Congratulations ASHAsphere Blogger Kenneth Staub!

ASHAsphere is proud to announce that Kenneth Staub, M.S., CCC-SLP, was won one of The Stuttering Foundation’s 2011 Awards for Excellence in Journalism. His ASHAsphere post about The King’s Speech, won third place in the Internet Blog category. What a great achievement for Kenneth–an SLP–to be recognized alongside professional journalists from the likes of CNN! We’re proud to have him on ASHAsphere!

Bolivia Bound

Market in Bolivia

 

This month, for the sixth year in a row, 16 master’s students from Teachers College Columbia University and four ASHA-certified SLPs travel to La Paz, Bolivia to provide free services to children with disabilities. The non-native Spanish speakers arrive a week early (May 22) for intensive Spanish classes at Instituto Exclusivo in La Paz. The next weekend (May 28) the six native Spanish speaking students and four ASHA-certified SLPs arrive. Beginning on May 31 and for the next three weeks, the students provide assessment and intervention services and offer workshops for parents, teachers, PTs, and doctors. The SLP students and the supervisors participate in an academic seminar to integrate their experiences with readings on anthropology, religion, politics, and educational policy.

Please follow our trip blog for what we hope will be an extraordinary journey. We would especially like to hear your comments.

Catherine (Cate) Crowley, J.D., Ph.D., CCC-SLP, is a lecturer in the program of SLP at Teachers College Columbia University where she coordinates the bilingual/multicultural program focus and directs the Bilingual Extension Institute. Cate has led TC students to Bolivia each year for five years and to Ghana for the past three years. She is on the steering committee of ASHA’s SIG 17 Global Issues in Communication Disorders.

Technology’s Emerging Frontier in Speech-Language Pathology, Part 1

landscape with mountains

Photo by Panegyrics of Granovetter

For my culminating experience I have been working on a project about the history of technology in education and in speech-language pathology. The current trends of technology were also something I considered during this project. As part of the “final product” of my project I wanted to share the experiences I have had, some information I have gathered, and some of the resources I have compiled throughout the school year.

As we all have seen, and some of us experienced, there has been a noticeable increase in the amount of technology in today’s classrooms and throughout education. However, there has been a more noticeable increase in mainstream media attention around the hottest new pieces of technology. But for the first time mainstream technology is beginning to gain more popularity in the education setting, such as iPads and iPods. Technology has been consistently a part of education since it was introduced decades ago, but not until recently has there been such an exciting time to learn about and begin utilizing this new technology.

It is important for graduate student clinicians and practicing speech-language pathologists (SLPs) to be aware of what technology and resources are currently available for several reasons:

  1. Technology is rapidly changing and growing, which means staying up-to-date is important to keep engagement and motivation high for the students you are working with
  2. Exposing students to new and different technologies while working towards language and/or speech goals will help children adapt to a future involving continued use of technology. These students will grow up and face a world that will have entirely new professions and a new set of problems to solve just as the current generation is working to solve problems created from previous generations. The challenge now becomes to prepare students “. . . for a world that has yet be created, for jobs yet be invented, and for technologies yet undreamed” (Molebash, 1999 [PDF]). This is a similar idea to what a quarterback does. A quarterback does not throw the ball to where the receiver is located but instead anticipates where the receiver will be and throws the ball there. So too SLPs and other educators need to anticipate what the future has in store for current students and do our best to prepare them for what is to come.

School-based SLPs have a unique opportunity in that they have access to a growing number of children on their caseload. The use of technology can aid in the efficiency of treatment of speech/language disorders by keeping the attention and motivation of the students. It is especially important for SLPs to keep an eye on the ever-growing technology because the technology that is devoted to speech and language development is just beginning. Similar to other areas of rapid technology development, I expect that specific technology that is useful to school-based SLPs to rapidly grow. This is just the tip of the iceberg.

With such rapid acceleration of technology development there is a limitless number of directions that will develop in technology. However, knowing what the new technology will be or in which directions they can lead us is not only impossible but unimportant. “It is the recognition of what is possible that educators must consider” (Molebash, 1999). The future is an inevitable reality, of which we either adapt to or resist, but that we have the power to “envisage and take action to build alternative and desirable futures” (Facer & Sandford, 2010).

I recently had a practicum experience student teaching at an elementary school where my supervisor had a grant accepted for two iPads to use during treatment. I was fortunate enough to be there and help implement these new tools with the students. There were not many apps to start with, but from my perspective the students responded very well to using the iPad when coming to the speech room. What I found most interesting was that these young students had already experienced technology like this or similar to iPads such as an iPhone or Android and other smart phones. The familiarity they had around technology like this was impressive. One group working on language goals, particularly wh-questions at that time, were all standing around the iPad reading through the questions together and excitedly waited their turns. That experience provided a great learning opportunity for me and demonstrated the effectiveness that technology can have.

