Following Your Schedule: How to get Back on Track

note book with daily routine

Holidays can be a time when the normal routine is disrupted. It’s time to get back on track and follow your daily routine.

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Teletherapy Tips for Families

drawing of therapist performing teletherapy

As we are all beginning to adjust to teletherapy as well as online or elearning, we thought it best to share some tips to make you and your loved ones time in therapy, albeit significantly different than ever before, more successful. 

  1. Count on some sort of technology failure – if you count on the fact that the mic won’t turn on or your wifi will be running slow, you won’t panic when it does happen.  If there is a technology failure (on your side or on the therapist’s side), the first thing to do is breathe. Next calmly begin to troubleshoot. Prior to the appointment, you may want to trial the mic and speakers on the device you intend to use for therapy.  If your bandwidth on your wifi is slow, as those in your home to stay off the network or not engage in activities (streaming videos) that use a lot of bandwidth. If the session can’t happen, you can reschedule. Flexibility is key.
  2. Create a “Therapy Space” or designate a “Therapy Space” for the duration of the session.  You may want to create a ‘Therapy in Session’ sign with your loved one and hang it on the door of the room you are in for the session.  If you will be in a shared living area, you may want to consider the use of a headphone and mic combination. This will decrease the amount of background noise your loved one will hear as well as the therapist. Consider scheduling therapy at a time when others in your family would be napping or engaged in more quiet activities as well.  Creativity is key. 
  3. Count on staying with your loved one for the onset of the therapy session. For individuals that may need support to pay attention, consider this time extra snuggle time.  Have your loved one sit on your lap or very close to you during the session to help guide her/his attention to the therapist. This is time for your loved one to receive the critical therapy services needed as well as a time for YOU to better understand the techniques used to elicit specific behaviors, actions, and sounds from your child.  Teamwork is key. 
  4. Listen to the therapist and therapy session.  Remember, this is your loved one’s therapy time, not necessarily yours.  While it may be hard, refrain from answering the therapist’s questions for talking for your loved one. You may consider the situation/task that the therapist is asking your loved one to do is too difficult, but creating these situations to ‘push’ your loved one to the next level is necessary in progress towards mastery of goals. Trust is key. 
  5. Carryover of all the new skills learned during the therapy session (both for you and your loved one) is extremely important for everyone! You will have new skills to support your loved one as he/she works on speech-language skills.  Share what you have learned with others in your family. Help everyone realize the necessary supports to help your loved one succeed. Practice is key. 

Keeping in mind the importance of flexibility, creativity, teamwork, trust and practice will ensure your loved ones success with this different approach to speech-language therapy.  

More information about the telepractice services offered at Lakeshore Speech can be found at www.lakeshorespeech.com/telepractice or by calling 1-440-417-4190.

Yours in Speech, 
Lakeshore Speech Therapy, LLC

Practice Makes Permanent

children trick or treating with pumpkin baskets

We’ve shared the idea of “practice makes permanent’ in previous posts. This technique is ever important when preparing for an evening of ghosts and goblins and candy acquisition – aka, Halloween. You may think it’s too early and there are so many days to prepare before the end of the month, however we all know how quickly the days fly.

Practicing for an evening of trick-or-treating does not have to look like ‘practice’ or be announced as such. Take a walk on the trick-or-treat route you intend to follow during the day. Make sure to point out various landmarks as well as the changes (different decorations, leaves falling off the trees, etc.). Expand that practice walking the route as it begins to get dark, note the street lights turning on as well as pointing out how the houses may look different, but are the same during the day or night. If your loved one enjoys a good map, make a map of your route and fill in the landmarks together.

As the day draws closer, practice trick or treating from room to room in your house. Close the bathroom door and have your loved on practice trick-or-treating for toothpaste or a toothbrush. While it sounds silly, it’s a safe non-pressured way to practice this exchange as well as gives you a marker for future experiences (“Remember how we did this at home for toothpaste?”). Trick-or-Treating for everyday items (ie: while getting dressed or cleaning a room) may also be the ticket for ‘fun’ buy in for a less enjoyable activity.

