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What's in a name?

blogEntryThumbnailOn March 6, 2014, my wife and I welcomed our first child, Levi James Sailers, into this world. Since his birth, we have been asked about his name. People have speculated that Levi was named after Matthew McConaughey’s son, or that his name was picked from the bible. Although I’m sure that Levi McConaughey is a great kid, and Levi is a biblical name, we selected his name from another place.

Levi was named after a child I worked with in Tucson, AZ during the summer of 2001. At that time, I was a research assistant in a study at Wings on Words preschool, and one of my participants was named Levi. He had several speech sound errors that made him difficult to understand. He reminded me of myself when I was his age because I had similar difficulties. Throughout the 4-6 weeks of the study, I watched Levi improve his speech and language skills.

One day toward the end of the study, the preschool’s speech-language pathologist (SLP) asked me to watch Levi practice his speech sounds. He accurately produced his speech sounds in words, one flashcard after another. I was floored by his progress. Then, after the study had completed, I returned to the preschool to do paperwork. I walked through Levi’s class, and he ran up to me. His teacher was nearby and she told him that I would not be seeing him. Our time together was over. Immediately, he ran into the corner and cried. I went over to console him and to tell him how much he meant to me. As I was talking to him, I thought about how much he really touched me, and how speech-language pathology was a career that I wanted to pursue. So, without any hesitation, I went on to become an SLP.

Over the years of being an SLP, I thought about Levi and how much I liked the name. So, when it came time for my wife and I to name our son, I strongly encouraged the name, Levi. After some convincing with a story similar to the one here, my wife agreed with the caveat that she gets to pick our second child’s name. And she repeatedly said that she wanted it in writing, so her wish is my command. :-)

I just wish I would have stayed in touch with Levi from Wings on Words, as it would have been cool to see him grow up and to tell him how I named my son after him. Unfortunately, that was not to be. Oh well. At least I will always be reminded of him by my first born child, who my wife and I named Levi.
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Summer speech for little Eric

firefighters2
Image from the US Air Force

My mom was reading this blog post for expanding language on holiday, when she got the idea to email a story about how I practiced speech as a little guy. She shared the following with me:

I read this and remembered how we seized the opportunity to work on your speech while on vacation. The summer after you turned 4 years old, your speech therapist wanted us to practice your speech. To maintain the “f” sound that you had learned during the school year, we practiced it as we drove up the California coast to Monterey. You really liked firefighters and firetrucks, so I created flashcards for those words and others. I had the cards prepared in advance for the coastal trip, and we brought markers, too.

In the car, I sat in the backseat with you so that we could practice your words. I would show you a card and ask you to say the word. Once you repeated a word, you were allowed to draw a picture of it. The speech therapist had said, “First you say it, then you draw it!” You loved drawing pictures, so that helped motivate you to practice your sounds.


As we were driving along the beautiful coast, hard at work practicing in the back seat, the traffic on the freeway suddenly started to slow down. Upon looking up, we saw thick clouds of grey smoke, and several policemen standing in front of a blockade. The traffic came to a stop. A policeman approached our car and told us that we needed to get off the freeway due to a severe fire ahead. It looked like our trip to Monterey had hit an unexpected detour.

We exited the freeway and decided to stop off at a hotel for the night since it was unlikely we would be able to travel any further. The front desk clerk at the hotel informed us that firefighters working in the area would be using part of the hotel to take breaks between shifts. Even though the hotel would be busy and a bit noisy, we said that was fine and we went to our room.

Once we arrived in our room and looked out the window, I could tell this would be a great opportunity for you to gain some speech practice with real life images. We could see all kinds of “f” sounds right in front of us: firefighters walking around, fire trucks in the parking lot, and flames in the distance.

Keeping in mind what the therapist said, “First you say it, then you draw it,” the unexpected detour of the fire that day led to more valuable practice and quality time with you.

