This is it. You finally have your first clinical assignment. A multitude of feelings come over you, excitement about finally being able to “do” the task that you have been putting so much academic effort into, anxiety about what your client will be like, sheer terror that you really won’t know how to do the treatment.
It is natural for these feelings and in truth this is part of being a speech and language pathologist. I have been a speech and language pathologist since 1979 (I know you are thinking boy I wasn’t even born then) and I have these feelings when I am meeting a new client.
The most important thing that you can do is being prepared!
Remember when we are working with pediatrics we are working with the entire family. It is important that you reach out to the families. You may if you would like call the family and introduce yourself as their child’s next student clinician. This can serve to break the ice. During this phone call you might ask them what are their goals for their child, is there anything in particular that they would like to have worked on. You can ask them about their child’s interest, as this will aid you in making a connection with the child.
All clinicians should give their families a way that they can contact the clinician as well as any holidays from clinic and information about what might occur if there is inclement weather or other closure of clinic. It is best if this is a typed document or card.
The day of clinic, wear you white lab coat and go out to the waiting room with a smile. This will relax everyone. Greet the family and the child giving your personal information to the parent. Tell the parent which treatment room you will be using so that they can go to the observation room if they would like.
Set up the clinical room so that all the materials are in the cabinets. The clinical rooms have been set up so that they are plain on purpose. We want the client to be attending to what we have planned. Although we want to decrease the distractions in the room we also want to have an inviting environment. Plan your first activity to have some material that will entice the client into the treatment room. For a very young child it might be an exciting toy, whereas the older child it might be the schedule with some activity that the child will look forward to.
Your first activity should be planned so that you can get to know your client and develop a good therapist- client relationship. Think of yourself. If you were going into the doctor and he began doing testing before he had a conversation with you, your anxiety might go up. For a child it might be playing a game or exploring some novel material. For the older child it might be bringing some pictures or some item from home that is really interesting. Some student clinicians have brought maps to show where they are from, or a painting that they made to discuss their hobby or their phone to discuss what level of Candy Crush that they are on, all which served to make a connection with the child. I like to begin my sessions with an attention set to get my students into a routine and then immediately go to something that allows me to get a feel for the student’s interactions. Although I am saying to have a fun activity for your first session, this does not mean not to use this time to get some information about the client ( intelligibility, pragmatics, sentence structure etc.). Here is a Pinterest board that has some ideas. Get to know you. Know that for a child with a speech or language problem sometimes conversation may be difficult, so a more active activity might be a better choice especially if it is the first session.
An important part of your first session is to develop a positive routine. Not all children know what the expectations are. It is important to establish these protocols during the first meeting and to display them so that the child knows them. This can be as simple as the schedule, which tells the child the expected activities. It is important to reinforce a child’s behavior. “ You are sitting so nicely”, “ Wow that was hard and you finished it” You want to insure that you are highlighting the behavior that you are expecting and reinforcing it with positive reinforcement. For some student they will need a tangible expression of this positive reinforcement through tokens, tallies or check marks whereas other just the positive comment is enough. It is important to be specific in your praise so instead of saying “ Good job” say for example“ I liked the way you used your words. I understood what you wanted”
Be careful not to reinforce the negative behaviors, as that will increase these. Determine if the behavior is dangerous and if not planned ignoring sometimes is the best course of action. For example some children will turn the therapy room’s light on and off and look for a reaction. Having a big reaction to this will increase this student’s behavior. If you ignore the behavior and go to the next task planned and wait for the child more often than not they will tire of the light switching and go on to the next task. (Of course this does not mean they won’t try this again!).
It is important to be well prepared. Create a lesson plan that has more than what you might need for the day. It is way better to have too much than to find that you have run out of activities and you still have twenty minutes left in the session. Turn your lesson plans on time to allow the supervisor to review and comment on them. Make sure that the materials you are using are available. If you are bringing items from home use your lesson plan to check off that you have packed them in your bag. There is nothing worse than getting to clinic to realize that you left the book you were reading to the client at home.
I love what I do! It can be like a roller coaster ride. You look up at the height of the ride and you can’t believe you are getting on line. You prepare yourself researching what other riders have said about the ride. You insure that you are safe buckling up. It is your time on the ride and you feel nervous and excited. ……and it is over in seconds. YOU MADE IT!