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Oral-motor techniques and childlessness.

I should be researching literature for my final capstone presentation. But I'm reading ASHA articles instead.

Here's an ASHA article about oral motor exercises. It's interesting that, in clinic, many of my classmates were using tongue strengthening exercises for articulation intervention, but ASHA maintains that the evidence is insufficient for it. I get the impression that this is still a gray area. And what about range-of-motion exercises as opposed to strengthening exercises?

Speaking of articulation therapy, my internship supervisor and her colleague really like Char Boshart's workshops. Their favorite motto is "Where the tongue rests is where the tongue moves." If the tongue can't move there, the speaker will compensate with the jaw. I'd love to attend one of her workshops to learn more about her techniques. Here's her website.

I love my internship and never want to leave. But one thing has been very interesting: I have never worked with so many parents before. I am one of a small few in my building who does not have children, and I sometimes choose to let this isolate me from the pack (God forbid I be unique). I'm not sure if having children is going to be a part of my path or not. Many of my friends my age do not have kids. My generation is generally having less children, and it honestly doesn't seem so bad. I see firsthand the amount of time and energy the teachers around me spend on/with their kids. They say it's worth it, and I believe them. But I'm glad that, today, I can be comfortable with both of the potential outcomes of my future.

The end is near!

September flew by! I'm loving my school internship. I'm working in a K-3 Elementary school with two great SLPs and wide range of disorders. I'm finally getting some articulation/phonology experience, as well as lots of developmental language and augmentative device intervention. 

The days go by so quickly seeing students back to back, but I love the fast-paced, ever-changing schedule. I also really enjoy working with pre-school and school-aged populations. The relief that comes with enjoying your career is phenomenal. At this point, I'd be happy in any setting. 

ASHA Convention is in Chicago this year and I'm planning to attend. It will be my first trip to Chicago (which is surprising, having lived so close my whole life). I'm so stoked to be in one place with a ton of SLPs/AuDs! 

Graduation will be here before I know it, and I'm nervous! It will be a big transition going from graduate school to the working world. But I am definitely looking forward to earning a real income (minus the student loan payments). Ideally, I would have a job and a new place to live in December, but I don't expect to get a job during the holiday season. It's making me anxious, but I trust that everything will work out. 

I blinked and then it was July.

When I wrote my last post, I was a week into my internship. Yesterday was my last day. I've somehow managed to forego any documentation of my experiences. Allow me to summarize:

• Therapy was mostly designed around cognitive communicative goals, such as attention, memory, problem solving, reasoning, and all of the other cognitive processes involved in communication. 
• My supervisor is an amazing mentor. She started TBI therapy when it was a new discipline, so she had a lot of down-to-earth experience and wisdom to share about the trials and tribulations of therapy. Especially when it comes to navigating the tricky symptoms and characteristics of brain damage. 
• One of my previous clinical educators used to say, "History is everything." And it really is. No person with a brain injury had a blank slate before their injury. 
• Speech pathology is definitely the right career for me. Whether or not I'm any good at it (which I'd wager that I am good enough since I've made it through all of my internships without any major hurdles), I truly enjoy it. The time goes by so much faster when I'm in sessions all day. 
• I met an amazing team of rehab professionals and learned so much more about what they do: OTs, PTs, counselors, behavior therapists, etc. 
• I have to get through an online statistics class (boring, but applicable) and then I'll start my school internship in September. 

So many changes, so little time.

WOW. I can't believe I haven't updated. I haven't been spending as much time in front of a computer lately and, I must say, it's kind of nice.

I've finished my stay at my graduate assistantship. I miss my work family terribly, but I also know that it was time to move on. Time to start doing what I feel I was meant to do. I started my adult health care internship at a traumatic brain injury clinic. Most of the clients are inpatient and receive a full range of services, including OT, PT, Rec therapy, music therapy, social work, counseling for addiction and other psychiatric issues, and behavior intervention. I started last week and observed for most of it. I was able to start some treatment today, with full supervision of course.

I've also started working as a part-time babysitter for an amazing family and their 4-year-old boy, which has kept me busy the last two weekends. But I won't see him again until June after yesterday and I miss him already!

Steve is job searching and it's an emotional rollercoaster (yes, I'm that girlfriend), but I am doing my very best to be supportive and remain confident that he is going to find the position that's right for him in the location that's right for him (and hopefully me!).

MSHA 2013

The Michigan Speech Language and Hearing Association conference was this weekend. I really enjoyed myself. The first year I went (2011), I was alone, brand new to the graduate program, and all of the presentations were way over my head. This year, a whole group of my classmates were there and I actually learned substantially from the sessions.

