March Update from MSHA President
What’s Been Happening . . . . . . . . . . . ?
- The MSHA Board has already held two meetings this year (January 20th (electronic meeting) and March 3rd (in person in Billings and electronic meeting). The newly expanded Board (17 members) has allowed MSHA to have a larger member representation at these meetings. Our next meeting will be an electronic meeting on May 5th. I want to thank all of the MSHA Board and MSHA Members for your enthusiasm, volunteer hours, expertise and dedication to your professions.
- As with previous face to face meetings, I am continuing to seek feedback on an Assistant Licensure Bill sponsored by MSHA during the 2019 Legislative Session.
- The MSHA Straw Poll and Opinion Survey are supportive of MSHA moving forward with a positions paper in support of Audiology and Speech – Language Pathology Assistants. You will see the information on the MSHA website prior to the MT Board of Speech-Language Pathologists & Audiologists receiving an update and a request for support at their next meeting on June 4th.
- We need member comments and questions regarding the Assistant Licensure Process. Please talk to your colleagues and supervisors as more information is provided on the MSHA website. The in-depth look at the Opinion Survey results will be posted on the website and sent out in an email blast when ready.
- New fee schedules for exhibitors and advertising were approved and will be posted on the website.
- At the February 21st meeting of the MT Board of Speech-Language Pathologists and Audiologists, I presented the MSHA Organization Award which was announced at the MSHA 2018 Fall Conference. The finances of the Board are stable at this time and they do not see any change to the most recent Licensure fee charge.
- The American Speech-Language-Hearing Association (ASHA) is awarding the Montana Speech Language & Hearing Association a $1,100 state association partial grant for our association’s assistant licensure bill project. Based on our proposal, ASHA recommends this funding be used towards travel and survey support. This grant is funded under ASHA’s Strategic Pathway to Excellence.
- “Creating Communication Connections” is the theme and title of our MSHA Fall Conference, October 18-20 at the newly remodeled Radisson Colonial Hotel in Helena.
- The state’s regional directors now have email addresses of most current MSHA members and addresses of most licensed professionals in the state. Please contact them is you have not heard from them in the coming months. You will find their contact information on the website.
- MSHA is in process of updating their website.
- Lezlie and Kathleen will attend the Council of State Association President’s Meeting in St. Louis May 17-19.
- Congratulations to Christina Hanson for graduating from the ASHA Leadership Development program. You will hear more on her project development in coming months.
- I recently attended an extremely helpful and educational Telepractice Webinar which was well attended and will be repeated soon by MSHA members. I want to thank Diane and Rachel for their contributions to MSHA and the clients who benefit.
- April 26 is the deadline for submissions for the MSHA May newsletter. Please send advertising or newsletter information to email@example.com
Congratulations MT Licensure Board!
October 12, 2017
Lucy Richards and the entire Montana Board of Speech-Language Pathologists and Audiologists were instrumental prior to and during the process of passage of HB 347 (Limited Speech-Language Pathologist License). MSHA wants to thank Lucy and the Board for their commitment, professionalism and many hours of dedication. In addition MSHA members consistently attend Board Meetings and are welcomed and provide information as well as provide feedback and suggestions. The Board has been open to communication and working with the MSHA members.
Lucy Richards and the Board have provided timely and helpful updates on the website, there is now a quarterly newsletter. FAQs appear on the website as do approved CE coursework. Questions left on the phone or via email are answered in a timely manner.
Lucy has paperwork prepared in advance for the board to perform their duties in a cost effective and timely manner. Budgets were available and many needed revisions to rules were completed this year in part to the administrator’s organization prior to each meeting where discussion was orderly and easily understood by audience members who frequently included our members and graduate students.
The Board worked to determine a reduction in cost for initial renewal licenses. Lucy
Richards will be attending the first day of the MSHA Fall conference in Missoula and be available to answer questions at an exhibitor table.
I enthusiastically support this MSHA Organization Award for Lucy Richards and the entire Montana Board of Speech-Language Pathologists and Audiologists. We look forward to working with them in the future and during the next Montana Legislative Session in 2019.
