Executive Function, Language Therapy, Pragmatic Language, Social Cognition

Ideas for Social-Cognitive, EF, Pragmatic Language Therapy: Part 2

I promised a part 2, and I shan’t disappoint (shan’t…I went there!). As a continuation from my first post with ideas for social-cog, executive function, and pragmatic language therapy, this second post will keep the ideas flowing and hopefully add to your arsenal of go-to activities.

Visuals, Visuals, and More (concrete) Visuals:

I am steadily learning the importance of supporting social communication intervention with tons of visuals. When I think I’ve reached the visuals peak, I cut and laminate one…more…thing. Why? Because so many of these clients benefit from visual supports early on in their therapy. I recognize that you might be worried about setting them up to be dependent upon these visual aids later, but in my humble experience, I usually end up spinning my wheels and banging my head against the wall when I nix the visuals and overestimate how well the client will perform. Here are a couple ways to make Social Thinking concepts more concrete through…(you guessed it…) VISUALS!

Are you working on mind files or friend files? Use an actual file folder to show how these mental files can store information about others. The amazing Sean Sweeney and Pamela Ely at The Ely Center taught me this fun acronym for teaching kids what kinds of information belongs in a mind file. As you can see, I ended up changing “mind file” to “people file” since my client had such a hard time remembering that these files are about people (and not everything under the sun). However you decide to coin the term, think about using concrete visuals to support initial stages of learning!

 

The Social Detective book from the Social Thinking curriculum is a great resource for introducing kids to critical social communication skills involved in being a social detective, but I have found that creating a real (ok, ok…paper) toolkit gives kids ownership over the social communication tools they are acquiring. I let them add the eyes to their toolkit once we’ve finished our “thinking with your eyes” activity for that day. As we target more concepts (like “thinking with your ears,” “brain in the group,” etc.), they get to add those tools to their toolkit. Sometimes it can be fun to pull out the tools you need in a particular situation. Once again, the visuals are just a support for teaching these foundational skills and making sure the information is relatable and concrete. 

Expected/Unexpected By Context Game

I used this activity to probe my client’s current understanding of expected and unexpected behaviors in different school contexts, but you could very easily use this as a teaching tool as well!

 

I start by having the client choose a context/environment/setting out of a hat (e.g., “In math class”). He then has to sort a variety of behaviors (also picked from a hat) to determine whether they are expected or unexpected in that particular context. Even if you only got this far in the activity, you would have some awesome information about how well the client can determine what’s expected versus unexpected in key environments throughout his day. Once this initial sorting is done (and the subsequent discussion has occurred, if you choose to discuss their choices), you then have the client choose a different context from the hat and switch it into the original context’s place. The client must now decide if some of the behaviors that initially were sorted as expected belong in the unexpected category (and vice versa). Some different context ideas are included below:

 

Why does this skill matter? It’s not enough that clients can determine what’s expected or unexpected in a static setting. They need to recognize that expected behaviors may change depending on the context: it’s fine to run around on the playground at recess, but running becomes unexpected when you are in the middle of social studies class. This activity helps to support the cognitive and social flexibility needed to shift expectations between settings.

Thinking With Your Ears: Easy Activity to Introduce Inferencing Skills

I had to start verrrrrrrrrry basic when introducing “thinking with your eyes” and “thinking with your ears” for my current client. Specifically for “thinking with your ears,” we spent a fair amount of time just identifying the sources of sounds with a couple different sounding board apps (Touch the Sound by Innovative Mobile Apps and SoundBoard by Lux HQ Ltd.). Once he was tuned into thinking about what he heard, I moved to the activity I’m here to highlight. I laid out sets of pictures I’d printed, and the client’s job was to think with his ears to choose the picture that best matched my verbally read sentence. I started with very concrete sentences, and slowly increased the complexity to include sentences or utterances that required increasing amounts of inferencing skill. The more abstract the sentence, the more the client had to listen for contextual clues to guide accurate picture choice!