Some highlights from the conference:

• Running into one of my mentor SLPs, for whom I was a regular substitute teacher during 2009-2010 school year. Working with her one was of the more important experiences that led me to getting an SLP degree. 
• Lunch with some EMU SLPers Friday. 
• The Michigan Common Core Standards session, which got me very excited for my public school internship in the Fall. 
• The Graduate Student Roundtable session. We got tons of information about job searching, interviewing, resumes, certification, licensure, and work settings. It made me very excited to start my job search. 
• I really can't wait for ASHA in Chicago this November!

In other news, I'm halfway to having my placements for my Summer and Fall internships. Happy! 

Thoughts/Reactions on Voice Disorders in Teachers

This ASHA article about the presence of voice disorders in the teaching profession got me thinking about my own experience in the classroom as a student teacher and long-term substitute in my local districts. I  developed hoarseness every so often, a problem that I've dealt with since high school (another story for another day). I observed other teachers overusing their voice or yelling over their noisy classrooms or on the playground, and now that I am learning more about healthy vocal behaviors and the prevention of voice disorders, I think it would be great to be able plan and implement a short inservice for classroom teachers.

Here are some thoughts I have about teachers and their voices:

1. I once observed an elementary teacher who had deliberately developed what I like to call a "culture of quiet" in her classroom. Students remained silent during independent work times and, when the teacher addressed the entire class, she practically whispered and made sure everyone was listening. Voice preservation aside: What a supportive environment for developing auditory comprehension and discrimination skills (especially since half of this particular class were English language learners). There was no background noise, no yelling. Instead, the classroom is a comfortable, calm space where students could hear their own thoughts.

2. As wonderful as the aforementioned classroom sounds, sometimes extraneous factors limit the ability of a teacher to develop a culture of quiet. For example, I've met several students with developmental disorders and/or communication disorders who yell instead of using an "inside voice" or who frequently yell or scream when they are agitated. In this case, portable voice amplification systems might be a better option for classroom teachers. I've used this myself while subbing in a kindergarten room and found it to be effective once I broke my habit of yelling while amplified. I don't suggest that.

3. With the exception of vocal music instructors and the like, I wonder: How much talking should a classroom teacher really be doing? How much direct lecturing should s/he be doing? Is it necessary for a teacher to be talking throughout the entire day? If I've learned anything in my clinical practicum (and from expert teachers!), it's the concept of "Less is more". The less we chatter and chatter, the more meaningful our speech. Silence can be a great classroom management tool, if used correctly. I wonder if changing our attitudes about classroom instruction might be a possible solution to the voice strain/fatigue that many teachers face.

I'm excited to learn more about vocal function exercises this semester in my Voice class, and I'm excited to get into my public school internship, where I can share my new knowledge with some of the hardest working individuals in this country: teachers.

Winter Blues

My sickness, whatever it is, has decided to travel down to my larynx and now I have no voice. I canceled my clients for tomorrow because I can't very well do therapy with no voice. I've been using my neti pot, gargling salt water, and I just got some antibiotics from the campus clinic.

Now I'm sitting in Bona Sera digesting my delicious tofu bahn mi sandwich and drinking decaf masala chai tea. I love this place. They serve the very best ingredients.
I leave for Mississippi in a week. Here's hoping I feel better by then. I guess if there were any time to fall ill, right before spring break is a good time. 

Sick at Midterms

It's okay, though. Bobby Darin is keeping me company.

February Updates

I realize I haven't updated since my last, whining post. Tuesdays and Thursdays were grueling for most of January because I have both of my clients on those days. But things have settled down since then, and I'm finding my groove. I adapted my child client's goals from last semester to be more functional, and I'm learning the difference between child and adult therapy. I feel like I'm growing immensely, and, here's the best news: I still love the career I've chosen to pursue.

Some things I'm looking forward to (and hopefully remember to blog about) in the upcoming months:

• Visiting Steve over Spring Break in Mississippi. I'm hoping it will be warm enough for us to rent bikes and ride The Longleaf Trace, a 40-something-mile-long trail that begins right next to his campus. 
• The Michigan Speech-Language-Hearing Association Annual Conference. I'm already registered and signed up for the seminars I want to attend. This is the last year I can take advantage of the super-low student registration rate. It's also a 20-minute drive from my apartment. 
• The end of Clinic Practicum. It will be bittersweet, as I won't get to see the people in my cohort anymore, but I'm excited to start my off-campus internship!
• Moving in May. Okay, I'm not actually excited for the moving part, but I'm looking forward to moving in with one of my SLP classmates and her adorable dog in a house about 15 minutes east of campus. 
• The 4th Annual Girls' Weekend. Every summer, a group of my lady friends and I go camping and tubing/kayaking down the Rifle River in Sterling, Michigan. What happens at Girls' Weekend stays at Girls' Weekend. Unless it's uploaded onto Facebook.

I'm not doing as well as I'd hoped in the realm of diet and exercise. I get so bogged down with schoolwork that I just don't take the time to plan meals or exercise. It's so much easier and tastier to order pizza. But I'm still trying, one meal at a time.  

