Speech & Language Consultants

I recently went to a LAMP training given by PRC and cringed when the first sequence for communication training instructed the use of "more".  Sadly it's more common than not.  I interviewed and SLP and during her demo session with the child with Autism, she decided he needed to say the word "more".  And early in my career, I too thought teaching "More" was important for first words...but its not.  Here's why:

•  When your child says "more"..you are probably thinking "more what?!?"  
•   If a child says "more" and doesn't have the nonverbal skills to look, point, turn their body towards the object.  Is that true communication?
• If a child has a reduced level of patience, high levels of frustration...teaching more is not effective and results in screaming because communication has not happened.

In natural conversation between typical brain learners, words and vocabulary are shared.  Labels are produced.  

• Baked Lays
• Book
• Radio
• Music

Typical people use words!  The interesting thing is that in ABA teaching sessions, in language teaching sessions...children with special needs are learning words.  The are learning to label and receptively identify nouns, actions, location, etc.  

The SAD TRUTH is that therapists are not often thoughtful in the programming to create a true bridge between the words taught and communication.  

How do I know this?  Well I meet parents daily who want their children to communicate with them.  When I ask for the word lists and what words have been taught in the program...there are categories upon categories of word lists!  But no true communication.

Here is the TRUTH: If communication were taught in conjunction in building word lists...the parents and families would be able to talk to each other.  This is generalization...from the beginning.  When you teach more...you don't teach independence but increased dependence resulting in a cyclic breakdown in communication.

So as I sat and cringed at the LAMP training and the sequence of language teaching for "more"...I created a new curriculum for labels that moves along the ABA-VB sequence for mands, tacts, intraverbals.  

That's what any behaviorally based speech-language pathologist would do :-)

Enjoy and Be Empowered.

Landria Seals Green

While there is much controversy over the use of computers and technology with children wtih special needs and using technology and videos for language learning.  I'd like to point out that adults use technology all the time: We use Rosetta Stone when planning a trip to Italy and identifying the need to learn a new language.  We use organizers electronic or paper to organize our lives.  We use our mobile phones to communicate and send text messages to one another.  The question of "Should technology be used to teach or support education is not a vaild one, I think. 

But the statement of "Too much of any of one thing isn't great! 

• Too much Baby Einsten does interfere with real social interfacing and talking with parents. 
• Too much My Baby Can Read may be neglecting other needed areas of development (motor, social).
• Too many activities can create an overscheduled family with no quality time.
• Too much pizza can add inches ... a personal reminder for me :-) 

It is necessary when creating and developing a cognitive set for children (nontypical or typical brain developers), the practice makes perfect mantra must ring true.  For someone with severe cognitive challenges to learn...3 hours of practice in speech, reading, or writing is not enough.  The number of hours needed and the consistency needed to create the neuropathways needed or regenerate those brain cells is tremendous.  Think about it...people who are identified as "experts, prodigy's, superhuman" did not wake up that way...they PRACTICED!

• They practice daily
• They practiced more than one hour per day
• They practice. They practice. They practice.

With the practice.  The brain learn.  The brain creates new pathways.  New cells are formed.

Can this practice be achieved in the classroom alone?  Can it be achieved in private therapy alone?  NO!!!  The supporter of the classroom, the supporter of the private therapist is technology.

To continue to make special education SPECIAL...educators must

1.Recognize and Implement the philosophy that technology is essential

2. Understand what technology is out there and thoughtfully implement it for their students.

3. Not be afraid of the technology and see its value.

4. Abandon sticking children on the computer in the name of "assistive technology" 

5. Make special education, SPECIAL by TEACHING WITH THE BRAIN IN MIND.  Children with special needs must have educators and therapists who understand and create programs that train their brains...the purpose of therapy is so people actually get better...and not just by the aide of development and growth...but by concentrated influence from the knowledgeable therapist.

Check out this article about technology and education

Enjoy and Be Empowered!

Landria Seals Green

I have always always been a therapist on the go!  Whether it's a school observation, therapy appointment, PPT or IEP meeting, phone conference...JUST ALWAYS MOVING!

