A healthy child with autism often has a harder time developing self-esteem than their typical peers. They struggle to find their value and self-identity and may have a hard time understanding their own internal worth, especially when they don’t always understand their own emotions.
Here are a few tips for helping your child on this journey to self-esteem.
Find Their Passion
Help your child find something that catches their interest and have the whole family support it. This can be a great help when they are feeling down about something they aren’t good at or have failed at and you can shift their focus to something they are great at and enjoy
It should help them identify things about themselves to be proud of and things they can share with other members of their family and peers to start conversations and develop a feeling of importance in their social space. Whether it’s a love of space and playing chess or an affinity for dinosaurs and facts about past presidents, let them find their niche and shine!
Remind Them That Bad Days Happen to Everyone
Having a bad day doesn’t mean you’re a bad person. It’s important to remind your child that even though they will have days they are struggling, those days are only 24 hours long and the next day is a chance to start over.
This will also help them learn forgiveness of other people’s bad days – when mom is yelling for seemingly no reason and grandpa is grumpy at dinner – those people deserve their bad days too and it doesn’t mean they aren’t as valuable a person because of it.
Point Out Differences in Others and Celebrate Them
Talk about how some of the best people in their lives are different and how those differences help make them who they are. Celebrate the little quirks in each person in your family and focus on how being different is something to be proud of.
Talk about people’s unique personality traits and compare them to their own. Have each family member describe their favorite things about others. Write them down and review them when your child is having a bad day or feeling low. Different does not mean less!
Model Healthy Self Esteem
If your child constantly hears you down on yourself, they will think this is normal behavior and follow suit. You want to show your child that while it is important to set goals and work towards them, failure is a part of life and it does not change who you are as a person.
Express your disappointment in a healthy way by verbalizing it but also focusing on how you will try something different next time or change your goals to something else you want to accomplish. Show pride for trying and the important thing is not to give up.
About BlueSprig
BlueSprig is on a mission to change the world for children with autism.
BlueSprig Is the Premier Provider with the Highest Standards in ABA Therapy Our mission is simple: we are focused on changing the world for children with autism.
The main question we seek the answer to is “what if?”
What if we focus on quality services? What if we are a leader in ABA research? What if we are strong advocates for the rights of all children with autism? Instead of choosing, we’re pursuing all three together – that’s the BlueSprig difference.
If you’re a helping professional working with kids, such as a child psychologist, clinical counselor, behavior analyst, occupational therapist, or speech and language pathologist, you may find yourself working with your client’s teacher. Learning to effectively collaborate with teachers is a critical skill to have.
Teacher collaboration can be an important part of your job if you’re a helping professional working with kids.
Sometimes this relationship may be a brief interaction, and others it might be frequent contact, depending on the situation.
Ideally, you’re able to build a relationship with a teacher you’re working with in which you can share ideas, collaborate on interventions, and truly feel like team members. After all, the goal of effective collaboration with teachers and outside professionals is better student outcomes.
As a teacher and behavior analyst, I’ve been on both sides of this relationship. As school starts back this fall, I’ve been reflecting on my experiences over the years and thinking about lessons learned. I wanted to share it with other helping professionals who find themselves going into schools to support clients this year.
Here are some things I think all professionals collaborating with school teams can consider going into this school year, boiled down from my personal experience.
The purpose is to share some ideas that can help build a foundation for deeply effective collaborative work.
Teachers have REALLY hard jobs
Communication is key
Teachers are professionals
Schools and school boards have policies and procedures. There’s no way around this.
A little kindness can go a long way
A classroom is like a teacher’s home
Going out of your way to help can make all the difference.
Teachers Have REALLY Hard Jobs
It is no easy task to be the one responsible for planning, implementing, teaching, evaluating, and reporting on the learning, development and overall student achievement of anywhere from 20-40 children with very little paid planning time.
Furthermore, there are few breaks. During instructional time, you’re on. Time between lessons is usually spent going to the bathroom, eating a snack since you coached a team or hosted a club at lunch, and tidying in the classroom before the kids return and you move on with your lesson.
Teachers just never have enough time in the day to get done what they need to get done. Not to mention, they often put in a lot of unpaid time for professional development, trying to stay on top of best practices.
Teachers put an incredible amount of unpaid time into their jobs to see their students succeed. I highlight this because I remember the times that a helping professional would show up in my room and then want to chat with me during my preparation time which I had planned to use to get my next class ready.
If you’re working in schools as an OT, SLP, PT, BCBA, psychologist or counselor, consider this harried context when scheduling time to work with teachers.
Always let them know you are coming and, if possible, coordinate a time convenient for them. You may even consider requesting from school leaders that coverage be provided for the teacher should you need to meet outside of the classroom during instructional time.
You will learn that school culture and school leadership have a lot to do with whether teachers are released for meetings with outside professionals. Sometimes teacher teams may provide coverage for each other
Lastly, even just a simple recognition of the work they’re doing, the effort they’re putting in, and thanking them for having you into their classroom can really help build rapport. Building this rapport through empathy of the position they are in can build a solid foundation to effectively collaborate with teachers.
Communication Is Key
As a teacher, I always appreciated when outside professionals were open with communication, being ready and willing to provide updates, reach out with questions, and check in with the school team. It really felt like we were creating strong partnerships.
Try starting out by giving them the benefit of the doubt that they want to work with you and are capable and willing partners. Sometimes this will not be the case and the administrator has asked you as an outside professional to come in, resulting in a less-than-willing colleague. However, beginning with the benefit of the doubt until proven otherwise is a great place to start.
It only serves your client better to be open and transparent with the school team, sharing things that have worked for you, offering help and communicating and changes on your end.
However, the tone of your communication is also really important. Recognizing the challenges and constraints of the school environment and getting their input on a client sets a respectful tone.
One key area for this is with observations. If you’re asked to go observe a student, discuss ahead of time with the classroom teacher about how they should introduce you and what they would prefer from you during the observation. For example, do they want to you interact with students or not?
