When I graduated almost 2 years ago from grad school, the job search and the possibilities for employment seemed overwhelming, daunting even. Should I work in a school, hospital, skilled nursing facility, outpatient clinic or home health? In what type of work setting did I want to foster my newly acquired skills? When I landed my first job I was thrilled to have the opportunity to work in both a pediatric outpatient clinic and in a nursing home. Both settings offered challenges and a chance to learn totally different skills. I'm thankful I had the opportunity to do both. But I would quickly realize that a healthy work environment was the key to happiness. There was office drama, and little control over my schedule. I felt opportunities for growth were limited, and that the patient's needs were not being put first. It all came down to management, and choices that were being made that indicated that the company I was working for was on a downward spiral with no looking up.
So I began exploring other options. I had several good friends who worked in home health who loved it. At the same time I began reading blogs about individuals who had adopted children, or worked with non-profit groups. In my heart I felt a longing; a longing to work with a company that put children first, and who supported the therapists that worked for them. I wanted to work in an environment where I could grow and learn. I wanted to make a difference in a big way. I wanted to create opportunities and really change the lives of my patients. Friends shared their stories of working with low income families and I felt inspired. And so I began my search and found my current job.
Nine months later I see no turning back. For one, I found a company to work for that truly embodies and shares my core values. On top of that, working in home health has been an incredible adventure. I love being in the homes of the children I work with. It's amazing how different therapy can be when the parents are there, involved and working with you to help their child. For example, one little girl I see, I started out seeing at her daycare. But when the daycare closed, the family had no choice but to keep her at home after school. So I started seeing her at home and what a difference. For the first time I am starting to see a real difference in how this little girl communicates. The family has been involved and learning to carry over the techniques I use with her. I have even seen a change in her feeding skills. The point is, that as a home health therapist I have a unique opportunity to see my kids in their natural environment. The parents of my kids are the most important people on my team. By counseling parents I hope to empower them to be advocates for their children. And in the home, it's so much easier to get them involved than in a clinic setting. I can take the child's toys and show the parents how to play with their children. I can involve the siblings in feeding therapy. I can go to their pantry and see what food items are available. I can go to their room and play with them to teach them language using their toys. I have learned to be a minimalist and in doing so I am starting to sharpen my therapy skills. It's easy to do therapy when you have everything there at your fingertips. But when you're forced to work with what the child has, you learn to go with it. And in doing so, the activities become that much more meaningful to the child because it stemmed from their interest.
That's not to say there are no challenges. Some days I walk in and the TV is blaring, or the dogs are barking. Or they have the running water turned off because of a leak they cannot afford to fix. There are weeks when I get cancelation after cancelation because a child is sick, or I show up at their door on the coldest day of the year and they aren't there because they forgot about another appointment they had with a doctor or the WIC office. But these are minor inconveniences. And I'm learning to train my families. I'm training them to organize, and stay on top of things, because God knows they are overwhelmed. Some are just better at managing it all than others.
I have a families where the parents are just young and need a lot of support. A lot of times people give them a bad wrap...accuse them of not caring, or accuse them of being irresponsible. Many would say of my 19 year old mom, who got pregnant before she graduated from high school "she should have known what she was doing." I say to anyone who says this, "whoever is without sin, let him be the one to cast the first stone." Sometimes people make mistakes and then they have to deal with the consequences. And sometimes those consequences can be more difficult to handle than could have ever been anticipated. When that happens what they need is someone to say, "you have the power to make the best of this situation". And as a therapist, I have to look at the child I serve and focus on the fact that no matter what the circumstances are, this child needs help. So there are days when being a therapist means being a counselor, cheerleader, encourager, or even an older mentor to help a child raise a child. It's messy sometimes, and sometimes it's not pretty. And some days planning gets thrown out the window, but that's okay. I am a part of their lives. The most rewarding part is getting that text or phone call from a parent saying "thank you so much for all you're doing for my child." Or seeing a young parent begin to grow in confidence and take responsibility as she begins to learn how to navigate the murky waters of being a parent of a child with disabilities.
