Group Therapy – Challenges and Solutions

by Viktorya Bukhman

I have to admit I sometimes dread when I get assigned children with completely different goals to be placed in a group together. It seems unethical, overwhelming, and on some days I feel that I ignore one child’s goals in order to target the specific needs of others. AND THAT FEELS TERRIBLE.

A couple of ideas I’ve used to ensure that everyone’s goals are targets, you keep track of the target goal for each child, keep everyone’s attention and have a good time, without frustration:

1)      Make sure you have the specific goals for each student.

a.       Lay out each IEP and compare goals. Sometimes they IEP may have some similar goals that are appropriate (i.e. pragmatic language, social skills, following directions). If the kids have a split mandate (receive both individual and group therapy), shared goals can be targeted in group and individual goals can be targeted in individual sessions.

2)      Keep track of goals and progress.

a.       Make a tracking sheet that works for you with target goals for each child.

b.      I like to use tracking sheets that refer to where you seat the kids. It allows me to take notes, make check marks, tally marks without having to look away from the group for very long. Here are the few samples of what I have been using:

Group of 2:                           Group of 3:                           Group of 4:

 

 

 

3)      Maintain everyone’s attention: 

a.       A major problem I have is keeping attention. When it’s not a child’s turn, his/her attention often wavers. To combat this I have used:

i.      The Superflex Super Hero from Social thinking by Stephanie Madrigal and Michelle Garcia Winner. They suggest to avoid the Brain Eater, who makes it hard for a student to focus and makes his brain “roll away” from the group, a student should turn their body and eyes towards the group, use fidget toys to keep the body busy and the brain focused, and notice when you are thinking about something else and try to get it refocused.

ii.      Help kids who have difficulty attending by giving them an important job. They can be in charge of making sure others answers are correct, giving out tokens, responsible for writing down what happened. This important job will make them feel good, and give them a concrete task to focus on.

4)      Have a good time!!!

a.       Group non-competitive games such as those made by http://www.superduperinc.com/ can target multiple goals within the same game board. These games are motivating because the kids can early token, there is no end so you can go around again and again, and they are easily modified to use any set of stimuli (artic cards, labeling picture cards, reading tasks). Here are a few of my favorites:

i.      Turtle talk http://www.superduperinc.com/products/view.aspx?pid=GB137&stid=

ii.      Go for the Dough http://www.superduperinc.com/products/view.aspx?pid=GB339

iii.      Make your own paint chip board http://thrillinglythrifty.blogspot.com/2010/08/toddler-friendly-board-game-using-paint.html

b.      Barrier Games can both be bought and made. They allow for children to both follow and give directions, understand and use prepositions and basic concepts, use longer utterances, increase vocabulary, and can be adapted for many other uses.

i.      A free resource for pictures that are great for barrier games is KizClub http://www.kizclub.com/stories.htm . This website has manipulative for most common stories that we read (i.e. Go Away Big Green Monster). I would suggest printing out as many sets as group members and give each student a role. Some students can give directives; other students can follow the directives (everyone should have similar looking pictures at the end). As a therapist you can monitor which child doesn’t understand the directive.

ii.      To make these easier the therapist can premake a scene and if needed can make directive cards with pictures and visual supports (ie put the fish next to the whale)

c.       Cooking Activities make great application of everything else we teach and the children are so excited for special cooking days. I worked with a teacher last year that had a special cooking day every week. The students voted what they wanted to make, and followed visual recipes (with the help of adults) to make delicious and special treats.

i.      http://visualrecipes.com/ has real pictures for some recipes (some can be tough to do in a therapy room) if you don’t have a hot plate or microwave.

ii.      http://www.speakingofspeech.com/Cooking_Materials.html These use boardmaker symbols with simple steps and have “no-cook” options.

iii.      http://familyfun.go.com/recipes/cooking-with-kids/making-food-fun-photo-gallery-848181/view-all/ playful recipes with photo of finished product.

iv.      Do the activity with kids who can read and don’t need visuals, take pictures of each step and use the pictures for students who do benefits from visuals.

v.      Cooking makes for great recap activities, sequencing of all necessary steps, and some kids can write up the recipe after looking at the pictures.

