Is that iPad Hazardous to Your Health?


Photo by dospaz

The iPad revolution has engulfed the communication disorders field. We love our iPads and other handheld devices. Just ‘flipping’ through the cornucopia of apps related to speech, language and hearing in the App Store, it is no wonder these devices and the apps they hold are becoming therapy toolbox essentials.

As our younger clients have become more engaged in activities that utilize technology, therapy programs that are supported by apps have become increasingly popular. Young people often use other, similar technology after school to play computer games, do homework or interact on social networking sites.

Whether it’s watching TV, doing homework or playing games on a computer, or using a mobile device to play games or send or receive text messages, there is a common denominator among activities many people regularly engage in: screens.  Some are large and some are the size of the palm of your hand. We spend hours viewing screens on computers, iPads and other tablets, TVs, iPhones and other handheld devices. And sometimes we view these screens in less than optimal conditions.

As an audiologist and ASHA National Office staff member, I often receive consumer questions regarding dizziness and balance problems. These complaints commonly arise from problems within the inner ear. I typically send consumer information on dizziness and balance and recommend a visit to the audiologist for hearing and balance assessment as a good first step in understanding the causes of these symptoms and to begin a plan for rehabilitation treatment for inner ear balance issues.

But I digress….back to screens. The Internet houses many discussion forums on dizziness, headaches and vision problems while viewing screens. Enough people are complaining that a term for the syndrome has been coined; the American Optometric Association refers to this group of symptoms as “Computer Vision Syndrome.” These symptoms are not related to inner ear problems or more serious neurological problems but rather to eyestrain and can include:

  • headaches
  • dizziness
  • nausea
  • confusion and fuzzy thinking

Apple does have some warnings within the iPad manual about complaints of headaches, dizziness, and eyestrain. These warnings are not highlighted, though–you have to do a thorough search to find them. There is also a discussion about these symptoms on the Apple support community.

There appears to be little scientific evidence about screen/vision safety but I have seen some recurring suggestions on the discussion forums and from ophthalmologists:

  • use task lighting and turn off the overhead fluorescent lights
  • take frequent breaks…look away from the screen and focus on something about 20 feet away for about 20 seconds
  • use special lens/glasses for computer use
  • adjust the lighting of the screen, some folks lower the backlit screens and get improvement
  • increase font size
  • adjust the ambient room lighting
  • position computer screens slightly lower than eye level (about 4 inches)
  • remember to blink. This will reduce dry eyes.

Have you or any of your clients noticed any of these symptoms when using iPads or other mobile devices?

Pamela Mason, M.Ed., CCC-A is the director of audiology professional practices at the ASHA national office. Before working at ASHA, she directed the Audiology Center at the George Washington University Hospital in Washington DC.

Hearing Health and Development Following Adoption

LOUD speaker

Photo by woodleywonderworks

All my life I have been blessed with excellent hearing perception and health. Now due to my mold allergies, I have started to have fluid in my middle ear when the humidity and mold count rises above normal. The extra fluid in my ears has annoyingly affected my hearing acuity and balance. On one hand, I now understand how children feel when they have otitis media but on the other hand, I want to get rid of this ailment as quickly as I can! Naturally I sought the advice of an audiologist who completed impedance testing. As it turns out, my tympanograms showed only a small loss of flexibility in the tympanic membrane and fell in the low normal range. Typically most medical professionals would not treat a patient who exhibited these symptoms preferring to wait until the patient demonstrated consistent flat tympanograms or infection. Although I exhibit neither of these conditions, the small amount of fluid in my ear has significantly reduced my hearing acuity especially in noisy environments like the classroom. I wonder how can children focus and learn when they have fluid in the middle ear?

Children who reside in orphanages around the world may receive less than adequate medical care. Otitis media is often untreated and children’s hearing is not tested or monitored (Bledsoe & Johnston, 2004; Johnson, 2000). Due to the lack of attention to hearing health, it is not unusual for children to become accustomed to the symptoms of ear pain, imbalance, and poor hearing acuity. When parents adopt these children, they may expect the children to demonstrate behaviors of discomfort when ill. However, because of the lack of attention to hearing health, the children do not show symptoms of pain or lack of balance and the parents may not recognize when to seek medical care. At the International Adoption Clinic at Saint Louis University, I have seen children with undiagnosed hearing loss and ear infections, some of whom had previously seen a pediatrician the day before.