Even throughout this school year while working on this project I have noticed changes in how SLPs use technology. There are continuously more and more blogs reviewing different treatment apps and exchanging therapy ideas with one another. ASHAsphere in particular is a great resource for the profession and provides a great opportunity for graduate students as well as practicing professionals to contribute bits and pieces of our interests and expertise. I have compiled a short annotated list of resources I have come across that can serve as a good starting off point to incorporating technology into practice, which will be posted next week on ASHAsphere. You will find, as I did, that one website will lead to another, which will lead to another, and so on. The list I have compiled are some of my favorite that I have found to date, and will continually update throughout my career. While gathering information for my resource list I noticed the American Speech-Language-Hearing Association (ASHA) has a new technology page for school-based clinicians all about the pros and cons of new technology. Additionally, ASHA provides a few insurance funding resources. It is exciting to see the acknowledgement of and transition towards the inevitable future of a world filled with technology.

I believe the next step for ASHA is to develop some guidelines for technology use across settings and ages, specifically the current media technology that seems to be picking up momentum. ASHA sets guidelines for many aspects of the profession and current technology guidelines is the next step. These guidelines should describe ways to evaluate and determine the quality of speech and language apps that are continually being developed. The number of apps specific to our profession, as well as apps that can have specific uses toward achieving student objectives is constantly growing. With this growth there should be a systematic way of evaluating the use and effectiveness of the apps.

Technology is an exciting new tool for speech-language pathologists to use but we need to remember that language is social. “If an iPad helps a child share a smile with their parent, a shared moment of attention, attachment and engagement – that is a good thing. The tech device is just a therapy tool of gaining a child’s attention. It is only with joint attention that more opportunities for interaction can occur” (Bratti, 2010).

This has been a fascinating journey and I am excited to see what the future has in store.

Michael Tanner, BS, is a graduate student at Portland State University in Portland, Oregon. With the support of his wife and family he is preparing to graduate in June and begin his career as a school-based SLP in the Fall.

Summer Reading Part 2: Interacting with ASHA Journals on iPad

In last week’s post, I discussed how to access ASHA Journals on the web and how to stay connected to current publications by viewing abstracts in Google Reader.

The iPad is obviously a hugely popular device whose potential, I think, we are just beginning to glimpse.  So when the iPad is added to this mix, what do professional development and research look like? How can the iPad move us past printing and marking up journal articles (for me at least, I haven’t really processed something unless I have marked it up) and into digital learning and collaboration?

In the following video, I demonstrate on the iPad how to:

  • Use Safari to browse and read journals (pretty much the same steps as our last post, but more fingers-on)!*
  • Save journal articles to iBooks for later reading and organization into collections.*
  • Annotate journal articles in iAnnotate PDF using the highlighting, underlining, drawing, and text annotation tools.
  • Share your annotations with colleagues for collaboration and research.

*Note: these two steps work the same way for iPhone/iPod Touch!  iAnnotate PDF is iPad-only, but GoodReader is a similarly well-regarded (and a bit cheaper) app that has different versions for all iDevices.

View the video on YouTube

This has been a fun process for me, learning about Journals 2.0. I hope you enjoyed it as much as I have!

 

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.

Confessions of an SLP During Better Hearing and Speech Month

Better hearing and speech month logo

May is “Better Hearing and Speech” month. As a professional, it’s an exciting time for me to share my passion to increase awareness about communication sciences and disorders. I have loved every moment of seeing articles, hearing radio interviews and also listening to TV personalities talk about fluency disorders after watching The King’s Speech. Fabulous!

But, I confess that I have an ulterior motive. I am a speech-language pathologist. I am confident in my ability to diagnose and intervene with communication disorders. My first love in the field was working with aphasics in the hospital to help them remember that they have a voice. My professional path led me to working in the schools with children to help them find their voice. I love this field. I don’t think that I was too bad at it either. I loved clinical practice.

My first confession is that I don’t need to go anywhere to practice. Both of my children and my husband all have a communication disorder, of some sort. My husband is a person who stutters. He received services in the schools as a child. He isn’t often disfluent. Only when he is anxious or when very tired. My daughter has some pragmatic differences secondary to ADHD. She needs reminders not to isolate herself and to talk to others. My son has been receiving articulation and language intervention since he was two. At two, he had a few words, but his connected speech consisted of one almost word: “biggum”. He would excitedly tell me about his day with perfect prosody using “biggum” over and over again. I had no clue what he was saying. He is going into 7th grade next year. The only thing left on his IEP is very stubborn distorted vocalic r.