Shortly after I read my mom’s email, I contacted her to ask if I could use the story in a blog post. I thought the story was great and I also felt that SLPs and parents would be interested in reading it. In this age of technology, when parents can easily be overwhelmed by thoughts of how to help their children effectively practice speech, this story offers a reminder that even the simplest of activities can make a big difference.
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What Causes Speech Disorders in Children?

blogEntryThumbnailThe following is a guest post from Erica L. Fener, Ph.D. at Progressus Therapy.

All children go through periods where their speech is not perfect. That's true of any skill as it's acquired and then perfected. However, concern about a true speech disorder in your child is warranted. What causes childhood speech disorders and how can they be remedied?

Environmental reasons:
  • Lack of proper speech models
If children are around people who do not model appropriate speech, they won't learn how to speak properly. For example, children whose parents use "baby talk" for too long often don’t know how to speak properly.

Remedy: As a child grows, the speech patterns he or she hears should mature also so that the child learns to mimic and then fully understand language and appropriate pronunciation.
  • Too little time spent in conversation with older children and adults
From two to five years old, most children chatter nonstop if given the chance. This is actually an important part of their speech development. If they are not allowed to speak freely or if language is discouraged in some way, speech disorders may result. 

Remedy: While good socialization skills necessitate children being quiet at times, parents should allow children to engage in conversation as much as possible, for full speech development. These conversations also provide great opportunities for adults to appropriately model proper speech.

Physical or developmental reasons
  • Structural abnormalities
If a child cannot hear properly or has structural abnormalities in the mouth or throat that affect speech, such as cleft palate, speech does not develop normally.

Remedy: Surgery and/or use of assistive devices can restore hearing and speech capabilities, so that speech can develop normally. For example, young children often have frequent ear infections and buildup of fluid in the ears, making it difficult or impossible to hear others’ language so that it can be imitated correctly. Surgically implanting ear tubes can resolve fluid buildup, so that hearing is possible. Similarly, correcting a cleft palate makes normal speech development possible.
  • Developmental language and speech disorders
Learning disabilities, such as developmental speech and language disorder, may cause children to have difficulty with or be incapable of producing speech, communicating through spoken language, or understanding what other people are saying. Unfortunately, such developmental disorders often coincide with other learning disabilities such as dyslexia. It should be noted that this in no way reflects on a child's intelligence, and early intervention is key to remediation.

Remedy: As children get the assistance they need with their disabilities and acquire the tools they need to manage their disabilities, they learn to express themselves clearly, acquire new vocabulary and concepts as quickly as their peers do, and understand written and spoken direction so that learning proceeds at a normal pace.

Developmental disorders such as autism can cause speech delays to varying degrees. Children who are severely affected may speak very little, or when they do, may simply "echo" what someone else says using the same tone, inflection, etc., with no real understanding of what's being said. Special, intense language therapy is required.

Remedy: Early intervention is key to minimizing developmental speech delays.
  • Neurological disorders
Children with neurological conditions such as cerebral palsy may have difficulty with speech because of brain damage that occurred during birth. This speech difficulty is not structural in nature and usually does not affect receptive language, only communicative language.

Remedy: Similar to an adult who has had a stroke, these children can learn to speak with varying degrees of success, or can use assistive devices that create speech for them, at their direction, much like the voice device famed physicist Stephen Hawking uses to communicate.

About the author:
Erica L. Fener, Ph.D., is Vice President, Business Development Strategy and Analysis at Progressus Therapy, a leader in connecting their candidates with school-based
SLP jobs and early intervention service jobs.
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A Birthday Wish for Eric

blogEntryThumbnailI decided to hijack my husband’s blog today in order to wish him Happy Birthday! There have been many early mornings when I awake to him typing away about iPad accessories, a great app, or a teaching strategy he wants to share. So, this is my chance to share a little bit about Eric. (Though, I’m a night owl, so my crazy typing happens late at night!)

Eric is one of the most caring, dedicated people I have met in the field of education. The time and energy he devotes to helping colleagues through training, app development, and email support is admirable; even more than that, his love for making a difference in the lives of children with special needs is inspiring. I am always in awe of how he finds a way to help every child communicate and to have fun while working to overcome obstacles. As an educator, I know first hand how many challenges we face in our field today, and Eric embraces all of them with a positive attitude, a compassionate heart, and a remarkable spirit. I so often wonder how he manages to do it all and still put up with me ;) Honey, here’s to an incredible 33rd birthday and hope for many more happy days to come!

