Wednesday, September 20, 2006
AAC
Today was my first AAC evaluation ever. A little girl with CP, and I think after hearing in class and learning about AAC and physically disabling disorders, I finally got to the heart, or at least, had a little taste of what how it stands and lives in a person. She was amazing, bright and full of life. She expressed herself in all means possible that was available, given to her. At such a young age, she surprised me with understanding and problem-solving beyond her age. It was all up there, receptive language typical, IQ/cognitive typical...it was just the limiting body that prevented her from so much. 'Trapped in a body that betrayed her' is what one of my profs called it. When reaching out to pick up something, to touch something, the arm moves everywhere but at the target and betrays the mind's command. It takes so much longer to say or do anything, anything at all. You don't have privacy anymore, you always need another person beside you. The knowing is the worst I think. Or perhaps not. Perhaps it's the trying to get other to understand you that's the worst. Just because of the way you look. This reminds me of how God looks at our heart, the inside and not the outside. This experience allows me to revisit this revelation again in new light.
Thursday, July 27, 2006
Summer II
Summer II is almost, just almost coming to an end. YEAH!
Doing camp was not as hectic as I had imagined it to be but it certainly did not leave room for anything else to do during the week. I learned lots about me as a clinician. One, preschoolers are energized beings that do not run out of energy...if they do, they turn grumpy before they run out of energy. And I am not loud or energetic or playful enough to keep them entertained to the level that they would appreciate. Secondly, kids who are old enough to walk and go potty themselves, etc. still can malleable in the mind and like to do things their way. But the fun is often out because they are also old enough to sit still and do serious work for acceptable long periods of time. So, therapy is still 'child-like' but less bouncing off the walls fun. It reminds me of Hey Dilly Dilly (Lavender Blue). Thirdly, I still don't know a lot and have a TON to learn which is kinda scary since it's almost time to graduate. But the key to learning is to keep those brain cells a-moving and a-pushing...which is tiring me out real quick.
I get to see First Child and her sister daily in the mornings...not talk and play with them, but I do get to see their smiles and get an occasional wave and bitty chatter.
Doing camp was not as hectic as I had imagined it to be but it certainly did not leave room for anything else to do during the week. I learned lots about me as a clinician. One, preschoolers are energized beings that do not run out of energy...if they do, they turn grumpy before they run out of energy. And I am not loud or energetic or playful enough to keep them entertained to the level that they would appreciate. Secondly, kids who are old enough to walk and go potty themselves, etc. still can malleable in the mind and like to do things their way. But the fun is often out because they are also old enough to sit still and do serious work for acceptable long periods of time. So, therapy is still 'child-like' but less bouncing off the walls fun. It reminds me of Hey Dilly Dilly (Lavender Blue). Thirdly, I still don't know a lot and have a TON to learn which is kinda scary since it's almost time to graduate. But the key to learning is to keep those brain cells a-moving and a-pushing...which is tiring me out real quick.
I get to see First Child and her sister daily in the mornings...not talk and play with them, but I do get to see their smiles and get an occasional wave and bitty chatter.
Monday, May 22, 2006
I am an awesome clinician
I am an awesome clinician
I am an awesome clinician
This is my new mantra, in hopes of building myself up as an awesome clinician.
I got an adult client this summer semester, surprisingly. I had adults all last semester. But I just know I'm going to get kids in summer II and the Fall, and ECC and I am going to die then. But maybe it will turn out to be a pleasant surprise. Maybe I'll get an externship in the Fall, then no matter what age group I see, I'll be ok.
My client this summer is a peer, diagnose with TBI. Which reminds me constantly of how any life altering occasion can happen. It humbles me alot, so see the struggles my client goes through. She's only 5 months younger than me. She's also pretty amazing, I admire her spirit and the will she has to work work work to become better. She gets down at times, but not anywhere near at the danger level. She's also a challenge to me clinic-wise. Very high functioning, so I need to find ways to work on what needs to be worked on, and find out exactly what needs to be worked on and how. First high functioning client. Veyr interesting. I find that I rely a lot on her evaluation of how things went/are going. Very interesting.
