By Craig Coleman
By now, many people have seen the opening segment of the Super Bowl (https://www.youtube.com/watch?v=EP0ALpfJons) featuring Peyton Manning. In the segment, Manning says “Was I stuttering before?” to emphasize an earlier point that he made to his colleagues sitting around a conference table. First, let me begin by saying I don’t think Peyton Manning was being intentionally hurtful. Manning himself was born with a cleft palate (http://www.carolinapeds.com/2014/09/peyton-manning/) and has done a lot of work to raise money for children in need. The phrase “Did I Stutter?” has seemingly been around forever in some form. When you think about it, it’s fascinating to dig a little deeper into why it has been used as a punchline when others are not understanding or the lines of communication have broken down. “Did I stutter?” Why have people used that line? In fact, when people do stutter, others can still understand them. It might just take a little longer for the message to come out. Unfortunately, the phrase perpetuates many of the myths that have surrounded stuttering:
These all rank high on the “fake news” scale, and it is important to help people understand what stuttering is:
So, what is the problem with saying “Did I stutter?” Really, there is none. The problem is that there needs to be a follow-up response with “Yes, you did. And I was still able to understand you. It’s ok to stutter. Please continue talking and tell me what you want to say. I’m listening.” Maybe can hope for that in next year’s Super Bowl! I encourage anyone who wants to learn about the experiences of people who stutter to watch Stuttering: Part of Me (https://www.youtube.com/watch?v=YtWxqQCC3Ew). To get more information on stuttering: www.stutteringacademy.com www.westutter.org www.stutteringhelp.org www.stutteringhomepage.com www.friendswhostutter.org www.stuttertalk.com www.asha.org/practice-portal/clinical-topics/childhood-fluency-disorders/
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By: Craig Coleman, M.A., CCC-SLP, BCS-F, ASHA-F
West Virginia HB 2697: What it means for Speech-Language Pathologists and Audiologists This post hits close to home, as the legislation being discussed (WV House Bill 2697) directly impacts speech-language pathologists (me) and audiologists in my state. The bill would allow non-licensed providers in our fields to practice as long as they disclose that they were not licensed. The good news? They have to disclose that they don’t have a license in at least a 14 pt. font! The rationale provided in the bill does little to explain why anyone would believe this is a good idea for consumers. First, the bill claims that one of the purposes is to “expand opportunities.” I like opportunities. For example, everyone has an opportunity to get an undergraduate degree, get a Master’s degree in speech-language pathology or doctoral degree in audiology, obtain the over 350 clinic clock hours and nine months of clinical practice, and supervision needed to obtain a license. This bill is not providing opportunities, it is providing a means to undercut professional services from qualified providers to people with speech, language, swallowing, and hearing disorders. A second purpose listed is to “encourage trade associations to self-regulate.” That’s exactly what licensure boards do! Board members are appointed to make sure that the laws are current and reflect the scope of practice. Boards typically contain professional and public representation. Third, the bill states that this will “relieve providers from burdensome occupational licenses.” It will likely relieve qualified providers of jobs, and relieve consumers of qualified services. Licensure protects professionals from encroachment, but most importantly, it protects consumers from service provision by unqualified providers. For example, I am quite certain no member of the House or Senate would want me to do their plumbing work, no matter what font size I used to disclose my lack of license. For the record, I am NOT A LICENSED PLUMBER. So, why is this bill important to all of us in the professions? If it happens in one state, other states will surely follow. Please take time to write to the following sponsors of the bill to tell them why this is a really bad idea! You can use any of the above post in your message or draft your own. Thanks for taking the time to be an advocate for the professions and consumers. [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] In a nation gripped by the opioid epidemic, Huntington, WV has experienced its share of suffering. Our community, however, is rallying to be the epicenter of change. Numerous efforts are being made to support those dealing with addiction, who are in recovery, and those who experience the tragic effects of addiction second-hand. This past semester, the Department of Communication Disorders at Marshall University decided to contribute to that change by launching a new seminar on professional's involvement in caring for people and communities affected by the opioid crisis.
