Then life threw a curveball, and I resigned from the schools.  I ended up taking a position with a teletherapy company and providing services to various schools.  I was hesitant at first, but after working as a teletherapist for six months, I can say I completely LOVE it!

Comfort

Need I say it? Yoga pants!!!  Business on top, (slumber) party on bottom, am I right?!!  I had a 40 minute, each way, commute before, now I walk down the hall to my office.  I can run to the bathroom or to get a coffee refill or a snack whenever I need.  And have I mentioned no boogers on my stuff?!  I haven’t had a sick day from any child-borne illnesses so far!

Variety

Not all teletherapists have the variety I do, but I have students ranging from mild middle school students to non-verbal kindergarteners.  I enjoy the different caseloads, although it does mean a bit more prep as there is more diversity in goals and materials.  In the morning I get to talk about animal sounds, and in the afternoon I get to teach /r/, and the next day I’m teaching a great short story to work on language skills.

Use of Time

When I worked in the schools, a good part of my time was spent doing duty, attending teacher meetings, filling out paperwork required by the district, completing screenings I was unable to take any action on, performing before or after school requirements such as parent-teacher meetings whether or not I actually had any parents wishing to meet.  Since I was on a contract, I was paid by year, and these times were all under a blanket “duties of the position” statement.

As a teletherapist, I am paid for indirect time as well as direct time.  This differs somewhat from one teletherapy company from another, but from my, admittedly limited, experience, this is typical.  I only attend meetings that directly affect my students.  I feel like I am able to return back to my actual occupation!

Freedom of Scheduling

Along the same lines, I get to draw the lines of my schedule.  I don’t want to work past three?  Then I say I’m not willing to.  I only want to work 30 hours a week?  Then that’s what we shoot for.  I’ve also found that the schools that I work with are more willing to work with me as far as scheduling than I experienced when I worked in a district.  Perhaps I’m just in a sweet spot?  Time will tell.  But I’m loving it right now!

Less Drama

All those powerplays that you couldn’t keep out of in the schools are far less apparent as a teletherapist.  Because we aren’t physically there, we don’t hear the conversations in the halls or the teacher’s lounge. It’s much the same as being at a school part time, where you see your handful of kids and leave.  This, for me, was a fantastic load off my shoulders, because that kind of conflict stresses me out – and there was always someone who was running to me complaining about something.  Now, this can be a drawback as well, especially if you thrive on those connections.  But you can also make connections with your team of teletherapists.

Efficacy of Therapy

Now, do I think I can do therapy as well through a computer as I can in-person?  Yes!  Now, that being said, there are, of course, some caveats.  The method of therapy should be considered for each client just as the time, length and frequency of therapy should be considered.  Often, as my younger students have, a facilitator may be present to aid the client in attention and accessing the technology. 

Other clients may need a different service model that is more of a parent training model.  A setup that includes a separate camera that shows the student’s AAC device so you can see their key presses, or other modifications might be necessary.  With flexibility and creativity, there really is a lot more you can do in teletherapy than you ever thought!

Drawbacks

Ok, yes, I miss the goodies in the teachers’ lounge.  And I REALLY miss the hugs and actually seeing my kiddos.  Sometimes, it is challenging when I have a student that just can’t get a specific speech sound…but I’m not sure being in person would help that either.  Tech issues can be frustrating, when the microphone isn’t catching a nuance of sound or the connection isn’t good.  But there were also times when the hallway outside my room, or the room beside my room, or the restroom beside my room, were so loud that I had trouble then too.  So I might be comparing apples and oranges there.

I’m not necessarily writing this to convert any of ya’ll from in-person therapists to teletherapists, but definitely, should it come to you, don’t be afraid of it.  It could be your next great thing!

If you want to know more about teletherapy, or the company I contract with (starting on my third year with them), feel free to reach out!

If you are interested in the topic of teletherapy, you might also be interested in my comprehensive guide, “So You Want to Be a Teletherapist.” It covers all these topics and more, including setting up your workspace, navigating legal documents like BAAs, and building a secure and efficient digital practice from the ground up!

Until next time, keep on clicking, my e-speechies!

Social Media Icons: designed by rawpixel.com – Freepik.com

The post Why I Love Being a Teletherapist: From Skeptic to Superfan appeared first on Mrs. Speech Online.

