Convention Must-Have: Twitter

I was really excited when I was selected to become an official ASHA blogger.  I blog anyway, so it was nice to get an official title.  I had planned on blogging a little everyday, but things have been crazy and before I know it, it’s time for bed.  I decided to go ahead and blog on Friday, the next to last day of the convention!

Throughout convention I kept hearing “how do you incorporate Twitter into therapy?” or “so how do you use Twitter?”  It seems there is either a lot of resistance to Twitter or people just really have no idea how to use it or how to get started.

Originally, I intended to write about my trip here, the sessions I attended, etc., but I think I’ll save that for later and instead write about Twitter.

I started my Twitter account about two or three years ago, around the time of my first ASHA Convention.  As much as I enjoyed the convention, I really didn’t socialize a lot or leave my hotel room other than to go  to sessions.   Through that convention, I started getting more involved in Twitter and started forming friendships there.

The 2011 convention was so much better having such a large group of friends to spend time with and share my ASHA Convention excitement.

This year has been a whole new experience.  I have a much larger group of friends, a really great roommate and amazing opportunities coming my way, all thanks to Twitter.   We had a great “Tweet up” this year with many new and familiar faces.  It’s always so nice to meet those people you’ve been talking to online.

How do I use Twitter?  I use it in so many different ways.   I ask and answer therapy questions through Twitter.  We have a whole network of SLPs called the #SLPeeps.  We have specialty people in various areas: literacy, fluency, technology, apps  and dysphagia.

I use Twitter to announce changes to my website, new blog posts, exciting news like earning my BRS-S, and to share links to videos or websites that I find relevant or interesting. I use it to share important information at ASHA from professional development sessions that I attend, or CEU events that I attend outside of ASHA.  If I find a really great session, I share that.  If I find a new product, I’m excited to talk about it and let others know.

So many people say they don’t have time for Twitter.  I can access Twitter on my phone and on my iPad, allowing me to post a Tweet any time of day.  I can post on Twitter in just a few minutes.  It’s really only as time-consuming as I allow it to be.

When I talk to people about Twitter, I tell them that’s it’s an excellent learning opportunity for me and a way that I have met many new friends that I may not have otherwise met.    I proudly wear my “I Tweet” and “#SLPeeps” ribbons on my badge and tell everyone who asks me about Twitter that it has been one of the most life-changing opportunities I have experienced.

(Tiffani is one of the official ASHA Convention bloggers. These three bloggers were selected to blog about the ASHA Convention in exchange for complimentary registration. Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

Tiffani Wallace,CCC-SLP, has been an SLP specializing in Dysphagia for over 11 years.  Tiffani has been very active in the social media world, creating 2 Facebook groups, Dysphagia Therapy Group and Dysphagia Therapy Group-Professional Edition.  Tiffani is also the co-author of the app Dysphagia2Go, available on iTunes.  She is preparing to travel nationally and speak on the topic of Dysphagia.  Tiffani writes a blog called Dysphagia Ramblings and is the author of www.dysphagiaramblings.com.  She is a 5 time ACE awardee and recently obtained her BRS-S.

Pre-ASHA Convention Blog Roundup

2012 ASHA Convention logo

At long last, the 2012 ASHA Convention is upon us! If you’re either already in Atlanta or heading there, here are some links to helpful posts by fellow attendees, both past and present:

  • Tara Roehl gives instructions on how to create your convention schedule using Google Docs.
  • Aubrey Klingensmith has reated an “#ASHA12 Survival Guide” of apps that might come in handy during Convention.
  • Ruth Morgan has scoped out Atlanta for gluten-free options and offers some great suggestions for those who can’t just grab a quick bagel or a muffin during Convention.
  • While Kristin Mosman unfortunately won’t be attending this year, she has compiled a great list of things she wishes she’d known before attending past ASHA Conventions.
  • Ready to finally bite the bullet and learn what all this social media stuff is about, but not sure where to start? Lucky for you there will be many resources at Convention to help. There is an invited session on Thursday at 10:30 am (Session #1003) “A How-To of Social Media: Technologies, Trends and Traps.” I will be attending Convention from Thursday through Saturday and happy to help give hands-on help with the ASHA Community and/or any other social media question you may have. I’ll be splitting my time between the Volunteer Village, the exhibit hall and various events including the ASHA Tweetup on Friday at 5 pm in the Leader Lounge. Finally, the #slpeeps and #audpeeps have paired up with Pediastaff and will be offering many different social media resources including a learning lab, a social media learning center, and several “Tweet & Greet” sessions.

