SLP Takes Fight for Reputation To Supreme Court And Wins
West Virginia Supreme Court of Appeals - Clockwise from top left, Menis Ketchum, Elizabeth Walker,
Margaret Workman, Allen Loughry and Robin Davis.
August 29, 2018 | by Christina Antoine, MA, CCC-SLP
In case you didn’t know, all health care providers, including speech-language pathologists are required to carry liability insurance. If you’re going to work or are already working at a sizeable organization such as a school or hospital, your employer should already carry insurance to cover its employees. If working or contemplating to do so at a smaller establishment (i.e. a clinic, skilled nursing facility), it is recommended that you inquire about liability coverage during the interview process. If you are an independent contractor, whether you have another position with a big organization where you are covered (for example, many SLPs take on additional cases through agencies where they are classified as independent contractors), getting your own liability insurance is a must.
This particular case out of West Virginia is a clear reminder why all speech-language pathologists need to have liability insurance.
A speech pathologist (SLP) was contacted by a woman seeking services and referred her to Raleigh General Hospital to seek services. The woman was then admitted to a hospice care facility that offers its own speech and language services, therefore the appointment she had made with the hospital was cancelled. The SLP explained this to the woman’s power of attorney, who then asked the SLP to conduct an evaluation and recommend treatment methods. The SLP shared that she did not have any openings in her schedule and that she should consider alternative modes of communication (i.e. augmentative alternative communication - AAC), as traditional therapy would not likely benefit her.
The hospital realizing that the woman cancelled her appointment, inquired with the power of attorney about the cancellation. The latter revealed to them that they were following the SLP’s advice and that she refused to perform an evaluation. The hospital consequently filed a complaint against the SLP with the West Virginia Board of Examiners for Speech-Language Pathology and Audiology (WVBESLPA), who decides to officially reprimand the SLP and require that she complete one year of supervised practice.
The SLP finding this decision unfair, takes the WVBESLPA to court arguing that the woman was never her patient and the court agreed, reversing and vacating the WVBESLPA decision. The WVBESLPA consequently took their fight to the Supreme Court, which decided to uphold the lower court’s decision.
This whole ordeal started in 2013, when the SLP was contacted by the woman. The WVBESLPA entered their order for a reprimand and one-year supervised practice in May 2015. The Raleigh Circuit Court’s (lower court) order was given in May 2017. The Supreme Court upheld the lower court’s order in June 2018.
That’s a five plus year legal battle originating from someone who wasn’t even the SLP’s patient. Could you weather such a legal storm out of pocket and for that long?
Insure yourself.
To read the Supreme Court’s decision, click here.
In case you didn’t know, all health care providers, including speech-language pathologists are required to carry liability insurance. If you’re going to work or are already working at a sizeable organization such as a school or hospital, your employer should already carry insurance to cover its employees. If working or contemplating to do so at a smaller establishment (i.e. a clinic, skilled nursing facility), it is recommended that you inquire about liability coverage during the interview process. If you are an independent contractor, whether you have another position with a big organization where you are covered (for example, many SLPs take on additional cases through agencies where they are classified as independent contractors), getting your own liability insurance is a must.
This particular case out of West Virginia is a clear reminder why all speech-language pathologists need to have liability insurance.
A speech pathologist (SLP) was contacted by a woman seeking services and referred her to Raleigh General Hospital to seek services. The woman was then admitted to a hospice care facility that offers its own speech and language services, therefore the appointment she had made with the hospital was cancelled. The SLP explained this to the woman’s power of attorney, who then asked the SLP to conduct an evaluation and recommend treatment methods. The SLP shared that she did not have any openings in her schedule and that she should consider alternative modes of communication (i.e. augmentative alternative communication - AAC), as traditional therapy would not likely benefit her.
The hospital realizing that the woman cancelled her appointment, inquired with the power of attorney about the cancellation. The latter revealed to them that they were following the SLP’s advice and that she refused to perform an evaluation. The hospital consequently filed a complaint against the SLP with the West Virginia Board of Examiners for Speech-Language Pathology and Audiology (WVBESLPA), who decides to officially reprimand the SLP and require that she complete one year of supervised practice.
The SLP finding this decision unfair, takes the WVBESLPA to court arguing that the woman was never her patient and the court agreed, reversing and vacating the WVBESLPA decision. The WVBESLPA consequently took their fight to the Supreme Court, which decided to uphold the lower court’s decision.
This whole ordeal started in 2013, when the SLP was contacted by the woman. The WVBESLPA entered their order for a reprimand and one-year supervised practice in May 2015. The Raleigh Circuit Court’s (lower court) order was given in May 2017. The Supreme Court upheld the lower court’s order in June 2018.
That’s a five plus year legal battle originating from someone who wasn’t even the SLP’s patient. Could you weather such a legal storm out of pocket and for that long?
Insure yourself.
To read the Supreme Court’s decision, click here.
South Carolina's Francis Marion University adds Graduate SLP Program
Great news for prospective graduate speech-language pathology students.
Francis Marion University in South Carolina recently added a Master of Speech-Language Pathology program, accredited by ASHA, only becoming the third such program in the state. The inaugural class of 25 graduate students will start this Fall 2018.
As with other graduate SLP programs, those with a bachelor in communication sciences and disorders can directly apply to the program and those without will first need to complete a year of prerequisite courses consisting of 25 credits.
Francis Marion University in South Carolina recently added a Master of Speech-Language Pathology program, accredited by ASHA, only becoming the third such program in the state. The inaugural class of 25 graduate students will start this Fall 2018.
As with other graduate SLP programs, those with a bachelor in communication sciences and disorders can directly apply to the program and those without will first need to complete a year of prerequisite courses consisting of 25 credits.
The Benefits of Bilingualism
April 2, 2012 | by Yudhijit Bhattacharjee, The New York Times
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SPEAKING two languages rather than just one has obvious practical benefits in an increasingly globalized world. But in recent years, scientists have begun to show that the advantages of bilingualism are even more fundamental than being able to converse with a wider range of people. Being bilingual, it turns out, makes you smarter. It can have a profound effect on your brain, improving cognitive skills not related to language and even shielding against dementia in old age.
