Archive for “Thoughts about Therapy”

It’s been a frustrating couple of days at work—six out of the seven children I booked in ‘did not attend’ (DNA). I call families the day before their appointments, and try to see them at a Children’s Centre rather than the clinic, if it’s closer to home, but this obviously isn’t enough—I think it’s time for something radical!

My partner suggested I double book appointments—invite two children to every appointment, on the assumption that one won’t come. I think that’s a bit too radical! But what about ‘over booking’ appointments? At the moment I book appointments in one hour slots. I think this is the norm where I work. It gives me time to write the notes, sort out the therapy room, get a cup of tea etc., between clients.

When I talk about ‘over booking’, I envisage booking in ten children, at 30 minute intervals. Here are my calculations.

Appointments generally last 40 minutes, but I’d book the appointments in half-hour slots. There’d be two one hour slots, which would allow me ‘catch up’ time. So, if all ten children came (which with current form, seems highly unlikely!) four children would be seen on time, four would be seen ten minutes late and two would have to wait 20 minutes for their appointment. More realistically, 50% come, I see five children, do a good day’s work and stop getting so grumpy.

(For clarity: I’d use the following appointment times: 9.30 am, 10.00 am, 10.30 am, 11.30 am, 12 noon, 1.30 pm, 2.00 pm, 2.30 pm, 3.30 pm and 4.00 pm.)

Perhaps I’d be able to ‘reward’ good attenders, by giving them particular slots so they’d be seen on time. Do you think a system like this would be feasible? Have you tried anything similar? What are the pitfalls?

I know I need to investigate why people are not bringing their children to speech and language therapy appointments. Maybe I’ll do a telephone survey, but I find it hard to ask people why they DNA’d without sounding cross! Something to work on then!

At work recently, the issue of whether our standard advice for language enrichment is compatible with Montessori education came up, during peer supervision. When a Montessori school asked for help extending their younger pupils’ language and conversation skills, my colleague began by mentioning that the “home corner” was a great setting for encouraging language. She was told that home corners are contrary to the Montessori ethos.

According to Wikipedia, the Montessori method “is characterized by an emphasis on self-directed activity on the part of the child.” My colleague was told that her suggestions to comment on a child’s play, play games involving following instructions and ask questions about a book were adult-directed and therefore not appropriate. The colleague left the meeting feeling frustrated and unsure how to move forward with the situation.

In supervision it was suggested that perhaps the Early Years Foundation Stage would provide a common ground. When I searched google I found that the Montessori Schools Association have put together a document (PDF) which demonstrates how their approach shares the underlying principles of the Early Years Foundation Stage. I found a number of examples of Montessori practice in the document which SLTs could use to model ways of extending and developing language. These included farm, hospital or any other “small world” play, using puppets and props to re-tell stories, and role-play such as “shop”.

I think it’s a helpful document—hopefully the ideas in it will make the next meeting with the school more productive! The same colleague also told the supervision group about many positive experiences working with Montessori schools. What is your experience of working with staff in Montessori settings? Any tips you could share? SLT games / activities that are compatible with their ethos? It would be great to hear other people’s ideas!

Rhiannan

This week I tried out an idea that Deborah contributed; tube posting. I merrily spent an evening decorating a tube with sparkly paper and got some strange looks carrying it to work the next morning on the bus.

I took the tube along to my first session; I was working with a child who has severe attention and listening difficulties. He focussed on the tube for approximately 3 seconds, watched me post one ball and then got up to find another toy to play with. A disappointing first outing for my sparkly tube!

However, half an hour later, a very different child walked into my therapy room. He couldn’t get enough of the tube game! The tube (and I) held his attention for more than 15 minutes; it was a great informal assessment tool, allowing me to check the child’s key word understanding and how he was able to make choices. Thanks Deborah!

Since I started writing this blog, I have been having a nosey around the web for other SLT-related blogs. So far I haven’t found all that much out there… add a comment if you’ve found (or write) something!

I did find one interesting blog: Tower to Trenches, by Judy Stone-Goldman. I enjoyed Judy’s most recent post. I hadn’t really considered how having a favourite client puts that client under pressure. Judy suggests that we should try to be honest with ourselves about how we feel, that “we like some clients better than others.” She takes a quiet moment before sessions to think both about the child she is going to see and herself. Do you do something similar? I’m going to try this over the next couple of weeks, I’ll let you know how I get on!

Rhiannan