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

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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).

Beware of Scams Targeting Private Therapy Providers

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(photo credit)

Internet scams targeting Physical, Speech, Behavior, and Occupational Therapists are on the rise. Last year, I received 3 different scams via email. Initially, I was shocked that I, along with other Therapists across the United States and Canada, were being targeted for our specific services. After the shock subsided, I realized that it made perfect sense. We, as Therapists, are ideal targets. We have big hearts, want to see people improve, and we can be …well, there is no easy way to put this, a little on the verbose side. We do fit the perfect profile for a viral scamming nightmare. Typically these scams tug on our emotional heartstrings and appeal to our sense of altruism.

Shirley Kunkel, M.A., CCC-SLP, a Private Practice Owner in Escondido, CA and Speech Pathologist for 33 years, recalls a recent encounter with a scam artist.

I became mildly suspicious when they asked if I worked on receptive and expressive language, reading disorders and fluency disorders. I felt like their request was not specific enough. So I tried to ferret out what specifically they were trying re-mediate. Sounded like all the disorders I work on in listed in an Ad. Also, the person signed off as Mitchell one time and Michelle the next. I couldn’t understand why the mother who had used Dr. in her title would be coming to my town for 4 months. It is not a scientific research community at the local hospital where I live. They said they presently lived in London and sometimes visited Egypt. I did not lose any money, but I regret that I invested my time and energies into responding to this thief.

Unfortunately, many Therapists are being targeted and are unknowingly engaging in these traps. As a result, some Therapists are losing their hard-earned money by the thousands. Tom Jelen, Director of Online Communication with American Speech-Language-Hearing Association (ASHA), has also noticed this growing problem within the Private Practice Community.

ASHA has received several reports from our members about a scam that is being attempted on members in private practice. The scammer is requesting to have his or her child visit a private practitioner while visiting the United States. The scammer requests to pre-pay for an evaluation and then sends a cashier’s check that is in an amount well above the evaluation charge. At this point, the scammer requests that the practitioner deposit the money in his or her bank and send back the overage (minus some money for the inconvenience). This scam has been reported to the Federal Trade Commission.

In the article, Fake Checks, the Federal Trade Commission describes normal banking activity.

Under federal law, banks generally must make funds available to you from U.S. Treasury checks, most other governmental checks, and official bank checks (cashier’s checks, certified checks, and teller’s checks), a business day after you deposit the check. For other checks, banks must make the first $200 available the day after you deposit the check, and the remaining funds must be made available on the second business day after the deposit.

However, just because funds are available on a check you’ve deposited doesn’t mean the check is good. It’s best not to rely on money from any type of check (cashier, business or personal check, or money order) unless you know and trust the person you’re dealing with or, better yet — until the bank confirms that the check has cleared. Forgeries can take weeks to be discovered and untangled. The bottom line is that until the bank confirms that the funds from the check have been deposited into your account, you are responsible for any funds you withdraw against that check.

You Can Protect Yourself

The Federal Trade Commission offers some helpful ways to avoid being the latest victim of online scams in the article, “Giving the Bounce to Counterfeit Check Scams.”

  • Know who you’re dealing with, and never wire money to strangers.
  • If you’re selling something, don’t accept a check for more than the selling price, no matter how tempting the offer or how convincing the story. Ask the buyer to write the check for the correct amount. If the buyer refuses to send the correct amount, return the check. Don’t send the merchandise.
  • As a seller, you can suggest an alternative way for the buyer to pay, like an escrow service or online payment service. There may be a charge for an escrow service. If the buyer insists on using a particular escrow or online payment service you’ve never heard of, check it out. Visit its website, and read its terms of agreement and privacy policy. Call the customer service line. If there isn’t one — or if you call and can’t get answers about the service’s reliability — don’t use the service.
  • If you accept payment by check, ask for a check drawn on a local bank, or a bank with a local branch. That way, you can make a personal visit to make sure the check is valid. If that’s not possible, call the bank where the check was purchased, and ask if it is valid. Get the bank’s phone number from directory assistance or an Internet site that you know and trust, not from the check or from the person who gave you the check.
  • If the buyer insists that you wire back funds, end the transaction immediately. Legitimate buyers don’t pressure you to send money by wire transfer services. In addition, you have little recourse if there’s a problem with a wire transaction.
  • Resist any pressure to “act now.” If the buyer’s offer is good now, it should be good after the check clears.

Remember, if you think you’ve been targeted by a counterfeit check scam there is something you can do. Simply report it to the following agencies:

Sources

  1. Fake Checks, http://www.consumer.ftc.gov/articles/0159-fake-checks
  2. The Nigerian Email Scam, http://www.onguardonline.gov/articles/0002l-nigerian-email-scam
  3. Giving the Bounce to Counterfeit Check Scams, http://www.ftc.gov/bcp/edu/pubs/articles/naps29.pdf

A version of this post was originally published on The Independent Clinician.

