2. Articulation Boxes
Using my articulation boxes during sessions with my clients proved successful
during my summer 2022 clinical placement. Initially, I had primarily used Kaufman
cards, but my clients were not engaged, which hindered meeting therapy goals. To
make a more entertaining, versatile tool that could be used with all my clients,I
made my articulation boxes. Each box is full of miniature objects and articulation
cards that are organized by phoneme and place of articulation. For each phoneme in
the beginning, medial, and final positions, there are objects and cards.
My articulation boxes improved engagement during the sessions, which supported
what I learned about how engagement affects therapeutic productivity. With the
option to select which of their targeted sounds they wanted to practice as well as
several practice methods, it offered my clients a sense of control. It gave them
freedom to be creative with how they worked during the session, such as using the
box for a game of seek and find, iSpy, or to create stories. My clients became more
involved, which resulted in more effort toward goal achievement as they were
excited to come to therapy and participate. This increased engagement led to my
clients meeting their articulation goals more regularly. This had given me a sense of
achievement as a clinician and I will continue to use my articulation boxes in future
practice.
3. Stuttering During my spring 2023 semester placement, I worked with a 3-
year-old child who stuttered. During an informal evaluation,
she demonstrated word and sound repetition, sound
prolongations, and pauses within words, all of which made it
difficult for her to be understood. Although she did not show
awareness of her stuttering, her family expressed concern
about the severity, especially because stuttering was present
on her father's side of the family. To effectively address early
childhood stuttering, I expanded my knowledge by reading the
book pictured. This tool informed my intervention choice and
delivery. Since our direct intervention time was 45 minutes
weekly, I focused on family education and involvement so that
therapeutic strategies would carry over outside the session.
Each week, I encouraged family participation and showed them
how to promote fluency through home changes and how to
communicate with a child who stutters. I also gave the family
resources with materials on how to support fluency through
play and answered any questions. At the end of the semester,
the family reported a noticeable shift in their child's speech,
with the most noticeable differences being a slower speech
rate, pausing between sentences, and a decrease in
dysfluencies.
4. Voice and Resonance
Brochure
At my fall clinical placement, I used my brochure that I created
in my voice and resonance class. There was a young adult client
who was having reoccuring loss of voice, glottal fry, and
breathy voice due to vocal abuse. During one of our sessions, I
used the brochure to inform them about general signs and
symptoms of phonotrauma, treatment options, and
preventative measures.
The client used the brochure as a reminder of how they can
take care of their voice at home to prevent issues from
reoccuring. Using evidenced based practice, we continued 1:1
therapy and 'homework' was provided to reinforce techniques
practiced in session. Four months later, he had consistently met
all his goals and was discharged from therapy.
This experience taught me that giving clients visuals,
reinforcement, and feedback are necessary for meeting goals
and successful therapy sessions.
5. Receptive &
Expressive Language
Working at my current clinical placement has shown me the power of
music in developing expressive and receptive language. While play
therapy using preferred toys is effective, I found that my clients respond
the most to music. Music has a beat and focuses on intonation, which
has helped my clients with syllable awareness and other aspects of
verbal communication. For literacy goals, I use developmentally
appropriate literacy skills alongside music to follow along and point to
pictures, or act out the lyrics from the song. This creates links between
actions and words. Overall, using music during sessions with my
expressive and receptive language clients helped me put the theory I
learned about language and music therapy into practice. Seeing clients
demonstrate their understanding of new vocabulary, connect meaning to
words, and expand their communication abilities is what I enjoy most
about being an SLP!
Chudakova, Ekaterina. Simple Hand Drawn Notes and
Musical Notes in Doodle Style. - Illustration. 30 Apr.
6. At my fall clinical placement, I provided therapy for a 4-year-old child
with bilateral profound sensorineural hearing loss. He had cochlear
implants (CIs) and it was one-month post-implantation. To ensure his
CIs were working correctly, I used the Ling 6 Sound Test at the
beginning of each session. This ensured that he had appropriate access
to his auditory system. I was also able to note any difficulties or
inconsistencies in his participation, as it may have been due to the
implants or maybe a problem with the ear itself.
To make it more engaging, I created tangible representations of the
sound produced. When he heard the sound, he picked up the
associated coin and put it in the piggy bank while verbally repeating
the sound. Afterward, we worked on activities that addressed his
auditory-verbal goals.
