Sunday, April 9, 2017

Call Me What You Wish

I am a Speech-Language Pathologist to my speech department and to my former grad school professors and to New York state.

I am a Speech Therapist to the families of my students.

I am a Speech Teacher to my administrators and to the teachers who I work with.

I am Speech to my students who are verbal.

I am an eye gaze and a smile to my students who are not.

I am the person who treats your child as their own, who wipes their nose, wipes their eyes, wipes their mouth.

I am the person who spends hours upon hours working with your child to help them learn how to play, how to listen, how to speak or sign or use communication devices.

Call me what you wish, because it will not change who I am or what I do or how I do it.

Thursday, March 23, 2017

15 Red Flags that your Student may have an Undiagnosed Hearing Loss

So often I hear people describing their students, and their students'  challenges, and I become concerned that their student may have a possible hearing loss.  For SLPs who do not specialize in children with hearing loss, or who do not see this population on a regular basis, it is so easy to confuse the signs of an undiagnosed hearing loss with that of a language disorder.  Students who have special needs (autism, down syndrome, cerebral palsy, etc) may be at a higher risk for going long periods of time without having their hearing loss identified because a delay in language development can easily be blamed on the diagnosis that they already have.  Hearing loss is time sensitive, and if your student does have a hearing loss, it is imperative that we help identify it as quickly as possible so that the gap between them and their peers in terms of articulation or language does not continue to grow.

Here are 15 red flags that your student MIGHT have an undiagnosed hearing loss.

1. Child is not responding to their name
2. Child does not turn or react to loud noises
3. Child is omitting the /s/
4. Child is omitting /f/
5. Child is omitting morphological markers.  What do I mean? Plural -s, possessive -s, past –ed
6. Child omits function words (remember these are the little words like: and, in, on, the)
7. Sounds robotic- poor intonation/rhythm in their voices
8. Confusing /n/ and /m/ in speech
9. Poor volume modulation
10. Looks like they have poor attention
11. Don’t socialize well in noisy environments
12. Difficulty following directions – be careful, these are the students who may appear good at following routines and will assume the directions you give are part of that routine 
13. Frequent ear infections – Are they frequently rubbing their ears, are their ears red inside (use your iPhone flashlight to look), is their discharge from their ears?
14. Family history? Do you have their sister in speech and she has hearing aids?
15. Do they understand you less when your back is to them?

Bonus red flag to look out for -> Does your student omit the final sound of words?  Often people assume this is the phonological process of final consonant deletion.  Please note, that the final sound of words is often omitted by students with hearing loss because these sounds are less acoustically salient, and thus perceived less often. 

 "Oh no, Lauren! My student meets like ten of these red flags! What do I do now?"

Don't panic!  Here's what to do:

1. Contact the family – see if the child has had a hearing test lately and see if the family has any of the same concerns
2. Speak with their teacher and see if they share any of your concerns. 
3. Speak with the school nurse  - some nurses can give hearing screenings right in their office
4. Lastly, document all of these events.  Keep track of the speech characteristics that you’re noticing so that you can see if they fluctuate or are consistent.

Friday, February 24, 2017

How to Declutter, SLP Style

Do you have boxes and boxes of speech materials piled up in the back of a closet in your house?  Or maybe shelves piled so high that you worry for your safety when sitting under them?  Perhaps its the junk drawer(s) that you have to open two inches, then slide your hand in to push the stuff inside down, so that you can continue opening the drawer?  It's not your fault! You're an SLP, and SLPs are naturally innovative and thrifty - constantly finding new uses for old objects. I'm guilty of keeping things way too long.  I'm sure my coworkers or husband have heard me say things like, "I know this puzzle doesn't have all the pieces, but I can totally turn that into a language lesson on the word "missing!" or "Well, I might eventually need a half of a piece of blue construction paper that already has a circle cut out of it."  But, if you're like me and are feeling overwhelmed with items in your office or personal space here are a few tips on decluttering.

-If you haven't used it in the past year, donate it or chuck it!

-If it's broken and you won't be able to fix it in the next 48 hours, toss it!

-If it's not appropriate for the population you are working with, sell it!

-If it's a test that is outdated, get rid of it and replace it!

