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!

The Tax Man Cometh: Make the Most of Your Hard-Earned Cash!

imagesTax time can really take the zing out of Spring!  While I don’t have any magic words to make taxes go away, I can give some advice on how to make the most of your hard-earned cash.

  1.  For the past several years, the IRS has allowed educators to take a $250 deduction for unreinmbursed teaching expenses.  Here are the details:  Educator Expense Deduction.  Of course, you’ll always want to check with your accountant about this.  And save your receipts!
  2. I have been using Ebates as my starting point every time I shop online for goods, services, and travel. Then, when my Big Fat Check arrives, I put that $$ toward therapy supplies.  This is so easy to do, and it is amazing to see how many stores and other companies participate in this.
  3. I just learned of a new program that gives rebates for online shopping:  Giving Assistant.  Like Ebates, you earn cash back on your online purchases.  A bonus with Giving Assistant is this program’s social mission.  For every qualifying purchase you make, Giving Assistant will donate a meal to Feed America.  In addition, if you don’t need the rebate $$ for therapy supplies, you can designate all or a percentage of your rebate to be donated to the charity of your choice — a very easy way to provide ongoing support to worthy causes that are important to you.  Check out the “Thoughts” page of the site to read about lots of ways college students can earn cash back — I had no idea! giving_assistant_hero
  4. Once I have my rebate money in hand, I shop Zulily for therapy materials.  This can be hit or miss, as the participating businesses and their offers change frequently. A search of “education” or “toys” will usually turn up something useful and interesting but you’ll really hit the jackpot when “Super Duper Publications” is offering their materials at 45% off.
  5. Obviously, TeachersPayTeachers is a great source of inexpensive materials.
  6. I always shop for puzzles, games, toys, and books at yard sales, rummage sales, and thrift stores.
  7. Arrange a swap meet with other SLPs and teachers.  Exchanging books, toys, and games costs nothing and will give the students something new to use.
  8. Make your own materials.  Yes, this takes some time, but using an inexpensive game generator like Lesson Pix allows you to customize materials to your students’ needs.  Spend a professional development day with colleagues and then share what you’ve made!
  9. At absolutely no cost to you:  FREE materials on the Speaking of Materials Exchange!!  If you haven’t scrolled through there in a while, it is worth another look!
  10. And you know, a creative SLP will never walk out of the dollar store empty-handed.

Listen up!

In my career, I’ve known all kinds of listeners:  some who take in all of the message, some who only get part of it, and others who need multimodality support to attend and process.  Personally, the auditory channel is not my best way to take in information.  I need to hear the message more than once to recall the details, have the auditory combined with visual input, or I write it down.  Fortunately, I was well taught in the art of note-taking in elementary school so that my notes were salient and well-organized.  Note-taking not only provided me with a useful written account of the verbal information that I could review over and over as needed, but also helped me to stay on task and fit the information immediately into a schema, which increased my understanding from the get-go.

Graphic organizers abound for gathering all kinds of information.  But before we can teach the skills of winnowing out main ideas and supporting details, separating what is important from what is not, and linking new information to prior knowledge, we first have to get the student to attend.  For years, I’ve used “Whole Body Listening” prompts based on the work of Susanne Poulette Truesdale.  And apparently, I’m not the only one.  A quick search on Teachers Pay Teachers produces a long list of materials based on this strategy.

Screen Shot 2019-04-01 at 3.48.51 PMI love to use books in therapy whenever possible because they combine the auditory with the visual, and engage the students in the topic through stories.  Imagine how happy I was, then, to find these two illustrated children’s books by Kristen Wilson and Elizabeth Sautter:  “Whole Body Listening Larry at School!” and “Whole Body Listening Larry at Home!”  Both books begin with an explanation to adults about the conceptual basis of using one’s whole body — head to toe — to increase attention through sensory integration, executive functioning, and perspective-taking.  This is followed by suggestions on how to use the book to encourage understanding, self-awareness/control, and functional strategies for self-advocacy in listening situations, plus accommodations that can be tried with students who are especially challenged in this area.  The story ends with a section on how to teach and implement Whole Body Listening throughout the day with preschool and elementary school students, and includes a coloring page handout to further engage the students.

In the school-based book, twins who are new to the school do not display characteristics of good listeners;  indeed, they sometimes interfere with their classmates’ ability to listen.  In an effort to help them learn the rules of the school, Larry politely points out how they can listen better and distract others less by active and passive use of their body parts.

