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Related Services- Speech and language service Sharmila Choudhury -…

- - - - Reasons for Speech Therapy
        
        Speech and Language disorder-
        speech and communication disorder may lead to struggle in academic and social environment in at school. Disorder in communication can be due to known causes such as neurological disorder, brain injury and intellectually disability. often the cause of the problem is unknown.
        
        Types of speech and language disorder
        
        Receptive language disorder
        Expressive language disorder
        Apraxia of speech
        Stuttering
        Dysarthria
        Articulation disorder
        
        Symptoms of speech disorder
        • problem Understanding verbal directions from the teacher
        • Speaking in long sentences
        • Speaking fluently without stuttering
        • Projecting his or her voice so that others can hear
        • Putting words together in a meaningful way
        • Articulating their words
        • Sharing thoughts or ideas so that others can understand the communicative intent
        • Reading or writing (i.e., written communication)
        • Communicating appropriately in social situations
        • Hearing what others are saying
        
        Role of Speech and language pathologist
        Speech and language pathologists are trained professional educated in the study of human communication, its development and disorder.
        Speech pathologist help diagnose the speech and language disorder and they provide speech therapy.
        Speech and language pathologist help students in academic (classroom) and non-academic (social interaction) and extracurricular activities ( social clubs) areas
        
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        Medical and developmental conditions
        
        Autism spectrum disorder
        
        Right hemisphere brain injury can be due to truma.
        
        Cleft palate and lip
      - Autism and speech Therapy
        Children with autism have challenges in communication and social skills, they often find it hard to have conversation and find it difficult to pick up the social cues. Sometimes children with autism are mute or may be able to talk but find it hard to make friends.
        
        Issues with communication in autism
        • understanding and using gestures like pointing or waving;
        • understanding and using words;
        • following directions;
        • learning to read or write—some children with autism read early but do not understand what they read (called hyperlexia)
        • having conversations.
        • lose early words;
        • be hard to understand;
        • repeat words or phrases they just heard or that they heard days or weeks earlier (echolalia);
        • use a robotic or singsong speaking voice;
        • talk very little or not at all; and
        • use challenging behaviours instead of words or gestures to communicate what they want
        
        Issues in social skills
        • share attention with someone else and focus on the same object or event
        • join in play with others and share toys
        • respond when others invite them to play or talk;
        • understand how others feel;
        • take turns in play or in conversation; and
        • make and keep friends.
        
        How SLP work with Autism
        
        Speech therapist can be a major help for the autistic child to learn communication and engagement. The SLP can work with the child may work in 1:1 setting, in groups , depending on the child’s functional ability the SLP can work on one or all the skills.
        
        • Non Verbal communication-This may include teaching gestural communication through visuals, electronic devices and other non-verbal communication skills.
        • Body language-speech therapist can help autistic child to recognise subtly physical signs.
        
        • Asking and answering questions- children with autism may not develop the ability to ask and answer questions properly, with the help of SLP they learn how to recognize the question and formulate appropriate answers.
        • Speech pragmatism- training helps child with autism to understand idioms and how to use them accordingly.
        
        • Prosody- prosody means melodic sound of voice as it goes up and down in conversation. Children with autism have a flat prosody, SLP can work with them to develop the vocal skills.
        • Grammar- often children with autism have problem using proper tenses and persons, they will identify themselves in 3rd person. SLP will work with them to help correct the grammar mistakes
        
        • Conversation skills- children with autism have major problem with conversation. SLP uses the “joint attention” method of back and forth exchange to help develop conversation skills.
        • Concept skills- understanding basic concepts like “few”, “justice” are difficult to understand for children with autism. SLP works on building the concepts.
        
        • Social skills- to help develop social skills the SLP along with occupational therapist, art therapist help build communication skills.
      - Speech therapy in High school
        
        SLP work mostly with children in early childhood and elementary level some students in middle school will need SLP services. In high school the SLP work becomes more academic focused. SLP in high school work on
        
        • Strategy based language intervention- which is explicit guidance in planning and performing the task.
        • Development of metacognitive skills- thinking skills
        • Development of metalinguistic skills- understand and reflecting about language
        • vocabulary development- emphasis is on development of functional and curriculum- specific language vocabulary
        • Development of written expression- written expression is a prerequisite for students in high school. SLP address the deficit of written expression they use interactive verbal scaffolding along with, planning, graphic organisers and editing.
        • The SLP may work with the child within the classroom or outside the classroom to provide support.
- - - - Counselling services
        • Providing individual/group counselling to students with special needs within the scope of the school counselling program.
        • Providing short term, goal-focussed counselling using them as strategies as a part of IEP
        • Encourage family involvement in the students educational process.
        • Consulting and collaboration with staff and families to help understand the adaptation and modification needed to assist the student.
        • Advocating for the students in school and community.
        • Contributing to the multidisciplinary/ IEP team and help identify students who may need to be assessed to determine special education or 504 plan eligibility.
        • Collaborating with other related student support professionals in the delivery of services.
        • Providing assistance with developing academic, transition and post-secondary plans for students with IEP’s and 504 plans.
      - Administrative / supervisory roles
        • Making decision regarding placement and retention
        • Serving in any supervisory capacity related to implementation of the idea
        • Serving as school district representative for team writing IEP
        • Coordinating, writing or supervising the implementation of the IEP
      - School Counselors in High School
        School counselors focus more on improving mental health and behavioral symptoms through individual and group counseling and education. They serve the entire school population.
        
        High school counselors implement a school counseling program to support students through this developmental period. They do not work in isolation; rather they have collaborative efforts with other school personnel.
        
