Wednesday, November 27, 2013

Personal update!

Hey all,

Just for fun I thought I would let you know how things are going.  I'm still pregnant- 23.5 weeks along.  Get my first kick this week!  Had a rough lower back injury a couple weeks ago.  Oh, and I am only 2 days apart with my sister!

That's her on the left, and me on the right a couple weeks ago.  We are excited!  I'm having a girl and she's having a boy.

Have a great Thanksgiving holiday!  Hope you get some time off.


Thursday, November 21, 2013

Therapy task ideas for working on impulsivity and other pragmatic deficit areas

Dear fellow SLPs,

To me, this is the hardest area to target.  When a patient is impulsive, they are often both unaware of it, and not receptive to education and training in this area.  

Common patient reactions to pragmatic therapy:

Yes, it's easy to want to shy away from taking the bull by the horns and addressing these things, but...

 I have a few commonly used phrases when talking to patients about these potentially sensitive areas.  I often say something like this:

          "One of the things I watch for closely during my evaluation are subtle social changes in patients' behavior which can be very common after [an injury like yours].  Many times these are things that can go unnoticed, or even ignored.  I would like to be very frank with you when and if I ever notice these things in you- if you are open to my feedback."

          At this point the patient usually says they are very open to any feedback and frankness.
I then say something along these lines:

         "Let's talk about the most common social and behavioral changes that go along with [this type of 'injury"] and some of the things I have noticed during our evaluation/interactions.  And any time in therapy when I notice these things, I will very frankly point them out.  I don't want to make you feel embarrassed- in fact you shouldn't!  This is why we are here.  And I always say, 'No one is going to be honest with you like you speech therapist is," at least with regard to these subtle social things.  Actually, people will often feel uncomfortable bringing them up with you, so I would rather we discuss it all openly while you're here so you are aware and you can start using strategies and techniques to help you when you interact with others, go back to work, etc."

This tends to create more openness and at least provides a way for me to point out behaviors as they occur.  

Can you add anything to this list below?  Does anyone else have any great materials for working on this area?  Leave your comments below- I would love to hear from you!

Here are all the ideas I could think of today, plus a couple from my fellow SLPs.  What else can you add?

Tasks for pragmatic/social skill areas such as:  Self-Awareness, Self-Monitoring, Self-Regulation, Impulse Control, Disinhibition:

·  Video the patient and have him analyze his behavior/performance
·  Have the patient list his deficits/goals
·  Have the patient predict how they WILL perform on a given task, and then assess how they DID perform afterward (scale of 1-10 or percentage).  
·  Have the pt. take data for themselves
·  Practice social role-plays
·  Give scenarios of “wrong” behavior and have them identify it and propose a solution
·  Descriptions of self (“What motivates me?”, “What do I imagine myself doing in a year from now?”, “What are things I like to do?”)
·  Social interaction role-plays including discussion of compensatory strategies and behaviors
·  Role play job interview questions (i.e., “What is your greatest strength?”) (There are good example is this workbook-- Focus on Function p. 299)
·  Develop tactile cue system for patients with tangential conversation to let them know they have been talking too long/off topic
·  Before starting any task, ask the patient how they think they will perform.  Discuss any differences in expected vs. real performance

·  Moron Test (if you're too impulsive, you'll mess up!)
·  Doodle Pro

What else, SLPs?  Add your ideas in the comments below!

Monday, November 18, 2013

On the Flip Side

So, the other day I got a little nudge.

Kristin got her cousin to send me a hint. Where's the educational SLP? Isn't he suppose to post things as well? His he permanently stuck writing progress reports and IEPs?

Well, yes. He is.

So, I am going to blame the same things I always blame... parenthood and netflix. What can you do?

Anyway, I wanted to talk briefly about my experience on the flip side. What is it like to be a parent with a child who has special needs, at least from my perspective.

My son, Logan has always been a bit rambunctious and a little behind his sisters when it comes to many developmental milestones. Yet we didn't right away recognize that he might have special needs. Many people had told us that boys are more difficult than girls. We just assumed that they were very right. Once our little boy became mobile then he learned real quick how to get into just about everything. He also demonstrated many characteristics that were similar to students with ASD. At the time he was very echolalic, he wouldn't socialize with others, he couldn't handle any changes to his routine, and he got hyper-focused (obsessed) on particular items or topics.

