5202 11/23/16 Class Lecture3 terms that define professionalism prepared knowledgeable competent - terminology and explain it respectful organized drawing the line between personal opinion and professional opinion considerate of feelings it’s not what you think - it’s what they think… if the client doesn’t see you as professional based on what yIf you want to learn more check out michael mcgregor uri
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ou are wearing, then you must change how you present yourself its how someone else sees you and the culture of the people you work with Examples how do you say your message in a way that I’m going to do something about this… I don’t know about this… what do you think? emails - be careful how you address it; always provide a reason why it’s late - admit if you make a mistake - owning it ask for help own that maybe they cant help me don’t go in and say “fix this” understand other people are doing the best they can no one is trying to mess you pu update on what doing well… this is a problem.. are you seeing the same thing at home? what works? calling to be a partner - don’t just tell them stuff externship email use kean emil include context on who you are and where you come from what works for them and provide times for things you cannot rearrange - or your availability around that first impression thank them for the opportunity describe what you’re seeing go to pediatrician for their recommendation leave it vague we cant make asd diagnosis in nj concerned about this and this and maybe you want to pursue it further really concerned and should get more medical support remember you’re talking to someone or to someone in pain they care… they may not be able to show that they care Clinic Expectations come in with ideas and ask if it will work - don’t say i don’t know what to do end of first semester should be a 3 end of second semester should be a solid 4 higher expectation in semester 2 clinic if you don’t understand - ask a supervisor - ASK - don’t be afraid to ask…. bring in a binder and dividers first day of clinic!!!! First DayRead through clinic handbook supervisor goes over it on first day no clients first day they will give you a schedule 3 students per supervisor; 3 supervisors per clinic look over chart - get to know client on paper cd of session in chart talk to anyone who knows the client - they will tell you everything they know can ask the clinician of the last semester don’t forget they have their new ones and are busy - but they become family review the charts SOAP notes TP semester summary were goals met? recommendations great idea of where you might want to start Second Day ideas of what you want to work on with that client TP cannot be superficial binder is ready - dividers and sheet protectors one section for each client TP SOAP notes - document that gets signed - will be re-written ask about what the comment is… respond to the comment…. if theres a comment - RESPOND - just to know that you read it Lesson Plan - rarely re-written, but read the comments Calling the clientremind them of day and time introduce yourself parking pass do you need anything anything they think you should know about client bring something from home favorite toys? LP for day one: establish rapport played and wants to come back waiting room no one comes back to the room themselves not even adults offer to caregiver to come back ask the client if they want caregiver to come back 4 forms that clients have to fill out very important to get these forms back What are you doing with your client first day?ask them what they liked - just continuing a program don’t need to start all over again Artic look listen for overall intelligiblity if a lot of artic errors - you may not be able to tell what they are moqst common test - articulation test maybe second or third day make note about what you think you saw bring in materials that will elicit those sounds that you know were problems last semester Language data collection sheet to assess previous errors want to see if he has that previous skill that he was working on? have enough materials and enough of a data sheet Aphasia want to work right away do not want to waste time know what goals from last semester talk to them about the goals from last semster - work well? want to cont with? have them help you - can still do what they did last semester writing, reading, expressive, receptive 2nd day Artic tighter plan stimulable for that sound where in error? give a test at the end of this session - you should have an idea of what you want to work on Aphasia write lt goals and st goals FOR day 3 and see if they work TP: EBP use prior ones... textbook library ASHA goals and methods and activities all wrapped up in a package for 45 minutes 3rd day try out your goals after 3rd day - expected to be able to write your TP ask supervisor lots of questions before and while your’e writing it you want your sessions to NOT be boring - change some part of it - change some of the part, so that you don’t get caught in a rut LP first daydetermine baseline no ltg stg - assess current skill level THe client will demonstrate current skill level in _______ taking baseline data here - what the CAN do what is it specifically that you want to know don’t go in too broad - so that you come out with some information HIPPPA initials all the time everything is being recorded if parent wants to talk about something - bring in therapy room - eliminate conversations from happening in waiting room or hallways Supervisor will sign your hours will give you feedback keep paper hours FOREVER log your hours in calypso at midterm - daily keep your hours on paper TP and SOAP get uploaded data sheet and LP don’t You help each other - share an activity with other clinicians sharing ideas talk about clients you are struggling with watch videos of yourself don’t get behind on paperwork Clinic Rulesdress codes no sneakers no jeans professional how other people would perceive you its the only no wet hair nothing dirty or ripped sleeves — no straps only no open toed shoes no skin showing cameras look down on you bend over in front of a mirror - and look at yourself if you’re not sure if you should wear this… DO NOT wear it way you dress and way you carry yourself