Our Stories

ASHA-certified professionals are committed providing the highest quality care. Read below to learn more about how some of our members are making a positive difference in their patients’ lives.


Lean On Me

Boosting Communication Skills Through Technology

Video: Garvin & Marianne – Cultivator

An Advocate for Early Intervention

Lean On Me

This early identification audiologist ensures that parents have the support they need to handle their new normal

When parents discover their child has a communications disorder, they’re understandably afraid. They worry about treatment and wonder what it will mean for their child’s future. Pediatric audiologist Christine Cook is there to hold their hand and support them every step of the way.

Christine, the supervisor of Nemours Children’s Specialty Care’s audiology department in Jacksonville, Florida, has walked through each stage of diagnosis with families, from early identification and testing to beginning treatment and eventually graduating from high school.

When the hearing loss is confirmed, says Christine, oftentimes parents are overwhelmed with the diagnosis. There is a grieving process for most and sometimes tears.

“It is difficult not to be emotional with the families at that moment,” she says. But one of the most important things Christine does is she tells families that everything is going to be okay. And that she, as their audiologist, and other caregivers will be there to help guide them through treatment options and therapy, helping them to put their children on a healthy, happy path.

Building that trust and a strong relationship with families is key.

Because some of the families that are seen through Nemours Jacksonville are low income and can’t always afford treatment services, she helps ensure they have adequate support at their local schools.

When children in Christine’s county come to the care facility for the first time and a potential communication disorder is identified, their school is generally notified. This ensures the local schools Nemours works with are well equipped to serve students with these types of disabilities. It’s something Christine recognizes as being very unique to their area but has been incredibly helpful, especially to parents who can’t afford or don’t understand treatment.

“Follow up with some families can be challenging,” Christine says. So, along with treatment services, her audiology department tries to put those families in contact with their school’s social workers to make sure their child gets exactly what they need on a day-to-day basis.

And it’s her training as an ASHA-certified audiologist and her more than 25 years of experience that has allowed her to be this source of comfort and guidance for her patients’ families. Spending countless hours with patients in clinical settings has helped her better understand a family’s needs when new information arises and how to help them take the next steps. Though not every case is that simple.

“We encourage families to be involved as much as possible, but it doesn’t always work out,” Christine says. “Unfortunately in the long run, these children with hearing loss and communication disabilities end up struggling both academically and socially.”

Despite these pitfalls and moments of frustration, when a child does receive the right support from treatment to their school environment, Christine has seen many of her patients struggle less in school and ultimately succeed.

“When you see the impact you’ve made on [these kids’] lives,” she says, “it’s the most rewarding experience. We [audiologists], along with the entire team of providers, played an integral part in that child’s success. We are so much more than people think.”

Boosting Communication Skills Through Technology

A love of technology allowed this speech-language pathologist to help professionals worldwide provide care

When Bárbara Fernandes was an exchange student in the United States in 2004, she relied on technology to communicate with her family back home in Brazil. Throughout the six month program, “Promoting the Inclusion of Persons with Disabilities in Society Through Assistive Technology: Culturally Appropriate Solutions,” she was given the opportunity to explore the ways technology was used to help those with disabilities. Each experience during her program was a glimpse into how assistive devices support communication. In both her personal and professional life, technology was constantly enabling communication.

That experience launched a lifelong drive for using technology to make communicating easier for people worldwide. Today, Bárbara leverages technology to support people with communication disorders and speech-language pathologists who provide services to those individuals.

When finishing up her last two years of undergraduate at Temple University, Bárbara improved her mastery of English and learned Spanish on top of her native Portuguese. Though Bárbara had always been a straight-A student and stellar communicator back home, she learned communicating fluently in a new language posed challenges.

Having faced resistance during her undergraduate program, Bárbara considered not even applying for her master’s in speech-language pathology and taking up a career in information technology instead. But that was before she attended a life-changing seminar at the 2005 American Speech-Language-Hearing Association (ASHA) convention. There she learned that ASHA was beginning to put in place new proficiency guidelines for students from other countries, helping non-native English speakers successfully become SLPs and audiologists.

“It was the first time I saw that someone was aware of how we were struggling,” Bárbara says. “It gave me enough validation to say, ‘you know what? You’ll get better at this, keep going.’”

And it’s that attention and sensitivity to different cultures she’s kept in mind ever since.

In 2006, while attending the bilingual track for a master’s in speech-language pathology at Texas Christian University, Bárbara was awarded another life-changing program — ASHA’s Minority Student Leadership Program. It not only gave her the tools to become a successful leader in her professional life, but the program also gave her a crucial support system.

