Fruits of perusing toy stores

First of all, happy holidays to everyone! I haven't really had much to write about since school is on hiatus, but I've really enjoyed reading everyone's posts about Christmas goodies and festivities. I feel like Christmas is always more fun when wee ones are involved.
Second of all, I found these books in a bookstore yesterday and was intrigued. There are several little books in one binder and they have rhyming words and phoneme targets and the whole nine yards. I was looking at a level 2 book about food and I really liked the way they started with a simple sentence or phrase and then added a little bit to it every page, to show kids how they can expand sentences while working on target sounds. I might have to invest in some of these!

Half an hour after my dog gets a new toy...

She is the face of repentance, isn't she? So much for getting her a durable dog toy. I tremble for our Christmas tree; she already chewed off some of the pre-strung lights over the summer when it was stored in the room where she sleeps, but I doubt Christmas will go by without her snatching an ornament or two! The other day she took out a couple of potatoes and a party hat. My mom caught her with a potato hanging out of her mouth! What a goofball. Her name is Darby, and she is almost a year old. She certainly makes life interesting. ;)
In other news, I am DONE with school for a glorious month and have epic plans to clean everything. We'll see how that goes!

It's the most wonderful time of the year...

It's finals week!
I'm two down and have two more to go. I have no idea how to study for my Articulation final. None at all. I will stare blankly at my notes and pray for knowledge, in the proud tradition of students everywhere during finals week. Posting grades online has made doing the, "How badly can I mess up and still pass?" ritual calculations even easier, and the atmosphere around the clinic has the familiar twang of stress to it. However, there is an additional twang of anticipation; only two more finals, and then we are done for a month! My apartment will be clean again! :D
Good wishes and prayers are much appreciated. Around 8pm on Thursday, I'll be done with my first semester of graduate school!

An arsenal of toys

I am going to be in the schools for at least two years after I graduate, and after that, who knows? But if I am working with children, I am going to need toys and books (and markers and posterboard and Play-Doh and 2 sets of extra hands!). I have already started building my collection, but so far it is rather small. I have a few cars, some blocks, and some rubber animals. I do not have any books other than the children's books I have from when I was small. So, dear readers, I put the question to you: what toys and books would you recommend I have on hand to delight my future clients, and possibly teach them speech? ;) I love toys and books, and whatever is mine personally I can take with me everywhere instead of having to check in and out of the university clinic and leave behind when I graduate. Toys and books that appeal to a variety of ages would be ideal, and they should be able to handle some jostling and curious hands. Paper books are fine, because I will eventually have elementary school-aged children who know how to handle books. (Right now I have toddlers, who are not so gentle with books!) Leave any and all ideas, please! My clients will thank you. :)

Almost done!

Next week is Thanksgiving, so I only have two days of classes and clients. Then I have one more week of classes and clients, and then finals. This semester is almost over! Next semester I will have all new classes and clients. (We have to get a certain number of hours with every population, so students in our clinic usually do not keep clients longer than a semester unless they got the client close to the end of the semester or the client requires a longer transition for whatever reason.) I feel like I learned more in these months than I have in the rest of my life combined! And, as is my wont at the end of a semester, I can't wait for a break. Eventually I will miss my clients and classmates, and I will be ready to go back for another go at Epic Learning, but right now...I just want to make cookies and sleep. ;)

Never Forget

Today I was reading/fuming at a certain Brave Hero's insurance company and I thought back to the day I finished my observation hours with my brave, wonderful, wise supervisor. She sat me down and said, "Katie, the most important thing is not to get paid. It is to provide this service to people who need it. Insurance companies will lie to you, hang up on you, be rude to you, and lose your paperwork. You have to keep fighting. People need you."
This sat well and deeply with me. How many professionals out there are truly fighting to give people the services they need? How many professionals are willing to cut fees and battle insurance companies and make less so they can see more people? My supervisor opened her own practice because she was tired of being told to deny people services because insurance companies wouldn't pay, and people needed her. How many doctors would do the same?
I think many professionals (and insurance companies who take exotic company retreats during recessions) could learn a lesson from my supervisor. I am forever indebted to her because of what she taught me.

What is so wrong with being personal?

Twice recently I've started to comment over at 5 Minutes for Special Needs about an issue that directly affects me as a person instead of me as an SLP-in-training, and stopped. It has been interesting for me to step back and watch the stopping and starting, the half-typed sentence that is deleted and replaced with two sentences that are deleted again.
Part of it is that commenting would involve sharing information about my brother, which I don't know if he would appreciate. Talking about my experiences as a sibling is difficult without talking about the other person. And part of it is that I don't know how I feel about the issues in question. If/when I decide to have children, my future husband and I will have to choose whether to take a significant chance that our baby will be born with disabilities or to take steps to have a "normal" baby. More testing will have to be done before that day, and more research on what the other steps may be, but right now it's a big foggy unknown. The post on 5MFSN was a little scary; it talked about how testing embryos for various conditions could lead to people creating "designer children." I certainly do not want to contribute to the idea that you can pick bits of your baby that you like and throw out bits that you don't like, but...having a healthy baby would be nice too. I don't know. It's a really tough judgment call, and I'm not looking forward to it.
As for today...a shower, a craft show, and a few hours of work before the aforementioned future husband shows up for our weekend visit make up my agenda. I have a degree, a marriage, and a job to get through before we seriously consider children. Mayhap I shall find some sweet wee one whose parents could not take care of him/her, and they can be mine, and then I can just avoid the issue altogether. :)

Lovely

I'm not sure if there's a storyline going on in this dance, but it is certainly inspiring. Here is another dance that made me grin. Different styles, different countries, different music and costumes, but same talent and strength. I think it's easy to focus on the "dis" in "disability," but these people have yanked the spotlight right over to "ability!"