Lezlie Pearce-Hopper, M.S., CCC-SLP
Montana Speech Language and Hearing Association (MSHA)
Diane Simpson shares about SOS (Strategies Offer Solutions)
I am a speech language pathologist serving preschool through high school age students. I primarily serve as an in- person therapist; but, in the last three years, I have also served home school and public- school students via telepractice. I love my work because no two students are alike and I get to learn and grow with them. As both an in -person therapist and a telepractitioner, I have had the opportunity to evaluate how I serve students. I try to create a great learning environment in my speech therapy room. My students come in and we get right to work until another student appears and says that it’s time for “John” or “Sally” to come back to class for a) gingerbread house building, b) practice for the upcoming music program, c) fire drill, d) balloon lady, etc. It can be challenging to share student’s time with other professionals. We all teach important skills and we all need time with the same students. The question for me, how can I help students achieve their goals and incorporate the skills they are learning in other settings? I was determined to find a solution, not unique to my little corner of the world. I did some research and found a continuing education opportunity that sounded, promising! For the last several months, I have been using a strategy based program created by two speech pathologists plagued by the same issues as I. Yea, I’m not alone! Ruthann Jarvis and Elizabeth Peterson created Strategies Offer Solutions to teach strategies that can be easily incorporated into the classroom, home, and other settings to help students achieve their speech and language goals.
I began using this program last fall with my language students. This fall I included more students. I have enjoyed Strategies Offer Solutions because it often works well with the materials and programs that I already use. Ruthann Jarvis and Elizabeth Peterson also share ideas for teaching their strategies. The strategies taught are short and easy for students to remember. Parents can learn the strategies and use them at home to help build their child’s speech and language skills. I have a couple of parents who were thrilled to have something that they could use at home. This strategy program works well in both an in person and telepractice setting. I taught my telepractice students these strategies and they learned them as well as the students I see in-person.
If this sounds like the solution you have been searching for, please check out Strategies Offer Solutions on this web-site: https://www.northernspeech.com/best-seller/strategy-based-interventions-for-the-school-age-child/
MSHA Member Webinars
On September 19, MSHA wrapped up it’s last webinar for 2017 with Tracy Sippl presenting on Teletherapy. Tracy provided an overview of how to get started in Tele-speech with technology needs, privacy compliance, and practice. She advocated for the use of Tele-speech in rural areas as well as with different populations. If you missed this class, Tell me about Teletherapy From A-Z, it is available with the link below.
Course description: Numerous websites offer Teletherapy opportunities, but what do you need to know before becoming a Speech/Language Teletherapist? Various facets of teletherapy: equipment, licensure, HIPPA-compliance, and materials are explained in detail. After completing this course, attendees will have the necessary information to genuinely consider becoming a Teletherapist.
Tracy has a lot of good information on her website and in her Blog. She is also available for individual practice sessions for teletherapists. https://www.s-lteletherapyconsulting.com/
Exciting New for MT SLPs and AuDs!!
MSHA’s Efforts On Behalf of all Speech-Language Pathologists and Audiologists in Montana Have Resulted In Benefits For All!!!!!!!!!!!!!!!!!!!!!
MSHA members donated over 300 hours in the past 2+ years (one member totaled over 160 hours) by attending, writing and testifying at all Licensure Board meetings, all Labor and Industry Hearings, all Legislative Bill Hearings, the Day With the Legislatures, the signing of HB 347 with Governor Bullock, the hearings at DPHHS.
The MT Licensure Board recently responded to the repeated input and feedback requests to address our licensure fees and completed many much needed updates to rules. The MT Licensure Board is a partner with MSHA ensuring Montanans will access speech/language/audiology services from the highest trained professionals.
I first want to update you on the results of the 8/3/17 MT Licensure Board meeting regarding the limited license and lowering the overall fees. The proposed fee reduction is 45% which breaks out as follows.
|Current Fee Amount||Proposed Fee|
|Original License Fee for Speech Language Pathologist or Audiologist||$ 350.00||$ 192.00|
|Active Renewal Fee for Speech Language Pathologist or Audiologist||$ 200.00||$ 110.00|
|Inactive Renewal for Speech Language Pathologist or Audiologist||$ 100.00||$ 55.00|
|Limited Speech-Language Pathologist License Fee||$ 50.00||$ 27.00|
|Registration Fee for Speech Language-Pathologist/Audiologist Aide or Assistant||$ 30.00||$ 30.00|
The formal notice of all the proposed rulemaking will likely be filed on 8/28 and published on 9/8. That means the public comment period will officially run from 9/8-10/6. A hearing will be scheduled between 9/29 and 10/6.
When the notice is published the Board will send out notice to all the interested parties and licensees as well. Please wait to comment until the formal notice is filed. That way you can see the complete proposal notice along with the legal reasonable necessity.