Share with neighbors and family the ‘practice makes permanent’ theory and request a practice time that is more similar to the actual event. While your loved one may need a few rounds of practice, it will soon make sense how the exchange of events will occur and the pay-off is well worth the time invested in practicing. Note: the pay-off does not necessarily need to be candy. While candy may be a delight and preferred, practicing these skills can result in the acquisition of other items not necessarily of the sugar food group sort.

A final round of practice making permanent may be partaking in some of indoor or less conventional trick or treat options in the area. Here are a few links that may help in planning these practice sessions:

We’ve said it once and we’ll say it again, practice makes permanent which can significantly decrease unexpected behaviors which creates a less stressful situation for EVERYONE to enjoy!

Yours in Speech,
Lakeshore Speech Therapy, LLC

It’s All Routine

This month we’ve focused on schedules and free activities to fill those schedules. This week we are discussing routines and the importance of routines related to speech-language development.  Personal, familial, classroom, or therapy routines provide a framework of certainty. Within these routines are the skills and expectations that help to introduce and maintain speech-language skills, social pragmatic skills and increased independence with executive functioning skills.

Take a moment and replay your morning routine back in your head.  Do you brush your teeth before you wash your face? Do you take a medication right away or do you take it with your first cup of coffee? It’s easy to picture yourself completing your morning routine and if something is off, you know it immediately.

Routines for infants and toddlers provide a number of opportunities to practice important speech-language and social skills. Anticipating the steps, sequencing steps, learning the vocabulary associated with the steps are all skills infants and toddlers need to develop meaningful associations with language and action. Daily routines provide the repetition of vocabulary and actions leading to independent participation in these routines.

Routine for school aged children can provide a calming environment for anticipating activities as well as expectations throughout the day.  Similar to infants and toddlers, sequencing steps, learning vocabulary and making associations provides the foundation for increasing successful independence throughout the day.  Routines also give the child the opportunity to learn the expected behaviors and unwritten social rules in a repeat practice setting. Daily routines facilitate conversations between child and adult to specifically explain and model appropriate social and behavioral expectations.

Routines for older children and young adults create a setting where focus can be more on new skills and independence versus the actual steps.  These routines are not only part of the day, but provide the opportunity to increase independence and demonstrate expected behaviors and social skills which should be the focus of mastery for young adults.  Routines at this age also provide opportunities for increased independence imperative for vocational and secondary education settings.

Individuals who have tendencies to become rigid regarding implementation and execution of routines, such that any variation creates adverse behaviors need to have their routines continuously changed.   This does not mean the target task or activity needs to change, however change when the task or activity occurs. For example, night time routine might go tv time -change in pjs – brush teeth – book time – lights out. Consider changing to book time – brush teeth – change in pjs – tv time – lights out or some variation.  You know your loved one best and will be able to determine how often the change needs to occur.

If you have any questions or need a sounding board regarding routines, please reach out to your speech-language pathologist.

Yours in Speech,

Lakeshore Speech Therapy, LLC

Plan for the Day

note book with daily routine

It’s finally here…. JUNE!  Days are longer…much longer. Weather it warmer…. much warmer. Everyone is home… school’s out…..everyone’s home…. all day.  Did we mention the days are longer?

While June ushers in a time a carefree days and weeks, pay attention to just how important a daily routine (dare we say schedule) is for your loved one’s success, ease of mind, and ability to manage behaviors.  

“But we just finished a school year worth of schedules!”

We hear you, but these summer routines and schedules are a lot less time specific.  Summer routines and schedules make the ‘unknown’ day more concrete. They also provide the adults with a reminder or recap of the day.

Resources for creating schedules are available online.  Use simple pictures of places and events or if your loved on is literate, use text.

There are many different types of set-ups for schedules or routines you might want to consider.  Ultimately, create a combination of different types that suits your family’s needs best.

Object schedule: Using objects that represent the events throughout the day may give your loved on the visual support needed to easily transition from one activity to the next.  This also provides a concrete explanation of the expectations throughout the day so there is no ‘arguing’. It’s so much easier to ‘blame’ the schedule for completing a non-preferred task. “I’m sorry, but the schedule says it’s time to clean-up. Check the schedule.”