So in the long run home health was for me. I've found a way to be involved with my families in a way that I was not able to be involved before. I've found a way to feel like I'm really making a difference. And that's what it all boils down to. I think each of us has to look deep in our hearts and ask ourselves where we feel our skills could be used the most. We have to look back to the day when we decided to become a speech-language pathologist and remember why we chose to go into the profession of helping people. And then when you step out into that job market, find what setting speaks to you most. Every one of us has the power to make a difference, no matter what the setting. But even though a lot of us SLP's are wired alike, there are things that make us all different. I think the most important thing is to 1) find a company that shares your core values as a therapist and that will allow you to abide by our code of ethics, and 2) find a setting where you feel you can blossom as a therapist. Discover what's out there by talking to others, reading blogs and the ASHA leader. It's not just about research, it's about a wonderful supportive community of SLP's who know the day to day struggles that come with working in this field. I'm learning to lean on them more and more. And day by day I'm finding my passion in this field. I'm developing my own set of skills, and learning skills beyond what I ever would have dreamed.
Sunday, April 20, 2014
Monday, April 7, 2014
A Call to Play!!
Over the past week or so I've been listening to a seminar in the car (one of the beauties of home health...time to think between therapy appointments) called "The Power of Play" by Cari Ebert, M.S., CCC-SLP (visit her website here: Learning Through Play). If you ever have a chance to hear her speak, I would encourage you to do so! Let's just say her seminar changed my life, changed the way I think about therapy, changed how I think about goals for my little ones, and changed my thinking about how I would raise my own children if I ever have them. Play is a powerful thing! I don't think I realized just how powerful until listening to the research presented in this seminar. So I decided to do something a little different for "Research Tuesday". The article I read isn't specifically "speech" related. However, I feel the information I'm going to share with you is completely relevant to our field. Some of us work in schools. Some of us work in home health with the birth-3 population. Either way, as SLP's we have the ability to empower parents, educators and policy makers to improve the future of education and the social, emotional and physical development of both typical kids and kids with special needs.
The information I'm sharing was taken from an article entitled "Crisis in the Kindergarten: Why Children Need to Play in School". You can read it here.
Think back to kindergarten...what was it like? For me kindergarten was half a day. My teacher's name was Mrs. Mick and she was AWESOME! I remember participating in free play at the "kitchen" station, making arts and crafts, coloring, playing with play dough, blocks, and a variety of toys. Somewhere in there I'm sure I learned my colors, letters, numbers, though I don't specifically remember. I went to kindergarten in 1985. Kindergarten rocked! I loved learning! Today, most children go to pre-school and kindergarten all day. In many schools and districts, curriculum is focused on teaching to the test, and has increased in academic focus as the years have progressed. In addition there is an increase in didactic, adult directed instruction in many early childhood classrooms across the country. When you combine that with the hyper-busy lifestyles of many American families, there is little time left for child-directed play and exploration of the world through free play.
Here are a few quotes from Crisis in the Kindergarten demonstrating how early childhood curriculum has shifted in recent years. Information provided here was gathered from nine research studies, which surveyed kindergartens in the country in order to: 1) collect the thoughts of educators, 2) find out what methods are being used currently in kindergartens today, and 3) find out what kind of time is allowed in kindergartens for child-directed, open ended play.
1) "New York and L.A. teachers consistently reported major differences between their views of the importance of dramatic play, block play, and sand and water play and their perception of the views of school administrators. A large majority of teachers indicated that such play is important, while roughly half of the teachers perceived administrators as not valuing it."
2) "Scripted teaching and other highly didactic types of curricula are widely used in kindergartens despite a lack of scientific evidence that they yield long-term gains."
