Thursday, September 29, 2005
Session Two
This morning was my second session with First Child. She and her sister are always happy and smiling when they arrive. I thought I could do everything I needed to do in time before the session. I was dead wrong, I arrived at school 10 minutes before the session, rushed to checkout items I needed, and then rushed to put in the videotape...but lo and behold, the kids were already walking down the hallway towards the clinical room with the other clinician. Argh! I forego taping, and desperately hoped to remember what happened. I'm worst at recording data during the session, so I ended up with inaccurate tallies, so impressions is all have I to go on...the SOAP notes are not going to be detailed :(. The good part is today's session went a lot better than the last, I got her attention more (less people for her to pay attention to). The plan I had made up for her was too advance, I tried to soon to do things she might be doing at the end of the semester. Laurie prompted me to scale down, work on getting her attention more. After several awkward moments of not coordinating reinforcement after every attempt, I managed to reinforce at the right moments. First Child always performs better when I'm doing better. It hidious to think that I could impend her progress. Today was good for her...I messed up on the tape, actually fulfilling what I needed to do based on my preplan plan, but it was good. Sigh...I need to do things that will push up my grade as well...
Tuesday, September 27, 2005
More of firsts: Grad school
Today was the first day of clinic as a graduate clinician. I had not been worried or nervous until about 1 minutes before the session was supposed to start: I had forgotten the forms (oh so important that all was associated with HIPAA violations, etc. if those forms wasn't signed right then, and I might be expelled, etc.) and I had forgotten to check out a ball for the session...and every clinician working with kids knows that a ball is all important and necessary in almost all cases during the first contact session. It is the most obvious item to have.
Once in the room, I realized I had boring toys...nothing was a complete set, one was but it wa boring after a while. Thankfully, my client, a young child with implants was also a bright, happy smiley joyful child (going to call her First Child, she is my first official one). She displayed a smile at everything and appeared to be pleased at everything. She primarily signs, which I do not (I have to learn, and quick too!) but still smiles despite my blunders to try to get her to talk more. I've slipped a little in my child-clinic behavior, but have no doubt I will improve as I get warmed up. I really need to get all excitable and happy...I need to be more child-like and forget about the day's burden...it helps a lot when the child senses your enthusiasm and play attitude.
But in short, I thought today's session was an absolute disaster on my part. It must get better.
Once in the room, I realized I had boring toys...nothing was a complete set, one was but it wa boring after a while. Thankfully, my client, a young child with implants was also a bright, happy smiley joyful child (going to call her First Child, she is my first official one). She displayed a smile at everything and appeared to be pleased at everything. She primarily signs, which I do not (I have to learn, and quick too!) but still smiles despite my blunders to try to get her to talk more. I've slipped a little in my child-clinic behavior, but have no doubt I will improve as I get warmed up. I really need to get all excitable and happy...I need to be more child-like and forget about the day's burden...it helps a lot when the child senses your enthusiasm and play attitude.
But in short, I thought today's session was an absolute disaster on my part. It must get better.
Second semester
Second semester of clinic was better. I was a lot more un-attached to being perfect in everything, because I finally accepted that clinic is never perfect, and if it is, it's because your clients are perfect. I enjoyed my second semester in clinic even more than the last, I had to two individual clients this time. I jumped from Wernicke's to Broca's, about the same severity level, or perhaps slightly less. It helped that the two gentlemen I worked with this time had been in therapy until then. I learned a lot from my supervisor this semester, too much to write down here. I also learned a lot from my clients and clinical partner, too much to write down here. I have on paper, the traditional way, the way that honors what is written down on it. But one lesson that stands out is:
-if you don't focus on your client and how they are performing, you're not focusing on the right things. Forget about what you have planned and how and what you intend to do when you walk into that therapy room...if your client is not up to it, it'll never work. If the plan doesn't work, it's the wrong plan. If the client is not performing as good as usual, it's probably your fault as a student clinician. But even then, don't feel bad, try all the harder (and smarter) and remember it's a learning experience...that's why you're called the student clinician. Also, honesty coupled with compassion and love is the best policy.