Some will want you to sit quietly in one spot and observe. Others may prefer you to mingle in the classroom and interact with students as you observe your client.
Discussing these details before the observation helps avoid awkward or frustrating situations during the observation. This may differ based on grade-level or whether this is a high school or elementary classroom.
The bottom line is, simply asking the teacher about their preferences is a great starting point. Taking the time to communicate can be a great way to set a positive and respectful tone and effectively collaborate with teachers.
Teachers Are Professionals
Regardless of whether teachers have completed a degree beyond their teacher training and undergraduate degree, teachers are professionals and should be treated as such.
They’re experts in their curriculum, assessment and, most importantly, their students. Teachers work incredibly hard to do well for their students and (in my opinion) are the backbone of our society, so should be treated with a commensurate level of respect.
Teachers participate in professional learning communities (PLCs) that involve professional development around specific topics.
This can mean delving into best teaching practices as found in educational research, problem-solving current issues in education, using educational research to plan for student success or school improvement, giving feedback to each other on lesson plans, or other learning experiences based on relevant educational topics.
PLCs are ways for teachers to stay current in best practices and improve their pedagogy and instructional practices through teamwork in a small group setting.
Teachers want to see their students do well, and are always looking for ways to improve students learning and overall well-being at school. The job of a teacher is never done.
There is constant reflection and response to student learning that drives teachers to seek out ways to be an increasingly effective teacher. Teachers are lifelong learners and try to instill the same in their students.
To effectively collaborate with teachers, come in with a respectful tone that shows admiration for the work they do, listen to their insights, and actually integrate this into your work. This builds a successful collaborative relationship.
Schools And Boards Have Policies That Can’t Be Avoided
Part of being respectful when entering a school as an invited professional is adhering to school (and classroom) rules. Knowing what policies are relevant to you ahead of time is best. An initial call to the Office Administrator or Principal can help set common expectations at the outset.
My recommendation is to not try to haggle for exceptions, instead be flexible and work around their policies and procedures. Being accommodating and toeing the line can help you effectively collaborate with teachers becuase it shows respect and doesn’t ruffle any feathers before you even set foot in the school.
Examples of policies to be aware of are:
Forms to be signed ahead of time
Certain school staff being notified of your visit
Not wearing scented products
Adhering to set times for visiting the school
Signing in upon arrival
Wearing a ‘Visitor’ tag and signing out when you leave.
Covid pandemic-related protocols.
Asking about school policies at the outset can help show respect without having to be asked.
A Little Kindness Can Go A Long Way
This relates to point #1 about a teacher’s job being hard. After spending some time in the classroom, you’ll get a good idea of how you can help out and what the teacher might appreciate.
To effectively collaborate with the teachers you are working with, I guarantee extending some simple acts of kindness can really help.
Going out of your way to help a teacher by making materials for a strategy you’ve suggested, bringing a treat to a meeting, volunteering some time in the classroom, being really flexible to suit the teacher’s schedule, or helping to tidy the classroom at the end of the day are all ways that you can show kindness to a teacher you are working with.
A Classroom Is Much Like A Teacher’s Home
Most teachers spend a lot of time and effort intentionally designing their classroom environment. Respecting this by asking about classroom rules or procedures ahead of time can help start your relationship with the classroom teacher off on the right foot.
You are entering a teacher’s personal space that they have carefully curated. Take their cues, and show respect by treating it as if you are going into someone’s living room.
You never want it to seem like you’re coming into their space and critiquing their home. This is especially true as, when outside professionals are observing, it’s not your role to critique their teaching but rather just observe your client in the context of the classroom.
Be cognizant of not leaving any garbage in the classroom like empty coffee cups, tucking in your chair when you leave, or helping with other classroom chores.
Some special education classrooms have no-hot-drink policies due to risk of spilling. Consider not bringing any food or drink into the classroom just to be safe. The last thing you want is to be that person who spills something on student work!
Think about the little things like stacking your chair after an observation. All of this adds up.
Don’t Take Yourself Too Seriously
Schools are full of kids. Kids like fun. Teachers (generally speaking!) also are lighthearted and accustomed to having fun with their students. Being too serious can make it harder to build rapport.
That being said, read the room. You’ll get a good sense of classroom culture and teacher personality by spending some time in a classroom. If invited, participate in what the class is doing and have fun participating and interacting with students.
After spending some time in the school, you’ll also get an idea of its culture. Participating in activities, buying some cookies at a bake sale, or eating your lunch in the staff room (if welcome to do so) are all ways to get to know staff in a laid back manner.
The Bottom Line on How to Effectively Collaborate with Teachers
It’s common for outside professionals like psychologists, BCBAs, OT, PTs, SLPs or counselors to be invited into a classroom to collaborate with a school team.
There are some basic things to keep in mind about school culture and collaborative practices before heading in to help.
It’s a privilege to be invited into a teacher’s domain, their classroom. Keeping these few tips in mind can go a really long way to building rapport. If you start out on the right foot, you’re likely to get where you are going faster: better success for the client/learner you are both there to serve.
About Behavioral Collective
The Behavioral Health Collective is a multi-disciplinary behavioral health resource for clinicians, families and educators. We believe that only through working together, listening and learning from each other and our clients can behavioral health professionals truly create meaningful change.
This is a community for allied behavioral health professionals who are passionate about working together across disciplines to improve client outcomes by valuing collaboration, connection, humility and best-practices.
We want to empower caregivers and educators with the knowledge you need to make informed decisions around promoting behavioral health with the children and young people you work with.
As clinicians, it is our ethical responsibility to provide effective and culturally sensitive treatment for individuals with autism. Addressing diversity in treatment plans is essential to ensure that we meet the unique needs of each individual and create interventions that are respectful, inclusive, and meaningful. Cultural competence plays a crucial role in understanding the influence of culture, ethnicity, language, and other aspects of diversity on an individual’s development and behavior. By embracing diversity and actively incorporating cultural considerations into our treatment plans, we can enhance the effectiveness and social validity of our interventions. This post aims to provide practical strategies to use when creating treatment plans with a culturally sensitive approach. By doing so, we can foster better outcomes and promote equity, inclusion, and respect for all individuals and their families.
