Does Technology Inhibit Our Engagement With Children?

toddler apps

Photo by jenny downing

I had an interesting online discussion with a colleague as to whether or not technology detracts from or enhances communication. She wrote, “…communication is a relational activity, it’s all about relationships. Should we be investing so much energy on encouraging children to engage maybe more with technology than they do with people? … Do we really need all of the apps in order to engage children with spoken communication or do we need to get back to the real function of speech and language which is to connect people with people?”

As a speech path, I fully agree, to a point. But does technology disengage children from human interaction? Does our enthusiasm for the iPad, and using it in therapy, have the potential for reducing the child’s interpersonal relationship with us and others? I believe the answer is that it depends on how we use technology.

Technology is a tool like any other, but with expanded possibilities. There are apps available that can be used as a starting point for conversation. New app innovation holds the possibility of animating the standard pictures we have been using in therapy for years. I find it hard to understand why that is a negative. As with all materials available to us, it all depends on how we put them to use. Letters replaced human messengers, books replaced human storytellers, radio and television took their place alongside live entertainment. Today’s technology is another medium of interaction on this continuum.

Another colleague offered this anecdote. “At the end of school last year, I grouped two preschoolers who I had been seeing separately and at the end, we used the iPad for some free time. Boy, was I surprised at the amount of spontaneous conversation between the two boys! They shared their favorite app, described how to play it, asked questions about the other boy’s app, and made helpful suggestions. I hadn’t gotten such spontaneous language from the one student for over a year of therapy!!”

(This post originally appeared on Apps for Speech Therapy)


Mirla Raz, CCC-SLP, is a speech pathologist in private practice (Communication Skills Center) and the author of the Help Me Talk Book: How to Teach a Child to Say the “R” Sound in 15 Easy Lessons, How to Teach a Child to Say the “S” Sound in 15 Easy Lessons, and How to Teach a Child to Say the “L” Sound in 15 Easy Lessons (also available in Kindle). Her latest endeavor is her blog Apps for Speech Therapy.

ASHAsphere One Year Later


Photo by melalouise

Ok, technically it’s been over a year (the first ASHAsphere post was published August 31, 2010), but I wanted to mark the belated one-year anniversary of ASHAsphere by saying thank you.

Thank you, faithful readers, who comment on and share and tweet the posts we publish here each week. We appreciate your support and hope you continue to find this blog engaging and useful.

Thank you, talented ASHAsphere bloggers, who are generous enough to share your insights here. You are the reason this blog has been such a success, and I personally am deeply grateful to you all and hope you’ll continue to contribute to ASHAsphere.

If you’ve thought about blogging for ASHAsphere but haven’t applied to become a blogger yet, please do.

Here’s to another year of shared insights and ideas!

FaceTime calls on iPad are HIPAA compliant


You heard it right! FaceTime calls are HIPAA compliant. In an age in which privacy laws often become burdensome to healthcare providers, it is so refreshing to be able to share this exciting news. While I have never done telepractice myself, I am an iPad user and recently used FaceTime to discuss a new app development project with another SLP up in Canada. I loved it!  As an SLP and an iPad geek, I could not help but to want to share this with you guys.

FaceTime is a video calling service that runs on Apple devices such as the iPad and iPhone that allow video conferencing. Just like any other function on the iPad, it opens the door  to a host of new possibilities. The front camera make it the perfect way to communicate  with others who also use Apple devices. When the iPad 2 camera was announced I remember thinking about all the possibilities for therapy. The fact that video conferences are encrypted using HIPAA standards just reinforces the iPad’s status as  my favorite toy of all time.

Now why should SLPs care?

The  Health Insurance Portability and Accountability Act (HIPPA) requires that electronic health care transactions are designed to keep patient records secure to protect patient privacy. Speech-Language Pathologists who deliver services at a distance can now use FaceTime to deliver their services if the patient owns an iPad and/or iPhone. The delivery of services at a distance is also known as telepractice. ASHA defines telepractice as “the application of telecommunications technology to delivery of professional services at a distance by linking clinician to client, or clinician to clinician, for assessment, intervention, and/or consultation.” So in order to follow HIPAA guidelines for telepractice, SLPs have to use a service that has been encrypted (which is the case with FaceTime)

Besides using FaceTime for service delivery, SLPs can also now be sure that they can “face call” their co-workers to consult on a case. The uses are immense!

Now, in order to be fully HIPAA compliant, SLPs must make sure that their wireless connection utilizes WPA2 Enterprise security with 128-bit AES.  WPA2 is a security protocol that was develop to protect the information that goes in and out of your computer using your wireless signal. Here is a well-written article on how to WPA2 Enterprise your Home.

