Posted in Assessment, Perspectives from the Field

Perspectives from the Field: A Private Practice SLP’s Take on Assessment

I recently spoke to a private practice SLP with great insights regarding the assessment process. Due to this SLP’s extensive experience in the field prior to working in private practice (some of her previous experience includes working in the school board, at the Geneva Centre for Autism, as part of a preschool speech and language initiative, in acute and long-term care facilities, etc.), the information she shared with me was based on many years of experience working with a diverse population of clients.

Before seeing the child and parent, this SLP conducts a phone screening to gather information when she receives a new referral. This is especially helpful in cases where the child’s L1 (Native of first language) may not be English, so that she can learn about the child’s exposure to English and other language(s) as well as the child’s expression style (i.e., communicates in L2 but understands L1) prior to the assessment. She will occasionally use parents as translators (when the parents have good mastery of English, and after providing careful instruction regarding what the parent can and cannot say to the child) during the assessment of bilingual/multilingual children, but will note this in the report since there could be issues with reliability using this method. Sometimes she will conduct informal observation during language-based play for most of the first visit with the child, in order to determine which areas need to be investigated further using the appropriate standardized test(s). However, she mentioned that tests like the CELF-4 (or even using a few of the subtests of the CELF) are helpful to get an idea of a wide variety of language skills.

One important consideration which impacts this SLP’s assessment process is the family’s financial resources (i.e., if a family has limited insurance coverage for SLP services, and cannot afford to pay for more services beyond this coverage). For this reason, the SLP stated that she approaches assessment as “diagnostic therapy” – similar to what we have been discussing in class as ‘dynamic assessment’. I think this is a good strategy to ensure that too many hours and dollars aren’t spent on assessment, since many parents bring their children to my course partner’s private practice because their child is not receiving/did not receive direct intervention in the school board (the SLP mentioned that many school board SLPs in the GTA only provide consultation and Tier 1 or Tier 2 intervention).

The SLP also stressed the importance of observing children during assessment because these observations can reveal valuable information beyond raw scores. For example, if you asked a child to complete a written sample in two minutes and the child only produced two sentences, this may have been due to motivation (child quickly wrote two sentences and then was looking around and fidgeting for the rest of the time) rather than actual difficulties with production (child took two minutes to slowly write out each word in the sentences), or vice versa. Beyond observation, she mentioned that we should listen and ask children what they find difficult too, because sometimes they are able to effectively describe why they find a certain task or skill difficult.

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Posted in Perspectives from the Field, Reading

Perspectives from the Field: Speaking to a School Board SLP (Part III)

I recently spoke to an SLP in the Peel District School Board about her thoughts on service delivery in the school board.

Reading Programs
The SLP mentioned that over 50% of her referrals are students who can’t read, and thus she spends quite a bit of time targeting goals related to the “Big 5” of reading. The SLP mentioned that she has found the following reading programs useful (prices may vary; the prices included were estimates from the SLP):

Explode the Code (https://www.explodethecode.com/):
This program offers workbooks which provide phonics instruction (i.e., vowel rules, spelling rules, etc.). It can also be accessed through an online subscription instead of purchasing the physical workbooks for children. The SLP mentioned that she sometimes suggests the program to parents who want to give their child more practice with reading (i.e., As an alternative to expensive tutoring or Kumon sessions, since the online subscription option is $65 USD), or it is used in small groups in the classrooms.

Empower Reading (http://www.sickkids.ca/empower/):
This program focuses on decoding strategies. The SLP doesn’t directly deliver this intervention (she mentioned that teachers are typically trained in the program and it is quite costly to complete the training…about $5000) but supports teachers who are implementing it with students who have reading disabilities.

Teach Your Child to Read in 100 Easy Lessons:
This book is about $20 from Chapters and provides a step-by-step phonics-based reading program. The SLP mentioned that it is a quick option for parents to use at home (i.e., Parent only needs to spend 20 minutes doing a lesson with the child).

Apps & the Use of Technology
What’s “app” with all these iPads in schools nowadays? Technology now seems to play a significant role in most classrooms across schools, particularly the use of iPads and educational apps. For this reason, I wanted to get the SLP’s thoughts on the use of apps with clients. She mentioned that iPads are very popular and abundant in the PDSB. She stated that there are no apps she swears by to target a specific speech or language concern, especially for phonological awareness, and instead tends to look for apps which can be used as a “game” or tool to support language development. For example, Toca Boca and My Playhome are apps where children can interact with certain settings (i.e., hair salon, kitchen, etc.), but the apps themselves don’t produce any speech, which allows the SLP and child to use their own language while interacting with the settings (i.e., To support practice with wh- questions or prepositions while interacting with the kitchen: “Where should we put the pot? On the stove?”).

Service Delivery Delivery Challenges
In terms of challenges when delivering intervention, the SLP stated that the main challenge is that many staff and administrators in the school board don’t really understand what therapy and the SLP’s role entails. The role of the school board SLP may be further confused because a child’s CCAC SLP may be playing a different role in the school (i.e., targeting articulation and less involved in the classroom). The SLP stated that it’s important that the teacher understands why she is there (to help the child succeed in the classroom…not just to help with articulation issues, which is what some teachers may think!) and that SLPs establish a partnership with the teacher. These partnerships can also create more opportunities for Tier 1 and Tier 2 interventions, since the teacher can appreciate the role an SLP can play in the classroom setting. Speaking to this school board SLP helped me better understand what types of resources and constraints can shape an SLP’s practice.

