Full Course Description
Adapting Pediatric Feeding Therapy for the Clinic, Home, School, and Online – Not Just the Kitchen Table
Upon completion of this program, participants will be able to:
- Determine the challenges and advantages of a variety of feeding environments including school, home, clinic, and online settings.
- Utilize two strategies to ensure safe feeding/swallowing in educational settings.
- Implement three strategies to facilitate carryover from medical/clinic to home feeding environments.
- Conduct effective tele-therapy sessions with children with feeding and swallowing disorders.
- Where, what, and with whom?
- Challenges and environments
There’s No Place Like Home
- Early Feeding Intervention at the kitchen table
School-Based Feeding Therapy
- Yes, it is educationally relevant
- The challenge of carryover
Making Teletherapy Work
Ethnographic Interviewing: Assessment Strategies for Culturally & Linguistically Diverse Needs
Participants will be able to:
- Assess the role of ethnographic interviewing in evidence-based practice and the International Classification of Functioning.
- Conduct an ethnographic interview to inform the clinician’s choice of treatment.
- Analyze interview data to establish intervention goals and objectives to improve client engagement.
Foundations for Clinical Assessment and Intervention
- Evidence-based practice (EBP) framework
- International Classification of Functioning framework
Ethnographic Question Types – Asking the Right Question in the Right Way
- Descriptive questions to help clients describe experiences, daily activities, objects, and people
- Grand tour and mini tour
- Example, experience, and native language
- Structural questions to determine relationships among ideas
- Stages of rapport
- Problematic questions
- Questioning that facilitates rapport
- What they are
- Why to identify
Analyzing the Interview Data
- Domain analysis
- Identifying barriers and facilitators
- Determining strengths and needs
- Setting goals and objectives
Video demonstrations are woven throughout presentation to show the types questions/interactions Copyright :
Video Modeling to Teach Authentic Communication and Connection
- Determine appropriate methods of video modeling for various settings and client/patient/student needs.
- Integrate video modeling with traditional communication techniques to accelerate effectiveness and enhance carryover and skill maintenance.
- Employ available technologies you already have for recording, viewing, editing, and sharing videos with patients right away.
- Execute and maintain privacy and HIPPA regulations to protect the integrity of persons and settings captured in the videos.
Why use video modeling
- Improved focus and skill development
Types of Video Modeling
- Others, POV, self, hybrid
- Choosing which method to use
- Weak and strong outcomes
Not just watching
- Must also include passive and active engagement (mediated learning and doing)
- Carryover and latency (spontaneous use of learned skills)
- Memory and learning
How to integrate video modeling in various settings for different client/student needs
- Identify goals and skills to target
- Video examples and discussion
- Pairing with traditional communication techniques
Parkinson’s and the SLP: Treatment Approaches for Voice, Speech, Language, Cognition and Other Issues
- Evaluate key areas of cognitive dysfunction associated with Parkinson’s and potential implications upon communication.
- Investigate core features of Parkinson’s with respect to communication deficits and swallowing dysfunction and relevant treatment approaches for each.
- Employ computer and/or smart phone-based technologies that can be employed by the speech language pathologist to help improve speech and voice in patients with Parkinson’s.
Hallmarks of Parkinson’s-Speech
- Quiet voice/hypophonia
- Sloppy articulation - excess noise due to frication
- Visualization of the vocal folds
- LSVT LOUD (formally Lee Silverman Voice Therapy)
- SPEAK OUT (Parkinson’s Voice Project)
- PLVT (Pitch Limited Voice Therapy)
Articulation Difficulties & Fluency Disorders
- Parkinson’s Swallowing
- Drooling and risk for swallowing dysfunction
- Potential impacts for each stage of swallowing
- Emerging tools and other possible ways to help
- Other interventions with strong evidence
Cognition – The Intersection of Language and Cognition
- Influence of other cognitive domains
- Set shifting
- Executive function
Stop Challenging Behaviors from Derailing Therapy: 7 Must-Have Interventions for Clients of All Ages and Diagnoses
- Differentiate the application of applied behavior analysis in feeding and swallowing; traumatic brain injury; learning disabilities; and ADHD.
- Apply methods of data collection and preference assessments to enhance client interaction and treatment progress across a spectrum of diagnoses.
- Employ the use of behavior interventions cross the pediatric and adult client population.