helps overcome how young you look like you are the SLP and not the student anymore no sick days, no options for being out, no vacation days Seizure call someone else - help immediately call 911 open door and ask for help tell your supervisor if someone gets hurt don’t be afraid to tell someone families want to be included talk with supervisor about how to talk to them work with them to understand realistic 1479932494.546844Treatment for AutismTheoretical models Functional/ behavioral emphasis: improving effectiveness as a communicator doesn’t follow any developmental sequence target behavior: individualized to match their skill and needs (and family priorities) Developmental emphasis: spoken language (moves away from functional speech and lang) uses typical language development as rubric for language intervention programming meaningful gestures/ vocalizations -> single words -> phrases/sentences -> complex language forms Programming Considerations UDL: Universal design principles for learning multiple means of access to the curriculum multiple means of expressing knowledge multiple opportunities for meaningful practice of newly learned skills to sustain motivation for learning EI: Early intervention appropriate stimulation capitalizes on neural plasticity minimization of the emergence of the maladaptive behavior Comprehensive and intensive intervention address multiple areas of deficits across all of child’s daily settings and activities intensity of 25-40 hours/ wk Structure vs flexibility function best in predictable environments rules are clear and consistent need some degree of flexibility to learn new skils use small, incremental changes - and let them know in advance Generalization learn in specific ways - generalization is not spontaneous Behavior and emotions emulate the emotion of their communication partner so be soft positive and even tone Visual supports visual thinkers visual processing strength picture schedules behavior graphing help transition from one activity/context to another Interdisciplinary/ collaborative team OT Social worked Physician Psychologist Psycho-pharmacologist Treatment Approaches Age of onset of treatment and treatment intensity are more important than use of specific treatment program or model TEACCH: Treatment and education of autistic and related communication - handicapped children AAC: Assistive technology - for those who are nonverbal 1. organize the physical environment to maximize learning and to minimize distractions 2. use visual teaching to capitalize on the child’s relative strength in visual/spatial information processing 3. individualize goals and activities to engage the child’s attention 4. facilitate meaningful child-initiated communication ABA: Applied behavioral analysis ABA definition: represents a class of interventions that apply behavioral science principles to address behavioral based on Skinner: stimulus - response: immediate reward to inc desired behaviors or dec with punishment some focus on reducing disruptive behavior others focus on inc: adaptive beh communication spoken language they all break complex tasks, actions, and behavior into smaller sequential parts INTENSIVE 30-40 hrs of 1-1 tx/ week emphasis: role of parents as primary intervention agents DTT: Discrete trial training form of ABA rewarded behavior is increased presents stimulus along with correct response -> reward EACH correct response with praise, food, other incorrect responses are ignored immediate feedback to clearly establish the expected behavior PRT: Pivotal response teaching ABA approach “pivotal” areas: motivation to learn initiation of activities designed to inc motivation to participate in learning new skills developmental drives target behavior selection RIT: Reciprocal imitation therapy variation of PRT teaching play skills teaching spontaneous, reciprocal imitation skills in play context clinician imitates actions/vocalizations of child in an obvious manner child is rewarded when attempts imitative behavior lots of prompting, modeling, physical guidance Social Stories social stories: designed for higher-functioning children and adolescents with autism (mild-above avg intellectual function) scripts that provide explanations of appropriate behavior in social situations - tailored to level of language comprehension contain sequential statements: descriptive statements intended to help a child understand a particular situation provide words, phrases, or sentences for a situation that child cannot generate on own perspective statements facilitate the child’s ability to verbally identify: feelings wants motivations of OTHER people directive statements specific social cues that tell them what to do in situation to be more appropriate socially foster executive functioning skills SCERTS: Social-Communication, emotional regulation, and transactional supportfocuses on core deficits of children: communication and language focuses on functional use of preverbal and verbal communication skills PECS and picture symbols often incorporated to facilitate communication initiation and responsiveness social relatedness and social-emotional reciprocity DIR/Floor Time - emphasis on developmental progression in naturalistic contexts sensory processing sensory integration therapy and environmental modifications, adaptations, and supports PECS: Picture exchange communication system definition: structured AAC system that promotes symbolic communication in nonverbal children, encouraging spontaneous initiations Goal: help them to discover/understand the power of communication 6 phases: 1. develop concept of how to use symbol to obtain desired item/action 2. simple requests 3. single words 4. phrases 5. comments 6. answering questions they make choices that allow them to have more control over their world through the use of communication clinician helps the client give the clinician the symbol for the item they want immediately Video modeling uses video format to teach social and communication behavior watches repeated videotaped exchanges using appropriate communication behavior used to teach basic communication skills and more complex RDI: Relationship development intervention Goal: gradual development of child’s reciprocal social communication that underlies the ability