ETA: I forgot to add that YouTube commenters can be extremely rude and vulgar, as this webcomic points out, and with each video that I linked above having over 1 million views there are bound to be some jerks lurking in the comment section. Ya'll probably already know the nature of the beast that is YouTube, but I wanted to give a heads up just in case so people wouldn't think I agreed with/supported/paid attention to/read any of the comments there.

Breaks are Good Things

Instead of chaining myself to my desk this weekend, I went shopping with my family and went to a folk festival with Chester. We found the Irish band and I was SO HAPPY. And then Monday Chester and I went to a new trail and walked the dogs. My half-blind 11 year old Labrador energetically tried to drag me down a ravine. It was awesome.
Of course I did not get enough work done. I will never get enough work done, because there is always more work that I could/should be doing. At some point in this semester I have GOT to relearn my diacritic marks. However, that point was not over break. It might not be this weekend either. I am slowly but surely coming to terms with the fact that I cannot accomplish fifteen assignments a day.
I will close with two posts that I have enjoyed very much recently. This lucky mama actually got to meet Barry Prizant. And talk to him. And I am jealous, because I am a huge nerd. XD It was fascinating to read about how her son Bud moved from copying others' speech (echolalia) to forming sentences on his own. It was great to have a real-life example of Dr. Prizant's research.
I thought that this dad's keynote address at the Assistive Technology Cluster Conference did a fantastic job of comparing and contrasting the role of parents and professionals when it comes to getting services for children in school. I was also keenly interested to hear about his beautiful daughter Schuyler, as AAC is an interest of mine and I won't take that class for another year.
Now to bed!

Fall Break

Fall Break is next Monday and Tuesday...two days to catch up-er, I mean, get ahead on massive amounts of homework and reading! My friend is having a hen party this weekend. I am not going. :( It's three hours away, and I can't afford to forgo academia for a whole weekend. I also can't afford the gas, as the school was supposed to deduct my monthly tuition payment on the 1st and they haven't done it yet and so $800 might go randomly missing in the night at any time. -_- I am hoping to forgo academia for two weekends coming up, to go to the wedding of the friend having the hen party and the party of another friend. I am just waiting to get 15 new clients the week that I am supposed to go, necessitating that I pitch a tent at the clinic and rewatch therapy videos/write SOAPs/write lesson plans/pick play-doh out of my hair all weekend instead of having fun with my friends.
I continue to work with the clients I currently have, two through early intervention and a group for accent modification. I'm having trouble hitting the right level with one of my little ones...I do things above his level and below his level but keep missing where he actually is. The accent modification is good transcription and data-taking practice, as well as an exercise in finding synonyms on the spot when they inevitably don't know the vocabulary in the readings I pick. ;) My clients are at opposite ends of the spectrum, and they present very unique challenges. I'm really excited to be working with them...only on a beautiful fall Friday morning before a break, it's hard to focus on the afternoon's therapy. ;) Ah well. Happy weekend all!

It's that time already?!

I have midterms this week. When did it become the middle of the semester already? Can it be Christmas break tomorrow? ;)
I think the hardest part about this program is balancing classwork and client work. I think working with clients is so much more fulfilling than filling out study guides for midterms, but I know that the academic coursework is necessary to make me a better clinician. I have more classes than clients and so academia tends to fill my evenings, which is exactly when I'd rather be doing something creative and fun like planning therapy! I don't have much energy left after a hard day's work and it's hard to make myself focus on something distasteful.
I also forgot all of my syntax since summer. Ooops. :(
On the plus side, my little ones are ADORABLE and making progress. My supervisors say that they are pleased with how I'm doing in sessions. And I'm sure one day I'll know all the different predicates AND the diphthongs. So really, not so bad.
On that note, I'm going to go fill out a study guide for aphasia. Wish me luck!

The perks of sharing

Yesterday I had a very fulfilling experience as a result of openly sharing my diagnosis with Fragile X Syndrome. The whole story is not mine to tell, but I think I was able to bring some comfort and hope to someone by relating my experiences. The someone does not have Fragile X, but when a label hangs heavy around your neck the exact wording of said label is not so important.
There have been times when the FXS label felt like it defined me. It was the scapegoat for all of my quirks and flaws. There have been times when the FXS label was a tool to help me play "the system" to get accommodations or services. And then there have been times when the FXS label just meant my genes are a bit funny and having kids will be a bit tricky but really, that's all. Labels are based on numbers and statistics and stanines and standard deviations, and that does not capture the essense of a person at all. It certainly does not capture the essense of me, or the individual who spoke to me yesterday.

I thought I was losing my mind...

