Greetings!
We SLPs know the unwritten rules of therapy. Most of our students don’t. So, what if we took a few minutes with them to make our expectations explicit? It totally helps!
This interactive activity helps to lay the groundwork for cooperation, session-to-session continuity, and potentially more effective therapy results. We’ll establish interactive expectations for you and your students to bridge a therapeutic relationship. After all, therapy is a team effort.
So what does interactive expectations actually mean?
Interactive expectations go beyond the identified speech goal of producing a sound correctly in conversational speech. Expectations clarify the students’ role during the therapy process. And interestingly, from the student’s perspective they also define your role.
As a private practitioner and a school-based therapist, I omitted this powerful piece for many years. Actually I never thought about it until it dawned on me that I knew the seldom mentioned rules of ideal interactions during therapy, but they didn’t. Once I began implementing a few interactive strategies, my therapy sessions became smoother and more controlled—you know what I mean! I, also, believe the kids appreciated knowing ahead of time what was expected of them.
Char Boshart here. I’m excited to be with you for this first-in-a-while Therapy Matters Blog—and Therapy Matters Video, if you prefer to listen and/or watch. From now on, these offerings—designed to help you think about therapy and how to apply it—will arrive in your email every month. I’m going for quality content, not quantity. My focus is on you, the SLP, and what I can share to lighten your load.
This is the first in the Therapy Matters Blog series Transform Your Therapy Sessions.
Let’s jump in with a couple benefits of addressing interactive expectations with clients.
Two Positive Consequences
First, after discussing group expectations, future redirection becomes much easier. When a student’s attention or behavior becomes a concern, the correction doesn’t only come from you. It reflects the prior agreements the group made together because you previously discussed what paying attention and giving your best effort looks like. Now you can remind students of those agreements rather than interrupting therapy to create new rules in the moment.
Second, knowing that everyone appreciates encouragement, those initial discussions provide wonderful opportunities to recognize compliance during subsequent sessions. You’re not simply saying “Good job!” or praising their general effort. You can acknowledge something specific: “I noticed you waited for your turn even though you knew the answer. That helps everybody have a chance to speak.”
Sometimes we simply have to state what we want from our therapy-kids. We cannot assume they know. Because they probably don’t.
SLP Expectations of Students During Therapy
The following are ten primarily verbal and behavioral expectations designed to clarify the student’s role in therapy.
Be specific about what you want students to do—and not do—during therapy. The italicized statements below are the expectations; the questions in quotation marks may help you discuss the meaning of that expectation.
Be sure to ask them what they think and go as deeply into the discussion as your students are capable of going. You will probably have to nurture them along. That’s okay; you’ve planted the seeds. The goal isn’t simply compliance; it’s to help students understand how they can participate successfully in their own therapy.
The following are not listed in any particular order; do all or pick and choose:
1. “Feel free to ask questions. If you didn’t understand or didn’t hear the instructions, let me know.”
Discuss: It’s important for them to say, “I don’t understand,” “That’s hard,” “Show me again,” etc. It teaches self-awareness, self-monitoring, self-advocacy, and active participation. Let’s think of some situations you might want to ask a question. What words could you use?
2. “Sometimes I’ll ask you to do easy tasks, sometimes I’ll ask you to do harder tasks. When that happens, do your best.”
Discuss: What does ‘do your best’ mean to you? Ask them about other times in the past when they did their best. What did they do and what happened?
You might introduce this simple reminder: Listen. Look. And Think. “Sometimes you must listen carefully, look at what you’re being asked to do, and then let YOUR brain to tell your mouth what to do. As you say the words, gesture toward your ear, an eye, and the side of your forehead.” (You’ll use this one often!)
3. “Sometimes I’ll ask you to repeat a speech sound, or word, or other task. That’s called ‘repetition.’”
Discuss: It doesn’t mean you did something wrong. Repeating and practicing helps your mouth muscles learn what to do. You may want to connect this concept to something they already know, such as learning to print, draw, ride a bike, or perform some other motor task.
4. “Stay focused on the tasks; do not get distracted.”
Discuss: What are some things that might distract you from doing our work? Help them identify distractions and think about what they can do when those distractions occur.
5. “Taking turns is important—in fact, it’s required.”
