Monday, December 01, 2008

Professional collaboration and referrals

Notes from NSSLHA meeting, 11-17-08
Guest speaker: Dr. Maryann Abbott

CCS (California Children’s Services) provides medical, OT and PT services for children aged birth to 21, as well as durable medical equipment, with Medi-Cal dollars. Doctors who identify children with physical impairments should refer to CCS. They cover equipment such as wheelchairs, bath chairs, splints, braces, and communication devices. CCS needs SLP referral for communication devices, as well as written permission from doctors. SLP must refer with proof of medical necessity. CCS covers medical aspects—e.g. helping children to walk. The OT/PT at school provides services for access to the curriculum, so the eligibility is a little different than CCS eligibility. A student may potentially be eligible for one (CCS or school services) but not the other. OT’s, PT’s, doctors and case workers work for CCS, so they need to go through a private SLP, a non-public agency or a school to get speech-language reports.

The Regional Center is state funded. Depending on where you live, you are covered by a separate Regional Center. Each is a separate entity and may provide different services. Anyone can refer to the Regional Center for disabilities birth to 3. After the age of 3, services are taken up by the school district. If there is a cognitive or physical impairment, the Regional Center services are life-long. They provide services that are mostly related to daily living, such as diapering. They may cover respite care. They also pay for one conference a year for parents to go to, and after-school activities such as swimming lessons. This may even include transportation.

If a child has a disability, we have to go through CCS, which uses MediCal dollars, to get something like a communication device. If a student has either aged out of CCS or is not eligible for other reasons (e.g., undocumented) the Regional Center may provide services. Neither of these services employs SLP’s directly. It’s great to collaborate with specialists from the Regional Center (e.g., behaviorists) if possible, and have them come to the IEP meetings.

Low incidence disabilities includes: severe orthopedic, vision and hearing impairments. Some federal money is allotted for these students, so larger school districts may be able to purchase devices for these students. For students with autism, we may need to depend more on MediCal dollars or private insurance to cover communication devices. This works the same way as going to the doctor, including co-pay, deductible, and whatever else isn’t covered by insurance (e.g., 20% of cost).

Referrals: We might refer to OT’s if students are having trouble forming letters but can spell. Young children should be sitting independently by 6-7 months. Some children crawl late. Most children are beginning to walk by 12-15 months. Young children rake things in that they want, then use palmer grasp, then pincer grasp. Many children don’t get a hand dominance until the age of 5 or 6 years. There are some good developmental milestones online, but look at the Department of Health, National Institute of Health, or another reputable source. With autism there are usually referrals to OT for sensory integration or motor planning. However, some problems may be due more to attentional problems or sensory overload. Attention spans should be your developmental age, minus one (e.g., four minutes for the age of five), and it is also affected by interest level. If OT’s try something with them but it doesn’t make a difference for their attentional level, it’s probably not a sensory integration issue.

Make sure that you keep within your realm of practice and expertise. If we don’t, we breach ethics and may lose our license. OT’s work on tasks that require physical manipulation, motor planning or sensory integration. In the schools, it’s OT’s (not SLP’s) who provide swallowing services. Physical therapists work on range of motion. On a school campus, they may look at whether students can travel over different kinds of terrain and keep their balance, or whether they need equipment such as walkers or helmets.

Tuesday, November 25, 2008

Alumni Spotlight: Kristin Reisch, MA, CCC-SLP, Class of 2007

(full article)

1. Where do you work, and how long have you been there?
I work at Presbyterian Intercommunity Hospital (PIH). I completed my externship at PIH and was then hired on as a full-time SLP. I began working as an employee in July 2007. I received my CCC’s last month!

2. Where did you work during your CFY? What is/was like, and how much support (from supervisors, fellow alumni, former professors, etc.) did you receive throughout that time?
I completed my CFY at PIH. It was a challenging experience. Going from being a student to the professional provided some new stresses in my life. Even though I always felt responsible as a student for the decisions I made, the ultimate responsibility lay with my extern supervisor. As a CFY (and now SLP with my C’s) the sense of responsibility for decisions made and their impact on patients was stressful.

3. What is a typical day for you?
Typical? What’s that? In the hospital setting we don’t really have typical days. I work in all areas of the hospital (critical care, intermediate care, acute care, transitional care, acute rehab, and outpatient) and on any given day I may see a patient from each area. The priority of each day is always new evaluations, followed by patients who are NPO, followed by patients on restricted diets, and then patients on less modified diets, with the speech-language/voice patients mixed in. If I have an outpatient he/she will take priority during their appointment time and then I will be back to in-patient care.

One of the benefits of working in a large hospital is the great diversity experienced almost every day with both population and disorder. One of the challenges is not really getting the opportunity to specialize and become an expert in one area.

4. What are the pros and cons about your job?
· Educating patients and family re: their impairments; their prognosis, their plan of care, etc.
· Diversity in caseload, e.g., aphasia, dysphagia, apraxia, TBI, RHD, etc. In the hospital I get to see a wide variety of disorders most days.
· Good benefits/pay
· 4 day work week (10 hour days; the days are long but I have an extra day off during the week)
· For the most part the SLP’s at my hospital are well respected by the physicians, nurses, and other staff
· Patients and family who really appreciate the efforts we make to help them improve!
· Working weekends and holidays
· Schedule changes throughout the day – so I might start with two evaluations and five therapy sessions, but if new evaluations come in or the patient I want to see is with PT or out for an MRI, etc. the therapy gets bumped – so it is hard to plan the day into a set schedule. (This is typical of acute care, so just comes with the territory.)

5. How long did it take you to feel comfortable/confident with your work?
I have been working at the hospital for about 11 months and am just starting to feel pretty confident. Although to be honest, I still have days or sessions when I feel like I am still a complete beginner. But I can say, after about a year, it does get better!

