United States

Native American culture is widely misinterpreted, which has resulted in healthcare bias and inequities that has adversely affected the health and quality of life of Indigenous peoples. In this presentation, we will briefly discuss Indigenous culture, key historical outcomes, current healthcare accessibility, and explain the effects of these biases to increase cultural competence and promote culturally responsive care.

Many speech-language pathologists may be unaware of historical factors that affect care for Native American clients and cultural considerations in clinical interactions. Native American culture has rich cultural traditions. In traditional Native Americans culture, extended family is the central organizing unit, emphasizing interdependence, reciprocity, and obligation to care for one another. Within this extended network of care, children develop strong relationships and attachments with not only their immediate biological family, but also with aunts, uncles, cousins, and grandparents. (Sarche &amp; Spicer, 2008) In some tribes, children are given tribal names, decided by an elder family member, to provide purpose and help strengthen spiritual bonds and family connection. The close intergenerational relationships also provide opportunities for elder members of the family to pass on tribal stories, songs, and practices that convey values by which to live. (Sarche &amp; Spicer, 2008).

Historical factors caused irrevocable harm to families and communities. During the cultural invasion on Indigenous peoples, many were displaced onto reservations far from their known hunting grounds. Children were taken to boarding schools; the plan was to “Kill the Indian, Save the Man” (Gone, 2013) which meant forced enrollment of young Native American children in boarding schools initially planned to civilize and educate these young children. The hidden agenda included a stripping of native cultural identity and prohibition of cultural practices. Young Native American children were physically punished for speaking their native languages and were not allowed to practice traditional ceremonies while in these boarding schools. (Allison-Burbank, 2016) Many mass murders and massacres occurred and had the effect of substantially diminishing the NA population and tribes across the United States. (Allison-Burbank, 2016) As a result, Native American people experience generational trauma response, poverty living on rural reservations, and general mistrust of the government. 

Current Healthcare and Accessibility
When considering healthcare, Native Americans have disproportionate negative health outcomes. Native Americans experience high incidences of stroke, heart disease, diabetes, mental health concerns, obesity, alcoholism, poverty, and suicide. (www.ihs.gov) The primary health care service provider for NA persons is the Indian Health Services (IHS), a sector of the Public Health Services of the U.S. Department of Health and Human Services. Beyond constant reduction in federal funding and limited areas of service, the history of the IHS health care system has been somewhat checkered in providing preventative, primary, and specialty care to NAs across the nation. (Allison-Burbank, 2016) Although IHS fulfills treaty responsibilities to provide health care for members of more than 560 recognized tribes, Congress has consistently underfunded the agency, forcing hospital administrators to limit the services offered. As a result, tribal members have a different health care reality than many other U.S. citizens. (Americanbar.org) In 2016, the Indian Health Service budget was set at $4.8 billion. Spread across the US population of 3.7 million American Indians and Alaska Natives, that&#39;s $1,297 per person. That compares to $6,973 per inmate in the federal prison system. (Whitney, 2017) 

Historical factors, biases, and access limitations affect speech-language pathology services to Native American clients and directly impacts rapport building, establishing a trusting relationship, and developing effective goals and treatment plans that include cultural considerations. Additionally, there is little research in the field regarding Native American’s health, American Indian and Alaska Native communities have been increasingly frustrated by research that serves simply to document problems that they have long known to exist. At the same time, they are reluctant to accept interventions derived from other&#39;s experiences that do not consider their unique social and cultural contexts. (Sarche &amp; Spicer, 2008)

Speech-language pathologists can increase culturally responsive services by researching a client’s tribal affiliation, learning about indigenous forms of learning and teaching will be helpful in tailoring services (Allison-Burbank, 2016). Future implications in research supports the recruitment and inclusion of Native Americans within study populations for preventative healthcare and treatment outcomes. We found no published studies of interventions targeting young American Indian and Alaska Native children; for older American Indian and Alaska Native children, we found only a few—most of which focused on the lack of services for American Indian and Alaska Native children or were largely descriptive and provided few data on the effectiveness of the services. (Sarche &amp; Spicer, 2008) Acknowledge historical relevance for some clients and what generation disparities have been inherited. Identify trauma response when interacting with a client; make note when you are observing triggering behavior and help to mitigate symptoms when possible. Give additional time to build a relationship with your client that places importance on trust and open communication; unpacking years of generational trauma and trauma response will take time, and your awareness as a clinician can create positive change. If we don’t situate this problem within a societal, historical, and political context, we may inadvertently perpetuate pre-existing inequities. 