The MT Licensure Board also voted that Lucy Richards should represent the board at the MSHA fall meeting per MSHA’s request.
On behalf of MSHA I would like to thank all of the diligent members; including students from the University of Montana, who have attended every MT Board meeting or hearing or provided letters over the past 2+ years regarding our professional dues increase. We are very pleased with the increasingly positive working relationship and open communication MSHA has enjoyed for the past year with the Board. A special thank you to Lucy Richards for her able and willing assistance through the process.
More Perks of MSHA Membership
1) Professionalism – MSHA is the only organization in Montana that represents the interests of audiologists and speech-language pathologists and their clients. Its sole mission is to “provide and promote education, networking and advocacy for professionals and the public with quality and compassion.” Whether you are in private practice, a medical/hospital setting, public schools, or academia, it is essential that you stay abreast of developments in your profession and prepare for the future in today’s increasingly competitive world. That is why hundreds across the state are members of MSHA. They think the involvement is critical to their careers, and they are given an opportunity to “give something back” to their profession by participating in MSHA activities.
2) Advocacy – MSHA continually monitors legislation and regulations affecting the practice of audiology and speech-language pathology at the state and national levels. By staying in touch with legislators, testifying at committee hearings, sponsoring bills or participating in letter writing campaigns, members have a tremendous impact on governmental issues. In the 2017, MSHA played the leading role with communicating with the MT Licensure Board in preparation and passage of HB347. You will find additional information on this bill from the MT Licensure Board website. In addition to members’ efforts, MSHA employs a professional lobbyist to monitor legislation with support from ASHA grant monies.
3) Education – MSHA provides its members with many opportunities for continuing education to help them keep up with advancements in diagnostics and treatment methods. Every year MSHA offers an annual convention, and there are usually four other opportunities year-round. With the exception of convention, all continuing education activities are available to MSHA members at no cost or at significantly reduced rates.
4) Networking – When you attend a MSHA meeting, serve on a committee, or participate in other activities, you have an excellent opportunity to interact with your colleagues one on one, share common interests and concerns, and network for employment and professional activities.
5) Information –MSHA publishes a newsletter, membership directory, and other materials to keep members informed on issues and developments affecting the practice of audiology and speech-language pathology. However, the most timely and accessible source of MSHA information is its web center. The center provides members with updates on legislative and regulatory issues, job listings, publications, a calendar of events, message forum, leadership contacts, and valuable links to other professional websites.
Licensing News – Limited Speech-Language Pathologist License Application is Live
- The limited speech-language pathologist license application is now available. Click on the “License Information” menu for more details.
- This non-renewable license is for speech-language pathologist license applicants who: (1) have not completed a 36-week supervised professional experience following graduation from a master’s degree program; and (2) do not have a current certificate of clinical competence from ASHA.
Background and Legislative History on Limited Speech-Language Pathologist License
HB 347 was signed into law on March 23, 2017. What does this mean?
- The license that was previously issued to new graduates from a speech-language master’s program will now be called a “limited license” instead of “temporary license”. “Limited license” more accurately reflects the type of license being issued as “temporary” has other connotations.
- Nothing will change for those currently operating under temporary licenses. Those licensees will just complete their supervised professional experience requirements before becoming licensed as speech-language pathologists.
- The board is no longer issuing “temporary licenses”. As of May 2, 2017, all new graduates/applicants will apply for a limited speech-language pathologist license. The process will be the same as the old process for the temporary license. The limited license will function exactly the same as the temporary license did. The application and licensure requirements also remain the same.
- Please contact the Licensing Bureau at 406-444-5711 or UnitB@mt.gov if you have any questions on the application process.
Lezlie Pearce-Hopper, M.S., CCC-SLP
MSHA Monday: SEAL Update
I’ve been struggling to write a blog about my experience as Montana State Education Advocacy Leader (SEAL) at the recent ASHA CONNECT Convention in New Orleans. What could I possibly write that would come close to the powerful blogs already submitted by my erudite MSHA colleagues? How would I sum up my experience? Should I mention that New Orleans has so much delectable seafood, fascinating architecture and toe tapping music it is overwhelming? Should I urge everyone to check out a summer ASHA Connect because the speakers are all on point and the atmosphere is more laid back and promotes interaction with new friends? Do I try to reach out for more grassroots advocacy and involvement? All of the above!