However, one thing you must always do in any setting is project confidence, regardless of how you feel! Our patients and their family members look to us as the experts and we must present ourselves as such. This does not mean to make stuff up when we don’t know, but to give the best information we have (and we really know more than we might think at first) and then go back with additional information as needed. If we don’t look confident our patients and family members will doubt our skills and expertise and be much less likely to follow through on our recommendations. So always, always, always project confidence!!

6. What is the most memorable moment of your career so far?
The day a former in-patient’s daughter called to thank me for always introducing myself to her dad and for always explaining why I was there. She was so genuinely appreciative of all I had done to help her dad go from NPO to oral gratification.

I treated him for probably about two weeks and each time I would introduce myself to him and his family. I just make this as a habit for each patient and sometimes think they must think I am wacky because I always re-introduce myself. However, patients are exposed to so many therapists, nurses, doctors, etc. in just one day we cannot expect them to remember us. In addition to telling him and the family who I was I always told them why I was there (e.g., “to work on your swallow,” or “to see how you are doing with eating,” etc.).

This daughter’s phone call helped me to know I was doing the right thing in constantly re-orienting the patient to his therapist and the purpose of my visit. Now I never doubt the need to tell them why I am there.

7. What do you wish you learned in grad school before hitting the real world?
I think ultimately I was as prepared as I could be. However, one thing to realize is that in grad school we typically learn all about textbook cases and theory. In the real world, people and their disorders rarely fall neatly into one specific category (e.g., only Wernicke’s Aphasia), but often have components of several impairments. Somehow this surprised me. Real people are much “messier” than the people in the books, be prepared to have to really mix your knowledge base up and blend!

8. Do you have any advice for the COMD students of CSULA (e.g., things to focus on, clinic advice, praxis tips, shout outs, etc.)?
· Buy a good penlight! I am not kidding, spend the $20.00 and get one with batteries that is well made and bright! It is well worth it and far, far, far superior to the cheapie free ones you collect from conventions, etc.
· Use the blue book and the accompanying CD for the Praxis; consider buying a 30 day (or so) subscription to : (I really think this helped me), do not study the night before instead eat a healthy and yummy dinner, go to bed early, get to the test sight a little early (not too early!), and relax! You will find you are more prepared than you thought! After it is over, go out to lunch to celebrate!
· Remember grad school is only for two years, your career will be many, many years. You can do it! Team up with your classmates to study and relax together (our class started knitting together!). You are all in this together! Make the most of it!

Sunday, October 26, 2008

Susan Simon- Los Angeles Unified School District

(Notes from NSSLHA meeting, 10/20/08)

Benefits of working in LAUSD
• 700 square miles, 670,000 students aged 3-22 with a wide variety of disabilities, 300 SLP’s
• Urban or suburban settings
• Second largest district in USA, after NYC, which means that they can be cutting-edge in some ways with research in conjunction with local universities.
• Caseload variety; normally SELPA pools resources (e.g., DHH students in one district), but LAUSD is its own SELPA, so assignments may be arranged in many different ways depending on your area of interest
• Innovative programs, e.g. 3:1 model therapy:non-therapy, RTI intervention without IEP’s
• New therapist support—this is one of their strengths and one of the most important things for a new clinician. This is more than just CFY supervision, which may be very minimal. LAUSD provides good-quality master clinicians, professional development events, and 3 SLP’s who have part of their job away from the caseload, working with new therapists beginning with intensive training for a few weeks, and continuing supervision all year long. Additionally, you have CFY supervision as well as an administrator who does ongoing evaluation and support.
• Opportunities for advancement
• Good pay, starting at $61, 433 (180 workdays)/$70,756 (210 workdays) with master’s degree and CA license (special services pay scale). With credential (teacher’s pay scale), starting at $45,637-$72,592.
• District sponsored continuing education, where professionals are brought in to the district.
• Prevention and intervention services, following IDEA—to combat the “wait to fail” model, the focus is now on RTI (Response to Intervention) model.
• Web-based IEP’s and daily documentation
• LAUSD-provided laptop
• District-paid medical, dental, vision and mental health for you, spouse and children, as well as lifetime health benefits, life insurance, and STRS (state teacher’s retirement system) membership, which is a powerful pension fund.
• Paid holidays and illness leave—10 days of sick leave each year that rolls over if not used. Districts often don’t tell you that you can take sick leave with you when you leave a school district; it transfers with you to the new district.
• Loan forgiveness programs—up to $17,000 of Perkins Loan forgiven.
• Set of new materials and tests.

Employment requirements: online application, master’s degree, CBEST, letters of recommendation, health/TB clearance, fingerprint clearance, 2 sets of transcripts, etc.

For more information, contact:
Susan Simon, 213-241-3325,
Wililam Hatrick, 213-21-5200, ext. 29176,,

Q and A at the meeting:

You can’t request a particular region to work in LAUSD. Assignments are partially based on seniority. If you’re brand-new, you need to stay in one school for at least 2 years. After that, LAUSD tries to give you one school that is based on preference (e.g., region, assignment) and the other is need-based. You will not be asked to drive more than 20-25 miles or sit in a car for too long. They try to keep therapists within the local district within LAUSD or the next one over.

LAUSD no longer hires clinicians on waivers, unless you are currently within a master’s program and that you can demonstrate clinical experience with diagnostics and therapy.

Caseload size- you are part of the union (UTLA) as an SLP, which is pretty powerful. Caseload is protected by union contract under class size. It’s capped at 55 with teacher’s salary, and 68 with SLP’s salary. If you want to take more, LAUSD will pay for it with teacher’s salary table. This is in your employment contract. To handle workload, LAUSD is moving to 3:1 model to help provide some down time.