My next confession is that I couldn’t fix them. As much success I felt as a professional, I felt like a failure as a mother and as a wife. My days are filled with intervention tips and tricks. I have tried everything that I know how to do, yet they all still struggle with communication. It was very difficult as a young mother and wife. Now that I am slightly more seasoned, I have come to look at the strengths that come with it. I can very much relate to the parents that I speak to. I know what their nights are like when their children can’t follow one step direction. Although, universally, I will say that they really do understand “Clean your room” and “Do your homework” after the first 100 times you ask. That’s just choice. But, I know the tears and the frustrations. I know the exhaustion. I know the prayers that you have to just help your loved ones be able to express themselves.

For years, I thought that I failed them. I felt that they were worse despite of all of training and expertise. A very wise person reminded that maybe they are better because of my training and expertise. May be the patience and love that I can provide them helps them be more confident to try the techniques taught to them by other professionals, their SLPs.

So, as your colleague, I appreciate and value the work that we do together to advance ASHA’s vision of making effective communication, a human right, accessible and achievable for all. As a parent, from the bottom of my heart, I value the work that you do to help my family find their voice.

Andrea “Deedee” Moxley, CCC-SLP, is Associate Director for Multicultural Resources at ASHA. She worked at Montgomery County Public Schools prior to coming to the National Office. Deedee is responsible for responding to technical assistance questions, developing resources for working with diverse populations and co-managing the S.T.E.P. Mentoring Program. Her areas of interest include cultural competence, bilingualism and health literacy.

The End is the Beginning

Graduation caps tossed in the air

Photo by Shiladsen

The end is the beginning.

Today is commencement. Our latest crop of graduate students will parade across the stage, after many photos filled with laughter and a few tears, and after a grueling gauntlet lasting two years or more.  I remember, quite sharply, how it felt to graduate with my master’s degree in communication disorders; as a member of the faculty, I now get to relive those feelings every May.  Some people hate to go to graduation, but not me.  I enjoy the yearly ritual, the pomp and circumstance, the excitement of the graduates.  This year is also a personal transition for me.  I have defended and deposited my dissertation at last, and will be attending commencement in my doctoral tam and hood for the first time.

The class of 2011 holds a special place in my heart, because the majority of them started their graduate studies at the same time that I started my position at Mercy.  I was a doctoral student at the time, and I was hoping the juggling act of professor/student/person with a private life was possible.  There was so much to learn!  Some of it was mundane, such as where the clinical supervision forms were kept, and some of it was fraught with meaning.  How many tests to give?  How many lab assignments?  What was the best way to measure true learning?  I can almost always find the clinical supervision forms these days, but the deeper pedagogical issues are continuously under revision.  By entering the academy, I am truly learning every day.

We call it graduation and we call it commencement and, of course, both are true at once.  My students are suddenly my newest colleagues, as they march off to varied and interesting Clinical Fellowships.  They are headed to California, and Arkansas, and right up the street, to work in schools, hospitals, home care and rehab. They leave having completed small-group original research projects, something I did not get to do until I was a doctoral student.  The adventure is just beginning for them.  I’m a little jealous.

I look at next week’s calendar.  We have orientation for the new graduate students.  I will meet most of them for the first time that day.  Some will have eyes as wide as saucers, still pinching themselves that they have finally made it to graduate school.  Some will look frozen in terror.  Some will have a veneer of confidence, although it might not take much to shatter it.  All will be eager to start on this path, the long, winding path to graduation.

Welcome…and…farewell.

Shari Salzhauer Berkowitz, PhD, CCC-SLP is an assistant professor at Mercy College in Dobbs Ferry, NY.  She teaches courses in speech science, voice disorders, behavioral feeding disorders and research design.  Her research interests include cross-language and bilingual speech perception, multi-modal speech perception and integrating technology and instrumentation into the communication disorders curriculum.  She has been a practicing SLP and feeding interventionist since 1998.

Summer Reading, Part 1: Accessing ASHA Journals Electronically

I have to admit, ASHA’s announcement that members would no longer be receiving our journal subscription in the mail did not initially make me do flips of joy. I appreciated the opportunity to quickly peruse the contents and decide which topics I’d like to explore after picking my copy of Language, Speech and Hearing Services in Schools out of the mailbox,  I worried that I miss friend’s jokes about my nerdyness upon seeing scholarly journals in my magazine rack: “Oh, you read AJSLP too?”