This is definitely great news, and just one more reason why the iPad is transforming service delivery in speech therapy.

For additional information on Telepractice you can visit the ASHA website.


(This post originally appeared on GeekSLP)


Barbara Fernandes is a trilingual Speech- Language pathologist, a geek  and an app developer. She is the founder and CEO of Smarty Ears Apps , a company that creates apps for speech therapy. Barbara is also the face behind GeekSLP TV, a blog and video podcast focusing on the use of technology in speech therapy. Barbara has also been a practicing speech therapist both in Brazil and in the United States. Barbara has created over 21 applications for the mobile devices for speech therapists.

Top 5 Foods I Wish My Speech Therapy Students Would Stop Eating

Pizza Face

Photo by ayesamson

Speech-language pathologists are no strangers when it comes to the human oral and facial anatomy. We are always (consciously or subconsciously) analyzing our students’ teeth, tongue range and motion, and lips to ensure that they are able to produce adequate speech articulation. So here is my silly little question to you: have you ever looked inside of a child’s mouth and then all of a sudden screamed out, “Eww! OMG! What did you eat?!” Trust me, we have ALL been there before (oh the joys of being a speech therapist). Never a dull moment, indeed!

The following is a list of the top 5 things I wish my students would stop eating right before they come to speech therapy.

5. Ice cream

  • They say that you should wash your face twice a day with warm water and soap if you want to keep your skin nice and clean. For some reason though, I feel like my younger clients wash their face with ice cream and chocolate syrup every time they eat that sweet treat! “My friend, please walk to the bathroom and wash the ice cream off your face, then we can start speech therapy.”

4. Oreo cookies

  • Don’t get me wrong, I love Oreos just as much as the next guy, but when students come into the speech therapy room with those chocolate crumbs all over their mouth and in their teeth, I can’t help but think that they ate a handful of dirt. “Guys, did you go outside during recess and take a bite out of the ground? How did it taste? Should I try eating the ground, too?”

3. Blue lollipops/blue gum

  • In speech therapy, I typically see red and pink colored tongues, so you can imagine my shock when a child comes to speech therapy with a full blown BLUE tongue. “We can’t do speech therapy today because we have to get you to the nurse! You are turning into a Smurf!”

2. Fruit punch

  • Imagine seeing a child with a mustache. Pretty wacky thought, right? Now imagine seeing a child with a RED mustache. Super distracting when we are trying to work on the /TH/ sound, don’t cha thing? “I like the red mustache you are sporting. Not only is it stylish, but you can also taste it when you get a bit hungry. Convenient!”

1. Doritos chips

  • Wow. Ok. I don’t think there is a worse smell on this planet than a child’s breath after they have devoured a bag of Doritos. “Please, keep your shoes on during speech therapy because your socks are kinda stinky. Wait, your shoes ARE on?! Oh, that is the Dorito breath I am smelling.”

In closing . . .

Agree? Disagree? Did I miss any foods? Writing this post sure has made me a bit hungry for a snack. Lucky for me, I packed some S’mores Pop-Tarts in my book bag. Haha! Have a great day and I look forward to writing a new blog post soon! Oh, and please feel free to share this post with all of your SLP friends :-)

(This post originally appeared on the ArticBrain blog)


Erik X. Raj, M.S., CCC-SLP ( is a speech-language pathologist who has provided direct care to pediatric, adolescent, and adult clients who exhibit a broad spectrum of communication difficulties. He is presently pursuing his Doctor of Philosophy degree in Communication Sciences & Disorders as a Thomas C. Rumble University Graduate Fellowship recipient at Wayne State University. Erik is also the founder of ArticBrain, LLC, a speech therapy product development company.

Dear Patient

365: 31 -  31.01.09

Photo by Foxtongue

Dear patient,

When you were admitted to my facility I was literally heading out of the door to go home and relax for the evening. I probably planned to have some dinner, read and maybe if I was lucky I’d have a good beer to round out the night. But on my way out I was flagged down by a nurse saying that you wanted to drink regular, thin water.  Actually, the nurse said that you were demanding and yelling about it. At this point, I had no idea who you were; I had no idea we even had any new admissions.  So, I put down my bag and made my day a little longer to see what the buzz was about. I know this isn’t your fault; you probably had little control over what time your transfer took place, and even if you did, I was probably the last person on your mind, but probably not even that. There’s a good chance it didn’t register with you that you’d be seeing someone like me. I don’t mind, and since I like my job and I care about your well-being I came straight to your room without even looking at your chart, something I almost never do, to have a little chat.

