Speech Language Pathology

Applications:

Andrea Stoker integrating ILP with reading.

 

iLs has a global effect on the brain and central nervous system, influencing the following systems: balance, visual, auditory, motor, coordination,  behavior and emotional regulation.  As a result, it is successfully implemented for a wide variety of conditions:

 

Training

See training page for more detail:

  • Interactive Language Certification Training (ILCT), a 4-hour distance course for speech therapists
  • Practitioner Certification Training (1-day PCT), on site at locations throughout the country
  • Distance Training which can be taken from home and is self paced (DPCT)
  • Advance Certification Training, a 4-day advanced course  (ATC)

“While all of the children showed some improvement in the other areas of auditory processing, 22 of the 29 tested at or above normal limits in ALL areas of auditory processing (auditory decoding, prosodics, integration, organization, and association) after the program…”
- Aimee Levin Weiner, AuD commenting on measuring results of Therapeeds Clinic, where iLs is combined with OT and speech services

Support

iLs Equipment in Use

Once trained, iLs Associates may access the  iLs Professional Resources pages of the web site for forms, documents and materials related to the marketing and application of iLs in their practice.  Additionally, webinars, newsletters, case studies and special training prices are available to support ongoing professional development.   Equipment and light clinical support are available at no cost via email and telephone. For more detailed case consultation, iLs’ Clinic Director and Advanced Certification trainer, Ron Minson, MD, is available by appointment.

The iLs Difference   iLs’ Interactive Language Program sets it apart from “listening therapy” providers.   Speech therapists incorporating the receptive and expressive components of iLs into their traditional therapy are practicing within scope of care guidelines and providing added sensory input/feedback that cannot be provided with traditional practices alone.

The iLs Satisfaction Guarantee  While no one can guarantee results with each individual student, we can guarantee each schools’ satisfaction with our service and our products.

Frequently Asked Questions on iLs and Speech Therapy (each question links to answers below)


Andrea Pointer, CCC-SLP on implementing iLs in her clinic, Kids Kount Therapy Services:

 

 

Why do SLPs incorporate iLs into their practice?

SLPs incorporate iLs into their practice because this therapy tool provides a means to enhance sensory input (i.e. address subcortical functions) while continuing to address targeted speech-language/voicing goals, increase attention and focus with directed tasks, enhance auditory and language processing skills, and address organizational components of speech and language.  Social skills improve through the use of the microphone (Interactive Language Program) and through the interactive components of the program.  The multi-tasking required with adding iLs as a therapeutic modality is more intensive within a shorter time frame and the progress is at a much faster rate. A key point to remember is iLs is not intended to serve as a stand-alone speech therapy modality; the iLs program should be used as a dynamic and integral component of the therapy.

What is ASHA’s position on iLs?

ASHA’s position on “listening programs,” or any program which includes an auditory component, is based on their position regarding a specific company by the name of Auditory Integration Therapy (AIT).  The current position of ASHA is to caution against therapies which are similar to AIT, and to request therapists engage in research on the efficacy of any auditory-based program before using it so that they are making an informed decision.  “If it appears that the program (in question, e.g. iLs) is so different that it is not a form of AIT, then it may be something that you can be trained to use.  If, however, your review indicates that it is similar to or a direct form of AIT, then it would be a violation of ASHA policy for you to engage in this treatment. “

The question for ASHA comes down to this: Is the therapy in question substantially similar to AIT?  The iLs answer is, “No, it is not.” The ways in which iLs differs from AIT include every aspect of the therapy, from content to structure to hardware:

  • Overall Therapy: iLs programs combine receptive language and expressive language activities,
  • Visual, Vestibular, Balance Activities:  iLs uses a multi-sensory approach to further body organizations support for the integration of language
  • Music selection and processing methods: iLs processes music using audio techniques such as filtration and gating; AIT uses a device called Digital Audio Aerobics
  • Sound delivery: iLs is delivered via air and bone conduction; AIT is air conduction only;
  • Hardware/equipment: iLs’ audio program is delivered via iPod; AIT’s is delivered via the DAA
  • Program structure: iLs programs are 40-60 hours in length; AIT programs are 10 hours
  • Complementary: iLs is used in conjunction with other therapies such as OT, PT and Speech; in fact, iLs’ receptive language phase is used simultaneously with speech therapy exercises, which may include other headphone/microphone exercises.  AIT recommends headphones never be used following completion of an AIT program.

