Changes, Changes

There comes a time in every SLP’s career when we have, to paraphrase the Beatles, “memories longer than the road that stretches out ahead.”  I have reached that point.  Due to family circumstances, after nearly 30 years in the field, I will be retiring at the end of this school year.

In August 2017, a week before I started a new school year in a new school, my dear dad passed away from complications related to strokes.  I wrote about this rough experience, from both a daughter’s and SLP’s perspective, in my post, “The Therapy Voice.”  My parents lived 70 miles away with no family around, and I had promised my dad that I’d move Mom back to Bucks County (where she had lived except for the last 20 years when they retired to Lancaster County) before the winter.  All through June and July, he would repeatedly grab my hand and say “it’s going to snow; get her out” and “take care of the house; sell it.” After he passed, I kept that promise.  I continued to make the 70-mile journey every weekend through November to help my devasted mother pack up and sell off the house and extraneous belongings.  In December, we closed on the house and Mom moved in with my husband and me.  Meanwhile, I continued to work full-time in my new school 3 days a week and as an assistive technology consultant 2 days a week.  When the holidays came and went, it was apparent that the stress of what we had been through and my mom’s continuing bereavement was taking a toll on me, so I reduced my AT work to one day a week, leaving me with Wednesdays off.  The financial cost of this change was far outweighed by some of the weight this lifted off my shoulders.  Life was still very stressful, but at least was more manageable.

Mom stayed with us until July, when she finally felt she had the strength and need to move to an independent living retirement village 3 miles from my home.  The move was rocky, as Mom was still very fragile and this was one more change in a series of changes that were not part of her original life plan.  It wasn’t until early September that she finally settled into her beautiful new home and community, and started to make friends with some amazing women who seemed to be put there for the purpose of supporting her.  I started the 2018-19 school year with much more energy and focus than I was able to muster during that difficult year before.

Then, fates changed our plans again.  On October 5, Mom was diagnosed with a rare form of ovarian cancer.  Biopsies and scans revealed widespread involvement, so that surgery was not an option and we were told this wasn’t a cancer to be cured, just contained for as long as possible.  Being that Mom is 84, otherwise very healthy and energetic, but still missing my dad terribly, we had many conversations in between tests and consults about quality vs. quantity of life and how the options of chemo vs. no chemo might play out.  By late October, Mom decided to give chemo a try.  Treatments would be on 3-week cycles;  2 trips to the hospital on the first 2 weeks for chemo and fluids (averaging 4 hours per trip), then bloodwork and doctor appointment on the third week, the results of which would set up the schedule for the next 3 weeks.  Scans and consults with a specialist in Philadelphia every 3 months were also in the mix.  It became immediately clear to me, and fortunately to my supervisors and HR director, that there was no way I could keep up with work and care for Mom, so I started on a medical leave on November 1.  My intention was to go back to work on March 1, but that was not to be.  Tests showed very minimal improvement (but no worsening!) and we were told that chemo would continue through the end of March, followed by a short break and reevaluation.  Because of the high incidence of breast cancer in my family (Mom, my sister, my aunt, a cousin, and me), I was advised to have preventative surgery to protect me from ovarian/peritoneal cancer.  I had that surgery last week and, while I am still very tender, the peace of mind is a wonderful thing.

By mid-May, we will know what options are available for Mom.  Blessedly, she is looking and feeling really good right now, and is enjoying life with family and friends.  However, we know this isn’t going to go away, so some form of treatment or maintenance chemo will be needed, unless Mom decides otherwise.  In any event, I need to be available to support her, so have decided to retire in June.  I know this sounds like a terrible tale of woe and, yes, a lot of this has been hard.  But the gift in all of this is the time I’ve had with Mom.  During their 20 years in Lancaster, I’d typically only see them every few months, usually at holidays and birthdays, and always with my family with me — nice times, but never one-on-one time.  We’ve certainly had lots of time together throughout the past year and a half, when she lived with us and especially since treatments began:  time to laugh, to cry, to remember, to share.  In between treatments when Mom is feeling up to it, we’ve had fun, too:  shopping at her favorite department store, seeing displays of Christmas trees and quilts at our county visitor’s center, attending a presentation by one of her favorite authors, touring the local Designer House, taking a drive along the river to see the daffodils and rhododendrons in bloom, and enjoying visits with family and friends (especially 5-year-old Miguel, my grandson, who lights up every room he is in).  We’ve decorated her lovely home for each holiday, so that it really does — finally — feel like home to her.  None of us know what the future will be, but I am so relieved — and blessed — to know that I will be here for Mom, come what may.