If you aren’t attending this year’s convention, stay tuned to ASHAsphere for updates from the official ASHAsphere Convention bloggers, as well as follow-up posts from other attendees. You can also watch from afar on Twitter by following @ASHAconv and the #asha12 hashtag. And you don’t have to suffer alone–there’s even a hashtag for those who aren’t able to be at Convention: #ashaless!

 

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

Southern Charm at #ASHA12

Image of an owl

Where the food is fried and the tea is sweet, Atlanta promises to be a great host for the 2012 ASHA Convention. It’s only appropriate that my first-ever ASHA Convention is in my home state. I’ve been living in a Graduate School cocoon for the past year, so it will be fun to take off my speechie training wheels and revel in the knowledge and fun. I have been reading and listening to the #ASHA12 hype on Twitter and blogs, which makes me even more excited for the three-day event. I keep finding sessions I want to attend, like the First Timers Orientation, the pre-convention session “The iPad & Your Therapy: Apps, Accessories, Accessibility, & Features,” or “Laryngeal Manipulation: Why, When, & How.” Then there are the vendors I don’t want to miss like Pediastaff (Booth #1823), LessonPix (Booth #617), and Tactus Therapy (Booth #828). So many excellent sessions and vendors to choose from; how are you deciding which ones to attend?

The annual ASHA Convention seems like the best opportunity to learn the newest techniques, listen to what others have been doing, and determine the best way to not seem overly creepy with excitement for this profession. Since I am almost done with graduate school, everything seems to revolve around my enthusiasm for our diverse profession. I’m just trying to take advantage of all these amazing sessions and vendors in one place without overwhelming myself. How are you keeping it all straight? I’ve received the most support from the #slpeeps on Twitter. Based on their stories and advice, I think I can control myself enough to attend sessions and still have equal amounts of fun.

I’m also looking forward to dining around the Georgia World Congress Center. There are so many great places to choose from like Googie Burger, Taco Mac, Der Biergarten, Park Avenue  Deli & Market, and so many others right around the convention center. If you are new to the Atlanta area and plan to leave time to venture further out, consider The Varsity, Max Lager’s Wood-Fired Grill & Brewery, The Vortex, or Ormsby’s. Wherever you choose, I hope you enjoy the beautiful city of Atlanta.

I would also like to take a moment to impart some southern charm upon the excitement of #asha12. Especially to those who have also never been, or to those may not be as excited as they’ve been in previous years:

  • To all of the seasoned, flavorful, and spicy SLPs, I look forward to meeting you at the convention. I will giving away handshakes if you can find me (@SLP_Echo) during the convention (Get ‘em while they’re hot)
  • To my fellow SLP graduate and undergraduate friends, let us convene upon Atlanta with our eagerness to learn and willingness to volunteer for anything.
  • To my fellow #slpeeps, may we entice new SLPs to join the Twitterverse.
  • To those who slaved over a poster presentation, oral session, technical session, or any other session, may those who attend the sessions bring enough enthusiasm it’s worth every minute.
  • To those attending the Wednesday workshops by GSHA , may the extra day in Atlanta make you want to eat peaches and  drink Coca-Cola till you have a southern accent.
  • To those who are dancing in the flash mob (aka #ashamob), may people appreciate the happiness it brings as well as the eloquence of the ‘booty roll’.
  • To the adventurous #asha12 attendee, may you fill up on southern comfort food and fall prey to using “Ya’ll” at least once while you are here.

Keep track of all the happenings before, during, and after the convention on Twitter and ASHAsphere. Wait, what’s that? You don’t use Twitter?? Well, don’t be shy; join the ranks and check out how to get started here.  Can’t wait to see everyone at the 2012 ASHA Convention in Atlanta, GA!!

(Katie is one of the official ASHA Convention bloggers. These three bloggers were selected to blog about the ASHA Convention in exchange for complimentary registration. Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

Katie Millican, B.S. Ed., is a second year graduate student in Speech-Language Pathology program at the University of West Georgia (UWG). Katie is the current UWG local NSSLHA chapter President.  She is active with the #slpeeps and #slp2b on Twitter (@SLP_Echo) and on Pinterest, and she writes her own blog SLP_Echo: Just another SLP in the Making. Katie has a passion for using technology and sharing evidence-based ideas. 