Hmm...I don't think I've written about this: I volunteered at H.N. here in Mt. Pleasant for a month. It was the best month of clinic here ever! I hardly can say it was volunteering, I learned so much about different kinds of clients, how things work in the office, with other professionals, etc. It was great! I saw a whole variety of clients, you don't get these kinda clients in university clinics. It was interesting to see that.
I am an awesome clinician
This is my new mantra, in hopes of building myself up as an awesome clinician.
I got an adult client this summer semester, surprisingly. I had adults all last semester. But I just know I'm going to get kids in summer II and the Fall, and ECC and I am going to die then. But maybe it will turn out to be a pleasant surprise. Maybe I'll get an externship in the Fall, then no matter what age group I see, I'll be ok.
My client this summer is a peer, diagnose with TBI. Which reminds me constantly of how any life altering occasion can happen. It humbles me alot, so see the struggles my client goes through. She's only 5 months younger than me. She's also pretty amazing, I admire her spirit and the will she has to work work work to become better. She gets down at times, but not anywhere near at the danger level. She's also a challenge to me clinic-wise. Very high functioning, so I need to find ways to work on what needs to be worked on, and find out exactly what needs to be worked on and how. First high functioning client. Veyr interesting. I find that I rely a lot on her evaluation of how things went/are going. Very interesting.
Hmm...I don't think I've written about this: I volunteered at H.N. here in Mt. Pleasant for a month. It was the best month of clinic here ever! I hardly can say it was volunteering, I learned so much about different kinds of clients, how things work in the office, with other professionals, etc. It was great! I saw a whole variety of clients, you don't get these kinda clients in university clinics. It was interesting to see that.
Thursday, April 27, 2006
End of year one (quite)
I haven't really been blogging much, I think I forget, and am rushing and thinking too many things at once. This semester is officially going to end Thursday of next week. It hasn't been a bad one altogether, very relaxed compared to other semesters in my lifetime. Annoying, but relaxing. One week break and then crazy summer classes and clinic will begin. I will then, be either ranting and complaining here, or not blogging at all. Please pray that I will get an externship for the Fall semester 2006, or I might just roll over and play dead in the on campus clinic.
Last Tuesday was my final day at the nursing home. Happy to get done with clinic, sad to leave those great clients behind. My individual one was not feeling well, she hadn't been for quite some time, so that was sad cause I didn't really get to spend much time with her, except to give her some gifts and say goodbye. She's found a spot in my heart, I had a tough time initially with her, but after a while, rapport was gained! and I found out her ways and managed to built a fun relationship with her. It's amazing how little things perk her up like nothing else. Finding out what she really liked, and especially those that can be incorporated into therapy seriously brightened up her day and helped temporarily forget the physical pains she had. So, here's challenges and lessons from the nursing home as a SLP student:
-Age does not matter, beauty and macho-ness is still important and must be taken care of at all cost.
-Not wearing glasses, hearing aids, and other assistive devices does increase boost the residents self-esteem, thus, work your way around this (i.e. learn how to talk in a very loud voice without killing your voice, and use extra large print whenever possible).
-Do not take comments from persons with memory loss and difficulties personally.
-Along with that, hoping that the person will not remember what you said wrongly just a minute ago is a valid kinda hope. But try not to say anything bad in any case.
-Talk about what they like, what they did in their time, and they will love you. Show care.
-The little things in life do matter, and bring joy.
-Things move very slowly, take your time, enjoy and smile, you don't get these moments just like these just in any place.
-Humor is a valuable and essential tool.
-Always check feeding and swallowing safety records for the residents, you can't just use food all the time in this setting, as you could in other settings. And anyways, food is not always a great motivator for residents to do what you want them to do. They get full to fast, and they usually can't eat the food they love (e.g. sweets and fried goodness).
-Don't make faces or cringe at 'accidents' that happen, even when the person is unaware of it...but the other residents are allowed to hold their noses.
