So you want to be a Pediatric Speech Language Pathologist? Making Sense of (and Choosing) the Best Settings and Terms for You – Part Two of Two

(This article was adapted for ASHA from the the “PediaStaff New Graduate Guide” [PDF])

In my last article I reviewed some of the basic terminology that you need to know before starting your job search as a pediatric or school based SLP. We talked about ‘terms’ (‘direct hire’ vs. ‘contract’ and ‘travel’) as well as definitions of the different pediatric settings such as school-based, outpatient clinic, hospital or early intervention. The ‘term’ part isn’t too hard to decide if you sit down and make a list of your priorities. However, it is much more slippery for someone like me to suggest exactly which setting is best for you, because there are a variety of factors specific to your particular search that should have a far greater impact on your choice over just the setting. So we will chat more about those factors and other practical considerations, rather than the ‘pros and cons’ of each.

TERMS: Direct, Contract or Travel?

The advantages of direct hire placement often include opportunities for professional advancement. The size of the organization that you are joining will also determine whether and how quickly you can move into a supervisory role. Benefits may be better in a direct hire environment, especially with larger organizations. Generally school districts have excellent benefits; and although the pay is much lower for district employees vs. contracting, therapists with large families may find that the better benefits package outweighs the lower annual salary. Large hospital systems, as you might guess have better benefits than small privately run clinics, which might not offer any.

Travel or contract placement can be preferable for a therapist in several situations. For one, pay is generally much higher when contracting. If you are traveling in a state or city away from your permanent place of residence you may be eligible for tax-free per-diem to cover the costs of your housing and meals while working away from your primary residence. This can be a fantastic way of socking away some extra cash for later because the money that you are spending on your daily living is not taxed like it is when you are working at home. Traveling/contracting is also ideal if you are looking to explore new areas of the country for a while.

Depending on your personality, what your leadership potential is and the type of chemistry you are looking for will influence what type of direct hire position you should consider. Are you looking for a large team where you can share your experiences with peers on a daily basis and rise in the ranks to eventually manage, or are you looking for a tight knit group where you may have a chance to work with a wider variety of clients, with a range of populations and diagnoses.

Settings and the ‘Rest of the Story’!

So you say, “Ok, I understand the different terms. What can you tell me about the pros and cons of all of the different settings?” Well, for this one, the ‘devil is in the details.’ It is impossible to generalize (so I won’t even try) the advantages and disadvantages of one setting over another because every employment situation is going to be unique based on size, location, demographics of the client base, the clinical population, caseload, and most importantly the people who work there. The clinician with no roots and flexibility to move anywhere has the unique privilege of choosing his or her preferred setting in a vacuum, but most of us have to work within certain geographic parameters. If I live in a big city, I can’t work in a small country school house.

For most of us, it’s going to come down to the people. Do your homework. How often does the staff turnover? Are there long term employees you can talk to who can tell you why you should work there? What is the reputation of the company or organization? 99 times out of 100, the places that are ranked the best companies and organizations to work for get those rankings because of the people working there and the culture created by those people.

To be sure, there are also other practical considerations that will “trump” even the quality of the people. A new graduate in her Clinical Fellowship probably isn’t best served if she is working alone in home-health setting, even if the clinic with the contract is a wonderful employer. Better to work with babies in a hospital with someone who can mentor you first if you must work with babies.

On the travel/contract side, there are also practicalities that might fly in the face of what you might really want to do. The best candidate for a school-based, travel or contract position with peds is the SLP with his or her C’s. But just because you are experienced doesn’t mean the short-term jobs will be easy to find everywhere you might want to go. Competition for local short term pediatric positions can be fierce. Most hospitals, for example, will reward a current clinician who is working with adults in another part of their organization a temporary transfer to the pediatric unit before hiring someone from the outside. Additionally, would-be travelers to major cities must compete with local PRN pools. Short term openings in medical and home-based settings do exist, but the trick is finding the employer that will offer money for living and travel expenses. This is where working with a good agency that knows the ins and outs of the school and pediatrics market comes in.

And then, of course, there are the realities of being a new grad. If you are a new grad and need to complete your CFY you may be a bit more limited if you want to try contract or travel therapy, but the opportunities do exist if you know where to look. As you might imagine, it is fairly costly to bring on a CFY. So you will need to find an employer who a) will need you for the entire nine months; b) has the means and staff to supply you with supervision, and c) needs you badly enough to pay for your supervision despite the fact that they will essentially be training you to leave after the year is up. At PediaStaff, we place a large number of CFY’s in schools all over the country. The key is just knowing who has the critical need.

