Helpful Lessons Learned: SLP Intern Interview includes a transcript of an interview I did with my SLP intern during her private practice internship. Read on to review lessons Dene learned during her internship at this clinic. This would be an excellent read for other SLP students who are looking ahead at having an internship of their own, or for SLPs who are taking on interns who want to start them off on the right foot.
Helpful Lessons Learned: SLP Intern Interview
This Fall in the clinic, I’ve been working with a graduate student named Dene. She has learned and grown so much throughout her internship. We’ve had some wonderful conversations about speech therapy and what she’s learning. This is a transcript of the conversation we’ve had about some of the most valuable tips she’s learned in this internship.
Taking Data: The Overwhelm
First up, Dene and I talked about taking data. What went wrong? What went right? What would Dene recommend for other students starting an internship?
Dene: So it’s kind of interesting when I think of myself being at graduate school, in the clinic, taking data, having my sheet out, and basically- overdoing it. And the whole entire session was spent with me taking data. My head was down, my pen was down, and I’ve done that in my last couple practicum experiences. And it’s been really nice to be able to be with Sarah right now and have one student at a time for 45 minutes and for Sarah to really be able to watch and help me become a better therapist. And with that, taking data – it almost seems like it should be simple, such as at the beginning of the session, figure out what you’re going to take for data, take the data, and then move on. So I feel like one of the best things I’ve learned when taking data is to look at the goals, revisit the goals, figure out what you’re going to take the data on, take the data, and then be present in the therapy session. Be present during the therapy so that you’re able to be a speech therapist, not just the data collector. Over the last month or so, being able to do that has really changed the way that I run sessions.
Sarah: I totally agree, and I would add that it’s a really common thing that both interns and new SLPs do, and it’s something that I certainly did my first several years of practice. There’s such a focus on data, you start to think that data’s the most important thing about your session. Then you start to take data on EVERYTHING – every production, every activity. Like Dene said, your head is down for so long that you’re not really present for the session. So, what I like to do is take data on one or two objectives and have them written on a small sticky note. Then, tally about ten (you can do twenty if you want), or if it’s a preschooler you can do 5 productions. And then get your head up, get into the session, and really teach. Because sessions are not about data, no matter what they tell you in grad school. They’re about teaching. They’re about learning skills. They’re about modifying the lesson. And you can’t do any of those things if your head is down and you’re just thinking about the numbers. So it makes a huge difference, it’s an easy tip, and I think it’s something that any intern or new SLP can do that will really help you have a lot more success in your sessions.
Playing for phonology/articulation versus play for language
Sarah: So in my own experience as an SLP, I was definitely trained in a child-centered philosophy. I found when it came to actually doing therapy, I never learned about the difference between playing for articulation and phonology, where you’re working on a specific sound target, versus play for language, when you’re working on a specific grammar form – for example, using ‘he’ or ‘she’, or using possessive s, like “the girl’s shoe”, or “the dog’s bowl”. So what Dene is going to talk about is what does play for articulation look like, what do you have to know ahead of time, and how is that specifically different than the general, child led play for language, because it is quite different.
Dene: So, something that I’ve definitely taken away since I’ve been here is that my sessions looked kind of similar at the beginning for phonology/articulation and language. I was trained to get productions from the kids and I went in thinking that I knew what sounds I wanted them to make for the phonology/articulation part. But since I didn’t have a word list or something right in front of me, I would find myself getting confused during the session. The kids were running around and there seemed like there wasn’t enough structure. My language kiddos kind of looked similar where I was trying to get productions. I felt like I was getting the whole thing confused and it wasn’t because I didn’t know what I was doing. It was because I needed a more structured session. I needed to structure it more and plan more ahead. So what I’ve been doing lately is making sure that I have a word list. Making sure that when I am going to take my data, that I know exactly what words I’m taking them for. If it’s language, I’ll know that I’m working on nouns, or prepositions. And I know which ones they are going to be. And I have been making sure that I have been in control lately of that session. Instead of letting the kid have 20 animals and naming them, I’m in control of the animals. That has been beneficial to have each session more structured and to be able to get the productions that I need, whether it’s articulation or language.
Phonology Play: an Example
Sarah: I’m going to use an example here. We had a toddler who was working on word final /f/. So that toddler wanted to play, he wanted to be in control of the materials, he wanted to have all the toys at one time. The play wasn’t working. So Dene and I had a conversation and we kind of came out with this hypothesis about the difference between play for language and play for phonology. You would think that you’d come up with a word final /f/ word (or lots of them) in the moment. But you know what? There’s so much going on in that session, that it’s a lot easier if you know your exact target before you start the play. So for this child, our words were “off” and “roof” to target word final /f/. So after we had this conversation, we played with the dollhouse, and this boy was having the toy people fall off the roof. It was a much more productive session and it was still play. It was fun for the child, but we got the data and the productions that we needed from that activity. So I would say a tip for SLP students and new SLPs is if you’re doing an articulation or phonology play session, know your exact targets ahead of time. Don’t expect yourself to come up with them in the moment, and know what that play activity will be.
Using visual prompts
Sarah: Now lets talk about language sessions for older students. So one session that didn’t go as great as we had hoped was with one student working on conjunctions. So he was creating- or we were expecting him to create- long sentences with words in the middle like “although, because, but, and”….it was really hard for him. The more verbal prompts we gave him, the more frustrated he became. In the end when we reflected on that session, we realized that we weren’t giving him the support that he needed to be successful. Children with language disorders many times have difficulty processing language. By giving verbal directions and verbal supports over and over, we were actually making him feel more overwhelmed. After we discussed what to try next time for that student, we started using visuals. Visual supports made all the difference in the world. This student was able to complete the activities, feel confident, and get the right type of support. So I’m going to ask Dene to talk specifically about what visual supports we gave for this student and how they allowed him to be more successful.
