancing services for ELLs, we encourage and welcome you to share additional presentations and resources on the topic of ELLs on this website that would be of benefit other SLPs. Stay tuned!

 

 

Posted in ASHA, CF, Communication Disorders Graduate Programs, early intervention, ELLS, english language learners, Home Speech Activities, language development, language impairment, literacy, SLP Advice, slp assesment, SLP Therapy Ideas, Speech-Language Pathology Careers, TESELL, Training to Enhance Services for ELLs | Tagged , , , , , , , , , , , , , , , , , | Leave a comment

Orofacial Myofunctional Disorder (OMD)

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

The scope of speech-language pathology is so vast that it is challenging to thoroughly cover all disorders in graduate school. Orofacial myofunctional disorder is an area that many SLPs would like to learn more about.

What is OMD?
According to ASHA, OMD refers to “any pattern involving oral and/or orofacial musculature that interferes with normal growth, development, function of structures, or calls attention to itself.

What are the signs of OMD?
The International Association of Orofacial Myology indicates several signs that might be symptomatic of OMD. When the mouth is in rest position, the child may display habitual mouth breathing, parted lips (referred to as lip incompetence), forward tongue carriage and excessive tongue contact with the teeth (referred to as tongue thrust). The child may be particularly messy or drool when eating. When swallowing, the child may display tongue thrust, facial grimacing, gulping, and/or head bobbing upon completion of the swallow. The child may experience stomach discomfort due to inadequately chewed food. Lip tone may appear flaccid. The child may also appear to have a long face due to extended facial growth.

What are problems associated with OMD?
Oral myofunctional disorder contributes to improper orofacial development, dental growth, and misalignment of the teeth and jaw. The majority of children with OMD also have speech distortions and/or misarticulations, most noticeably on alveolar, palatal, and liquid phonemes. Speech therapy alone is often insufficient to remediate articulation errors that are related to OMD; orofacial myology treatment may also be necessary.

Who is qualified to treat OMD?
In these cases, treatment should be delivered by a professional with specific training in OMD. The International Association of Orofacial Myology provides a referral list of professionals, such as SLPs, dentists, and other health professionals, who have attained specific training and certification in this area. The goal of orofacial myology treatment is to improve muscle tone and posture to promote normal growth, development, and function, and research indicates that treatment is indeed effective.

For more information, visit the following websites on OMD:
www.iaom.com/index.html
www.asha.org/SLP/clinical/Orofacial-Myofunctional-Disorders/

Posted in ASHA, Communication Disorders Graduate Programs, language development, language impairment, OMD, Oral myofunctional disorder, SLP Advice, slp assesment, Speech-Language Pathology Careers, Uncategorized | Tagged , , , , , , , | Leave a comment

Dual Language Assessments

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

I took my boys to Baskin-Robbins the other day, where they still have the flavor that has been my favorite ever since I was a child. The ice cream was awesome, of course, as was the conversation with my 8-year-old and 4-year-old sons.

Older: How many scoops are in a double?
Younger: Two.
Older: How many are in a triple?
Younger: Three.
Me: How about in a quadruple?
Younger: Cuatro.

Now you may wonder why he said “cuatro” in Spanish. Does he often mix English and Spanish? No, not often at all. Actually, his receptive language skills in Spanish are good, but he rarely speaks in Spanish spontaneously, without prompting. I thought he would have been primed to say “four,” given the preceding “two” and “three” cues. Interestingly, though, the prefix “quad” primed him to produce the similarly sounding word choice, “cuatro.” It is fascinating to consider how language is represented in the brain and how the neural circuitry in bilinguals differs that of monolinguals.

This is all an important reminder that we cannot compare apples to oranges during our assessments. Even if a child produces mostly English, this does not mean that we can ignore his dual-language experience and easily use monolingual norms to compare his skills to that of an English monolingual. In fact, it is possible for a client to perform better on expressive tasks in one language and better on receptive tasks in another language. One cannot judge proficiency based on expressive skills alone. The bottom line is that we need to collect thorough language histories and document these histories in our reports. And we need to remember that the bilingual brain is amazing and unique.