This view of bilingualism is remarkably different from the understanding of bilingualism |
through much of the 20th century. Researchers, educators and policy makers long considered a second language to be an interference, cognitively speaking, that hindered a child’s academic and intellectual development.
They were not wrong about the interference: there is ample evidence that in a bilingual’s brain both language systems are active even when he is using only one language, thus creating situations in which one system obstructs the other. But this interference, researchers are finding out, isn’t so much a handicap as a blessing in disguise. It forces the brain to resolve internal conflict, giving the mind a workout that strengthens its cognitive muscles.
Bilinguals, for instance, seem to be more adept than monolinguals at solving certain kinds of mental puzzles. In a 2004 study by the psychologists Ellen Bialystok and Michelle Martin-Rhee, bilingual and monolingual preschoolers were asked to sort blue circles and red squares presented on a computer screen into two digital bins — one marked with a blue square and the other marked with a red circle.
In the first task, the children had to sort the shapes by color, placing blue circles in the bin marked with the blue square and red squares in the bin marked with the red circle. Both groups did this with comparable ease. Next, the children were asked to sort by shape, which was more challenging because it required placing the images in a bin marked with a conflicting color. The bilinguals were quicker at performing this task.
The collective evidence from a number of such studies suggests that the bilingual experience improves the brain’s so-called executive function — a command system that directs the attention processes that we use for planning, solving problems and performing various other mentally demanding tasks. These processes include ignoring distractions to stay focused, switching attention willfully from one thing to another and holding information in mind — like remembering a sequence of directions while driving.
Why does the tussle between two simultaneously active language systems improve these aspects of cognition? Until recently, researchers thought the bilingual advantage stemmed primarily from an ability for inhibition that was honed by the exercise of suppressing one language system: this suppression, it was thought, would help train the bilingual mind to ignore distractions in other contexts. But that explanation increasingly appears to be inadequate, since studies have shown that bilinguals perform better than monolinguals even at tasks that do not require inhibition, like threading a line through an ascending series of numbers scattered randomly on a page.
The key difference between bilinguals and monolinguals may be more basic: a heightened ability to monitor the environment. “Bilinguals have to switch
languages quite often — you may talk to your father in one language and to your mother in another language,” says Albert Costa, a researcher at the University of Pompeu Fabra in Spain. “It requires keeping track of changes around you in the same way that we monitor our surroundings when driving.” In a study comparing German-Italian bilinguals with Italian monolinguals on monitoring tasks, Mr. Costa and his colleagues found that the bilingual subjects not only performed better, but they also did so with less activity in parts of the brain involved in monitoring, indicating that they were more efficient at it.
They were not wrong about the interference: there is ample evidence that in a bilingual’s brain both language systems are active even when he is using only one language, thus creating situations in which one system obstructs the other. But this interference, researchers are finding out, isn’t so much a handicap as a blessing in disguise. It forces the brain to resolve internal conflict, giving the mind a workout that strengthens its cognitive muscles.
Bilinguals, for instance, seem to be more adept than monolinguals at solving certain kinds of mental puzzles. In a 2004 study by the psychologists Ellen Bialystok and Michelle Martin-Rhee, bilingual and monolingual preschoolers were asked to sort blue circles and red squares presented on a computer screen into two digital bins — one marked with a blue square and the other marked with a red circle.
In the first task, the children had to sort the shapes by color, placing blue circles in the bin marked with the blue square and red squares in the bin marked with the red circle. Both groups did this with comparable ease. Next, the children were asked to sort by shape, which was more challenging because it required placing the images in a bin marked with a conflicting color. The bilinguals were quicker at performing this task.
The collective evidence from a number of such studies suggests that the bilingual experience improves the brain’s so-called executive function — a command system that directs the attention processes that we use for planning, solving problems and performing various other mentally demanding tasks. These processes include ignoring distractions to stay focused, switching attention willfully from one thing to another and holding information in mind — like remembering a sequence of directions while driving.
Why does the tussle between two simultaneously active language systems improve these aspects of cognition? Until recently, researchers thought the bilingual advantage stemmed primarily from an ability for inhibition that was honed by the exercise of suppressing one language system: this suppression, it was thought, would help train the bilingual mind to ignore distractions in other contexts. But that explanation increasingly appears to be inadequate, since studies have shown that bilinguals perform better than monolinguals even at tasks that do not require inhibition, like threading a line through an ascending series of numbers scattered randomly on a page.
The key difference between bilinguals and monolinguals may be more basic: a heightened ability to monitor the environment. “Bilinguals have to switch
languages quite often — you may talk to your father in one language and to your mother in another language,” says Albert Costa, a researcher at the University of Pompeu Fabra in Spain. “It requires keeping track of changes around you in the same way that we monitor our surroundings when driving.” In a study comparing German-Italian bilinguals with Italian monolinguals on monitoring tasks, Mr. Costa and his colleagues found that the bilingual subjects not only performed better, but they also did so with less activity in parts of the brain involved in monitoring, indicating that they were more efficient at it.
The bilingual experience appears to influence the brain from infancy to old age (and there is reason to believe that it may also apply to those who learn a second language later in life).
In a 2009 study led by Agnes Kovacs of the International School for Advanced Studies in Trieste, Italy, 7-month-old babies exposed to two languages
from birth were compared with peers raised with one language. In an initial set of trials, the infants were presented with an audio cue and then shown a puppet on one side of a screen. Both infant groups learned to look at that side of the screen in anticipation of the puppet. But in a later set of trials, when the puppet began appearing on the opposite side of the screen, the babies exposed to a bilingual environment quickly learned to switch their anticipatory gaze in the new direction while the other babies did not.