Feeling overwhelmed by IEP meetings and juggling multiple speech therapy goals? You’re not alone! This blog post dives deep into the world of strategic planning. It offers tips and tricks to maximize student progress and transform your therapy sessions. Here, we’ll explore the concept of yearly initiatives. This powerful approach can streamline your planning and supercharge your students’ learning.

Streamlined Goal Setting with Yearly Initiatives

Traditionally, we’ve used cyclical approaches for phonological processes. But have you considered extending this idea to encompass broader language development? This post explores the magic of yearly goal initiatives. It involves choosing a specific language area you focus on for the majority of your caseload throughout the year.

Here’s why yearly initiatives are a game-changer:

• Deeper Dives: Focus on crucial areas like problem-solving, inferencing, prefixes/suffixes, defining/describing, or comprehension instead of broad or multiple themes. This allows for a deeper dive and more impactful therapy.
• Cohesive Learning Journey: Focusing on one area creates a cohesive and effective learning journey for your students. This ensures all activities build upon each other.
• Research-Backed Benefits: Studies on spaced repetition show that distributing learning over time with focused practice sessions leads to better long-term retention.¹ This aligns perfectly with yearly initiatives. Students engage with a key skill throughout the year, solidifying their understanding and building strong memory pathways.
• Myelination Matters: Research on myelination suggests that repeated practice strengthens the connections involved in a skill.² The focused sessions encouraged by yearly initiatives can promote myelination. This increase the speed and efficiency of processing the targeted skill.

Individualization Within the Initiative

While your yearly initiative guides your planning, you can certainly individualize goals within it. This might include:

• Adjusting difficulty levels (e.g., percentage accuracy, task complexity)
• Tailoring prompting strategies (frequency, type)
• Shifting focus (utilizing similar materials for other purposes)
• Utilizing individualized rubrics for assessment

Example: Let’s say your yearly initiative is problem-solving.

• Joe: Focuses on identifying problems in longer stories, creating multiple solutions, and predicting outcomes.
• Jane: Needs visual aids and shorter stories to identify problems and may require prompting to create solutions. Uses the same rubric as Joe.
• Carl: Works on explaining solutions with appropriate pragmatics and grammar. Also provides a model for higher level problem-solving for the other students.

Sample Yearly Initiatives:

• Problem-Solving (social and safety scenarios, sequencing, predictions, wh-questions)
• Inferencing & Context Clues (predictions, character traits, vocabulary, multiple meaning words, non-literal language)
• Prefixes & Suffixes (vocabulary building, context clues)
• Defining & Describing (categories, antonyms, synonyms, multiple meaning words, inferencing, forming wh- questions, vocabulary)
• Comprehension (wh- questions, main idea, summarizing, story arc, sequencing)

Finding the Perfect Balance: Goals and Efficiency

Now, let’s talk about IEP goals. Most language students require at least two therapy goals. However, bombarding them with too many can be counterproductive. This aligns with Cognitive Load Theory, which suggests that overwhelming working memory with excessive information or tasks impedes effective learning.³

Here’s a good rule of thumb: Limit to 2 or fewer goals per 30-minute/week on the IEP, unless the skills are quick to learn or complement each other (e.g., identifying story elements and summarizing).

5 Goals is the High End: Prioritize focus! With fewer goals, progress accelerates. You can always add more goals later if students master their current ones.

The Power of Focused Sessions: Deep Learning vs. Superficial Exposure

Imagine an orchestra. Are you more likely to learn the music if you spend 5 minutes on each song, or dedicate focused sessions to mastering one at a time? The same principle applies to language therapy.

• Deep Learning: By dedicating 3-6 sessions (1-3 weeks) to a single goal, you allow students to truly grasp the concept. They build strong memory pathways.
• Data Collection Made Easy: This focused approach simplifies data collection. Collect data at the beginning, end, and potentially during the middle of a longer cycle. This helps document progress and regression (critical for ESY services). Create a rubric or data probe usable throughout the year for consistent data collection across multiple students.
• Elaboration for Long-Term Learning: By dedicating 3-6 sessions (1-3 weeks) to a single goal, you allow students to truly grasp the concept and build strong memory pathways. This helps them apply their learning to different contexts. This deeper understanding, fostered by elaboration, is crucial for long-term skill development.⁴

A Personal Discovery: The Unexpected Benefits

This concept wasn’t something I initially planned. In grad school, I was taught to cover each goal every session. It left me feeling overwhelmed! About 10 years ago, after taking a course on executive functioning, I noticed many of my students struggled with these crucial skills. Naturally, the focus of their IEP goals shifted to address these deficits.