After completing her degree and starting her first job, Bárbara continued her learning as an ASHA-certified SLP where her constant immersion in her line of work inspired her to think differently about solutions for those who have communication disorders and how to treat them.

From? Starting out as a Pre-K SLP working with bilingual students in Texas Public Schools to creating culturally sensitive and diverse symbol sets and over 60 specialized apps covering every area within speech therapy — from children who have speech disorders to adults who’ve suffered from a stroke — Bárbara has helped change the way patients across the globe engage in treatment.

While primarily used by U.S.-based SLPs, her apps have also been made available in seven other languages and are being used by professionals around the world. The Portuguese-translated apps are ones that have a special place in Bárbara’s heart. Ever since her experience with the exchange program, she’s wanted to make sure that people in her home country with communication disorders have access to programs that help them.

By jumping in at the start of mobile technology’s rise, Bárbara says, “I was able to create apps that therapists around the world can use, raise my profession higher through my work and impact people I’ve never met.”

Video: Garvin & Marianne – Cultivator

An Advocate for Early Intervention

A speech-language pathologist jumps in to help a toddler learn to speak

The two-and-half-year old only knew five or six words. But he understood most of what people said to him and communicated often, by grabbing at his mom, dad and fulltime caregiver’s hands and pulling them to what he wanted.

“Typically children his age have about one hundred words down,” says Bethesda, Maryland, speech-language pathologist Jennifer Gaum, who worked with the boy because his parents recognized that he had significant language delays.

Knowing the signs of communication disorders in children and intervening early are the best ways to ensure they’re getting the therapy they need to learn to communicate and meet their developmental goals at a pace that works for them, Jennifer says.

“People don’t realize ‘Oh, my baby’s looking at my face, that’s communication!’” Jennifer says. “Your baby is communicating with you. It starts almost from birth.”

When parents see warning signs, as Jennifer’s patient’s family did, they can recognize when babies aren’t communicating, and get them the help they need.

ASHA’s new Identify the Signs PSA for Better Hearing and Speech Month. Coincidentally, Jennifer’s house came up as a site during a production unit’s search for one for the PSA. A promotion of the importance of early detection, the PSA was filmed at Jennifer’s house in April.

During her initial assessment, Jennifer observed how the little boy would interact with his surroundings and the people in them. She also figured out his favorite playthings. Meeting with him once a week, she brought her son’s old toy dinosaurs, cars and racetracks. She made obstacle courses out of cardboard tubes the boy’s family collected during the week.

“We’d put words to what we were playing with,” she says. “The goal was to just get him to talk.”

To keep track of progress, Jennifer summarized their sessions in writing for his parents, listing the words and phrases the boy had learned and used, like “horse run,” so his mother and father could see the improvements for themselves. She also modeled for the caregiver how to use play to stimulate his language.

Jennifer would also leave his parents and caregiver resources on different activities to do with him, reminding them to make language simpler when reading to the boy and telling them not to worry too much about the exact words on the page.

“Ask him questions, give him choices,” she advised.

In the few months Jennifer has worked with the child, he has shown substantial improvement. Like other two-year-olds, he is beginning to put words together into short sentences and able to answer simple questions such as “Do you want to play with trucks or dinosaurs today?”

Jennifer has also encouraged the boy’s parents to apply for free services from their county’s early intervention program for infants and toddlers.

Now, the boy is taking on preschool. Though he still has a language delay and some difficulty pronouncing certain words, Jennifer hopes his skills will improve in an environment where he is surrounded by peers and educators who can help foster his development.

And because his parents realized he had a speech disorder early on and quickly sought out speech-language services, he’ll have the tools to grow and continue improving his communication abilities. Jennifer hopes other parents can learn to do the same.

“The earlier you identify a need or a problem, and can provide services and remediate the issue for [your] child, the better,” she says.

Calm in a Noisy World

Everything You Need is in the CCCs: Q&A with ASHA President Elise Davis-McFarland

Audio: Q&A with ASHA-certified SLP Matt Hott

Calm in a Noisy World

The ringing just never goes away.

That’s a complaint Portland, OR-based research audiologist and Veterans Affairs Rehabilitation Research and Development (RR&D) Research Career Scientist Jim Henry has heard time and again in his longtime work with people with tinnitus. The common audiological issue stems from age-related hearing loss, ear injury or a circulatory system disorder, causing patients to perceive nonstop noise or ringing in the ears. It has no cure.