For a time I did miss having paper journals (change is always hard), and at first felt a bit disconnected from these great resources. However, I have recently embraced minimalism, carefully considering each physical item I allow to cross the threshold of my home or office, and I prefer to have less stuff, including journals.  Additionally, I really respect ASHA’s environmentally-friendly and cost-saving decision to avoid shipping countless reams of paper quarterly to members who, let’s be honest, may or may not be reading them. We can’t always be, as Stephen King calls his fans, the “Constant Reader,” but ASHA digitizing our journals has had another positive side effect: choice. We now have access to all four ASHA journals anytime we like, instead of just one subscription.

We can therefore think of our journals as On-Demand: they are there when we are ready and willing to read them!  In this series of two posts, I’ll be showing how to access our ASHA journals online and (next time) through your iPad.  I will also be focusing on keeping journals, a critical professional development resource, a little closer to the front of our mind by viewing and sharing abstracts through Google Reader.  Google Reader is what is called an RSS (Really Simple Syndication) aggregator, a fancy term for a site that helps us keep online content of our own interest accessible in one place. Once you have a Google Reader account (your Gmail or Google Docs logins get you into Google Reader too), you can easily subscribe to feeds that show you the contents of any and all ASHA journals. See something you like? Just click through to the ASHA Journal site and log in to see the full text of that article.  If you are Google-phobic, and I know some are, you can consider using an alternative like Netvibes to organize your journal feeds and other blogs you like to read (such as ASHAsphere!)

Are you a visual learner? Check out this little video to see how it works!

View the video on YouTube

Prefer more straightforward steps? Check out this document:

Accessing ASHA Journals Electronically

Tune in next week for options for using iPad for professional development: viewing (and annotating!) ASHA journals…

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.

Do Twins Have a Secret Language? (A.k.a. The One Where I’m Debbie Downer)

(This post originally appeared on Child Talk)

You may have already seen this very cute video of two twin boys having a grand time “talking” to each other:

These two are clearly enjoying each other and it is very sweet to watch them do so.  And, in this case, the boys look to be very early communicators who are just having fun playing around with sounds. The video does spark an intriguing question though: Do twins really communicate to each other in their own secret twin language?

The idea of a “twin language” (or “cryptophasia” if you want to get really fancy) has been around for some time now.  It’s been reported that up to 50% of young twins will have their own twin language–one which they use to communicate only with each other and one that can not be understood by others outside their little duo.  The theory behind this “twin language” goes a little something like this: twins are so close to each other and rely on each other so much that they don’t have as much of a need to communicate with the outside world, so they make up their own idiosyncratic language that develops only between the two of them. It’s a fun and almost magical idea, for sure. But does it stand up to reality?

It turns out that many researchers think it does not. Some research studies seem to indicate that what appears to be “twin language” might actually be two children with the same delay in phonology. Phonology refers to rules that children use to put speech sounds together into words.  As I’ve explained in other posts, children tend to develop speech sounds in the same general order and they often make the same types of errors in their speech.  Children with phonological delays have speech sound systems that don’t develop as we’d expect, and this makes it hard to understand their speech.  Some researchers now believe that what is often described as “twin language” is actually two children whose speech sounds are not developing as we would expect.

Researchers further theorize that these speech sound errors (the “phonological delays”) are prolonged in twins because each twin has a partner who seems to understands him and uses the same type of speech as he does.  While this does make it kind of a “twin language” (because the two twins seem to understand each other when others can not), it’s also a delay in speech sound development that might need to be addressed by speech therapy. And in fact, studies have also linked the presence of a twin language to language delays later in the school age years.

This is not to say that parents of twins who have their own language should panic. There does seem to be a small percentage of twins who have both their own language and are able to communicate effectively with their parents in the “real” English language. These twins will switch back and forth between their own language and the English language, depending on who they are talking to.  This type of “twin language” is not linked to later language delays.  It’s also, however, less likely to occur.

It’s also important to note that researchers have not found that all twins who have their own language will go on to have language delays. Twin language seems to be a risk factor, not an absolute indicator the twins will struggle with speech and language. It’s enough of a risk factor, though, that an evaluation by a speech-language therapist might be beneficial in helping decide what’s really going on.

Bishop, D.V., & Bishop, S.J. (1998). “Twin language”: A risk factor for language impairment? Journal of Speech, Language, and Hearing Research, 41(1), 150-160.