References

Sarche, M., &amp; Spicer, P. (2008). Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects. Annals of the New York Academy of Sciences, 1136(1), 126–136. https://doi.org/10.1196/annals.1425.017
Allison-Burbank, J. (2016) Historical Influences on Healthcare and Education in Native American Communities. Intercampus Program in Communicative Disorders, University of Kansas Kansas City, KS.
Westby, C., Moore, C., &amp; Roman, R. (2002). Reinventing the Enemy’s Language: Developing Narratives in Native American Children. Linguistics and Education, 13(2), 235–269. https://doi.org/10.1016/S0898-5898(01)00063-8
Disparities: Fact sheets. Newsroom. (n.d.). Retrieved April 27, 2023, from https://www.ihs.gov/newsroom/factsheets/disparities/ 
Whitney, E. (2017, December 12). Native Americans feel invisible in U.S. health care system. NPR. Retrieved April 28, 2023, from https://www.npr.org/sections/health-shots/2017/12/12/569910574/native-americans-feel-invisible-in-u-s-health-care-system 
Americanbar.org. (n.d.). Retrieved April 28, 2023, from https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/native-american-crisis-in-health-equity/ 


OSHA 2023

Decolonizing Perspectives on Indigenous Healthcare

Native American culture is widely misinterpreted, which has resulted in healthcare bias and inequities that has adversely affected the health and quality of life of Indigenous peoples. In this presentation, we will briefly discuss Indigenous culture, key historical outcomes, current healthcare accessibility, and explain the effects of these biases to increase cultural competence and promote culturally responsive care.

Many speech-language pathologists may be unaware of historical factors that affect care for Native American clients and cultural considerations in clinical interactions. Native American culture has rich cultural traditions. In traditional Native Americans culture, extended family is the central organizing unit, emphasizing interdependence, reciprocity, and obligation to care for one another. Within this extended network of care, children develop strong relationships and attachments with not only their immediate biological family, but also with aunts, uncles, cousins, and grandparents. (Sarche & Spicer, 2008) In some tribes, children are given tribal names, decided by an elder family member, to provide purpose and help strengthen spiritual bonds and family connection. The close intergenerational relationships also provide opportunities for elder members of the family to pass on tribal stories, songs, and practices that convey values by which to live. (Sarche & Spicer, 2008).

Historical factors caused irrevocable harm to families and communities. During the cultural invasion on Indigenous peoples, many were displaced onto reservations far from their known hunting grounds. Children were taken to boarding schools; the plan was to “Kill the Indian, Save the Man” (Gone, 2013) which meant forced enrollment of young Native American children in boarding schools initially planned to civilize and educate these young children. The hidden agenda included a stripping of native cultural identity and prohibition of cultural practices. Young Native American children were physically punished for speaking their native languages and were not allowed to practice traditional ceremonies while in these boarding schools. (Allison-Burbank, 2016) Many mass murders and massacres occurred and had the effect of substantially diminishing the NA population and tribes across the United States. (Allison-Burbank, 2016) As a result, Native American people experience generational trauma response, poverty living on rural reservations, and general mistrust of the government. 

Current Healthcare and Accessibility
When considering healthcare, Native Americans have disproportionate negative health outcomes. Native Americans experience high incidences of stroke, heart disease, diabetes, mental health concerns, obesity, alcoholism, poverty, and suicide. (www.ihs.gov) The primary health care service provider for NA persons is the Indian Health Services (IHS), a sector of the Public Health Services of the U.S. Department of Health and Human Services. Beyond constant reduction in federal funding and limited areas of service, the history of the IHS health care system has been somewhat checkered in providing preventative, primary, and specialty care to NAs across the nation. (Allison-Burbank, 2016) Although IHS fulfills treaty responsibilities to provide health care for members of more than 560 recognized tribes, Congress has consistently underfunded the agency, forcing hospital administrators to limit the services offered. As a result, tribal members have a different health care reality than many other U.S. citizens. (Americanbar.org) In 2016, the Indian Health Service budget was set at $4.8 billion. Spread across the US population of 3.7 million American Indians and Alaska Natives, that's $1,297 per person. That compares to $6,973 per inmate in the federal prison system. (Whitney, 2017) 

Historical factors, biases, and access limitations affect speech-language pathology services to Native American clients and directly impacts rapport building, establishing a trusting relationship, and developing effective goals and treatment plans that include cultural considerations. Additionally, there is little research in the field regarding Native American’s health, American Indian and Alaska Native communities have been increasingly frustrated by research that serves simply to document problems that they have long known to exist. At the same time, they are reluctant to accept interventions derived from other's experiences that do not consider their unique social and cultural contexts. (Sarche & Spicer, 2008)

Speech-language pathologists can increase culturally responsive services by researching a client’s tribal affiliation, learning about indigenous forms of learning and teaching will be helpful in tailoring services (Allison-Burbank, 2016). Future implications in research supports the recruitment and inclusion of Native Americans within study populations for preventative healthcare and treatment outcomes. We found no published studies of interventions targeting young American Indian and Alaska Native children; for older American Indian and Alaska Native children, we found only a few—most of which focused on the lack of services for American Indian and Alaska Native children or were largely descriptive and provided few data on the effectiveness of the services. (Sarche & Spicer, 2008) Acknowledge historical relevance for some clients and what generation disparities have been inherited. Identify trauma response when interacting with a client; make note when you are observing triggering behavior and help to mitigate symptoms when possible. Give additional time to build a relationship with your client that places importance on trust and open communication; unpacking years of generational trauma and trauma response will take time, and your awareness as a clinician can create positive change. If we don’t situate this problem within a societal, historical, and political context, we may inadvertently perpetuate pre-existing inequities. 