“Many tinnitus sufferers are trapped,” says Jim, who understands well what they are going through because he lives with the disorder, too.

Jim has dedicated himself to uncovering what works best to manage the condition and help patients deal with the emotional stress and isolation it can bring. Because of the devastation and desperation some tinnitus sufferers experience in their everyday lives and relationships, they’re often willing to grasp at any therapy that might provide relief. And that means snake-oil salesmen abound.

“Anyone can claim to be a tinnitus expert,” Jim says, “especially on the internet. They can pretty much do anything and charge anything—there are no standards.”

To lay the groundwork for a baseline of consistent protocols patients could seek out from certified audiologists, Jim has tested a range of audiologic procedures on research participants. He’s conducted numerous randomized controlled trials to evaluate different methods. Two of the trials have involved the use of hearing aids — with and without a built-in sound generator — to determine how they provide relief from tinnitus. Each of these methods and participant responses have helped pinpoint techniques that work, and others that don’t, for diagnosing the level of tinnitus a patient has and recommending the right treatment.

“One big reason for tinnitus research, especially clinical,” Jim says, “is to establish standards so that we’re all doing the same thing and there’s an evidence base for what we’re doing.”

Since 1999, Jim and his colleagues have held support groups at the VA hospital for tinnitus sufferers.

“We try to make these groups informative and helpful,” he says. “We’re not charging them to be there, or asking them to buy anything. Our research has led us to the point where we can be very specific about what we think is most effective and most helpful to patients.”

Everything You Need is in the CCCs: Q&A with ASHA President Elise Davis-McFarland

Elise Davis-McFarland has dedicated her career to supporting children and the vulnerable, as well as professionalizing and promoting the field of speech-language pathology. From a school speech-language pathologist in North Carolina, she rose to oversee South Carolina’s Medicaid program. Later, Davis-McFarland helped develop and head the interdisciplinary graduate communication sciences and disorders program at the Medical University of South Carolina. She’s also taken her expertise overseas, receiving a Rotary Faculty Fellowship to teach speech-language pathology at the Medical University of Southern Africa.

A longtime ASHA volunteer and leader on committees ranging from practice guidelines and ethics to multicultural issues, Davis-McFarland will continue to promote excellence in speech-language pathology and audiology as ASHA’s 2018 president. We recently spoke with her about her views on what members, their patients and students and their employers can gain from the CCCs.

ASHA: What are your thoughts about the value and importance of ASHA certification?

Davis-McFarland: I think it’s very important because it ensures that graduates have a certain level of education and competence based on the courses they’ve taken, as well as the clinical experiences they’ve had. Certified individuals have at least a master’s degree that covers each area of speech-language pathology they’re likely to come across in the real world, like disability and communication disorders that occur at various stages of life.

People who are certified have provided services for people across the lifecycle — infants, children and adults of all ages, including the elderly and diverse populations. Whether that’s diversity of nationality, ethnicity or language proficiency, certified speech-language pathologists and audiologists are provided information, education and clinical experiences that give them the tools to interact with people of all backgrounds. So when an employer hires someone who is certified, they can be sure that person is a professional who has had a wide range of experiences.

ASHA: The certification program recently observed its 65th anniversary. What does that longevity say about ASHA’s commitment to high professional standards and excellence?

Davis-McFarland: ASHA is really dedicated to high professional standards and competence, and I think the fact that certification has continued for so long is truly a testament to that commitment. But we haven’t stood still. The standards for certification have evolved over the years to keep the profession current. For example, we’ve worked with colleges and universities to develop curricula educating graduates about the various disorders as our understanding of those disorders and treatments have changed.

ASHA: What would you say to employers looking to hire an SLP or audiologist?

Davis-McFarland: When you hire an ASHA-certified SLP or audiologist, you can be sure that person has reached a high-level of education and competence. You know you’re getting a lifelong learner, because to maintain the CCCs you have to complete a requisite number of continuing education hours every three years. Certified members also have a professional community of peers and resources they can depend on for current research on evidence-based practice or to answer questions they have about assessment and treatment. 

ASHA: What opportunities do you plan to take advantage of to promote the value of ASHA certification during your term?

Davis-McFarland: ASHA’s Board recently voted to continue the “Value of the CCCs” campaign for at least three more years. That’s a great opportunity to keep promoting the ways certified ASHA professionals improve lives. It’s something I am constantly calling people’s attention to, especially people considering going into the profession. My goal is to highlight the value of being certified. Every opportunity I have to speak with students in speech-language pathology or audiology programs, I talk about the certification, and I’ll continue to do that during my tenure as president and beyond.

