ASHA’s Online Community Goes Mobile

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I love my smartphone and iPad so much that my husband often makes jokes about my need to be with one of them at all times. No matter what I’m doing, one of these mobile devices is almost always in my hands. I think it all relates to my inability to do just one thing at a time.

So while we are watching MasterChef or The Next Food Network Star in the evenings, I am also keeping up on what is happening in the ASHA Community.

As with any relationship, there are habits or characteristics that are less than appealing about the other person. The pet peeve I have with my mobile devices is the constant need to use pinch-to-zoom maneuvers to read or navigate the browser. To avoid this, I usually download the app when there is one available for a particular website or service.

Until now, the only way I could surf the ASHA Community was with my mobile devices’ browsers. You can imagine my excitement when the ASHA Community Mobile App idea was formed—my hand was definitely raised to be part of the team working on that project! Well, the day has finally come. The new ASHA Community Mobile App is not only helping my relationship with mobile devices, it helps all ASHA members with these unique features:

  • Convenient. Read all the latest discussions from your subscriptions in a single feed.
  • Seamless. Reply to discussions and post new discussions without pinch-to-zoom maneuvers.
  • Searchable. Find your colleagues in the directory and easily add them to your personal contacts. With a couple of taps on your screen, you can send an e-mail or make a phone call to another ASHA member.
  • Latest news. Find ASHA’s Twitter feed and read this and other ASHAsphere blog posts directly in the app.

If you are as excited as I am, then you have already downloaded the app on all of your devices. Just in case, here are the steps:

  1. From your mobile device, click on the appropriate link below or visit your app store and search “ASHA Community.”
  2. Download the app.
  3. Log in with your ASHA username and password.

Get it on Google Play

You’ll see your name at the top of the navigation. Under your profile, you will see Discussions, People, Inbox, Announcements, and a list of communities to which you subscribe. The ASHA Community Mobile App will help you stay connected with other ASHA members and allow you to post questions to your colleagues on the go–or when you are sitting on the couch enjoying your favorite show.

Visit community.asha.org/mobile to learn more about ASHA’s new mobile app. If you have app-related questions, e-mail community@asha.org.

Jill Straniero is ASHA’s online collaboration manager. 

Kid Confidential: My Top 10 Reasons for Attending the ASHA Schools Conference

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I know I typically write about some topic related to child development but I thought I would take a detour this month and write about my first experience participating in the ASHA schools conference.  The reason I think this is important is because so many SLPs out there are school-based or work primarily with pediatrics and my experience at the schools conference this year was a very good one full of great insight into various topics, issues and research on child development.

First, let me say that I get no financial or non-financial benefits for writing this article.  So that being said, rest assured this blog post is coming solely from my personal experience and opinions.

This year was the first year in my long career as a speech-language pathologist (yes, you heard that correctly) that I was able to attend the ASHA Schools Conference.  Although I had wanted to go for some time now, between marriage, my husband’s multiple deployments and motherhood, I just couldn’t find the time or financial means to attend before this year.  However, with that said, I had such a wonderful educational experience that I do regret missing out on conferences of previous years and I knew I needed to share with you that it truly is worth saving your quarters, dimes, nickels and pennies over the next year to ensure you can attend.

In an effort not to take myself too seriously and to make this fun for you, I will, like some famous evening talk show host I will not name, give you….(drum roll please)….

 

My TOP 10 Reasons for attending the ASHA Schools Conference:

10.  Location, Location, Location:  Every year it is at a new location in the United States and it’s a nice reason to go check out some parts of the country you might not otherwise ever see.

9.  It’s Some Work and Some Play:  Presentations are over by 3:30 on Friday and Saturday so you have the choice to stay for round table discussions or poster presentations but if you choose not to participate, the rest of the evening is yours to spend sight-seeing.  Sunday, the conference is over by lunch time so you have the rest of the day to grab your camera and officially play tourist.  I was able to head on over to enjoy the beach while the sun was going down one evening, walked about the harbor tourist shops on a Sunday afternoon and strolled along the palm tree lined streets and bike paths with my family.  It was some fun, work, and some super fun play!!!

8.  A Family Affair: I decided to bring along my husband and 3-year-old son on this trip.  They were able to spend some quality Daddy time while I was enjoying the conference and we had some nice family time in the evenings.  It was a win-win situation for me, still having some time to enjoy my summer with my family.