My Treo died almost 6 months ago and against my fiance (now husband's) suggestion, I bought an iPhone!  What encouraged me most was watching my clients with their iTouch's sitting in the waiting room developing leisure skills with technology.

Now that I have an iPhone, I will never turn back.  Here are some apps that have enhanced the ease of my life as therapist.

1. Camera: I can take great photos and videos of my clients while in the session. The quick editing allowed for the use of videomodeling!

2. iTalk Lite: This allows for recording of speech samples.  Although speech-language samples are long to analyze and require a great level of attention...they are great in looking at speech intelligibility ratings, language, and social language use.

3. Behavior Tracker Pro: This is great for school observations for the behaviorally based SLP and the ABA therapists.  It allows you to track and record behaviors of your students.

4.ICD-9: Enough said!

5. You Tube: I can have quick access to reinforcers that include Little Bill, Cailou, and much more

6. Pandora: I created music stations based on what my clients like.  Another reinforcer.

7. Flash Cards: There are many many apps for flash cards!

8. Munch Munch: For clients on a food sensitivity/eating program..this allows me to take a picture of the target and let the kids watch the character munch munch munch.  Disclaimer: Therapist should follow a specific sensory program specifically created for their clients.

9. IEP Checklist: This is a great tool and FREE app for parents  and teacher. So that you don't forget anything while you are in the IEP meeting!

I have many many more apps that I absolutely love!  And then I have some development ideas too!!!

My goal for health was to save my back and body and reduce the bags and load as I travel.  So now with my trusty HP Touch Smart laptop and my iPhone no need to carry materials!  I have it all on my technology...what do I do if it fails?  It's all backed up and any therapist worth her weight can make a dynamic lesson based on anything! (inside joke of the elite SLP- JK)

Enjoy and Be Empowered,

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

It appears as if the proposed revision from the American Psychiatric Association is to put all types of PDD under one classification for Autism 299.00.  This means that Aspergers, High Functioning, PDD-NOS will now be under the same heading.  One true benefit of this is that parents of children with PDD-NOS and Aspergers may be less challenged in advocating for services for their children.

It is true according the APA rationale that Autism is distinguishable from other disorders.

The interesting part is that two days ago I was speaking with a fellow SLP and Northwestern Alum about how psychologists and SLPs in her area were still having a challenging time identifying the person who is not classically autistic. The amazing fact is no two children with this diagnosis are the same!  

It is important to note and recognize that Autism is not the only proposed change.  Included in this are Rett Disorder, Learning Disabilities, etc.  

The APA allows for people to comment on the severity criteria.  You must register to do this and it is extremely important.

The effected revision and nonconsumer advocacy can effect the following:

1. Insurance reimbursement.  Especially if the diagnosis is allowed oncer per lifetime.  Check your state law on this!

Enjoy and Be Empowered!

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

Executive Director

Everyone needs a context to simply understand an idea, thought, or situation better.  This holds true for neurotypical as well as those with special learning needs. Literature, specifically story and picture books, can be used to teach language concepts for all students especially those who use augmentative communication.  I work with many children who may not have the ability to touch, taste, physcially enter and participate in experiences.  However, story books allow them real experiences. 

Using picture books to derive "talk" and teach "what to say, how to say it" can create real talkers!  These children can look at characters, see them and figure out what they would say using their picture communication systems.  

Do you always need to present a piece of chocolate to teach the picture or symbol or "eat"? NO.  Sometimes you show their favorite character eating and model the many different things one would say such as "I'm hungry", "Wow, that smells great", and much more.  With using the context, we are teaching them not to rely on static pictures but to think using their ENTIRE communication device.

Today I was asked what would a trial of success look like for a student using an AAC device.  I replied, when the child is shown the context in which to apply the language, the teacher model and shape "how and what to say".  Magic does not happen when an AAC device is presented, but language and communication can happen when a context that is socially and personally relevant to the child is presented!

Enjoy and Be Empowered

~Landria

An article in the December issue of Medical News today discusses research on Dyslexia and IQ.  Interesting that they are finding that there is less of a link between IQ and reading!  This is wonderful for people who have IQ numbers that scream what they cannot do to the untrained and less creative practitioner.  Anyone can learn! 

Here is a snipet of the article. 