I hope this has been helpful, and that you will feel a bit more prepared when challenged with a group of kids that aren’t necessarily the best fit.

If you have any questions, comments or suggestions please don’t hesitate to email me at viky@speechlanguageplay.com and visit me at www.speechlanguageplay.com

 

Spinlight Studio – the apps you need!

When I find apps that I cannot live without in therapy, I feel compelled to share them so that colleagues and parents can enjoy and use them as well! I was fortunate enough to discover Spinlight Studio Apps recently and have enjoyed using them in therapy. I have tried 4 apps from Spinlight listed below:

1. Tallytots: This is not your average counting app. With an array of colors, activities for each number and sing-a-longs, it is sure to keep children motivated and eager to learn their numbers. The constant repetition helps reinforce the numbers learned. Verbal reinforcement (through an adorable airplane) also adds to the fun!

2. Alphatots: You guessed it, for learning the alphabet! This app helps children learn the alphabet using 26 different interactive activities per letter which allows for them to associate the letter with a word/activity.

3. TableTots: By far one of the best apps I’ve found to use in therapy! This app allows you to have a virtual “table” and place objects such as numbers, letters, shapes and other objects (pictures, Dominos for counting, and even money). You can change colors, create puzzles and designs. My clients love it and always request it at the start of each session!

4. Swapsies: My favorite thing about this app is the adorable characters. Children have the opportunity to identify 10 occupations including police officer, baker, etc. Children can take quizzes so that you can see how much they have learned/remember from the activities.

Has anyone else tried these apps? Share with us on Speechbop!

Teaching the /L/ sound

Had an interesting session with a client who had difficulty producing the /L/ sound today. I wanted to share some techniques for both parents  and speech pathologists to assist in producing this sound at home or in your own speech sessions!

There are two things that must be done in order to appropriately produce the /L/:

1. The tongue must touch the alveolar ridge (see below for details).
2. Lateral emission: When air flows out the sides of the tongue.

Okay, lets get started! The area behind your top front teeth is called the alveolar ridge. In order to produce the /L/ sound, one must place their tongue on the alveolar ridge. How can you get your child to identify the alveolar ridge without putting hands in his mouth? There are several techniques that I have tried. Don’t give up if one of these techniques don’t work. Every child is different and because of this, it may take a few tries in order for it to work. Here are a few ideas that I like to try with my clients:

 

1. Toothette: A toothette is an oral motor tool that can be used to gently touch the alveolar ridge on your child/client. These tools come individually wrapped to ensure sterilization and can simply be thrown out after a session. To increase sensory awareness, Toothettes come in flavors such as mint. You can find them at Medexsupply.com

 

2. Oral vibrator: An oral vibrator can be used with children who have sensory concerns. These children may need extra stimulation in order to appropriately feel and identify their alveolar ridge. Talktools.com is a great website to buy these oral tools!

 

 

3. Peanut butter: I have had parents in the past who have tried this technique. Try placing a small dab of peanut butter behind the child’s teeth and then tell them to lick it off. They will not only feel their alveolar ridge, but also be appropriately placing their tongue where they need to in order to produce the /L/ sound.

 

 

Once a child can appropriately place their tongue behind their teeth it’s time for the lateral emission! In order to get your child/client to allow air to flow through the sides of the tongue, have them suck in and feel the cold air on the sides (try it yourself). Then have them slowly flow the air out. Once voicing is added, your child/student/client will hopefully then have a better idea of how to appropriately produce the /L/ sound.

 

Have a technique not mentioned here? Share it here on Speechbop!