7.  It’s Like Looking in a Mirror:  Have you ever seen a convergence of 1000+ pediatric SLPs on one convention center?  We are all dressed in our khakis and flip flops with our bag of notepads, binders, tablets, pens and pencils slung over our shoulders.  It really is like looking in a mirror and seeing thousands of ourselves out there.  After registration, I was walking back to my hotel room and waiting at the crosswalk were two women who looked like … well me.  So I asked them “Are you SLPs?” and one woman turned around and said “Yes, but that’s a heck of a pick-up line don’t you think?” Ha!  So true!

6.  Feed Them and They will Come:  Yes you guessed it, your registration fee includes (or at least this year included) breakfast each morning, lunch for Friday and Saturday, and snacks.  The food was very healthy and delicious too.  No too shabby!

5.  It’s About What You WANT to Know:  The feel of the schools conference is not about who you know, what researcher you like or who’s work you just finished peer reviewing.  It’s about what you WANT to know.  “What session are you going to next?” was a question I heard often that weekend from strangers who became new found friends because they happened to sit next to each other in a session.  It’s all about what we have come there to learn and what we can share with each other when our sessions are done.  The exchange of educational information for the pure purpose of learning!  Ah, does it get better than that?

4.  The Social Network:  What I love about school SLPs is that although we love our technology, we also love our old school email (strange that email is actually old school now, don’t you think?).  Of the speech pathologists I talked to and exchanged information with, there weren’t any future “tweets” planned or Facebook private messages offered.  It was more of “Shoot me an email when you get back to ____ and we’ll talk.”  So yes, we are able to build our network of SLPs in a way that works for us.  And let’s face it, what SLP can really stick to 140 characters?  Limiting our ability to “talk” is really the worst nightmare for an SLP, don’t you think?!

3.   It’s Not What You Say, It’s HOW You Say It:  The presenters chosen for this conference (I can only speak to the 5 presentations I partook) were down to earth, engaging, interactive and some of them were very, very humorous!  David Hammer, an SLP who presented on CAS, introduced himself by saying he’s NOT an expert but a specialist because he believes he is always learning.  This is one example of how things said really change the dynamic of the session.  Luckily, he was not the exception.  All of the presenters I encountered and talked to were there because they wanted to share their passion for their field with us.

2.  Use Our Time Wisely:  Each presentation was FILLED with useful information, techniques, strategies and therapy activities we can use on a daily basis for a variety of different deficits and disorders.  I was very happy to see that my money and my time was NOT wasted on theory or upcoming research while only spending the last 15 minutes on therapy as many times happens at conferences.  Rather, after every presentation I left with the feeling that I had new tools in my toolbox ready to try in therapy with my clients.

And my number 1 reason for attending the ASHA schools conference is…

1.  It Only Takes a SPARK:  The number one reason I recommend going to the ASHA Schools Conference is because it helps flame the fire and passion we have inside of us for our field.  It only takes a spark, but once our fire gets going, we are hard to stop!

So those are my top 10 reasons for attending the ASHA Schools Conference.  Did you go this year?  What are your impressions?

I have already started saving for next July’s schools conference which incidentally is being held in my old stomping grounds of Pennsylvania.  I hope to see some of you in Pittsburgh next summer!

Maria Del Duca, MS, CCC-SLP, is a pediatric speech-language pathologist in southern, Arizona.  She owns a private practice, Communication Station: Speech Therapy, PLLC, and has a speech and language blog under the same name.  Maria received her master’s degree from Bloomsburg University of Pennsylvania.  She has been practicing as an ASHA certified member since 2003 and is an affiliate of Special Interest Group 16, School-Based Issues.  She has experience in various settings such as private practice, hospital and school environments and has practiced speech pathology in NJ, MD, KS and now AZ.  Maria has a passion for early childhood, autism spectrum disorders, rare syndromes, and childhood Apraxia of speech.  For more information, visit her blog or find her on Facebook.

Never Having to Say ‘I’m Sorry’

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“I’m sorry to tell you that Sara has a permanent hearing loss.” One of the less glamorous aspects of being an audiologist is telling a parent that his or her child has a hearing loss. Although this is difficult news to deliver, how you convey that information can potentially have as much of an impact as the hearing loss itself.

