Meeting Recap from Dr. Biel

Thank you to everyone who made to our last meeting of the school year with Dr. Biel.

Here are the notes from the meeting:

Michael Biel CScD, CCC-SLP
05/10/11
Intensive Aphasia Treatment: Case of Non-Lexical Recurrent Utterances

• This is a case about a gentleman in a program called Pirate (Pittsburgh Intensive Registration Aphasia and Treatment Evaluation) in Pittsburgh.
• Why did this program become established? Aphasia is a complex disorder to treat and several veterans at the time had Aphasia.
• History: 61 y/o male, with left MCA (Middle Cerebral Artery) CVA (Cerebrovascular Accident) in 2005, global aphasia and severe AOS (Apraxia of Speech)
• He had nonlexical speech where he only said, “Ba ma ma ma, huh, ba bum bum ma ma.”
• treatment Hx:
• had 1-year inpatient rehab
• 2 years outpatient treatment (tx)
• group treatment
• various experimental txs
• despite tx, his speech did not improve; he was unable to repeat sounds.

• In PIRATE:
• tx for 6 hours a day for 6 days a week for 4 weeks.
• 4 hours of treatment were individual tx and the other two hours were in a group setting.
• COGNITION:
• he scored WNL on the Raven’s colored Progressive Matrices (assesses problem solving) and scored WNL on the pyramids and Palm Trees Test (assesses semantics)
• MOTOR SPEECH
• no cranial nerve signs
• motor speech testing was difficult- did show signs of nonverbal oral apraxia (NVOA)
• could imitate a “Uh” and /h/ via a PROMPT
• could manipulate rate and prosody of recurrent utterance when given a model
• AUDITORY COMPREHENSION
• Comprehensive Aphasia Test (CAT)
• he scored 21%ile for single word
• VERBAL OUTPUT
• all tasks resulted in production of the recurrent utterance
• chance level performance on a pictured rhyme judgement task from the PALPA; the PALPA is used supplemental to other Aphasia tests.
• a picture rhyme subtest is used: a picture of a fan and van are showed and the person has to indicate whether or not the words rhymed or not (yes or no)

• On PALPA’s picture-rhyme test he scored in the low percentile level; this means that his apraxia of speech could be and issue of something else.
• READING
• he had good visual lexical decision making (58/60); this means that for reading, he has some comprehension. He had poor with written rhyme judgment (31/60)
• perhaps he had impaired phonological processing?
• or impaired subvocalization or verbal working memory

• WRITING
• he was able to write 6/40 written items on PALPA; this suggests something that we can work with; he was also abel for write by dictation 5/6 3 letter words.
• WHY CAN’T SJ (client) REPEAT?
• Apraxia of Speech?
• He did show non-lexical recurrent utterances; he had some Nonverbal Oral Apraxia; in tx, he demonstrated overgeneralization during articulatory tx.

• TX GOALS

• 1) improve ability to repeat 2) use social greetings 3) improve ability to use writing to communicate
• TX PLANNING
• Dr. Biel looked up research articles that focused on treatment for individuals with recurrent utterances and studies with individuals with global aphasia and significant AOS. Most of the articles he found were antedotal. One article he found dealt with PROMPT.
• Dr. Biel used PROMPT since it was likely that SJ had AOL.
• INITIAL GOALS with PROMPT
• 1) control voicing during production of /h/ and “uh” contrasts
• 2) control jaw opening in /m/ and “uh” contrasts

• PROMPT RESULTS
• both goals were not met; he overgeneralized /h/ for “uh”
• NOW WHAT?
• Do we abandon goal to work on speech?
• Try antedotal txs like VCIU or MIPT (multiple input phoneme tx)?
• Try melodic intonation therapy?
• Dr. Biel tried MIPT after several attempts to contact the author of the research paper about MIPT.
• MIPT:
• How does this work?
• Step 1: gain control of involuntary utterance
• Step 2: use sounds in the recurrent utterance to generate new words to practice/probe (if the person says “ma ma” get them to say “ma mom”
• CONTROL
• Multiple inputs of the target phrase before production attempt.
• Integral stimulation (look, listen)
• Rhythmic tapping on the ipsilesional arm
• Choral repetition with the clinician being louder.