- Analyze client behavior to better understand the purpose or why of the client challenging behavior being presented.
Applications of ABA for Challenging Behaviors Related to:
- Traumatic Brain Injury (TBI)
- Cerebral Palsy (CP)
- Attention Deficit Hyperactivity Disorder (ADHD)
- Feeding and Swallowing
- Learning Disabilities (LD)
Antecedent Behavior Interventions: Enhance Client Interaction and Treatment Progress
- Best practices for pediatric and adult clients
- Preference assessments
- Data collection and client interactions as tools for analysis
Understanding Client Behavior as an Essential Clinical Skill
- The ‘purpose or why’ of the client challenging behavior
- Environmental variables that impact client behavior
- Client with TBI with verbal aggression or obstinate behavior
- Client with identified learning disability and ADHD
Social Effectiveness: Strategies for Clinic, Home, and School
- Articulate the signs attributed to foundational deficits in Theory of Mind, Central Coherence, and Executive Function.
- Implement treatment strategies designed to improve cognitive thinking, misinterpretation, and poor planning.
- List the signs of deficiencies in your client’s social interaction, social communication, and social regulation.
- Design treatment strategies to improve play skills, pedantic speech, and anxiety.
THE “ROOTS OF SOCIAL SKILLS”: IF THE ROOTS AREN’T VIABLE, THE TREE WON’T SURVIVE
Theory of Mind
- Treatment for: Poor perspective taking, imaginative play, cognitive thinking
- The Zone (Kowalski, 2010)
- Comic Strip Conversations and Social Stories
- Barrier and detective games
Central Coherence: Seeing the Forest Through the Trees
- Treatment for: Hyperliteral, “Argues”, misinterpretation
- Loosey-Goosey Language
- Cognitive flexibility
- Big Picture
Executive Functions (EF): Tools for Executive Function Deficits
- Treatment for: Poor planning, problem solving, flexible thinking
- Contingency statements
- Stroop-like tasks
THE SOCIAL TRIAD
- Treatment for: Naïve, poor play skills, obsessive interests
- Structured play groups
- Social autopsies
- Social cause-effect
- Treatment for: Pedantic speech, difficulty with conversation, poor nonverbal communication
- Visual strategies
- Grice’s Maxims
- Expansion and Repair
Social-Emotional Regulation and Emotional Intelligence: EQ
- Treatment for: Easily stressed, anxious, ritualistic
- Recognizing emotions in yourself and others (prosopagnosia)
- Language of emotions (alexithymia)
- Forget About It Box
Dysphagia and Medication Management – A Hard Pill to Swallow
Upon completion of this program, participants will be able to…
- Determine three potential medication modifications for people with dysphagia and their consequences.
- Analyze three common medication side effects that can impact swallow function.
- Devise three strategies for improving swallow safety during medication administration.
- Implement three strategies to reduce medication errors in individuals with dysphagia.
Pill/Tablet Swallow Physiology
- What happens when we swallow a pill?
Issues in Administration for People with Swallowing Disorders
- Medication type – liquids, tablets and capsules
- Potential for medication errors
- Altering medications – easier to swallow but is it really safer?
Medication Induced Dysphagia
- Neurological impacts
- GI impacts
- Impact on salivation, dry mouth
- Compensations and maneuvers – making swallowing easier
- Improving dry mouth
- Sensory interventions
- Reducing medication errors related to dysphagia
- New directions – changes in formulations for easier swallowing
Bilingual Parent Coaching in Early Intervention Settings
- Apply professional knowledge to child’s needs and modify it according to family culture, language, and desires for ethical service delivery in early intervention.
- Integrate a hybrid approach (in-person and telehealth settings) for bilingual and multicultural parent coaching and education.
- Possess and create developmentally and linguistically appropriate materials and resources to use the next day.
Parent and Therapist roles in Early Intervention Bilingual homes
- Different language, different culture, different expectations
- Terms to consider when describing yourself and your clients: Proficient, fluent, native, non-native, English Language Learner, Dual-language Learner, etc.
- Common hurdles and complaints
I am not Fluently Bilingual/Multilingual. What are My Options?
- Ethical considerations
- Use of interpreters (professional, friends of family, family members)
- Become the student investigator; be willing to learn; trust your skills
- Who is my client, the child or the family?
- Case examples with video demonstrations
- Prepare children and families for future language use
End the Blame Game
- Disability, difference, or disadvantage?