Audio: Q&A with ASHA-certified SLP Matt Hott

Headshot of Matt Hott

ASHA: As a radio and TV producer, Matt Hott knew he wanted to do something different that would make a difference somewhere. So after hearing his friends talking about their jobs as speech-language pathologists, it really clicked for him. He would quit his career and go back to school to become an SLP.

So we are joined here with Matt now to discuss his career transition from broadcaster to ASHA-certified SLP, and how his CCCs have helped him throughout his career.

Matt, thanks so much for joining us.

Matt: Thank you so much for having me on.

ASHA: Well we’re really excited to talk to you, and it sounds like you have a really cool story. So first we want to hear a little bit about yourself. I know you started your career in broadcast before deciding to move, to become an SLP. What’s the story behind that? What made you make that transition?

Matt: Yeah, so a little background, I was originally a play-by-play guy for the college baseball team and thought that I fell in love with radio and television. And then I started to do all of the hours in radio and television and felt like I was not fulfilling a destiny or doing something that felt like I was making a difference in anyone’s lives. And one of my anchors, I worked behind the scenes on a TV station, one of my anchors she did speech-language pathology on the side every Saturday. And her and I got to talk and I realized that was the career I wanted to do because I could also work with swallowing, and we have a family history of my sister not being able to swallow when she was born.

So what I did was I called my wife, who was my girlfriend at the time, and said, “Kimmy, I know you’re 10 hours away in Columbus and I’m up here in upstate New York. I’m going to quit my career, I’m going to go back to school to become a speech-language pathologist, I hope I get into grad school. If you want, this is your opportunity to say ‘thank you, but I’ve had a good time with you’ or you can stay with me.” And she did. I made it through Kent State, went to Ohio University for my graduate program and then got my CCCs and now I’m a speech-language pathologist working in the school district in home health care.

ASHA: That’s incredible. A huge change and it’s obvious you had the support of your family, too, which I’m sure is huge. Did you realize as you were going through broadcasting that speech and language was something that you were interested in? It obviously plays a huge role in your career in broadcasting, but did it really click until you started to have those conversations with your coworker?

Matt: Well, funny enough I took a phonetic class when I was in my undergrad because I felt like that would help me on my radio and TV days. Learning how to pronounce words correctly, if I knew how they were phonetically spelled. So I kind of had that background, I had friends in college go off to be SLPs, but it never really clicked until I sat down and talked with my co-worker Naveen. She was just telling me about how she gets to spend Saturdays working with the students and getting them to communicate for the first time. And I think it was right around Christmas time when I was working a double where I worked at the TV station in the morning, the radio station in the afternoon and then the TV station again at night, that I realized that I could be making so much more of a difference.

So, I don’t know if it really was there all the time or if it just kind of clicked, you know, as I was researching at the TV station on Christmas reading about everything that an SLP could do.

ASHA: Got it, got it. And you’re, I’m sure, working with so many people and really feeling that fulfillment you weren’t feeling before. But what are some of the most enjoyable aspects of being an SLP? What is really, truly fulfilling to you?

Matt: Really the most fulfilling part for me is working with my students with multiple handicaps and getting them into a communication device, and getting them to request either a cookie or the swing or go to the bathroom on their own. It’s such a unique, powerful feeling watching a kid gather words for the first time and then use them with meaning.

Other than that I really love working with my home health care patients, as well. Where I could work also with a patient or an adult who was working in a factory and get them back to where they were before; where they were able to call their grandson on the phone or play chess with their daughter and really get them to be able to communicate again at the house.

ASHA: That’s incredible, but I’m sure there’s, too, as you go through that process, there’s some challenging moments along the way, right? That you have to sort of get through, so can you maybe explain one of those moments that has really stuck with you and sort of taught you how to even improve your own work as you move forward.

Matt: Well, I think it’s hard any time that you have to tell a patient or tell a family member that their loved one at this moment in time is at the peak of what they can do. Either that being a student and saying you know, I’m sorry I’m not sure they’ll ever be able to use their voice, but you know here’s a communication device and we’re going to make this their voice. And seeing that disappointment in the family’s face of coming to terms of their new normal.

Or watching an adult who may be able to do math with a calculator or using an Excel spreadsheet or using a line and paper to do their math, but they want to be able to balance their checkbook without any assistance. And helping patients come to a new normal is very difficult because you want them to be able to succeed in the ways that they want to, and it teaches you every time as a therapist that sometimes our goal doesn’t always match up exactly to what the patient’s goal is. And vice versa that their outcomes don’t always match up with what we think that they can do as well.