 

Posted in ASHA, bilingual intervention, Bilingual Speech Pathology, deficit thinking, early intervention, family intervention, Home Speech Activities, language development, language impairment, literacy, slp assesment, SLP Therapy Ideas | Tagged , , , , , , , , , , , , , , , | Leave a comment

Health Literacy Month and Halloween

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

October is one of my kids’ favorite months, for Halloween, you know. Well, October is one of my favorite “professional” months, for Health Literacy Month. Okay, I suppose that as a person who is passionate about promoting literacy, every month is literacy month in my book. But in any case, it is so important that professionals spread information about the critical relationship between language and literacy.

We know that language learning starts at birth. Therefore, the idea that children learn to read in school needs to change to reflect the reality that both language and literacy develop from birth.

Recently, I supervised a graduate student who taught a parent to use dialogic book reading strategies with a young child who reportedly disliked sitting down to read with his parents. We were, of course, taking data on the child’s vocabulary and language growth, but the data simply did not capture the full impact of treatment. Watching the child sit on his parent’s lap while sharing a book, both smiling and so cozy together, it was marvelous. Dialogic reading was just one component of the broader speech and language therapy plan, but with the transformation in their interaction, it may have been the most powerful component. And although the young child had not yet formally learned to read, he was already developing a love of reading.

Last year, I wrote a blog about a remarkable program called Reach Out and Read in which medical providers support healthy reading practices in the home with children as young as six months old. I presented at the Reach Out and Read-Wisconsin annual conference last year and was graciously invited to present again this year. I encourage everyone to spread the word about this phenomenal program and to share this video that the founders developed, available on YouTube.

Hmmm, maybe I should give out books with a piece of candy inside this year for Halloween. Now that would be a real treat!

Posted in Bilingual Speech Pathology, Communication Disorders Graduate Programs, health literacy month, Home Speech Activities, language development, language impairment, literacy, SLP Advice, slp assesment, SLP Therapy Ideas, Speech-Language Pathology Careers, Speech-Language Pathology Graduate Programs | Tagged , , , , , , , , , , , , , | Leave a comment

Tips for Great Clinical Writing

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

What is “good” clinical writing ?

As part of an English assignment, an undergraduate student recently asked to interview me about clinical writing in speech-language pathology. She is also planning to major in Communication Sciences and Disorders.

At first, I thought it would be a fairly straightforward interview. Clinical writing is vastly different from the casual writing styles of texting, email, and blogging that we do every day. Strong clinical writing requires correct grammar and punctuation. Active voice is preferable to passive voice. The writer must also present information clearly and concisely to reduce wordiness.

Not that the story need be long, but it will take a long while to make it short.
- Henry David Thoreau

The more the student and I talked, the more I remembered to appreciate what a complicated and unique task clinical writing really is. She then asked if I could compare the clinical writing of “strong” graduate student writers with the writing of students who struggled.

As a supervisor, I have found that one common area of difficulty is with terminology. Clinicians should use proper clinical terminology that other professionals who read the report will understand. When writing clinical reports, therefore, students should review terminology that they learned in class. At the same time, the writer should define any jargon that the client or a family member would not understand.

Another area of difficulty that I have seen often is with objectivity. Clinicians should report what the client actually did, sticking to facts and data, rather than describe the client’s behaviors subjectively. For example, instead of writing that the client “seemed” tired, we might say that “The client closed his eyes and put his head on the desk during the assessment.” The client may have been tired, but his behavior may also have resulted from frustration or boredom. The clinician can only know for sure what she saw.

Then, there is a very common corpus of words and phrases that experienced clinicians use, such as:
“His parents/teacher reported…”
According to his parents/teacher…”
“His parents/teacher expressed concerns that…”
“His parents/teacher expressed no concerns with…”
“The client demonstrated/displayed…”
“The client performed within normal limits for his age…”
“His score fell in the ____________ range”

“There is nothing to writing. All you do is sit down at a typewriter and bleed.” 
-Ernest Hemingway

I know that many students feel a great deal of frustration with all of the revisions their supervisors request that they make. Thank goodness for computers! Try not to take it personally. Their comments are fully intended to benefit you and your clients. Your documentation may become a legal document. Other professionals who read your reports will make judgments about you and your competence based on your writing. Someday, you will too.

