2014 Awards and Honors

We are thrilled to announce the winners of the 2014 Plural Publishing Research Awards given in honor of the late Dr. Sadanand Singh. These two scholarships are awarded by the Council of Academic Programs in Communication Sciences and Disorders and honorees and their faculty sponsors are acknowledged at the annual CAPCSD meeting, taking place this year in Orlando, FL, April 10-12. Congratulations to Doreen Hansmann, the master’s level winner and to Meg Simione, the doctoral level winner.

Doreen Hansmann, Master’s level Research Award recipient

Doreen Hansmann, Master’s level Research Award recipient

Meg Simione, Doctoral level Research Award recipient

Meg Simione, Doctoral level Research Award recipient

We would also like to extend our congratulations to Plural author, Brook Hallowell, who will be receiving the 2014 Honors of the Council of Academic Programs in Communication Sciences and Disorders; one of the most prestigious awards recognizing lifetime professional achievements in communication sciences and disorders.  Dr. Hallowell has served the Council in a multitude of ways including extensive committee work and executive board membership in varied positions including the presidency in 2010-2011. In addition to her contributions to CAPCSD, her research in neurological disorders, in collaborations with professionals from around the world including Russia, China and India, Dr. Hallowell has made significant contributions to her profession. She is a Fellow of the American Speech Language and Hearing Association and has provided service to ASHA in various capacities.  Finally, Dr. Hallowell has mentored innumerable students, both in the United States and abroad. She has served the College in a variety of leadership capacities including in the school director and associate dean roles.

Brooke Hallowell, PhD, 2014 recipient of the Honors of the Council of Academic Programs in Communication Sciences and Disorders

Brooke Hallowell, PhD, 2014 recipient of the Honors of the Council of Academic Programs in Communication Sciences and Disorders

Featured Article: An Unconventional Childhood by author Jerry Northern

Jerry_Northern

Jerry L. Northern, PhD
Professor Emeritus, Dept. of Otolaryngology (Audiology)
University of Colorado School of Medicine
Denver, Colorado USA

This is a personal story about an unconventional childhood.  Maybe “unusual” childhood is a better description.   It begins way back in 1942 when I was 2 years old and my parents were in the midst of an unpleasant divorce.  While my parents were engaged in drawn-out skirmishes over custody for my older brother and me, we were sent to live with my grandparents in Denver, Colorado.  The unusual part of the story is that my grandparents were totally deaf.  And I mean rock-stone deaf – no measureable hearing and no hearing aids in those early days.  The communication between them was solely by American Sign Language (ASL).   My brother and I arrived at their home to meet them for the first time and realized that we no means of talking with them.

At that time my grandparents were in their early 60s and probably not prepared to take on the tasks of rearing two young, wild grandsons for an undetermined length of time.  Both grandparents had been deaf since their childhood.  Both had lost their hearing through childhood episodes of cerebrospinal meningitis which spread as a near-epidemic during the 1880s. Common health issues resulting from meningitis include blindness and severe cardiac problems; profound hearing loss is the most common adverse outcome experienced by some 50% of those stricken.  The hearing loss of my grandparents was, fortunately, the only health issue they suffered following recovery from this serious infectious disease.

Author Jerry Northern, Age 2 years, circa 1942

Author Jerry Northern, Age 2 years, circa 1942

A major difference between my grandparents was that my grandmother lost her hearing at age 6 months – within the period that we now identify as pre-lingual.  In contrast, my grandfather was 9 years of age when he lost his hearing – so he was post-lingually deafened.  Accordingly, their speech skills were dramatically different from each other.  My grandmother, having never heard herself or others speak, was always reluctant to use her noticeably deaf speech outside our home environment and was sensitive about her limited language skills.  My grandfather, on the other hand, with a significant amount of normal hearing for speech and language development in his early childhood, had near-normal voice quality and good language skills.  Although from different states in their childhood, both attended Gallaudet College (for the deaf) in Washington DC from 1889 – 1902 where they met and married after graduation.

As an aside to my story, a bit of history may be of interest.  Until the mid-1940s, persons with profound deafness were commonly known as “deaf and dumb” or “deaf-mute.” The “dumb” and “mute” terms were related to the view from outsiders that the deaf could not speak because they chose to communicate in signs. In those early years, these terms were not necessarily derogatory, but actually socially acceptable.  In fact, my grandfather referred to his deaf friends as his “dummie friends.”  The manual sign for deafness was conveyed by pointing to the ear, pointing to the mouth, and making the sign for “closed.”  Whereas, the sign for a hearing person was fingers moving forward from the mouth – as in speaking.  The first school for the deaf in the US was established in Hartford in 1817 and was named The Connecticut Asylum for the Deaf and Dumb.  In the following years, states established their own schools for educating the deaf with support from the federal government.  Because many deaf children had to travel some distance to attend the state school, the schools were often residential and from early in their lives the students studied and lived on the school campus.  So in the case of my family, my grandfather attended and was a resident of the Kentucky School for the Deaf in Danville and my grandmother grew up at the Colorado School for the Deaf and Blind in Colorado Springs.

