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Autism on the playground: Lessons from the Parenthood episode

Fri, 23 Sep 2011 08:26:38 -0700

This week was the season premiere of one of the shows I have a like/love relationship with: Parenthood on ABC. My love relationship is because its good TV. My like relationship is because I can’t stop being a therapist when I watch it. So true to form, I must provide lessons and strategies for playground success.

Truth be told it is a challenge for the person with social language deficits (whether its ADD, ADHD, Autism, Aspergers) to navigate the unwritten rules of the playground. More than that, therapists/coaches/psychologists teaching social skills groups must think about HOW they are teaching these skills. As a parent reading this, you would probably be shocked at how many hands do not raise or how many quizzical looks I get when I ask “Do any of you watch Phineas and Ferb, Do any of you watch Zach and Cody, etc?” As therapists teaching these skills, we must understand that teaching the skills of social behavior does not place the therapist as peer, but as coach. As a coach, we must know the social information that our clients need to know in order to better coach and facilitate the real skills of being social.

For therapists, refer to a past blog post on the social connection: http://slctherapy.com/blog/landria/the-social-connection/

In order to teach playground skills at any age range or skill level:

Get up from the table! It’s clear that Max’s social teaching was very formal, taught by an social coach focused on etiquette. ..and lacking flexibility and social thinking. How do I know this? Because Max extended his hand.

Parent tip: Make sure that your child’s social group (school, private) focuses on the importance of role play. Role play and getting up from the table will remove those kinks. AND MOST IMPORTANTLY, the therapist is coach…not peer. The therapist should not be creating mini-me’s or little adults but teaching and providing REAL information and feedback.

Therapist tip: Motor patterning and Role Playing. Excuse my small yell of encouragement...GET UP FROM THE TABLE! If we want our kids to be social...we have to get up from the therapy table. We need to have social postures: sitting, walking, playing, sports, hanging out and all those physical postures in between. Role playing is crucial as embedding social thinking does not mean thinking in solitude and the quiet...true social thinkers do this on the fly. They are walking and talking. They are dribbling the basketball and thinking and talking. They are gesturing and talking. We have to teach our kids to read and understand social information (using static pictures and short snipets of movies) as well as inhabit the motor pattern of what it means to participate socially.

Codeswitching: Codeswitching is referred to moving between various language styles. It is frequently used for speakers of African-American English (AAE) and Standard American English (SAE) as those are two different language dialects. I would go as far to say and backed up with research that dialects and language are based upon: age, culture, race, geographic region. It is clear that Max’s character is very formal in his language presentation, but he has been shown to have moments on past episodes when he is a tad bit more relaxed in his verbal and nonverbal language presentation.

Parent Tip: Make sure your child’s social language group is working not on changing them, but giving them flexibility in how they present. When you watch the Parenthood episode, it wasn’t that Max said “hello”. The social turnoff was when he said “my name is Max ___, (and extended his hand)”.

Therapist Tip: Move away from teaching the many ways to say hello. But have your clients/learners participate in lessons on perspective taking. Turn on You Tube..show formal/informal ways to say hello. Let them judge other people and use terms like Weird (Good Weird or Bad Weird), Great, Comfortable, etc. Get them to give you information on how they want people to feel when they are around, and let them work toward that.

The little people and adults are more forgiving, same age peers are not. Okay! We cannot create nor manufacture relationships for our children beyond the 2^nd grade. Third grade is when the real social silos are developed. And adults teaching social groups and adults in the community are very forgiving for social nuances (well except me, I am a social coach I can be proud of J. (I digress). Little people or younger peers are more forgiving as well. BUT little people grow up and become the third graders with tastes and opinions, leaving the person with social deficits behind. So what’s a parent to do?!?

Parent Tip: Raise your social expectation and barometer. Think about it, if my child did not have these social deficits..what would I tell them? How would I help them? Then , in the modified words of Nike, “Do just that!”. Why? Because they need you to teach them, model them, tell them the truth in love. And find places that work for them. I had a student who loved to ask people about the number of stairs, doors, etc. inside their house. Now the “normals” balk at the relevancy of such questions. My recommendation…find a club, group of kids that love to build things. That group (social deficits, normals, real/regular people who like to create) will be at ease with those questions…and as a parent you don’t have to manufacture or keep that playdate going. Rather, it is a natural meaningful situation that provides reinforcement to all its participants. The stage has been set for the natural relationship to emerge.

Therapist Tip: Stop hooking up your students by telling parents…”oh Susie and Laura would get along so well”. Instead, find the natural stage and allow the relationships to develop. Because (as a side note), what are you going to say to mom/dad when they don’t get along so well….

Here are a few of my past blogs addressing social communication:

http://slctherapy.com/blog/landria/the-look-of-cool-and-the-connection-to-social-entry/

http://slctherapy.com/blog/landria/social-soap-box/

Enjoy and Be Empowered,

Landria Seals Green, M.A., CCC-SLP

Twitter: @SLPGuru

Toolkit Tuesday: Writing and Communication Tool for Parents and Therapists

Tue, 20 Sep 2011 08:21:33 -0700

Hi Everyone and Welcome to Toolkit Tuesday!

Each Tuesday I am committing to "share" tools that I've used to support clients and their progression in treatment. My motto is "therapy should make you better". Well I believe, one of the better methods is the use of technology.

This tool created by ReadWriteThink can be used by reading specialists, speech-language pathologists, parents, and tutors. More than that, it can be used in a variety of ways.

http://www.readwritethink.org/classroom-resources/student-interactives/comic-creator-30021.html

Here are some suggestions:

1. Social Stories with an interactive Comic Strip. Set up the good idea, the bad idea, and the open ended comic strip. Infuse the Conversation Colors to make the feeling states concrete and the story alive.

2. Conversation Skills and Fluency: It is important for the teacher to type! (as this activity goes fast and after all, fluency is a goal). With this, you can create a scenario, have the student take on a character and flow with the conversation. Analysis comes after!

3. Written expression: Move away from the essay and the lined paper or blank compute screen. A quick comic strip can target any type of expository writing and actually target the quality of the skill acquisition rather than getting the length. Length comes later. AND this heightens the cool factor for the teacher and the socioemotional buy in needed to get to the goal of length.

4. Synonyms/Antonyms/Vocabulary: In this idea, one character (teacher's character) can supply a simple statement. The learner's character has to restate it using the targeted vocabulary words from classroom curriculum. This supports the student's ability to demonstrate real vocabulary use and application to the curriculum. The learner gets to demonstrate that he/she really understands the deep structure of the word through the development of a comic strip.

