Piecing It Together: A Systematic Approach toward More Effective Language Therapy - Softcover

Cheslow MS,, Martha Frimer

Softcover

ISBN 10: 1491749369 ISBN 13: 9781491749364

Publisher: iUniverse, 2015

Synopsis

Speech-language pathologists (SLPs), once relegated to our schools' broom closets, now play a vital role in working with language-learning-disordered children. SLPs are always rethinking their standards about what constitutes language and about their part in students' academic and social success. But what has been lacking is a clearer, more orderly way to work with language disorders.

Building on decades of experience in the field, author Martha Frimer Cheslow presents just that in Piecing It Together. Designed for SLPs working with language-impaired children, this practical guide considers the abstract and sometimes puzzling world of language therapy. It focuses on teaching systematically in a clear and organized way and includes features such as valuable background information on each language area, fourteen language skills broken down into manageable objectives, and strategies that SLPs can use to guide themselves through individual goals.

A reliable resource for therapists at all levels, this manual can be used in either special education or mainstream population environments. Piecing It Together provides therapists with methods for making good intervention choices and making therapy easier and more satisfying for their clientele and for themselves.

About this title

Excerpt. © Reprinted by permission. All rights reserved.

Piecing It Together

A Systematic Approach toward More Effective Language Therapy

By Martha Frimer Cheslow

iUniverse

Copyright © 2015 Martha Frimer Cheslow, MS, CCC-SLP
All rights reserved.

ISBN: 978-1-4917-4936-4

Contents

List of Tables and Diagrams, ix, 
Dedication, xi, 
Preface, xiii, 
Acknowledgments, xxi, 
Introduction, xxiii, 
Chapter 1. How to Use This Manual, 1, 
Chapter 2. MARCHing Orders, 5, 
Chapter 3. Skill Area 1: Play Skills, 45, 
Chapter 4. Skill Area 2: Basic Linguistic Concepts, 50, 
Chapter 5. Skill Area 3: Vocabulary, 58, 
Chapter 6. Skill Area 4: Associations, 69, 
Chapter 7. Skill Area 5: Classifying, 72, 
Chapter 8. Skill Area 6: Listening, 85, 
Chapter 9. Skill Area 7: Phonological Awareness, 92, 
Chapter 10. Skill Area 8: Following Directions, 106, 
Chapter 11. Skill Area 9: Syntax, 118, 
Chapter 12. Skill Area 10: Story Comprehension, 134, 
Chapter 13. Skill Area 11: Narrative and Expressive Skills, 149, 
Chapter 14. Skill Area 12: Thinking Skills, 162, 
Chapter 15. Skill Area 13: Social-Pragmatic Language, 187, 
Chapter 16. Skill Area 14: Study Skills, 203, 
Afterword, 215, 
References, 217, 
Additional resources, 257, 
Index, 259, 

CHAPTER 1

How to Use This Manual

Choose a goal that seems right for you and strive to be the best.

—E. O. Wilson (The most important thing I Know, 1997, p.85)

In the text that follows, the reader will find separate sections on each language macroskill. These macroskills serve as umbrellas for that area of knowledge. Each macroskill is followed by a list of supporting skills which serve as objectives or goals for that particular umbrella language area. The ultimate aim is to have children learn all the objectives under each skill area, although this may not be a realistic goal for some students.

Each objective will likely (but not precisely) represent a more advanced level than the objective before it. Or it may represent a logical sequence of equivalent levels. The order of presentation does not represent a hard and fast hierarchy of development. They should be viewed, instead, as a cumulative hierarchy (Krathwohl & Anderson, 2009): each supporting the other but with some apparently more or less complex than others. Intervention is, after all, "a continuum whose elements are affected by what has preceded it and what will follow" (Ehren, 1994, p. 393). Alternatively, each objective can be looked upon as a dimension of the particular language skill area under which it is found.