The question often asked is how did I learn speech and language at age 2 in a home that was silent?  The answer, of course, is that this home was far from silent.  My brother and I communicated normally – in whatever terms an 8-year-old might talk to a 2-year-old. Both grandparents spoke to us orally as best they could.  I have been told that I enjoyed having my grandmother read to me in spite of her poor vocal qualities.  And, apparently my brother and I picked up the manual language of signing and finger-spelling quickly.  Although I was too young spell words, the sign language was sufficiently illustrative for me to get my needs and thoughts communicated.  We were largely entertained by the radio that my grandparents purchased for us. The radio turned out to be language rich with nightly serial stories such as The Green Hornet, Amos and Andy, The Lone Ranger, the spooky mysteries of Inner Sanctum, and the comedy of Edgar Bergan and his puppet, Charlie McCarthy.  Saturday morning radio was aimed at children with shows such as Let’s Pretend, Sky King, Terry and the Pirates, and Dick Tracy. Apparently, I entertained my grandparents by enthusiastically trying to tell them through pantomime and signs what I was listening to on the radio.

It is a common mis-perception is that the hearing children of deaf parents have trouble learning spoken language. There have been reports of delayed and inadequate language acquisition from such children.  However, I quickly became “bilingual,” i.e., learning American Sign Language and spoken English at the same time.  As the hearing child of deaf grandparents, I really lived within two languages and two cultures.  I had my own normal hearing family and friends and mixed well within the circle of deaf friends of my grandparents. As a preschooler, it was a matter of making pictures and signs with my hands in the language of my grandparents; at the same time learning to speak words and sentences by listening to visitors, the radio, and ultimately kindergarten.

In the homes of deaf persons, you will find a few peculiarities.  For example, the doorbell not only “rings” but it is often hooked into the lighting system of the household so that lights in each room blink on and off as the doorbell is pressed.  A very loud alarm clock also vibrates the pillow and may flash a light on and off to awake the deaf sleeper.  We had a wonderful mutt of a dog who was likely the first “hearing service dog” before that concept was developed.  Our dog, General, seemed to understand that my grandparents could not hear.   He served as their daily “ears”.   Certainly no one could approach our house without General sounding the alarm – or even pulling one of them to the front door.  One gets the attention of a deaf person by casually waving a hand or wildly waving an arm and hand to gain immediate attention for more important matters.  As persons with deafness are extraordinarily aware of vibration, stomping on the floor can also be used as an attention gaining behavior.  To ignore someone, you simply refuse to look at them.

Early on I learned that I could be of great help to my grandparents by serving as an interpreter.  By the age of 3, relatives tell me I would hear the weather forecast on the radio and pass it on to my grandmother through signs and facial expressions.  By the age of 4, and thereafter throughout life, my job was to accompany and interpret for them.  It made me feel very grown up and mature – and I remember how surprised the clerks were to see me conversing in signs.  Our grandparents had a telephone installed in the house so that my brother and I could place phone calls for them – making their lives easier.  For the most part, being their interpreter seemed a normal part of my life.  Perhaps it forced me to mature sooner than my peers. Being dragged everywhere your parents went so that you could interpret for them (e.g., the post office, doctor’s appointments, the driver’s license bureau, the courtroom, etc.) tends to involve one in a number of grownup things that most children are not exposed to until their adult years. Such children (known today as CODA – Children Of Deaf Adults) learn spoken language as a natural part of growing up; however, they are naturally required to navigate the border between the deaf and hearing worlds, operating as a liaison between their deaf parents and the hearing world.

Of course, my deafness connection caused me no end of embarrassment during my teen years.  I had to often accompany my grandparents and openly sign and communicate for them.  What if any of my friends would see me?  And, it was a difficult situation to be put into when my grandfather was angry over some issue and I had to transmit his words and feelings to someone else.  I was in middle school before I realized my friends thought my skills with ASL were “pretty neat.”  Many young people try to learn the manual alphabet with thoughts of secret communications with friends; however, few of them ever become sufficiently skilled to actually carry on more than a word or two in conversation.  It was with some pride when I finally realized that my ASL abilities were viewed as a talent and brought me special recognition.

There were a number of memorable events related to their deafness. At about age 16, I was eating in a restaurant with my grandparents and, of course, we were talking to each other through ASL.  I was aware of an older couple intently watching us from a nearby table.   As they finished their meal, the woman come over to my grandfather, tapped him politely on the shoulder and said to him, “I think it is wonderful what you are doing for this young boy.”  As he could not understand what she was saying, it fell to me to tell her that he was the deaf person and I could hear just fine.  She was suddenly so embarrassed she turned and fled without another word.  I also recall the occasion when a group of my high-school football buddies were invited to my home for dinner served by my grandparents.  After a time, one of the friends asked me, “How do you know they are not faking and actually listening to everything we are talking about?”  To test this question, the guys casually dropped some swear words that should never be used at any dinner table; when my grandparents did not respond or show interest, the dinner situation unfortunately descended into deplorable conversations – much to the amusement of my depraved friends.