Discuss: Taking turns makes sure everyone has an opportunity to learn. During the game (or activity), to be successful what do you need to do before it’s your turn so you are ready when it is your turn?
6. “Don’t blurt out someone else’s answers.”
Discuss: It’s unfair to take someone else’s turn away. Discuss why. What is required to be a patient person? What does patience look like and feel like?”
7. “When we are working on the tasks, tell me when something isn't working for you.”
Discuss: This is an important part of being an active participant in therapy. What could you say if you don't understand? What words could you use? What could you tell me if something feels too difficult, or you need me to show you again? This teaches students to communicate their needs and become part of therapy itself.
8. “Think about what you are doing.”
Discuss: Your brain tells your mouth what to do and also helps you determine how you did. And, it’s okay to not always wait for me to tell you how you did on every task. What does this mean—let’s determine what you need to think about. How can you figure out what your mouth did when you did the task correctly—so you can do it again? How can you figure out what your mouth did when you did the task incorrectly—so you can correct it?
9. “Sometimes you’ll need extra practice.”
Discuss: There will be times when additional mouth-training is helpful, so I may ask you to practice at home. The tasks will be things you are familiar with and will take only a few minutes. Does this sound like something you’ll be able to do? Where is the best place for you to practice?
10. “Everyone has a difficult day once in a while.”
Discuss: Go easy on yourself. Nobody does everything perfectly. And don't compare yourself with someone else in the group. I don't expect you to be perfect. I do, however, want you to notice what you're learning and keep working toward your goal.
Students’ Expectations: “What do YOU Expect of ME?
Now for the interesting part.
Ask your students: “What do YOU expect of ME during our time together?
This question may throw them off a little, but it will capture their attention. They probably won’t know how to respond at first. That’s okay. Guide them through it just as you did with the above expectations.
Expectations should be mutual—therapy a team effort. This provides a perfect opportunity to discuss topics that are often assumed and unspoken. Ask:
1. “Do you expect me to be on time for our session?”
Discuss: You’ve turned the table—mutual expectations.
2. “How would you want me to treat everyone during our time together?” “Do you expect me to treat you with respect?
Discuss: Again, mutual expectations. What does that mean and look like to you?
They may respond with, “Be nice.” Help them make that more specific, for example: Do you want me to say your name? Do you want me to look at you so you know I’m listening? Do you want me to let you finish talking before I respond? Then ask, Is it fair for me to ask you to treat me with respect, too? Absolutely.
3. “If someone is disrupting our time and making it difficult for others to hear and learn, what would be best thing for me to do? What would be fair?”
Discuss: Brainstorm together. Their recommendations may be more stringent than yours! Whatever your behavior-management approach, explain the consequences ahead of time and then be consistent. Students should know what will happen if their behavior makes it difficult for others to participate.
4. “I’m going to tell you what I see and hear, then we’ll work on it together.”Discuss: Say something like, when we're working on your speech or a mouth-task and something doesn't go right with your mouth and it doesn't come out correctly, I may say something to help you. Is that okay? We're a team. I'm not here to hurt anybody's feelings—I'm here to help you figure out what to change. Otherwise, how would you know what to change?
As an SLP, I think you’ll understand when I say, we just opened the door to being honest with them—and them being honest with us.
It’s a Process
The number of expectations you do at one time, or how deeply you address each expectation is up to you. Choose the ones that are most relevant to your students, their ages, and the way your therapy sessions operate. Add others as the need arises.
Also, the beginning of the year or the beginning of therapy is best, but in reality it’s never too late to bring up the topic. Revisit the expectations throughout the months of therapy. As new situations arise use the opportunities to remind students of what you agreed upon together.
I hope this helps you and your students make therapy a little better for everyone.
Feel free to leave comments and questions at the bottom of this Therapy Matters Blog page. Also, I would love it if you would email me with topics you'd like to see covered in this blog, write to char@speechdynamics.com.
Also, watch for next month’s blog Motivation & Engagement During Therapy. This totally impacts all of us—no matter the client age, population, or work-setting. You’ll enjoy hearing of some intriguing research on the topic, along with many helpful therapy options for you to directly shape your client’s motivational mindsets and their engagement.
Here’s to a productive month!
With admiration,
Char
Char Boshart, M.A., CCC-SLP
Speech-Language Pathologist
SpeechDynamics.com