In Summary – Be Open Minded and Write it Down!

All this said, if you have a setting that you are particularly excited about, certainly check out all your options – but don’t get too emotionally attached to that choice, in case reality doesn’t jibe with your ideals for your ‘dream job.’ Sit down with pen and paper and answer questions that can help you prioritize which things will be most important to you. You might even call on a friend, loved one, or professional mentor to be a sounding board to help you answer questions like these:

  • How important are specifics about cash money and/or benefits?
  • Do you want to see the country or be closer to family and friends?
  • How much drive time or are you willing to have or are you willing to move across town?
  • How important are opportunities for advancement?
  • What is your ideal caseload size, population age and diagnosis?
  • What about the SLP staff? What is the quality of the supervision available if you need it? How about their experience and specialties?
  • Is it better to wait for a particular experience that I want later in my career in favor of something that needs to take higher priority in my current situation?

Remember too, much will depend on what job offers actually arrive on your table and whether you have the good fortune to have options. When you sit down and start to make your list of priorities, you will quickly realize that your choice will probably have a lot more to do with the people who are currently (and will be) in your life as well as the kinds of kids you want to treat, more than it will be about exactly what type of setting it is.

Happy searching and remember to stay relaxed and enjoy the journey!

Heidi Kay is one of the founding partners of PediaStaff and is the editor-in-chief of the PediaStaff New Graduate Guide [PDF], and the PediaStaff Blog, which delivers the latest news, articles, research updates, therapy ideas, and resources from the world of pediatric and school-based therapy. PediaStaff is a nationwide, niche oriented company focused on the placement and staffing of pediatric therapists including speech-language pathologists.

Mobile Information and Communication Technologies (ICT) – New Tools for the SLP

iOS tablets in various sizes

Photo by Kevin Marks

The iPad, iPod, and the competitors of these products that will continue to emerge in the next months provide SLPs with unique and flexible additions to their “toolbox”. In particular, the applications for augmentative and alternative communication (AAC) have been widely embraced by SLPs as a low-cost alternative to expensive, purpose-built “dedicated” speech generating devices (SGD). Third party payers from schools to private insurers are jumping on the “least expensive alternative” bandwagon (although it is unlikely that Medicare or Medicaid will ever consider an iPad as “durable medical equipment”). These tools are generally affordable solutions to individuals with disabilities and their families (even if it takes a little saving up for…). The available “apps” range from automated flash cards to well-developed, evidence-based software conducive to the development or re-acquisition of language.

Here we have a classic good news – bad news situation! The good news – we have another tool that will be effective for some individuals as their primary AAC device, or as a scaffold to more complex systems, or for some, for use as a back up device or part of a multi-modal system that includes a dedicated SGD, signs/gestures, vocal approximations, etc. The bad news – practitioners may be pressured to abandon what they know about appropriate practices in matching technology to the individual’s needs in favor of the inexpensive (and perhaps, more readily obtainable) option. So – the bottom line is to remember all we know about appropriate practices in assessment, advocate for those practices, and remember that AAC includes both devices and, importantly, the services to SUPPORT the use the of device in order to obtain effective and efficient communication.

SLPs and others interested in this topic should also review the “White Paper” recently issued by the Rehabilitation Engineering Research Center on Communication Enhancement. The White Paper is based on interviews with more than 25 AAC “thought leaders” between January and March, 2011, representing multiple stakeholder groups. In addition, I encourage you to join SIG 12, to be part of ongoing discussions on these technologies on the SIG 12 listserv!

Amy S. Goldman is an associate director of the Institute on Disabilities at Temple University where she directs Pennsylvania’s Initiative on Assistive Technology. Amy has specialized in AAC throughout her long career as an SLP and is chair of the steering committee of ASHA’s Special Interest Group on AAC (Special Interest Group 12).

Early literacy support in the home language for emergent bilingual children and their families

Mural about literacy

Photo by Urban Aquarium Video and Light

We have limited research and understanding regarding the needs of preschool children from bilingual backgrounds. Our knowledge is even more limited when we consider preschool children with language impairment and communication disorders from Non-English-speaking homes. Most of the services available to these children are in English, and there is limited support for the home language. In fact, there is a prevailing notion among parents and educators that children with language impairments cannot learn two languages and should only be exposed to one language. This notion should come as no surprise, given that even among the parents of typically developing bilingual children, there is confusion regarding bilingual language acquisition. The Head Start Dual-Language Report (2008) revealed that Non-English-speaking parents of children in Head Start described thinking that learning the home language could interfere with their children’s ability to learn English. These parents also reported making an effort to only use English at home, even though their English proficiency was limited and communication with their children had suffered.