Bilingualism’s effects also extend into the twilight years. In a recent study of 44 elderly Spanish-English bilinguals, scientists led by the neuropsychologist Tamar Gollan of the University of California, San Diego, found that individuals with a higher degree of bilingualism — measured through a comparative evaluation of proficiency in each language — were more resistant than others to the onset of dementia and other symptoms of Alzheimer’s disease: the higher the degree of bilingualism, the later the age of onset.
Nobody ever doubted the power of language. But who would have imagined that the words we hear and the sentences we speak might be leaving such a deep imprint?
Yudhijit Bhattacharjee is a staff writer at Science.
To access the original article on The New York Times, click here.
In a 2009 study led by Agnes Kovacs of the International School for Advanced Studies in Trieste, Italy, 7-month-old babies exposed to two languages
from birth were compared with peers raised with one language. In an initial set of trials, the infants were presented with an audio cue and then shown a puppet on one side of a screen. Both infant groups learned to look at that side of the screen in anticipation of the puppet. But in a later set of trials, when the puppet began appearing on the opposite side of the screen, the babies exposed to a bilingual environment quickly learned to switch their anticipatory gaze in the new direction while the other babies did not.
Bilingualism’s effects also extend into the twilight years. In a recent study of 44 elderly Spanish-English bilinguals, scientists led by the neuropsychologist Tamar Gollan of the University of California, San Diego, found that individuals with a higher degree of bilingualism — measured through a comparative evaluation of proficiency in each language — were more resistant than others to the onset of dementia and other symptoms of Alzheimer’s disease: the higher the degree of bilingualism, the later the age of onset.
Nobody ever doubted the power of language. But who would have imagined that the words we hear and the sentences we speak might be leaving such a deep imprint?
Yudhijit Bhattacharjee is a staff writer at Science.
To access the original article on The New York Times, click here.
SLP Spotlight: Grey's Anatomy
March 22, 2012 | by Christina Antoine
To watch this episode, click on the image above.
If you had the chance to catch the latest episode of Grey’s Anatomy, your SLP antennas must have lit up with talks of damage to Broca’s area and aphasia.
Derek, Dr. Shepherd, has a 27 year old patient who comes in for surgery. She also happens to have a brain tumor that he decides not to operate on and to instead follow. He explains to the patient that later on, if the tumor grows, then he’ll consider removing it. However, during the surgery he is called to another case and Lexi (Little Grey) and Meredith (Dr. Grey) are left to continue the surgery. Everything goes smoothly until they spot the tumor Derek had decided not to operate on. “It’s right there” says Lexi, as she points out how easy it would be to take it out. Meredith agrees and they make the joint decision to remove the tumor. All seems to go well, with no visible sign of damage. However, when Meredith mentions to Derek that they removed the tumor, he is furious.
Then Meredith and us the viewers realize why: Although the patient wakes up seemingly well post-surgery and has good sensory and motor functions, she is unable to talk. That is when Derek explains that the patient now has aphasia and that with therapy she has a small chance of regaining some of her speech. A better explanation is given by a somber Meredith to Lexi:
“We damaged Broca’s area, so she can understand speech, she knows what she wants to say, but she can’t say it.”
“Tell me that he can fix it” begs Lexi. But Meredith’s answers “He can’t, it’s irreparable”.
The lesson for us future SLPs: if you ever work with a neurosurgeon or neurologist or are asked your opinion about a tumor in or near Broca’s area, make sure to communicate the dire possible consequences of damaging this center. All may seem to go well, but the true results won’t be seen until the patient wakes post-surgery.
Derek, Dr. Shepherd, has a 27 year old patient who comes in for surgery. She also happens to have a brain tumor that he decides not to operate on and to instead follow. He explains to the patient that later on, if the tumor grows, then he’ll consider removing it. However, during the surgery he is called to another case and Lexi (Little Grey) and Meredith (Dr. Grey) are left to continue the surgery. Everything goes smoothly until they spot the tumor Derek had decided not to operate on. “It’s right there” says Lexi, as she points out how easy it would be to take it out. Meredith agrees and they make the joint decision to remove the tumor. All seems to go well, with no visible sign of damage. However, when Meredith mentions to Derek that they removed the tumor, he is furious.
Then Meredith and us the viewers realize why: Although the patient wakes up seemingly well post-surgery and has good sensory and motor functions, she is unable to talk. That is when Derek explains that the patient now has aphasia and that with therapy she has a small chance of regaining some of her speech. A better explanation is given by a somber Meredith to Lexi:
“We damaged Broca’s area, so she can understand speech, she knows what she wants to say, but she can’t say it.”
“Tell me that he can fix it” begs Lexi. But Meredith’s answers “He can’t, it’s irreparable”.
The lesson for us future SLPs: if you ever work with a neurosurgeon or neurologist or are asked your opinion about a tumor in or near Broca’s area, make sure to communicate the dire possible consequences of damaging this center. All may seem to go well, but the true results won’t be seen until the patient wakes post-surgery.
Gabrielle Giffords: Rebuilding Language Center in Right Hemisphere
Last updated: March 29, 2012 | by Christina Antoine
Originally posted: February 26, 2012
On January 8, 2011, congresswoman Gabby Giffords received a gunshot wound to the head. Miraculously she survived, but had sustained substantial damage in her left hemisphere, causing aphasia. Since that is the part of the brain where language is processed, doctors believe that she might never speak again. But she proved them wrong. With the help of team consisting of a neurologist, speech-language pathologist and music therapist, congresswoman Giffords first was able to sing, then slowly but surely regained some of her speech ability and is still making progress.
Contrary to language, music is processed in both the left and the right hemispheres. So after many sessions with her music therapist, she regained her ability to sing. It was a victory but what the public didn’t know was that singing didn’t necessarily mean that she would be able to get language back. Regardless, she also went for speech therapy and little by little reclaimed her ability to speak. Although her language is not yet as it was pre-injury, she made considerable progress that even allowed her to give an interview to Diane Sawyer. We can clearly see that she comprehends what is said to her, indicating what appears to be normal receptive language skills. Speaking, or her expressive language, is where she seems to have difficulty. But how is she able to speak and comprehend language if her left hemisphere was compromised?