Pamela Rowe, MA, CCC-SLP, is the Clinical Director of Pamela Rowe, MA, CCC-SLP, LLC in Longwood, FL. As a Speech Pathologist, Community Partner, Wife, and Mother of 3, Pamela enjoys mentoring the next generation of Speech Pathologists and hosting various community health events within Central Florida.

Website: www.speechorlando.com
Facebook Group: www.facebook.com/speechorlando

ASHA’s Listen To Your Buds Campaign Brings Safe Listening Message to The 2013 International Consumer Electronics Show

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Annette Gorey, ASHA’s Public Relations Specialist, works to get ASHA’s booth ready for the show.

More than 150,000 people may hear more about ASHA’s Listen to Your Buds campaign at this week’s 2013 International Consumer Electronics Show (CES) in Las Vegas. This marks ASHA’s fifth consecutive year as a CES exhibitor, and the ASHA Public Relations team couldn’t be more excited to spread the word about listening safely and preventing noise-induced hearing loss.

The Listen to Your Buds exhibit will be in the heart of the CES Digital Health Summit. And new this year, ASHA joins the show’s MommyTech Summit to connect with influencers, mommy bloggers, key children’s health and technology media and more. We’ll convey how Listen to Your Buds can help parents help young people use personal audio technology safely. As you probably well know, the parent blogosphere is more powerful than ever and growing fast. This is an increasingly important audience for our Listen to Your Buds campaign and outreach efforts.

The time has never been riper for a safe listening message. Spend a day with a toddler, elementary school student, tween or teen – or just walk around the mall, stand in line at Starbucks or stroll down the street – and you can’t help but see how kids are more connected to personal audio devices than ever before. Headphones have become a fashion item. The latest color iPod is in the hands of a six-year-old. Teens are at the gym listening to music. And this past holiday season, personal audio technology items were among the hottest gifts around. Now, in the wake of technology gift-giving and increased daily technology time, parents should monitor their child’s usage and volume levels and model safe listening behaviors – and the tips at www.listentoyourbuds.org can help.

We know even minimal hearing loss can affect children’s social interaction, communication skills, behavior, emotional development, and academic performance. Some parents are now realizing this, too. Eighty-four percent of parents are concerned that misuse of personal audio technology damages the hearing of children, according to the results of an online poll commissioned by ASHA last May. Parents also show overwhelming support for hearing screenings for tweens and teens—71% for 10- to 11-year-olds and 67% for 16- to 17-year-olds—according to a University of Michigan Mott Children’s Hospital National Poll on Children’s Health released just last month.

ASHA’s exhibit booth in the Living in Digital Times area has information about hearing loss prevention, warning signs of hearing damage, and how to find a local ASHA-certified audiologist using ASHA’s ProSearch. ASHA member and Las Vegas audiologist Dr. Daniel Fesler, CCC-A and Buds Coalition Musician Oran Etkin will be on hand to talk with attendees.

The Consumer Electronics Association (CEA), who puts on the CES each year, is among the Buds’ dozen dedicated sponsors; we joined forces in 2007. Recently, CEA President and CEO Gary Shapiro highlighted just how important the Buds message is. “As a longtime supporter of the Listen To Your Buds youth campaign, CEA represents companies that create audio technologies for listeners of all ages,” says Gary Shapiro, president and CEO of CEA. “We promote products, like noise-canceling and sound-isolating headphones, that help minimize outside sounds, and volume-controlled headphones that give control to parents of young children. New innovations are still to come that will help us practice and teach safe listening so that we can all listen for a lifetime.’”

Erin Mantz is a Public Relations Manager for ASHA.

Nothing Smaller Than Your Elbow Please

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(Photo credit)

Ear wax: We all have it. We all want it gone.

Most audiologists are often asked about ear wax. What is it? Why is it sticky? Why do I make so much? How can I get rid of it?

Say “yes” to ear wax.

Ear wax actually helps to keep your ears clean.

The wax traps dirt, dust and debris such as dead skin cells from the ear canal, dried shampoo and shave cream and possibly the occasional flea or gnat. This debris is held together by oil and wax secreted by glands living in your ear canal. The secretions also have natural antibiotic properties that help keep bad bacteria from growing in the warm dark and cozy environment of ear canals. And you thought it was just a nuisance!

What kind of wax do you produce?

Ear wax or cerumen comes in two varieties: wet (honey-colored and sticky) and dry (grayish and flaky). Ear wax type is highly heritable and considered a Mendelian trait that follows the laws of genetics. The trait of wet or dry ear wax was once attributed to a single gene but today, research has identified another gene contributing to this sticky situation. Your ear wax type was determined by your ancestry. Almost all people with European or African ancestry have wet wax. If you have northeastern Asian ancestry will most likely have the dry and flaky variety.

