As a speech-language pathologist (SLP), I work primarily with middle school students who have an IEP (individual education plan), and I support them in their journey to meet specific speech and language related goals. I have discovered several roadblocks along the way, however. A few realizations are that even by middle school, many of my students have a difficult time:
- Naming what an IEP is.
- Understanding their own IEP goals.
- Choosing goals that are important to them or determining how they might work on them.
- Advocating for themselves about their special education.
- Asking questions.
- Visualizing their future.
My job is ultimately to make sure that students on my caseload make progress toward their goals each year. Their goals, not my goals. If they don’t realize they have goals, or even an IEP for that matter, how can we accomplish them together? How can I help motivate and engage students to want to find out more about what they need to succeed? Ultimately, how do I support my students in this moment and for the future?
I realized I first have to figure out what students know, don’t know, and want to know about their own educational goals: I need to hear their questions.
Armed with this insight, I began to use the Question Formulation Technique (QFT) a few years ago to help students with a speech and language impairment learn to ask better questions, understand their disability, and self-advocate.
I have found this work particularly helpful and necessary with my neuroatypical caseload (including those on the autism spectrum, students with ADHD, and others) who benefit from increasing their self-awareness and understanding of their disability. I see how their social awareness can result in difficulties forming friendships, working in groups with peers, responding to teachers, understanding the perspective of others, and regulating their emotions.
Much of the social and pragmatic work with these students is done in small groups working specifically on goals such as perspective-taking, communication, and self-regulation. However, I have found that the self-advocacy and self-assessment piece has been best practiced in a structured, one-on-one (individual) setting. I tend to first work with students individually to increase their knowledge about their own IEP, often with a QFT exercise, and later move to participation in small groups to practice specific skills. This sequence ultimately encourages progress toward their IEP goals.
The following are three examples of my experimentation with QFocus designs that relate to students’ individual goals. Each QFocus resulted in insightful questions that moved students closer to self-understanding. A side benefit was that my students’ questions also ultimately helped me to answer some of my own questions that had been percolating about my role and how I could best support them.
If students don’t realize they have goals, or even an IEP for that matter, how can we accomplish them together?
I was uncertain if my students even know they have an IEP and what their goals are.
I began using the QFT to discover how much my students knew about their IEP.
Example 1 QFocus: I have IEP goals
Working with one sixth-grader, I had him ask questions around the QFocus, “I have IEP goals.” Here were his questions:
- What is IEP?
- Am I supposed to know what IEP is?
- Can you tell me about IEP?
- What are my IEP goals?
- Do I do it alone?
- Do the teachers help?
- Who else does this?
- Is anyone going to do this?
- Does anyone I know do this?
- Do my friends know?
- What if my friends know?
As you can tell from his question brainstorm, this sixth-grader came into middle school with not only little awareness of his IEP, but also concern about what his friends and teachers might think about him having one. Often by middle school students are keenly aware of being different, of having separate classes, and they know they are in special education. This is the age that a stigma begins to form. For this student, the QFT served as a jumping off point for raising awareness of his disability and giving us opportunities to address his self-esteem along the way. It was our chance to delve into the philosophy of having a growth mindset and the ability to take on challenges and strengthen goal areas (turn lemons into lemonade!) We spent time discussing how everyone learns differently. From my early experience as an SLP, and now as I mentor graduate students, I understand the eagerness to be data-driven, make progress, and jump into goal work as quickly as possible. However, I have come to learn that everyone reaps the benefits when time is spent building a stronger foundation involving student self-awareness, self-advocacy, engagement, and the therapist-student relationship.
How can I help motivate and engage students to want to find out more about what they need to succeed?
I also thought it would be helpful to understand how much each student knows about their disability and how they feel about it. It is important to note that I always check with parents to see if they have told their child their diagnosis before trying this QFocus.
Example 2 QFocus: I have autism
In response to the QFocus I presented of “I have autism,” a seventh-grader asked these questions:
- Does it impact your repeating?
- Does it impact screaming?
- Is it a disability?
- Does it impact aggressiveness?
