Speech Sound Solutions: Managing Your Articulation/Phonology Caseload by Using Efficient Treatment Practices

  This text-based course is a written transcript of recorded course, “Speech Sound Solutions: Managing Your Articulation/Phonology Caseload by Using Efficient Treatment Practices”, presented by Teresa Farnham on August 18, 2011.   Communication access realtime translation (cart) is provided in order to facilitate communication accessibility and may not be totally verbatim. The consumer should check with the moderator for any clarifications of the material.   >> Amy Natho:  Welcome to “Speech Sound Solutions: Managing Your Articulation/Phonology Caseload Using Efficient Treatment Practices.”  My name is Amy Natho and I'll be moderating today.  At this time it is my great pleasure to introduce Teresa Farnham.  Teresa has more than 30 years of experience working with children and adults with Communication Disorders as a speech-language pathologist, speech pathology supervisor, and assistive technology consultant.  She has experience in both the Private sector and public education, and is currently a speech-language pathologist for the Mount Vernon Ohio City Schools.  Teresa has served as ASHA SEAL from Ohio, co-chair of the OSSPEAC Conference, and is President of OSSPEAC for the 2011 to 2012 term.  She has presented at the regional, state, and national level on assistive technology, language and literacy, and best practices in speech-language pathology.  Please join me in welcoming Teresa Farnham.  We’re very glad to have you here today, Teresa. (Applause)   >> Teresa Farnham:  Thank you, that thunder of applause is always impressive.  I'm happy that all of you are joining us today.  I'm assuming you are joining us because this is a big area of concern and you desire to become better acquainted with what effective practices are in something that really dominates our profession, particularly in the school-based setting.  I will be largely addressing the school-based setting, but the practices certainly apply across the board.    The Challenges The challenges that we face in the area of speech sounds are, first of all, students with speech sound disorders are nearly half of our median caseload according to ASHA's surveys, and 91% of school SLPs serve them.   Our second challenge is to face that half of our caseload by finding and using evidence based methodologies.  The third challenge would be to implement Response to Intervention (RtI).  Those of you who are in the school setting know that's a big part of the last reauthorization of the Individuals with Disabilities Education Act (IDEA), and it's a challenge to do that in our profession if, as often happens here in Ohio, we're the only person providing services.  We don't have speech assistants, and anything in this realm falls under our umbrella for licensure, so how do you do Response to Intervention in a way that doesn't make more work?  A big challenge always – especially for those of us who have been in the profession for a long time and remember the days before we had to document adverse educational effects for students with speech sound disorders – is avoiding the Statute of Liberty Effect.  That is, “Give me your tired, your poor,” taking on everybody in the school who might need some help.  I have a first grade teacher in my building and I know which students from kindergarten she's going to be calling me about.  We met about the class list yesterday.  Since she doesn't know the students yet but I do, I can bet who is going to be a referral. I think sometimes she does view me as that port into the land of the free and the home of the brave, and accomplishing everything that needs to be accomplished for children.  We can't do that.  We have to look at adverse educational effects in the educational setting.  Our next challenge is to then schedule efficiently and effectively.    How can we meet all these challenges? So how can we do all this?  We're going to address some of these one at a time and then roll them all together.  When I was asked to do this presentation, it was in response to a presentation I did with Nancy Craighead last year addressing phonology disorders in very young children more efficiently and effectively. We are going to talk about that today, but we’ll be addressing things more broadly, because our request was to take it  beyond those very young children, primarily kindergarteners and preschoolers, to what to do in the school-based setting for older children.  We'll talk about that in a moment.    The first challenge, though, is that those students with speech sound disorders constitute nearly half of our caseload.  On my caseload this year, I have fifty-five students as of yesterday with move-ins and move-outs, from kindergarten through fifth grade, with all degrees of disability from very severe cognitive disabilities to children with mild speech sound disorders.  Twenty-nine of those fifty-five have speech sound disorders.  Fourteen of those twenty-nine have language impairments as well.  There are six at kindergarten, twelve at first, and then three at each of the other grades: second, third, fourth and fifth.  The ones at fifth grade I'm hoping are going to come back cleaned up when we see them next week for the first time, but that's a lot of students, twenty-nine out of fifty-five.    The good news is that if I make a change in this area, it will have a significant impact on my workload day to day.  If I can see these students more effectively, if I can schedule more carefully and provide services that specifically address the needs of each student in the best possible way, it is going to have a huge impact on how much work I have to do on a week-to-week basis and how many students are actually on my caseload.    The bad news is that we're all really comfortable with speech sound disorders and how we've done them for years.  I've had a share of students over the years, and even they are rather reluctant to let go of the practices that they have very limited experience with, because they're comfortable.  I'm hoping today that I can challenge you to break out of the mold and try some new approaches particularly to addressing phonology...