Reflecting on Intervention in the School Board
As an SLP, I think the school board would be an exciting work environment because you can integrate so many creative resources and programs into practice. In the case of school boards with larger SLP teams, you can also consult with knowledgeable colleagues from diverse professional backgrounds to strengthen your own evidence-based practice. I also enjoy the opportunity to work with parents and an inter-disciplinary team of professionals, including teachers, psychologists, and social workers, since my school board placement at the Thames Valley District School Board made me realize how each of these team members brings unique findings and insight regarding how to best help the child succeed. I’m glad I received some valuable insights from an SLP actually working in the school board setting this term!

Posted in Assessment, Perspectives from the Field

Perspectives from the Field: Speaking to a School Board SLP (Part II)

I recently spoke to an SLP in the Peel District School Board about her thoughts on assessment. Assessment and intervention varies across school boards, so I was interested to hear about what the approach is like in Peel.

On the “standard assessment”…
The SLP mentioned that the following tests and tools are typically used in an assessment battery:
• Peabody Picture Vocabulary Test (PPVT)
• Expressive Vocabulary Test (EVT)
• Clinical Evaluations of Language Fundamentals (CELF)
• A reading and/or writing assessment (i.e., Phonological Awareness Test)
• An informal spelling test
• A review of writing samples (i.e., past assignments the child has completed)

A full language assessment can take 8-10 hours, and thus the SLP stated that it is important to carefully consider when it is or is not appropriate to complete an extensive, formal assessment. She also stated that she likes that the CELF is comprehensive in the sense that it “covers a little bit of everything”.

On assessing English language learners (ELLs)…
The SLP explained that she works with a diverse population of students where bilingual and multilingual students are the norm at her schools, rather than the exception. Many of these children have enough exposure to English that they can be tested using standardized tests such as the CELF. However, in the case of children who are not as proficient in English, she explained that she will often administer the CELF, but will not report the child’s percentile scores. Instead, she interprets the CELF results as a “starting point” in her assessment. She observes the child in the classroom, reviews the child’s class work, and consults with teachers and parents about the child’s strengths and weaknesses to gather more information for her assessment. She stated that even without standardized test results, she is still able to set intervention goals to target for these children based on the abovementioned sources of information.

I think this highlights the importance of assessment beyond standardized tests, since there may not always be a test or set of norms which is best suited for each child, especially when working with children from a highly diverse background of cultures and languages. Standardized tests are important, but usually need to be supplemented with other information in order to fully understand the child’s capabilities.

Since this SLP works in a diverse school board, she has the advantage of being able to access translators when a child and/or the child’s parents do not know very much English. Thus, information can still be reliably gathered from the child and their parents. This resource may be more difficult to acquire in a school board where encountering multilingual children is less common.

On writing effective assessment reports…
I also wanted to get the SLP’s thoughts on the “Strategies and Recommendations” section of the assessment report, since we discussed the issues surrounding generic or redundant recommendations (i.e., Almost identical/vague recommendations across both the psychoeducational assessment report and the speech and language assessment report) in class. The SLP agreed that strategies included in assessment reports are often too generic to be meaningful for educators. She mentioned that she tries to address this issue by recommending apps, programs, or workbooks to teachers (i.e., Explode the Code phonics program) because teachers often prefer hands on materials. I think this is a great approach because both teachers and parents can then have tangible resources to help the child develop their speech and language skills.

Expect some future blog posts where I delve deeper into assessment tests, tools, and resources!

Posted in Perspectives from the Field

Perspectives from the Field: Speaking to a School Board SLP (Part I)

I recently spoke to a Speech-Language Pathologist (SLP) in the Peel District School Board and gained some insight into service delivery and professional collaboration in the school board setting.

On the ins and outs of service delivery…
The SLP highlighted how multiple models of service delivery are used in the school board, but noted that the multidisciplinary or “pull out” model is not used very frequently in her board, since many SLPs find it inefficient for their large caseloads. She mentioned that an interdisciplinary team discusses referrals and how to approach intervention for students (the team usually includes a social worker, teacher, psychologist, and other relevant professionals depending on the child, such as an occupational therapist), and then a consultative approach is often used in the classroom to provide teachers with the modelling and coaching needed to implement suggestions. The SLP explained that she often uses scaffolding and modelling to help kindergarten teachers adjust the inquiry-based approach used in kindergarten classrooms, so that it can better cater to children with learning disabilities (i.e. “How” and “Why” questions may be more difficult for these children, so strategies like expanding and extending may need to be utilized). She has also used the transdisciplinary model in the form of co-teaching a literacy program called Links to Literacy with classroom teachers, to help children learn concepts like print awareness and decoding.

On collaborating with other professionals…
Outside of the interdisciplinary team which meets to discuss referrals and students currently receiving intervention, the SLP mentioned that she often collaborates with other professionals (such as teaching assistants) when assessing and crafting recommendations for children with special needs. She stated that professionals who work closely with these children know their needs and skills best (i.e., education or teaching assistant, occupational therapist currently working with child, etc.), so joint visits in a more natural setting provide useful information regarding what strategies would work best for a child. I also found it interesting to learn that school settlement workers can be closely involved with SLPs to help acquire informed consent from the parents of students who are new immigrants and/or ELLs. Additionally, if a child will be seen by CCAC as opposed to a school board SLP, she stated that these parents also often need help understanding that they will receive a home program in the interim, before a child will receive services from CCAC later on. We also discussed how in some cases, a child may be receiving services from both a school board SLP and a private practice SLP, so consent is required from the parents to allow open communication between these two SLPs. Open communication is essential in these circumstances, because my partner mentioned how the SLPs often work on separate goals (to ensure that the child is not confused by working on the same goal but with 2 SLPs, each potentially using a different technique).

As a student interested in working in the school board as an SLP someday, I found my conversation with this SLP very informative!