Addressing Diversity in Treatment Plans
When considering the social significance of behavior interventions, diversity and culture must be discussed. A comprehensive understanding of the individual’s culture allows us to make ethically sound decisions for treatment. By taking into account the cultural context, we can develop interventions that are relevant, meaningful, and promote the individual’s overall well-being.
Strategies to Incorporate Diversity and Culture when Creating your Treatment Goals
Culturally Relevant Materials: Incorporate materials, resources, and activities that reflect the diversity of the individual’s cultural background. For example, if the child comes from a bilingual or multilingual family, provide materials in their native language to promote engagement and understanding.
Collaborate with Families: Involve the family in the treatment planning process and seek their input regarding their cultural values, traditions, and goals for their child. Respect and incorporate their perspectives to create a collaborative and culturally responsive treatment plan.
Cultural Contextualization of Goals: Tailor behavior change goals to be culturally meaningful and relevant. For instance, if the child comes from a culture where extended family support is highly valued, consider incorporating goals that foster social interactions and connections with extended family members.
Understanding Social Norms: Familiarize yourself with the social norms, customs, and traditions of the individual’s culture. This knowledge can help guide treatment decisions and ensure that interventions align with the cultural expectations and values of the child and their family.
Culturally Responsive Strategies: Adapt behavior change strategies to accommodate cultural differences. For instance, if the child comes from a culture that values communal decision-making, involve the extended family or community members in the treatment process and decision-making.
Sensitivity to Religious Practices: Respect and accommodate religious practices within the treatment plan. Consider scheduling therapy sessions to avoid conflicts with religious obligations or incorporating religious rituals into the session if appropriate and desired by the family. You may even create goals on how to improve participation in religious environments that are significant to the child’s culture.
Training and Professional Development: Continuously engage in cultural competency training and professional development to enhance your understanding of diverse cultures and build your skills in providing culturally sensitive treatment. Stay informed about current research and best practices in the field of cultural competence. Most importantly, if you do not feel competent to serve the client and address your potential cultural biases, it is vital to recognize your own difficulties and provide the family with another clinician that can better suit their needs, whenever possible.
By actively addressing diversity in treatment plans, we can create interventions that are respectful, inclusive, and effective for children with autism from diverse cultural backgrounds. It is essential to approach each child as an individual and tailor treatment plans to their unique needs, cultural values, and experiences.
About the Author
Nicole Gorden, M.S., BCBA, LBA has over 14 years of experience implementing Applied Behavior Analysis principles with the Autism Population. She currently works for Comprehensive Behavior Supports in Brooklyn, NY.
As a black behavior analyst, I have personally witnessed how culture and diversity profoundly impact the effectiveness of treatment for children with autism. It is crucial for us, as professionals, to recognize the role of culture and be conscious of our own biases when creating behavior change programs. We will explore the importance of cultural sensitivity in creating treatment plans and discuss how being attentive to diversity can lead to more ethical and effective interventions. Whether you are a parent, clinician, or teacher, understanding the influence of culture is essential for providing the best support for children with autism.
The Impact of Culture on ABA Treatment
Culture plays a significant role in shaping an individual’s beliefs, values, and behaviors. It influences how we communicate, perceive the world, and respond to interventions. Recognizing and respecting the cultural backgrounds of children with autism is vital in tailoring treatment plans that are both effective and ethical.
Cultural Bias and Behavior Change Programs
As professionals, it is essential for us to examine our own cultural biases. Our biases can inadvertently influence the goals we set and the strategies we employ in behavior change programs. By being aware of our biases, we can ensure that treatment plans are culturally sensitive and respect the unique needs and values of each individual.
For example, a provider working with a child from a collectivist culture may set a goal to increase the child’s independent decision-making skills during play activities. However, in the child’s cultural context, interdependence and collaboration are highly valued, and decision-making is often a shared process among family members. By overlooking this cultural aspect, the clinician’s bias towards individualism may unintentionally disregard the importance of cooperative decision-making, potentially limiting the cultural relevance and effectiveness of the treatment goal.
Cultural Sensitivity and Ethical Considerations
Behavior-change interventions must meet the culturally sensitive needs of the client to be considered ethical. Cultural sensitivity requires us to be attentive and respectful of the individual’s culture, considering how cultural contingencies can support their behaviors and aligning treatment recommendations with the values of their culture. It is crucial to foster an inclusive and culturally responsive environment to promote positive outcomes.
Consider a therapist working with a child from a culturally diverse background who exhibits challenging behaviors during mealtime. The BCBA recognizes that the family’s cultural practices include communal eating, eating with their hands, and the preparation of traditional foods. In this case, an ethically sound intervention would involve understanding and respecting the family’s cultural practices while addressing the challenging behavior. Instead of imposing rigid expectations of eating independently, forcing the child to eat with utensils, or conforming to other Western mealtime norms, the therapist would collaborate with the family to develop strategies that promote positive mealtime experiences while honoring their cultural traditions. This approach ensures that the behavior-change intervention is culturally sensitive and respectful, promoting the client’s well-being while maintaining the integrity of their cultural background.
Promoting Diversity in the Field
As highlighted by Dubay, Watson, and Zhang (2018), “The lack of racial, ethnic, and linguistic diversity in service providers is an issue facing many clinical fields.” Increasing diversity within the field is essential for ensuring culturally competent and effective treatment for individuals from diverse backgrounds. By promoting diversity, we can enhance our understanding of different cultures and provide more inclusive and tailored interventions.
The Importance of Culture in Achieving Socially Meaningful Goals
Recognizing the influence of culture in behavior analysis allows us to design interventions that are relevant, respectful, and aligned with the values of the individual and their community. This leads to interventions that are more meaningful, promote independence, and improve the quality of life for individuals with autism. In addition, it allows our clients to access naturally occurring reinforcement within their own environment which is critical for generalization and maintenance of skills.
