This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Q: I am faced with cutting my caseload down considerably due to budget cuts. We will see the more severe kids a max of one time per week, and that’s fine. However, we are being asked to cut the mild kids more, and even eliminate them from our caseloads. Do you have any ideas?
Many therapists are facing this today. Here is a brainstorm I had that may get you thinking outside the box.
The idea is to use four levels of interaction. Consider it a type of RTI model.
Venue: School Assembly (Whole school? K-3?)
Topic: “Good Speech”
Goal: Get everyone thinking about speech.
Content: Teach all the kids about good speech. Good speech is made by sitting or standing up straight, by speaking up, speaking out, speaking like you mean it, by using appropriate question and statement inflection. Don’t speak with a harsh voice or use glottal fry. Inside/outside voice. Expressing emotion—happy, sad, angry, inviting, rejecting, whispering secrets, cheering at a game, singing, etc. This is good, old-fashioned elocution.
Venue: Classroom (Whole class)
Topic: “Making Sounds”
Goal: Address all the kids who only need a little bit of instruction.
Content: Design a series of classroom activities to teach basic auditory discrimination and production of a wide variety of sounds.
- Do a basic listening activity. Topic: Am I saying these words correctly or incorrectly? Use word pairs like “Alligator” vs. “Aggilator”.
- How do we make B? D? M? S? R? L? F? Z? Sh? CH? Etc.
- Teach that ALL sounds are made with the tongue inside the mouth except one. Design a game/contest to see who can figure out what sound is made with the tongue sticking out (Th).
- Teach that R can be made in two ways— with the back of the tongue pushing up high or the tip curling back. Have the kids use mirrors to discover how they personally make the R sound.
Venue: Small group.
Topic: “Learning Better Sound Production”
Goal: Fix the easy kids who need some direct instruction.
Content: Enroll the kids who do not succeed with levels 1 and 2 in typical small group therapy. Put 4-5 kids in a group for 4-8 weeks? to focus on their specific errors.
Venue: Individual therapy.
Topic: “Remediating Errors”
Goal: Remediate the difficult kids who failed at all three levels above.
Content: Enroll the kids in regular weekly 1:1 therapy. Perhaps do this the second year.