3) "A separate evaluation commissioned by the Institute of Education Sciences found that the federal government’s Reading First program had significantly increased (by about 20%) the amount of class time spent on didactic, phonics-heavy reading instruction; nevertheless, the program “did not have statistically significant impacts on student reading comprehension test scores in grades 1–3.” The evaluation also found that the program actually reduced second-grade students’ engagement in reading and writing."
4) "Play in all its forms, but especially open-ended child-initiated play, is now a minor activity, if not completely eliminated, in the kindergartens assessed. Teacher-directed activities, especially instruction in literacy and math, are taking up the lion’s share of classroom time. Standardized testing and preparation for tests are now a daily activity in most of these kindergartens."
So is there evidence to support child-directed, adult guided free play to facilitate learning in the kindergarten and beyond?
First of all, how do the authors of this article define play?
The authors define play in this way: "we use the word “play” to describe activities that are freely chosen and directed by children and arise from intrinsic motivation. Within this definition are many different kinds of play, including dramatic and make-believe play, block play, sand and water play, art activities, play with open- ended objects, spontaneous physical play, exploring the outdoors, and so on."
Unfortunately, in the U.S., the development of "educational toys" and the promotion of "educational videos and products", by manufacturers who know nothing about child development have conditioned many parents to believe that pushing hard core literacy, math and academics on children earlier, leads to smarter more academically successful adults.
But just look at these statistics and quotes from Crisis in the Kindergarten....
1) "Long-term research casts doubt on the assumption that starting earlier on the teaching of phonics and other discrete skills leads to better results. For example, most of the play-based kindergartens in Germany were changed into centers for cognitive achievement during a wave of educational “reform” in the 1970s. But research comparing 50 play-based classes with 50 early-learning centers found that by age ten the children who had played excelled over the others in a host of ways. They were more advanced in reading and mathematics and they were better adjusted socially and emotionally in school. They excelled in creativity and intelligence, oral expression, and “industry.”* As a result of this study German kindergartens returned to being play-based again."
2) "China and Japan are envied in the U.S. for their success in teaching science, math, and technology. But one rarely hears about their approach to schooling before second grade, which is playful and experiential rather than didactic. Finland’s children, too, go to playful kindergartens, and they enter first grade at age seven rather than six. They enjoy a lengthy, playful early childhood. Yet Finland consistently gets the highest scores on the respected international PISA exam for 15-year-olds."
3) "The American Academy of Pediatrics, in its clinical report on the importance of play, found that “despite the benefits derived from play for both children and parents, time for free play has been markedly reduced for some children” and addressed “a variety of factors that have reduced play, including a hurried lifestyle, changes in family structure, and increased attention to academics and enrichment activities at the expense of recess or free child-centered play.”
So what are we doing? Why aren't policy makers listening? And why aren't parents, teachers, educators, and therapists educating and advocating for our children? After reading this and listening to Cari's presentation I feel strongly that we are doing a disservice to our children when we ask them to develop skills at an age when their brains are not ready to learn them. We don't expect an apple tree to produce apples until it has first developed blossoms. In the same way, a child's brain develops sequentially, and purposefully, by design. Think about the progression of play as a child develops. First they explore their world by reaching for objects and placing them in their mouth. Next, they learn that doing things with certain objects (like dropping a cup on the tile floor) creates a certain effect. Next, they learn that the cup is for drinking, and will even put water in a toy cup and sip from it themselves. Finally, they learn to apply that knowledge to the world around them through pretend play. They take the cup and give the baby doll a drink. Even more compelling evidence of the importance of free play is found in the list of skills children develop through play. Take this quote, for example, "Young children work hard at play. They invent scenes and stories, solve problems, and negotiate their way through social roadblocks. They know what they want to do and work diligently to do it. Because their motivation comes from within, they learn the powerful lesson of pursuing their own ideas to a successful conclusion." WOW!