 

Examples of sentences for the pictures above:

Easy/Concrete: “The man wore a tiny hat”

More Challenging: “It was cold outside”

 

Examples of sentences for the pictures above:

Easy/Concrete: “The boy was working on his test”

More Challenging: “All his studying paid off in the end” or “I wonder what the teacher will ask”

 

Examples of sentences for the pictures above:

Easy/Concrete: “The kittens snuggled on the blanket”

More Challenging: “They looked almost identical” or “All three enjoyed being in the sunshine”

Well, that sums up part 2 of my therapy ideas for this tricky, but awesome group of clients! There are so many great resources out there, and I encourage all of you to find ways to share the cool intervention techniques you’re using!

 

 

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Nominations for the 2012 Edublog Awards

As the excitement of ASHA 2012 settles, it’s time to turn our attention to another exciting time for all those social media guru’s out there with the Edublog Awards! If you’re not familiar with these awards, they were originally started in 2004 to “promote and demonstrate the educational values of these social media.” For more information about how you can nominate your favorite blogs and sites, check out the Edublog Awards website. Considering how much I rely on and benefit from my social media family, it’s nearly impossible to nominate just one blog/person/site for each of these categories. That being said, I’ve done the (nearly) impossible and my nominations are as follows:

Best individual blog: There are so many fabulous blogs out there, but Jeremy Legaspi’s blog, The Speech Guy: Tech Savvy Speech Therapy rises to the top. Jeremy shares the ideal mix of app reviews, career-related information (job searching, salary expectations, etc.), assistive technology tips, and (best of all) functional ways to adapt apps to be excellent therapy tools! I have certainly become a more tech-savvy clinician from reading Jeremy’s blog and am always impressed by the new ideas he brings to the table!

Best group blog: My vote in this category goes to the ASHAsphere blog. Maggie McGary has done (and continues to do) and amazing job compiling great posts from various bloggers in the field to create a blog that’s educational, relevant, creative, and all in all a nice resource for sharing SLP ideas!

Best student blog: Being an SLP grad student myself, I put a lot of stock in high-quality blogs written by fellow grad students, and Katie Millican’s blog, SLP_Echo: Just Another SLP in the Making is not to be missed! Katie’s posts range from helping readers learn about the wonderful world of social media to offering countless ideas and recommendations for students getting ready to apply to an SLP grad program!

Best ed tech / resource sharing blog: Sean Sweeney has emerged as our field’s expert when it comes to integrating technology into awesome therapy and his blog, Speech Techie is the golden ticket to learning more about the amazing benefits technology can offer. I never thought it was possible to find a blog where every single post is well-written, interesting, and beneficial…until I found Sean’s Speech Techie!

Best individual tweeter: Tara Roehl, better known on Twitter as @SpeechyKeenSLP, makes me feel ever-connected to the SLP world through her regular tweets. Each and every day she can be counted on to tweet about the latest news in the field, great therapy ideas, thought-provoking questions, and the occasional morale booster for a fellow SLPeep. Thanks to her awesome tweeting, I felt like I was right alongside her in her ASHA convention sessions, learning about her sessions and mine!

Best twitter hashtag: No competition here: the one and only #slpeeps! This hashtag is a gateway to an amazing community of speech-language pathologists and speech-language pathology graduate students! On any given day, you can follow #SLPeeps to learn about new apps, ask and answer questions, engage in professional discussions/debates, and network with friends across the country (and even world)!

Best educational use of a social network: PediaStaff’s Pinterest boards are an incredible resource for speech-language pathologists, occupational therapists, physical therapists, special education teachers, general education teachers,…you get the idea! They are amazingly well organized and span so many categories that you just might get dizzy with all that scrolling!

Best Mobile App: Custom Boards Premium by Smarty Ears is the app that gets the most use on my iPad each and every quarter. Between the countless layouts, thousands of Smarty symbols, ability to tap into saved photos on the iPad, and access to Google images, there’s no better or faster way to make visual schedules, games, articulation boards, etc.!

Writing this post on Thanksgiving makes me extra thankful for the amazing contributions the above people and blogs have made to the field of speech-language pathology. I am constantly awed to be a part of this great community!

