Richmond Community Schools Faces “Critical Shortage” of SLPs

Just days before school started, the Richmond Community Schools realized they had a “critical shortage” of speech language pathologists (SLPs) and reassigned one of their middle school principals to serve as a SLP instead. According to pal-item.com, this Indiana school district serves 5,463 students in total and now has six full-time SLPs.

 

The former principal, Kathy McCarty, will carry a caseload of 70 to 75 students, serving on evaluation teams, making medical referrals and performing speech/language screenings at district schools.

 

Speech language pathologists continue to be in high demand and short supply. Graduate education is mandated for certification by the Council for Clinical Certification (CFCC) of American Speech-Language-Hearing Association (ASHA). A graduate degree, clinical experience and a national exam are all part of the demanding qualification process.

 

How can schools overcome this ongoing shortage? More and more districts are turning to live online speech therapy services such as those provided by PresenceLearning (presencelearning.com). PresenceLearning has built a nationwide network of fully qualified speech language pathologists, enabling districts to access desperately needed SLPs to serve their students “virtually”, stay in legal compliance and save money in the process. By breaking down the geographic barriers to accessing qualified SLPs, PresenceLearning can help all school districts meet the needs of students with speech/language issues.

PresenceLearning Partners with Amprey and Associates to Broaden Awareness of Telepractice Services for Schools

PresenceLearning, the premiere provider of live online speech therapy to K12 students, announced that it has partnered with Amprey and Associates, a leading provider of change management consulting and leadership development services to large school districts nationwide, to help broaden awareness of the company’s services to education. This partnership will help large school districts realize the substantial cost-savings and improved outcomes offered by incorporating live online speech therapy often referred to as telepractice into their special education programs.

“Drawing on his decades of experience as a superintendent in challenging school districts such as the Baltimore City Public Schools, Walter Amprey helps districts find ways to innovate, produce better results and use district resources ever more effectively,” said Clay Whitehead, one of the founders of PresenceLearning. “Amprey and Associates will help us reach students who have communication issues and need our services to learn and thrive.”

“This agreement continues our effort to bring about change through highly-effective partnerships between school districts and businesses,” said Dr. Walter Amprey, founder and president of Amprey and Associates. “We are delighted to have PresenceLearning as one of our selected partners and feel they provide exceptional and effective solutions to school districts nationwide.”

PresenceLearning delivers live online speech therapy using a large and growing network of fully credentialed speech language pathologists (SLPs).  SLPs work with students face-to-face in real time via live videoconferencing sessions using established, evidence-based therapeutic practices without the scheduling and geographic limitations of conventional therapy. SLPs work flexible hours from home without having to travel, taking advantage of PresenceLearning’s scheduling, tracking and reporting tools, as well as its unique suite of interactive activities that make the therapy experience highly-engaging.

Presence TeleCare Changes Name to PresenceLearning to Better Reflect their Focus on Education

Presence TeleCare, the leading provider of live online speech therapy services to K-12 students, announced today that it has changed its name to PresenceLearning (PresenceLearning.com).

“This new name highlights our broad commitment to special education and the growing acceptance of our live online speech therapy solution in school systems across the country,” said Jack Lynch and Clay Whitehead, co-founders of PresenceLearning. “From traditional public school districts to virtual and charter school organizations, educational administrators are discovering that PresenceLearning helps them reach more students with consistent, high-quality speech therapy at lower costs.”

Over the past year, PresenceLearning’s online therapy services have been adopted by a growing number of educational organizations, including dozens of traditional school districts and many virtual academy and charter school management groups. To date, PresenceLearning has delivered more than 10,000 speech therapy sessions, and is expected to exceed 20,000 sessions in the coming months. In the face of continuing budget challenges, as well as chronic shortages of speech language pathologists in many areas, school districts are realizing significant cost savings with PresenceLearning while also seeing better outcomes for their students.