I had the opportunity to co-facilitate the class with Pam Holland. Together, we learned alongside 6 eager, compassionate graduate students. The course was rooted in conversation about the issue and how we can serve those in need. Students conducted literature reviews, engaged in community awareness events, learned from amazing guest speakers, and even had the opportunity to visit and assist at the local Neonatal Therapeutic Unit (NTU). As a culminating project, they conducted a live webinar on various topics discussed throughout the semester and developed educational materials which can be freely used. The links to those resources are below. A sincere thank you to all of those who contributed to the course this semester and to those who work every day to help serve those affected by addiction. Sincerely, Mary Weidner
By: Courtney Massey, Cassidy Forth, & Cara Stump
What is tele-practice? Why should I care? These are questions you were probably wondering when you read the title of this post. We hope that by explaining what tele-practice is, how it is used in the field of speech-language pathology, and how it could be used in the future, you will see why it is so important for us to advocate for this important service delivery model to be reimbursed by insurance companies so that it can become a widely used tool and help a great deal of people overcome their communication disorders. Knowing there are people that are not receiving care who could be receiving it through tele-practice is saddening, especially when you realize that it is because insurance companies do not cover tele-practice for speech-language pathology. There are many reasons that tele-practice should be implemented in therapy and covered by insurance companies, and we plan to outline some of these below. The American Telemedicine Association defines telemedicine as “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s health status”. The American Speech-Language-Hearing Association, the governing body for the speech-language pathology profession, has defined tele-practice as “the application of telecommunications technology to the delivery of audiology and speech-language pathology professional services at a distance by linking clinician to client/patient or clinician to clinician for assessment, intervention and/or consultation” and is in support of the adoption of this service delivery model. You may hear the term “telemedicine,” “tele-practice”, “telehealth,” “teletherapy”, etc. used in the literature; however, all of these words mean the same thing and are used to reference the act of providing a service in an online format rather than face-to-face interaction. With the evolution of technology that is continuing to grow, we must also evolve and take advantage of this new way of connecting people who may not otherwise be able to meet with various healthcare professionals. Tele-practice is an amazing new way for people to get the care they need in a more convenient way; as patients and healthcare professionals are evolving to accept and embrace this new service model, insurance companies must also realize that it is a valid and effective way of assessing and treating patients and should therefore be reimbursed in the same manner that face-to-face sessions are reimbursed. There are several benefits to utilizing teletherapy as an SLP. There are many rural areas throughout the United States that do not have access to services. Teletherapy allows everyone to have access to therapeutic services as long as an internet connection and computer are present. Previously, patients had to travel hundreds of miles to see specialists but now they can see specialists from their own home; this is allowing specialists to promote themselves as a professional, their knowledge, and their services to people all over the world. A specialist could also use teletherapy to teach other professionals their skill sets and potentially allow more professionals to develop expertise. Teletherapy could also be cost effective - currently some SLPs travel from home to home over multiple counties to provide services. This is costing companies an abundance of money in mileage fees and reimbursing individual professionals for gas. Being able to provide even half of their sessions via tele-practice instead of driving to each individual home would save companies thousands of dollars per year. Many states are recognizing the need for speech and language therapy provided by telepractice and are beginning to provide laws and regulations that govern SLPs in this practice. These new laws are allowing SLPs in many states to provide tele-practice, but it is billed to the patient at the full expense because it is not covered by insurance. Many people who may benefit from the speech and language services may not be able to afford the out of pocket costs. Medicare, a federal program for people who are 65 or older, is a source of insurance that does not currently consider speech-language therapy via tele-practice as reimbursable. Medicaid, a program for low income families, and private insurance have not set up reimbursement standards for speech and language teletherapy services. In other words, insurance has not stepped up to cover tele-practice services, because they don’t believe there is a high enough