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The NSSLHA discount brain explosion!

21 May

I’m writing this because I was misinformed and I want to make sure new SLP students get the correct info!

When I was in undergrad, my CMDS program encouraged us to join NSSLHA – for the support, for the resources, and because of this great program: 2 years in NSSLHA and you get a discount for your first ASHA membership. It’s that simple! Join NSSLHA – it’s $60 a year and it is TOTALLY worth it. I joined (I think) my junior year and continued to renew my membership through my first year of grad school. By my second year of grad school I thought, “I got no money and I’ve met my ‘Two Years’ so it will be okay for my membership to lapse.”

Fast forward to my application for my CCCs: I call ASHA’s Action Center to get my NSSLHA number and was told to not expect my discount because too much time had elapsed between my last year in NSSLHA and my ASHA membership.

And I was like, “UHHH HUH? WHAT?”

As far as I knew – there was no expiration date on my two+ years in NSSLHA. No one ever mentioned that I basically had to be in NSSLHA at the time I graduated from grad school in order to get my discount. When I was in grad school no one ever even talked about NSSLHA – it was what the undergrads did. Right? Right.

HOWEVER, I was wrong! (As were a majority of my peers it turns out.) Everyone I’ve talked to thought you just had to be in NSSLHA for two years…at SOME point. After talking to an Exec NSSLHA member I was told that INDEED: you are SUPPOSED to be a NSSLHA member for the two years directly prior to applying for your CCCs!

Who knew?! Not me. I mean it says it directly on the website but I never even looked because why would I? Professors are never wrong! (Right? Hahaha.) (Also I’m not the brightest crayon in the box.)

So grad students – JOIN UP (like, yesterday). And grad schools – TELL YOUR STUDENTS. Encourage your students! Don’t just make NSSLHA about undergrads! This is important, yo.

And don’t forget about Gift to the Grad!

NP: Lisa Loeb – Stay

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Undergrad – What to look for!

3 Mar

Howdy. It’s four AM and I’m wiiiiiide awake. I went to bed weirdly early because I felt crappy and now here I am, blogging and answering emails because…what else is there to do? (Eat.)

I got an email from a high school junior (Melissa) this week, asking me what to look for in an undergraduate speech therapy program. (Which may be known as any number of things: communication disorders, communication sciences and disorders…who knows?)

GOOD QUESTION! Never really thought about it since I sort of…fell into my program. But if I was specifically looking for a program, I came up with some things that I really liked about my program (Or didn’t like…though there wasn’t much to dislike.)

1) Class size! My undergrad was teensy. We had about 30-40 girls in my program. And consider, that’s 30-40 girls that I saw every day. For four years. So depending on your personality a small class size or a big one might make more sense. To me, small was better than other state schools that had 60-100+ students in the comm dis program. I got to know the girls in my class, some of them are my best friends. But also, small means cliquey. Small means getting to know EVERYONE (even the people that make you INSANE. You may sit by your best friend for four years, but you may also sit by someone you want to judo chop for four years.) In a bigger program there’s more of a buffer.

Another benefit to a small class size is getting to know the professors more personally. These are people you’re going to be asking for references and recommendation letters in three years. If they don’t know you, your letters may be rather impersonal and vague. I got to know my professors, I’m friends with them on Facebook, I give them big hugs at state conferences. If your class size is humungous you’re going to have to work very hard to stand out.

2) Do they have a NSSLHA chapter? We had one at my undergrad but it was sort of…disorganized. It was affiliated, but involvement was rather willy nilly and professors didn’t really push you to be in it. If you were in it, it was likely just because you wanted it to be on your resume. We did community projects and that kind of thing intermittently. But some programs have really cool NSSLHA programs! They have a lot to offer students, they support students, and they push students to get involved early. NSSLHA is awesome too, because if you’re in it for …two consecutive years (?) you get a discount when you become a grown up ASHA member. Which is sweet. So yeah, ask about NSSLHA. If they don’t have one or it isn’t well-organized, and you really like the program, get in there quick and help organize it yourself! I’m pretty sure National NSSLHA has resources to help students put together their local chapter.