Mike McLaughlin, superintendent of the highly-diverse John Swett Unified School District near San Francisco, CA, has relied on PresenceLearning for the past two years to address a chronic shortage of speech therapists in his district. “It’s a great service,” he said. “We’re seeing real financial benefits—PresenceLearning is saving the school district money. I really think it’s the future of support services for students.”

New Report on Educational Progress for LD Students

Report Finds Progress, Problems for Students With Learning Disabilities

An Education Week blog On Special Education, by reporter Nirvi Shah

“A new report from the National Center for Learning Disabilities says too few students with learning disabilities graduate from high school, and some racial and ethnic groups are still disproportionately represented in LD programs, but early intervention strategies appear to be reducing the overall number of students who are identified as having a learning disability.”

Weak synchronization in toddler brains may be a biological marker for autism

A finding that ties weak synchronization in brain activity to autism could lead to earlier diagnosis of the disorder.

ScienceDaily (July 27, 2011) — “The biological causes of autism are still not understood. A diagnosis of autism is only possible after ages three or four; and the tests are subjective, based on behavioral symptoms. Now, in research that appeared in Neuron, scientists at the Weizmann Institute of Science, Carnegie Mellon University and the University of California, San Diego have found, for the first time, a method that can accurately identify a biological sign of autism in very young toddlers.”

Weizmann Institute of Science (2011, July 27). Weak synchronization in toddler brains may be a biological marker for autism. ScienceDaily.

What I Learned at CSHA

2011 CSHA Conference

This post is by Presence TeleCare’s Chief Clinical Officer, Melissa Jakubowitz.

I just returned from CSHA’s annual convention in Los Angeles. There was great turnout and an incredible amount of energy flowing in the beautiful old Biltmore Hotel. I enjoyed reconnecting with friends and colleagues, and was really encouraged by the positive response to my presentation on telepractice.

Since I was asked several questions about client selection, I want to emphasize that telepractice sessions are not appropriate for all clients. After all, SLPs never have a “one size fits all” program for all clients with a specific disorder or disability. As clinicians, we must use all available information to determine which approach or therapeutic techniques will work best for each particular client. We consider everything from the client’s goals and values to the clinical evidence before us in planning an appropriate strategy. The same is true for telepractice.

There are a number of areas that must be addressed in order to determine client candidacy for telepractice. ASHA has issued a Technical Report and a Knowledge and Skills document that addresses these issues (available at www.asha.org/telepractice).

The client’s physical and sensory issues must be carefully considered:

  • Can the client sit and attend to the SLP on the computer for an appropriate length of time?
  • Are there sensory issues that may affect the client’s ability to use headphones?
  • Does the client need consistent sensory feedback from the remote SLP and is this possible or are there alternatives?

Cognition and behavioral issues should also be addressed:

  • Does the client’s cognitive, hearing, and visual ability support their participation in a telepractice session?
  • Is the client able to sit in front of a computer monitor with and without behavioral support?
  • What is the client’s manual dexterity for using the keyboard and/or mouse?
  • What is the client’s ability to follow directions?

Other questions to consider include:

  • What are the cultural and linguistic considerations for the family?
  • Does their internet network support appropriate upload and download speeds?
  • Are they comfortable with technology?
  • Are there support services available—either a paraprofessional or a family member?

These are just a few of the questions that each SLP should think about in determining whether a particular client will benefit from telepractice. While this may appear time consuming, it is exciting to know that we can place SLPs anywhere the internet is available, including many places where clients might not otherwise be served.

The excitement and buzz around telepractice is growing rapidly. It keeps me energized about my work and excited about the daily challenges that come my way.  Looking forward to seeing you again at the next conference!

Interview with Ellen Estomin

Ellen Estomin, former Special Education Director of Pittsburg Public Schools, recently spoke with us to share her perspective on telepractice.  Read on for the full interview below:

What excites you about telepractice?
I think it opens an avenue that we haven’t explored before when we are talking about not being able to find someone on site. As a special education director, and as a former administrator for speech and language programs, I would definitely consider telepractice for positions when I could not find anyone. I would use it for substitutes, as well as full-time positions, in case I can’t find anyone.

