Errorless Learning or Learning from our Mistakes?

Have you heard of "errorless learning"? It is a theory of learning developed by psychologist B. F. Skinner to describe a learning environment that is exactly tailored to the learners needs and level of performance.  The term is thrown around in discussions about speech/language therapy to describe the way we scaffold support to allow students to work at a level where they can be successful. This might include having our student with articulation goals work on the isolated sound in front of the mirror before trying to put it in a word or syllable. Or it might mean starting work on asking questions with a direct model that the student repeats, and fading cues their skills improve.

But what about all the inspiring inforation out there about the best learning coming from our mistakes, like this and this?

How can we scaffold support for students so that there are lots of correct productions and successful experiences to strengthen the neural pathways of newly developing skills AND encourage student to take risks and make mistakes and learn from them. Maybe it's not as contradictory as it seems...

Building new habits requires lots of repetition. We want our student to repeat correct responses, not reinforce their mistakes. We are, after all, providing specially designed instruction to students, who, for whatever reason, did not learn these speech/language habits the same way their peers did - by listening and watching correct models around them. Their IEP team has decided that they need explicit instruction in these areas. 

But instead of 'mistakes' could we think about learning by taking risks? Here are a couple of ideas on how we can support our students to take risks: 

  • We can help kids identify what they're working on - remind students why they're doing what they're doing, have the student explain what he's doing to a parent or teacher! 
  • We can experiment by taking risks ourselves - by trying new things in therapy and modeling our thinking:  
    • "I'm going to try a new way of explaining this..."
    • "Wow! That seemed to work really well. I'm going to make a note of that so I can use it with other groups!"
    • "Hmmm, that didn't seem to go so well. I'm going to need to think about a different way of doing that."
  • We can support risk-taking in our colleagues and professional teams
    • "What did you try today?" "Here's what I'm doing. Do you have any ideas?"

Pay attention to the work you do this week. How do you find balance between practicing success and taking risks? 

Hello Live: Help! I Have to Write a Feeding Protocol! with Wendy Gunter

Feeding Protocol Hello Live Wendy Gunter

Does assessing dysphagia in the schools scare you a little bit? Does creating a feeding protocol for a student seem overwhelming and impossible? Join Wendy Gunter as she shares the steps you need to take to assess dysphagia for a student and complete a safe feeding protocol.  She will discuss the history and ethics of managing dysphagia in the schools, and will give you concrete steps for working with your team and developing a plan.

Wendy references the ASHA Code of Ethics, the ASHA Professional Issues Statement on the Roles and Responsibilities of the SLP in Schools, and the ASHA Pediatric Dysphagia Portal. Be sure to listen to our conversation after the show, too, to hear more of Wendy's thoughts on the roles and responsibilities of the school SLP when it comes to managing dysphagia. This is one of her favorite topics, so she encourages you to contact her with any questions and concerns you have!

Research Tuesday: Delivering Stuttering Intervention via Telepractice

Goodness. There is so much interesting research going on out there! I had a hard time picking an article this month, but finally settled on one that looked at the viability of a telehealth model for working with adolescents who stutter. We do a fair amount via telepractice around here (both via our Hello There approach, and our Hello Online private online therapy), and I am thrilled to see that the research community is starting to look at best practices for this new frontier!

Research Tuesday

The Details

Carey, B., O'Brian, S., Lowe, R., & Onslow, M. (n.d.). Webcam Delivery of the Camperdown Program for Adolescents Who Stutter: A Phase II Trial. Language, Speech, and Hearing Services in Schools, Vol. 45(October 2014), 314-324. Retrieved October 14, 2014, from http://lshss.pubs.asha.org/Article.aspx?articleid=1895438

The Question

Phase I of this study established that it was viable to deliver the Camperdown Program via webcam to adolescents who stutter. This study (Phase II) sought to evaluate the efficacy of the Camperdown Program in this same population.