Does iLs fit into the SLP’s ‘scope of care,’ as defined by ASHA?

iLs’ three main components of receptive language, expressive language and movement may be used independent of each other or they may be used together.  Speech therapists incorporating the receptive and expressive components into their traditional therapy are practicing within scope of care guidelines, provided speech therapy exercises occur simultaneously.

In order to maintain records and practices within a SLP’s scope of care, the critical documentation always focuses on progress made with regards to speech-language, cognitive-linguistic, voicing, literacy/phonological awareness, and auditory processing goals.  The focus of goals and progress towards goals should always include evidenced-based practice guidelines for each therapy session.

Based on the ASHA’s Position Statement (2005) regarding (C)APD and the Role of Audiologists, programs for treating and managing APD should

1-     Involve a combination of bottom-up and top-down approaches. 

2-     Service delivery should be intensive and extensive. 

3-     Therapeutic approaches should take advantage of cortical reorganization and principles of neuroplasticity.

iLs is based upon the principles of neuroplasticity (www.integratedlistening.com).  As such, it is important that iLs programs be implemented both intensively and extensively to achieve optimal results.

Utilizing the iLs Interactive Language Program (ILP), both bottom-up (auditory training) and top-down (i.e., cognitive, metacognitive, and language strategies) approaches are utilized.  For example, the dichotic and auditory figure ground tasks of the ILP incorporate a bottom-up approach.  Top-down approaches are addressed with auditory sound blending, rhyming and songs, tongue twisters, auditory associations, auditory memory and other exercises.

Additional points regarding iLs and the SLP’s scope of care:

  • iLs incorporates  focusing techniques utilizing the interactive role of the clinician. 
  • The clinician is able to supplement auditory presentations with visual reinforcements.  Tape recording of signals is not needed as the client gets immediate, direct feedback of his/her voice as well as the clinician’s voice via use of the microphone/headphone system. 
  • During certification courses, iLs trains the clinician to individualize programs based upon the client’s individual needs and utilize the iLs Interactive Language Program in a dynamic manner that serves as a therapeutic tool and not an isolated therapy.
  • Signal interpretation at a linguistic level becomes a language component rather than an auditory component (Richard, 2004).  The iLs Interactive Language Program instruction recommends the addition of treatment goals for teaching linguistic level deficits such as labeling, conceptual knowledge, expressive language organization and retrieval, word meanings/multiple word meanings, and semantic relationships.
  • The potential of auditory stimulation changing auditory behaviors is documented in literature (Kraus, McGee, Carrell, Kind, Tremblay, & Nicol, 1995; Musiek, 2004; Tremblay & Kraus, 2002; Tremblay, Kraus, Carrell, & McGee, 1997; Tremblay, Kraus, & McGee, 1998; Tremblay, Kraus, McGee, Ponton, & Otis, 2001).  Inter-hemispheric transfer exercises are also important components of an auditory stimulation program (Bellis, 2002, 2003; Musiek, Baran, & Schochat, 1999).  iLs as a therapeutic tool maximizes on both of these concepts.
  • As all strategies and activities should be practiced in a variety of contexts and settings for carryover of skills, iLs expanded this accessibility with development of a home unit (the Focus Unit) which allows for home practice under the guidance and direction of trained professionals.
  • The use of iLs Systems requires greater interaction with the client, incorporates more traditional therapeutic techniques, and offers flexibility in addressing a wider range of the client’s deficits/weaknesses. 
  • iLs as a supplemental therapy tool also addresses the elaborate communication needs between the visual, auditory and vestibular systems which must be coordinated efficiently and smoothly for optimal speech language functioning to occur.  iLs should always be utilized by SLPs while traditional therapy is being conducted.