Instead of apologizing for delivering this news, another way to frame the conversation is to say, “I know this may come as a surprise to you, but…” Although semantically similar to the apologetic statement, qualitative and anecdotal research has shown that parents will remember verbatim how the news was delivered to them.  As Dr. Jeffrey Lewis, a professor of mental health counseling at Gallaudet University who also teaches counseling skills to audiology students, comments, “This kind of subliminal language, though not intentional, can have real consequences for how the family approaches this news and can set lower or even negative expectations for the abilities of the child”.

Another example of negative messaging is using the word “fail” with regard to newborn hearing screenings.  Not only does “fail” suggest a hearing loss that very well may not be present; it can also make parents defensive. As one parent commented, “How could my daughter fail a test that she didn’t know she was taking?” Many institutions, including Boston Children’s Hospital and Gallaudet University, have incorporated this language into their clinical practice.

Knowing your audience is also important. For example, some deaf parents may be excited and happy to learn that their child has a severe to profound hearing loss. As one deaf parent explained, “With my first child, my husband delivered the results of the newborn hearing screening. He came into my room saying, ‘Alright she did it! Our baby passed the test; she’s deaf!’  When this occurred with our second child however, we were both surprised to learn that he passed in the sense that he was hearing and not deaf like us.”

Other deaf parents may be disappointed or have mixed feelings about this news. Most deaf babies are born to hearing parents who are in complete shock when they learn of the results.  By framing the news in a neutral manner, you are putting yourself in a position to support the parent and answer any questions they may have.

Although we are certainly not denying the shock and grief that most parents experience when facing a diagnosis of hearing loss, the less negative we can make the message, the better. Suhana Alam, a deaf adult recently selected to speak on a panel of successful deaf college students at the Annual Early Hearing Detection & Intervention Meeting in April commented, “The provider…needs to make sure the parents understand that their child’s brain works just fine; he or she just has limited hearing capability.”

As audiologists, we can then work with the family in providing information on the full range of communication options available to them.

Regardless of whether we are seasoned audiologists with years of experience or new audiologists beginning our professional careers, we are constantly adapting to change in audiology and critical evaluation of our language and word choice are easy adjustments that we can make for our patients and family members.
Cynthia Frey wrote this article with Whitney Kidd. Both are graduate clinicians in the Deaf and Hard of Hearing Infants, Toddlers, and Families: Collaboration and Leadership Program at Gallaudet University.

Collaboration Corner: Why Finding Your Virtual Peeps Is Important

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This month I wrote an article for Perspectives in School-based Issues (SIG 16), speaking to the benefits of professional learning communities (PLC). Professional learning communities are the ultimate form of collaboration (DuFour & Eaker, 2010). But consider expanding your boundaries a little further. Consider virtual PLCs; online communities through Twitter, Facebook, and online discussion threads. That’s right, social network sites and online forums can support your professional development, all from the comfort of your living room.

When I bring this up to my colleagues or friends, many groan… it’s one more thing, and how can you possible learn anything in 140 characters? Consider this:

  • One-third of public school speech pathologists travel between two or more schools (Edgar and Lugo-Rosa, 2007), thereby complicating the ability to meet face-to-face with colleagues
  • Professional development is meaningful when it is learner-centered, and by choice (Morewood, Akrum & Bean, 2010).

Virtual discussion forums can provide:

  • Opportunities to globally network with colleagues (Davis, 2012). More than just sharing hyperlinks and lesson plans, chatting with interdisciplinary teams and other educational staff, has broadened my perspective as a practitioner.
  • Online forums foster a chance to reflect (Davis, 2012). I have learned from the #slpchat colleagues, the #slpeeps, #spedchat folks, and the #edchat folks enormously. Many of these groups hold regular chats either every week or at least once a month.
  • Access information, or ask a question whenever you want (Dunlap & Lowenthal, 2009). Anyone with a smartphone can troll Twitter, or participate in an online discussion, any time of the day.
  • Access the only information that you need (Davis, 2012). Social network sites are completely dependent upon the user. This make finding information learner-centered, and not a boring, mandated, policy-driven affair.
  • A way to feel connected and supported (Hur & Brush, 2009). Sometimes getting out of your own workplace can help you regroup after a tough day.

So go ahead, dabble a little. Then advocate for yourself. Talk to your administrators. Write it into your professional development plan. Use the hyperlinks in this blog the and references listed below to support your case. Social network sites can be an affordable, meaningful tool for learning. For all the push to individualize learning for our students, doesn’t it make sense to do the same for those who teach them?

