ASHAsphere Summer Vacation

Summer Time (I)

Photo by pasotraspaso

Hope you all are having a great, relaxing summer. This is just a quick post to say ASHAsphere is taking a little summer break too–so enjoy a few days with one less item in your Google reader or email inbox! We’ll be back with a new post on Thursday, August 9, but in the meantime, if you’re looking for some reading material, you can always check out some of the blogs from “The Best Speech-Language Pathologist Blogs from A-Z” post that Heidi Kay did back in March.

Spending your summer online time on Pinterest instead of reading blogs? You can follow us there for a mix of ASHA content, study resources, therapy ideas, classroom organization ideas and even just some fun crafts.

If you’re a blogger and interested in applying to be an ASHA Convention blogger, there’s still time–applications are due on Friday, August 10. The details and link to the application are here.

Finally, a huge thanks to all the wonderful ASHAsphere bloggers for their continued contributions–they are what makes this blog such a great and popular resource. And of course thank you, too, readers–there are many, many CSD blogs out there with more cropping up each day, and we appreciate you reading along with us each week. As always, if you have suggestions for posts you’d like to see, leave a comment or, if you would like to write for us, apply to become an ASHAsphere blogger.

For Children with Hearing Loss, Parents’ Desired Outcomes Should Drive Early Intervention & Use of Hearing Technology


Photo by bjorn knetsch

Just this past week, a hallway conversation with a colleague underscored the frustration that parents and caregivers of children with hearing loss seem to encounter on an all-too-frequent basis. My colleague described a situation whereby some very diligent parents had chosen to pursue bilateral cochlear implantation for their 10-month old son with a profound bilateral sensorineural hearing loss. Even though they had gathered a mountain of information, received support from their pediatrician, approval from their insurance company, and spoke to countless other parents – some of whom had chosen cochlear implants for their children with hearing loss and others who had not – they found the most resistance from their early intervention providers. Not only were these professionals unsupportive, they provided grossly inaccurate information about cochlear implants and listening and spoken language outcomes. It was plainly obvious to these parents that they had obtained more knowledge than the “professionals” who were there to serve them. Unfortunately, this scenario is repeated too often throughout the United States.

Almost without exception, parents want their children to have more successful lives than themselves. Whether that success be academic, social, or career-related, parents want what is best for their children. Determining what is “best” is a complicated process. Parents must use their own familial experiences, cultural perspectives, belief systems, and knowledge to make decisions that will affect the developmental, communicative, and academic success of their children.

For parents of young children with hearing loss, research informs us that approximately 95% of these parents are hearing themselves and have little or no experience with deafness. Usually, their only exposure to deafness is what they’ve seen portrayed in the media or the occasional interaction with an older relative with an age-related hearing loss.

So, what are parents to do and how should they determine what is best for their infant or toddler who has been diagnosed with hearing loss? Once that diagnosis is confirmed, parents need access to information about communication options and expected outcomes, hearing technology, and the available services in the community. The child’s audiologist is a pivotal professional in this process as he or she should get this discussion started. The range of hearing technology, such as digital hearing aids, cochlear implants, and assistive listening devices should be thoroughly reviewed and prescribed. Then, the family should be referred to an early intervention program (usually a statewide system), and appropriate early intervention services should be initiated.

The type, frequency, and intensity of the early intervention services should be based on the parents’ desired outcomes for the child. That is, if the child’s parents have decided that they want their child to be eventually mainstreamed in a local public school with hearing peers and to communicate using spoken language, then early intervention services should be structured to support those desired outcomes. Too often – in too many states – parents are given a very limited menu of services that are available and simply told which services will be provided. Of course, when this occurs, it fails the test of having services that are individualized, and the services certainly are not driven by what the parents want for their child with hearing loss.

Ultimately, parents need to make informed decisions about what they consider is appropriate for their child. They need to gather information from multiple sources, speak to other families who have navigated the system, and make sure they are informed about their rights. Each state has its own unique way of doing things, including how federal laws are interpreted and services provided. With perseverance and due diligence, parents usually can structure services that are appropriate for their child. The key is to be persistent and to not give up until the services provided support those long-term, desired outcomes that are envisioned for the child!

