That’s not my job…or is it?

Tip of the Iceberg

 

Speech therapists have worn many hats over the years in a school setting.   It always amazes me when someone finds out the scope of our practice includes language, syntax, AT, phonological awareness, listening comprehension, oral expression, executive function, social communication AND articulation.  They usually respond, “I thought you just taught kids to say /s/ and play games.”  Ouch.  That being said, we need to do a better job integrating our services into the school environment beyond our speech closets classrooms.  Not to toot our own horn, but to demonstrate to our colleagues how we can partner with our teachers and support staff, ultimately benefiting our students.  I talked about this with connecting language and literacy in all academic settings here .

Working with students who have social language impairments is a brave new world for many slps and teachers.   Often times we focus on the behavior issues and not the underlying reasons/deficits that may be causing them,  because the behavior is the what the teacher sees as the most pressing concern in the moment. However, the behavior is really only the tip of the iceberg.  The TEACCH model out of UNC gives a great example of this visual here:

 

What is often happening is once a team figures out what else might be going on with a student, or the family shares a medical diagnosis such as ADD or ASD, the next question is who is going to address these deficit areas?   Speech language therapists (SLPS) are often the first line of therapeutic intervention, and as a whole, we often take on more than we should.  We need to also consider that while the student may have a medical diagnosis, in the school setting we need to carefully and thoroughly evaluate the child as a team and determine if their diagnosis is impacting them socially and/or academically.  This is not always the case, so it shouldn’t be assumed that a diagnosis=eligibility for services. The medical/private model does not have the eligibility paradigms present in school. This is often a cause of frustration for parents and the team needs to be sensitive to them and have open dialogue with families to address these concerns.  Everyone needs to be working towards the best outcome for the student.

With social language impairments (and the behaviors that often are embedded), the SLP is a critical team member, but not the whole team. If a student does need support with social communication skills, they need to be taught, practiced and generalized beyond the walls of the speech room.  A one on one therapy session with an adult is not a natural social language environment.  For many kids who have been in therapy since they could walk, they figure out that adults will modify their own behaviors and language around the child’s deficits.  Peers don’t do this.

A good social language plan for most students (not all) with social language impairments is a combination of learning strategies, developing self monitoring tools and then having opportunities to practice these skills with their peers.  The team to support the student includes teachers, peers, SLPs, OTs, administration in the schools, counselors, and families.   It’s great if a student can talk about what they should do in a socially challenging moment within a speech therapy session, however, if they cannot try it and apply it in real-time with their classmates, it isn’t really that beneficial.  It’s only the tip of the iceberg.

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