Enjoy and Be Empowered,

Landria Seals Green, M.A., CCC-SLP

Teaching Nonvocal Learners to Become Nonverbal Communicators

Wed, 10 Aug 2011 12:38:08 -0700

Nonvocal learners are, most times, silent. For the sake of this conversation, let's call them silent participators. There is no directed form of vocalization to demonstrate happiness, participation, or requesting. Most vocalization is seen in signs of displeasure. For me, as an SLP, the vocalization (any vocalization) found in any form of displeasure (cry, protest, refusal) becomes my baseline. Most parents of silent participators want them in speech so that talking can occur. And yes, they are correct in that the end goal is to support talk or verbal behavior. However, there are steps to be taken before we get to that point. Here are a few things to consider for parents when wanting to move from Nonvocal to Verbal.

1. Make sure the SLP understands that the end goal is Verbal Behavior. Understand the plan of intensity to make this happen.

2. Make sure the SLP is not treating in a box. That is, well run, supervised, and language based ABA programs are very beneficial (please note the criteria for ABA in well run, supervised, and language based) in that they should be targeting imitation (gross, fine, speech motor) and heavy manding/requesting programs. Because speech motor is the most finite of the motor system, it is clear that it is, in most cases, the last developed. First crawling, then walking, grabbing and manipulating objects, then talking.

3. Nonvocal or silent participators must be taught to move their mouths AND pair vocalizations in vocal play like activities. This can be done in play, during eating, and requesting.

4. Teaching silent participators to Reach, Point, and Request is essential. The truth is that communication is more than a verbal exchange. It is a whole body experience comprised of at least 50% being nonverbal. It's how you say it and what you say that makes a message.

Communication development can be best described in the development of babies and toddlers. They learn to gesture, pair vocalizations with mouth movements, they play with sounds in babble, they point and request, they make up their own language to speak and communicate meaningfully, and then they then create words. This is the process that is taught to children who are silent participators, nonverbal and nonvocal. The challenge is that it is socially acceptable and safer for babies and toddlers to be nonverbal because we know developmentally they will improve and then own the communcation standard of their environment. In contrast, it is not safe, does not foster independence, nor promote social acceptance when the seven year old with autism is silent and nonvocal. With the latter child, there is a greater sense of urgency. With this urgency, the intensity should be present in an intensive combined ABA and speech therapy program.

ABA alone is not best in promoting speech simply because there is a science to it beyond Shaping Theory. SLPs learn and have foundational knowledge isn anatomy and physiology. SLPs understand muscle movement patterns, nerves that evoke responses, are foundationally taught how to elicit sounds and which muscle movements matter most. SLPs write in phonetic symbols that can track how your child produces sound systems. With that, speech therapy (including oral motor) in isolation is not best when trying to evoke and promote communication in silent participators. Applied behavior analysis done well provides the repetition, behavior momentum, and frequency that the brain needs. Combined together, they are purposeful and promote progress. When they are at odds with each other and not combined, not implemented from an evidenced based perspective, or have less than optimal credentials, the child and family are the ones who lose.

At our center, we have made speech-language a heavy portion of our ABA programs. Why? Because communication and language are everything. SLPs are instrumental to that process.

I do believe that Mr. Daniel Webster put it best "If all my possessions were taken from me with one exception, I would choose to keep the power of communication, for by it I would soon regain all the rest"

I was inspired to write this as I listen to a child who is no longer a silent participator but now babbling nonstop, move his mouth, pair vocalizations, and produce "Ma" for mama.

Enjoy and Be Empowered,

Landria Seals Green, M.A., CCC-SLP

Twitter: @SLPGuru

Becoming a Great Therapist: A Tribute to Anne Sullivan

Mon, 01 Aug 2011 15:56:55 -0700

Most people who know me well, know that I am huge fan of Anne Sullivan. In clinical discussion meetings with senior staff "On Leadership in Therapy", I may often make reference to Anne Sullivan or a lesson that I have learned just by watching her through various media outlets. After completing assessments, holding supervision meetings with CF-SLPs (first year on the job SLPs), I began to openly discuss the fact that Anne Sullivan understood and implemented what most therapists (new and old) are still grasping to learn.

Most people look at Helen Keller as the end product, but don't pay as much attention to the process. The process of Becoming.

Here are the lessons from Ms. Sullivan, the ultimate therapist for those looking to Become…

1. Effectiveness Happens when Ego Exits. Ms. Sullivan herself had challenges with vision. She understood the struggle and loss of independence and the isolating feeling of that particular darkness. She understood her clients perspective. Ms. Sullivan was humble enough to listen to those who taught her at the Perkins school, learn from them, and pass it on. Her clients (Helen and family) needed to be understood, accepted as they were, and transformed. Ms. Sullivan wanted Helen better not for professional accolades, but for the purity of helping. Most people appreciate the pause and praise they receive when pronouncing their profession, it feeds the ego. When ego is in the room, you cannot see your clients…I mean really ‘see’ them. When ego is in the room, your colleagues always meet your representative. When your ego is in the room, you only hear…you never listen. The ego and the presence of it is different than confidence, the ego is prideful and can be heard in statements such as “Well he/she doesn’t do that with me”. When ego exits, the transformative statement becomes “Let’s work on this client/learner gaining this skill or reducing this behavior with everyone”.

2. Getting dirty and sweaty is necessary. Think about when Anne taught Helen the sign for water. Therapy isn’t always sit at the table, let’s have a conversation type of interaction. Most times (at least for me and those that work with me), it can get messy. Teaching someone how to play the game Chase in a safe way is exhiliarating ….and a quick cardio 20 minute workout at the same time. Anne Sullivan knew that the point of treatment is that the client/learner understands and applies the skill…our sweating, getting dirty is totally irrelevant …even for the SLPs :-). Sweat. Hot. Uncomfortable are not things to run away from, but learn from…it is the heat that makes the beautiful pottery. It is the rough that makes the Pearl.

3. Home WORK is necessary. Any therapist worth his/her salt knows that Anne combed research, past teachers, and more to help move Helen toward independence. A couple of weeks ago, a senior staff member confessed that she had been combing journal articles to gain some clarification, to see if any anything new about a particular topic was on the horizon. She was invested in her client beyond the session. This therapist took work home and (hold it....) actually READ materials. I am often astounded when therapists seek supervisors out and begin to look to them for their walking reference materials. I am doubly astounded when I ask "what is the last professional reference that you have read..." and I get answers such as "I just got out of school, so I haven't read much;etc.". Passion makes Home WORK easy.

4. One to Two therapy sessions is not enough. Anne knew that Helen needed more than just a couple of visits per week to create an environment of Independence. So she went to live with this family. Now while most of us don’t have their personal want or freedom to live with our clients…what she didn’t do was very important. In short and in the words of my grandmother…she didn’t give them a wooden nickel. Without giving my perspective (that’s another long blog post) about frequency of sessions…let me ask you a question “What do you do once a week or twice a week for 30 minutes that is effective?” If vitamins are taken daily and physicians recommend 30 minutes of exercise daily….then atypical brain developers would need more than our general recommendations of one to two sessions per week. Anne Sullivan knew this…why are we still Grappling? Grumbling? Debating?

