Tim Starling, Division Director, Bilingual Therapies

Tim Starling is currently the Division Director of Bilingual Therapies. Tim received his introduction to healthcare in 2000 as a recruiter who placed neurological, orthopedic, and general surgeons in some of the country’s leading hospital systems. He later joined Soliant Health where he pioneered the schools division that places speech, physical, and occupational therapist in school districts across the country. In August of 2006, Tim had the opportunity to join Bilingual Therapies where he continues to assist the team in being the profession’s leading source for bilingual speech-language pathology services in the country.

Did I get your attention yet?

For the past two or three years, the US economy has really been on a roller coaster that has seen more shrills than thrills. The job market has been bleak, schools are cutting jobs and mandating furlough days, and our leaders in Washington can’t get on the same page. So what does it mean for us? Here comes the answer that you have been waiting for: WE JUST DON’T KNOW! That is the honest truth when it comes to our job of providing much needed services to our clients in schools, hospitals, clinics, and other medical facilities across the country. Our clients, which are both the healthcare providers and the facilities they work in, are all operating in very unique markets right now. Let’s look at our nation’s school districts and see what is truly happening. 

Federal and local governments are tasked with running their services while decreasing their operating budgets. With fewer people working and private business not doing so well, it means that tax revenues are down. This forces leaders to make budget cuts, which drives them to become very creative in how they conduct business. In our sector of education, we are seeing extreme measures to keep jobs and provide the quality of services that everyone has grown accustomed to in education. In parts of California, they are decreasing the number of days that children attend school, thus decreasing the cost of maintaining facilities. In parts of Georgia, they are asking educators to take several furlough days. In parts of Illinois, they are dramatically increasing class sizes. In parts of Texas, they are using a surplus of stimulus dollars that are still left over from the infusion by our federal government. In parts of Virginia, they have levied new taxes to keep the public schools running without any major cuts or disruptions to current staff. At our nation’s capital, there is a potential bill that will provide another 10 – 20 billion dollars in federal aid to save the jobs of educators across the country.

So here is the good news! You are good at your job! Students, Parents, Principals, Directors, Administrators, and Employers all recognize that what you do is very unique and special. You have a gift that influences so many lives. Your profession is one of the most admired careers in the workforce. Therefore, when I say you are good at your job, I really mean that you are valued and it is understood that your services are not easily duplicated.

As a business leader at my workplace and in my community, I am frequently asked how someone can find a job or keep a job during these difficult times. My standard response is “be more valuable today than you were yesterday.” If you become extremely valuable to a team, to a school district, to an employer, and to the individuals we serve; then it makes it very difficult for an employer to eliminate that position. As a person who is a hiring authority, I look at what each individual brings to the team and how much value he or she creates. By the way, I practice this same mindset on myself in hopes that my boss sees my value. There are some rare situations where value is not the ultimate factor. Sometimes politics and poor decision making comes into play and good people become the casualties of these decisions. For example, a committee may make cuts without seeing the true value or impact or a purchasing group may make a recommendation understanding what really goes on in the trenches. Regardless of the situation, you are good at your job! Good people with good skills will always have the upper hand in situations like these.

Healthcare is not recession proof, but it is definitely more insulated than most professions.

Thank you for all the wonderful work you do every day. What you do really makes a difference in people’s lives!

Marlene B. Salas-Provance, Ph.D., F-CCC-SLP, Director of the Program in Communication Disorders, New Mexico State University, Las Cruces, New Mexico

Dr. Salas-Provance currently serves as Director of the Program in Communication Disorders at New Mexico State University.  She earned her bachelor’s and master’s degrees from New Mexico State University, her doctorate in speech-language pathology from the University of Illinois and a second master’s in Healthcare Administration from the University of Missouri-Columbia.  Dr. Salas-Provance joined the faculty at New Mexico State University in 2009 having served as a faculty member at the U. of Montevallo, U. of the Pacific, Southern Illinois University, St. Louis University and Fontbonne College. She is an ASHA Fellow and 2009 recipient of ASHA’s Certificate of Recognition for Special Contributions to Multicultural Affairs. Her clinical and research interests are in the areas cleft lip and palate, bilingual medical interpreter training, multicultural issues and speech production of young children with cleft palate and of deaf children following cochlear implantation.