People with normal hearing are able to reflexively adjust the volume of their voice according to the presence of background noise.  I smile now as remember my grandfather attempting to whisper to me in the midst of a seriously quiet church moment, but unfortunately loudly voicing his message to me so that all could hear him.  On the other hand, in a noisy situation he was unaware that he needed to speak with a louder voice.  In somewhat the same regard, I shudder as I remember him driving slowly to a crawl to turn a corner, blissfully unaware of the honking horns and screeching brakes of the drivers behind him.

They are both gone now having lived healthy and happy lives.  Yes, they often mentioned how frustrating it was to be deaf, yet they managed living every day to the fullest.  My grandfather had a successful printing business in downtown Denver. Their social life involved groups of deaf friends who played cards together, went bowling, picnic outings, and church activities. Their deafness did not hold them back from experiencing most of the activities of normal hearing persons.  In today’s technical environment they would have likely been among the earliest to step up for digital hearing aids and cochlear implants; visual-voicing devices and texting would have been such an incredible benefit for them.

My family evolution is notable for having four generations involved with deafness and hearing loss as both my aunt and my daughter are certified teachers of the deaf.  As for me, being a child raised by loving deaf grandparents created many opportunities as I pursued a career of more than 50 years in various aspects of audiology.  Fondly looking back now in my near-retirement years, I owe much to my deaf grandparents for making my “unconventional childhood” so exceptional.

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(Jerry L. Northern, PhD, is Founder and President of the Colorado Hearing Foundation – a non-profit organization that supports education and research in hearing and hearing disorders, and provides services to children with hearing impairment.  A brief biography of Dr. Northern can be found at: http://www.coloradohearingfoundation.org/bio-jnorth.pdf)

Guest Blog Post- The Frontal Lobe: Front and Center

The Frontal Lobe: Front and Center by Jennifer Hatfield, MHS, CCC-SLP

frontal_lobe

How often have you touched your forehead and told yourself to “pay attention” or “think, think, think?”

Also known as the cerebral cortex, the frontal lobe consists of a right and left lobe, located directly behind the forehead, that have the ability to solve problems by allowing us to think flexibly and express language. It also is responsible for our memory, monitoring our impulses and allowing us to get started by initiating activity. These skills, referred to as executive function skills, are what we know to be the process of “thinking.” We can see then, that the practice of touching one’s forehead, while not a sound technique for improving thinking skills, is based in some truth.

In real world terms the frontal lobe provides us with a blueprint or map of specific instructions on where we are going and what we are doing. While we are navigating our travel, it utilizes a system of Checks and Balances that lets us know how we’re doing. It motivates us, cheers us on and even lets us know when we have made it to our destination.

At times, like with most travel, things don’t always run smoothly. We may lose the map, forget the map, take a wrong turn, leave too late or take off without having a plan for where we’re going. When this happens, we may need a guide to help us navigate the twists and turns and teach us how to best plan for the next time. As clinicians, parents and teachers we need to be ready to step in as a guide, or surrogate frontal lobe, until the individual is able to manage on their own.

 

HOW CAN WE BE THE BEST GUIDE?

 

As Clinicians, We Can:calendar

  • Instruct our clients on how to use a daily schedule to foster independence for self care
  • Encourage a client to utilize an audible alarms to assist with weak memory skills

As Parents We Can:

laundry

  • Text our tweens after school to remind them to complete a chore until they are able to independently remind themselves- gradually texting less to foster more independence
  • Show our child how to tackle room cleaning by using self-talk and asking them questions along the way to get their input on a system that might work for them

 

As Teachers, We Can:

  • Utilize task cards to teach students how to follow multi-step directions for classroom procedures- giving a card with the next step after they have successfully completed the first task
  • Within the classroom, provide clearly marked areas for where certain tasks are to be completed or materials belongclassroom

No matter the reason we need to act as a guide: brain injury, slowed development or a diagnosis such as ADD. The key is that we act truly as a guide by only providing support as long as necessary. Using this method, we allow the frontal lobe to shine, front and center, in it’s own time.

 

ABOUT THE AUTHOR:

Jennifer M. Hatfield MHS,ccc/slp has been a licensed and certified speech language pathologist in private practice for 16 years. She specializes in coaching parents, professionals and children with strategies to improve executive functioning and picky eating. An active user of social media, you can talk with Jennifer on Facebook, Twitter and of course at http://www.therapyandlearningservices.com.

Featured Article: One New Year’s Resolution to Keep

One New Year’s resolution to keep – learn more about being an effective speech-language pathology assistant (SLPA) supervisor

by Plural author Jennifer Ostergren

If you are like me, as 2014 swings into full gear, you look to your newly inked New Year’s resolutions. One resolution on my list this year is to expand my knowledge and skills as an educator and supervisor of speech-language pathology assistants (SLPAs). Those of you with similar aspirations know that serving as an SLPA supervisor can be highly rewarding, but also challenging, especially given a lack of resources and tools specific to SLPAs. This year, however, the American Speech-Language-Hearing Association (ASHA) continues to expand its efforts in this area, with new programs, policies, and resources specific to SLPAs and their supervisors. In particular, ASHA’s new Practice Portal on the topic of SLPAs, located at http://www.asha.org/Practice-Portal/Professional-Issues/Speech-Language-Pathology-Assistants/, is an excellent source of current information and resources on this topic. The sections that follow also highlight several key resources from ASHA that may be of help as well.