The unexpected result? A year-long focus on problem-solving! This unintentional initiative highlighted the importance of these skills and created a cohesive therapy journey for my students. All activities built upon each other, addressing their specific needs. Interestingly, the collaborative environment fostered unexpected benefits. Students seemed to learn from each other’s problem-solving strategies, creating a more engaging atmosphere.

Planning Efficiency and Deeper Learning: A Win-Win

The impact wasn’t limited to student learning. My own planning became much more efficient. Therapy materials were readily available, student goals were clear, and data collection was streamlined. We weren’t constantly switching gears – we were all focused on mastering the same core skill, allowing for deeper learning and richer student interaction.

This experience truly solidified the power of yearly initiatives in my therapy sessions. It’s a framework I wholeheartedly recommend to any speech therapist looking to maximize student progress, lesson planning, and create a more cohesive learning journey.

But It’s Not Perfect: Considerations for Yearly Initiatives

While I’ve witnessed the positive impact firsthand, and some research supports this approach, there are limitations to consider:

• Limited Research: While studies on spaced repetition and myelination offer some support, more research is needed to definitively establish yearly initiatives as “evidence-based.”
• Individualized Needs: Yearly initiatives may not be suitable for every child on your caseload. Consider developing two initiatives targeting different areas of language for diverse needs.
• Stimulus Material: Because you’re focusing on the same skill, you’ll need a variety of engaging activities and materials to keep things fresh for students. The upfront investment in creating these materials may be higher than with a constantly rotating set of goals.
• Medicaid and District/State Requirements: If you are required to address every goal or need percentages to report for every session, you may have to revise or take time out of the initiative cycle to fulfill these requirements.

Despite these considerations, yearly initiatives offer a powerful framework for planning and delivering effective speech therapy. By incorporating these tips and acknowledging the limitations, you can explore how yearly initiatives can benefit your students and streamline your practice.

Ready to Transform Your Therapy Sessions?

Download our free guide on TPT:  Yearly Initiative Template This downloadable resource provides a guide to help you implement yearly initiatives in your own practice.

Take Action!

Leave a comment: Share your thoughts and experiences about yearly initiatives! Has this approach transformed your therapy sessions?

By incorporating yearly initiatives and focusing on deep learning through focused sessions, you can maximize student progress and transform your speech therapy sessions!

Social Media Icons: designed by rawpixel.com – Freepik.com

References:

1. Cepeda, N. J., Pashler, H., Vul, E., Wixted, J. T., & Rohrer, D. (2006). Distributed practice in verbal recall tasks: A review and quantitative synthesis. Psychological Bulletin, 132(3), 354–380. https://doi.org/10.1037/0033-2909.132.3.354 ↩︎
2. Fields, R. D. (2008). White matter in learning, cognition and psychiatric disorders. Trends in Neurosciences, 31(5), 268–277. https://doi.org/10.1016/j.tins.2008.04.001 ↩︎
3. Sweller, J. (1988). Cognitive load theory, learning difficulty, and instructional design. Learning and Instruction, 1(1), 53–62. ↩︎
4. Bjork, R. A. (1994). Memory and metamemory considerations in the training of human beings. In J. Metcalfe & A. P. Shimamura (Eds.), Metacognition: Knowing about knowing (pp. 185–205). MIT Press. ↩︎

The post Secret to Streamlined Therapy: Yearly Initiatives for Maximum Impact appeared first on Mrs. Speech Online.

Less is More: Spacing Out Data Points

Data collection shouldn’t dominate every therapy session. Think of it as a progress report, not a live feed. Leave room for teaching and practicing new skills before measuring performance.

Consistency is Key: Setting the Stage for Meaningful Data

Data only tells a story if it’s collected under similar circumstances. Here’s how to ensure your data paints an accurate picture:

• Baseline Before Takeoff: Always collect data at the beginning of a session, before any specific training takes place. This establishes a baseline of the student’s current skills.
• Data Probes: Your Unsung Heroes: Develop consistent data probes for each goal. These probes should directly assess the specific skill you’re working on and be age-appropriate for the student.

