Podcast Transcript - Episode 20
SLP Toolkit Podcast, Episode 20, Transcript
Sarah (00:47):
Well, hi Lisa.
Lisa (00:48):
Hi, Sarah. How are you today?
Sarah (00:49):
I'm good. And I just realized, I feel like this is my podcast voice.
Lisa (00:54):
I recognized the sultry underpinnings.
Sarah (00:58):
I always thought I should be on radio. But I don't talk like that ever. I will say-- so I listen obviously, to every episode we publish. Cause that would be weird if I didn't, and I hate the sound of my voice.
Lisa (01:12):
I hate all the ums I do.
Sarah (01:14):
Yeah, I know.
Lisa (01:15):
But that would require an actual editor to get those out. So everyone's just going to have to live with it.
Sarah (01:21):
I agree. A lot of ums. I talk very fast, especially when I'm excited about something, or if I think I need to hurry and make a point. So my apologies. I'm working on it. Yep. So the last episode we did was the one with Kelly on the speech sound norms. Did you have any idea it was going to be that popular?
Lisa (01:44):
Well, even just the reaction to the article itself, I had a sense that maybe this would be kind of well-received from that aspect of people just wanting more information. I think we are a group of problem solvers, as SLPs, that if I'm doing something wrong or if I've been interpreting norms in the incorrect way, just tell me how to do it and I'll work it out. I'll learn and change what I'm doing.
Sarah (02:09):
Yeah. That was a really eye opening episode for me in a lot of ways, because I think in particular, I always felt very strong about my ability to qualify a student with speech sound difficulties. That was never anything I struggled with. I just didn't realize that I was probably looking at norms incorrectly.
Lisa (02:29):
Or even just some of the connections of how she pointed out what those single sound errors can really bleed over into other areas of academics. But that's the thing, we can get to that point where we learn something one way and then we forget to keep on learning. Or, say we're too busy or whatever. So I love having the opportunity to pull out some of that. I love resources like the Informed SLP, because then I can get highlights that keep me on my toes.
Sarah (02:56):
I hope everybody read the blog post that she did on the topic.
Lisa (03:01):
Meredith.
Sarah (03:01):
Yes, because she's the one who really had the idea. When she saw the response to that infographic that everybody had-- a lot of feelings about that infographic. And so she saw that right away and realized that there was definitely discussions that needed to be had on it. And so that's when she had brought up that idea of having us record the episode with Kelly, who's a researcher in that area and had a lot of information. And so read the blog post Meredith did because it gives a lot of clarification. I think we packed a lot into that episode. We probably need to unpack it a little bit and highlight some of those areas more specifically. Even just talking about alright, so if we are going to pick up these kiddos at five for R, and we might need some more tools in our tool bag to be able to treat that sound. Especially with a kiddo who's just younger and needs a different approach than maybe a child who's cognitively able to handle more. So we're going to get somebody on for that.
Lisa (04:03):
And we're hoping too to involve courses when we are mapping out future SLP summits, to have people that can help us learn some new tricks when it comes to those harder sounds. I think /th/, "bite your tongue and blow" I can do that all day.
Sarah (04:16):
Or the "s" lisp. Keep their snake in the cage people. How many times did I say that to kids?
Lisa (04:22):
Do we have to mark this x-rated now?
Sarah (04:25):
I know it is kind of a questionable cue, but it worked. I would tell the kids, your tongue is a snake and you need to keep it in its cage. Your teeth are the cage, keep your tongue back in the cage. It worked!
Lisa (04:34):
Maybe snake in the aquarium.
Sarah (04:39):
They're six, I think we were fine.
Lisa (04:44):
You could be teaching vocabulary too.
Sarah (04:45):
So anyway, yes, some sounds are much easier than others. So we will, we are going to tackle some of those more difficult speech sounds and give some more information on that. I also think there's going to be a lot coming out now talking about how we approach districts and maybe we need some new guidelines and some more information to be presenting to districts. And so I think we're going to be seeing some things come out.
Lisa (05:07):
Well, and I will say in general, my experience in the role that I had as a lead SLP, I worked with a lot of directors closely. And it's usually how you ask that makes all the difference. If you come prepared with data, with rationale and not just like, "well, I want to do this" and you don't have any kind of evidence to back up. They're super data-driven period. If you think about how they're always looking at reports and numbers and grades and test scores and all that kind of stuff, they like data. So if you can come to them with actual evidence on this topic.
Sarah (05:37):
Well and when ASHA writes guidelines, those are always really, really helpful. So I think we're going to be hearing and seeing more about this. It's just the beginning. And so I'm glad. I'm excited. I think we're all-- we talked about this on the last episode. We like having information and get comfortable with guidelines and things that help us to do what it is that we're supposed to be doing, which actually segues perfectly into today's confession. Actually, that was an accident. Sometimes it just works out. I think we've told you guys, this is totally unscripted. We have an idea for a topic and then we just go with it. So I like when that happens. But anyway, it's that idea of when we're qualifying-- not qualifying students, that's the easy part. When we are doing the testing and determining whether or not a student qualifies for services, which kind of addresses what we talked about last time in qualifying students at what age for speech disorders. The testing and procedures of that are somewhat systematic and we have a plan and we know what we're going to do to attack that. When we go to write present levels on students, that is a whole different ball game, and there's a lot of things that impact it. And first and foremost, the fact that we have a wide range of ages and diverse needs, and we have to know something about everything if we're truly gonna write this comprehensive present level on students. And so guidelines, things that help us to be able to gather that information effectively is really, really powerful. And so that's what we really wanted to talk about today. Do you want to do some confessing about how you used to write present levels?