That doesn’t mean, though, that I won’t still be involved in the profession I love.  My website will go on;  in fact, you can look for some very exciting improvements in the next school year!  I’ll continue to blog twice a month and send out my monthly newsletter.  And I just might finally be able to travel and present to school districts and SLP conferences.  I’ve presented at national speech and special education conferences, and I’ve done loads of trainings in visual supports and functional communication, but these were always in conjunction with or timed around my full-time job.  I’ve turned down many invitations in the past that didn’t fit my work schedule, but maybe now I’ll have some time to explore these opportunities.

The changes in my life over the past two years haven’t been easy, but much of the hard stuff is now behind us and I feel I have the strength to handle what comes next.  I consider myself very blessed to have the support of my family, friends (including so many wonderful SLPs I’ve met through my site), and employer, and, now that the decision has been made,  I am really looking forward to the next chapter of my life.  Spring is a wonderful time for change.  Expect to see photos of my garden, my quilting, and my grandson’s “Nailed It!” cooking creations to pop up in future newsletters among all the SLP-related articles, as proof that life is good.  I have so many wonderful memories from my career, and I look forward to sharing them in future posts with the hope that they encourage and inspire you to continue supporting our kiddos who have communication challenges.  Thank you, as always, for all you do and for sharing this journey with me!

Challenging Parents

f7a5478d223be000631d6d90ed0968f2In my career, I’ve met all kinds of parents.  Most have been supportive, appreciative, and trusting, but there have been others who have been, at one time or another, angry, argumentative, or distrusting.  Dealing with challenging parents is probably the least favorite aspect of our job. If you build a good rapport with the parents from the initial contact, actively keep channels of communication open, and always be the consummate professional you know you are, then you may well avoid many conflicts.  But, inevitably, you’ll have some experience at some point with challenging parents.

I’ll say right up front that there are toxic people, and some of those are parents who will never agree or be satisfied, so what I’m about to say does not apply to all parents or situations. Believe me, I get that!

As with so many aspects of life, I believe that attitude is everything.  When I’ve been involved in conflicts with parents, either as case manager or member of the IEP team, I’ve tried to view those conflicts as growth experiences.  Rather than get defensive, I do my best to examine the situation objectively.  That’s not always easy, but it does help to keep me calm and focused, and often leads to important insights.  One of the most memorable conflicts, and the situation that first taught me this valuable lesson,  involved the mother of an elementary age boy who had profound disabilities.  (This happened early in my career, when the movement toward inclusion was just taking hold, and multiple disability support classes were more about keeping the students comfortable, safe, and entertained, rather than engaged in a strict curriculum.  Related services were typically weekly consults with the teacher, rather than direct therapy with the student).  This mother was loud, brash, often jaw-droppingly inappropriate in language and dress, but she had made herself well-versed in current literature and best practices, and was going to make darn sure her son was the recipient of the latest educational trends.

There was nothing subtle about this mother’s manner.  She’d pop into the classroom, unannounced, disrupt the staff with loud questions and comments, and demand weekly team meetings which caused high anxiety among team members.  You can imagine that the team was none too pleased with this mother. After all, no one wants to feel bossed around or to have their professionalism questioned, and some of the things she was insisting upon were unheard of in our program.  There was a mutual lack of trust between the parent and the team, and the immediate reaction on both sides was to dig in their heels and defend their position.  Little compromise was achieved;  tensions grew.

Always much more comfortable being proactive rather than reactive, I took a critical look at what we were doing and read over the notes I had taken of the mother’s demands in the last meeting.  Away from the emotionality of the meeting, reading these notes made me much more open to ideas.  I started researching Environmental Communication Teaching with its task analysis and the new view that Every Move Counts.  I became a fan of Linda Burkhart and her simple assistive technology.  I took training in PECS.  Through reading, workshops, and videos, plus networking with special education teachers and SLPs in other programs who were already implementing new teaching strategies and equipment, I was convinced that we could develop an exemplary educational program in what was already a very warm and supportive classroom with a team that got along very well.