SLPA’s- there are only 700 SLPA’s in California, but LAUSD is now in the process of hiring them. Because there are so many uncovered schools, children accrue compensatory time that SLPA’s will cover.

Dr. Susan Downey, plastic surgeon: cleft palate surgery in third world countries

Notes from NSSLHA meeting, 10/6/08

Reconstructive surgery means to restore to the normal form or function (vs. cosmetic surgery). If the lip and/or palate doesn’t fuse, then form and function need to be restored.

Dr. Downey has been on 13 missions to different countries, but most recently she’s been focusing on Ecuador. Organizations she’s been with include Healing the Children, Interplast, and Operation Smile. The ultimate goal is to train people in other nations, and to go as teachers and educators. The type of palate repair surgery developed at CHLA is innovative and is not taught in other parts of the world. The advantage to this is that the muscles are repositioned and the palate is lengthened, which might result in little to no need for speech therapy following surgery.

Cleft lip/plate are among the most common birth defects worldwide, and are increased in areas with poor nutrition- especially folic acid. They affect an estimated 1 in 600 newborns. In some cases, there may be genetic components from smaller mating pools.

The goal is to operate on children or adults at any age. As long as children can eat appropriately, the need is not as urgent as with other surgeries. Palate repair in the US is ideally done at 1 year of age.

The team: nurses, anesthesia, plastic surgeons, medical records/coordinator, dentists, speech therapists, youth from a high school volunteer program, and med students.

Once in-country, Operation Smile does a screening of children. People find out about it through radios, churches, and non-profit organizations in the area. Because there is no back-up if things go wrong, they have to be careful not to operate on people with complicating medical conditions. Then they organize the charts to think about how they’re going to do the schedule of surgery. Because adults wake up slower from anesthesia, they have surgeries first in the day.

The airway is suddenly changed after surgery, so a “tongue stitch” can help bring the tongue forward and children are also placed on their side to help them breathe after surgery.

Operation on a cleft lip may take 45 minutes, whereas palate repair will take about 2 hours.

Some people walk for days and take the bus for hours afterward, in order to come for surgery. Often the father, then, is the one to accompany the child.

In surgery, they work closely with local doctors and anesthesiologists so that they can take over after the team leaves. Unfortunately, they don’t often get long-term follow-up, which is a problem for SLP’s—whose role is most effective when they do education with local professionals.

Operation Smile has training programs in the US also, to bring professionals for training. Occasionally children are also brought to the US for surgery. They often partner a lot with local organizations (e.g., Rotary Clubs, Mormon missionaries) overseas, and people in the community help with translation.

To find out about volunteer opportunities on these trips, consult the Operation Smile website or ask to accompany a speech therapist who has contacts in the community. The best way to get in is to be totally flexible in terms of time and say “call me if you have an opening”. If you speak another language, this increases the likelihood that they will need you. Some countries have stipulations on whether (or how) students can have a role on a team. Most trips last 1-2 weeks, with the first week for screening and the second week for operations.

Thursday, October 09, 2008

FREE Offers from ASHA!

1. Free 1 Month Trial of NSSLHA/ASHA Website

NSSLHA and ASHA are pleased to announce the launch of a NSSLHA national membership recruitment project on approximately 20 campuses early next month. Both associations, in partnership, will offer CSD students who are not currently national NSSLHA members on YOUR campus, a free, one-month trial subscription to ASHA's web site, .

Please note that national membership is different from a local chapter membership. Please note that access to the site will be available from October 1 – 31, 2008, regardless of the date students register for it, so the sooner they sign up (beginning on October 1), the longer their access will be.

2. Free Mentor Service from ASHA's STEP mentor Program

The Student to Empowered Professional (S.T.E.P.)
program offers one-to-one mentoring for students enrolled in undergraduate, graduate and doctoral communication sciences and disorders programs. All students are eligible to apply, however, preference for program placement and matching with mentors will be given to those students from racial/ethnic backgrounds that have been historically underrepresented in the communication sciences and disorders professions. Students are strongly encouraged to
be national NSSLHA members in order to reap the full benefits of the S.T.E.P. mentoring program.

Tuesday, September 30, 2008

Who is "Abby?"

Our "Abby" for the September newsletter was ......(drumroll please)........

Dr. Cari Flint!

Thursday, September 25, 2008

Alumni Spotlight - Cindy Siu, MA, CCC-SLP, Class of 2002

(full article)

Where did you work during your CFY? i worked at Little Company of Mary in San Pedro.

What is was like, and how much support (from supervisors, fellow alumni, former professors, etc.) did you receive throughout that time?

it was very informative and eye opening to get a taste of what responsibilities and duties are required of you in future professional arena. it was a good safe prep ground before entering into a hospital setting on my own. i was allowed to work with variety of outpts and inpts with many neurological, voice, speech, communication problems. the hospital also had a few outpatients who were children so that was fun to also have a diverse variety of ages as well.

Where do you work now? i currently work at little company of mary in torrance.

How long have you been working there? for 5 years, gosh time flies by!

What is a typical day for you at work? this is kind of a general question... but... i'll try to answer as best as i can. i get into work around 7:30/8:00 am, collect my referrals from the printer for the day, then prioritize my evals and treatments. the referrals can encompass anything from dysphagia evaluations, OPMS (a swallowing test), to speech/language/cognitive linguistic evaluations. after i finish with evaluations i proceed onto to priority patient treatments.

What are the pros and cons about your job?
1. interdisciplinary team approach with all physicians and therapists working towards benefitting pts' physical and mental health as well as accomplishing their goals.
2. working with great coworkers who are very informative and listen to you.
3. very mentally stimulating and challenging at the same time- learning something new everyday on the job, medically, clinically, etc.
4. it's fun for me deal with different types of personalities on the job... from dealing with aggitated pts, to grateful family members, to educating uninformed nurses, to discussing and working on pt goals with other occupational and physical therapists.