I discovered something about myself while I was at ASHA Connect. I relish knowing what is going on, how it affects me, how it affects my clients – and you’d think this would be the case with all Speech Language Pathologists and Audiologists.
However, I have discovered something else at MSHA and ASHA Conventions as well – a sort of bystander mentality among some of our colleagues when it comes to advocacy. Obviously this isn’t true of all of us, and I hope it is the exception. There seems to be a sense that issues outside of our direct services for clients and our place of business are just too much to grasp. During our graduate training we were taught that advocacy is within our scope and responsibility, and we may think of it in terms of advocacy for clients but we also need to stand up for ourselves.
I attended great sessions related to schools, medical settings and private practice, and partook in meetings with SEALs from all the other states. We discussed issues directly related to schools, and ways to promote advocacy as related to legislative, regulatory and other public policy affecting us.
ASHA has a plethora of tools available on its website including: strategies for self advocacy, data, strategies for meeting legislators, advocacy for specific federal and state issues, and contact information for legislators in each state.
At the SEAL meetings we learned ASHA has taken a position on the following issues related to education.
-Role of the US Department of Education- Oppose proposals that would abolish and/or significantly diminish the role of the U.S. Department of Education’s (ED) oversight of education policies and programs at the state and local level, which ensure high standards and equitable access to educational opportunities for students across the lifespan.
Parent’s Right to Choose Support a parent’s right to choose the best education for their children and maintain that principles regarding access, funding, accountability, and privacy must be included in any education reform legislation. These principles are core concepts that must be included in any reform. Parents must be provided accurate information regarding the consequences of choosing to leave a public school including provision of SPED services, due process, qualification of providers, maintenance of adequate funding for public schools, provision of full continuum of both Special education and general ed and uphold equitable access to education for children with disabilities, ensuring funding follows students, and ensure HIPAA and FERPA.
Alice Cogswell andAnne Sullivan Macy Act Oppose the Alice Cogswell and Anne Sullivan Macy Act that would establish a new precedent of placing visual and hearing disabilities ahead of others identified in IDEA by adding specific disability-related mandates and requiring additional resources to accommodate only visual and hearing disabilities. ASHA opposes this Act because it establishes new precedent of placing visually impaired and hearing impaired students ahead of others identified in IDEA.
Please contact firstname.lastname@example.org and let them know whether you support or oppose these positions. More details are available on the ASHA governance page.
I get it. We go to MSHA, AAA and ASHA to learn how to better serve our clients (oh, and to see our Speech and Audiology friends). Holding the client paramount is our duty. But how can we hold our clients paramount if we don’t have the IDEA/ESEA/Medicare/Medicaid funding to do it? How can we hold our clients paramount when our professions are being threatened by lack of federal and local financial support and administrations that don’t see the needs of our clients as vital? How can we hold our clients paramount when our credentials aren’t universally recognized as a benchmark for licensing, providing speech, language and audiologicalservices, and other professional standards?
We have to help ourselves, to help our clients (kind of that whole “Put your oxygen mask on first” thing.) Our MSHA movers and hustlers can not do it all. We cannot continue to assume that someone else will get to it. We cannot continue to run our professional lives with a “want something done-give it to a busy person” mentality. Want to know more about advocacy, for you and your clients? Contact ASHA PAC. Contact leaders in MSHA. Go to the ASHA website. Contact your SEAL (Janis Hayes-Strom at email@example.com). Contact your STAMP and SMAK (Carol Morse firstname.lastname@example.org).
Become a grassroots captain. Start early by encouraging students, CFYs, and newbies to get involved! There are a million resources and you can access them from the comfort of your own chair on the ASHA website as well as the MSHA facebook page. Do what you can, or at the least support people who are trying. While you’re thinking that someone else may do it, someone else may be thinking that YOU will do it.
HAVE JUST A FEW MINUTES?-log onto ASHA’s Take Action site, select an issue from the ones listed below and “take action”. Most of the work is done as ASHA has already drafted sample letters. All you need to do is sign your name.
Tell your members of Congress to cosponsor the Medicare Telehealth Parity Act of 2017 (H.R. 2550) and the CONNECT for Health Act of 2017 (S. 1016/H.R. 2556). Both pieces of legislation would make leaps and bounds by providing Medicare beneficiaries with access to services (e.g., audiology and speech-language pathology) that they may not otherwise receive.