(Note: This blog was adapted from an original posting by the author on the Better Hearing Institute’s Pediatrics Blog.)


K. Todd Houston, Ph.D., CCC-SLP, LSLS Cert. AVT, is an Associate Professor in the School of Speech-Language Pathology and Audiology at The University of Akron. His primary areas of research include spoken language acquisition in children with hearing loss, strategies for enhancing parent engagement in the intervention process, Auditory-Verbal Therapy, and telepractice. He directs the Telepractice and eLearning Laboratory (TeLL), an initiative to evaluate clinical practices in the area of distance service delivery in Speech-Language Pathology.

6 Things to Look For When Choosing Your Continuing Education Provider

Made me smile...

Photo by Brett Jordan

The Internet is changing how and where we learn. Make sure you know what to look for when shopping for your next online continuing education course.

Creating and selling online continuing education is a rapidly growing industry, a fact that is great news for busy SLPs and audiologists. It’s become easier than ever to complete your national association and/or state mandated CE requirements quickly, conveniently and inexpensively.  And that means it’s more important than ever to know what to look for when shopping for a provider. Choosing the wrong one can result in a very dissatisfying educational experience and unwanted stress.  The following list will help you find the best fit for your CE needs.

  1. Accreditation:  Has your regulating board approved the provider or the provider’s courses? There are strict rules and regulations that must be adhered to and a good provider will be transparent in disclosing their accreditation. It’s also a smart idea to check with your national and state regulating bodies. Websites like will generally list all approved continuing education providers.
  2. Reputable Instructors: When you’ve located a provider and checked out some of their courses, do a quick online search on the instructors. Make sure they are licensed healthcare professionals, experienced educators or individuals with the appropriate credentials/specialized training in their field of instruction.
  3. Large and Varied Course Selection: Advances in medicine and documentation require that the practitioner must continually update their knowledge base. Continuing education providers should be doing the same thing. Look for one that is adding new courses to their catalog on a regular basis. Does their course catalog cover a wide spectrum of subjects that will not only keep you current but also enhance you professionally?  Providers can and should offer a large selection of informative and engaging courses.
  4. Understanding of Your Needs: When you’re shopping for continuing education courses you should feel confident that the provider understands your needs and requirements. Any provider worth their salt will be able to help you understand the rules and regulations that govern your profession.
  5. Production Quality: Simply having good content isn’t enough; it should be presented in a professional format, with clean visual components and clear audio. It’s no good spending money on a video course that is blurry and hard to hear or fails to even provide any visual demonstrations. It should be easy to access, too. A few clicks of your mouse button are all it should take to get to your material. You can check the provider’s website for screenshots or video samples of their courses to evaluate the value they place on production quality.
  6. Cost: It’s always nice to save money, but be wary of the provider with ridiculously low prices. That usually means that corners have been cut, never a good thing.  Prices should be reasonable based on the amount of content provided in the course, and the production quality of the course. Some providers will offer options to combine courses together at a lower cost than buying them individually. One that offers flexibility to buy exactly what you need to meet your requirements and takes your budget into consideration can be a lifesaver, especially if you’ve left those requirements to the last minute!

It’s always smart to do your research before you commit to a continuing education course,as for the SLP or audiology professional the fallout from a bad choice can create extra stress and unwanted complications in your life. Following these few simple tips can help you make the decisions when it comes to choosing an online continuing education provider.


Amy-lynn Engelbrecht is the Online Content Specialist at is an ASHA Approved CE Provider, provides online continuing education courses that are convenient, affordable and user friendly. provides that offer ASHA CEUs for Speech-Language Pathologists, Physical Therapists, Physical Therapist Assistants, Occupational Therapists, Occupational Therapist Assistants, Athletic Trainers, Massage Therapists, and Certified Strength and Conditioning Specialists.


Call for 2012 ASHA Convention Bloggers!


ASHA is looking for three bloggers to cover the 2012 ASHA Convention for ASHAsphere. If you’re interested in attending the 2012 ASHA Convention, November 15-17 in Atlanta, GA, and willing and able to blog about your experience before, during, and after the event, this could be your chance to win free registration. Selected bloggers will receive complimentary base registration, but will be responsible for their own travel costs and expenses.