1. Nursing is not always compliant and sometimes do not follow through with our recommendations. this happens at all hospitals.
2. Hospital administration is often difficult to deal with for all therapists.
3. sometimes pts stay in 2 patient rooms and that gets a little distracting for my patient to focus on my therapy, especially if her/his roommate has visitors.

How long did it take you to feel comfortable/confident with your work? immediately! j/k i was pretty confident and prepared in regards to my clinical skills on site, i think it took a little bit more time to get used to the procedural aspects and computer system at the hospital. with hospital and paperwork procedures it took me probably 3 months before i was fully comfortable where i was working at.

What is the most memorable moment of your career? probably when i received the "employee of the month" award from among the entire hospital staff/facility. it just validates that i'm in the right profession and that my patients and coworkers appreciate all the hard i do.

What do you wish you learned in grad school before hitting the real world? there are many skills you learn on-site rather than in grad school. i think majority of skills you acquire is based on hands on experience as with most professions. .....mmmmhhh.....i think my graduate program really prepped me for the real world setting.

Do you have any advice for the graduate students of CSULA?
Yes, it's not all about the money as long as you have the passion!!!

Saturday, August 16, 2008

The Many Faces of ADHD: Michael Phelps, Olympic Gold Medalist

by Eileen Bailey

Michael Phelps was born June 30, 1985 in Baltimore MD. He enjoys football, music and video games. He became a professional swimmer at the age of 16. Michael was also the younger male world record holder in modern history. In he 2007 FINA World Championships he won seven gold medals and shattered five world records. At the Olympics in Beijing, he is hoping to break Mark Spitz's record and win eight gold medals. (In the 2004 Olympics, he won eight medals: 6 Gold and 2 Bronze).

Michael Phelps has ADHD. He was diagnosed at the age of 9 years old. Michael's mother, in an interview for WJZ in Baltimore MD., discussed his diagnosis and some of the difficulties he has overcome in his life. Michael was hyperactive as a child, according to his mother he "never sat still, never closed his mouth, was always asking questions, always jumping from one thing to another."

Although he started medication and behavior modification, he stopped medication by age 11 and instead ADHD symptoms were managed through tightly managing his time and swimming. According to his mother, swimming helped because, "it's very regimented. There's time management build into that component, there's set things you do sequentially."

A blog on pinpoints one of the reasons Michael Phelps is a winner is because of his ability to hyperfocus. He is often described as having a laser-like focus when swimming and has a level of concentration not often seen. Michael has the physical characteristics to make swimming the perfect sport, he has the training and the family support. He also has the mental focus that allows him to rise levels above other swimmers and break world records.

As of the writing of this Share Post, Michael Phelps has won two gold medals in the Beijing Olympics, one for the Men's 400m Individual Medley and one for the 4 x 100 Freestyle Relay.

Wednesday, July 23, 2008

CFY and Contract Negotiation

(Notes from July's meeting with Maria Rubalcaba and Carl Borders)

How to manage a big caseload

Organization is the key, because caseloads are always large. Do it in stages, working slowly to see what children need speech and how much. Not every child needs the same amount of therapy each week, whereas others will need more intense intervention. Later in the year, you can begin to thin out your caseload. Observation and assessment will go a long way to keep the caseload a reasonable size. Best practice requires some standard assessment and informal observation to warrant dismissal, although you can also point to their meeting of goals and objectives, or a plateau in performance. Talk to parents about changing service delivery models, which requires an addendum IEP. Help parents know that you are approachable, knowledgeable, and want their child to do the best.

You may not be able to do the paperwork of dismissal until you have completed your CFY and are well-established. Do what is appropriate for the child, and use good clinical decision-making. These might be difficult conversations to have with parents, especially if children have been in speech therapy for a long time. The average special education student costs the district $70,000/year.

As a new SLP, you’ll probably be given a large caseload. Some districts have caps, although the average caseload is 55.

ASHA introduced the 3:1 model, which is three weeks of therapy and one week of assessment (some districts use this). IEP-writing has been changed, in some districts, to required therapy hours per month or year versus per week. This allows you to draw therapy time back for children that are moving toward dismissal or need less time. A lot of this depends on the philosophy of the school district or SELPA that you belong to. Discuss these things with your superiors. Consider the intensity and severity of the disorders of children on your caseload, because this affects your workload level. Diagnosis, level of services, level of impairment are involved. Also monthly meetings, high-profile parents, IEP’s, etc, will take your time.

Having communication with the administration, teachers, and parents will help you on your caseload. A certain tone was set by your predecessor, who may or may not have developed a good reputation for the speech therapist. Be willing to explain your approach and how it may differ from the SLP who came before. These things will take time, and it will be a process.

Look at therapy with a triage approach. Kids with cerebral palsy, autism or unknown disorders have a higher priority than children with mild articulation problems. If you don’t know how to work with a particular student or situation, ask for advice from your colleagues. Move students to a consult model, vs. direct therapy, when possible.

If parents and children are happy, then the administration will be happy with you.

How to negotiate your contract

Negotiating your contract is hard as a first-year SLP. You need to be competent, confident and willing to work hard. Some SLP’s in the schools are on an itinerant contract basis, whereas others are hired by the school district. If you’re not sure where you want to settle permanently, working for an agency gives you a little more flexibility, and may cut through some of the red tape for working out of the state where you got your credential. Working for school districts requires you to honor your contract for the year. If you work directly for the district, collective bargaining units usually include SLP’s. Some districts have SLP’s on a separate salary schedule than teachers, because of the high need. Look at the benefit package (including health insurance) for the various districts in the area, especially if you have a family. If you want to negotiate through an agency such as Progressus Therapy, call to talk about salary, benefits, weekly hours, and vacation time (because you will get sick your first year!). If you are confident and know what you want and what you are willing to give, you will be able to advocate for yourself. Look at the school contracts and ask for something comparable. They will give you whatever they think they will be able to get out of the school district.

