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SLP Report Writing 101

At this time of year, my work life consists of writing report, after report, after report. Paperwork is definitely not my favourite. Writing reports is hard and some do it better than others.   What I talk about here is not new or earth shattering but writing good reports are crucial, and these are areas where I struggle/have struggled. They are also areas that  I see other Speech-Language Pathologists struggle.

1. Who is your audience?

An essential aspect of report writing is to know who is going to read it. Just as important, is identify ing or anticipating the background knowledge of the people who are going to read the report.  For me, most of my reports are not read by other SLPs.  They are read by parents.  For many, English is not their first language. Most don't have the background or haven't yet been immersed in all the jargon us SLPs love to use. My reports are also read by doctors, who may or may not be as well versed in speech and language development as we would like.  Finally, reports are often read by people who determine the types of funding and services a child will receive.  In my case, these people are typically not SLPs.  Knowing when to include technical jargon and when to back off relies heavily on who is reading your report(s).

2. Why are you writing this report?

 This is closely tied to the question, "Who is your audience?" What is the purpose of the report?  Is this to make a referral to a clinic (e.g. get a swallow study done)?  Is it to help the family receive additional services?  Is it to re-qualify for services?  Each type of report can sound very different. What I include in a report for children who will definitely qualify for services next year can look very different from a child who may not qualify or from a child who is moving on to his neighbourhood school.  The vocabulary I use can be very different.  What I include and don't include can also be very different.

3. What kind of vocabulary are you going to use?

This is a big one for me.  It always amazes me, but really it shouldn't, that what language we SLPs use and consider basic really isn't.  In one of my first years as an SLP, I had a parent come up to me and asked me to "decode" and "translate" her son's speech and language report from another agency.  At that point, her son had had speech services for about four years.  She was struggling to understand some "basic" terminology such as receptive language.  I have also had some very highly educated parents ask me what a preposition was, and what are visuals?

Move away from the jargon as much as you can.  If you are going to use more technical language then back it up with definitions and examples.  This will help those non-SLPs reading the report understand what we are trying to say.  So include more words such as comprehension along with receptive language and pictures along with visuals. This can be challenging, using technical vocabulary can feel like a warm blanket in the winter, warm and comforting. It can also sometimes be challenging describing terms that are clear and easily understood by people with little or no background.

4. Did you include the necessary information or sentences that are required for this type of report?

There are certain sentences or phrases that I need to include in a report in order to have a child qualify for services.  I have to talk about how a child's deficits will negatively impact their education.   If I don't include this part, it could affect whether they get approved or not. If I'm writing this report to help a family get more comprehensive home services, I need to talk about how the parents and child are struggling in the home. When I write letters recommending a Video Fluoroscopy Swallow Study (VFSS) for a little one, I have to write out Video Fluoroscopy Swallow Study.  If I'm not explicit they might not get their VFSS, or it may not be deemed a priority, and they are put further down the waitlist. Lastly, what are your licensing body, school or program requirements? It can be a lot to remember. When I first started my job, I had a checklist on what I needed to have in each report.  That way I knew I had all necessary information.

I am not a master report writer by any stretch of the imagination. In fact, when I first started my career, my reports were atrocious.  I worked very hard at improving them, and these are the parts of report writing that I am very conscious about and are areas that I often see as needing to improve in others reports. Happy report writing!

Using Balls in Therapy

Balls are a great therapy tool for early intervention up through to children of elementary school.  You can play quick games which allow for a high number of repetition in artic therapy, and because the activities can be short, it can keep the attention of young children.    They can also be used one on one but also in small groups. Here are some ways I have used balls in therapy.

1. Communication temptations:  We will take turns rolling/throwing the ball.  I will wait until the child reaches to/points to/says ball then I will roll/throw the ball back.

2. Requesting: This goes with communication temptations. I wait until they ask for the ball before sending it back.

3. Making Choices:  I will often have more than one ball with me.  I have the child choose which ball they would like use. If choosing which ball to play with is too complicated,  I will often give them a choice to play with it and something they don't want to play with (e.g. a sock).  

4. Taking Turns: Roll or throw a ball back and forth. Rolling usually works better for young children. This allows children to interact with others and they get the idea that conversations are two-way.  I will also use a ball like a talking stick, whoever has the ball get to talk.  When you are done with what you want to say you give it to another, and then that person responds. 