2013 SLPA Scope of Practice

In 2013, ASHA introduced a new scope of practice document entitled, Speech-Language Pathology Assistant Scope of Practice (ASHA, 2013). This new document consolidated older ASHA documents into one policy. Many key recommendations remain, including a clear emphasis on the role of an SLPA as an individual who supports/assists (but must not supplant) the services of the speech-language pathologist (SLP). Rather, ASHA states that SLPAs must seek employment only in settings where adequate and systematic supervision is available and perform only those tasks specifically prescribed by a qualified SLP and within the scope of duties of an SLPA. ASHA’s new document reiterates this and states that the supervising SLP “retains full legal and ethical responsibility for the students, patients, and clients he or she serves but may delegate specific tasks to the SLPA.” (ASHA, 2013, Responsibilities within the Scope for SLPAs)

A notable addition to this new document is the discussion of ASHA’s Code of Ethics (ASHA, 2010) as it relates to the supervision of SLPAs. This is particularly helpful for supervisors as it highlights “guidance” in interpreting applicable ethical principles and rules relative to SLPA supervision. From a legal perspective, this new document also recommends that SLPAs, who engage in service provision, obtain liability insurance to protect against malpractice.

ASHA’s new document again highlights the critical importance of careful and documented supervision of SLPAs and offers supervisors additional guidelines on the nature of supervision, for both new and experienced SLPAs. ASHA’s new document also recommends that individuals who supervise SLPAs: 1) hold a certificate of clinical competence; 2) have practiced for at least 2 years after certification; and 3) complete academic coursework (or at least 10 hours of continuing education) in the area of supervision, prior to/or concurrent with their first SLPA supervision experience (ASHA, 2013, Qualifications of a Supervising SLP).

ASHA’s new document again outlines in detail those activities/duties inside and outside the scope of responsibilities of an SLPA. A notable addition to this new document pertains to the provision of services for culturally and linguistically diverse individuals, for which this new document states (provided adequate training and supervision) SLPAs can:

  • Assist the SLP with bilingual translation during screening and assessment activities exclusive of interpretation.
  • Serve as interpreter for patients/clients/students and families who do not speak English.
  • Provide services under SLP supervision in another language for individuals who do not speak English and English-language learners.

In the area of service provision, this new document also reiterates the importance in SLPAs complying with the Health Insurance Portability and Accountability Act (HIPAA) and the Family Educational Rights and Privacy Act (FERPA) regulations. Further, ASHA’s new document outlines several advocacy and prevention activities within the scope of an SLPA, including, among others, presenting primary prevention information to individuals and groups known to be at risk for communication disorders, promoting early identification and early intervention activities, and providing information to emergency response agencies for individuals who have communication and/or swallowing disorders (ASHA, 2013, Prevention and Advocacy).

Overall, this new ASHA document is much more comprehensive and is a key resource in navigating the complex task of supervising SLPAs. Supervisors interested in viewing this document can access it directly at: http://www.asha.org/policy/SP2013-00337/.

Associate Program

In 2011, ASHA initiated a new program offering affiliation status to support personnel (Robinson, 2010). Individuals with this new status are referred to as ASHA associates. This program is not a certification program in that ASHA does not provide direct oversight or regulation of certification for ASHA associates; however, ASHA associates can be listed on ASHA’s online member directory as an associate. ASHA associates also have access to many ASHA member benefits, including an e-newsletter and e-group specifically for support personnel, access to The ASHA Leader and scholarly journals, reduced convention registration fees, continuing professional development opportunities, and many other benefits (ASHA, 2011, para. 5). In exchange, ASHA associates must agree to (ASHA, 2011):

  • Adhere to all applicable policies pertaining to the use and supervision of support personnel, including performing only those tasks assigned by a supervising speech-language pathologist or audiologist.
  • Work only under the supervision of an ASHA-certified SLP or audiologist.
  • Adhere to all applicable state (province) laws and rules regulating the professions listed above.
  • Pay annual fees to maintain their affiliation.

ASHA maintains a website specifically for ASHA associates, located at http://www.asha.org/associates/. Supervisors interested in learning more about this program can find additional details on this site. ASHA members can search for an ASHA associate via ASHA’s Member Center, located at: http://www.asha.org/members/.

State-by-State Resource

State-level regulations regarding the training, use, and supervision of support personnel continue to vary greatly from state to state. ASHA’s State Advocacy Team maintains a website that can be helpful to supervisors in identifying applicable details about their state’s policies on support personnel, located at http://www.asha.org/advocacy/state/. After selecting their state name, supervisors can select “support personnel” to be directed to a page summarizing that state’s support personnel regulations and, as applicable, direct links to state websites and related documents.