Speech-language pathologists should always be striving to challenge their students to new heights. Choosing the correct goal for therapy is imperative at the outset. When we begin therapy at too low a level, we can guarantee correct answers but not much advancement (Kuhn, 1972). Likewise, if we begin at a level that is too advanced, we inevitably guarantee frustration for both the student and therapist. Broader language areas are built on more specific skills that support them. Without being taught these supporting skills in an organized and systematic fashion, students never truly master the broader language goal.

For the most part, the umbrella skills are not listed in any specific order, although those toward the back of the book tend to be at a more complex level than those in the front. When confronted with a globally challenged student, I would begin therapy with classifying and vocabulary before critical thinking and narratives.

Once the SLP decides which of the fourteen macroskill areas therapy will cover, she can peruse that section of the manual and ascertain at what point intervention should begin. Therapy can start at any point that is appropriate for the student. Sessions within that language area should adhere as closely as possible to the order laid out here, even if steps are skipped.

It is a crucial element of this systematic process that therapists try to target as many of the objectives in each language area as possible, albeit not all at the same time. The nature of therapy is such that SLPs find themselves targeting several problems for each child in one session. Therapists might have to address articulation errors as well as language problems, for example. Part of being organized is moving deliberately and slowly from one step to another on a certain path.

When students present with splintered skills or gaps in their knowledge, it is commonly the result of a therapy program that did not cover enough objectives. All the objectives listed are there for one reason—to make students proficient.

If you go down the list of objectives for each skill area and think about the people you know who are good academic models, you will find that they are able to accomplish virtually every objective in any language skill area. If, for example, they are excellent readers and can easily talk about the stories they read, you will likely find that this is because they can accomplish all the skills needed for good story comprehension. They can do everything we ask our students to do, from using the story title to infer what the story might be about to gleaning the moral of the narrative.

We want our students to cover as many of the objectives in each skill area as their developmental ability will allow, whether it is over the course of a year or an entire school career. Our students will achieve no further than the level to which we bring them.

The reader will note that there are no grade or age levels assigned to the objectives, with the exception of those found in the basic concepts and phonological-awareness skill areas. This has been done intentionally, since therapy must always proceed based on thorough assessments of student ability, not grade or age. Intervention for a particular language objective is completed when the student (a) has reached a level commensurate with IEP standards; (b) has reached a level suitable for the child's age, grade or ability (c) has achieved criteria or (d) has demonstrated a need to work on other language areas.

Since most therapy covers more than one area of language at a time, each area covered should proceed as laid out in its corresponding chapter. Every therapist will have her own techniques for pursuing each goal. In some cases, school districts and clinics might insist on using specific programs, such as Prezas and Hodson's (2010) approach to phonological processes or Winner's (2008) curriculum for social thinking. What is of utmost importance is that each goal be presented in a variety of exercises over many, many sessions in order to achieve best results.

Therapy may not necessarily begin at goal one and may not end with the last step in that chapter. It can, however, be continued from whatever point therapy stopped by including the next few objectives in the annual review or progress report, allowing for a smooth transition and avoiding spotty progress and splinter skills.

We all know too well that much of therapy is done based on someone else's assessment. Many of us have encountered therapy students with individualized education plans or evaluation reports that do not seem to actually fit the student's needs. This may happen for several reasons. Among them: students come to us from another location with an outdated or poorly written evaluation report; the examiner did not provide a thorough assessment; there are multiple therapists working with the student, each with his or her own goals; or student maturation has taken place since the report was written. Sometimes SLPs must create plans around incomplete or inaccurate testing.

We are confronted with gaps between what we observe and what is written in the report. Previous therapists may have tackled higher skills based on faulty reports or poor choices. Students may have been taught more complex skills without a basic foundation being established. Many of us have seen students who are already reading, however poorly, with missing phonological awareness skills. We have seen therapists work on analogies, only to discover that the student knows little about classifying. When students struggle to advance in therapy, it is frequently the result of targeting therapy at too high a level or of activities being presented in a learning style with which the student cannot relate.