- Adapt the environment or the expectation?
- Prevent further need for interventions for the school-aged child
Do This not That
- Choose wisely: good sessions or better communication?
- Active engagement and home practice success
- Case studies, video examples, and discussion
Stroke and Aphasia: Breaking Down Barriers to Access Mental Health Services
- Employ quality of life and depression screening tools for post-stroke patients.
- Investigate counseling skills and limitations as they apply to SLPs.
- Evaluate strategies to overcome avoidance behaviors that decrease the likelihood of receiving mental health services in patients with aphasia.
Impairments Following Stroke: Impact on Quality of Life and Depression
- Stroke aphasia and quality of life
- Stroke aphasia and major depressive disorder
- Internal risk factors of post-stroke depression
Quality of Life and Depression Screening Tools: Purpose, Administration, Scoring and Interpretation
- Stroke and Aphasia Quality of Life Scale-39 Generic
- Geriatric Depression Scale
- Stroke Aphasic Depression Questionnaire
Counseling and Counseling Skills
- Counseling role of the SLP
- Limits of counseling by the rehabilitation professional
- When and how to refer to a behavioral health professional
- Barriers to counseling and possible strategies and solutions
Autism Identification: How Early is too Early
- Assess for subtle differences in neurotypical and at-risk infants for purposes of parent/family psychoeducation.
- Analyze ‘red flags’ found in young children who are at-risk for autism to inform clinical assessment and treatment planning.
- Determine symptoms and behavioral patterns of infants and toddlers at risk for a diagnosis of ASD.
- Employ specific clinical strategies/techniques to reduce and replace challenging behaviors inherent to autism.
Screening and Identification
- ‘Red Flags’ of Autism Spectrum Disorder (ASD)
- Subtle differences in neurotypical and at-risk infants
- Characteristics and behavioral patterns found in infants and toddlers at risk for ASD
- Magic and pitfalls of questionnaires
- Questions to anticipate from family members
- Increase the child’s overall learning trajectory
- Preventing the development of secondary behavioral patterns
- Consider a ‘new look’ at “stimming”
- How to approach reduced engagement
- Turning hyper-focusing behaviors into an asset
- How replacement behaviors can help and what’s behind repetitive behaviors
Case Studies for Screening, Assessment and Treatment
- 3-year-old who turned vomiting into a successful career
- 2.5-year old 24/7 head banger and what helped him turn the corner
- Music ‘saves a child’s life’
- Sometimes, silence is the best form of ‘communication’!
Children with Adverse Childhood Experiences (ACEs): Interventions for the Caregiver & Child
- Determine the effects of adverse childhood experiences on children’s language and social-emotional development
- Develop caregiver-child interventions that promote attunement/affect management
- Implement strategies to promote resiliency and language for personal narratives/self-regulation
ACEs and Development
- Types of ACEs
- Biological/neurological effects
- How attachment mediates trauma
- Autobiographical memory
- Narratives in parents & children who have experienced ACEs
- Framework for intervention
Interventions that Promote Attunement/Affect Management
- Goals for caregiver intervention
- Recognizing temperaments
- How children respond to danger
- Using mindfulness and mindsight in responding to children’s behaviors
Promote Resiliency for Personal Narratives and Self-Regulation
- Aspects of self-identity to develop
- Childhood competencies to development
- Characteristics of reminiscing
- How to reminisce
- Develop child’s emotional understanding: emotion coaching, reading body cues, recognizing emotions in stories
Rehab Strategies for Patients with Tracheostomies & Ventilators
- Describe steps to assess both vent and nonevent dependent patients for speaking valve utilization
- Identify contraindications for use and safety measures for successful placement of a speaking valve during acute and long-term rehabilitation
- Recognize at least three unique aspiration risks for the tracheotomized patient and three ways in which a speaking valve positively impacts swallowing physiology
- Explain three mechanical vent settings for which a speaking valve can be safely used in the tracheotomized patient
When Should You Use a Speaking Valve?