Representatives Cathy McMorris Rodgers (R-WA) and John Larson (D-CT) and Senators Bill Cassidy (R-LA) and Amy Klobuchar (D-MN) have introduced the Steve Gleason Enduring Voices Act (H.R. 2465/S. 1132). The legislation builds on the Steve Gleason Act of 2015 to permanently fix Medicare’s policy that limits access to speech-generating devices (SGDs).
· Take Action NOW to repeal the therapy cap The House and Senate have both introduced legislation to repeal the Medicare therapy caps. Representatives Paulsen (R-MN), Kind (D-WI), Blackburn (R-TN), and Matsui (D-CA) have introduced a House bill (H.R.807) to repeal the cap. The Senate bill (S.253) was sponsored by Senators Cardin (D-MD), Collins (R-ME), Casey (D-PA) and Heller (R-NV).
INTERESTED IN DOING MORE?-Sign up for ASHA Headlines, follow ASHA Advocacy on social media, check out the grassroots advocacy section on ASHA’s website and get information on meeting with members of congress in your home district and on Capitol Hill. Volunteer as a writer/author, or become a mentor. Volunteer as a MSHA Board member. Contact email@example.com, firstname.lastname@example.org
By: Janis Hayes-Strom
THE FLOW OF INTERVENTION By: Nancy Rice, MA, CCC-SLP
SOCIAL THINKING® and THE FLOW OF INTERVENTION
By: Nancy Rice, MA, CCC-SLP
This blog is written based on my experience working with individuals with social communication disorders, which is largely based on the Social Thinking curriculum designed by Michelle Garcia Winner, MA, CCC-SLP, and colleagues. I will attempt to summarize the process I use in treating my clients with social communication disorders. This framework is designed primarily for individuals who have average to above average cognitive abilities; however, with creativity and care, it can be adapted to meet the needs of a wide range of clients.
Working with individuals with social communication disorders is challenging, to say the least. These clients are complex and their skills vary tremendously, making it difficult to know where to start and how to proceed. I have found that it’s important to start at the beginning (see diagram below), no matter the client’s chronological age or stage of social communication development. I have many adult clients with whom I adapt the materials and content delivery to respect their age and stage. Nonetheless, I always start at the beginning, with self-regulation of behavior.
Spend time teaching the “zones.” Blue Zone: sad, sick, tired, bored, moving slowly; Green Zone: happy, calm, focused, ready to learn; Yellow Zone: frustrated, worried, excited, loss of some control; Red Zone: mad/angry, mean, terrified, out of control. Work on developing an emotional vocabulary and tie each term to a real-life situation or role-play activity. Talk about how the body acts and reacts when experiencing each emotion (i.e. smiling, hitting, yelling, jumping, etc.). Develop strategies and “tools” for self-regulation of emotions and behavior. Zones can be continually inserted throughout the therapy process, so start with developing an understanding of the four zones and establishing tools that help the client, for example – breaks, physical activity, fidgets, problem-solving tools, etc.
Materials: “The Zones of Regulation” by Leah M. Kuypers, MA Ed. OTR/L; Problem and Reaction Meter (PDF)
- Develop an understanding of thoughts, feelings, actions and reactions. You want the client to understand that our thoughts and feelings can be comfortable or uncomfortable, and our actions/reactions can be expected or unexpected. Then, develop an understanding that, when we do something expected, we start (or continue) a positive chain reaction that makes us and others feel comfortable AND when we do something unexpected, we start (or continue) a negative chain reaction that makes us and others feel uncomfortable. The goal of this stage is to help the client realize that choosing to do what is expected (i.e. starting and continuing positive chain reactions) will result in making him/herself and others feel comfortable – a good choice to make.
- Develop an understanding of “thinking with your eyes,” including an understanding of WHY we should think with our eyes. This stage takes a while because the concept and process is new to them, and their eyes and brain are connected in a much different way than in a neurotypical brain. This stage involves a great deal of mirror work, imitating facial expressions, using exaggerated affect, and “look where I’m looking” games.
- Develop an understanding of how and why we want to identify and follow “group plans.” At this stage, start connecting all that was learned in skill #1 (above) with daily activities, games and learning activities. This is where the client really starts to understand the concept of expected and unexpected actions. Following the group plan is expected; and when one doesn’t follow the group plan, it starts a negative chain reaction.
- Develop an understanding of why we want to keep our “body in the group” and help the client to do so in a variety of activities. Along the way, you’ll be strengthening the ability to keep their body and brain in the group AND the “green zone.”
