Transitions are a part of everyday life at home and school.  However, they can be challenging for children and adults alike, and the demands can be complex!  During transitions, the sensory environment is more stimulating, and expectations are often higher than during lessons or structured activities.  Often there is more noise in the room, lots of movement, and visual distractions.  We expect students to follow multiple-step directions and navigate their bodies through the room while their peers do the same.  The following strategies offer ideas to support our students during this frequent occurrence in the school day.  


1.  Calendar


Younger classrooms often have a visual schedule, but older kiddos can benefit too!  Offer a written plan for students who can read.  When a child asks what is next, refer them to the schedule to teach them to use it.  As adults, we often use our planners or apps to keep track of our days.  Learning to check a calendar is a tool that kids can use in their childhood and beyond.  Be sure to keep your schedule updated to prevent unexpected changes.  


2.  Provide a Warning


Unexpected transitions are more challenging.  Think of the last time you experienced a surprise fire drill.  It feels alarming and dysregulating!  Many children feel this way during routine changes.  A simple way to prevent this is by giving the group advance notice of the upcoming transition.  You can direct this by announcing how much time they have left or making it more concrete.  For example, let them know they can color one more shape, and then they will wash their hands.  


3.  Keep It Structured


We have children with a variety of needs in our classrooms.  It can be challenging to develop a transition routine when you have students who need different supports.  Some children will complete the transition quickly and become impatient or unsure of what to do while waiting for the next direction.  Offer an activity to keep the structure going.  For example, when children complete an art project, they can grab a book and return to their seats.  When they finish lunch, they can pick a center.  


4.  Sing it! Move it!


An efficient strategy for younger ones, singing provides a constant familiar activity while students complete their transition.  You can use the same songs for daily changes to give an extra level of consistency.  Similarly, offering a movement activity can provide a motor break and support the flow of the transition.  Try marching to the bathroom, tip-toeing to cubbies, or walking heel-to-toe to another room.  


5.  Recognize a Job Well Done!


Transitions are a complex routine to learn for young children.  Provide plenty of praise for students who follow directions and stay regulated.  Providing positive reinforcement helps students understand what expected behavior looks like by observing what their peers are doing well.  


CBS Therapy is passionate about helping children with special needs and serving the schools, therapists, and families who support them. New England’s premier provider of school-based and special education staffing services in the Northeast, CBS Therapy also has therapy clinics that offer speech-language, occupational and physical therapy services.  


Anxiety disorders occur on a spectrum and can impact children in a variety of ways.  Some children may deal with low levels of apprehension, while other children develop severe and intense anxiety.  While students with anxiety will benefit from the following recommendations, consider implementing them in larger groups such as classrooms or group therapy.  This promotes an inclusive environment from which all learners can benefit.

Use structure:

Incorporate daily and weekly routines to help children learn what to expect.  Post schedules in a visible area.  This is especially important for older children who have rotating or complex schedules.  If there are any upcoming changes in routines (such as a substitute or a fire drill), give children advance notice whenever possible.

 

Provide a ‘just right’ challenge:

Allow students to learn and grow while building their self-confidence.  Grade your activities so that they are just challenging enough to stretch the child’s learning. 

 

Offer choice: 

By using a topic, subject, or medium that is exciting to students, they will naturally gravitate toward engagement.  Especially when an assignment or activity is new and daunting, a small piece of choice can motivate children toinitiate the task.  This could include anything from designing a math problem based on their favorite sports team to giving a book report on their favorite classic.

 

Use positive feedback:

Positive reinforcement signals to children that they are doing what is expected and can be a great way to boost the confidence of children who have anxiety.  Feedback can be in the form of a token system, a smile, nod, or words of affirmation. 

 

Teach challenging skills: 

Sometimes, learners need extra direction.  Direct instruction can be a great way to improve skills and, therefore, confidence for activities with a physical component, such as writing or playing a sport.  Break down tasks into smaller chunks, demonstrate skills to your students, and practice.