In the home-based version, Larry helps his younger sister learn to use Whole Body Listening strategies to be a better communication partner with family members and friends.  As in the school-based book, this home version contains information and strategies for parents.

The story lines are simple, the illustrations are engaging, and the approach to Whole Body Listening is consistent.  The authors even weave in elements of Michelle Garcia Winner’s Social Thinking to help students understand what others are thinking when they do (or don’t) apply Whole Body Listening strategies.  I love that there are two versions that can be used simultaneously to encourage carryover and generalization.  The fact that parents and teachers will be using the same vocabulary and prompts will surely help young children internalize the expected listening behaviors.  Once students have improved their ability to listen, the work on processing and recall can begin.

One caveat to keep in mind:  I have had students for whom looking at the speaker is actually a distraction for them.  I remember one little guy in particular who was continually being prompted by the teacher to “look at me, look at me” when she was reading books to the class and giving directions.  We instituted a 10-question, multiple choice with symbols follow-up quiz after each weekly story that I read as part of their classroom therapy.  The scores went up on all of the students over time, except for the little guy who was getting frequent prompts to pay attention.  The teacher and I decided to ignore his looking at the ceiling or the pattern on the rug to see if that made a difference.  Lo and behold, it did!  When left to look wherever he wanted, he actually took in more information than when he was prompted to “use his eyes to listen.”  This is just another reminder that children have different learning styles, and the wise educators will tune into and accommodate for those differences.

“Whole Body Listening Larry at School!” and “Whole Body Listening Larry at Home” are available through Make Social Learning Stick!

What does that mean??

Some years back, my son moved to Brazil to marry a lovely Brazil college professor.  During his time there, my son became fluent in Portuguese, and this became my grandson’s first language.  When little Miguel was 2 years old, my son started exposing him to English in preparation for their planned move to the US a year later.  When Miguel arrived here at age 3, he had some conversational English, but Portuguese was still his go-to language.  One of the first things I taught him was to ask, “what does that mean?” when encountering unfamiliar vocabulary.  Now he is nearly 6 years old and his language skills are off the charts, mainly because parents and grandparents speak to him in an adult-like manner and read to him constantly (his favorite activity).  He has a deep love for words and is always happy to learn new ones.  Here’s an example of a recent conversation as we walked home from the bus stop;  mind you, he does know what some of the words mean but enjoys playing this as a game.

  • Me: Miguel, I have a proposal for you.
  • Miguel:  What’s proposal mean?
  • Me: It means a suggestion.
  • Miguel: What’s a suggestion?
  • Me:  It’s an idea I want you to consider.
  • Miguel:  What’s consider mean?
  • Me:  It means to think about something to see if it is a good idea or not.
  • Miguel:  Oh, so you have an idea you want me to think about, like “I propose that we go to the Crayola Factory!”

Bingo!  By encouraging Miguel to ask for definitions, by using vocabulary and reading books that are above his age level, and by making word-play (puns, riddles, knock-knock jokes) fun games that we play, he has become a very competent speaker of English and has learned a very useful strategy for life-long learning:  if you don’t understand something, ASK!

product_wad_Storyteller_s-Word-a-Day-three-assembled-illustration-and-facts_900xI recently purchased a stand-up book for Miguel from called “Storyteller’s Word a Day.”  The book is kept on an end table in the living room and is the first thing Miguel goes to when he comes over.  A recent word was “incessant.”  After we reviewed the meaning, he told me that they had a fire drill that week and the alarm was incessant.  Then he flipped back a few pages to another word and said, “It was this, too — grating!  The noise was incessant and grating!”   Pretty good carryover for a kindergartener, don’t you think?

This book would be ideal for SLPs to use in school, as there are words for every day from September to May.  Each page has a cartoon drawing depicting the meaning, the word, the definition and part of speech, and an easy to understand example.  (That’s as far as I go with Miguel right now).  For those who are really into words, the back of the page provides etymology, word pairs, synonyms, frequency of use, and a story starter.  Wow!  Just think of how many IEP goals you can hit with this!  “Storyteller’s Word a Day” is designed for ages 6-13, making it ideal for your middle-grade language students. Also available through this website are a similar book for 3-6-year-olds and an illustrated dictionary.  All use colorful, humorous cartoons to bring the words to life.