- Develop an understanding of using “whole body listening” – which is done with lots of help from the “Zones” tools. We want the client to realize that listening doesn’t just involve our ears. We listen with our brain, quiet hands, quiet mouth, caring heart, etc.
- Develop an understanding of how to “follow the leader” (i.e. understanding the concept of an authority hierarchy). This is done with lots of work on what it means to be a good leader/follower; and how and when to be leaders vs. followers. This stage is not in the Michelle Garcia Winner curriculum. It is my own stage that has been added because I’ve found that individuals with social communication disorders don’t know where they “fit in” and so they tend to take the lead (usually in an unexpected way – and then get confused because they think they’re doing what’s expected) or they get anxious (which also causes unexpected actions/reactions). In additions, individuals with social communication disorders tend to have difficulty identifying good leaders/followers. Taking time to add this stage helps clients deal with issues surrounding friendship, bullies, handling boring moments, parent/teacher/employer relationships, and more…
Materials: “Meet Thotso, Your Thought Maker” by Rachel Robb Avery, Ph.D.; “What is a Thought?” by Jack Pransky & Amy Kahofer; “We Thinkers, Volume 1” (formally “The Incredible Flexible You” series) by Ryan Hendrix, Kari Zweber Palmer, Nancy Tarshis & Michelle Garcia Winner; “Whole Body Listening Larry at School” and “Whole Body Listening Larry at Home” by Kristen Wilson & Elizabeth Sautter
- Develop an understanding of the “hidden curriculum:” the idea that there are always rules that we aren’t told but are still expected to follow. Spend time studying the rules of different settings and activities to the client. Practice following the rules by “thinking with our eyes.” Do this in role-play and pretend play activities and then in “real-time.”
- Introduce the concept of being “flexible.” We don’t have to do things our “own” way, we can do things “any” way. At this stage, provide lots of practice on being flexible about day-to-day things, i.e. playing a game someone else wants to play, doing an activity in a new way, dealing with disappoint or losing a game, not getting the color desired or handling it when told “No.”
- We have to teach our clients with social communication disorders to “share imagination.” This is done in pretend play with the younger clients and joint storytelling and conversation with the older clients.
Materials: “We Thinkers, Volume 2” (formally “The Incredible Flexible You” series) by Ryan Hendrix, Kari Zweber Palmer, Nancy Tarshis & Michelle Garcia Winner
- Develop an understanding of how to identify cues that help us to know what’s “expected and unexpected.” This is the stage where clients practice seeing and using social thinking skills in real-life experiences.
- Learn to use “flexible thinking” is all we do. Practice identifying when and where flexible thinking was or was not used.
- Develop “strategies” that will result in more flexible thinking – resulting in successful social interactions.
Materials: “You are a Social Detective!” by Michelle Garcia Winner & Pamela Crooke; “Superflex: A Superhero Social Thinking Curriculum” package by Stephanie Madrigal & Michelle Garcia Winner; “Superflex Takes on Glassman and the Team of Unthinkables” by Stephanie Madrigal & Michelle Garcia Winner; “Superflex Takes on Brain Eater and the Team of Unthinkables” by Stephanie Madrigal & Michelle Garcia Winner; “Superflex Takes on One Sided Sid, Un-Wonderer and the Team of Unthinkables” by Stephanie Madrigal & Michelle Garcia Winner; “Social Town Citizens Discover 82 New Unthinkables for Superflex to Outsmart” by Stephanie Madrigal, Michelle Garcia Winner & Pamela Crooke; “Superflex Superdecks”; Social Thinking YouTube (PDF); Video Modeling; Individual Social Thinking Binders (PDF)
Along the road to Social Interaction, try to keep the activities very content driven and always explain the “why” behind what you are doing. In addition, involve parents! After all, social thinking is a 24/7 thing.
I will be forever grateful for the contributions Michelle Garcia Winner and colleagues have made to the field of speech language pathology. They have provided a greater understanding of social communication development and disorders, and have opened my eyes to a world of intervention resources and techniques that really work! ~Nancy Rice
PRIVATE PRACTICE- TAKING A LEAP OF FAITH
By Kitty Griffin MSCD, CCC-SLP
Thinking about private practice? You could spend years writing a business plan or you take a leap of faith and get in there in the near future. Never once in my neatly laid out professional goals did the word private practice get written. My practice rose out of the ashes of a job loss. ( I should have called my practice the “Phoenix”!!!) Healthcare changed, and rehab jobs were eliminated or pared down to a point where it would be hard to support yourself, much less a family.