The Method

Researchers engaged 16 adolescent boys who were seeking treatment for stuttering, ages 12-17. All participants had greater than 2% Syllables Stuttered (%SS), were proficient English speakers, and had not received treatment for stuttering in the previous 12 months. Assessment was conducted prior to treatment, upon entry into the maintence phase of treatment, 6 months after entry into maintence, and 12 months after entry into maintence. Participants recieved the Camperdown Program via webcam in their own homes for a mean of 15.5 hours.

The Results

The mean %SS at the start of the study was 6.1%, and was reduced to 2.8% 12 months after entry into maintence. Participants "significantly reduced their stuttering in terms of frequency and severity," although the authors note that there was variation in the degree of improvement between individual participants. The adolescents also reported that they enjoyed receiving the treatment via webcam, and fewer than half stated that they would have liked to have visited the SLP in person "a few" times in order to get to know the SLP better. In addition, they expressed that they would prefer to receive their services online in the future.

Researchers note that only around half of the participants maintained their original reduction in %SS at the 12-month mark. Interestingly, this regression was not reflected in the participants' self-report measures, which remained positive at the 12-month assessment. This level of regression/relapse is typical of other, traditionally-delivered intervention programs that have been studied with this popultion.

The Take-Away

It's no shock that adolescents really liked receiving services via webcam, but it is always nice to have a gut-instinct reinforced by research. While it only demonstrated true success for half of the participants, it seems to me that this has more to do with treating stuttering in general than by the delivery medium. Also, stuttering is a disorder in which self-perception matters at least as much, if not more, than the quantative measures of severity. That the participants rated themselves highly after 12 months is very encouraging to me. I was also excited to learn about the Camperdown Program, which can be downloaded for free. All in all, this study suggests that, at least with this population, telepractice is an excellent option.

The Talk Shop: A New Social Network, Just for You

We're Big Idea folks around here. The bigger, the better. In fact, Hello was started with the Big Idea that a staffing company can offer the highest caliber service to it's clients while simultaneously offering it's clinicians a workplace that values and empowers them both professionally and personally. Now, we have a new Big Idea, and that idea's name is The Talk Shop.

The Talk Shop is a bran' spankin' new social network that was created to help bring our internal company culture of open and safe communication to a wider audience. It's a place where professionals around the world can gather together for a new level of digital collaboration. Delivering Quality, Putting Kids First, and Practicing Work-Life Balance are Big Ideas. They're also 3 of our 4 core company values, and we know they don't happen in a vaccum. It is our hope that The Talk Shop becomes an incubator for those and thousands of other Big Ideas that are just looking for a place to grow.

It's free to join and participate, and always will be. We'd love to see you there and, to entice you a bit more, we're employing our 4th core value, Give. If you register as a new user before October 21, 2014, you'll be entered to win a $250 Visa Gift Card that you can spend on whatever your little heart desires.

So, welcome to our new Big Idea. Like all new ideas, it's probably a little rough around the edges. It needs the help of our community to test it out, poke holes in it, challenge it, push it to it's limits, and help make it stronger. So please, go give it a whirl. If you hit a bump in the road, click on that little envelope in the lower right-hand corner and let us know. We're eager for your feedback and to create a space that works for the community we feel so grateful to be a part of.

See you at The Talk Shop!

October 2014 Clinician of the Month

Our October 2014 Clinician of the Month, Helen!

We have a tradition of honoring a clinician each month who exemplifies one of the core values of our organization. This month we have chosen to recognize Helen, for the way she models our value of “Put Kids First!".

Helen took a leap into the Hello There service model this fall! She is serving middle school students at 2 schools in Corvallis, OR. District administrators approached Hello with big needs and a complex set of limitations. Facing a new service model, an unfamiliar caseload, and no available assistant time, she impressed staff with her “can-do” attitude. Not having an assistant has been a bit of a hurdle, but she has managed her own anxieties, put kids first, and has been able to assure staff “we can make it work!”

After her first month on the job, she reports, "I am hoping to help some of the hesitant sped teachers next week with FaceTime or Skype in order for me to [be on video] during meetings instead of just ... speaker phone. I find that I do a lot of PR and reassuring folks that using technology is just fine and will work well."

Thank you, Helen, for truly putting kids first - even when it means taking some risks! Congratulations on being our October 2014 THF Clinician of the Month!