need and desire by the people who have their plans to actually cover it. Tele-practice for speech and language therapy should be covered by all insurances (federal, state, and private). In addition to the many benefits listed above, people should have the right to all options for their healthcare needs. With the addition of tele-practice coverage under insurance plans, more people will have options to speech and language services they may not have previously been able to attend or receive due to reasons, such as time, location, availability, and affordability. The most important thing you can do is to advocate! Advocate for your family, friends, colleagues, neighbors, and anyone else who would benefit from tele-practice! Being silent on a cause/policy or hoping that the issue will arise will not result in change. The best way to advocate for reimbursement of teletherapy is by supporting current efforts and writing to anyone you can! A few potential points in your letters could include: personal experiences with tele-practice, personal experiences of not being able to receive services, a lack of available resources in your area, cost reliefs, and much more! Several states already have policies in place, therefore, research may be required before writing your letters. References American Speech-Language-Hearing Association (2018). Telepractice. Retrieved from: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934956§ion=Key_Issues#Reimbursement American Speech-Language-Hearing Association. (2018). Reimbursement of telepractice services. Retrieved from: https://www.asha.org/Practice/reimbursement/Reimbursement-of-Telepractice-Services/ Dudding, C. (2013). Reimbursement and telepractice. SIG 18 Perspectives on Telep ractice, Vol. 3, 35-40. doi:10.1044/teles3.2.35 Frailey, C. (2014). A primer on medicaid telepractice reimbursement. The ASHA Leader. 30-31. By: Kellan Mallory, Erin Dial, Whitney Wright, Kendra Markwell
Stuttering is a speech disorder in which there is an increase of disruptions in a person’s speech. These disfluencies can consist of blocks (no sound coming out), repetitions (repeating the same sound, syllable, or word), prolongations (making sounds longer), and interjections (“uh,” “um”). Additionally, individuals who stutter may also have increased tension in their neck and face as well as secondary behaviors associated with their stuttering (e.g., eye blinking, foot tapping). Most importantly, a person may experience negative thoughts/emotions related to stuttering and a negative impact on social, academic, or vocational interaction. According to the The Stuttering Foundation (2018), the disorder affects 70 million people worldwide and 3 million people in the United States alone. Though the exact cause of stuttering is unknown for each individual, research heavily indicates neurophysiological and genetic factors. This is supported by the incidence of individuals who stutter with a family history of stuttering. Despite popular belief, stuttering is not caused by emotional instability or parenting style, but rather genetic and neurological predisposition. However, temperament and environment can certainly impact a person’s reactions to stuttering. Currently, reimbursement for stuttering therapy is largely non-existent. This is likely due to the misconception that stuttering is a psychological disorder rather than a genetic and neurophysiological condition. However, research indicates that stuttering therapy by a speech-language pathologist is effective in providing individuals who stutter with strategies to use in order to decrease disfluencies. Additionally, more recent research discusses the importance of targeting negative reactions in relation to stuttering. This tends to be the most important aspect of stuttering due to the social and emotional impact stuttering can have on individuals. A study by Craig, Blumgart, and Tran (2009) found that stuttering negatively impacts vitality, social, emotional, and mental functioning in adults who stutter, and that the impact on quality of life is comparable to the impact from other medical diagnoses such as TBI or coronary heart disease (2009). Further, these findings have significant therapeutic implications for children who stutter. It is reasonable to assume the negative impact of stuttering may be due to stuttering becoming a chronic condition arising from childhood. Therefore, it is imperative that treatment access continues to improve for children and adults who stutter so that stuttering may have less of an impact on quality of life as children transition to adults. Studies show that stuttering has a negative impact on daily life activities in adults and children. In the work setting, research has found that adults who stutter have a decreased likelihood of getting a job and being promoted due to the negative perceptions held by many employers. In school settings, children who stutter were associated with lower test scores and an increased likelihood of being held back a grade. However, with speech therapy the negative effects associated with stuttering have been found to decrease significantly. In the workplace, individuals who received speech therapy and experienced a reduction in stuttering as a result were promoted within 10 months after receiving