Case Study: IPP Team Works With 10-Year-Old Girl to Improve Communication and Social Interaction
Work Setting: Schools
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Summary
Patty is a 10-year-old student with a seizure disorder, attention-deficit hyperactivity disorder (ADHD), receptive and expressive language impairment, and below-average cognitive functioning. A team of professionals at Patty’s school created a plan to help Patty improve her daily communication and social interaction with speech-language therapy telepractice services and a speech-generating device (SGD). Patty now uses the SGD to participate more fully in the classroom and continues work on her communication at home.
Background
Patty is a 10-year-old student with complex communication needs. She has an individualized education program (IEP), which began at age 5, and has received traditional in-person speech-language therapy for multiple years. Patty’s teachers and parents were particularly concerned about her receptive and expressive language, unintelligible speech for daily communication, learned helplessness in challenging tasks, decreased social interaction, and impaired hand/arm coordination. Upon entering her current school district, speech-language therapy became available through a telepractice service. The speech-language pathologist (SLP) did a trial intervention and determined that Patty would benefit from telepractice services.
Meet the Team
The IPP team consisted of the following professionals:
How They Collaborated
At their initial meeting, the team discussed Patty’s case and agreed to an assessment plan. The SLP would assess Patty’s language skills and assist with AAC trials via a telepractice service. The AAC regional consultant would provide the AAC devices and collaborate with team members during AAC trials. The school psychologist would assess Patty’s cognitive, reasoning, achievement, and attention skills. The OT would evaluate fine motor skills, upper limb skills, and sensory-visual skills. The intervention specialist would assess Patty’s academic skills. Patty’s parents would provide case history and background information. The team also discussed the AAC options that would best match Patty’s current skills and help meet her communication needs and goals, both at home and in the classroom.
After each team member completed their assessments, the team met to review their findings. The SLP found that Patty demonstrated the ability to use a hybrid approach to communication, including verbal productions that are intelligible to most listeners (e.g., greetings, yes/no responses), gestures, and messages generated using an AAC device. AAC trials with the AAC regional consultant revealed that Patty would benefit from an SGD that enables her to generate messages using pictures. The school psychologist noted that despite an impairment in cognitive functioning, Patty demonstrated the ability to learn new tasks, including learning how to use an AAC device, and the OT found Patty’s fine motor skills adequate for using an AAC device. The intervention specialist revealed that Patty’s biggest challenges in the classroom are reading, writing, and spelling, although communication breakdowns do occasionally frustrate Patty.
To address Patty’s communication challenges, the team decided to purchase an SGD and developed a plan to help Patty use the device. The SLP taught Patty how to use it, and the AAC regional consultant conducted an in-service on how to integrate the SGD into daily classroom use. The OT worked with Patty on the fine motor skills she needed to use the device, and the intervention specialist provided weekly updates on classroom vocabulary to program into the SGD. The team members all collected data on a weekly basis and met quarterly to report on Patty’s progress.
Outcome
Quarterly meetings revealed that Patty consistently used the SGD to make comments and to answer questions after a verbal prompt. She also made considerable gains in fine motor skills and no longer required services from the OT to use her SGD.
The team also noted that although Patty made good progress using the SGD, she was inconsistent in using what she learned in the classroom at home. For this reason, the intervention specialist, along with the parent, developed a home-based plan to help Patty’s parent practice at least three times per week. In addition, the team determined that some members were unaware that Patty had a language impairment in addition to a speech disorder. The SLP explained her impairment more clearly, and the team was able to set more realistic expectations regarding what Patty would be able to express with the SGD.
Ongoing Collaboration
The team continues to ensure that Patty uses the SGD in the classroom and at home. They now communicate weekly and meet monthly to review Patty’s progress and to refine the intervention plan.