Nonviolent Crisis Intervention

A few days ago I was lucky enough to have had the opportunity to be trained in Nonviolent Crisis Intervention. Why you ask, was a speech pathologist attending such a training? Well the answer is simple. Many speech pathologists work as part of a multi-disciplinary team. This team can include psychologists, occupational therapists, physical therapists, social workers, special education teachers, etc. As part of this team, we often encounter children with a variety of disorders which can often include behavioral. It is not uncommon for a child to receive speech therapy as well as counseling.  Many of these children are unaware of how to take out anxiety and frustration. Because of this, it can come out in other ways such as verbal or physical aggression. I had a wonderful instructor named Lindy Blazek. She made the training very enjoyable using personal experiences. The goal of this program is to provide for the Care, Welfare, Safety and Security of everyone involved in a crisis situation. Some of the things I learned included the appropriate CPI stance to allow children to feel respect, have personal space yet allowing myself an escape route if necessary. The class learned about verbal intervention when a child may show signs of escalation. We also learned several block and move techniques to protect ourselves in such a case. These blocks are not only important to keep ourselves safe, but more importantly, keep the child safe by preventing them from hurting themselves. My favorite part of the training was when we all had a chance to share personal experiences. It was so interesting to hear all of my colleagues who have been in these predicaments. Overall, I really enjoyed the class. My colleagues and I are presenting the information to my school next week as we felt this is information was too important not to share!

 

 

Can texting really help children improve spelling?

I’m not sure if anyone else subscribes to Scholastic’s magazine, “Instructor,” but I often enjoy reading articles that can help me improve my speech sessions. I came across a really interesting article in the Spring 2012 issue. The article claimed that texting on a cell phone can actually improve spelling in kids. My first thought was, NO WAY could that be possible. As I read on though, the article mentioned a lot of interesting facts that had never occurred to me. I wanted to share them here! A recent Nielson survey states that the average American teen texts 3,339 messages per month. How can we use this information to help the students we teach every day? According to the article, two recent studies have proven this idea to be true. A British study that was published in the Journal of Computer Assisted Learning concluded that texting helped in the development of phonological awareness and reading skills. The second study was published in the Australian Journal of Educational Development & Psychology and concluded that texting improves spelling because phonological skills are also increased. Here are a few ways the article advocates for texting:

 

  • Texting helps students read: Children have to often become creative when texting to help them shorten their messages. An example of this is “C u l8ter” for see you later.
  • Texting boosts phonology: When being creative with texts which can be seen in the example above, children must understand how sounds and letters are put together. Texting allows children to be able to do this on a daily basis.
  • Texting is a fun way to play with words: Essentially, texting is writing, and why would we ever stop a group of children from writing? ::Especially when its hard to get them to even start in the classroom::
  • Inventing new textisms is creative: Having to abbreviate words is not easy to do. By creating textisms such as “gr8″, children have to use creativity to make texting quicker.

But how can I stop children from texting in the middle of class? Firstly, why do we need to have children STOP completely? This article also showed me how to incorporate texts into my classroom so that children are doing work while doing what they enjoy at the same time. They listed some incredible resources that I just had to share:

  • classparrot.com: This website is a “hassle-free way for teachers to text their students.” Teachers can remind their students of upcoming exams (test Monday!) and send homework and event reminders (class trip tomorrow, don’t forget to pack a lunch!). The cool thing about this website is that parents can also be added to the contact list, which is great when working with younger children who don’t have phones of their own.
  • polleverywhere.com: This website is a way to gather live responses in any venue: including schools! You can easily creat polls that can be text to students who then respond. Students can then view the results of the poll.
  • studyboost.com: This website allows teachers to create study questions and have their students discuss them via text messages. 
  • clickerschool.com: This amazing website allows students to choose multiple choice and short answer questions via cellphones. 

One of the biggest things that I took from this article was that I am no longer going to ban cell phones from my class, but rather, try to incorporate it as often as I can. By doing so, I can hopefully provide an environment that is more exciting and most importantly, motivational!
Have you already used texting to assist in your classroom? Share with us at Speechbop!