Contrary to popular belief, some very smart, accomplished people cannot read well. This unexpected difficulty in reading in relation to intelligence, education and professional status is called dyslexia, and researchers at Yale School of Medicine and University of California Davis, have presented new data that explain how otherwise bright and intelligent people struggle to read.

Click here to read more about this dyslexia article.

Enjoy and Be Empowered

~Landria Seals Green

Well...yes!  Providers who are committed to working with and creating success for people with autism are well aware of this!  Evidenced Based Treatment such as Applied Behavior Analysis has proven to be one of the most effective forms of treatment.  The challenge for parents is finding providers who are exceptional and not being afraid to leave those who are are not effective.  The title shouldn't read that Autism Therapy helps but Effective Treatment Models Provide Success for Young Children with Autism.

I'm glad the findings from this study has hit the media especially with the rate of autism rising to 1 in 100.  What is needed:

1. Effective Treatment. Treatment can make or break progress.  Bad ABA is worse than no ABA.  It's tough, but families should absolutely seek providers that understand language, its progression, and the interaction of communication and behavior.  A strong SLP (who knows ABA) is neccessary and should be an integral part of the team.

2. Early Diagnosis. Stop waiting to diagnosis!  Get the diagnosis so that real treatmnet can begin.

3. Giving Children what they need when they need it.

4. Educate parents on the efficacy on the holistic methods that work and DON'T work!  Many spend an  extraordinary amount of money, countless hours..and let's be honest...gluten free diets don't work for everyone!  (Please understand that my family tries to eat with this diet for health reasons and it is HARD WORK...I speak from experience with natural and holistic methods.)

 Again, I'm excited about getting this news out.  Autism Therapy does work...WAIT!....Great Therapy works for Autism!  We at SLC know and understand this.  Our Early Childhood ABA Program begins in our new 5,000 square feet (yes we had to expand!!!)...in April!  It will be lead by a BCBA and SLP.   Contact us at admin@speechandlanguageconsultants.org to learn more about our ABA Early Childhood program in Fairfield County, CT.

Until next time....Landria

The school year is coming to a pleasant close and we have been able to collaborate with many districts and parents for the new IEP!  Many questions surrounding social communication are formed:

“What should we work on?”

“Can we really measure social goals?”

“Isn’t social communication subjective?”

These questions return periodically, but not as frequently as the goal  for turn-taking  and the elusive phenom of “Your Turn … My Turn”.

Let’s put a few things to rest!

1.       What should we work on?  There are social language development norms that should always be used for treating and creating goals for social communication.  Evidenced Based Research can be found in many fields that include speech pathology, sociology, psychology.  The target for social goals should always include social thinking or social cognition, theory of mind, reasoning, flexibility, experience sharing, referencing, and verbal communication.  Please not the emphasis on verbal communication as being last!  Because it is the surface skill, we tend to work on that first…it should be a shared priority with those things that are hidden but necessary in social interaction.  What are those hidden skills?  Social thinking and engagement to name a few.

2.       Can we measure  social goals?  Absolutely.  Just need to know what is being measured. The goal has to be written in a measurable way or as discretely as possible. 

 3.   3. Is social communication subjective?  No social language development has established norms for typical development. Therefore it is not subjective. However, social skills are subjective.  Social skills are what parents and society teach anyway.  That includes polite greetings, “speak when you’re spoken to”, etc.  Social skills depend up on the culture of age, color, geographic space, economics.  Social communication is the engagement, flexibility, declarative language, perspective taking, and much more!  Social communication work takes the people who verbally label items to demonstrating the surface skill of verbal interaction.  The difference between social skills and social communication is that social skills training builds a house with a very weak foundation…destined to fall!

4.       4. Your Turn…My Turn.  Can we teach it? Be careful about how Your Turn My Turn is being taught to your child.  Picture several children playing.  When do they really verbalize “Your Turn”.  Is it at every turn?  Or is it when the person is not engaged, does not move fast enough.  Your Turn/My Turn is really a nonverbal social thinking act rather than something to tell a person.  We figure out it is our turn when we play with our friends. We are only informed that it is our turn when we are not participating at the level expected by the other players.  When they tell us its our turn, what kind of vocal tone is used?  Is it a patient tone?  Does it include a long statement “Jennifer, it’s your turn”.  Nooooo!  Typically we say things like “Hey take your turn”, “Go,”, Hurry Up”.  Most times, we use an impatient tone or a humorous tone.  So what should we then teach?  Engagement, Rhythm, and Social Thinking. 