References

Sarche, M., & Spicer, P. (2008). Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects. Annals of the New York Academy of Sciences, 1136(1), 126–136. https://doi.org/10.1196/annals.1425.017
Allison-Burbank, J. (2016) Historical Influences on Healthcare and Education in Native American Communities. Intercampus Program in Communicative Disorders, University of Kansas Kansas City, KS.
Westby, C., Moore, C., & Roman, R. (2002). Reinventing the Enemy’s Language: Developing Narratives in Native American Children. Linguistics and Education, 13(2), 235–269. https://doi.org/10.1016/S0898-5898(01)00063-8
Disparities: Fact sheets. Newsroom. (n.d.). Retrieved April 27, 2023, from https://www.ihs.gov/newsroom/factsheets/disparities/ 
Whitney, E. (2017, December 12). Native Americans feel invisible in U.S. health care system. NPR. Retrieved April 28, 2023, from https://www.npr.org/sections/health-shots/2017/12/12/569910574/native-americans-feel-invisible-in-u-s-health-care-system 
Americanbar.org. (n.d.). Retrieved April 28, 2023, from https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/native-american-crisis-in-health-equity/ 


poster

The Oregon Speech-Language and Hearing Association (OSHA) is excited to present 2023 Fall Conference theme “Community in Action”. In addition to professional development content at the conference, we look forward to recognizing and celebrating the research, clinical work, and advocacy of our colleagues through our OSHA honors and awards.
![](https://assets.underline.io/markdown_image/1/image/92e74f01eb24c636be05cffbeb8a6fd5.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAZP4XRUPAQFEPSF6P%2F20231005%2Feu-west-1%2Fs3%2Faws4_request&X-Amz-Date=20231005T092853Z&X-Amz-Expires=172800&X-Amz-SignedHeaders=host&X-Amz-Signature=46282c851bac71ec0759d4bc020befeafa87b9563672c42adee427c9a43129d5)

<br>
Join us from November 1st to 17th for a compelling virtual experience and continuing education opportunity to those involved in the Speech-Language & Hearing industry on the Underline platform!


#### [**OSHA 2023 On-Demand Offering**](https://drive.google.com/file/d/1jwrAmTttlBTCTRgErURL06kXcmGhJco9/view?usp=sharing)


#### [**The Official Website of the OSHA**](https://www.oregonspeechandhearing.org/fall-conference)


To access the site please register [**here**](https://www.oregonspeechandhearing.org/event-5462300). 

Please register for the 2023 OSHA Fall Conference to join the event.

The Oregon Speech-Language and Hearing Association (OSHA) promises to be a forum of growth, learning, and meaningful exchange, encompassing a rich tapestry of topics that are shaping our field in profound ways. The conference agenda is designed to address a wide array of critical subjects, each reflecting the evolving landscape of speech-language pathology. From early language and literacy development to the provision of gender-affirming and culturally responsive care, we are diving deep into the issues that matter most to our profession and the individuals we serve.

Background
Social communication is an integral part of everyday functioning and is often employed to interact with familiar and unfamiliar communicative partners to develop friendships and social connections (Macdonald, 2017). People living with acquired brain injury (ABI) often experience challenges with cognitive and communicative functions which limit their socializations or participation in everyday life activities. This affects their ability to develop and maintain friendships, community reintegration, and return to work (Mitchell et al., 2014; Salas et al., 2018).

Participating in leisure activities with peers can enhance self-identity, foster a sense of community, and yield positive health outcomes among adults with and without neurological impairments (Haslam et al., 2014). Conversely, social isolation and loneliness can negatively affect quality of life, emotional wellbeing, and increase the risk of depression and mortality among individuals with acquired brain injury (Holt-Lunstad et al., 2015; Salas et. al., 2021). Furthermore, the COVID-19 pandemic has exacerbated social isolation among individuals with ABI (Bellon et al., 2023). This has led to limited opportunities for social engagement and a lack of access to support services, consequently impacting mental health and well-being, particularly for persons who are homebound due to mobility issues or live in rural communities. Further, very few non-therapeutic opportunities exist that specifically target improvement of social communication in the context of community-based leisure reintegration (e.g., Alves-Stein et al., 2022) highlighting the critical need for such supportive opportunities for persons with ABI, specifically for those who cannot access existing in-person services. The Friends Program was established as a partnership between Brain Injury Connections-Northwest (BIC-NW) and the Department of Speech and Hearing Sciences at Portland State University to address this important gap in services for the ABI community. The program seeks to provide opportunities to reduce social isolation and enhance their social skills by developing friendships by pairing individuals who have different types of ABIs (e.g., traumatic brain injuries, strokes) with student volunteers.

