Welcome to the Children's Speech Therapy Corner

Welcome to a Corner filled with Information related to the Speech and Language disorders seen in Children. Information on assessment, intervention strategies, and the latest updates in research. You will also be able to interact with other professionals and parents.

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Wednesday, January 28, 2009

What is Telepractice?

What is Telepractice?

In ASHA's recent position statements, telepractice is defined as "the application of telecommunications technology to delivery of professional services at a distance by linking clinician to client, or clinician to clinician, for assessment, intervention, and/or consultation."

ASHA's position is that "telepractice is an appropriate model of service delivery for the professions of speech-language pathology [and audiology]. Telepractice may be used to overcome barriers of access to services caused by distance, unavailability of specialists and/or sub-specialists, and impaired mobility."

Telepractice offers "the potential to extend clinical services to remote, rural, and undeserved populations, and to culturally and linguistically diverse populations."

How Telepractice Is Being Used...

...By Audiologists:

* Infant hearing screening
* Hearing screening
* Hearing aid programming and counseling
* Auditory brain-stem response (ABR)
* Otoacoustic emissions (OAEs)
* Audiologic rehabilitation

...By Speech-Language Pathologists:

* To provide speech and language services to schools in remote or undeserved areas
* To provide voice, aphasia, or cognitive-communication treatment to satellite clinics from hospitals
* In clients' homes as an adjunct to home health visits
* For specialized services such as laryngectomy rehabilitation and augmentative and alternative communication

Client Selection for Telepractice

To select clients who are appropriate for assessment/intervention services via telepractice.

Knowledge and skills:

3.a. Understand the potential impact of physical and sensory characteristics on the client's ability to benefit from telepractice, and provide modifications or accommodations (as appropriate) for factors such as:
  • hearing ability,
  • visual ability (e.g., ability to see material on a computer monitor),
  • manual dexterity (e.g., ability to operate a keyboard if needed), and
  • physical endurance (e.g., sitting tolerance).

3.b. Understand the potential impact of cognitive, behavioral, and/or motivational characteristics on the client's ability to benefit from telepractice, and provide modifications or accommodations (as appropriate) for factors such as:
  • level of cognitive functioning,
  • ability to maintain attention (e.g., to a video monitor),
  • ability to sit in front of a camera and minimize extraneous movements to avoid compromising the image resolution, and
  • willingness of the client and family/caregiver (as appropriate) to receive services via telepractice.
3.c. Understand the potential impact of communication characteristics on the client's ability to benefit from telepractice, and provide modifications or accommodations (as appropriate) for factors such as:
  • auditory comprehension,literacy,
  • speech intelligibility, and
  • cultural/linguistic variables (e.g., availability of an interpreter).
3.d. Understand the potential impact of the client's support resources on his or her ability to benefit from telepractice, and provide modifications or accommodations (as appropriate) for factors such as:

  • availability of technology,
  • access to and availability of resources (e.g., telecommunications network, facilitator),
  • appropriate environment for telepractice (e.g., quiet room with minimal distractions), and
  • client's and/or family/caregiver's ability to follow directions to operate and troubleshoot telepractice technology and transmission.

Selection of Assessments and Interventions

To use technology to deliver appropriate assessments and interventions.


4.a. Knowledge of the potential benefit of providing assessment/intervention in the patient's natural environment

4.b. Knowledge of the appropriateness of commercially available computerized clinical tools

4.c. Awareness of the potential impact on standardized tests, diagnostic procedures, and intervention strategies when administered via telepractice


4.1. Selection and administration of formal and informal diagnostic tools at a distance

4.2. Identify supplemental tools/technology (e.g., fax machines, telephones) for clients to receive optimal services at a distance

Cultural/Linguistic Variables

To be sensitive to cultural and linguistic variables that affect the identification, assessment, treatment, and management of communication disorders/differences in individuals.

Knowledge and skills :

5.a. The influence of one's own beliefs and biases in providing effective services

5.b. The need to respect an individual's race, ethnic background, lifestyle, physical/mental ability, religious beliefs/practices, and heritage

5.c The influence of the client's traditions, customs, values, and beliefs related to providing effective services via telepractice

5.d. The impact of assimilation and/or acculturation processes on the identification, assessment, treatment, and management of communication disorders/differences when delivered via telepractice

5.e. The clinician's own limitations in education/training in providing services to a client from a particular cultural and/or linguistic community

5.f. Appropriate intervention and assessment strategies and materials, such as food, objects, and/or activities that do not violate the client's values

5.g. The need to refer to or consult with other service providers with appropriate cultural and linguistic proficiency, including a cultural informant/broker, as it pertains to a specific client

5.g. Ethical responsibilities of the clinician concerning the provision of culturally and linguistically appropriate services

Use of Support Personnel

To train and use support personnel appropriately when delivering services via telepractice.