Last Tuesday was my final day at the nursing home. Happy to get done with clinic, sad to leave those great clients behind. My individual one was not feeling well, she hadn't been for quite some time, so that was sad cause I didn't really get to spend much time with her, except to give her some gifts and say goodbye. She's found a spot in my heart, I had a tough time initially with her, but after a while, rapport was gained! and I found out her ways and managed to built a fun relationship with her. It's amazing how little things perk her up like nothing else. Finding out what she really liked, and especially those that can be incorporated into therapy seriously brightened up her day and helped temporarily forget the physical pains she had. So, here's challenges and lessons from the nursing home as a SLP student:
-Age does not matter, beauty and macho-ness is still important and must be taken care of at all cost.
-Not wearing glasses, hearing aids, and other assistive devices does increase boost the residents self-esteem, thus, work your way around this (i.e. learn how to talk in a very loud voice without killing your voice, and use extra large print whenever possible).
-Do not take comments from persons with memory loss and difficulties personally.
-Along with that, hoping that the person will not remember what you said wrongly just a minute ago is a valid kinda hope. But try not to say anything bad in any case.
-Talk about what they like, what they did in their time, and they will love you. Show care.
-The little things in life do matter, and bring joy.
-Things move very slowly, take your time, enjoy and smile, you don't get these moments just like these just in any place.
-Humor is a valuable and essential tool.
-Always check feeding and swallowing safety records for the residents, you can't just use food all the time in this setting, as you could in other settings. And anyways, food is not always a great motivator for residents to do what you want them to do. They get full to fast, and they usually can't eat the food they love (e.g. sweets and fried goodness).
-Don't make faces or cringe at 'accidents' that happen, even when the person is unaware of it...but the other residents are allowed to hold their noses.
Saturday, February 18, 2006
S is for stuttering
I'm taking a course on stuttering this semester. Just so happens I am also doing my thesis on stuttering. I interact with PWS (people who stutter) but don't think I have a deep sense of understanding, how the pieces come together and play out in a life. We're reading a book by Jezer, "Stuttering: A Life Bound Up In Words," which has by far wonderfully (and thankfully) put together the scientific and academic side of stuttering together with the reality/person-invovled side. Sure, we learn about emotional and behavioral characteristics of stuttering, but Jezer puts the same points into meaningful words. Anyhow, I'm at chapter 11 now, and this section stood out to me, telling me something that I should have realized when I first began chapter 1: "The shame of being so identified--of having that "S" letter hung from my neck--was so powerful that it became etched into my consciousness. Recalling a humiliating incident forty years after the fact, I can still feel the blow in my gut, my stomach tightening up (Jezer p. 84)." Everyone has labels, what we identify ourselves as, most commonly, we introduce ourselves to others in terms of our occupation or relational/familial connection. Our primary identity drives our life, how we perceive and value ourselves, guiding our actions. A form of speech, stuttering is enough to be a defining label for a PWS. Needless to say, such a term does not promote happy feely thoughts or positive self-concepts. Typically with a childhood onset, the person has a lifetime to reinforce negative habits and struggle with self-esteem.
We are called as Christians to identify with Christ. We hear it in Sunday School and at the pulpit, to call ourselves as children of God, to make that our primary identity and live accordingly. Sinner but redeemed, heirs of God. Reading Jezer's book has renewed this concept to me. A PWS struggles to come to terms with their stuttering, and the label 'stutterer' because they mark it as their primary identity, above any other identity. Therapy (if it's good) does include help to form a positive self-image, accepting stuttering as a part of themselves but not allowing to conquer themselves. The goal is to view stuttering in neutral or positive ways, which often is the key factor to opening doors which actually address the stuttering behaviors themselves, in keeping stuttering under control, or giving life to a PWS. I think that treatment then, should not only be emphasizing that stuttering is only a part of their identity, and not the whole, but also filling in the void previously filled with 'stutterer' by actively identifying healthy and positive identities, especially a primary identity. And what better identity that a child of God.
We are called as Christians to identify with Christ. We hear it in Sunday School and at the pulpit, to call ourselves as children of God, to make that our primary identity and live accordingly. Sinner but redeemed, heirs of God. Reading Jezer's book has renewed this concept to me. A PWS struggles to come to terms with their stuttering, and the label 'stutterer' because they mark it as their primary identity, above any other identity. Therapy (if it's good) does include help to form a positive self-image, accepting stuttering as a part of themselves but not allowing to conquer themselves. The goal is to view stuttering in neutral or positive ways, which often is the key factor to opening doors which actually address the stuttering behaviors themselves, in keeping stuttering under control, or giving life to a PWS. I think that treatment then, should not only be emphasizing that stuttering is only a part of their identity, and not the whole, but also filling in the void previously filled with 'stutterer' by actively identifying healthy and positive identities, especially a primary identity. And what better identity that a child of God.