3) Can you be a clinician as an undergrad? This was one my most favorite things about my undergrad program and such a bragging point for me in grad school! I was a clinician as a senior. And as a junior I was an “assistant” clinician. It was awesome! I had clients! Three to be exact. It was so nice to go into grad school with clinical hours already and clinical experience under my belt. I felt so much more confident and secure than many of my peers. And God knows, I love feeling confident and secure.

4) How else can you get involved in your department? I knew as an undergrad that I needed to get in there, get to know the professors, get to know our department administrators. I wanted them to know my face, know my name, and to like me. So I worked for the department – I started working for our admin assistant shredding confidential papers 2 hours a morning, 3 days a week, for a whole summer. Then I moved up in the world and started working for our professor who was in charge of the alumni files, so I spent a lot of time filing, inputting data, sending out surveys, etc. Then I started working for another professor just doing her general bidding (seriously, one time I vacuumed bugs from under her desk. I also opened her mail for her. WHATEVER. I’LL DO IT.) I spent so much time in our department it was ridiculous. But guess what — they knew my name, they knew my face, they knew I was a hard worker. And I made some excellent friends/colleagues/mentors.

5) WHAT ELSE CAN YOU DO FOR THEM? My undergrad program had a lot of opportunities for research. Which is rare for an undergrad program so ask about it. As a junior I did research in a group setting – there was five or six of us. We picked a research project, put it all together with the guidance of a professor, and presented it at our university’s undergrad research conference. Then senior year my best friend and I did an independent research study, so the two of us picked a topic, did the project, and presented it at a local and state wide conference. It was awesome. And it gave me great experience for when I went to do my thesis in my Master’s program.

6) MELISSA! – I forgot something important: do they have an onsite clinic? Some schools don’t! And that means you have to go out in the world to do your 25 observation hours. Which might be good because it is more realistic. But it might also be super inconvenient. I honestly had ENOUGH going on as an undergrad without worrying about driving all over creation trying to do my observation hours.

7) @goldstein25 pointed out that undergrad programs don’t have to be accredited so I deleted this. But in its place I’m replacing it with this tid bit: if the school you’re looking at doesn’t have an undergrad SLP program, but you want to go to SLP grad school – you’ll have to “level“. Which means that you’ll have to take both the undergrad SLP courses as well as the grad courses. So you DEFINITELY want to find a university with a CMDS major for undergrads. Otherwise you might as well slap at least another year onto the 2 years for your Masters.

If anyone can think of anything else, please comment and share your ideas. This is just what my brain produced with minimal sleep.

NP: Brandi Carlile – Heart’s Content

The CF

15 Oct

Okay I was GOING to blog about AAC assessment and device trialing but I am doing my first days of device trialing this week and I figure I should wait until that actually happens to have an opinion on it. (Don’t worry though – I already have opinions.)

The Clinical Fellowship. The ol’ CF. Ye olde CFY. (It isn’t a year anymore I HATE when people call it the CFY now. IT ISN’T A CFY STOP THAT STOP IT RIGHT NOW.) (STOP IT.)

What’s the deal with the CF? According to ASHA:

The Clinical Fellowship (CF) is a transition between being a student and being an independent provider of clinical services that involves a mentored professional experience after the completion of academic course work and clinical practicum.

Purpose of the Clinical Fellowship

  • Integration and application of the theoretical knowledge from academic training
  • Evaluation of strengths and identification of limitations
  • Development and refinement of clinical skills consistent with the Scope of Practice
  • Advancement from constant supervision to independent practitioner

It is 36 weeks of full-time clinical practice. You get paid don’t panic. It isn’t a continuation of an internship. You’re expected to do real work and you’re the SLP. You just don’t have your CCCs yet because probably you’re a screw up. Don’t worry – we all are. As my mom says, “YOUR PROFESSION HAS A CF FOR A REASON.” (And I’m all, “Yeaaah Mom but like, I like being perfect at everythiiiiiing.”)

