Brain Rules and the speech therapy session

September 18, 2014
Kira Wright, CCC-SLP

I recently read Brain Rules: 12 Principles for Surviving and Thriving at Work, Home, and School by John Medina, a developmental molecular biologist and research consultant. These kinds of books with research and science presented through stories and real life self-improvement suggestions always interest me, and this one was specifically appealing to me as parent and educator.

This time though, I began to look specifically for tips and techniques that I could share with my SLPA - ideas for making our speech/language sessions into the most efficient and effective learning periods possible. We work with students who are not learning the same way their peers are. By the time they come to us, someone has noticed that, despite typical exposure to adults speech, interaction with friends, instruction in reading and math, etc., these students have not acquired the expected skills. We are tasked with providing specially designed instruction to explicitly teach these skills, be they tongue position for an /s/ sound, syntax for questions, or academic vocabulary.

How can we make the most of the usually very short time we have with students? And if the instruction and exposure that has worked for their peers has not been effective for these students, what can we do differently?

With these questions running through my head, I was initially disappointed by the first couple chapters, which highlighted big, obviously important issues like sleep and exercise and stress. I didn't feel like I had any control over these factors in the 20 or 30 minutes I might spend with a student. But then, it started to get juicy!

Medina has chapters on Attention, Memory, and Gender, as well as real speechie favorites, like Sensory Integration, Vision, and Music. Here are a couple of my personal take-aways:

1) Choose one task to work on at a time - It is inefficient to switch between tasks, especially since our students are working on new skills, skills that are not yet habit. In his chapter on Attention, Medina writes at length about the myth of multi-tasking. In reality, our brains have a structured sequence of neural messages that take place every time we shift our attention between tasks.

  • To keep this in mind during speech sessions, I plan to limit the extraneous work that goes on while students take turns (flipping a chip into a hippo's mouth after each turn, even rolling a die, spinning the spinner, or moving a game piece!). This is distracting from our therapeutic purpose, not only decreasing time spent on our goal, but requiring the added cognitive effort of frequent shifting of attention and re-focusing. "Sustained" practice may mean different things for different students. Maybe a given student needs to shift tasks frequently in order to maintain focus.
  • I wonder if we could design a session to allow shifts between tasks that all share our chosen goal, instead of shifting attention between hungry hippos, rolling dice, and spinning spinners?

2) Medina emphasizes, in his chapter on Vision, that 'a picture really is worth a thousand words'. Our brains learn and remember visual images, especially those with sound and motion, many times more accurately and with fewer repetitions than spoken or written information. My SLPA and I already use lots of visuals with our students to support learning, memory, and recall in the speech room and the classroom, but I wonder if we might use visuals, and video in particular, to support the effort mentioned above: increased and sustained focus on our chosen goal.

  • What if students working on narrative structure watched a 1-minute video or animated powerpoint on the important pieces of a well-organized narrative? Maybe using the same visuals we will use to support narratives during our session (setting, character, etc.). The goal for the video or powerpoint would be "Less text and words, more pictures!"
  • Could we show a video of correct placement and production of target sounds to start our articulation sessions? Or make better use of the video portion of some articulation apps?
  • What about our students whose academic skills are far below grade level, but are still in the classroom for core instruction? We could support them and their communication and participation goals by collaborating with classroom teachers to identify video to support the grade-level curriculum.

3) We consolidate information into our long-term memory by incorporating new information gradually and repeating it over time. From this, my take-away is that I should stop thinking about the scheduling of speech/language therapy in the schools as a downside to be overcome, and start realizing the benefits of repeat and review information at regular intervals, gradually stepping back supports and adding complexity. This is what we are trained to do, what we are good at! How wonderful that this method is also supported by brain science!

I recommend this book for anyone interested in a quick look into what we know about our brains and how they work. And those chapters on sleep and exercise and stress? Well, if I can't use them in my sessions with students, I can certainly use the ideas to boost my own performance. This blog post came together easily after allowing myself a short mid-day snooze! (see Brain Rule #3: Sleep well, think well)