...because I kept on losing my writing utensils!
I'm something of an office supplies junkie. Staples and Office Max are dangerous places for me. I can be scatterbrained with other possessions, I quite admit, but I usually keep up with my pens and pencils.
Naturally, then, I was distressed when every two or three days I would lose a pencil. Was graduate school so stressful that I did not have enough brain cells left to keep up with a pencil? What would happen if I ran out of extras and had to take my data on a client with *shudder* a pen? (For me, taking data in pen is the academic equivalent of doing a crossword puzzle in pen. You're just asking for a big, scribbled mess.)
This morning I was refilling my new backpack with yet more pencils when I noticed that the pencil slot in my backpack travels the entire length of the backpack. The organizer pockets on this backpack are located on the sides, and I've noticed before that some of the slots are too long to be of any real use. I fished around in the slot, pushing up from the bottom, and retrieved a whooping 6 pencils and 2 pens that I hadn't even realized were missing!
And then I had a good laugh at myself. ;) The mystery is solved, and my mind is (mostly) intact. My professors are at a conference so I have some time to catch up on work. Better go make the most of it!

A trip to the art museum

Deborah's post at 5 Minutes for Special Needs inspired me to dash off a quick blog post.
When my mother taught at a private school for children with special-needs, I would occasionally come to help out when I was on break from college. Her kids were little charmers, and I enjoyed my time there. One day they got to go on a trip to the local art museum, and I came along to be an extra pair of hands and eyes. And because, hey! Art museum with kids! :)
One elementary school-aged girl on the trip was named Sarah. (Well, not really, but for the purposes of this blog.) Sarah has autism. She required an aide, who came with her on this trip. Her aide told me that Sarah liked to tap any glass that she saw. She liked the sound, or the feel of it. She did not like to pass glass without touching it.
You know how sculptures and vases at museums have those plexiglass cases over them? Do you see where I'm going here?
The museum staff did not seem to know how to deal with our group. I remember one woman in particular following us like a hawk and getting very agitated whenever Sarah touched the glass. Towards the end of the trip, Sarah would pass the art, glance at it, and say, "Don't touch...don't touch..." She would also say, "I'm ready [to leave]." She was seriously unhappy. But they would not let her touch the glass.
Now, I understand why they have those rules. A careless shove could destroy a very important and beautiful piece of art. But Sarah was not shoving. Sarah was lightly tapping. The worse that would have happened was a smudge on the plexiglass. The best that would have happened was that Sarah would relax enough to actually enjoy the art she was seeing.
The other children were having a good time, and were excited to see work by artists they had studied in art class. Everyone, including Sarah, was well-behaved. I just wish the museum could have relaxed a little, so that Sarah could have relaxed a little too.

That which does not kill me...

...will ultimately make me stronger. I've had two days of graduate school, and already I feel like I've learned so much. A lot of this learning has come through making mistakes, and that is never easy. However, I keep telling myself that if I already knew everything, I would not have to be in school. So much of the vital knowledge in my field can only come with experience. My supervisor for my observation hours told me once, "Katie, our clients don't read the textbooks." She said this because I noted that a child was actually making sounds more difficult for herself instead of easier. However, that child did not read my textbooks and did not know that sounds at the front of the mouth are generally easier to produce than sounds at the back of the mouth.
I am realistic enough to know that I will not be this into learning once November or even October hits. I will be scrambling around to finish assignments and get signatures and write reports. Hopefully I will do a little bit better at time management this semester and still have time to let everything I'm learning soak in.
Speaking of which, I should probably go to bed!

ASHA speaks up about autism

ASHA, or the American Speech-Language Hearing Association (the "l" would throw off the snazzy acronym ;) ) recently spoke up in response to remarks by both major presidential candidates concerning autism. Apparently, both candidates indicated the belief that vaccines are contributing to the rising number of autism diagnoses. ASHA's response was to send a letter to both candidates to commend their respective interests in autism, but to urge them to base their comments (and policy!) on scientific evidence. As many of you may know by now, the evidence has thus far failed to establish any link between vaccines and autism. I'm really glad that my professional organization was paying attention and spoke up to inform the candidates about this important and growing issue.
ASHA is the organization that is responsible for certifying speech-language pathologists in this country to practice. We also have to get licensed by the state in which we practice, and sometimes the organization through which we work (for example, the public schools). The ASHA website has materials for parents and educators as well as for professionals, so if you need some resources, check it out! :)
I'll get off my professional soapbox now. :)

Here we go...

I can't believe that it all starts Monday. I will meet my first client at 9am. I already feel awkward, inexperienced, all volume and enthusiasm. There so much to get done in the first week for clinic alone; I am afraid that my academic classes are going to suffer under the barrage of clinical paperwork. Hopefully this will all become routine soon. I hear repeated activities tend to do that. I also hear that students have survived this before, although I am doubtful. ;) In fact, the load used to be heavier, but the professors listened to the wailing and gnashing of teeth and made some adjustments. I have a whole new respect for medical students.
Wish me luck!!!

Speak of the devil...

My reaction to this comedy gem was something along the lines of, "They...said that? Out loud? That's kind of...really? But it's so stupid and asinine!" In an earlier post I mentioned the satirical lyric, "If you're not a friggin' tard you will prevail." I have issues with that line, but I honestly didn't notice it until I read the lyrics to the song. This movie scene is so disgustingly blatant that I am at a loss for words...to believe that anyone could chortle over that trash would be to give up my faith in human decency.
I think anyone who cracks such base "retard jokes" should have to explain to any puzzled individuals with special needs why these jokes are funny. I bet the instances of "retard jokes" would drastically decrease once the ones cracking them have to deal with the consequences.

Melting down and mathematics

Joey's mom wrote a very insightful post about meltdowns a while ago that got the cogs turning in my brain. My brother has special needs, although he does not have autism, and I had about 15 false starts on a comment on her post to try and address meltdowns without saying too much personal information about my brother. I just don't think he would appreciate it. And then I thought, "Duh, Katie! Math!"