Tuesday, February 07, 2006
Do charts for pictures to match a name?
I catch a glimpse of First Child this morning! They came early for their session, and I was just about to leave for my own clinical site. I didn't get to talk to her though. She looked very good and happy.
Today was a fairly tough day at clinic. We had our first session at group and tried out my 'nursing home' voice...loud and deep...did not go so well, and I admit this as a weakness, but one that I can conquer, hopefully without getting larygnitis. We saw a new client today as well. E. was sick, so it was just M. and myself as student clinicians. We walked into the client's room with our supervisor, she introduced us, and asked if she was so-and-so. The client started shaking, literally shaking and looked like she was almost going to cry, saying that how nice it was for us to come visit, etc. She grasped our hands, hugged and kissed us (like relatives do, lah). She then appeared to be looking for something, glancing around the room, and did a very cool thing (to me...cause I seldom see any client do this by themselves): she verbally cued herself for the object she was looking for by saying its first letter. it turned out she was looking for her cup that had her name on it. We assumed she was who we were suppose to assess, but as it turned out, when she found her cup, we found out she was the roommate of the client we were suppose to meet...and we very well then could not just leave as she had been so emotionally involved when we came into the room. By the conversation that followed, it was obvious she had a form of dementia and was probably at the stage where one begins to forget personally related information (like her name, who's who in family pictures). I haven't thought much of the social side of living in a nursing home, from a personal standpoint. But today I did. I was kinda scared, mad and very sad to see this side of the nursing home, where a resident might not get many visitors or any at all, having all the time in the day to do nothing. Many of the residents here talk about waiting for family, refusing to leave the room just in case they miss a visitor, waiting to return to a home (they no longer have), not being able to see so-and-so, etc. It's heart breaking, the physical response I saw today was the most extreme response I've seen yet. Sure, it could be her dementia in play that influenced her behavior as well, but I think it's more than that.
Today was a fairly tough day at clinic. We had our first session at group and tried out my 'nursing home' voice...loud and deep...did not go so well, and I admit this as a weakness, but one that I can conquer, hopefully without getting larygnitis. We saw a new client today as well. E. was sick, so it was just M. and myself as student clinicians. We walked into the client's room with our supervisor, she introduced us, and asked if she was so-and-so. The client started shaking, literally shaking and looked like she was almost going to cry, saying that how nice it was for us to come visit, etc. She grasped our hands, hugged and kissed us (like relatives do, lah). She then appeared to be looking for something, glancing around the room, and did a very cool thing (to me...cause I seldom see any client do this by themselves): she verbally cued herself for the object she was looking for by saying its first letter. it turned out she was looking for her cup that had her name on it. We assumed she was who we were suppose to assess, but as it turned out, when she found her cup, we found out she was the roommate of the client we were suppose to meet...and we very well then could not just leave as she had been so emotionally involved when we came into the room. By the conversation that followed, it was obvious she had a form of dementia and was probably at the stage where one begins to forget personally related information (like her name, who's who in family pictures). I haven't thought much of the social side of living in a nursing home, from a personal standpoint. But today I did. I was kinda scared, mad and very sad to see this side of the nursing home, where a resident might not get many visitors or any at all, having all the time in the day to do nothing. Many of the residents here talk about waiting for family, refusing to leave the room just in case they miss a visitor, waiting to return to a home (they no longer have), not being able to see so-and-so, etc. It's heart breaking, the physical response I saw today was the most extreme response I've seen yet. Sure, it could be her dementia in play that influenced her behavior as well, but I think it's more than that.
Friday, January 20, 2006
Second Semester
I'm placed at the nursing home this semester, orientation was good, seems to be very interesting and fun. Residents themselves were a treat. Hopefully I'll get more hours this semester, else I'll be two semester's behind...argh! this system rots.