5. Empowering Families is doubly important. Working with Helen meant working with her family. Working with this family without judgment. Quite frankly, making time to judge how a family arrived at accepting certain behaviors, etc. is irrelevant. Teaching them, not telling them. Freeing them, not judging them. Being a value added member of that team was important and Ms. Sullivan did that from day one, with clear communication.

Anne Sullivan worked from a calling. She was called to help this family. She was called to do this work. This servant role is not for those seeking fame, fortune or praise (while those should not be out of reach)…being a therapist is very important work…for me it is my Life’s work, what I was born to do.

Anne Sullivan, for me, exemplifies the statement "Your Clients should be better for having known and encountered you". This is the perspective from which I work, teach my staff, and Empower families.

Enjoy and Be Empowered…Always

Landria Seals Green, M.A., CCC-SLP

Executive Director

Choosing between speech and more ABA. Should this be choice between disciplines or is it time for a new therapist?

Tue, 31 May 2011 11:29:36 -0700

This blog post is inspired by an all too familiar discussion in online groups, parent support groups, and conversations within homes worldwide. The discussions that lead to decisions typically involve one of these phrases

"I think I'm going to let go of speech and increase ABA. ABA can target social skills."

"I think I need him in a social group because ABA is not improving the social skills."

"I need him to have more hours in ABA to target social skills and language. All speech works with is articulation and phonology."

I must admit that I cringe when I read or overhear such discussions. I cringe because I want the general popoulation to understand what a speech-language pathologist really does. I cringe because I want the general populatino to understand that Language is Listening, Speaking, Reading, Writing, and Pragmatic (social). I cringe because I want the general population to understand what ABA Therapists traditionally know and do not know. So instead of writing this information to the listserve, I am blogging in an effort to reach and teach.

1. Speech-Language Pathologists have training in evaluating, diagnosing, and treating speech and language disorders. Language encompasses the ability to speak from a speech sound-coordination perspective (articulation) as well as language of communication (sentences, vocabulary, social communication, nonverbal communication).

2. Not all professionals are the same. It is true that all SLPs do not work with or desire to work with certain disorders. Our profession is wide spread in terms of specialties. General population or consumers must do their due diligennce in finding an SLP who has a speciality in autism in terms of Applied Behavior Analysis and social communication. These two approaches can work very well within and complement the ABA program. By just working with an SLP who only specializes in oral motor, articulation, etc. the disservice is that a narrow approach to treat a whole disorder does not move progressively nor does it empower. It's like trying to see the world through a keyhole....now you get the picture :-)

3. ABA Therapist's have a great method of collecting data, analyzing data, and it is a true evidenced based approach to treatment. Still, they should not be working alone. Autism is a language based disorder. The foundation of the lead therapist or a key therapist on your child's team shoudl be an SLP who gets it. One who knows the progression of language, understands behavior as a function of communication, can use behavior principles to shape language albeit social, vocabulary, receptive, or expressive. The ABA Therapist needs guidance and consulation on what to shape, when to shape, and what those expectations should be. The program should not be separate but together.

4. Cost wise. Speech by the hour is more expensive in comparison to the hour of ABA. But it will all add up eventually. Cost effectiveness should be based on the program, the results, and the progress. Yes you can get two hours of ABA for the cost of one hour of speech therapy. But, the move to adding more should be based upon programming. When decisions are based upon programming, it moves the decision making to be based on the vision, the data, and the goal toward making the client more independent.

Often times when I overhear or read about the decision to add more of something, take away something else; I always inwardly ask

1. Did the parent make clear their expectations for treatment?

2. As consumers of the general population, does this family understand the components and contributions of each member of the team?

3. Did the questions to therapists' move beyond the basic requirements of credentials, into higher or more meaningful conversations about treatment paradigm, philosophy, data from single case studies of treatment?

So to the parent who simply stated "I'm getting rid of my SLP to add more ABA to work on social skills...any thoughts?" My thoughts are simply Did you choose the right team from the beginning?

Having Crucial and Critical Conversations are essential in a treatment program. After working with many families for over 10 years, I know that not addressing the elephant in the room will just consume the treatment space. Being an SLP who loves ABA (BCBA cometh soon) and sees the value of ABA, I know that great programming will give parents answers to the unanswered questions and simultaneously Empower and Make our Clients Better.

After all...our clients should benefit from having known us. It is our job to make them better. When parents don't see better happening...they should move on with better questions for the next team.

Enjoy and Be Empowered,

~Landria Seals Green, M.A., CCC-SLP

If I'm Not Sweating, I'm Not Working Hard Enough

Fri, 06 May 2011 08:43:46 -0700

I'd like to introduce my first guest blogger and staff person, Tamina Stuber, BCBA. Tamina embraces the Empowering People and Expandinging Independence at SLC through hard work. When supervising and coaching therapists, Tamina can be overheard saying "If you're not sweating, you're not working hard enough". A recent experience at a community event further solidified this very real and crucial philosophy for not only therapists, but even those who market, answer the phones, and schedule "Sweat plus hard work multiplied by all members of the team = SLC Therapy"

"If I'm Not Sweating, I'm Not Working Hard Enough"

I often tell therapists working 1-on-1 with clients, “if you’re not sweating, then you’re not working hard enough”. I borrowed this expression from a very talented behavior consultant who inspired and taught me that good therapy doesn’t come without a cost. There’s a cost not only for the caregiver and client, but for the therapist as well. As a therapist the cost we often associate with our work is the sweat we pour into the countless hours of service. Since then I have operated from the philosophy of “if I’m not sweating, then I’m not working hard enough”: hard enough to motivate my client, hard enough to implement programs with high levels of accuracy and procedural integrity, hard enough to collect data, and hard enough to train parents to be proficient and fluent in both the principles and components of their child’s program. In general, not sweating means I am not doing all that I can to offer good therapy services.

I recently attended a day long workshop. As I surveyed the room I saw a number of vendors and professionals. I began to notice the significant difference between those of us that were breaking a sweat in our efforts, and those of us that appeared to be barely breathing. It was apparent that for some this workshop offered an opportunity to break away from the monotony of their daily professional routine. For others, it was solely about bringing in extra dollars by whatever means necessary. And then there were those of us who were not only there, but present and available to serve and connect with the families, individuals, and community members so greatly affected by ASD, developmental disabilities, and behavioral challenges (just to name a few). Sure, I can appreciate the change in scenery that the workshop had to offer and certainly, we all have to make money to keep the lights on at the office. Still, what does it say about the kind of services we have to offer if the focal point of our hustle isn’t client-centered and evidence-based?

I was humbled when our Marketing and Community Coordinator guided a high-functioning traumatic brain injured vendor to a seat for lunch when a room full of clinicians, teachers, and doctors failed to notice that the chaos of the room and the lack of social awareness left this person standing alone unsure of what to do to get invited to a table to eat. How can we claim to reach people, when our arrogance as professionals overshadows or causes us to neglect critical opportunities for connectedness? The act of this non-clinician caused me to consider whether this philosophy extends itself beyond the therapists working directly with the client. To what extent do administrative staff overseeing client records and scheduling, or senior clinical staff who attend conventions and workshops, or marketing staff who participate in public community events share in this so called sweating? Shouldn’t every member within the same organization be expected to work hard and sweat? My answer: Yes! If ALL members of the organization aren’t contributing to this communal drip then we are not as likely to provide the good therapy services we are truly capable of.