Lisa (07:16):
Well, if it wasn't an artic kid, it would go a little something like this: I used to pull things out of my bleep and put that in the present levels. And it was either really brief or really vague.
Sarah (07:28):
I can't believe you did that.
Lisa (07:30):
What? pull things out of my bleep?
Sarah (07:32):
I can't believe you just pulled things out of thin air. You didn't have concrete data?
Lisa (07:36):
I'm probably the only one that's ever done that ever. No, that's the thing is it was because I didn't have the data and I didn't really know how to get the data. And so it led to-- the problem with that is when we are looking at the IEP as just paperwork we have to do-- because we know our students and we're going to pick out some great goals and everybody needs vocabulary. I mean, that's important.
Sarah (07:59):
All students need to work on synonyms.
Lisa (08:00):
Yeah. But the problem is that if we can't articulate why, or have it really connected to data that we have, it just opens up this Pandora's box of trouble. So if you're in a meeting with-- I always think of those fun meetings that are involving an advocate or an attorney, then that's problematic if you can't answer why you picked those goals. And they will. That's specifically what they're looking for in those meetings is data. They want to know how you got to something and then if you don't have it, that's when they tend to throw in some of their "I want" statements and guess what happens? The district sides with them. Because if we don't have the data as teams to support our recommendations, then that means that if it ever went to court, we would not win that case. And so that's oftentimes why districts sometimes it feels like they're always siding with parents and whims of advocates or attorneys, but that is really what it all boils down to. If the team-- even if they know this child and have the child's best interest at heart, if they don't have data to support it, you're screwed.
Sarah (09:06):
Right. And one thing I did always know is that the present levels drives the rest of the IEP. That PLAAFP section in the IEP is what's going to drive service delivery and times, and the setting of services and goals and accommodations, and we need a really thorough present level in order to identify those areas of need that need to be accommodations or goals or whatever they are. So that part I didn't question. What would happen as I was go to write present levels, typically it would be at the last minute. Even though I should've been working on it a couple of weeks before the meeting and getting all this input from teams and hopefully sending it home for parents to look at.
Lisa (09:49):
Now I'm calling you out. You wrote things at the last minute?
Sarah (09:52):
Yeah, I did, Kathman. I know. That's what I'm saying. Like, this is a confessional.
Lisa (09:56):
Like, I have an IEP after school today and I have--
Sarah (09:59):
I'm gonna write it right now. Yeah. That just was the reality of the job. Now, I am a terrible time manager and a procrastinator by nature anyway.
Lisa (10:07):
Or I just get motivated by timelines.
Sarah (10:09):
I do. That's true. That's a positive way of looking at it. So that is true. And some of it's that. But some of it is also, I just was a hamster in a spinning wheel. And so I did things as I could. And usually it'd be the morning of an IEP. And so what would happen is I go to write this present level section, and I start looking at all the data that I do have on this child. If I've been fortunate to have worked with them up until this point. And he didn't just move in yesterday and his IEP is due. I look at the data and oftentimes the data that we have is whatever those goals are that we're targeting right now. That's the data I have. I may not have had other information that shows that whole picture of all their communication abilities.
Lisa (10:49):
It's always zoom in, zoom out. I think when we're working with students, we're so zoomed in on what's happening right now that we forget to zoom out and look at that kid as a whole. And so the IEP is meant to do that. That's when you're supposed to be zooming out and saying, okay, at this moment in time, what does the child look like? What are the strengths and needs from not just a communication perspective, but behavioral, academic, social, emotional, all of those kinds of things. And I always think too, we're supposed to be looking at those accommodations and that's supposed to be really detailed to in the moment, but nobody ever does that. I've seen some IEPs where it's a laundry list of accommodations that was started in preschool, even. They're in third or fourth grade and still have the same accommodations, which when you say that out loud, that logically doesn't make sense that what a child needed when they were three is the same as what they need when they're eight.
Sarah (11:41):
Right. I think it always goes back to it is this moment in time. And so I think we're all kind of guilty of, we've also taken present levels of past IEPs and tweaked them and changed them a bit. That isn't accurate either. A whole year has gone by. Things have changed. Goals. We shouldn't be taking goals from last year and just bumping them up like, "oh, he didn't master it. So I'm just going to say that he's going to do it with a higher percentage of accuracy now." Didn't master a goal in a year? We need to take a hard look at why.
Lisa (12:12):
Well, and we should have looked at if that was happening even in quarter one
Sarah (12:17):
Exactly, it shouldn't be a surprise a year later, that he didn't master it. You should have known along the way that something wasn't right, and then looked at why. Was the goal just too challenging? And we needed to work at some level-- go down a few levels and target a different skill? Whatever the case is. So there's all of these red flags that happen when we're writing IEP's and we're not using data and thinking about where they are in this moment of time.