Thursday, December 08, 2005
Last session with First Child...I am soo so so so so relieved that clinic is over!!!!!!!!!!!!!!!!!!!!!!! I think the last session went very well, because it was parent conference and play time with F.C., so it was a lot more relaxed and I let her have her way more. She did still say the words and perform what we targeted during the semester, soooo SUCCESS!!!
She's so good-natured and mischevious and smiley...I'm gonna really miss her.
She's so good-natured and mischevious and smiley...I'm gonna really miss her.
Monday, December 05, 2005
One down, one more to go
I had my last session with First Boy tonight. Whew...it went fairly well I think. I went a little bit to advanced and chose hard games for him to play, but we switched easy and it was good. He smiled and seems to enjoy and also work hard. Parent conference went well, except when I messed up my sentences, and had to explain what phonological processes were when my supervisor asked me what they were, after I had just explain what they were to the mum. So I felt like I repeated myself a lot. He/she gave me a card...I was touched...I did my best to serve them and hopefully, it was helpful to them, more so encouraging.
After the session, also had my 'grade' conference with my supervisor. It was okay and I did not feel as bad as I did the last time, I felt neither upset or glad. I was professional, haha...professionally stoic. I guess I was just too tired to react.
What I thought of the most today: How do you tell a mother her child needs years more of help? How do you convey and explain the numbers and percentages and scales that measure a child so objectively and coldly? How do you tell the truth yet bring hope that is not just in words at that moment? How do you encourage and put back peace in her heart when you're describing the challenges her child faces and how you think s/he can improve, or not? How do you say 's/he' needs help in the same breath as 's/he's' a remarkable and intelligent person? How do you bring hope and motivation in a matter that cuts a parent's heart the most?
After the session, also had my 'grade' conference with my supervisor. It was okay and I did not feel as bad as I did the last time, I felt neither upset or glad. I was professional, haha...professionally stoic. I guess I was just too tired to react.
What I thought of the most today: How do you tell a mother her child needs years more of help? How do you convey and explain the numbers and percentages and scales that measure a child so objectively and coldly? How do you tell the truth yet bring hope that is not just in words at that moment? How do you encourage and put back peace in her heart when you're describing the challenges her child faces and how you think s/he can improve, or not? How do you say 's/he' needs help in the same breath as 's/he's' a remarkable and intelligent person? How do you bring hope and motivation in a matter that cuts a parent's heart the most?
Monday, November 28, 2005
I just about am bursting with pride for my First Child. I feel kinda sad each time when she comes, all smiles and ready to go...and smelling of cigarette smoke. She's bright, smiley and just a little dancing pixie! This week is the last week of therapy with her, conference is next week. I'm going to miss her a lot, she has made a lot of progress this semester and I surely wish that she will make leaps and bounds in the near future.
Changing focus, my First Boy was a no-show today. No call...so I waited for bout 15-20 minutes just to make sure, after all, it was I who was always rushing to set up the clinic room and rush to greet them, fresh out of the classroom. Am kind disappointed he did not show, because I really prepared well and was anticipating a good session...and I really do need the data too! The end of the semester conference is next week...and I don't see him til then...how the heck am I suppose to show change when I only had him for two therapy sessions? But the very cool thing about the whole (well six weeks) semester I had with him, is we went from extreme bad to extreme good...I think anyhow.
Changing focus, my First Boy was a no-show today. No call...so I waited for bout 15-20 minutes just to make sure, after all, it was I who was always rushing to set up the clinic room and rush to greet them, fresh out of the classroom. Am kind disappointed he did not show, because I really prepared well and was anticipating a good session...and I really do need the data too! The end of the semester conference is next week...and I don't see him til then...how the heck am I suppose to show change when I only had him for two therapy sessions? But the very cool thing about the whole (well six weeks) semester I had with him, is we went from extreme bad to extreme good...I think anyhow.
Sunday, November 13, 2005
You go girl!
First Child said 'help me' and 'bye' and 'pop' spontaneously!!! She's also looking out for cues and using a greater variety of sounds, and also communicating more with her sister using verbalizations instead of just nonverbals!!!!!!!!!!! I am going to be soooo sad when this semester ends and I don't get to see her anymore.
