Today I'm gonna challenge you to take a step back from your back porch, and you are gonna self-evaluate today your own therapy. I'm gonna give you five areas to look at, and you're gonna rate those areas on a scale of one, meaning we have room to grow, or five, this is a strong area, I don't need to focus on this area at this time. These five questions I'm gonna share with you today, they're actually from the Council for Exceptional Children, and they use these questions to evaluate proposals.
I was invited this year, I felt so honored, to be a reviewer for the Council for Exceptional Children in their annual conference that's going to occur next year. I'm done reviewing the research proposals.
Now I get to share with you what these five questions are that you're gonna apply to your therapy sessions. So if you know me, I always have one foot in the research world and one foot in the clinical world, being a speech pathologist and also a clinical researcher for these last 25 years.
So I really don't see a line between the research to practice. This is an example of that. I'm gonna give you the questions that you would use to evaluate a research proposal, but these are the exact same questions you're gonna wanna ask to evaluate your own therapy. So the first area we're going to look at is we're gonna look at how life-changing this is that you're doing in speech therapy.
The question is relevance. Is this essential, the skill that you are working on? So when you're thinking about this, a score one, would be, well, I picked the skill I'm working on 'cause they got it wrong on a standardized test. It was wrong on the speech or language test, so this is what I'm gonna work on.
Now, a five would, I know this child's strengths and weaknesses, and I know that this skill is going to address many areas for this child, and this skill is not only gonna be game-changing today, but it'll be game-changing in the future.
For instance, if you work with a child with developmental language disorder, I would argue not even knowing the child, that giving that child or empowering that child with the ability to tell a story Is likely a pivotal skill.
Not knowing the children on your back porch, I would put my money on that that would probably be the most pivotal skill that many of your kiddos could work on. That would be an example of a five for a child that has a lot of executive function difficulties, a child that has a lot of difficulties dealing with frustration, social frustration, academic frustration, emotional frustrations, which many of our children with developmental language disorder do have.
This is what they need. They need an ability to name it and frame it, to express their frustration in a way that is not maladaptive behaviorally. So this is a skill that I would say would be a five. A skill that I would say would be a one is to work on a grammatical morpheme. The research indicates that over time, grammatical morphemes tend to naturally develop.
Aside from that, so when we're looking in the crystal ball in the future, is that grammatical morpheme or knowing that grammatical morpheme really gonna change that child's life today? So you really need to think about, am I gonna work on... level one, a grammatical morpheme skill, this discrete skill, something like if, as a fitness instructor, someone came to me and they were out of shape, and they said, "I wanna get in shape," and I said, "Okay, let's point our toes, and we're gonna flex our calves that way.
Now, I'm only working one muscle, right? I'm not changing this individual's life. When you're working on a single grammatical morpheme for a year, I'm gonna put my money down that you're not changing their lives. So really thinking about what is pivotal when it comes to the goals that you're gonna work on with this child.
The second area that we're gonna look at that I stole right from being a reviewer for the Council for Exceptional Children are do my goals align with the skill is that I wanna work on? So for instance, maybe you're like telling a story is what I'm working on with this child with developmental language disorder.
And when we look at the goals, we're saying, well, the child can name parts of a story. They can name the author is, what a title is, what a page number is, what a front cover is. You know, you're looking at literacy, vocabulary, in describing literacy, but that doesn't help the child tell the story. So thinking about working on goals for complex sentences, which are the child's first story, the complex sentence that they're telling, that would lead to the child telling a story.
So, so thinking about are my goals in line with the big life-changing skill, essential skill that I'm working on? Are the objectives going in that direction? The third area we're going to look at is the functionality of the goal right now today. So for instance, when I'm working with a child in speech therapy, I oftentimes will work on verbs such as 'scrape', and, and I get this big backlash, and people are like, "That's not functional.
And the reason it's on purpose is because I'm working on the S, the s- the stopping, because this child has the phonological process of stopping, fronting, and I'm working on gliding. I'm working on three phonological processes at the same time to maximally change the child's life and to get gains today.
Why am I working on this word that nobody says? Because nobody says the word. If I work on a common word that the child said a million times already incorrectly, I'm gonna have to fight the motor programming, fight the motor planning that's errored and established. I do not want to do that. I want a blank slate when I'm building these new skills.
That's what a novel word allows me to do. So when people think, is it functional? Think deeper than that. I'll say, oh, yes. The child, because I'm working on the word scrape, right? Instead of working on what is next in line that the child can't say, okay, well, the child can't produce the K sound, so I'm gonna spend a year working on the K sound, and we're gonna do it with all these prompts, and by the end of the year, they will hopefully have the K sound.
This child is now producing many sounds because I am working on a complex sound, and the higher you aim, the higher you gain, the higher the gains. So by working on the complex sounds, I'm getting all of these spontaneous sounds developing for free. Can the child say SKR blends, the three-and-a-half-year-old, four-year-old?
The child can do the, the SKR blends with all of my tools in my toolbox, that I'm helping them do it correctly with. But as a result of me working on the SKR blend, the child can say the F, V, S, Z, SH, ZH, J, CH. I'm getting all of these underlying sounds for free. I wouldn't get that if I worked on the K sound.
So when I say, "Is it functional today?" Yes, it's the most functional thing I can do. I am getting all of these sounds for free instead of working on one sound and working, getting one sound. Thinking about, am I making change right now with what I'm doing? So if I was to work on, for instance, okay, I see that the child can't do vowels.
I'm gonna work on the vowel sounds. We're just gonna do vowels. You're gonna get the vowels. Is this functional? Is this gonna change the child's life? So you really have to think about, when I give you every tool in my toolbox, and accuracy matters because practice makes permanence.
