Speech Therapy Treatment Technique: Offering Choices

Speech Therapy Treatment Technique:

Offering Choices

By Rebecca Turner, CCC, SLP

 

Offering choices is a wonderful therapy technique to elicit language.  It can be used with kiddos who are non-verbal where you are targeting pointing to or looking at a specific object, all the way to those kiddos who working on expanding their sentence length to multiple words.  This technique helps to increase communication, but it also gives the child a little bit of control over their environment.  

There are hundreds of opportunities throughout the day to offer choices, it does not have to be solely play based!  If you do choose to utilize toys, some of my favorite ones to use when targeting this skill are puzzles, trains, and Mr. Potato Head, but you can do this with anything that has more than one option. 

1.     You need a way to hold the pieces, either a bag, container or simply putting the pieces in your lap.  This is VERY important because if the child can independently access the toys, it gives them NO reason to communicate. 

2.     You want to make sure child is in front of you so that you can have good eye contact and engagement. You want to get them excited about the toy and this can be done with your facial expressions, voice and possibly demonstrating the toy, especially if it is not a toy the child is familiar with.  You also want to decrease the distractions in the environment, like turning off the tv, putting away other toys, etc so that they can focus on the language being presented.

3.     Once you have set up the interaction, you are going to take 2 of the items.  Using your “Tell me face”, which is eyebrows raised so they know you want them to respond, label the items and move them toward the child.  You want to make sure that you provide that verbal model in clear, simple language.  For example, Do you want “car or train”, “car or train”.

4.     Repeat the options if they do not respond.  The type of response you are targeting varies depending on the level of the child. 

5.     If they grab both items, don’t give them the objects, we want them to make a choice of 1 item, so model the choices again.  Then if they are still grabbing both, model and give one of the items to them.

Making choices is the foundation for establishing the importance of the need to communicate with your child, even if they are just pointing to an object and unable to verbalize! 

Continued Re-opening of Amazing Kidz Therapy

As Amazing Kidz Therapy has begun its reopening process this week. We wanted to share with everyone what the remaining re-opening schedule will look like so that everyone can begin to make more regular appointments.

Week of May 25:

-        AKT will be closed on Monday in observance of Memorial Day

-        Two therapists will be present and seeing clients in the clinic each day. Here is the schedule for this week:

o   Tuesday: Miss Kat – 9am to 5pm; Miss Becky – 11am to 5pm

o   Wednesday: Miss Ashley and Miss Brittany – 9am to 5pm

o   Thursday: Miss Ashley – 9am to 5pm; Miss Becky – 11am to 5pm

o   Friday: Miss Kat and Miss Brittany – 9am to 5pm

-        Therapists will continue to offer Teletherapy sessions throughout the week. This is an option for those that do not feel comfortable returning just yet and/or are unable to come in at the aforementioned times. If you have had a standing Teletherapy time it will remain as scheduled, even if your therapist is in the office on that day.

Starting June 1^st therapists will all resume their regular hours within the clinic. All therapists will continue to offer Teletherapy to clients to prefer that delivery mode.

All of our precautions will remain in place, including:

·        Our staff WILL be wearing face masks. We recognize that this may be scary for some of our children, so we ask that if you are choosing to return to the office that you begin wearing a mask in front of your child to work to desensitizing them.

·        We expect all adults to wear face masks when in the office. We encourage children who are able to tolerate masks to wear them in the office as well. This is for your safety as well as ours.

·        When choosing an in-person appointment, you will be asked the following questions PRIOR to us taking your child back into a treatment room:

a.      Has anyone in your house been confirmed OR suspected to have COVID19 in the past 14 days?

b.      Have you been in contact with anyone with confirmed OR suspected COVID19 in the past 14 days?

c.      Does anyone within your house have a fever or cough at this time?

d.      Have you or anyone in your house traveled in the past 30 days?

·        If your answer to any of the above is Yes, your child will not be seen in person on that day. We ask that with knowing this in advance, if the answer is Yes, that you do not schedule an in-person appointment until you can answer No to all of the above questions.

·        Families are asked NOT to come into the building upon arrival. Parents are to call the office from their car when they have arrived in the parking lot. Once it is time for your child’s appointment, the office will call the parent/caregiver to notify them that they may enter. This is to assist with keeping every family socially distancing.

·        The waiting room will remain closed. If you are not accompanying your child into the treatment session you are asked to wait for them in your vehicle.

·        No more than 1 person is to accompany the child into the clinic. If you have other children with you, we can meet you outside to collect your child and can then bring your child back out to you when their session is complete.

·        All visitors entering the clinic will have their temperatures taken to ensure that no one is entering with an elevated temp.

·        All payments MUST be made over the phone with your credit card PRIOR to beginning your child’s appointment. This can be done when you arrive in the parking lot or ahead of time. We can also run it manually if you have completed a Credit Card Authorization Form.

·        All treatment rooms and equipment/toys are being disinfected after each treatment.

·        A very strict cleaning schedule has been implemented for numerous times throughout the day in all common areas.

