#055: Therapy Planning Bootcamp – Revamping Your Therapy Routine

Marisha: Hello there and welcome to the SLP Now podcast. I'm your host Marisha And this month we are diving into all things therapy planning. So if you want to check out all of the things that we have going on to help you with your therapy planning, head to SLPnow.com/plan. And I cannot wait for you to dive into today's episode. So, grab your favorite beverage, sit back, and relax and enjoy the episode.
Hello and welcome to therapy planning bootcamp. I'm really excited to nerd out with you guys about this topic today. This is something that I struggled a lot with as a new clinician and I pulled out my hair, tried a lot of different solutions, and I'm really excited just to be able to share the different things that I found. And hopefully you can learn from all of my trial and error and have a little bit of an easier time at it. And then if you've been at this for a long time, hopefully it'll just give you some new ideas to refresh what you're doing, especially given all of the craziness of today.
So, the first thing that we'll be talking about is the therapy routine. And sometimes this gets a little bit of a groan from people, like, "Oh, a routine. Come on." But hopefully we're all okay with routines. And I just wanted to share a little bit about why I think routines are a good evidence based strategy to use in our sessions and just what the benefit of it is. And it doesn't make our sessions boring. It actually increases student engagement because they know what to expect and they have more resources available to engage with us and to make the most of the session and really practice those new skills.
And it also increases our efficiency because I don't know about you, but I would love to be a little bit less stressed when managing my caseload. So, by having a routine, it makes it easier to plan. It makes our transitions a lot easier because it's easier to manage our groups and we don't get behind on our sessions or anything like that. And it also frees up our own cognitive resources.
If we have a really good grasp on what is going to happen in the session, and we're not just like, "Oh my gosh, the students are walking in, what are we going to do?" If we have a routine. "Okay, the students are going to walk in, we're going to review their goals, we'll get some quick data, then we'll do some teaching." If I know exactly what's going to happen and I have those materials ready to go, it gives me a lot more cognitive space too. If Johnny is struggling, I have a lot more resources available to figure out how to best support him and how to set him up for success.
And then as we go, we'll go through the different steps. I dug through a bunch of their research and pulled out some common themes across different routines and there's evidence to support these different steps. So, it's a great way to incorporate some evidence base into your treatment.
So, here's what we've got. So, we'll be breaking it down into four main parts. Different studies will break things up in different ways. This is just how I summarize it and how it made sense for my practice. It definitely is more ... Because speech therapy is an art and a science, and this is part of where the art comes in. So we get to use the science to give us some principles and ideas, but it really depends on the group and the dynamics and all of that, and our clinical expertise. Drawing on that clinical expertise to really figure out the best way to set this up for any given student or any given group.
So, do keep that in mind as we go through some of these ideas. So the first ... Oh, and just to recap: The four parts that we'll be talking about are one, introduction. Two, teaching. Three, practice. Four, wrap up. So introduction, teaching practice, and wrap up.
And the first one that we'll be talking about is introduction. So this is what we do when we first pick up the students or when they first walk in the room. Establishing rapport, if we have rapport with our students, they are going to work that much harder and make that much more progress with us and just checking in with them and making sure that they're okay is a great way to do that. It's also a great way to make sure that they're ready to learn.
If they have a huge scowl on their face, because they didn't get to eat breakfast and they're very hungry, they probably won't be very ready to learn. And sometimes it's just a quick, simple acknowledgement. Like, "Okay, we just have a little bit on the way back to the classroom. We'll grab you some crackers from the nurse."
Or something like that. But just addressing it and helping them come up with a solution can help them reallocate those resources, put them back towards the therapy session, and then we can move on and really focus on the good stuff.
And then even just asking them how they're doing is just a great way to establish that rapport and show them that we care. Then we can review their goals. And I love doing this with some different goal cards. I just cut up pieces of paper. I have the students write their goals in their own words and then we use that as we set up the session and this is something that I started doing more recently.
But when we review the goals, the students will get to look at their goals, they've written them in their own words and they often say why that goal is important. So again, emphasizing that buy in and why we're doing the things that we're doing, even if they're hard sometimes. And while we're doing that, that's typically the time where I'll collect some quick probe data. So, it's just a quick minute data collection per student, or even less than that. Just so I have some data to see how students are coming into the session. But we'll talk more about the logistics of that in the data collection section. But this is where I would fit that in.
And then we might take some time to review the last session and checking in and see, just revisit where we left off and then get ready to get started. So, some examples of what the check-in could look like. I really liked this clip chart that Nicole Alison made. It's a good behavior management strategy and it shows, it has different colored zones. And then the students learn what the different colors mean. And when they come in, they can clip in their name to show where they're at. So, that's a really quick nonverbal way and there's tons of clip charts available on Teachers Pay Teachers or on Pinterest. So, that's a good option.
Amy Harris is a special education teacher who shares some really amazing strategies as well and she taught me this temperature check and it's just on a scale of one to five or one to 10, where one is the worst day ever and 10 is the best day ever. And she said she uses this with her students. They walk in and then they just get to hold up fingers for how they're feeling. So, if I walk in, like today, I would probably put up a seven or an eight. But if a student puts up just one finger, it's a worst day ever. Or if they're like this, shaking their hands with all 10 fingers up, saying it's the best day ever. That gives us some really good information on what that student might need to be successful in the session.
So, if they're having the worst day ever, we might get the group started and do a quick check in with the student. Or if they're having the best day ever and they're just really hyped up, maybe we'll give them some alternative seating to help them ground and get calmed down or whatever works best for the student. The strategies will be very dependent on the students. But hopefully that sparks some ideas.
