Sophia Guarracino

Together with Shining Star: Our Mission and Vision at Work

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Sophia Guarracino, Speech-Language Lead, LIH Olivia's Place Shanghai

Sophia Guarracino, Speech-Language Lead, LIH Olivia’s Place Shanghai

Since the summer of 2016, LIH Olivia’s Place has provided multi-disciplinary speech, occupational, physical, and even behavioral therapy, to children at Shining Star. Shining Star is a program for blind and partially sighted orphans who live in a residential home in Shanghai. It was established in June 2012 for these children to receive one to one care and instruction in basic life skills.

Therapists from each discipline visit Shining Star on a six week rotation, to assist staff, care managers, and volunteers, who work with the children each day, to provide specific therapy targets for each child. Through modeling, demonstration, and feedback, the staff is then able to carryover individual targets in each therapy discipline until the therapist’s next visit. There are also written notes for each child so the caretakers can remember what to work on.

The speech therapy team has been an integral to the program, using speech-language therapists to help these children improve their basic communication needs. On a few occasions, experienced speech-language pathologists from outside of LIH Olivia’s Place have accompanied the team to volunteer their time and expertise at Shining Star, while gaining a fulfilling volunteer experience in China.

One of the more notable aspects of LIH Olivia’s Place’s involvement with Shining Star, however, has been the training opportunities for Chinese-trained therapists. This successful training model has given junior staff members, such as Xieling Zhou, a chance to develop a high standard of clinical skills, specific to children with moderate to severe vision weaknesses and developmental delays, all while receiving supervision from internationally-trained therapists.

Typically, in a speech-language session at Shining Star, Xieling sees approximately 5 children in one day, each individually for about 30 minutes. She starts her sessions by having the staff model what they have been doing with each child in the previous weeks. She is able to gain an idea of what has been worked on and what has been helpful for each child, while also being able to provide more structured guidance in how the staff can improve each activity. Xieling also works with the children and staff in Chinese. Therefore, the children receive intervention in their native language and the staff receive specific and immediate feedback to help them carryover the treatment plan.

Since LIH Olivia’s Place began collaborating with Shining Star, many of the children have gone from being non-verbal, to speaking sounds and words. They are now imitating language more, are saying earlier developing sounds, and seem more motivated to use words and sounds to request their basic needs.

It is hoped and expected that the children will continue to make progress in the future, as the staff and children gain more opportunities to work on all areas of functional living skills. More and more local therapists will also be able to work with these children to gain more clinical experience. Shining Star and LIH Olivia’s Place have a relationship which is mutually beneficial; it is also a perfect example of the LIH Olivia’s Place vision and mission to change how therapy is done in China.


Clinician Profile: Sophia Guarracino, Speech-Language Pathologist

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Sophia Guarracino, Speech-Language Lead, LIH Olivia's Place Shanghai

Sophia Guarracino, Speech-Language Lead, LIH Olivia’s Place Shanghai

Sophia Guarracino is the Speech-Language Therapy Lead at LIH Olivia’s Place in Shanghai.

Sophia is a speech-language pathologist from the United States. She received her Masters degree at Bowling Green State University, Ohio (USA). Sophia previously worked in the public schools working with children with varying needs and disabilities from the preschool to high school age. She also provided Early Intervention in the home setting for children ages birth to three, with a focus on parent and caregiver training. Sophia has since spent the last 3 years specializing in the field of pediatrics while working in Shanghai. She has experience working with children with a variety of diagnoses including those with developmental delays, speech and/or language delays, autism, cerebral palsy, Down syndrome, and children with learning disabilities specific to reading and writing. Sophia has previously volunteered her time to some non-profit organizations and has completed teacher and staff trainings for local schools. She currently provided supervision and management expertise as the speech-therapist lead for the LIH Olivia’s Place Shanghai. Languages: English

 

 

How long have you been in China?

I moved to China in February 2012. My original plan was to work abroad and travel around Asia for a year, but I have now been living in Shanghai for over 3 years.

 

Why did you choose to work at LIH Olivia’s Place?

I chose to work for LIH Olivia’s Place because I really wanted experience working in another country while being completely immersed in the culture. I also enjoy the professional setting of working in a multi-disciplinary private clinical setting, which was a career aspiration of mine. I hope to contribute to the company’s ongoing mission to improve the standard of rehabilitation and therapy in China. At the same time, LIH Olivia’s Place provides opportunities for me to only further develop my clinical skills, while also providing me with teaching and management experiences.

 

Why did you choose your field?

I chose to study speech-language therapy because I enjoy learning and studying languages, I enjoy working with children, and I like how speech-language therapy combines educational methods and practice with a more medial and specialized framework.