Cari points out in her seminar that play provides rich sensory experiences that help to develop life long connections in the brain. It is well proven fact that if you want the brain to learn something, provide information through multiple modalities. Think about studying for an exam. Most of us are not blessed to be able to recall information heard once in a lecture. Most of us had to also read the information, write the information, or speak the information out loud to truly recall it. And TRUE learning happens when we are able to apply that information to the world around us, to think critically about it and use it in a way that is meaningful. Compare learning colors by matching colored squares on an Ipad screen to learning colors by sorting through a laundry basket or walking through a field of muli-colored flowers! Free play allows creativity to blossom. Media and pre-programmed battery operated toys (i.e. Buzz Light Year toy) limit creativity and imagination. Imagine the possibilities in a generic astronaut toy compared to a battery operated Buzz that can only say "To infinity and beyond!"
So, what does this mean for therapists, teachers and parents? I join Cari in saying this...allow children to experience their world through play! Play with them and let them take the lead. Remove obstacles in your life that take away time for your child to truly engage in sensory rich, child-directed play. Step away from media sources of entertainment and limit your child's screen time. "The American Academy of Pediatrics (AAP) discourages TV and other media use by children younger than 2 years and encourages interactive play." Children learn through play, so encourage it as much as possible!!
As a home health therapist:
1) Limit use of the bag of toys. Going through a bag of "pre-planned" activities is adult directed and more didactic in nature. Go into the child's home and let them choose a toy. Or, let the child choose from your bag and build your therapy from there. A good therapist can create language opportunities from anything. This will increase the chances of generalization of skills and increase the child's willingness to participate in activities.
2) Step away from the Ipad. Build sensory rich opportunities for language learning. Relying on the Ipad inhibits a child's development.
3) Play with a purpose. Model appropriate play with toys in the same way that you model language. Think about where the child is developmentally and model one step up. For example, if the child is exploring their environment through exploratory play, demonstrate cause/effect.
3) Educate parents on different types of play: exploratory, cause/effect, functional and pretend play, parallel and cooperative play. Educate parents on ways they can create language rich opportunities in the home. Teach parents how to play with a purpose. Encourage them to step away from their phones and be involved with their child.
As parents of young children (under the age of 7):
1) Increase your child's opportunities for free play by limiting your child's screen time, and adult directed, didactic instruction at an early age. Guide your children and provide structure, while allowing them to experience their world through play. For example, let them explore letters/numbers on a magnet board in their room. Model language that builds understanding when the child shows interest, but move away from drilling them. Read books that model sounds, but let the child choose the book. Use their natural curiosity to guide your interactions with them.
2) Increase opportunities for free play by de-cluttering your schedule. Kids don't need to be on a "social schedule" with a list of "adult driven" activities to complete every day. Free play should happen every day, not just in play groups once a week.
3) Learn how to guide your child in free play by seeking help from professionals who know about child development
4) Advocate for child-directed, adult guided, play based kindergartens
Just think of the opportunities for learning in the world around us. We live in a vivid and colorful world! As adults, we have the opportunity to bring to life a 3 dimensional world for our children who unfortunately spend much of their time in a 2 dimensional screen. I'm calling all parents, teachers and therapist to bring free play back! Let children be children and watch learning and discovery happen!
The information I'm sharing was taken from an article entitled "Crisis in the Kindergarten: Why Children Need to Play in School". You can read it here.
Think back to kindergarten...what was it like? For me kindergarten was half a day. My teacher's name was Mrs. Mick and she was AWESOME! I remember participating in free play at the "kitchen" station, making arts and crafts, coloring, playing with play dough, blocks, and a variety of toys. Somewhere in there I'm sure I learned my colors, letters, numbers, though I don't specifically remember. I went to kindergarten in 1985. Kindergarten rocked! I loved learning! Today, most children go to pre-school and kindergarten all day. In many schools and districts, curriculum is focused on teaching to the test, and has increased in academic focus as the years have progressed. In addition there is an increase in didactic, adult directed instruction in many early childhood classrooms across the country. When you combine that with the hyper-busy lifestyles of many American families, there is little time left for child-directed play and exploration of the world through free play.