Successful Placement of a Speaking Valve during Acute & Long-term Rehabilitation
- Patient assessment
- Equipment and placement options
Unique Risks & Solutions
- Contraindications for use and safety measures
- Impact of speaking valve upon voicing and communication success
- Problem-solving strategies for difficult placements
Safe Use of Mechanical Vents with Speaking Valves
- Overcoming aspiration risks
- Impact of swallowing physiology
- Research and case studies
- Modes of ventilation the speaking valve can be safely used
- Parameters on vent that impact candidacy for successful use
- Case Study
Dementia Assessment & Management in Acute Care: The Role of Rehab Professionals
- Summarize the key collaborators and roles of other disciplines in the management of persons with dementias in an acute care context.
- List at least three factors that contribute to decisions about our level of involvement (consultatory or direct care) for persons with dementia in acute care contexts.
- Incorporate potential elements of assessment batteries, which balance impairment-based diagnostic elements with non-standardized, observational elements that foster insights into diagnosis and treatment planning.
Key players (disciplines) in an acute care context and their roles.
Roles of social workers and case managers in discharge planning.
Role of the system/team in managing behaviors, safety, and participation while an individual with dementia is hospitalized.
Key issues related to presence or lack of diagnosis, behavioral concerns and related management issues, swallowing concerns - meeting nutritional intake needs, cognitive effects on swallow, and/or physiological safety; follow through with precautions, counseling.
Screening measures versus standardized assessment batteries that are sensitive to identifying specific types of dementia.
Non-standardized and observational assessments that provide more information about functional performance and provide direction for treatment planning. Copyright :
Telehealth: Successful Treatment for Children with Moderate to Severe Communication Disorders
Teletherapy is Here to Stay
- Improved accessibility of services
- Functional communication is key to long-term success
- Collaboration and coaching take the lead
- Teletherapy is as good or better than traditional service delivery models
- Children are getting better faster with Teletherapy. Why?
- Children with more complex disorders and diagnoses benefit more from teletherapy than traditional service delivery models
Improved Accessibility of Services
- Factors leading to fewer cancellations and interruptions of services
- Access to specialized services and populations is enhanced
- Shorter and more frequent sessions per week for effective and lasting outcomes
- Demonstrate why candidacy and efficacy of teletherapy may be higher for those with more complex diagnoses.
- Integrate strategies to motivate and engage children within sessions, train caregivers, and develop home plans to promote carryover for various settings and needs
Written Language: Roles, Responsibilities, and Ethical Considerations
- Determine the roles, responsibilities, and ethical considerations of SLPs in regard to working with students with written language challenges.
- Assess risk factors for young children in developing reading and writing challenges.
- Articulate the relationship between oral language and written language.
- Employ evidence-based strategies for addressing written language through each of the components of language (phonology, morphology, syntax, semantics, and pragmatics).
- Build speech and language assessments that contribute to the understanding of a child’s written language challenges.
ASHA Code of Ethics – Specific Applications for Written Language Disorders
Roles and Responsibilities of Speech-Language Pathologists with Regard to Reading and Writing
- The connections between spoken and written language.
- How SLPs play a critical and direct role in the development of literacy.
Identifying Children at Risk and the Relationship Between Spoken Language and Literacy (Colenbrander et. al. 2018)
- Genetic factors
- Oral Language
- Phonemic awareness
- Letter knowledge
- Vocabulary knowledge
- Morphological awareness
- Hearing difficulties
- Speech sound disorders
- Other cognitive factors
The Role of the SLP in Assessing Reading and Writing
- Can SLPs diagnose dyslexia?
- Speech and Language Assessments
- Considering state and local standards
- What the new DSM-5 says about IQ testing
Using Evidence Bases Strategies to Target the Components of Spoken and Written Language
- Pragmatics and Discourse
Advancing the Knowledge Base
- Improve your own knowledge base (IDA Knowledge and practice standards, additional training).
- Provide knowledge and assistance to general education teachers, parents, and students
- Advocating for effective literacy practices in the school and district
Additional Professional and Ethical Considerations
- Determining your role on the literacy team, acknowledging the role of others
- Following state and local guidelines
- Promoting evidence-based practices
- Assessing gaps in your own knowledge and knowing where to go for information
Reduce Emotional Outbursts, Shutting Down and Oppositional Behaviors in Social and Academic Settings: Proven Language-, Communication- and Attachment-Based Interventions
- Assess children’s comprehension and connection of internal states to plans, goals, and actions.
- Implement language-based strategies to help children identify and use internal state words to express emotions and reactions.
- Integrate communication and attachment-based strategies to promote relationship building, social problem solving, and academic performance.
