Touching and Meaningful Moment

I have had two really rewarding work experiences in the past two months, both adults with brain injury. I continue to receive referrals and recommendations from my friend the neuro-psychologist who is currently working with the armed forces in Edmonton. The two experiences stem from my work with him. I will recount the first one in this post.

I first saw a woman 10 years ago, after she had a bad fall from a horse and sustained a devastating closed-head injury. The injury left her with tangential speech and speech too rapid for most people to understand. She had a great deal of difficulty staying on topic while in conversation with people, and this affected all areas of her life, especially in her work. She worked in a care facility for seniors, and her rapid speech and tangents made it difficult for her patients to understand her. She came to see me for 30 hours of the Visualizing and Verbalizing program, because the neuro-psych believed that it would stimulate the frontal lobes and have a calming effect on her brain. It did.
I quickly skimmed my previous posts and don't see one about this amazing program, other than a brief mention in my post "What I learned from Sarah" so I will give a quick rundown...

The Visualizing and Verbalizing Language Comprehension Program is one of the most powerful programs I have ever worked with. It was devised by Nanci Bell, who is a partner in the Lindamood-Bell Learning Processes. Basically, Nanci created an step by step process for teaching visualization for what is heard and read. It is making movies in your head, but with form and structure to ensure that salient information is retained and understood. About 10 years ago, I was renting office space from a neuro-psychologist; I began describing the work to him and he became very interested in the program. He sat in on a few sessions and was really interested in it's therapeutic application. He is a specialist in learning and memory- and saw a great application for improving impaired executive function. That was the beginning of a ten year partnership. He has been using the program in his work with prison inmates and now injured soldiers in the military. He has done pre and post testing and has found remarkable changes in executive functioning in his patients. So, that's the background...

Now, 10 years later, this amazing woman with the brain injury has graduated with a degree in social work and is looking to find work. Her latest assessment through her Rehabilitation program suggested that she needed a refresher of the V/V program, so they sent her back to me. It was such a treat to see her again. She has had to work extremely hard to recover from her injury- the speech issues were only part of the difficulties encountered. That she was able to complete a university degree is amazing. She not only managed to get her degree, she did it part time and worked all the way through it as well.

I could tell that her speech had sped up a little over the years, and she did go off on several tangents at first. However, once she started visualizing, it was like flipping a switch! Almost immediately, as she began to describe her mental pictures, she spoke in a normal rhythm and at a normal speed. I watched the clock and saw that the calming and slowing effect lasted for up to 10 minutes after each visualization exercise. We spent another 10 hours together, in which we used her real life situations as material to be visualized. We worked on a meditation technique to enable her to get into that same visualization mode quickly.

It was through these exercises that I learned of some of the challenges of living with brain injury. The one that impressed me the most was how people seemed to doubt her abilities and discount the contribution she could make, once they learn she has sustained a brain injury. When people treat you differently because of this, you begin to doubt yourself. We did a few exercises around job interviews and we ended up doing some role playing so she could practice some of the techniques we discussed for staying on topic. At the end of each interview, as the "boss", I thanked her for her time, and then in one situation I shook her hand and offhandedly improvised, "I think you would be an asset to our company- welcome aboard". I was taken back when she smiled at me and tears started streaming down her cheeks. After a moment she said, "Even if this is just pretend, it is wonderful to hear those words."

She was so afraid of not being given a chance and so convinced that she wouldn't get one. For a moment, I was overwhelmed at the injustice;I though of all that she had been through, her accomplishments and hard work- only to realize she would likely never get past a first impression. There was a fearsome hug at that moment, let me tell you.

What about Central Auditory Processing Deficits?

Hi There!
I am seeing quite a few learners with the diagnosis of CAPD- and they are all prescribed a lengthy program of individual sessions with a speech therapist or audiologist to work on auditory processing skills. I don't know much about it-and after 25 years of teaching kids with learning disabilities, I haven't run into it as a diagnosis that stands on it's own. There was some work being done on this in the early 80s- around the time that the vision therapy was making it's first rounds- but for the most part auditory processing has been seen, in my experience, as part of the bigger picture- dyslexia. I am wondering why now auditory processing seems to be "extracted" from language as a whole and focused on as a discrete skill set?
I would love some discussion around this- it's a fairly expensive treatment, and I have listened to a CD program that one of my learners was "prescribed", and it seemed like very basic Rosner auditory discrimination-type exercises. Does anyone out there know anything about this? Are there any SLPs or Audiologists out there who can comment?

