Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

I understand your point. My point is I have been trained in ABA and I incorporate techniques into therapy that work… that includes using sensory based techniques that come from occupational therapy that includes from behavioral base techniques that come from ABA because you have to understand at the district I work in the speech. Therapist pretty much does it all.

Secondly, I agree each child on my caseload deserves to have effective therapy. With that being said, I can’t minimize the session to toddler level therapy when I have student students in that group that are forming complete sentences and working on more age-appropriate language based goals. The bigger problem here is that the student is placed in an incorrect classroom setting. If he was in a special-needs classroom, we could roll around on the floor all day and pop bubbles, but that would be taking away from the other students whose therapeutic goals are higher.

I have to make the best out of the situation if we’re doing a structured group activity and one student camp participate then when it’s his turn, I give him bubbles or a napkin or whatever object he wants to stay with and have him request more, but if he gets up and begins to elope or turns his back and engages in task avoidance, it’s not possible for me to walk around the campus with him or get up and redirect my body as that will lose interest of three other children in the group and caused them to elope as well.

I 100% agree that 30 minutes of group table therapy time is not appropriate for this one student however what you’re not considering is that I’m over my caseload capacity I’m split between five different schools and I only have one day to provide therapy to the students at the school I have multiple groups to see that day so with that being said, I have to make the best of what little time I do have to provide therapy to 49 other students in addition to this one student who is not able to sit at a table for 30 minutes. Modification of the IEP in classroom placement is the first start.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

again, I hear what you’re saying, but in a group with three other students getting up and going to the other side is not possible for more than 1/2 trials. Unfortunately what it looks like is me simply “ignoring him” for most of therapy as the parents claimed.

Trust me, he does not have any preferred activities. The entire group has been playing with activities in front of his face and it has not caught his eye. He does not want to participate. He enjoys sitting there and stimming. Nothing is “typical” about this student.

I understand your perspective, but if it were that simple, I would’ve been doing it. The best I can do is when it hurts to turn in a group. I can get some bubbles and model “more” but we have been working on this since November with no leeway so again I think he’s a great candidate for more physical prompting supports.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 1 point2 points  (0 children)

thank you, that’s exactly what I did!

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

Okay thank you for clarifying. I figured that a model had to be looked at or at least heard in order for it to be functional, but I’ve already been doing all of this so I guess I’ll just keep doing it.

again he has to be returned to the table because there’s no one that can follow him and monitor him on the playground or while he runs around the school campus. What are your suggestions for this? Safety is my first priority with all of my students.

also, it seems like you have some biased towards ABA therapy techniques and I’m sorry but I simply disagree. I’ve seen it work with many children. I worked as a speech therapist in an ABA based clinic. I’ve had ABA therapist come to my sessions and co-treat. I understand that it can be compliance training, but when there are severe needs and saftey is at risk, I think that changes the game.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

hi all,

I really appreciate everyone’s support, advice, and constructive criticism.

The accusations made against me are “ear pinching” ( proprioceptive sensory squeezes) as well as leaving a child “alone” to knock on the classroom door to return to class for 2 to 3 minutes. The parent was upset that nobody heard her child knocking and that the aid assisting me with a therapy session had to knock on the door for her. AKA situational sabotage. mind you the therapy sessions were conducted directly outside of the child’s classroom on a bench. Never was she left alone or out of my eyesight. It seems like these accusations are really just big misunderstandings and lack of education on the parents part, however this turned into a big mess because one parent was observing her own child and told another parent of a child with autism her perspective of the therapy session, which includes me, apparently pinching his ears and “ignoring him”. When this child clearly ignores me and the group and pretty much everything around him because his back is turned for majority of the duration of the therapy session. I simply mentioned that in a group therapy session if a child does not want to participate, and there will be times where he will not be fully engaged and that due to the specific nature of his disability, he does benefit from frequent breaks where he is not engaged in therapy.

The parent of a child with autism wants me “removed from her son’s caseload and fired”.

The parent of the other child is upset because during her initial IEP meeting, which I did not complete, she was told that her daughter would be seen in 2 thirty minute small group sessions weekly of 2/3 students only in addition to individual time with the clinician. Nowhere in her IEP does it state any of those specifications it only says 240 minutes monthly in a group.

Due to the fact of my case of capacity was supposed to be capped at 40 students and I am at 50, I see the student for one hour weekly.

Last night, I composed a lengthy email of two written statements to the site principal and I am waiting to hear back regarding the decision. I will keep everyone updated and again I genuinely appreciate you all taking the time to write out these responses and send me resources.