Dene: So, I think that it’s kind of fun because for that session, I had created all of these visuals. There were cute little colored pictures by the sentences. But really those pictures were just graphics that went with the sentence, they weren’t visual supports or teaching prompts. Illustrations or graphics isn’t the same thing as a visual support. For example, a graphic of Mr Lee and a sentence starter “Mr Lee teaches music __________.” At the time, I’m thinking, oh he has all these visuals that he’s going to be able to take and he can say something about the guitar and he can say something about the other instruments. Well, I didn’t give him the structured sentences. I gave him what I thought were these visual prompts and it wasn’t what he needed. He needed actual visual cues. He needed me to write down actual sentences to match the beginning of a sentence with a conjunction with the end of the sentence that would go with. We talked about making it more like a receptive activity and increasing the visual cues by doing that.
We also used way too many conjunctions. I’ve learned now to work on one at a time and then randomize from there.
So what we’ve done now is we’ve built these sentence endings (I made a visual) so that he can match the start of the sentence (provided in the material) and the end of the sentence (a visual I made). And we decided to scale it back with the conjunctions, so now we are working on one at a time and really teaching what that is. For example, ‘because’: what does ‘because’ mean? What should go in front of ‘because’? What should go after ‘because’? And then I’ve created these sentences that are typed and cut out and he can match them and he can put ‘because’ in between.
After that session, I still wasn’t sure how well it had gone. I thought that maybe it was too easy because he was really successful. But then Sarah reminded me that that is OK. We needed him to be really successful and then we can start taking away some of those visuals instead of starting with nothing. Give him the support that he needs and then take it away. That was very useful information for me and we’ve really seen success in his sessions.
Visual Supports: Lessons Learned Take Aways
Sarah: To summarize that one, there’s so many takeaways.
1. Think about the receptive component. Make sure your student understands what they need to be doing.
2. Think about visual supports. Think about, for example, with conjunctions- match the beginning of a sentence with the end of a sentence that’s already written out.
Let them be successful. Provide them that support. Then, when they’re ready, you can fade it. Giving too many verbal prompts can be very overwhelming and can sometimes not be a great teaching activity. So that’s a lot of takeaways but I would say make the task small and simple and give your student lots of support and if they’re successful, fade it away. We don’t want students to be overwhelmed and we certainly don’t want to give them so much language to process that the task that’s already difficult for them is further complicated.
Motivators for older articulation students
Sarah: Now lets talk older articulation students. Specifically, there are lots of articulation students who feel really burned out in speech therapy who may or may not want to participate and who have given up. Unfortunately, that’s pretty common with older articulation students because they’ve been in speech for a long time. So this last conversation is about how to define expectations for these students. We have to let these students know how we want them to act in speech therapy, what we want it to look like when they’re trying their best, and also finding out what the currency for that student is. So Dene and I have both talked about how everyone has a currency. My personal currency is a cup of coffee if I finish progress reports or a couple of evaluation reports.
We have an older student working on /r/ and he had really given up and we had a lesson in particular that just didn’t go well. So Dene is going to talk about how we problem solved, created a star chart for him, found out what his currency was and used that to make the session a success.
Dene: This particular student was very frustrated, put his head down and his eyes filled with tears. I looked at Sarah and I said, is there a way we can make this more fun for him? I felt really bad for him and wanted him to be successful. Sarah said- and I think this is great advice- we still need those productions. We can’t just sit in here and play with him just because that’s what he wants to do. We still have to do drill. This was a student who was ready to move on to the structured conversation level and we needed those productions. Making it easier wasn’t going to help him.
So it wasn’t necessarily about playing games for him. That wasn’t even that motivating for him. Then Sarah grabbed some candy and a star chart and we basically just bombarded him with compliments. We told him if you make these productions and work your hardest, we’ll get candy at the end. We were talking about the candy, he was excited about the candy. He was building sentences about the candy, reading the wrappers, and both candies had the /ar/ in their names. It was exciting to see him be excited about therapy and be really playful during it. He was highly motivated using the star chart, which I thought he’d be too old for. But it worked. The last couple sessions we have had, he’s been so motivated and done such a good job and really trying.
Older Articulation Students: Lessons Learned
Sarah: I totally agree, and the candy tip was given to me by another SLP and I’m really thankful. You can bring Snickers, Starbursts, a Hershey’s bar-there’s so many candies that have the /r/ in it. You can have the student tell three sentences about each candy. You can make a Venn diagram and have them compare and contrast each candy. Meanwhile, they’re getting tons of /r/ productions. So that was really a lifesaver. Also, if the student gets his star chart filled, he gets one Starburst. So what’s the cost of just giving a child just one Starburst at the end of the session? It’s so small and the payoff is so great. So in general, I don’t use food treats, but when the situation calls for it, I’m not afraid to bring out the candy when I need to.
Private Practice: Opportunities to Learn for Teacher and Student
Having Dene in the clinic these last few months has been a learning experience for both of us. It has reminded me of what it’s like to be starting out in speech therapy and how overwhelming it can be in the beginning. I hope you enjoyed reading our transcript and that you’ve benefited from some of these tips. For more of what I’m doing in the clinic, feel free to keep in touch via Instagram!