-If it's a piece to a game or toy that you can't locate, out it goes!

-If it's got a coat of dust on it, you don't need it!

-If it has a questionable stain, bye!

-Cassettes or VHS videos when you don't actually have a tape player or VHS machine, Good Will it!

-If you still have grad school text books for topics you do not work with (i.e. you work in a special needs autism preschool, and you have shelves stocked up with text books on geriatric dysphagia), donate it to a local college or library!

-Would it fall into the category of scrap paper aka it's less than half the size of a sheet of paper? Out it goes!

-Is it a kind of electronic or a device that requires a special battery or cord to charge, and you've lost that battery/cord?  Get rid of it!  Don't kid yourself with thinking you'll take the time to search the depths of the internet for a replacement. 

*There are a few exceptions that should be noted when deciding whether or not to get rid of something, such as was it given to you by a special person or if you have a sneaking suspicion that it doesn't actually belong to you and maybe you forgot to return it to a coworker three years ago during that snow storm.  

Good luck decluttering!!

Thursday, February 9, 2017

5 of My Favorite FREE Valentine's Day SLP Resources!

Today was a blizzard in New York, and somehow, someway, the NYC Department of Education closed for a snow day!! After the initial shock wore off, I started thinking about how I wanted to spend my day.  After a few hours of the West Wing and pancake eating, it hit me that Valentine's Day was next week already!  This year has been going by so fast, and I don't feel like I have been taking advantage of holiday themed activities in my speech room as much as in past years.  So, today I took some time to find 5 awesome free Valentine's Day activities that I (and you) can put to use tomorrow, Monday, and Tuesday!  I also plan on saving them in a labeled folder so that I can pull them out easily for next year.

Here we go and in no particular order...

1. Following Directions Valentine's Day by The Pedi Speechie
I like this resource for a few reasons, but primarily because the directions are placed in adorable rhymes that will be fun for your students to each read aloud, or listen to.

2. Valentine's Day Mini Book Freebie
I've recently been a big fan of mini book resources because they can be started and completed all in one session. My students love being able to feel like they accomplished something that they can then bring home and show to their families.  I've also been trying to collaborate more with the OTs in my building, who would be happy to see all of the cutting activities being utilized.

3. Valentine's Day Interactive Book for Describing/Listening Freebie by Fun in Speech
So this is definitely something that you want to put in a safe place to use year after year, because interactive vocabulary books take a little bit of extra time to make.  This one is totally worth it though.  It has cute pictures and a lot of repetition (think Brown Bear, Brown Bear), which is great for our beginner readers to read aloud.  Really nice for targeting attending to stories and auditory comprehension.

4. Valentine's Day ABCs Alphabet Cards! by Lauren DiBiase
Okay so I'm a little biased here, but I really love using this alphabet cards with my kindergarteners who are working on phonological awareness, all the way up to my 13 year olds who somehow slipped through the cracks and still don't have the alphabet committed to memory. We use them by putting them all in order, by naming the sounds they make, and by thinking of words that have those letters in the beginning, ends, or middle of words.

5. Valentine's Day Craftivity Freebie! by Speech Paths
Holidays are absolutely an excuse to have some extra fun in speech, and extra fun means crafts to me!  This is an open ended resource so you can use it for anything- following directions, WH questions, describing, really anything.  I'm planning on using it with my higher functioning students who have emotional disturbances, to think of characteristics that they love in people!

Do you have any favorite Valentine's Day resources that I missed? If so, please share!!

Monday, January 2, 2017

What an SLP is thankful for this year

This year has been jam packed with unexpected changes, growth, and life-lessons.  An SLP has to be a jack of all trades, especially when juggling house-work, a family, a job, a second job, sometimes a THIRD job (high-fives to all my hustlers out there), and normal day-to-day responsibilities like banking, grocery shopping, and appointments.  Sometimes you feel like you're not going to survive the week and other times you feel like you might not survive the next hour.  During these moments, it helps to have a reminder of things you are thankful for.  This blog post will serve as my reminder and maybe yours as well :)

I am thankful for:

-My most challenging students who constantly serve as a reminder that I need to be the best I can be, for myself and for them

-Three flights of stairs to my office, because sometimes it's the only exercise I get in a day

-Friendly coworkers to ease the difficulty of Monday mornings

-Mac n Cheese, because, mac n cheese

-Fast fingers and computers to type those reports and log-notes (imagine if it was still by hand!)