While this book is new to me, the strategy of teaching students to ask goes way back in my career when I developed a game I call “Hit or Miss” for my language students.  I realized that reading comprehension issues are often related to vocabulary deficits AND the student’s tendency to read the word fluently but never stopping to figure out the meaning.  I liken this to the students as Swiss Cheese reading:  they are solid on a lot of the words but they do have some holes that can greatly affect their comprehension.  The “Hit or Miss” game goes like this:  As a student reads aloud from his textbook or grade-level library book, he is to stop and ask the definitions of any unfamiliar words and earns a point (a “hit”) each time he does that.  If he doesn’t stop at a word that I suspect might be unfamiliar, I will stop him and ask for the meaning.  If he does know the word, he gets another point.  If he doesn’t know the word, that’s a “miss” and I get the point.  After the first session or two, the student nearly always wins because he has learned to ask for help when he needs it.  I’ve shared this strategy with their classroom teachers, who have then used it in small group reading instruction — ideal carryover support!


Make Social Learning Stick!

When I was getting my Bachelor’s and Master’s degrees in Speech/Language Pathology, social skills were not mentioned in the context of young children, only in terms of functional life skills for adults with aphasia.  Of course, that predates the rise of autism spectrum disorders.

Early in my career, students with social skills issues were referred to the guidance counselor or school psychologist.  Gradually, students with these needs were moved to the SLP, which left some of us scrambling for materials and strategies to use in therapy.  Enter Michelle Garcia Winner with her books and presentations on “Social Thinking” and Carol Gray’s introduction of “Social Stories.”  Whew!  Now we had published materials to guide us into this new phase of therapy.

Since then, a great deal of research has been done in the areas of social skills, executive functioning, and behavior.  In common use in schools today are “the Incredible 5-Point Scale” (Kari Dunn Buron), “Zones of Regulation” (Leah Kuypers), the “SCERTS Model” (Emily Rubin), and “Integrated Play Groups” (Pamela Wolfberg), to name a handful of research- and evidence-based resources available to SLPs, teachers, and parents.  Still, we recognize that our students have very complex and diverse needs.  We can’t count on a “one size fits all” approach;  therefore, we often find ourselves cobbling together elements of various strategies and that, in itself, can be daunting.  After all, social skills don’t only happen in the therapy room.  Students need to be able to apply learned skills in a wide variety of settings, with a wide variety of social communication partners.  This generalization requires educators and caregivers to work closely together in support of the student.  And while SLPs and teachers now receive training in social skills, parents do not.

Screen Shot 2019-02-24 at 11.45.07 AMTo answer this need, Elizabeth A. Sautter, M.A., CCC-SLP, pulled together the best practices outlined by the above-mentioned authors to create an amazing resource for educators and caregivers to support social and emotional competence and participation by simplifying targeted needs of “following directions, thinking about others, being flexible, reading nonverbal social cues, working in small groups, participating in conversation, advocating for themselves, seeing the ‘big picture,’ and making friends.”  Her book, “Make Social Learning Stick! How to Guide and Nurture Social Competence through Everyday Routines and Activities,” is a must-have for anyone supporting young children with these needs.  This well-organized and illustrated book is divided into three sections:  At Home, In the Community, and Holidays and Special Events.  Each of the nearly 200 daily routines is distilled onto a single page to help the adult guide the child through observation, critical thinking and decision-making, recognizing social cues, understanding expected behavior, and active participation and interaction with adults and peers.

IMG_1187Each page presents “Hidden Rules”:  those unstated social contracts and expectations that are often missed by students on the spectrum. Scattered throughout are examples of “job talk,” modifications in how adults speak to children that result in more active participation.  Additionally, social learning vocabulary is italicized;  this helps all adults to be consistent in the words they use with the student.  The book ends with an extensive resource list, visual supports, sample narratives, and a great list of recommended games and social activities for after school and weekend play dates and family interactions.  At $21.95, this comprehensive book from AAPC Publishing is an affordable resource for all team members, and that is the key to carryover.

Be sure to visit Elizabeth A. Sautter’s website.  There you will find two children’s books about Whole Body Listening Larry, her blog, her events/presentations schedule, and additional resources.  Sign up for her free e-newsletter to keep abreast of useful information in the field of social learning.