Purpose
The study aims to evaluate the feasibility and acceptability of an updated iteration of the virtual Friends Program to support social connections between individuals with ABI and undergraduate student peers. 

Method
The preliminary portion of the program involved two main phases, namely recruitment and training, which were designed to ensure the successful implementation of the online version of the 5-month Friend’s Program. During the recruitment phase, speech-language pathology graduate student program leaders recruited potential student volunteers using engaging materials (e.g., informational emails, videos). Interested students completed an application to document interest in the program, their comfort and previous experience with ABI, and personal traits they would bring to the program. Matching was accomplished with the help of the leaders at Brain Injury Connection Northwest. Pairs were matched in terms of similarities of interests and specific preferences (e.g., age, gender, availability).
The next phase of the program involved training of the volunteers. Program leaders modified existing program manual and training materials and further developed them to optimize the viability of the online version of the Friends Program. Following review of training materials, all student volunteers completed the “Interact-ABI-lity” program (Togher et al., 2022) and participated in an hour-long remote training session. which covered basic information about brain injury and physical, cognitive, communication, and emotional consequences associated with it. The training also included scenario-based learning opportunities for students. Following training, all friend pairs attended an introductions meeting to exchange information and availability. Informal feedback information was sought from student volunteers regarding the program training. 

Results and Discussion
The program received 15 student volunteers, out of which seven students were selected to be matched with their friends with ABI. Preliminary analysis of the post-training survey responses from undergrad volunteers revealed an increased perception of preparedness in interacting with individuals with ABI. Students felt training was appropriate and not excessively lengthy and that they enjoyed the online formatting of the program (full results will be analyzed and presented at the OSHA conference in October 2023). 

Conclusion
Preliminary results indicate that the updated Friends Program is feasible to implement in a remote format and is well accepted by individuals with ABI and students serving as friends. Programs such as these have an immense potential to address the social communication needs, preserve self identity, and improve quality of life outcomes of those with ABI. 

References
Alves-Stein, S., George, S., Lannin, N. A., & Jolliffe, L. (2022). Implementation of a leisure reintegration programme for people with acquired brain injury in a community rehabilitation programme: A feasibility study. Brain Impairment, 1–13. 
Bellon, M., Idle, J., Lay, K., & Robinson, S. (2023). Community in the pandemic: Experiences and strategies by people with acquired brain injury and their families during COVID-19. Disability and rehabilitation, 45(6), 1038–1045. 
Haslam, C., Cruwys, T., & Haslam, S. A. (2014). “The we’s have it”: Evidence for the distinctive benefits of group engagement in enhancing cognitive health in aging. Social Science & Medicine (1982), 120, 57–66. 
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on psychological science: a journal of the Association for Psychological Science, 10(2), 227–237. 
MacDonald, S. (2017). Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury. Brain Injury, 31(13-14), 1760-1780. 
Mitchell, E. J., Veitch, C., & Passey, M. (2014). Efficacy of leisure intervention groups in rehabilitation of people with an acquired brain injury. Disability and rehabilitation, 36(17), 1474–1482. 
Salas, C. E., Rojas-Líbano, D., Castro, O., Cruces, R., Evans, J., Radovic, D., Arévalo-Romero, C., Torres, J., & Aliaga, Á. (2022). Social isolation after acquired brain injury: Exploring the relationship between network size, functional support, loneliness and mental health. Neuropsychological Rehabilitation, 32(9), 2294–2318. 
Salas, C. E., Casassus, M., Rowlands, L., Pimm, S., & Flanagan, D. A. J. (2018). “Relating through sameness”: A qualitative study of friendship and social isolation in chronic traumatic brain injury. Neuropsychological Rehabilitation, 28(7), 1161–1178. 
Togher L, Brunner M, Power E, Avramovic P, Miao M, Riedijk., R (2022). Interact-ABI-lity. https://abi-communicationlab.sydney.edu.au/courses/interact-abi-lity.


Friendship in acquired brain injury: Efficacy of virtual friending program

According to the American Speech Language Hearing Association 2020 Certification Standards (ASHA, 2020), applicants for their Certification of Clinical Competence must complete a minimum of 400 clockhours of supervised clinical experience in the practice of speech-language pathology. Of the 400 clockhours required, 375 must be spent in direct client/patient contact with supervision. Clinical clockhours are obtained in graduate programs via off-campus and on-campus settings, including clinics, hospitals, schools and rely heavily on community supervisors. The issue of clinician productivity is a concern for some corporate policies, however studies have found there to be either no significant difference in productivity with a student (Bourne et al 2019) or an increase in productivity with a student (Dillon, et al 2003). Productivity aside, there are speech language pathologists that are eligible to host students but opt out. 