All my love, always

Kelly

Photo of Eric and Kelly Sailers was captured at the 2012 ASHA Convention.
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5 ways to use Apple voice dictation

blogEntryThumbnailAs I've had access to voice dictation on my Apple MacBook Pro and iPhone for the last year or so, I have been using it more and more to increase productivity (as long as it’s working properly). I use voice dictation several times each day for leisure and professional purposes. Here are 5 ways that I use voice dictation on the MacBook Pro and iPhone:

1. Composing multi-paragraph documents

Since it can be difficult for me at times to begin writing a multi-paragraph document, voice dictation gets me started and keeps me going when writing blog posts, reports and proposals. I just have to remember to dictate formatting (e.g., “new line,” “new paragraph”) and punctuation statements (e.g., “comma,” “period,” “question mark”), then proofread the document carefully for dictation errors. Otherwise, the document appears as a poorly formatted written composition with typos.

It’s also important to note that voice dictation can only convert a limited amount of speech (approximately 30s) to text. It takes some time to feel comfortable with continually activating voice dictation after each chunk of text is converted. Just remain patient and you will soon see how composing sentences and paragraphs via voice is significantly faster than typing.

2. Brainstorming and reminding

When I have a thought that I don’t want to forget, I use voice dictation to brainstorm ideas and set reminders. Whether I have a good idea for an app feature, or I need to remember to take out the trash, voice dictation enables me to do either quickly. The efficiency is great because I’m typically in the middle of doing something else.

3. Calendaring events

Using Siri (the intelligent iOS assistant), I can quickly and easily schedule an event such as a staff meeting. For example, I can activate Siri and say, “Schedule a staff meeting for Tuesday, April 9th at 2 PM.” Then, all I need to do is confirm the event and configure additional options such as an alert.

4. Finding contact information for businesses

If I’m somewhere unfamiliar, I can use Siri to help me find a business. For example, if I’m on a work trip and I want to go out for food, I use Siri to ask, “Where are nearby restaurants?” The results provide nearby restaurant information with hours, a map, and reviews from Yelp to help me find quality food.

5. Texting and emailing

Texting is very easy with voice dictation, especially since abbreviations are acceptable input and punctuation is rarely necessary. Emailing with voice dictation has a slightly higher learning curve, but it’s not impossible. Similar to writing multi-paragraph documents, it’s important to use dictation commands for formatting and punctuation. Additionally, it may seem a little strange at first to dictate emails when others are around, but it soon feels similar to talking on the phone in public.
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Substitute SLP

blogEntryThumbnailFor the past month, I was a substitute SLP at a local speech clinic in San Diego, CA. I covered for a couple clinicians while they were out. It was interesting because I never substituted like that, plus I was asked to provide therapy to different age groups and do it in a private practice setting. One of the age groups is two-year-olds.

It had been a couple years since I provided therapy to two-year-olds, and even then, I only worked with them for a year during my six years as an SLP employee of a school district. Prior to that, I received some experience with two-year-olds during grad school, but I usually gravitated to working with older children. So, I felt the need to prepare for the little guys.

After reviewing goals, I realized that I needed to practice signs and phrases appropriate for fun activities. I went to YouTube almost immediately to search for child-friendly ASL signs, and discovered great video demos from a woman with a business called My Smart Hands: http://www.youtube.com/user/SmartHandsCA/videos?view=0. The real-life and animated videos reminded me of signs for finished and fish, but also taught me signs for farm and songs like Twinkle, Twinkle Little Star. Viewing the signing videos led me to thinking about activities I would do, and what I would say during the activities.

