The assignment: As of 8/31/13, WKU is going to tell the world
that you have speech-language-hearing competencies in nine areas. Given
that just because you're recognized as being competent doesn't mean that you
are, what are your thoughts? Do you feel competent to assess and treat each of
the big nine across the lifespan?
So basically, when I graduate, I
will technically be an expert in the “Big 9” competency areas, as defined by
our governing body, ASHA. It’s all
sort of loosely defined here, but according to the
database that is getting checked off with each internship I complete, the Big 9
are:
Language, Articulation, Voice & Resonance, Fluency, Swallowing, Hearing, Cognitive Aspects of Communication, Social Aspects of Communication, and Communication Modalities
Since it’s summer and we’re in
America and I love America’s Pastime, I have decided to address my competency
in each of these areas with a baseball analogy.
If the competency was a pitch, lobbed to me as I waited in the batter’s
box, what would I do with it?
Language: Home Run
And….it’s…OUTTA HERE!
Oh yeah, I love Language. I love
breaking down our spoken language into building blocks and deciphering where
the breakdown is occurring. Is the child
having trouble with answering detailed questions from a story because she doesn’t
understand temporal or positional concepts or because there is a deficit in
vocabulary or because she did not effectively sequence the events of the story
in her mind? I love tying language
to literacy and using children’s books to teach language
concepts. I love bringing colorful
manipulatves into the therapy room and watching a child learn a concept and
have fun at the same time. Oh yeah,
bring it on! I’m competent like The Babe! 
Ok, so this one is not a no-doubter that flies over the
fence to the roar of the crowd. Maybe
more of a squibber down the third base line.
But social aspects, in my opinion encompass a lot of the work we do with
individuals on the autism spectrum. Because I
live with autism 24/7, as well as two neurotypical children, I have a microcosm
social study in my home and it never fails to amaze me how natural it is for my
girls to navigate that maze of social interaction and how much of it needs to
be taught to my son, like learning all of the ‘Stans in geography. Social aspects means helping my clients
understand emotions, the rules of conversation, the rules of the playground,
the rules of personal space as well as the rules of the game – whether that game is Pokémon or dating. I truly enjoy
this and have had experiences working on social development through drama therapy, in
structured conversations and semi-structured activities such as cooking. I have no doubt I could score a run for the
team in this area, even if it means I had to count on the left fielder taking a
bit of an early dive in a failed attempt to make the big play.
Communication Modalities: Stand up Triple
Communication Modalities encompasses the use of an
alternative system for communication. There are several options for higher tech
devices, such as iPads and Dynavox computer systems, but there are also
simpler, lower tech forms of allowing someone to communicate nonverbally. This is a special interest to me and I have
had a pretty good amount of experience over the course of my prior 2
internships, with clients at a variety of communication levels using a variety
of devices. While I doubt I could put a
run up on the scoreboard myself in this area right now, I feel like it could
definitely be an area I could specialize in with some more training and
experience. Articulation: Slid into second, just under the tag
Yeah, so I can get on base with articulation, but I don’t feel
super confident. I can elicit some of
the more visual sounds pretty easily, like /l/ and /th/, but I still struggle
with /r/ and vowels. The ADHD that attracted
me to this profession because of the inherent variety involved in conducting
therapy in 30 minute blocks, also makes it hard for me to stick with the
drill and repetition needed to make changes in a client's muscle memory. I can get it done, but
not in one swing, and I need an assist to score, which will likely come in the form
of Pinterest ideas.
Swallowing: A base hit
Granted, I am only 2 weeks into my internship that focuses
on dysphagia treatment and assessment, but I feel like I could be the guy who
consistently gets the single, gets on base, keeps the inning going - Ms Dependable, but none of that will get me
into the Hall of Fame. I understand the
anatomy involved, I have a good grasp of the exercises and why they are used
and I think that by the end of my internship, I will be pretty competent at
swallowing treatment. Put me in coach....I'm ready to play....today.
Hearing: Reached on an Infielder
Error
I hit it hard,
it went flying off the bat, but the short stop bobbled it and that allowed me
to get to first base. I am still going to be able to help the team
score, since I didn’t get out, but I am not very confident with how I got
there. I have trouble deciphering the
difference between working on articulation versus the specifics of aural
rehabilitation for clients with Cochlear Implants. I still struggle to keep my voice loud
enough, consistently, for elderly clients with presbycusis. I
could use a lot more time in the cage, practicing my swing in order to
effectively serve those with hearing impairments.
Voice: Hit by Pitch
Hey, I’m on base.
Maybe it wasn’t pretty, but I got here and the inning isn’t over
yet! So I worked with an adult voice
client and I took data and measured her pitch and led her in her voice
exercises, but I don’t have the confidence that I personally did anything profound
to help her. I do have an interest in
instrumental assessment, so maybe one day I will have a chance work in a voice
clinic and check out someone’s vocal folds with a scope. Until then, I’ll just straddle the plate a
little too much and hope to keep the inning alive. 
Cognition: Sacrifice Bunt
Cognition, or working with the effects of language and memory
with patients who are suffering from dementia, is very difficult for me. Again, I am only 2 weeks into this aspect of
treatment, so I know that with experience, I will better be able to handle the
emotional ramifications of short term memory loss and deterioration in
cognitive skills. In the meantime, will
make that sacrifice bunt to get the runner over. In other words, I will do what is expected of
me, but I would much rather swing for the fence with language or social
aspects. 
Fluency (aka stuttering) is a pitch you don’t want me to
face. Bring in the pinch hitter. I worked with one preschool client and one
of the hardest things for me to do in his treatment, was not to treat. A lot of the basis of early fluency treatment
is to deal with it indirectly. The therapist is supposed to model and
encourage slow, easy speech, educate the parents, but not directly address the
stuttering. I’m a doer.
And despite the fact that I saw this very approach work very well with a
young client of ours, I know that in the real world, I will start swinging for
the fences and in my attempt to overachieve, I will hit into an inning ending
double play.
All that said, I feel very fortunate to be entering a field
with so much diversity that I will challenge myself to
continue learning, developing new skills, and expanding my own comfort
zones.
PLAY BALL!
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