Best Practices in Educational Therapy

Ann Parkinson Kaganoff

• Publisher: Routledge
• Year: 2019
• Print ISBN:
  9781138319929
  9781138319912
• eBook ISBN:
  9780429843440
• Edition: 1
• Topic: Didattica
• Subtopic: Didattica generale

Best Practices in Educational Therapy provides actionable strategies and solutions for novice and veteran educational therapists. Given the diverse backgrounds of educational therapists and the varieties of specialization and client types, there is no single approach for all therapists and all clients. This book is built on a foundation of individualized intensive intervention, offering generalized principles of application across many contexts. Featuring practices informed by documented experiences of educational therapists as well as research in memory and cognition, attention, speech/language, specific syndromes, and the role of emotion in learning, this well-rounded guide will serve educational therapists at all stages in their career.

Part I

The Educational Therapist’s Habit of Mind

1 Decision-Making in Educational Therapy Before, During, and After a Session

What Am I Seeing? What Am I Missing?

Decision-Making Indicators in Educational Therapy

Every interaction between educational therapist (ET) and client involves decision-making. Because of the nature of intensive individualized intervention, it could be argued that decision-making is at the heart of educational therapy. Decisions are made at all points along the way: before, during, and after each intervention. It begins when we decide that we are a good fit with a particular client, that our skill set meets that client’s needs, to the best of our ability to determine. It continues as we look at all our diagnostic information and select from a variety of approaches to meet the needs of our varied clients. Decisions are made when we evaluate what is working, what is not, and what needs to be changed. Decisions are made as to when it is time to finish the treatment. Decisions are made during the entire life span of the treatment relationship with every client.

Given this pervasive need to make decisions, we might ask if there is something unique about the decision-making process as it applies to educational therapy. Are there specific conceptual frameworks by which we can better understand the task and how to do it effectively? Would the use of conceptual frameworks make us quicker in our analysis and hence more effective in our treatment?

Chapter 1 reflects an ongoing professional effort to develop a conceptual framework for the decision-making practices of the ET. Many of these ideas on decision-making in educational therapy emerged initially in connection with a specific problem, with a specific client with whom I was working. As I began to consider the nature of the decision-making that goes on, on virtually a minute-by-minute basis in a typical session, I wondered if there were fundamental patterns here that might be common to most, if not all, educational therapy sessions. An opening section in a best practices book unquestionably had to explore and formulate those decision-making frameworks that underlie much of the practice of educational therapy. Conceptual frameworks of this nature could contribute to a better understanding of the processes involved in the conduct of our work. In other words, if these processes could be labeled and made explicit so that they could be accessed consciously as we practice, we then would be better able to self-reflect and refine what we do.

My inquiry began with a set of questions that I felt would lead to a formal decision-making framework. The questions had a broad scope, from the initial decision to take on the client, to the beginnings of the working relationship with the client, into the design of treatment interventions, and through the inevitable changes that such treatment always entails, especially when one sees a client over time. Since educational therapy is by nature diagnostic, I focused on “diagnostic indicators” that might be present at all stages of our involvement with our clients. These indicators might be grouped into four categories: diagnostic indicators, intervention indicators, progress evaluation indicators for the client, and self-reflection indicators for the ET. For each of those categories, the following questions required consideration.

Diagnostic Indicators

1. What indicators do we as professionals use to establish the “goodness of fit” between ourselves and a potential client? Given the wide range of ET backgrounds and skill sets, and the wide range of client types, are there general principles or is this a matter of individual judgment? (See Kass, “Developmental Stages of the Educational Therapy Process,” in Ficksman and Adelizzi, 2017, pp. 28–53.)
2. What diagnostic indicators help us establish the foundation and formulate goals for intervention and treatment? Would well-specified diagnostic indicators help the ET save time and provide a rational and supportable foundation for intervention?
3. Are there specific “diagnostic tasks” that can be used to provide critical indicators for a wide range of client types? When during the course of intervention are these tasks best used?
4. What diagnostic indicators might signal a need to modify the intervention?