Although we plan to be physically reopened at this time with the highest level of precautions being taken, we understand this may not be an option for some of our families. We are continuing to offer virtual services. This is another mode of us to deliver high quality services to your child to prevent regression and continue with their progress. We have seen tremendous success with this delivery method over the past several weeks. ALL group therapy offerings will remain virtual only at this point. We want to inform all clients that as of June 1^st all of our Private Pay services, both in person and Teletherapy visits, will be $60/30 minutes.

Our business office will begin contacting families to begin scheduling appointments for next week as well as for regularly scheduled visits starting in June.

We thank you all very much for your continued patience with us, as we all transition to a new norm within the office. We are working are very hardest to keep the environment as safe as possible for everyone, which will take extra time from our normal daily routine.

We are so very excited to see you all very soon! Stay well.

Developmental Norms and Early Intervention

Developmental Norms and Early Intervention

By: Brittany Haller, MS, CCC-SLP

As an SLP, I receive countless texts, Facebook messages, and phone calls from friends and family members regarding their children’s speech and language development. These parents are typically trying to find out whether or not they should seek a formal evaluation for their kiddo(s). You should know that I am never bothered by these questions, and love that I am able to provide information and resources to them. However, not everyone has an SLP for a sister, or was able to stay in touch with the girl from their high school who grew up to seek her degree in Speech-Language Pathology. So, where do you turn when you start to have concerns and can’t just reach out to your friendly neighborhood SLP?

I personally recommend the website below:

https://www.speech-language-therapy.com/index.php?option=com_content&view=article&id=35:admin&catid=2:uncategorised&Itemid=117

Caroline Bowen provides accurate information on developmental norms in all areas of communication. The information is very well organized, and easy to understand.

Being aware of the developmental norms is crucial because early intervention is such a powerful thing. Research has found that diagnosing a speech/language disorder at an earlier age can lead to increased progress through speech-language therapy. If you have increased questions/concerns after familiarizing yourself with typical speech and language development, I highly recommend seeking an evaluation with a local speech-language pathologist. More information on the benefits of early intervention can be found using the link below:

https://www.cdc.gov/ncbddd/actearly/whyActEarly.html

Parents:Therapist Teletherapy Relationship

Parents Are Great Teachers to Therapists

By: Ashley Akers, M.S. OTR/L

Due to COVID-19, telehealth (the provision of healthcare remotely via electronic information and telecommunication technologies), has seemingly overnight changed how therapists around the world provide services. As an occupational therapist who is used to working hands-on with her kiddos daily (maybe to correct pencil grip or to provide deep pressure to facilitate calming for example), telehealth has admittedly been a novel experience in which I have had to quickly expand my thinking about how I provide services.

A question I have often asked myself during these times is: “How can I make sure telehealth is as effective and as helpful as possible for my kiddos’ and their families?” This question led me to research about OT and telehealth, and in all honesty, I wasn’t expecting to find too much. Let me tell you that I was pleasantly surprised! There ARE studies out there and studies still being done right now that are empowering us therapists to better understand telehealth and how to use it to serve YOU. One article I really enjoyed reading discussed parents’ perspectives on occupational therapy services through telehealth. Listed below are recurring themes that were identified from the parents in the study “Parent Perspectives Of An Occupational Therapy Telehealth Intervention” from the University of Kansas (2019) that were big “take-aways” for me:

 1) Parents believed that telehealth was COMPATIBLE with their daily life and parents’ goals for their children. Many parents felt that OT through telehealth better addressed their concerns and goals for their children than other practice settings such as schools, or even outpatient. (Wow! This is all we want as OT’s- to improve our kiddos independence in their daily lives in a way that is meaningful to the kiddo and their family! This was hands-down the biggest take-away for me. I have had first-hand experience with this in the past few weeks, when some of you have told me that certain goals are not high on your priority list but other skills I hadn’t considered are! I am grateful you told me because now I can better help your family! I need to make sure that first and foremost I am addressing what you value as important for your child to learn and that is my commitment to you all.)

2)  Parents found telehealth to be CONVENIENT for their schedules and made therapy accessible to more children

3) Parents believed that telehealth allowed therapy to be more COLLABORATIVE

4) Parents reported a feeling of EMPOWERMENT to better help their children as they tried new strategies and were able to problem-solve with the therapist (I loved this one!! Parents, you all have become rock stars during this time! I have been continuously impressed with how well you all have been working on goals outside of sessions. A parent the other day told me “He has been holding his crayon with a tripod grasp and his 1:1 reinforcement schedule has helped him to stay motivated” and that was a GREAT encouragement to me and exactly why I love being an OT!!)

As much as we may “teach”, you all as parents are so valuable to us and teach us just as much, if not more! So, in reading this study, I want to ask all you parents out there some of the questions from this insightful study which include:

1) What do you like most about telehealth?

2) What do you like least about telehealth? (Tell me! We want to know.)

3) How has telehealth been different from your past experiences with therapy sessions, whether good or bad?