- Design personal narratives to help children process attachment disruptions and trauma to increase emotion understanding.
- Employ mindfulness, guided imagery, and sensory awareness techniques to help children improve regulation.
- Utilize movement-and sensory-based strategies to address behavioral, communicative, and social goals.
Relationship Among Self-Regulation, Language, and Social-Communication
Language and Behavior Assessments
- Self-regulation deficits in children with ASD, ADHD, ACEs, and LLD
- Development of self-regulation, emotion understanding, and Theory of Mind (ToM)
- Language and cognitive processes involved in social-emotional development
- Link among attachment, relationships, and emotions
- Exercises to measure understanding of words for internal states
- Tools to assess comprehension and connection of internal states to plans and actions
- Mechanisms to chart and monitor behavior
- Rubrics to assess social skills
- Checklists to determine factors that influence language and behavior
INTERVENTIONS AND STRATEGIES TO:
Develop Social-Communication Skills and Emotion Understanding
Address Dysregulation and Challenging Behaviors
- Apply attachment theory to emotion understanding and social interactions
- Scaffold interactions to achieve topically-related turn taking
- Social narratives to establish social roles and rules
- Co-regulation strategies to build relationships
- Teach language to identify and express internal states
- ”Emotional Thermometer” to match feelings to appropriate responses
Promote Self-Regulation Within Language and Curricular Contexts While Meeting ELA Standards
- Personal narratives to process emotionally-charged events
- Self-talk, positive messaging, and labeling of internal states to manage emotions
- Move from tight routines to flexible scripts to ensure participation in group activities
- Calming, mindfulness, and bibliotherapy techniques
- Intrinsic motivation, positive engagement, and self-efficacy to improve behavior
- Movement and sensory experiences to engage children in learning
- Project- and team-based learning opportunities to establish rules for social participation
- Reinforcement system and procedures to manage behavior
- Apply Theory of Mind (ToM) to text comprehension
- Connect internal states with plans, goals, and actions
- Tell, map, and analyze personal and social narratives
- Link social, behavioral, and educational goals
- Guide participation in instructional conversations
- Scaffold inferencing and predicting
Play with a Purpose: Effective Play-Based Therapy & Early Child Development
- Summarize the benefits of play across the five developmental domains (cognitive, communication, social-emotional, physical, and adaptive)
- Describe the limitations of popular educational toys and apps and their effect on the development of young children with developing brains and bodies
- Outline a plan to incorporate functional play-based assessment into standardized testing
- Identify naturally occurring routines and activities to promote development in the home environment
- Recognize the best strategies and toys for play-based interventions
- Design individualized play-based therapy sessions that focus on the child’s strengths, needs and interests
OVERVIEW OF PLAY
TYPES OF PLAY
- Definitions of play
- Common societal myths about learning and play
- Developmental benefits of play
- Play as the foundation for learning and development
- Connection between neuroscience and play
TOYS — TOOLS FOR LEARNING
- Active play vs. passive entertainment
- Child-directed play vs. adult-directed play
- Object play vs Social play
- How toys can enhance development
- What kinds of toys are tools for learning
- Why low-tech toys are best for young children with special needs
- Natural activities to promote development in the home
- Standardized testing vs. functional play-based assessment
- Why play based assessment works
- Assessing the whole child across the 5 domains
- Play-based assessment guide
- Case studies and discussion
- Recognizing the value of child-directed play
- Keeping therapy natural and functional
- How to play with a purpose
- Relationship-based learning
- Partnering with parents and caregivers
Screen Time, Learning, & Communication in the 21st Century
- Determine the benefits and risks of screen time and why some persons are at increased risk or negative effects of screen time
- Formulate why children with developmental disabilities are more at risk for the negative effects of screen time
- Utilize strategies and resources for managing screen time and alternatives to screen time that meets each child’s unique needs
Screen Time: Risks and Benefits
- Positive benefits
- Concerns regarding screen time
- Multitasking and continuous partial attention
- Health concerns
- Violence and games
- Effects on memory and learning
- Social media
- Mental health
Children with Higher Risk for Negative Effects
- Developmental disabilities
- Factors in choosing appropriate media
- Children’s environmental sensitivities
Strategies for Managing Screen Time and Alternatives
- Context: technoference
- Content: engagement, active involvement, meaningful, social
- Meeting each child’s unique needs