Lisa (12:42):
Well, and beyond the fact that I've switched my view over the years. The IEP is really this child's story. So even if we look at it as just a paperwork hoop, it's telling the story of this child, that if they move on to another school, another SLP or even just for purposes of if they're yours for the whole year, but the parents have a good understanding of all of the things that their kid can and can't do. And then we're showing how we're supporting that student. But besides the fact that it should be personal and it is more--
Sarah (13:15):
individualized, big capital I.
Lisa (13:15):
than just paper. This is actually supported in statute now, too. So I know we get the opportunity to travel across the country and speak to groups of SLPs. And one of the questions we always ask is if anyone has heard of the Andrew Case, which is a case that went through the Supreme court, and we're actually coming up on the two year anniversary of when they made this ruling March 22nd, 2017. And just a little bit of background and I encourage you to check it out and we'll actually link to we wrote a blog post when they enacted this ruling or whatever you say, judged, ruled? I don't know.
Sarah (13:55):
I only watch SVU. Is that what it's called? Law and order is where I get all criminal information.
Lisa (14:01):
I thought you were going to say "I only watch Bravo TV."
Sarah (14:01):
So I have no idea how this works in the court system.
Lisa (14:06):
No, so, but what was interesting about that case is it was based on a student that had been in a district in Colorado since preschool and ended up by fourth grade, the parents felt like his academic and functional performance had just stalled over time. And that his IEP's were really looking similar from year to year. So they kind of called out the district and said, this is not acceptable. So when they tried to work with the district, it didn't work and they decided to pull their student out and put him in a private school. And he made really good gains in this private school. So then the parents said, well, you're going to pay for this because he can make progress. You weren't giving him the supports he needs to make progress. And that's what started this chain of lawsuits basically. So the way that it works, even for something to get up to the Supreme Court is you have to go through all of these lower level courts before you even have an opportunity for something to be presented there. So all of the lower courts ended up siding with the district saying that in statute, currently in IDEA, that a student has to make progress but how that's defined is not really clear. So they said that the district could show he was making progress. They ruled with them. So it finally went up to the Supreme Court and they unanimously determined that they sided with the parents and said that really the wording that they used is that kids have to make more than de minimis progress on their goals. And we have to be introducing rigorous goals.
Sarah (15:43):
I'm sorry, de minimis is Latin for what? Minimal?
Lisa (15:48):
Minimal.
Sarah (15:48):
So they have to at least make minimal progress?
Lisa (15:51):
They have to do more than de minimis. So that's what I think they were saying that even if the district had data to show he was making some progress, the Supreme court said, no, that's not enough. You have to do more than just some. And so because this is a Supreme court ruling, that's why I'm saying you definitely need to check out more about this because it impacts everyone here in the United States. It's not just-- you know, a lot of times with lawsuits of any kind, but especially in schools, what they'll do is they'll look at local precedence on how things have ruled in those lower courts, but Supreme court is what everyone will go to. So that is what it established. And so I think where we see this a lot-- it really boils down to that individualization piece. And so when we're talking about like what we were talking about before that the IEP just looks the same, or it's really vague or basic or vague or vague, I don't even say vague. So I don't know where that came from. If it looks the same from year to year, or if all of your IEP's look the same, then you're really going to be in trouble. So that's where even like I was working one day a week last school year at a school district that was mostly artic kids, some were language and artic, but no matter-- and some were just language. And I think I had one fluency student. But within that day, every student on my caseload had 30 minutes a week of speech, which doesn't make sense because they were all ages. They all had different needs. I had some students that just had one goal. So maybe that makes sense for one goal, I had other students that had four goals. It was impossible to meet the needs and make progress on that IEP with just 30 minutes a week. So we really need to be looking at making sure that our IEP's, are reflective of, even in terms of developing them, but our service time too, it has to be individualized.
Sarah (17:52):
Yeah. Yeah. And that's the thing is I always hope everyone knows this. If you've been listening or know anything about us up until this point, you know this. But we are not being judgmental about how people have been writing IEP's cause we did all of it. So, and I think that's the thing. We're the first to throw ourselves under the bus. There are times I question if we should be doing that because I've had some moments where I think God do people just think these girls are total idiots? Maybe. But the reason that we do it is because we-- and why we do everything we do is because we know. We had done it ourselves. We have struggled with these things ourselves. And so we didn't like it. We didn't like the way it felt. I didn't love writing present levels that were basic. And I always had kind of like these sentences I would use. And it would always start with something like this; Michael receives speech services once or twice weekly. He always comes to each group on time.
Lisa (18:53):
with a smile.
Sarah (18:54):
and is cooperative. He is a pleasure to work with. Michael has been working on, you know, whatever it is and is making great progress
Lisa (19:02):
The end.
Sarah (19:04):
Right? Like what that is. And I'm telling you, I did this. So I know — what is that telling anyone other than he's lovely, but that's not going to help guide anything, right? Or you would have the kids where you've got a laundry list of needs and you know those, so that is helpful. That is helpful. I know all of his needs. And so I list them all out and then I got nothing for strengths.
Lisa (19:29):
Right.