I am a very verbal person. I have always loved words, and words have always come easily to me. I am not a numbers person. As a child I developed a sort of mental block around math. I hated math, and math would always be hard and dumb. I could feel my brain shutting down when I sat down in front of a sheet of math problems. When I tried to verbalize how I was feeling, all I came up with was, "It's hard. My brain doesn't work that way. It just doesn't." I think what bothered me the most about math was how all the concepts they taught you seemed so random and unrelated to each other. I never understood the logic behind how I was taught to solve the problems, and I had trouble just blindly memorizing the steps. I often gave up because I just did not care. My parents had and have high expectations of me, and I was expected to get A's in my other classes, but with math...they learned to settle with low B's and C's. (Yeah, horrible grades, I know. The real bad ones came at college-level French, which is another post entirely ;) )

Slightly guilty confession: In high school I got diagnosed with a learning disability in math so my SAT scores wouldn't look so bad. I'm pretty sure I got in on a technicality; there was a large gap between my verbal IQ and my math IQ and apparently that gap is what determines if you have a disability.

Just recently I was encouraged to tutor children struggling with 5th grade math. I was so stressed out about it that I cried. My assigned child showed up extremely rarely, but the one time our paths crossed I had to call over the professor multiple times because I did not and do not know how to do fifth grade math. It was extremely embarrassing and frustrating.

Now, I am grateful for my experience with math. I understand how it feels now to have one's brain just shut down when presented with a task, and to not feel capable of turning it back on. Having a tantrum was so much easier than solving those math problems. It's still easier for me to count on my fingers to figure out 7+9 than to reason that since 7+7 is 14, 7+9 must be just 2 more, i.e 16. It is nothing like what it must be to have multiple brain shutdowns across the board like what I gather can happen during a meltdown, but it is a small-scale something that I can use to relate.

Who wants to know?

In this day and age, most research is done online. Colleges get electronic subscriptions to articles and make them available to students via huge databases. If your library doesn't have it, you can interlibrary loan it and another library will send it to you. This means that students can accumulate a lot of articles over the course of doing papers in various classes.
I am one of those students. ;) I have so many articles about autism saved to my computer and filed away in my file drawer. I have a whole folder of narrative and autism and another whole folder of echolalia and autism. I also have a lot about token economies and a bit about the PALS language test.
I have also kept almost all of my textbooks. I have three just about neurology and how it relates to communicate disorders. Apparently the brain is complicated; who knew? ;)
Mind, I am just a student. I do not have much practical experience to back up all of these articles and textbooks. But since I have access to these resources, I might as well use them. Therefore, I was wondering if anyone has any questions or needs any resources that I might be able to provide. Sign language, PECS, when children normally start using sentences, what new programs are out there and what evidence there is that they work, what speech-language pathologists are in your area...anything about language, really. I am loving this website and all the sharing and growing that I see happening, but as I have no child of my own, I cannot share myself. When I get clients this fall, there is only so much I can share about them, if anything at all, due to confidentiality. And I want to give back a little, because I am learning so much! So please, if I can answer any question or provide you some ammo for those IEP meetings, let me know!

On the word "retarded"

I have a confession to make, dear readers. I have been known to refer to events, activities, and even people as "retarded." I still do, occasionally, although I try to self-correct. I hear others do it, and sometimes I don't speak up. No one really MEANS any harm by it, but I know it still CAUSES harm, and I want to be sensitive.

Recently I have become enamored with "Dr. Horrible's Sing-Along Blog", which is a funny little 3-part video series about a lovable villain named Dr. Horrible and his misogynistic nemesis, Captain Hammer. Captain Hammer is funny because he is supposed to be a hero, yet he looks down on everyone and is very conceited. At one point he is singing a song about how everyone can be a hero (only not as cool as him) and one of the lines is, "If you're not a friggin' 'tard, you will prevail!"

When I heard that line, I laughed. But then I thought, "What if someone who really does have special needs hears that line? How would I explain to them why the line is funny? What is funny about saying a retarded person won't prevail?"

I am learning to be a communications professional. I know that the offhand slang ("friggin' 'tard" instead of "retarded") and the contrast between what a hero is supposed to be and how Captain Hammer is acting is probably what makes the line funny. I know that the writers of the song didn't MEAN any harm by the lyric...and yet, as I sit here thinking about it, I would rather inhale chili pepper than try to explain a statement like that to a person with special needs. It's so awkward to face the potential consequences of what you think is funny. And I know that jokes about "retards" are abundant, and no one MEANS any harm by telling them and laughing at them, but...it all adds up to the perception that people with special needs are substandard. The more I read and see and hear, the more I realize that people with special needs are vital. They teach us so much. And I ache that some people would rather laugh than learn the lessons they have to teach us. And I ache that sometimes, "some people" means me. I don't want to put myself on a high and mighty pedestal of righteousness here, because I chuckle too. But I don't think I'll ever hear that line again without cringing a little.

Finding Courage Through Sharing

National Fragile-X Awareness Day was July 22nd, and I didn't say anything. But then I took another look at the statistics. And I feel like I need to say something now.
I am usually not at all shy about telling people I am a carrier of the full mutation of Fragile-X. After all, I'm certainly not alone! And my thought is, if you think less of me for my genetic background, then you're not the kind of person I'd want to be chummy with anyway.
Although I have been very angry with Fragile X in the past, I am actually grateful for it now. I have been very blessed. I have some hard decisions to make further on down the road if I decide to have children of my own, but I still would not change anything. I feel like I can identify, in some small way, with the families who will walk through the door of my clinic.
My thoughts are not coming together well tonight...I'm pretty wiped out, and I need to study. But I wanted to be one more voice chiming up about FXS, to maybe reach one more person and tell them that life with FXS is not so bad.
In fact, it is beautiful.