 Dr. Kerry Davis is a city-wide speech-language pathologist in the Boston area. Her areas of interest include working with children with multiple disabilities, inclusion in education and professional development. The views on this blog are my own and do not represent those of my employer. Dr. Davis can be followed on Twitter at @DrKDavisslp.

References:

DuFour, R., & Eaker, R. (2010). Revisiting professional learning communities at work: New insights for improving schools. Bloomington, IN: Solution.

Hur, J. W., & Brush, T. (2009). Teacher participation in online communities: Why do teachers want to participate in self-generated online communities of K-12 teachers? Journal of Research on Technology in Education, 41(3), 279-303. Retrieved from http://www.iste.org/learn/publications/journals/jrte.aspx

 Morewood, A. L., Ankrum, J. W., & Bean, R. M. (2010). Teachers’ perceptions of the influence of professional development on their knowledge of content, pedagogy, and curriculum. College Reading Association Yearbook, (31), 201-219. Retrieved from http://www.aleronline.org/

 

 

What Has ASHA Done for Us Audiologists Lately?

hearing aid shutterstockRecently, I was asked by a friend (another audiologist) why I belong to ASHA and what do they do for me? After all, they were the organization for speech-language pathology and really didn’t care about audiology except for the CCC-A, as believed by some. This led me to reflect on why I feel ASHA’s membership benefits me as an audiologist, focusing on the past few years.

Just in the last year, ASHA has provided me with a wealth of information related to reimbursement issues, which was developed in collaboration with the Academy of Doctors of Audiology, the Directors of Speech and Hearing Programs in State, Health and Welfare Agencies, Academy of Rehabilitative Audiology, the Educational Audiology Association, and the American Academy of Audiology.

For me, the guidance for audiologists on reviewing third party payer provider contracts was a very timely and helpful reminder because—at that time—my practice was being approached by a number of entities to provide hearing aid services.

Another helpful resource was the question and answer document about the new Otoacoustic CPT Codes that gave me information on how to bill these codes appropriately. There was also information on new requirements for the Physician Quality Reporting System, which helped me too. Aside from these useful and helpful resources, I appreciate that the information was developed jointly and shared within the audiology community.

When I think about advocacy being a member benefit, I’m thankful for quite a few things that ASHA’s advocacy team has pushed for, including:

  • A comprehensive audiology benefit. This will allow me to provide the necessary rehabilitative/habilitative services to the people I serve. This proposal will recognize that audiologists are the best providers of these services. As health care moves toward prevention of health problems and a new payment system, this will allow me to provide therapy services as part of a team!
  • Legislation related to early detection of hearing loss. The outcome of that work has benefited so many of the children and families we serve.
  • Legislation that averted the proposed 20 percent cut in Medicare payments. These have been scheduled to take place every year for the last several years, but keep getting extended. I can’t help but think that ASHA’s lobbyists have been instrumental in helping in that effort.

ASHA’s ongoing advocacy for the profession of audiology has benefited me in so many ways. Recently, ASHA was very helpful working out the “kinks” in the federal employee health benefits hearing aid plan. ASHA is also developing and implementing plans to help us navigate through the new accountable care organizations.  And, they are working diligently to see that we have a voice in the implementation of the Affordable Care Act.

As I continued to think of all of the benefits from ASHA membership—as an audiologist—I realized there has been great value in continuing to be a member of ASHA!  I want to thank my friend for asking me why I still belong.


Stuart Trembath, MA, CCC-A, is chair of ASHA’s Health Care Economics Committee and co-owner of Hearing Associates in Mason City, Iowa.

The Top 10 Take-aways for CSD Work With Families

familyportraitAccording to my dusty hardcover Webster’s dictionary, a family is defined as: All the people living in the same house; household, 2) a social unit consisting of parents and the children they rear…” (Neufeldt, V, 1988). Since this was dated, I thought I should go to The Free Encyclopedia – Wikipedia. They define family as: “In human context, a family is a group of people affiliated by consanguinity, affinity, or co-residence. In most societies it is the principal institution of the socialization of children…”

In our profession, we have had to make a mind shift from client-based services to the child to family-centered services focused on collaborating with and supporting the family. In this partnership, all people involved acknowledge that each possesses unique skills and knowledge, and they demonstrate trust and respect for one another. Professionals recognize the decision making power of the parent.

