December 1, 2013 Departments

Inbox: December 2013

Using Common Core Standards to Write Goals

I enjoyed the October 2013 issue and read most of the articles in it. I am a longtime SLP in a public school setting, and Laura Justice's "A+ Speech-Language Goals" hit a nerve. In this article, she encourages targeting academic language and using the Common Core Standards to write goals for our students with language problems.

I think that is OK if a student with language deficits is at that level of metalinguistics. However, I strongly feel that our speech-language goals should be driven by what the child needs and what will best improve their success with communication and thus academics. School SLPs have had what we do watered down by the school setting: the caseload numbers, the paperwork, lack of support for continuing education in our specific field. Writing individual goals is an area where we still (at least in my district) have some autonomy and decision making ability.

If working on grade-level academic language is irrelevant to students because they lack basic core vocabulary, or have trouble accessing the vocabulary they do have, I am not going to use my limited therapy time working on that. I am going to try to be therapeutic during my time with the student. That is how I stay accountable to the student and to my professional standards. That is my mission, not improving my "academic relevance" to an increasingly test results-driven public school mindset.

Mary Price, Bloomington, Ind.

Stuttering Study

Tim Mackesey of Atlanta (Inbox, October 2013) misrepresents the conclusions of the Australian study that investigated the natural history of stuttering to 4 years of age and was recently published in the journal Pediatrics.

Far from suggesting that treatment for stuttering in preschool children can be ignored or is not necessary, the study's conclusions include the recommendation that treatment be started if the child is upset or in distress, if the parents are concerned, or if the child withdraws from talking. Related to that recommendation is the robust research finding that the effectiveness of treatment with the Lidcombe Program is not compromised if intervention is delayed up to one year post-onset. Even so, the Lidcombe Program guidelines recommend intervention before 1 year if the child or the family demonstrates concern, or if the child develops negative feelings toward communication.

Joseph S. Attanasio, Montclair, N.J.

Casualties of Intimacy

Thanks for this courageous and informative article ("Casualties of Intimacy," October 2013). It is a most relevant and important article and the references are very valuable for clinicians.

Lauren Grant, Brooklyn, N.Y.

Appalled at Photo

I was appalled when I saw the photo ASHA used to draw attention to the article "Casualties of Intimacy" (October 2013). It is sad to see a "professional" organization stoop to such tactics.

If we wish to be seen as professionals ... we demonstrate professionalism in all that we do. My teenage daughter wondered what magazine I had obtained! It made me feel ashamed to be a part of an organization that would employ such an unnecessary display. I certainly hope this will be the first and last of such photography.

Michelle A. Ickes, Roanoke, Va.

Keep It Clean

I've been reading The ASHA Leader for eight years now and have appreciated the obvious effort and expertise that has gone into making it a publication I respect and value. That well-earned respect was violated for the first time in the October issue when I opened it to see a full-page sexually suggestive picture accompanying the article "Casualties of Intimacy." My husband and I work very hard to keep images like that out of our lives and home and the last place I ever expected to find one was in my professional magazine. Please keep The ASHA Leader clean and appropriate. I want to feel comfortable reading it and sharing it with my husband and children.

Thank you.

Heidi Bigelow, Everett, Wash.

Sustenance ... Lost

"Sustenance ... Lost" (October 2013), written by an ASHA employee about her mother's experiences with tongue cancer, was heartbreaking to me. When I read, "In retrospect we probably should have sought help from a speech-language pathologist" (this after her mother had already had two surgeries and radiation therapy) and when I read, "I can't really say that the SLPs were instrumental in helping my mother regain speaking and eating functions ... ", I felt a jolt of incredulity. It is really disheartening to learn that ASHA's own employees don't know how, when and where to access appropriate speech-language pathology services. As a speech-language pathologist who has seen hundreds of head-and-neck cancer patients over my long career, the idea that this lady had no SLP help until late in the game, even though her daughter works for ASHA—well, as I have said, it was heartbreaking. I am not a marketing person, but certainly we, as a profession, can and must do a better job of telling both patients and physicians (and our own employees!) how, when and where to access appropriate services from us.

Mary J. Bacon, Elmhurst, Ill.

The author replies:

Our issue was not lack of knowledge of what to do, but one of access—finding a provider with the appropriate expertise within a specific travel radius. I consulted with several ASHA colleagues and the SLP in the surgeon's office for guidance and received knowledgeable advice.

Telepractice Issues

As I was preparing a presentation on telepractice for the International Association of Orofacial Myology convention this month in Washington, D.C., I suddenly was made aware of two unaddressed issues:

  1. No matter how HIPAA-compliant you are in every other aspect of doing telepractice, if you are not using a HIPAA-compliant videoconferencing service, you are placing your patient and yourself at risk. I had reviewed all the ASHA documents on the telepractice portal and taken the webinar on telepractice in the schools, and not once had this issue been brought to my attention. I strongly suspect that there are many other well-intentioned SLPs who have no idea this could be a major problem. I had never thought about the fact that Skype and many other videoconferencing sites are not HIPAA-compliant. I would like to see ASHA bring this to that attention of all members. There are compliant sites available, but one needs to know to look for them.
  2. As I explored further, I came upon some very slick websites that offer speech-language treatment to the public over the web. Several have tabs at the top: one for parents, and another for SLPs. But nowhere could I find anything about the sites being HIPAA-compliant. One website even boasted about how easy their service was to use because they use YouTube! I would like ASHA to check into these sites, so that other ASHA members do not fall into this potential legal nightmare.

Dianne Fonssagrives, Bakersfield, Calif.


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