We thrive on routine. There's a way that things are done, day after day, that gives our lives structure and predictability. Routine is comfortable. But sometimes, the routine isn't serving us all that well.

When we examine everything we're doing with fresh eyes, we can often find ways to improve upon it. But we have to be brave enough to question why we perform each step of our routine and be open to trying something new to see if we like it.

Speech therapy is the same - it can become very routine. Some of this pattern is what we learned in school or from our early supervisors or mentors. Some of it is prescribed by our employers or payors. And some of it is just what we've always done.

So today I want to challenge you to think about these traditional ways of doing speech therapy, and consider what it might mean if you flipped it around. Let's look at a few scenarios:

1) We always start with an assessment

Did you know that when you go to the ASHA Practice Portal, setting goals is NOT listed as a purpose of an assessment? So why are we completing the assessment first and letting this drive our goal-setting?
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Let's flip our practice and set goals before even administering an assessment tool. This is an example of patient-focused goal setting and it leads to higher client satisfaction, quicker recovery times, and improved participation in life.

Sounds great, right? So why aren't all SLPs doing this? Well... because it's hard! It's hard to set these goals. It's hard to measure these goals. And it's hard to get our clients to communicate these goals.
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That's why I've created a FREE Settings Goals in Aphasia e-book to help you out. It offers all kinds of helpful links, resources, and guides to make goal setting a lot less scary. Try doing it first to see how it changes your relationship with assessments and how your therapy becomes much more focused.

2) We focus only on the problem

It makes sense that if someone's speaking is impaired, you'd focus on speaking, right? But sometimes doing the thing that's hardest can be the most frustrating and slowest way to make progress. What if, instead, you took a break from speaking to focus on listening, reading, writing, and thinking skills? Would that help?
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Research shows that nonverbal cognitive skills are predictors of success in language therapy. And often we see gains in language areas we haven't targeted directly when we use an approach that targets the whole semantic or phonological system. For example, doing an oral reading treatment can improve speaking, reading, and writing, even when no writing is involved in therapy!

This is why we bundled our 4 language apps together in Language Therapy (and later in Advanced Language Therapy) - we truly believe in the benefits of working the WHOLE language system, not just the part that's most damaged.

3) We spend therapy time doing drills

Are you using the "train & hope approach" in aphasia therapy?🤞We all love our evidence-based therapy protocols for aphasia, but what if I told you that research conditions are not equal to our clinical reality? You'd probably agree, but here are some hard data:
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Most restorative researched treatments are delivered intensively, averaging 25.1 hours over 20.1 sessions at 3.6 sessions/week. Clinical reality is 10.9 hours over 14.5 sessions at 1.5 sessions per week. That's a pretty big gap isn't it? So, what's the answer?

Source: Cavanaugh, R. et al. Is there a research-practice dosage gap in aphasia rehabilitation? (Poster presentation at Aphasia Access Leadership Summit 2021)

HOME PRACTICE may be a way to make up the dosage gap! Let's flip the standard practice and instead of drilling exercises, we can spend our valuable therapy time focused on activities that the person wants to be able to do and train a home program so restorative drills can be done at home!
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All of our apps are evidence-based ways to help our clients with aphasia get the repetition and intensity they need to help them recover. Find the right apps for you or your clients using our simple App Finder.

Want more FLIPS?

Follow me on Instagram and Facebook for more content like this. Helpful tips, clinical insights, and timely events. Here are 3 more flips for you examine:

• Why are so many of our goals impairment based? (Instagram or Facebook)
• Should we work bottom-up or top-down? (Instagram or Facebook)
• When is the right time to focus on impairments vs participation? (Instagram or Facebook)

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Hope you're having a wonderful summer! Let me know if any of these flips resonated with you!

-Megan

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P.S. If you're too hot, cool off by watching The Ice Road on Netflix. This new Liam Neeson movie features a character with fluent aphasia, inspired by my viral video interview with Byron!