Chapter 1- HH Flashcards
- Speech-language pathology
2. Performing Art
- is academic, clinical, based on scientific research, with broad-based practical application for clients
- is artistic performance-based dramatization designed to positively impact an audience. (idea of showtime)
How are these discplines different?
Are they really that different?
***You need to know all the background and how to use it
SLPs compare well to performing arts
- SLPs perform acts to positively impact clients to improve communication
- SLPs benefit from research-based knowledge
- SLPs embrace best practices
Research and application (know this)
At the juncture of research and practical application of the best tenets is the concept of “the art of speech-language therapy”
SLPs focus on:
SLPs focus on:
- knowledge
- skills
- models
- theories of the profession
Basically we are teachers, teaching individuals communication skills
SLP research
Research is necessary for ensuring that SLPs adequately and accurately understand the
structures and functions of the communication mechanism.
Anatomy and physiology (structure and function)
SLP focus (once understanding is achieved)
- learning theories,
- physical science,
- behavioral sciences, and
- social sciences
To affect the appropriate change in the client’s skills.
- Research
2. Practical Application
- Research tells us the WHAT of speech-language pathology
- Practical Application tells us the HOW of speech-language pathology
- How to best:
1. implement specific techniques2. attain desired outcomes (communication)
The merging of what and how
- is artistry
- This directly impacts the QUALITY of service presented to the client
- The SLP must be able to interface research with practical application
- Artistry is often the difference between the “good” and the “excellent” clinician
Showtime
“Showtime” is an underlying guiding concept for the SLP
*** Showtime is an underlying guiding concept whereby clinicians come to understand the significance of the therapy provided to clients.
The SLP learns and demonstrates, at will, specific therapeutic skills
The concept of “Showtime!” helps us to understand the idea that speech-language therapy is important and serious business
Regardless of the numerous requirements that impact SLPs, the task of providing learned skills for effective therapy is paramount
You need to be able to apply what you learn to every client that you meet
What showtime is and isn’t
- SLPs do NOT provide entertainment
- Client communicative competence depends on the SLP’s professional skills
- SLPs must provide therapy services to clients to the best of their professional abilities at ALL times.
- WE CANNOT GIVE THE CLIENT LESS THAN OUR BEST!!
—-Anything less than our best is not ethically okay
Speech-Language Therapy and Task-Analysis
- Clinicians lead, guide, model, direct, facilitate, collect data, encourage, and reinforce efforts
- These skills are labeled therapeutic interaction, a highly responsive and fluid exchange between clinicians and clients during therapy
- Task analysis always look at what you did and see if it works
- What do I have to do to learn this
- Produce /s/ is the task, and explaining how you do it is the analysis
Task analysis
- Clinician mastery of therapeutic interaction skills is achieved through the use of task analysis-
- a behavioral concept whereby tasks, or skills, are broken down into component parts in order to learn the parts separately; then the parts are put back together to demonstrate the target or required tasks.
- You need to analyze the task that the client is unable to do.
- /S/ –> to a s blend, it is a totally different sound, you can teach the child to break it down, but you need to teach them proper timing and how to communicate it properly
There are two broad-based skill areas that SLPs must demonstrate:
- Interpersonal communication skills
2. Therapeutic-specific skills
Interpersonal communciation skills
- These are the personal behaviors or interactions used for engaging others. They include character traits such as:
a. Empathy- not sympathy, understanding what someone is going through (let them know that you understand something is difficult)
b. Friendliness (we are their friends, but still in charge and professional)
c. Politeness
d. Honesty in feedback- get the wrong information ( you can tell them that they are improving
e. Appropriate nonverbal interactions (eye contact, body language, proximity)
**Interpersonal communication skills – are as important as therapeutic skills – if you want to be a successful SLP
Therapeutic-Specific Skills
Therapeutic-specific skills are the fundamental professional skills necessary for effective speech-language therapy
- All skills demonstrated in speech-language therapy are learned skills.
These skills include-
a. Enthusiasm
b. Animation
c. Volume
d. Seating arrangement
e. Proximity
Therapeutic Specific Skills 2
f. Preparation (need to be prepared or therapy won’t happen)
g. Pacing- need to have an appropriate pace
h. Fluency
i. Alerting stimuli- give them cues
j. Cueing
k. Modeling
l. Prompting
m. Learned modalities
Therapeutic Specific Skills 3
n. Questioning
o. Wait-time (need to give an appropriate think time)
p. Shaping (work with what the client gives you)
q. Verbal praise
r. Corrective feedback (be positive, tell them the right way to do it)
s. Data collection (you need to collect data so you know when to move on, prove kid is there)
t. Touch- tell child you will touch them, use gloves
Therapy goes back and forth along the continuum (not a straight line of progress)
Therapeuctic specific skills and the SLP
The SLP must develop the –
- appropriate use of therapeutic-specific skills
- interpersonal communication skills
- broad-based knowledge of the profession per disability area (A, L, V, F, etc)
Once the SLP accomplishes the appropriate blend of the required skills, EXCELLENCE in therapy becomes, not only possible, but probable
(Therapeutic-Specific Skills)
EXCELLENCE in THERAPY=
KNOW THIS CARD
Excellence in Therapy = interpersonal communication skills + therapeutic-specific skills + broad-based knowledge of disabilities
Therapeutic mindset
for the SLP, this is the mental disposition or attitude that predetermines the SLP’s responses to and interpretations of situations that occur within therapy sessions.