My kids were 5 years old when that job loss came and I was scared. I called my parents. I thought some sympathy might be in order. My mom (ever the fainting flower-NOT!) said “Are you any good?” I was taken off guard and didn’t answer. “Are you?” she pressed. “Then open your own office- just do that”. We went on other topics.
If nothing else, I am a woman of Faith. I called some local doctors, packed some toys in my old 65 Mustang and entered into home based treatment. Things went well and I learned about insurance, Medicaid and how to submit billing forms. I drove around MT with no phone- cell phones were not big yet! I then saw patients from a dedicated space in my home. I later rented space from our local hospital.
Nothing lasts forever, and the space in that area was needed for other functions. The hard choice was here: move to another space or buy something so I never had to move again. The day I came home and asked my low key husband Jeff :”Do you think we could use our house as collateral?” I held my breath. He said “You know what you are doing.” I never loved him more. We renovated a 2 bedroom house and State of the Heart Therapy moved into Taylor Drive. We have been in this location for 10 years now.
Everyone is different and I think every private practice is different, too. Just a few things to know:
- Try to grow slowly, many new businesses fail in the first 3-5 years due to the cost of doing business.
- You will work harder than anyone else you know, your life depends on it.
- Surround yourself with people to advise you, who are from different backgrounds in business. It could prevent costly mistakes. Jeff once said; “You are NOT doing that!!!” PS- he was right and I was crabby that he WAS right.
- Go for diversity in your caseload payors. A mix of contracts, clinic patients with insurance and with entitlement programs like Medicaid offer stability if the bottom falls out of one payor. Trust me, it is likely.
- ASHA has wonderful resources: asha.org and type in private practice!
- You will not be raking in the big bucks; the owner is paid last.
- This is the time to shine clinically. You will get referrals if you give more than is expected. It will cost you time and effort. And it will keep you in business.
- Take a leap of faith sometime soon. Maybe not in private practice, but somewhere: have Faith not fear.
You can reach Kitty on her mobile email email@example.com
Catherine “Kitty” Lebahn Griffin, M.C.S.D. CCC-SLP is a master’s level speech and language pathologist. Kitty has spent her career working with families in home based and clinic based treatment. She has worked across the nation including The Helen Beebe Center in PA and the Listen Center in CO. One of Kitty’s clinical specialties is working with families whose children have hearing loss. Kitty has worked for MSDB as a Family Advisor and is currently a DHH Outreach Consultant in SW MT. She is a certified Baby Signs® instructor.
Kitty is a former MT Speech Language and Hearing Association president and currently chairs the PR committee of that organization. (She likes to get the word out about services!) She also owns and operates her private practice, State of the Heart Therapy, Inc. in Dillon MT. Kitty’s most prestigious and rewarding assignment thus far is as mother to twins David and Elizabeth, who are studying at UM and making their Mom proud!
Conversational Skills: Teaching them can be Free!
Conversation Skills: Teaching Them Can Be Free!
Jennifer K. Schoffer Closson MS CCC-SLP
Teaching conversation skills is not something to be accomplished in two or three sessions. In fact, according to Spitzberg and Adams, the developers of The Conversational Skills Rating Scale, there are 25 skills that are required to be a conversationalist. In reality it could take two to three years to meet one’s conversational potential with intervention.
For a communicator that is daunted by conversation, The Conversational Skills Rating Scale will help identify areas of challenge. It is very subjective, however, SLPs are highly trained to make judgements about communication. It is also a little loose, but lends itself to follow-up observations and questions. For example, one of the items is “personal opinion expression (neither too passive nor aggressive).” If this item raised concern, the clinician may look deeper into flexibility, ability to respectfully disagree, personal space, tone, emotional regulation, etc.
Conversation skills are tough to teach. Every child with autism or related disorder is going to have a unique constellation of challenges with conversation. For this reason, I encourage SLPs to individualize their approach and implement evidence based practices (EBP).
The National Professional Development Center on Autism Spectrum Disorders (NPDCASD) http://autismpdc.fpg.unc.edu/evidence-based-practicesis my favorite resource for EBP. They have joined forces with The Ohio Center for Autism and Low Incidence (OCALI)http://www.autisminternetmodules.org/ and this is my favorite training resource for when it is needed now. These two resources are user friendly and reveal what really works.