 

Use clear expectations:

Letting students know exactly what you expect is a great way to communicate mutual respect. Particularly when a project or activity is brand new, knowing the outcome will be helpful to children with anxiety.

 

Be flexible about participation: 

Try making group participation optional.  Let students know that they can contribute to the conversation when they are ready and that you will not call on them. 

 

Eliminate busywork:

A child working on fractions does not need to complete 100 problems to master the skill and demonstrate competence.  If a worksheet looks overwhelming or visually ‘busy ,’ it could likely benefit from being revised or broken up into smaller assignments. 

 

Identify strengths:  

Use one-on-one time to reflect on past successes, strengths, passions, and skills.  If you want to use an example in a group setting to provide an example of problem-solving skills, ask for student permission beforehand.

 

Teach self-management: 

Another strategy that students with and without anxiety disorders can benefit from is self-management skills.  Talk about self-regulation, brainstorm symptoms of being dysregulated, develop language, and teach strategies.  Use examples from your personal life to connect with students and demonstrate the importance of this life skill.

Documentation for therapy services can be a time-consuming yet essential component of service delivery. Many practitioners and clinicians attempt to streamline their daily note process. Some critical details should not be overlooked, though it is still possible to create a concise note while including everything that reimbursement experts need to see.

 

Many professions, including occupational therapists, physical therapists, speech-language pathologists, ABA therapists, and others, use SOAP notes for their daily sessions. SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. SOAP notes are valuable because they provide information about different therapy components, and since therapists use them widely, the interdisciplinary team can use them as a means of timely communication. 


S: Subjective: What is the client saying about their experience?

Subjective information may include reports of pain, challenges since the last session, or what the client shares they can or cannot do. You may record behavior during the session for pediatric clients, including arousal level and engagement in therapy. You can also include reports from the client’s family or teachers. 


O: Objective: What are you observing? What data can you collect?

Include any compensatory strategies your client uses, physical or cognitive strategies for participation, and data you collect. The objective section could include the percentage of trials completed correctly and the client’s level of support needed to perform the activity. If your client needed any adaptive equipment, assistive technology, or modification of a task, include that information here as well. It is vital to make sure that you focus on the active experience of the client rather than the therapist. For example, note that the “Client needed moderate physical assistance for bathroom mobility” rather than “Provided moderate physical assistance to the client.”  


A: Assessment: What is your interpretation?  

Consider what you wrote in the subjective and objective categories. What does this mean? You’ll use your clinical expertise to interpret the information into an analysis of the client’s performance. Note any improvement, regression, or progress toward your client’s goals. Refer back to the subjective and objective categories to support your assessment. 


P: Plan: What is going to happen next?

Include the frequency, duration, and location of recommended services. If you are recommending discharge, include specific information about recommendations for follow-up. Otherwise, include detailed information about your intervention plan and how you will use it to address the problems noted in this session.   Daily documentation and SOAP notes are a tool that are essential to all parties involved in therapy:


  • The client: Timely and thorough documentation informs the therapist that they are making progress and are responsive to the selected interventions.  
  • Professionals: Since SOAP notes are commonly used in healthcare, SOAP notes can help the interdisciplinary team communicate quickly and effectively.  
  • Payors: Reimbursement parties can be assured that the intervention is effective and taking place.  
  • The therapist: Recording comprehensive notes allows the therapist to provide ethical, evidence-based service and meet the client’s ongoing needs. 

CBS Therapy is the premier provider of school-based and pediatric special education staffing services in the Northeast.  

Now more than ever, children with special needs benefit from effective collaboration by their interdisciplinary providers.  On a given IEP team, a child may have special education, speech-language pathology, occupational therapy, physical therapy, applied behavior analysis, and more.  In many cases, several of these practitioners may see the child only one time per week.  So, what about the rest of the time when the specialists are not in?  It is our responsibility to collaborate to provide the child with as much carryover as possible.   