to form emotional bonds and interpersonal connections/ relationships parent-implemented; home-centered parents receive formal training in behavior methods to slowly and systematically change/shape the interaction patterns between themselves and their children in everyday activities an settings based on “dynamic intelligence” - ability to think flexibly ability to take the perspective of others adapt to changes in the environment integrate information from a variety of sources Core objectives to foster flexible thinking: emotional referencing ability to learn from the emotional and subjective experiences of others social coordination the ability to control one’s behavior to successfully participate in social relationships declarative language ability to use verbal and nonverbal communication to express curiosity, invite interactions, share perceptions and feelings, and coordinate with others relational information processing the ability to solve problems that lack clear-cut solutions FCT: Functional communication training DIR: Developmental, individual difference, relationship-based/ FloortimeDIR identifies 6 developmental milestones for health emotional and intellectual growth: 1. attending 2. relating 3. purposeful communication 4. problem-solving interactions 5. using ideas creatively 6. using ideas logically emphasis: identify ea of the child’s individual differences in the way they process sounds, sights, sensations, and movements Floortime technique for implementing this model of intervention encouraged to “get down on the floor” and do this for 6-10x/ day: pay attention to the child’s individual behavior locate an “entry-point” to child’s system by imitating/ joining in their beh engage the child this was for a few min and then introduce variation on the theme for both of you to embrace gradually lead the child into mastering the milestones identified above to create the experience of a ‘shared world’ between the child and adult Administration 5227 is clinic Next week data sheet take lesson plan we wrote - take a data sheet and make up how the session went - meet some goals and not meet others, etc… progress note with data sheet in progress note is plan for next session lesson plan for the following session hand in 3 things: data sheet, progress note, lesson plan Thanksgiving meeting next week and not last week of semester Literacy: Passion of hersWhy do we care? School is all about literacy and all about learning to read if you can read - you can do everything else you need to do if you can read - you will be sucessful most of jail people are reading under a 5th grade level kids cant read if they don’t have the language skills teachers don’t get this lots of language pieces in reading easier comprehension - more they read - more vocal and syntax - easier to read - more language - more reading - more language not reading at 1-2nd grade - not reading at 5th grade level Emergent LIteracy pre-literacy skills books: cover dark things are leters left to right where front is, where back is how we open it families that are language rich but don’t read more we can give kids when exposing to books - better off they are going to be language based use the classroom instruction and what they are doing in class and use it in therapy young kids - exposure use books as a means of supporting language develop use a book to support whatever it is you are working on writing is just as important draw doodle shared book readingexposing them to literature getting their attn ask to make prediction answer wh question vocal in a book pragmatic skills - ! = excited teaching flow of language repeat books over and over sent structure plan ahead know whats going to come want the consistency relate the book to their own experiences read aloud ask questions what do you think is going to happen - model response you are expecting alphabetic letter name and sound knowledge tell them the sound that goes with it show them the wiggle marks that go along with that sound expose it even if not working on it Reading COmprehensionsemantics syntax sent attn something to attach information to george washington - on a coin help them make associations so they can retain the information strategies read questions first figure out what we are looking for before reading information graphic organizers ladders or hamburger, etc… recording information as they read and look back - not asking them to retain it at first break down complex sent structures teach kids how you read an academic article mapping compare and contrast different ways of helping kids organize information Adult Literacyvery different kids - building skills they don’t have adults - what skills DID they have how does it impact their life memory? vision? language - breakdown with reading? or problem with language totallY? functional reading is important - must be defined now its emails grocery lists reading the circular what are the skills that they want to get back analyzing the steps to reading sometimes how much can you remediate? but ALSO how many different ways to compensate? Remediation what skills are still in tact? copying? having letters in order to write? where is their breakdown and what supports can we provide? books on tape - slow down the story njsltbbc.org access to a free player and titles via NJ library for the blind and handicapped Compensations read it several times say the letters if you read it first more time writing it self-cued word retrieval write the first letters of the word on her hand lots of listening to your client nothing works in a day give it a shot - its going to take some time though B is for Ben articulation of /b/ answering wh questions labeling… kinda great for auditory bombardment find stories that are going to meet your goalsanswer questions make predictions sequencing rhyming fill in the blank - rhyming is natural rhyming is prosody syntax taking another person’s perspective change the ending label it dear zoo - apraxia /k/ in final position: “I sent him back” - fill in the blank trouble with getting interested in books - manipulating books - open flips, etc.. assessing stories pragmatics - people’s faces expressions past tense inferencing different tenses curious george is great robert munch is great - stephanie’s ponytail