Going Beyond the Call of Duty

Hi,

I am finishing up an on-line Post Bachelor program to get my degree in comm. disorders in the spring then off to Grad School, but ultimately, my goal is EI in homes when I earn my CCC's. I lOVE this profession and am kicking myself that I didn't do anything about it while in college the first time!!  It's good to see(and hear) that it is ok to go "above and beyond" a regular speech session.  These are all things that I could see myself doing in a home.  Helping to fill out a questionaire, advice for dealing with family etc.  I thought that wasn't "part of the job" and was concerned how to turn that personal side of me off when entering a home, but it's good to see that I don't HAVE to!

Thanks for all the advice SLP's!!

Wish me luck and hope to see you out there one day!

Michele

I rememeber a comment shared with us by a favorite professor when I was a graduate student, "We don't work with speech problems, we work with people."  God bless you Dr. Kammermier!

I really appreciate this site and knowing what other SLP's are doing. sometimes I feel all alone out there and yet I know I'm not but it helps to hear other people's experiences. We did not go over any of this in grad school!!!!

to MF working in early intervention. some of the best "therapy toolss' are a shape box, which teaches shapes and frustration tolerance and the basic memory cards. the cards are small enough yet thick enough to be held easily by small hands. and you can use them for matching or sorting into categories. don't forget the weekly grocery flyer which can be "read" or cut and sorted into categories. You can glue the pictures onto construction paper. You can also make small books using magazine pictures and construction paper.

I think the basic idea of in home EI servies is to model for the parents on how to encourage communication in the home when we (SLPs) are not there. Its important to consider the parent's level of education, confidence, esteem and other issues.  With that said, many parents may just need someone to tell them (in a loving way) that their children need a bath everyday, learn to dress themselves, help clean up, work on potty training, and stop using the bottle when its time. This is all indeed outside the scope of speech, but many times we are the only outside person that is in regular contact with the parent and see what really is happening at home.

During my CFY year, I provide EI services for low income families. Many times I felt like I was babysitting, with the parent not in the same room or observing the session, not addressing behavior issues, and we had very little communication. Today, its very different, I encourage the parent to watch and really emphasise how important it is for THEM to work with the children. I suggest using bath time to work on body parts, daily story time, working on requesting for all meals/snacks, and speaking at the appropriate developmental level to their children. Therapist are going to come and go but the parents will be there for a life time.

Tickle games to work on body parts and requesting, peek a boo, talking a walk outside to work on vocabulary are all free activities I regulary suggest and do. I think the most important activity is to give the children undivided attention and encourage and enjoyable experience with another person.

I often go to thrift stores and yard sales and pick up inexpensive toys that I can pass on to the families. Using old shoe boxes, ice trays, contruction paper is a great way to make some TEACCH tasks to work on attention and task completion. I also find lots of things at the dollar store. I got a packet of poker chips and use them as reinforcers for all kinds of goals. The older kids like to earn the chips then we toss them into a hat or bucket. One thing the kids love is using a fly swatter to slap picture cards (receptive ID) spread out on the table or floor. We're getting a little OT in there too!!

I think the other comments were correct when saying that we get into this field because we want to be helpful and of service. So accepting situations for what they are but looking for any and all ways we can be creative, supportive and motivating to all we contact is a vital component of what we do.

Lets keep doing what we're doing!!

Christy Aycock, SLP Long Beach CA

Hi Stephanie, I totally understand how it feels to walk into a home that has nothing. I have bought groceries and paid for vet bills and bought toys just to try to make things a little better. I don't officially report any of these things, I just consider it my tithe to make the workd a better place.

Dear Stephanie,

I'm really enjoying the blog.  As an SLP who now owns a company that provides EI in rural PA, I supervise 25 employees who do EI.  The stories we could tell!!  Some days, providing hands on therapy seems to be the last thing that we do.  I once spent an entire ST session with the mom, filling out a 200 question questionaire from Children's Hospital because the child was scheduled for an Autism evaluation, and mom couldn't read the questions.  It's all about "what does this child need right now?"  Sometimes what the child needs (as you've stated) is for the caregiver to be okay.

I'd like to see you address the role of the ST as a  support/resource person, as counseling is one the primary things our therapists do.  I would also like to see you talk about (esp. for new EI therapists) the devastation and grieving process that families go through when their child is given a diagnosis.

Another fun story from EI:  One of our families involved a teenage mom with 3 children, all of whom were born 6-12 weeks premature.  Mom was pregnant with the fourth, and started labor during an OT session (3 months early).  She refused to call an ambulance (due to money issues) and wanted to wait until her boyfriend returned.  The OT knew that a premature birth at home would almost certainly lead to a fatality.  The OT drove mom to the hospital after getting the other kids to the neighbors.  Baby David (not real name) was born 20 minutes later.  While I certainly do not condone therapists driving clientele around, this was absolutely the right call given the direness of the situation!

Keep up the good work!

Tracy Cowles SLP/Administrator Next Step Therapy, Inc.

Hi Stephanie,

When you work in peoples' homes you have the privilege of becoming a trusted friend. I come home laughing many days, recalling how I have been asked to give a mom advice on what outfit to wear, what to do with in-laws, give advice on personal problems etc.

I am complimented that they trust me with a little piece of their lives.

Sherry Artemenko, SLP

www.playonwords.com

Sherry Artemenko

What a great site! In response to your question, I've had to step out of the SLP role too many times, but have been happy to do so. While working in a rural area, it became commonplace to whisk children over to the sink and wash little faces and hands that didn't seem to ever be washed or to make sure they'd gotten enough to eat that day. When more and more kids were coming to school with ripped and too-small shoes, I collected gently used shoes and purchased some new ones to give to some of the needy kids I worked with. They were so proud to wear them, but I don't know who felt better them or me. I enjoy working with all kids, but you really feel like you make a difference with the needier ones. The desire to help others is what brings most of us to speech pathology to begin with.

Lara DiMartino, MS, CCC-SLP

www.speechlanguagehousecalls.webs.com

Hi -

I have only just started as a CF in Early Intervention a few months ago and already I've had many experiences like you've described here.  The Maslow hierarchy has come to mind many of times over the past few months :)   Parents who are overwhelmed by other issues -  health, finances, etc.  

I also find it very challenging to work with families who have very little...not only are the parents (or parent, single) working just to make ends meet, but the children really have very little as well.  I just started with a new child who has a total of 2 toys - a ball (it's actually his sisters) and a toy riding car.  My creative juices only take me so far with these toys so without bringing in a bag of toys every week...I try to use common household items creatively.  For example, a simple bucket of water and a sponge can be used to do a cleaning game - you can wash cups, dishes, toy cars(if they have), and just about anything else that can get wet.  Or add some dish soap and use a straw to blow bubbles!  

I was wondering if anyone else had suggestions like this for games/activities/toys that can be made from common household items?