Reading this report reminded me of meeting a Portuguese-speaking mother of an 18-year old girl with language impairment. This meeting took place many years ago. At the time, I gave a parent workshop and reassured parents that it was fine to use their home language with their children. My message was to love and to nurture their children in the language that could best facilitate a constant flow of communication—the family language in most cases. When my talk was over, the Portuguese mother came over and through tears described how she had stopped talking to her daughter around the age of 5 years, when advised to not use their native language at home. This mother described how their communication had suffered and the distancing that took place over time between her daughter and the rest of the family. It is difficult for me to understand what it must feel like for parents to not be able to talk to their children for fear of hurting them. The idea that using language can hurt is certainly alien to me as a speech-language pathologist.

However, whenever I pose the question of whether children with language impairment should learn more than one language, the responses I get are invariably mixed. In a recent poll among speech-language pathology students, I found nearly 50% thinking that exposure to two languages was not a good idea for children with language impairments. When I ask preschool teachers, responses can be even more biased toward English. And parents are the most confused—they often say English, but then confess to not being able to speak English fluently. It is indeed sad. I should also mention the countless number of times I have heard teaching staff say “speak English” to a child who comes from a Non-English-speaking home. This is clearly not a welcoming message to a young developing mind.

As speech-language pathologists, we must reassure parents that communication in the home language is an important aspect of social-emotional and language development for their children. Promoting early literacy in the home language and supporting parents in their efforts are best practices when working with emergent bilingual children.

Elizabeth Ijalba, Ph.D., CCC-SLP is Assistant Professor in Linguistics and Communication Disorders at Queens College, CUNY. She formed the Bilingual/Biliteracy Lab and conducts research in early-literacy and home-language stimulation with Non-English-speaking parents of children with language impairment.

Getting in on the Conversation: Tips to Get Involved in Twitter

A man huddles in fear from a squawking flock of twitter birds.

Photo by petesimon

(This post originally appeared on Lexical Linguist)

In my first post about using social media for a professional learning network (PLN), I introduced various forms of online media (mostly social media) that can be used to help speech, language, and hearing professionals create their own professional/personal learning networks. I then introduced Twitter by explaining the terminology you’ll encounter and a bit about the way Twitter works. Mary Huston then guest blogged on her intro to Linked In and has more in store for you on that topic at a later date. Right now, however, I want to get back to Twitter, since it has been the richest source of professional learning and collaborating for me.

There are some things you can do in order to get into Twitter and start using it to its fullest potential. I have listed my top 10 tips to get the most out of your experience. Some of these tips speak to gaining followers, but I want to be clear that you should never get caught up in how many people follow you. Twitter should not be a competition for followers for several reasons, but the biggest is that WHO is in your network is much more valuable than HOW MANY are in your network. Having more people following you is helpful because it gives you access to more connections, information, and makes crowd sourcing (i.e. posing a question to your community in the attempt to get multiple responses) much easier. However, you get more bang for your buck connecting with people in your profession who will stimulate and challenge you. Besides, just because someone has many followers, doesn’t mean that those followers aren’t spam or random people who don’t contribute to the community.

Have a real picture (called an avatar)

This picture doesn’t have to be of you, per se, although it is very helpful. The picture should, however, convey some sense of you to your followers. Please, please, PLEASE never leave the Twitter default egg as your avatar. You come off looking like spam or worse (not that there’s much worse than spam). I also consider it poor Twitter etiquette because you require your followers to be more vigilant about whether or not you are spam when you contribute to discussions. If you want to get more followers, ditch the egg.

Say something in your profile and give us a real name

This is especially important if you are using Twitter professionally in any capacity. I would say that lack of information in the ‘profile’ section is the number one reason I won’t follow people. Mainly, it’s because I don’t know if you’re worth following if I don’t know what you do or who you are. A brief description (e.g. ‘grad student in audiology’ or ‘SLP working in schools’) helps people to know who you are and why they should bother following you. I also suggest you include at least a general location such as province/state and country. It’s also nice if you can include your real first name (last name is more optional) so that people have a ‘real’ name to attach to you beyond your twitter handle.