 

  1. Schedule designated times for collaboration: It is not uncommon for teachers and therapists to have an impromptu quick chat in the hallway.  While this gives professionals a moment to touch base, it simply does not offer the time, needed preparation, or quality of a pre-planned meeting.  Periodically-scheduled verbal meetings are the evidenced-based standard (Huang et al., 2011).  
  2. Have an agenda: Be sure to recommend a brief agenda for your aforementioned planned collaboration time.  This allows the team to prioritize needs, do any preparatory tasks prior to meeting, and share goals and ideas to make the collaboration time more effective (Hart Barnett & O’Shaughnessy, 2015).  
  3. Don’t forget about those communication skills: While we are all very busy, make the most of your time by being fully present in the meeting.  This translates to active listening; making eye-contact; asking clarifying questions; and paraphrasing to ensure understanding.  
  4. Share your role: The specific role of specialists is not always well-known by teachers, parents or other team members.  At the beginning of collaboration, define your role as related to the case.  This sets a foundation for collaboration in which other professionals will know when to consult you for ideas and strategies.  Evidence even shows that better collaborative outcomes occur when the role of therapists is known (Suc et al., 2017).  
  5. Embed your services: Embedding services into the classroom routine benefits the student, teacher, and provider!  How?  Sharing a space results in natural communication opportunities, better understanding of the classroom context for the provider, more carryover of specialist strategies in the classroom, and generalizable skills.  
  6. Use your tools:  Providers commonly use multi-modal learning strategies with children, but the rest of the interdisciplinary team can benefit from them too.  Tap into your intervention strategies and offer modeling, role-playing, coaching, and problem-solving.  When a provider or therapist can successfully carryover strategies from another specialist, the child (and the whole interdisciplinary team) benefit.  
  7. Include the child’s caregivers:  Whenever possible, include the child’s parents or caregivers for collaboration.  These valuable team members can offer insight onto strategies that they have had success with and often appreciate the ability to communicate with several providers at once.    

 

 

References:

Hart Barnett, J. E., & O’Shaughnessy, K.  (2015).  Enhancing collaboration between occupational therapists and early childhood educators working with children on the autism spectrum.  Early Childhood Education Journal, 43, 467-472.  

Huang, Y., Peyton, C. G., Hoffman, M., & Pascua, M.  (2011).  Teacher perspectives on collaboration with occupational therapists in inclusive classroom pilot study.  Journal of Occupational Therapy, Schools, & Early Intervention, 4(1), 71-89.  

Suc, L., Bukovec, B., & Karpljuk, D.  (2017).  The role of inter-professional collaboration in developing inclusive education: Experiences of teachers and occupational therapists in Slovenia.  International Journal of Inclusive Education 21(9), 938-955.

Goals to Achieve During a Clinical Fellowship Year for SLP

You’ve worked hard in school and reached the point where it is time to put your new knowledge into practice. Moving from the university classroom into a clinical fellowship is an exciting transition – giving you hands-on experience that will prepare you to start your new career.

Not only is choosing the right CFY program critical to your success, but also consider how your intention and efforts will affect your results in the future. As you step into this new chapter, hold onto clear goals so you can gain the best knowledge and skills during your fellowship year.

5 Goals for Your Clinical Fellowship Year (CFY)

This 36-week program prepares students to move into real-life career opportunities, with ongoing application and training that will support their future. This fellowship is required to achieve your Certificate of Clinical Competence for Speech-Language Pathologists (CCC-SLP) through ASHA, the American Speech and Hearing Association.