And then in terms of reviewing goals, I just have a couple of different examples of the goal cards and how you can set them up. So, I've tried a bunch of different things. I used to cut up the goal cards and put them on binder rings and just hang them in the speech room. Nicole Alison has some really cool common core goal cards that you can, if you want some that already written out and you just want to have them printed. There's also the really nice pocket charts, like the calendar charts that they have at all the teachers stores. That's a nice way to keep different student's goal cards organized as well.
And if we're doing this digitally, I really like using Google Slides to keep my information organized. So, I would just have each student create a slide with their goals in their own words and the why of why they're working on it. So, these strategies can be applied whether we're in person or digital.
And then the second step of the framework. So, we just talked about the introduction and now we're going on to teaching. So, this is incredibly important and we'll talk a little bit more about this in the core materials piece, because the core materials that we're putting together are largely focused on teaching these.
But this is something that I would often skip as a newer clinician. I'd just be so excited to dive into the cute activity that I downloaded from Teachers Pay Teachers. We'd just start working on those context clues or answering those comprehension questions. But I didn't take the step back to teach what we were doing.
So, explaining what a context clue is or breaking down the question types or whatever it may be. So this is just a reminder that we want to teach our students what we want them to do before we expect them to do it. And then using all of our amazing clinician strategies to help break that down for students. And there's also some research to support doing that. So, that's awesome.
Then for step three, we get to dive into practice and there are some basic principles that I like to use when implementing this with my students. So, a lot of the research emphasizes using authentic contexts. So, that might include curriculum based therapy. So using materials from the curriculum, using literacy based therapy, which often comes from the curriculum as well. But just using the types of materials that they'll encounter throughout the school day and in their lives.
Some other important elements are to provide feedback and give them the appropriate level of scaffolding, giving them appropriate prompts and cues. And I know that these are things that a lot of us are already doing, especially as we're going through steps one, two, and three, and four probably won't be a surprise either. So, a lot of these are things that we are doing, but it's important when we are feeling overwhelmed, it can be really helpful to evaluate:
"Okay. So what does my therapy routine actually look like?" And give yourself a pat on the back for all of these things that you're already doing, all of the things that you're feeling great about. That is a huge step in the right direction. And if you are feeling like your sessions are a little bit overwhelming or difficult to manage or whatever it may be, then you can look at this as a framework to help identify something that you can add or change in your session to help it just flow more smoothly, make it easier for you and your students to be prepared. So, that's what we've got for step three.
And then for part four, we get to wrap up the session. So we'll do a quick recap. We might give a review of the student's performance or just how they did on the task or how they participate in it. This is a great place to talk about growth mindset and praising effort versus performance as well. And just having a chance to reflect on what went well or not and why for ourselves as the clinicians or for the students and then it can also be helpful to talk about what we'll do next time. So, this is part of being prepared for the next session.
So, if we just started a literacy based therapy unit, we did some pre-story knowledge activation because we're reading Stillman at night. And we're in Arizona, the students have no clue what snow is. We just did a little bit of learning about what snow is while I was recasting grammar and introducing different vocabulary concepts in the context of that activity. We might say, "Okay, so now we know a lot about snow." Next time, we're going to read a story about snowmen. And just set them up for what to expect next time.
And for older students especially, this can be a good opportunity. If we learned about context clues, for example, we can talk about how they might be able to use that during their reading lesson. In the reading class that they're heading to after your session and just talking about how they can use this in the, "real world."
Okay. So, another part of the wrap up is homework. So, this is really important for carry over and continued progress. And this is one area of weakness for me, I have to admit. So, I've always really struggled to send home worksheets and therapy activities, all of that. But I did start having a lot more success when I started using ... One of my districts used Remind, which is a type of communication app. So, that was a game changer for me and that helped me really revamp how I view homework.
So, I think if you've got a good system at sending home activities, then that's amazing. But I think the most important thing that we can do is just to communicate with parents how things are going. I feel like everyone is so busy and overwhelmed, especially during this time where a lot of parents are working from home and kids are home too.
So, I think giving just quick notes and sharing quick, actionable things that they can do. Like, "Oh, on your way to and from the grocery store." They're probably not going, but, "At that time, read this story and use this one strategy."
And so I found that I got a lot more carry over and generalization using that versus sending home worksheets because those just got buried at the bottom of the backpack. So, I really like that strategy. That's how I would approach it and that's how I troubleshot. And yeah, so that's what that looks like for the wrap up and just some different ideas on how to make that happen.
So, to wrap up this first step process. Again, the takeaway is that you are doing a lot of these things already and celebrate the things that you're doing well, and take this as an opportunity to potentially identify one or two things that you might add or change.
And one other thing to note, we talked about this a little bit at the beginning. But the four steps might not be appropriate for all students on your caseload and maybe some components of the steps are appropriate for where others are not. But we get to put on our clinician hats and determine what is the most appropriate routine for our students.
And even if all four steps are appropriate for a given group, it's not always linear. So, there are some sessions where the student just is not ready and we spend all of the time in step one, in that introduction phase where we're just working on, especially with new clients or new students. Maybe we just need to focus on establishing that rapport and maybe that's all we do for a little bit.
And then other times we've been in the group, we're doing a great job with therapy. The students trust us. And then maybe we have to spend a ton of time in teaching and that's where we spend the bulk of the session. And then other times we might have to spend it all in practice. Maybe we've got the rapport, we've got the teaching down, and we're just hardcore practice mode.
And so it always is adjusting and dynamic. But the basic elements are typically there and we just get to adjust it depending on what's happening and what the data tells us. So, that is what we've got for our therapy routine.
And that's all that we've got for this week. Head to SLPnow.com/plan to see the other live chats and the upcoming topics and we'll see you next week here on the podcast.