Special Interest Group (SIG) 11

ASHA’s SIG 11 (Supervision and Administration) is also an excellent source for information on supervision in general, including continuing education opportunities in the area of supervision and SIG 11’s online publication, Perspectives on Supervision and Administration. SIG 11’s website is located at: http://www.asha.org/SIG/11/
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References

American Speech-Language-Hearing Association. (2004). Knowledge and skills needed by speech-language pathologists and audiologists to provide culturally and linguistically appropriate services [Knowledge and Skills]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association (ASHA). (2011, July 5). Welcome! ASHA initiates new affiliation category for assistants. The ASHA Leader. Retrieved from http://www.asha.org/Publications/leader/2011/110705/Welcome–ASHA-Initiates-New-Affiliation-Category-for-Assistants/

American Speech-Language-Hearing Association. (2013). Speech-language pathology assistant scope of practice [Scope of Practice]. Available from www.asha.org/policy.

Robinson, T. L., Jr. (2010). Associates in ASHA: A new initiative. The ASHA Leader. Retrieved from http://www.asha.org/Publications/leader/2010/100803/From-President-100803.htm

Guest Blog Post – What’s in a CEU?

by Mary Huston, MS, CCC-SLP

One of the fabulous things about the profession of speech-language pathology is that we are expected to constantly learn. There is always new research being discussed, new ideas to practice, new breakthroughs for therapy, and sadly, new paperwork requirements. Most state licensures require a certain amount of continuing education hours every year or two and ASHA requires a certain amount over three years. Thankfully, we can usually double-dip and count the same CEUs for both state licensure and ASHA. However, in today’s busy schedule of high caseloads and insane paperwork, no one has time to sit through yet another conference that doesn’t pertain to our work.

bored_meetingAfter discussions on social media, it has come to my attention that not everyone realizes there are alternatives to sitting in a conference room just to get the CEUs. Don’t misunderstand me – I’m all for conferences. There is a lot to be said about the camaraderie of sitting in a room of similar professionals. However, as wonderful as that camaraderie is, if the subject matter doesn’t pertain to your job, or interest you, is it truly time well-spent? Thankfully there are many alternative ways to gain professional development and continuing education credits. Thankfully there are many alternative ways to gain professional development and continuing education credits.

First, I feel it’s necessary to state that professional development goes beyond continuing education. Even though I can’t get CEUs for it, I use twitter and to some extent Facebook as a way to increase my professional development. In both venues there are SLPs and Audiologists that are active and willing to share information and ideas. It is truly like being at a conference every day, and I highly recommend getting involved with it for your personal professional development. Unfortunately, neither state licensing boards nor ASHA recognize time spent on twitter as continuing education (go figure!) even if it is incredibly valuable. However, most state licensing boards and ASHA recognize online learning as a viable alternative to conferences.

One recurrent question is where to get CEUs. Thankfully there are many areas that cater to CEUs for both SLPs and Audiologists. For instance, if you are an ASHA member and have joined an ASHA SIG you have access to $5.00 CEUs through that SIG’s Perspectives publication. Many people also use Linguisystems or SuperDuper Inc. for CEUs. Personally, I like speechpathology.com and the wide variety of courses they offer. Although it’s a fee per year, its unlimited CEUs and they are reported directly to my ASHA CEU Registry so I don’t have to worry about reporting them. Best of all, I get to choose which sessions I’m going to. Having a choice definitely makes all the difference between active learning and merely suffering through.

One of the things that many people seem to struggle with is figuring out which CEUs to take. Just as sitting in a conference that doesn’t pertain to you is a waste of time, sitting through a session that doesn’t pertain to you or worse is not evidence or research based is a waste of time. As with any activity, the professional needs to look at the information and decide if it is worth his or her time. ASHA has some great information on how to choose CEUs.

It is important to recognize that while ASHA does not limit the number of CEUs that are taken online, some state licensing boards do. Some states require that only 50% of the required CEUs can be online as they are considered “independent study”. However, it is important to recognize there is a distinction between Independent Study and Self-Study. Be sure to check out your state’s requirements. It may be that not all online learning is created equal in the eyes of the licensing bureau.

Finally, continuing education and professional development can be (and perhaps should be) designed to be a year-long event. With the use of online webinars, it can be very easy to get in some great sessions without having to miss work or take an entire weekend away from home and family. I have challenged myself (and my followers on twitter) to a CEU challenge of earning one CEU per week. Imagine the knowledge that can be gained over the course of the year by devoting one hour/week (or a month) to an online seminar.

Our ever changing career requires ongoing learning. Our busy schedules demand effective time management. Combing the two for online continuing education is a way for everyone, professional and client, to benefit.

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ABOUT THE AUTHOR-

Mary Huston, MS, CCC-SLP is a school based SLP in rural North Dakota. An avid user of technology, Mary has authored iPad applications, presented on using iPads in therapy, and is a member of the Smarty Ears Advisory Board. She is an active user of social media and collaborates with SLPs internationally via twitter, facebook, and her blog at  www.speechadventures.com. Mary has been published in the ASHA Leader online social media column.