While packing my bags to leave the event, I was uncomfortable by the heat radiating from my own body and the water running down my back. I was sweating because I was moving. I was reaching out to parents too timid or reluctant to approach the vendor booth and seek help for their child. I was making connections with other colleagues who are feverishly working to support children with ASD diagnoses and finding out more regarding the direction of the field of ABA across the nation. I was educating parents and other professionals about the importance of taking an evidence-based data-driven approach to treatment. I was meeting other community members and networking with agencies that might be able to enhance the services currently provided by our company.

I loaded the last of my belongings into my car, blasted the air conditioning, and reflected on the day. I realized I worked hard but felt well spent; I was proud of how our staff represented themselves and the company but was humbled and inspired by their willingness to treat people as people. What we do to provide good quality services isn’t easy but neither are the everyday lives of the families we work with to empower to expand the independence of their loved ones. So if you’re not sweating, are you working hard enough?

Enjoy and Be Empowered

~Tamina Stuber, BCBA

AAC and the Digital Divide. Access and Money

Thu, 31 Mar 2011 11:05:15 -0700

I am the first to raise my hand or nod in agreement when and if the question "Do you think current top of the line AAC devices are cost prohibitive?"

Absolutely they are! They have always been. Alot of things are expensive...

As a consultant and evaluator of Assistive Technology, I was and still am currently excited about how the world is moving to create technology devices for people with disabilities. I am impressed with the apple iPad, iTouch, and iPhone products. I am excited about the Android apps. I am thrilled with Tablet touch screen computers. I am enthusiastic about the technology reaching the consumer level.

I just wish someone would just say that the iPad, iTouch, and iPhone were created for all consumers. If they were completey geared towards people with special needs..challenges seen in Motor Access, Visual Access, and Hardware flexibility would not be present. Do I own apple products? Yes! Do I use them in assessments? Yes Do I recommend them? Sometimes.

I am glad that so many useful apps are being created. I am saddened that training is not a component. The apps for AAC seem to present to consumers as a Magical button to families and make the non tech SLP an AAC expert. It looks visually welcoming and more socially acceptable than a larger dedicated speech generatinng device. The apps meet the demand without quality assurance or review...Consumers are screaming for the tool that will work for their family members with communication impairments. It is our job as a profession to impart knowledge, training with whatever tool is being recommended.

Along with challenges of motor and visual access is the economic access. Insurance is nonsupportive in reimbursement or paying for non speech generating devices. Most people want and should be able to use their medical benefits. Not every family can afford to purchase with experimentation and hope that this new app will get Johnny talking!

Sure the medical insurance panel community should step into this century. At the same time, we need to have more reasons for recommendations than "it works". They need data...and so should SLPs and other AAC Consultants. I'm amazed at the number of professionals abandoning sound analysis and sacrificing that last $700 a family has to use an iPad. Let' make our analysis look like a true evaluation with a process map that will actually get the person talking. If the iPad is the recommendation, so be it! But give them a plan to actually get talking.

Last Christmas the Hollyrod Foundation accepted donations for the iPad and the Proloquo2Go. It was/is a wonderful program. I gave and was happy as an SLP that the child's SLP had to be listed and actually be part of the planning of the device.

Here is a link to a white paper by AAC-RERC discussing AAC apps and mobile devices:

My utopia wish:

1. Develp an affordable AAC device using the One Child Per Laptop mode.

2. Insurance Panels allow people to use their benefits for durable medical equipment suitable in this century.

3. Stop the cool AAC app and focus on quality control and letting parents know what the APPS are capable and incapable of doing...and asking parents "Does this app work with the communication vision you have for your child?"

4. Apple donates iPads to families as learning tools as a way of saying Thank you to a market they did not think of when they created the iApple family products.

Enjoy and Be Empowered,

Landria Seals Green, M.A., CCC-SLP

Teaching Honesty to People With Aspergers and other Social Language Challenges.

Mon, 07 Mar 2011 06:24:26 -0800

For as long as I can remember, the very popular phrase "Honesty is the Best Policy". While there are many others, I remember hearing this one frequently in classrooms, in church, and at home. It is true, honesty equals peace. And peace is priceless. Recently on a listserve to which I belong the question was posed "Do we Teach Honesty is the Best Policy" to people with social language challenges such as Aspergers. The person who posed the question went on to illustrate how this particular population may be too honest when following this rule based policy regarding honesty. While it is true that honesty does not always make everyone feel comfortable, it is needed.

So my emotional, personal, and professional answer to the question "Do we Teach Honesty is the Best Policy?" is a resounding Yes!

The challenge to the provider is how you teach, the underlying brain processes that are necessary to address, and much more.

In the HOW of teaching honesty. It's important to move towards teaching Perspective Taking and Theory of Mind. Here we want to teach the learner to understand the perspective of another from an Emotional and Situational Perspective. When we teach from a systematic, schema building, and fluency standpoint ( the brain building process of perspective taking); we are bringing to light the common phrase "Think Before You Speak".

With Theory of Mind and the thought process of Perspective Taking, we can begin pairing "thinking about how another person may feel" and using language with another person in mind. This is when the application of the speech-language therapy targeting sentence forms, reasoning, vocabulary specifificty, tone of voice, and body language all become very important.

Honesty that hurts is often a combination of truth, words, vocal tone, and body language. With learners and people with ASD the tone of voice, body language may not appear to be as empathetic; and when combined with the clear truth...it becomes an OUCH! situation for the conversation partner.

When teaching formal and informal language, SLPs will often work on the HOW from a language perspective. In teaching honesty, it is never (or should never be the goal) in taking away or dampening a learner's ability to tell the truth. It is teachign them HOW and WHEN to deliver the news and to know the intent:

Here's an example:

Samantha is with her mom at the grocery store. She sees her neighbor Mr. Bill. Samantha says hello and begins small talk. Mr. Bill is enjoying the conversation with Samantha and her mom. At the end of the conversation, Samantha tells Mr. Bill that his breath stinks. Mr. Bill is embarrased and mom is mortified.

Do we teach Samanthat to NOT tell another when their body odor offends her? NO!

What do we do:

1. Examine her intent. Did you want to embarass him? She answers No. (side note: If embarassment was her intent...change focus of teaching).

2. Thought bubble and speech bubble exercise. Fact: Mr. Bill is in the store. Fact: You enjoy talking to him. Fact: His breath stinks

3. If your goal is to NOT embarrass (turn his stick figure yellow...credit to Carol Gray conversation color)....then what can you do...

