Monday, June 29, 2015

Mushed Brain.....

I am definitely starting my summer vacation 
with a completely 
empty brain. 
It has 
turned 
to 
mush.

Once I have put the mushed brain into a jello mold and let it solidify into what I would consider adequate for creative postings, I will start writing again.  Until then, I am going to work on some much needed work-play balance. Read, go outside, color, clean, etc.   Hopefully my brain will recharge shortly  In the meantime, check out some of the awesome blog posts from other therapy bloggers like Handwriting with Katherine,  Miss Jamie OT, CanDo Kiddo, Your Kids OT, Therapy Fun Zone and Your Therapy Source.  If you would like to add any others to the list, please do so in the comment section!

Thursday, May 14, 2015

AT in the Classroom: Supporting Communication for Students with Complex Needs with Switch Access

If you work with children with complex medical backgrounds, then you know supporting communication needs can be daunting at times.  Cognition, vision, hearing, musculature and more can impact the way in which the child is trying to communicate.  Switch access can be a viable option to increase communication, but it takes a team to make it work.

Position, Position, Position
It is always a priority to address positioning for children with significant physical challenges when assessing communication needs for a multitude of reasons.  First, breathing.  If a child's posture is not in best alignment, with or without support, lung capacity is going to be diminished.  It will be more difficult to produce sounds without proper air supply.  Second, if tone, strength or coordination is an issue, it will be difficult to assess an access point for alternative means of communicating.  The old therapeutic statement "Proximal stability before distal mobility" is just as important to communication as it is to ambulation.   Physical Therapists and Occupational Therapists are both educated in positioning.  Sometimes it takes just a few modifications such as a changing to a chair with arm rests or making foot rest adjustments to improve alignment.  Other times, it is more complicated.

There are a variety of seating and standing systems available on the market like Special Tomato Seats, Leckey, or Rifton Seats, but low cost accommodations can be created with many things that can found at the dollar store, like pool noodles to use as bolsters.  But if you are not sure, refer.  Talk with the parent and determine if the child is followed by anyone already for wheelchairs, strollers and other seating systems.  If they are, you may want to consider requesting permission to speak with outside providers to voice concerns or recommendations.

Once a child is successfully positioned in a functional system, then you can look at the switch based options available in specialty markets and even on Amazon.

Switching it Up
Switches can be a good option for children with a combination of physical and cognitive needs.  They come in a variety of styles, shapes, contours, sizes and sensitivities to fit the unique strengths of a student.  Many styles can be easily plugged into a variety of Cause and Effect toys allow children interact with intent and independence.  Others provide alternative and augmentative communication options to generate single or multiple recordable messages.  Single speech generating switches like the BigMack and multiple message generators like the Step by Step, provide a vocal outlet for requests and comments.

The selection available toys are on the market has left much to be desired, which is why battery device switch adapters, like those found on Enablemart, make battery operated toys available to those with limited mobility.  The copper disk insert has an attached outlet to plug in a standard switch.  Sometime you do have to hack the battery cover to make sure everything fits but now the child has access to turn a toy on and off.  Getting a child to understand and use cause and effect is a powerful tool towards communication.

iPad and Switch Access
There are now Bluetooth Switch Interfaces for the iPad.  I have had good luck with the Pretorian APPlicator.  It provides 4 channels, each with a multitudes of modes.  But just because you have a interface AND a switch, doesn't mean you will be able to use it.  Not all apps are switch accessible.  However, developers are becoming more and more aware of complex needs.  Some of my favorites are from Inclusive Tech.  Also, some augmentative alternative communication apps are more accessible, like Go Talk Now.

Mounting Systems
Now that you have an iPad with usable apps, how do you make sure the child has access to it?  Well, there are a variety of mounting systems.  If the child will be primarily in a wheelchair, Mount'N Movers offers systems and support to walk through the assessment.  What I really liked about them was their adjustability.  Some set ups have swing arm action which comes in handy when a child needs to be transferred.  Other options like AbleNet's Goose Neck Mount and Friction Knob Mounts offer different levels of stability and flexibility, and the cost is much less in comparison to the Mount'N Mover.  Loc Line, a modular hose system originally made for piping needs, created non-traditional, but awesome, do-it-yourself mounting kits too.