Additionally, children residing in orphanages are cared for by a rotation of adults where the child to adult ratio may be high. Johnson reported on conditions of care in Romanian orphanages where children were often left in their cribs/beds, received little if any social interaction from caregivers, and had few experiences with toys or educational stimulation. As a result, children’s hearing experiences were unmentored and they may not have learned which sounds were meaningful to attend to or what certain sounds meant.

Sometimes years after they were adopted, some children who passed a hearing screening and audiological evaluation did not alert to environmental sounds (whistles, knocks on the door, telephones, or their name being called). I have also seen children who have difficulty attending to and discriminating speech from noise as well as children with an undetected/undiagnosed hearing loss. Without careful assessment by professionals with expertise with internationally adopted children, these children may slip through the cracks and not receive appropriate services.

It is important to conduct a thorough evidence-based assessment when an internationally adopted child is referred or presents with hearing, speech, language, or attention problems. Hearing screenings including otoscopic evaluation, impedance audiometry and sound field or pure tone audiometry should be included unless the child has recently been evaluated by an audiologist. An in-depth case history of hearing, attention, speech and language behaviors and development should be collected. If the child passes all audiological measures, the speech-language pathologist should also assess the child’s knowledge of meaningful sounds as well as hearing discrimination and perception in quiet and noise and in some cases, additional audiological assessment for auditory processing disorder may be warranted.


Bledsoe, J. M., & Johnston, B. D. (2004). Preparing families for international adoption.
Pediatrics in Review, 25(7), 241-249. Retrieved from:

Johnson, D.E. (2000). Medical and developmental sequelae of early childhood
institutionalization in Eastern European adoptees. In C.A. Nelson (Ed.), The
Minnesota symposia on child psychology: The effects of early adversity on
neurobehavioral development (Vol. 31, pp.113-162). Minnesota Symposium on
Child Psychology.

Deborah Hwa-Froelich, Ph.D., CCC-SLP, is a Saint Louis University professor and Director of the International Adoption Clinic with interests in social effects on communication such as culture, poverty, parent-child interaction, maternal/child health, and disrupted development.

The SLP New Graduate’s Timeline for Success

Road to Uluru

Photo by Jo@net

(This blog article has been adapted for ASHASphere from the “PediaStaff New Graduate Guide.”  Click here to download the entire guidebook.)

We’re sure you’ve heard the old adage that “Timing is Everything!”  This has never been truer than as you take the next step toward becoming a Speech Language Pathologist. This blog article will help you navigate what we like to call the “road map to success.”

At the Beginning of Your Degree Program:

  • Create a favorites folder in your computer browser where you can start to catalogue the various websites of job search and clinical resources that you will come across.
  • Start ‘networking socially’ specifically for your profession. For example, join Twitter and follow the “#SLPeeps” hashtag, join the ASHA LinkedIn group, and if you are going to work with kiddos, the Pediatric and School Based Therapy group on LinkedIn.
  • Subscribe to all professional newsletters and blogs you can find relevant to your course of study. Many of the not-for-profit organizations that specialize in specific communications disorders have robust newsletters that contain information-packed articles and current news items. SLPs are prolific bloggers! Sean Sweeney of the Speech Techie blog has put together a great Blog Bundle of 17 bloggers that blog about speech-language pathology topics.
  • Begin preparing your professional resume. List all pertinent class work, projects, awards, publications, and workshops you’ve attended. Also include para-professional employment and volunteer work if applicable. Use bullet format please. This is a work in progress!
  • Since I am not fond of “Don’ts,” here are a few “Do’s” for you to consider when beginning your search:
    • Do post your resume…but limit where and how many…YOU take control of your job search.
    • Do choose your recruiter carefully…the right one is your “best friend and ally” in your search.
    • Do stay focused on what’s important now….your clinical experience and preparing for your professional exam.