4. Let the problem solving begin! (Here are a few choices generated by Samantha: Whisper to her mom after Mr. Bill leaves, purchase mints for Mr. Bill and tell him why you are giving them to him and you did not want to hurt his feelings by talking about it at the grocery store).

Side note: We did not teach her to just randomly offer a mint (that can be rejected) to Mr. Bill. Her Verbal Behavior was telling him the problem. You have to teach her to use that same modality to continue to the current relationship. That is, you must teach her to pair a solution with her stated version of the problem. Employ the use of an empathetic voice for HIS feelings not hers.

This was a real scenario and a real HONESTY teaching experience for mom, Samantha, and me (her therapist). This happened in her Keep the Conversation Going social group :-)

Resources:

Teaching Children with ASD to Miind Read

Great Video by Dr. Uta Frith - Autism and Brain's Theory of Mind

Enjoy and Be Empowered,

Landria S Green, M.A., CCC-SLP

author of Keep the Conversation Going (available November 2011)

Teletherapy

Wed, 12 Jan 2011 07:06:44 -0800

The American Speech Language Hearing Association (ASHA) defines teletherapy as "the application of telecommunications technology to delivery of professional services at a distance by linking clinician to client, or clinician to clinician, for assessment, intervention, and/or consultation."

Teletherapy at SLC is affectionately called SLC Web Therapy. With this medium, our clients don't have to leave their homes, but can tune into their therapists and receive intervention via the web. We used teletherapy with a select few clients over the last year with a range of diagnosis (ASD, speech delay, and language impairment) to develop a protocol, get creative about our reinforcers, and compare the progress of the same child seen in the clinic vs. teletherapy. Our biggest question was: Did progress stop when the client changed from center based to teletherapy.

HERE ARE OUR RESULTS:

1. When teletherapy was initiated, two of the four clients were on the road to dismissal of services due to progress. Those two clients were able to be dismissed earlier as the home practic component became more intensified.

2. Parents were our parents in a more meaningful way. We even made video samples of prompting, homework samples, etc. so that generalization could skillfully be applied by parents.

3. Social communication therapy can be very cool via web therapy. Both from the therapist perspective and the client perspective.

4. Our families were less stressed about getting to therapy! This was huge, especially during the winter months, client illness, etc. Our clients were ready for therapy and rescheduling was very easy. We found that this therapy fit into the family schedule a bit easier.

5. Private schools were open to this option as it allowed for better teacher and para collaboration.

6. Providing ABA Therapy via teletherapy can be done. Creating the programs, implementing, and using the parent as our partner has been wonderful. It's great to see a child who could not wave and say hello with fluency do it quite readily with us on the web and generalize it to his home environment.

7. It placed parents in a better position of power and partnership.

8. Clients still made progress, 30 minute sessions 2x per week for mild- mildly moderate impairments. Mild: 1x per week with home program component.

9. Most families already had a webcam and skype account. Our skype account (SLC business account) is secure, and we were able to provide this using with no additional cost to our clients.

To begin in teletherapy as any other therapy, an assessment, evaluation, or consultation is conducted. Treatment plans are still created. In addition, we complete a mock session in which a client eligibility form is completed to determine if they are ready for teletherapy.

As I sit in my office in Michigan and listen to my "snowed in staff" in Connecticut discuss their plans for the day, I smile because I know many would benefit from loosiing the hustle and bustle of getting to therapy and would say "yes" to WebTherapy or Teletherapy.

For more information about Teletherapy, visit:

American Telemedicine Association: http://www.americantelemed.org/i4a/pages/index.cfm?pageid=1

American Speech Language Hearing Association Position Statement: http://www.asha.org/practice/telepractice/

http://www.asha.org/Publications/leader/2006/060815/060815f.htm

http://www.asha.org/Publications/leader/2002/020611/f020611_2/

http://www.hrsa.gov/telehealth/publications.htm

Enjoy and Be Empowered! (Maybe we will see you via teletherapy).

Landria Seals Green, M.A., CCC-SLP

The Social Connection

Wed, 29 Dec 2010 19:04:19 -0800

Social Communication Therapy should be mulitlayered and meaningfully address the areas of deficit and build the strengths simultaneously! Whew...that's a lot of work and preparation on the part of the astute therapist and challenging work for the client. Still no social intervention program that expects to work beyond the round table and the walls of the treatment room should be void of parent work, community involvement, and real life social patterning and experiences.

Social skills are one small component of building the social person. Social skills teach the politeness, the niceties, the way to be. Social skills can often be reflective of the norm of the person teaching rather than the social norm of the general population and the culture of the client.

Real layers of building the social being include: Emotional Development, Regulation, Social Connections, Social Cognition, Conversation Fluency, Nonverbal Comprehension, Nonliteral Language Comprehension and Use and much much more.

Whatever stage social intervention meets the client (early intervention or otherwise), the work should include home, family, community so that the social layers can be created and the difference is made in the clients life in the ways, places, stages, and interactions that matter most.

A study recently funded by NIH and mentioned in the Journal of Child Psychology and Psychiatry supports the need for early intervention in social communication and the value of the home component.

My cautionary key word to the EI therapist is MEANINGFUL, EVIDENCED BASED THERAPY WITH INTERVENTION TOOLS THAT ARE EFFECTIVE...many EI therapists believe that being in the home will mask the lack of effectiveness in the tools being used. I would like to caution that in this study the therapist provided real intervention with a training system with a complementary home program for families. In addition, they measured the progress with data, assessment information, and clinical information.

To understand my deeper perspective on social communciaiton, here is a a previous blog about Social Communication and Patterning.

Coincidentally I am preparing for an internal SLC CROSSTRAIN in the AM in our method of Keep the Conversation Going.

Enjoy and Be Empowered

~Landria Seals Green, M.A., CCC-SLP

One Language or Two: The Bilingual Quandry in Autism or Is it?

Tue, 28 Dec 2010 09:36:45 -0800

I appreciate great research, well founded studies with clinically relevant recommendations that can be utilized by therapists and consumers. The topic of Bilingualism as it relates to autism or even relevant research with strong implications for bi or tri language acquisition in people with autism is a subject not well researched. However, the answer of "No, use one language only preferably English" is often communicated to families (typically Spanish speaking families) whose children have a diagnosis of autism.

While I understand the perspective of the well meaning therapist. I must ask, why are we communicating "No use of a second language" without real evidence in practice?

Language is personally relevant as it demonstrates a person's identity from a cultural, socioeconomic, and/or religious perspective. Language is a source of identity. When parents strive to teach a child a language such as Spanish, French, German, Japanese, Swarti, etc. that is typically part of who they are. In fact, these families usually seek to teach these languages first and also add English. When a therapist states that one language should be utilized, it is in fact, asking a family to choose their identity. Is this fair? Is it okay to ask a family to choose a language?