And so what we have learned, applies to our lives today...

I have learned a lot from reading blogs written by Mommas of kids with special needs. I was reflecting on this as I went through my daily list of blogs today, and decided to write up some of what I've learned.
1. Down Syndrome is much more than mental retardation. I never realized all the medical problems that can accompany it.
2. Kids with a trach cannot smell or taste. Little Parker has weak lungs and can only go off of his trach tube for an hour every week. I can't imagine how overwhelming smells and tastes must be for him, and what it would be like to go through life without those senses.
3. Kids with g-tubes can have some major sensory issues once they are healthy enough to eat again. Michelle has posted some fantastic insights and tips about how to prepare kids to start eating via mouth again. I especially like her Eating Jar idea whereby her daughter Jacqui gets rewards for finishing all of her food and trying new foods.
4. I really need to get ahold of some Signing Time DVDs if the clinic at school doesn't have them. They break down walls for lots of kids.
5. As my Fluency professor told us, it really is all about the Benjamens. I have been appalled at the behavior of hospitals towards Parker and Rhett's families, calling and demanding large bills be paid out of pocket at that very moment while refusing to offer them any financial help. Let's think about this: medically fragile child, lots of surgeries, lots of doctor's visits and therapies, Mom staying home to watch after said child...probably not a 6 figure income here. Yet without these surgeries and doctor's visits and therapies, their children would not be alive. My supervisor for my observation hours told me that the most important thing is to provide a service for people who need it. End of story. Money is secondary to being able to communicate and eat and swallow without choking. No one should have to live in silence for want of a co-pay.
6. Always be on the lookout for communication opportunities. Sweet Maizie and her family communicate a lot through Webkinz, giving each other virtual gifts and sending each other messages. I never would've thought of Webkinz as a sort of augmentative communication, but it really works for her, and I enjoy reading about all the ways she finds to express herself.

I am really grateful to all of these families for giving me a glimpse into their lives...it has been the best resource I've found so far, and certainly the most entertaining and fufilling!

Greg

I swear I thought I updated this thing more recently. Gah. Anyways, I thought I would introduce you to a friend of mine who I hope will be friends with my young clients as well! This little guy is Gregarious, or Greg for short. I made him 2 years ago before I went to Ireland. My good friend Sophie was going to Greece, and I wasn't going to see her all summer. I made us both bears to take with us and photograph as we traveled. I had a lot of fun taking pictures of Greg in Ireland, and now I take him around with me whenever I go places and photograph him. When I started getting into speech-language pathology, I decided that I would bring Greg and his photos into the therapy room with me. I'm going to try him out this fall, if I get my supervisor's blessing. Children could describe Greg in his pictures, what he was doing and how he felt. They could sequence the pictures. They could tell their own Greg stories by looking at the pictures, and I could even make them bears to take on adventures themselves! This particular picture is of Greg in the preschool room in the student clinic. There are all kinds of super-neat toys in there. I hope I get a few preschoolers who won't get overloaded by that room so we can play. :)

The bottom line

As an SLP, I am not going to be qualified to diagnose conditions such as mental retardation (Is there a more politically correct term I should be using? I'm trying to be sensitive, but I honestly don't know.) or autism or Downs Syndrome or anything like that. If an individual has an undiagnosed condition pertaining solely to communication, then I can make a diagnosis, but other than that I can only make suggestions or referrals. For example, if I see a child who is flapping his hands, avoiding eye contact, and having lots of difficulties with expressive communication, I could suggest that the child see a developmental pediatrician or child psychologist. I could not diagnose the child as having autism.
Even so, communication impairment diagnoses can be devastating in and of themselves, and every family reacts so differently. One family may be thrilled to finally have a name for their child's difficulties. Another might want a diagnosis only to get more insurance money. Still another may completely deny that anything is wrong with their child, and another might be very angry at everything in general for a while.
I was thinking today about my professional and personal reactions to these various reactions of families with whom I will work. I do not envy those doctors who have to give the heavy diagnoses. You have to remain professional, and that means distancing yourself to some degree from the emotional impact of the diagnosis you give. Only a trained counselor/psychotherapist can deal with that aspect. Indeed, my Traumatic Brain Injury professor told us to always recommend family counseling with any TBI case we get, no exceptions. TBI can be especially devastating because sometimes the brain loses its capacity for higher functioning and will never regain it; there's just too much damage. Plus, personality changes are a common side-effect of TBI, and if you've known someone for twenty years and all of a sudden they seem like a completely different person, well...that's tough, to say the least! So as an SLP, I am not qualified to get into all of that. I have to keep some distance for my own mental health.
However, completely distancing myself from the family isn't the answer either. I need to be able to sympathize, commiserate, and celebrate with my families. If families think me callous or cold, I will not be a very effective therapist. I need to get to know the individual, what s/he likes and dislikes, favorite movies and TV shows and books, favorite subjects in school, etc. Why would the individual want to have a conversation about soccer if he's never played it in his life but tap-dances for 2 hours every day? It would make much more sense to talk about tap-dancing. (In my personal opinion, it ALWAYS makes sense to talk about tap-dancing. The only thing that makes more sense is actually tap-dancing. But that is just me ;) )
The bottom line is, I need to work out a healthy balance for myself. I need to be involved, but not too involved. This is going to be one of the hardest things for me to learn, and there is only so much help and advice I can get from other people because it is a personal emotional thing for each person. How much should I leave at the door of my clinic? How much should I take home with me every day?
For now, I need to shower and get to work. At least it's easy to leave office work at the door! ;)