It is for reasons such as these that we have the tried-and-true process of ongoing assessment. By constantly assessing just how much students can do independently, we can determine whether it is necessary to move therapy back one or two steps before moving forward once again.

The goal section that follows was taken from the individualized education plan of a student I was asked to evaluate. The therapist for student Z chose to target antonyms, synonyms, and multiple-meaning words as part of Z's vocabulary intervention program.

This lesson plan, though, fails to cover other vital objectives that will lead to true vocabulary proficiency. For example, moving from teaching antonyms directly to teaching synonyms omits an opportunity for Z to learn different degrees of the same descriptive word or action (see skill area 3). Then, by targeting multiple-meaning words next, the therapist has missed a chance to teach vocabulary for community activities or prefixes.

Whether or not Z's therapist covers these objectives in order is of less relevance than whether she covers them at all.

Goal: To improve knowledge of the meaning of words. Core Curriculum Content Standard

3.4 To listen actively to information from a variety of sources in a variety of situations.

Z. will, given words, provide an antonym for each during therapy activities 85% of the time (skill area 3, objective 7).

Z. will, given words, provide a synonym for each during therapy 85% of the time (skill area 3, objective 9).

Z. will state two definitions for target words having multiple meanings (e.g. light, used as a verb and as an adjective) during therapy activities 85% of the time (skill area 3, objective 21).

Clinicians can also seek answers about their students through classroom observations. Watching a child in the classroom setting helps SLPs to assess language performance in a more natural situation rather than relying solely on standardized testing (Secord and Wiig, 2006). Teacher interviews can provide the therapist with clear functional assessments of the child whenever classroom observations are not possible. Classroom observations are also useful when we want to assess how well a student transfers therapy skills into the academic setting. Continual informal testing, classroom observations, and functional assessments can help us understand how to better target our therapy students.

Speech-language pathologists will find that many of the objectives can fit comfortably under more than one skill area. Figurative language, for example, can be targeted for purposes of expanding thinking skills or for improving social skills. Similarly, if an SLP is working with a student who appears to understand what pronouns are but does not understand pronouns and their referents as used in a passage, then pronouns should be addressed under the domain of story comprehension rather than syntax.

It is imperative, therefore, when choosing goals for intervention, that we attain a clear and precise understanding of the reasons our students make the errors they do. The SLP must also consider the following points when choosing language goals:

1. What is developmentally appropriate?

2. Which skill is the language/academic area of greatest weakness?

3. Which skills will have the greatest impact on school or daily functioning?

4. Which area is of most concern to the parents, teachers, or student?

5. Which area can be most easily taught?

6. Which objective is in common with the rest of the therapy group?

7. Which language objective correlates with the Common Core State Standards designated for the student?

8. Does one learning object facilitate the learning of another? For example, a student who has difficulty with both basic concepts and following directions should always begin work on the former, since the understanding of basic concepts aids in the ability to follow directions.

CHAPTER 2

MARCHing Orders

Tell me and I'll forget; show me and I may remember; involve me and I'll understand.

— Chinese proverb

Some students are fortunate to be able to learn via any method, even if their neurological makeup favors one style over another. These students manage to adjust to any learning environment in which they find themselves. Instructors need not concern themselves with how material is presented to learners such as these.

Conversely, students with language-learning disabilities and/or cognitive impairments rely on teachers and therapists who can accommodate their specific needs. It is not, however, just learning-disordered students who require special treatment. It has become evident to me that when I pass information along to teachers, parents, and colleagues, I often need to adjust my presentation to meet their preferences. Some parents and teachers respond better to the written word, while others prefer to discuss each point, and still others want a demonstration. Each of us has an individual approach and style when it comes to learning new information.

If we agree with Piaget's conclusion that education is based on the idea of accommodation of stimuli in the environment (Wadsworth, 1989), and if we trust that learning problems can be overcome when teaching is approached by another route (Piaget, 1973), then it is incumbent upon the speech-language pathologist to meet the student's individual learning style in order to best effect the assimilation of ideas.