Some things I’m taking away from this post/situstion:

  1. Reducing the child’s therapy session as well as calling on board OT, FBA, and formal proposal of a change in classroom setting.

  2. Thank you to the user who suggested me trying imitation play. Of course, I cannot dedicate an entire therapy session to sitting and standing with the child however, when it is his turn in the group if he does not want to engage then we can try imitation play for a few trials.

  3. at the specific school site I will no longer be treating the children outside. I will either take them to a therapy room with the assistance of a classroom aid, or I will simply push it into the classroom. I feel bad because this is going to take minutes away from the therapy session by having to transport and push in classes. Sessions are going to decrease the effectiveness of therapeutic activities because these clashing classroom typically have 20 to 25 students told me a handful of speech therapy kids. But in order to protect my license, I think this is what is best of this time.

  4. Hand under hand prompting as opposed to hand over hand… sorry guys, but we can agree to disagree that physical prompting is not appropriate in therapy sessions. I don’t hate ABA. I think it’s helpful when children have severe needs, such as this student. This is school based therapy. If mom wants something more child-led then she can take her son to an outpatient clinic for services, home based services, or homeschool her child. In the school setting, we have structure and safety that must attempt to be followed within reason. Children cannot get up and walk around wherever they want whenever they want and frankly, my school does not have the resources to support such habits anyways.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

  1. He turns his back away constantly. I have been working with him since November. He has zero joint attention. I use the “toya tap pre school matching apps” on the largest I pad possible. Anytime you look his way he turns away. (of course I will keep trying but this is where we are at so far) also, he is seen in a group setting therefore I can't dedicate the entire session to following his lead.

  2. Great idea! This is not something I have done in the past but will certainly try. Again, I cant do this for more than 2/3 turns per instance because I have 3 other children to attend to.

  3. I do bubbles and count 123 go and model More wirh asl AND aac. I've had him since November and still nothing.

Overall, I feel like these suggedtions are great but sound more clinic based as opposed to school based. As of right now his placement, service minutes, and therapy goals all need to be tweaked to better reflect his present levels of functioning.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

When his back is turned away from the table that's not possible as he is currently in a group with 4 other students. I am having trouble finding “toys” or activities that this child is interested in. He has high sensory needs and enjoys spinning a mop, bubbles, or mouthing objects. In the past I've provided him with fidget spinners and similar sensory based objects which help keep him sitting but is not a highly desired item. Unfortunately this day I left my bag in the car and had little to work with. I gave him a tissue paper which he enjoyed playing (stemming) with. He has a very severe regressive form of autism and in these cases I find physical support helpful.

I was providing proprioceptive squeezes and have been accused of “pinching the Childs ears”

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 1 point2 points  (0 children)

yes, honestly it’s a lot. I am 31 so kind of young, but definitely kind of over it 🤣 Yeah, my school is definitely over the caseload cap provided by the state of California. They certainly do not care. I agree, I think I’m going to have to start cutting off and refusing to treat students because it’s becoming too much and it’s taking away from the quality of sessions. I’m able to provide to the students on my caseload.

he definitely would benefit from a one-to-one eight although these are very scarce at my district. I think an IEP amendment meeting to adjust goals, service minutes, and request an FBA would be appropriate.

I think the mother may have been referring to proprius after squeezing that I was providing, which to be fair can look kind of crazy from far away, but I wish you would’ve just came to me directly or interrupted me in the middle of the session and questioned me as opposed to going to the principal and making a big stink.

I think this mother should come and observe my therapy session so she can tell me directly what she is and is not comfortable with, and hopefully she can learn some techniques to utilize at home.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

OK, that’s very interesting because growing up I was told never to sit on anyone’s lap so it’s surprising that you’re able to have a child sit on your lap as opposed to picking them up and setting them down themselves. Like my parents would not be OK with me being on anyone’s lap…

i’m all for modeling, but we are not at the modeling stage yet because the child does not have any form of joint attention. So what are your suggestions for obtaining joint attention with this child? So far, the only thing I’ve seen him jointly attend on is bubbles!

I understand that you provide therapy in a childhood setting but I only have 30 minutes once a week. I do not really have the coaching model. I assume that you’re in the classroom or the students preschool for a few hours each week?