treatment. In the school setting, timely treatment for stuttering was found to improve the academic performance of children. (Conture, 1996). Speech therapy has been found to improve patient attitudes about their stuttering through counseling techniques. Speech-language pathologists teach their patients how to be more accepting of their stuttering and to limit stuttering's influence on their lives. They also help desensitize patients from their fear of stuttering by having them participate in activities that push them outside of their comfort zone. These activities promote transfer the of their new skills to real life speaking situations (Irani, 2012). In addition to emotional gains, patients who stutter learn various techniques which help them to decrease the amount of disfluencies they experience. Speech therapy for stuttering must become more accessible and affordable for patients. Insurance reimbursement for speech therapy is important for all individuals, so they can learn to manage their stuttering effectively and not let it interfere with their ability to have a successful and happy life. References American Speech-Language-Hearing Association. (n.d.). Childhood fluency disorders. Retrieved from: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935336§ion=Causes Conture, E. (1996). Treatment efficacy: Stuttering. Journal of Speech and Hearing Research, 39(5), 18-26. Craig, A., Blumgart, E., & Tran, Y. (2009). The impact of stuttering on the quality of life in adults who stutter. Journal of Fluency Disorders, 34, 61-71. Irani, F., Gabel, R., Daniels, D., & Hughes, F. (2012). The long-term effectiveness of stuttering therapy: A mixed methods study. Journal of Fluency Disorders, 37(3), 164-178. Onslow, M., Costa, L., Andrews, C., Harrison, E., & Packman, A. (1996). Speech outcomes of a prolonged speech-treatment for stuttering. Journal of Speech, Language, and Hearing Research, 39, 735-749. The Stuttering Foundation. (n.d.). FAQ. Retrieved from: https://www.stutteringhelp.org/faq By: Samantha Graffius, Hannah Roy, Christian Boles, & Elaine King
What are Voice Disorders? For most of us, our voice is a tool we use each and every day; we chat with the ones we love, speak to the clerk at the supermarket, and sing with our friends. For others, it’s an essential part of their career. Teachers, singers, actors, and the like all use their voices constantly. Voice disorders are a problem throughout professions, but the aforementioned few are particularly vulnerable to voice disorders due to their prolonged use of their voice. If a teacher loses his or her voice after a long week, they are unable to perform their job; likewise, a singer who cannot sing due to vocal nodules is ineffective. But what is a voice disorder? A voice disorder is when a person’s voice is different than the expected age, gender, cultural background, or geographic location. Voice disorders can occur in any individual but are more prevalent in adult females, elderly adults, and occupational groups such as teachers, manufacturing/factory workers, salespersons, and singers (ASHA, n.d). Studies have shown that voice treatment provided by speech-language pathologists can improve the quality of life of people with voice disorders. The following list of examples demonstrates the effectiveness of voice therapy as seen in the research literature: Following voice rehabilitation, patients with laryngeal cancer reported positive effects on overall psychological well-being as well as lower ratings of anxiety and depression (Bergstrom, Ward, & Finizia, 2016). “Voice therapy has been demonstrated to be effective for hoarseness across the lifespan from children to older adults” (ASHA, 2018; Ramig & Verdolini, 1998; Thomas & Stemple, 2007). Therapeutic techniques used during voice therapy have shown positive results for individuals diagnosed with muscle tension dysphonia (da Cunha Pereira et al., 2018) What we are asking? If Kim has a stroke that severely debilitates her, the insurance company (in this example, Medicare) will provide, at maximum, $3,000 of annual coverage. This amount is static and will not change. If Kim needs additional therapy, Medicare will not allow for reimbursement once that amount is met. This presents a problem. Kim may begin to show improvement early and have no need for additional therapy. However, in the likely event that additional therapy is required, Kim will be ineligible to receive more until the next year. A break in therapy this large could impact her recovery. Research shows that the amount of therapy given impacts the recovery time of individuals with voice disorders (Fu, Theodoros, & Ward, 2016). So, what can we do about this? Insurance companies need to be educated that patients should be covered for the entire time it takes them to improve. It’s important that the insurance companies hear from a large amount of us; they respond to the requests of the many, not the few. Without your help, this limitation forced by insurance companies will continue to affect the lives of those with voice disorders - from stroke and Parkinson’s victims to those with vocal trauma. Speech therapy for those with voice disorders is a necessity by increasing their quality of life. References ASHA, (n.d). Voice Disorders. Retrieved from