ASHA: And would you say the CCCs were sort of an integral part in terms of how you go about dealing with that and handling those circumstances?

Matt: Oh, for sure. Knowing that I got my CCCs and I have access, as well being part of the ASHA membership, but I have access to all the journals that I can be on the cusp of evidence of research that I can turn to and say, ‘you know what this is the most recent research that we have in this field and this is why we’re going to go in this direction or why we can’t go any further in this direction just as well either.’ Also, knowing that I can turn to somebody else that has their CCCs as well who may be a little bit more seasoned than I am. To ask them for guidance or assistance as needed as well when dealing with a tough patient or a tough caseload or a tough situation. Those CCCs allow me to know that that person at least has as much of the same background that I do or even more so.

ASHA: So it sounds like obviously you would really encourage any SLP or audiologist to have their CCCs, as well.

Matt: Oh, for sure. I believe that having those CCCs behind my name not only gives me confidence that I know what I’m talking about, but it also allows the patient and the family to truly know that I’m not just somebody who is coming off the street and saying I’m a speech therapist. I’m the speech-language pathologist, I’ve gone through schooling and I know how to find research to help their family member achieve their pinnacle of rehab.

ASHA: Absolutely, that totally makes sense. And you know, taking that type of experience and weaving it into your background in media, as well, how would you go about talking about the importance of the certification to media outlets? And what points do you think are important to convey?

Matt: I think it’s important to tell anybody that’s working in the media that when we talk about something as benign as new research and fluencies, that it’s important to find somebody who is a working speech-language pathologist, who can lead the conversation of why that new research may be flawed. Or why that new research may be the best thing out there. But it’s important that we turn to the professionals that we can rely on to kind of lead that conversation.

ASHA: And it really sounds like it’s that group sort of mentality, where everybody working together and bouncing ideas off of each other that’s really beneficial as well, right?

Matt: Correct, and, if I may, this is also what spurred us to do our weekly show that we do called Speech Science, where myself and three or four other speech-language pathologists all holding our CCCs, we discuss those new stories weekly. We discuss and have interviews with people from the president of ASHA to the researcher at Ohio University leading AAC studies. So really try to get the importance of how research can impact everything that we’re doing and I think that having our CCCs really impacts the way that we are looked upon as being truthful and trying to find the most useful information versus being just a group of people having a conversation about speech and language therapy.

ASHA: Wonderful. Well, Matt, that’s an incredible story and you’re obviously doing some great work. So we really appreciate your time in sharing that story and really encouraging other SLPs and audiologists to have their CCCs and to move forward with teamwork and research and everything.

Matt: Thank you so much.

ASHA: Thank you.

Video: Denise & Emily – Navigator

The Powerful Act of Listening

Video: Pat & Susan – Sparkplug

Video: Denise & Emily – Navigator

The Powerful Act of Listening

To help parents and families identify developmental delay in children early, this speech-language pathologist starts by lending an ear

New Mexico speech-language pathologist Nancy Lewis learned a lot about communications early in her career thanks in part to a serendipitous seating arrangement: Her office in a middle school was located near a large hallway intersection that made it easy to pick up on student conversations and observe what their body language was saying that their words were not.

That kind of listening is a skill that Nancy has deployed for the majority of her career as an SLP who has worked closely with families whose children have developmental disorders and speech-language impairment.

“As SLPs, it’s one of the skill sets we bring to the table that’s often overlooked,” she says.

In order to craft realistic and usable plans, Nancy does more than just hear out her students — she interprets their needs. That allows her to identify underlying issues and craft treatment plans that can be easily incorporated into families’ daily lives.

Now, her rich expertise in communication is having a broader impact.

Nancy is the Act Early Ambassador to New Mexico, appointed by the Centers for Disease Control and Prevention (CDC) and serving through the University of New Mexico School of Medicine. In this role, she helps promote collaboration among early childhood stakeholders in her state to improve systems of early identification of developmental delay and linkage to services as needed.

Her role once again involves a lot of listening — to how families learn about developmental milestones, what they know about signs of delays, and what they say their children’s needs are.

“According to a national survey, only about 30 percent of parents have said their primary care physician has administered a standardized developmental screening for their children within the last 12 months,” she says.

Those screenings probe how children are meeting certain milestones in how they play, learn, speak, act and move between birth and age five, and help inform parents what to look for and what to do if they have concerns. The CDC’s Learn the Signs. Act Early. campaign provides useful materials, along with a new app, to make it easier for parents to track their child’s development.