-if you don't focus on your client and how they are performing, you're not focusing on the right things. Forget about what you have planned and how and what you intend to do when you walk into that therapy room...if your client is not up to it, it'll never work. If the plan doesn't work, it's the wrong plan. If the client is not performing as good as usual, it's probably your fault as a student clinician. But even then, don't feel bad, try all the harder (and smarter) and remember it's a learning experience...that's why you're called the student clinician. Also, honesty coupled with compassion and love is the best policy.
Saturday, September 24, 2005
First client
The client: My very first client was 1. She had a last name that I still have to stop and think before I attempt to pronounce. I loved her! She was the dearest lady. Recently, I bumped into her daughter, who is also wonderful, who told me that 1 is no longer attending therapy at my school, but she is going to keep on working at the communication book we had set up for her. But anyhow, 1 had been priorly diagnosed with severe Wernicke's aphasia. She came to us about 10-years post CVA and we thought had limb apraxia as well. Her speech was fluent, traces of a foreign tongue (thought to be European, her daughter did confirm that she had spoken a foreign langauge before, but lost it soon after in the US) was there, but for the most part, it was neologism. Automated speech occured in rare occasions. We worked on building a communication book and gestures. I don't think gestures really worked out for the best because of the apraxia. I think the part in therapy that helped was when she did get the task right, it boosted her self-confidence, or at least took off the self-consciousness and frustration of not being understood, and not understanding others. Maybe that was supposed to be the main goal in therapy: to increase interactions with others in outside the home settings. At the end of the semester, she wasn't pleased to find out MJ and I wouldn't be her clinicians anymore, I took that as a sign that I didn't totally upset her (and change is hard for anyone too) and she perhaps did like me despite all the rough spots. Big things I learned that semester:
-It's an ongoing process, it doesn't stop, just changes. Be aware of these changes, facilitate them.
-Pay more attention than usual to nonverbal cues, anticipate needs and wants. MEMORIZE a client's likes, dislikes, hobbies, background info, etc. How can they trust you if you don't care enough about them, jsut as you would for a person you're interested to get to know more.
-Wanting success is not enough, put your brain in the equation.
-Step back, chill. Don't be so wrapped up in the downside and pain that you can't see the promising future.
-If you don't have confidence/trust in yourself, don't expect to see anything good happen. Even if it does, you'll miss it.
-Pray for your clients.
-Encouragement and minute breaks go a long way.
-More is less...don't talk so much, listen to the client.
-You don't cure the client, you provide triggers that will help them remember how to communicate. They cure themselves with the help of the Almighty above.
-Healing first begins when the client is at peace with what has happened, is able to acknowledges the challenges and difficulties, and is ready to struggle to beat them.
I also had a group session, lead it with two other student clinicians. Group therapy was divided into three: verbal, moderately verbal and nonverbal. I was in the verbal group, most were clients that had gone through individual therapy and were about to step out of therapy, or had already stepped out of therapy and was there for just the 'last bit;' it was a safe place to practice communicating. I was fortunate to be in this group...it was the other end of the specturm I suppose...I had to do all the talking for individual and here in group, the group did all the talking (which is good). I learned a lot about humility in that group. I learned the changes, that life never really goes back to be the same, but it evolves to a different level. And a big part of getting well is learning to live at that level. Out of all those sessions, one thing stuck out the most to me: one session the topic of what life was before their accident came up. One thing in common that seemed to resonate through the group is that the group of friends and people they socialized with changed. Friends they hung out with Friday night moved away, new friends were made. Eveyone except one, he said, his friends stuck to him even more the closer. And it was terrific to hear this, he credited it to his religion, He was a Christian, and the friends he talked about were friends from his church. His zeal for Christ was not unusual, he would bring in His love for Christ and materials to read about Christianity every chance he got during therapy, sharing with the others. I don't know how much the others appreciated this, because we did have only an hour per week, and time was limited for each one to talk..but I know I learned more from that gentleman that semester than I had in years as being a Christian in college.