Pros and Cons

The school caseload Is variable, which keeps work interesting. Every day is completely different. There is a lot of energy in each day, and you and your kids will become attached. There is constant flexibility and change. You will see children on your caseload with medical problems, such as myasthenia gravis or TBI, and you might be the only one on campus with clinical training in these areas. You make good money for 181-192 days per year, and you don’t need to work weekends and holidays. This makes it a good job for parents. You’ll probably be done at 3:30 or 4:00 each day, depending on your contract, although your first year you will work much more. In the hospitals, you will rarely see things to completion due to death or transition to other settings for further services, and you will work long hours and often weekends.

In either hospitals or schools, you will see a lot of joys and pains of people you’re working with. Find out what your strengths and leanings are as an SLP, and you will find an environment that fits you well. Give yourself the opportunity to explore. You can even work in multiple settings part-time, or work per diem. When you work per diem, you’ll see patients on a one-time basis, or do intake assessments that other therapists will follow up with.

Common mistakes made by first clinicians

  1. Doing a full assessment for every single child that is referred to you; trying to please everybody by doing more than is reasonable or needed
  2. Lacking organizational skills; not planning ahead
  3. Being afraid to ask for help when needed (CFY supervisor, other SLP’s, other specialists in the district, online discussion boards)

More resources


See for more information on the CFY. You will get a packet once you graduate.

Speech-Language Pathology and Audiology Board (the board that gives your state license)


Saturday, May 03, 2008

Gwendolyn Meier on autism

(Notes from April NSSLHA meeting)

Gwendolyn Meier works at Villa Esperanza, which mostly serves children with severe communication disorders (often autism), aged 2-22. Many children come to them because they can’t be managed in their own school district. They have a Speech-Language center adjacent to the school. It’s a very specialized place, because they see very few stuttering or voice disorders, or even articulation unless it is a verbal apraxia in conjunction with autism.

Autism is a behaviorally-defined disorder. There is no medical battery given to confirm it; it is characterized by behavioral symptoms. It was first talked about in 1943. The incidence estimates have significantly increased from 1 in 10,000 in 1980 to 1 in 100 today.

Key aspects of an autism diagnosis:

1) Limited social interaction—including eye contact, response to communication, initiation of interaction (e.g. peek-a-boo)

2) Communication—verbal communication may be disordered, with words used unusually and, the developmental progression won’t be ordered typically. For example, the first words might be requests instead of comments (unlike typically-developing children).

3) Restrictive, repetitive, stereotyped behavior—including self-stimulation. We think this might be due to sensory stimulation, although it may serve some sort of purpose (we don’t know much about this).

Symptoms may appear to different degrees and affect different areas of functioning. There is reduced connectivity shown between brain regions (association tracts); these are underdeveloped and don’t work as a whole system.

The core deficits of ASD affect many areas of function. For example, an inability to shift attention easy can result in stereotyped behaviors. Impaired use of symbols (shared meanings) especially affects abstract concepts.

There are very few standardized measures that look at the core deficits of autism. We know that standardized measures usually look at form and content, which are often disordered. However, this might not be their biggest area of need, e.g. Can they use. back-and-forth interaction with another child?

Language functions, initiation and rate of communication are very different from a typically-developing child. Requests are the easiest to teach, while commenting is much more difficult. Few resources aid us in evaluating pre-intentional, preverbal and non-verbal communication. PECS (Picture Exchange Communication System) is one example of an AAC strategy, but there is little guidance on selecting and implementing such intervention.

Other important factors:

1) Communication mode—e.g. using eyes or sounds to communicate, even if these don’t seem intentional to a casual observer

2) Rate—we need to look at rate of initiation vs. response. Do we need to ask questions differently in order to get a response?

3) Communicative functions—do they comment/show/share at all? These may be absent, especially for younger children

a. Request

i. Object/activity

ii. Information

b. Response

c. Comment

d. Express feelings

e. Prosocial statement

f. Conversational skill

4) Non-verbal communication—eye gaze and facial expression for social regulation, regulating interaction, gaining info—e.g. looking at someone for a request to spin around

5) Social communication—the most basic is back-and-forth between mom and baby’s smiles, up to more abstract, such as appropriate ways to interrupt mom when she’s on the phone. A high-functioning intervention are “social inferencing” questions. Register-switching is also under this category.

6) Language content and form—although the more foundational skills are basic turn-taking and conversational abilities that enable them to make friends and have interaction!

Aided language stimulation/visually cued instruction—gives visual cues along with oral language input, building off their visual sense and using an intransient form of communication.


  1. Context- have natural communication exchanges (Wetherby et al. 1997)
  2. Who the individual is interacting with
  3. What cueing is helpful; including what parents are doing
  4. Motivation to communicate
  5. Hidden abilities or inroads—where can these kids function? Some grow up and write that actually, they understood much more than we realized. Non-verbal children may learn how to type or use visual forms of communication.
  6. Multiple sources of information, such as interviews with parents or teachers, observations of everyday situations.


1. Functional communication (basic wants and needs)—including understanding of cause and effect, reducing learned helplessness by reinforcing any type of communication. For the adult, these skills might include toileting skills, identification of feelings, school readliness, yes/no responses, labeling. However for the child, these are most likely to be foods, toys and activities at the very beginning.