Time for a career change?

I have been considering a career change these past few months... after working with occupational therapists the last few years, I have become interested in this work. While helping my daughter research this as a career, I realized that I only need two years at UBC to get my Masters degree in occupational therapy. There is a real shortage of them in our area. Hmmm.
I love working with kids with reading problems- I have to say it's amazingly rewarding- and I love my work with SelfDesign... but every once in awhile I wonder what it would be like to work in another field not education-related! I get overwhelmed sometimes by the enormity of the systemic problem and at how difficult it is to effect real change.
Maybe I could to do both...

Video Tutorials

Well, the interface didn't materialize in time for me to use it for my tutorials, but I am making video clips with my Mac computer then posting them privately on YouTube. After viewing a clip the parents comment and post in a conference and we have a conversation that way... it seems to be working fairly well. This way they can all view them in their own time and can watch them more than once. It has actually been fun, but a bit of a challenge to keep my wordiness down to 10 minutes or less!

Gaining Some Ground...

Merry Christmas and a Happy New Year to you all. I have had a nice break and have enjoyed having my children home for the holidays. While I have taken two weeks off from my regular duties at SelfDesign, I have been working on a new conference that I will be hosting in January on the "ABC's of Reading".
The basic philosophy of SelfDesign is that if we allow children to explore their own interests at their own pace, (which also means we don't impose our methods and ideas on them)they will learn everything they need in life, and will learn it better because they are intrinsically motivated. To be able to adopt this philosophy, parents (and some learning consultants, myself included) have to be prepared to adjust their perceptions of the timeline imposed from the system. We have to be able to accept and embrace that learning will happen in it's own time, and it may look very different from the school system with it's definite expectations from year to year.
I have found this very challenging as a "systematized" teacher. I have made excellent progress for the most part, but there is one area that I have stood firm on, and that is, early intervention for children who have learning disabilities.
I have had mild and not-so-mild discussions with administration and some parents over this- and I remain unapologetic- to no-one's surprise, I'm sure! The executive of SelfDesign Learning Community encourages me to adopt a "hands off" approach, believing that these kids will read when they are ready, and while I respect their combined body of knowledge and experience, I can't ignore my own. For some learners, remaining "hands off" is the worst thing you could possible do. It's akin to waiting for them to fail, before offering assistance. (check out the link on my page to Joe Torgesen's article, "Catch Them Before They Fall")The learners I will be focusing on have diagnosed learning disabilities, have had several interventions and have indicated they want help- as have the parents.
So I am very grateful that the exec team and my special ed cohort within SelfDesign is supporting me in this endeavor... I am hosting a conference, to offer practical assistance for parents who want to understand the nature of their children's struggles with reading, and to workshop techniques and strategies that teach parents how to teach their own kids. This is NOT what SelfDesign is usually about- but I believe it's a move that acknowledges that there are all types of learners, and some have brain structures that make learning to read with casual or intermittent exposure impossible.
I am now researching web conferencing so that I can present a workshop to 8 or 9 parents over the Internet. I have been using iChat with great success for teaching reading in a one on one situation, but I now need to find something that allows me to interact with more than 3 participants at a time. That seems to be the limit for most small scale interfaces.
This is going to be a very cool process for me,and I am so excited about this whole thing! I will update you all from time to time on how this reading conference works out!

More about Hannah

I have been really busy with SelfDesign and another student online for reading, but I wanted to give a quick update regarding Hannah. Her mother wrote the week after she went back to school, and the school tested her reading. She had improved her skills by a full year! They are very pleased of course. Hannah feels like a million bucks too... she still has a little way to go, but she is out of the starting gate now.
So... despite my worries, Hannah is happy in her new class and she is holding her own. Her reading skills have improved enough that she can work on developing comprehension strategies now, and continues to develop fluency.

I wish you all a Merry Christmas, and a happy New Year.

Adaptations- who are they for?

I have been really busy with my work with SelfDesign, and I have had a steady stream of "in person" learners as well as internet learners. This post is going to be SCREECH... I have encountered some issues around the learners I'm seeing in person that are making me crazy... it's time to get it off my chest.

First... I have been working with a family from another province since the end of August. It's a little girl with fairly significant phonological processing problems.
She may or may not have ADHD but she does have difficulty staying focused. There could be different reasons for this so I can't say- but regardless this precious little girl has to work really hard to learn. Hannah was in French Immersion for the first two years of her education, so she hasn't had any formal English instruction, however, her difficulties would have been just as obvious in the French Language. In the Fall she was transferring to a new school and to English Instruction. The parents had a meeting in August with the principal and shared their concerns about their daughter and told the principal about the reading clinic.