Why is family-centered care important? Outcomes! For a child to reach his or her fullest potential, it is essential to have appropriate resources, qualified professionals and family involvement. In family partnerships, families receive support not only from professionals, but from other families with similar circumstances and from the community at large.

Here are the top 10 take-aways for the next time you work with a family:

10) Time. As a professional everything is fast paced. After all time is money — and you serve a lot of people. For a parent, however, time is very slow; they are constantly waiting.

9) Don’t make assumptions or generalizations. Every family is unique with very specific needs. Present all options…don’t be biased in what you say.

8) Don’t label families—or each other.

7) Don’t make inappropriate comments about your profession. Talking negatively about your workplace or another professional reflects poorly on you. The average “wronged” customer will tell 25 others about the bad experience. Don’t reinforce negative experiences.

6) Be confident but not arrogant.

5) Communicate! Communicate! And communicate some more! You cannot overstate anything. Monitor your tone of voice, body language, rate of speech, and be mindful of professional jargon.

4) Listen! Listen! And listen some more! Show the family you are listening (body language). Provide feedback, defer judgment, and don’t try to rescue—empathize.

3) Acknowledge the parent’s efforts and strengths. No matter how small it is — acknowledge something positive.

2) Keep in mind the lack of consistency in our field. Families will see a variety of specialists, and each will provide an opinion about what the parents should do. “This method is better because”…or “You should try this.” The various opinions can be confusing and overwhelming for the family. Be respectful of one another.

1) Respect and patience. Remember parents are people too!

To learn more about family support and family-centered practices, check out the transcript of an “Ask the Expert” online chat about these services, held April 30 by ASHA Special Interest Group  9, Hearing and Hearing Disorders in Childhood.

Tamala Selke Bradham, PhD, CCC-A, is coordinator of ASHA Special Interest Group 9, Hearing and Hearing Disorders in Childhood. She is also associate director of quality, protocols, and risk management in the Department of Hearing and Speech Sciences at Vanderbilt University. She and Joni Alberg, PhD, executive director of BEGINNINGS for Parents of Children Who Are Deaf or Hard of Hearing, Inc., in Raleigh, N.C., answered questions during the SIG 9 online chat.

How Bombs and Other Loud Booms Can Damage Hearing—and How People Can Get Help

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We live in a time of constant exposure to loud sounds. Some of them are completely unexpected and earsplitting, such as last month’s blasts at the Boston Marathon and explosions at the fertilizer plant in West, Texas, or the roadside bombs constantly encountered by military service members overseas.

The newspapers and television media share some of the awful lingering effects for survivors, particularly the physical and psychological trauma. Occasionally the media comment on the disorientation and temporary effects on hearing. But we seldom learn of the long-term effects that many of the survivors experience, especially in relation to hearing loss.

The hearing system is a wonderful and a very delicate tool that allows us to hear a wide range of sounds and words. We take our hearing ability for granted until something occurs to disrupt it. We attend a thunderous rock concert, watch booming 4th of July fireworks or listen to our electronic devices on top volume. Afterward we notice that we are not able to hear clearly for a while. But then our hearing gradually returns to what seems like normal, and we expose ourselves to that same noise again and again. Each time we do this, we increase the likelihood that our hearing will gradually be permanently affected—and we cannot get it back. This deterioration happens because the tiny sensory hair cells of the inner ear get destroyed. These cannot be restored!

Those who happened to near the Boston Marathon bombings were rendered disoriented and unable to hear by the sudden blasts. Some may have found their hearing improving and feeling OK by the next day. But others may now have a noise in their head that is either constant or intermittent—the result of the huge blast their ears were exposed to. These people may find it useful to speak with an audiologist about reducing the effects of this noise on their lives.

Others exposed to the blast may not be able to hear as well as they could before this traumatic event. Their speech may be unclear, or even greatly reduced, and they may hear themselves quite loudly but cannot hear others when they speak. They may wonder at the fact that others next to them have no such permanent effects. All of us are different. And for some reason, some of us can tolerate loud sounds a lot better than others and don’t seem to react as much as others. There is no way to predict at present who can tolerate loud sounds versus who cannot.