Incorporating cultural sensitivity into treatment plans is crucial for creating effective and ethical interventions for children with autism. Recognizing the influence of culture, addressing our own biases, and promoting diversity within the field are key steps toward providing inclusive and meaningful support. By embracing cultural awareness, we can develop interventions that respect and value the unique cultural backgrounds of individuals, leading to better outcomes and enhancing the overall well-being of children with autism.
References
DuBay, M., Watson, L. R., & Zhang, W. (2018). In search of culturally appropriate autism interventions: Perspectives of Latino caregivers. Journal of autism and developmental disorders, 48, 1623-1639.
Fong, E. H., Catagnus, R. M., Brodhead, M. T., Quigley, S., & Field, S. (2016). Developing the cultural awareness skills of behavior analysts. Behavior analysis in practice, 9, 84-94.
About the Author
Nicole Gorden, M.S., BCBA, LBA has over 14 years of experience implementing Applied Behavior Analysis principles with the Autism Population. She currently works for Comprehensive Behavior Supports in Brooklyn, NY.
This month’s ASAT feature comes to us from Kate McKenna, MEd, MSEd, MS, BCBA,and Lindsay Bly, MS, CCC-SLP, Melmark. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!
The science of speech-language pathology in the United States had its roots in the study of elocution, what we now call articulation, for rhetoric debate, and theatre, which had risen to prominence in 18th century England. Several clinicians of the era (e.g., Potter) that were considered legitimate came from the profession of education, medicine, and elocution. With the publication of Speech and its defects. Considered physiologically, pathologically, historically, and remedially (Potter, 1882), the field expanded to include speech and language disorders. Potter provided a taxonomy of all speech disorders and a definition and suggested treatments for each. This publication then became the model for the field of speech-pathology in the early period in its history. Speech production continued to be the primary focus of the field in the United States as reflected by the establishment of the American Academy of Speech Correction, in 1925 at a meeting of the National Association of Teachers of Speech (NATS), held in New York City, whose members wanted to promote “scientific, organized work in the field of speech correction.” (https://www.asha.org/about/history/) The establishment of the Academy was the birth of American Speech-Language Hearing Association (ASHA).
As an organization the Academy has gone through several name changes and in 1978 took its current title of the American Speech-Language Hearing Association (ASHA). The organization that began with 25 charter members now represents over 228,000 speech-language pathologists. Based in Rockville, Maryland, ASHA is committed to a mission of empowering and supporting audiologists, speech-language pathologists, and speech, language, and hearing scientists.
As with the professions of physical and occupational therapy, injuries in the World Wars also spurred growth and diversification in the field of speech and language therapy. Soldiers returning from the battlefields had suffered brain injuries that resulted in aphasia, a language disorder that involves loss of the ability to understand or express speech and language. Consequently, during the 1940’s and ’50s, as brain studies, technological advances, and the development of standardized testing procedures gave rise to more useful receptive and expressive language assessments and treatment techniques, speech therapists began to expand their focus into the treatment of language disorders. The field of speech pathology became speech-language pathology during this time.
Although speech and language disorders can occur by themselves, they often exist together, which is why speech-language pathology is a combined field of study. During the 1960’s through the ’80’s, advances in linguistic studies further enhanced the speech-language pathologist’s understanding and ability to treat a variety of language delays and disorders in persons of any age. In the 21st century, speech-language pathologists have begun to research and treat the pragmatic use of language along with the other areas of communication disorders.
Today’s speech-language pathologist is a professional whose professional practice and expertise is in diagnosis, screening, assessment, and treatment of challenges and difficulties, in the areas of communication, including speech, language, cognition, voice, fluency, resonance and hearing, and swallowing in people of all ages. Moreover, SLPs practice within eight domains of speech-language pathology service delivery: collaboration; counseling; prevention and wellness; screening; assessment; treatment; modalities, technology, and instrumentation; and population and systems. In addition, SLPs engage in five domains of professional practice including: advocacy and outreach, supervision, education, research, and administration/leadership. A speech disorder is identified as when someone has a hard time producing speech sounds and misarticulations, has a voice problem, or stutters when speaking. A language disorder is when an individual experiences difficulties understanding and using language to communicate, sharing their thoughts and emotions, and engaging in conversation with others as a conversational partner.
Education
The education and training of speech-language pathologists is overseen by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), which is an entity within the American Speech-Language-Hearing Association (ASHA). ASHA is the national professional, scientific, and credentialing association of speech-language pathologists and audiologists. According to ASHA, to practice as a speech-language pathologist (SLP), a masters, doctoral, or other recognized postbaccalaureate degree from a CAA accredited program is required along with completing 400 supervised clinical hours, with at least 25 hours spent in guided observation and at least 375 hours spent in direct client/patient contact, with 325 completed at the graduate level. Supervision is required in real time and never less than 25% of the student’s total contact with each client/patient. Aspiring speech-language therapists must also pass a Praxis Exam in Speech-Language Pathology and complete a clinical fellowship of at least 36 weeks and 1260 hours of full-time experience or its part-time equivalent. During the clinical fellowship applicants are rated by their mentor according to the Clinical Fellowship Skills Inventory (CFSI), which consists of 18 skill statements covering the areas of evaluation, treatment, management, and interaction. Mentees are judged on accuracy and consistency, which assesses the performance of a skill without error, consistently across cases, as well as independence and supervisory guidance, which measure both the level of independence and the ability to self-monitor skill level and request support as necessary. After being granted a Certificate of Clinical Competency (CCC) from ASHA, speech-language pathologists are required to complete 30 hours of professional development every three years. Other license requirements vary by state.
Speech-Language Pathology Assistants (SLPA) can become certified through three different educational pathways and must complete 100 hours of clinical field work under the supervision of an SLP. In addition, applicants take courses in ethics, universal safety precautions and complete the ASHA online SLPA education modules. As with SLPs, speech-language pathology assistants pass a certification exam and renew their certification every three years.