Hannah came to BC for a few weeks holiday in August, and during that time I started the program with her and did a full week "in person". We continued online from her home after that. When we started she was virtually a non reader, and she required alot of hands-on refocusing and direction.

When the family left to go back home, I suggested that her new school contact me if they had any questions about what we were doing- and they did.
I was speaking to her new classroom teacher, so I explained a little about what I do and then asked what they had in place for Hannah. I was stunned by her response. She said, "Oh, we don't do special education here." I was sure I misheard her but she said it again. When I suggested that the law requires it, she said, well we have it but "she" is too busy to see kids and does mostly testing. !!!
I asked if she knew anything about Hannah, and she said she didn't really but did notice Hannah was not reading. I filled her in on what I found during testing and how Hannah responded to the clinic and from that moment on the teacher seemed to be convinced that Hannah was in the wrong class. She said she couldn't do anything for her. She thought their special class would be better- it had a small number of kids in it and Hannah would feel less pressure there. I asked what the other kids were like in there and she "assured" me that Hannah would be OK and that none of those kids could read well at all, and that many had significant developmental delays. I made sure she knew that Hannah could learn in a regular class but needed some sort of support as she was coming out of French Immersion and also that she needed intensive phonemic awareness training. She needed an adapted program, not a modified one, and the most important thing was that she needed to keep receiving intensive instruction in phonemic awareness. The classroom teacher, who is retiring next year, said that she didn't know what that was (Oh please- she teaches reading to grade 2s!) but that she thought the special ed teacher might.

A week later Hannah told me she had a new teacher. In speaking to the mother after our online lesson, she told me that they moved Hannah to a room with only 9 students.
Sigh- not what I wanted to hear. However, Hannah seems happy and her mother was just glad that the pressure was lifted for the time being. This new teacher seems to know what phonemic awareness is, but the other kids in the class are quite challenged.
I am worried about Hannah's self esteem. The bottom line, in this situation, the family has to go outside the school to get Hannah's needs met.


The second thing that made me screech lately is the plight of a boy named Jeremy. He has been coming to see me since he was 11 and he is now 15. He is a tall handsome boy who is very athletic and has a good self image. He also has a very stubborn written output and expressive language problem. He is dyslexic too, but he has worked really hard over the past four years and has improved his reading ability quite a bit. While he is far from a fluent reader, he can decode and apply strategies to unfamiliar words.

Jeremy came back to see me because he was worried about his English class. He said that there was going to be a big writing component and he was pretty sure he would not be able to keeping up. I asked him if he had ever used Dragon Naturallyspeaking or MacSpeech Dictate, which are both speech recognition software programs. He said no.
I would have thought that was one adaptation that most high schools would put in place right away because here in BC, high schools do not do much, if any, direct instruction anymore. It's a pretty simple yet direct way to help kids like Jeremy. I spent a week teaching him how to use it and then set up small writing assignments for him to do. He caught on right away, but more importantly- he was stoked. He was excited about it! His mother remarked at the beginning of the second session, that Jeremy had never showed this much excitement about any thing school related.

It wasn't just that the program was cool to use, which it is- it was more that he seemed to have a renewed sense of hope. Jeremy could see that with this working for him, he would finally be able to do what all his classmates could do- and he could do it for himself.

In the span of one week Jeremy wrote four 1/2 page paragraphs and one full page essay that he wrote by reading and synthesizing two different articles. He did it willingly- happily actually. He kept saying that it would have taken him three times as long to do these and he would have hated it. I have seen his spontaneous writing and believe me when I say that for him to read an article, organized his thoughts so he could retell it, and then write 1/2 a page and edit it in 45 minutes for him is astounding.

His mother was convinced, and sent a note to the learning assistance teacher at his high school asking if he could use Dragon Naturallyspeaking in the resource room there to do his assignments, and she wrote about the difference they believed it would make for him. It was surprising that an email came back saying that no, they couldn't accommodate him. They don't use it for kids like Jeremy- they use it for kids with physical problems, like amputees and kids in wheel chairs.

So now I'm screeching like a banshee... SR software is an adaptation- and adaptations are appropriate for kids like Jeremy...
What's wrong with those people!!!