 Until Next Time….Landria

 ©2009 Keep the Conversation Going

©2009 Landria Seals- Social Soap Box

NEW YORK, NY (June 10, 2009) -- Autism Speaks, the nation's largest autism science and advocacy organization, today joined the Connecticut autism community to praise Governor M. Jodi Rell for signing into law Senate Bill 301, which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies. Connecticut is now the thirteenth state in the country to enact comprehensive autism insurance reform.

The Connecticut law requires insurers to provide coverage for behavioral treatments, including Applied Behavior Analysis (ABA) therapy, of up to $50,000 for a child who is less than nine years of age, $35,000 for a child who is at least nine years of age and less than thirteen years of age, and $25,000 for a child who is at least thirteen years of age and less than fifteen years of age. ABA therapy is recognized as an effective, evidence-based treatment for children with autism.

“This new Connecticut law is another significant victory in the national effort to secure autism insurance coverage in all fifty states and provide families with the help they so desperately need and deserve,” said Bob Wright, Autism Speaks co-founder and Fairfield, CT, resident. “We thank Connecticut’s legislators and Governor Rell for having the courage to put families and their needs first.”

Read the rest of the article on the Autism Votes website

NEW YORK, NY (June 10, 2009) -- Autism Speaks, the nation's largest autism science and advocacy organization, today joined the Connecticut autism community to praise Governor M. Jodi Rell for signing into law Senate Bill 301, which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies. Connecticut is now the thirteenth state in the country to enact comprehensive autism insurance reform.

The Connecticut law requires insurers to provide coverage for behavioral treatments, including Applied Behavior Analysis (ABA) therapy, of up to $50,000 for a child who is less than nine years of age, $35,000 for a child who is at least nine years of age and less than thirteen years of age, and $25,000 for a child who is at least thirteen years of age and less than fifteen years of age. ABA therapy is recognized as an effective, evidence-based treatment for children with autism.

“This new Connecticut law is another significant victory in the national effort to secure autism insurance coverage in all fifty states and provide families with the help they so desperately need and deserve,” said Bob Wright, Autism Speaks co-founder and Fairfield, CT, resident. “We thank Connecticut’s legislators and Governor Rell for having the courage to put families and their needs first.”

“Legislatures across the country are introducing and passing bills that put an end to the discriminatory practices by insurance companies against children with an autism diagnosis,” said Elizabeth Emken, Autism Speaks vice president of government relations. “We must continue to fight until every child has access to medically necessary autism therapies and families are no longer forced to mortgage their futures.”

In many states, insurers explicitly exclude coverage of these therapies from policies, which places a significant financial burden on families seeking to provide their children with necessary services. Connecticut is the fifth state to pass autism insurance reform this year, and joins twelve other states – Arizona, Colorado, Florida, Illinois, Indiana, Louisiana, Montana, Nevada, New Mexico, Pennsylvania, South Carolina, and Texas – that have passed similar autism insurance reform bills.

Senate Bill 301 was sponsored by State Senate Majority Leader Martin M. Looney (D-11) and State Speaker of the House Christopher G. Donovan (D-84).

"We know that aggressive treatment and early intervention are critical to enable autistic children to reach their full potential,” said Senate Majority Leader Looney. “This initiative also helps families coping with autism by preventing them from being financially devastated by out of pocket costs of providing effective care."

“This bill will provide many Connecticut families who have children with autism spectrum disorders with access to life-changing treatments,” said House Speaker Donovan. "I am so pleased that the Governor had the wisdom to recognize its importance and make it the law."

The bill was helped throughout the process by the thousands of hardworking families in Connecticut affected by autism.

"The lives of families with autism will forever be changed by this law," said Shannon Knall, Autism Speaks Connecticut chapter advocacy chair. "Our families have spoken and our legislators on both sides of the aisle have allowed our voices to be heard. We are so grateful."