Are you Functioning Executively?

If you are an SLP and you haven’t yet heard the term “Executive Function” it’s definitely time to catch up.

Over the past couple of years this new ‘buzz term” has emerged within the SLP field, and has been working its way into clinics, schools, reports, IEPs, webinars, and social media conversations worldwide. The response to this new area has been varied, ranging from “I use it daily in my practice,” to “What the heck is it?”

Amanda Morin from understood.org defines Executive Function as the “CEO of the Brain,” It is in charge of ensuring that things get from the planning stages of the job to the final deadline. It describes how we manage those cognitive processes such as

• working memory
• impulse control
• self-monitoring
• planning and prioritizing
• and organization

One of our own #slpeeps Tara Roehl has written an excellent blog post about Executive function Skills which goes into these skills in more detail, and can be found here.

For our upcoming #slpchat we want to hear more from you about your interests and/or experiences working with clients with Executive Function deficits. We will be discussing resources and skills for assessment and intervention, and clinical populations who may benefit from this treatment. We’ll also be sharing useful information and resources to get you started, and on your way to becoming an Executive Function Expert.

Join us this Sunday February 15^th, 2015 at 2pm EST, for an exciting and informative discussion. Also over the week we will be sharing some great resources which we have found on Executive Function, for you to have in your therapy toolbox, so follow @slpchat on twitter to stay informed.

We look forward to seeing you soon!

SLPChat is Back!!

This chat occurred January 25th, 2015 at 2 pm EST. There wasn’t an Australian counterpart chat this month. Here is a complete archive of the chat.

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Would you believe it if we told you that it has been over 5 years that SLPs from different corners of the globe have been using Twitter to network and share their expertise? Furthermore would you believe that the steady daily buzz of thousands of #slpeeps sharing, questioning, interacting, researching on Twitter was at that time a slow trickle, from a handful (literally) of peeps (The term #slpeeps wasn’t coined until later in 2010) searching for ideas, and more importantly similar persons within the field. It must be hard to imagine with the current #slpeeps presence on Twitter, but it truly highlights how far we have come as we continue to make our mark on social media, and on the world.

Another familiar hashtag is about to turn 5 this year as well…..you guessed it #slpchat!! Although we have been dormant for a while (due to work and life commitments) the founders have decided that this is the best year to resume our lively discussions for our #slpchat veterans and newbies. We sure have missed you all and still believe that #slpchat is an essential part of our twitter community.

We therefore wish to invite you all to our “welcome back” chat on Sunday January 25^th 2015 at 2 p.m Eastern Time.

This chat is all about YOU; we want to know:

• How twitter has changed for you over the years
• How it has supported (or not supported) your practice over the years
• Are you still a die-hard twitter user? Have other social networks (linkedin, facebook etc.) started to fill your professional needs?
• Is twitter still your go-to place for information/meeting other professionals?
• Are you keeping up with current trends or are you getting lost in information [overload]?
• Are there any tools/apps that have made navigating twitter easier for you as more professionals tweet?

We also want to hear some of your ideas for hott topics for this year.

We’re so glad to be back, and we’re looking forward to having you back with us as well!

Telepractice in Speech & Language Pathology

This chat has already occurred. You can read the North American edition here and the Australian edition here. We strongly suggest you look over both since different interesting links and information came up in both.

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Technology is changing the way we think, learn, communicate…live.

Technology has opened up access to a range of learning opportunities which were never even imaginable. If you have participated in any of our past #slpchat discussions you would have seen a true demonstration of new ways of learning in action via internet technology.

Technology is also changing the way we do therapy, as well as how access is provided to therapy services.  The emergence of telepractice, for example, has increased access to those who might otherwise be unable to receive therapy, and has created other benefits, including: reduced costs, more naturalistic environments for service delivery (in home telepractice), and increased motivation and client responsiveness  (ASHA,2005a).

ASHA (2005b) defines telepractice as “the application of telecommunications technology to delivery of professional services at a distance by linking clinician to client, or clinician to clinician, for assessment, intervention, and/or consultation.”ASHA’s position is that “telepractice is an appropriate model of service delivery for the professions of audiology and speech and language therapy.” However it also indicates that the services provided over  a telepractice medium must be comparable in quality to face to face services.  Therefore, the clinician intending to conduct telepractice services should have “detailed knowledge and skills in telepractice models, technology associated with service delivery, matching clients to technology, selecting assessments and interventions that are appropriate to the technology, cultural/linguistic variables, use of support personnel, evaluation of service effectiveness, and documentation of services.”  (ASHA, 2005b).