Standards of Practice and Guiding Documents
In their practice speech-language pathologists are guided by the ASHA Code of Ethics, which reflects the values and expectations for both research and clinical practice. The code is intended to provide a framework for ethical decision-making and professional conduct. Four Principles of Ethics form the philosophical base of the Code: 1) responsibility to persons served professionally and to research participants, 2) responsibility for one’s professional competence, 3) responsibility to the public, and 4) responsibility for professional relationships. The Scope of Practice in Speech-Language Pathology also governs the practice of speech-language pathologists. This document is a framework for practice and describes the domains of service delivery. The work of speech-language pathologists assistants is guided by similar documents, a Code of Conduct, and a Scope of Practice, that describe the limits of service delivery as they work under the supervision of SLPs. A goal of SLPs is to provide evidence-based treatment and interventions to clients. To this end, ASHA has created Evidence Maps, a searchable online tool designed to assist speech-language therapists in making evidence-based decisions in their practice.
Professional Organizations
The American Speech-Language Hearing Association (ASHA), is the professional and credentialing organization for audiologists, speech-language pathologists, scientists studying speech, language and hearing, and has 20 Special Interest Groups (SIG) that indicate the breadth and depth of study in the professions. Its mission is “Making effective communication, a human right, accessible and achievable for all.”
ASHA publishes five peer-reviewed journals. American Journal of Audiology (AJA) is an online only peer-reviewed journal that publishes research and other scholarly articles pertaining to clinical audiology methods and issues. American Journal of Speech-Language Pathology (AJSLP) is an international journal that publishes clinical research on diverse aspects of clinical practice in speech-language pathology, including screening, diagnosis, and treatment of communication and swallowing disorders. Articles in the Journal of Speech, Language, and Hearing Research (JSLHR) touch on speech, language, hearing, and related areas such as cognition, oral-motor function, and swallowing. Language, Speech, and Hearing Services in Schools (LSHSS) focuses on school age children and adolescents and audiological and communication disorders that impact full participation in the school setting. Perspectives of the ASHA Special Interest Groups, a bimonthly online peer-reviewed journal, publishes research related to the 20 SIGs. The ASHA Leader, which highlights the latest research and practice advances in communication sciences and disorders, is a bimonthly newsmagazine for and about audiologists, speech-language pathologists, and speech, language, and hearing scientists available to all ASHA members.
Scope of Practice
The SLP profession falls under the larger discipline of communication sciences and disorders, which also includes audiology. Speech-language pathology is focused on a range of human communication and swallowing disorders affecting people of all ages. The practice of speech-language pathology includes those who want to learn how to communicate more effectively, such as those who want to work on accent modification or improve their communication skills. It also includes the treatment of people with tracheostomies and ventilators and those who use Augmented and Alternative Communication such as manual signs, gestures, picture or letter communication boards, and speech generating devices.
Speech is a verbal form of communication that is comprised of articulation, how speech sounds are produced (e.g., manner, placement, and voicing), voice, the coordination of the breathing/respiratory apparatus and vocal cords to produce those sounds, and fluency, the rhythm of speech. Speech problems often occur because a person has difficulty producing sounds due to difficulties or incorrect movement or development of the lips, tongue, and mouth, and/or coordination of the speech motor and respiratory mechanism. Language consists of socially shared rules that govern what words mean, how new words are created, and how words are put together in sentences. It also includes what we call the pragmatics of language, the socially accepted rules for interacting in daily life. This includes non-verbal communication (eye contact, facial expressions, body language) as well as conversational skills such as turn taking, asking questions, appropriately maintaining conversations, and adjusting language and vocabulary based on the situation. Speech-language pathologists treat both receptive (difficulty understanding others) and expressive language disorders (difficulty communicating thoughts, ideas, and feelings).
Stuttering: Interruption in the flow of speaking characterized by specific types of disfluencies.
Cluttering: Characterized by a perceived rapid and/or irregular speech rate, atypical pauses, maze behaviors.
Speech Production Disorder:
Motor planning and execution disorders:
Childhood speech apraxia: Neurological childhood speech sound disorder resulting from neuromuscular difficulties, such as abnormal reflexes or abnormal tone.
Adult speech apraxia: Speech disorder caused by neuromuscular difficulties, such as abnormal reflexes or abnormal tone; usually because of stroke, traumatic brain injury, dementia, or other progressive neurological disorders.
Speech sound disorders:
Articulation: Errors (e.g., distortions and substitutions) in production of individual speech sound
Phonological: Predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound.
Language Disorder:
Language disorder: A significant impairment in the acquisition and use of language across modalities due to deficits in comprehension and/or production across any of the five language domains (i.e., phonology, morphology, syntax, semantics, and pragmatics).
Written language disorder: A significant impairment in fluent word reading (i.e., reading decoding and sight word recognition), reading comprehension, written spelling, and/or written expression. Dyslexia – word reading disorder.
Areas of language include phonology, morphology, syntax, semantics, pragmatics (language use and social aspects of communication), prelinguistic communication (e.g., joint attention, intentionality, communicative signaling), paralinguistic communication (e.g., gestures, signs, body language), literacy (reading, writing, spelling)
Cognition:
Cognitive-Communication Disorders: Difficulties paying attention, planning, problem-solving, or organizing their thoughts. Many times, these disorders occur because of a traumatic brain injury, stroke, or dementia.
Voice:
Voice disorders: Includes vocal cord nodules and polyps, vocal cord paralysis, spasmodic dysphonia, and paradoxical vocal fold movement.
Dysarthria: Impaired movement of the muscles used for speech production, including the vocal cords, tongue, lips, and/or diaphragm.
Resonance Disorder:
Resonance disorders: Too much or too little nasal and/or oral sound energy in the speech signal.
Feeding and Swallowing:
Swallowing Disorders: Difficulty eating and swallowing. Swallowing disorders are often a result of an illness, injury, or stroke.
Speech, language, communication, and listening skills impacted by hearing loss, deafness.