In the Final Year of Your Degree Program (6 months from graduation):

  • Continue working on items in the section above.
  • Begin the process of identifying your location preferences and communicate them with the recruiters you’ve identified and others who you have asked to help you with your search.
  • Set up a separate email account (Yahoo, Gmail, etc.) for ONLY job search related issues. Keep it professional! (For example:, or
  • Update your resume. Include all clinical work…quantify whenever possible (worked with 8 students at John Jay Elementary School…list diagnoses and treatment used.)

Three Months from Graduation – During your Clinical Fieldwork

  • Same as above. Begin to narrow down your employment preferences.
  • Definitely start connecting with a recruiter that you trust in your area to discuss job prospects, specifically one that will customize a search for you.  Establish and convey your availability for phone and face-to-face interviews to that person or persons.

Two Months from Graduation

  • Schedule your PRAXIS exam if you have not already done so.
  • Make sure you update your resume to include clinical affiliations and resend to everyone that you previously sent a copy.
  • Develop a reference list – Ask your references for permission so they know you’re listing them, and ask each for a written reference, these are sometimes helpful.
  • Build a schedule of available times for phone interviews and visits with prospective employers.

One Month from Graduation (Oh my Goodness, it’s Getting Close!)

  • Continue to conduct interviews as needed.
  • Begin licensure research, review requirements for the state(s) you are interested in.
  • Develop plans for relocation (if necessary).
  • Finalize your resume with graduation, professional exam results, and any articles published or continuing education taken.
  • You should be in weekly contact with the recruiter(s) that you are working with.
  • Be sure to have your relocation plans in place to include cost of relocation.

We highly encourage you to plan for some down time for yourself! It is important for you to begin your new career rested, refreshed, and ready to tackle the challenge ahead!

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.

Encouraging Speech and Language Skills while Sharing Books with a Group of Children

Sailor reads to Filipino children

Photo by Official U.S. Navy Imagery

(This post is part two of last week’s post by Stephanie Sigal, How to Read Books with Children with Language Delay)

Parents often read to their two year old and four year old simultaneously.  Early childhood teachers read to their students every school day.  When reading to a group of children, it is vital that you are familiar with the text.  You may wish to take a moment to think about open-ended questions you can ask children before you begin a story.  For example, if you were to be reading Bear Snores On by Karma Wilson, you could ask “Does anyone know what bears do all winter long?”  If you get a response such as “sleep” or “hibernate,” great!  If you do not get a response, inform the children.  Giving them a glimpse into the story will enhance their understanding and appreciation.

Ask questions during the story.  Perhaps there is a vocabulary word the children might not be familiar with.  In the book Don’t Let the Pigeon Stay up Late by Mo Willems, the pigeon insists the children listening to the book let him stay up so he can watch an educational program on television.  You can ask, “What does educational mean?”  You can also explain to the children how the pigeon is trying to “trick” (manipulate) them into letting him stay up late.  Then, ask the children “How have you tried to trick your parents?”

At the conclusion of a story, ask children to carry over a main theme from a book into their daily lives.  For example, after reading My Friend Rabbit by Eric Rohmann, ask the children “What does it mean to be a good friend?”

Adding props and puppets to group story time can engage kids with various levels of attention.  In Caps For Sale by Esphyr Slobodkina, the peddler walks around carrying many caps on his head.  The children can do the same with caps that you have previously collected for story time, or they can use their winter hats, or caps that they make as an art project to accompany the theme of the book.

Using different voices and revealing the characters’ emotions while acting out the story can also help children attend and relate more effectively.  The mother dog in Bark, George by Jules Feiffer gets frustrated with her son, while he makes great animal sounds.  The children will laugh when you over-act the role of George, his mother and especially the veterinarian reaching deep down into George’s mouth to pull out all the animals he has consumed.

Children are inspired to verbally participate when their peers say the repetitive line in a story together.  In Tikki Tikki Tembo retold by Arlene Mosel, the older brother’s name is Tikki tikki tembo-no sa rembo-chari bari ruchi-pip peri pembo.  Opportunities to say this long name come up numerous times, sometimes fast, sometimes slow, and children listening will want to try to say the name along with you.