Originally posted: February 26, 2012
On January 8, 2011, congresswoman Gabby Giffords received a gunshot wound to the head. Miraculously she survived, but had sustained substantial damage in her left hemisphere, causing aphasia. Since that is the part of the brain where language is processed, doctors believe that she might never speak again. But she proved them wrong. With the help of team consisting of a neurologist, speech-language pathologist and music therapist, congresswoman Giffords first was able to sing, then slowly but surely regained some of her speech ability and is still making progress.
Contrary to language, music is processed in both the left and the right hemispheres. So after many sessions with her music therapist, she regained her ability to sing. It was a victory but what the public didn’t know was that singing didn’t necessarily mean that she would be able to get language back. Regardless, she also went for speech therapy and little by little reclaimed her ability to speak. Although her language is not yet as it was pre-injury, she made considerable progress that even allowed her to give an interview to Diane Sawyer. We can clearly see that she comprehends what is said to her, indicating what appears to be normal receptive language skills. Speaking, or her expressive language, is where she seems to have difficulty. But how is she able to speak and comprehend language if her left hemisphere was compromised?
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Her neurologist himself was stunned at the discovery that was made during her therapy sessions. According to him, functional magnetic resonance imaging showed that congresswoman Giffords was able to reconstruct a language center in her right hemisphere. Her ability to sing was not compromised and since music and language share words, singing laid the groundwork for the re-acquisition of language by allowing her to use lesser used pathways to the same original destination. The speech- language pathologist started with the words used in the songs, then used related words and concepts, unknowingly building a new language center in her right hemisphere, based on music.
Watch the video for all the details on congresswoman Giffords phenomenal recovery and for more information on this scientific breakthrough. Go to ABC Nightline for more about rebuilding speech through song. |
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Speaking After Laryngeal Cancer
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The diagnosis of laryngeal cancer is the most serious in terms of voice. Why? Because it often requires a total laryngectomy (complete removal of the larynx), leaving the individual without vocal folds and the associated structures of speech.
In this case, even breathing becomes and issue, since the trachea is no longer attached to the larynx and the natural flow and reflexes of breathing have been disrupted. To this day, the only option has been to redirect the trachea exteriorly: its superior end that was right under the glottis is turned towards the throat, where it connects to a surgically constructed hole to allow for air to enter and leave the trachea. This mouth-like opening where the trachea meets the throat is called a stoma. But the vocal folds are gone, how then can this person disrupt the airflow to create sounds? Well, the person can’t, which is why two options are used to produce voice. |
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1. Esophageal Speech
In this method, the speaker uses the esophagus as a vibratory source by using “burps”. More specifically, through speech therapy the individual learns to intake air through the mouth, then passes it to the esophagus. The esophagus thus expands slightly and the air is subsequently released it in a controlled manner through the mouth with simultaneous articulation of words. It is a challenging technique to learn and some people find themselves unable to lean this method. Those who are able to produce esophageal speech generate fewer words per minute as opposed to natural laryngeal speech. Though the man in the video example is not an English speaker, you can clearly see when he intakes air and "burps" to produce speech. |
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2. Electrolaryngal Speech – Electrolarynx
An electrolarynx can be added to the process of esophageal speech to produce voice. It is a handled mechanical device that is placed at the corner of the throat and jaw and vibrates to help produce sound. It can be used immediately after surgery, but still requires speech therapy to master its use. You can probably remember the famous anti-smoking commercial where the man uses an electrolarynx and produces a robot-like voice. Check out the video for another example of electrolaryngeal speech. 3. Tracheoesophageal Puncture / Tracheoesophageal Shunt Both terms describe the same technique and are often referred to as TEP. Here, the |
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trachea still forms a stoma (it’s a necessity, there is no other option), but is surgically connected to the esophagus. Small punctures (holes) are made in both the trachea and the esophagus, and a one-way air valve is inserted to allow the tubes to communicate. In this method, the speaker can take in air through the trachea instead of the mouth. That air passes through the air valve to the esophagus to produce speech. This technique is very popular as speakers can achieve a more intelligible voice and is easier to master.
Let's not forget that the main cause of laryngeal cancer is smoking. So if you smoke or know someone who does, quit or help them quit now. Visit the National Cancer Institute for more on laryngeal cancer. Visit the American Cancer Society for more on laryngeal cancer. |
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Why Do Babies Start to Babble Between 5-7 Months?
October 10, 2011 | by Christina Antoine
Babies start to babble (sounds start to sound like phonemes) between 5 to 7 months. But have you ever asked yourself why? Here’s the reason:
To be able to phonate, the air stream needs to go upwards through the larynx, then take a directional change at the level of the pharynx to reach the oral cavity, where the articulators will further shape the sound stream.
Have you ever noticed that infants don’t actually have a neck? Their head instead sits right on top of their chest. This means that at that stage, their larynx is located at the same level as the oral cavity. This is the normal animal location of the larynx, which also enables babies to nurse without choking. As the infant grows older, the larynx will gradually “drop” or lower, corresponding to the gradual appearance of a neck. At about 5 months, it reaches a position that allows for enough of a pharynx for sounds to be able for a wider variety of sounds that form the babbling behavior.
The larynx however reaches its final position at age four, meaning that it continues to “drop” and that the baby sees his intelligibility and his ability to produce a wider variety of sounds increase even more.
To be able to phonate, the air stream needs to go upwards through the larynx, then take a directional change at the level of the pharynx to reach the oral cavity, where the articulators will further shape the sound stream.
Have you ever noticed that infants don’t actually have a neck? Their head instead sits right on top of their chest. This means that at that stage, their larynx is located at the same level as the oral cavity. This is the normal animal location of the larynx, which also enables babies to nurse without choking. As the infant grows older, the larynx will gradually “drop” or lower, corresponding to the gradual appearance of a neck. At about 5 months, it reaches a position that allows for enough of a pharynx for sounds to be able for a wider variety of sounds that form the babbling behavior.