During the speech sessions, I targeted signs in activities with toys, songs, and books as I sat on my cushion with the child nearby on the ground. I also found myself modeling words with VC (Vowel-Consonant e.g., “up”), CV (Consonant-Vowel e.g., “go”), and CVC (Consonant-Vowel-Consonant e.g., “pig”) combinations in 1-3 word utterances. It all came back to me as I demonstrated self-talk (talking about what I was doing) and parallel-talk (talking about what the child was doing) strategies to facilitate communication. Despite occasional tantrums, it was very fun and rewarding therapy with the two-year-olds. I also liked sharing strategies with the parents during or after sessions, so they could enhance progress at home.

Preparing in advance for the sessions seemed to help me a lot. Overall, I enjoyed my substitute SLP stint that consisted of a fair amount of therapy with two-year-olds. I look forward to upcoming opportunities as a substitute SLP. Luckily enough, I was recently asked to cover again at the private practice in April.

Image source: YouTube page for My Smart Hands.
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Summary of a video modeling tutorial

blogEntryThumbnailWhile preparing for a recent workshop in San Diego, I discovered a video modeling tutorial, “Incorporating Video Modeling Into a School-Based Intervention for Students with Autism Spectrum Disorders” by Kaitlyn P. Wilson. The article - in the January 2013 edition of Language Speech and Hearing Services in Schools (LSHSS) journal - described the steps for Speech-Language Pathologists (SLPs) to effectively implement video modeling for students with Autism Spectrum Disorder (ASD). I thought the content was excellent for including in my workshop and a blog post.

For this blog post, I’d like to summarize the five procedural phases presented in the tutorial:

Phase 1: Preparation
  • Choosing an appropriate target skill - Choose a skill that is clearly modeled and easily observed, as well as individualized to the student’s needs. Internal skills such as receptive language (e.g., comprehending vocabulary words) or social understanding (e.g., recognizing others’ emotions) are not appropriate targets for video modeling. However, observable external skills such as greetings, requesting, taking turns in play, or initiating interactions are the most appropriate targets for video modeling.
  • Choosing a model type - Intervention has been proven effective using all types of models, including peers, adults, and self (i.e., the student). Studies have shown that using the student as the self model is most effective when the goal is to reduce problem behaviors or increase compliance.
  • Choosing a setting - The ideal setting for the video model will be the setting in which the student is expected to perform the targeted skill. Using the natural setting has been shown to produce greater intervention effects and higher levels of skill maintenance and generalization.
  • Scripting the video model - The optimal length of the video model is 3-5 minutes, but studies have shown intervention effects with videos ranging from 35 s > 5 min. To determine the optimal length for a given student, consider the student’s attention span or arrange a trial viewing. There are additional considerations for scripting the video model such as whether to add a voiceover narration. For some students, the added narration can pose an auditory processing problem that reduces the intervention’s effectiveness.

Phase 2: Recording of the Video Model
  • Choosing equipment - Choose a video recorder that will provide adequate video and audio quality during playback to the student.

Phase 3: Implementation of the Video Modeling Intervention
  • Determining setting and frequency of viewing - In regard to the setting for video playback, it is best to choose a setting that is quiet and free from distractions. In regard to the frequency of viewing, research suggests repeated viewing (two to four times per session) increases intervention effects for some children with ASD.
  • Determining timing of viewing - The video model can be played immediately prior to the child demonstrating the expected behavior (to target imitation of the behavior). Or, the video model can be played at a time removed from the situation in order to target learning, maintenance and generalization of the skill.
  • Determining who will implement the intervention - With some instruction from the SLP, any of the student’s caregivers or classroom staff can implement the video modeling intervention.

Phase 4: Monitoring of Student’s Response to the Video Modeling Intervention
  • Choosing methods of data collection - Since few standardized tests are sensitive to changes in targeted behaviors, an adequate form of progress monitoring is behavioral observation. A predetermined criterion can be used in the behavioral observation to assess the student’s progress based on their goals. You may also choose to include the student in the data collection via self-monitoring of the targeted skill.
  • Promoting and evaluating generalization and maintenance of skills - Generalization of video modeling intervention in different settings and with different people has been demonstrated for students with ASD. Generalization has been shown following as few as three video modeling sessions; plus, maintenance of acquired skills has been observed for as many as 15 months following video modeling intervention.