When I give you every tool in my toolbox, how high can I aim? The higher I aim, the higher the gains today. Today. If I am working on a child in speech therapy, and we are telling stories, that child is going to be producing spontaneously complex sentences, compound sentences, expanded sentences. I didn't even need to work on those.
I just worked on the stories, and that came naturally. So the higher you aim in speech, the higher you aim in language, the higher the gain spontaneous today.
So let's look at the next area. This one is so important. Where's the research? You should have numbers for every detail of your practice. And if you don't, now you can do a search, and you can ask, "Is there research, is there peer-reviewed, published research to support blank?" Whatever you're not sure about, and then, "Show me the articles."
And get the articles. And I know you're probably like, "Kelly, I don't have time for this." You have time to read an abstract. So if you're getting a peer-reviewed research article, and you are a full-time speech language pathologist, you have time to read a paragraph. You have time to read that abstract, and that abstract will tell you what you need to know.
You need to know if what you're doing is evidence-based. And if you don't know if it's evidence-based or not, you should not be doing it, period. Now, if the research just hasn't been done on it yet, right? There's many things that I do, and if you're with me, we, we get funky, and we're, we're like, "Let's do what's never been done before."
We like doing frontier work. That's fun for us, right? We like to go where no woman's gone before. If you're doing that, do that, but have your numbers. Say, I compared this blend to this blend, or I compared this language structure to this language structure, and I spontaneously swapped them off, and this one's much more effective.
Here are my numbers. I kept everything the same except for this, and these are the numbers. This works, and that's why I do it. So you must have numbers for every single detail of your practice. Many of the commercially available programs or programs that school districts adopt, programs that are, you buy off the shelf for 400 or $500, they have aspects of them that are effective.
They have strategies within that program that are effective. And what I found in every single program that I've reviewed, they have strategies in there that are very ineffective. So you have to buyer beware, caveat emptor. You need to know your numbers, and you need to say, "You know what? I'm gonna do A, B, C, but I'm not doing D, 'cause that's a waste of our time, and we've only got this much therapy time."
You only have 30 to 45 minutes a week. You can't be wasting speech therapy time. So have numbers for every single detail of your practice. If I asked you, "Well, why do you do this?" And it's just any little detail of your practice. You should be able to be like, "Here's the research," or you should be able to pull out your, your Google spreadsheet and say, "Here are the numbers.
If you don't have numbers, you shouldn't be doing it, period.
We're going to go to the next one. Number five, this is the last criteria that we look at for the Council Exceptional Children when you're evaluating a proposal, whether or not to accept or reject the proposal, is, how do we know that the participants are learning?
So this is where we look at for measurable, observable goals, like the participants will do this, and typically they use kind of that Bloom's taxonomy. They have the knowledge, they have the application, they have the synthesis, so they have the lower level to the higher level skills.
You're not going to look at goals that say they're gonna learn this, they're gonna learn that. You- how do you observe learn? How do you measure learn? This is where we get to see some action. So here we're gonna look at is the child actively participating?
So what I'm gonna say here is we're going to look at with the active participation, a score of one, for instance, in my book, would be auditory bombardment. Now, auditory bombardment is a part of effective approach. It's a part of the cycles approach. However, when the cycles approach has been done without the, auditory bombardment compared to with the auditory bombardment, there's been no additive effect.
There's been no benefit to the auditory bombardment piece. This is where we take out our scissors and we cut the fat. We get rid of it because the child's not actively participating during that time. The child's heard the R said correctly millions and millions and millions of times. Why are they sitting in your room?
Why do they need to hear it correctly from you and wasting your very limited thirty to forty-five minutes a week speech therapy time? Active participating. You can't measure that. That's you doing the child's pushups for them. We need to see active participation. Now, when I'm talking about active participating, some children I've found, they have very, very sensitive temperaments, and in language development, they benefit from more of a responsive approach in which you're not asking questions, in which they're not speaking on demand.
You're taking what they're doing and you're linguistically mapping it out. You're taking the words or two that do come out, and you're expanding upon them, and I like to put them into complex sentences, of course. But you're giving the complex sentences, you're giving the linguistic mapping, you're following the child's lead.
The child is actively participating. The child is engaged with you. The child's engaged in back and forth interaction. You're present, and the child's present. But I wanna say, it's the child that's actively participating throughout.
And that's not easy, because there's children that have sensitive temperaments that are reluctant to participate. That's not easy, because there's children who are fight, flight, freeze brain that freeze. That's not easy, because there's children that escape. There's this, having a child actively participate with you in an interaction for the entire 30-minute session, that's huge.
But is the child actively participating? And when it comes to the Council for Exceptional Children, they're looking at the goals. Are the participants actively participating in the learning process? Can you see measureables that show that the participants are putting this new information to use in an active manner?
So those are the five areas. What you're gonna do is you're going to look honestly at your own therapy session and give a rating of one being weak areas to grow, five, okay, I don't have to focus on this right now. I can focus on other things. You can go and look at your sessions and say, "Yeah, over the summer, I wanna beef up in this area, and what am I gonna do?" And make yourself a plan. How am I going to turn this three into a five? You know yourself better than anyone with a million degrees behind their name, any expert.
You know what your strengths and weaknesses are, and you know what needs to be done and how you need to do it. But it's nice to take time this summer to reflect, and what this does is it gives you a way to reflect in an objective manner on your practice. So I want you to do what you do best, which is to roll up your sleeves and make the world a better place one child at a time.
You are always gonna be first.