The larynx however reaches its final position at age four, meaning that it continues to “drop” and that the baby sees his intelligibility and his ability to produce a wider variety of sounds increase even more.
Free Summer Webinars
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Confirming Aspiration: Modified Barium Swallow
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Some patients, when having difficulty swallowing, particularly with aspiration (when food or liquid enters the trachea), will have a reflexive cough that aims to get the food or liquid out of the trachea. In the case of silent aspiration, (aspiration without the expulsive cough) a Speech-Language Pathologist may suspect it as a culprit if the patient isn't gaining weight or is actually losing weight although eating normally. The "Gold Standard" for observing the swallowing process from its oral to esophageal stages is the Modified Barium Swallow.
Since food or liquid isn't visible on x-ray during the swallowing process, Barium is added to controlled amounts of solids, liquids and semi-solids, then the mixture is swallowed. Barium is a radio-opaque substance that shows up during x-rays and outlines the structures it encounters. This allows for imaging of the swallowing process and will be able to show if the patient's bolus is indeed going through his/her airway or is following the right path down the esophagus. |
No need to say that this can also help identify other issues such as
Laryngeal Pharyngeal Reflux - But this is a whole other topic.
For a visual of a Modified Barium Swallow, check out the accompanying video. You can see the epiglottis moving to cover the trachea, although some of the barium is erroneously finding its way down the airway. Having trouble distinguishing the esophagus from the trachea? Remember that the esophagus is at the back, and in the video, it is where most of the barium goes. The little bit that is going down a path at the front is going down the trachea to make its way to the lungs.
For a visual of a Modified Barium Swallow, check out the accompanying video. You can see the epiglottis moving to cover the trachea, although some of the barium is erroneously finding its way down the airway. Having trouble distinguishing the esophagus from the trachea? Remember that the esophagus is at the back, and in the video, it is where most of the barium goes. The little bit that is going down a path at the front is going down the trachea to make its way to the lungs.
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Case: Spastic Dysarthria
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Are You Ready?
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 The 2011 Call for Papers is now open. Notifications will be e-mailed in July. |
Carryover Provides 'Skills' to Graduate From Therapy
March 6, 2011 | by Ruby Miranda, MA, CCC-SLP
"My child gets frustrated every time we try to correct him at home"
is the chief complaint parents have when their child's speech homework
isn't carrying over into the home. Working with speech sound cases is
not easy. Articulation skills are mastered at the word and sentence
levels during structured therapy tasks, but those skills are not heard
at the conversation level due to the lack of carryover outside the
therapy setting.
Students exhibit shyness, frustration and embarrassment when they attempt to practice their speech sounds. They typically are more comfortable around family members, who are aware of and understand the problem. Practicing in front of friends and unfamiliar people is another story. As a result, children often make minimal progress at the conversation level.
Helping students become more aware of their articulation is challenging. Their motivation decreases as their frustration builds. To enhance communication awareness and understand the importance of good communication skills, they need to be engaged in real-life situations.
As part of the caregiver education process, I tell families that verbal communication takes a lot of practice during and outside of therapy. Interacting with unfamiliar people must be taken into consideration when working at the conversation level.
My conversation-level program includes various tasks to enhance awareness of articulation skills. Having students read passages into a tape recorder is the first step toward auditory awareness. They listen to the playback and analyze their speech.
Students also call a business, such as a flower shop or pizzeria, to request information. Those working on /r/ can ask the prices of certain items, the hours of operation, or directions.
Making a presentation in front of an unfamiliar audience can be a daunting task, but it is an invaluable experience. Students select a topic, read a one-page report next to a display piece that complements their subject, then interact with the audience. This allows them to engage both in oral reading and spontaneous conversation.
Students come to understand that their speech intelligibility must be demonstrated outside the therapy room. Carryover gives them the final skills they need to "graduate" from speech therapy.
Ruby Miranda is on staff at Frederick Memorial Hospital Rose Hill in Frederick, MD. She can be contacted at [email protected].
Visit Advance for the original article
Students exhibit shyness, frustration and embarrassment when they attempt to practice their speech sounds. They typically are more comfortable around family members, who are aware of and understand the problem. Practicing in front of friends and unfamiliar people is another story. As a result, children often make minimal progress at the conversation level.
Helping students become more aware of their articulation is challenging. Their motivation decreases as their frustration builds. To enhance communication awareness and understand the importance of good communication skills, they need to be engaged in real-life situations.
As part of the caregiver education process, I tell families that verbal communication takes a lot of practice during and outside of therapy. Interacting with unfamiliar people must be taken into consideration when working at the conversation level.
My conversation-level program includes various tasks to enhance awareness of articulation skills. Having students read passages into a tape recorder is the first step toward auditory awareness. They listen to the playback and analyze their speech.
Students also call a business, such as a flower shop or pizzeria, to request information. Those working on /r/ can ask the prices of certain items, the hours of operation, or directions.
Making a presentation in front of an unfamiliar audience can be a daunting task, but it is an invaluable experience. Students select a topic, read a one-page report next to a display piece that complements their subject, then interact with the audience. This allows them to engage both in oral reading and spontaneous conversation.
Students come to understand that their speech intelligibility must be demonstrated outside the therapy room. Carryover gives them the final skills they need to "graduate" from speech therapy.
Ruby Miranda is on staff at Frederick Memorial Hospital Rose Hill in Frederick, MD. She can be contacted at [email protected].
Visit Advance for the original article
A Shopping Trip in The Life of A Person Who Stutters
December 20, 2010 | by Christina Antoine
For a class project, I was assigned to team up with two classmates and to pretend to stutter with two different individuals to experience what it feels like to be a to Person Who Stutters (PWS). I've learned in theory about the anxiety that PWS feel on a daily basis, and this exercise would give me some insight into the actual feelings that they go trough. As this opened my eyes and certainly made me even more understanding of their impairment, I thought it a good idea to share this with the Winning Speech community.