What can a person do when there has been a long-term effect on hearing? There are two groups of people who specialize in hearing disorders: Physicians who are ear, nose and throat specialists, and those who are doctors of audiology (audiologists). An audiologist has the training and knowledge to treat hearing disorders, and the physician is trained to treat medical issues related to hearing. Audiologists help those with noise in the ear or hearing loss reduce these effects. Physicians work to repair problems in the ear with medication and surgery.

But a physician’s work may not be enough to solve the problem, and that is when an audiologist may provide the most assistance. The important take-home message is that you do not have to live with deteriorating hearing. Reach out to audiologists and physicians, who can help you continue functioning well in society and access a high quality of life.

 

James Blair, PhD, CCC-A, is a professor of audiology at Utah State University and an affiliate of ASHA Special Interest Group 8, Public Health Issues Related to Hearing and Balance.

Practice Portal: Making Its Way to You …

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If you’ve been a member of ASHA or NSSLHA for any length of time you probably know about the ASHA website and the resources offered for SLPs and audiologists. ASHA is currently focusing efforts on a new resource, known as the Practice Portal.  The Portal is designed to support your professional practice by offering guidance on professional and clinical topics, evidence maps, client/patient handouts, as well as templates and tools. As with any project, the work takes time. So far, development is complete on  five topics including aphasia, superior canal dehiscence, audiology assistants ,speech language pathology assistants, and caseload/workload.

Several more topics are on the horizon and more will be published later this month. Those include pediatric dysphagia, social communication and permanent childhood hearing loss. ASHA currently has dedicated staff members who work daily to move this project forward. We also gather input from our members from the relevant area of practice to assist with writing and reviewing the content at three separate stages of subject matter expert review. We are very grateful for the member volunteers who have graciously offered their time, skill and expertise to ensure the content is of the highest quality.

Each Portal page follows a similar framework depending upon the type of topic. The clinical topics begin with an overview, and include incidence and prevalence, signs and symptoms, causes, roles and responsibilities, assessment, treatment, resources and references.  Professional issue topics include an overview, information on key issues, resources and references. This framework makes each page easily navigable and user friendly.  Every portal page includes links to technical assistance, relevant Special Interest Group(s), products, events and related resources. All of ASHA’s clinical resources on the topic are included in one place.

The site is currently in “beta” or “trial” mode. During this time we invite you to review the site content and offer feedback. ASHA staff members will read and consider all feedback offered.

If you’re a school-based SLP, check out the SLPA and the Caseload/Workload Portal pages. The SLPA page features a newly developed Scope of Practice for SLPAs along with supplemental content that is designed to inform and enhance your daily practice as you supervise SLPAs.
The Caseload/Workload page features guidance on conducting a workload analysis, School Survey data and approaches used to manage workload. ASHA applauds the member experts who assisted with these pages.

When available, clinical topics also include evidence maps that are intended to provide you with tools and guidance for evidence-based decision making. These maps highlight the three components of evidence-based practice (EBP):

  • external scientific evidence,
  • clinical expertise/expert opinion
  • client/patient/caregiver perspectives

Learn more about the evidence maps

 

Join us as we develop new pages!  You can nominate yourself and others  as a subject matter expert (SME) to review pages and provide feedback.  Just send us a message indicating your clinical or professional area of interest.  We look forward to hearing from you!

Lisa Rai Mabry-Price is the associate director of school services for ASHA. She can be reached at lmabry-price@asha.org.

Kid Confidential: Hearing Loss, Classroom Difficulties, and Accommodations

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(photo credit: sound waves via Bigstock)

Ah, the familiar sounds of rustling papers, fast paced walks from meeting to meeting room, and that all too common groan, a mixture of frustration and exhaustion in equal parts, remind me that it is that time of year in the schools.  It is “IEP season”.

In honor of the countless hours of reassessment, data collection, and paperwork completion you will be doing over the next few months, I thought I’d write a post to help out those of you who are once again, hitting the keyboards and staring at that blank section on your IEP.  You know the one I’m talking about.  You spend a lot of time thinking about it only after all the data and classroom observations are compiled.  You know it needs to be completed but after writing your student’s present level of performance, his goals and objects and of course his service time, who has the energy left to even think about classroom accommodations and modifications.  Well that is where I step in, at least for those of you who have students with hearing loss on your caseloads.