As I came into your room I noticed right away that you had a trach. I introduced myself and explained my role as the person who works with swallowing and diet modifications, among other things. Without an acknowledgement of who I was, you began to curse and yell at me that you wanted water and that your previous speech pathologist at the other facility let you have ice chips and water. Not that I expected anything less; you’ve been through a lot, I’m sure, and you’re just trying to advocate for yourself. I get it. And I actually believe everything you told me, but being diligent with my duties and to ultimately look out for your well-being I needed to look through your medical chart to get a better sense of your history and to see if there was any information to clear up this misunderstanding.

After you made your needs known to me, I checked your chart. Your transfer order stated that you should have honey thickened liquids. I found no notes from your previous speech pathologist and no other indication that you were allowed water and ice chips. I also learned you had a PEG and some other conditions that put you at risk for swallowing difficulties. Not to mention you have a trach which adds another level of potential problems. Believe it or not, I still believed what you said about about drinking water and having ice chips but that doesn’t mean I can just change your diet.

I came back to your room to tell you what I learned, but before I could explain what this information meant, you flipped out at me, continued to curse at me and demanded that you be allowed to have thin liquids. Obviously you knew where I was going with this conversation. Between your outbursts, I did my best to explain that even though you may have had thin liquids at your last hospital, you came here with a honey thick liquid restriction and that I couldn’t find anything in your chart that indicated you were able to drink thin liquids safely, that is, drinking thin liquids without it entering your lungs. I couldn’t even find a single note about thin liquid trials with your previous speech pathologist. I don’t blame you for how you felt, nor did I get upset about it. Even though I work with dysphagic patients every day, I still can not fathom what it would be like to not drink what I like, on top of that, having a stranger tell me what I can and can not drink. That would totally suck. I once even tried to drink the stuff we give you. Its gross, and I couldn’t imagine drinking that stuff with every meal. That would also totally suck. I could see you were upset because you kept swearing at me. You really do have some foul language! I still don’t blame you, because your situation is awful and I can imagine myself acting very much in the same way. So, as a last ditch effort I called your last hospital but could not get a hold of anybody in the speech department or anyone in nursing who could clarify what your diet was. So honey thickened liquid remained your diet for at least that night.

You see, I did everything I could to determine if thin liquids were safe for you. I do care; I empathize with you, because I do not envy what are going through. But I have to make my decisions not based on entirely what you want, but based on the data I have about you. I believe you when you say you had water and ice at the last hospital, but I have no way to verify that. I don’t have the tools at my immediate disposal to determine if you can drink water without it going into your lungs. You came to my building with a honey thick liquid restriction and that will remain until I can verify that you are safe for thin liquids, whether it be a report from your previous speech pathologist or passing a video swallow eval. This isn’t because I’m a jerk, even though you might think I am-its because I actually do care and I don’t want to make a careless decision that could land you back in the hospital with pneumonia. Pneumonia will undoubtably prolong your course of hospitalization and it will add quite a bit of money to your bill. Not to mention that aspiration pneumonia is life-threatening. You could die if I mindlessly changed you to thin liquids. That is simply a risk I won’t make. Not just for you, but for any of my patients.

You seem like a good person and I do look forward to working with you. I look forward to hopefully getting rid of that nasty honey thick restriction and seeing the happiness and relief on your face when you hear the good news. I want you to avoid getting sucked into the blackhole of health care, bouncing between hospitals and skilled nursing facilities for preventable issues. Instead, I want to see you go home healthy and fit so you can live a happy life. I hope that you realize I’m not some dolt, but someone that does genuinely care about your health.

Your Speech Pathologist,

(This post originally appeared on slowdog)


Adam Slota M.A., CCC-SLP is a speech pathologist working in long term care and long term acute care settings, primarily with tracheostomy and ventilator dependent patients. He is also the author of the blog slowdog where he writes about various topics in speech pathology and beer, among other frisky and/or mundane missives.

Talent is Overrated

I recently picked up the book, Talent is Overrated, by Geoff Colvin and it’s one of those books that continues to occupy my thoughts several weeks after reading.  The author’s argument, supported by numerous studies, is that there are very few instances of true giftedness or talent.  That in almost every case, performance is a result of increased time, effort and focus.

I’m a very competent cook.  I enjoy making everyday meals, elaborate holiday feasts and most kinds of baking.  (I don’t make pie; I don’t like pie).  I’ve received lots of compliments over the years on the way everything looks and tastes, how the menus go together and how “easy” I make it look.  But I’ve always known that it isn’t that it’s easier for me, it’s that I’ve had so much experience doing it that my methods are streamlined.  For example, my husband, who can also make a great tasting dish, uses about twice as many pots, pans and utensils as I do.  And the counters tend to be more…let’s say cluttered at the end of the preparation.  But it’s my years and years, hours and hours in the kitchen that bestowed “accomplished home cook” on me, and not an innate understanding of kitchen chemistry.