 

What are some of the most rewarding experiences you have had in your chose profession?

No matter if I am having a good day or a bad day, working with children always brightens my day. Some of the more rewarding experiences are when I am walking in a hallway at a school and a student sees me and they become so excited to say hello to me. In addition, when a child makes even the smallest amount of progress on a skill you have been working on, it is quite rewarding.

 

What’s your favorite thing about living in China and working at LIH Olivia’s Place?

The fast pace and ever-changing social and physical landscape in China makes living here a daily adventure. The therapists at LIH Olivia’s Place embrace this attitude and it’s great to be part of a growing and dynamic team. No matter how complex the needs of a child might be, the close-knit team at LIH Olivia’s Place is always able to provide support and share their experience and expertise from different corners of the world.

 

What would you like to be doing in 5 years’ time?

The field of speech-language pathology is so broad and diverse so there is always something to be learned. Therefore, I hope to continue developing my clinical skills by delving into areas where I would benefit from more clinical experience. I also hope to broaden my leaderships and teaching skills.


Changning Special Needs Center Focuses Training on Speech & Language

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by Sophia Guarracino, Speech-Language Lead, LIH Olivia's Place Shanghai

by Sophia Guarracino, Speech-Language Lead, LIH Olivia’s Place Shanghai

IMAG7572 (2)LIH Olivia’s Place collaborated once more with Changning Special Needs Center in Shanghai to provide training for professionals working in local schools across China. These trainees ranged from teachers, to therapists, to teacher assistants, most of whom work work with preschool or school-age severely speech and language impaired children. Over two days in November 2015, I presented three training modules related to speech language pathology: Assessment and Intervention, Treatment Approaches for Autism, and Oral Placement Therapy.

Throughout the training, trainees were inquisitive and eager to discuss to topics of interest. They were especially passionate to discuss autism treatment methods. At the end of my lecture on the first day, I facilitated small group discussions of how they can implement the presented intervention strategies in the classroom setting. The trainees discussed incorporating a more structured reward system to facilitate compliance. They were also eager to alter the classroom set-up and implement more visual schedules for students with autism.IMAG7563 (2)

At the end of the second day, two teachers from a school in Hangzhou toured LIH Olivia’s Place Shanghai to gain a more hands-on understanding of our speech-language therapy materials. We discussed simple, yet effective small classroom changes to better meet the needs of students with severe speech-language, and even behavioral difficulties. I hope that all of the professionals will be able to use some of the speech-language strategies when working with their students and were inspired by the presentations.


China Hosts Renown Autism Event

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2015 1107 -1On November 6th- 8th, 2015 China hosted the first ever Regional International Meeting for Autism Research (IMFAR) Conference in Shanghai. Many well-known organizations and universities, such as Autism Speaks and Duke University, have been working with the Chinese government and universities with the goal of working collaboratively to improve the lives of people with autism spectrum disorder (ASD) and their families as well to support and advance ASD research. The conference was a huge success as it allowed many scientists, clinicians, educators and parents from around the world to meet and exchange knowledge with one another and encompass global perspectives about ASD. Five clinicians from LIH Olivia’s Place, one from each discipline, created an e-poster on using an inter-disciplinary team approach for screening, diagnosis and early intervention of ASDs. They discussed the assessment and interventions highlighted with many well- known researchers, clinicians, local educators, and parents. Fengyi Kuo, Occupational Therapist, also presented an e-poster on transition and therapy services for adolescents and young adults with ASD. An LIH Olivia’s Place high school intern, Tiffany Lu from Dulwich College Suzhou, also participated in many informative professional sessions that this conference had to offer. In addition, the clinicians and other participants attended lectures on a variety of topics, many of which highlighted the huge progress that is being made worldwide in developing effective interventions and assessment measures for children with ASD.

 

LIH Olivia's Place IMFAR Delegation (left to right); Lis Ringrose, Chief Therapy Officer; Laura Lofy, Psychology Lead Beijing; Jamie Fanelli, Behavior & Learning Support Lead; Sophia Gurracino, Speech-Language Lead Shanghai; Fengyi Kuo, Occupational Therapist

LIH Olivia’s Place IMFAR Delegation (left to right); Lis Ringrose, Chief Therapy Officer; Laura Lofy, Psychology Lead Beijing; Jamie Fanelli, Behavior & Learning Support Lead; Sophia Gurracino, Speech-Language Lead Shanghai; Fengyi Kuo, Occupational Therapist

For Jamie Fanelli, Behavior & Learning Support Lead at LIH Olivia’s Place, the conference was an incredibly rewarding experience; she reflected that it  “reinforced why I personally love my job so much— the opportunity to move forward in improving the standard of therapy in China and positively impact quality of life for so many individuals with ASD and special needs. It was a true pleasure to meet and develop relationships with several of the world’s leading researchers in ASD and even more so with local educators, physicians and parents. All of whom are extremely dedicated to improving the lives of children with ASD and their families here in China.”