You are constantly thinking about what is working, task analysis, attitude must be good so the client has a good attitude
Therapeutic mindset is the mindset that guides the SLP to continuously –
- access stimuli, responses, and all other interactions of the therapeutic process, and to
- act, or respond, acordingly (there are several possible, but different options for any situation)
Modify for clients that fidget, let them move and be active during therapy
Functions of the therapeutic mindset:
- awareness of options within the therapy session
2. preparedness to select and implement the appropriate option for the situation
Plans for therapy must include:
- details of what is elicited in therapy
- what is expected as an acceptable client response
- client and clinician safety (we are responsible)
- an element or desire for improved communication as an outcome
- identification of strategies or techniques in the event therapy does not proceed as planned (adjust as needed)
Well-executed therapy involves more than can be seen by the untrained observer.
There are three elements of the therapeutic mindset:
1-anticipation (plans a,b,c)
2-evaluation
3-interaction
— Multitasking
Anticipation
SLPs must learn to:
- consider,
- predict, or
- anticipate
the possibilities of events ranging from best to worst case scenarios.
The range of possibilities includes everything from client’s lack of understanding, or interest in, his/her role in therapy, to the client’s actual production of the desired response.
A lot of areas that things can go wrong
The SLP cannot anticipate every possible therapeutic sequence or occurrence
However, the SLP should be familiar with and anticipate probable sequences based on client status and established therapeutic outcomes
Evaluation
Once a therapeutic event occurs, the SLP must accurately evaluate the –
- quality
- correctness, and
- acceptability of that event
The evaluation process is based on comparisons of the client’s productions to the established norm
To the degree that these two entities match, the SLP evaluates the response and communicates this information to the client
- For all responses, the SLP must indicate, to the degree possible,
- aspects of client responses that were correct, and why, as well as
- aspects in error, and why.
- aspects of client responses that were correct, and why, as well as
- The quick identification of the exact nature of difficulties is not always easy, but is necessary for effective therapy.
Importance of evaluation
- It is just as important to evaluate the elements of CORRECT productions as it is to investigate the elements of INCORRECT productions.
- Correct productions = correct in EVERY aspect of production
- Not okay unless every aspect is correct if the client is capable.
Interaction
- The SLP must be prepared to act, interact, or respond in a manner appropriate for sustaining the therapy session.
- This “ready-to-respond” mode is attributable to the SLP’s interactive skills in therapy.
- The SLPs words and actions in therapy impact therapy (we are in charge, we are directing it)
- The client’s communicative behaviors impact therapy
- The SLP’s seemingly random interactions are not at all “random”
— they are designed to evaluate the client’s targeted communicative skills
- The SLP is encouraged to “see with broader eyes” the possibilities for interactions that transpire within the confines of a given therapy session
An SLP may ask a question concerning the client’s weekend activities. This type of questioning may be used to note the client’s:
- expressive language
- phonological skills
- conversational pitch
- intensity
- fluency
- other skills depending on the identified client goals
Behavioral objectives-what you want the client to do. If you want to build a relationship with the client you need to evaluate their expressive language skills, phonological skills conversational pitch
Role of the Speech-Language Pathologist in the Therapeutic Process
The SLP serves in the role of “facilitator” in the therapeutic process
- “Facilitative” teachers are:
a. Natural
b. Spontaneous
c. Sensitive
Role of the SLP
- “Facilitative” teachers
a. Conduct long conversations with their students (helps with their communication skills)
b. Are individualized
c. Are less constraining (make it work) - These teachers –
a. Use humor
b. Clarify strategies (explain the concept to the child and family, model, and explain)
Facilitative” teachers’ communicative styles include -
a. Fewer topics (topic maintenance)
—- Topic of interest to the client
b. Rare use of direct questions
—- y/n answer so you want to use open ended questions
Facilitative practices
SLPs are encouraged to emulate these facilitative practices in the therapeutic process.