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This experience clearly proved to me that those who stutter go through their daily tasks feeling an extreme amount of anxiety and at times even feeling that they’re worth less than others. However, I was surprised that some people could be so insensitive and have such obnoxious reactions to a person’s disorder. Nevertheless, it was clear to me as well that people who stutter often misinterpret others’ behaviors, proof of their sentive temperament.
SUNY Geneso to Cut Speech Pathology Program and Two Others
December 13, 2010 | by Christina Antoine
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Citing budget issues, SUNY Geneso announced that it will make cuts, translating to the elimination of the Speech Pathology, Computer Science and Studio Arts majors within the next three years. Additionally, 54 positions that were vacated due to retirement will not be refilled.
Students and faculty are outraged at the decision and are letting their opinion be known with protests on the school's ground and by sending letters to Assemblyman Sheldon Silver, Governor-elect Andrew Cuomo and Senators Kirsten Gillibrand and Charles Schumer, among others. The school's Provost Carol Long declared "These are not things we enjoy doing. We know that they cause damage but we really had no choice if we wanted to balance the budget going forward." Geneso is reportedly millions of dollars in debt due to state budget costs. The Speech-Language Pathology Program at Geneso is a popular one, where 220 students are currently enrolled. Acceptance into a graduate Speech Pathology program has just been made that more difficult. |
Speech Pathologists Using the Web To Connect to Patients
December 3, 2010 | by Steve Gigliotti, The Epoch Times
While job growth may be slow in most sectors, there is a shortage of speech pathologists in the United States. The Bureau of Labor Statistics predicts a 19 percent increase in demand for speech pathologists in a 10-year period from 2008 to 2018. Contributing to the demand is a growing number of children with autism spectrum disorders. Many of these patients live in rural areas, where there is little access to qualified pathologists.
Researchers at the University of Massachusetts Amherst (UMASS) funded through an $800,000 dollar research-to-practice training grant from the U.S. Department of Education are using live secure video via the Internet to connect professionals with schools and families in need of speech pathology.
"The lack of trained specialists is a major obstacle when trying to provide services to individuals with disabilities. Rural areas are the hardest hit," says Michelle Boisvert according to a UMASS press release. Boisvert is a doctoral candidate in the speech language pathology concentration at UMass Amherst.
According to UMASS, the most challenging part of this new approach is technical issues such as bandwidth and firewalls, but with strong IT support, these obstacles are being overcome.
"The number of children in the United States diagnosed with an autism spectrum disorder has increased and is now reported to be as high as three to six cases per 1,000 children," Boisvert said. "It’s important that we provide services for all who need them. Early intervention using evidence-based practices is an effective vehicle for improving long-term outcomes for these children."
According to the American Speech-Language Hearing Association's (ASHA) website, “Telepractice is an appropriate model of service delivery for the professions of speech-language pathology [and audiology]. Telepractice may be used to overcome barriers of access to services caused by distance, unavailability of specialists and/or subspecialists, and impaired mobility."
They say it follows that telepractice has, "the potential to extend clinical services to remote, rural, and underserved populations, and to culturally and linguistically diverse populations."
With the shortage of speech pathologists growing and the demand of patients increasing, this new medium may prove to be a bridge between supply and demand in this growing sector.
Visit The Epoch Times for the original article
Researchers at the University of Massachusetts Amherst (UMASS) funded through an $800,000 dollar research-to-practice training grant from the U.S. Department of Education are using live secure video via the Internet to connect professionals with schools and families in need of speech pathology.
"The lack of trained specialists is a major obstacle when trying to provide services to individuals with disabilities. Rural areas are the hardest hit," says Michelle Boisvert according to a UMASS press release. Boisvert is a doctoral candidate in the speech language pathology concentration at UMass Amherst.
According to UMASS, the most challenging part of this new approach is technical issues such as bandwidth and firewalls, but with strong IT support, these obstacles are being overcome.
"The number of children in the United States diagnosed with an autism spectrum disorder has increased and is now reported to be as high as three to six cases per 1,000 children," Boisvert said. "It’s important that we provide services for all who need them. Early intervention using evidence-based practices is an effective vehicle for improving long-term outcomes for these children."
According to the American Speech-Language Hearing Association's (ASHA) website, “Telepractice is an appropriate model of service delivery for the professions of speech-language pathology [and audiology]. Telepractice may be used to overcome barriers of access to services caused by distance, unavailability of specialists and/or subspecialists, and impaired mobility."
They say it follows that telepractice has, "the potential to extend clinical services to remote, rural, and underserved populations, and to culturally and linguistically diverse populations."
With the shortage of speech pathologists growing and the demand of patients increasing, this new medium may prove to be a bridge between supply and demand in this growing sector.
Visit The Epoch Times for the original article
Transgenders Learn to Match Voice to New Sex
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 Nicole Hatch spent six figures on her transition from a male to a female, but her voice still gave her away. So Hatch came to the University of North Carolina at Greensboro, where speech pathologists teach transgender people how to speak like the people of the sex they're becoming or have become. |
"To me, there's nothing worse than seeing someone dressed as a woman, a beautiful woman," said Hatch, 57. "Then she opens her mouth and she sounds like a sailor. It's very off-putting for people."
The former Florida chiropractor took eight private classes at UNCG, learning to redirect her voice through the front of her mouth instead of her throat or chest so that she sounds more feminine. "Voice is, I would say, 50 percent of being able to pass," Hatch said.
Each semester, speech pathologists within UNCG's School of Health and Human Performance teach about eight or so transgender people in a program that began 12 years ago, says Dean Celia Hooper, who taught the transgender voice classes at UNCG for five years until she became dean in 2008.
