3 Easy Steps to Carry Over Any Skill
Carryover and generalization are often the most difficult stages of therapy. It is easy for the child to produce a sound during drill and practice in therapy, but how do you get her to correctly produce it in spontaneous conversation? How do you get a child to use a social skill outside of a scripted practice conversation? How do you get an elderly patient to use compensatory memory skills out in the community? Here are three steps to take to target carryover skills:
STEP 1:
Establish the environment
A child spends almost all his time in two places: school and home. Therefore any skill you want the child to carryover should focus on these two environments. Is the child working on a social skill? Then you need to consider who that child will be socializing with. Parents? Siblings? Teachers? Peers? The child’s carryover practice should focus on who he will be interacting with and adjusted accordingly. If the child is working on greeting, then he needs to learn how to appropriately greet not only a peer, but an unfamiliar adult. This means the child should practice when it is appropriate to say “Hey, what’s up?” versus “Hi, how are you?” Alternatively, a dementia patient living in a skilled nursing facility does not need to work on navigating a grocery store. Carryover activities should focus on things applicable to the skilled nursing environment, such as remembering the way to the dining hall or recalling the name of the therapist.
STEP 2:
The More, the Merrier
Expand practice to include other people. Someone who stutters may feel comfortable using fluency strategies when speaking to her therapist, but becomes anxious ordering food in a restaurant. Once a client learns a skill, practice using it with different people in places outside the therapy room. A person with Parkinson’s may speak at an appropriate volume when conversing with the therapist because he is mindful that his voice is being assessed, but then drop back to a whisper when asking his wife where the newspaper is. Get family members, friends, teachers, and caretakers involved on the therapy goals.
STEP 3:
Self Monitor, Self-Assess
Encourage the client to self-monitor and self-assess. Instead of giving feedback on a skill, ask the client how he thinks he did. Ask him what he thinks he did well, and what he needs to correct. You, the therapist, will not be with him all the time to model skills, correct mistakes, or confirm mastery of a target. Once you have taught him the skills and strategies he needs, it is his job to remember and employ them.
Independence is always the ultimate goal!