Last year at this time I had a few students with hearing loss managed with both hearing aids and cochlear implant (CI) on my caseload.  As a multidisciplinary team, we had to do some research to find appropriate accommodations and modifications for those students.  However, I recently read the book Children with Hearing Loss: Developing Listening and Talking Birth to Six, by Elizabeth Cole and Carol Flexer which provided some clinically useful information on the specific deficits a child with hearing loss might have in the classroom setting.  I wish I had read this last year while I was struggling with the multidisciplinary team to write an appropriate IEP.  But now that I found this information, I thought I would adapt parts of it and compile that information into a table for quick reference in the future.

The accommodations and modifications in the graphic below are suggestions of possibilities you may attempt to provide for your students.  This is by no means an exhaustive list nor would every student benefit from each suggestion.  Therefore, I recommend you use this list as a guide only while working collaboratively with your multidisciplinary team to determine appropriate accommodations and modifications for each student on an individual basis.

You will notice that the first accommodation for any hearing loss is the use of an FM system alone or in conjunction with auditory management (e.g. hearing aids, cochlear implant, other technology).  Research has shown the use of individual FM systems positively impact students with hearing loss of any severity level AND that classroom or sound field FM systems benefit ALL students.  One can’t help but wonder how different a student’s behavior would be in a classroom where the speech to noise ratio was in fact the recommended +15-20 dB rather than the typical +4 dB (Cole, Flexer 2007).  That is why the recommendation of an FM system is first as it is not only practical but very beneficial even for a child with very mild hearing loss.

Here are the levels of severity, classroom difficulties and possible accommodations and modifications for children with hearing loss.

You can download your copy of the above materials here.

I hope these materials help guide you and your multidisciplinary team when writing IEPs for your students with hearing loss.  Do you have additional modifications or accommodations you would add to this list?  Let us know by commenting below.

Thanks for stopping by and reading our second installment of Kid Confidential.  If you have any topics you would like us to discuss here, feel free to share.  You just might see your topic suggestion in one of the upcoming columns.  I’ll meet you back here on the second Thursday of next month.

Until then, remember, knowledge is power, so let’s keep learning!

References:

  • Cole, Elizabeth, and Carol Flexer. Classroom Accommodations for Students with Hearing Impairment. San Diego, CA: Plural Publishing, Inc., 2007. Print

—————–

Maria Del Duca, MS, CCC-SLP, is a pediatric speech-language pathologist in southern, Arizona.  She owns a private practice, Communication Station: Speech Therapy, PLLC, and has a speech and language blog under the same name.  Maria received her master’s degree from Bloomsburg University of Pennsylvania.  She has been practicing as an ASHA certified member since 2003 and is an affiliate of Special Interest Group 16, School-Based Issues.  She has experience in various settings such as private practice, hospital and school environments and has practiced speech pathology in NJ, MD, KS and now AZ.  Maria has a passion for early childhood, autism spectrum disorders, rare syndromes, and childhood Apraxia of speech.  For more information, visit her blog or find her on Facebook.

Primary Prevention in Communication Sciences and Disorders

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(photo credit)

Recently I walked through a speech clinic of the near future. You might expect that the examination rooms of this clinic would be stocked with high-powered flexible endoscopes, that would allow one to see with stunning detail oral, laryngeal and pharyngeal structures. You might also look around for powerful tablets and smartphones and high-fidelity digital audio speakers, to provide crystal clear reproductions of a person’s speech output. Today’s communication sciences and disorders (CSD) professional is rapidly reformatting current practice models, with wholesale changes for third party reimbursement occurring as this blog is written. But instead of the high technology fittings of a large scale speech clinic, this speech clinic of the near future has barely changed, but for shelves that contain a number of prevention products. The CSD professional encounters something new but also something old, when introducing prevention activities into a clinical practice. What is prevention to a CSD professional? How futuristic is the push to include prevention as a CSD product line? Can most CSD practices absorb prevention into their business models?

When the American Speech-Language-Hearing Association (ASHA) advocated for prevention of disorders of communication, cognition and swallowing in its 1987 position paper, a slow-rolling but persistently accelerating snowball had been born. Prevention of communication* disorders, on the one hand, seems a radically divergent activity from traditional clinical practice for many speech-language pathologists and audiologists. “You mean I have to not only work with my patients to help them improve, but I also have to help change the world so I have fewer patients?” Exactly. That’s it. On the other hand, prevention is set firmly within the foundation of ASHA practice patterns. Prevention may in the short term help some in your community forestall the need for treatment. It will also in the long term bring more persons in need to the CSD professional’s door.