The ASHA Board of Directors and Special Interest Division Board of Division Coordinators announced the creation of a new division to focus on international topics of interest to ASHA members. Division 17, Global Issues in Communication Sciences and Related Disorders will be the primary resource for advancing the exchange of clinical, research, and educational information about communication and related disorders in the international and global market arena. The Division’s mission is to provide international leadership related to audiology and speech-language pathology services by promoting research, networking, collaboration, education, and mentoring for its affiliates and NSSLHA students in the global marketplace.

The founding members of this Division include, Carolyn Higdon, coordinator, University of Mississippi, Marlene B. Salas-Provance, associate coordinator; New Mexico State University, Deanne Owre, Woonsocket, Rhode Island School System, Cate Crowley, Columbia University Teachers College, and Dolores E. Battle, Buffalo State College. Leigh Deussing from ASHA will serve as Ex-Officio for the Division.

Background
During the past ten years, ASHA has increased international outreach efforts to countries around the world as well as U.S. Territories. These outreach initiatives are part of ASHA’s new Strategic Pathway to Excellence. Division 17 came out of ASHA’s international efforts and the increased interest of ASHA members in global research, clinical practice issues and other professional topics.

Need for New Division
Today, as the globe is shrinking rapidly, as technology continues to be developed, and as people work and travel all over the world, the need for a special interest division for speech and hearing professionals interested in international issues is long past due. Our future will bring us increased cultural and language diversity, varied experiences, insight into the culture of poverty, awareness of challenges to world literacy, conflict and unrest. These challenges force professionals in speech and hearing to be increasingly engaged in understanding communication disorders around the globe. The challenges encountered by a person with a communicative impairment may be aggravated in countries with more limited health and education resources. There is growing recognition of the need to develop effective services for the rehabilitation and management of clients with a variety of different communication impairments across settings. In conjunction with this increased recognition of the demands on health and education systems, the past decade also has seen extensive growth in research relating to communicative impairments including speech, language and hearing deficits. It is important, therefore, that there be an effective division forum for members interested in the exchange of clinical, research, and educational information.

Broad Goals and Narrow Goals
The three broad goals for Division 17 include:

1. To emphasize facilitation of (international) global cooperation and collaboration among speech-language pathologists, audiologists, speech/language and hearing scientists who are interested in communication and related disorders with international breadth.
2. To focus on creating and sharing information across countries the U.S. and its territories.
3. To provide a platform for (international) global networking. The Division’s purpose will include promoting development and standards (of) for diagnostic, therapeutic, rehabilitative and preventative work, research, education and training in human communication and related disorders of all ages.

The seven narrow goals for Division 17 include:

1. To promote global education about persons with speech, language, voice, swallowing and hearing disorders.
2. To promote the development and standards of diagnostic, therapeutic, rehabilitative and preventative work, research, education, and clinical expertise for individuals with communication and related disorders across professional settings around the world.
3. To provide avenues for scientific and professional exchange of information in developing countries.
4. To maintain international recognition of the field of communication sciences and disorders as a special and distinct field.
5. To cooperate with other ASHA and international organizations with an interest in communication and related disorders.
6. To encourage and establish opportunities for international research, as well as for researcher to researcher exchanges across countries.
7. To encourage opportunities for U.S. trained speech-language pathologists and audiologists to practice in various capacities in countries other than the United States.

Prospective Members
Division 17 members will include ASHA members including audiologists, speech-language pathologists, and speech and hearing scientists residing in countries around the world as well as in the U.S. and its territories.