Sometimes parents get a blindside to their own children which was definitely the case for us. It wasn't till our child was old enough to go to the children's class at our church when we began to realize that our child wasn't like the other children his age. He was the only kid who couldn't sit still during class. We had the "problem child", the kid that people tend to question what the parents are doing. Were the parents doing any discipline in the home at all? Don't get me wrong, most of the people at my church were very nice about it, trying their best to help Logan participate in primary
. Yet, we knew that something was wrong, or at least suspected.

I called up my sister-in-law and point blank asked her, "Do you think my son has a disability?"

She replied, "I would never say anything negative about your son. You know we all love him, but to be honest, none of my kids were ever that hard."

I felt like I was kicked in the stomach. What did I do wrong? I was suppose to know how to fix children who had problems. I was suppose to be a better father. Did we not give him enough attention? Were we not consistent enough in our disciple? What did we do wrong? My wife took it equally hard. She felt that everybody hated our son. She felt that people thought we were bad parents when he was melting down in public over one thing or another. My wife also has Special Education background. So, she also felt the double guilt that I was feeling. Not only were we bad parents in our minds, we were also bad professionals.

Its easy to tell parents that it isn't their fault that their child has special needs, but its difficult as parents to listen and believe that simple truth. That nagging feeling of "what if I just did this differently?" clings to our minds. It's difficult to shake off.

We had Logan tested. The local elementary school's preschool team gave him a variety of assessments including developmental, cognitive, expressive and receptive language, social, etc. We had to wait even longer for special Autism testing.

Several labels were thrown around willy nilly. I started to realize why first person speech was so important. We could tell who saw our son as a disability first and who saw him as a little boy first. It was a huge difference to us. Parents are a lot more perceptive than you might think. They can tell if you really care about their child or not. It makes a big difference to have people working who want the absolute best for your child, people who will look at their strengths as well as their weaknesses. I found also that I didn't care about the label; it seemed much more important to other people.

This experience has completely changed how I see my profession and how I interact with students and with parents.

There is much more I could write about this, but frankly I need to get back to my family.

Wednesday, November 13, 2013

Convergent Thinking Speech Therapy Task Ideas

Here's my next cognitive area in this series of posts adapted from my old student Janelle Barret's  "student project." Convergent thinking tasks! 

First of all, to better understand Convergent Thinking (CT), read my previous post HERE on the differences between CT and DT (Divergent Thinking).  It can be a tricky topic to understand in some ways.

Still having trouble understanding the differences?  Here are a couple of simple posts and quizzes I found on a blog about teaching children.
  • Linear thinkingor convergent thinking, is about learning facts, follow instructions, and solving problems with one right answer.
  • Divergent thinking is generating unique solutions and seeing various possibilities in response to questions and problems.
  • - See more at:
  • A Test of DT: Break Point and Beyond

And without further ado:

Convergent Thinking Therapy Task Ideas:
  • Identifying the “best” solution to a problem
  • Given 4-5 examples, have patient name the category they belong to
  • Basically any task with a SINGLE correct target answer.  General information questions, naming a target word based on a description.
  • Name similarities between 2 items (this is an interesting cross between CT and DT!)
  • Elimination tasks (which of these is not like the other?). WALC 2 has some good ones.
  • List several foods with one ingredient in common- have the patient name the common ingredient (e.g., eggs, sugar, meat, etc.)
  • Games and Apps:
    • 20 Questions
    • Riddles
    • Crossword puzzle apps
    • Analogies for Kids app
  • Giving clues for figuring out the described object
  • Taking several pieces of information and then making the best educated decision
  • Following Directions tasks of all kinds (verbal, written, etc.).  Yes- this is convergent thinking too!
  • Category and first letter grids (animal that beings with "O")
  • Crossword puzzles
What do you do to target convergent thinking? 
Leave us a comment below!

Thursday, November 7, 2013

Speech Therapy Task Ideas for Divergent Thinking

Here's my next cognitive area in this series of posts adapted from my old student Janelle Barret's project. This blog post was an exercise in divergent thinking! Ha ha ha. It took me a lot of work, so I hope you enjoy!