If you’re interested in applying to be a 2012 Convention blogger, please fill out and submit the application by Friday, August 10. Three selected bloggers will be notified by Friday, August 24.

Maggie McGary is the online community & social media manager at ASHA, and manages ASHAsphere.

Take a Speech Vacation

Summer vacation 2011 friends and family

Photo by kevin dooley

Everyone’s in the midst of planning summer vacations, signing up for camps and stocking up on popsicles and sunscreen.

May I make a recommendation? Take a break, maybe even a big break, from therapy at some point this summer.

Odd advice coming from a therapist? Perhaps. But I’m a parent too. Certainly consult your own provider(s), but let me list here five very important reasons you should take 5 this summer.

  1. Get perspective: There’s nothing like uninterrupted time together to realize, “Hey, this is so much easier than last year”, or “Wow, the waitress understood her order!” or “He can put on his Velcro sandals himself now.” It’s hard to see growth when you’re staring at it all day. Sit back and bask in the accomplishments no matter what the size.
  2. Re-evaluate goals: Therapists have great ideas for achieving the chronology of development, but they don’t live your life. Maybe it’s 3:00pm, he’s tired and fussy. You know he needs the peach smoothie in the blue cup before nap because you’ve been running this script for years. So maybe you aren’t so vested in a verbal request for “drink,” “smoothie,” or “nigh-nigh” (especially if you’re on the brink of the only quiet 30 min. you’ll get in your day). But getting him to say “Mimi” on the phone to your mom, which would make her year, even if he did it without communicative intent? It’s ok to prioritize this way. Figure out what you care about.
  3. Decrease mileage: Gas is expensive and the emissions are bad for the environment—so go green. Even more importantly, lose all that time spent commuting to appointments and sitting in waiting rooms. Use it on playing and living.
  4. Integrate lessons: A skill learned in therapy is useless if you can’t achieve it in your everyday life. The connections your child is making when they ask you for “more” on the playground swings? And then uses it again on the slide? That’s mastery. Practice carry-over.
  5. Build confidence: Both you and your child need to realize that it’s not the professionals getting you through the day—it’s you. Scary, I know, to think “the buck stops here?” You’re doing better than you think. Get assertive. “The buck stops here.”

Now….send us a postcard.

(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.

Rate That App

Day 99, Project 365 - 1.29.10

Photo by William Brawley

More and more SLPs are using apps in therapy and more and more speech/language apps are flooding the app store.  I love to use technology and apps in my therapy sessions, but how do I pick which apps to use?  Honestly, as the market for apps and the number of apps increases, it is becoming harder to determine what apps to buy.  I wrote an earlier post about where to go to find apps.  I also have shared my spreadsheet of apps for speech/language listed by target area.

Today, I want to talk a bit about determining what apps are appropriate and useful in therapy or educational settings.  In order to make this decision, we really must talk about a rating system for apps.   I know some people love rating systems and some people hate them.  I have found that the more reviews I read, the more I want reviews to be to concise and tell me whether or not the app is worth my time and money.  With that in mind,  I have been searching the web to try to find a “good” system for rating apps.   During my search I found rubrics, guiding questions, checklists and star ratings.  After reviewing a variety of these sources, I developed two checklists and star rating systems for apps.   One checklist/rating system is for reviewing speech/language/educational apps and the other is for reviewing game/book/productivity apps.  The original idea for the checklists was based on a list created by Tony Vincent (more info about Tony is written further down on this page).

The basis of the system is to allot one point for each item on the checklist, adding up points for a total score.  The total score is then translated into a star rating.  I am hoping that this system will allow me to be more objective and consistent in my app reviews.  It will also allow me to post star ratings on iTunes as I know iTunes reviews are important to app designers.

Here is a preview of the App Review Checklists and Rating Charts:

If you would like to take a closer look at my checklists, you can download themhere and here.  As always, I am open to sharing.  My only request is that you link back to my blog, and provide any feedback for ways to improve the checklist and rating chart.  I know my system is not perfect and I will most likely tweak it as I use it to evaluate apps.