https://www.asha.org/practice-portal/clinical-topics/voice-disorders/ Bergström, L., Ward, E., & Finizia, C. (2017). Voice rehabilitation after laryngeal cancer: Associated effects on psychological well-being. Supportive Care in Cancer, 25(9), 2683–2690. https://doi-org.marshall.idm.oclc.org/10.1007/s00520-017-3676-x da Cunha Pereira, G., de Oliveira Lemos, I., Dalbosco Gadenz, C., & Cassol, M. (2018). Effects of Voice Therapy on Muscle Tension Dysphonia: A Systematic Literature Review. Journal of Voice, 32(5), 546–552. https://doi-org.marshall.idm.oclc.org/10.1016/j.jvoice.2017.06.015 Fu, S., Theodoros, D., & Ward, E. C. (2016). Long-term effects of an intensive voice treatment for vocal fold nodules. International Journal of Speech-Language Pathology, 18(1), 77-88. doi:10.3109/17549507.2015.1081286 By: Hannah Carey, Madison McDaniel, Haley Conner, Kaitlin Weaver, Maggie Westfall
Introduction: “Imagine what life would be like needing to take 20 minutes away from whatever it is your doing just to take a sip of water… I can’t imagine.” This is the reality for individuals suffering from a disorder known as dysphagia. Dysphagia occurs when there is a disruption in the processes involved in feeding and/or swallowing. Without appropriate intervention, dysphagia can greatly impact an individual's overall quality of life. What are pediatric feeding and swallowing disorders? Feeding disorders are formally defined by the American Speech-Language Hearing Association [ASHA] as, “problems with a range of eating activities that may or may not include problems with swallowing” (ASHA, 2018). This includes problems with actions such as, sucking from a bottle, being fed with a spoon, chewing, and moving the food or drink back toward the throat for swallowing. Swallowing disorders occur when there is a disruption in the “process during which saliva, liquids, and foods are transported from the mouth into the stomach while keeping the airway protected” (ASHA, 2018). Implications of both feeding and swallowing disorders include aversion to different foods, malnutrition, gastrointestinal issues, behavioral issues, social implications, etc. In order to eliminate or minimize the effects of dysphagia, it is imperative that children receive appropriate intervention/therapy. What does swallowing intervention look like and SLPs role in treating the patient? Swallowing therapy can be used to restore a person’s normal function, modify behavior without totally restoring function (compensatory strategies), or a combination of either of these. Patients who need swallowing therapy include those who have suffered damage from traumatic brain injuries, multiple muscle-weakening diseases, and many other causes. The amount of treatment necessary is dependent upon the severity of the problems experienced by the person. The role of the speech-language pathologist is dependent upon the specific patient’s needs. First, the SLP will be responsible for giving an assessment and diagnosis of the swallowing or feeding disorder. Once an issue or disorder has been determined, the SLP will then carryout treatment using a variety of techniques: biofeedback (where the patient can see the swallow), diet modifications (making food and liquids a desired consistency), and oral-motor therapy and exercises (asha.org). Why do services for this population matter? During childhood, the body is growing at a rapid rate. The vitamins and minerals from food helps support the growth and development during this time. The nutrition from food allows the bones, muscles, tendons, joints and organs to develop and work as they should (Seidenberg). Along with the skeletal growth during these stages, good nutrition is needed for brain development. A study done by the CDC found that children who are not receiving the right amount of vitamins and minerals are receiving lower grades than the children that do. According to Dr. Reynaldo Martorell, when a child is receiving a poor diet without the proper nutrients required for growth, it can lead to learning disorders, attentional issues and behavioral/social problems (Brinkman, 2017). What can we change? Given the prevalence of swallowing disorders, and effects of feeding and swallowing disorders on children, it is critical that insurance companies cover therapy sessions for people with these disorders. Sessions should not be capped, as the focus of the treatment should be on the needs of the child and not on financial costs. Advocate for the number of session they should get. Number of visits should be based on patient’s needs. Every therapy session is going to be different, just like the number of therapy sessions is going to different based on the person and their needs. For instance, a person who has had surgery for a torn ACL is going to have more physical therapy sessions versus someone who is receiving physical therapy who has a sprained ankle. The same effect applies to those receiving swallowing services from the speech-language pathologist. The maximum number of therapy sessions insurances will cover is approximately 20 per year, which is a fairly small number. That being said, it is important to take into consideration the extent and severity of each case, and allow the recommended number of sessions based on what the professional thinks, rather than having