According to the U.S. Bureau of Labor Statistics in 2021, the field of Speech-Language Pathology was on track to have a 21% job growth rate between 2021 and 2023 whereas the national average job growth is 5%. Graduate programs must continue to enroll students at their top capacity in order to keep up with this growth however this ability may be limited due to lack of adequate supervisors willing to host students. In 2015, 33% of SLP master's programs identified insufficient clinical placements as a barrier to increasing program size (ASHA, 2015). 

This poster will systematically look at barriers and facilitators to agreeing to host graduate students based on survey data collected from 119 ASHA Certified speech language pathologists in the United States. The poster will discuss survey findings and potential changes that can be made at the University level to ensure that SLP graduate students are able to meet the minimum hour requirements for graduation while supporting the supervising SLPs in a meaningful way. 

References:
American Speech Language Hearing Association (2015). What most affects graduate program size? 20 (9). https://doi.org/10.1044/leader.AAG.20092015.28

American Speech Language Hearing Association (2020). 2020 Standards and Implementation Procedures for the Certificate of Clinical Competence in Speech-Language Pathology. Retrieved from asha.org.

Bourne, E., McAllister, L., Nagarajan, S., & Short, K. (2019). The effect of speech-language pathology students on clinician time use and activity. International Journal of Speech-Language Pathology, 21(2), 163-174. 


Bureau of Labor Statistics, U.S. Department of Labor. (2022). Speech-Language Pathologists. Occupational Outlook Handbook. Retrieved from https://www.bls.gov/ooh/healthcare/speech-language-pathologists.htm

Loretta, S. D., Tomaka, J. W., Chriss, C. E., Gutierrez, C. P., & Hairston, J. M. (2003). The Effect of Student Clinical Experiences on Clinician Productivity. Journal of Allied Health, 32(4), 261-5. https://uoregon.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/effect-student-clinical-experiences-on-clinician/docview/210980314/se-2


Barriers and Facilitators to Externship Supervising

"In this poster presentation, we aim to 1) highlight the need for neurodiverse professionals in speech-language pathology, 2) describe barriers for neurodiverse undergraduate and graduate students, and 3) examine existing practices and/or programs at undergraduate institutions across the United States that have specific aims to recruit and support neurodiverse students. We aim to identify institutional best practices for supporting these students and consider how the initiatives may be specifically applied within undergraduate and graduate communication sciences and disorders programs. The authors of this presentation include neurodiverse undergraduate and graduate students and their allies. We note that our university, like most, does not currently have a specific program for self-identifying neurodiverse students or a neurodiverse affinity group within our Office of Equity, Diversity, and Inclusion. Knowledge gained through this project could support faculty members and administrators in higher education across institutions.     

The field of speech-language pathology benefits from having a diverse workforce. Clinicians who understand and have experienced variety within culture, dialect, and communication style are beneficial collaborators with clients, students, patients, and their families. ASHA strives to increase diversity within the workforce of speech-language pathologists (ASHA, n.d.), and it is important to recognize neurodiversity, and disability broadly, as an element within diversity, equity, and inclusion (DEI) (Donaldson, 2021). 

Professional representation of neurodiverse individuals is important. ASHA does not survey its membership related to disability or neurodiversity status; however according to a recent survey in several midwestern states, few therapists identify (via self-disclosure) as autistic: less than 3% (Freeman Barnett, 2022). Despite this, our patients, clients, and students benefit immensely from the perspectives of neurodiverse individuals, and we need to rely on input from the autistic community and autistic providers to guide our clinical services and research practices (e.g., Dorsey et al. (2020)). 

Drawing neurodiverse individuals to the field is a possible strategy; however, it is not sufficient.  The professional pathway for a career in communication sciences and disorders is rigorous and requires students to successfully complete undergraduate work, be accepted into graduate school, and succeed in graduate studies. With regard to graduate school admittance, several recent papers have described the benefits of holistic admission practices within speech-language pathology graduate programs to increase the diversity of our students (e.g., Mandulak, 2022; Guiberson & Vigil, 2021; and Wong et al., 2021). These practices value lived experiences and attempt to balance these experiences with academic metrics and other personal attributes. Application of these principles may also help support admissions for neurodiverse individuals.  

Several institutions across the United States have recently developed some dedicated systems of support (e.g., Stanford Neurodiversity Project), campus-wide education (e.g., The Neurodiversity Initiative at William & Mary), and career-specific partnerships with STEM-related organizations (e.g., NASA’s Neurodiversity Network at Sonoma State). We will conduct a comprehensive review of existing programs and describe specific actions schools have taken to meet student needs and examining career related advantages to neurodiversity (Ortiz, 2020). We aim to identify institutional best practices for supporting neurodiverse students at the undergraduate and graduate level and consider how these broadly applied practices may support those students interested in a speech-language pathology career. 