Some of my go-to EBPs are great for teaching conversation skills:
Social Narratives: Social narratives describe the expected behavior clearly. They tell the learner what the setting looks like and how to respond. The nice thing about Social Narratives is that they can be shared with teachers, parents, and other support personnel for generalization of skill. This allows the stakeholders to have common language, common expectations, and a tool to pre-teach a skill to support social success. The NPDCASD and OCALI (the two sites above) will support you in learning how to develop social narratives. My favorite person to consult is Carol Gray.http://carolgraysocialstories.com/social-stories/
Video Models: Video models provide expected behaviors for the learner to emulate. These videos can be purchased or be made quickly on a smart phone by using the learner, an actor, or the point of view of the learner. One of my favorite tools for purchase is Fitting In and Having Fun. Here is a video they produced about Taking Turns Speaking. https://www.youtube.com/watch?v=3RjRZ9jMfs0The reason why I like these videos is that they share the perspective of the participants. They show the old way and the new way and provide social narrative at the end. But, for those of us that have a budget of $0, go ahead and make your own. Here is one about Making Plans. If you are curious about the point of view video “Petting the Dog” is an example.https://www.youtube.com/watch?v=ieM8GHE6RLk
Scripting: Scripting is quite useful for skills related to employment or independent living. A script can be faded as the communicator becomes more competent. Here is a script that would be affixed to a pouch for ordering food (fill in the blanks with dry erase marker):
Hi, I would like ____________________________ please.
Here is my money. Inside you will find ____________ dollars.
Please put my change and receipt in the pouch. Thank-you.
Teaching conversation skills is hard. Sometimes we don’t know where to start or how to teach a skill. Using The Conversation Skills Rating Scale can provide a guide or a starting point. Implementing evidence based practices ensures that you are using researched methods of intervention. Generalization can be supported by sharing social narratives, video models, scripts, and other materials with stakeholders. Working as a team, individualizing instruction, and using EBP will likely help your client develop his or her conversation skills.
MSHA Monday-Summertime Teletherapy Update
Diane Simpson and Rachel Stansberry offered another webinar on “Getting Started in Montana Telepractice” on June 27, 2017. Diane and Rachel have been offering these two-hour webinars several times each year to help MSHA members add telepractice to their service delivery models. Telepractice offers us a chance to reach areas in our state that are not receiving speech therapy and audiology service and Diane and Rachel are committed to getting services to these areas.
Each webinar contains four parts. First, they discuss the Montana telepractice Law and the Rules and Regulations governing telepractice in Montana. Next, they cover the expectations of privacy for HIPAA and FERPA compliance. The third part deals with the equipment, platforms and physical needs to provide telepractice and they conclude with web-based resources, both for therapy sessions and for getting additional training. Diane and Rachel will continue to offer these webinars as long as there is interest. They will are also planning to present a poster on telepractice during MSHA’s fall convention in Missoula
MSHA will host another webinar on Telepractice on September 19. This one will be taught by Tracy Sippl. Tracy is a telepractioner who offers a variety of services to telepractioners. She has a course through ASHA and she does individual consultations. Rachel recently consulted with Tracy to get more ideas for online therapy materials to share. “Tracy was a great help and shared techniques to help me better utilize my teleconferencing platform and she gave me a list of online activities I could use in therapy,” Rachel reported, “and all for a reasonable price”. You can check out her site and blog here. Watch the MSHA Facebook page for more information on the September 19, 2017, webinar.
Her latest Blog was on e-helpers.
ASHA also sent this information on Sig 18 that I thought was worth sharing.
“Advocacy State-by-State pages have had a new edition – Telepractice/Telesupervision! This has been a big initiative to track the laws and regulations specific to telepractice to assist members in their endeavors to provide appropriate services within the confines of the law. Go to the Advocacy Tab, Click on State-by-State then select the state you would like to research. Telepractice is listed as one of the subsections. http://www.asha.org/advocacy/state/ Contact Cheris Frailey with questions at firstname.lastname@example.org. ”
Are you looking for ways to incorporate more authentic materials into your current telepractice? ASHA has a recorded webinar and has a lot of good ideas for making your own materials as well great tips for managing technology and using web based resources.
If you’d like to be listed as a telepractioner on this website, be informed of the next webinar, or receive periodic emails about telepractice resources, contact Rachel at email@example.com or Diane at firstname.lastname@example.org