I was right.

Yesterday was, indeed, the 

Longest 
              Day     
                         Ever.

But it ended, thankfully. And I survived my first two sessions of the semester. I didn't really survive my Voice lecture, though. Much of the content was over my head, which may have more to do with my fatigue than anything else. I need to read through the lectures again to find out what is confusing me.

Another challenge this week: my car needs a new battery and currently will not start without a jump. 

Is it April yet? 

Day by Day

I spent a wonderful weekend in Toledo celebrating my birthday with family and friends, but now, it's back to life. Back to reality.

I'm seeing both of my clients tomorrow for the first time, and I want to feel as prepared as possible. I still have to prepare some materials and practice the standardized test I will be giving, as well as doing some visualizing strategies to plan my session and figure out how to take data as clearly and succinctly as possible. 

Tomorrow has the potential to be chaotic, and it will definitely be long (2 assessment sessions, 2 assessment SOAPs, clinic class, planning for Thursday, and my Tuesday night class). I literally have to live day by day this semester because I have no other choice. Chin up! 

The Madness Begins

Clinic 2 has begun. It's only been a week, and I already know that it's not going to be any easier than Clinic 1. Time is going by so fast and there is so much to do! It's funny because I'll probably look back one day and laugh because I only have two clients.

Winter Break Goal Breakdown

I made it through Clinical 1! I'm so grateful. I also finished the semester with [mostly] the grades I had hoped for. Now I'm trying to enjoy my winter break between semesters before the clinic madness begins again. I tend to use this season as a time to re-evaluate and reflect, and then come up with some goals for myself in the coming year. Here are some goals I have for the coming semester:

Career/Academic Goals:

• Pass my classes.  I know this goes without saying, but it's high on the priority list, so it's worth mentioning.
• Continue to improve time management skills. I've gotten a lot better at time management. I don't get so overwhelmed by all the responsibilities of life anymore. But I still see some room for improvement, especially in the following:
• Estimating and planning for an appropriate amount of time to finish tasks.
• Eliminating/resisting distractions and focusing on "work time". (Specifically internet and television).
• Staying a couple days ahead of schedule, whenever possible.
• Allowing time for other activities in my week that are important to me, such as exercise, cleaning my apartment, or catching up with close family and friends.
• Saying "no" without feeling guilty or fearful ("What will people think?")
• Become a better therapist.  I want to take advantage of whatever type of communication disorder I'm presented with in clinic and learn the most that I can about it. I want to push myself to use the best therapy techniques to the best of my ability and change things when necessary. I want to prioritize my client's needs and not let any of my own insecurities get in the way of the best intervention possible.

Health/Personal:

• Plan and commit to a regular fitness routine. Last year was a great year for me overall when it comes to fitness. I lost 20 lbs with the help of Weight Watchers online. But the last couple of months have been a slow and steady decline back into some of my old habits: making excuses for not exercising and mindlessly stuffing food into my face. I want to plan to exercise at least 5 days a week, in the evenings.
• Mindful eating. I'm about 15 lbs away from my goal weight, so I need to combine mindful, healthy eating with regular exercise in order to get there. I plan to count calories daily with the help of My FitnessPal, while leaving room for the occasional indulgence. 
• Meditation. I've been wanting to start meditating for a while now. My goal is to simply explore meditation and begin meditating 2-3 times a week. 

Semester's End

The semester is winding down.  I have three therapy sessions, one family conference, one take home final, one presentation, a final exam, and two weeks of weekly paperwork left between me and my Christmas break.  I probably shouldn't even be writing. 

Here's what I've learned this semester:

1. Therapy is hard.  Experienced SLPs make it look so easy!  But when you combine collecting an accurate amount of trials and data, maximizing the client response, responding with feedback, and scaffolding up in the session to work at the correct level of difficulty, I forget where I am sometimes!  Multitasking has always been difficult for me, so I've learned to take a deep breath, pause if I need to, and to keep practicing. 

2. Actually taking a few minutes to write out a priority list and plan my day/week saves time in the long run.  I feel more organized this semester than any other, because I had to be. 

3. Humility is endless. Every person I meet can teach me something. My classmates are brilliant resources, and my clinical educator is resiliently patient with me while I learn.  Even if I don't like something, it's still an opportunity to learn that I don't like that thing. 

4. There's no "finish line" in speech-language pathology.  I will never know everything.  But that's what's great about the science of language.

5. Data is important. 

6. The world goes on outside of my clinical practicum, and it's important to poke my head out regularly to maintain a healthy perspective.  This is one of the areas that my classmates with children don't need much help with.  They go home to real life every day.  But I can get glued to my chair in the study room of the clinic all day if I'm not careful. 