American Speech-Language-Hearing Association.(n.d.).Diversity and inclusion at ASHA. Retrieved March 29, from https://www.asha.org/About/Diversity-and-Inclusion-at-ASHA/

Donaldson, A. L. (2021). Disability in speech and hearing sciences: Reflections on representation. Perspectives of the ASHA Special Interest Groups, 6(3), 513-519.

Dorsey, R., Crow, H., & Gaddy, C. (2020). From My Perspective/Opinion: Putting Autistic Voices at the Forefront of Care. Leader Live.

Freeman Barnett, Rebecca, ""Speech-language pathologists on the autism spectrum"" (2022). Master's Theses and Doctoral Dissertations. 1127. https://commons.emich.edu/theses/1127

Guiberson, M., & Vigil, D. (2021). Speech-language pathology graduate admissions: Implications to diversify the workforce. Communication Disorders Quarterly, 42(3), 145-155.

Lizotte, M. (2018). I am a college graduate: Postsecondary experiences as described by adults with autism spectrum disorders. International Journal of Education and Practice, 6(4), 179–191. https://doi.org/10.18488/journal.61.2018.64.179.191 

Mandulak, K. C. (2022). The case for holistic review in communication sciences and disorders admissions. Perspectives of the ASHA Special Interest Groups, 7(2), 476-481.

Ortiz, L. A. (2020). Reframing neurodiversity as competitive advantage: Opportunities, challenges, and resources for business and professional communication educators. Business and Professional Communication Quarterly, 83(3), 261-284.

Wong, A. A., Marrone, N. L., Fabiano-Smith, L., Beeson, P. M., Franco, M. A., Subbian, V., & 
Lozano, G. I. (2021). Engaging faculty in shifting toward holistic review: Changing graduate admissions procedures at a land-grant, Hispanic-serving institution. American journal of speech-language pathology, 30(5), 1925-1939.

If oral presentation, we would use the following Time-Ordered Agenda: 
5 minutes—Introductions and Disclosures
15 minutes—Overview and Background
25 minutes—Case Studies for 3-4 University Programs
10 minutes—Summary and Best Practice Ideas, Consideration of barriers
I5 minutes—Conclusion and Wrap-Up

Neurodiverse Representation: How Higher Education Programs Can Support Diverse Students DEI Topic

Speech-language pathologists’ approaches to augmentative and alternative communication (AAC) assessments

Writing Scripts to Address Sexual Health and Consent: Choose your own adventure!

Literature Review 

Speech-language pathologists’ (SLPs) expertise in the language underpinnings of speaking, listening, reading, and writing is critical when working with teams to serve individuals with written language difficulties. SLPs’ roles and responsibilities include prevention, assessment, and treatment of written language disorders (ASHA, 2010). Reading and writing disorders, which often co-occur (e.g., Kim, 2022), present in a variety of profiles. Reading disorders are frequently described in terms of decoding and listening comprehension (e.g., the Simple View of Reading) as well as by multi-faceted models such as Scarborough’s (2001) Reading Rope, the Language Literacy Network (Wasowicz, 2021), and the Interactive Dynamic Literacy Model (Kim, 2022). Dyslexia is one such profile; in broad terms, individuals with dyslexia have strengths in language comprehension and difficulties with the phonological aspects of language. Other reading disorder profiles include Developmental Language Disability (DLD) and reading comprehension disorder. 

The presence and nature of reading and writing disorders involve spelling assessments as part of a comprehensive evaluation. Spelling assessments may be standardized norm-referenced (e.g., SPELL-2; Masterson et al., 2002), criterion-based (e.g., Words Their Way; 2008), and/or authentic using spelling samples. An assessment approach that involves an analysis of spelling errors, as opposed to scoring based on the number of words spelled correctly, is powerful in several ways (Masterson & Apel, 2010). First, spelling error analysis provides a window into an individual’s linguistic knowledge (e.g., Henbest & Apel, 2021). Specific types of spelling errors indicate strengths and weaknesses in the language areas of phonological awareness, orthographic knowledge, morphological awareness, and semantic knowledge (Henbest & Apel, 2021; Masterson & Apel, 2010). Second, spelling error analysis informs a treatment approach that builds on the linguistic knowledge not yet mastered by the student. Third, error analysis embedded within the treatment plan allows for ongoing assessment of progress over time. Although there is ample information to support the provision of effective literacy interventions, including word study, SLPs may not be completely comfortable or confident in their ability to provide these interventions (Marble-Flint et al 2022). However, when supported through evidence-based professional development, SLPs may provide effective literacy interventions, leading to improved outcomes for all children (Mahowald & Rentmeester-Disher, 2019).