Picture schedule: Simple clipart pictures or actual photos can serve as  visual reminders for the schedule or routine of the day.  Providing a method of indicating the event is complete provides a very concrete message for your loved one.  Some suggestions to show an event is complete include turning the picture over, removing the picture from the schedule, or placing a check-mark next to the picture.

Text Schedule: If your loved on is literate, consider a simple checklist for the day’s events or using a white boards to catalogue the schedule for the day. These types of schedules can include exact times as well as specific locations.

High Tech: If your loved one is more comfortable using a ‘smart’ device, consider using the calendar built in to the operating system or a daily planner app (free ones are the best when trialing this support). Work with your loved one to set up the calendar, make sure to include alarms or notifications for each event. Using a ‘shared’ calendar provides everyone the flexibility to add or change items accordingly.  

 

Providing visual supports and schedules to loved ones gives everyone the opportunity to enjoy the lazy days of summer more successfully and with much less stress.  The speech-language therapist at Lakeshore Speech Therapy, LLC will be happy to provide more ideas and assistance with developing visual supports specific to your loved one’s needs.

 

Yours in Speech,

Lakeshore Speech Therapy, LLC

In Anticipation of Summer

Last week of April – hard to believe how quickly this year is flying by. Many schools will be out for the summer in one month and the lazy hazy days of summer will be upon us.  There is still a good amount of time to get to those warm sunny days.

Anticipation …. so exciting … so nerve wracking …. so the cause of many behaviors.  Anticipating something good or something less pleasant can set a loved one down a path of unexpected behaviors.  Anticipating the end of the school year, the beginning of swim lessons or the change in schedule can really affect behaviors more than one might anticipate, especially if communicating is difficult for an individual.

Creating a plan, anticipating the anticipation, may result in a more positive transition for you and your loved one. Here are a few tips to consider.

  • Timing – be aware and truly plan out how much in advance you will mention or discuss a change.   Consider the end effect on your loved one when determining how far in advance to share information.  A trip to a major amusement park, while exciting, if shared too much in advance could result in your loved one being fixated on this information for weeks or months.  Springing summer camp on your loved one the morning of the first day, may result in a complete melt down or increase in negative behaviors.
  • Making everyone aware – Make sure everyone who is aware of the change knows when or if your loved one will be made told.  The people around your loved one need to also know your game plan for revealing the change or event. Well meaning family members and friends may ask your loved one direct questions about the change or event before you have had an opportunity to execute your plan. This is definitely a ‘surprise’ you and your loved one do not need to navigate.
  • Create a tangible ‘count down’ to the event or change – Your loved one may need the ‘count down’ to the change or event to be very visible and presented in such a way that they can access this information independently.  Sharing a specific date or time or simply saying “Later this summer.” may be too abstract and create more anticipation (and perhaps behaviors).
    • Use a calendar with the date of the event well identified (stickers, arrows, pictures) and have your loved one cross out each day to the event.
    • Create a count-down chain .  Each day, your loved one removes a link of the chain, visually getting one step closer to the big event or change.  You can use clothes pins or paper clips or any item you can link together to create the chain.
    • Create a simple social story that explains the event and when it will occur.
  • Give your loved one the language to communicate – make sure to include a way in which your loved one can make comments or ask questions about the change or event.  Make a simple communication board with pictures or photos.  Think about the phrases your loved one might want to express:  “I’m excited” (use a picture of excited), “I can’t wait.” (use of picture of a clock or watch), “Tell me again.” (use of picture of talking), “Who will be going?” (use a picture of a silhouette of a person), “How much longer.”(use of picture of a calendar), etc.

A little up front work on your behalf could really make a huge impact when helping your loved one adjust, plan and anticipate a change or up coming event.  Mention this to your speech-language therapist, she/he will be happy to help.

Yours in Speech,

Lakeshore Speech Therapy, LLC.

Holiday Prep – Part II

In a few days we will gather with family and friends to be thankful for all we have our lives. The days leading up to Thanksgiving (or any holiday) can be exciting, yet filled with anxiety, which could result in unexpected behaviors and reactions for some of our loved ones.

