1. School-age Speech and Language Center
Group Meeting: October 2nd, 2018
Supervisors: Frank Bender, Emily Mosqueda, sara sarlin (Maple Elementary School), Katie mason, Alison Hintz, lori Hornfelt

2. Today’s Agenda
Framework of the Flipped-Class Approach to Group Meetings
Client-based questions/comments regarding formal or criterion-based assessments
Client-based questions regarding behavior management techniques and resources on infoCDS
Client-based recommendations regarding LTGs and STOs

4. Assigned Clients to Be Discussed During Targeted Client-Based Activities
Shaundra: ROMA
Camille: HUEM
Christina DAJA
Rachael I.: COET
Leigh: GAEZ
Anna: Maple Experience
Nate: New Client to be Assigned
Brittaney: DINA
Olivia: COCO
Rachel L.: POHA
Molly: BAKA
Kasey: New Client to be Assigned

5. Informal Assessments: What & How?
Speech Sounds
Language (content & form)
Social Skills

6. Behavior Modification Overview
Consider the Client and Their Perspective
Setting: Think about room arrangement (especially pertaining to your client’s attention and distractibility)
Expectations: Visual schedules (e.g., First/Then), Agendas (e.g., White Board), Contracts, etc. Routines can be your friend
Reinforcement: Token-based system (fixed or ratio); timed timers, DAP language
Family Involvement: Plan on how and when you might need to include caregivers, parents, or siblings (e.g., Create a word or phrase when you may need some assistance.

7. Prevention Strategies
It’s all about avoiding power struggles
Give the client a “sense of control”
Examples: Directives and Forced Choice & How we use our language is very important
Encourage preferred behaviors
Extrinsic vs. Intrinsic Reinforcement: E.G., Token-based systems coupled with verbal reinforcement (Avoid…. “Good Job”)
Give the client a reason for following the “agenda”
What’s the payoff?
Don’t be afraid to wait and not talk!!!! How to redirect? (Eye contact, self- play, if you have an assistant, use them, change of stimulus item, my turn/your turn, etc.

8. Goal Writing Why do we write goals/objectives?
What is important to include in a goal?
Who has seen poorly written goals?
What was wrong with them?

9. LTG vs. STO
Goal/LTG: Overall statement of targeted behavior (e.g., Intelligibility, MLU, C-Units, etc)
Goals are dependent on the setting in which the client is served or expected to accomplish the goal
Most IEP/IFSP goals written for EC CARES or the school district will be for one year
Goals written for the clinic may be for one-term or longer, depending on the needs of the client
Objectives/STO: Task analysis; small steps to achieve the goal; small steps to monitor progress
Can be sequential or additive

10. Goal with Sequential Objectives
SS will produce target sounds (k,g,s, s-blends) in conversation with 80% accuracy over 2 sessions. 1. Given cues and prompts, SS will correctly produce target sounds (k,g,s, s-blends) in isolation in 8 out of 10 trials over two consecutive sessions. 2. Given cues and prompts, SS will correctly produce target sounds (k,g,s, s-blends) in words 8 out of 10 trials over two consecutive sessions. 3. Without cues or prompts, SS will independently produce target sounds (k,g,s, s-blends) in words correctly in 8 out of 10 trials over two consecutive sessions. 4. Given diminishing cues, SS will independently produce target sounds (k,g,s, s-blends) in phrases in 8 out of 10 trials over 2 consecutive sessions. 5. Given diminishing cues, SS will independently produce accurate target sounds (k,g,s, s-blends) in sentences in 8 out of 10 trials over 2 consecutive sessions.

11. Goal with Additive Objectives
FT demonstrate increased utterance length my maintaining an average of 3-word utterances (MLU=3.0) across settings (classroom, home) as measured by 2 language samples (50 utterances minimum). 1. FT will name 10 nouns (family members, animals, toys), with 80% accuracy, without a cue, during a structured language activity. 2. FT will routinely say at least 10 action words (e.g., “want”, “go”, “run”) as measured during a language-based structured activity. 3. FT will routinely say at least 3 pronouns (e.g., “I”, “me”, “you”) as measured by a language-based structured activity.