 

#ASHA12 Infographic

If you’re following the 2012 ASHA Convention hashtag #ASHA12 on Twitter, you know that the excitement has reached a fever pitch with just one week to go. Here, in infographic form, are some tips to help you navigate Convention.

For more detail on how to customize your own planner as I mention in tip 1 above, here’s another post detailing how I did it.

(Jeremy is one of the official ASHA Convention bloggers. These three bloggers were selected to blog about the ASHA Convention in exchange for complimentary registration. Stay tuned for more insights from him and the other bloggers before, during and after convention.)

 

Jeremy Legaspi, CCC-SLP, is a Speech-Language Pathologist at Foundations Developmental House. He concentrates on autism, AAC, apraxia, articulation,phonlogy, and some feeding. You can follow him on twitter @azspeechguy and check him out on azspeechguy.wordpress.com and www.therapyapp411.com

11 Tips for the 2012 ASHA Convention

I am officially excited about ASHA 12. (Not that I haven’t been since last year in San Diego). I hope to meet many of my readers, Facebook and Twitter friends at ASHA in Atlanta this year. I figured it’s that time of year that I should post a little bit about my recommendations in preparation for ASHA.

  1. If you don’t already have one, create a Twitter and Facebook account. Join SLP groups and on Twitter, find the #Slpeeps. I am @apujo5 on Twitter. Benefits of social networking for the ASHA convention? You get all the heads-up on the behind-the-scenes info. You meet great new friends so that you don’t have to be at the conference alone. You can also find someone to share a room and save a little money. There is a “tweet-up” on Friday at 5 pm in the Leader Lounge where you can meet the people behind the Twitter handles. This year we are having a “pre-conference” dinner and there are several that met up last year staying in the same hotel.
  2. Pack comfortable clothes and shoes. Yes, as professionals we often dress nicely, but trust me, you will appreciate the Nikes and jeans. Last year I was away from my hotel room from 7 a.m. until about 11 p.m. I was EXHAUSTED and just missing my comfy clothes. You can learn new information whether you are in a dress or in a pair of jeans! (Besides, if this is your first convention, the exhibit hall is ENORMOUS!)
  3. Bring a backpack. I personally am not a huge fan of the infamous Super Duper bags. Not only do they stink, they are not all that comfortable to haul around. There are so many freebies at ASHA, you definitely need something supportive to carry your stuff. If your backpack is big enough, you can stuff a Super Duper bag into it.
  4. Bring your phone, tablet and your charging cords. No matter how great your battery is, you will more than likely need to charge it at some point during the day. Especially if you are one of those #Slpeeps who tweet throughout the entire convention. There are also chargers you can bring for your phone that you don’t have to plug in during a session. Last year I purchased the iGo Green charger. You plug it in to charge overnight and can use it to charge up to two devices while it’s charging. While you’re sitting in a course, you can plug in your phone (doesn’t have to be an iPhone) and charge it from anywhere in a room. No mad dash for a seat close to an outlet needed. Also, by bringing a tablet, you eliminate the need to haul around pens and notebooks.
  5. The scheduler for ASHA is finally up! So many people are so overwhelmed by the seeming millions of available sessions to attend. I am a very visual person, so I have to do everything a little different for scheduling. I have to make my own calendar, then highlight all the sessions I want to attend and put the session number on the calendar. I then narrow my sessions down to two per time slot. Be sure you select some alternate courses as there are times you get to the convention and some of the courses/posters have been cancelled.
  6. It’s never too early to start packing. The more you plan what you need to take, the more prepared you will be! I personally do much better if I pack early because I will inevitably remember things I need to take later on. Also, the more room you can make in your bag the better. (Remember, the exhibit hall is ENORMOUS and full of wonderful FREE items. You can also purchase many items at a discounted rate!)
  7. Make sure you sign up for all the freebies. The opening party, awards ceremony and closing party are actually a lot of fun. Better yet, they’re also free! You are already spending all that money on registration anyway. The conference also offers a box lunch for a small price (I think $7 a day). It really beats having to fight crowds at restaurants and all the waiting (giving you more time at the exhibit hall). The boxed lunches are pretty decent and quite affordable.
  8. Prepare to have FUN. The ASHA convention is a blast. It takes forever for it to come around every year, but once it starts, the time flies. There is so much to do and so many people to meet. Prepare for one of the greatest  convention experiences of your life!
  9. Don’t forget, leave some time for socializing and the exhibit hall. You won’t regret it. There is an enormous amount of knowledge to learn from all the exhibitors. (Did I mention that many give away free items?)
  10. If you really can’t find a session you want to attend during a certain time period, you can always do poster sessions. Remember you can do six posters for every 90 minute time slot!
  11. Also, I have found the greatest app. If you are attending ASHA with friends, and split up, download Voxer. It turns your phone into a walkietalkie and is available for both the iPhone and Android phones.