-Fast reflexes to dodge tiny pinches or bites

-Amazon Prime for two day shipping

-My family's patience and willingness to respond to the crankiest of text messages on bad days

-Breyers Ice Cream - we go way back

-Starbucks drive thru on Monday and Friday mornings

-That paycheck that comes in the middle of the month rather than on the day rent is due

-My decision to become an SLP, rather than a zamboni driver like my career readiness test in high school suggested (nothing against zamboni drivers, the cold just isn't for me)

-This blog that has helped me connect to SLPs world-wide, meaning I'm thankful for YOU

Happy New Year everyone!!

Sunday, November 27, 2016

5 Awesome Motivators for Children with Autism (and no, they're not all food!)

Hi everyone!

I hope everybody had a wonderful and peaceful Thanksgiving.  Black Friday, Small Business Saturday, and the upcoming Cyber Monday, have had me thinking about what the best purchases would be for an SLP on a budget. Since I recently changed student populations, I have had to begin building a toolbox of common motivators that appeal to children with autism, that help me get in a lot of trials of whatever it is we're targeting that day. Here are five that I have found a lot of success with.  I hope that you do as well!  I am also including links to where to find items that I have recently purchased.

1. Battery Operated Car & Track - Have you seen these?! I had never, until a coworker offered to give me one of hers for free.  Mine is taxi and NYC themed, but you can find a ton of different themes on Amazon.  It is made up of puzzle pieces, designed to look like a road.  Once the student earns each puzzle piece and puts them together, he now has a really cool road that is always different from the last time he built it, since the puzzle piece roads can be put together in a multitude of directions. Then, the motorized car is another way to motivate your student to accomplish your targets! First, I have my student earn the car (by requesting, commenting, or a multitude of other goals we work on). Then, the child gets a turn watching the car drive on the track!  Depending on how much time is left in a session, I may stop the car every so often and prompt the child to request to see the car drive once again.  I found this adorable one on amazon that I wanted to share with you.  It's school bus themed and may just be a Christmas gift to myself!
--> Battery Operated Car & Track

2. Bubbles - They are a motivator especially for my sensory seeking children.  I'm talking about our kids who may like to smear mucus or saliva on desks. Bubbles are a great way to decrease undesired behaviors, while our students have fun popping them.  Plus, they disappear quickly which requires the student to get a lot trials in of whatever your target is.  I just bought these ones off of Amazon because of the No Spill label and am very happy with them  --> No Spill Bubbles

3. Goldfish Crackers- I like these because most of my students do. As a disappearing motivator, they are eaten quickly with little mess, allowing for multiple trials like the bubbles.  You can pick up Goldfish Crackers at your local grocery store, or even the dollar store! Nothing better than cheap motivators that last a long time.  Of course, be sure to check with the teacher about food allergies, and the parent/guardian about their feelings on edible motivators, prior to feeding your student.

4. Stacking Blocks - I'm partial to Melissa and Doug because of how pretty the colorful wooden blocks are, but really any stacker that is color coordinated should work well.  A lot of my students with autism love stacking, and enjoy keeping things orderly.  I like this particular Melissa and Doug stacker
--> Block Stacker because it comes with FIFTY FIVE blocks.  I mean comeon - any session where you manage to fit in 55 trials of a target is pretty phenomenal.  I like to use this block to teach a very specific skill in an isolated environment, before carrying it over to other environments.  For example,  teaching a skill such as saying "want" while looking at the blocks, or saying "thank you" after receiving one.  This is a nice activity for a group of two as well, as you can have your students pass blocks to one another while targeting turn taking.  There's just SO much you can do, besides the obvious of learning colors and counting.