Because this topic is important to my clients, I decided to conduct a review of research so that my recommendations have evidence and not my opinion disguised as fact. The truth is, the spare research made public, is not based in the US primarily. In fact, the research is coming from Canada and other countries. Is this because being bilingual is the norm in other countries in comparision to the US culture that sublimally states that bilingualism or the L2 is an extra language and English is the norm and prmary? Is this fair in a world of cultural, ethnic, and linguistic diversity?

I suspect that my readers may be thinking that these statements are acceptable for typical language development, but autism or atypical language acquisition should have different rules. While this may or may not be true, there is little research in the area of autism and bilingualism. The research that is available has found:

1. The research that has been conducted is positive in the acquiring Language 1 and Language 2.

2. Children seem to acquire both and use one or both primarily.

The authors of the research studies separately state that the although autistic, each brain is different in how and what it will acquire. In addition, no research stated the teaching a second language has an adverse effect on progress. I think ineffective therapy masked as effective, unfounded information, and a therapist that does not seek to understand a families dynamic including how a family identifies themselves will have greater adverse impact.

Tasking a family to choose the language form they should communicate with their child is not only unfair but culturally dismissive.

When faced with this language quandry, families should:

1. Require that their therapy tem provide Evidenced Based Practice and Relevant Research

2. Request data that shows how their child is progressing in either and both languages

3. Be allowed to decide and not forced to make the choice

4. Get therapists that understand them from this language relevance perspective and therapists who will move beyond their comfort zone and seek to learn about the families language and utilize this language in therapy.

In short, families make many many choices. And a diagnosis is heavy regardless of severity. A diagnosis makes people readjust and create new norms on something that is unplanned, can be unpredictable, and not always smile worthy. To add "no to the use of a family identifer" is not the best way to create a buy in to the therapy process.

If my family were fortunate enough to be bilingual and this news was given to us as we are a family of people that has a few sprinkles of people with special needs (an uncle with a severe cognitive impairment, cousin with CP, and a cousin with language learning disability) ...I can just imagine the "kitchen table" conversation...and we would not adhere to the recommendation because our language is relevant to who we are. In fact, we would reduce the impactfulness of the therapist and thereby listen less to future recommendations...especially if this person did not have proof that this was more than an opinion.

We would want our therapist recommendations to meet us where we are and founded in relevant research.

Enjoy and Be Empowered!

~Landria Seals Green,M.A., CCC-SLP

Things That are Just Beautiful!

Mon, 15 Nov 2010 20:03:16 -0800

I think this is one foundation where you can See yourself Make A Difference in the lives of people with autism. The HollyRod Foundation is not only asking for monetary donations, but they are also giving iPads away to eligible families. To those that are looking for a way to give, consider this. For those that know a family with a child with disabilty, here are a few gift ideas:

1. Coupons (House Sitting, Date Night, Mom's Day Off, Dad's Day Off, etc.) that gives parents a break with the relief that their child is with someone they love and trust.

2. Donate to HollyRod Foundation for the iPad giveaway

3. Pay for a month of therapy

4. Host dinner and make it gluten free or with all the person with ASD's favorite foods so that parents can pack less

5. Giftcard to Costco or another Wholesale Club for obvious reasons

6. Gas Card (because of all the appointments to and fro).

Do you have any other ideas?

By the Way, Don't Forget to Donate...to the HollyRod Foundation.

Let's Empower by Giving

~Landria Seals Green, M.A., CCC-SLP

Waiting for Superman

Tue, 28 Sep 2010 09:15:16 -0700

Much has been said, written, with even the daytime talk show circuit discussing the movie, Waiting for "Superman". I too, have found myself in talks over dinner when the topic of education comes up. I find myself offended for those dedicated and knowledgeable educators, the unsung heroes, who educate our children everyday without praise, pay increase, or resources to do the job they are evaluated to do and passionate about doing. So on Friday evening, when a well meaning adult male decided to say that he was trying to volunteer in a school system under his own organization ...I quickly said "if you are truly passionate, then go and get certified..get licensed...go and teach". To my comment, he stated "No I don't want that full responsibility". I inwardly smiled until he said "After all, teaching is not rocket science". I then turned to him, meaningful looked in his eyes, and stated "No its not, but since the rocket scientist had a teacher, I would think twice about demeaning the profession that is responsible for educating each and everyone of us at this table". Needless to say, that there was silence and this man could not look at me for the remainder of the evening.

But this movie, has people talking. This is a good thing. Long over due in my humble opinion. See, I am the daughter of an educator who has watched, through the years, my mother wash the school uniforms of students, purchase school supplies for students, buy toilet paper/hand sanitizer/papertowels/carpet, buy equipment for after school programs she runs, and solicit my father (the engineer) to fix and network her classroom computers. This happens every year and it is our normal as a family to support my mother's classroom. When I am in town, I visit and clean her library, organize her books and lend a helping hand. Teachers,like parents, are also "Waiting for Superman".

But let's go deeper...the examples of the movie are in Regular Education. What about parents of learners with special education needs? Is superman coming for this population too? Are the special funds being sent to charter schools and public schools donated by millionaire and billionnaires.. reach special education? Can children with special education needs get qualified and specialized paraprofessionals, teachers, and speech pathologists? I am reminded of a recent meeting with a school system (who shall remain unnamed) when I was told that while they had a need for people with backgrounds in autism and speech pathologists, it wasn't necessary. As I sat shocked, I uttered "but they are listed on your site as critical shortage areas"...I was then told "So what, we just need people to do the job, they don't need to have a speciality.

In my world of Utopia, I would like for Superman to:

1. Come and change the mindset of those in charge of supplying people with special needs of the tools and teaching resources that will make them better.

2. Increase the value we place on people with special needs and how they can contribute to society.

3. Expand the talk about Education to INCLUDE those with special learning needs and how their parents, too, have been waiting.

As I write this, one part of me says "Superman isn't coming". And this is true, Superman is a fictional character that comes and saves the day and then the people start smiling again. The reality of this is true, but the symbolism of hope says: We are Superman! We must continue to meaningfully advocate, create, bring awareness...so that the children are better for knowing us and us for knowing them.

Enjoy and Be Empowered...Always!

Landria Seals Green

First Words...Amazing Days Ahead

Wed, 15 Sep 2010 18:08:34 -0700

Today I received a text message from one of our behavior analysts, that read " X said gukie for cookie...YAYYY..and he said it twice!!"

To put this story into context. This child was marked as a "he will never..." by doctors and many professionals. As the parents tell us more and more each visit about the stories of hopelessness I am wonderfully amazed and pushing with hope always to see what other flowers will bloom in this child's life. Because he can blossom and bloom! Many families are told the "he will never story" and I say aloud "in 2010?!?" And then I move toward the importance of discussing the need for special education to be special enough so that people get better. I mean that was its intent anyway. Even Dr. Lovass (may he rest in peace) challenged others to increase the IQ potential of people with special learning needs through applied behavior analysis...and the list of trailblazers goes on.

