Stephanie Downey Toledo is a bilingual speech language pathologist in New York City as well as a professor at Teachers College, Columbia University. She has collaborated with the LEADERS project on this module series and others.
Category: Evidence Based Practice
Evidence Based Practice (EBP) is the integration of the best research evidence in the field with clinical judgment and patient values. One who uses EBP conscientiously, judiciously, and explicitly uses the current best practices according to external evidence from systematic research and internal evidence to clinical practice. Such evidence is then applied to the preferences of the fully informed patient.
Relevant Research: Discriminating Disorder from Difference Using Dynamic Assessment with Bilingual Children
Downloadable PDF: Research Summary- Discriminating Disorder from Difference Using Dynamic Assessment in Bilingual Children.pdf
This study builds on recent evidence of the usefulness of dynamic assessment (DA) along with a mediated learning experience (MLE) and graduated prompting as a more appropriate method of determining the presence of language disorder (LD) in culturally and linguistically diverse (CLD) children. Read More
Test Review: Proceed with Caution PLeaSe- PLS-5, English Construct Validity Concerns
Proceed with Caution PLeaSe- Construct Validity Concerns in the PLS-5 English.pdf
Two recent graduates of the Teachers College Columbia University speech-language pathology program, supervised by Cate Crowley, created and presented this poster at the ASHA convention in Chicago, 2013. Read More
Parent Training and Home Practice: How Much is Too Much?
More and more, researchers in speech-language intervention are confirming what practitioners have suspected for years: that intensity matters. Research has suggested early, intensified intervention is most effective in rapid, long-lasting improvement. It would be wonderful if we, as clinicians could accommodate every child or adult 5x weekly for hours at a time. Unfortunately, conventions of time, insurance, and practicality render that infeasible for ourselves as well as our clients. In particular for young children, where such a great impact can be made with early, intense, intervention, scheduling 1-2 sessions per week is difficult enough.
The natural solution is to foster carryover and development of skills through parent and caregiver training, but often conveying importance of home practice is difficult. And, caregivers have such busy schedules, even 10 minutes a day feels like asking a lot. Beyond that, it’s a difficult, fragile line to tread when training parents on new strategies. Particularly for young clinicians without children of their own, such suggestions feel almost intrusive to make, presumptive. Of course, it’s vital to establish some sort of rapport with clients and families prior to this, to find out their daily schedules, values, practices, and work with them to figure out a valid solution.
Even so, it’s a very real fear to cross some line you didn’t know was there before. In New York City specifically, as a school-based SLP, I find it difficult to coordinate with parents, to establish carryover practices. Parents are overloaded and have other responsibilities. Children, too. But in schools—and realistically, in most clinics—they’re only receiving services twice, maximum three times weekly, usually at 30 minutes per session. That’s not nearly enough to make the sort of rapid impacts we know can be made. How can we stress the importance of daily language development practice at home when these families have so much else to worry about?
A question from a new clinician: How can we as clinicians stress the importance of intensity and establish carryover routines?
International Resources: Parent‐Friendly Information about Nonspeech Oral Motor Exercises in Spanish/ Información Amena Para Padres Sobre Ejercicios Motores Orales
Parent-Friendly ternformation about Nonspeech Oral Motor Exercise Spanish.pdf
This document is intended for SLPs to use in discussions with parents.
Este document es para que los fonoaudiólogos lo puedan usar en conversaciones con padres sobre los ejercicios motores orales. Read More
International Resources: Parent‐Friendly Information about Nonspeech Oral Motor Exercises
OralMotor EnglishWatson-Lof.pdf
This document is intended for SLPs to use in discussions with parents.
Holograms Part 1 (Preschool Disability Evaluations: Module 22)
This module discusses the necessary data and information that must be in every evaluation so that the administrator can feel comfortable giving the child an IEP or not. Read More
Relevant Research: Dynamic Assessment of Word Learning Skills: Identifying Language Impairment in Bilingual Children
Source URL: View this document on the ASHA website
The purpose of this article was to determine whether dynamic assessment (DA) of word learning was accurate in identifying the presence of language impairment (LI) in preschool-age bilingual children. Bilingual children are often misidentified as language impaired under current assessment practices due to flawed assessment procedures.