2. Initiation and Motivation

Motivation drives communication—first teach cause and effect, then expand communicative functions. Increasing functional equivalents to challenging behavior have been shown to reduce such problems. Find out what is reinforcing and personally meaningful to the child.

3. Language development

Language is learned in interaction with others. Competence is much more than vocabulary and sentence structure; we want to teach warm communicative interactions. Pragmatic functions make children stand out vs. blending in- much more dramatically than proper grammar or complete sentences. Interaction skills may be more important to real-world functioning than other language skills.

4. Plan for and practice generalization from the very start.

Online resources:

Indiana Resource Center for Autism

Susan Stokes Autism Articles and IEP goals

Autism Inspiration Sensory Ideas

WIRED magazine article

Thursday, April 03, 2008

Ask Abby (or Cari/Ed/Nancy, etc.)

Have a question you've always wanted to ask any/all of the professors, but didn't have the guts (or time) to? Well, here's your chance!

There are 2 ways to submit questions:
* By leaving a "comment" thru the blog (link below)
* By sending an e-mail to

ONE question will be picked and featured on the next NSSLHA newsletter. Please indicate in your message WHO you'd like to answer the question. Your identity will remain anonymous in the feature unless requested otherwise.

And by the way...
Don't miss out on a great workshop on treatment tips for kids with Autism (by our very own, Gwendolyn Meier).

Thursday, March 27, 2008

Autism: The Musical

Hi all!
There is a really great movie titled "Autism: The Musical" that is currently available on  It's available to view online for free for about a week. 

Take advantage of it! You won't regret it!

big thanks to  ms. truelashes for fwd'ing the info. =)

Monday, March 10, 2008

Sharon Hendricks- Accent Modification

(notes from NSSLHA meeting, March 3rd)

Sharon Hendricks was trained in SLP at University of Washington in Seattle. When she was a grad student, she became a TA for “American speech sounds” for international students, often doctoral students who had brilliant minds and needed competency in English to communicate with Americans. There are many similar students on our campus!

Accent modification is about breaking down these barriers to communication. The goal is not to “reduce” an accent, but increase communication/intelligibility. You can do this with an “accent”, which is an actually interesting and important part of a person. An accent tells about their heritage and their culture; we shouldn’t want to eradicate these. Modification refers to change of behavior, giving tips/tools on how to produce certain sounds or words to be more intelligible.

Sharon works now full-time at LACC, teaching classes for non-native English speakers. There’s a lot of ethnic and age diversity on that campus. There is an effect of age on second-language acquisition; it becomes more difficult because speech sound patterns become imprinted. Many of her students are older Russian women who want to get a job to support their family, but most of their social life is with Russians. Younger people might have a career path in mind.

Components of accent modification:

1) 1) Talk with client to know what/why they want to learn. Most people who do accent modification, do it one-on-one (even though she teaches a class). What do they want to communicate for? How much do they want to learn (functional intelligibility, expanded vocabulary?) Intelligibility really affects your social life because people react to you, you might withdraw from going out into the neighborhood and send your daughter to the store instead. These things lead to emotional frustration.

2) 2) After the initial interview with client: they need to hear the difference between their production and the intended production (e.g. /th/ vs /z/), which is not too different from articulation therapy with kids. If they can’t discriminate the difference, they probably can’t make it. This is especially true for /r/ and /l/. Then, they practice discriminating with minimal pairs (contrasting vowels or consonants). She covers her mouth to prevent visual cues. For example, the “a” in “bad” is very distinct to American English. She teaches them the parts of the mouth (alveolar ridge, hard palate, etc.), IPA, place/manner/voicing, then they go to the speech clinic and practice the sounds that are particular their own language.

3) 3) The biggest component is practice. She emphasizes that her students need to spend a lot of time with native speakers, to listen to radio stations like NPR (clear pronunciation, educational, etc.), watch American movies (hear the dialogue, see context, stress and intonation), ask a classmate out to coffee. It takes a lot of initiation on student’s part; they want you to “fix” them but you give them tools and the rest is up to them. Natural language environments are very important.

LACC has a speech lab. The students come to the lab and listen to different sounds on headphone with native speakers pronounce the word as they practice, recording themselves on the computer so that they can compare productions. This has been really effective.

Books she uses:

“The Communication of Standard American English” by Luter.

“Fundamentals of Voice and Articulation” by Lyle V. Mayer

“Speaking Clearly “by Modisett and Luter

Some arenas to work in accent modification: Private practice, working at a city college or adult school, CORP-span (corporate SLP). For example, she’s giving a talk at Boeing, 10-session series for engineers. Remember, however, that we are not ESL teachers. This is outside our professional scope of practice.

Relevant websites:

ASHA has phonemic inventories for different languages, - speech accent archive, listen to various accents/languages. It allows you to look up the native phonetic inventory of most languages. - great resource for theater/drama students, allows you to listen to accents from all around the world. - gives a visual aid for speech sound production, great resource for demonstrating articulatory placement - nonprofit organization of SLPs who exchange information/resources in order to best serve the arena of corporate SLP. - example of corporate SLP site that offers accent modification among other communication resources.

Riddle Me This - the Answer!

The riddle from the March '08 issue of the NSSLHA newsletter:

"3 men are going on a business trip. They decide that in order to save money, they are going to share a room. One man goes to the front desk and asks how much a room is. The front desk attendant replies $30. The businessman collects $10 from each of his co-workers and they pay for the room and go upstairs. Shortly after, the front desk attendant realizes that he made a mistake; the room was only $26! He gives the $4 to the bellboy and tells him to run it up to the guys room. The bellboy knows that it will not be easy to split up $4, so he puts $1 in his pocket, and gives $1 back to each of the 3 business men ($3). Therefore, each man paid $9 for the room… 9x3= 27, The bellhop put $1 in his pocket…. 27+1=28
So, where did the rest of the original $30 go?"