• EARLY MIPT RESULTS
• SJ controlled production of his recurrent utterances, BUT was unable to produce words generated from the recurrent utterance.
• MIPT MODIFICATIONS
• Include PROMPT cuing
• Try and create unique errors, i.e. errors that contained new sounds or sound combinations; this helped diversify SJ’s phonetic inventory.
• After a word was taught, SJ was immediately taught to generalize these words, such as “Hi.”
• RESULTS
• By the end of tx, he could produce 60 words, mostly one syllable with anterior, visible consonants.
• 50/60 repeated on post-testing with integral stimulation
• On the Syllable Length Repetition subtest (PALPA), he scored he got 6/24 by the end of treatment; initially he scored 0/24. By the end of treatment, he did not use “Ma bum bum.”
• By the 4th week of treatment, he was able to produce, “Hi,” “Fine,” and “Bye,” for social greetings.
• By the 4th week of treatment, he made improvement with writing but only with specific items which did not generalize.
• WHAT CAUSES NON-LEXICAL RECURRENT UTTERANCES?
• There is a damaged phonological system that is cut off from other systems in a loop.

NSSLHA T-Shirts & Our Next Meeting!

T-Shirts are in and ready for pick up! $17 a piece.

Pick up and purchase:

>4-6pm on Wednesday 4/27, outside the Clinician Prep room at the COMD Dept.

Details about our Next Meeting:
When: Tuesday May 10th from 6-7pm
Where: King Hall B4016
What: Michael Biel, a SLP who recently received his clinical doctorate degree from the University of Pittsburgh will be our guest speaker. He has worked for the VA (Veteran Affairs) and recently began working for UCLA. His experience is adult specific. His topic for the meeting will be Intensive Aphasia Treatment: Case Study of an Individual with Non-Lexical Recurrent Utterances.

Autism Walk 2011

Thank you to everyone who joined us on Saturday for the Walk for Autism! And a special thanks to those who contributed to this charitable cause. We enjoyed walking amongst hundreds of people yesterday and know all of the proceeds will be paid off well :)

Spring 2011 Newsletter- Special Edition

Hi NSSLHA members!

This is a special edition of our NSSLHA newsletter featuring
Jacqueline Ortiz's experience as a participant in ASHA's Minority
Student Leadership Program (MSLP). The regular quarterly newsletter
will still be published at the end of spring quarter, but we wanted to
put this early edition out because the application deadline for the
MSLP opportunity is fast-approaching and due May 2, 2011. Read the
attached newsletter for more information regarding the program and
Jackie's personal highlights.

April 2011 Meeting Notes!

Thanks to everyone who made it to our meeting about working with children who are deaf, especially Jane Freutel and Jen De La Paz. If you missed anything, here are the notes from the meeting!

April 11, 2011 Meeting Notes

Announcements:

1. Walk for Autism- Saturday April 23^rd

How to Sign up: http://www.walknowforautismspeaks.org/faf/search/searchTeamPart.asp?ievent=442586&lis=1&kntae442586=6A9703936DEA4476A71068660C84A096&team=4014439&tlteam=0

Meet: us at the check-in section at the Rose Bowl; find our CSULA sign! Walk starts at: 10am

Registration starts at: 8am

Opening Ceremony starts at 9:30am

2. Survivor Symposium at Chapman University- Saturday April 16^th

Includes a panel of patient with ASL, TBI, Strokes and more!

Deadline to sign up is TONIGHT! $10 to sign up (includes refreshments and snacks)

3. T-shirts: will be a black, American Apparel shirt with white writing. See our Facebook page for the design: http://www.facebook.com/event.php?eid=183709131671679#!/pages/Nsslha-at-Csula/188094447878024

4.

Guest Speaker: Jane Freutel, Assistant Director of Teacher Education at John Tracy Clinic

www.jtc.org

History of JTC

· In 1942, Louise Tracy found the John Tracy Clinic (JTC.) She has a child who is deaf. JTC has programs for parents and children who are aged 0 to 6-years-old.

· These programs are free for the children and their families. This includes educational meetings and support groups and counselors that work with families.

What is JTC all about?