Facilitative skills promote student learning
We need to present a model of proper English (but dialectical differences are okay)
Interpersonal Demeanor in therapy
- Communication – a response-seeking, two-way symbolic, yet real-life process
- it is a receiver phenomenon
- There is always the possibility of a breakdown because the speaker knows what they are communicating but the receiver needs to know what the speaker is saying
- it is a complex, transitory, continuous, and context based event (Samovar & Mills, 1986)
- Can teach turn taking during games
- Highest level of communication is writing
- Hierarchy- Isolation, syllable, word, phrase, sentence, conversation, reading, and writing
- Those who honor all, or most of these characteristics, are viewed as effective communicators
- those who do not, may be viewed as less effective, poor, inept, awkward, or possibly even crass communicators.
SLPS and interpersonal demeanor
- SLPs need to bring good interpersonal communication skills into the therapy setting – model good speech and language (they will learn from you)
- the basic elements of good communication must be emulated before the SLP begins the process of direct speech-language therapy.
I. Nonverbal Behavior and Emotional Affect in the Therapeutic Process
- Nonverbal behaviors exhibited by the SLP in therapy are important for client success.
- These nonverbal behaviors include:
- -eye contact
- -body language
- -facial cues
- -other nonverbal
- -proximity communicators
- These behaviors impact the outcomes of therapy and should be controlled by the SLP
- All of these things will help us as a SLP, we are in control of all of this
- Another aspect of nonverbal communication is the concept of “emotional affect”
- “affect” – the “feeling, emotion, mood, and temperment associated with a thought”
You can communicate a thought this way
Emotional affect determines –
- attending
- responding
- valuing
- organizing, and
- characterizing
information which integral to learning
Student attitudes and beliefs must be considered because the “affective elements” are related to classroom/therapy room behaviors
SLPs are responsible for the affective behaviors of clients in therapy
Need to think about another’s culture
SLPs are encouraged to –
- learn to manipulate indicators of appropriate therapeutic affect (joy, excitement, enthusiasm, animated pitch, volume, etc.)
(Nonverbal Behaviors)
- Learn to “read” the affective behaviors of clients in order to determine:
- attitudes
- beliefs
- feelings
- emotions
- moods, and
- temperments associated with the client’s work during speech-language therapy
Just as the SLP is encouraged to “read” the emotions of the client –
-the client is able to “read” the faces and body language of the clinician
Nonverbal behaviors and SLP practice
SLPs are encouraged to practice exemplifying “excitement” and “encouragement” using only facial expression or other nonverbal communication
Professionalism
Professionalism –a characteristic style, practice, or habit for personal and professional presentation, representation, and general demeanor.
–it is further defined as professional standing, techniques, attributes, or ethics.
- We are accountable to a certain standard of behavior
- It is easier to accept professionalism and professional ethics if personal integrity is consistent with the requirements of professionalism
- Students are encouraged to assess whether their traits of personal character (beliefs, ideals, etc.) are consistent with the concepts of professionalism and to work toward alignment of these entities
Professional Appearance
- Professional appearance–is influenced by dress, hairstyle, and personal grooming choices. This impacts the SLP’s overall presentation.
a. Dress – SLPs are encouraged to consider professional dress at all times of professional practice. (see textbook p.19)
Hairstyle
- Hair length and color does not seem to matter as long as color is viewed as more traditional in nature.
- Hair that falls over the eyes, completely or partially, interferes with communication when the eyes are not visible for communication interaction.
- One negative aspect of hair in the SLP’s face is the distraction of constantly brushing it back from the face, a motion that is often viewed as nervousness or uncertainty.
Personal Grooming Choices
- Fragrances may matter to some clients - some may have allergies
- Loud, flashy clothes may be a distraction
- Avoid revealing or provocative clothing—it is a distraction
- Rethink personal choices for wearing large dangly earrings, noisy bracelets, tongue, nose, lip, or eyebrow jewelry
- Good oral hygiene practices are important due to the proximity needed for modeling speech-language targets
Excellence as a Hallmark of Therapy
- Excellence in speech-language therapy is the achievement of therapy to a level of exceptional quality
- Excellence becomes the standard or hallmark by which clinical performances are measured.
*** Strive for excellence
Time-On-Task as a Hallmark of Excellence
- School improvement research indicates-
- Time-on-task interactive activities WITH a teacher/clinician produces greater student achievement than time-on-task activitries WITHOUT a teacher/clinician
- SLP and teacher make a difference, them working alone is not enough.
(Time-On-Task)
- SLPs are encouraged to take a MINUTES MATTER attitude:
— It MATTERS how many minutes are devoted to small talk
— It MATTERS how much time is spent getting out, setting up, and putting away therapy materials
- MINUTES MATTER!!!- Be prepared
- Working on their communication skills
Artistry serves as:
Artistry serves as the bridge between knowledge-based research and the practical application of techniques and skills within the profession.
- artistry and research interact
Therapeutic interaction
Clinicians lead, guide, model, direct, facilitate, collect data, encourage, and reinforce efforts