- Does it impact bad behavior?
What emerged from this student’s questions was an insight that he realized he had, and he was embarrassed by, certain behaviors, and he wanted to know if this was typical. This resulted in several opportunities to discuss when the behaviors occurred, what he was able to control, and how it impacted his friends, family, and teachers. He helped establish his own treatment plan of developing coping strategies and role-playing alternative behaviors in response to different situations.
How do I support my students in this moment and for the future?
The same seventh-grade boy wanted to set a goal to make at least one friend in summer camp. He told me he had no friends in school back in Texas where he came from. (Mom reported a couple of friends in Texas, but true to ASD, self-perception is everything).
Example 3 QFocus: I can make friends
This QFT example came directly from a conversation the student and I had addressing the previous autism QFT. It demonstrates some of the increased awareness and self-advocacy that emerged from the prior QFT. It was meaningful to me to use language from a positive point of view for the QFocus prompt (I can make friends) as opposed to his more negative point of view (I have no friends or I can’t make friends).
The positive QFocus “I can make friends” resulted in these questions from the student:
- Who are you?
- Where are you from?
- What happened to your shirt?
- Why make friends?
- Can you hang out?
- When is a good time to make friends?
- What qualities do you look for in a friend?
- How can I make more friends?
- What do friends do together?
- How old are you?
Initially his question brainstorm seemed to focus on questions he could ask friends during small talk (i.e., Can you hang out?) Further along in the process he began to ask the questions we could build lessons on, and we chose questions 6, 7, 8, and 9 to investigate further. Because of those four questions we had several discussions about when to approach his friends in camp (lunch time) and who was a good match for him there (sense of humor and trust were his two most important friendship qualities). We used the technique of role-playing to practice small talk. He was then able to practice those interview-style questions in his summer camp with other neuroatypical peers. By week three of his five-week therapeutic day camp, this seventh-grader had made a friend connection. Both parents had facilitated a get-together for the boys to hang out.
Questions help bring clarity
I’m often reminded of an old Dick Van Dyke Show episode where Richie asked Rob and Laura where he came from. After 30 minutes of uncomfortably trying to explain the birds and the bees to him, Rob and Laura found out Richie only wanted to know what city he was born in. Funny enough, this reference brings me to my final points of reflection: My job is to help students better understand themselves and advocate for their needs. Attuning to and working with the questions students authentically have, rather than the questions I have or the questions I think they should have, just gets us so much further.
Sometimes, as I begin a QFT brainstorm with a student, I don’t always have a plan of where it will go or what we will do with the questions. I don’t assume that students know what they don’t know; it is often an organic development that grows from the questions each student brainstorms. Sometimes we don’t include every step of the process. No matter how we end up using a QFT though, we both learn something valuable from it!
I believe it is imperative to make sure each student understands their IEP and individual goals. Students need to understand their why as much as we adults working with them do. No one wants to do things without a reason. I also have to involve my students actively in goal setting. It can’t be just what a teacher has reported as an issue or what an evaluation has determined is a “deficit.” The goals are their goals and the students need to be motivated to meet them. Along the journey, I always give the students a choice — engagement and motivation will follow when students have agency.
About the author: Nancy Fell Cohen M.S. CCC/SLP is a speech and language pathologist with over 35 years of experience. Currently, Nancy is part of the special education team of Northwood Middle School, in North Shore School District 112, where she works with adolescents to navigate speech and language challenges in an academic setting. Nancy is also employed part-time at Comprehensive Speech and Language Pathology, LLC, running adolescent pragmatic social groups in collaboration with staff social workers.
Nancy received both her bachelor’s and master’s degrees at University of Wisconsin, Madison. She is a member of the American-Speech-Language-Hearing Association (ASHA), the Illinois-Speech-Language-Hearing Association (ISHA), and the North Suburban Speech and Language Association (NSSLA), where she has been involved in panel discussions, course presentations, and served on their board. Nancy has a middle school (MS) endorsement and graduate work toward the English as a second language (ESL) endorsement from National Louis University.