Sunday, April 25, 2010

Reflect on Your Story

Some of you have requested some speech ideas and tips, so I'm trying to honor that. These ideas are just general strategies that work for me, and should in no way to be taken as medical advice. If you have a child or grandchild who needs speech and language support, there is no better way to get it than in person with your very own SLP. You can find a certified SLP in your area by going here.
"The diary of every man is a diary in which he means to write one story, and writes another; and his humblest hour is when he compares the volume as it is with what he vowed to make it." -James Matthew


I know this quote doesn't seem all that speechy. But give me a second.

When I was in Georgia, I was trained pretty intensively in an early intervention model called Teaming or Coaching, or the Primary Service Provider Model. Whatever you call it, the general idea was that early intervention services were provided to every child in our program by a whole team of service providers: a speech language pathologist, an occupational therapist, a physical therapist, a social worker, a developmental specialist, a nutritionist, etc. So, each family in our program was assigned the whole team to support them, and then one of us served as the "coach" for the family to do the hands-on day-to-day support to help the child develop and grow. Our team met regularly to discuss concerns and to help one another with problem-solving any issues that we were having with the families we served. But for the actual service delivery portion of our work, there was just one therapist for each family.

That's right. Each family got just one of us to deliver the services and meet the goals that the whole team developed. You can imagine that we SLPs were pretty intimidated at first if a child we were assigned also had some motor concerns, and WE were the ones to provide support for all of those issues. I was not convinced at first that it was going to work, or that it was best for the kiddos we served. We were allowed covisits (visits where I would bring a PT or OT with me for a session with the child), and I was only willing to serve a few kiddos because I knew that I could have tons of covisits with the "motor" experts along with me.

But the amazing (and sort of surprising!) thing is, this teaming model worked. Fast.

Kids on our team met their goals in record time. Goals that I had initially written thinking they'd be met in around 6 months were being met in 2 or 3 months. Children were actually making so much progress that they didn't qualify for early intervention services anymore, before they aged out of the program! To put it bluntly, team kids were way outperforming kids who were being served on the traditional model.

We were surprised. We tried to figure out what was different. I mean, more services typically equals faster recovery, right? So when services were pared down to just one therapy type, how could it be that we were seeing faster progress?

After a few months of trying to figure out what was different about this new model, we finally determined that there were 2 key things that were happening for our team kids that weren't happening for our traditional model kids:
1) Because our program was new, we spent time during each of our team meetings to reflect on how it was working and how we could make it better.
2) We were building-in parent reflection (not just participation) and problem-solving opportunities into each session for our team kids.

What came out was this idea of reflection.

Apparently, when we as therapists continuously reflect on our performance and how it can improve, it actually does improve.

And when therapists support parents in becoming reflective problem-solvers for their children, their children make progress.

So now, back to the quote. Is it a reach, or do you think it applies here, too? When we take a look at the story we are trying to write for the kids we work with, as compared to the story that's actually being written, we're reflecting on what we're doing. And there's something about reflecting on things that makes us get humble pretty quickly. That makes us get our tail in gear and work hard to get a little better at whatever it is we're doing.

Parenting. Cooking. Teaching a child his /r/ sound.

So next time you've just had a great therapy session (or a terrible one, even!), take time to reflect on it. Whether you're the parent or the therapist, or the babysitter bringing the child to therapy, what strategy from today really made the difference? What just didn't work at all? Reflect, and then get to work with that new understanding you've gained.

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There's a lot of research on reflective practice for educators. But here are some interesting articles about teaching physical therapists and even engineers to be more reflective practitioners, as well.



How do you build in moments to reflect on your life, on your work, on your family? For example, I blog; I sometimes write letters; I do progress reports for my speech kiddos.

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