What do you have to DO for a CF? Here, read this:

Clinical Fellowship Requirements

  • 36 weeks of full-time (35 hours per week) experience (or the equivalent part-time experience), totaling a minimum of 1260 hours. Part-time work can be completed, as long as the CF works more than 5 hours per week. Working more than 35 hours per week will not shorten the minimum requirement of 36 weeks.
  • Mentoring by an individual holding ASHA certification in speech-language pathology. It is the responsibility of the Clinical Fellow to verify certification of the mentoring SLP, and can do so by contacting the ASHA Action Center to verify at 1-800-498-2071.
  • A score of “3” or better on the core skills in the final segment of the experience, as rated by SLPCF Mentor using the SLP Clinical Fellowship Skills Inventory form.
  • 80% of time must be spent in direct clinical contact (assessment/diagnosis/evaluation, screening, treatment, report writing, family/client consultation, and/or counseling) related to the management of disordered that fit within the ASHA Speech and Language Pathology Scope of Practice.
  • Submission of an approvable CF Report and Rating Form.

I actually filled out my own rating scale the other day of how I think I’m doing. I mostly gave myself 3s and 4s. November 15th is the last day of Segment 1 for me and then my supervisor and I will compare and discuss.

Something you’ll also note on the CF Rating Form is:

A full-time SLPCF consists of a minimum of 35 hours worked per week and equals 1,260 hours throughout the 36-week SLPCF. The SLPCF must consist of at least 36 mentoring activities, including 18 hours of on-site direct client contact observations and 18 other monitoring activities.

Ew.

That equals 6 hours of direct supervision and 6 hours of “mentoring” per segment. THAT’S A LOT OF BONDING TIME. Sheesh ASHA, you’re killin’ me.

Overall I think the CF is going pretty well – I love my supervisors and I have wonderful support at my facility. I think for a CF it is SO important to have support – you NEED other SLPs, you SHOULD HAVE an onsite supervisor who you see regularly. A few jobs I interviewed for would have supervisors for me in other buildings, or I’d be doing only home health and wouldn’t really have a home base. It would have been a mistake for me to take one of those positions. I have a sounding board, I have people to observe, people to bounce ideas off, people to share/commiserate with.  I do group therapy twice a week where I get to see PTs, OTs, and Early Childhood Educators in action. My supervisor and I meet every Friday. There are SIX other SLPs for me to talk to and they’re such amazing resources. If you’re considering somewhere for your CF – please consider the support system your facility will have in place for you, it’s incredibly important.

Shoot me questions! I’m happy to help.

NP: Lee Brice – Hard to Love

Don’t be alarmed, we’re taking over the ship.

17 Sep

Whoa! Speechie off the port bow!

This post is in dedication to Talk like a Pirate Day (September 19th…of course.) The fine folks over at LessonPix asked the #slpeeps for some pirate-y themed therapy and we obliged (because we’re da bomb dot com.)

First let’s start by saying: LessonPix is AWESOME. I’m not just saying that because they asked me nicely to write this post and be part of their blogging hearties. I’m saying it because I DO WHAT I WANT, YO. What is LessonPix you ask, Dear Reader?

Well, “LessonPix is an easy-to-use online resource that allows users to create various customized learning materials.”

For serious – you can make SO MANY THINGS. It’s $36 a year, and in comparison to something similar (think in the ballpark of $400) I think it is WELL worth it. Especially since I can login on any computer – I don’t need a disk. For $36/yr I’m getting what – 11 years to the $400 one time price. (Obviously prices change and products change and therapy changes so don’t come crying to me in eleven years, that’s just a way to think of it if you’re having trouble with the cost in your brain.)

 What sorts of things can you make? I’ll tell you. Picture cards such as THESE:

Seriously. Do Not Copy. Or I will hunt you down.

