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Why I Love Token Systems...

I have tried 12309 different ways to manage behavior and set clear visuals for my students over the past four years. I cannot express how much a simple token board has increased student participation and success in my therapy room. During my CF year, I remember a specific student whom I couldn't get to come into my room and sit down without rummaging through all the books on my bookshelf first. I had had enough so I requested that a para-professional from her classroom come and help me manage the impulsiveness and actually get some work done. It was like magic. As soon as the para-professional walked in and noticed the student demonstrating non-compliant behavior, she whipped out her favorite book "Frozen" and the student sat down. The customized blue token board was hers. She got to earn three Elsa tokens and then had 2 minutes to flip through her book. 
This might seem like a "DUH Mrs. Lacee" moment, but as a first year SLP, I hadn't yet realized how impactful a simple token board could be to a student. I truly believe customized token charts work wonders and the students enjoy having something "just for them." If you need a set of token boards or want to try them out, click here to see my bundle pack and click here for a FREE token board. 
I hope everyone has a great week!

Speech Me Maybe
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Working with High Functioning Students with ASD

Have you ever had a student that just didn’t seem to qualify on any standardized measure you gave him/her? When I was a brand new SLP, I stuck to those standardized scores like they were the end all be all. Learn from my mistake. Standardized measures do not always grasp or show the whole picture of a student and sometimes, they don’t even come close. For those students with what some call, “high-functioning autism” we have to dig a little deeper and our assessment looks a little different than what we usually do. According to the new DSM-5, there are three levels of severity when we are looking at ASD.

Level 1: In a nutshell, these are our students with severe communication deficits whom are typically non-verbal.
Level 2: These are our students whom posses substantial deficits in the area of communication. They make speak in simple phrases or sentences and have difficulty with basic language concepts.
Level 3: These are our students who need social language supports. They have trouble making friends, understanding conversation rules, and many other social pragmatic concepts.

I want to talk about our students that fall in that Level 3 area. These students typically had Asperger’s Syndrome. Now, we call it, Social Communication Disorder (SCD). Personally, I think that is a better reflection of the struggles they may face.

These students may have difficulty with:
-Eye referencing (moving their eyes for communicative purposes, joint attention skills)
-Reading and interpreting those non-verbal social cues
-Predicting what other will do next in a situation (vital skill in the classroom setting)
-Identifying what others might think or feel
-Knowing whose turn it is to talk
-Talking to much or too little (interrupting, off-topic comments, one-sided conversations)
-Understanding when to respond
-Lack of empathy
-Failing to demonstrate salient emotions

Where do we go from here? There really isn’t an objective standardized measure to assess these specific areas out there although, there are a few that are a great supplement during assessments. Here are a few suggestions when you are going through an evaluation period.

1) Social Competency Interviews: These interviews should be with a VARIETY of people including: parents or family members, teachers, friends, and the student. Check out my social competency questionnaire HERE. 
2) Observation: I typically try to observe in 2-3 different settings with different people. Check out this great observation rating form, HERE. Some things to consider while completing an observation are:
a. Who are they with? (Familiar or unfamiliar people)
b. What is the context? (class, P.E., lunch, small group, large group)
c. Preferred or non-preferred activity?
3) Collect a language sample. Observe a VERBAL interaction and attempt to take a language sample. Language samples can tell us SO much information about the student. Look for those unwritten rules of conversation.
If you are looking for an Informal SCD Measure, check out this resource!

Social Communication Interventions
You’ve collected all your data, made your decision, and believe that this student may benefit from skilled speech and language services in the areas of pragmatics. Some things to think about before you begin treatment…

1) Individual or group setting?
2) Contrived or naturalistic learning opportunities?
3) Incidental or direct treatment?
4) Setting? In the home or school?
5) Peers? Same-age? Typical or atypical?
6) Amount of time?
*No matter what you choose, it should be individualized for each student.

There are a huge variety of social skills curricula out there and there is no right or wrong way to go about it. Some things that I have found effective when conducing social groups are…
1) Social Stories by Carol Grey
2) Counseling techniques
3) Social Behavior Mapping by Michelle Garcia-Winner
4) Video Modeling
5) Zones of Regulation by Leah Kuypers

An important item to consider when treating students with SCD is anxiety. It is not uncommon for our students to have co-existing anxiety disorders. These may decrease academic and social performance and if left untreated, we may never see their true potential.

I hope this post gives you some kind of idea on where to start when you are assessing and treating individuals with social communication disorders. Please comment below with some intervention techniques that have worked in your therapy room!
Speech Me Maybe
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7 Behavior Strategies You Should be Implementing

I wanted to share 7 general behavior strategies that are super helpful in my speech room. You are probably a rock star therapist and already implementing these on a daily basis BUT a good review never hurt anyone.

Tip #1 – Use a visual schedule.
Why you ask? It decreases anxiety about the unexpected. It shows what is expected of them. It shows when a preferred activity will occur.

Tip #2 – Give choices.
Why? If you choose two activities that will work towards the objective and let them chose, it gives them a sense of power. Share the power.

Tip #3 – Provide Assistance.
Why? Establish yourself as someone the student feels safe with and WANTS to be around.

Tip #4 – Take breaks.
Why? Multiple breaks are better than pushing until they break and not being able to return to the session.

Tip #5 – Slowly increase demands.
Why? If you don’t pair with your student and establish that rapport, they will not want to work for you.

Tip #6 – Use visuals.
Why? Because providing the quickest most effective response form allows our students to be more successful. Visuals can be symbols for “outs” like ‘break’ or assistance like ‘help’. You can also use visual timers so they students knows how long he/she as to work.

Tip #7 – Gain their trust.
Why? Build rapport. Have a couple sessions where you do not place any demands on them. It will pay off in the long run!

I hope these tips are helpful for you in your speech sessions this week!
Speech Me Maybe
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Tips for Working with Students with Complex Communication Needs

Most of my caseload this year is made up of students with complex communication needs. Some students have multiple-disabilities that can make treatment planning and implementation difficult – but not impossible. I want to share some tips that I’ve found to be helpful when working with this population.

1) My first tip is probably the most important. A professor of mine from graduate school always stressed that we need to give these students POWER. Power with their communication devices as it is the only way for them to access the world.

2) In order to give them the most power, we must give them the tools to be an ACTIVE participant in the classroom. It makes me so sad to walk into a classroom and the student’s device is in his/her binder or desk. How are they expected to participate without a voice?

3) Adapt materials to best meet their needs. Do they need large visuals? Do they need an eye gaze system so they can make their own choices? Maybe they are at the object level or need textures to identify with familiar items?

4) Implement functional communication in the classroom. Place a single message device next to the door and prompt them to hit it if they need to leave to go the restroom or if they want to take a walk.

5) Use what you have. In this product you can see that I’ve use common battery operated toys, low tech, and high tech devices to meet each individuals needs.

6) Have fun with these students! The students that seem to present the biggest challenges always reveal the biggest rewards in therapy.

Check out this resource if you need specific lesson plans for students with multiple disabilities.

-Stay amazing!
Speech Me Maybe
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