References
American Speech Language and Hearing Association (2009) Strategic Pathways. Found 4/12/09 http://www.asha.org/about/pathway

Tice, P., & Moore, M. (2009, Jan. 20). Six nations now participate in certification recognition. The ASHA Leader, 14(1), 34-35.

For more information, please go to the Division’s Web page:
http://www.asha.org/Members/divs/division17.htm.
ASHA (regular and International affiliate) members and national NSSLHA student may join by calling ActionCenter at 1-800-498-2071 or submitting the application form:
http://www.asha.org/uploadedFiles/DivisionsAppForm.pdf
Information about ASHA membership can be found at http://www.asha.org/members/

Nancy Lewis, M.S. CCC-SLP. Pediatric Speech-Language Pathologist, Denver, CO

Nancy Lewis, M.S. CCC-SLP has been a pediatric speech-language pathologist for 30 years. Currently, she leads a Bilingual Consultation Team for a large school district in the metro-Denver area, providing bilingual assessments (English-Spanish) and consultation to schools regarding English language learners. Her areas of expertise have included child phonology and the provision of services to culturally and linguistically diverse populations. She is the co-author of the Khan-Lewis Phonological Analysis-Second Edition. Nancy is the Coordinator of the ASHA Special Interest Division 14: Communication Development and Disorders in Culturally and Linguistically Diverse Populations.

It is February 2010. Punxsutawney Phil has seen his shadow. And we all know what that means. ….six more weeks of winter! I am writing this from Boulder, Colorado, where this forecast is quite believable.

Currently, I have the good fortune of being the Coordinator of the ASHA Special Interest Division 14: Communication Disorders and Sciences in Culturally and Linguistically Diverse (CLD) Populations (hereinafter referred to as Division 14). As you may know, there are 16 Special Interest Divisions that operate within ASHA. The idea of offering ASHA members a manner in which to become affiliated with a smaller group of professionals that allows members to identify with their distinct clinical interests has been wildly popular. So popular, in fact, other professional associations have replicated ASHA’s model.

Since the beginning of the program, the growth in the Special Interest Divisions (SIDs) has occurred primarily through grassroots efforts. The SIDs are an integral part of ASHA, yet they are fueled by the organizing efforts of volunteer steering committee members and the enthusiasm of affiliates. In 1994, Division 14 was established to offer a SID that was devoted to cultural and linguistic diversity issues among the populations that we serve.

If you are reading this blog posting, that means that you are familiar with the Bilingual Therapies website. Perhaps you are a bilingual speech-language pathologist (SLP)? Or maybe you are a graduate student? Obviously, you have discovered that Adelante is a terrific resource for multicultural issues. However you got here, it is probably safe to assume that you are dedicated to providing the best services possible to culturally and linguistically diverse populations.

Having spent much of my thirty-year career serving children who represented aspects of cultural and/or linguistic diversity, it was a natural fit to become an affiliate of Division 14. It is a delight to be in the role of Coordinator for many of the same reasons that it is enticing to be an affiliate of the Division. I’ll describe some of the benefits of affiliation and highlight some opportunities within the SIDs.

Division 14 offers a venue to deepen our knowledge and understanding of CLD issues, to strengthen our clinical skills, and to build a professional learning community in the process. One of the ways that we do this is through Perspectives, a small online journal that is published three times a year. The topics in Perspectives are fresh and current and the articles offer a way for affiliates to earn ASHA Continuing Education Units (while in your pajamas!). We sponsor seminars and short courses at the annual ASHA convention helping to ensure that the convention program addresses issues that bilingual clinicians want to hear about. Our sponsorship at the ASHA Schools and Health Care conferences results in a discounted registration fee for Division 14 affiliates. And to keep the dialogue active, we offer a web-forum (http://www.asha.org/forum.aspx?g=topics&f=10737493965).