Or you can create about a zillion other things. You pick the PIX you want, and the website creates PDFs with your material.

Materials Frankenstein

You can search what you need, upload personal images – it pretty much does all of the things. Which is awesome because I’ve got things to do, I can’t be hanging out in Paint all day trying to draw with my arrow mouse. I couldn’t do that in fourth grade and I can’t do it today.

Self Portrait

Anyway back to the pirates. I’m working for the MOST part as an Early Intervention Therapist. My caseload is composed primarily of two year olds (Yeah I didn’t know I had patience either, you aren’t the only one who is surprised.)

When LessonPix asked if I’d use their pirate materials to do therapy I was all about it. Here are some things I made:

Shapes treasure map

These are GREAT, because obviously I can put anything I need to in there. For a lot of my kiddos we’re working on receptive language – specifically identification of familiar objects/toys and following directions. So in the case of the treasure map up there, I put in images that correspond to a puzzle I was using in therapy. Then I can provide not only a verbal cue, but I can point to an image. Many of my clients require an extra prompt or two so adding a visual component is a great way to supplement cues I’m already providing. And since it’s on a treasure map, I can use these little guys to hop along to the next piece:

Me crew

If I wanted to do a themed therapy session with pirates, I could use the game board and a corresponding toy for a scavenger hunt type of activity. I found this in our therapy cabinet and it worked great for such a task:

Tis me ship

You can see that this toy has many components, such as cannon, helm, mast, spyglass, ladder, etc. While playing we could go over these vocabulary terms and then use the gameboard to prompt “giving” specific items or identifying by pointing. In early childhood therapy themes are often used so even if there was an ocean or beach unit, this type of toy could fit in nicely. And having engaging, novel materials to use with little ones is pretty much key to your survival so LessonPix really helps out with that!

I will absolutely be using LessonPix materials again, I think their product is amazing! My brain can’t even understand how the picture gets to the TV Screen so I have no idea how they’re making customizable materials out of thin air that make my life so easy.  Now all I need is a real pirate to help me cotreat…

NP: The Little Mermaid – Part of your World

Aphasia therapy

26 May

APHASIA!

If you’re working with adults you’re PROBABLY working on aphasia. There are maaany types of aphasia. If you use the WAB, which there is a good case you will, then you will give your patients any one of eight aphasia diagnoses (Broca’s, Wernicke’s, Transcortical Motor, Transcortical Sensory, Global, Isolation, Conduction, Anomic). Most aphasias  be classified as fluent (receptive) or non-fluent (expressive). And there are other aphasias out there like primary progressive, alexia, agraphia etc. AND the way you classify aphasia will depend on your “theory” of aphasia.

I say all of this, but really you won’t see “pure” aphasias often – I would say many are mixed. You’ll see patients with a variety of difficulties that manifest themselves in all sorts of exciting ways.

AND QUITE FRANKLY – sometimes the diagnosis is SORTA irrelevant. To me – I’m not treating a diagnosis. I’m treating the issue. Just because someone has Broca’s aphasia doesn’t necessarily mean that the treatments typically used for Broca’s aphasia will work for this patient.

So what do you do with these patients – who may have difficulty speaking, understanding, reading, writing, spelling and a plethora of other troublesome word related tasks?

I’ll try to narrow it down a bit.

The patients I saw MOST OFTEN were having difficulty with word finding. I’ve had one patient with global aphasia and one patient with Wernicke’s. My externship had a very cool “Evidence Based Aphasia Clinic” which analyzed the aphasic characteristics of patients enrolled in the clinic, and then looked at EVIDENCE BASED protocols for treating aphasias. WHICH IS SO SMART. Everyone should do this. Not just with aphasia. With all things. One day I’d like to have at least one legit journal article printed off that explains why I do what I do with each kind of disorder that I focus on.

Back to what I was saying – What do we do with these patients? With a global aphasia you’ll likely be trying to find some kind of multi-modality communication system that will be consistently and appropriately utilized in the patient’s life. These are tough patients but you’ll find a way to communicate. One of my most favorite patients had global aphasia. She was the sassiest.