Very long story short, the team joined me in actively pursuing professional development, and we worked together — one piece at a time with support from administration — to build a program that incorporated clearly defined and measurable goals, integrated therapy, assistive technology, visual supports, Standards- and IEP-based task analysis and use of a consistent prompt hierarchy, data collection and videotaping for progress monitoring, and regular team meetings for curriculum planning, review of data, and sharing of observations. (All of this seems so obvious and commonplace now, but remember this happened years ago).  The result was so positive that our classroom became the model for the larger program in the county.  Both students and staff grew that year, and that growth has continued because the team, encouraged by the success of implementing the first new ideas, remains open-minded and forward-thinking.  The mother became a partner, rather than an adversary, and strong bonds were formed among all team members that continue to this day.

Very often, we would label a mother like this as “difficult,” and there were times when that would have been an understatement.  But I prefer to think of such parents as “challenging,” not in the sense that they are hard to deal with, but that their questions and demands challenge us to honestly assess what we are doing (or not doing) and to make improvements where needed and possible.  Sometimes, that challenge can be all we need to keep us growing as SLPs.

Half Way There….

downloadThe excitement of the upcoming holiday break is palpable! But then comes January and that long stretch of soul-sucking winter (at least, for those of us who have to deal with ice and snow and bitter cold).  It can be a challenge to keep one’s spirits up when the winter blahs take over.  Since New Year’s is all about resolutions, here are some suggestions that might help you over the hump, and it all falls under the heading of “Take care of yourself.”  You know the saying about caring for yourself before caring for others in a crisis situation?  Well, that holds true all of the time, although our own needs often take a backseat as we routinely care for family, friends, colleagues, students, and community. Resolve to change that!  Here’s what has worked for me in my 28-year career:

  1. Exercise.  Ugh, I even hate the sound of that word.  Going to the gym is torture for me, especially when the only time I can go is when it is dark and cold.  When I expressed this to my doctor, she said, “so don’t go! Just find a way to exercise at home.”  And that’s what I’ve done.  Each night as we settle down to watch TV, I do a half-hour of pilates exercises and stretches with bursts of cardio worked in-between.  I still can’t say I enjoy it, but the TV provides some distraction, and it’s become an easy routine to maintain.  I also try to pick up my pace when walking throughout the day, park on the far end of a row to add more steps, take the stairs instead of the elevator or escalator, and try to carry all my groceries from the store to the car instead of using the cart.  I’ll never win a bodybuilding contest, but as long as I still fit in the jeans I bought 5 years ago, I’m happy.
  2. Yoga.  I have attended yoga sessions but, like the gym, it’s hard for me to commit, especially in the winter.  Instead, I try to work in some yoga with YouTube. In fact, my goal for January is to take the 30-day Yoga Challenge. I also work some kids’ yoga into my therapy sessions;  the breathing and stretches are great for warming up and settling down the students, and I find it relaxing for me, too, a great way to loosen the tension that I tend to hold in my neck and shoulders.
  3. Drink!  I know many SLPs who sip water all day long, an excellent habit.  I’ve never been one for drinking throughout the day (I think mainly because I rarely have time to visit the ladies room in school!), but I realized a few years ago that I really should make the effort.  I bought myself an attractive, transparent water bottle with an infuser core that I fill each morning with fresh lemon wedges (microwave the lemon for 45 seconds before cutting to get lots more juice from it), then I fill the bottle once in the morning and once in the afternoon. Being able to see my progress through the bottle has been reinforcing for me, and also reminds me that I had better start drinking to meet my noon and dismissal deadlines.
  4. Read, sew, cook, watch movies or do whatever gives you personal pleasure and satisfaction.  I absolutely must read at least a few pages every night when I go to bed, just my way of blocking out the noise of the day.  I try each weekend to do some quilting — much easier to do in the winter!  I find those dreary, cold, wintery days just fly by when I am immersed in a project, and I end up with something nice to show for it.
  5. Aim for balance.  All work and no play is no way to live!  It’s so easy to get swept up in the demands of work, family, and home.  My husband and I vowed years ago that we would schedule time for friends and each other every week.  Sometimes that means the house doesn’t get cleaned or the clothes stay in the dryer for a week.  I can honestly say that we have survived this occasional neglect, and have certainly benefitted from the social activities that we did instead.
  6. Stay organized.  Organization at home and at school is the only way I can live. I make sure that every day before I leave, my therapy table is cleared, my desk is neat, and my “to do” list is prioritized.  There’s nothing more demoralizing than walking into the therapy room in the morning and seeing a mess to deal with. (I do the same at home — bed made in the morning, dishes washed at night really helps the day start and end well for me).  How to organize is up to you, as everyone has their own style (highlighters? stickie notes? color-coded folders? charts and graphs?  all of the above?).  Just make sure it is working for you.
  7. Avoid negativity.  I learned very early in my career that, for my own mental health and well-being, I needed to avoid complainers.  I don’t for a minute mean to minimize the legitimate gripes we have with paperwork, difficult students/parents/teachers/administrators, and crazy schedules.  Those are certainly some of the issues we need to deal with on a daily basis.  But complaining about it doesn’t help, and listening to others complain only makes things worse. Pretty soon you find yourself in a downward spiral of negativity, and who needs that?
  8. Focus on the positive.  We applaud our students for their progress and give them a certificate or reward when they are dismissed from therapy, but do we stop to give ourselves a well-deserved pat on the back as well?  After all, their achievement is our achievement, too!  Celebrate accomplishments, large and small, with colleagues;  create a dismissal sticker chart and give yourself a gold star every time you dismiss a student;  toast yourself at dinner with a glass of your favorite adult beverage.  Just a few moments of basking in a job well done will have a positive effect on your outlook.
  9. Laugh more.  Watch funny movies, use jokes in therapy, have a “family fun night” of playing games with your kids, laugh at yourself instead of putting yourself down.
  10. Unplug.  We know that too much screen time is bad for kids.  Well, it isn’t great for us, either!  Make a determined effort to put down the phone or tablet, turn off the TV, set digital limits for yourself, and get involved in a hobby or community activity instead.

You are a creative, compassionate, and dedicated SLP.  You couldn’t have survived in this field if you weren’t.  So give yourself the credit you deserve and the time you need to protect your mental and physical health to get through the second half of the school year and beyond.  Nobody else will do this for you.  It’s all up to you.  Happy New Year!

Gobble, Gobble, Talk!

Thanksgiving!  A time when families come together to share a delicious meal, renew connections, and watch some football.  We’d like to think that our holiday will be Norman Rockwell perfect, but that requires navigating a bunch of hurdles, especially with kids at the table.  Following are some tips for getting kids engaged and communicating that will, hopefully, make your holiday gathering more peaceful and pleasant. (How to overcome adult differences in politics and current events is beyond me — good luck with that!)

Screen Shot 2018-11-18 at 10.23.13 AMWhile you are busy getting the dinner together, engage the kids in making treats.  Already on my list are ice cream cone teepees.  I’m skipping the cupcake baked inside the cone because (1) we’ll have enough dessert with pies and (2) I don’t have the time or oven space for baking cone-filled cupcakes.  Just the creating and decorating will be enough fun and should keep little ones busy for a while.  Here are a couple of examples that I will be combining:  Teepees 1Teepees 2

Screen Shot 2018-11-18 at 10.27.48 AMAnother treat we will make:  pilgrim hat cookies.  Simple, fun, and yummy!  (Caution:  Contains peanut butter).   Click HERE for directions.  Both the teepees and pilgrim hats would make fun and easy therapy activities, too, that hit on a number of speech and language goals:  following directions, problem-solving, making choices, describing, to name a few.

 

 

Screen Shot 2018-11-18 at 11.04.39 AMAs long as you are in a creative mood, engage the kids in making decorations for the holiday.  Give them a supply of construction paper, glue sticks, scissors, markers & crayons, and let their imaginations run wild.  For those who need some guidance, you can print out samples of finished projects and coloring pages, especially good for very little kids. Simply google “kids Thanksgiving crafts” and you’ll have more than enough activities for all ages and ability levels.  The photo to the left is from https://iheartcraftythings.com/15-terrific-turkey-crafts-for-kids.html.