Crafting Powerful Probes: What to Consider

Here are some key elements to consider when developing effective data probes:

• Target the Goal: Ensure your probe directly assesses the specific skill you’re working on
  increasing. Don’t phrase it in terms of decreasing a deficit.
  • For example, instead of saying “Decrease the phonological process of stopping,” a more positive phrasing would be “Increase the student’s ability to produce fricatives.”  I’ve gotten some worried phone calls from parents who see the graph rapidly decreasing!!
• Age Appropriateness: Consider the student’s age and developmental level. A picture card probe might be appropriate for younger children working on articulation of /b/. In contrast, older students practicing narrative skills might handle a written story prompt better.
• Multiple Forms: If possible, develop probes in multiple formats (pictures, written words, real-life scenarios). This approach assesses a skill from different angles and reduces the chance of memorization affecting results. For example, a student working on vocabulary might be shown a picture of a banana and asked to name it. Then later describe it using simple adjectives in a sentence.
• Error Analysis: Design probes that allow you to analyze the types of errors a student makes. This can provide valuable insights into their specific challenges and areas for intervention. For instance, a probe assessing a student’s ability to follow two-step directions might involve asking them to “Touch your elbow and then hop on one foot.” Observing if they complete both steps in the correct order or struggle with a specific part helps tailor future therapy sessions.

Examples of Goal-Probe Partnerships:

Let’s see how these principles translate into practice:

• Goal: Improve articulation of the /p/ sound in single words.
• Probe: A list of 10 words containing the /p/ sound at the beginning (e.g., “pan,” “pig”), middle (e.g., “apple,” “happy”), and end (e.g., “cup,” “hop”) of words. Note the number of correct productions and any specific errors made (e.g., substitutions, omissions).

• Goal: Increase expressive language skills by using synonyms in sentences.
• Probe: Provide the student with a sentence with a blank space (e.g., “The dog is very _____ today”). Offer a list of synonyms for the missing word (e.g., happy, joyful, excited) and see if they can choose and use the appropriate synonym in the sentence.

Embrace the Nuance: Moving Beyond Pass/Fail

Data shouldn’t be a simple yes or no. When possible, use rubrics or detailed observations to capture the nuances of a student’s progress. This provides a richer picture of their strengths and areas for development. For example, instead of just marking articulation attempts as correct or incorrect, note if the sound was produced accurately for the first time, required multiple tries, or needed specific prompting.

Feeling overwhelmed by creating rubrics? Don’t worry! In our next blog post, we’ll delve into the world of rubrics, providing step-by-step instructions and helpful examples to make crafting these powerful tools a breeze: Mastering the Art of Measurement: A Guide to Creating Rubrics in Speech Therapy (with Bonus Example!).

Let’s Chat!

Have questions or success stories about data collection in speech therapy? Share them in the comments below!

Social Media Icons: designed by rawpixel.com – Freepik.com

The post Making Data Meaningful in Speech Therapy: How Often, When & Why appeared first on Mrs. Speech Online.

They can offer invaluable perspectives from parents, teachers, and even the students themselves, giving you a much richer and more comprehensive understanding of their communication skills across different environments. Let’s dive into why these tools are so powerful and how you can effectively use them!

Why Rating Scales are Your Secret Weapon

Think about it: we often see our students in a specific setting, be it a quiet therapy room or a structured testing environment. We have those crucial standard scores. But how do they communicate in the classroom? At home? With their friends?

Rating Scales bridge this gap, providing insights into real-world communication in various contexts. They’re especially golden for those communication skills (or deficits) that might not always shine through during formal testing – and you get it without overwhelming the student with lengthy testing. This is where your experience as an SLP moves beyond giving a rote test.

Questionnaires/Rating Scales can be used to:

• Guide an evaluation or demonstrate the need for an evaluation
• Generate a discussion about speech/language skills
• Develop child-centered, functional goals
• Track progress over time
• Identify areas of most need
• Provide insight on communication in different environments

Important Note: Rating Scales should NOT be used as the sole diagnostic tool for speech or language disorders. However, they can easily demonstrate the need for related services as well as change over time.

Choosing Wisely (or Creating Your Own Magic!)

Selecting the right questionnaire is key, and of course, age-appropriateness is the name of the game. While finding that perfect age-specific tool can sometimes feel like searching for a unicorn, don’t despair! Even broader questionnaires can be helpful in painting a picture of the “end goal” and where our students currently stand in relation to it.  “Questionnaire” is an umbrella term that usually signifies open-ended questions, but rating scales are super useful because the response forms are limited, and therefore easier to compare.