 

One of the more memorable experiences for Sophia Guarracino, Speech-Language Therapy Lead at LIH Olivia’s Place Shanghai, was listening to a parent question-answer forum. During this time, parents were able to ask any questions to a panel of presenters. Most of the parents’ stories were heartfelt, sharing feelings of being overwhelmed, helpless, and not knowing where to turn for knowledge to better understand their child’s condition. For Sophia, hearing parents’ stories about their children being asked not return to school “made it so clear that there is such as a need of more education and support for both Chinese families and China’s educational system, to better help serve the needs of these children with autism. That is why it is inspiring that LIH Olivia’s Place can help support this need as it continues to develop and spread the expertise in this field.”


Strategies for Parents & Educators: Vocal Quality, Hearing Difficulty, and Ear Infections

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by Sophia Guarracino, Speech-Language Pathologist, Olivia's Place Shanghai

by Sophia Guarracino, Speech-Language Pathologist, Olivia’s Place Shanghai

One of the most important points to keep in mind when your child or a student in your class is receiving speech and language services is the importance of carrying over intervention in both the home and school settings. It is ideal for parents, therapists, and educators to work together and discuss the techniques that will be effective for each child. There are many strategies that can be incorporated into a child’s daily routine to boost their speech and language skills. In this post, we will focus on the topics of vocal quality and hearing difficulty and ear infections.

Vocal Quality These strategies are intended for students with consistently poor vocal quality. This means their vocal quality may be hoarse, breathy, rough, or they have no voice or their vocal quality gets progressively worse as the day wears on.

  • Allow the student to have a water bottle at their desk in order to take frequent sips. If necessary, use a visual aid for the student to track intake- a reward may be needed.
  • Discuss healthy ways for students to use their voices, i.e. drink water, no caffeine, no yelling or making strange noises, or to use a quiet voice, but NOT to whisper.
  • Provide a positive comment to a student for using good vocal hygiene such as not shouting to get attention.
  • Place a visual cue on students’ desk (like a picture of someone talking). When you hear vocal misuse, touch the picture on the desk to help remind the student to use good vocal techniques.

 

Hearing Difficulties and Ear Infections Ear infections, and/or fluid in the middle ear, are common childhood problems which can reduce a child’s ability to hear effectively within the classroom. Although these are often outgrown by age six, children with persistent problems may have them until approximately the middle school years. They often impact a child’s school performance, as seen by difficulties listening and attending to information presented, thus affecting their language learning and use. Language is the cornerstone of all learning. Understanding and use of appropriate language is necessary for all subjects, from gym to math and science. These strategies are useful for children suffering from ear infections and hearing loss.

  • Parents whose child has a history of ear infections are well versed in their knowledge of how to medically manage this problem. The teacher is often notified each year at the beginning of school but often there is no further discussion. There are, however, additional ways which you, as a parent, may become a participant in making sure your child’s needs are met in school when he/she may have fluid in the ear.
  • Tell the teacher of your child’s specific signs of an ear infection or fluid because every child is different. These may include some of the following: (Pulling on his ear, ear pain, discharge from the ear, congestion from a cold, decreased attentiveness, irritability, increased questioning-“What?”, inappropriate answers-misunderstanding what is asked or said, or other sudden changes in behavior that you have noted previously).
  • Let the teacher know if your child has frequent episodes of ear infections.
  • Inform the teacher as soon as you suspect a cold or fluid in the ears so she/he may accommodate your child.
  • Request that she/he inform you of noted signs of an infection/fluid.
  • Provide a list of ways that the teacher can increase your child’s understanding during these times.You may copy the following list and suggest that they be considered:
  • Be responsive to the child/ tune into their current language needs.
  • Face the child at all times when addressing the student and the class.
  • Gain the child’s attention prior to speaking/ remind to listen.
  • Use visual support, stand close to child, and reduce noise levels.
  • Provide more small group opportunities and/or use a buddy system.

 

Your ear nose and throat doctor is the best person to consult with for proper management of ear infections. Consultation with a speech-language pathologist may also be appropriate if you are concerned about your child’s language and speech development due to frequent ear infections or hearing difficulties.