-It's an ongoing process, it doesn't stop, just changes. Be aware of these changes, facilitate them.
-Pay more attention than usual to nonverbal cues, anticipate needs and wants. MEMORIZE a client's likes, dislikes, hobbies, background info, etc. How can they trust you if you don't care enough about them, jsut as you would for a person you're interested to get to know more.
-Wanting success is not enough, put your brain in the equation.
-Step back, chill. Don't be so wrapped up in the downside and pain that you can't see the promising future.
-If you don't have confidence/trust in yourself, don't expect to see anything good happen. Even if it does, you'll miss it.
-Pray for your clients.
-Encouragement and minute breaks go a long way.
-More is less...don't talk so much, listen to the client.
-You don't cure the client, you provide triggers that will help them remember how to communicate. They cure themselves with the help of the Almighty above.
-Healing first begins when the client is at peace with what has happened, is able to acknowledges the challenges and difficulties, and is ready to struggle to beat them.
I also had a group session, lead it with two other student clinicians. Group therapy was divided into three: verbal, moderately verbal and nonverbal. I was in the verbal group, most were clients that had gone through individual therapy and were about to step out of therapy, or had already stepped out of therapy and was there for just the 'last bit;' it was a safe place to practice communicating. I was fortunate to be in this group...it was the other end of the specturm I suppose...I had to do all the talking for individual and here in group, the group did all the talking (which is good). I learned a lot about humility in that group. I learned the changes, that life never really goes back to be the same, but it evolves to a different level. And a big part of getting well is learning to live at that level. Out of all those sessions, one thing stuck out the most to me: one session the topic of what life was before their accident came up. One thing in common that seemed to resonate through the group is that the group of friends and people they socialized with changed. Friends they hung out with Friday night moved away, new friends were made. Eveyone except one, he said, his friends stuck to him even more the closer. And it was terrific to hear this, he credited it to his religion, He was a Christian, and the friends he talked about were friends from his church. His zeal for Christ was not unusual, he would bring in His love for Christ and materials to read about Christianity every chance he got during therapy, sharing with the others. I don't know how much the others appreciated this, because we did have only an hour per week, and time was limited for each one to talk..but I know I learned more from that gentleman that semester than I had in years as being a Christian in college.
The Day of Firsts
I started my very first semester in clinic in Fall of 2004. I was a senior in my four-year undergrad program. Didn't actually feel much excitement or anything until the minute before I was suppose to go greet my client and lead them into the therapy room to get started. I was jumping up and down to get rid of the jitters and my clinical partner, I feel so bad for my clinical partner, MJ, she musta feel like I was the worst mistake to be paired up with. My clinical supervisor, Heather, was actually a student that had graduated from my school, gone on to her grad program and then returned (I don't know if there's more in between her movements) to her alma mater to become one of the clinical supervisors. Heather was very sweet, she directs by 'let's see how we can do this together' and always has that bit of 'you cna do it!' to give to you. She really made herself available to us...if I recall correctly, we met in the early AM each week to discuss about our weekly plans. One moment is especially stands out is halfway during the semester, I was just at the end of my rope...she took me aside into an unused therapy room, and ask what was wrong, and we talked. I find it hard to explain myself/be politically correct, so her attempt to figure that out was unexpected and touching.
"My child"
That's what we called (at least I did) our child clients for the two semesters we had them for phonological and language disorder classes. I had my first child assignment (it wasn't really clinic, more speech facilitation/play as we weren't supervised live time) in my sophomore year. It was junior/senior level class, but it just didn't work out that way for my schedule. So it was great opportunity for me to be in a seminar-like, hands-on class with students who had gone through a lot more classes than I had and to learn how they think, process stuff. I loved it! I had an almost 2 year old girl, diagnose was still being determined. Part of my job was to report what I did (obviously) and saw to help in this process. That was the sad part, because towards the end of the semester, it was pretty clear what it was (high functioning autism) and I wasn't allowed to say anything to the parent (and I didn't want to) and it was hard watching the mum talk about the uncertainty of it all. My child was very smiley and easy-going, and her mum caught on to techniques very quickly. It was good. I gave her a ball with my school colors on it as a gift, she had loved them that semester and we played with them a lot.
