Addressing Anxiety in Fluency Therapy

Anxiety Blog.png

I think it is important to talk a little bit about why we tackle speaking anxiety with our fluency students. A good number of you ask the question, “Is this in our scope of practice?” and the short answer is, absolutely.

So very many of our fluency students experience anxiety, and anxiety leads to muscle tension, which leads to MORE stuttering.

Anxiety

We have touched on using guided relaxation to manage muscle tension, but how do we help our fluency students learn to manage their feelings of stress and anxiety so that they can become more fluent?

Recognizing and understanding anxiety does not come naturally to children, so it helps to guide them through what anxiety is in general before just diving head first into talking to them about their speaking anxiety.

  1. Talk to about what worries are.IMG_1757.jpg
  2. Talk about negative feelings that worries cause and the difference between negative and positive feelings.IMG_1758.jpg
  3. Talk about how we can get rid of worries and turn negative feelings into positive feelingsIMG_1761.jpg

For these and other great fluency worksheets, please consider purchasing our Stuttering Made Simple Resource, which can be found here or click any of the pictures above.

Some students will pick speaking anxiety as an example, and if that is what they pick it is fine to to talk through it with them. If they pick something else, such as a fear of the dark, test taking, etc. that is still extremely effective. Although it may SEEM off topic, you are helping the student learn important strategies that they can then carry over into fluency related tasks.

If you feel that the topics of conversation are out of your area of expertise and require more intensive, non speech related therapy beyond just discussing simple positive and negative emotions, that is when I personally would choose to involve a social worker or mental health professional. Working as a collaborative team is important in these instances. Make sure the professional knows your fluency goals and that they are respectful of those goals as they move forward with their therapy. Keep in contact and collaborate as a team with any mental health professionals involved in the care of your client. This may require a signed release of information, which can be completed at the discretion of the parent or guardian of the client or by the client themselves if they are an adult.

It is important that we do not ignore anxiety as it is an integral part of fluency therapy.

As always, if you have any questions about this or any fluency related topic, feel free to comment on this post or email us at speechinthesand@gmail.com!

Ana

 

SLPs and OTs: The Benefits of Co-Treatment Sessions (and Five Great Resources to Get You Started)

SLP and OT

I am lucky to work with some fantastic professionals from other fields. Some of my favorite people happen to be OTs (Occupational Therapists) and COTAs (Certified Occupational Therapy Assistants).

Co-treating with OTs the school setting is so rewarding! In one case I planned a weekly, hour long push in group with the OT in a classroom of students with varying exceptionalities. We would ask the teacher for her letter of the week and reading theme and we would each plan two activities to go with that theme. We would keep in mind each other’s target goal areas by choosing activities that were both language rich and had a fine motor component.

I see SO much growth in these groups because there is opportunity for carryover!! I continue to learn so much about the OT objectives in therapy and am able to carry over many of these in my sessions during the week. My OT friends report the same with my language rich goals and tell me they find themselves encouraging students to elaborate verbally on their ideas, make requests and use their AAC devices in ways that they hadn’t thought of before.

It is both fun and productive collaborating with other professionals and learning about what they do to help our students.

Here are some of my favorite products available on TPT for co-treating with OTs to get you started with thinking about tasks to include numerous target goal areas:

Say it
This is one of my favorite resources for co-treatment because students can practice articulation words by saying the sound, writing the word, then drawing a picture of the word in the box provided. You can also have the student describe the picture to hit language targets, or have to student follow your verbal directions to draw the picture a certain way!

Mazes For Articulation
This resource is great for some of your more advanced students! Consult with your OT to see if it would be appropriate for your co-treatment group. There is also a language version that you can buy here! You start by working your way through the first maze until you reach the target picture. Practice your target word or use it in a phrase or sentence 5 times. Five boxes are provided directly under each picture for easy data collection!

Trace and Say.png

This awesome resource from Ms. Gardenia’s Speech Room incorporates fine motor and handwriting skills into phonemic awareness activities and articulation drills. SLPs, OTs and students alike love the fun and interactive nature of these activities. It really is worth investing in the bundle!

Playdoh.png
We use SO much playdoh in our co-treatment sessions! You can use playdoh for following directions activities or as a reinforcer for open ended games and activities. Sometimes the OT brings a thicker clay that is harder to work depending on the needs of her students. These awesome mats by Creating Communicators take the guesswork out of planning a playdoh based session. The children can choose items that belong with the main category to increase their vocabulary skills. As the child chooses items from the main category, they can then label each item, targeting their expressive language skills. We have smashed playdoh directly onto the mats, and sometime the OT has the students use another item such as a tongue depressor to do the smashing!

Crafts.png
Almost any kind of craft is also great for co-treatment sessions! Cutting, gluing, tying and attaching are all prime targets for OT goals, and requesting, labeling, following directions, and sequencing are all great for our speech and language targets! You can find so many great easy craft ideas on Pinterest or you can keep it quick and simple by using these great pre-made craft ideas from Peachie Speechie! It’s great to have this bundle in your arsenal of materials for those days when you need a craft idea in a flash!

Do you co-treat with the OT or COTA at your school or clinic? Let us know what your favorite activities are!

Happy Co-Treating!

Ana

Supporting Educators As They Implement A.A.C.

AAC Post

Hi everyone!

I want to talk about an area of difficulty many of us experience in the schools when working with students with complex communication needs. Often we put in the time and effort to implement a communication book or other high tech AAC device only to experience abandonment of these tools at the classroom level. This can be frustrating, to say the least. So, how can we get teacher buy in in order to help our students succeed?

Teach the teacher Set aside time to train the teacher. Sometimes it is easy for us as SLPs to see an AAC device as intuitive without considering that to a teacher or aid, this may not be the case at all. Try not to drop the student off with a new device one day, sight unseen to the teacher and expect them to just roll with it. Sit with the teacher and those working directly with the student and model for them how you expect the device to be used.

Give it time If a teacher is able to jump in and use the device with the student all day from the very beginning, great! If not, try to start small and work your way up. The first week, have the teacher use the device during a specific time, such as morning circle. Try to be there during this time to support the teacher and model the use of the device.  The next week, add in several more blocks of time. This will help the teacher and the student feel more confident with the huge change in their schedule.

Unexpected use Explain what to do when a student is using the device in an “unexpected” way.  For example, I have had students who will press one button over and over when they get a new device or who ask for a desired item, such a cookies repeatedly instead of participating productively in classroom discussion. The teachers have taken the device and put it out of reach to solve the problem. Explain to the teacher that this is like turning off a student’s voice and is unethical. Tell them they should treat the student like any other talking out of turn, by telling them “It’s not time to talk about cookies, right now it is math centers.” They should redirect the behavior as they would with any student.

Push in when possible The more time you are able to spend working with the child in the classroom setting, the more modeling you are doing both for the student and the teacher. Buy in is best when there is a shared understanding of the goals and usefulness of the device.

Do you have any advice to share about helping educators value AAC? Share it in the comments below or send us an email!

Ana