Executive Function, Language Therapy, Pragmatic Language, Social Cognition

Ideas for Social-Cognitive, EF, Pragmatic Language Therapy: Part 1

I work with a high schooler who (in honor of Thanksgiving) has a cornucopia of challenges in the social cognition, executive functioning, and pragmatic language realms. I am by no means an expert on this population, but I’ve been lucky enough to spend time interning with a few experts in this area of speech-language pathology (Pamela Ely and Sean Sweeney), and also received a scholarship to attend the Social Thinking conference in Portland, OR this past October. These experiences have given me a solid foundation for developing intervention plans for kids who fall somewhere on the spectrum of social language deficits.

Just to complicate things a bit, clients with social communication deficits rarely have isolated issues with pragmatic language. Often, they have concomitant challenges with executive functioning, cognitive flexibility, and overall impaired cognition. As such, effective intervention requires lots of adaptation and a willingness to incorporate ideas and methods from a variety of sources. I love mixing resources from Michelle Garcia Winner’s Social Thinking ® curriculum, Sarah Ward’s executive functioning curriculum, Pamela Ely’s social cognition curriculum, and Bonnie Singer’s self-talk curriculum. This 2-part blog post is all about sharing some of the ideas and visuals I’m using in my therapy with this current client, and highlighting the amazing minds who have come up with the awesome ideas underlying what I’m doing!

Probe for Perspective Taking

Although I did this as a probe to gather some baseline data about my client’s perspective-taking abilities, you could easily use this as a treatment activity to support the development of perspective-taking skills. I used sequence scenes from the following set of cards:

The reason I like this particular set is that it has sequences with 6-8 cards each (which makes the task more challenging for the client). You’ll want to pull out all the cards that relate to a single sequence and flip them over so the pictures themselves are hidden. Ask the client to choose one card and keep it hidden from you while he looks at it. First, ask him who knows what card he has (correct answer: “me”). Next, ask if you know what card he has (correct answer: “no, I’m the only one who knows what’s on the card”). Then, ask him how he could help you know what’s on the card without just showing it to you (correct answer: “I can describe it to you”). The client’s response to each question provides valuable information about their ability to take another’s perspective. Finally, have the client describe the picture to you using whatever details he chooses. Once he’s done describing the card, slide it back into the pile (still face down), shuffle all the cards, and then flip them all over so the pictures are showing.

You then try to guess which card the client had based only on the details he described. Since many of these cards have similar items (bike, boy, mom, helmet) and the client likely didn’t give enough detail to isolate a single card, you can narrow down your choices of possible cards and see if he can provide enough specific details to identify his chosen card from the others. This is a great little task for both determining a client’s current level of perspective taking and for teaching the skills associated with strong perspective taking!

Self Talk Visual

My client requires LOTS of visual support as we tread through the concepts of social cognition and pragmatic language. This is a super easy way to help him contextualize self talk as something that occurs like a thought bubble. Even though we do a lot of audible self talk right now, I’ll eventually fade that along with the visual aid. For now though, I model self talk by holding up this laminated thought bubble (yeah yeah, I know it looks like a laminated intestine…it’s not art class!) and often ask him to do the same. All you need is some card stock, a laminator, and a few straws (covered in tape) for the handle!

Sometimes, I use this same thought bubble to demonstrate when I’m having a red or green thought, and the kinds of feelings those thoughts give me. The beauty of laminating everything is that you can write on them with dry erase markers and then just wipe them clean. I stick my green or red thoughts to the velcro inside the thought bubble and specifically indicate the emotion that I’m feeling:

Conversation Roadmap

Once I taught my client how to introduce short, concise topic statements that let people ask “wondering” questions (i.e., wh- questions), I moved onto the conversation timeline. Little did he know that conversations don’t just involve one person talking for 20 minutes about the topic of their choice. This visual gave him a concrete way to recognize the basic components of a conversation, and even helped to reinforce the idea of talk time I’d previously introduced (color coding the cards made this a piece of cake). Since we were practicing conversations as a pair, I had two differently colored sets of cards. The “topic” card indicated a topic statement for the conversation, the “C” card indicated a comment, the “?” card indicated a question, and the “R” card indicated a response to a question.