Thursday, October 20, 2005
Jointly
Today we did something a little different...the clinician working with First Child's sister and I got together with the children for the last quarter of the session so they could play together. I think it was the activity, but the two ended up playing by themselves, but yes, in each other's company. Cueing (getting her attention!) didn't work so good, and I felt like I was talking over the head, repeating words, but not being listened to, which is what's expected, but I didn't know how to get her attention back again. WHen I did, cueing was off and so were the corresponding actions.
I didn't manage to fit in one of the main tasks I usually do, which I feel it's ok, but I don't know about my supervisor. I felt I didn't have much control over the session this time. I know one of my goals is to move back more and more, giving control over to rmy kid (also mentee?), yet still maintain the sanity of the session/overall structure or control. I don't know how to give that 'light touch' that lets everything else just fall into place. I've seen it so many times, done by my supervisor, and today, by the other clinician, but I just don't seem to get what they are doing, how they are doing it. I try, but it just flops. Needless to say, I felt bad at the end of the session, and this is not a good time to be so, because I have to write my clinical journal for the week and do a self-eval feedback form...and I probably will be graded down for inconfidence, which I feel was more lack of ability and skill than inconfidence. But perhaps that inconfidence is the lack of taking risks, because I know what works in general, but do not try novel strategies I have never seen done before, never heard about.
I didn't manage to fit in one of the main tasks I usually do, which I feel it's ok, but I don't know about my supervisor. I felt I didn't have much control over the session this time. I know one of my goals is to move back more and more, giving control over to rmy kid (also mentee?), yet still maintain the sanity of the session/overall structure or control. I don't know how to give that 'light touch' that lets everything else just fall into place. I've seen it so many times, done by my supervisor, and today, by the other clinician, but I just don't seem to get what they are doing, how they are doing it. I try, but it just flops. Needless to say, I felt bad at the end of the session, and this is not a good time to be so, because I have to write my clinical journal for the week and do a self-eval feedback form...and I probably will be graded down for inconfidence, which I feel was more lack of ability and skill than inconfidence. But perhaps that inconfidence is the lack of taking risks, because I know what works in general, but do not try novel strategies I have never seen done before, never heard about.
Thursday, October 06, 2005
Speak!
Things are going well for the most part with First Child. Something funny happened yesterday in session...the lights went out for a second...the room's lighting is monitored by motion sensors, so I guess we were too still too long. Anyhow, she was surprised and a little frightened. I tried to divert her attention with extra reinforcement for simply not looking scared and talk and smile a lot. But a few seconds later of it's ok, she stopped looking shocked and trying to tell me somethin with sign, and gave me the saddest face ever and gave out a wail, "mama." I think it was "mama." Then I got up, held her hand, took her to the light switches, opened the door, so there was some light coming in (didn't want her to get more scared!) and showed her how the lights turned on and off. I made it look like a fun game, and got her to believe so...she started giggling too. I felt absolutely competent at that moment for the first time since I've started grad clinic. But then, after the session was over, she started heading towards the light switches to show the new game she had learned...hmm...good thing she's not tall enough to properly reach them. She's one very smart young lady :)
I am having some trouble trying to get her to talk more often. I need to vary my own words I think and scale down too...think children words. Comment on situation, not just what? all the time.
I am having some trouble trying to get her to talk more often. I need to vary my own words I think and scale down too...think children words. Comment on situation, not just what? all the time.
Tuesday, October 04, 2005
Routine
The goals and kinds of activities in therapy are beginning to shape up and solidify. I pretty much have activities I want to continue, maybe a tweak here and there, but for the most part it's going to be: practising maintaining eye contact and attention, bilabials in isolation and words approximations, saying sign and word together.
For me, practising signs accurately (today, I messed up with 'say' and point to my cheek, so she gave me a kiss while I tried to get her to watch my lip again for a cue...it didn't look to good on tape, me backing off and she moving forward), and learning more signs, and pacing the session better between play and table-time.
For me, practising signs accurately (today, I messed up with 'say' and point to my cheek, so she gave me a kiss while I tried to get her to watch my lip again for a cue...it didn't look to good on tape, me backing off and she moving forward), and learning more signs, and pacing the session better between play and table-time.
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.
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