Stuck Thinking

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I had the misfortune of walking into a spider’s web the other morning.  I was caught up in my own thoughts and didn’t see the web draped across the hedges until it was too late.  There’s nothing quite like a spider web freak out, and I am glad no one was nearby to witness it (or they would still be on the ground, laughing).  It took me a good twenty minutes to untangle myself from the sticky webbing, and at least another twenty minutes to calm down.

This experience made me think of my students who get caught in their own thoughts but can’t get “unstuck”. Mental health is a big issue in our society, especially with our older kids. Many of our students with social language impairments, anxiety, and ADD struggle with managing their focus internally and externally.   It’s easy for someone who doesn’t struggle with these thoughts to say, “Just stop thinking about it!”, but it is harder than it seems.   Negative or perseverative thought patterns often upset our students, keep them disengaged in learning and conversation, and make it difficult for them to establish friendships if they become stuck in a chronically negative mindset.

This is one of those gray areas that overlap speech therapy and counseling’s scope of practice.  It doesn’t have to be one or the other, as our students can benefit from the support of both specialists.  From a social language perspective, helping our kids connect the concepts of keeping their “brains in the group“, taking the perspective of others, connecting how their choices might make other people think or feel, and emotional self-regulation  are all valuable tools in their coping toolbox. Using a five point scale to talk about the size of a problem and matching the size of a reaction to that problem, are also helpful strategies with our kids. We need to make sure that we are working on these skills  outside of the moment, as our students are often not available when they perseverate.  They need to hear the message that they don’t have to do this on their own,  and there are supports all around them!  If the anxiety or compulsive thoughts are overwhelming for the student, then we need to dialogue with the family and encourage them to involve their pediatrician or psychiatrist in the conversation.

A friend once told me that she can’t be in her head too much because it’s a bad neighborhood to linger in.  What she meant was that she can get stuck in dark and negative thoughts when she thinks too much on her own.  She needed to talk through her worries with others who could put her concerns into perspective when she couldn’t. This is a similar  premise of cognitive behavioral therapy .  CBT is a “short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel.”  This sounds like an approach that aligns with social thinking concepts and emotional regulation strategies, doesn’t it?

I created a TPT product for my older students to work on strategies and problem solving to get unstuck in their social thinking.  It walks them through the steps to learn to “change the channel” in their mindset from negative to positive! Want to check it out?   Social Skills: Change the Channel from Negative to Positive .

 For your younger students, I really love the book by Kari Dunn Buron,  When My Worries Get Too Big , or Julia Cook’s fantastic book,  Wilma Jean the Worry Machine .

How do you work with students who are chronically stuck in an internal or negative mindset? Share here!

Sometimes the Speech Therapist Shouldn’t Talk.

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My first post CF job as a SLP in a rural Florida school many years ago, was a bit interesting.  The SLP before me had apparently gone a bit off the rails, by choosing to not do any IEPs for the year. Yikes! I worked through my caseload of more than 80 kiddos that year by getting creative, setting up centers in my tiny room and slogging through that towering pile of IEPs to get them up to date.  It was a huge learning curve for me!

One of the things my littles told me was that the aforementioned SLP would also tell them “no talking” in speech as she put in a movie for them to watch every day.  “No talking in speech???” I thought in a huff.  While that “therapy” is definitely not effective or appropriate, it sparked a memory of the Hanen Program that I had used in my hospital internship. “It Takes Two To Talk” is still such a great resource for families working on language development and they have added the “Make Play Rock” series for supporting language growth in kids on the spectrum.  The concept of OWL:  Observe, Wait and Listen, has stuck with me all these years.  Here’s a great info-graphic from Hanen about this technique HERE .

To generalize our field, we love to talk and we are word nerds extraordinaire!  However, with many of my students on the spectrum, constant talking is like turning a fire hose on their brains.  They need quiet and time to process all the language demands headed their way.  I try to share with the teachers that I work with, especially when my kids head into inclusion classes, that the premise of OWL is really important…and hard to do!

Less language is also crucial when our kids melt down.  Talking is often not helpful in these circumstances, in fact, it tends to tick them off more.  Reducing sensory input, including language, can calm a situation down and give the child the ability to reset themselves emotionally. You can find a time later to process what happened without the emotion of the event, and it is much more effective!

I have also found with my students on the impulsive side of the curve, that teaching them to use this technique results in people wanting to engage with them more often.  When they see that the student isn’t going to talk over them or interrupt them, and will actually listen to what they are saying, that makes them a valuable friend.  Good listeners are hard to find these days!

It may feel like the opposite of what we are supposed to do, but in reality sometimes it’s okay for the SLP not to talk!  Share your thoughts here….

Which April Fool are you, Jokey or Jerky?

April Fools

April Fool’s Day is upon us about a week from now.  I was never a big prankster, but my younger brothers had many hours of enjoyment playing tricks on family,friends and each other. Most jokes were harmless fun, like switching out the salt for sugar. My college boyfriend’s roommates thought it was hilarious to put tacks (pointy side up) on the floor, just outside a running shower, and yell to the person taking the shower that they had an urgent phone call. I found this mean-spirited and not one bit funny, but those crazy college boys thought that was the best joke ever!  Ugh. Everyone has a different idea of what is funny (Jokey) and what isn’t (Jerky).

So how do you figure out the boundaries of April Fool’s Day? For my kids who struggle with social language and humor, I found they needed background knowledge, perspective taking and very clear rules to participate successfully on April Fool’s Day. This group can include students with ASD, ADD (impulsive + jokes=potential social trainwreck) and ESL learners (humor has a LOT of figurative language components). These skills translate into unstructured time with peers too, as humor is a way to connect socially, when it’s done with the right people, in the right place and at the right time.  You can find my social language packet in my TPT store here: “April Fools”  to work on these skills.  This 18 page pack is perfect for elementary and young middleschoolers and includes:

  • A one page summary of the history of April Fool’s Day
  • A page to create your own April Fool’s Day ad
  • A discussion chart with questions to ask BEFORE you play a joke or prank. Remember how I mentioned very clear rules?  Here it is and it would make a great classroom poster! 
  • A cut and paste chart to determine if April Fool’s Day actions are JOKEY (funny) or JERKY (mean)
  • Five April Fool’s Day social scenarios to talk about what someone might be thinking/saying/feeling, identifying problems and figuring out solutions
  • A list of suggested books to go along with April Fool’s Day theme and an Expected/Unexpected* behavior chart to discuss the character’s actions from the books

* Expected/Unexpected are terms used in the  “SocialThinking” (R) curriculum by Michelle Garcia Winner.

This Pinterest page dedicated to April Fools has a lot of cute, kid friendly ideas and you can talk about them in light of being “Jokey or Jerky”.

What is the best April Fool’s Day prank you ever pulled?  Share here (we won’t judge 🙂 )

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.