5. Increasing Sentence Length/Describing:  I will often have more than one ball with me.  The balls are usually different in size, and colour and sometimes in patterns.  We will pass the ball back and forth for a couple of turns and then I will ask which ball they want and have them use phrases such as "big ball" or "green ball" or "I want the big yellow ball." As you can see, I also use this to work on describing skills.

6. Increasing understanding or use of verbs:   When working on comprehension of verbs, I will tell them how to get the ball back to me.  You can use words such as roll, throw, kick, bounce, dribble,  walk, hand (me),  hold, jump, run, skip, march, etc...  When working on having the child use the verbs, they get to tell me how to get the ball back to them.  This is usually a huge hit as what child doesn't like to "boss" an adult around.

7. Following directions/increase understanding of longer sentences:  There are many different ways to work on following directions.   They can be used for single-step all the way up to multi-step directions. Here is a couple.  Have some balls out.  Tell the child which ball to use, how to get it there and/or where the ball needs to go.  Have pictures out/draw pictures.  Tell the child to throw the ball at the different pictures on the wall. If you are in the gym or at a playground, you can use the equipment available and tell the child(ren) where to roll their balls.  This is also an excellent way to work on prepositions. 

8. Asking and answering where questions.  Roll/throw/kick a ball and have a child say where the ball landed.  E.g. "The ball is under the slide." or "The ball is in the ball pit."  You can do this with pictures on the wall.  Have the child say which picture they hit with their ball. 

Another fun but ultimately messy activity is to paint with balls.  I have used this as a reward or on days where I know that focusing is going to be difficult (e.g. near Christmas).  Draw a picture on a sheet or paper.  I usually use old bed sheets. Put the large sheet on the wall and a couple of sheets on the floor.  Get balls that are different sizes, and textures.  As well, get out different buckets full of paint.  Have the child(ren) throw balls covered in paint at the sheet on the wall and tell you where their ball hit the sheet.  You can do this over a number of sessions/groups.  It can make some very interesting pictures. 

9.  Artic therapy:  I will use balls during artic therapy frequently.  You can throw balls back and forth as the child(ren) are practicing their sounds.  As well, you can dribble/bounce a ball off a wall as you are saying the words/phrases/sentences etc...  I have also played a version of HORSE with older children.  Each letter is randomly assigned a number.  Before you shoot, the child has to say their words X number of times.  If they miss, they have to say addition words based on the number associated with the letter.  

I'm sure there are more ways to use balls in speech therapy, but these are how I have used them.  For more ideas on doing speech therapy in the gym or playground check this post out.  Do you use balls in therapy?

Using Objects to help with Transitions in the Classroom

Using visuals in a Special Education classroom and really in any classroom, home, or treatment room is very valuable.  It helps children know what they need to do or what their schedule will look like (go here for more info).   Visuals are also critical to help a child move from one activity to another (aka transitions), especially if this is hard for them. In a special education preschool, this can mean moving from centre time to circle time, snack, gym, etc.. 

Some children respond really well to pictures or symbols, and those can be used to help children transition.  I tend to have a variety of sizes of visuals as some respond to smaller visuals and some respond to full page size visuals. The child typically carries it from one activity to another and puts it away when the new activity starts. For some kids, 2D visuals just aren't as compelling. For many of these children, I have found that using objects to represent different parts of their day have worked.

Some objects work better than others.  Here are some of my guidelines.  

  1. The object has to be related to the activity the child is going to do.  For example, using a ball to represent gym/recess. 
  2. You use the same object for the same transition. 
  3. The object is only used as a transition object.  Once the activity or the transition is over, it goes back to its proper place.  It is NOT a toy to be played with.  
  4. It can't be too enticing meaning that it is more attractive than the activity.  For example, I don't use a jar of bubbles because then most children would want to blow bubbles instead of participating in the next activity.   
  5. It has to be light enough for the children to carry.  
  6. It has to be 3D.  

Some objects that I use

Implimenting this has been very helpful.  While transitions can still be difficult, using objects has  helped to reduce the stress and anxiety that transitions can evoke.