We talked about making changes in the actual celebration to better support your loved ones.  We need to focus on preparing them for what they might experience – the different smells, sounds and expectations – during the Thanksgiving celebration.

Social Stories:  These tools help by creating a simple straightforward explanation of what will happen during or leading up to an event, as well as behavior expectations.  Ideally social stories should be reviewed multiple times prior to an event and directly before. Bring the social story to the event and reread it in a quiet place. This may help to decrease the stress and refocus behaviors.  Please feel free to print and use these social stories or you may find some free by searching the web.

Visual Schedule:  Enjoying a relaxed unscheduled day may sound perfect, however your loved one may need to ‘see’ his/her day to decrease anxiety and unexpected behaviors.  A visual schedule may prove to be the needed tool. Visual schedules are helpful for all family members. You can use actual photos, simple stick-figure drawings or icons to depict your daily events.  You may choose to split the day by listing the AM schedule first and then changing it to the PM schedule at a natural break. You may choose to list the entire day and have your loved one remove the icon/picture as each part of the day is completed. Please feel free to print and use these icons to create a visual schedule of your loved one’s day.

First-Then cards: First-Then cards may be a new tool in your toolbox.  These cards use the same icons or pictures as a visual schedule, however are presented two at a time.  This tools gives your loved one a focused message of the immediate expected event or behavior and what will directly follow.  You may consider following a non-preferred activity with a ‘break’ or ‘leisure choice’ to increase his/her attention to the non-preferred activity.  For example, First: eating dinner – Then: going outside to swing. Please feel free to print and used these materials to create a First-Then card for your loved one.

Remember to take a moment to step back and truly see all the beauty that surrounds you.  Cherish your time with family and friends. We at Lakeshore Speech Therapy are thankful for our Lakeshore families.  We wish you and your family a wonderful Thanksgiving day filled with laughter and happiness.

Yours in Speech,

Lakeshore Speech Therapy, LLC

Friday Night Lights

Friday night lights! High school traditions!  Go Team!

Fall is the time of year to grab your favorite sweatshirt and enjoy an evening of high school football.  “Enjoy” – that’s the difficult part especially for some. The many sounds and smells as well as the number of people all in one place can cause loved ones with integration issues difficulty in large  crowds. There are a number of proactive steps families can take to help loved ones adjust to these situations.

Paint a picture of what the individual will experience during their time at the game.  For example:

  • We are going to park the car in the parking lot (or, in some instances, the – field, street, etc.)
  • We will walk to the gate or entrance of the field.
  • We will have to stand in line to get our tickets.
    • Note: if available, please consider purchasing tickets ahead of time.  Less time anxiously waiting, the better.
  • There will be a lot of people around us; you will hear them talking and shouting.
  • We will walk to our seats
  • We will walk up or down the stadium steps
    • Note: if the stadium steps are open (meaning you can see the ground below) you may want to consider sitting in an area closer to the ground or where the steps are solid.
  • We will sit in our seats
    • Note: if the individual is sensitive to pressure – consider bringing a blanket or stadium chair to decrease the sensation of the ‘hard’ stadium bleachers.
  • Etcetera
    • Don’t forget to include what will be
      • heard (band, horns, cheering, etc.)
      • seen
      • smelled

Carry an ‘important tools’ bag.  This bag should contain items that calm the individual, items that may distract attention from an unpleasant sensation and items that will help to diminish non-preferred sensations. The bag may include noise canceling headphones, headphones and a music source,ear plugs, fidget toys, extra blankets, weighted blankets, etc.

Plan your arrival and departure around preferred events.  If the individual loves watching the marching band, but is bothered by all the whistles during the game, arrive at the game 15-25 minutes late. If the individual does not appreciate the marching band, make arrangements for an activity or get special permission to leave and re-enter the the stadium during halftime.  If the individual does or does not like the mascot, plan your seats in the location accordingly.

Give your loved one a voice during the game.  Pre-record a cheer or a special message on a voice recorded switch.  No need to get too high tech, this is a high energy exciting time, it’s more important to get the message out! If a device is not an option, make a sign that shares the message or use a horn or bell for the individual to be part of the roaring crowd.  If you need more information or ideas, please do not hesitate to ask any speech therapist at Lakeshore Speech.