Everyone wants to hear first words...see first signs...see and hear intentional communication. Everyone wants shared participation and communication. From a family-historical-relational perspective, we all want to hear and share our stories. Many of you may know that my need to be a speech-language pathologist was through a personal journey of growing up with a grandmother who could not communicate. To this day, I think her therapist gave up and didn't push enough and with this she had few words...but you could always tell she wanted to say more to us. She wanted to share her story. She tried to communicate but was not very successful and then apologetic. I treat children and young adults who want to express how they feel, what they are thinking, and what they want. While they may not always present with socially palatable behavior, they are communicating. They just require speech-language pathologists, behavior analysts, and aba therapists who are not afraid to push, persist, program with hope and determination for more...so that first words and much more are achieved and dispel the label of "never".

I am still reveling in the joy of the text message as is the behavior analyst that worked with this client today. His first words are as much of a joy to me just as they are to his parents. For me, this is more than a job...a career...a business. I am fortunate and blessed to live out my life's mission every day in a tangible fashion working in a way that I wish someone had worked for grandmother.

So tomorrow...we push for more words...putting the SPECIAL back in Education.

~Enjoy and Be Empowered!

Landria Seals Green

Using patterning to teach Social Skills

Mon, 09 Aug 2010 19:45:25 -0700

I read an article today posted on the web about teaching social skills. The authors of these articles are correct: We cannot leave the teaching of social communication to the teacher.

I'd like to add some other lessons as we enter the school year

1. Magic is magic and only left to the magicians. With this, we cannot put our kids in social situations and expect them to just get it...it's like putting me in a football field and expecting me to make a tackle, touchdown, and win the game. Sure I would run..but have no idea about the purpose, whose team I'm on, and what I should be getting from this game of football. So yes, teaching the why, the how, and giving practice (scrimmage..for you football fans), and then getting in the game makes much more sense.

2. Tolerance must be taught to the typicals. Therapy and social groups are always for the people with social language deficits. May I suggest that those without social language challenges need some support too! Not support to be fake friends, allowing our kids not to get the real social experience they need...but support to be real people...not hand holders with gentle voices, with a bombardment of questions. Tolerance is teaching the difference, what to expect, and how special doesn't mean treat so differently that real relationships cannot be cultivated. But tolerance teaching emphasizes how this experience is a win win for everyone.

3. Some things happen because its what kids do...not because he's autistic. One of my therapists had this fabulous conversation with a mother. The mother was saying that her son was not telling her everything that happened at camp. She wanted details. Instead she was getting one word responses. The therapist gently reminded the mom that her 13 year old son may be like most 13 year olds...they don't have much to say about their day and an increase in questions may result in a decrease in the length of the response.

4. Let's focus on talking and not the Q&A. One of my greatest pet peeves when observing a social group (not the Keep the Conversation Going groups run by our staff) is the barage of questions and the responses by our kids versus teaching them to have statement to statement communication. If you listen to the typicals talk, watch Nick or Disney..you will see there is more social commenting and opinions rather than the questions. Questions are only asked if the statements are not informative enough.

5. Motor patterning or Role Playing. Excuse my small yell of encouragement...GET UP FROM THE TABLE! If we want our kids to be social...we have to get up from the therapy table. We need to have social postures: sitting, walking, playing, sports, hanging out and all those physical postures in between. Role playing is crucial as embedding social thinking does not mean thinking in solitude and the quiet...true social thinkers do this on the fly. They are walking and talking. They are dribbling the basketball and thinking and talking. They are gesturing and talking. We have to teach our kids to read and understand social information (using static pictures and short snipets of movies) as well as inhabit the motor pattern of what it means to participate socially.

6. Social therapy is just not for those with high functioning or Aspergers. Everyone needs to understand social information and be social. Social interaction is at least 60% nonverbal...40% talk. So those who are nonverbal or use AAC systems should be participating in social groups and social therapy too! There was a study by Kuehn and Weiner that discussed how those even with low IQs had the ability to be more social despite the IQ number. BUT their social IQ was dependent upon opportunities. This means, that going to the one time a week social group or lunch bunch is not enough opportunity. And being included without appropriate and faded support is not opportunity. Systmatic teaching, systematic coaching is opportunity.

Let's get in this school year and BE SOCIAL!

~Enjoy and Be Empowered

Landria Seals Green, M.A. CCC-SLP

Support System

Tue, 03 Aug 2010 14:43:09 -0700

About two years ago an eight year old boy with autism who was being treated by our therapy team had a massive seizure in his sleep and died. I will always remember him because he was one of the severe children with self injurious behaviors and a great smile when he was happy. I will remember his family as his mother was trying to master the English language and did not receive all the services she could have due to the language barrier. I will remember the day I received the news that he passed away...it was right in the middle of my day..I still had clients to see after I received the news. I found that throughout that day and week...I just couldn't seem to pull myself together enough.

What I knew for sure about his death is that he was loved by his family. The autism brought a stressor to this single mother of two and first generation American. I knew that this mother was stressed and what I respected most about her is that she spoke to anyone who would listen. She soaked up all the encouragement she could from others and loved on her son.

She always communicated. She spoke aloud. She screamed. She tried to understand what the therapist were saying. She worked with him at home. She found therapists that cared who found other agencies to support her and the family.

I am disturbed by the number of deaths of children with autism by those that love them as this phenom continues to be highlighted in the media. I am disturbed that this has not caused people to move beyond the talk of disbelief and ridicule of these families. I am disturbed by the level of judgement toward people who could not deal with their life's stressors. Because the truth is, we all get stressed.

Each time I read or listen to these particularly disturbing news stories, I wonder "Did this person not feel comfortable to be authentic and articulate how they really felt?, Did those around this person brush aside the feelings articulated?" I also wonder "Were the danger signs ignored?".

I honestly don't know how it feels to parent. That does not discount my argument because it is strengthened by the fact that I am a human being with feelings. I know that whether your child is an atypical or typical learner, it is challenging work. I just can't imagine not being able to artciulate to those close to me how I feel when my life is challenging and thankful to those that don't dismiss my statements whether "over the top" or understated.

As the world moves forward and as we start to support families of people with special needs...let's give them room to be honest about how they feel, where they stand, and offer yourself as a resource to them.

I continue to applaud the mother of the client that passed away. She vented. We listened. We provided a professional counselor as a resource. She was healthy.

Remember it only takes one person to assist and listen to another person.

Let's Support Families (Moms Dads Siblings) and allow them to SCREAM when they must! Truth be told, we all need to scream...sometimes! :-)

Enjoy and Be Empowered

Landria Seals Green

The Time Has Come!

Sat, 12 Jun 2010 18:20:41 -0700

There are so many phrases like "The time is now, The time has come" to describe what I have just done. I find it exciting, necessary, and a tool that many families and even educators will benefit from. The truth is therapy is expensive and the costs add up. Not all families can afford to pay for a therapist and then pay more for a quality therapist. They want to give their children the best and may feel guilty because they can't afford it. How are people supposed to live, buy healthy food, and pay for the 40 hour therapy program recommended?!?

