Mentoring P.D. 2 Talitha Riley and Fang Min Lim 27 March 2019 WHY IS GOAL SETTING IMPORTANT? WHY SET SMART GOALS FOR OUR CLIENTS? - Goals can be set in order to change behaviours, increase motivation, reduce anxiety, increase ability/ awareness… - SMART goals and the data we collect allow us to demonstrate how effective our intervention is on the specific target/s selected. SPECIFIC - As detailed as possible, i.e., if you’re working on articulation, you include the exact phonemes you’re targeting. MEASURABLE - Think about how and how often you’ll collect data to show the goal has been achieved. Measurements either show progress or guide you to reconsider the goal being targeted. 80% is considered the level of mastery of a skill. Ideally, as the client’s ability (% score) increases, the level of support decreases. ATTAINABLE - Can this goal be achieved by the client? Think about whether this goal is acceptable: what are the needs of this client and are you prioritising them appropriately? Consider the Zone of Proximal Development. RELEVANT - Consider whether the goal is functional/ a priority for the client/ the client’s family? TIME - How much time are you dedicating towards working on the goal? Anticipated date of completion/ achievement. REFERENCE: INTERVENTION IN SPEECH PATHOLOGY NOTES Mentoring P.D. 2 Talitha Riley and Fang Min Lim 27 March 2019 INCREASE STEPS - Change the initial goal by increasing the cognitive load of the task. To be implemented when the goal that was initially set has been achieved (after approx. 3 target attempts in a row). DECREASE STEPS - Change the initial goal by decreasing the cognitive load of the task. To be implemented when the initial goal has not been achieved (after approx. 3 target attempts in a row). Example Initial goal: For 80% of students to identify (label) 2 target items themed from “Dear Zoo” with moderate clinician support. Increase - Ask for attribute/s to describe the selected animal: What can you tell me about this animal? - Ask child to identify differences: “How are item 1 and item 2 different?” - Ask child to identify similarities: “How are item 1 and item 2 the same?” Decrease: - Identify (label) one item. Implementing Increase/ Decrease steps helps to keep the child motivated and engaged in the activity. Increase/ Decrease steps are used in conjunction with the Cueing Hierarchy. If the activity is too easy, it may become hard for the child to stay engaged. If the activity is too challenging, the child will lose the motivation to persevere with the task, which might also impact other activities! REFERENCE: INTERVENTION IN SPEECH PATHOLOGY NOTES Mentoring P.D. 2 Talitha Riley and Fang Min Lim 27 March 2019 CUEING HIERARCHY - A stimulus that provides information about the desired answer but does not provide the answer – an indirect instruction. A prompt (maximum support) is direct instruction. Cues do not change the cognitive load – they step the client towards the correct answer/ production. Cues can be used with any goal or increase/ decrease step. The type of cues depend on the activity o Example: if working on a semantic activity, aim to use semantic cues. This aims to guide the client in using semantic information in order to achieve the target. Examples Minimum support: - Facial expression: looking at the client to indicate that you want them to use the new skill that has been taught/ remind them to self-correct. Extra time to respond. Verbal reminder: repeating or giving a quick reminder about the instruction/ question. Moderate support: - Tactile cue: a gentle tap to guide them toward the task (i.e. if a picture based task). Phonemic cue: start the word for them, by verbalizing the first phoneme/s. Visual cue: a picture prompt of the aim of the activity (what you want them to do/ say) Gestural cue: pointing to the target item/ picture (more direct than a tactile cue). Maximum support: - Hand-over-hand: gently, physically guide them to do what is required (i.e. if clapping syllables for a Kindy P.A. task). Model: tell the child what you want them to say/ how you want them to say it o e.g. “‘Sip’. Keeping our tongue behind our teeth, we say ‘sip’. I’ll say it, and then you say it… ‘Sip’…” Mentoring P.D. 2 Talitha Riley and Fang Min Lim 27 March 2019 WHAT IS THE REASON FOR THIS ORDER OF CUES? - The cues are ordered sequentially indirect to direct. Minimum supports allow the client more time to process the instruction/ question. Extra time/ repetition of the instruction gives the client a chance to hear and process the instruction again, already having been primed. Moderate supports are different ways to step the client closer to the target, without the SP giving the target away. Maximum support (direct instruction) gives the client the answer, helping them to achieve it through imitation or with hand-over-hand help (depending on the goal/ task). REFERENCE: CHAPEY, R. (2008). LANGUAGE INTERVENTION STRATEGIES IN APHASIA AND RELATED NEUROGENIC COMMUNICATION DISORDERS (5TH ED.). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. PRAISE/ CONFIRMATION OF CORRECT RESPONSE Repeated modelling in praise: e.g. with a sorting activity: “Great job, that’s a X and it goes in the Y (group)!” - Emphasis/ extra exposure to the target in praise: e.g. articulation targets, if targeting /s/ sound – ‘Super work!’ o Modelling within praise, emphasis/ extra exposure within praise aims to give the client more opportunities to hear the correct answer/ production. Scheduled praise: praise often at the beginning of an activity and reduce the amount of verbal praise (continuing with positive, nonverbal cues) as the activity progresses. - - REFERENCE: INTERVENTION IN SPEECH PATHOLOGY NOTES Mentoring P.D. 2 Talitha Riley and Fang Min Lim 27 March 2019 PROGRESS NOTES REFERENCE: CURTIN SCHOOL PLACEMENT MANUAL, 2019 S.O.A.P – WHAT DOES IT STAND FOR? SUBJECTIVE - This includes perceptions and statements provided by the client or their caregiver. o When including such statements, use direct quotes (include quotation marks). OBJECTIVE - Generally, includes an account of measures and objective observations made within the session. ANALYSIS - PLAN - Analysis and interpretation of the information gathered, and observations detailed. o Making meaning from the observations (subjective and objective). A plan or recommendation/s for home practice and/or future sessions. GENERAL POINTS - The most recent entry is to be positioned at the top of the document. Make sure you are reporting correct and relevant information. o Incorrect observing mentor names have been used. o Where possible, include observations about the types of supports that were found to be useful (and the ones that weren’t useful!) The client’s manner on the day (easily fatigued/ hesitant/ energetic etc.) impacts on their ability to perform the task/s. These types of observation statements help to provide a more comprehensive snapshot of the client, rather than just the data collected. - Language: o Where possible, use definitive language. ‘Appeared to be’ has been used frequently. State what you observed that backs up this statement. o Tense is often changed within the same entry. Progress Notes report what has happened – past tense. - Proof-reading, fonts and formatting – why is this important? o All Progress Notes reviewed had several edits to proof-reading. Most of you are keeping on top of the use of consistent fonts and formatting. INDIVIDUAL CLIENT: Preferably in one document. KINDY WHOLE CLASS: Preferably in two documents (Kindy Class 1 and Kindy Class 2).