Each time someone added something to the conversation, they mapped out their addition by laying down the corresponding card. This gave us a concrete way to go back and consider the parts of our conversation and what worked/didn’t work! It also let him see how often each person was contributing (if one person dominated the whole conversation, there would be only one color).

My second post will include a couple more therapy ideas and visuals to consider when working with kids with social-cognitive/pragmatic language impairments. Hopefully these ideas spark your own creativity!

Just for Students, Random SLP

Research Methods for the Common Denominator: Part 2

I have no doubt that part 1 of this (very) mini-series was one of the most exciting blog posts you’ve read to date. In fact, you probably walked away from your computer feeling 1.0563 ounces smarter (yes, intelligence is obviously measured in ounces). As I sit here writing part 2 of my research methods informational post in my new reading glasses, I know I already feel just a tad bit more brilliant (yes, the reading glasses definitely help).

In this post, I’m going to impart upon you some facts about the statistics that you’re likely to find in research papers. To start off, there’s an important distinction to make between descriptive statistics and inferential statistics.

Descriptive Stats: describe or summarize data about your sample/group of subjects.

Inferential Stats: uses what you now know about your sample (since you just performed research) to infer about the population that your sample represents. So, if you were testing a new treatment method on a subject pool of 30 children with Down Syndrome, you would likely be inferring something about that treatment method for all children who are similar to your sample (i.e., kids with Down Syndrome).

Within descriptive statistics, you will want to consider a handful of different specific statistical measurements, starting with distribution. A frequency distribution generates a curve that shows you the frequency of responses/scores at different levels (e.g., different ages, different severities, etc.).

from: http://www.sciencedirect.com

The curve might come out looking like a normal curve, which is symmetrical, has a mean, median, and mode with the same value, and aligns with 68.2% of the population being within 1 standard deviation of the mean.

On the other hand, your curve might end up being a skew curve (positive or negative) or a kurtosis curve (leptokurtic, or platykurtic). Regardless of how your frequency distribution curve turns out, it’s important to understand that different curves imply different things about the effect of the independent variable on the dependent variable. In addition to considering the frequency distribution, you may also have information about the central tendency: mean (average), median (half the values are higher and half are lower), and mode (value that occurs most frequently).

Variability is a critical factor of descriptive statistics. The standard deviation tells us the average deviation of scores from the mean, and this range of variability might indicate that most scores were similar to one another, and therefore the mean can be confidently counted upon. If the scores are all over the place, the mean might not be very representative of the actual range of scores received by the sample.

Inferential statistics begins by testing a hypothesis. The alternative hypothesis hypothesizes some kind of effect of the independent variable on the dependent variable (e.g., X treatment will benefit Y population). Often this is what the researchers hope to find at the end of their study. The alternative hypothesis cannot actually be proven by statistical tests (although it can be supported); rather the null hypothesis (which says the independent variable will have no effect on the dependent variable) is rejected when the alternative hypothesis is supported. In order to reject the null hypothesis and support the alternative hypothesis, researchers use a cut-off value, or significance level (alpha), to decide the point at which the independent variable was effective and statistically significant. Typically, the significance level is <.05: if the observed p-value is <.05, the probability of this result occurring by chance is less than 5 in 100, and therefore can be attributed to a real effect of the independent variable. Although <.05 is the most common significance level, it’s actually just an arbitrary number and, at times, may lead to Type I or Type II errors.

Various characteristics can affect whether the results of a study are significant (i.e., p = <.05). A bigger effect size (more difference between the treatment group and the control group) typically supports significance. Less variability (aka a smaller standard deviation) also supports statistically significant results. Finally, a larger sample size is more likely to support statistical significance.

With all this being said, statistical significance is just one piece of the inferential statistics puzzle. Other statistical outcomes that look at testing differences and correlations must also be considered. However, I’d like to think your brain has worked hard enough for one day, so I’ll leave those explanations for another time and another place!