Statement of Purpose 

Recent results of national outcomes testing indicates that literacy outcomes in most US states declined significantly when compared to scores from 2019 (NAEP, 2023). In addition to reading specialists and special educators, SLPs potentially play a key role in improving reading outcomes for all children, not just those with identified disabilities. They bring expertise in different components of language and the reciprocal relationship between written and oral language that is important in understanding literacy development in all children. The purpose of this presentation is to equip SLPs with the background knowledge and tools that will allow them to elicit and analyze spelling samples, using the multilinguistic model. Attendees will also learn how to identify treatment options that align with language needs based on the results of the analysis. 

Summary of Proposal 

The presenters will review the multilinguistic model of reading and spelling, including phonology, orthography, morphology, and semantics, with emphasis on phonology and orthography as they pertain to beginning readers and spellers. The simple view of reading and reading disorders will be reviewed, including dyslexia and literacy difficulties resulting from developmental language disorder. The presenters will then demonstrate how the multilinguistic model can be applied to spelling analysis. A variety of typical and atypical spelling samples will be presented and participants will be guided through the process of spelling analysis using the language blocks, followed by the development of treatment targets based on the results of the analyses. The presenters will share a variety of resources related to literacy disorders, assessments and interventions. There will be ample time for questions and discussion. 

Outline

5 mins- Introductions and disclosures
10 mins- Review of Simple View of Reading 
10 mins- Review of different types of reading disorders and profiles
30 mins- Language blocks of spelling with examples
30 mins- Spelling Analysis
20 mins- Case studies; Discuss implications for instruction based on spelling error analysis
15 mins- Share resources related to reading disorders and interventions; Q & A



What’s Spelling Got to Do With It?

This presentation is based on a recent article published by Katie Gore and Courtney Luckman Margulis in the May 2022 issue of Perspectives of the ASHA Special Interest Group #4, Fluency and Fluency Disorders (Gore and Luckman Margulis, 2022). As a therapist with 45 years of experience, one learns to pay attention to those occasional articles that have the potential to change how we do our work. This is one of those. I would describe it as seminal, one that will hopefully change how therapy is provided in the future. The concept is simple and long needed: how do we help non-specialists in fluency disorders, including school based SLPs, and especially those who see only one or two clients per year, navigate the tremendous amount of, yes, evidence-based therapy approaches that may unfortunately present competing ideologies. How do we give clinicians a place to start based on best practices that also allow them to use the other two parts of the evidence-based triangle: clinical expertise and client values? How do we increase clinician confidence that they indeed can be of help and not harm? How do we ensure that the therapy they provide is holistic, treating the whole individual and not just their lack of fluency? 

First 15 minutes: This article (and this presentation) introduces a treatment organization and therapy planning tool, NOT a new intervention. It presents and defines three organizational concepts that allow almost all existing therapy approaches to be categorized. The three concepts, each beginning with the letter E are Education, Ease, and Empowerment. 

Education refers to any activity helping the client learn about stuttering: stuttering facts and myths; anatomy and physiology; types of approaches, and how others deal with stuttering. Education taps into the Cognitive aspect of stuttering from the ABCs of stuttering (Cooper and Cooper, 1998). 

Ease refers to ways of reducing the struggle involved in stuttering, making speech less tiring and less effortful, and includes fluency shaping and stuttering modification approaches. Ease deals with the Behavior aspect of stuttering. 

Empowerment relates to the person learning to see herself as more than her stutter, as learning to move toward accepting some stuttering as she says what she wants to say, when she wants to say it and to whom she wants to say it. This of course relates to the Affective (attitudes and emotions) part of the ABCs of stuttering. Empowerment approaches might include self-disclosure, voluntary stuttering, giving a talk where stuttering is allowed to happen, or reducing avoidances. 

The remaining 45 minutes: Once these introductory remarks are out of the way, the bulk of this presentation will be a collaborative activity where participants will be encouraged to name every stuttering therapy approach or activity they have used or heard about in graduate school or read about in the literature, and then place those activities in one of the three E categories. 

A major goal of this session will be to ensure that attendees, as they anticipate providing speech therapy for clients who stutter, will be encouraged to include activities from each of the Es and in so doing to realize they will be delivering helpful and comprehensive (not fluency-only) affirming therapy that yes, may require some reeducation of family members and school personnel about what stuttering is.

REFERENCES: 

Cooper, E. & Cooper, C. (1998). The Cooper Fluency Workshop. Nova Southeastern University's Program in Communication Sciences and Disorders one-day presentation September 19th, 1998.

Gore, K.& Luckman Margulis, C. (2022). 3Es: An All-Inclusive Stuttering Therapy Tool. Perspectives of the ASHA Special Interest Group 4 (May, 2022)

A New User-Friendly Framework for Organizing Stuttering Therapy Approaches

The utilization of telepractice has grown exponentially since early 2020. Innovations abound in the practice of teletherapy, however, not much has changed in terms of telepedagogy or its use in preparing graduate students for clinical practice. This seminar will review current research in teletherapy and introduce its innovative use in telepedagogy. 