Sarah (19:30):
So that's where you would get those vague, like Michael, it's a pleasure to work with and has such a shining personality. The point of it was I didn't have enough information to be able to write objective data. And so I used fillers and I use fluff and I used all these things that I knew. I needed some words in that section. So I kind of had to have a hard look at what it was that was my problem. Why was I struggling with this so much? I mean, one: clearly went until the last minute, never a good idea. But if it wasn't that, if I actually had spent some time thinking through what I needed comprehensive information on areas, different areas, I didn't know how to gather it other than looking at the data I had on current goals. And maybe hopefully that I took notes sometime along the way, maybe pointing out some other things that I noticed like “Oh man, I didn't realize he's really struggling with this.” You know, hopefully that's on a data sheet somewhere. But when I needed to get that comprehensive information, I actually didn't know where to go. And so oftentimes I would pull like a help book off the bookshelf and maybe quiz him in some areas . How did he deal with it? How does it vocabulary? And that’s so concrete and easy. So we just do it. But we also know our kids do struggle with vocabulary. So it's usually a safety net. But I would kind of pull some random things I had to gather information but it was grasping at straws. And so that's when it really came down. We knew there had to be a better way. I remember at one point, especially as more and more things started coming online and more and more resources became available through blogs and teachers and things. I do remember finding some screening tools and I thought, “Oh, these are super cool. Like at least I've got some questions and prompts and things to probe, right? That's going to help me gather this information I need.” But then I would look closer at the screening tool. And I would think it's like a K through sixth grade screener. Kindergartners and sixth graders are very, very different. And I don't want just like general knowledge. I want to know what the child's communication underpinnings are for where he's at right now, because everything I do has to go with that idea of ‘he needs to be able to access curriculum’, right. And so that didn't always sit well with me when I would look at these screening tools that were available, that there, you know, that is broad communication skills, yes. But is it going to give me really detailed information that's gonna help me right now in this moment of time, help this child access his curriculum? Probably not necessarily. I think the common core standards really changed the game. They broke out all of those communication underpinnings. They gave us the listening and speaking section.
Lisa (22:19):
And the language.
Sarah (22:21):
Yeah. So I think that kind of gave us that guideline of what it is that we should be looking for to help support students in the classroom. And so that's really where this came from. We thought we need to come up with some informal measures that just guide your thinking. They do not replace your clinical judgment. They are not norm referenced assessments. I am not comparing Johnny to another student. I'm just comparing ‘what is Johnny able to do right now?’ And so that's where we came up with and we named them present level assessments because that was the idea. I wanted an assessment that helped me to write comprehensive, present levels.
Lisa (22:54):
Well, and I think I was like, you, I inherited, you know, being in the field forever, you always have these awesome mentors, wherever you go, that will share materials. And I remember inheriting some screening assessments and it was the same thing, like K through six, where I was like, “well, that didn't make sense, but it's better than nothing.”
Sarah (23:13):
Right.
Lisa (23:14):
So I would still use those. And then the trend that I saw when common core first came out is then new screening assessments would pop up, but sometimes they'd pull just the standards.
Sarah (23:22):
Right.
Lisa (23:23):
I think those are a starting point.
Sarah (23:24):
Yes.
Lisa (23:25):
But our role is not to teach the standards. That's what the teachers are doing. We have to look at the communication underpinnings of how, where are their strengths and needs are and how that relates to how they will access and perform on those academic standards. So I think that was what was unique about our role. And when I saw some of the screening that came out, sometimes they would pull word for word what the standard said. And then also didn't look at it from the perspective that there would be one for each grade level. And those standards are what the students are supposed to know by the end of the year. So if I'm pulling out second grade standards, common core standards, and then trying to see if a student could do that because they're in second grade, they shouldn't be, they need to be able to acquire that skill by the end of the year. So that was kind of my thing. And then the biggest a-ha came as we were developing our present level assessments when we were like, “but why is this an issue?” Part of it is understanding. I think just understanding what our role is and that whole idea of everything we should do should be geared towards that idea of access. But it also goes back to the point that you had made earlier that with evaluations, we have a system. So if I have two different students and today is Wednesday and for each of those students, I have something different to do. By next Tuesday, they both have a due date. One has a due date for an evaluation. One has a due date for an IEP. I will be pissed as I have five days and it sucks. But with the evaluation, all I have to do is find time. I know exactly what to do with that student. I'll pull out my standardized test. I'll do a language sample, I'll do a classroom observation. I have this process and system that will give me the information I need to write up that met report. Student B with the IEP due, this is the one that makes us all panic and you start to make those statements like, how the heck am I supposed to write an IEP on a student that I don't even know?
Sarah (25:24):
Right.