Sophia Guarracino is a US licensed speech-language pathologist with ASHA certification (CCCS). She has four years of experience in school, clinical, and rehabilitative settings. Sophia has evaluated and treated children with articulation and phonological disorders, learning disabilities, attention deficit hyperactivity disorder, autism, and other health impairments. In addition, she has treated children with severe cognitive communicative and sensory disorders in an inclusive school setting. She has been a national-level ASHA presenter for several learning disability topics and has volunteered with organizations that serve children in the US, Latin America, and Germany. Sophia holds a BS in Communication Disorders and an MS in Speech-Language Pathology from Bowling Green University (Ohio, US). Language: English


Strategies for Parents & Educators: Stuttering

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by Sophia Guarracino, Speech-Language Pathologist, Olivia's Place Shanghai

by Sophia Guarracino, Speech-Language Pathologist, Olivia’s Place Shanghai

One of the most important points to keep in mind when your child or a student in your class is receiving speech and language services is the importance of carrying over intervention in both the home and school settings. It is ideal for parents, therapists, and educators to work together and discuss the techniques that will be effective for each child. There are many strategies that can be incorporated into a child’s daily routine to boost their speech and language skills. In this post, we will focus on stuttering.

  • Allow the student to complete his/her thoughts without interrupting or completing the sentence for them.
  • It is important not to ask the child to stop or start over their sentence. Asking the student to ‘take a breath’ or ‘relax’ can feel demeaning and is not helpful.
  • Maintain natural eye contact with the student. Try not to feel embarrassed or anxious as the student will pick up on your feelings and could become more anxious. Wait naturally until the child is finished.
  • Use a slow and relaxed rate with your own speech, but not so slow that you sound unnatural. Using pauses in your speech is an effective way to slow down your speech rate as well as the student’s.
  • Give the student your full attention when they are speaking so that they know you are listening to what they have to say. You can be most supportive when the child does not feel that they need to fight for your attention. With younger children it is also helpful to get down to their level, placing a hand on their chest as well as using eye contact assures them that they have your attention.
  • After a student completes a conversational turn, it would be helpful for you to rephrase what they said in a fluent manner. This can be helpful as the student realizes you understand what they said, but also provides a fluent model for them.
  • Try to call on the student in class when you feel that they will be successful with the answer (when the student raises his/her hand) versus putting the student on the spot when they have not volunteered information. In addition, new material or complex information may cause the student to feel more stress and thus, increase dysfluencies.

Speech and Language Strategies for Parents & Educators: Following Directions

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by Sophia Guarracino, Speech-Language Pathologist, Olivia's Place Shanghai

by Sophia Guarracino, Speech-Language Pathologist, Olivia’s Place Shanghai

One of the most important points to keep in mind when your child or a student in your class is receiving speech and language services is the importance of carrying over intervention in both the home and school settings. It is ideal for parents, therapists, and educators to work together and discuss the techniques that will be effective for each child. There are many strategies that can be incorporated into a child’s daily routine to boost their speech and language skills. In this post, we will focus on following directions and processing information.

Following Directions: These strategies are intended for students who have difficulty following directions.

  • When giving directions, repeat them using different words.
  • Using gestures when giving directions can be beneficial.
  • If there are several directions, give one to two directions at a time versus all at once.
  • Be specific when giving directions.
  • If possible, give a visual cue. For example, if you are making something with your child or students, you can demonstrate the steps as you go along. Showing the completed project will also provide them assistance.
  • When working with projects that have multi-step directions, it may be helpful to write the directions on the board.
  • Create a list of common directions that are used throughout the day. When needed, they can be laminated and placed on the board for the entire class, or  a smaller version can be placed on the child’s desk or a prominent space at home.
  • The student may benefit from sitting next to another child who would be willing to provide assistance with multi-step tasks.

 

Processing Information: These strategies can be used with children who have difficulty listening and processing information they hear.

  • Ask basic questions that have the answer in a picture or can be demonstrated through a hands-on activity.
  • Provide small group opportunities where the children can discuss newly learned concepts or ideas.
  • Provide adequate time for the child to process what you have asked and to form their answer. If the child does not respond after a given period of time, ask the question in a different way.
  • Use several modalities when teaching (speaking, reading, writing, listening, visual, hands-on).
  • Do frequent comprehension checks when teaching. Stop periodically and discuss the information you have presented.
  • Encourage the child to ask for help.
  • Provide additional support for writing down information, such as assignments in the student’s homework notebook. Actual pictures could also be taken of what needs to go home (e.g. math book, writing notebook). Some students may need written directions that explain how to complete assignments so that parents can assist them in the home.

 


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