The takeaway here is that everyone can learn. It is not so difficult to change the way we teach to accommodate a student. What is difficult is to think of what those accommodations should be. I am hoping that this section will steer the reader in the right direction. After all, it is supremely unsatisfying to teach an individual for whom therapy just doesn't work. When we present and reinforce lessons through customized programs that suit the individual learning style of the student, then not only are we effecting change in our students but we are making ourselves better therapists. There is a one-to-one correspondence between the effectiveness of instruction and an increase in learning (Costa and Lowery, 1989). To that, I would add, "And a surge in job satisfaction."

Multiple Intelligences

There is no question that people learn in all different ways. Each person acts upon the world using one predominant behavioral style, even when other behavioral and learning styles may be available to them. If you look closely at people you encounter every day, you will notice the ones who cannot read a map, those who have trouble adding numbers in their heads or making change, and still others who find writing a challenge.

Do these people possess such divergent abilities because they never learned how to do the tasks demanded of them in the first place? Maybe, or maybe they experience these deficits because the skills never became ingrained in their minds and so were never generalized for functional purposes. When a skill is taught in a manner not conducive to a person's style of learning, then that individual never develops the sense of confidence nor ability to make that skill useful.

In 1983, Howard Gardner first published his theory of multiple intelligences. This theory is still popular among educators today. It is my desire to see it used in language intervention, as well. If we think about Gardner's term intelligences and substitute the phrase learning styles, it might help us appreciate that, in fact, our students do all learn differently. In Gardner's own words, "I was claiming that all human beings possess not just a single intelligence...Rather, as a species we human beings are better described as having a set of relatively autonomous intelligences" (2011, p. 3).

This would account for the differences that an SLP might see among three students, all of whom need help with story comprehension. One student might catch on more quickly when the story is mapped in a diagram. Another might learn better when he reads the story to himself. A third might not be able to understand without the use of a story board and manipulative parts. These are what Gardner (2011) terms their "intellectual strengths and weaknesses." By teaching the same material in three ways, not only do we continually reinforce the skill for each student, but we also ensure that each one learns it in the first place.

In this way, the SLP is both individualizing and pluralizing her lesson. Through the individualization of learning styles, the SLP can tap into the full capacity of each child. By pluralizing, she reaches multiple students and makes sure that they all have a thorough grasp of the material (Gardner, 2011).

Making modifications makes us better therapists. The process of modification teaches us to assess our message, evaluate our approach, create new methods, and monitor the results. In effect, while we teach the students, the students teach us.

Speech-language pathologists need to understand the strong connection between what they teach and how they teach. We need to think in terms of designing learning experiences that can ultimately improve the depth and quantity of student learning (Fink, 2010).

In the late 1980s, researchers at the Center for Applied Special Technologies (CAST) conceived a checklist of tools for overcoming curriculum barriers (as cited in Ralabate, 2011). Among them were suggestions for instructors to:

• Offer ways of customizing the display of information.

• Offer alternatives for auditory/visual information.

• Illustrate through multiple media.

• Provide options for physical action.

• Vary the methods for response and navigation.

• Provide options for expression and communication.

• Use multiple media for communication.

• Use multiple tools for composition.

Fink (2010) may have put it best when he said, "If we want more powerful learning, we need more powerful teaching" (p. 3).

Showing the Way

One of the most important lessons I can teach student clinicians is that therapy does not consist of the SLP sitting across from the child, asking a series of questions, and waiting for correct responses. This type of scenario is more representative of testing, not teaching.

(Continues...)

Excerpted from Piecing It Together by Martha Frimer Cheslow. Copyright © 2015 Martha Frimer Cheslow, MS, CCC-SLP. Excerpted by permission of iUniverse.
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Edition details

• Publisher: iUniverse
• Publication date: 2015
• Language: English
• ISBN 10: 1491749369
• ISBN 13: 9781491749364
• Binding: Paperback
• Number of pages: 296