Featured Article: The Challenge of Clinical Education in Speech-Language Pathology

This article provides an overview of important issues facing clinical training of graduate students today. In light of current training models, budget constraints, staffing shortages, and productivity demands, it is time to take a hard look at the requirements and demands set by our profession in the hopes of making needed changes

The 2005 and 2014 ASHA Standards require that the student enrolled in a Master’s degree program in Communication Sciences and Disorders (CSD) obtain 400 clinical hours “across the lifespan with varied disorders”: 375 hours in direct contact with the patient/client and 25 observation hours.  This is a broad guideline and superficially seems reasonable and achievable. After all, the requirement that the student obtain a specified number of contact hours in each of the disorders, with adults and children, in assessment and treatment have been removed. Unfortunately, the current service delivery contexts in which speech-language pathologists practice are all impacted by fiscal constraints, staffing shortages, and productivity requirements.  Although these three factors may not necessarily affect the quality of care, they are seriously impacting the ability to clinically train graduate students in CSD.  It is imperative that other models be developed for clinical education and training and that the discipline reviews the evidence that supports maintaining the status quo.  This is especially critical as some programs are being asked to admit more students into the graduate program, creating the need for even more external clinical practicum experiences.

There are four elements to the current model of clinical training that must be revised or at least reviewed for their practicality and value:

  1. The 1:1 supervisor/supervisee model of training
  2. The fiscal constraints that affect resources and staffing.
  3. Staffing shortages due to budgetary constraints and attrition
  4. Productivity requirements imposed on staff due to (1) and (2) above.

It is true that across disciplines in the “helping professions”, e.g., speech-language therapy, physical therapy, occupational therapy, psychology, social work, etc., the student must obtain direct clinical field experience in order to support the academic knowledge that they have obtained through formal education.  In CSD, the graduate student must demonstrate both academic proficiency with “knowledge” as well as proficiency in the “skills” of client assessment and treatment.

Current models of supervision and training need to be modified for practicality. During graduate school, students generally receive 1:1 clinical supervision from a faculty member, although that faculty member may have other students in their teaching section.  The current model of clinical education outside of the university clinic also typically involves a 1:1 student/field supervisor ratio.  This model may be optimal but it is no longer practical due to staffing shortages within professional placements.  However, if a particular agency is willing to change the ratio to 2:1, (i.e., 2 students to 1 field supervisor), the learning experience may be enriched as the students learn from and support each other, using the supervisor as a resource. In addition, collaboration with colleagues is a practical experience worthy of development.

We know that staffing shortages in both the educational and health care sectors abound within the speech-language profession. In addition to shortages there are fiscal constraints operating across service delivery sectors that impact student clinical education.  Many institutions will not, or cannot, replace a full-time speech-language pathologist (SLP) if that individual retires, leaves for a new position, is laid-off, or dismissed.  This reduces staffing and as a consequence the workload for those remaining employees invariably increases. Making a decision to support a student for a semester may not be the wisest choice under those circumstances and therefore many institutions choose not to do so.  Both staffing shortages and fiscal constraints reduce training opportunities for graduate students in CSD.

Finally, productivity requirements in the health care sector have significantly impacted clinical training for students.  The current figure is between 85-90% productivity per day, per SLP.  The agencies and institutions that set high productivity requirements have their reasons (primarily fiscal) for doing so and that is understandable.  However, a clinician who is facing a productivity requirement of 85-90% of billable time each day is often very reluctant to take a student for clinical training due to the impact that added training time may have on her productivity.  That is a reasonable but distressing concern in today’s data-driven productivity market.

Is there a solution?  We believe there is and it is not some idealized plan fabricated in the gilded towers of academia.  First, reduce the total hourly requirement of clinical contact hours. There is no evidence to suggest that 400 hours is the “magic number” necessary to create an entry-level clinician. Second, maintain the requirement that the student experience varied disorders across the lifespan, as possible.  This will reduce the pressure on universities to provide the student with practicum experiences which may not be available in a particular geographic location.  Third, introduce the standardized patient into the clinical education programs in CSD.  This is part of medical student training and has great value, especially for teaching entry-level skills, e.g., gathering case histories, conducting evaluations, and practicing certain treatment programs.  Fourth, introduce into the discipline the idea that 1:1 supervision at an external site can be adjusted to 2:1.  This will be a difficult adjustment for some and a simple one for others. However, over time the mutually beneficial outcome will be notable:  staff productivity will be less affected since the students will learn with and from each other and student critical thinking and problem-solving skills will increase simply due to the collaborative learning context.

Our decision to write a book on acquired language disorders in adults using a case-based approach is directly related to the clinical education of students.  We believe, as many do, that making the disorders as accessible and relatable to the student as possible facilitates both academic and clinical learning.  Acquired Language Disorders in Adults:  A Case-based Approach (Mancinelli & Klein, 2014) is used by our students in class, in clinic, and is on their shelves in their offices when they leave school and are working professionals.  Pairing a skillful field supervisor with a practical and valuable case-book produces a clinician who is simultaneously developing the knowledge and skills necessary to provide optimal services to the people that we serve.

James M. Mancinelli, MS CCC-SLP
Evelyn Klein, PhD. CCC-SLP

Blogs by Plural Authors

Our authors are the best in the business. They are leaders in their given fields, winners of prestigious awards and constant innovators. Follow their latest news by visiting their blogs:

His blog Hear the Music focuses on all things related to hearing aids and music. What are some tricks that can be used to improve a hearing aid for music?, How can we prevent hearing loss from loud music?, etc.