To help families communicate with physicians and other service providers, Nancy and her team are interviewing families who have children with developmental disorders to understand their journey to seek assistance. Employing that often-overlooked skill set, they approach each family “not as clinicians, but as listeners,” she says. They ask “about life with their child and the conditions that support family engagement.”

That kind of direct communication — and interpreting — is empowering, Nancy notes. It allows families to become advocates for changing how systems, such as administered developmental screenings, help them.

“SLPs and audiologists can play a key role in this work,” she says. The first step is being a good listener.

Video: Pat & Susan – Sparkplug

A Voice for the Voiceless

ASHA Certification is 65 Years Old. See How It’s Changed with the Times.

Speaking Their Language – Helping Individuals with Autism Develop Social Skills

A Voice for the Voiceless

How one speech-language pathologist is speaking up for her patients to try to get them the treatment they deserve

Starr Cookman is a speech-language pathologist by training, but her role has come to encompass so much more. “I become many things to my patients,” she says. “Sometimes a resource and a teacher, but more times than not, a counselor or adviser.”

Most recently, she’s added a new role to that list: Advocate.

When a patient that Starr’s team had successfully treated for muscle tension dysphonia — or, vocal cord spasms — was denied payment for the treatment by her insurance company, Starr found that her calling to give a voice to the voiceless took on new meaning. She became determined to speak up for her patient.

The insurance company had agreed to pay for the treatment, Starr explained, but when the bills arrived, the company balked, and Starr discovered the code was divided into two bulletins, which made it slightly misleading.

“That really bothered me,” she says. “It felt like a bait and switch, it felt illegal and wrong.”

Though not always the case, as some insurance companies do cover these services, Starr realized changes needed to be made. She scoured the provider’s bulletins, highlighted misleading language and noted what she described as cherry picking of research. Then she provided the company with signed letters and pages of references.

Starr is not sure if these objections made it through to decision-makers, but they did impact her. The experience transformed Starr into a dogged advocate for her patients who works closely and effectively with her colleagues to get the best outcome.

Now, Starr tries to stay knowledgeable about the current policies her clinic’s insurance providers have, and is able to give guidance to her patients during the appeal process. Furthermore, she always appeals insurance decisions at the state level to give patients a better chance at winning their case. Harnessing the advocacy support that ASHA provides, Starr works together with her peers and support staff to streamline the appeals process as much as possible.

In her line of work, Starr understands the importance of having a voice. “When a chronic voice problem comes into play — a chronic inability to sound like you, a fatigue and an effort every time you go to talk — the voice becomes this all-important, overarching problem and people are overwhelmed by the disability and discomfort,” she says.

Helping people recover that voice is part of what drew Starr to her calling as a speech-language pathologist. Now, as an advocate, she does more than heal her patients’ voices — she helps them speak out.

ASHA Certification is 65 Years Old. See How It’s Changed with the Times.

Speaking Their Language – Helping Individuals with Autism Develop Social Skills

ASHA-certified speech language pathologist Emily Kinsler helps students learn valuable life skills by venturing outside the classroom to explore the world and their passions

As a speech language pathologist and Coordinator of Countywide Services in Howard County, Maryland, Emily Kinsler knows some lessons don’t come from a textbook. She came to that realization early in her career while running social skills groups for adolescents on the autism spectrum who had trouble communicating verbally. Whenever she worked with them on how to interact socially, classroom time always seemed too short. She needed more hours in the week to help them gain valuable skills for communicating, making friends, and finding jobs.

She also believed that by observing students in settings that resembled their lives outside of school, she and other educators would be able to better understand how to boost each student’s social skills. Students could benefit from the real-life settings, too.

“There is some level of appropriate behavior when we are out in the community and interacting with others,” says Emily. “So being able to talk about and see what is appropriate in regular conversations and why it’s appropriate makes students more independent.”

With permission from parents, Emily created the Leisure Time Activity Group. Students and some of Emily’s friends whom she had managed to recruit as chaperones hopped in the school van one Saturday a month and went to bowling allies, corn mazes, arcades, baseball games, lunch spots and museums. Often, the students gave input on where they wanted to go.

Over the course of the program’s two-year run, the impact was significant and clear. Emily remembers one particular student who knew all about fires and fire prevention. A trip to a Rockville, Maryland fire station gave him the chance to come out of his shell.

“He was just so excited,” Emily says. “They were speaking his language.”

Throughout the experience, the student was just a regular kid — because of the practice he’d had on the monthly outings and his passion for the topic at hand. People talking to him might not have known he was on the autism spectrum or had any difficulty speaking and interacting with others, Emily says.

