Aphasia

Happy New Year! I was so busy last semester that I didn't really have time to blog. Glad it's over!

Well, with 2011 came a volunteer opportunity for me in January. I worked with one of my professors on an intensive communication workshop for aphasic adults. It was so exciting for me because I haven't had any experience interacting with stroke survivors. Although I was not doing therapy (this was research) it was still very rewarding and challenging.

I am a very empathetic person and also have a giant soft spot in my heart for older adults. I was terrified before starting this project that I would cry when they struggled to speak. However, I was pleasantly surprised that I am much stronger than I thought and the adults were so interesting and fun! I had such a great time talking with them. The goal was to get them talking as much as possible so we discussed different things using activities my professor provided.

It was difficult at first because I realized I needed to slow down my speech (but not so slow that it was condescending) and that I sometimes needed to rephrase things or use simpler words (with some people, not all). Another really important factor was waiting. Similar to a stutterer, waiting without pressure and letting the stroke survivor finish their thought or search for their word. We didn't want them to get too frustrated so when appropriate we would help them find the word they were looking for, but most of the time they produced it or used a similar word instead.

Anyway, here is a video of an aphasic woman. She is much younger than the adults I encountered but this is just so you have an idea of what I'm talking about. Clearly everybody is different, so she does not represent every person with aphasia in the world.

Hello October!

I am just saying hello to October in this blog while it is almost on its way out! This semester has been flying by (but not nearly fast enough because I'm already ready for it to be over)! Just thought I would do a quick check in and let you know that I am knee deep in midterms and will be back very soon with a new blog. I'm thinking about writing on apraxia since it's kind of a hot button issue in the field!

I was just sitting here studying and thinking about how much I have learned since August. It's pretty mind blowing. Things have really started clicking for me at work (since I'm an interventionist) and at school since I am starting to see the bigger picture of the roles SLPs and interventionists play in early intervention services. It's my "a-ha" moment as one of my high school teachers would say. (I went to a high school that had a unique multidisciplinary program and she would always tell us we would have our "a-ha" moment when all four disciplines came together in our brains and started making sense in conjunction with each other, not separately.)

Sigh.

Ok, back to work!

What does a Speech Therapist do??

I have been reading over the ASHA (American Speech-Language-Hearing Association) Scope of Practice and Code of Ethics for my observation lab. They are an interesting, if not repetitive read for me, but I thought my readers might enjoy learning more about what an SLP does.

Some highlights from the Scope of Practice are listed below. They really spell it out in terms of what an SLP does and I think you will all find it very informative!


The overall objective of speech-language pathology services is to optimize individuals' ability to communicate and swallow, thereby improving quality of life.



Speech-language pathologists address typical and atypical communication and swallowing in the following areas:

• speech sound production

  • articulation

  • apraxia of speech

  • dysarthria

  • ataxia

  • dyskinesia

• resonance

  • hypernasality

  • hyponasality

  • cul-de-sac resonance

  • mixed resonance

• voice

  • phonation quality

  • pitch

  • loudness

  • respiration

• fluency

  • stuttering

  • cluttering

• language (comprehension and expression)

  • phonology

  • morphology

  • syntax

  • semantics

  • pragmatics (language use, social aspects of communication)

  • literacy (reading, writing, spelling)

  • prelinguistic communication (e.g., joint attention, intentionality, communicative signaling)

  • paralinguistic communication

• cognition

  • attention

  • memory

  • sequencing

  • problem solving

  • executive functioning

• feeding and swallowing

  • oral, pharyngeal, laryngeal, esophageal

  • orofacial myology (including tongue thrust)

  • oral-motor functions

If you missed the links above, you can find the entire "Scope of Practice" from ASHA's website: http://www.asha.org/docs/html/SP2007-00283.html and "ASHA's Code of Ethics" here: http://www.asha.org/docs/html/ET2010-00309.html

Back In School!

Hello friends! I am back in full swing with classes this semester. It was a nice summer break from school, but it does feel good to be learning again. I'm in the clinical phase of my studies which means lots of observation hours! I will be running around getting my hours done and absorbing all the techniques I see. I will keep you posted on the new things I'm learning as they are happening.

No More Ads, Apparently!

You might have noticed my ads are gone. Google sent me an email saying that my AdSense Account was invalid and all the money it had generated will be going back to the advertisers! Rude, right? Not like I generated anything of note, however they did make me fill out all this tax information and stuff, so I essentially gave Google all of my personal information for nothing! Lesson to be learned, don't trust the googles! And don't trust 'free' money!!