Some of you may be interested in reading more about the resources that I used to help me create my lists/rating charts.  You can find links and information below:

  • Speech Techie’s Fives Criteria:  Sean Sweeney of SpeechTechie.comcreated this criteria system for evaluating technology.  It is a general set of criteria that can be used when determining if particular apps are useful for speech/language therapy.  If you aren’t familiar with Sean, he is a certified SLP and technology specialist.  He is involved in app development at Smarty Ears and he presents around the country regarding use of technology in sp/lang therapy.  To learn more about his 5’s criteria, you can download his booklet here.
  • Evaluation Rubric for iPod Apps:  This rubric was created by Harry Walker, a teacher, elementary school principal and blogger (I Teach Therefore IPod).   I found that many educators site his rubric when discussing ways to evaluate apps.  I found several app review rubrics that were based on his original rubric for evaluating iPod apps.
  • Ways to Evaluate Educational Apps:  This is a blog post written by Tony Vincent of  Tony shared a rubric and checklist he created for evaluating apps.  He also discussed several rubrics and checklists that have been developed by other educators and school systems.  The idea for the overall set up of my checklist as well as items to include was based on a checklist that he created called, Educational App Evaluation Checklist.  If you love technology and you don’t read Tony’s blog, you should start today.  His blog is an amazing resource for all things technology in education.

If you have any feedback regarding the checklists, I would love to hear from you.  Stay tuned for app reviews that include my checklist and rating system.

 (This post originally appeared on Speech Gadget.)

Deborah Taylor Tomarakos, MA CCC/SLP, has been pediatric speech language pathologist since 1994.   She has experience in both public school settings and in outpatient pediatrics.  She is currently employed by a public school system.  Deb has provided therapy services to children with a wide variety of communication deficits, including children with Autism Spectrum Disorders, CAS, Down Syndrome, Cerebral Palsy, language based learning disabilities, and literacy deficits.  Strong areas of interest include technology use in therapy, CAS, and literacy.  You can find her online at where she shares therapy ideas, resources, websites, and technology integration tips. 

Adventures in RTI (and Speech)

Adventure Aquarium Fish

Photo by Jim, the Photographer

What is Response to Intervention and what does it have to do with speech? Great question…and I don’t know that I can answer it fully, but I do have some ideas.

I just returned from a three day conference on RTI-A and RTI-B (Response To Intervention – Academics, Response To Intervention-Behavior). Now, my school has been doing RTI for a few years now and we are making headway. It is by no means a final product and there have been lots of growing pains…but we are making progress.

Basically, RTI is a way to get students help early, before they fail, and hopefully, before they are failing so poorly they need special education. There are three tiers (1, 2, 3) in RTI. Each tier requires more individualized help, more time, and fewer students. Ideally, a child who is struggling with a certain skill gets differentiated instruction in the classroom. You know, those 5-10 minutes of teaching the skill in a slightly different way. Sometimes that little bit of extra help is all the student needs and they go on their way. An example of this would be the teacher helping the student learn what a Noun is or a slightly different way to help teach number sense. This is called Tier 1.

Sometimes the student requires a bit of additional help – more time and less distractions. So the student may receive Title services, or a reading intervention, or small group instruction (no more than 2-4 students) in a certain skill. Quite often this enough, the skill is learned and the student catches up. An example of this would be Title I help with Intensive Phonics or a Reading program (Duet Reading, Repeated Reading, etc.). This is called Tier 2.

The final tier is individual (or at most 2 students), an additional 30 (or so) minutes of extra help over and above Tier 2. This is intense intervention and the final step before determining if a child qualifies for special education. This may be when the reading specialist comes in and does additional reading instruction, additional math instruction, pre-teaching, etc.

Data must be taken (and analyzed) for each tier. The data will show if the intervention is successful or if a different intervention or additional help is needed. A number of different interventions must be tried before moving to the next tier. For instance, if a student is struggling with reading in the classroom, the classroom teacher will try a few different interventions to help determine where the student’s skill is lacking. If the student responds well to an intervention and catches up on that skill and no longer needs help, the student is dismissed from RTI. If the student is not responding or responding but not at an appropriate rate, additional help and/or a more intensive intervention is needed.