Virtually utilizing real patients in the classroom, student clinicians were provided an opportunity to learn about and to demonstrate application of evidenced based concepts in real time. Faculty, student and patient responses in a reflective questionnaire highly supported this telepedagogy. Faculty and students reported positive attitudes towards telepractice engagement, their experience with technology, implementation of the virtual session, learning course content, and professional development.

Current research and innovations were reviewed prior to and during this study. Telepractice is an ever-evolving mode of service delivery that includes innovations and changes in videoconferencing platforms as well as in assessments and therapy materials. Real patients virtually attended class time weekly for the full course of a semester. Small student groups created an informal assessment and treatment plan targeting course constructs. Qualitative data was collected from students via a reflective questionnaire at the end of the semester pertaining to comfort with use of telepractice, value in, and perceptions of professional development. 

Introduction
The use of telepractice as a telepedagogy has the potential to facilitate the application of course constructs to clinical practice, thus improving student learning as reported by faculty and students. Telepractice has grown exponentially since early 2020. Innovations abound in the practice of teletherapy, however, not much has changed in terms of telepedagogy or its use in preparing graduate students for clinical practice. This presentation will review current research in teletherapy and introduce an innovative use of telepractice in telepedagogy. 

Procedures 

Faculty, student clinician and patient questionnaire responses, addressing the phenomenology of perceptions of the use of telepractice during classroom instruction, were collected post completion of virtual assignment. Assignments utilized real patients virtually in the instructional classroom. Faculty developed student assignments considering course objectives and learner’s knowledge & skills. Small student groups developed evidenced based informal assessment measures and clinical activities reflecting course constructs. Remaining students observed and documented the application of course constructs with real patients in real time. Patients attended remotely, engaging with student clinicians and participating the in planned activities. 

Faculty, student clinicians and patients responded to questionnaires addressing the telepedagogical experience. General perspectives on telepractice engagement, experience with technology, implementation of virtual sessions, and overall satisfaction with the experience were obtained from each group. 

Results
Faculty responded to questions addressing perceptions of pedagogical effectiveness, assessing student application of course content to clinical application, changes in faculty - student engagement, and student acquisition of learner objectives. 

Students responded to question addressing perceptions of confidence with virtual engagement, facilitation with learning course content, ability to self-assess effectiveness in engagement with a virtual patient, professional development, an employability. And finally, patients responded to questions addressing their experience with virtual student engagement, and willingness to provide feedback to students. 

Discussion
Faculty responses were highly positive to questions addressing pedagogical effectiveness, observation and evaluation of student application of course content, frequency and quality of faculty-student engagements, and acquisition of learner objectives. Student responses were overwhelmingly positive addressing perceptions of gained confidence in virtual engagement, facilitation of learning theoretical concepts and ability to self-assess effectiveness of virtual engagement. Patient responses were generally altruistic in nature, reporting satisfaction with engaging with student clinicians, providing opportunities for “giving back,” providing real time verbal feedback to students, and in the opportunity to support student learning based on personal experiences with speech-language pathology.

Utilization of telepractice, innovations in practice delivery, and clinical application continues to expand. Positive faculty, student and patient responses to the experience of telepractice in telepedagogy has merit for its inclusion in academic training programs to prepare entry level clinicians for the continuous evolution of the scope of practices in speech-language pathology. 

Overby, M. S., & Baft-Neff, A. (2017). Perceptions of telepractice pedagogy in speech-language pathology: A quantitative analysis. Journal of Telemedicine and Telecare, 23(5), 550-557.
Kim, S., Roman, A. M., & Moore, A. (2022). Patient and caregiver satisfaction regarding telepractice versus in-person services at a university speech, language, and hearing clinic. Clinical Archives of Communication Disorders, 7(3), 83-93.
Lenkey, L. (2020). Connecting speech-language pathology graduate students to their future; Telepractice pedagogy in the classroom. In EDULEARN20 Proceedings: 12th International Conference on Education and New Learning TechnologiesOnline Conference. 6-7 July, 2020. (p. 6740). IATED Academy
Bhattarai, B., Sanghavi, T., & Panchakshari, A. B. (2022). Experience Delivering Tele-practice Services among Upcoming and Working Professionals of Speech Language Pathology. Journal of Health and Allied Sciences NU, 12(04), 441-447.

5 minutes—Introductions and Disclosures
10 minutes—Overview of telepractice in telepedagogy
30 minutes—Présentation/Demonstration - implementation / Questionnaire responses to telepractice in telepedagogy
5 minutes— Conclusion
10 minutes—Q & A


Innovations in Telepractice-How do we integrate it into Telepedagogy

OSHA 2023 Awards

Empowering the survivor of head injury presentation is a model for collaborative treatment including a resource coordinator, occupational and physical therapy working primarily with adults. Motivational interviewing is program foundation. The treatment is individualized to build on the client’s strengths with all clinicians educating in core skills of recovery.

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