Many clinicians have embraced this addition to service delivery and are successfully using telepractice across a range of settings, with various clinical populations. Others prefer to stick to traditional face-to-face practice, due to personal preference, lack of  knowledge or skill in this area, previous experience and many other reasons.  Therefore, for this month’s #slpchat we want to hear your views on telepractice. Join us on Sunday March 24th at 2 p.m .Eastern Time, then again on Monday March 25^th at 8 p.m. Australian Eastern Time, and give us the inside scoop on:

• Who is using it and in what areas
• Who is not using it, and why
• What types of skills and equipment help the therapy process?
• What are the benefits and limitations of using telepractice?
• Working with telepractice companies
• Ethical considerations in telepractice
• Comparisons between telepractice and face-to-face service

And your overall experiences.

We look forward to hearing and learning from you!

American Speech-Language-Hearing Association. (2005a). Speech-language pathologists providing clinical services via telepractice: technical report [Technical Report]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2005b). Knowledge and skills needed by speech-language pathologists providing clinical services via telepractice [Knowledge and Skills]. Available from http://www.asha.org/policy.

The Link Up- A Special Type of Chat

These chats have already occurred and can be read in their entirety as archived chats. The North American based chat can be read here. The Australia based chat can be read here.

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Occupational therapists help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes.

www.aota.org

If you have ever worked with an Occupational Therapist you would be well aware of the valuable resources which they contribute to our work in adult and paediatric assessment and intervention.  They often provide that missing piece of the puzzle that fits to make sessions run more smoothly, assist in the child/ adult reaching his maximum potential, and help to ensure best practice all around. The OT has great knowledge and skills to offer in activities of daily living, feeding, AAC use, sensory integration, motor skills development, and much more. Most of us in our daily practice aim to achieve that full multidisciplinary approach for integrative goal setting, to ensure the most holistic and complete care for each individual.

So why not do this in our social networking as well? 

The emergence of a number of OTs on twitter, who have been sharing a wealth of information on various areas relevant to Speech & Language therapy, has inspired the @Slpchat team to pave for the way for a more multidisciplinary social network. As a result the next #slpchat will be a ‘link up’ with #slpeeps and #OTpeeps across twitter, where professionals from each field can ‘tweet up’, get to know more about each profession, and ask any questions they may have related to each field.

We will be having two opportunities to meet and discuss: the first will occur at 2 pm EDT (New York/Toronto) on Sunday, October 14th, and the next one at 8 pm AEST (Sydney) on Monday, October 15th. If you need to know what time that is where you are, you can use everytimezone.com to help.

Seeing that many of the #OTpeeps are not yet aware of #slpchat, we would like the #slpeeps to spread the word and invite at least one OT to our Link up.

#OTpeeps and other newcomers to the chat can find more information about participating in the chat here on our ‘tips’ page.

We’re very excited about this new collaboration and look forward to your participation!

Treatment of Fluency Disorders

This week is National Stuttering Awareness Week and what better way for the #slpeeps to contribute, than to make it the topic of discussion for our upcoming #slpchat! Yes we are aware!

Dysfluency/stuttering and its treatment have been making the rounds across conversations all over the world with the release of the popular Academy Award winner “The King’s Speech.” We watched the more unorthodox techniques of  Lionel Logue, which poses the question “What has changed since those early days of stuttering treatment?” “What techniques are being used now to treat stuttering in preschoolers, school aged children, adolescents and adults?”

Treatment options for the various age groups vary across countries. For preschoolers indirect therapy may be used to create a fluency enhancing environment, by teaching parents to slow their rate of speech, avoid interrupting, reframe responses, and modify questions to reduce demands on the child. Other therapists may use a behavioural approach such as the Lidcombe program , which uses verbal contingencies to praise “smooth speech” and to acknowledge or correct unambiguous stuttering.