Lisa (25:25):
So that was where even like the idea of present level assessments, we started talking about that there really is no system for writing these IEPs. Everybody has the same template. We all have to include present levels and goals and accommodations and medical information and all of that kind of template that we fill in the boxes. But there was no systematic way to collect the data that we need to really write this story for this child. Right? And so that's where, when we developed those and really, we spend a lot of time. It was a combination of, for the younger kids, we use developmental norms as far as they would go. For the older kids, we really were unpacking curriculum and standards, and looking at what are the types of things and skills they have to acquire throughout the grades. And when we were really looking at it from that lens, we determined that doing it by grade band was a better way to formulate these tests versus specific grades. When one by one, and that's a question we get sometimes is like, I wish we had like just for each grade, but when we were looking at it from that perspective, that's why we decided to go with the band. So our bands are narrower for the little kids because the skills were drastically different from preschool to even kindergarten. Then we moved up into, we have a screener for first through second grade, third through fifth grade, six through eighth and ninth through twelfth. And it gives you so much information. But with that being said, it's not the end all be all. This is all being filtered through your clinical judgment, what you know about the student, the information you have from the team. But it gives you this foundation of, I can collect a lot of information and find out a lot about the student just by using this assessment.
Sarah (27:11):
Yeah. And, you know, it's funny when we first started building out this app, you know, our original idea, it all kind of focused more around progress reports than it even did this present level section. And it was about, it was going to be it's about saving time. We know how overwhelmed SLPs are and the paperwork and all of the craziness and all of that. So we really want to just save them time.
Lisa (27:33):
I will say we did that with the progress report. That is awesome.
Sarah (27:37):
But what I was starting to say is we realized how are you even getting to writing progress reports? How are you even getting to picking goals? How are you even getting to that? So that's where this — we thought we've got to go back a step and we've got to write some kind of screener that's going to allow us to get the information we need to determine goals. So we had to back it up a minute and then we realized, now we didn't maybe save time for everyone. The whole app was all going to be about stringing, you know, streamlining all of these things to save time. And then we realized, no, we probably just gave you an extra thing to do. But here's how I look at that is I would rather spend the 30 minute it takes to assess a student using the screening tool than the 30 minutes it's going to take me to bullshit levels because that's what it was.
Lisa (28:18):
Or you do scramble.
Sarah (28:21):
I would waste so much time making shit up.
Lisa (28:24):
Yeah.
Sarah (28:25):
Why is that a better use of time? Like that's terrible. And again, it never felt good. It's not like I had that personality where I was like, Oh, screw it. I'm too busy. Yeah. I don't have time. I'm just going to do the best I can. I didn't have that mentality. It was just this panic and scramble and guess that I just did because I was doing the bestI could in that moment and, and really just kind of in survival mode and I didn't have a better way.
Lisa (28:49):
Right.
Sarah (28:50):
And so having, you know, so yes, I need to spend like 30, maybe 45 minutes even using one of these assessments to work with this student and gather this information, but then guess what? Now my present level section is easier to write because I've got strengths and needs that I copy and paste into the present level section. And then all I have to do is tweak it, make it more of a narrative.
Lisa (29:10):
And that I can explain.
Sarah (29:11):
Right.
Lisa (29:12):
That I can literally come in with my recommendations with data that supports my recommendations, because I know like when we do our talks across the country, I always love when you there's this one part where you're like, “please don't ask me why you picked those goals”, like sitting in meetings and praying that, you know, nobody asked me why I picked this because I really can't answer that.
Sarah (29:31):
Right. I couldn't answer it with evidence.
Lisa (29:35):
Right.
Sarah (29:36):
I know really good that like we've got that skill that allows to see things and like figure out, you know, our needs and our clinical judgment like experience. I mean, it does help. The more we do it, we see things. But just get, don't ask me to show you proof of why they needed that.
Lisa (29:55):
Well, to me, it's like math. Like when I learned math, I was great at math and I loved getting to the solution. But if you would have asked me to explain how I got the answer, right. Not in a million years.
Sarah (30:06):
Right.
Lisa (30:07):
And so it's that kind of like critical thinking piece where you have to step back and meta analyze like your process as far as, why am I thinking this way? Like what is leading my clinical judgment in this way? And if we don't have enough data, that's where it gets tricky. And not just for purposes of developing the treatment plan, but if we're not really picking goals and targets to work on that are individualized to what the student really needs. And so that's kind of that, that prong of “we'll get the strengths and needs from an assessment like this.” We have to connect that in with what really is going on in the classroom. Where's the kid struggling in the classroom. And then how can I best support based on all of this? So whether that be then I'm writing a goal, or maybe I can work with the teacher on some accommodations that she or he can implement the classroom. And then one of the other things that I think was for us super important as we develop these is we have these kind of subtests that have more splinter skills where it's something really language targeted. Like maybe it is naming synonyms
Sarah (31:07):
Categorization, inference.
Lisa (31:09):
Or those kinds of things. Right. And that gives you a lot of information, but one of the things that is huge, and we know this even from, you know, what research tells us this connection of how students perform on a language sample —
Sarah (31:19):
Contextualized.
Lisa (31:21):
Right. And how that connects into how they're performing academically. So we really wanted an opportunity for every student on our caseload that has a language based learning disability to really get a language sample and see how are they using it. So we have opportunities to collect a language sample in conversation. And then depending on the age of the student, another opportunity to either do like a picture retell or a narrative where they listen to a story and retell it back and answer questions about it, or some informative sort of texts.
Sarah (31:53):
Yes. But we're not saying that you do a language sample, write every single word out, transcribe the entire thing, then run it through a program like Salt and analyze it. And dah, dah, dah. No, we're not doing that. I mean, again, that we're still in the real world.