Always read the title, author and illustrator’s names.  Ask the children “What is an author?” “What is an illustrator?”  Provide the information accordingly.  If the author has written other books the children may be familiar with, ask them “What other books has this author written?”  If necessary, name one or two of the books and you may notice how excited the children become when they realize they have shared a previous experience with you.

If you need help choosing the right books based on your child’s needs, you can ask your speech therapist, child’s teacher or librarian.


Stephanie Sigal, M.A. CCC-SLP, is a speech language therapist practicing on the Upper East Side of Manhattan, NYC. She works with babies, toddlers and school age children with expressive language delay and articulation disorders. Stephanie provides home based speech therapy and encourages parents to facilitate their children’s speech and language skills. To learn more about Stephanie, please visit

How Speech Therapy and Battlestar Galactica Create a Momentous Week

Battlestar Galactica

Photo by

This has been a momentous week for me. I closed the door on my private speech-therapy practice: with one last session, a small celebration, and some final hugs, a transition long in coming transformed into the end. Lights out, door closed.

Given this big professional ending, it is no surprise that I am blogging about it. Except I’m not going to continue. I’m going to write about Battlestar Galactica.

For those of you outside the Battlestar Galactica world, Battlestar is a television series remade from a 1970s sci fi show. It ran from 2004 to 2009, but I never saw it on air. In January 2008 my husband and I rented the 2-hour miniseries, which launches the four-season show. With that viewing, we became devoted fans, and we spent the next 3-1/2 years working our way through 4.5 seasons, 21 discs, 58 shows, and a slew of extras.  We watched every show, viewed a good many podcasts, saw every deleted scene, and talked—a lot—about characters, plot, meaning, predictions, and whether we could be cylons.

This week, we finished the show. Rapt and barely breathing, we watched the last episode: a heart-pounding hour of action, an emotional 30-minute conclusion, and a somewhat confusing brief coda (less confusing on the second watch). Then we sat in our darkened living room, each of us saying in turn, “I can’t believe it’s over.”

What is this show’s hold on me? How can I begin to convey its place in my consciousness and the reason for that?

This is a show of human (and non-human) relationships, of characters who challenge you and engage you and own you (and then break your heart). It’s a show where you form alliances, only to be thrust into new ways of viewing the very people you thought you understood. It’s a show where you confront your own contradictory feelings and are forced to reconsider what you believe to be true.

This is a show of story, of narrative so complex you search for (and beg for) explanations (many of which don’t come until the end). It is also a show of action, with spectacular battle scenes that demand multiple viewings just to see all that’s happening. It’s a show where the major reveals and unexpected moments leave you gasping and screaming and lying awake at night.

But above all, this is a show of endless big questions.

  • What does it mean to be human?
  • What fantasies and hopes keep us striving under the direst of conditions?
  • How do we know what’s real? How do we know what is us?
  • What happens when we are forced to consider a radical new version of ourselves?
  • What is faith? What is loyalty?
  • What motivates us to bravery?
  • Must we repeat old patterns or can we really change?

I loved Battlestar for these questions. I loved it for the drama and amazing story lines, for the movie-quality editing and deeply integrative music. I loved it for the complex and beautifully enacted characters. I loved it because my husband and I shared its intensity and emotion. I loved it beyond any logical analysis.

Even as I write this, I am thinking, “I can’t believe it’s over.” But in keeping with the energy of this week, I know that it’s time to move on. Battlestar Galactica will remain in my consciousness, but it’s time for the next great thing. Real life is beckoning.

Questions for Reflection: Have you ever watched a television series that captured your imagination and felt significant in your life? Which of the questions posed by the show might interest you?

Writing Prompts: “This post makes me think of the show ______” (then keep writing); “I am most attracted to shows that make me think about ______” (then keep writing); “I get hooked on a show that ______” (then keep writing).

Any fans of Battlestar out there? I would love to hear from you—I need to debrief!

(this post originally appeared on The Reflective Writer)

Judy Stone-Goldman, PhD, CCC-SLP, LMHC, is an Emeritus Senior Lecturer with the Department of Speech and Hearing Sciences, University of Washington. After a long career in teaching, supervising, and providing service, she has shifted her focus to writing as a means of exploring personal-professional balance, boundaries, and life choices. You can read her blog—and join in with your own reflective writing—at The Reflective Writer.