For first-timers, the ASHA convention can be very overwhelming, but in the end is definitely worth the exhaustion!

(Tiffani is one of the official ASHA Convention bloggers. These three bloggers were selected to blog about the ASHA Convention in exchange for complimentary registration. Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

Tiffani Wallace, CCC-SLP, has been an SLP specializing in Dysphagia for over 11 years. Tiffani has been very active in the social media world, creating two Facebook groups, Dysphagia Therapy Group and Dysphagia Therapy Group-Professional Edition. Tiffani is also the co-author of the app Dysphagia2Go, available on iTunes. She is preparing to travel nationally and speak on the topic of Dysphagia. Tiffani writes a blog called Dysphagia Ramblings and is the author of www.dysphagiaramblings.com. She is a five time ACE awardee and recently obtained her BRS-S.

It Really is a “Brave New World” for Speech-Language Pathology!

In 1931, Aldous Huxley’s novel A Brave New World told us a tale of what society in the distant future would look like… a place of advanced technology, new social structures and radical changes in how humanity interacts with each other… sound familiar?

Well, arranging the Georgia Speech-Language Hearing Association’s (GSHA) short course offerings has opened my eyes to how very fast the role of being an SLP is changing from year to year. We are now serving highly diverse populations of multiple nationalities, utilizing technology that just 10 years ago was science fiction and becoming more and more an integrated part of the healthcare community in general. From NICU to hospice, home health care to the public schools, SLPs are involved with communication and swallowing disorders across the lifespan. We are providing these services in a cost effective, evidence based manner that is making real and measurable change in the populations we serve.

It is with this “Brave New World” in mind, that GSHA would like to present to our fellow convention-goers three short course opportunities that are sure to make a positive impact on the clients, patients and students we all serve. ASHA has given the Georgia association the wonderful opportunity to provide ticketed pre-convention and convention related short courses on November 14th and 15th. Please join us on November 14th for-

Barbara Fernandes, M.S., CCC-SLP The iPad and Your Therapy – Apps, Accessories, Accessibility and Features

Jose Galarza, M.A., CCC-SLP Spanish Influenced English: What Every SLP Should Know

and on November 15th for-

Kate Krival, Ph. D. CCC-SLP Anticipation: Neural Bases and Clinical Implications in Swallowing in Adults

Our pre-convention activities on November 14th will include presentations from Barbara Fernandes, M.S, CCC-SLP and Jose Galarza, M.A. CCC-SLP. Barbara (better known as GeekSLP) will be presenting on all things Apple, Ipad and App related. Bring your Ipad and/or Iphone to her presentation and you will leave better understanding how to use it with your respective population. Jose’s presentation will address the needs of monolingual SLPs working with bilingual children in the school setting. Since school SLPs are increasingly faced with the communication needs of Hispanic children, his presentation is especially relevant to the English speaker attempting evaluation and treatment of those children. Barbara and Jose are both experts in their respective areas and will highly impact the attendee in a positive manner.

On November 15th, join GSHA in welcoming Kate Krival, Ph. D., CCC/SLP. Dr. Krival directs the Swallowing Research Lab at Kent State University and she is a Research Investigator in the Head and Neck Neural Interface Lab at Louis Stokes Veterans Administration Medical Center in Cleveland, OH. She is particularly interested in clinical research targeting sensory-based interventions for swallowing disorders in adults with neurogenic dysphagia. If dysphagia is your area of interest, Kate will leave you with tons of evidenced based ideas for use with your patients!

So, Join GSHA and ASHA in facing this Brave New World of ours with the confidence that these courses will keep you informed, up to date and ahead of the curve!!! See you in Atlanta…

 

Edgar V. (Vince) Clark, M. Ed., CCC/SLP, advocates for the importance of state association participation whenever possible. He is currently the GSHA to ASHA Liason for the 2012 convention, current GSHA CEU chair and is a past-president of GSHA. Professionally, he is interested in adult dysphagia, all things technology, and the use of social media for promoting the professions.