With primary prevention, the CSD professional attempts to reduce or eliminate conditions that may bring about a communication disorder. You do this through either altering a person’s susceptibility to a condition (if I am exposed, what are the odds I will stay healthy?), or reducing the degree of exposure (should I simply avoid the risk in order to stay healthy?) that makes you susceptible. An example of altering your susceptibility might be improving your speech breathing, to speak over noise you encounter while working at a busy restaurant. The same restaurant worker may, in turn, reduce exposure by changing her or his work schedule to rest the voice.

Primary prevention appears the most alien of the prevention concepts to CSD professionals. After all, most of us stop considering a new product line when there is no reimbursement for it! And it’s not testing or treatment, but – but – it’s selling or teaching stuff, to people who may not have impairments. Can I teach healthy people things that may head off their becoming disabled? Can I sell things, and keep track of sales taxes? Yes, we can. If we are willing to lurch out of our comfort zones as clinicians, there may be tremendous return on investment with the increased community visibility we gain as health promotion professionals. So, how do we do primary prevention in CSD? What is the stuff of it? What are the outcomes we want?

On the primary prevention shelves of this near future clinic, I saw tools that included:

I. Oral-motor/motor speech:

II. Fluency

III. Voice:

  • C.O. Bigelow Elixir White/Green hair and body wash @ $10
  • 1 gallon of distilled water @ $1

IV. Swallowing:

  • 1-qt Ziploc bag, containing a roll of Life Savers and a dispenser of mint waxed dental floss @ $5
  • 1–qt. Ziploc bag, containing a bound supply of 1 doz. sterile tongue depressors @ $5

V. Cognition:

  • Radius model ergonomic garden trowel @ $10
  • GAMES magazine: single issue @ $5

VI. Speech and language:

Readers should note that the selection of brand name products is purely coincidental by the blogger. Products have neither been trialed prior to this writing, nor are there financial or non-financial relationships between the blogger and any product company. Primary prevention products are chosen for stocking in this clinic of the near future for their relatively low price; their ready availability in the community, and their applicability to the needs of the prevention consumer. Price points are strictly ad hoc at this writing; experienced CSD practitioners will adjust the price point and product selection to a level that their customers will bear.

The sales area for primary prevention has its own entrance from street level, thereby controlling the mixing of regular clinic patients (tertiary prevention consumers) with those shopping for their CSD wellness needs. Adjacent to the sales area is a video viewing room, with four computing devices available to consumers to view demonstrations of each primary prevention product. Reading racks mounted at eye level near the viewing stations, contain fliers and magazines from community services that support and announce wellness activities on community calendars.

Let’s make sure the original questions posed are answered. To wit:

  • How do we do primary prevention in CSD?
  • What is the stuff of it?
  • What are the outcomes we want?

Ideally, primary prevention products and activities bring your customer into your marketplace. You help them stay healthy to function in their communities, so that the probability of their entering the healthcare system to identify and treat impairments is lowered. You do primary prevention through teaching, training, referring, marketing, selling, cooperating and participating in a large network of community and supports and services for your customer. Your collaborators in primary prevention may include office managers; health educators; fitness center trainers; bodyworkers; priests, rabbis, imams and healers; drama and singing and cooking teachers; and all those who work in wellness and health promotion. Outcome measurement may be as simple a function as that of measuring the customer’s changes in both health literacy and patient “activation”, as in the Patient Activation Measure of Hibbard and colleagues. The long-term outcome desired is that community healthcare costs are ratcheted downward. The story of primary prevention in CSD is, again, being written as we walk through this near future clinic. What do you see in the clinic of the future? Time to move into the secondary prevention wing now….

*communication, cognition and swallowing.

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Carey Payne, MCD, CCC-SLP, is an SLP in Elmhurst, IL.  He knew nothing about speech-language pathology as a profession until he needed it as a client. He was helped at his university’s speech clinic to improve his fluency. He has helped persons of all ages in numerous work settings, for almost thirty years hence.  Carey Payne is an affiliate of ASHA Special Interest Groups 2, Neurophysiology and Neurogenic Speech and Language Disorders and 13, Swallowing and Swallowing Disorders (Dysphagia).