Lisa (32:08):
Right.
Sarah (32:09):
You know, but I love the language sample part because that's where we get the most information about students' abilities to use their language. And so, and then you can, here is there are tic issues. Am I hearing grammar issues? Am I hearing, you know, so you've got all of this information. And so I love our language sample section because it's guiding questions again, it's a guide that just helps you think of what should I be listening for while the student's having a conversation with me now, I do make notes in the notes section where I actually write out as much as I can, because I like to have that as a reference as, as when I want to maybe analyze it a little bit more. But at least like while that child's talking, I'm just going through those guiding questions and making some notes
Lisa (32:48):
Right. So the guiding questions, what we have, even for like the conversation example, we will have some prompts that you can use, or you can use your own and just engage the child in conversation. But then you're either thumbs upping. if the child is doing something well or flagging it, if it's an area of concern and its questions, like did the student use sufficient details? Did the student use correct grammar? Did the student have any articulation errors, things like that where you're looking, did they use specific vocabulary? Are they organizing, you know, the information? Are they using sentences —
Sarah (33:21)
Like that reference, right? Those kids who like start telling stories from the middle of nowhere,
Lisa (33:23)
Is the sentence length an expected sentence length for this child's age? So these are things, again, you need to use your clinical judgment to determine if it's a flag or a thumbs up, but it helps you not forget things. So even think of one of the actual present level assessments that we created that is not just language based. We have these for other areas, but we have a classroom observation, and that's the best analogy I can think of like where this language sample connects into, because when I would go in and do observations in a classroom, they were pretty much all where the child was sitting.
Sarah (33:56):
Does he raise his hand?
Lisa (33:58):
Yep.
Sarah (33:59):
Is he playing with his pencil?
Lisa (34:00):
Right. Because what else am I looking for?
Sarah (34:02):
Looking at things on the walls?
Lisa (34:03):
And so I think it's not that we don't know things. It's that we forget to kind of look for them in the moment. So we have this really amazing classroom observation tool that — for sure check that out. It really helps when you're in the classroom in real time, be able to thumbs up or flag certain areas and then gives you a lot of information. Again, this is all data then that can support recommendations for treatment.
Sarah (34:24):
And that's why it goes back to walking into an IEP meeting, feeling like a boss.
Lisa (34:29):
Yeah.
Sarah (34:30):
Versus how I used to walk into IEP meetings. I mean, even five, six years in, I would walk, I dreaded every IEP meeting, dreaded it. And again, I actually think I was a really good therapist.
Lisa (34:39):
I think you didn’t want to look stupid.
Sarah (34:42):
I would panic that maybe I wasn't as prepared as I should have been, because I did kind of maybe, you know, rush the writing of the IEP and maybe I don't have concrete evidence and data. And so they're going to see that and they're going to ask me something, and I think what it comes down to is I've always been this way. If you put me on the spot I freeze. So if I'm not prepared for something, then I might not have an answer for it.
Lisa (35:05)
Right.
Sarah (35:06):
And it's just a really crappy feeling.
Lisa (35:07):
Right.
Sarah (35:07):
That I'm not prepared enough to walk into this meeting confidently and report this, what I know. And even if I felt super strong about this student, BEcause I've worked with them for a long time. And I do know them very, very well. If I didn't have like some really concrete data to share it, I walked into meetings feeling really just gross and here's the deal. I think we're all great talkers and resourceful and problem solvers. And I think we actually do well in these and it's not like I've ever sat in a meeting and somebody did, You know, call me out. And I, you know, looked like a fool. That never actually happened.
Lisa (35:44):
I have sat in meetings with, but I think when their emotions involved. So whether it, maybe there's a teacher that you know, is like maybe more of a difficult teacher to work with, or we have parents that can be more vocal and ask a lot of questions. Or again, going back to attorneys and advocates, where for me, if there was ever an emotional component, it was like, I forgot everything in life that I ever knew.
Sarah (36:05):
I did have some moments like that. I'll never forget. I had another specialist who was for TBI in an IEP meeting. And she asked me some direct questions I wasn't ready for. Had you just been having a casual conversation with me, I could have answered them, but because they're got all of these people now looking at me, I wasn't ready. I froze, and I know I looked so incompetent. And so that's what it goes back to is once I had used these assessments to gather all of this information, I walked into meetings feeling so confident because look, here, let me show you, let me show you exactly what I'm seeing and what this means. You know? And then I was not going to, I could spend more time talking about what this means, you know, versus pulling this stuff out of complete thin air.
Lisa (36:49):
Well, and I love, we get testimonials from users that will write us and we love them all. Please send more. We like them. Yeah. but no, one of my favorites was somebody who was specifically referencing using present level assessments and our progress monitoring tools. And she said, I'm going to go into that meeting and speech pathologize the shit out of it.
Sarah (37:06):
Yeah.
Lisa (37:07):
And I was like —
Sarah (37:08):
One of my favorite quotes to date.
Lisa (37:08):
It was literally amazing because that's how, you know, I think what happens often is we are looked to as the expert on campus and we don't always feel like the expert.
Sarah (37:22):
In all areas.