6.a. Guidelines for training, credentialing, use, and supervision of support personnel as described in the ASHA Code of Ethics (ASHA, 2003) and ASHA practice policy documents (ASHA, 1996)

6.b. State regulations regarding credentialing and supervision of support personnel

6.c. Information needed by support personnel about the technology and delivery of services via telepractice


6.a. Selecting clients, clinical activity, and technology that are appropriate for support personnel during telepractice service delivery

6.b. Providing appropriate training to support personnel in the delivery of services via telepractice (e.g., patient and family/caregiver instruction, equipment check and maintenance, clinical task performance, record keeping, universal precautions)
  • appropriate training for privacy and electronic data interchange consistent with state and federal regulations
6.c. Providing appropriate supervision to support personnel (e.g., developing an effective relationship, providing feedback, and modeling appropriate communication and ethical professional conduct)

Friday, January 23, 2009

A new world of Telespeech Therapy

I am proud to be part of a telespeech therapy practice.Being a team member in a pioneering work is fabulous. Its been 6 months since I have been giving children speech therapy through the internet to the opposite part of the world, sitting in the comforts of my home in my pajamas!!! How cooler can that get. Moving away from my comforts, its sheer joy to know that I and my team mates are helping out these kids(mostly in remote areas) where no speech therapists are available. We are making a difference!!!

In the next few weeks, I will be putting up posts introducing you to Telespeech Practice and what its all about.

Parents,your child can receive speech therapy (after looking into if he/she satisfies a few criterion).It has remarkable results. The kids love it and so will you.

And to you Speech therapists, it may be a questionable area,totally taking you out of your comfort zone, questioning your ethics, but it is a possibility. It is not just in its research stage, or scary territory. It has become an accepted part in the delivery of Speech and language services.

Thursday, January 15, 2009

Selective Mutism

My experience with Selective Mutism is quite limited and having a patient now, I haven't seen much of a breakthrough yet. Searching through the internet, I stumbled upon this paper presented at the ASHA 2008 by Jan Middendorf and Jessica Burungrud. It truly gave me a new perspective to treat and an encouragement, when I was running out of ideas. There are other fabulous handouts from this years ASHA convention that you can access.

Click on the link : http://convention.asha.org/handouts.cfm

Selective Mutism: Strategies for Intervention
ASHA 2008
Jan Middendorf, M.A,CCC
Jessica Buringrud, M.A.,CCC
Shaping Nonverbal to Vocal to Verbal Skills
Warm up activity
  • Non vocal act, such as stick out tongue, close teeth and smile, place upper teeth on lower lip. These acts were repeated with air flow, creating an approximation of the speech sounds /th, s, f/ respectively.
  • Non vocal blowing act and then stopping of the air stream at the level of the lips, then tongue tip at teeth, then at soft plate, creating an approximation of the speech sounds /p, t, k/ respectively.
  • Repeat above task with voicing (cue, make it noisy) to produce speech sounds /th, z, v, b, d, g/.
  • Introduce vowels by opening mouth after production of consonant. Shape vowel by describing mouth positions (fish mouth - /u/, cave mouth - /ah,/ smile mouth - /e/).
  • Slowly introduce true words with in content of consonant vowel repetitions (say, see, so, Sue, day, do, may, my bye, boo, key, etc.
  • Transfer repeated words to functional words. For example, say word “go” in order to get picture to appear on screen.
  • Continued to generalize us of true words, for example, name word in order to “win” it in card game.

Wednesday, January 14, 2009

The New Year


I would like start off this new blog by wishing all of you a blessed new year.
In many ways this is a new phase in my life . I started my professional life here in The Netherlands 6 months ago. Things were really slow and uncertain in the beginning. But I must say, things are settling and new opportunities arose before the new year.


This blog will serve as an open forum on Preschool Speech therapy issues. This blog will try its best to highlight information on various disorders as related to speech and language development, on latest trends and technology, traditional and alternative treatment, my experiences with Telespeech Therapy Practice. In addition to this I will also try to list new books , website other resources .

Most importantly I want to equip and encourage , grow and learn from my fellow colleagues and parents. I want to provide a platform for parents to recieve help and guidance in making their life and the life of their children better. Their feedback and concerns will be welcomed with open arms.