Marshall Chasin, AuD,MSc, Reg. CASLPO, Aud(C) is an Audiologist and the Director of Auditory Research at the Musicians’ Clinics of Canada in Toronto, the Coordinator of Research at the Canadian Hearing Society, and the Director of Research at ListenUp Canada. Chasin has been involved with hearing and hearing aid assessment since 1981, and is the author of over 100 clinically based articles. He is the editor of Hearing Loss in Musicians: Prevention and Mangagement.

Chasin Blog Screenshot

 

Her blog The Practice can be found on her personal website Curly Girl Studio. The Practice is a compilation of speech-language pathology cartoons she has drawn- made for SLPs by an SLP!

Jennifer L. Loehr, MA, CCC-SLP, a graduate of Humboldt State University, has been practicing speech pathology since 1989. The focus of her career has always been on geriatrics and she has spent the past ten years working with the dementia population. She specializes in developing dementia programs that focus on functional goals that will enhance the quality of life for patients, caregivers, and family members. She is a co-author of Here’s How to Treat Dementia.

Loehr Blog Screenshot

 

Speaking my Languages is part of the Future Fellowship she was awarded in 2009 by the Australia Research Council. Her she explores and presents her research findings.

Sharynne McLeod, PhD, ASHA Fellow, is a professor of speech and language acquisition at Charles Sturt University, Australia. She is an elected Fellow of the American Speech-Language-Hearing Association and Speech Pathology Australia and is the Vice President of the International Clinical Linguistics and Phonetics Association. She is the author of three books with Plural- Seeing Speech, Speech Sounds and Working with Families in Speech-Language Pathology.

McLeod Blog Screenshot

 

20 Questions with Gus Mueller is featured on AudiologyOnline’s website. It covers the latest developments in audiology and hearing science by asking 20 questions from an impressive array of industry experts.

Dr. H. Gustav Mueller, PhD, is Professor of Audiology, Vanderbilt University and holds faculty positions with the University of Northern Colorado and Rush University. He is the Senior Audiology consultant for Siemens Hearing Instruments and Contributing Editor for AudiologyOnline. Dr. Mueller is a Founder of the American Academy of Audiology and a Fellow of the American Speech and Hearing Association. He has published extensively in the areas of diagnostic audiology and hearing aid applications, and has co-authored several books including- Modern Hearing Aids (books 1, 2 & 3) and Fitting and Dispensing Hearing Aids.

Mueller Blog Screenshot

 

Susan Rvachew’s blog Developmental Phonological Disorders is directly connected to her new textbook with us by the same name. Here she will detail her experiences teaching with the book and related topics.

Susan Rvachew, PhD, S-LP(C), is currently an Associate Professor in the School of Communication Sciences and Disorders. Her research is focused on phonological development and disorders and the development of more effective interventions to treat phonological disorders in children and prevent reading disability in this population. She has published over 50 journal articles and book chapters describing the speech perception, speech production, and/or phonological awareness skills of infants, children, and adults.

Rvachew Blog Screenshot

 

Hearing International covers topics ranging from differences in audiology training, expertise, and scope of practice from one country to another to interesting practices, stories of travel, clinical practice, research and training diversity to name a few.

Dr. Robert M. Traynor, EdD, MBA, practices Audiology at Audiology Associates of Greeley, Inc. in Greeley, Colorado with particular emphasis in amplification and operative monitoring offering all general audiological services to patients of all ages. For the past 15 years has been an active consultant in Audiology for the hearing industry including Bernafon A/G, Switzerland , Maico, Internacoustics, and Otologics, LLC . A practice manager for over 35 years, Dr.Traynor has lectured on most aspects of the field in over 40 countries, including the United States. He is a co-author of Strategic Practice Management.

Traynor Blog Screenshot

Plural’s book donation helps stock library in India

We are proud to announce the inauguration of the Sadanand Singh Library at the Madras ENT Research Foundation (MERF) in Chennai, India. Plural’s donation of books helped stock the new library’s shelves and Plural’s President, Angie Singh, attended the dedication ceremony on December 7 in India.

MERF library dedication

Dr. Mohan Kameshwaran and his wife Mrs. Indira Kameshwaran (pictured with Angie Singh) established the Institute with a clear and determined vision to create a world class institute providing quality education and training to professionals in the field of Audiology and Speech Language Pathology. It is Plural’s hope that our contribution to this library will help further the study and training of India’s future audiologists and speech-language pathologists.

Angie with institute founders

In addition to the library dedication, the event also celebrated the launch of the first CE-approved, software-based app that combines hearing aid and music player with hearing loss compensation in a mobile phone. MERF and Jacoti, Belgium-based hearing technology company, have come up with the mobile app called Jacoti Listen App that can be downloaded for Rs 500.

Tips for Assessing Bilingual Children As a Monolingual SLP – by Leisha Vogl

Hello Speech-Language Pathologists-

We are re-posting an article from ASHASphere on bilingual patients written by Leisha Vogl. We hope you find it insightful.

-Plural Team

 

Tips for Assessing Bilingual Children As a Monolingual SLP

by Leisha Vogl

There are an estimated 337 different languages used (spoken, written, and/or signed) in the United States. Even bilingual speech-language pathologists will encounter situations in which the client’s primary language is unknown.  There are standardized, evidence-based tests for the Spanish-English population. But what about Russian, Vietnamese, German and so on? What do you do?

