4 Ways to Tell if Your Therapy is Working

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It seems like a question all of us should be able to answer: Is my therapy working? But it is more difficult to pin down than it seems. After conversation with a number of colleagues this week, and some careful thought during my own therapy sessions, I've nailed down some factors to think about. You'll know your therapy is working if...

1) you have data to back you up. This may sound obvious, but good data, especially on great functional goals, can be hard to come by! If there are multiple people working with the student (think SLP, SLPA, aide, etc.) or if activities vary based on context, then tallies or plus/minus marks may not tell the whole story. I find that intermittent video recordings can be a very thorough and efficient way of tracking progress on speech/language goals. Take an audio or video recording of a language task (story retell, read aloud, talk about your weekend, etc.) once a month or once a quarter, and you'll have an easy way to look at skills and accuracy - you may even go back and look at skills you didn't know you'd be targeting! 

2) the student knows what her goals are and, in a developmentally appropriate way, can tell you and others what her job is in working on them. For example, "I'm working on my /k-k-k/ 'scraper' sound. These are the words I'm practicing..." or " I'm working on ways to learn new words. When I draw pictures, it helps me remember." or "I'm learning about question words like 'who' and 'when'. Each one means a special thing."

3) your collaborators in therapy can tell you it's working! It's true, you should not be doing this all on your own. The best and most effective therapy involves other people in different contexts for observation, cueing and reminding, and practice! Parents and teachers are the most obvious, but especially when there are some skills to generalize, there is no reason you couldn't have the secretary, lunch lady, or bus driver in on it, as well! These collaborators can be valuable sources for information on successes, as well as areas of continued need. 

4) your goals are well-written. We've all been there - frustrated trying to measure progress because we didn't write the means for measuring in to the original goal! We know our goals should be measurable. This means that one of the most important times to think about how you'll know if therapy is working is when you're writing the goal!

How do YOU know your therapy is working? What are the most meaningful ways to share that progress with team members?

Cupcake Day!

The THF fairies were out and about making special deliveries yesterday! Staffers arrived home to find a box of cupcakes on their doorstep, and really, is there any better way to end a Thursday?! We have so much to celebrate, but none of it would be possible without the tireless work of our amazing staff. Cupcakes for everyone!

Special thanks to Bliss Bake Shop for our local cupcakes, and Wicked Good Cupcakes for our out-of-town deliveries. They were all so delicious!

Research Tuesday: Adolescent Outcomes of Children With Early Speech Sound Disorders With and Without Language Impairment

I've been working as a high school SLP this year, and it's gotten me thinking about the last stage of childhood speech/language disorders. Of course, many students "graduate" from speech before they enter high school. But are they now functioning the same as typical learners? The researchers in this article attempt to answer that question.

The Details

American Journal of Speech-Language Pathology, Newly Published on March 23, 2015. doi:10.1044/2014_AJSLP-14-0075 from http://ajslp.pubs.asha.org/Article.aspx?articleid=2089543

The Question

The authors of this study wanted to know if adolescents with histories of speech sound disorders (SSD) differed from those with histories of SSD and language impairment (LI), as well as if they differed from typical peers on measures of speech, language, and literacy.  They also wanted to know how adolescents with persistent SSD differ from adolescents with resolved or no SSD on speech, language, and literacy measures.  Finally, they questioned if any other factors (SES, gender, nonverbal cognitive ability) were associated with adolescent language and literacy skills.

The Method

This was a longitudinal study of 316 participants who were part of an ongoing family study of speech and language disorders.  Participants were recruited at early childhood (4–6 years of age), then followed at school age, and again at adolescence (11–18 years).  Children were administered speech and language assessments (speech sound production, oral motor skills, phonological memory, oral language, vocabulary) and literacy measures (word level reading, reading comprehension, spelling).  Performance Intelligence Quotient (PIQ) was assessed by the WISC-III (11–16 years) or the Wechsler Adult Intelligence Scale–Fourth Edition (16+years) to measure nonlinguistic cognitive skills, such as problem solving, spatial perception, working memory, and visual-motor coordination. Parents also completed questionnaires that provided information about their children's educational and medical history, as well as socioeconomic status.

The Results

Not surprisingly, adolescents with comorbid SSD and LI did poorer than those with histories of SSD only or no SSD.   Also, adolescents with SSD only and SSD+LI had lower Performance Intelligence Quotient (PIQ) than their peers with resolved/no history of SSD.  What was also interesting was that adolescents with resolved speech disorders performed lower than than those with no history of speech delay on language, reading comprehension, and decoding assessments. Low language and literacy skills were associated with persistent speech sound problems, lower nonverbal intelligence, and lower socioeconomic status.

Here's another thing: individuals without overt speech sound errors, but difficulty with production of multisyllabic words, were also associated with poorer language and literacy outcomes.

The Take-Away

So, I guess it does matter if a student has had a speech or language delay ever in their life. They may have a harder time with language based tasks, reading comprehension, and tasks that require strong nonlinguistic cognition.  "Resolved" does not mean "typical," and it's good to keep this in mind when working with adolescents, and probably adults too. Another thing that I found interesting was that students who had difficulty with multisyllabic words, but no overt speech errors, performed as poorly on language and literacy tasks as adolescents with SSD.  Could this be an identifying factor for students at risk?  Food for thought.  

Do you work with adolescents or adults?  Have you seen this in your own practice?  Share your experience below!
 

April 2015 THF Clinician of the Month

Karen Clifton is The Hello Foundation's April 2015 clinician of the month

Sometimes we recognize clinicians for a recent event or effort, but this month it is the sheer volume of evidence accumulated over time that makes this person stand out. Karen Clifton was the first clinician to take a contract with our company 10 years ago, and since that time she has worked in a variety of placements and service models - from less than .2 FTE to near full-time!

A talented clinician, she is frequently asked to return to districts because of the deep relationships she forges with students and co-workers. But she has been thoughtful about her work commitments, and doesn’t hesitate to set boundaries that work for herself and her family. I personally love that when I talk to Karen about her work, it inevitably leads to a conversation about her family, her kids, her husband and his job, their home, and their plans for the future. These pieces of her life all play together in a balance that makes it all work! It’s never simple, but Karen has been a model for all of us working towards this kind of balance. 

7 Lessons Learned from the Best Special Education Programs

I am proud to announce that we have just published our very first eBook! It's titled Lessons Learned: 7 Practices Observed in the Best Special Education Programs, and it is a behind-the-scenes look at what our staffing company observes daily as we work with districts throughout the West. My hope is that you find it insightful, inspirational, and maybe even a little helpful. 

Please enjoy the preview I've included in this post. If you're interested in reading more, simply click on the big red box below the preview and you'll be taken to our download page. When you get there, you'll be given different download options, as well as the option to request a (free!) hard copy for you (or anyone else).

As always, thank you for joining us in Putting Kids First!


Sharon Soliday

Sharon loves to help people communicate more effectively. She has been a licensed speech-language pathologist for 18 years serving both young children, teens and adults. She has a passion for adolescent language, communication and social skills. Individuals with disabilities have benefitted from her services as well as individuals just wanting to refine and improve their skills. She has worked internationally and has been recognized on a national level for her excellent work.