Intervention Indicators

1. Is there a formal decision-making process that applies to educational therapy interventions, given the wide range of learners who receive educational therapy and the many types of assessments that form the basis of intervention? Does the process of designing the intervention involve common elements across clients?
2. What record-keeping procedures should I use in my private practice, or my work with special needs students, to insure that I am not missing these indicators?
3. Are these indicators and/or procedures generic over age groups and client profiles?
4. Do these indicators and/or procedures differ between short-term and long-term clients? Many clients come to educational therapy with the prognosis that they will be “lifers,” in need of ongoing support as educational challenges change over the lifetime of the educational process. Some who come to us as short-term clients become long-term clients as demands and needs change. Do long-term clients require a different form of vigilance than that for short-term clients?

Progress Evaluation Indicators for the Client

1. What type of decision-making framework supports the overall plan for evaluating progress? Will I constantly find new client issues to address? How much progress is enough?
2. How does our decision framework enable us to accommodate and adapt to change over time? Can some “changes over time” simply be changes that occur with our clients as they mature and develop? Which changes can we reliably attribute to our interventions? What changes might be a result of our own increased expertise and professionalism?
3. How do I know when to terminate treatment? Who participates in the decision?

Self-Reflection Indicators for the ET

1. With whom should I or can I consult regarding the need to modify, expand, or terminate treatment?
2. Who are the other important stakeholders involved in our own self-reflection, such as parents and caregivers, or the clients themselves?
3. How do we document our own trajectories of development professionally, other than through meeting periodically with colleagues or sharing informally? What benefits accrue to ourselves and to our clients as a result of age and experience? Where can we formally note that as we age, we may be more aware of the passage of time and hence have a heightened sense of urgency when dealing with clients and parents?
4. What are the markers of professional growth? What resources and research findings must we be apprised of, to remain current with our methods and services?

Goals of Chapter 1

Some of the above questions can be answered given the state of the profession at this time, and some questions await further generations of ETs. The goals of Chapter 1 are the following:

• To explore and define the indicators we use in educational therapy as the basis of decision-making for diagnostic intervention, and for the design and/or modification of the treatment plan.
• To identify specific instructional tasks that provide maximum diagnostic data and maximum direction for the next steps of intervention.
• To recommend ways to track progress through effective record keeping.
• To integrate the decision-making process with the evaluation of progress.
• To highlight situations in which change indicators might cause us to adjust goals, redirect our efforts, employ different strategies and materials, and enlist the client in different ways or at different levels.

The Decision-Making Process in Educational Therapy: An Overview

The practicing ET operates in three spheres of time simultaneously, with each time frame informing the other two in a coherent and seamless fashion. The first time frame is the present, in two senses of the word present. The ET operates in the present moment in a highly specific fashion. Our work requires a capacity to be present in the moment, using skilled powers of observation that allow us to identify what is “going on” with the client. What we detect about the client’s state of mind, emotional set, and expectations will frame the interaction to come. We must be prepared to adapt as needed, a frequent occurrence no matter how carefully we may have laid out a plan for the session. Additionally, we have a plan for each part of that present moment, based upon careful evaluation of client strengths, needs, and goals. This plan, usually thought of as “the lesson plan” or “the treatment plan,” consists of activities and materials that are drawn from a wide variety of sources, all carefully tailored for the individual client. Educational therapy interventions are typically carried out within time constraints that are unlike those of the classroom. These constraints may reflect a degree of urgency for the client who is under pressure or under stresses of various sorts. We must make every moment count.

The second sphere of time involves the information we carry into the session from the past. Educational therapy interventions are based initially upon assessment data gathered from allied professionals who provide us with the diagnostic framework that helps to form the rationale for all decisions we make about subsequent treatment. Many ETs gather additional diagnostic data through informal measures such as interest inventories, informal reading inventories, writing samples, review of client work samples, etc., as we build a more complete profile of client strengths and needs.