So, how does Talent is Overrated fit into speech and language?  This is what I’ve been thinking about:

For the speech-language pathologist:  Colvin lays out a very humbling truth which is that experience is not always the equivalent of better.  An SLP that shows up for work everyday and goes through the motions is gaining very little improvement from year to year.  Continuing education and then, more importantly, putting that into practice is critical.  Re-visiting those dusty old text books and notebooks from graduate school is a good idea from time to time.  Getting critiqued or watching a peer could bring ho-hum therapy and results to a much brighter place.

For our clients:  Deliberate practice.  This is one of Colvin’s cornerstones, that deliberate practice, not just repeating the same thing over and over again, is what improves performance.  We already know this, but it’s a great reminder.  The child that comes in, is hard to motivate and just repeats the target words each week is really just coming to practice his error pattern.  We need to stop those kids dead in their tracks, make them think a new way, make them produce something different–maybe even if it’s still not quite on target…yet.

I’ve got a busy fall ahead of me.  Screenings to do, warm stews to simmer and fresh bread to bake.  But I pulled down the stairs to the attic yesterday and I think I’m going to stick my Hodson textbook in my car for the next few weeks.  I noticed all sorts of notes in the margins.  I think that student might have some good advice for an experienced clinician.

(This post originally appeared on Activity Tailor)


Kim Lewis M.Ed, CCC-SLP has a private practice for pediatrics in Greensboro, NC. She is the blogger at, providing creative ideas for speech therapy, and the author of the Artic Attack workbook series.

Interview Tips


Photo by Javrsmith

This blog post will help you prepare for interviews and improve your chances of landing a great job. Please note, that while some of the advice offered here may seem obvious to you, it might not be obvious to everyone, and we would rather share things that sound basic rather than omit something that we assume you know.

These tips are provided for your consideration for both direct hire positions as well as contract assignments. Although a contract job is not a “commitment for life,” the employer conducting the phone or face to face interview will be looking for a strong indication that you are committed to the position you are being considered for and that you are truly interested in their district. Many interviews for contract jobs are done strictly by telephone, and as such are often perceived by the candidates as less important as an interview that takes place face to face. In fact, the opposite is actually true. A telephone interview may be your only chance to make your best impression. It is much more difficult to get the “real you” across by phone, so you need to make the most of every minute by preparing ahead of time.


Research the employer in advance. Learn specific details about the organization, the department, and specifics about the job so that you may be as informed as possible about them. Most of this information can be found on the organization’s website or by “Googling” them and reading articles you find online. If you are working with a recruiter they should be able to help you collect much of this information, but whatever else you can learn on your own will only serve to help you even more. For example:

  • Size – the number of clients served, and if it is a school based position, the number of schools, administrators or managers.
  • Recent awards and honors the company, district or organization has received.
  • Reputation – How is this employer or school district perceived in the city/town compared to others.
  • Administration – a visit to the school or company website will generally lead you to current news and information about the organization.
  • The makeup/census of the caseload – What are the economic, geographic, cultural and socioeconomic factors for the families that you will be serving. If the employer is a school district, is it growing or shrinking?
  • How big is the department? Number of therapists? Number of administrators?
  • Total number of clients/students served – Is the caseload growing or is there attrition?
  • If a school, how are the children served? Are the students served through a pullout model? Are therapy sessions done one on one or in groups?


  • Why is the job available?
  • Exactly where is the position located?
  • What will be the population and makeup of your particular caseload?
  • Is there a supervisor over your area or will you report directly to the Director or Assistant Director?
  • How many hours am I guaranteed (or can I expect) per week?
  • Is paperwork done by computer or manually, and will I be provided with all the tools I need to succeed?
  • Email address of the interviewer so you can send him/her a “thank you” note.

All of this will not only create a stronger image of you in the interview, but likewise will provide you with a better basis for evaluating the opportunity if an offer is made.


  • Schedule a time where you can give the interviewer your undivided attention.
  • Keep the interview “clinical” and focused on the job duties. Other, more general questions can be answered by your recruiter or through your research.
  • Don’t talk about money yet. If you are working with a recruiter, they will have that information for you. If you are interviewing on your own, get through the interview first and follow up with human resources for salary information.
  • Let the interviewer ask his or her questions first to ensure that the interviewer covers all that they want to learn about you. If there is time, feel free to ask job related questions.