People have no trouble cleaning belly button lint and removing mucus from the nose, but most have no clue how to safely take care of excess ear wax. For most people the ear is self-cleaning and ear wax is removed by the natural flow of the wax out of the ear. Ear wax problems are typically self-inflicted. If you listen with ear phones for long periods of time, (at safe loudness levels please) wax can become trapped because the natural flow of wax out of the canal is blocked with the ear phone. However, most problems arise when the wax becomes impacted up close to the ear drum– down deep in the ear canal. This usually occurs from attempts to clean ear wax using implements of destruction such as cotton swabs, hair pins and tooth picks. If you choose to use these tools to clean your ears, you run the risk of puncturing the ear drum (ouch!) or impacting the wax in the canal in an area beyond the oil secreting cells. The soft wax dries up into a hard ball and can cause a temporary hearing loss or dizziness until it is professionally removed. Contact an audiologist if you think ear wax may be the cause of your hearing or dizziness problems. Audiologists will advise you on how to prepare for a professional ear cleaning. They often provide ear wax removal. And if you make more than is typical, the audiologist will schedule appointments once or twice a year to keep things under control.

Do you have too much of a good thing?

Stress (even physical exercise) and anxiety can increase wax production as well as medications that either activate or diminish the “flight or fight” response. Anatomical structures of the ear canal can cause wax to become trapped. When the ear canal twists and turns or narrows a bit, the wax will not easily flow from the canal. Even normal aging increases wax production.

Just as grandmother reminded us…put nothing smaller than your elbow in your ear and let Mother Nature do her work.

What other common questions do you get from patients in your audiology practice?

Pamela Mason, M.Ed., CCC-A is the director of audiology professional practices at the ASHA national office. She is a member of ASHA’s SIG 8, Public Health Issues Related to Hearing and Balance.

Most Popular 2012 ASHAsphere Posts

2012 ASHAsphere Wordle

Since the year will soon be coming to a close, it’s the inevitable time for year-end lists.  Rather than be left out, we want to celebrate the upcoming New Year’s holiday by sharing with you the most popular posts from ASHAsphere for 2012.  A broad range of topics was presented this year.   We want to thank all of our contributors and readers for making ASHAsphere a continued success.  We look forward to another great year in 2013!  If there are specific topics you’d like to see us cover in 2013, please provide them in the comments.

The Best Speech-Language Pathologist Blogs from ‘A to Z’
Heidi Kay presents a fairly comprehensive list of SLP blogs in her popular post. The comments fill in any missing holes in her initial list.  This is a great post to start exploring the SLP blogosphere.

Google Forms and Spreadsheets—Fun Times with Data Collection!
How often are the words “fun” and “data collection” used in the same sentence?  Ruth Morgan shows you how to make your data collection a little more enjoyable with Google Forms and Spreadsheets.

Speech Therapy Ideas for Preschoolers
Sherry Artemenko provides some great tips for parents and SLPs getting started with a preschool aged population.  Key take-away: Play-Doh is an essential.

Habilitation – What it is And Why it Matters to You
Habilitation is getting a lot of national attention right now due to the implementation of the health care reform law. ASHA’s former Associate Director of Health Care Services in Speech-Language Pathology, Amy Hasselkus, gives readers a quick breakdown on what it is and why it matters to SLPs and Audiologists.

Auditory-Verbal Therapy: Supporting Listening and Spoken Language in Young Children with Hearing Loss & Their Families
Todd Houston discusses the trend of parents choosing spoken language options, such as Auditory-Verbal Therapy, for their children with hearing loss.

Fun Resource for Therapy Ideas: Pinterest
ASHA’s Maggie McGary breaks down Pinterest for the uninitiated. “SLPs and other therapists and educators are ‘pinning’ therapy ideas by the hundreds, making Pinterest an invaluable resource for therapy ideas and inspiration.”

Rate That App
“More and more SLPs are using apps in therapy and more and more speech/language apps are flooding the app store.” Deborah Taylor Tomarakos discusses how SLPs can determine which of those apps are appropriate and useful in therapy or educational settings.

Low-Tech Speech Therapy
While high tech tools and apps seem to be all the rage these days, Elizabeth Gretz shares some decidedly low-tech (and “super cheap”) options for speech therapy.

Using Your iPad in Dysphagia Therapy
Tiffani Wallace takes the app theme into the field of Dysphagia therapy.

Picture Books to Improve Your Toddler’s Speech
Kimberly Scanlon selected and reviewed a sampling of picture books for toddlers that are having difficulty producing Ms, Bs, or Ps.