This is not nearly representative of everything I've learned this semester, but it's what I'm able to articulate right now.  I'm very grateful for this experience, and can't wait to get into Clinic 2 with everything I know now.  

Much has happened since my last post.  I established my goals for my client and have been working the very best I can each session to pick the best stimuli, collect accurate data, and get the maximal response from my client.  I am so grateful that I've made it this far, and that I've been able to learn so much.  I think back to my semester of student teaching (which you can read about if you like, in my 2008 archives).  I did not have the maturity back then that I have now, and I wasn't willing and able to change myself to accomplish what I needed to accomplish.

This time around, I'm able.  Thank goodness for life experience and lessons so valuable that led me to where I am today.  I'm not so hard on myself anymore.  I am now able to look at a situation for what it can teach me.  Turns out this is an important skill to have in my chosen profession.

Other recent happenings:

I visited Steve in Mississippi:

My new baby cousin is growing fast!

Kelly and Chris got married!

I cut my hair!  

Holy clinic!

My first semester of clinical practicum as a SLP student has been underway for about a month now.  I would have posted sooner, but I haven't been able to make the time!  My brain has been working in overdrive; my Clinical Educator, at the end of our clinic class, likes to ask, "Are your brains saturated?".  What an accurate summary of the past month.

This has by far been the hardest semester of my educational experience thus far.  (I can't actually be sure because I like to block out my memories of student teaching).  But it's been a huge period of growth.  I'm trying very hard to keep my stress to a minimum, which can be tricky at times because, as a cohort, my classmates and I have varying instances of difficulty with our clients, and we all individually handle stress in different ways.  Top that off with a heaping truckload of paperwork.  Deep breaths have been my saving grace.  

Today, instead of hanging out in the clinic, I decided to pack up and so the rest of my work at home.  It gives me a chance to do a couple loads of laundry and be able to work with some daylight streaming onto my work area.  

Now, back to work on SOAP notes...

Diet Woes

This article about glycemic index got me thinking about about my life long battle of the bulge and how it sometimes seems like a battle not worth fighting.  Maintaining weight loss has been hard for me.  I have watched the scale slowly creep back up by tenths of a pound.  I tell myself every day that I will plan my meals the next day and stick to it!  But alas, it's so much more fun to eat boneless fried chicken chunks slathered in buffalo sauce.

I met a young guy this weekend from Italy.  I mentioned that I had done a spinning class that morning, and he asked how many times a week I go to the gym.  I told him I aim for 5, and he seemed surprised.  "Why do you go so much?"  "Because I love to eat," I said.  "Why don't you just eat less?"  Exactly.

I think part of my issue is that I eat when I'm overwhelmed.  I don't know how to start my to-do list, so I just eat instead.  I also hoard calories--as if I don't know where my next meal is going to happen, so I am pre-programmed to eat until I'm full.  Sounds nuts, right?

I don't want to examine how or why I developed an abusive relationship with food.  All I know is that I want to change it.  Tomorrow's meals are planned; let's see if I can stick to it just for tomorrow.  When tomorrow is over, I can worry about Wednesday.  I need to start taking one bite at a time, living in the present and having faith that I will get the nourishment I need when I need it.

Time Management for the Student Clinician

Hello again, my long lost blog!  What have I been doing?  I've been working, exercising, enjoying the last of the warm weather, nourishing my long-distance relationship, and preparing for my first semester of Clinical Practicum.

I'm anxious and excited to meet my client.  I'm also interested in seeing how my time management skills hold up with this new kind of schedule.  Perhaps I should dust off my copy of Time Management for the Creative Person to refresh and reevaluate some of my priorities.  I've already started keeping a to-do list on the front of my binder to keep everything I need to do in one place.  

Saying no has historically been the hardest part of time management for me, but I've been getting better.  I worry a lot about what I'll be missing out on if I say no to a last-minute dinner with friends or to a family gathering.  I also worry that people will hear "No" once and think I don't want to hang out ever again.  Then I remind myself that, frankly, I'm not that important.  My loved ones will not give up on me after one "no".  And trusting that choosing to follow through on something I committed to doing, such as homework or exercise, will result in good things.  I won't be missing out on life when I'm making a mature, responsible choice.  Rather, I'll be investing in my own livelihood.  I still have to make time for myself and for my loved ones, but it doesn't have to get in the way of my goals. 

I love the start of a new semester.  It's a new beginning.  

You know what else I love?  Flower deliveries!  

Recent Happenings

Celebrated Andrea's last days of freedom at Put-In-Bay

Took a lovely walk at Parker Mill Park

Discovered mango sorbet.

Went to Cedar Point.  Felt officially old the next day.

Watched Ryland leave for his first national tour with his band, Citizen.

Andrea's wedding!  (Left:  Jeremy, her brother who flew in from Portland with his new fiance).  

And here's me.