The answer:
This is a very old and misleading question. Of the original $30, we know exactly where it all went: $26 went to the hotel, $1 went to the bellhop and $3 went back to the guys in the room. The mistake lies in saying that each man paid $9 for the room. They did not each pay $9 for the room, rather they each paid $10 for the combined cost of the room, the $1 that the bellhop kept and the $3 that they received. $27-$1=$26, which is the price of the room, and $26+$1+$3=$30, which is the total amount of money involved. There is no missing part.
hehe =)

Thursday, March 06, 2008

2008 Minority Student Leadership Program

Call for Applications is Now Open!

The Minority Student Leadership Program is open to students who wish to enhance their leadership skills, interact with leaders in the professions, and learn how their association works. Now in its 10th program, the MSLP has given over 275 students from racial/ethnic minority backgrounds insight into their leadership abilities, a better understanding of how leaders affect change within ASHA, and has empowered these students to take risks and meet their own challenges. All students are eligible to apply; however, preference will be given to students from racial/ethnic minority backgrounds that have historically been under-represented in the Association.

Visit ASHA Award Programs for more information and to download an application packet [PDF].

Thursday, February 21, 2008

Autism Breakthrough: Girl's Writings Explain Her Behavior and Feelings

Feb. 19, 2008

Carly Fleischmann has severe autism and is unable to speak a word. But thanks to years of expensive and intensive therapy, this 13-year-old has made a remarkable breakthrough.

Two years ago, working with pictures and symbols on a computer keyboard, she started typing and spelling out words. The computer became her voice.

"All of a sudden these words started to pour out of her, and it was an exciting moment because we didn't realize she had all these words," said speech pathologist Barbara Nash. "It was one of those moments in my career that I'll never forget."

Then Carly began opening up, describing what it was like to have autism and why she makes odd noises or why she hits herself.

"It feels like my legs are on first and a million ants are crawling up my arms," Carly said through the computer.

Carly writes about her frustrations with her siblings, how she understands their jokes and asks when can she go on a date.

"We were stunned," Carly's father Arthur Fleischmann said. "We realized inside was an articulate, intelligent, emotive person that we had never met. This was unbelievable because it opened up a whole new way of looking at her." This is what Carly wants people to know about autism.

"It is hard to be autistic because no one understands me. People look at me and assume I am dumb because I can't talk or I act differently than them. I think people get scared with things that look or seem different than them." "Laypeople would have assumed she was mentally retarded or cognitively impaired. Even professionals labelled her as moderately to severely cognitively impaired. In the old days you would say mentally retarded, which means low IQ and low promise and low potential," Arthur Fleischman said.

Therapists say the key lesson from Carly's story is for families to never give up and to be ever creative in helping children with autism find their voice.

"If we had done what so many people told us to do years ago, we wouldn't have the child we have today. We would have written her off. We would have assumed the worst. We would have never seen how she could write these things  how articulate she is, how intelligent she is," the grateful father added.

"I asked Carly to come to my work to talk to speech pathologists and other therapists about autism," said Nash. "What would you like to tell them? She wrote, 'I would tell them never to give up on the children that they work with.' That kind of summed it up."

Carly had another message for people who don't understand autism.

"Autism is hard because you want to act one way, but you can't always do that. It's sad that sometimes people don't know that sometimes I can't stop myself and they get mad at me. If I could tell people one thing about autism it would be that I don't want to be this way. But I am, so don't be mad. Be understanding."

**To view the full article + video, CLICK HERE. **

Source: (thanks Christina!)

Monday, February 18, 2008

ASI resources

The Associated Students, Inc. is a great resource for students.

They offer the following services:
-laptop rentals $15-20 a week (printers are also available for an additional
-locker rentals - $15 for the first quarter, then $5 for every quarter after
-$150 textbook voucher (deadlines are approaching mid-February and March)
-Student health and dental insurance: covers students AND their dependents
for very low cost. Covers illnesses or injuries on or off campus.
-local business discounts
-movie/amusement park discounts
-free scantrons and blue books

The Cross Cultural Center located right next to ASI allows students
to print up to 10 pages free per day on their laser printers.

Saturday, February 09, 2008

Reminder: Spring Quarter Registration Fees

Hey everyone! Just a quick reminder that CSULA's Spring quarter registration fees are due by 3/3/08, if you want to avoid a late fee.

~thanx Dione =)

Thursday, February 07, 2008

Graduation 411!

For those of you who are graduating...

The Graduation Committee has decided to hold two graduations by Colleges, rather than by Undergraduate and Graduate.

The college of Health and Human Services (where COMD is housed) will have graduation ceremonies FRIDAY EVENING for all our graduates, Undergrad and Grad.

Master’s graduates will still be hooded at that ceremony.

** Please pass this info on to the people who may not have heard about the update. Thanks! **

Sunday, February 03, 2008

Campus resources!

Hey guys... we'll be sharing at our NSSLHA meeting this week about resources you might be interested in. Here's the summaries for those who are interested.


Family PACT is a state-funded program that provides family planning services to low-income men and women - for FREE! Services include, but not limited to:

- Personal & confidential healthcare (as it pertains to family planning/prevention)

-Education, counseling, assessment & treatment to protect reproductive health

-Contraceptives: Birth control pills, male/female condoms, diaphragms, contraceptive implants, Fertility Awareness Methods (FAM), Lactation Amenorrhea Method (LAM), and male/female sterilization <~ I’m sure everyone will jump on this one! Jk To be eligible, you need to be a California resident and not exceed a certain amount of income. (This may vary every year so please check on the Family PACT website or ask someone who works at the CSULA student health center.) Signing up is easy. Just go to the 2nd floor of the student health center and ask for a Family PACT application. Fill it out, turn it in, and get your FREE Family PACT card – all on the same day. Can we sound any more like a commercial? But seriously, Family PACT is an easy way to save a big chunk of change. For more information, visit:

ASHA's Minority Student Leadership Program

Opportunity to attend ASHA conference for free (including hotel accommodation and meals), network with ASHA leaders, and build leadership skills.