My second one was an almost 2 year old boy...he was a charmer! I had him my junior year, and his case ended 'more' happily ever after. When I met him, he was only one or less months behind in communication development. He loved noisy, manipulatable toys...had to keep up with his busy movements! It was tough getting him to speak while he concentrated hard on pushing the button to make a toy beep or make music, he gave me the impression of "I'll speak when I want to ok, and that's that!" Auditory bombardment seemed to work though, he said little but when he did, it was good. He progressed quickly over the course of the semester in terms of his speech, but after that semester ended I thought of something I didn't before...he had frequent colds, this might have affected his development. He did slow down towards the end of the semester, he was having a lot of colds then. He'd probably catch up soon though, he had a good enough base. His mum was very worried at the beginning but she looked less stressed out towards the end, I think he had shown enough progress to relieve her. She was a lot more quieter than the mother of my first child experience, but very cooperative and helpful, actaully, her mothering style is one I'd like to emulate. I was fortunate to work with him.
"My child"
That's what we called (at least I did) our child clients for the two semesters we had them for phonological and language disorder classes. I had my first child assignment (it wasn't really clinic, more speech facilitation/play as we weren't supervised live time) in my sophomore year. It was junior/senior level class, but it just didn't work out that way for my schedule. So it was great opportunity for me to be in a seminar-like, hands-on class with students who had gone through a lot more classes than I had and to learn how they think, process stuff. I loved it! I had an almost 2 year old girl, diagnose was still being determined. Part of my job was to report what I did (obviously) and saw to help in this process. That was the sad part, because towards the end of the semester, it was pretty clear what it was (high functioning autism) and I wasn't allowed to say anything to the parent (and I didn't want to) and it was hard watching the mum talk about the uncertainty of it all. My child was very smiley and easy-going, and her mum caught on to techniques very quickly. It was good. I gave her a ball with my school colors on it as a gift, she had loved them that semester and we played with them a lot.
My second one was an almost 2 year old boy...he was a charmer! I had him my junior year, and his case ended 'more' happily ever after. When I met him, he was only one or less months behind in communication development. He loved noisy, manipulatable toys...had to keep up with his busy movements! It was tough getting him to speak while he concentrated hard on pushing the button to make a toy beep or make music, he gave me the impression of "I'll speak when I want to ok, and that's that!" Auditory bombardment seemed to work though, he said little but when he did, it was good. He progressed quickly over the course of the semester in terms of his speech, but after that semester ended I thought of something I didn't before...he had frequent colds, this might have affected his development. He did slow down towards the end of the semester, he was having a lot of colds then. He'd probably catch up soon though, he had a good enough base. His mum was very worried at the beginning but she looked less stressed out towards the end, I think he had shown enough progress to relieve her. She was a lot more quieter than the mother of my first child experience, but very cooperative and helpful, actaully, her mothering style is one I'd like to emulate. I was fortunate to work with him.
Post Number One
At last, I have this space to write. I'm not allowed to devulge personal information regarding my clients (obviously), but I felt the need to go over the cases in my mind, to:
-grow in knowledge and experience as a future professional SLP
-grow in knowledge and understanding as a service-provider and care-giver
-develop a frame of the SLP I want to be
-document cases that may help me in the future when I actually become certified.
I'll try to be as specific to the therapy details while remaining as general as possible to the person. Hopefully, this will help me bring together the pieces I've learned and draw connections, and differences, between cases.
-grow in knowledge and experience as a future professional SLP
-grow in knowledge and understanding as a service-provider and care-giver
-develop a frame of the SLP I want to be
-document cases that may help me in the future when I actually become certified.
I'll try to be as specific to the therapy details while remaining as general as possible to the person. Hopefully, this will help me bring together the pieces I've learned and draw connections, and differences, between cases.
Subscribe to:
Posts (Atom)