But, it’s not just about academics. RTI can be used for behavior interventions as well. The presenters at the conference; Randy Sprecks, Anita Archer, and Kevin Feldman, were fabulous. They were all very dynamics and had several key suggestions. All three of them agreed though, that for many kids, if we can get behaviors under control – we can get academics under control…and vice versa. The other thing they all agreed on is that we must engage all students every day with every thing. That means that we don’t call on students individually, we have everyone answer…that means we don’t single out kids for poor behavior, we have the same requirements for all students.

I’m going to be going through the information from the conference and post several smaller posts about specific intervention ideas. I’m hoping to include several links about the different interventions and presenters as well. Stay tuned for more information.

(This post originally appeared on Speech Adventures.)


Mary Huston, MS, CCC-SLP, is a school based SLP with James River Multidistrict Special Education Cooperative. As part of the school-system, Mary is an active part of the RTI team for her district. Mary authored the iPad application Categories Learning Center, co-authored the SLP Goal Bank, and has another app in production. In addition to her own apps, Mary has consulted on apps with other SLPs (Pro-PA, T. Coyle, Canada; Easy Concepts, S. Benton, Barbados). Mary is on the Smarty-Ears Apps Advisory Board and routinely consults on Smarty-Ears applications with founder and CEO Barbara Fernandes.  Mary has guest lectured on using Cycles Technique for phonology therapy; Lambton College, Sarnia, ON (2011) and has presented on using iPads in therapy at North Dakota Council for Exceptional Children (2011) and Minot State University (2012). Mary is also an active user of social media and collaborates with SLPs internationally on a variety of subjects, and the author of the blog, Speech Adventures.

Summer Regression- How to Avoid it!

Summer Shoes

Photo by Klearchos Kapoutsis

Regression is when someone or something goes back to its original state. In this instance, we are talking about a child’s loss of skills or a dip in progress. As a speech pathologist, I see this quite often. Kids tend to relax over the summer, go on vacation, play lots of video games and overall do less academic work. Parents often ask me, “what can I do to help my child’s language over the summer?” I have listed some of my suggestions below:

  • Make sure to visit the library often! Set up a schedule with your child and try to make trips to the library exciting. Many libraries have summer reading programs but if your local library doesn’t, you can easily create a book list or set a goal to read a certain amount of books by the end of the summer. If the goal is reached, a prize or medal can be rewarded to your child to increase confidence and sense of accomplishment. Make sure you ask your child questions about the book to increase literacy skills, sequencing skills and reading comprehension skills.
  • Stick to a schedule! Many children are given a lot of freedom during the summer but many kids need structure like the school day! Start each morning by discussing the plans for the day. If there is a lot of free time, make sure that “screen time” (video games, computer games, tv, movies) is kept to a minimum. Some children may also require a visual to help them understand the sequence of events throughout the day. The extra time you put into it as a parent could make a big difference come September!
  • Make every outing a good one! Whether you are going to the grocery store or running errands, make sure you keep your kids talking! Ask lots of questions and encourage independence in your child! (ex: Johnny, where are the pears? Or Johnny can you grab the red shampoo? Find the lotion that says Jergens, what letter will that start with?)
  • Make sure you ask your child’s teacher what else you can do to support your child during the summer and avoid regression!

(This post originally appeared on Speechbop)


Erica Gosling, MA CCC-SLP is a full time SLP working in both Stamford, CT and New York City. She received her M.A. from New York University. She has worked in a variety of settings including schools, private practices and home based therapy. She has experience with a variety of communication disorders. For more information about Erica and speech therapy, please visit her blog at

Dinner with Friends, or the Value of Interdisciplinary Collaboration and Follow Up


Photo by tangi_bertin

Several months ago I had dinner with two of my colleagues, a pediatrician and a clinical social worker, to iron out the details of our upcoming conference presentation. As time went by we managed to discuss every topic under the sun, yet still the subject of our presentation was sadly not on the agenda. Exhausted from working at the hospital a full day and seeing private clients afterwards, I was getting distinctly antsy as the hand clock kept climbing closer to midnight.