Forgetting why I do this

As I may have mentioned before, I have not started to do actual therapy yet in the course of my education. I begin to have clients this fall, and am closely observed by a qualified SLP as well as videotaped during my sessions. When I talked to other students who had not had clients yet, they said they were terrified. I then feel like kind of a jerk for saying, "I can't wait!" I know that having clients is going to be difficult. When you are a student clinician you have to write out lesson plans for every therapy you do in a specific format, and then write up how the session went in a specific format. It's a lot of extra paperwork. We have to get 375 hours of therapy in, but the preparation and follow-up do not count as therapy hours because we are not actually with a client. Also, many children are unpredictable and inattentive by nature. I heard about a client last summer who would not listen to the student clinician at all. Her supervisor, who has two children and thus has developed a "Mom Voice," had to sit at the door of the therapy room to keep the child from running away.
Despite all of the extra stress and work that comes with clients, I find myself eagerly anticipating them. Why? Because they are the reason I am doing this. They are the reason that I am sitting through classes and making flashcards and reading never-ending chapters in textbooks and memorizing and forgetting the cranial nerves on a regular basis (don't judge, those buggers are slippery...ask any med student). You cannot learn to be an SLP sitting in a classroom, and sometimes when I'm sitting in a classroom I forget this fact and think that the book-learning is the most important part. Then I get depressed and overwhelmed. I cannot wait to be thrown into the fray, to make mistakes and learn from them, to watch children learn and grow. And it is good to remind myself of this when an afternoon of Morphology and Syntax homework and Traumatic Brain Injury studying stretches before me. Thus, I go to shower, and hopefully to conquer! :)

"Everybody stutters one way or another, so check out my message to you..."

http://www.youtube.com/watch?v=mpHLEm9-0bg

John Paul Larkin (March 13, 1942 — December 3, 1999), better known as Scatman John (sometimes credited as Scatman internationally), was a famous American stuttering jazz musician who created a unique fusion of scat singing and Euro Dance, best known for his 1994 hit "Scatman (Ski Ba Bop Ba Dop Bop)". As he liked to say, this was a process of "turning my biggest problem into my biggest asset." He has sold millions of recordings world-wide and was also named "Best New Artist" in the Echo Awards in both Japan and Germany. He was a recipient of the American Speech-Language-Hearing Association's Annie Glenn Award for outstanding service to the stuttering community and was inducted into the National Stuttering Association Hall of Fame. He died of lung cancer at his home in Los Angeles, California at the age of 57.
(taken from http://en.wikipedia.org/wiki/Scatman_john)

I love the Scatman. As I get ready for Fluency class on Friday and scramble around doing Traumatic Brain Injury homework, Scatman John is running on loop through my head. I like to try to sing the scat parts of his songs along with him, and find myself utterly unable to keep up. Sometimes, I think the people with so-called "impairments" teach and help me more than I shall ever be able to teach and help them. They are truly gifts from God.

Oh, the irony...

The irony of the fact that I am sick with jealousy of three friends who are in Italy right now just struck me. Read this if you don't get it.
And yes, I know I'm not a mom. I'm Holland itself. I'm a sibling to Holland. My mother teaches in Holland. And I'm spending all of my time, energy, and money preparing to teach Holland how to communicate. I like to think that I am a bit familiar with some aspects of Holland by now. When it comes down to it, I wouldn't have it any other way.
But I am still jealous of my friends who can afford to cavort around Italy for 10 days.

Summer classes and beyond

I am finished with spring semester and came through unscathed with all A's and B's. Hurray! My organization skills left something to be desired, so I have since set up Microsoft Outlook in hopes of improving them for summer semester. This summer I shall be taking:
-Traumatic Brain Injury, which will probably be as interesting as it is complicated. I shall have to get out my neurology textbook and familiarize myself with the general layout of the brain again.
-Fluency, with one of the foremost experts in the nation. We are really lucky to have Dr. Robinson agree to teach this class for us! One of the assignments in this class that I have heard people talk about is that you have to go to a store or restaurant where no one knows you and pretend that you have a fluency disorder (for example, a stutter). Then you have to come back and report how people reacted to you. I think this is an excellent assignment because it forces us to experience the feelings of frustration and rejection that our dysfluent clients likely deal with every day from well-meaning individuals who don't understand why the person is "talking weird."
-Physics, because I need another science. I am less than enthused about commuting an hour 4 days a week to take this class, especially with gas prices so high, but it will be easier at the community college than at my university.