You can read the full study at the link below, just click “Download the PDF”: http://telerehab.pitt.edu/ojs/index.php/Telerehab/article/view/6274

More great research about the benefits AND challenges of telehealth can be found at:

https://otpotential.com/blog/research-articles-about-telehealth-ot

                                                                              References

WALLISCH, Anna et al. Parent Perspectives of an Occupational Therapy Telehealth Intervention. International Journal of Telerehabilitation, [S.l.], v. 11, n. 1, p. 15-22, June 2019. ISSN 1945-2020. doi:https://doi.org/10.5195/ijt.2019.6274.

COVID 19 Re-Opening Plan

Amazing Kidz Therapy has continued to closely monitor this unusual situation that we are all facing with COVID19. We have analyzed the advice of the U.S. Dept of State, local authorities and the CDC to assist us in determining what the best next steps are for us to help maintain the safety and well being of our children and therapists. We know how important therapy is to our families and we want to be able to return to the office to provide in person sessions as soon as we feel that it is appropriate and safe. It is with all of the above in consideration, that AKT has made the decision to begin re-opening our office on Monday, May 18^th. This re-opening will be gradual, as well as fluid, as we will need to continue to closely monitor the situation. Here is what this re-opening will look like:

-        Only one therapist will be present and seeing clients at a time in the clinic. Each therapist will be treating clients on only one weekday with the following schedule:

o   Miss Kat (OT) – Monday afternoons

o   Miss Brittany (ST) – Tuesday mornings

o   Miss Becky (ST) – Thursday afternoons

o   Miss Ashley (OT) – Friday mornings

-        Therapists will continue to offer Teletherapy sessions on the other days of the week as well as the times they are not in person for sessions, as scheduled. This is an option for those that do not feel comfortable returning just yet and/or are unable to come in at the aforementioned times.

We want to inform all of our families that our staff WILL be wearing face masks. We recognize that this may be scary for some of our children, so we ask that if you are choosing to return to the office that you begin wearing a mask in front of your child to work to desensitizing them. We also encourage you all to wear face masks when in the office. This is for your safety as well as ours.

When choosing an in-person appointment, you will be asked the following questions PRIOR to us taking your child back into a treatment room:

1.      Has anyone in your house been confirmed OR suspected to have COVID19 in the past 14 days?

2.      Have you been in contact with anyone with confirmed OR suspected COVID19 in the past 14 days?

3.      Does anyone within your house have a fever or cough at this time?

4.      Have you or anyone in your house traveled outside of the state in the past 14 days?

If your answer to any of the above is Yes, your child will not be seen in person on that day. We ask that with knowing this in advance, if the answer is Yes, that you do not schedule an in-person appointment until you can answer No to all of the above questions.

Families are asked NOT to come into the building upon arrival. Parents are to call the office from their car when they have arrived in the parking lot. Once it is time for your child’s appointment, the office will call the parent/caregiver to notify them that they may enter. This is to assist with keeping every family socially distancing and not having more than one family in the waiting room at a time.

We are intent on maintaining the highest standards in cleanliness and disinfecting, taking all necessary and preventative steps set forth by healthcare professionals. We are taking additional daily measures to ensure the business in continuously cleaned during business hours, and overnight to the highest sanitary standards during this time. Here is what you can expect from AKT during this time:

1.      In an effort to minimize frequently touched items in which cleaning after each use would be impossible, we have closed the additional waiting room.

2.      We ask no that more than 1 person accompany the child into the clinic. If you have other children with you, we can meet you outside to collect your child and can then bring your child back out to you when their session is complete.

3.      All visitors entering the clinic will have their temperatures taken to ensure that no one is entering with an elevated temp.

4.      All treatment rooms and equipment/toys are being disinfected after each treatment.

5.      A very strict cleaning schedule has been implemented for numerous times throughout the day in all common areas.

6.      We are asking that all parents/caregivers pay over the phone with your credit card PRIOR to beginning your child’s appointment. This can be done when you arrive in the parking lot or ahead of time. We can also run it manually if you have completed a Credit Card Authorization Form, which is attached.

7.      Clients and staff are asked to continue to follow basic personal sanitary protocol, including frequent hand washing, etc.

8.      We are advising that you continue to adhere strictly to our Sickness Policy, for both kids and any family member accompanying the child. No one should enter the premises with symptoms of illness and should remain off premises for 24 hour following their final symptoms. This includes all coughs, sore throats, runny noses, etc, despite of what you believe the reason to be (ie allergies, common cold, etc).

Although we plan to begin to physically reopen at this time with the highest level of precautions being taken, we understand this may not be an option for some of our families. We are continuing to offer virtual services. This is another mode of us to deliver high quality services to your child to prevent regression and continue with their progress. We have seen tremendous success with this delivery method over the past several weeks. ALL group therapy offerings will remain virtual only at this point.

Our business office will begin contacting families on Monday, May 4^th to offer in-person slots beginning on May 18^th, should you be interested. 

We thank you all very much for your continued support during these challenging and worrisome times. As a small business, it is only thru our families that continue to support us that we can remain open and offering services to your children. We truly thank you from the bottom of our hearts and we cannot wait to begin to see you all again!