Tom Jelen is the Director of Online Communications for ASHA.

Telehealth = Tell Me The Definition!

Yes, we know it’s coming, but what does it mean?  Some use the word “telehealth” to describe a virtual service delivery model between a patient and clinician.  Others expand the definition beyond the patient and clinician to also include innovative platforms.  Until the term is defined in the Scope of Practice for the American Speech-Language Hearing Association (ASHA) or American Academy of Audiology (AAA), acknowledged by insurance companies, and understood by policy makers, we will continue to vaguely use this term.  In the meantime, this is my humble perception of “telehealth” in the future.  Specifically, these are my ideas for a mobile application that is beneficial for the manufacturers, profitable for the audiologist, and most importantly, easily accessible and user-friendly for our patients.

What’s your definition of Telehealth?

(This post originally appeared on TinaTheAuD)

Tina Penman, CCC-A, AuD, is a clinical and research audiologist.  She received a BS in behavioral neuroscience (2006) and clinical doctorate in audiology (2010) from Northeastern University.  She has enjoyed her time serving ASHA as the SIG 8 CE Content Manager and looks forward to continued service to the organization.

Disclaimer:  Content represents only the blogger’s views.  Content does not represent the views of the blogger or any other organizations the blogger belongs to or represents.

Crickets: Beautiful Sound or Terrible Noise?

Pet Crickets, just hanging around

Photo by IvanWalsh.com

On a recent evening walk I stopped to listen to a familiar September melody: crickets singing.  In a flash the sound brought memories of the summer that had just passed by and summers that preceded it.  It also got me anticipating the season change, with colorful fall days followed by short winter ones, then melting ice and the burst of life that signals spring.  All this from a few crickets!

Attending the National Hearing Conservation Association annual convention about ten years ago I was invited to write my favorite sound on a little white index card.  That was the first time I learned of the Favorite Sounds project, and it was probably the first time I had ever thought of sound in that way.  In this ongoing study of favorite sounds, 70% of respondents have indicated they enjoy sounds categorized as “natural” whereas 30% chose “mechanical” sounds.  Further broken down this includes:

  • Natural sounds: weather related (29%); animals (29%); and human (24%)
  • Mechanical sounds: music (70%) and vehicles (13%)

Now that I am a convert to the topic, I add new favorites to my own list regularly–like crickets.  And I use Favorite Sounds as a discussion starter and writing prompt in my classes at Boston University.  It’s a good way to engage students, and if I can’t draw them out with favorite sounds, this follow-up question usually does: What are some sounds you dislike?   Through the years I’ve learned that a lot of people like the sound of crickets, but others can’t stand them–for various reasons.  One example: some people who experience tinnitus describe it as sounding like annoying crickets.  Tinnitus is a distressing condition associated with hearing loss, and with noise induced hearing loss in particular.

The topic of favorite and un-favorite sounds is relevant in hearing loss prevention and other broad questions of public health.   In the 1980’s some research groups investigated whether exposure to loud music is less risky to hearing when the music is considered by the listener to be pleasant vs. unpleasant.   Although the result of one study seemed to indicate such an effect, in general there is agreement in the research community that exposure to very loud sound is risky to hearing, enjoyable or not.   And noise can affect more than our hearing: current research suggests that exposure to noise in our daily lives is associated with stress and elevated risk of cardiovascular problems, even at levels well below those that can damage the hearing mechanism.

So whether you like the sound of crickets or close the windows when they begin their serenade, noise in the environment impacts all of us in many different ways.  Noise is one of the interesting topics addressed frequently by ASHA’s Special Interest Group 8: Public Health Issues Related to Hearing and Balance.  Join us and learn more!

References

Lindgren, F., and Axelsson, A. (1983).  Temporary threshold shift after noise and music of equal energy.  Ear & Hearing, 4(4), 197-201.

Meinke, D., Lankford, J. and Wells, L. (2002).  Collecting favorite sounds. Available online at: http://hearingconservation.org/associations/10915/files/Favorite%20Sounds%20Handout.pdf

Moudon, A. V. (2009).  Real noise from the urban environment: How ambient community noise affects health and what can be done about it. American Journal of Preventive Medicine 37(2), 167-171.

Swanson, S.J., Dengerink, H.A., Kondrick, P., and Miller, C.L. (1987).  The influence of subjective factors on temporary threshold shifts after exposure to music and noise of equal energy.  Ear & Hearing, 8(5), 288-291.

 

Ann Dix, CCC-A, grew up in a musical family and became interested in speech and hearing through her background playing and singing in rock and roll bands.   She has been a clinical faculty member of Boston University’s Speech Language and Hearing Sciences department since 1997.  Ann blogs at Now Hear This, a Boston University blog about sound and hearing. 

 

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

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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.