I was also thinking about possible future research projects while folding my clothes this morning. I am interested in augmentative and alternative communication devices, and not much research has been done to prove the usefulness of the current plethora of electronic devices on the market. I know how difficult and frustrating it can be to get a hold of these gizmos, because of their 3 and 4 figure price tags, so I want to provide professionals and parents with as much unbiased information about them as possible so that all that money is not wasted. However, it would be hard to get a hold of the gizmos for the study, and to find enough children in my small town who have similar communication needs and motor requirements to be my subjects. I have found some tutorials on instructables.com for modifying electronic devices, including toddler toys. Wouldn't it be great if a parent could make an AAC device for their child from a toy they purchased at a thrift store and some simple electronics supplies from RadioShack? I know firsthand how busy a parent of a child with special needs can get, and how implausible it is that Mom/Dad/Uncle/primary caregiver would have time to fiddle around with a soldering gun, but hey! It's a pleasant, if implausible, idea to me that I could empower parents to help their children communicate in this fashion.
I'm also somewhat intrigued by Signing Time. I read a couple of blogs written by parents of exceptional children, and Signing Time has helped many of these children with communication breakthroughs. I wonder if any research has been done using it? Mayhap such research could be used to convince schools and libraries to purchase the DVDs to have available. I really want to help! I'll email my research professor. Please leave any ideas that you may have about communications research that you would like to see in the comments. :)
And now I am away to work! Yay for summer jobs washing dishes ;) At least the food at the Bakery is delicious, and the company is good.

General frustration

I am completely swamped with homework, and most of it is my fault; apparently when you don't keep track of due dates, you miss them. Who knew? My time management skills have been not so good this semester, and I keep needing to remind myself that I'm actually good at and excited about speech therapy. I got a test back today and I had forgotten to answer an essay question. I turned it in blank and lost 5 points. What is WRONG with me?
I am impatient with all my classes and just want to get some clients and get started. There is so much to do, so many children to reach, and I just wanna hit the ground running, even though I know that I do not have the knowledge and experience to do so yet. I'm worried that my lack of patience with classes and my rambunctious puppy means that I will not have patience with my clients. I'm worried that I won't get back on top of life. I'm tired of learning by failing. I'm a student taking a buttload of hard classes and it's the end of the semester. Such is life.

It's that time again

It is that time again, the time that every student dreads: the pile-up. There are always 2-3 weeks every semester when it seems like everyone is giving tests, projects, and papers, and you never quite seem to manage your time well enough to get it all done without panicking. Well, maybe some people do, but I don't. ;) I've been slack the past 2 weekends or so, just visiting with Chester instead of doing my homework like I usually do, and this week I'm paying for it. The domino effect of procrastination has begun! For example, I have a test in roughly an hour or so. However, I am typing a blog entry instead of studying or eating lunch.
Some quick shout-outs: happy birthday Joey! (joeyandymom.blogspot.com) Feel better soon Rhett! (rhettsjourney.blogspot.com) Good luck with your AAC, Nik! Keep up the good work! (http://maternal-instincts.blogspot.com/)

"Education is an admirable thing, but it is well to remember from time to time...

...that nothing that is worth knowing can be taught." -Oscar Wilde
The observation and clinic hours that we do in my program are so important for that very reason: there is only so much that a person can learn sitting in a classroom looking at a PowerPoint presentation. For example, the other day I observed a 7o-something year old man who was a dentist for many years. This man had suffered a stroke which left him with aphasia. This condition did not affect his intelligence, but his ability to process words was slowed. He has trouble finding words in conversation. For example, if he wanted to say the word "camera", he might say, "The thing that takes a picture, you know..." because he cannot think of the word "camera." His therapy session consisted of having a conversation with my supervisor. I was a little confused and later asked my supervisor about it. She told me that she didn't want to do word drills with him in front of me because it might embarrass him, so she engaged him in conversation and kept a mental tally of how many times he needed help finding a word. She said that marking down errors on paper makes the client feel like they're being tested or something, and that it's just not necessary. There are two lessons right there: treat clients with respect, and try to make as few notes during the session as possible to avoid making them feel self-conscious. I feel like I learned more practical knowledge in that one hour than I do during many classes.
Now I should scoot to the living room, as our new puppy may be wanted to do some oral-motor exercises soon ;)

Oh, I'm ready for it, c'mon, bring it

The other day I posted in my personal blog about SOAP notes. I'm not exactly sure what they are; I think they are just notes on how a session with a client went, but as I have yet to have any clients, that particular mystery has yet to be revealed. I said I would keep the blog posted on if I ever found out what SOAP stood for, and Julianne replied with the obvious answer that it stood for Snakes On A Plane. The subject title is in honor of that. ;)
Yesterday I did my first three observation hours. I got lost getting there and getting home (in the dark, lolz), but my supervisor is an angel and talked me back to the right road, and I listened to the SOAP song and felt empowered. I observed 3 children. Child #1 had started therapy in August as a non-verbal child. I did not know this until after the session and I was really surprised, because Child #1 was talking up a storm! I thought he was just there for articulation, but man. Angelic Supervisor is a miracle-worker for sure. Child #2 had a cochlear implant. Very simply, cochlear implants can help some deaf children regain some measure of hearing. Child #2 had just discovered Star Wars and was extremely inquisitive, often interrupting Angelic Supervisor to ask questions about the toys they were using and activities they were doing or to tell her that he had recently acquired a Wookie. He was darling. Child #3 was the sister of Child #2. She was extremely animated; she talked with lots of inflection, facial expressions, and gestures. I was really hungry at this point, but she kept me amused by pointing out how her mispronunciations just "wouldn't make sense" and telling a very interesting story involving twins, triplets, a party, and a person in a wolf costume.
I love this. I really do. I feel like speech pathology is where God is calling me to be. I've got my Psychoeducational Assessment textbook open next to me right now, but it's so dry in comparison to all of the exciting linguistic wonders I've heard about in the past 24 hours that I just can't focus on it. Everything that I'm learning is coming together...at least for the moment. I hope this novelty doesn't wear off. I'll need the excitement to carry me through.