This experience solidified what I learned about speech and its relation
to hearing. In class, I learned that the Ling 6 sounds are within the
frequencies necessary for a person to hear, understand, and detect
speech. In practice, I saw that when his CIs weren't working effectively,
he wouldn't hear the sounds during the Ling 6 sound test. Then, since
he could not hear well, I would have to repeat instructions and use
gestures to communicate, which would cause him frustration.
Hearing
7. Swallowing
For my Swallowing Disorders class, I completed
the Modified Barium Swallow Impairment Profile
(MBSImP) training and certification. During these
modules, I learned about the assessment and
reporting of physiologic swallowing impairment
based on observations obtained from the MBS
study. As a result, I can skillfully assess the 17
components of the swallowing mechanism in
adults and objectively score physiologic
impairment of swallowing function. After
completing this class in the summer of 2022, I was
able to use my training to assess patients during a
winter break opportunity I was offered at VCU
Medical Center in Richmond, VA. I am grateful that
I could take the knowledge I learned and put it into
practice. I look forward to more opportunities to
build my skills in the future.
Northern Speech Services. (2023). The MBSImPTM Training Zone with Scoring Feedback. The MBSImPTM
Standardized Training And Reliability Testing. 22 June 2023.
8. Cognitive Aspects of Communication
This is my interactive display of the human brain. I used this to address my
clients' executive functioning goals. I worked with my clients to develop
context language, such as "executive functions" and "strategies," in their own
words. Then, I described executive dysfunctions—what happens if the client
lacks a plan for success—using functional tasks they engage in. Next, I wrote
their examples of executive dysfunctions on a sticky note and used a blue
string to link the dysfunction to the appropriate executive function.
I would bring it full circle by helping them name potential countermeasures to
the dysfunction. I would write the strategy on another post-it note
positioned on the brain’s frontal lobe, and connect it to the ‘strategies’ sign
with another blue string. The completed product was a large display of
strategies for executive functions that students could reference.
I was amazed to see that my clients' understanding of executive functions
'clicked' once I started using this visual and had them implement the
strategies during our sessions. They demonstrated self-awareness of their
dysfunction. I observed them use metacognition to pinpoint where their
dysfunction started, identify what executive function required support, and
brainstorm solutions to combat the dysfunction. Furthermore, I saw clients
‘catching’ and refocusing themselves when they were experiencing
dysfunction. I felt accomplished knowing that my efforts paid off by the
positive feedback I received from my clients, parents, and teachers.
9. Social Aspects of Communication
I coordinated and co-led group therapy sessions for pediatric clients targeting
pragmatic skill development during my fall clinical placement. Led by speech
and occupational therapists, the Sensorimotor Affect and Relationship-based
Therapy (SMART) program teaches children the fundamental social skills
required for the development and maintenance of relationships. It hosts
toddler, preschool, and elementary school groups that meet several times
weekly. Children who are eligible for this program demonstrate both pragmatic
and sensorimotor deficits. Autism, pervasive developmental disorder (PDD),
attention deficit hyperactivity disorder (ADHD), and developmental delay are
the most common diagnoses exhibited by children who qualify for the
program.
I used interprofessional collaboration with the OT and parents to design group
activities that addressed therapy objectives. These activities were completed
via communication and play with other children. In addition to encouraging
parents to participate in the sessions, I provided handouts that reinforced
newly learned skills and ensured carryover outside the clinic. Throughout the
10-week program, my clients demonstrated growth in pragmatic skills such as
having a variety of language use, following a visual schedule, joint attention,
play skills, and use of language or alternative communication with others. As a
graduate clinician, this experience demonstrated the importance of pragmatic
language and social skills for a developing child.
10. Communication
Modalities
In the spring of 2023, I completed this
AAC course assignment. The aim was
to develop a goal and associated
activity for a Simucase client whose
AAC needs had been assessed. I used
the client's case history and my
knowledge of best practices for AAC
to develop an appropriate expressive
language goal. I then used her favorite
toy, Potato Head, to create an
engaging scavenger hunt that elicited
requests, comments, and labeling
through her use of AAC. This shows
that I know of appropriate AAC
objectives and activities. As a result, I
now have the knowledge and skills
necessary to organize and implement
AAC treatment for future clients
thanks to this project.
11. I hope you enjoyed
my presentation!
Thank you for reading.