How would you explain telepractice?
Telepractice is when services are delivered by a certified professional, but the person is not located on site. I would make the analogy to telemedicine in that both give you access to service through technology.

What would you tell speech therapists about telepractice?
It’s an option that they may never have considered before, can provide services without having to travel, and can be provided from home. The field of speech and language pathology has so many options and this just opens up another.

What would you tell special education directors about telepractice?
When they are unable to fill positions because of shortages, for medical leave or any other reason, then this gives them another option. I would also tell them that this is through technology and to make sure that they have the equipment hardware and software that they need. Certainly, given the shortages in SLP availability, it gives SPED Directors another option to make sure that services are provided.

Last question:
There are some things that schools need to consider. For example, who is going to be with the student?  Schools will need someone to escort students to sessions and to monitor behavior while the student is participating in the session. They also have to figure out a way to connect the telepractice SLP with general education, special education, and parents.

An Unexpected Success

BRISTOL, UNITED KINGDOM - FEBRUARY 24: A scho...
Image by Getty Images via @daylife

At the end of the school year, professionals working in education often recount their successes. Oh sure, we have the usual student “graduations” from Speech, a new school assignment,  a hard-won new or improved employee benefit, or maybe even an expanded supplies budget. As long and as hard as I searched through my various sources, though, I just couldn’t find a report similar to one of my most prized successes, parental anger and derision for a job well-done.

My original success story unfolded in a medical setting – a TBI rehabilitation unit. A popular high school sophomore, actively courted by several prestigious universities for his athletic prowess, sustained life-threatening injuries in an accident with a Highway Department snow plow during a blizzard. Comatose for six weeks, a dedicated, organized and skilled treatment team worked diligently to create a new life for Tory and his courageous family whose entire lives were changed in an instant.

But as progress slowed and inpatient care came to an end, Tory still looked different, walked with an unsteady gait, and processed information at a kindergarten level. It was painfully clear to the family that the service team would not return Tory to his prior state of great expectations. It was at this juncture that the family’s grief manifested as anger toward those who failed to reverse the multiple and debilitating effects of his injuries. Though we did the best we knew to do, we just had not met the family’s expectations – we had not answered their most fervent prayers.  The upside to the situation was sharing the experience with my colleagues, all of whom verbalized a conviction that we had served our patient and his family with the utmost professionalism.

But I faced the most recent circumstance with no such loyal and collegial support.

Brittany, a bright, creative 2nd grade student being served in an educational setting, was dubiously identified as suffering from Reactive Attachment Disorder by the age of two. Sadly, Brittany’s adoptive parents were counseled to follow a verbally confrontational and physically coercive treatment regime that has been denounced by all leading medical associations, which they did with vigor and commitment.  Once enrolled in the local school, a timid and ill-informed school team cow-towed to the unusual demands of the parents for unprecedented services and accommodations for Brittany who, quite strangely, was categorized as brain-injured.

Oh, had I known the true folly of contradicting control and fear with reason and evidence!

In both described situations, the emotional discomfort yielded an unexpected sense of success and a renewed commitment to render the best evidence-based, professional service. Our work is a discipline: we do the right thing to do for the right reason. We don’t work to achieve an emotional response.

Have you ever experienced an unexpected success?

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Changing your lot in life: 4 suggestions to impact caseload size

In our first post on caseload manageability, as proposed by Katz, et al (citation below) in a recent article in Language, Speech, and Hearing Services in the Schools, we discussed the identified factors that impact one’s perceptions of her caseload size and those that contribute to job satisfaction. The authors also shared several proposals  to impose some controls on an unrelenting work situation.

Response to Intervention (RTI) – While RTI is in the early stages of implementation, it holds promise for SLPs, especially those with unreasonable caseload sizes. RTI allows special education professionals to use their knowledge and expertise working with students and teachers not only in remediation, but also with prevention in mind.