5. Button Art - I discovered these a few years ago while creating a Donors Choose project.   It kind of reminds me of when I was a child and had a Lite Brite, except these don't light up.  These button art activities come with a bunch of boards with kid-friendly pictures printed on them (think cat, house, boat, etc).  They are color coordinated, with color peg holes, so children know which color peg to use, to create the picture.  My students LOVE them.  These are nice because there is a clear ending to the task, so students have an idea of how long the activity will go on for.  They are also simple in that a student does not need to follow along and match colors to still have fun with the peg art!
--> Button Art

Have you guys found other motivators that your students with autism love?
 Let me know if your students love these activities as much as mine do!

Friday, October 21, 2016

Things an SLP Learned when Starting at a New School

In August I made one of the biggest decisions of my life, in a period of 24 hours.  I decided to leave my job where I had been working the past four years, and begin working in the public school system of NYC.  Let's be clear.  I loved my job.  I worked at the school I would have described as my dream job ten years prior.  So, making the decision to leave was incredibly difficult, but I was excited and anxious to start a new journey. I knew that changing schools would be a large adjustment, however, besides the obvious change of populations, I really didn't think of the many other differences that I would be facing.

Here are a few things you should be aware of if planning on changing jobs.

At my last job, I had one insurance card.  This was the insurance card that I would use for anything and everything.  Hospital visits, walk-in doctors, prescriptions, trips to the dermatologist- I'd whip that insurance card out of my wallet and hand it over.  This is not the case for all employers.  I had to learn and figure out that I now have a couple of insurance cards.  One is for doctors' appointments or going to the hospital.  I actually have two different, separate prescription cards now.  One is used if I were to need injectable drugs or chemotherapy, and the other is used for common medications like antibiotics.  It's important to look into how your health insurance will work prior to dropping your old insurance, to make sure you don't get behind on filling/ordering prescriptions because you tried to use the wrong insurance card.

Short and sweet - don't make assumptions about parking at your new school, based on parking at your old school.  You may need to walk farther.  Or parallel park.  Or rent the driveway of someone's house for you to park in during school hours (this is not a joke - NYers will understand).  Make sure you leave yourself plenty of time those first few days to find parking, if there is no parking lot for your school.  If there is a parking lot, make sure that A. You are allowed to park in it, and B. That you don't need a parking sticker to park there.

I'm not trying to be funny, but when I left my last school, which only had one glorious floor, I never thought about how many floors my next school would have.  Invest in a good pair of walking shoes that also look professional, because you cannot assume your new school will have an elevator, and you should assume that your speech room will be on the highest floor and all the students you need to transition will be on the lowest.  I just found a few pairs of really comfortable, but semi-professional looking shoes from Sketchers.  I highly recommend them.  If your feet aren't happy, then your not happy, and then your students won't be happy.  It's a dangerous cycle.

Every school has it's own culture.  My last school had an exceptional and strongly defined culture.  One where all members spoke a second language, frequently code-switching throughout the day in a way that made you feel like you were part of the same tight-knit family.  If you are coming from a school with a similar environment, you may feel a little bit isolated when you start at your new job.  Everybody at your new school will probably be very friendly and welcoming, and you may absolutely love your new students, but when you want to whisper something funny to a friend that just doesn't translate correctly in English, you may feel a little lonely as you laugh to yourself.  It's good to prepare yourself in advance and realize that every school has it's own culture, and it may take some time for you to feel like you belong in this new one.

Everyone at your last job knew how awesome you were, right?!  You rocked those IEP meetings!  You totally integrated your student's AAC device into every part of their school day!  You helped that student initiate conversation with a peer for the first time ever!  So, now that you're at a new school, make sure you don't forget what everyone at your last job knew.  You are awesome! You are competent! You treat your students with respect and help them achieve their communication potential!  Walk into your new school with this knowledge, so that you don't forget how great you are.  At the same time, though, be sure to enter your new school with the humility to know that you are in a new place, and you need to learn the ways of that school.  Ask questions.  Shadow other staff members.  Push-in to classrooms to observe and see your new caseload in action.  Find a compromise between showing that you are excellent at your job while also being respectful of the fact that you are new and have much to learn.

In conclusion, it's okay to be scared, excited, eager, nervous, stressed, and confused all at the same time.  Take a deep breath, close your eyes, count to ten, and then open your eyes and start making a difference in the lives of all these new children who you are blessed to now work with.