Here are some key practices that can aid any SLP evaluating a child who speaks an unfamiliar language:

  • Conduct a family/caregiver interview, which can help minimize cultural and linguistic biases. Understanding how others in the family view the client’s communication gives insight into expectations and the possibility for deficits. Is the client able to meet these expectations? If not, why and how? Do they differ significantly from others in that communication circle?
  • Use an interpreter. Meet with the interpreter prior to any contact with the family to review the process, terminology, and what you want him or her to do. If possible, use someone outside the child’s family and circle of friends to reduce the possibility of bias. Interpreters can provide key information, such as, “It was very hard for me to understand him,” or, “He doesn’t use prepositions correctly.” Using such information, along with additional testing measures can help support or negate a true disorder.
  • Use highly pragmatic tests if formal/standardized testing is not available in the child’s primary language. These tests will help determine the client’s grasp of conversational language, which is the first building block to more complex language. The same is true in monolinguals—that the first language we learn is social in nature. We e acquire more complex understanding and use of language by building on social language. You cannot report standard scores when using standardized testing not normed for that language. You can use the information as qualitative data to support the rest of your findings. I personally like administering the Oral and Written Language Scales (OWLS), now a second edition, for this population. It is relatively easy and quick to administer.
  • Employ Dynamic Assessment, which  involves pretest of a skill, an intervention to address that skill, and then a post-test to determine if there was progress. This method of assessment can be useful for evaluating multilingual individuals. If intense intervention is needed, this can indicate  impairment.Review the ASHA website for more information on Dynamic Assessment.

Things to be mindful of regarding typical bilingual language development include the following.

  • The silent period occurs when a client is first exposed to a new language. Typically this period ends between six months to a year. Some common misidentifications in this phase are Autism Spectrum Disorder, Selective Mutism, and language delay. It has also been noted that with a significant change in school, family situation and the like can trigger some children to revert to the silent period. This is why family and caregiver interviewing is so essential to diagnosing a language disorder.
  • Bilingual development is recognized in two stages. Basic Interpersonal Communication Skills (BICS), also known as “conversational language,” typically takes two to three years to acquire. Cognitive Academic Language Proficiency (CALP), also known as “academic language,” takes five to seven years to develop. Some common misidentifications during these phrases are Language Disorder and Specific Learning Disability. Be careful that the years refer to a 12-month period of constant and consistent exposure. Our academic calendars are typically nine months, so it may take more academic years to acquire conversational and academic language.

Remember when evaluating any child that there is variety among the “same” cultures and languages.

What additional information do you, or would you, include in an evaluation?

ABOUT THE AUTHOR: Leisha Vogl, MS CCC-SLP, is the owner of Sensible Speech-Language Pathology, LLC, in Salem, Oregon. She’s worked in the field of speech-language pathology for about 7 years ranging from early intervention, school-age populations, and adults in an acute care setting. Leisha is proficient in Spanish and American Sign Language. You may follow Sensible Speech on Facebook or Twitter. Check out the website at www.sensiblespeech.com

Section from Jerger’s “Audiology in the USA” Makes its Online Debut

Hello Plural Community-

This week we are re-posting an article from the Hearing Health & Technology Matters blog regarding Plural author James Jerger. We hope you enjoy.

-Plural Team

Section from Jerger’s “Audiology in the USA” makes its online debut - By David H. Kirkwood, the editor of Hearing News Watch and editor-in-chief of Hearing Health & Technology Matters

James JergerNo one has done more to advance the field of audiology over the past half century than James Jerger. As a researcher, writer/editor, teacher, and founding president of the American Academy of Audiology, Dr. Jerger has played an out-sized role in shaping the history of audiology and in preparing the profession to meet the needs of the 21st century.

That’s why when our blog, Hearing Health & Technology Matters (HHTM), had the unprecedented opportunity to publish an extensive passage from Dr. Jerger’s book, Audiology in the USAonline we seized it. With the permission of the book’s publisher, Plural Publishing, Wayne Staab has posted a 10-page section on rehabilitation from the book on Wayne’s World, his blog at HHMT.

Jerger_AITUHere, Dr. Jerger presents a fascinating and fast-moving chronicle of hearing aids from the carbon granule devices of 1902 through today’s advanced digital instruments. The Distinguished Scholar-in-Residence at the School of Behavioral and Brain Sciences, University of Texas at Dallas, also recounts the development of real-ear measurements, the discovery of the phenomenon of auditory deprivation, and the invention of outcome measures to determine patient benefit. Especially interesting are the portraits Dr. Jerger paints of some of the men and women who made important contributions to audiology.

As Wayne Staab states on his blog, HHTM is honored to have the privilege of being the first to publish a chapter from Audiology in the USA on the Internet. To read it, visit Wayne’s World.

HOLIDAY SALE!

We are offering 30% off list price PLUS free ground shipping now through December 24th on any title published before 2012- including Dr. Jerger’s Audiology in the USA. Just enter promotion code HOL1330 at checkout and select DEFAULT SHIPPING METHOD to apply your discount.