· JTC is parent focused. JTC provides parents with hope; parents who go to JTC experience distress and loss about finding out their child has a hearing loss. JTC offers parents guidance in a form of “What do you want to know?” JTC doesn’t preach. If parents do not find a means to meet their needs at JTC, JTC provides resources of where to get help. Lastly, JTC provides empowerment to help parents find resources for their children.

· At JTC, there is an auditory approach where all kids wear hearing aides or cochlear implants.

· The teachers at JTC are expected to know more about teaching speech and the development of speech for children who are profoundly deaf, more than speech and language pathologists.

· If you are interested to see how the teachers in JTC teach children who are deaf, you can look on Youtube and search John Tracy Clinic or go to the website www.jtc.org

· All of the classrooms at JTC have Sound Field FM systems.

The Masters Program for Special Education

· The program is a Masters degree in Special education with an emphasis in deaf deduction at the University of San Diego.

· All of the course work is at Los Angeles. Students start in August and finish the first week of June. There is a total of 44 units.

· 10 month program

· They finish with a master’s degree and after apply for the credential to work with children who are deaf and hard of hearing. The most difficult thing to get finished is the portfolio required (about the state standards for working with people who are deaf.)

· All of the graduate students get jobs for having a background in auditory skill development, auditory focus on speech development, and developmental speech.

· There is a $10,000 fee for tuition.

· There are resources that include scholarships and low-interest loans that provide for survival for a year; it’s not recommended for graduate students to work while in the program.

· Classes start in August. During this time, students observe practicing students work with children who are deaf and hard of hearing.

· There is a Friday Family School with children who are 0-3 years-old. Teachers play with the children; and parents are separated in a different room where they are educated on how to work with their children to encourage speech development.

· Courses also include Audiology courses such as Diagnostics and Amplification. Audiology classes taken at CSULA will be very helpful to do well in these classes.

· Students graduate on May 20^th at the JTC clinic and another graduation at USD.

· The cohort has up to 8 students.

· There is also a distance cohort with students who work across the country with children who are deaf and hard of hearing.

· Students in the master’s program are taught to teach children from 0 to 6-years-old. The credential however is to work with people who are hard of hearing and deaf that are 0 to 22-years-old.

· When students graduate, the options are:

o early intervention (work with children from 0-3 years old)

o work in a special day class

o work with children who are mainstreamed into classrooms

o work with school districts

o work in regional programs

JTC and Speech-Language Pathology

· both share information with oral motor therapy

· both share interest in language development

· at JTC, there is a lot of vocal play

Powerpoint notes from Jane Freutel

· JTC provides hope, guidance, and encouragement to families without a charge, worldwide.

· JTC provides audiological testing, which includes non-sedated ABR (0-60-months-old)

· Screening services are provided at JTC.

· JTC provides Parent-Infant Services

· JTC provide

o parent education classes

o international summer sessions & Latin American summer sessions for parents with children with hearing loss/deaf

o distance learning courses for parents about babies, preschoolers and children with vision and hearing loss.

· New possibilities for people who are deaf: newborn hearing screening, advanced technologies, digital hearing aids, cochlear implants

· Impact of hearing loss: careers, daily living, psychological issues, academic, reading, behavior, emotional, social, speech, language, communication

· Mainstreaming issues: preparation, implementation, support, environment, social

· Information to get involved:

o Tours can be provided

o www.jtc.org/teachered

o prerequisites

§ a 3.0 GPA

§ GRE

§ a bachelor’s degree

§ taken an ASL class

§ experience with children

o call 213-745-8391

o Mary McGinnis, Director

o Jane Freutel, Assistant Director

NSSLHA Meeting- APRIL!

Greetings NSSLHA Members!

Spring Quarter is finally here and it's time for another NSSLHA meeting!!

What: Jane Freutel will speak about opportunities to work with children who are deaf.

More information about Mary McGinnis can be found at the John Tracy Clinic Website
Where: King Hall B3016
When: Tuesday April 12th at 6pm

Food and drinks will be provided for paid NSSLHA members and a raffle for a Voice textbook will take place!

Other Announcements:
1. You can still sign up for the Autism Walk! We are SO close to meeting our goal!

How can I join the NSSLHA team for the Autism Walk?