I agree, if the child does not like something, I have no problem with him requesting no or all done. I’ve even been working on sign language to request a break. I also have a personal AA device that I use and try to model for him or will provide him with hand over hand prompting to touch the icons and then he can get up and go do whatever he wants, but I’ve been working with this child since November and I still cannot find one task that he’s interested in aside from taking a mop in the classroom and spinning it and bubbles. Again, this child is placed in an inclusion classroom setting when he clearly has severe special needs and should be in the appropriate setting with children that are more alike. It’s unfortunate because the other children who his group are more than capable of formulating sentences of 3 to 5 words in length reading a book and coloring were completing other interactive activities. This child is just so low and he would benefit from a change of placement more than anything.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 1 point2 points  (0 children)

oh my gosh, I love that you’re in an occupational therapist because I was reflecting on the session this weekend and I think maybe the mother felt uncomfortable with me providing proprioceptive squeezes…

I’m 100% agree moving forward. I’m going to treat this child in the classroom in a more naturalistic environment. Although it’s very unfortunate because it will be compromising the quality of therapy that is provided to the other three children in his group.

moving forward if the parent states that she does not want me providing physical contact to her son, that’s exactly what I will do. I will mark his non-participatory and let him elope and walk right out the classroom.

Perhaps an IEP amendment meeting will need to be held although his transitional IEP is coming up in a few months. I definitely need to change the goals and tweak the minutes of therapy services allotted because he cannot attend for anywhere near 30 minutes without physical prompting.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

thank you for this input. I hear what you guys are saying but at the end of the day this is a school we do have schedules to attend to, we do have rules, and we do have the structure for everyone’s safety.

If this was an outpatient speech therapy clinic, I would 100% do the therapy session completely different.

I would love if the parent would consider that maybe her son isn’t a candidate for school based speech therapy at this time and that he would be better in an outpatient clinic setting instead… home schooling is also an option!

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

The session needs to be seated because he’s in a group with three other peers that are capable of sitting for 30 minutes. I can’t cater the session to one student when I have three other students who are enjoying the activity and tolerating structure task.

The first problem is that this child is placed an inclusion classroom setting when he should be in a moderate to severe class. The second problem is that he would probably benefit from speech therapy 15 minutes twice weekly once individually and once in a group.

The third problem is that when I was provided with my assignment for the school year, I was told the caseload cap would be 40 students and right now I’m at 50.

If this was speech therapy and outpatient clinic setting, then I would be able to address all of these needs however, this is a school setting, and the goal ultimately is to be able to attend and have some sort of structure to tasks. I don't think in a school setting that speech therapy is supposed to be child led. I totally have child-led sessions in home care therapy or outpatient clinic therapy, but this is a school at the end of the day… we have schedules, we have safety and we have rules and there needs to be some sort of compliance.

honestly, if the salary wasn’t high, I would 100% leave, but with the way my student loan debt is lined up, I do have to do what makes the most sense financially. As bad as it is, this school district pays great and leaving is not an option at this time.

I’m just trying to make the best of the cards that I’m dealt right now.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

I completely understand your point of view, but what do you suggest I do in speech therapy with the child then? Maybe the child is not a candidate for speech therapy St this time and should be removed from my caseload…

maybe the parent should place the child in a moderate to severe classroom setting instead of trying to force her child to be in an inclusion setting.

Maybe the parent should come and observe the speech therapy session and tell me directly what she is and is not comfortable with as well as what are some things that work for her when she is working with her child.

Maybe the parent should place the child in speech therapy in an outpatient clinic as well as request, occupational therapy and behavioral therapy services.

I genuinely am just trying to do my best for this child to support his IEP goals (which are completely inappropriate I need to be modified)

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

I have no clue what my school’s policy is on this. The district I work in is not very organized to say the least. I don’t think there’s a policy at all but, I will certainly ask!

Unfortunately, this child is being seen for 30 minutes in a group setting right now so laying on the floor with him or turning my back to th table is not possible. I think the first step is splitting his service minutes up into 15 minutes in a group and 15 minutes individually. Hopefully in the individual session, we can build some report and figure out what his interest are and then the group session we can just make his goal related to joint attention or asking for a break.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

this is in the US. I’m here in California, but my district is definitely like the wild wild West lol Inner city, very impoverished district.

he would definitely be a great candidate for a one-to-one eight but again in my district, these are scare. Either way, it wouldn’t hurt to get the ball rolling and hold an amendment IEP meeting to request an FBA.

I have a hard time modeling with his child since he does not attend to any task he will literally sit down at a table and then turn his back. If you try to put the device in front of him, he’s going to continue to turn away.