Lisa (37:23):
Right. We have to know everything about everything. And if people ask you questions about it, you know, it just, it puts us in this kind of spot that can be tricky because if we either, I think we are all experts when we're working like with a child, we may have a different lens, but we're all looking at the same set of data. So if we can come in with this unique set of data that can help the team and the parents, you know, who are part of the team, but you know, the parents and the teacher really understand why this is happening because to me, access to curriculum is, or even not kids in special education, everything that they learn or everything that they demonstrate learning of is a direct correlation to their language abilities. Because if you can't understand something or express yourself in a certain way, then it's impossible to access curriculum,
Sarah (38:16):
Right. That data that we've taken is powerful and can, and can really drive a lot of the IEP because of those connections that we then can make. Well, when the resource teacher brings up the, the difficulties that, that child's having in an academic area, we can say, yeah, I can tell you why. Look at this information I found out, I discovered that he's really struggling with this. And that's super powerful and who doesn't want to impress the IEP team.
Lisa (38:39):
Right.
Sarah (38:40):
Like it's such a cool feeling when you're like, just I've looked at all of this data and I'm gonna show you all of this stuff and they look, they do, they look at you like dang, she knows her stuff.
Lisa (38:51)
Do you remember that one SLP that wrote in to us and said that she actually didn't want to share that she was using SLP Toolkit with the rest of the SLPs in our district because they just thought she was super smart and she just wanted to keep it? (Scattered agreeing.) I am that smart. Here's the thing, we're all smart. We wouldn't have gotten through grad school. We wouldn't be doing the amazing things we're doing with kids. If we weren't smart. It's just that whole idea of sometimes we can feel ill prepared, which then, you know, knowing us SLPs where, you know, that's an icky feeling. Nobody wants to feel like that. So if I can feel confident and feel really good and have those answers, right, there's no better feeling.
Sarah (39:27)
And we are smart, but we can't know everything about everything. It's impossible. And so if I might be really great with speech sound disorders or maybe working with, with children on the spectrum, but I am not super strong with maybe a different area. And I still have to write an IEP on that. Like we talked about stuttering a lot. If I have a student that I have to work with with stuttering —
Lisa (39:47):
I call Nina Reeves.
Sarah (39:48):
Exactly. You know what I mean? That's not my strength. And so I still have to write a really great present level on this student. And so having something that will help guide my thinking so that I can do that, that doesn't make me a bad therapist. It's just that I can't, again, I can't know everything about everything. I think that my favorite present level assessment is the functional communication present level assessment. That's for students that have more complex communication needs. That was always a very area, difficult area for me. Because again, I could tell you a lot of what they can't do, but maybe I didn't have as much information about what they can do, which is just as important. And not only so we keep meetings positive, but also because I need those strengths to help guide those, you know —
Lisa (40:31):
Build those weaknesses.
Sarah (40:34):
The areas of need, right. And so to be able to have that guide of all of these things that I can be looking for, it is amazing. The information you find out about those kids and be able to take into this team and say, Hey, they can do this and they can do this. And look at this. They can do, you know, here's the areas I'm finding where they're struggling and there's some difficulty, and those are the things that we want to tackle and target. And so that, again, that's what this all comes down to is just having this, this guide that helps you to gather really comprehensive information in all areas of language. I've got a CF right now who's I mean, first of all, the, I swear, these graduates came out like 10 times smarter than I did. She's just super great and competent in so many ways. But one thing I know I have to read every IEP and one thing I looked at, you know, early on and that, that one thing I had to point out to her is sometimes we just focus on those areas we're targeting and we forget to, again, zoom out on all areas. And so maybe if it was an articulation only child, she would only talk about the speech. Or if it was a language student, but then she doesn't address articulation and social language and, you know, voice and fluency. And even if it's a one liner, like we still need to consider all areas of language.
Lisa (41:51):
Not just language, if we're case manager, we're also making those strengths and needs related to again, behavior yeah.
Sarah (41:57):
Academics. Yep.
Lisa (41:59):
Social.
Sarah (42:00):
Yeah. And so you need to get that information, obviously for academics, we want it. That's where we want to talk to the teachers and get the information for those sections. Social language, there's the present level assessment for that that we came up with that really guides you and get you to get a lot of information. Now those aren't assessments I would use with the child. It's more of a, kind of a checklist that helps me just think of what it is I should be considering.
Lisa (42:21):
But the language ones you would definitely use with a child, and we have some articulation ones that you would use with the child.
Sarah (42:28)
So here's the point. You go through these at the very end. And like I said, you get these strengths and needs. Now I can look at these needs. And as a team, we can decide what goals we want to write to help support them. I am not going to write a goal for every area of need. It might simply just be an accommodation, or it might be something that the resource teacher supports, or it might be something that, you know, another specialist supports. And it's not me.
Lisa (42:51):
That is a big, that was an aha for me though, with that whole idea of you do have to address all of the needs that you put in there, but it's not necessarily with goals, like you mentioned. But you can't do this laundry list of needs and not say how it's being supported. So it could be like you said, accommodations, goals, you determine that.
Sarah (43:10)
Even just a sentence in the present level.