The conversation began to feel more productive when we started to touch base on our mutual clients. Mostly they wanted to hear from me, since they both share an office suite and I was the only one located off-site. So, even though we all individually conferred frequently via phone regarding clients, that was the first time all three of us got together in the same room to discuss them. Quickly, I rattled off each of my clients’ progress in therapy, until I got to D, and paused. Oh, don’t get me wrong I am very proud of my work with D, with whom I’ve been working for several years, and who went from being limitedly verbal, severely echolalic, and “autistic-like” at the age of 4.5 to fluent complex sentence speaker, fledgling problem solver, and a little charmer by the age of 6.5. Yet something was still bothering me that I couldn’t put my finger on regarding D’s performance. Despite the absence of a particular diagnosis (e.g., ASD) and significant gains, his issues with attention and cognition persisted, and his progress was still halting and inconsistent, even with rigorous language therapy and supplementary academic instruction at home four times a week.

In my desperation I had already considered and mentally rejected a number of referrals (“No it doesn’t seem to be a psychiatric issue,” “Yes he can benefit from a neurological but should I refer him for a psychological assessment first, could it be an IQ issue?”) I pondered out loud as I shared my concerns with my colleagues. Neither of them have seen him for about six months so the clinical social worker immediately whipped out his chart, busily looking for appropriate information, while the pediatrician frowned, searching her memory for an “appropriate entry.” “Wait a second,” she said, “when I last saw him, during his physical exam I saw brown café au lait spots on his skin that I didn’t like at all, so I referred mom to get some blood work done but I haven’t heard from her since that time. Since you see her every week, can you please ask her to call me ASAP so I could remind her to do the blood test, as the information you are telling me makes it even more imperative that she follow up with the lab work.”

Right away, I became alert. Though the pediatrician was not stating her suspicions explicitly, through years of working with medical professionals I was familiar with the implications of what café au lait spots can potentially represent and that is neurofibromatosis. It is a neurocutaneous syndrome that leads to benign tumor growths in various parts of the body and can affect the brain, spinal cord, nerves, skin, and other body systems. In additional to all the medical implications of this syndrome (e.g. tumors becoming cancerous), it can also cause cognitive deficits and subsequent learning disabilities that affect appropriate knowledge acquisition and retention.

To me the situation was clear; no matter what the outcome, as the only team professional in contact with the parent at the time, it was my job to counsel the parent that she get in touch with the pediatrician so she can successfully pursue the recommended course of action. It may not have been the position I wanted to be in but unfortunately I knew that if this matter was left unpursued, I was left with a whole host of unanswered questions regarding further treatment options for this child.

I use the above example to emphasize the value and importance of working as part of a team to treat the “whole” child. Therapists specializing in working with children on the spectrum are most familiar with being part of a team, since they are just one of many professionals such as behaviorists, OT’s, psychologists or neurologists who are working with a child. Being part of a team is also a much more acceptable practice when a child is treated in a hospital or a rehab setting and presents with a complex disorder (e.g. is medically fragile, has a genetic syndrome, etc).

However, in our field, even outside of specialty settings (hospital/rehab) we are frequently confronted with speech or language disordered clients who stump our thinking processes, and who require the team approach (including the involvement of specialized medical professionals). Yet oftentimes that creates a significant challenge for many clinicians who are working contractually (through an agency) in school settings or in private practice. Being part of a team when one is contractor or a sole practitioner in a private practice is a much more difficult feat, especially when the clinicians are just striking out on their own for the first time.

Both interdisciplinary and multidisciplinary teamwork is oftentimes so crucial in our field. Working as part of a team allows us to collectively pursue common goals, combine our selective expertise, initiate a discussion to solve difficult problems, as well as to have professional lifelines when working on difficult cases. Different providers (neurologist, SLP, OT) see different symptoms as well as different aspects of the patient’s disorder. Consequently, different providers bring different perspectives to the table, which ultimately contributes positively to the treatment of the whole child.