While it’s essential to complete the requirements to gain certification, there are other goals you will achieve through this program:

  1. Integrate Academic Learning: After spending years in the classroom, it’s time to implement your education and skills. Moving into a practice environment helps you see real-world examples of how your new knowledge is essential for your ongoing career.
  2. Hone in Areas of Opportunity: This hands-on experience provides clarity to help you identify your strong points as well as areas of improvement. The opportunity to work under supervision is a great way to receive feedback and advice to improve your skills and approach as an SLP.
  3. Improve Clinical Skills: Understanding the textbook principles is just the first step in your education. Your CFY is the time to learn the clinical skills and techniques to use for patient care. Integrating the concepts and stratigies you learned in graduate school into managing a full-time SLP caseload will be a key goal of your CFY.
  4. Transition to Independence: During your CFY, you will spend a lot of time working under the supervision of a certified SLP. This supervision creates the opportunity for transition to start working as an independent Speech-Language Pathology practitioner. By the end of your CFY you should have the tools and confidence to practice independently.
  5. Complete Certification Requirements: The CCC-SLP requires you to meet specific requirements before earning certification, such as 1,260 hours of supervision, 80% of your time focused on patient care, supervision from an approved mentor, and an evaluation to measure core skills.

Why CBS Therapy for Your Clinical Fellowship?

Our team at CBS Therapy is committed to providing an optimal experience for Clinical Fellows. As you learn more about our program, you will see that our SLPs are working hard to provide the most comprehensive CFY program available in the industry.

We are proud to offer more than 13 years of experience supervising Clinical Fellows. Through every stage of your 36-week program, we provide ongoing support to help you build confidence through your training. In-depth training paired with personalized mentoring helps you apply your academic education to a clinical training environment. If you are interested in more information about this program, then we invite you to reach out to our team with your questions.

4-Ways-to-Implement-Technology-into-Speech-Therapy

Many SLPs had to turn their practices upside down this past year, with a majority of students learning from home instead of in person. One silver lining from this pandemic was discovering how beneficial technology can be to teaching speech therapy. Even with students back in the classroom, there are so many resources that can’t be left behind.

Technology isn’t a thing that was magnified during Covid and will dissipate. Online resources and live or asynchronous virtual classes are here to stay. They are convenient, accessible, and efficient. Use technology in your classroom in order to optimize your speech therapy practices.

4 Technology Ideas to Implement into Speech Therapy

Now is the time to embrace technology and implement it into your lessons with virtual and in-classroom students. Every child will be thrilled with the variety and familiarity. Take a look at some of these ideas:

  1. Parent Involvement: Sending videos between speech therapy lessons or teaching online will reach parents more than the occasional meeting at the school. Parents can see you in action and model how an SLP asks questions and encourages the students.
  2. Videos: Use commercials, movie clips, and learning videos to teach your students. You can use the videos to work on the students’ vocabulary, articulation, recalling of details, and pointing out inferences. There are so many questions to get their brains thinking after showing a short video clip.
  3. No-Print Activities: Many resources are available online that use interactive worksheets that require no printing. Few families have printers in their homes, so it is unrealistic to require printing in your lessons. Provide easy fill-in activities that will sharpen the student’s typing skills as well.
  4. Game: There are endless games online that can be accessed for your speech therapy lessons. Choose an online matching game including works with s-blends, articulation games, or more. You can make speech therapy fun and collaborative with online activities. Children love the playful elements of these games and can learn and develop at the same time.

It doesn’t matter whether you are teaching your students virtually or are able to meet face to face, switch things up with technology. You can personalize each lesson to their preferences. And most importantly, make the student look forward to speech therapy.  

Finding the Balance with Technology

Technology can be a great support in SLP, but there is a balance to ensure the child isn’t in front of a screen too much. Research shows that too much screen time for younger children can potentially play a role in speech and language delays.

Don’t let technology or apps disrupt daily routines. Instead, use them as a supplement to enhance communication. With the right integration, technology encourages an interactive learning environment, supporting the needs of the child and their family.

Ideally, technology should supplement an overall speech-language therapy program – digital tools shouldn’t be the only activities to support speech and language development. In addition to apps and technology, also look for ways to integrate screen-free activities to support the child’s growth and learning.

Any questions? Give us a call!

401-270-9991

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