“People spend a lot of time making connections with each other, and these kids have a weakness in their ability to do that” Emily says. “By giving them a chance to work on it in a natural setting, we give them more opportunities to see what’s out there and what they’re capable of doing.”

Creativity at Work: How an ASHA-certified SLP Inspires Patients with the Arts

Finding Patients’ Stories to Pinpoint the Right Treatment

Going the Extra Mile: Q&A with School Principal and CCC-SLP Denise Lancaster

Creativity at Work: How an ASHA-certified SLP Inspires Patients with the Arts

Speech-language pathologist Dr. Fred DiCarlo, assistant professor and clinical supervisor at Nova Southeastern University (NSU) in Fort Lauderdale, Florida, draws on the arts to enhance communication skills and inspire new confidence in clients and patients with speech-language disabilities. 

“Quite often, when someone loses the ability to communicate, they become invisible,” observes Fred. “But when you give them an outlet that allows them to express themselves another way, people look at them in a different light.”

Fred works every day to inject a sense of creativity into the lives of his clients, most of whom have aphasia or Parkinson’s disease, and his speech-language-pathology graduate student clinicians. His lifelong passion for the arts motivated him to earn an undergraduate minor in theatre and dance, and he knows how the arts can increase social interactions and instill confidence and self-esteem.

“I think it’s really on the clinician to be creative when developing treatment plans that foster communication and engage clients,” he says. “That’s why I try and pull from the creative components of music, art and acting to motivate my clients to interact.”

When it comes to using the arts to treat his clients, Fred considers these events most memorable:

Introducing the Parkinson’s Players

To give some of his Parkinson’s clients the opportunity to tell their stories comfortably, Fred invited them to compose and later perform dramatic monologues that described their experiences with their disability. The idea came to him as an ode to the Vagina Monologues, an off-Broadway play in New York that tells individual stories of the” feminine experience”. The play inspired Fred to present monologues that instead would show the “Parkinson’s experience.”

The result was The Parkinson’s Players, a group of adults who participated in a weekly support and treatment group at NSU that not only helped them deal with their struggles with speech and language, but also turned them into actors with a capital A. By the time the players stood on the university stage and delivered their soliloquies to a 150-person audience, they were speaking with a clarity, conviction and confidence Fred always knew would surface if they had a more creative platform to express themselves.

… And the Aphasia Dancers

Several years later, when Fred became actively involved with an aphasia group at NSU in 2015, he found out two of his aphasia clients were ballroom dancers who came to life on the dance floor. Aphasia is a communication disorder that results from damage to the parts of the brain that contain speech and language, making it very difficult for individuals to communicate and engage with others.

It struck Fred that learning the waltz and foxtrot could nudge other aphasic clients out of their shells, too, and move them to interact and talk to others. When his clients agreed to give it a go, the “Dancing with the Aphasia Group Stars” show was born.

Over the course of a semester, Fred’s seasoned ballroom-dancer aphasic clients taught others the steps while he and his graduate student clinicians planned an event modeled on the Dancing with the Stars TV show. While they learned to dance, the clients followed specific instructions and used words tailored to their needs.

In the end, more than 50 people attended, from faculty members and students to clients and their families. After the dancing, the judging (by two speech-language pathologists and an occupational therapist) and the awarding of winners’ trophies, one patient’s spouse stood up to share her ultimate praise for the show and care received by her and her husband.

“Dr. DiCarlo, students, NSU, you changed our lives. You make every day worth getting up for. Now my husband is talking more and is more engaged.”

The effort proved so successful colleagues in Fred’s department have come to look to him for ways to inspire clients’ communication skills through creativity. He hopes his artistic movement in future therapeutic projects will continue and include those from other disciplines to foster inter-professional education and practice at NSU.

“It’s been a chain reaction ever since that show happened in December of 2016,” he says. “My plan now is to, at least once a year, have some artistic project that will showcase the students, the clients and NSU.”

Finding Patients’ Stories to Pinpoint the Right Treatment

ASHA-certified audiologist Julie Martinez Verhoff says a team approach helps her get to know patients and find the right treatment for each

Julie Martinez Verhoff thinks of herself as not just an audiologist, but also a listener and a coaxer of stories.

“All of the kids I work with have some story,” says Julie, who in March 2017 became director of pediatric audiology at Joe DiMaggio Children’s Hospital in Hollywood, Florida. “No child just has hearing loss.”