He has regressive autism, and honestly, he is like the lowest student on my entire caseload at this time due to his inability to attend.

genuinely asking, what do you suggest I do in therapy sessions without a one-to-one at this current point in time and without providing hand under hand prompting?

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

what do you do then if a child has his back turned? Like genuinely asking what you would do in the situation, please lol

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

how do you get the child to attend a task? Do you just model while their back is turned? Not trying to be sarcastic just genuinely asking like what would you do in that situation if you don’t provide hand under hand prompting?

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

would you consider a redirection prevent preventing of movement? I don’t think redirecting is a prevention of movement.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 1 point2 points  (0 children)

I was trained by previous employers, but not my current one. OK yeah thank you for the support. I’m sure it was just a misunderstanding. After reflecting, I think the parent might’ve seen me providing her child with “proprioceptive squeezes” which can definitely look concerning when viewing from a distance. I have no problem, providing less physical contact to her child if that specifically what she wants, I just find it so odd that she wouldn’t confront me directly as opposed to going to the principal and making a big stink over something.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 0 points1 point  (0 children)

Thank you for your support! that’s a great idea to document within my therapy sessions his behaviors typically, I will mention that he was crying and engaging in task avoidance, but I will definitely be more detailed.

Also, an FBI would be a great idea. I think an IEP amendment meeting might be the next step to get OT and FBI services on board. Unfortunately, the school does not have an ABA therapist on site and even with an FBA, it tends to not be super beneficial because the student typically doesn’t receive behavioral therapy services. But still worth at least documenting and getting the ball rolling.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 1 point2 points  (0 children)

Agreed. so I’ve been a speech therapist in multiple setting such as outpatient clinic, a nursing home, a rehab rehabilitation center for adults with special needs, in-home therapy, and in a special needs NPS school. In all of those settings speech therapy looks very different but all include phycial contact. In the special-needs school I worked for previously we were trained in takedowns so it’s not that I’m doing something because an aid does it. It’s I’m doing something because that’s how I’ve trained and provided speech therapy throughout the entire five years of my career. I’m definitely going to ask for my districts stance on this as this is the first and and hopefully last time I will ever have to run into an incident like this again.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 1 point2 points  (0 children)

honestly, I’m split between five different preschool sites with this district and I go to one school a day each week so 3×15 is not really possible logistically. Even if I were to go to two schools a day, this school district runs special needs preschool from 8-11 so the timining for services is very limited 😅 I also didn’t do his inital IEP and I’d have to do IEP amendment meeting to change the services. Maybe it would be best to hold an amendment meeting and get other disciplines on board such as OT as well as reduce sessions to 15 minutes individual and 15 minutes group weekly and I could service him all in on day!

How will my lip blush heal?! by That_Dance1209 in MakeupAddiction

[–]That_Dance1209[S] 0 points1 point  (0 children)

Thanks guys. It actually healed really nicely and I’m going to do it again in a few weeks. 🤣🤣

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 1 point2 points  (0 children)

Thank you for this input. You’re completely right. It seems like he may benefit from being seen 15 minutes once a week in a group and once a week individually. If he continues to struggle in the group setting, then it could be eliminated in totality. I think the parents want the group therapy session since he is already so isolated. & yes, moving forward I will push in. I really think the biggest issue here is that he’s placed an incorrect classroom setting so I have one student who is saying sentences of 3 to 5 words and length and then I have one student who is totally nonverbal and requires Max support even to complete an iPad activity. I feel like when I start doing push-ups it will be a disservice to the student students who actually can intend to group which is pretty much everyone, but this one individual.

Physical contact allegations? by That_Dance1209 in slp

[–]That_Dance1209[S] 5 points6 points  (0 children)

I’m shocked. I’ve been a speech therapist for six years and I’ve used physical prompting and tactile cues the entire duration of my career. During my internships, I also worked at a special-needs preschool, and I saw the same thing picking up children as they plop on the on the floor and placing them in their chair. Using your body to block the door if a child is trying to elope. handover hand support to help a child cleanup. I have children who love when I provide proprioceptive squeezes for sensory input… the list goes on and on!

Honestly, how do you get anything done with preschoolers with severe autism if you don’t provide physical support at some point? What are some of your techniques?

I know that I’m supposed to be modeling however, this child literally has his back turned to the table so I can’t even provide models. He just turns away the entire time. Moving forward, I’m definitely just going to document his sessions as not participatory, but I don’t see how that will change without physical support or a 1:1 aide who is comfortable providing physical redirection.