• join here: http://www.walknowforautismspeaks.org/faf/search/searchTeamPart.asp?ievent=442586&lis=1&kntae442586=5EAD7D71619946848C2C5A7444F0ADA0&team=4014439&tlteam=0
• If that link doesn't work, then:

1. Go to: http://www.walknowforautismspeaks.org/faf/home/default.asp?ievent=442586
2. Find "Join or Support a Team" and type in: "CSULA" and press Submit
3. Click: CSULA National Student Speech Language Hearing Association
4. 4Click Join Our Team and you're in!!

CSHA Convention 2011

Mr. Paulson received an award for Outstanding Achievement.

Some of our second year graduate students, one of which who had a poster board she presented (Wakana.)

This past weekend was the CSHA Convention at CSULA. Here are a few photos from the convention courtesy of Dr. Simon-Cerejido. See more at our Facebook page!

Announcements!

1) One of our COMD staff members will be receiving an award at the CSHA convention:

CONGRATULATIONS to Mr. Paulson!

for Outstanding Achievement! If you see him on campus, congratulate him for such an accomplishment!

2) Also, if you would like to learn more about working with children with Autism, you can volunteer for Floortime Family fun day on April 15th from 1-5pm at Griffith park. To sign up, contact:

Meghan Crawford at dr.meghancrawford@gmail.com

3) Applications are available to sign up for MSLP! More information here: http://www.goeshow.com/asha/mslp/2011/

March Meeting Notes

Here's our meeting notes for March!

Thanks to Diane Collins and Mitch Holden for coming!

March Mtg Notes
03/08/11
Guest: Diane Collins (CSHA President) and Mr. Holden
www.csha.org

• Announcements
• Autism Walk, April 23rd
• join here: http://www.walknowforautismspeaks.org/faf/search/searchTeamPart.asp?ievent=442586&lis=1&kntae442586=6A9703936DEA4476A71068660C84A096&team=4014439&tlteam=0
• Guest speakers: Mr. Holden (part of District 6) and Diane Collins
• Joining CSHA
• help at the upcoming convention March 24-27 at the Los Angeles Biltmore
• opportunities to help out
• there’s a student luncheon
• on the 25th of the convention there's a district reception where students receive scholarships that they applied for
• free president reception with food and a classic rock band afterward
• on 26th there’s a student luncheon where the students who received scholarships get acknowledged again
• be a Student Representative
• contact janice@csun.edu for more information
• to volunteer at the CSHA convention and let her know you want to help
• or contact Diane Collins: slpdicollins@aol.com
• can work at the state level or district level
• can possibly be in the state board
• Mr. Holden works for District 6
• Why get involved?
• room for professional growth
• good networking (e.g. get help making goals, get new connect ions etc)
• go to www.csha.org
• can see quarterly highlights
• see resources of opportunities for students and SLPAs
• get legislative updates (from Robert Powell) for professional development at calendar events
• one upcoming event is the Survivor Symposium (for students) at Chapman University
• you get subscribed to the CSHA magazine
• if you go to the CSHA convention you can get a reduced rate for CSHA membership
• there’s an Ambassador Program
• if you have a friend join, you get 10 points.
• each 10 points is a gift certificate
• if you get 5 friends to join, that’s one year CSHA membership
• 10 friends= one free convention registration
• Mitchell Holden
• responsible for District 6 (includes Los Angeles area)
• several legislatures of CSHA are responsible for protecting our profession
• CSHA is a great place for networking.
• Mr. Holden started to be a member in CSHA in San Francisco
• was mentored by many people and had several opportunities
• every job he received was due to his networking in CSHA
• great camaraderie
• use to work in the hospitals and presently works in the schools
• CSHA provides great discounts for conventions and CSHA workshops
• contact for more information: mholdenslp@msn.com
• If interested in going to the CSHA convention
• join by Thursday for the discounted rate (preregistration $110 for all 4 days; and after Thursday: $145)
• can sign up at www.csha.org
• Join CSHA as a student for $35
• get professional growth and opportunities
• can join online www.csha.org
• Student scholarship program
• this past year 5 scholarships were rewarded
• look for upcoming scholarship programs later this spring
• these are due by September 25, 2011