Friday night lights shine brighter when everyone is involved.  Go Team!

Yours in Speech,

Lakeshore Speech Therapy, LLC.

Getting out the door in one piece

A new school year, a new therapy schedule, just the time to create some new habits for a smooth transition.  Being pulled in a million different directions is enough to make anyone harried . You and your family’s stress levels do not need to be off the charts.  Help yourself and those you love create a game plan that is sure to score big this Fall.

Organizing tasks, managing time and executing a plan are all executive functioning skills.  Skills we all (no matter the age) continue to polish and refine throughout our lives. Executive functioning skills are not innate to some, butare skills that need to be taught and practiced.  When executive functioning skills begin to mature and become second nature, the stress decreases significantly.

Your game plan to create an environment that supports and teaches executive functioning skills does not have to be elaborate.  Try a few of these suggestions and see the difference for yourself. .

  • Under 5 years old
    • Specific area or tub or bin where favorite toys are kept
    • Diaper bag filled and ready to go – this bag should be kept in the same location (ie: hook, shelf) at all times so it is easy to find and grab while you are running out of the door.
    • Keep an emergency bag/bin in the car at all times – stock with snacks, diapers, change of clothes (for your child and yourself), wipes, etc.
  • School Age
    • Backpack, coat, boots, etc. all have a specific location.  This does not have to be elaborate. Grab a few empty cardboard boxes, have each child (and adult) decorate the box, arrange boxes near the entrance door. Elminiates the “trail” of belongs going through the house when your children return from school.
    • In/Out Boxes/bins for school papers.  Inevitably, your child will have a ‘home’ folder and/or school papers that need your attention.  Make a simple In/Out box system using gift boxes (reinforced with tape) to ensure these important papers do not get lost in a pile. Work with your child in getting the home folder out of the backpack and into the In/Out box.  You won’t have to worry about losing the papers and can get to them when you have time to focus your attention.
    • “Everything has a place and every place as a thing.” Words to live by!  
      • Key hooks
      • Shoe mats
      • Lunch box baskets
      • Home information Centers
      • School clothes dresser drawers vs play clothes dresser drawers
    • Simple after school “To Do” list :
      • Put folder in IN/OUTBox
      • Change clothes
      • Get a snack
      • Start homework

Your family’s unique style will dictate the creative ways in which you discover to better manage executive functioning skills.  Do not hesitate to consult with a Speech-Language Therapist for specific techniques not only for the entire family, but for specific members who could use individual attention in this area.

Yours in Speech,

Lakeshore Speech Therapy, LLC

Summer, don’t leave us!

There’s still plenty of Summer left, but it’s getting to be that time of the year when our attention must turn back to the hustle and bustle of the school year.  For those not at that point or past that point, it’s that time of year that there seems to be some sort of switch from the lazy hazy days of Summer to the fast and furious time of Fall.

The types of clothes you are wearing will change, the leaves will change, and your schedule will change.  Much like our blog in June, it’s time to ask a few questions about these changes. Will you focus on a few activities or many? When is your child her/his best – morning? Late afternoon? Early evening? When do you have the most support? From whom? Spouse? Friend? Parent? In-law? How can the change to the Fall be less dramatic? Crock-pot meals? Pre-frozen meals? Assigning chores to everyone? Only you have the answers. However do yourself a favor, ask those questions and give yourself some REAL answers, you’ll be the better and so will everyone around you!

Lakeshore Speech has a number of amazing programs available for children this Fall season.  Ranging in areas of focus from Reading Tutor Groups to Social Skills Groups to Fluency Groups, we have something that your child might need or want to make a smooth start to the school year and the Fall.  Please check-out www.lakeshorespeech.com/events  for a full listing and explanation of our programs.

Lakeshore is also beginning to set up Fall schedules for private therapy.  Please contact Kelly (krigo@lakeshorespeech.com or (440) 471-7190) to arrange a therapy day and time that works best for your family’s schedule.

Yours in Speech,

Lakeshore Speech Therapy, LLC