Create a short, user- friendly handle

When you create your Twitter name, or handle, you should consider that people will hopefully be using it a lot. The best possible handle is your real name (e.g. @LNLeigh) or your first or last name with your job title (e.g. @SLPTanya). Please avoid long names when possible because your name takes away characters when people include it in tweets. Also, avoid strange characters like underscore or symbols at all costs – it is less user-friendly to type. Your handle, picture, and profile can work together to give people a flavor for yourself on Twitter (called branding). Give this some thought when setting them up. If you already have a Twitter handle and would like to change it, this is easily done. As an aside: if you are a speech therapist/pathologist, please avoid the word ‘speech’ in your handle – this has been flooded in our ‘market’.

Start tweeting

If you want to get into the game and start connecting with people you MUST start tweeting. Even if you have no followers and feel you are ‘talking to yourself’ you should be tweeting. Tweet relevant material such as links you found interesting and professional ideas or experiences you may have had. Before I follow someone, I usually check their previous tweets to see if they are ‘worth following’. A ready-made community such as the SLPeeps does allow for some leeway but signing up on the SLPeeps and Audiologists Twitter List will not automatically get you plugged into the community. At the time of writing this blog post, the audiologists do not yet have a centralized hashtag (that I can find) such as #SLPeeps to help create a cohesive community so it may be more difficult to plug yourself into that network without relevant tweets.

Retweet (RT) people

The BEST way to get people to notice you and to begin participating in the community is to retweet someone else. I frequently become aware of a new person worth following because they RTed me. It doesn’t guarantee you’ll be followed, but it certainly helps show your willingness to join the community. As I’ve said in a previous post, retweeting is very important to Twitter and RTing someone demonstrates to them that you are genuinely interested in their ideas and information, so much so that you feel it’s worth sharing again via RT.

Jump in on conversations (politely)

Twitter is a public forum so treat it like a party or giant convention room and join in on conversations at leisure. It’s not considered ‘rude’ to jump into a conversation, so long as you’re on topic and contributing to the conversation. You may want to start your first tweet with “butting in” to acknowledge you’re joining the conversation if you rarely tweet with the other tweeters, more as an introduction that you’ve joined. It’s also OK to just throw a link or resource that’s on-topic into the conversation and walk away again, although it’s better if you converse a little or acknowledge any tweets in response to your contribution. It is rude to bud into a conversation thread to plug your company, blog or similar in a random way, especially if you aren’t contributing to the conversation.

Tweet more than blog or company promotional tweets

It’s just not helpful to the community and in a social network, while networking is important, so is the social aspect. This means there must be give and take or sharing involved. If you are using Twitter SOLELY as a professional outlet for your company and your handle, profile, and picture proclaim this as such, it’s potentially OK. This is because people know what to expect when they follow you. However, I still urge you to participate in related discussions and provide tweets that go beyond promoting your company. @CASLPA is a great example of a ‘company Twitter account’ who also engages the related community. CASLPA is a professional organization that uses social media to maximize potential to connect with their members (and even their non-members). It’s the ‘social’ or relationship part that makes them so great at what they are doing on twitter.

Use hashtags to get noticed by people who aren’t following you

If someone is following a specific hashtag (e.g. #SLPeeps, #hearing, #slpchat, #audiology) they will see all tweets that include that hashtag (unless the person tweeting has protected their tweets). The #SLPeeps hashtag is probably the primary reason that SLPs on Twitter have been able to come together, grow, and create a very cohesive community. I often find people worth following because they tweeted with the #SLPeeps tag. Also, using tags appropriate to your conversation makes it easier to crowd source for information before you’ve amassed very many followers. You can add #SLPeeps to your tweet, for instance, and anyone following the #SLPeeps tweets will see your tweet as well, even if they aren’t following you.

Be unprotected (at least at the start)

Again, I can’t emphasize how important it is to keep your tweets public in order to develop your PLN. Many people won’t bother trying to follow you if your tweets are protected because they cannot see examples of what you’re tweeting. Also, it’s a hassle to request to follow and then ‘wait and see’ to add you to a list they may have created to make following certain types of groups easier (more on lists another time). Protecting your tweets may have its place, but when growing a PLN it is a hindrance rather than a help.

Engage with your network

People who contribute meaningfully to the community get followed. It’s as simple as that. This means put out tweets, join in on conversations, pose questions to your community and respond to tweets that mention you or are directed at you. Even when you have many people following you it’s best to make every effort to respond to people if they direct information or a question at you specifically. You need to be contributing to your PLN in order to grow it and gain value from it.