Interestingly, many private speech language practitioners have wide referral networks (e.g., pediatricians, OT’s, PT’s and others who refer clients to them) yet when asked regarding frequency of contact with respect to conferences/discussions about the progress of specific clients, many clinicians draw a blank.

So how can we develop productive professional relationships with other service providers that goes beyond the initial referral? I’ll be the first one to admit that it is not an easy task, especially when it comes to physicians such as psychiatrists, neurologists, geneticists, or developmental pediatricians. I can tell you that while some of my professional relationships came easy, others took years to attain and refine.

In my hospital setting I work as part of a team. However, when I first started out in private practice, in a fairly short period of time I ended up having a number of clients with complex diagnoses and no one to refer them to. What complicated matters further that in contrast to them being referred to me by a pediatrician, these clients came to me first, since their most “visible issues” at the time were speech language deficits. I had to be the one to initiate the referral process to suggest to their parents relevant medical professionals, which needed to be visited in order to figure out why their children were having such complex language difficulties (among other symptoms) in the first place.

So here are a few suggestions on how to initiate and maintain professional relationships with medical service providers:

  • Start with doing a little research. You have worked hard to build your practice and your clients deserve the best, so locate the best medical service providers in your area. In the past I’ve had some excellent recommendations from locally based colleagues who were active on the ASHA discussion forums, other client’s parents who already did the necessary legwork, or hospital based colleagues who recommended peers in private practice. Several times I actually liked the initial medical reports I’ve received on a client so much – that I’ve referred other clients to the same doctor.
  • When word of mouth fails to do the trick, I turn to “Google” to provide me with desired results. Surprisingly, simply typing in “best _______in _____(name of state)” frequently does the trick and allows me to locate relevant professionals, after browsing through the multitude of web reviews.
  • Of course depending on the length of client treatment, you will have different relationships with different medical providers. I have collaborated for years with some (e.g., pediatrician, psychiatrist), and only infrequently spoken with others (geneticist, otolaryngologist, pediatric ophthalmologist).
  • Typically, when I refer a client for additional testing or consultation, in my referral letter to the physician, I request to receive the results in writing, asking the physician to also include relevant recommendations (if needed). Oftentimes, I also try to set some time to discuss the findings in a phone call in case I have any additional questions or concerns. Of course, I also send the physician (and other providers working with the child) the information from my end (progress reports, evaluations) so all of us can have a more comprehensive profile of the client’s disorder/deficit.

After all, ST’s, OT’s and PT’s are not the only ones who are dependent on information from doctors in order to do our work better. There are times when physicians need information from us in order to move further in treatment such as order specific tests. For example, just recently a pediatrician used my therapy progress report in conjunction with another provider’s, to order an MRI on our mutual client. The pediatrician had significant concerns over client’s development and presenting symptomatology, and needed to gather additional reports supporting her cause for concern in order to justify her course of action (ordering an MRI) to the HMO.

As mentioned previously there are numerous benefits to teamwork including the fact that it allows for appreciation of other disciplines, creation of functional goals for the child, integration of interventions as well as “brings together diverse knowledge and skills and can result in quicker decision-making” (Catlett & Halper, 1992).

Given the above, it is important that speech language pathologists help coordinate care and maintain relationships with other medical and related professionals who are treating the child. This will improve decision-making, allow the professionals to address the child’s deficits in a holistic manner, an even potentially expedite the child’s length of stay in therapy.

Catlett, C & Halper, A (1992). Team Approaches: Working Together to Improve Quality. ASHA: Quality Improvement Digest.

National Institute of Neurological Disorders and Stroke (NINDS) Neurofibromatosis Information Page.

(This post originally appeared on Smart Speech Therapy)


Tatyana Elleseff MA CCC-SLP, is a bilingual speech language pathologist with a full-time hospital affiliation (UMDNJ) and a private practice (Smart Speech Therapy LLC) in Central, NJ. She received her MA from NYU and her Bilingual Extension Certification from Columbia University. She specializes in working with bilingual, multicultural, internationally and domestically adopted at risk children with complex medical, developmental, neurogenic, psychogenic, and acquired communication disorders.