Stories, in other words, give a picture of the whole child. And understanding a child’s story, Julie says, requires multiple points of view. Previously, she was director of audiology at The River School in Washington, D.C., an infant through third grade independent school that includes children with hearing loss in every classroom. In that role, Julie served on a team of occupational therapists, audiologists, speech language pathologists, educators and psychologists.

“I’m not sure I could have done my job unless we had each other and each other’s expertise,” she says. “If I worked with a parent and heard something that sounded like a red flag, I could walk down the hall and talk to someone about it. I rely on getting second opinions from professionals who know more about a subject than I do.”

For each child with hearing and language disabilities, Julie and her team pieced together a narrative that enabled them to ensure students got exactly the treatment they needed, with parents actively engaged in the process.

Bundle of Issues

One 18-month-old child had difficulty with balance, speech and language development because of hearing loss caused by meningitis. Julie and her team knew immediately where to start. They observed how the child interacted with the surrounding world through each of the five senses. Then they observed, tested and treated the child to improve function and performance.

They came away with a story whose progression toward a solution involved the whole family. The parents soon enrolled in a 16-week parent-child interaction therapy course, in which psychologists coach parents on communicating with their kids. Because parents who have children with disabilities tend to treat and talk to them differently, it’s important to help guide those relationships and that language and support the family as best as possible, Julie says.

A Wrong Fit Righted

Another child, four years old at the time, wore a loaner hearing aid that didn’t work consistently — and that she didn’t want to wear. The child’s mother said she tried to get attention in dangerous ways, like unbuckling the car seat belt and running onto the road. The family’s finances were tight, which explained why the hearing aid was on loan and hadn’t been replaced. Furthermore, the parents were overwhelmed and the mother needed support and guidance.

Julie and her team devised a solution that combined tactics for managing the girl’s behavior and helping her hear consistently. Drawing on each person’s expertise, Julie managed to weave together a care approach that more properly framed the child’s diagnosis and subsequent treatment.

“Every story is important,” Julie says. “And every story can have a happy resolution that sets children and families up for a positive future.”

Going the Extra Mile: Q&A with School Principal and CCC-SLP Denise Lancaster

As principal of Deep Run Elementary School in Howard County, Maryland, Denise Lancaster knows what it means to serve all children from preschool through 5th grade. And she also has a hidden advantage: she’s an ASHA-certified speech-language pathologist (SLP) with an intimate understanding of what is involved in supporting Deep Run’s students with autism and learning disabilities. Because Denise has been in her colleagues’ shoes and knows how well their certification education and training have prepared them, she highly values her team of three ASHA-certified SLPs.

We sat down with Denise to discuss the benefits of employing ASHA-certified SLPs and the positive impact they have in schools.

ASHA: Why do you think ASHA-certified SLPs are a top choice for the classroom?

Denise: There is a high level of professionalism that comes from so many parts of what is required to become a certified speech-language pathologist. Included in the required coursework are ethics courses, science courses, statistics and a clinical fellowship year when you are working under the supervision of a certified speech-language pathologist to make sure you are correctly applying what you learned.  Then, there is the national exam to pass.

There are so many levels of competence one has to show in order to not only earn one’s Certificate of Clinical Competence, but also maintain it. In this county almost every speech-language pathologist is certified. So principals always know the SLPs they hire have had the training, coursework and practicum hours to effectively address the needs of students.

ASHA: What role do ASHA-certified SLPs play at Deep Run?

Denise: SLPs are valued members of the special education team servicing students from preschool through fifth grade.  They assess and provide valuable input in determining educational disabilities. The SLPs provide direct therapy services to students in and out of the classroom setting. If teachers have students who are not making expected progress, teachers can seek support from a problem solving team. I make sure we have an SLP as a member of this team because they have expertise in language acquisition and knowledge of the foundations for reading development. In that role, the SLP in the building is providing and sharing her expertise and offering consultation to teachers in addition to providing direct therapy hours.

ASHA: What impact have they had on children?

Denise: One of my biggest examples comes from a kindergartener with autism who came to the school this year. He’s a dual-language learner, Spanish at home and English at school. He didn’t have an effective way to communicate, which really impacted his behavior. His needs weren’t being met because he couldn’t communicate them.

Now, thanks to one of our SLPs, she created a low-tech communication system with pictures that he can reference. As he became proficient using pictures to communicate his needs, we began to see a decline in his bad behavior and an increase in his interaction with his peers. Providing him with a communication system he is able to use, as well as training all of the adults involved, has made a huge difference in his success in school. His parents were also trained so now he has an effective communication for the home environment.