Don’t just take my word for it. Here are some other sources if you want to see more:

Follow Fail: Top 10 reasons I won’t follow you in return on Twitter

20 Twitter Tips for New and Experienced Tweeters

Tanya Coyle, M.Sc., S-LP(C), is a speech-language pathologist employed in schools in Southern Ontario, Canada, and also teaches part time at a local college. Tanya is a life-long learner who actively networks with other SLPs via social networking, is co-founder and co-moderator of the #SLPChat discussion groups on Twitter, and is co-founder of the SLPeeps Resource Share and SLP Goal Bank in Google Docs (if you’d like to be granted access to these documents you can contact Tanya on Twitter @SLPTanya. Tanya is also the author of the Lexical Linguist blog.

Student Focus: Things To Consider When Choosing a Graduate School

Chairs in a classroom

Photo by alamosbasement

By this time next year, I will be one of thousands of graduate school applicants crossing my fingers and hoping to be accepted into the school of my choice. In the here and now, I need to focus on determining which graduate programs I will apply to. A little thought today could go a long way toward helping me make informed decisions in the future. As I narrow my graduate school prospects and begin the application process, I plan to take the following criteria into careful consideration:

Program Focus and Features

Some programs boast a broad education that prepares graduates to work in any setting, while others offer a medical or educational domain focus. One school might feature a clinic with an outstanding reputation in the community, while another might offer opportunities to participate in cutting-edge research. I need to be sure I understand the focus of each program in order to determine whether it would be a good fit for me.

Clinical Facilities

In our field, facilities are a huge concern since so much of our education revolves around clinical labs and service to our communities. I need to think about the populations served by the clinics connected to each program I consider, as well as the condition, quality, and modernity of clinic buildings and equipment.


If I am open to the possibility of relocating for a program, I need to consider moving and living costs as part of my decision. If were to relocate for a program under the assumption that I would come home when finished, I also need to consider the possibility that moving after grad school could mean turning down job opportunities and leaving newfound friends.


It would be nice if comparing the cost of various programs were as simple as comparing the price of tuition, but it is not. While some programs seem, at first glance, to be far more expensive than others, I need to consider opportunities for scholarships, grants, and assistantships. A program whose cost seems prohibitive to me now could turn out to be the most affordable program for me if I am lucky enough to be offered funding.

Surrounding Community

I need to be sure I’ll be happy spending at least three years living in the community my graduate school is a part of. Would I be comfortable moving to a city that is a different size than my own? Will I be able to find the comfort foods I am accustomed to in my new city? Will I fit in well with the general lifestyle?

I would like to encourage readers to comment and discuss additional criteria important in making graduate school choices. May we all find the perfect program and enjoy success in our future endeavors!

Jane Lapham is a student in the California State University, Dominguez Hills Post-Baccalaureate Communication Sciences and Disorders program. She holds a Bachelor of Arts Degree in Language and Linguistics from Cal State Dominguez Hills, and looks forward to entering graduate school in the Fall of 2012.

Should You Buy an iPad Now?

(This post originally appeared on SpeechTechie)

Probably, yes.

We have all been witness to the flurry of blog posts, tweets, Facebook updates, and news stories on the potential of the iPad for teaching and learning. Though I was initially a bit delayed in drinking this particular flavor of Kool-aid, I am definitely a convert to this device’s portability, versatility, interactivity, and the instantaneous student engagement that results whenever it is pulled out (see Heidi Hanks’ post for a second on this, and Barbara Fernandes’ for a third). My one reservation is in the “versatility” area- the iPad still has its limitations with regards to producing work, especially written work, and though it contains a web browser, it cannot access many of the wonderful educational interactives out there that are Flash-based (and therefore should not be thought of as a replacement for a laptop). However, all that said, the iPad and the cornucopia of apps available for it have proved an essential addition to my therapeutic toolkit since I bought it last Fall (and keep in mind that I say that as a part-time SLP currently- if I had a more diverse caseload I think I would be even more enthusiastic about the iPad).

Why now? I have had a number of inquiries in the past months about the iPad, and my response has been that waiting for the arrival of iPad 2 would be wise. iPad 2 was just announced this week for release on March 11, and as expected it is faster, thinner, and equipped with dual cameras for FaceTime, PhotoBooth, and video creation. The pricing structure remains the same, with the 16G WiFi model (my recommended starting option as long as you know your district will let you put the device on their network- ask!!!) at $499. Now is also a good time to consider whether you would be happy with a first-generation iPad at a greatly reduced price, as many fanboys (probably me too) will be selling theirs and Apple is offering refurbished models for pretty cheap.