Lisa (43:12):
You might have a student who's artic only, and maybe his academic need is math. Well from an IDEA perspective, you have to support all needs for that student. And it doesn't mean that you have to write a math goal. If that student is maybe receiving small group instruction in the classroom or targeted interventions where they get pulled out, like with kind of like an RTI kind of model that they do for the school. You just have to note that because I think one of the biggest things that we often do is leave that in as a laundry list. And don't say how we're supporting the student,
Sarah (43:44):
Right. Yeah. So I think that's the value there is. I don't want to be asked, why did you pick this goal? I want the data in that present level section that will drive the rest of that treatment plan. And so we hope that this is a solution for you. If you have not ever checked it out, just know you can sign up for free and get access to all of our present level assessments and use them with up to five students. You know, we've, we've talked about this off and on. If we're ever going to change kind of our trial, you know, it's, it's not a time based trial. It's forever. You can use it for ever for free for up to five students. That's been a discussion for the last three years. We talk about these kinds of things. And here's the deal. We want people using it.
Lisa (44:23):
Right.
Sarah (44:24):
And so that's why I don't see it ever changing. We really, you know, if it's not something that you need to use with an entire caseload or you can't get your district to pay for it, which we highly recommend you encourage.
Lisa (44:35):
And we have resources for that, so reach out if you need some help,
Sarah (44:37):
Then at least you have access to these assessments for free. And so check them out, use them, see if they give you that information that you need.
Lisa (44:43):
And we also, we can attach to this blog post too — we created a way to scaffold your thinking for kind of breaking up all of that data that you have. So we call it a meaningful IEP worksheet where you're really looking at well, what's the data you collected, maybe through a present level assessment? How does that connect into what the teacher's saying? And then it really helps you break down like, well, what's the best way to then work on the need areas? Is it more of a goal? Is it an accommodation?
Sarah (45:08):
How much service time should I look at?
Lisa (45:10):
Right, because that's where that individualization with service time, it should be a direct relation to, well, how much time am I going to need to do these things?
Sarah (45:17):
Yeah. I'm glad you mentioned that because you're right now, you've got all this great data, but again, you're going to have to use your clinical judgment to decide what you're going to do with it.
Lisa (45:25):
So I always found that was helpful for me to do it a couple of times just to get my thinking, working like that. So maybe I wouldn't pull it out on every student, but it just helped me walk through that process. I did it every time I sat in one of the difficult, more difficult meetings, because again, I knew I'd probably probably be in my emotions. And what it saved me from to is in those kinds of harder meetings where you have questions being asked, or like attorneys or advocates that are saying, well, we want him to work on this or a parent, even sometimes they'll just throw out this random I want statement. I would always kind of like point to the worksheet and make it about the data on the worksheet. Where, where does that fit in? Because that's not one of the needs that we have on here. So it just helped me justify it where I wasn't just saying, I think he needs to do this, or he may need to do this. (Scattered agreement.) It was really data-based, which that's very hard to poke holes at. So yeah, definitely check that out.
Sarah (46:23):
Yeah. And again, that's it, we've just kind of identified now that we've got this concrete way to be able to get strengths in needs. And like I said, then, then you need to use your clinical judgment to decide what to do with them, but then there's also this huge big component about what does it all even mean? Like he's struggling in all of these different areas and what are the implications of that? And so that's something that Lisa and I have been looking into also is, is really trying to figure out what these things mean and how they impact. So again, like, it's great to be able to walk into a meeting and have this data to present, but then you still, you're still gonna have to make those connections. You know, and, and what does it mean when somebody struggles with synonyms and antonyms? How does that affect them? You know, what, what part of vocabulary is that, you know, as far as like, when we start talking about semantic relationships, and so if kids struggle in that area, what does it look like? And so, so there is, there's a lot more there that we know that this is just kind of again, about the collecting of data. And so we're always looking to find better ways to help break down all of these different roles, parts of our job, those things, again, it's all we want SLPs to feel confident. That's what it's all about. And we hope you do because you're smart and you're awesome. And you do amazing things. And then we're just going to try to keep working on tools that, that help you really feel that you feel that. Yeah. So anyway, that's it, Hey, couple of things, one thing we never say and mean to is will you rate and review us? I mean, again, if you have like nice things to say on iTunes, you can do that. Like, you know, check how many stars would you think we're worth or leave us a review because that will just help us to get more, you know, getting reachable.
Lisa (48:08):
Right. I even think of when I am looking for podcasts, not even speech related, I look at the reviews and rating. So it helps me determine if it's something that I want to listen to. So if you're loving the content that we're sharing, please let us know in those ratings and reviews.
Sarah (48:22):
And if you have ideas for future episodes, we love those. If you have questions, we'll talk about anything. It's a confessional and we have no shame apparently.
Lisa (48:30):
So you can email us@podcastatslptoolkit.com and so share those ideas for what you'd like us to talk about. If you have any guests that you think would be awesome, we bring people into the confessional. So we would love those kinds of ideas. If you have actually, we're going to do an upcoming episode where you can ask us anything. So if you want to send in your questions that way, we'll be doing more posts about collecting these fun questions. It could be personal, professional. You could ask Sarah, what kind of deodorant she wears
Sarah (48:59):
None. Secret. It's not a secret I used to. Anyway, so that's it. We love you guys so very much. Keep being your awesome selves, peace out.