The classes for transgender clients — people who want to live as the gender they weren't assigned at birth — are a tiny part of the work of UNCG's speech and hearing center. The classes concentrate a lot on pitch, but the clients also learn about loudness, quality of voice and movement, especially facial and hand gestures.
Learning differences in driving directions
Women use more adjectives, and they gesture more with the hands and use their face more to express feelings, Hooper said. During one activity, clients describe the art on the walls.
"And women will say, 'that's a beautiful picture, I see a bubbling stream ...' They'll really elaborate," Hooper says. "Men will just say, 'I see a house and a car.' And then women add, 'it's just a fabulous-looking house.''
The former Florida chiropractor took eight private classes at UNCG, learning to redirect her voice through the front of her mouth instead of her throat or chest so that she sounds more feminine. "Voice is, I would say, 50 percent of being able to pass," Hatch said.
Each semester, speech pathologists within UNCG's School of Health and Human Performance teach about eight or so transgender people in a program that began 12 years ago, says Dean Celia Hooper, who taught the transgender voice classes at UNCG for five years until she became dean in 2008.
The classes for transgender clients — people who want to live as the gender they weren't assigned at birth — are a tiny part of the work of UNCG's speech and hearing center. The classes concentrate a lot on pitch, but the clients also learn about loudness, quality of voice and movement, especially facial and hand gestures.
Learning differences in driving directions
Women use more adjectives, and they gesture more with the hands and use their face more to express feelings, Hooper said. During one activity, clients describe the art on the walls.
"And women will say, 'that's a beautiful picture, I see a bubbling stream ...' They'll really elaborate," Hooper says. "Men will just say, 'I see a house and a car.' And then women add, 'it's just a fabulous-looking house.''
 A clinician holds instructional materials used during a voice and communication program for transgender clients at the the University of North Carolina Greensboro's School of Health and Human Performance in Greensboro, N.C. |
The differences in word choice are rarely more evidence than in the how-to-give-directions project. The teacher tells clients to give directions on getting from point A to point B. Then they get handouts that compare male directions to those given by females.
Women use landmarks, while men use a compass. A woman might say: "When you get to the red house with the blue shutters, take a right, go three miles. You'll go past the store, you'll see a cornfield. You'll see a beautiful fire station. It's new, you know, they just built it last week. Then you turn left." A man would say: "Go west three miles, take a left at this road, go four miles, take a right." "It's just minimal," Hooper said. |
Movement is naturally constrained by what you wear. People wearing pants sit differently than those wearing skirts so clients wear different clothes in class to learn how to sit correctly.
"One thing we recommend, if you've never worn heels, probably your 40s and 50s are not a good time to start," Hooper said. "You can get cute shoes that are flat. So why be awkward and start doing that? Especially if you're large and have big bones, heels aren't for you."
Hatch says her life in the gay community — she lived as a homosexual man for about 10 years — meant she needed help only with pitch. So her eight private lessons — cancer treatments in nearby Chapel Hill prevented her from taking the classes — concentrated on moving from her natural gender-neutral voice to a more feminine one.
She learned to redirect her voice to speak from the front of her mouth, which raises the pitch.
"It's my natural voice, but I'm just using different mechanics," Hatch said. "It's probably one of the hardest things to do because it's so easy to fall back into the habit of the way you're used to speaking."
Up to 1 percent of population may be transgender
Although no one knows how many people are transgender, experts estimate the number is between .25 percent and 1 percent of the population, said Mara Keisling, executive director of the National Center for Transgender Equality.
Not all transgender people surgically change to the opposite sex, although they may live as that sex either full-time or part-time. Some can't afford the sex-change surgery, while others fear the social costs of transitioning. They are different from cross-dressers, who enjoying wearing the clothes of the opposite sex but don't want to change their sex.
Keisling attended a similar program at George Washington University. The College of Saint Rose in Albany, N.Y., has taught voice classes for transgender clients for about three years, says Jack Pickering, an associate professor at the school. Private practitioners and colleges in other countries tend to be on the forefront of such work, including in Australia, and Belgium, he said.
Clients at UNCG attend one weekly two-hour class for a semester, and some attend for two semesters.
"Mostly, their first complaint is 'my voice is too low,'" Hooper said. The voice is more of a problem for men transitioning to women than women transitioning to men because testosterone makes the voice lower naturally.
So the speech pathologists evaluate each client's voice to determine how high or low they can go and offer them a range of pitches to try to match.
"We look at voice. We look at fluency. We look at the language that they use, all the different characteristics of speech," Hooper said. "And we present to them, here's what women do, here's what men do. It's on a continuum. One speaker may sound feminine and another ... it's very subjective. So we talk about, what do you want to sound like?"
For Hatch, meeting other people like her was itself a revelation.
She credits an earlier trauma with giving her the courage to have the sex reassignment surgery in 2007. Six years earlier, while working as a man at a private hospital in Saudi Arabia, she opened a letter bomb addressed to her. Hatch lost an eye, a hand and was severely scarred on one thigh.
"I never really thought of myself as a strong person," Hatch said. "But now that I look back on what I've gone through, I think I'm a very strong person and a very courageous person for just standing up for myself and saying this is who I am and I have a right to be happy."
Visit MSNBC for the original Associated Press article
"One thing we recommend, if you've never worn heels, probably your 40s and 50s are not a good time to start," Hooper said. "You can get cute shoes that are flat. So why be awkward and start doing that? Especially if you're large and have big bones, heels aren't for you."
Hatch says her life in the gay community — she lived as a homosexual man for about 10 years — meant she needed help only with pitch. So her eight private lessons — cancer treatments in nearby Chapel Hill prevented her from taking the classes — concentrated on moving from her natural gender-neutral voice to a more feminine one.
She learned to redirect her voice to speak from the front of her mouth, which raises the pitch.
"It's my natural voice, but I'm just using different mechanics," Hatch said. "It's probably one of the hardest things to do because it's so easy to fall back into the habit of the way you're used to speaking."