insurance companies dictating the amount of sessions they believe a person should receive. References: Seidenberg, Casey. (n.d.). Why it’s so important to feed kids well during growth spurts. https://www.washingtonpost.com/lifestyle/wellness/why-its-so-important-to-feed-teens-well-during-growth-spurts/2018/04/03/c8d2cf98-2c7c-11e8-b0b0-f706877db618_story.html?noredirect=on&utm_term=.cc5c7bf6f31c Brinkman, J. (2017). Why is healthy diet important for child development. https://www.livestrong.com/article/355822-why-is-a-healthy-diet-important-for-child-development/ https://www.feedingmatters.org https://pedsfeeds.com https://youtu.be/buwFUkOFipE https://www.youtube.com/watch?v=MrbEUDO6S5U https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934965§ion=Treatment https://leader.pubs.asha.org/article.aspx?articleid=2289526 https://www.asha.org/Practice-Portal/Clinical-Topics/Pediatric-Dysphagia/ By: Chloe Adkins, Kaitlyn Adams, Skyler Brumfield, & Morgan Merritt
The Impacts of Social Communication Disorders: Why Insurance Reimbursement is Critical for Social Communication Treatment What is social communication? Social communication refers to the use of appropriate social skills during interactions with others. Some of these skills include: Conversational skills Asking for, giving, and responding to information Turn taking Eye contact Introducing and maintaining topics Asking questions or for clarification Avoiding repetitive information Adjusting language based on situation Using humor Using appropriate strategies for gaining attention and interrupting Offering/responding to expressions of affection appropriately Facial expression Body language Personal space Why is social communication important? Social skills are necessary for various everyday interactions that occur in educational, occupational/professional, and casual settings. For example, children in preschool need to be able to take turns while playing alongside their peers. The transition into school-age and adolescence may include interaction with peers and teachers in group settings (e.g., in-class group projects and extracurricular activities). As children get older, the use of social skills becomes more demanding, considering children/adolescents are “expected” to behave and communicate appropriately in various situations. A lack of proper social skills can make even the most simple tasks difficult (e.g., asking to borrow a pencil, ordering coffee). It can even lead to the devastating issue of bullying. Throughout adulthood, effective social skills are also important in the workplace and in personal life. Lack of these skills can lead to difficulties in the following environments: School Interactions with peers (e.g., building relationships/friendships) Interactions with teachers (e.g., communicating needs/wants) Grades (due to lack of participation) Bullying It is important for children and adolescents to be able to appropriately interact with peers and teachers. These social interactions can occur during meetings with teachers, group projects, lunchtime, recess, and/or extracurricular activities. In free social situations such as recess, children do not have adults to “supervise” conversations. Lack of guidance and structure can lead to unacceptable behavior such as bullying by peers. Challenges with social skills can leave a bullied child unable to respond appropriately to a bad situation. The child may be unable to defend themselves or talk to an authority figure about the situation, allowing the bullying to get worse. Workplace Relationships with co-workers Communicating with authority figures Appropriate and professional behavior and language Social skills are important in ensuring effective communication and productivity in the workplace. Employees must be able to form relationships with co-workers and bosses, as this is essential to working as a team. It is also important for employees to display appropriate manners, body language, and compassion during all interactions in the workplace (especially with clients) to demonstrate professionalism. Personal Life Dating/relationships Family Friendships Effective communication in emergency situations Within a person’s social life, they encounter many situations in which they have to know how to appropriately communicate with others. As members of society, we have the ability and choice to form relationships of varying degrees with those we come into contact with. Therefore, it is vital to have the skills needed to facilitate and build new relationships. It is also important to be able to interact with others in emergency situations, as those can be time sensitive. Being able to interact with others in adverse situations (e.g., car accidents, robberies, fires) is vital in ensuring the safety of everyone involved. Lacking appropriate social skills in the aforementioned situations does not only affect the individual, but potentially those around them, too. This speaks to the importance of the presence of social skills in every person’s life. Why is reimbursement of professional social skill intervention important? Social communication is a functional aspect of everyday life. People should not have to settle for less than adequate social skills, considering there are professional services available for improving