Negotiate caseload/workload issues with school administrators - Document job responsibilities and share results from the Katz, et al, study and others related to SLP job satisfaction and burnout with your most insightful administrator. Inform administrators about the significant relationship between caseload size and perceived caseload manageability. Doing so might help SLPs make a case for expanded discipline-specific service and time to complete other workload demands in lieu of unskilled responsibilities such as lunch or bus duties.

Inform administrators on the benefits and limitations of team collaboration – Mandated classroom collaboration could impact SLPs’ perceptions of caseload manageability. If an SLP is finding collaboration to be a particularly difficult endeavor in his or her school, based on substantial resistance among teachers, more reasonable and more familiar service options, such as more pullout services, could be proposed.

Alternately, SLPs could lobby for administrators to lend visible support for classroom collaboration by allotting time in SLPs’ and teachers’ schedules for planning meaningful and effective collaboration as well as supporting and encouraging SLPs’ efforts to participate in continuing education in how to create and maintain fulfilling collaborative relationships.

What could you add to the list of proactive solutions to merely succumbing to being perpetually overwhelmed? What has worked for you and your team mates in your district? We’d love to know. Please share!

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Katz LA, Maag A, Fallon KA, Blenkarn K, Smith MK. (2010). What makes a caseload (un)manageable? School-based speech-language pathologists speak. Language Speech and Hearing Services in the Schools, 41(2), 139-151.

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Caseload manageability and job satisfaction: Comments from the field

In an earlier post, we looked at research presented by Lauren Katz, et al, “What makes a caseload (un)manageable? School-based speech-language pathologists speak” (complete citation follows below), a discussion of the variables impacting a speech pathologist’s perception of the manageability of his caseload. Variables were divided into three (3) distinct categories:

  • demographics: who was more likely to feel like she was managing things well and enjoy a sense of job well-done;
  • job-setting: where one is more likely to perceive the ability to manage his caseload; and
  • job characteristics: team and time factors supporting job satisfaction.

Several of my colleagues responded to an invitation to comment on the research presented.

Eric, Director of Special Education (WI): Our team of four SLPs work together to organize the caseloads and work demands. We meet monthly to discuss issues and concerns, with the SLPs proposing the most reasonable options for dealing with the situation. We have two unfilled positions, but our Speech team makes the best of the challenges by actively supporting each other.

Gin, Speech Pathologist (IA): I’m nearing the end of my career in the schools. In my last assignment, no one got along. No matter what you did, it was never enough. Then my supervisor proposed a new assignment and I jumped at the opportunity. I love my new school. The parents are supportive and involved, and I have a chance to use my skills with a community grateful to have a speech pathologist back in the district.

Name withheld by request, Speech Pathologist (MN): As a private practitioner, I provide part-time service in both large and small districts. The larger districts seem to have a more “even” coordination of special education activities. Some of the smaller rural districts seem to be a bit more idiosyncratic. I was considered an “outsider” longer in the rural districts but once I was “in”, I was good to go.

Michelle, a new grad doing her CFY in a small town (MN): I don’t have any contact with the part-time SLP at the high school who’s been there a long time. We never meet to discuss what we do. The special education teachers send the LD kids down to my room and tell me I need to help them complete their worksheets or their homework. XXXX (the Special Education Director) stops by and answers some of my questions but I have so many of them! On top of it all, my husband’s ex- has been a real pain lately! I’m really stressed out.

While my colleagues report a range of experiences, interpersonal relationships seem to hold great value to each. It appears that even when work conditions are difficult or challenging, if you work with professionals who support you in explicit and ongoing ways, a speech pathologist could feel that the situation is almost quite manageable! Without that support, life can be miserable.

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Katz LA, Maag A, Fallon KA, Blenkarn K, Smith MK. (2010). What makes a caseload (un)manageable? School-based speech-language pathologists speak. Language Speech and Hearing Services in the Schools, 41(2), 139-151.

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