 

The ASHA Convention is quickly approaching! If you haven’t already registered, don’t delay–register today! Stay tuned to ASHAsphere in the weeks leading up to the ASHA Convention for posts by the official Convention bloggers–Jeremy LegaspiTiffani Wallace and Katie Millican. Not an official Convention blogger but want to write a post about it for ASHAsphere? No problem! Send posts to Maggie McGary at mmcgary@asha.org and it could be featured here.

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.

Quotable from ASHA Convention

 

view from San  Diego Marriott

Photo by Kim Lewis

My notebook is brimming with hastily scrawled notes and printed handouts.  I have presentations downloaded on my computer and a convention program loaded with descriptions of speech and language topics.

Much of my information relates to preschool or school aged children and a great deal of that pertains to reading issue (though I did dabble in other areas as well).  But I collected a few great quotes in San Diego.  Good reminders of what we do, how and why we do it.

“It’s not about the tool, it’s about the technique.” (session 1370)

This really resonated with me.  I love my iPad and I use it with regularity in my therapy sessions.  But I’ve heard numerous therapists say that parents have been pressing the device into their hands with the insistence that it be used to perform miracles.  Well, it’s pretty fabulous, I’ll agree, but it isn’t all that and as long as human beings remain social creatures there will always be a need for personal interaction.  So, yes, I will use technology but in therapy it will always be a tool I use and not the treatment itself.

“Availability, Affability, Ability and Accountability” (session 0416)

I attended a session on growing and maintaining a private practice that promoted these “Four As” as a basis.  The beauty of this though is that it really pertains to any therapist in any setting that strives for excellence in care.  Be fully present during treatment times and available to your clients and families.  Be friendly and easy to get along with.  Continue to further your learning and incorporate new ideas and research into practice.  Take responsibility for your actions (and document it while you’re at it).

“I can pick and choose which circuits I want to run.” (Opening session)

Each day we make conscious decision in our attitude.  Each day we have an opportunity to grow.  I imagine our brains as a dense forest.  We strike out and, with much effort, create a path.  And each day that we travel that path, the underbrush becomes more downtrodden, the space between the trees widens and the path becomes easier and more visible.  You make a decision each day where those strong paths run to.

“Enjoy the good life.” (San Diego Food and Wine Festival)

Ok, so this isn’t from the convention itself, but it was part of my ASHA experience.  And don’t we aim for this already?  Furthering our education, mingling with like-minded souls, helping others.  Absolutely, the good life.

enjoy the good life sign

Photo by Kim Lewis

(Kim is one of the official ASHA Convention bloggers! Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

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

 

 

Get involved! Why? Because I say so!

I’ve been struggling to write my last post about the 2011 ASHA Convention. What could I possibly have to say that would sum up my experience? Should I be funny? Light hearted? Should I try to send a message? Reach out?

ALL OF THE ABOVE?

That’s the one!

I discovered something about myself while I was at the ASHA Convention. I really like the administrative side of things. It’s been sneaking up on me – an interest in policies, positions, procedures, politics (whew – what an alliteration!) But there it is. Can’t be denied. I just really enjoy knowing what is going on, how it affects me, how it affects my clients – and you’d think this would be the case with everyone.

However, I discovered something else at ASHA as well – a sort of apathetic, passive, bystander effect among CSD professionals when it comes to legislative and regulatory issues. Obviously this isn’t necessarily the rule, and I truly hope it is the exception. But there seems to be this sense that issues which go outside of our clients and our place of business, go beyond us overall.

I attended a lecture entitled Advocacy 101: Add Your Voice, which was presented by ASHA’s Government Relations and Public Policy Board (Regina Grimmett and Shelley Victor.) The description was as follows:

  • This session is proposed by the Governmental Relations Public Policy Board (GRPP) to promote advocacy as related to legislative, regulatory, and other public policy activities affecting the professions. Presenters will explain strategies for self-advocacy, illustrate data use for advocating issues, and demonstrate strategies for meeting legislators/government officials.

After the lecture, learners would be able to:

  • describe their role in professional grassroots advocacy at the local, state, and/or national levels.
  • define advocacy–its goals, types, and benefits of grassroots advocacy efforts
  • advocate for specific federal and/or state issues that affect the professions of speech-language pathology and audiology.