So, I’d say go for it. Before the buzz around iPad 3 starts (probably in 2012) and kills our buzz.

Check out this snippit from the video used at the iPad 2 announcement on Tues, featuring Howard Shane’s (of the Children’s Hospital, Boston- Communication Enhancement Center) thoughts on it being a “game-changer” for kids with autism). It actually made me a little verklempt.

Sean J. Sweeney, MS, MEd, CCC-SLP is a speech-language pathologist and instructional technology specialist working in the public school and in private practice at The Ely Center in Newton, Massachusetts. He has presented on the topic of technology integration in speech and language at the ASHA convention and is the author of the blog SpeechTechie: Looking at Technology Through a Language Lens.

Not all Health Information on the Web is Created Equally

modern chair with attached computer monitor

Photo by Mads Boedker

In addition to being a speech-language pathologist, I am also working towards a Master’s degree in communication. My specific area of interest is health communication, which I came to rather naturally as my work at ASHA evolved. Part of what I do is develop content for brochures and other consumer materials, including what exists on the ASHA website. In the beginning, I approached this from my SLP background and clinical experience and described clinical disorders and other topics from that perspective. Over time, I started to realize that what I developed, while not wrong, was likely missing the mark in terms of what the reader wanted. I came to this realization after stumbling across information about health literacy, which led me to research on the readability of consumer materials developed by health professionals and organizations, including ASHA.

I also learned about how people use the Internet to search for health information and how the information they often find is difficult to understand or does not address their specific questions. I stepped back and took a more critical look at the information that existed in ASHA materials and on the website and found that there was room for improvement. And I’m happy to report that ASHA has spent a number of years now working on making those improvements, which hopefully some of you have noticed in products like consumer brochures and the Let’s Talk: Patient Education Handouts, as well as on the public side of ASHA’s website (for those of you who haven’t yet seen the recently updated information about hearing and hearing loss on ASHA’s public site, I invite you to take a look).

This semester I am taking a class on eHealth Communication, which focuses on the theory and practice of communicating health information via electronic means. We recently had a discussion about health related web pages and how they are “hit or miss” in terms of being understandable, valid, and meaningful. We talked about how the average web user may not always know whether a site is “good” or filled with misinformation. We had many questions, such as can people easily figure out if the content was developed by a credible source or guided by those with a financial interest in the decisions readers might make from what they read on the site? Are they able to make decisions based upon what they read (or see and hear if video and audio are included on the site)? Do they find information that means something to them or is it too generic or complex to have any real value?

Coincidentally, the day after this discussion, the leader of ASHA’s wellness team posted an article from the New York Times talking about this very issue. The article compared and contrasted two well-known health web sites – WebMD and the Mayo Clinic – and talked about the content, the design, and the motivations behind the two sites. The class discussion and the article got me thinking – how do I assess the sites I go to? I definitely look at the number and type of ads and I try to figure out who authored the information. I also look at how it is written and will only delve into really complex, technical content if I am highly motivated about the topic. Because of my background and personal interest in health communication, I may be more critical of the writing style, use of terminology, and layout than most, but I do consider that when deciding if I want to spend any time on a site.

So now I ask you – what factors do you consider when determining if you are going to spend time on a site? Do you suggest sites for your patients? How do you decide which ones are the most appropriate? Do you ever follow-up to see if they found the site or found it useful? The Internet is full of information and not all of it is good. Knowing that many people search the web for health information, it really seems that it is our professional responsibility to help guide our patients as best we can. And maybe we can learn something ourselves along the way.

Amy Hasselkus, M.A., CCC-SLP, is associate director of health care services in speech-language pathology at ASHA. She is also currently enrolled in a Masters degree program in communication at George Mason University, with an emphasis on health communication.

OSHA Policies on Noise Control and What You Can Do To Help

Sign - Hazardous Noise May Cause Hearing Loss

Photo by dabdiputs

Many of you know by now that the U.S. Department of Labor/Occupational Safety & Health Administration (OSHA) has recently made and then withdrawn an interesting policy change. Back in 1983, just after OSHA had issued the final version of the hearing conservation amendment, the Agency sent out a notice to its inspectors not to enforce the noise standard’s requirements for feasible engineering and administrative controls until workers’ time-weighted average exposure levels exceeded 100 dBA, and even then only if the other elements of the hearing conservation program, specifically hearing protectors, did not adequately protect them. This policy stayed in effect for 27 years although voices from ASHA, NHCA, labor unions, and other organizations protested. The result has been that the use of engineering noise control in this country has virtually disappeared, at least in the workplace. The situation in the general environment isn’t much better because EPA’s Office of Noise Abatement has been closed since 1982.