Screen Shot 2018-11-18 at 10.53.05 AMInvolve the kids in setting the table.  When I worked with students in Life Skills classes, we made placemats from large construction paper, on which the students glued paper images of a plate, napkin, utensils, and a cup.  This served as a guide for them when they set their place with the real objects.  Stamps, stickers, and markers were used to decorate.  Again, think of the IEP goals (speech/language and OT) that go into a project like this!  Pictured is a premade placemat available from Amazon. It’s more elaborate than the ones we made, but it illustrates the idea.

Screen Shot 2018-11-18 at 10.58.35 AMHave a picky eater?  These plates, which my grandson calls his “course,” are fabulous for getting kids to try a little of this, a little of that, as they work toward a reward.  Amazon has them in a number of variations.  I’ve also seen them in kitchen specialty shops.

 

Screen Shot 2018-11-18 at 11.16.38 AMHave some shy guys who need some help in conversing with rarely-seen relatives?  There are a number of commercially-made conversation cards that introduce topics and questions, but you can make your own.  Be creative!  Print out the conversation starters from THIS SITE and glue them onto paper feathers or leaves.  An excellent post about this very topic for AAC users and children who need help with social skills can be found on PrAACticalAAC.org.

Screen Shot 2018-11-18 at 11.22.36 AMI hope this provides some ideas for therapy lessons and holiday prep activities that will keep the kiddos actively engaged.  Here’s one more, a freebie from my TPT store:  Fall Vocabulary Cards!  Print 2 copies on cardstock, cut apart, and use for Memory and Go Fish games.  All of the words contain the /r/ sound and the symbols are great for thematic vocabulary activities, as well!  Happy Thanksgiving!!

Sticks and Stones

Screen Shot 2018-11-10 at 9.45.31 AM“Sticks and stones may break my bones, but words will never hurt me.”  Baloney!  As experts in the field of communication, we all know the powerful effect — positive and negative — that words can have.  In fact, bullying (verbal and written) is a leading cause of depression and suicide.  Clearly, words hurt, but they can help, too.  One of the best unintended perks to come out of creating Speaking of Speech.com has been the personal connections that have formed with SLPs all over the world.  There have been times (especially the two times when I had to recreate the entire site from scratch — ugh, the memory still makes me shudder) that I’ve been tempted to pull the plug on the website.  After all, the costs in time, energy, and money to keep it going for nearly 20 years add up, and I start to wonder if the site is really worth the effort.  Without fail, I’ll get an email out of the blue from a faithful follower or someone who is new to the site, telling me just how much the site has enhanced their practice and benefited their students.  Or the emails will be a personal response to something I’ve shared about my life in my newsletter.  Those words of encouragement, gratitude, and personal connection touch me deeply, and I can honestly say that this positive feedback is the reason the site still exists.  Words are that powerful.

I recently received a message from Jeanne Kleinman Williams, M.A.CCC- SLP about the power of words, and that inspired this post.  Jeanne is a long-time follower of Speaking of Speech.com, and, although we’ve never met, she has become a dear friend through emails, messages, and Facebook posts — a relationship forged solely by the power of words.  Jeanne has acquired much wisdom and experience in her 44-year career.  Her message to me, in part, was this:  “I am committed to making children feel safe, cared for, and nurtured. It is my responsibility to establish guidelines that help them to develop confidence in themselves, respect for themselves, and to be their advocate. If along the way I also help close that achievement gap, I’ve made a real difference. We are the ones who love the children who come to school with dirty clothes, mismatched socks, who look a little bit different from others, may act a little different, and definitely have communication deficits. When you can make a middle school student feel like they are a winner, it makes me emotional. It’s all in the little nuances of how and what we say to the children, the students. When they walk out with their head held a little higher, then I, a down-to-earth woman, will advocate to the end of time, for my students. I think this is to make a point that it takes little, small words sprinkled with kindness and compassion, to make others feel like a winner.”