12. Writing SMART goals/objectives
Specific Measureable Attainable Routine-Based Tied to Functional Priority
Jung, L.A. (1997). Writing SMART objectives and strategies that fit the ROUTINE. Teaching Exceptional Children, 39, p54-58.

13. Specific Goals & Objectives
Goals should be written so that everyone involved with the client can understand the target behavior
Specific terms for how client will reach the goal (supports, prompts, cues required for independent success)
Which is better and why?
DC will communicate better
When provided a forced choice, DC will request an item using a pronoun, verb, and object, with 80% accuracy, without a cue, during a structured language activity.
McWilliam, R. A., Ferguson, A., Harbin, G.. Porter, D. M., & Vaderviere, P. (1998). The family-centeredness of individualized family services plans. Topics in Early Childhood Special Education,

14. Measurable Goals and Objectives should be…
Quantifiable, observable, describable
Measurable
Which is better and why?
AR will say bilabial sounds (m, b, and p) in all positions of words with 80% accuracy.
AR will improve her ability to say bilabial sounds (m, b, and p).

15. Things to Consider… In Case You Win the Lotto
If someone else measures, will they get the same results? (reliability)
Who is going to measure?
Will the person measuring be able to do the measurement as stated without disrupting routine or without undue burden?
Have you dictated a specific strategy or procedure? Forcing clinician to DO it your way?

16. Word or Sound Production Word or concept comprehension Point Identify
Verbs that refer to measurable behaviors (Refer to Verbs Associated with Bloom’s Taxonomy)
Word or Sound Production
Use strategy
Produce
Retell
Name
Write
Rhyme
Blend
Describe
Word or concept comprehension
Point
Identify
Sort
Match
Place/Put
Look
Say
Repeat
Recall
Ask
Request
Comment
Meyer, S. M. (1998). Survival guide for the beginning speech-language clinician. Aspen Publication: Gaithersburg, MD.

17. Verbs that are not measurable
Understand
Think
Learn
Improve
Know
Remember
Comprehend
Discover
Demonstrate

18. Attainable Goals & Objectives
IFSP/IEP goals are typically written for 1 year, but objectives should be easy for the child to achieve within 2 to 4 months, so children and families can celebrate success & receive positive progress reports.
Parents or other team members might suggest a long-term goal, your job is to break it down into achievable objectives.
Baseline data is used to determine where to begin.
Client response to treatment might suggest how objectives should be organized
Jung, L. A., Gomez, C, & Baird, S. M. (2003). Family-centered intervention: Bridging the gap between IFSPs and implementation. In E. Horn, M. M. Ostrosky, & H. Jones (Eds.), Young Exceptional Children Monograph Series No. 5: Family-Based Practices [pp ). Longmont, CO: Sopris West Educational Services.

19. Zone of Proximal Development
Vygotsky, L. (1978). Interaction between Learning and Development (pp ). In Mind in Society. (Trans. M. Cole). Cambridge, MA: Harvard University Press.

20. Routine-Based Goals & Objectives
Goals should be written to increase the child’s success in the context of daily routines & activities
Functional, meaningful
Example?

21. Tied to a Functional Priority
Client needs/beliefs/values (EBP pillar)
Goals should be derived from family members & other team members based on needs/preferences
Goals should not be derived from standardized tests

23. Next Week
Frank will not be here – Emily will be running the group session
Ground Rounds for a specific client (Frank will assign) – See next slide
Client-Based Grand Rounds (No more than a 10 min. Discussion per Client)
Client Code
Age Dx
Relevant insights on background and initial assessment and behavioral observations
Client-based LTG and STO

24. QUESTIONS / COMMENTS / CONCERNS?
THANK YOU!
QUESTIONS / COMMENTS / CONCERNS?