Not all of these tasks are as strictly divergent thinking as others, but for lack of a more specific category (or post) I am going to lump them in together. Don't forget to comment and add your own ideas!

What exactly is Divergent Thinking or DT 
(aka: lateral thinking)?
How is it different from Convergent Thinking 
(aka: linear thinking)??

With many questions and problem-solving scenarios in life, we start with DT to create ideas, options, possible solutions, more questions, more ways of LOOKING at or interpreting the problem or question...
Then we use Convergent Thinking to make the actual choices and decisions.  DT is not the same as Creative Thinking, but is required for creative thinking!  (Convergent thinking typically involves situations in which there is ONE right answer or one right way of doing things.  Learning facts, and following directions also fall under the umbrella of convergent thinking.)
Do you have a hard time remembering which is which?  With divergent thinking you take a question and DIVERGE into many thoughts and possibilities.  Or a good memory association is that you have to "dive in" and think of various possibilities.  
Linear thinkingor convergent thinking, is about learning facts, follow instructions, and solving problems with one right answer.
Divergent thinking is generating unique solutions and seeing various possibilities in response to questions and problems.
- See more at:

Linear thinkingor convergent thinking, is about learning facts, follow instructions, and solving problems with one right answer.
Divergent thinking is generating unique solutions and seeing various possibilities in response to questions and problems.
- See more at:

Divergent Thinking Task Ideas:

  • List of 4-5 words: which does not belong? (i.e., dog, cat, bowl, bird, fish) 
  •  Catch phrase: describe a word without saying it 
  •  Multiple definitions of a word, WALC 
  • Apps and Games:
    • Tetris
    • Jumbline 2 (very addictive!) :)
    • Boggle 
    • Goo
  • Multiple/non-traditional uses of an object 
    • I encourage extreme creativity here - a paperclip can be twisted into different shapes and each of those shapes can do various things.  A paperclip could also be enormous and become an artistic sculpture in the park, or a heavy anchor for a ship)
  • Sorting task 
  • Name several words in a given category, or do Brainstorming tasks
    • WALC 2
    •  Can get really abstract and creative for patients who need more difficulty tasks (my hubby, Matt came up with all of the following!  Nice job, Babe.)
      • Ways to wake someone up in the morning)
      • Name a cooking ingredient and name all the dishes that can be made with it
      • Name a body part or muscle and name all the uses you can think of
      • Name a significant number and have them name all the ways that make that number significant (e.g., 3.  Three's a crowd, three's company, a trilogy, Goldilocks and the 3 bears, the 3 little pigs, 3 strikes and your out...etc.) (10 ones make $10 10 tens make $100, based 10 numbering system, 10 fing4rs, then toes, count down from 10 when a rocket is launching, etc.) 42: 4/2 = 2 Jackie Robinson's number, both even numbers)
      • Name a color and have the patient tell you as many things of that color as they can think of.
      • Give the patient a word and ask them to think of all the songs with that word in it (e.g., love, baby, tonight, stars, heart, sleep, can't).
      • Etc! 
  • Categorize a list of words into sub-groups
  • Take a list of things that are all related to each other in different ways.  Have the patient organize that list in as many types of organizational ways they can thing of
    • E.g., take a list of flowers and have them organize it by:  color, look of the petals, alphabetically, number of letters, vowels, etc, etc,
  • Mind mapping
  • Journaling
  • List-making
  • Take a word
    • Give the definition
    • Homonym
    • Synonym
    • Antonym
    • Examples
  • Break down a word or idea
    • What is it for?
    • How valuable is it/
    • How is it used?
    • When is it used?
    • Who would use it?
    • Where?
    • Etc.
  • Breaking down a task
    • Simple
      • Planning a trip
    • Planning a meal
    • Plannning a party 
    • How to catch a fish
    • Make a paper airplane
    • Do your makeup
    • Tie a tie or tie your shoes
    •  More Complex 
      • How to write an essay (and I'll have them actually write one, especially if they areplanning to return to school)
      • How to make a Powerpoint (if they are familiar witht his.  Again, If they do this for work, I will have them actually prepare one)
      • For that matter (Lawyer- prepare a case or argument, etc.)
Comment below- what do you do to target DT with your patients?