Wernicke’s? Wernicke’s aphasia is really cool. There is a Treatment for Wernicke’s Aphasia which works, but is extremely tedious and exhausting for EVERYBODY. Be sure to break up your sessions if you attempt it. The idea is you put out six photos (of 12 photos total) of everyday photos and first – hand the patient a card with a word on it. The patient matches the word to the picture. The patient then reads the word or verbally identifies the picture. The patient then repeats the word after you. Then you ask the patient to identify the picture with just a verbal cue. There is no scaffolding or cueing, but obviously for training purposes and for success purposes you’ll want to cue and prompt as necessary at the beginning. When I find the source for this I’ll share it – I’m not sure where I hid it. You can also do Response Elaboration Training, Cloze Procedures, Melodic Intonation Therapy, and I’m sure a number of other procedures.

And the biggie – word finding. This is going to change with each patient. I really enjoy category naming and teaching HOW to do this efficiently. I think often we say to a patient “Name all of the animals you can!” and then they have a hard time and we write down how many they got and then we tell them to name some other things. THIS IS NOT GOOD THERAPY.

Teach, don’t test, people.

So some ways we can deal with naming and word finding is to do semantic mapping tasks and semantic feature analysis. You can TEACH patients how to categorize by really thinking about how our brain works. How is our brain organized? Do we just have a jumble of animals in our brain all willy nilly? If someone asked YOU to name as many animals as you could what would you do? I often tell patients to subcategorize. Tell me animals, but first tell me farm animals, then zoo, pets, woodland, ocean, flying, etc. Tell me vegetables but envision yourself at the grocery store. And also consider – are you asking the patient to name CONCRETE items or ABSTRACT? Example time. Concrete: Animals. Abstract: Red things. Our brain is not organized by color.

Other tasks for word finding: synonym and antonym generation. And not just ONE word. Tell the patient to think of THREE antonyms. This gives you a good idea of where they are as far as what is difficult and what sorts of scaffolding is required. Can you give a patient a FIM score without really pushing them and figuring out what is hard? (No.)

Unscrambling tasks. Idiom defining.  Homonym explanation. Word defining. Seriously – ask a patient with a word finding disorder to define the word “tree”. Try that one. I really recommend the WALC books and Cognitive Reorganization if you work with aphasia often.

Now, I’m going to do the last edit of my thesis because I’ve been…not doing it.

NP: Anna Begins – Counting Crows

PS – if you Google just the word “WALC” you get this website. Lolz.

Memory Therapy

21 May

I don’t know about you guys, but I felt like in many of my SLP classes I learned a lot of “textbook knowledge.” Meaning it’s good info to know and it’ll help me pass the Praxis, but beyond that it’s sort of useless. For example, in aphasia we learned the symptoms of aphasia and the different classifications of aphasia and how to evaluate aphasia. But three months ago if I was presented with a person with aphasia and someone said “TREAT THEM!” I’d be all, “Oh Dear Mother of God.” The knowledge isn’t super practical sometimes.

Which is why externships and clinic are important.

Anyway, I thought I’d take some time to break down some of my favorite areas to work on in the adult realm. Today I thought I’d go over,

MEMORY

As SLPs we address cognition which is an umbrella term for: orientation, memory, attention, problem solving, reasoning, initiation etc. Executive functioning overall. You’ll find often that OTs work on this as well.

Memory is an umbrella as well, since there are so many types of memory. Short term, long term, delayed, procedural, working, autobiographical, muscle, semantic and so forth. And memory has many steps. Your brain has to absorb the info, it has to code it, store it, and make it available for retrieval.

Generally, what I worked on most often was working memory and training patients to compensate for short term memory loss. There are a few agreed upon tricks of the trade and I’ll share them with you now.