these challenges. For example, speech-language pathologists are health professionals with the ability to help those who need a boost in social skills. Basic insurance policies do not always cover the amount of speech therapy needed for an individual to be successful. As social skills are needed throughout the lifespan, it is important for people to be willing to contact their insurance companies and advocacte for needed services. What can you do? Advocating for reimbursement is as easy as… Contacting your insurance company to disucss the importance of these services. Furthering your own education regarding social communication. Sharing this blog post with family and friends to expand knowledge about the importance of social skills. References Abdoola, F., Flack, P. S., & Karrim, S. B. (2017). Facilitating pragmatic skills through role-play in learners with language learning disability. South African Journal of Communication Disorders, 64(1), 1–12. https://doi-org.marshall.idm.oclc.org/10.4102/sajcd.v64i1.187 Adams, C., Lockton, E., Freed, J., Gaile, J., Earl, G., McBean, K., … Law, J. (2012). The Social Communication Intervention Project: a randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder. International Journal of Language & Communication Disorders, 47(3), 233–244. https://doi-org.marshall.idm.oclc.org/10.1111/j.1460-6984.2011.00146.x Pietro, S. (2017). Social communication disorder basics. Retrieved from https://childmind.org/guide/social-communication-disorder/ Social communication disorders: Overview. (n.d.). Retrieved from https://www.asha.org/Practice-Portal/Clinical-Topics/Social-Communication-Disorder/ Team, U. (n.d.). Understanding social communication disorder. Retrieved from https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder Last month, teachers in West Virginia went on strike to advocate for higher wages and better insurance benefits. This month, Oklahoma teachers are now on strike for similar reasons. Over 50% of speech-language pathologists (SLPs) work in the schools. Thus, during strikes or work stoppages, SLPs are also on the front lines.
It is imperative during these times to remember the amount of work that SLPs in the schools are expected to do, sometimes with little budget, resources, or space. We can help our colleagues in these situations by contacting the appropriate state legislators and voicing our support for teachers and SLPs in the school setting. We strongly support our colleagues in Oklahoma and encourage you to visit http://www.oklegislature.gov and contact legislators to voice your support as well. If any of our colleagues from Oklahoma would like to share their experiences on our blog here, feel free to contact us! By Shawna Pope, Speech-Language Pathologist
I have long advocated for our field due to encroachment and sometimes outright take over from ABA therapists. I have numerous examples that have been sent to me regarding SLPs losing their clients due to an ABA therapist taking over and pushing them out. It has happened in schools, early intervention, private practice, and I am hearing about them making a move for nursing homes and home health. The biggest defense against this damage to our field is to point out that ABA is a set of principles that can be applied to any profession in an attempt to increase outcomes by using reinforcement. It is NOT a stand alone therapy, intervention, or teaching method. BCBAs or ABA therapists with no formal education hired by BCBAs to do therapy have zero training in language development, language disorders, anatomy, phonetics, literacy, literacy disorders, neuroanatomy, or any of the other coursework SLPs take to become speech, language, and communication experts. Often the stories that have been sent to be describe a situation that begins as collaboration and ends in the ABA therapist taking over. In ABA, there is no room for another perspective or approach. ABAs like to "collaborate" because they need information from SLPs to know what to target and how to do it. And yes, many SLPs have told them before they realized what was happening. I am aware there are examples of successful collaboration efforts between SLPs and ABAs and that not all ABAs practice outside of their scope. However, just because this sometimes occurs does not erase the need to advocate for our field and clients to attempt to lesson the damage being done. This plan has been in the works for years. When I taught in higher ed I saw the encroachment begin. Now, in my former department there is reportedly a sign with an arrow pointing down the hall to the BAT department that says " Speech and Language Lab." This encroachment is not an accident. Some states have successfully intervened in the licensing attempt of ABA therapists to ensure that our scope of practice was not included in theirs. All states need to be aware of this and do the same. This issue is being discussed and planned for by ASHA and by the state associations. They cannot do it alone. All SLPs need to be advocates for their field and educate parents, our schools, and the general public on the differences between the practice of speech-language pathology and ABA principles. |
Craig Coleman, M.A., CCC-SLP, BCS-F (Editor)Archives
February 2019
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