Auditory processing
SLPs practice in many settings including schools, homes, and hospitals. They also provide services to those in outpatient clinics or in long-term care facilities. In addition to working with adults with persistent speech/language needs who were diagnosed with developmental disabilities from a young age, SLPs work with people across the lifespan, providing care and treatment in early intervention to working with adults with whom a major medical event may have caused a speech or language disorder. They also work in mental and behavioral health settings. SLPs are also involved in academia and research advancing the knowledge base of the field. Given the various settings that SLPs work in, overlapping scopes of practice across health care, educational and other settings is a reality. As such, SLPs engaged in interprofessional collaborative practice to ensure that individuals served will benefit from the collaborative comprehensive approach, receive effective interventions that lead to meaningful and best health and educational outcome.
Speech-language pathologists are health care professionals who identify, assess, and treat speech, language and swallowing disorders, preventing, and treating communication disorders in people of all ages. The principles and code of ethics that guide members of the profession highlight safeguarding human dignity, protecting the rights of individuals seeking treatment, celebrating diversity, and embracing collaboration in their efforts to ensure that the individuals with whom they work can communicate effectively.
We would like to thank Dr. Lina Slim for her contributions to this article. We appreciate her insight and expertise.
References
American Speech-Language-Hearing Association. (1970, January 1). Assistants code of conduct. American Speech-Language-Hearing Association. Retrieved February 24, 2023, from https://www.asha.org/policy/assistants-code-of-conduct/.
American Speech-Language-Hearing Association. (1970, January 1). Scope of practice in speech-language pathology. American Speech-Language-Hearing Association. Retrieved February 17, 2023, from https://www.asha.org/policy/sp2016-00343/.
American Speech-Language-Hearing Association. (n.d.). History of Asha. American Speech-Language-Hearing Association. Retrieved February 24, 2023, from https://www.asha.org/about/history/.
American Speech-Language-Hearing Association. (n.d.). National Outcomes Measurement System (NOMS). American Speech-Language-Hearing Association. Retrieved February 24, 2023, from https://www.asha.org/noms/.
A Brief History of SPEECH-LANGUAGE PATHOLOGY. History of the Professions – Health Sciences Library – University of North Carolina at Chapel Hill. (n.d.). Retrieved February 24, 2023, from https://hsl.lib.unc.edu/speechandhearing/professionshistory.
Bullett, M. S. (1985). Certification Requirements for Public School speech-language pathologists in the United States. Language, Speech, and Hearing Services in Schools, 16(2), 124-128. https://doi.org/10.1044/0161-1461.1602.124
McKenna, K., & Bly, L. (2023). Focus on the treatment team: Speech-Language Therapy. Science in Autism Treatment, 20(5).
About the Authors
Kate McKenna, MEd, MSEd, MS, BCBA, LBA, received a Masters in Child Study from the Eliot-Pearson Department of Child Study at Tufts University, a Masters in Special Education from Pace University, and a Masters in ABA from Hunter College. In addition to New York state certifications in general and special education from Birth to Grade 2 and Grades 1-6, she holds a New York State Annotated Certification in Severe/Multiple Disabilities. Kate is currently completing a Masters degree in Children’s Literature at Eastern Michigan University. She was an extern at the Association for Science in Autism Treatment before joining the Board of Directors in 2020.
Lindsay Bly, MS, CCC-SLP, is an ASHA certified speech language pathologist. After receiving her master’s degree at Clarion University of Pennsylvania, she began specializing in dysphagia management and augmentative and alternative communication (AAC) evaluation and implementation. In 2018, Lindsay assumed a newly created speech language pathologist position in the intermediate care facility (ICF) at Melmark. Lindsay develops, creates, and collaborates on protocols to minimize the risk of aspiration in medically complex patients with significant and multiple disabilities including a rigorous evaluation schedule and maintenance treatment for all at risk patients. Lindsay has a passion for management of oropharyngeal dysphagia and maximizing quality of life through least restrictive and safest diets.
Reposted with permission from Action Behavior Centers
Applied Behavior Analysis therapy, most commonly known as ABA therapy, has grown to become the leading therapy for children with autism. Board Certified Behavior Analysts (BCBAs) primarily work with children on the autism spectrum and their families. As the field continues to grow, it is important to identify potential variables that will lead to a family choosing behavioral therapy (in this case ABA therapy) for their autistic child.
The therapy that BCBAs and RBTS (Registered Behavior Technicians) provide, when done effectively, creates a genuine relationship between each therapist and child. To better understand each child’s individual needs, it is important to recognize the child’s unique perspective. Vast majority of BCBAs are trained in educational programs that focus primarily on teaching technical and concept-based skills. However, to be able to successfully work with families of children with autism, we require skills beyond conceptual scenarios.
Critical interpersonal skills are essential when providing our families with the best, highest quality care possible. Amongst these skills, providing compassionate care is the most important stepping stone in building a relationship with the autistic child. This type of care also plays an important aiding factor in distressing families from any potential concerns. Compassionate care is vital to the success of ABA therapy as it builds the trust between the behavioral therapist and the child. This then helps strengthen the engagement and outcomes for each child. By providing compassionate care, a child is willing to move forward with the concept-based scenarios as if it is normal day-to-day activities, which ultimately results in the successful progression of positive skill development.
In simple terms, compassionate care refers to one being able to put themselves in the shoes of those they are working with by responding with sympathy, empathy, and compassion. By applying techniques of compassionate care, an ABA therapist can identify a family’s perspective and tactfully use their own personal experiences to provide the appropriate response to both the child and their parents. We understand that receiving an autism diagnosis for your child can be overwhelming. After receiving a diagnosis, parents have just as much to learn about autism as the child. By providing compassionate care, we are able to help alleviate the stress that these new situations can cause.
It is important to understand that being diagnosed with autism does not make your child less than. If anything, a child on the spectrum could be highly intelligent and extremely curious. Action Behavior Centers’ ABA therapist understands that providing compassionate care is understanding that your child may need a little extra support and attention. This extra support does not mean your child is lacking in ability. We believe in helping your child reach their full potential by believing in your child and helping them achieve new milestones.