PSA

Two updates in one day? What's going on? ;)
Yesterday in Speech Science we had a sound level meter, and we were measuring different sounds. Our professor told us to hold the meter 2 inches away from a hair-dryer to find out how much noise was right next to your ear while you were drying your hair. It measured 92 dB. The human voice is between 60-70 dB. 92 dB is LOUD, folks, especially right next to your ear. That's loud enough to cause damage over a period of time. Be mindful of your ears! The same thing applies to earbuds. All that volume funneled directly into your ear is dangerous. There is so much noise in the world today that we just don't think about, and our ears are not equipped to handle that constant bombardment.

My SLP flyer from Intro. to Clinic class

What does a speech-language pathologist do?

Speech-language pathologists evaluate and treat speech, language, communication, and swallowing disorders.

Aren't speech and language the same thing?

Nope! Speech refers to spoken communication, like greeting your neighbor on the sidewalk. If you write your neighbor a letter, you're using language, but you're not speaking it. A person can have problems with speech, such as making certain sounds, but not with language. Speech-language pathologists, or SLPS, can help people with both.

How can you have a swallowing disorder?

Swallowing is actually a pretty complicated activity that involves lots of muscles working together. If the timing is off or a muscle is weak, a person can swallow into their lungs and get some nasty respiratory infections. An SLP can spot this problem and help correct it.

I remember SLPs from grade school, but I don't want to work in a school.

Schools are just one of the many settings in which an SLP can work. Nursing home patients often need speech services after a stroke to help them re-learn how to speak or swallow. You can work with infants and toddlers with speech and language difficulties before they reach school age. Hospital patients may need speech services, including pre-mature babies, patients with brain injuries, and stroke victims. There are many therapy organizations that offer speech services, and you can even open your own private practice. Hospice organizations may employ an SLP to help a terminally ill patient communicate his or her last wishes and enjoy favorite foods. You can teach future SLPs in a university setting, or conduct research about new practices in the field. There is an incredibly wide range of opportunities from which to choose!

I had no idea you people were so versatile.

Yeah, we're a pretty talented bunch!

Is it hard to get a job as an SLP?

It is exactly the opposite. According to the American Speech, Language, and Hearing Association (ASHA), the profession of speech-language pathology is expected to grow faster than normal until at least 2014. Medical science is growing tremendously, and pre-mature babies and accident victims have a much higher survival rate, and they often need communication assessment and/or services. There is a greater awareness of the importance of speech and language, not to mention federal laws that mandate providing speech and language services to children who need them, and so more problems are being noticed earlier. The population of elderly adults is also increasing, and the risk of hearing and/or communication impairments in persons of advanced age can be considerable.

I bet you have to go to school forever, don't you?

Not necessarily! Although you can get a doctorate in speech-language pathology if you choose, you can practice with a Master's degree. If you go to school full-time, you can complete the program in as few as 5 semesters. You can also take classes online.

Wow! I can get my Master's degree without leaving my house?

Why would you want to do that? The clinic hours are the most fun and instructive part of your educational experience! All four hundred of 'em! I know it sounds like a lot, but since our profession covers such a broad range of populations, you need to be prepared for the challenges that face you when you begin to practice on your own. You will work with clients of all ages and needs. You will have a fully-trained supervisor checking up on you and providing you with guidance and feedback. Your first year in the field is called your Clinical Fellowship year, and another SLP will be checking up on you and observing you periodically in case you have any questions or concerns.

Well...okay. I'm interested.

Of course you are!

How do you I find out more?

I'm so glad you asked! The American Speech, Hearing, and Language Association (ASHA) is the number one resource for speech-language pathologists. This organization sets the standards for the speech-language pathology profession. ASHA gives you a license to practice, defines the scope of practice for SLPs, defines a code of ethics, and holds you accountable for unethical and unprofessional actions. It's also a resource to find and network with other SLPs or SLP students and to find out the latest research in your area of interest. Their website is www.asha.org.

I know someone who might need the services of an SLP. What should I do?

http://www.asha.org/public/speech/ is a section of ASHA's website designed for public use. It answers four basic questions: "What's 'normal'?, "What if my loved one has already been diagnosed?", "What if I have concerns?" and "Where can I get help?" I would especially recommend http://www.asha.org/public/speech/development/default.htm as a resource for a concerned parent of a child. Children develop at different speeds, and sometimes parents can worry when the neighbor's daughter is talking more than their son and both children were born on the same day. Most of the time it's completely normal, but when in doubt, always ask the communication expert and speech professional: the speech-language pathologist!

This is based on what I hear a lot of time when I tell someone I'm going to be an SLP. When I tell them I'm interested in working with children with autism, I get, "Oh, like Rainman?" I've never seen Rainman. I really need to get around to doing that. I do try to tell them that all children with autism are very different and Rainman is not the status quo by any means.

Another Semester, Another Round of Classes

The new semester started Monday, and thus far it is very promising. I have Intro. to Clinical this semester, so I will do observation hours. I'm really excited about that. XD I got Language Instinct by Stephen Pinker for Christmas, and I'll compile some quotes from that into a post here soon. I will probably have lots to write about this semester, what with observation hours and all, so yay! Synapses are forming already, or at least re-forming as I remember phonetics. XD