Treatment options become a bit more difficult in the school aged to adult years due to decreased neural plasticity, amongst other factors.  ASHA notes  that techniques that have the greatest efficacy for reducing the frequency of stuttering in adults and older children includes those that change the timing of speech (e.g. slowing down, stretching out sounds), or reduce physical tension during speaking (e.g. gentle onsets of speech movement).  Some other strategies that have come up in the literature are:

•  Self-Imposed Time Outs: where a person pauses after a moment of stuttering.
• Syllable-Timed Speech : involves speaking with minimal differentiation in linguistic stress across syllables and is achieved by saying each syllable in time to a rhythmic beat.
• Pull outs: During the moment of stuttering, staying in the tension and sliding out by breaking down the tension in the speech mechanism, before continuing with the production of the word. Discussed here
• Voluntary Stuttering . Discussed here

Another speech restructuring program for adolescents and adults which I (Shareka) learned about and practiced in grad school was the Camperdown program out of Australia, which presents a new way of teaching prolonged speech.

New Medical Technology has also introduced delayed auditory feedback, rate control and masking devices for stuttering treatment.

In our upcoming #slpchat on Saturday May 14th at 7pm ET, We’d like to talk about what types of treatment you use in your practice for stuttering at each age level, and what you view as effective/ineffective. Areas we also wish to look at during this time are:

• Assessment tools in Fluency Disorders
• When to start treatment in Preschoolers
• The SLP role in counselling in fluency Disorders: Dealing with avoidance, anxiety and negative perspectives on stuttering.
• Bullying and the school-aged child who stutters
• The Acquired Neurogenic Stutter

Don’t forget to follow @Slpchat this week for some useful links to pages and articles on stuttering treatment.

We look forward to your participation this weekend! See you there! 🙂

All About Words: Developing first words in Children with Language Delay

You have just assessed 2 year old “Tommy” at your clinic. He presents with severe expressive and receptive delays and has little to no single words.

Does this scenario sound familiar?  If you’re a practicing paediatric speech therapist/pathologist you most likely have met this child at some point during your profession.  If not, be prepared; he/she is coming.  The question is where do you go from that point? What type of intervention approach do you use? What words do you teach him to use first? Many of us immediately start banging our knuckles together saying “moooore.”  However do we have a basis for choosing this word as part of our “first faithfuls”?  Some therapists have argued that “more” actually isn’t a very functional word to learn, whereas others believe it is the most functional for children’s everyday interactions. Our next #slpchat, therefore, will discuss some of the considerations in choosing the first words to teach to children with expressive language delay.

Owens(2004), notes that an important consideration in choosing words for a first lexicon  is that words are functional and fulfill a broad range of communicative purposes. We want to teach children words that they can use often to accomplish their social goals. Lederer (2002) expands this to include not only functionality, but also developmental norms, motivation, lexical variety and phonological information.

Many researchers have compiled their lists of vocab targets for children with language delay. Some contain familiar items within a child’s environment such as names of family members, body parts, preferred foods or toys, while others expand to substantive and relational words as is shown in the table below by Bloom & Lahey (1977).



A good list of early words can also be found in Banajee, Dicarlo, & Stricklin, (2003). Core vocabulary determination for toddlers. Augmentative and Alternative Communication, 19, 67-73. Accessed:  http://www.minspeak.com/documents/1-BanajeeList.pdf

We’d like to hear from you! What are you using in therapy? Are you following any particular research/ hierarchy?

Join us for the #slpchat on April 10^th, 2011 at 2pm ET, where we will be discussing these vocab choices, as well as your own considerations for early vocabulary, whether it be through verbalization, sign language or any form of AAC. We also wish to look at the types of intervention techniques you use to target this vocabulary.

It would be useful to read the following articles in preparation for our discussion:

Lederer, S.H. (2002). Selecting and facilitating the first vocabulary for children with developmental language delays: A focused stimulation approach. Young Exceptional Children, 6(1), 10-17.

First Words: From Theory to Intervention
Susan Hendler Lederer, Ph.D., Adelphi University, Garden City, NY  http://www.speechpathology.com/articles/article_detail.asp?article_id=329

First Words, First Books, & Focused Language Stimulation
Susan Hendler Lederer, Ph.D. http://www.speechpathology.com/articles/article_detail.asp?article_id=374

We look forward to hearing from you!

Other References:

Lahey, M., & Bloom, L. (1977). Planning a first lexicon: Which words to teach first. Journal of Speech and Hearing Disorders, 42, 340-350.

Owens, R. (2004).  Language Disorders, (4th ed.).  Boston, MA: Allyn & Bacon.

Paul, R. (2006). Language disorders from infancy to adolescence (pp. 301-305). St. Louis, MO: Mosby.