Action Behavior Centers (ABC) is an organization committed to the treatment of children using empirically validated methods and strategies to assist each child in reaching his or her greatest potential and improving their quality of life.
Helping your child transition to a school sleep schedule can be a rewarding and empowering experience for parents of children on the autism spectrum. While it may initially seem challenging to adjust to the structured routine of the school year, especially after the more relaxed summer months, there are effective strategies that can make this process smoother. By implementing these 5 tips, parents can ensure their child is energized, refreshed, and fully prepared to embrace each school day with enthusiasm.
1) Create a Consistent Sleep Schedule
A consistent sleep schedule in a child’s routine is crucial for several reasons. Firstly, having a predictable routine can bring about positive effects by reducing anxiety and providing a comforting sense of stability. Secondly, a lack of sleep can exacerbate behavioral challenges and difficulties with attention and focus. It is recommended for children to aim for 8-12 hours of sleep each night. Ensuring a regular sleep schedule increases the likelihood of children being well-rested, which can positively impact their overall mood, behavior, and cognitive abilities.
2) Establish a Bedtime Routine
Establishing a consistent bedtime routine is essential for children. Following a predictable sequence of activities each night can help your child wind down and prepare for sleep. Begin by choosing calming activities, such as reading a book or a warm bath, to signal to your child that it’s time to relax.
3) Gradually Adjust Bedtime and Wake-Up Time
As you work to transition your child to a school sleep schedule, it’s important to do so gradually. Abruptly changing their bedtime and wake-up time can cause stress and resistance. Instead, make minor adjustments to their schedule each day, slowly shifting their bedtime and wake-up time closer to their school schedule. This will allow their body to adjust and make the transition smoother.
4) Create a Calming Sleep Environment
Creating a calming sleep environment is crucial for children to promote relaxation and restful sleep. Start by ensuring the bedroom is free from distractions, such as loud noises or bright lights. Use blackout curtains or a white noise machine to block out disruptive stimuli. Additionally, provide your child with a comfortable, cozy bed using soft blankets and pillows. Incorporating soothing elements like a nightlight or a weighted blanket (if appropriate for their age) can also help create a serene atmosphere.
5) Implement Visual Aids and Rewards System
Implementing visual aids and a rewards system can be beneficial when transitioning your child to a school sleep schedule. Visual aids, such as a visual schedule or a picture chart, can provide a clear and understandable visual representation of the bedtime routine. This can help your child understand and anticipate each step in the process. Additionally, a rewards system can motivate and positively reinforce bedtime routines and adherence to the sleep schedule. You can create a sticker chart or a token system where your child earns rewards for following the routine and going to bed on time. This can help make the transition more enjoyable and rewarding for your child, ultimately leading to a smoother adjustment to the school sleep schedule.
About BlueSprig
BlueSprig is on a mission to change the world for children with autism.
BlueSprig Is the Premier Provider with the Highest Standards in ABA Therapy Our mission is simple: we are focused on changing the world for children with autism.
The main question we seek the answer to is “what if?”
What if we focus on quality services? What if we are a leader in ABA research? What if we are strong advocates for the rights of all children with autism? Instead of choosing, we’re pursuing all three together – that’s the BlueSprig difference.
In the Applied Behavioral Analysis (ABA) field, it is believed that there is always an underlying reason for all behavior. Our behavior serves a purpose, even though it may not always be clear. All behavior can be narrowed down to one (or more) of four reasons, also known as functions. The 4 functions of behavior are categorized as attention, escape, tangible, and sensory. Trying to understand why an adult or child is engaging in a target behavior may be challenging, but determining the specific function of behavior that is being exhibited can assist in guiding a treatment plan to help decrease or increase a specific behavior.
Attention (Connection) – This function can be described as when someone engages in a behavior in an effort to gain attention. Children may behave negatively to get attention even if it isn’t positive attention. However, It is important to remember that not all attention seeking behavior should be perceived negatively. For example, raising your hand to be called on and screaming for someone to come over are both attention seeking behaviors, but one of the two is more socially acceptable.
Escape (Avoidance) – Escape is one of the most common functions. This occurs when people engage in certain behaviors in order to avoid or end an unpleasant experience. A child may behave in a certain way that is unacceptable to get out of doing something they don’t want to do. Examples of this could be sleeping in class to avoid working or taking a different route home to avoid traffic.
Tangible (Attaining) – This can be described as someone engaging in a behavior for access to something. In order to obtain an object or take part in an activity in which a person is particularly interested, a person may behave in a particular manner. A child screaming to get a toy or finishing their homework for tv time are both examples of a tangible function of behavior.
Sensory (Automatic) – This behavior occurs when people engage in certain behaviors because they physically feel good or to relieve negative feelings. It is referring to stimulating the senses. An example of this would be itching an ant bite or fanning yourself on a hot day.
Understanding Positive and Negative Reinforcements
In general, behavioral outcomes can serve one of two purposes. The reasoning behind these behaviors is to either acquire something or remove from something. When a child behaves in a way to acquire something, it’s called positive reinforcement. On the other hand, negative reinforcement is the removal of something unpleasant to the child.
To help with further understanding, both positive and negative reinforcements can be better understood through attention and sensory reinforcement. Attention positive reinforcement occurs when a child receives something as a result of someone else’s actions. For example, a child might ask their father for a blanket. To positively reinforce the child’s communication of asking, the father will provide the blanket. Whereas, negative reinforcement might be where the father removes the blanket because the child no longer wants to use it.
A third concept is that of automatic reinforcement. In this circumstance, the reinforcement happens without the help of anyone else. The child is able to meet their needs on one’s own. Using the same scenario, a child getting their own blanket is positive reinforcement. As far as negative reinforcement, this would result in the child pushing the blanket off of themself.
How can we help?