I know ..I know ..I am a therapist and yes I have a business. But, it is not without conscious. I think I've offered more free services than I can count and let's just say it's been a huge sacrifice. Simply put I think that if it were my child or family member I would hope that someone would help me at some point. To keep it real therapy is expensive and a diagnosis can be tough to live with.

So a secret dream I have had is to be a therapist on TV. Everyone sees, hears, gets the same information at the same time. Families are supported. We talk, we cry, we laugh, we teach, we learn. And I say We meaning all of us! Why not?!? There's Dr. Phil, Dr. Oz and cooking shows galore. I meet families who need a ME to be on TV...and now it's time.

This is a campaign of hands, brain, and heart. That's what I use when I provide services and my heart was present when I worked on this video. Yes I know I have many things to do...but this is not about me! Having a therapy company is not about me. It's about the families that we touch, support, help, assist and kids we move toward recovery.

I have put my hat in the ring and submitted a TV audition for Oprah's OWN next TV star. Please vote vote and vote again. Leave your comments, spread the word, email your family, twitter about this and help us get the word out.

Our goal 4 million votes in 20 days! I think we can do it!

There is a whole world out and the time for this programming is NOW! Here is the video!

As always...

Enjoy and Be Empowered

~Landria Seals Green

Where Do You See Yourself? A Call to Today's Speech-Language Pathologist

Thu, 10 Jun 2010 18:15:29 -0700

I was honored to be a presenter at a professional development seminar for speech-language pathologists. The topic: The SLP and Applied Behavior Analysis. As I prepared and conferred with one of my mentors, the question was asked "Where does the SLP see him or herself?" A very relevant question in light of the marketing and packaging of many therapies that parents are now asking by name at IEP meetings and private practices. As a practitioner and as an SLP I definitely understand why many parents are asking these questions, especially when looking at Applied Behavior Analysis. After all, as a profession they have better data collection methods and have the ability to approach therapy scientifically by breaking down the task to build skill sets.

The challenge here is speech-language patholgoists as a profession should be leading, guiding, teaching how in terms of language, communication, listening, social, literacy,and speech programming. So when I meet the ABA therapist who has no training in the aforementioned areas and they are teaching those things, I must ask the profession "Why and How did we allow this to happen?" "Where was the meeting that ok'd this, and where was I?"

We've given up our scope to so many other professions that our relevance has been diminished and I don't see the advocacy for it.

While in graduate school, I learned about swallowing, the oral motor mechanism, and physiology. So why are occupational therapist the people parents and other professionals call on to do feeding and swallowing therapy? After all, please correct me, but OT's do not have in their formal training the education of the anatomy and physiology of the waist up...and what's their course in swallowing called?!?

Here is more evidence:

Social Connectedness therapies (you know them....), have repackaged early childhood development, cognitive develoment theories. SLPs have given teaching social language development to a profession that does not know language.
I see Occupational therapists programming communication devices...(what else is their to say about that one).
ABA therapists teaching language and reading.
The advocacy and laws for insurance legislation for Autism, do not mention speech language pathologists, they mention ABA. If an SLP wanted to be part of this (i.e TriCare) and they do not have a BCBA or BCABA (bachelors level certificaton), they are identified as an ABA Tutor and work under the BCBA. Now there are a million things wrong with that picture! Where was our advocacy?!?

The relevance is taken away from us because we don't have data or enough of it. We say things like "you can't take data on social skills" We say things like" I dont' have time for it on my caseload". We whisper when we see the ABA therapist teaching language, but say aloud "I don't know what to do with that child, he has way to many behaviors". We sit at IEP meetings and are our reports are not exhaustive and the data reports no progress...as if it's the child's fault. SMH!

Here't the thing...we took ourselves out of the game. While everyone was getting their hands dirty and learning more and more about what we do...we continued to work and conform to the stereotype of "primadonnas of the therapy world".

Now while there are excellent speech language pathologist's out there...there are some that are okay with giving up on our relevance.

I am definitely not okay with SLPs as a profession becoming less and less relevant because so many our doing what we have been educated to do. It''s time for "Better Speech and Hearing Month" to be a call to the profession to stand up and be counted!

~Enjoy and Be Empowered

Landria Seals Green

No Phone Zone

Thu, 29 Apr 2010 18:39:37 -0700

I have been watching Oprah Winfrey's No Phone Zone in agreement! Yes Yes Yes we need to not talk on the phones with one another while in the car.

Our dilemma is that our staff is mobile providing therapy in homes, schools, communities. Therapists have bluetooth, headsets, and surround sound in their cars...making them hands free. But its still not good enough! Why?!? Because I know how the brain works...we were not built to drive and phone...and all that it involves.

I had the opportunity for 2 weeks not to use my phone at all in my car (due to phone issues) and it was not so bad at all! Radio, observing my surroundings...it was more peaceful!

But I do have to remember how our office works...we are virtual. We have partnered with Alfred Green, BKAEG Technologies, and our staff laptops have sofphones. So staff can talk when they are parked and have internet access. The sofphones are to deter staff from using cell phones. The computer based phones allow us to still be in touch and they can be actively used when our staff is not behind the wheel driving.

Beginning Monday...SLC staff will receive their No Phone Zone contracts and move forward from there.

They can use those times without phone use while on the job to decompress, decompress, listen to music, have coffee, etc.

Enjoy and Be Empowered

~Landria Seals Green

A Salute to a Trailblazer, Dr. Stanley Greenspan

Thu, 29 Apr 2010 18:30:04 -0700

Everyone belongs to someone. They belong to friends and family. It is an amazing feat to belong to a global population and share professional wisdom and teach therapists, both present and future, and parents. It is amazing to have a stretch of a professional career that makes an entire population of people say Thank you for your work! Thank you for showing us! Thank you for making us pause and think differently!

It is not important in this case how one feels or is positioned for or against the clinical approach of DIR. What is important is that one individual moved an entire paradigm forward. One individual gave creativity, thought, intellect to the field of autism and people actually benefitted. One individual decided that his purpose was to expand beyond his own borders and effect change. One individual decided to be a trailblazer and set a path of teaching and training new and old professionals so that the field of therapy would move forward.

Dr. Stanley Greenspan is well documented in his research, his methods.

As a professional, I hope his other lessons remain important. You know those lessons that require us to read between the lines.

Lessons learned:

1. Find the one thing that you do well and Do IT!

2. It is possible to be passionate about your profession!

3. Clients never benefit when we hold our information at a high cost or hostage..making it unattainable for those that need it most!

4. All professionals need to work within the same plan to push the child toward their potential.

Thank you Dr. Stanley Greenspan for the time you gave us.

Thank you Dr. Stanley Greenspan for sharing your information.

Thank you Dr. Stanley Greenspan for the emotional, intellectual sweat equity it takes to be a trailblazer.

May your memory provide current and future professionals with fortitude needed to continue!

~Landria Seals Green