Here are a few quotes from Crisis in the Kindergarten demonstrating how early childhood curriculum has shifted in recent years. Information provided here was gathered from nine research studies, which surveyed kindergartens in the country in order to: 1) collect the thoughts of educators, 2) find out what methods are being used currently in kindergartens today, and 3) find out what kind of time is allowed in kindergartens for child-directed, open ended play.
1) "New York and L.A. teachers consistently reported major differences between their views of the importance of dramatic play, block play, and sand and water play and their perception of the views of school administrators. A large majority of teachers indicated that such play is important, while roughly half of the teachers perceived administrators as not valuing it."
2) "Scripted teaching and other highly didactic types of curricula are widely used in kindergartens despite a lack of scientific evidence that they yield long-term gains."
3) "A separate evaluation commissioned by the Institute of Education Sciences found that the federal government’s Reading First program had significantly increased (by about 20%) the amount of class time spent on didactic, phonics-heavy reading instruction; nevertheless, the program “did not have statistically significant impacts on student reading comprehension test scores in grades 1–3.” The evaluation also found that the program actually reduced second-grade students’ engagement in reading and writing."
4) "Play in all its forms, but especially open-ended child-initiated play, is now a minor activity, if not completely eliminated, in the kindergartens assessed. Teacher-directed activities, especially instruction in literacy and math, are taking up the lion’s share of classroom time. Standardized testing and preparation for tests are now a daily activity in most of these kindergartens."
So is there evidence to support child-directed, adult guided free play to facilitate learning in the kindergarten and beyond?
First of all, how do the authors of this article define play?
The authors define play in this way: "we use the word “play” to describe activities that are freely chosen and directed by children and arise from intrinsic motivation. Within this definition are many different kinds of play, including dramatic and make-believe play, block play, sand and water play, art activities, play with open- ended objects, spontaneous physical play, exploring the outdoors, and so on."
Unfortunately, in the U.S., the development of "educational toys" and the promotion of "educational videos and products", by manufacturers who know nothing about child development have conditioned many parents to believe that pushing hard core literacy, math and academics on children earlier, leads to smarter more academically successful adults.
But just look at these statistics and quotes from Crisis in the Kindergarten....
1) "Long-term research casts doubt on the assumption that starting earlier on the teaching of phonics and other discrete skills leads to better results. For example, most of the play-based kindergartens in Germany were changed into centers for cognitive achievement during a wave of educational “reform” in the 1970s. But research comparing 50 play-based classes with 50 early-learning centers found that by age ten the children who had played excelled over the others in a host of ways. They were more advanced in reading and mathematics and they were better adjusted socially and emotionally in school. They excelled in creativity and intelligence, oral expression, and “industry.”* As a result of this study German kindergartens returned to being play-based again."
2) "China and Japan are envied in the U.S. for their success in teaching science, math, and technology. But one rarely hears about their approach to schooling before second grade, which is playful and experiential rather than didactic. Finland’s children, too, go to playful kindergartens, and they enter first grade at age seven rather than six. They enjoy a lengthy, playful early childhood. Yet Finland consistently gets the highest scores on the respected international PISA exam for 15-year-olds."
3) "The American Academy of Pediatrics, in its clinical report on the importance of play, found that “despite the benefits derived from play for both children and parents, time for free play has been markedly reduced for some children” and addressed “a variety of factors that have reduced play, including a hurried lifestyle, changes in family structure, and increased attention to academics and enrichment activities at the expense of recess or free child-centered play.”