How do I integrate iLs into my speech practice? 

  • Simultaneously with speech therapy: Speech therapists use traditional speech language therapy simultaneous to iLs’ receptive phase to address auditory processing, literacy, language, voice and cognitive-linguistic deficits. In this process, the client is wearing headphones, listening to iLs’ receptive language programs at a low volume while working with the therapist.  Sessions are the same length as the speech therapy session.
  • Expressive language exercises: Once a client has been re-introduced to language range frequencies through the receptive phase, each session can be split up to incorporate a receptive and expressive component.  The receptive component is described in the bullet above; the expressive component, iLs’ Integrative Language Program (ILP), involves the use of a microphone and headphones for the purpose of working on voice quality, auditory memory and auditory processing-related skills. The ILP worksheet is utilized as a screening to gather baseline data and to record improvement.  Weak areas are targeted in both pre- recorded activities (i.e. using pre-recorded language exercises from the ILP i-Pod) and a natural approach (i.e. using stimuli guided by interactions between the client and therapist).
  • Supplementary home program: Many speech therapists recommend an iLs home program for clients who are able to utilize activities from the iLs Playbook – balance, visual, proprioceptive, etc. – on their own, simultaneous to the clinic program.  Playbook activities help reduce stress, improve self-regulation, attention, sensory processing, etc., which makes any client more receptive to speech therapy.  Note:  the iLs Playbook is not a treatment modality; it is used by speech therapists to supplement brain/body integration during home programs.

How do I integrate iLs into my speech practice within a multi-disciplinary clinic?

  • After OT: Many SLPs working with OTs will begin using iLs after their OT colleague has completed the first phase of combining iLs with OT, which may vary from 10-30 sessions.  This lays the foundation (i.e. improved attention, regulation and sensory processing) for the speech therapist to use iLs’ Integrated Language Program (ILP). 
  •  Simultaneously with speech therapy: Speech therapists use traditional speech language therapy simultaneously with iLs’ receptive phase to address auditory processing, literacy, language, voice and cognitive-linguistic deficits.  In this process, the client is wearing headphones, listening to iLs’ receptive language programs at a low volume while working with the therapist.  Sessions are the same length as traditional speech therapy.
  • Expressive language exercises: Once a client has been reintroduced to frequencies of language through the music, each session can be split up to incorporate a receptive and expressive component.  The receptive component is described in the bullet above; the expressive component, iLs’ Integrative Language Program (ILP), involves the use of a microphone and headphones for the purpose of working on voice quality,      The ILP worksheet is utilized as a screening to gather baseline data and to record improvement.  Weak areas are targeted in both pre-recorded language exercises (i.e. using stimuli from the dedicated ILP i-Pod) and a natural approach (i.e. using stimuli guided by interactions between the client and therapist).
  • Supplementary home program: Many speech therapists recommend an iLs home program for clients who are able to utilize activities from the iLs Playbook – balance, visual, proprioceptive, etc. – on their own, simultaneously with the clinic program.  Playbook activities help reducing stress, improve self-regulation, attention, sensory processing, etc., which makes them easier to work with.  It is important, however, speech therapists do not attempt to utilize the iLs Playbook as a treatment modality in clinic because it addresses deficits outside the SLP’s scope of care.

How do I take notes in iLs sessions to ensure reimbursement through the SLP insurance code?

The focus of goals and progress towards goals should be noted in each session.  Speech therapists use speech therapy goals and techniques at all times in order to  comply with speech insurance codes for billing purposes.  This can be done by having music in the background and speech therapy exercises as primary/foreground activities, or incorporating the iLs ILP as part of the overall plan to target specific deficits.