One of the arguments against the 1983 policy change is that OSHA implemented it without going through the public rule-making process, so its legality has been questioned. Another argument is that this policy is contrary to all other OSHA health and safety regulations, where engineering and administrative controls are the primary methods of hazard reduction. During this period, however, there were some major court cases, the outcome of which required OSHA inspectors to perform cost-benefit assessments if they issued citations for lack of noise control. So while the other industrialized nations have developed quieter products and processes, the American workplace remains noisy. In Europe and Australia noise control technology has greatly outpaced the U.S., as has the protection of workers against noise-induced hearing loss. Some American manufacturers market quiet products in Europe and noisy ones at home. The OSHA noise standard lags behind those of the rest of the world in other respects. Out of some 25 nations, there are only 2 that use the OSHA 90-dBA permissible exposure limit (India and the U.S.) and four that use the 5-dB exchange rate (Brazil, Colombia, Israel, and the US). Most others have adopted a limit of 85 dBA or below and the more protective 3-dBA exchange rate.

In more recent years additional litigation has taken place, going as far as the U.S. Supreme Court, which struck down the necessity of a cost-benefit analysis. Consequently, on October 19th of last year, OSHA published in the Federal Register the intention of changing its current policy by redefining the word “feasible” as it relates to the noise standard as “capable of being done.” The Agency did say that if a noise control remedy threatened an employer’s viability (the capacity to remain in business), it would not be considered feasible. OSHA encouraged the public to comment on the proposed change with a deadline of Dec. 20th 2010, which has since been extended to March 21st 2011.

ASHA, along with NHCA and Council for Accreditation in Occupational Hearing Conservation (CAOHC), signed a coalition letter to Dr. David Michaels, the OSHA Director, supporting the recent policy change and requesting that the Agency continue to make improvements to the existing regulation. We later followed up with detailed reasons for our support, including the facts that workers are continuing to lose their hearing despite alleged compliance with the hearing conservation amendment, they often fail to wear their protectors or use them improperly, hearing protectors can have an adverse effect on communication and the perception of warning signals, and engineering controls can actually be less expensive in many situations because they are one-time rather than annual expenses. Also, there are many options available to OSHA to ease any resulting burdens on employers by giving long compliance times, exempting small businesses, and providing technical assistance.

Within a few weeks of its publication, there was a firestorm of objection from major business associations, such as the U.S. Chamber of Commerce and the National Association of Manufacturers, claiming that the policy change was not needed and that it would have an adverse effect on jobs. These groups maintained that employees were sufficiently protected with hearing protectors and other elements of the hearing conservation program. They conveyed the impression to their members that OSHA would crack down on them immediately (an impossibility), that the policy applied to workers exposed to noise levels over 90 dBA, when in fact it’s TWAs (averages not levels, resulting in far fewer overexposed workers). They also maintained that this was something new rather than something that had been an integral part of the noise standard since 1971!

Also around this time President Obama issued an executive order directing the agencies to reexamine the need for regulations, and certain members of Congress took a negative interest in OSHA’s proposed policy change. As a result, OSHA withdrew its policy on January 19, 2011, stating that this process required “much more public outreach” and that they needed to examine other alternatives. They would, however, review all comments that arrived by March 21st and some time after that hold a stakeholders meeting.

ASHA members should consider submitting comments on these issues to OSHA. Mail three copies to the OSHA Docket Office, Docket no. OSHA 2010-0032, U.S. Dept. Labor, 200 Constitution Ave. NW, Washington DC 20210.

Further information:

Dr. Alice Suter has been active in the field of occupational hearing conservation for 40 years, during which time she worked at the U.S. EPA, OSHA, and NIOSH, and more recently as a consultant.  At OSHA she was a senior scientist and manager of the noise standard.  Although she is a strong proponent of hearing loss prevention programs, she believes that these programs must include measures to control noise at the source for them to be effective.

Communication in the 21st Century: Effective or Flawed?