Looking at the child's strengths and needs from all angles takes many sets of eyes.  Working as a team to best support the student with complex communication needs is the key.  It ensures all areas of  facilitating communication are addressed.  If you are not sure, refer.  Once you have exhausted your expertise and techniques, follow your district's protocol to request for an Assistive Technology Evaluation.  They may be able to provide insight to strategies and tools available to help enable your student to speak what's on their mind.


For More information about Supporting Communication, check out the amazing insights of more therapy bloggers by clicking on the listing below....
Blog Hop School Based Innovation and RTI Logo


Wednesday, May 13, 2015

Blog Hopping for Better Hearing and Speech Month

I am thrilled to be part of this year's Blog Hop during Better Hearing and Speech Month, coordinated by Speech Language Literacy Lab, LLC.  Therapy bloggers from all over will be sharing strategies for school based interventions.  If you haven't visited the sites already, make sure you do! You never know what new technique or tip you may learn to use in tomorrow's sessions.
Here is the information on all of the great posts for the blog hop.
5/2/2015 RTI for the R sound! Badger State Speechy
5/3/2015 Response to Intervention in High School– A Journey from Abject Frustration to Collaboration and Student Success Stephen Charlton Guest blogs on Speech Language Literacy Lab
5/4/2015 Technology and RTI  Building Successful Lives Speech & Language
5/5/2015 Motor Groups and RTI Starfish Therapies
5/6/2015 Orton Gillingham Approach & RTI  Orton Gillingham Online Academy
5/7/2015 Evidenced-based writing that works for RTI & SPED SQWrite
5/8/2015 RTI/MTSS/SBLT…OMG!  Let’s Talk! with Whitneyslp
5/9/2015 RtI, but why?  Attitudes are everything!  Crazy Speech World
5/10/2015 Who Knew RTI Could be So Much Fun? (Artic RTI)    Consonantly Speaking
5/11/2015 Universal benchmarking for language to guide the RTI process in Pre-K and Kindergarten     Speech Language Literacy Lab
5/12/2015 Movement Breaks in the Classroom (Brain Breaks)   Your Therapy Source
5/13/2015 How to Write a Social Story   Blue Mango LLC
5/14/2015 Some Ideas on Objective Language Therapy    Language Fix
5/15/2015 Assistive Technology in the Classroom  OTMommy Needs Her Coffee
5/16/2015 Effective Tiered Early Literacy Instruction for Spanish-Speakers Bilingual Solutions Guest blog on Speech Language Literacy Lab
5/17/2015 Helping with Attention and Focus in the Classroom   The Pocket OT
5/18/2015 Vocabulary Instruction  Smart Speech Therapy, LLC
5/19/2015 An SLP’s Role in RtI: My Story Communication Station: Speech Therapy, PLLC
5/20/2015 Incorporating Motor Skills into Literacy Centers   MissJaimeOT
5/21/2015 The QUAD Profile: A Language Checklist  The Speech Dudes
5/22/2015 Resources on Culturally Relevant Interventions  Tier 1 Educational Coaching and Consulting
5/23/2015 Language Goals Galore: Converting Real Pictures to Coloring Pages  Really Color guest blog on Speech Language Literacy Lab
5/24/2015 Lesson Pix: The Newest Must-Have Resource in your Tx Toolbox Speech Language Literacy Lab
5/25/2015 AAC & core vocabulary instruction Kidz Learn Language
5/26/2015 An RtI Alternative Old School Speech
5/27/2015 Intensive Service Delivery Model for Pre-Schoolers   Speech Sprouts
5/28/2015 RTI Success with Spanish-speakers     Speech is Beautiful
5/30/2015 The Importance of Social Language (pragmatic) Skills guest post on Speech Sprouts
5/31/2015 Sarah Warchol guest posts on Speech Language Literacy Lab