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[phono-tx] Re: all about speech homework

 

Dear Caroline,

This is a great discussion topic! I guess I have two perspectives, one personal, one professional.

Personally: My experience with speech homework was not for me, but for my younger brother whom I thought had a lisp, but was given 'ch' homework to work on...still not sure exactly why, but I digress. I was only around 9 or 10 at the time, so I have only vague recollections, but what I do remember is that he absolutely, completely and utterly HATED it. He hated Speech Rx, he hated his therapist and he point blank refused to do homework.
According to my mother this is when I stepped in and started making up games for him to practise his words with, as apparently I was the only one who could get him to do anything. (For all those reading at home, this was when my mother decided that I should become a speechie for real- Thanks Mum!).
Subsequently as an adult I found those old stim cards in a box and saw that they were basically sh/ch min pairs, written in very small writing (no pictures) and I remember thinking 'No wonder he was bored!'.

Professionally: As in therapy in clinic, homework tends to be a bit of a mix of things and often I will give the sheet I am working on for homework, but I think part of it is in the presentation. All of my clients have speech folders and I encourage parents to let them pick the colour/design that they like. Most of the younger ones not at school LOVE that, as they have there own 'work' just like their brothers or sisters at school. Most of them tend to put their stickers from their session on their folders.

But I always give ideas of activities and motivators to use with whatever they are actually being given. As for making sure it is implemented, that is always the trick isn't it. I am a fan of the star chart concept. Basically any child upon commencing therapy with me is given some kind of picture with boxes or something that you can fill in, then they are given a stamp or sticker in the box at the end of each therapy session (I had one child who used to bargain to get two lol) or during depending on how much encouragement is required and then one each time they practise at home.

Once the sheet is full, they get a prize- sometimes this was something I had i.e a sheet of special stickers, or some marbles, or bracelets (never, EVER food), sometimes it was something provided by the parents i.e a special trip somewhere, a coveted toy, whatever. And I know that some people may object to the whole concept as bribery, but they way I look at it, they are earning that reward, they worked for it! It's the old 'Because you did such good work' rather than 'if you are good...' thing.

Another thing that I have found that is important to address is the concept of praise as a motivator itself. Lots of kids seem to love a high five, or a clap, or even a little whoop; I think sometimes this gets lost at home, as some parents are so stressed about them doing it right, there is a lot of pressure to perform.

I do find that parents prefer games and love anything on the computer or online, as they find it easier to get the children to go along with it. I also see lots of times that life can get in the way, however most parents tend to be honest about this and fess up at the start of the next session. And then most of those same parents put in more of an effort to 'make up for it' the next time.

At the end of the day, they are a parent first and you are the therapist, but there is usually a conversation about the importance of practise and carryover to home. I tend to explain this in simple time terms i.e they spend half an hour a week with me, they spend all day every day with you, which do you think is going to have a bigger impact? (I would love some actual literature to back that up though!)

My main tips with homework (regardless of what form it takes) for parents are thus:
- It doesn't have to be the amount of a full therapy session, 5 or 10 minutes is better than nothing. (In fact I tend to recommend they aim for 10 minutes of structured practise every day for the severe ones. I think even the most busy families can find 5-10 minutes, whereas the concept of finding half an hour is often like 'yeah right!').
- Get the child to pick something that they want to do from their folder of goodies. Allow them an element of control.
- If it's really not working and the child is getting extremely frustrated (a common complaint/excuse for no homework), try a different activity, preferrably something they can do, or take a break completely and try to come back to it later.
-Life happens. Sometimes stuff goes wrong and you really don't have time. Just be aware that if that is the case on a continual basis, it can negatively affect therapy outcomes and lengthen the process. What do you prioritise?

I have known therapists who deny therapy for children who don't do homework. I have never done this, as it seems to just be punishing the child- and I work in the public sector, so we are required to see them, unless they repeatedly DNA. However I do have that conversation with them regarding therapy outcomes every single session. And I still continue to give homework and ask them every session if they did it. In some cases this confrontation does wear them down and in some cases, they really aren't that committed, regardless of what you do. These are the ones who would never do anything at home unless you physically stood over them and did it with them in their kitchen. Luckily these are rare- or they tend to be the DNAs who get weeded out anyway.

But anyway, that is my two cents, I would love to hear what other people do!

-Erin

(SLP/T from Oz, transplanted to the UK)

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