sound practice in action
Posted by Karen MacIver-Lux on January 21, 2016 12:01 AM
I’m a toy enthusiast. Luckily for me, as an auditory-verbal practitioner, toys are the tools of my trade and I can share my love of toys with the children I work with and their families.
I have to admit, however, that toys have gotten me into trouble at times. Not trouble of the financial kind; the goal setting kind.
In other words, I have sacrificed appropriately set goals (short-term objectives) because I loved the toy and stubbornly thought that I could make it work for the child and parents/caregivers (family). The trouble was that short-term objectives ended up being adjusted to suit the toy or theme and not the child, resulting in an activity that was either too easy, too hard or not relevant to the child and family’s culture, interests or daily routines.
As you can imagine, the child was forced into an unfair situation and responded accordingly (e.g. crying, refusal to engage in play, etc.), and the family went home with unrealistic expectations of the child (e.g. inappropriate short-term objectives), and both the child and the family began to lose confidence in their therapy experience.
One of the toughest lessons I had to learn early on in my career were:
1. Appropriately selected short-term objectives primarily guide the toy/theme selection process.
2. The child’s interests and family’s environment, culture and daily routines play a supporting role in the toy/theme selection process.
3. The primary purpose of the session is to guide and coach parents/caregivers/family members in ways to play so that learning opportunities in listening, spoken language, critical thinking, and literacy development are bountiful. The toy/theme is a tool, to be used as a means to an end.
Many therapists would state that they can apply appropriately selected targets to any toy or theme. That may be true in some cases, but I find that I only do this during the session when short-term objectives have been adjusted due to changes in the child’s listening and spoken language abilities, or if the child has brought in his/her toys from home for “show and tell.” The mark of an effective therapist is one who plans well and is prepared to adjust to changes in the original plan.
As a rule, short-term objectives are planned before choosing the toy for the following reasons:
1. Some toys and themes are better than others at fulfilling all of the short-term objective and engaging the child’s interests. Therapists owe it to the families to choose the toy (or theme of play) that addresses all of the child’s short-term objectives within the time frame of the therapy session. In order to do this, the therapist needs to know what the short-term objectives are first.
2. When families don’t own the same toys at home that the therapists used, they may feel the need to go out and buy the same toy so that they can do the homework required. Therapists need to guide families in learning how the short-term objectives (homework) can be incorporated into the child’s daily environment, routines and play activities. At the end of each session, the therapist and parent should review the short-term objectives. Asking, “How do you think you can help [name of child] learn to understand and use [short-term objective] within their environment (or playtime with their toys)?” helps parents plan ways that they can create meaningful, age- and stage-appropriate listening and spoken language learning opportunities for their children daily.
3. Short-term objectives often influence which strategies are going to be used by the therapist to facilitate ease of learning. For example, a short-term objective for a child who has a high frequency hearing loss might be to “demonstrate understanding of morphological marker for plurals( -s).” The therapist must be prepared to check the hearing technology (e.g. hearing aid and personal FM system) to ensure that the child has auditory access to “s”. The therapist determines which strategies would make the “s” acoustically salient to the child, using techniques such as whispering the target word or elongating the “s” sound. The therapist must be prepared to explain why these strategies were used and when to use them during daily routines. When the family gains understanding of, and proficient use of, these strategies, the child will gain improved access to the listening and spoken language opportunities that naturally occur during the family’s daily routines and environment.
Weekly, I challenge myself by picking short-term objectives for various age groups (1, 2, and 3 year olds) and choosing toys or themes that are best suited for each age group. I then think about how I can use these toys to accomplish my short-term objectives. I often consider the culture and interests of the children and families on my caseload and assess the appropriateness of the toys/themes chosen. I recall strategies that, when used, make the short-term objectives in listening and spoken language easier to hear, learn, say, read and write. This is usually done as a mental or an exercise/conversation with colleagues.
By firstly becoming a short-term objective enthusiast and a toy enthusiast second, I am better able to focus on providing the best quality intervention I can, in hopes that I can help the child and family meet their long-term goals in an timely manner. By prioritizing short-term objectives I have found that I have become more confident in my practice as an auditory-verbal practitioner.
So, take a moment and reflect. Are you a toy enthusiast or a short-term objective enthusiast? We would love to hear from you!
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KAREN MACIVER LUX