Speaking of unicorns, I’ve found my own ‘Student-Centered Articulation & Fluency Scales’ to be incredibly insightful for student-centered evaluations. Giving students a voice in their evaluation can be so empowering and provide a unique perspective on their own communication experiences.  A time-saving Reporting Tool is now available for both scales!

For example, with stuttering, a student’s feelings about their speech can be the crucial factor that differentiates a mild presentation from one perceived as moderate or even severe. It can also highlight students who, despite ongoing stuttering, feel they’ve gained the necessary tools from therapy versus those whose negative attitudes indicate a need for more intensive intervention. 

I even have specific versions for articulation and fluency to tap into these nuanced self-perceptions in different areas of communication. This self-awareness piece is so vital and can significantly inform your clinical decision-making.  I’ve also thrown in a short, 10 question check-in scale for both articulation and fluency, for more frequent use.

Make your own rating scale!

And don’t underestimate the power of adapting existing rating scales, or turning a questionnaire with open-ended questions into a rating scale! Take something like Orion’s Pragmatic Language Skills Questionnaire – a simple tweak of adding “as compared to peers” to the questions can make it even more relevant and help raters focus on those crucial peer comparisons.

If you’re feeling creative, designing your own informal questionnaires can be incredibly rewarding. When doing this, consider these tips:

• Look at existing questionnaires, developmental milestones, or curriculum standards to get a feel for the skills and areas typically covered.
• Keep your rating scales concise – no more than four levels is usually best.
• Frame your rating scale in terms of ‘level of concern’ (rather than ‘always/never’) to encourage direct peer comparison.
• Ensure your top ratings reflect typical peer performance, not perfection.
• Maintain consistency in your chosen scale (e.g., 0 = no concern, 4 = high concern).
• Ensure all questions are easily understood by parents and teachers.

Finally, a quick but crucial note on published questionnaires: always double-check if they are free to reproduce, or make sure you purchase the rights to use them. We want to be ethical SLPs!

Handling the “Not Applicable” Headscratcher

We’ve all been there – a question on a questionnaire that just doesn’t fit the context. If you allow for a “Not Applicable” response (which I highly recommend!), here’s my simple approach: if a respondent marks a question as not applicable, I simply adjust the total number of rated items. For example, if there are ten questions and one is marked “N/A,” I calculate the overall score based on the remaining nine. Easy peasy!

Keeping It Peer-Focused

Finally, when you’re asking respondents to rate a child’s skills, it’s so important to emphasize the “compared to peers” perspective. Make sure your instructions clearly state that they should be thinking about how the child’s communication skills stack up against those of their same-age peers. This helps to provide a more meaningful and relevant comparison.

In Part Two, we dive into how to effectively present and interpret the valuable data you gather from questionnaires in your reports!

Freely Available Questionnaires and Rating Scales

1. Orion’s Pragmatic Language Skills Questionnaire (PDF): This is a widely shared questionnaire for screening pragmatic language abilities. I’ve made it into a fillable form for free on my TeachersPayTeachers store.
2. Early Childhood Speech and Language Assessment – Speech and Language Assessment Scale (PhenX Toolkit): Find it at https://www.phenxtoolkit.org/protocols/view/200302. The PhenX Toolkit offers various measurement protocols, including this one for early language.
3. Intelligibility in Context Scale (ICS) (PDF): Accessible via https://cdn.csu.edu.au/__data/assets/pdf_file/0010/399970/ICS-English.pdf. This parent-report scale helps understand a child’s speech clarity in different situations.
4. Speech Assessment and Analysis in Conversation (SPAAC): Located at https://www.csu.edu.au/research/multilingual-speech/speech-assessments/spaa-c. This tool focuses on analyzing speech within conversational contexts.
5. NESC Resources – SLP Tools: Visit https://nesc.k12.sd.us/resources.html#slp for a broader list. Be sure to check out the sections dedicated to Autism and Social Skills for more relevant questionnaires.

Social Media Icons: designed by rawpixel.com – Freepik.com

The post Unlock the Power of Rating Scales in Your SLP Evaluations: Part 1 – Value and Use appeared first on Mrs. Speech Online.