To me, this sounds like pretty important stuff. At the undergraduate and graduate level we are taught that advocacy is within our scope and is our responsibility. Usually we think of that in terms of advocacy for our clients, but this was quite obviously in regards to US. We like our jobs, yes? We like funding and support, yes?

There were probably 15 people present at this lecture. 10,000+ attendees at the ASHA Convention. Fifteen people who wanted to learn more about how to protect our jobs, advocate for ourselves, and interact with people who can make or break us.

Now, I get it. We go to ASHA to learn how to best support our clients (oh, and to see our best CSD buddies). Holding the client paramount – this is our duty. But how can we hold our clients paramount if we don’t have the IDEA/ESEA/Medicare/Medicaid funding to do it? How can we hold our clients paramount when our professions are being threatened by a poor economy and an administration that doesn’t acknowledge our existence? How can we hold our clients paramount when our credentials aren’t universally recognized as a benchmark for licensing and other professional standards? This presentation was two hours. Two hours out of your three day ASHA schedule could have been dedicated to learning how to stand up for yourself and your colleagues.

We have to help ourselves, to help our clients (kind of that whole “Put your oxygen mask on first” thing.) And I would guess that 15 people can’t do it all. We cannot continue to assume that someone else will get to it. We cannot continue to run our professional lives with a “want something done – give it to a busy person” philosophy. We are ALL busy but, we are ALL accountable.

Want to know more about advocacy, for you and your clients? Contact ASHA-PAC. Contact your state association. Go to the ASHA website.  Contact your SEAL.  Contact your State Liaison. Become a Grassroots Captain. Start early by encouraging students, interns, CFs, and newbies to get involved! There are a million resources and you can get to them while you sit in your office chair.

Listen, I’m not saying run for president or Occupy ASHA – just don’t stand by. Do what you can, or at the least support people who are trying. While you’re thinking that someone else may do it, someone else may be thinking that YOU will do it.

I loved every second of the ASHA Convention, and I hope when I attend in the future that I see more presentations about government relations – and I hope to see more of you there.

NP: The Zombies – Time of the Season

 

(Samantha is one of the official ASHA Convention bloggers! Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

Samantha Weatherford, B.A., is a second-year, speech-language pathology graduate student at Missouri State University in Springfield, MO.  She writes about speech-path and grad school on her blog, so to Speak. Does she think it is a coincidence that the first ever ASHA Convention was in St. Louis, MO, her beautiful hometown, and she chose to be an SLP? NOPE. FATE.

My nugget of ASHAcon knowledge

Friday was my first day of the ASHA Convention. For reasons I can’t remember, getting to ASHAcon on Friday rather than Thursday seemed work better for scheduling. I was wrong and missed out on a lot of great courses. I also missed out on a few meet-ups of those in the SLP blogosphere and Twitterverse. A learned lesson and a tip for future ASHAcon newbies: if you’re going to make the most of your ASHAcon experience (and the hard earned money you spend to get here!), get here on here on the opening day. The regret, it burns!

At any rate, I’m digressing from what I wanted to share with all of you good SLP folks. If you’ve ever thought about going to a short course, but have wavered because the cost (or the three hour, no break commitment), I’m telling you to reconsider. Short courses, if you’re not familiar, are ticketed courses on specific topics, many of which are put together by ASHA’s Special Interest Groups. The courses are presented by an array of panelists, usually those who have gained celebrity status among the ranks of their professional colleagues and humble followers. The partnership between such presenters and researchers provides an enormous wealth of knowledge to attendees in a way that is easy to follow along and digest. Among the seminars that I attended, the short course was a highlight of mine.

The short course I attended was Exercise Principles: How Much, How Often, How Intense? I believe that because there is a relatively small amount of course work on dysphagia in our professional training, many clinicians feel that there are gaps in our translational knowledge, that is the link between the science and our clinical practice. This sentiment may not be true for everybody, but I certainly feel this way at times. For example, what happens to our muscles when they are worked during exercise? How, on biological level, do muscles become stronger (or weaker)? What type of muscle do we use during swallowing, and will that influence that type of exercise we tell our patients to do? These are the types of questions that any of need to answer once we are already practicing and it exactly these types of questions that were answered by some of the biggest names in swallowing research: Dr. Lori Burkhead, Dr. Cathy Lazarus, Dr. Heather Clark and Dr. Michelle Troche. All of these presenters spoke at ease with the audience, with an authority gained by their years of experience and research, and it couldn’t have been a more informative and humbling presentation.