  • Getting there: Have good directions and allow plenty of time to get there.
  • As a starting point, it is critical to understand that the impression you make in the first few minutes of the interview generally sets the tone for your success or failure for the entire interview.
  • Dress conservatively; avoid bright colors. Make sure hair is clean and neatly styled. Avoid perfume and cologne but make sure you wear deodorant to control perspiration and odor.
  • Be exceptionally courteous to everyone you meet.
  • Even if you’re having a bad day, put on a smile and show your enthusiasm for the job. Many hiring decisions involve more than one candidate. Personality and motivation are often tie-breakers.
  • If you want the job, ask for it. At the very end of the meeting say why you’re excited about working there and that you’d like to have the position.


Heidi Kay is one of the founding partners of PediaStaff and is the editor-in-chief of 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.

Moving Therapy to the Gym: The Benefits of Gymnastics for Children with Autism

Rings for gymnastics(つり輪)

Photo by kawanet

The sport of gymnastics can provide children with Autism Spectrum Disorder (ASD) access to a differentiated approach, which potentially can create a model program to meet each child’s individual needs in a unique and effective manner. Gymnastics is a sport that provides an enriching environment filled with opportunities for sharpening the mind by stimulating the brain, fostering social skills, and strengthening gross and fine motor skills, while providing children with ASD an alternative method for learning and developing new skills.

Concentration or focus is required in each skill that is executed in the sport of gymnastics. Learning to focus in the gym can allow for increased attention to tasks outside of the sport of gymnastics. Children with ASD have the opportunity to develop the vestibular system and increase spatial awareness through various connections that the brain is building when performing routines on different apparatus that involve using various gymnastic skills.   The sport of gymnastics provides a highly structured and organized environment in which a child with ASD is able to learn at his/her own pace.  In addition to skills that initiate brain development, it is important to nurture and reinforce positive mental qualities.   Some of the ways that this can be performed is through modeling gymnastics elements, taking advantage of teachable moments, and providing positive reinforcement aligned with instruction.

As children with ASD continue to develop their social skills, they transition from home to school settings and other environments (e.g. gym) where they begin to experience a wide range of opportunities to communicate.   All of these interactions will have a substantial impact on the language and speech development of each child with ASD.  Interaction with other teammates and coaches allows for increased appropriate use of paralinguistic behaviors such as taking turns, listening and following directions, making verbal requests, and making eye contact with peers.

The sport of gymnastics provides a sensory-rich environment while simultaneously using physical exercise to develop fine and gross motor skills in children with ASD.  Gross motor skills (i.e. running, climbing, jumping) and fine motor skills (i.e. manipulating a hula hoop) are developed through gymnastics skills such as running and jumping on the springboard into the foam pit, climbing a rope, and other related activities.

Gymnastics also provides a learning environment for children with ASD by providing creative approaches for teaching each child new skills. Gymnastics instructors can organize and shape each learning opportunity to correlate with each child’s targeted learning goal(s) while allowing for additional exploratory time. In gymnastics, it is important to allow children time to feel comfortable with the skill before they attempt to execute it (i.e., one child may approach the end of the beam and jump cautiously, where another child may take quick steps with no hesitation when jumping).  Each child is provided with a tailor-made learning environment which allows the instructor to adapt and modify the program based on the child’s individual needs.

Gymnastics programs can potentially aid in providing a functional and invaluable learning environment for children with ASD.  Therefore, it is advantageous for parents and professionals to collaborate in defining, planning, and implementing participation in recreational activities (Potvin, Prelock & Snider, 2008).   Gymnastics gives children with ASD an opportunity to experience the joys of success through their individual achievements, or from the success of their teammates. Moving therapy to the gym could provide immeasurable opportunities for children with ASD, and promote generalization of learned skills to his/her natural environment.


Potvin, M.C., Prelock, P.A. & Snider, L. (2008).  Collaborating to support meaningful participation in recreational activities of children with autism spectrum disorder.  Topics in Language Disorders, 28(4), 365-374.  Retrieved from:



Jourdan Saunders, M.S, CF-SLP, received her Master’s degree at Loyola University in Maryland. She is currently completing her Clinicial Fellowship year in the Miami Dade County Public School System in Florida.  She is the creator of the website, and has a blog that is linked to her website.  She created the website to provide resources, inspiration and motivation for individuals who have chosen to major in the field of Speech Language Pathology. is directed towards students, but anyone can benefit from the resources provided on the site.  Jourdan has a gymnastics background of 23 years, she is looking forward to developing gymnastics programs for children with special needs.