1. Teach your patients to associate. This is most often used in the case of remembering new names. I always give my patients the example, “My name is Sam. I am a Speech therapist. And I’m a Student.” Lots of /s/. You could also use physical traits or personality. Like “Democratic Diana” or “Tall Tina.” You can make an association between new information and something you already know like, “My niece’s name is Sam and your name is Sam so I’ll remember you” (I never get how this works but patients always do this as their example.)

2. Repeat repeat repeat. If you want to memorize a list, a phone number, a poem, song lyrics – whatever – what do you do? You say it or do it over and over until you can do it without prompts. If a patient can’t remember what month it is – tell them during your session. A lot. And write it down. Several places. Repetition and rehearsal are great tools for committing something to memory.

3. Visualize it. This is good for prospective memory because you imagine yourself calling the doctor at 3 PM, or you imagine yourself turning on the TV to watch your favorite show. It’s like a little movie in your mind. A way to train visualization is to give a patient a list of words and have them make a story out of the words. Sometimes patients don’t really get it and will just combine a bunch of unrelated sentences. You want to encourage the story to have flow and be related, though it can be really silly. So if the list of words is:

Sock. Keys. Pink. Word. Chair.

They might say something like, “I’m wearing socks. I have keys in my purse. My favorite color is pink. Chair is a word.”

This is beneficial to no one. You want a story like, “I put on my sock but couldn’t find the other. So I got my keys and unlocked my pink car, so I could go buy a new pair. When I got home, I said a curse word because my sock was under the chair.

They’ll say the story to themselves a few times and then you remove the list from their line of vision. Ask them to verbalize or write the list immediately. Then ask again 20 minutes later.

4. Grouping. Which is one we all do a lot anyway – putting like things together. So if you’re making a grocery list, put the meats, dairy, dessert, veggies on the list together so it makes sense. Also then if you forget the list at home you have a better chance of remembering if you had categories.

5. Writing things down. Putting new activities into a planner. Writing notes on your day. Keeping a pad of paper by the phone. Reviewing the day with someone. Writing on a calendar. However you want to do it. But you’re more likely to retain something if you’ve put it on paper. A lot of patients physically can’t do this, so encourage their families or caregivers to help them.

You’ll also want to encourage your patients to make changes in their home environment so it’s more conducive to memory. Like keeping everything in a specific place everyday. Labeling drawers. Using a pill organizer. Using external aids like alarms and calendars. Whatever is going to make their life a little easier.

Working memory is something I really enjoy therapizing and that is just the retention and manipulation of information. So doing things like numbers reversed, or unscrambling letters into words when provided verbally. If you have a patient who has visual impairment these are good tasks to get them settled into therapy and get that brain moving. It’s a challenge for me too!

NP: Memory

I need to…

8 Jan

…drive to Bolivar, Missouri today to finish gathering thesis data. But you know, I went to a wedding yesterday and drank my body weight in vodka. As such, I just want to snooze.

BUT THE VODKA WON’T WIN. I’M GETTING UP. I’M DOING IT. IT IS HAPPENING. MOTIVATION.

I CAN DO ANYTHING GOOD.

oh yeah

21 Nov

Here’s my second post on ASHAsphere: If you are younger than 80 this post is for you.

 

ASHAsphere Blog Post Numero Uno

1 Nov

Hey ya’ll,

If you’d like to read my blog on attending the ASHA Convention (Especially if you’re a first timer) it is posted on ASHAsphere!

Follow me (@slweathersby), @ASHAWeb, @SpeechDudes, @slotaag, or any other number of Tweeters and Bloggers to learn more about the ASHA Convention and Speech-Pathdom in general.

NP: The Weepies – Nobody Knows Me At All

Thanks ASHA!

19 Aug

Well I am just tickled pink! I will be one of the three ASHA bloggers for the 2011 Convention in November. So keep your eyes peeled for more information about my ASHA-adventures. Be sure if you have the Twitter to follow me @slweathersby and follow ASHA  @ASHAWeb.

Also I just submitted my ASHA-blogging-agreement thing and this was the submission response:

hilarious