Grab the Ledge

That's the feeling in a nutshell. Off a precipice, whatever. The moments in your work life when momentous change is possible and you feel it possibly happening. It may go positively or not, but you know you are at the cusp, on the edge, entering the wormhole and embarking on an adventure. This post will attempt to identify instances of when that may be so, and why it may be important to recognize the ledge-grabbing moment by being "in the moment".

Why anticipate those life changing moments in your SLP work? Can't you just deal with them as they come? Consider it a function of your growth as a professional, that you experience and grow your powers to predict these pivotal changes happening within yourself, for the people you are helping, or in the environments around you. Many change events are the cycles every person served may face, whether they are among your total caseload, or within a group of persons with a similar diagnosis. An example is called for:

Feeding someone who does not do it well for themselves - that's a good one. The person may only occasionally raise the spoon herself, so you scoop up the food, briefly hold the delivery system at eye level so she might open her mouth and accept the spoonful, then apply light pressure to the tongue - so she will EXTRACT the food from the spoon bowl, not just receive a DUMPING of the food at the front of her mouth; this action alone helps engage the oral preparation phase to swallow what she has taken - and so the spoon is withdrawn, she closes her lips in rhythm with the withdrawal; the cycle starts again. You are the change agent in this instance, at least the one more empowered to accelerate the change at a critical moment - to hurl yourself into the void. To be that adventuress/r, you should know -

Therbligs. Pronounce it just as it is spelled. When you were trained in behavior management, ABA or whatever it was called - you most likely did not learn this term. The therblig is a unit of activity, a component of any work being done. Though it was popularized for industry by F.B. Gilbreth of CHEAPER BY THE DOZEN fame, it is a fun analogy for the skill of analyzing a functional task, like feeding, into components that you may help manipulate and change. Which therbligs in the action of feeding this person might be altered? That is your leap.

The volume of material swallowed? The timing involved for opening the mouth? Placement and tactile feedback with the spoon? Extra feedback (tactile, visual, auditory) to encourage lip closure and continue the swallow? Changing the food qualities to encourage appetite? Any and all these variables can be and are easily manipulated by you, the skilled professional behavior changer, so that your person can be successful in real life. Just as the real Frank Gilbreth - and his movie double - demonstrated how his children learned to shower efficiently, for the school principal, you can take that leap to make the quality of life for your persons served, scrubbed and shiny.