Jeanne makes an excellent point:  “the little nuances of how and what we say” are so critical to relationships, not only with our students, but also with their teachers, peers, and even family members, and can have influence far beyond the moment.  I’d like to believe that, as caring SLPs, we are always supportive and encouraging to our students, and that all of our students leave therapy sessions with a good feeling about themselves.  After all, “establish rapport” is the first lesson in Speech 101.  So let’s go with that assumption and think instead about the words of others and how they impact our students.  Are we doing enough to protect our students from unkind comments and even bullying related to their speech/language disorder?  Here are some eye-opening experiences I’ve had that touch on this question.

I was once pulled from my assistive tech assignment to be a short-term sub for an SLP who was out on medical leave.  When I walked into one of the special education classes, the teacher introduced me to the students and said of one girl, “this one doesn’t talk at all.  She can but she refuses to.  Come on, Susie, say something to the speech teacher.”  I don’t know whose expression was more horrified, mine or Susie’s.  This 8 year-old girl was a selective mute, and I quickly discovered that everyone in the school — specialists, the school secretary, the recess aids, and even the principal — badgered this child every day, “come on, you can talk, say something!”  Clearly, nothing had been done to educate the staff about selective mutism and to make them aware that their words were only making the situation worse.  I’d like to think the inservicing I immediately did made a difference for that little girl, but I left that position after a month and didn’t have the opportunity to follow up with the SLP, except to let her know what I had observed and what I did to help her.

An elementary Life Skills teacher with years of experience suddenly had 3 students in her class who used iPads with communication apps  — a new development in AAC at that time.  She observed that the boys stayed together and didn’t interact with their regular ed peers when included in specials, recess, etc.  We took a good look at the vocabulary on the devices and realized that (1) the vocab didn’t really lend itself to age-appropriate social interactions and (2) the boys needed to be taught how to engage with their peers.  Creative juices flowed and the devices were made much more conversational.  The teacher created dialogues and word games that got the kids talking, and even elicited suggestions on topics and expressions from the regular ed peers, which immediately invested them in the AAC.  She invited each 4th grade class to visit her room for a demonstration of the AAC;  she explained how and why the boys used this technology, then had the boys answer questions from their peers.   It didn’t take long before new friendships were formed and the boys were viewed by their peers (and other staff) in an entirely different light.  Again, the power of words — the words the boys used on their speech-generating devices, the words the teacher used to educate their peers.

I was recently assigned to a new school and held my first preschool transition IEP with parents and a wonderful kindergarten teacher.  The incoming student had multiple articulation errors, not all of which were developmental.  I explained to the parents the nature and severity of the errors, described what the articulators needed to do to correct production, and gave examples of how I was going to cue the student to elicit those sounds.  When the parents left, the kindergarten teacher said that she learned more about speech production in that IEP meeting than she had in her 30+ years of teaching, and asked if I would please do an inservice for all K-1-2 teachers. It was clear that she gained a new respect for just how hard these speech students have to work to correct their sounds, and now felt more empowered to support them in the classroom.  I was happy to share with her a copy of my children’s book, “The Mouth With a Mind of Its Own,” which I had written several years ago to make this very point.

I could go on and on…..classroom presentations to acquaint peers with hearing aids, teaching sign language to peers of deaf students included in regular education classes, educating parents and teachers about voice disorders and speech dysfluency, creating a functional curriculum for high school students in Life Skills and Multiple Disability Support classes that built relationships about the school with peers and staff.  All exemplify the power of words to educate, enlighten, and encourage not just our students, but also the adults and peers with whom they interact.  Speaking to Jeanne’s point about how our words affect how our students feel about themselves, I was tagged on a Facebook post by the mother of a young boy who stuttered.  We had worked for a couple of years in elementary school on fluency-enhancing strategies and also on acceptance of stuttering.  Her post was a video of him in middle school giving a presentation to his class, proudly and confidently.  Her tag said “he never would have had the confidence to do this without your encouragement and instruction.”  Wow, my words made a difference in this young man’s life, and his mom’s words brought me to tears.

For a first-person account by a parent on struggles with words, read “My youngest isn’t just quiet, he has a serious speech disorder.”