        High school counselors provide equitable and appropriate services by addressing students' academic, career and social/emotional developmental needs in addition to balancing delivery methods, recognizing students learn in multiple ways.
        
        High school counselors provide direct services including instruction by teaching the school counseling curriculum to students focused through the lens of selected student standards, appraisal and advisement by assessing student abilities, interests, and achievement to help them make decisions about their future, counseling by providing professional assistance and support to a student or small group of students during times of transition, heightened stress, critical change or other situations impeding student success. School counselors do not provide therapy or long-term counseling in schools; however, school counselors are prepared to recognize and respond to student mental health needs and to assist students and families seeking resources.
        School counselors provide indirect services including consultation by sharing strategies supporting student achievement with parents, teachers, other educators and community organizations, collaboration by working with other educators, parents, and the community to support student achievement, and referrals by providing support for students and families to school or community resources for additional assistance and information
    - - CBT
        CBT- cognitive behavioural Therapy- CBT is a type of talking therapy. CBT teaches coping skills for dealing with different problems. It helps people to learn how to identify and change destructive and disturbing thought patterns that have negative effect on behaviour.
        
        CBT helps in to deal with
        
        • Anger management
        • Anxiety and panic attacks
        • Bipolar disorder
        • Depression
        • Drug/alcohol problems
        • Eating disorder
        • Phobias
        • Post-traumatic stress disorder
        • Self- harm
      - Solution Focussed therapy
        Solution focussed therapy emphasis on the solution to the problems or issues by discovering the resources and strengths a person have. Rather than analysing why and how the issue arose it focuses on the issue here and now and how to move forward.
        
        Solution focussed therapy is used to treat
        
        Depression
        Anxiety
        Self esteem
        Personal stress
        Substance abuse
        Relationship problems
      - ART and creative therapy
        Art and creative therapies are treatments which involve art activities within therapy sessions.
        
        Art therapy generally aims to
        
        • Allows people to communicate thoughts and feelings that you can find difficult to put into words.
        • Help make sense of things and understand oneself better.
        • Help find new ways to look at problems or difficult situation.
        • Help talk about complicated feelings.
    - - Strategies used for students with learning disability
        • Cognitive behaviour therapy
        • Solution focussed therapy
        • Sensory Integration – Arts and creative therapy
        • Family therapy
      - Counselling for students with intellectual disability
        Students with intellectual disability experience developmental delays in most areas of functioning , children with intellectual disability require multiple services. Counsellors can help to coordinate school, home and community services for all areas of need. Counsellors work with parents, special educators, and teachers to advocate for appropriate educational modification and resources in general education classroom. They can help teachers promote social adjustment. Counsellors help in them develop self-reliance, age-appropriate social behaviour, and friendship making skills. Counsellors can help adolescent develop independent living skills.
        
        Strategies used for students for Intellectual disability
        • Play therapy
        • Family therapy
        
        Counselling for students with Behaviour disability( ADHD)
        Student with ADHD requires multiple intervention like behavioural modification, cognitive strategies, teacher consultation and social skills training.
        
        Strategies used for ADHD
        
        Behavioural modification
        one of the most effective treatments that counsellors use to change behaviour in children with ADHD is behaviour modification. Counsellors use positive reinforcement strategies that can increase the child’s task related attention and activity and decrease his disruptive behaviour. Frequent and specific behavioural feedback is given and redirection and mild consequences is used following inappropriate behaviour.
        
        CBT
        Counsellors use CBT to teach self-control through self-monitoring strategies. The child or adolescents use self-reminder statement to increase awareness and control his/ her behaviour. Self- instruction strategy help students learn and follow self- directed instruction for completing the class work. This is training is corroborated by self-reinforcement where the child uses different ways to praise/give himself or herself a reward, such as a check mark on a behavioural chart following positive behaviour when external rein forcers are unavailable.
        
        Direct counselling-
        Individual and group counselling can be offered to children and adolescents with ADHD to help them with issues of self-esteem and self-control. These individuals often feel low self-worth as a result of repeated negative feedback about their behaviour. Group counselling can help these children and youth feel less different and more supported. Adolescent groups can promote the identification of positive role models and can help members set long-range goals as a tool for seeing themselves as having the potential for success
        
        Social skill training
        Among the social problems that children and adolescents with ADHD exhibit are aggression, impulsive or intrusive conversational style, poor social problem solving, excessive talking, limited self-awareness, emotional over reactivity, and bossiness when initiating interactions. These social problems may lead to peer rejection and lower self-esteem, further complicating social adjustment. Counsellors use several social skill program for adolescents with ADHD like conversational skills, conflict resolution and anger management
        
        Support Groups
        Children and adolescents with ADHD can benefit from support groups that target stress, guilt, and co-dependency issues. Parents find comfort when they realize that they are not alone in their feelings. The support group meetings can include lectures, demonstrations, question and-answer sessions, or informal discussions. Counsellors can help parents locate a recognized support group. Counsellors can locally create, organize facilitate support groups for parents with a child or an adolescent with ADHD. These groups often are organised around specific topics.
- - - - Handwriting legibility and hand strength are closely tied. Hand strength can be developed through many creative, hands-on-activities, like blocks and rubber bands or rolling ball of play-dough. This activity is ideal for students with weak hand strength such as those with developmental delays, juvenile rheumatoid arthritis, autism, cerebral palsy, and other chronic illnesses
      - A kitchen tong activity is another fun way to work on important hand strength and dexterity skills. Using a large or small kitchen tong, students can grasp items. Foam blocks are a nice size and make great hand-eye coordination exercise with the tongs. Filling a bin with water and adding in the foam blocks. Ask students to grab the foam blocks as you call out colors for a color identification activity.