Sorry I have not been blogging more, I am on summer break from school and have picked up a second job since my client hours were cut back since all the kids are out from school. I will get back to blogging ASAP!!

Thanks for your support!

Sign Language

I love language, and learning sign was just one goal I had made for myself back in high school. I was inspired by a deaf friend I had made at camp. He was really sweet and we communicated via pen and paper, a good amount of fingerspelling and lots of dramatic, silent movie quality reenactments to tell stories. When I went to college, I ended up taking an AMAZING linguistics class on the structure of sign language that got me hooked on Linguistics as a major and even more interested in Deaf culture and signing. I could write an entire blog on ASL, it's origins, it's grammar, Deaf culture, etc...but I don't have the time and want to focus this on therapy. Anyway, I was pretty good at ASL for a couple of years, and then of course, like all language skills that go unused, I have forgotten a lot.

However, the amount that I can recall, is quite useful with small children, especially nonverbal ones! Children with delayed speech can use signs to communicate their needs. Since, let's face it, the purpose of language is to get our needs met. Many times the problem with little ones is we have NO IDEA what they want or need and thus they end up in a tantrum - frustrated and angry. Many of my co-workers/colleagues use ASL to help nonverbal autistic children communicate. Sometimes it works, sometimes it doesn't. I know one 2 year old who can't quite figure it out yet and will put his hands out and have the therapist manipulate the his fingers to make the sign. At least he knows that he has to do SOMETHING with his hands. I think with more repetition, he will figure it out. He is also not a typical developer, he has delays.

It has actually been shown that you can teach babies sign language to help them communicate and that they can begin signing at around 6- 9 months. And no, it won't stop them from using verbal language. Typically developing children will start a 'one word' stage at around 12 - 15 months, regardless of signing knowledge.

Anyway, here is a great online dictionary of signs to check out www.signingsavvy.com. It's all on video, so you search for the word you are looking for and the video will show up. It's not really going to get you producing long, complicated, grammatically correct sentences, but it will have individual words which are super useful with small children. Happy signing!!

Floortime Therapy

Dr. Stanley Greenspan, an Autism expert and creator of floortime therapy died yesterday. I thought it would be nice to post a little something in honor of him and because many speech therapists who work with children will encounter Autistic clients.

The work I do now, Early Intervention, is a direct result of Dr. Greenspan's research and efforts. He has contributed so much to early intervention and has affected me deeply in the way I approach all children. The key to floortime is having the child lead the adult/therapist. I feel like everything in a child's life is controlled by adults and they are constantly having to follow the leader, whereas in floortime, they are able to share with us what they are interested in doing, always within boundaries (I am definitely not one to let kids run amok! Boundaries are very important and help children feel safe).

When I first started working as an interventionist, I had no idea what floortime was. I had a lot of training before I actually got any clients (thank goodness), but the truth is you learn while you're in action. Floortime is child directed, meaning you are taking the lead from the child, seeing what they are interested in and expanding on what they're doing. For example, one of my clients likes to kick and seeks sensory input (pressure) from his legs. He was sitting on the couch kicking and so I started moving his legs up and down in big kicks and saying "BIG!" and then making smaller kicks with him and saying "Little!" and "Stop!" when I would stop. Then I would ask him, "Big or Little?" and he would tell me what he wanted. Then I would stop and ask him, "more?" or "all done?" and he would let me know. Basically, my client was already kicking, seeking input on his legs, and would have been kicking anyway, but I came in and expanded on it, turning it into an interaction that was fun and meaningful for him.

A lot of therapists I work with try to explain it to parents as "Wait, Watch and Wonder". Meaning, watching the child, waiting to see what they will do and seeing how you can expand on that. Sometimes, it can appear like I'm not doing anything, but in reality it's a dance. When to step in and how to do it. When I first meet a client (by the way, my clients range from 2 to 6 years of age), I don't usually begin by challenging them (aka, if they're impatient, forcing them to wait, allowing them to avoid certain activities). I will usually try to bond with them and get to know them and see what they're like. The best way to bond is laughter! Making a child laugh is a sure way to get on their good side. If they think I'm silly they feel more comfortable aorund me. Also consistency is key. I of course am frequently plagued by colds from working with little ones, but it's so important to show up for these kids. Structure is so crucial.

Again, it may seem like we're just playing, but floortime can help with social/emotional goals, language skills and expansion of routine behavior. Not a panacea, but I have definitely seen leaps and bounds made in a matter of months from floortime. It's amazing and we will all always be indebted to Dr. Greenspan!