A child’s motivation behind specific actions or behaviors can be pinpointed by understanding the four functions of behavior, but it is important to remember that a single behavior can hold two or more functions. In addition, it is important to comprehend both positive and negative reinforcements in order to fully grasp why a behavior is occurring. By identifying these functions, we can teach kids to meet their needs in a positive way. In ABA therapy, our staff will observe your child in their element. We will pay close attention to what is happening before and after the targeted behavior to identify the key function. After being assessed, we will teach replacement behaviors. The goal is to decrease target behaviors and increase desired behavior to ensure behavioral consistency in all environments to achieve success on the spectrum.
About Action Behavior Centers
Action Behavior Centers (ABC) is an organization committed to the treatment of children using empirically validated methods and strategies to assist each child in reaching his or her greatest potential and improving their quality of life.
Children with autism and other neurodivergence commonly struggle with transitions. The shift from summer to the start of a new school year is one of the most challenging transitions. Getting back into a new routine is not easy and often requires support and patience through these changes. Behavior analysts play a vital role in helping these children navigate the back-to-school season. Let’s review four strategies you can try to make for a successful back-to-school transition for your clients.
1. Maintain Open Communication with School Staff
Open communication between the ABA and school teams can help smooth the transition. Introduce yourself to your client’s teacher and support staff, communicating your desire to collaborate for your shared learner’s best interests. Use this as an opportunity to also share and celebrate your client’s growth during the summer. Share mastered skills that your client achieved over the summer and any new concerns to help the school team gain an updated picture of their current skills and behaviors.
2. Review and Update Goals
Take a look through your client’s goals and progress made. The ultimate goal of ABA is to prepare our learners for optimal functioning in the least restrictive environments. Consider updating goals to encourage the development of skills that will help them be more successful at school. If they attended school last year, review their IEP and reflect on areas they struggled with in the previous year.
One area to consider is your learner’s self-advocacy skills. Do they have the necessary skills to express their needs and desires in a manner that school staff can understand? Do they have the ability to communicate when something is uncomfortable, they need a break, or someone is bothering them? These skills are all critical for success in school and onward. Ensure goals are in place to teach these skills, if not already mastered.
3. Increase Caregiver Training and Support
During times of major transitions, parents and caregivers may also struggle to navigate the routine shifts that often come with behavioral changes in their child. Empower your client’s parents to support their child through this shift by enhancing caregiver training. If clinically appropriate and feasible, increase caregiver training sessions before and for the first few weeks after the school year starts. Providing additional support can set everyone up for success.
4. Implement New Antecedent Strategies
Consider the antecedent strategies you can implement to help your client better cope with the new routines and expectations. Visual supports, such as a visual schedule with the child’s morning routine or daily schedule, can help your client envision what comes next, making it easier for them to get into the swing of things. If your client enjoys social stories, you can create one to review with them (or have parents read it to them) to familiarize them with what to expect. Make sure it’s personalized and unique to them with components such as their teacher’s name and picture.
Plan Ahead for a Successful School Year
The back-to-school season can be a stressful time for children and their families. However, with caregiver planning and support, behavior analysts can help make this process significantly easier. Help your families navigate change and prepare for a year of success at school by trying the aforementioned strategies. Each client is unique, so as always, tailor your approach to their particular needs and preferences.
About the Author
Ashleigh Evans, MS, is a Board Certified Behavior Analyst. She has been practicing in the behavior analysis field for over 13 years and opened her own independent practice in early 2022. Her experience has been vast across different age groups, diagnoses, and needs. She is passionate about improving the field through education, reformative action, and better supervisory practices, leading her to create content and resources for families and ABA professionals which can be found on her website, https://www.abaresourcecenter.com/.
Reposted with permission from Ashleigh Evans, MS, BCBA
Visual supports are items used as prompts/cues to help guide one toward the expected behavior. Visual supports are not exclusive to children with autism. Even as adults, we all use visual supports, from our planners to organization apps and more.
Visual supports can be beneficial in reminding children of the expectations and guiding them through adaptive behaviors.
We’ll review a few common visual supports. If your child is receiving treatment, chat with their care team about implementing the most appropriate visual supports for your child. It’s easy to get carried away with all the visuals, but that can get overstimulating for many kids. Try one thing at a time to get a good idea of what is most helpful and build from there.
First-Then Visual
This is a tool that is simple to create and implement. The purpose is to help your child understand what’s to come next. You can create this in a simple way with a paper labeled first on the left side and then on the right side. You can use words or visuals to show your child what the current task is and what will come next.
Typically, the “first” side will have a non-preferred task such as “clean your room” and the “then” side will have a preferred item or activity such as “play outside.” So, first clean your room, then play outside.
Stop Signs
Ensuring your child’s safety is everyone’s number 1 priority. Teaching your child to respond to stop signs can be a great visual prompt as a reminder of locations they can and cannot go around the home.
Place a laminated stop sign on the doors leading outside (or any other areas in the home that are unsafe for your child). This can serve as a reminder to your child to pause and not go out that door if they are unaccompanied by an adult. This will take practice, but once they have the idea down, stop signs can be an excellent prompt!
Visual Schedules
The first-then visual is a simplified visual schedule showing two activities. A full visual schedule can be created to help your child understand several upcoming events. There are many ways to set this up. For example, you could set this up as a schedule of their full day. Or you may create one to support them through a portion of their day, such as the bedtime routine consisting of brush teeth, put on pajamas, bedtime story, etc.
Again, there are many ways you can go about creating this including using pictures or words. You could go about creating one yourself or purchasing one.
Visual Timers
Visual timers can be a really helpful way to help a child who doesn’t quite understand the concept of time, comprehend how much time is left of an activity. The red on the clock visually displays how much time is remaining for an activity or until an upcoming transition.
Visuals can be so valuable in prompting us through our daily lives. Finding effective visual supports for your child can make a huge difference.
About the Author
Ashleigh Evans, MS, is a Board Certified Behavior Analyst. She has been practicing in the behavior analysis field for over 13 years and opened her own independent practice in early 2022. Her experience has been vast across different age groups, diagnoses, and needs. She is passionate about improving the field through education, reformative action, and better supervisory practices, leading her to create content and resources for families and ABA professionals which can be found on her website, https://www.abaresourcecenter.com/.