Best Way to Find Cheap Books Online

PROJECT PASS (Preparing Autism Spectrum Specialists)

Project PASS provides up to $5700 of funding to students who are currently in masters degree programs in Special Education, Counseling, and related fields like Communication Disorders.

Autism Certificate consists of 4 courses:
1. EDSP 413 or COUN 501 (4 units)
2. EDSP 586: Teaching Children with Autism (4 units)
3. EDSP 587: Teaching Functional Communication (4units)
4. EDSP 503: Autism Fieldwork (6 units)

Students who are accepted will receive up to $1000 for 3 quarters (maximum total of up to $3000). Students who are on the grant will receive a summer living allowance of $2700 contingent on attendance of amandatory 10 day Autism Summer Institute at CSULA.

Completion of all of the above courses is required for eligibility and participation in summer institute.

Applications can be found at the bulletin board across the office of Special Education in King Hall C1064.

Dr. Jennifer Symon (Director of PASS program)
King Hall B1036 Office Hours: Tues/Thurs 3:30-4pm


Ever wonder exactly what you get charged for when you pay tuition? In case you haven't noticed, we all pay $55 each quarter for services at the student health center. So it's time to make that money count!

The services you pay for include: FREE doctor visits, cheap blood tests, free x-rays, free TB and hepatitis shots, free counseling services of all types, courses for stress/anger/time management, nutritional services, and chiropractic, acupuncture, and massage services. There is also the opportunity to access other services for small fees (which vary), these include the dental clinic, optometry clinic,women's and men's health care (i.e. contraception,check-ups, etc.) and CPR courses. You can also get your prescriptions at a reduced price (even if it's not from a Cal State doctor) at the small pharmacy located in the bottom floor of the HealthCenter.

To get all the information drop by the Health Center
(across from the Biology building) or go to


General tips for getting financial aid:

Fill out FAFSA early
Get to know your professors so they see your dedication and your interests and can write specific recommendation letters
Apply to as many scholarships as possible to increase your chances
Begin the application process early, especially if you need letters of recommendation!
Save your application essays and lists of community activities/jobs/volunteer experiences so that you can adapt and re-use them
When application dates fall around the same time, give an organized packet of recommendation letter requests and forms to a professor well ahead of time; make sure that they know the deadlines, and thank them for their help!

CSULA scholarships

General CSULA application (due March 7th):
This puts you in the pool of applicants for most of the scholarships available through CSULA

Other scholarship opportunities:
Look especially at...
President's scholarship (for entering undergraduates)
College of Health and Human Services (for graduate audiology students)
Perkins Loans-- these are cancellable for SLP's! (a certain percentage for every year you work)

For graduate students:

Alumni Association scholarship (due at the beginning of winter quarter)
inquire within KH D145

Emeriti fellowship
apply through the CSULA general application

Graduate Equity Fellowship (due fall quarter)
inquire within the Office of Graduate Studies and Research, Admin 710

COMD departmental scholarship (due fall quarter)
inquire within COMD department

Other opportunities to get funding:

PASS program
see above

Teaching Assistant positions (income does not get taxed or counted against you on FAFSA)
inquire within COMD department

Outside scholarships for COMD students:

Sertoma scholarship


Scholarship search engines

Grants for Research:


Acoustical Society of America (funds research in phonetics and speech production)

Pre-Doctoral Scholar's Program at CSULA (application due in March)
In addition to funding summer research, this program will also connect you with a faculty mentor and fund any trips you want to make to check out doctoral programs
Inquire within the Office of Graduate Studies and Research, Admin 710

Thursday, January 24, 2008

Erika J. Glazer Family Scholarship Fund 2008

Attention Undergraduates! Interested in a Scholarship?!

Established by the Erika J. Glazer Trust of 1985, the Erika J. Glazer Family Scholarship Fund will award several multi-year scholarships of up to $7,000 per year (the total amount of scholarship funds available per year is $30,000-$40,000) to academically qualified students in need of financial assistance. Deadline to apply is Thursday, March 13, 2008.
**If interested, e-mail us for a full application.**


1. Meet the requirements of California Assembly Bill 540 (Nonresident Tuition Exemption).

2. Be a graduating high school senior or an undergraduate college student who has attended high school in Los Angeles County for at least three years.

3. Be accepted to, or currently attend, California State University, Los Angeles during the 2008-2009 school year and for all subsequent years of the scholarship, while pursuing a full course load for a Bachelor’s degree in any discipline. Recipients must maintain good academic standing and notify the committee immediately regarding any changes in legal status.

4. Be the child of immigrant parents.

5. Be ineligible for federal and state financial aid and demonstrate financial need. Please note that there is no particular threshold of financial need we are considering. It is up to the applicant to decide if she/he would be a competitive applicant given her/his particular circumstances.

6. Demonstrate leadership, merit, a commitment to community service and/or potential for academic achievement. Involvement in student government and internships are highly prized by the scholarship committee.

7. Provide clear and detailed information about any disciplinary or criminal record (e.g., school suspensions, arrests, convictions) and a full and detailed explanation of the circumstances leading to such actions.

8. Make every effort to be available for a personal interview should one be required.

9. Be willing to attend an awards ceremony on a date to be determined in Los Angeles should one be awarded a scholarship.