In addition, each session adds another layer to the client history that we use to monitor progress and to plan ahead. We may have worked with the client over time, giving us a longitudinal framework for noting patterns of growth. We draw upon our history with the client to call attention to moments of insight, inspiration, or challenge. Our clients are often reassured to be reminded that we were there to see it happen. On the other hand, there are clients with whom, for whatever reason, we may have only a short past. Even here, we can reassure that client that we are taking note and bearing witness, for this form of feedback may be rare or unknown in the lives of some clients.

Third, we constantly look ahead to the future. For the client, it may involve planning for tomorrow’s homework, preparing for final exams or the term paper in two weeks. For the ET, it may involve selecting the follow-up tasks for the next lesson in this week, or for that ultimate moment when we mutually agree that the work is done. Our clients’ ability to continue on as efficient and strategic learners, as “lifelong learners,” and as confident and productive citizens becomes the standard we all aspire to. For the experienced ET, shifting between time frames may happen at a completely unconscious level, or it may happen with great deliberation and purposefulness. For the newly trained ET, this shifting must be a matter of conscious effort. Current training programs in educational therapy, including supervised internships, give the new ET valuable practice in this important skill.

Essential Skills for Decision-Making

Skilled Observation

Few professions in the field of education offer such unique opportunities for close observation of the learner as does educational therapy. And in few other educational settings is close, ongoing observation such a necessity. For the purposes of this chapter and this book, it is assumed that practicing ETs are in a setting where at least some part of the time is spent in intensive individualized intervention with a student who exhibits some form of learning disability or learning impairment. A wide range of ages is assumed, as is a wide range of the manifestations of the disability.

It is further assumed that the ET will have significant opportunity to observe the learner not only in the one-to-one context, but also in other contexts that relate to the particular case. This type of observation can be contrasted with that of the teacher who works with learners in groups, where intensive observation may be limited by outside factors, such as the ongoing presence of other individual students, or other groups of students. The kind of observation practiced by the typical ET is very different in both purpose and outcome than observation in most other educational settings, and requires a distinct level of skill. It results, over time, in the distinctive lens through which we observe.

The ability to do the kind of observation required for educational therapy, at the required levels, may be the result of an intuitive trait of the ET. Many ETs are naturally tuned in to the nuances of learner behaviors. However, it is also felt that observation skills must be practiced. Skilled observation is the result of conscious attention to relevant behaviors and details, and should increase with experience. Observation in an educational therapy session covers a wide range of points of interest: physical behavior, linguistic output, body language and gesture, emotional tone, movement, and response to interventions of all sorts and at all levels of difficulty. Observational data are of great importance in both the design and the modification of treatment, because they form the foundation of diagnosis, intervention, and documentation.

The constant problem-solving involved in educational therapy sessions, in turn, promotes the development of our observational skills, providing the cumulative benefit of ever-increasing expertise. With the exposure to a wide variety of clients and client issues comes the advantage of seeing and recognizing behaviors quickly. We may not immediately know the source of the behavior, or be able to quickly form a hypothesis, but at least we know what is important and deserving of further analysis and data gathering. We are in a field where it is likely that every day we use nearly everything we know.

As an example of the power of observation, early on in my practice, I encountered a young third-grade girl who came to me with a diagnosis of ADD and some rather obvious problems with distraction. However, over the course of several sessions, it struck me that there might be something else going on, as she seemed to be missing so much, both when she was with me and while in school. I had positioned her and myself at the corner of the work table where I was close enough to observe her eyes as we worked. Her direction of gaze did not follow the pattern of ordinary distraction, but seemed to reveal something else. When I questioned her mother about whether she had ever been checked for seizures, the mother noted that seizures had been considered several years prior, but there had been no recent examination by the doctor. At my urging, this conscientious mother did ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of Appendices
• List of Figures
• About the Author
• Preface
• Acknowledgments
• Introduction
• Part I: The Educational Therapist’s Habit of Mind
• Part II: The Literacy Skills Foundation
• Part III: How We Do What We Do
• Index