Phase 5: Planning of Next Steps
  • Next steps if video modeling is effective - If a student demonstrates progress in the targeted behavior, the SLP may wish to expand on the skill. For example, if a student displays progress on a pointing skill, the SLP may choose to expand the video modeling to pointing and a vocalization.
  • Modification options if video modeling is not initially effective - If the student initially demonstrates little or no progress with the targeted skill, the SLP may choose to modify the intervention based on the individual student’s preferences, strengths, and needs. Modifying the video modeling intervention could include changing the individuals modeling the targeted skill (if the student doesn’t like the individuals), or silencing the sound during video playback (if the auditory information is posing a processing problem).
  • Alternative intervention options if video modeling is not effective - Video modeling will not be effective for all students. If modifications to the video modeling intervention have not resulted in progress of the targeted skill, there are alternative treatment options. Alternative effective interventions include self-monitoring strategies, individual work systems, peer-mediated strategies, social skill groups, and social stories.

In this blog post, I summarized five procedural phases of implementing video modeling in a school based intervention for students with ASD. If you want to learn more, I recommend that you read the journal article in LSHSS: http://lshss.asha.org/cgi/content/full/44/1/105. Note that you must have access to the American Speech-Language-Hearing Association (ASHA) online journals in order to view the full article.
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Car accident implications on the Closing The Gap Conference

I was in a pretty bad car accident on Thursday, September 27. I had slowed to a stop behind several vehicles in a freeway exit lane, when someone’s car slammed into the rear of mine. Shortly thereafter, I was rushed to the ER, and to make a long story short, I sustained a gash in my left elbow that required stitches, a fractured tailbone, neck and back pain, and several abrasions.

Yesterday, I went to my general practitioner to follow up on my injuries. My doctor told me it would take about 6 to 8 weeks to recover. During the recovery process, he recommended that I rest, take pain medication and other over-the-counter medications, sit on an inflatable donut, and do physical therapy.

I asked my doctor about attending the upcoming Closing The Gap Conference which would involve flying for several hours. Due to the discomfort I'm experiencing in my lower back, he highly discouraged me from flying. The discomfort is quite an issue, as I have to stand regularly because it hurts to sit for an extended period, even on the inflatable donut.

This means that I had to make a difficult decision and withdraw from the 2012 Closing The Gap Conference. As a result, I canceled a StoryPals session and withdrew participation from an iPad pre-conference session and corresponding lab. I feel very bad about doing this because I put in a lot of preparation thus far, and I was really looking forward to presenting. However, I understand the priority right now is to recover fully from the car accident.

I notified my co-presenters and the coordinator of the Closing The Gap Conference, and it's my understanding that the participants have been notified of my withdrawal from the pre-conference session. Although I will not be participating, I am 100% confident that my co-presenters, Cathy Kingeter and Luis Perez, will provide an extraordinary experience during the sessions. My co-presenters will also provide several prizes that I procured for the pre-conference session. I would like to recognize the companies who graciously provided those prizes:
  • Wacom
  • Speck
  • Studio Neat
  • Big Grips
  • Trident
I hope to recover as I pursue all recommended treatments in the coming weeks.
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Back to School

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Photo by thebassoonist12

My wife is a middle school humanities teacher and I was talking to her about her first week back with students after summer break. Since I no longer work for a school district, I wanted to know what she liked about being back. She said five things that I’ll do my best to accurately list here:
  1. Getting back to a daily work routine
  2. Seeing the staff
  3. Contributing to society
  4. Having fun with the students
  5. The overall fulfillment from helping students and collaborating with colleagues
I think the last item involving overall fulfillment was the main motivation for me to return (when I previously worked at a school district). Having fun with the students was great, too. However, the other items weren’t as important to me, and the thought of scheduling student speech times or doing IEP meetings was depressing.

Working at a school is a labor of love that requires you to remember all the positive reasons for being there. So, if you’re going back to school, relish in what fulfills you.
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