 

Becca Jarzynski, M.S., CCC-SLP is a pediatric speech-language pathologist in Wisconsin. Her blog, Child Talk, can be found at www.talkingkids.org and on facebook at facebook.com/ChildTalk.

Recent Dysphagia Surveys

(This post originally appeared on Dysphagia Ramblings)

I have often wondered what others that work in the area of dysphagia do during therapy.  I always want to know what tools they use and what books they recommend, so I made a survey.  Actually I made two.

First, I sent out 75 surveys, in the surrounding areas in Indiana (mostly central).  I received 13 of the surveys.  Ok, 12 because technically I did one as well.  Most of the surveys came back to me partially completed.  I have the results posted on Scribd.

As a whole, we had an average of 10 years of practice, with the shortest time being 2 years and the longest being 30 years or more.  Most therapists work in a SNF (Skilled Nursing Facility).  One concerning factor for me was the lack of use of a standardized bedside assessment.  In our realm of changing and more evidence-based therapy/healthcare, can we really continue to afford to use only our judgement with no real data to back up our findings??

Another concerning finding to me is that the most widely used therapy technique is diet alteration at 85%, which tied with oral exercises.  Perhaps, a new survey should be devised to determine what people consider oral exercises.  I realize that in SNF’s there will always be those patients that require a diet change and are not appropriate rehabilitation candidates, however SNF’s are also becoming widely known for rehabilitation.

Techniques that actually engage the swallowing function and tax the system to bring about an actual change, such as the Mendelsohn, the effortful swallow, etc, were only reported to be used 46-38% of the time.  I guess this would also explain why the average percentage of return to a normal diet was only 50% with most likely, spontaneous return accounting for some of the return.

Expiratory Muscle Strength Training (EMST) is an emerging therapy incorporating respiration strengthening with swallowing exercises.  Items such as The Breather were only incorporated into therapy by 1 therapist.  Of course, keep in mind, this was a very limited survey response, it still, I believe, paints a big picture of how our therapy looks.

With the limited number of surveys that were returned to me per mail, I decided to also create a survey by Survey Monkey.  This survey had a response from 44 therapists.  Again, the majority of the therapists from this survey work in a SNF.  The most widely used therapy “tool” is tongue depressors.  I’m guessing because it’s the most accessible tool we can get.  The Breather/Spirometer for EMST was still fairly low on the list with 14-17% usage and the Iowa Oral Performance Instrument (IOPI) was at 9.5%.

Again, the most popular therapy technique is diet alteration at 95%.  Some of the rehabilitative strategies we use such as the effortful swallow, Mendelsohn, etc.were used by 50% or more of the respondents.

I think that one important thing we can learn here is that diet changes, head turns, chin tucks, double swallows are not “rehabilitative”.  They create a safe swallow for the present time while we rehabilitate the swallow for a diet upgrade.  While we may have our patients on an altered diet or have them employ compensatory strategies, we also need to work the patient, use that effortful swallow, the Mendelsohn.  Work the swallow system and make it work like it should.  That is rehabiltiation.  When we bring about a change, we rehabilitate.

Most of us do recommend The Source for Dysphagia by Nancy Swigert as our favorite book.

I think the main thing we need to ask ourselves when treating our patients with dysphagia is, “Am I doing everything I can to rehabilitate my patient?”  Then ask yourself do you feel comfortable in saying yes you are.  Treat your patients as you expect to be treated.

Tiffani Wallace, MA, CCC-SLP, currently works in an acute care hospital in Indiana.  Tiffani is working to specialize in dysphagia and is working to achieve the BRS-S.  You can find Tiffani’s blog at http://apujo5.blogspot.com.

Better Hearing and Speech Month Ideas

Better hearing and speech month logo

As you undoubtedly already know, May is Better Hearing and Speech Month (BHSM), a month dedicated to raising awareness about communication disorders and to promoting treatment that can improve the quality of life for those who experience problems with speaking, understanding, or hearing. Of course ASHA offers many resources for BHSM, but the prevalence of social media sharing means that you can also tap into lots of other resources and learn about how others are spreading the word about BHSM.

Wondering how to access  this wealth of information? One way is to follow the #BHSM hashtag on Twitter. Not sure what a hashtag is, or don’t want to bother using Twitter? No worries–just bookmark this link and check it throughout the month to follow the conversations about BHSM on Twitter.

Here are a few blog posts and other resources pulled from the #BHSM Twitter stream this past week:

If you have other blog posts or resources to share, please leave a comment. Every Friday during May ASHAsphere will do a roundup highlighting some of the previous week’s shared BHSM resources.