Strong clinical writing skills will only develop with practice and guidance, so try to look at the red ink and remember that your supervisors are helping you become the best clinician possible. So keep your head up. It will get easier!

Posted in ASHA, bilingual family intervention, bilingual intervention, Bilingual Speech Pathology, CF, clinical practicum, clinical writing, Communication Disorders Graduate Programs, family intervention, literacy, SLP Advice, slp assesment, SLP Clinical Success, SLP Therapy Ideas, Speech-Language Pathology Careers, Speech-Language Pathology Graduate Programs, Uncategorized | Tagged , , , , , , , | 1 Comment

ASHA Pre-Convention Workshop 2013

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director and Associate Professor in the Communication Sciences and Disorders Program at Elmhurst College

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

I was invited to present on bilingual issues in speech-language pathology at the American Speech-Language-Hearing Association Pre-Convention Workshop this November. I really want the session to address needs of both newer clinicians and seasoned clinicians who work with bilingual children, both monolingual and bilingual SLPs. Therefore, the title of the workshop will be “Tackling the Tough Issues in Service Delivery for Bilingual Children.”

I hear from colleagues and receive various emails from clinicians about specific situations that they face in their practice that they find particularly puzzling or troubling, and it is these types of issues that I want to be able to help clinicians address. So, I would love to hear from you, about your stories, your predicaments, as well as your successes in addressing tough issues in service delivery for bilingual children.

Send me your suggestions!

 

Posted in ASHA, bilingual family intervention, bilingual intervention, Bilingual Speech Pathology, Communication Disorders Graduate Programs, family intervention, graduate school, Home Speech Activities, literacy, SLP Advice, Speech-Language Pathology Careers, Speech-Language Pathology Graduate Programs, Uncategorized | Tagged , , , , , , , , , , , | Leave a comment

Surviving Your Clinical Practicum

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

I had the pleasure of attending and presenting at the LinguaLive conference in Las Vegas a few weeks ago. We had an intimate and dynamic group of conference participants that included graduate students, recent graduates, and experienced SLPs. I served as a discussion facilitator for one of the session for graduate students that addressed how to prepare for the external practicum, and one student posed the following thought-provoking question:

“I would really like to find out how to keep my sanity. I would like to find out how to be everything at once – a student who is learning everything (yet sometimes feels like I know nothing); a clinician who is trying to apply everything I am learning (yet it seems to be all trial and error); and a professional, who, despite limited experience, has to have credibility as to what I am doing and why.”

Even though it was a long time ago, I too remember feeling extremely nervous about starting my clinical practicum. It is very normal to be nervous, and you are certainly not alone. I think it is probably a good sign that indicates your motivation to do well. I would recommend being open with your supervisor about your concerns rather than trying to hide your feelings.  Then that stress, at least, would be out of the way so that you can focus on the tasks ahead of you. It may be helpful to sit down to write a self-reflection about your strengths as well as your areas of need for this particular placement. After putting some things on paper, recognize that you cannot possibly tackle and master all the needed skills at once. Instead, prioritize what skills you should tackle first, and ask for your supervisor’s input. Then, periodically review your progress and celebrate your growth.  This system of breaking things down and prioritizing may make the clinical practicum experience seem less daunting and more manageable.

All SLPs, even experienced ones, are always learning. Learning is a life-long process that makes our work stimulating and rewarding.

 

Posted in ASHA, Bilingual Speech Pathology, CF, clinical practicum, Communication Disorders Graduate Programs, graduate school, Lingua Live, SLP Advice, Speech-Language Pathology Careers, Speech-Language Pathology Graduate Programs, Uncategorized | Tagged , , , , , , , | 1 Comment
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