Because I’m a dork and believe in open-source knowledge in science, I want to share with you some of what I learned. First, some basic info on muscle anatomy. The basic unit of a muscle is a myofibril, which are essentially strands of proteins. Myofibrils are made up of repeating pieces of sarcomeres, which are also strands of protein. When the motor neuron releases acetylcholine and it binds to the muscle cell receptors, the sarcomere contracts, which causes the myofibrils to contract and in turn the muscle at large also contracts.

myofibril

(Source. 1. Motor neuron. 2. Neuromuscular junction. 3. Muscle fiber. 4. Myofibril)

To strengthen a muscle, additional myofibrils must be built. In addition to this, there are two types of muscle:

  • Type I; these are fatigue resistant and are good for endurance
  • Type II; these are used for power and strength. This can be broke down into Type IIa and Type IIb, for moderate activity/efficiency and for high power/less efficient activity, respectively.

So why is this important to know for dysphagia rehab? Because form follows function. In large, the tongue is made up of Type II muscle fibers, with the base of the tongue predominantly made of Type II and the tongue tip having more Type I than any other part of the tongue. When a muscle deconditions, neural activation, motor neurons and efficiency are reduced, which translates to atrophy and easily fatigued muscles. Another important factor of deconditioning is the phenomena of sarcophenia, age related decline of muscle fibers. As it is, this largely affects Type II fibers, which we know is predominant in the tongue. Swallowing, we have a problem.

It can be argued, they said, that when a person becomes npo, this deconditioning occurs because swallowing frequency declines, which in turn exacerbates dysphagia. I think this is a valid working theory. Then the question becomes ‘how do we reverse this trend? The answer: by conditioning muscles. This almost exactly the opposite of deconditioning, by increasing neural activation and the number of motor neurons. And do this, exercise must be a component of treatment, and exercise must have some distinct characteristics.

First, exercise must be specific, meaning it should mimic what actually happens during the swallowing. Citing some examples from exercise physiology as an analogy, people who want to improve in cycling will bike as exercise, and these people will not see any improvement in other sports, like running or swimming. Intensity also matters, in fact, there are some rather specific guidelines for this. To build those myofibrils, ate muscle needs to be overloaded during an exercise, at at least 60% of the maximum output of that muscle. To prevent plateau, it’s important to recognize gains and new maximum output after exercise to maintain that 60% mark.

They also cited numerous studies highlighting specific exercise effects for the tongue with some novel findings. Exercising the tongue against resistance in a variety of directions (protrusion, elevation and lateralization) yielded stronger forces, no surprise there. But they also found that exercising the tongue in a single direction improved strength for tongue movements in all directions. To me, this seemed to deviate slightly from the specificity principle. However, in studying exercise conditions, they found specific effects for targeting strength, power and endurance of the tongue, all of which were mutually exclusive (i.e., targeting strength did not improve power).

A little more murky was the research regarding duration of exercise. Should exercise be done two times a week? Seven days a week? There seemed to be positive effects from anywhere between 2 and 7 days a week for at least 4 weeks or more. Though, no clear picture was really made on this point, other than exercising more often than not is important.

This was essentially the meat of the course. There was a lot more than this, of course, and I could write a much longer post than this if I wanted. The panel also discussed changes to tissues and muscles following radiation therapy for head and neck cancer, the importance of pre- and post-dypsphagia exercise and the time frame of when to expect improved muscle and swallow function. There was also talk on the use of expiratory muscle strength training (EMST) and its application to swallowing function. I was only vaguely aware of EMST in general, which is the use of a device into one blows against resistance to improve muscle respiratory muscle strength. As it happens, use of EMST also promotes soft palate and laryngeal elevation and base of tongue retraction-all things that happen during swallowing. Needless to say, I’ll be following research on this a little more closely in the future.

This short course was exactly what I look for when attending a seminar. It had knowledgable presenters who engaged the audience, it covered basic scientific concepts and in turn used that science to garner translational knowledge to bridge that gap between the lab and the clinic. Did anyone else attend this course? Please add anything you thought I didn’t cover, or something that I didn’t make more clear. Did you attend another short course, or another seminar that blew your mind? Let us know here. Drop the name of seminar, the presenter and what you took away presentation.

 

(Adam is one of the official ASHA Convention bloggers! Stay tuned for more insights from him and the other bloggers before, during and after convention.)

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