Up to 1 percent of population may be transgender
Although no one knows how many people are transgender, experts estimate the number is between .25 percent and 1 percent of the population, said Mara Keisling, executive director of the National Center for Transgender Equality.
Not all transgender people surgically change to the opposite sex, although they may live as that sex either full-time or part-time. Some can't afford the sex-change surgery, while others fear the social costs of transitioning. They are different from cross-dressers, who enjoying wearing the clothes of the opposite sex but don't want to change their sex.
Keisling attended a similar program at George Washington University. The College of Saint Rose in Albany, N.Y., has taught voice classes for transgender clients for about three years, says Jack Pickering, an associate professor at the school. Private practitioners and colleges in other countries tend to be on the forefront of such work, including in Australia, and Belgium, he said.
Clients at UNCG attend one weekly two-hour class for a semester, and some attend for two semesters.
"Mostly, their first complaint is 'my voice is too low,'" Hooper said. The voice is more of a problem for men transitioning to women than women transitioning to men because testosterone makes the voice lower naturally.
So the speech pathologists evaluate each client's voice to determine how high or low they can go and offer them a range of pitches to try to match.
"We look at voice. We look at fluency. We look at the language that they use, all the different characteristics of speech," Hooper said. "And we present to them, here's what women do, here's what men do. It's on a continuum. One speaker may sound feminine and another ... it's very subjective. So we talk about, what do you want to sound like?"
For Hatch, meeting other people like her was itself a revelation.
She credits an earlier trauma with giving her the courage to have the sex reassignment surgery in 2007. Six years earlier, while working as a man at a private hospital in Saudi Arabia, she opened a letter bomb addressed to her. Hatch lost an eye, a hand and was severely scarred on one thigh.
"I never really thought of myself as a strong person," Hatch said. "But now that I look back on what I've gone through, I think I'm a very strong person and a very courageous person for just standing up for myself and saying this is who I am and I have a right to be happy."
Visit MSNBC for the original Associated Press article
Chronic Migraines Causing Aphasia?
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Stuttering and Successful
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People Who Stutter (PWS) often feel a debilitating fear of speaking and incredible anxiety that sometimes result in fainting or lead them to hurt themselves just to escape a speaking situation. Other times, secondary characteristics can be very pronounced and can also lead them physically harm themselves.
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However, stuttering is not a deterrent to success. There have been a number of famous people who were stutterers. From biblical times, Moses was believed to have been a PWS. And more recently, Marilyn Monrore, Bruce Willis and James Earl Jones. Marilyn's slower rate can be attributed to a technique widely used in Fluency Shaping therapy. The slow speech allows her extra time to get her words out in a fluent manner. Take a look at the video: at minute 5:41, she experiences a block on "num-number of people", then on "contri-buted greatly" where she also shows secondary characteristics: closing her eyes, swaying her body and visible tension in the face. |
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James Earl Jones' slow and extremely well articulated speech is his trademark. One little known fact however, is that slow speech and perfected articulation are all speech techniques to help him be fluent. In his acting roles and TV commercials, you'll hear the voice and rate that has been established by fluency shaping. But in this video where he gives an unrehearsed interview, you can clearly hear him struggle at the beginning of the video with his "l" sounds, and at 0:41 seconds he bounces on "c-counsels me". Throughout the video, you'll also hear him clearly stutter.
So who said you couldn't be a successful and even iconic PWS! |
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Hollywood Makes Movie About Speech Pathology
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Other cast:
Helena Bonham Carter Queen Elizabeth Guy Pearce Edward VIII Michael Gambon George V Timothy Spall Winston Churchill Length 111 minutes Rating R Director Tom Hooper |
Job Outlook for Speech Language Pathologists Steadily Rising
September 27, 2010
Employment change. Employment of speech-language pathologists is expected to grow by 19 percent from 2008 to 2018, faster than the average for all occupations. As the members of the baby-boom generation continue to age, the possibility of neurological disorders and associated speech, language, and swallowing impairments increases. Medical advances also are improving the survival rate of premature infants and trauma and stroke victims, who then need assessment and sometimes treatment. Employment in educational services will increase with the growth in elementary and secondary school enrollments, including enrollment of special education students. The 2004 Individuals with Disabilities Education Act is a Federal law that guarantees special education and related services to all eligible children with disabilities. Greater awareness of the importance of early identification and diagnosis of speech and language disorders in young children will also increase employment.
In healthcare facilities, restrictions on reimbursement for therapy services may limit the growth of speech-language pathologist jobs in the near term. However, the long-run demand for therapists should continue to rise as growth in the number of individuals with disabilities or limited function spurs demand for therapy services.
The number of speech-language pathologists in private practice should increase because hospitals, schools, and nursing care facilities will contain costs by increasingly contracting out for these services.
Job prospects. In addition to job growth, a number of job openings in speech-language pathology will be due to retirements. Opportunities should be favorable, particularly for those with the ability to speak a second language, such as Spanish. Demand for speech-language pathologists can be regional so job prospects are expected to be favorable for those who are willing to relocate, particularly to areas experiencing difficulty in attracting and hiring speech-language pathologists.
More from the U.S. Department of Labor, Bureau of Labor Statistics
In healthcare facilities, restrictions on reimbursement for therapy services may limit the growth of speech-language pathologist jobs in the near term. However, the long-run demand for therapists should continue to rise as growth in the number of individuals with disabilities or limited function spurs demand for therapy services.
The number of speech-language pathologists in private practice should increase because hospitals, schools, and nursing care facilities will contain costs by increasingly contracting out for these services.
Job prospects. In addition to job growth, a number of job openings in speech-language pathology will be due to retirements. Opportunities should be favorable, particularly for those with the ability to speak a second language, such as Spanish. Demand for speech-language pathologists can be regional so job prospects are expected to be favorable for those who are willing to relocate, particularly to areas experiencing difficulty in attracting and hiring speech-language pathologists.
More from the U.S. Department of Labor, Bureau of Labor Statistics