The other day, I sent a text message to a friend and it read, “Ok I’m done just sitting around if I can help out let me know.” After I sent the message, I re-read it and realized that I had sent the wrong message. What I meant to say was, “I’m done. Just sitting around. If I can help out, let me know.” There is a world of a difference between the first message and the second message. The first sounds like I’m frustrated with sitting around and I want to do something about it. The second one sounds like I just finished what I was doing and now I’m sitting around. If I can help out, I’m available. This text message is not the first and won’t be the last text that sends the wrong idea. Everyday, more and more people are using text messages, instant messages, social networking sites and e-mail to communicate with one another. Everyday, fewer and fewer people choose to meet in person or even pick up the phone.

When we have a face-to-face conversation with someone, we have a number of factors that help us get the message across. We have our eye contact, body language, vocal inflection and most importantly, the ability to correct a miscommunication immediately. Over the phone, conversations still have the vocal inflection and ability to correct a miscommunication. With a text message, you simply have typed words, often with poor grammar, and the way your message will be interpreted is at the mercy of the one receiving the message. At least we have emoticons that allow us to set the tone of the message.

So if face-to-face communication at its best is still challenging, what hope is left for us who choose to communicate via text messages, instant messages, email and social networking sites? How can we be sure that we are communicating effectively? It is important that we take effective communication into consideration when we send a text or instant message. We can start by simply proof reading our text messages to ensure that we are sending the clearest message possible. But more importantly, at some point, it would be wise to check in either over the phone or face-to-face with the person we are texting, to make sure that there wasn’t a communication breakdown. Use of emoticons helps as well. 😉

Hand holding smart phone

Tina Babajanians, M.S. CCC – SLP, is a speech language pathologist working in Los Angeles, California. She works in variety of settings including elementary schools, full-time and hospitals, per-diem. Her passion is voice therapy and she is working on launching a private practice that specializes in the treatment of voice and resonance disorders. You can visit her website and find her on Twitter @lavoicetherapy.

In a Pickle?

a row of jars of pickles

Photo by mariko

Trying to find some good reads for struggling readers with comprehension needs? It can be especially tough finding something to interest the boys. I recently came across a good book I wanted to pass along. Frankie Pickle and the Closet of Doom by Eric Wight is an excellent book to lure reluctant boys into reading a few more pages. It is a graphic novel for elementary age kids available from Scholastic or Amazon.

Frankie’s reality is written in typical book style, but his great, imaginative adventures are presented in comic book style. Lots of great vocabulary in this one, like “…it was made by a lost civilization most scholars…” Civilization and scholar? Now that’s some great Tier 2 vocabulary my kids can use! True to many graphic novels there are also plenty of slang terms, parodies, and idioms, but my kids need exposure to these terms to function in social conversation.

So, what would I do with a book like this? Well, besides that great tier 2 vocabulary instruction, I am a big believer in building background knowledge to support comprehension. One look at the front cover and title and most people make a connection between Frankie and Indiana Jones, except a lot of my kids don’t understand that connection. Dim the lights and show them a clip of Indiana Jones so they can figure out the connection between Frankie and Indiana Jones. Discuss why the author would want to do this.

Superheroes have made a big comeback in the stores and on TV. This book pays tribute to two well known superheroes, Superman and Batman. Chapter Six of Frankie Pickle uses a version of “It’s a bird, it’s a plane…”. Batman is spoofed throughout the book, especially in Chapter Nine with references to the “Pickle-mobile” and the “Pickle Cave”. YouTube is an excellent source to pull bits of video from vintage Superman and Batman TV shows. Consider showing your students clips from Superman with people pointing at the air shouting, “It’s a bird, it’s a plane, it’s Superman!” Or even a clip of Batman saying, “To the Batcave, Robin!” It might sound like television viewing, but these pop culture icons are spoofed in so many books and shows, that the superhero background building you provide them now will provide them with a lifetime of support in “getting the joke”.

All of these great comprehension and vocabulary building ideas are available for the price of a scholastic book and YouTube access. Check out Frankie Pickle and the Closet of Doom by Eric Wight if you need some fresh material for elementary boys!

(this post originally appeared on Educational Inspirations)

Nicole Power is an SLP and literacy consultant at Bethany Public Schools in Bethany, Oklahoma.  She provides language/literacy therapy as well as intervention primarily to elementary students.  Nicole is the district coordinator for the Response to Intervention program and collaborates with teachers and other specialists to provide high quality instruction to struggling students.  She presents area workshops and created and directs the Oklahoma School SLP Conference.