So what are we doing? Why aren't policy makers listening? And why aren't parents, teachers, educators, and therapists educating and advocating for our children? After reading this and listening to Cari's presentation I feel strongly that we are doing a disservice to our children when we ask them to develop skills at an age when their brains are not ready to learn them. We don't expect an apple tree to produce apples until it has first developed blossoms. In the same way, a child's brain develops sequentially, and purposefully, by design. Think about the progression of play as a child develops. First they explore their world by reaching for objects and placing them in their mouth. Next, they learn that doing things with certain objects (like dropping a cup on the tile floor) creates a certain effect. Next, they learn that the cup is for drinking, and will even put water in a toy cup and sip from it themselves. Finally, they learn to apply that knowledge to the world around them through pretend play. They take the cup and give the baby doll a drink. Even more compelling evidence of the importance of free play is found in the list of skills children develop through play. Take this quote, for example, "Young children work hard at play. They invent scenes and stories, solve problems, and negotiate their way through social roadblocks. They know what they want to do and work diligently to do it. Because their motivation comes from within, they learn the powerful lesson of pursuing their own ideas to a successful conclusion." WOW!
Cari points out in her seminar that play provides rich sensory experiences that help to develop life long connections in the brain. It is well proven fact that if you want the brain to learn something, provide information through multiple modalities. Think about studying for an exam. Most of us are not blessed to be able to recall information heard once in a lecture. Most of us had to also read the information, write the information, or speak the information out loud to truly recall it. And TRUE learning happens when we are able to apply that information to the world around us, to think critically about it and use it in a way that is meaningful. Compare learning colors by matching colored squares on an Ipad screen to learning colors by sorting through a laundry basket or walking through a field of muli-colored flowers! Free play allows creativity to blossom. Media and pre-programmed battery operated toys (i.e. Buzz Light Year toy) limit creativity and imagination. Imagine the possibilities in a generic astronaut toy compared to a battery operated Buzz that can only say "To infinity and beyond!"
So, what does this mean for therapists, teachers and parents? I join Cari in saying this...allow children to experience their world through play! Play with them and let them take the lead. Remove obstacles in your life that take away time for your child to truly engage in sensory rich, child-directed play. Step away from media sources of entertainment and limit your child's screen time. "The American Academy of Pediatrics (AAP) discourages TV and other media use by children younger than 2 years and encourages interactive play." Children learn through play, so encourage it as much as possible!!
As a home health therapist:
1) Limit use of the bag of toys. Going through a bag of "pre-planned" activities is adult directed and more didactic in nature. Go into the child's home and let them choose a toy. Or, let the child choose from your bag and build your therapy from there. A good therapist can create language opportunities from anything. This will increase the chances of generalization of skills and increase the child's willingness to participate in activities.
2) Step away from the Ipad. Build sensory rich opportunities for language learning. Relying on the Ipad inhibits a child's development.
3) Play with a purpose. Model appropriate play with toys in the same way that you model language. Think about where the child is developmentally and model one step up. For example, if the child is exploring their environment through exploratory play, demonstrate cause/effect.
3) Educate parents on different types of play: exploratory, cause/effect, functional and pretend play, parallel and cooperative play. Educate parents on ways they can create language rich opportunities in the home. Teach parents how to play with a purpose. Encourage them to step away from their phones and be involved with their child.
As parents of young children (under the age of 7):
1) Increase your child's opportunities for free play by limiting your child's screen time, and adult directed, didactic instruction at an early age. Guide your children and provide structure, while allowing them to experience their world through play. For example, let them explore letters/numbers on a magnet board in their room. Model language that builds understanding when the child shows interest, but move away from drilling them. Read books that model sounds, but let the child choose the book. Use their natural curiosity to guide your interactions with them.
2) Increase opportunities for free play by de-cluttering your schedule. Kids don't need to be on a "social schedule" with a list of "adult driven" activities to complete every day. Free play should happen every day, not just in play groups once a week.
3) Learn how to guide your child in free play by seeking help from professionals who know about child development
4) Advocate for child-directed, adult guided, play based kindergartens
Just think of the opportunities for learning in the world around us. We live in a vivid and colorful world! As adults, we have the opportunity to bring to life a 3 dimensional world for our children who unfortunately spend much of their time in a 2 dimensional screen. I'm calling all parents, teachers and therapist to bring free play back! Let children be children and watch learning and discovery happen!
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