When School Closes but Learning Doesn’t Stop

What is ADHD? ADHD is a medical condition where the brain develops differently in ways that affect a child's executive function skills. These are thinking skills (e.g. working memory, planning, inhibiting impulses) that allow us to take actions moving toward a goal, like completing a specific task. Children with ADHD typically have struggles with attention, hyperactivity/impulsivity, or a combination of the two. ADHD & Communication Executive function is a foundation that supports many areas children use to communicate and interact with others: motor skills to produce speech sounds, language skills to understand what people say and make their own responses, understanding the rules for how to use language for social functions, and social-emotional skills to build relationships with peers. Differences in executive function for children who have ADHD are therefore likely to influence their communication skills as well. Evaluating students for speech & language with ADHD Since ADHD has influences on communication, when evaluating students with ADHD for speech & language it's often helpful to adapt your administration to account for differences in executive function skills. Give breaks as needed & allow extra time to complete the assessment Adjust your testing environment (e.g. remove potential distractions)​ Structure the assessment (e.g. give client sense of what to expect)​ Adapt the assessment plan as needed Speech Assessments Look at speech sounds at levels with increased complexity above just single words (e.g. sentences, reading, structured conversation, unstructured conversation) Check for rate of speech, volume, or intelligibility changes in unstructured contexts Informally observe language/organizational skills in longer speech utterances (e.g. topic maintenance/shifts, narrative skills, organization of details) Language Assessments Consider working memory & attentional demands in instructions & tasks when selecting the assessment to use Look at narrative skills & organization of ideas in language samples Consider using dynamic assessment to look at whether language skills improve with teaching If assessing for pragmatics, look at social interactions one-on-one vs. in a group setting (e.g. the classroom) Therapy strategies for students When working with students who have ADHD, executive function differences are likely to affect how your sessions go. These are some strategies that can help you structure sessions & navigate interactions with students. Guide students back to tasks with redirection & give choices Use visual supports (e.g. visual schedule, first/then, visual timer) for activities to structure session Adjust level of scaffolding (prompts, cues) as needed to support the student. You can use more than one modality (e.g. visuals) if verbal supports aren't enough on their own Give a minimal number of directions or steps at a time Break tasks into smaller chunks Adjust level of movement, sensory inputs/demands (lights, noise, texture, deep pressure) Look at the level of variety or structure in your sessions. E.g. have a consistent routine to transition into sessions, incorporate student interests into activities, or go with the flow and follow your student's lead. Navigating obstacles/challenges For students who have ADHD (and students in general!), variability & motivation often affect progress in therapy. SLPs don't medically manage ADHD, or choose whether/how it happens. We don't choose what students do. We do treat areas that are affected by ADHD and its management, and we can choose how we work with students. When navigating sessions and behavior management, here are some recommendations. Look for patterns & contributing factors when sessions go off the rails (e.g. is it happening because they're missing a favorite period or preferred activity? If they take medication, how long has it been since they received it? Are there sensory factors/home life factors at play?) Consider what can you choose vs. not choose in your sessions Adjust expectations for what success is in your sessions Look at the intent vs. impact of behavior that students do Remember that our clients are more than what they do. Our students often pick up on spoken & unspoken perceptions of them, and many times they are looking for people who support them. Takeaways ADHD affects foundational skills supporting communication. We can choose how we approach & support students in therapy, and there may not always be simple solutions. Look at your perspective & expectations for what a successful session is for these students.  -Ian Quillen, M.S., CCC-SLP

OK, so you have your cute vision board, fitness goals, and maybe even a budget planner. You tell yourself you have a plan for the year, but do you really know the details of your career goals? Or did you just throw a magazine clip on a board, check the box, and move on? This year, I want to do things differently. Instead of vague ideas, I am focused on creating a clear, intentional vision that specifically outlines my professional goals as a speech-language pathologist. Step 1: What is our big goal? Before anything else, we have to identify the main goal for the year. Not ten goals. Not what sounds impressive to others. One clear priority that will have the biggest impact on your work life and overall well-being. This might be improving work-life balance, increasing clinical confidence, or creating systems that make your day-to-day workflow more manageable. Step 2: How do I get there? Once the big goal is identified, the next step is defining the requirements to achieve it. This means writing out the specific actions, habits, or changes that need to happen. Think step by step. What needs to be adjusted in your schedule, your caseload management, or your boundaries at work? Step 3: Break it into quarters Big goals become less overwhelming when they are broken into quarterly goals. Taking those steps and assigning them to realistic timeframes helps keep progress attainable and measurable throughout the year. Step 4: Make it aesthetically pleasing Whether it is a vision board, planner, or Canva document, your plan should be visually motivating and easy to revisit. If it does not invite you back in, it will not be used. Let’s be honest. Growth does not always look like major accomplishments. Sometimes it looks like finishing documentation on time, managing your caseload with intention, and creating space for rest, hobbies, and joy. The key to calming chaos is planning. When we create clear plans, we leave less room for stress to make an uninvited appearance. As SLPs, we carry multiple roles and responsibilities, clarity is not a luxury. It is a necessity. Curating vision with intention allows us to move through the year with purpose instead of pressure. When we take the time to define our goals, map out the steps, and create plans that actually fit our lives, we give ourselves permission to grow without burning out. This year, I am choosing clarity, consistency, and peace. Not just in my career, but in how I show up for myself every day.  Courtney Stafford, M.S., CF-SLP