Within Division 14, there are opportunities to develop leadership skills and discover ways to impact the field, especially in terms of communication development and disorders with culturally and linguistically diverse populations. Division 14 has a steering committee of five, an editor of Perspectives and a Continuing Education Administrator. Steering committee members are elected by affiliates and serve a three-year term. Actually, this month nominations will begin for two steering committee positions (for the 2011-2014 term) and electronic elections will be held later this spring. Affiliates may self-nominate. So, if you have a desire to become more involved in ASHA and to contribute to the field, consider a nomination for one of these positions. The ASHA website is the place to find more information about the steering committee elections as well as the way to become a Division 14 affiliate.

I recently discovered that 81% of ASHA members that are also an affiliate of at least one of the Special Interest Divisions define their “primary employment function” as clinical service provider. To me, this explains the power of the grassroots efforts that has lead to the growth and success of the Divisions. As bilingual clinicians or monolingual clinicians serving diverse communities, Division 14 is a place to share your ideas and concerns, influence the direction of our field, and establish relationships with other SLPs dedicated to serving our diverse populations. Check us out at the ASHA website: http://www.asha.org/Members/divs/div_14.htm.

Sandra Márquez, M.A. CCC-SLP, Bilingual Speech-Language Pathologist, Chicago, IL

Sandra Márquez is a Mexican-American native of Chicago. She earned her degree from Saint Xavier University in the Communication Disorders undergraduate program. Prior to graduate school, Sandra spent one year as a speech-language paraprofessional in the Chicago Public Schools. Sandra went on to receive her master’s degree from New Mexico State University where she was enrolled in Dr. Hortencia Kayser’s Bilingual Communication Disorders program. Sandra is in her tenth year as a bilingual speech-language pathologist, of which all has been spent working with Bilingual Therapies. She currently works in the Summit, IL school district as a supervisor for two speech-language paraprofessionals.

With the increasing demand for Speech-Language Pathologists (SLP) across the country, school districts face the challenge of meeting the needs of students identified with speech, language, and overall communication impairments. Compounding this challenge is the increase of English Language Learners (ELL) requiring speech-language services as the population increases in the United States.  As the demand for speech-language pathologists grows so do the demands for district administrators to meet the needs of all students requiring speech-language services, their school district, and to work within the legal guidelines delineated at the state and federal level.  To meet these demands, many states across the country have passed legislation allowing Speech-Language Aides (SLPA) or Speech-Language Paraprofessionals (SLPP) to provide varying levels of support in the field of speech-language pathology under the direct supervision of a certified and licensed SLP.  As the description of both an SLPA and SLPP vary from state to state, general descriptions will be discussed as well as general guidelines for supervising bilingual SLPAs and SLPPs working with a linguistically diverse population.

It is important to note that the acronym SLPA also refers to a speech-language pathology assistant whom many states use interchangeably with speech-language pathology paraprofessional (SLPP) or speech-language pathology aides (SLPA).  It is important for clinicians to seek out the description and responsibilities for a SLPA and SLPP for the state in which they practice, as there is great variance among states and may differ from the American Speech-Language Hearing Association’s (ASHA) descriptions and scope of practice.

Speech-Language Pathology Aide (SLPA) –

For the purpose of this article a SLPA has a narrower scope of responsibilities and is defined as those individuals that receive on the job training and have not received an associate degree from a technical training program specific to a speech-language paraprofessional job or a bachelor’s degree in Communication Disorders.

Responsibilities –

A SLPA’s  responsibilities can include, but are not limited to, preparing materials, maintenance checks for equipment used, clerical work such as ordering supplies and filing, preparing therapy rooms for a work session, and making phone calls to confirm appointments etc.  A SLPA works under the direct supervision of a certified SLP.   Responsibilities delegated to the SLPA typically reflect the level of training they have received, the needs of the supervising SLP, and individual state legal guidelines.

Speech-Language Pathology Paraprofessional (SLPP) –

For the purpose of this article, SLPP will refer to a speech-language assistant or paraprofessional who completes course work, fieldwork, and on-the-job training specific to speech-language pathology assistant/paraprofessionals job responsibilities and workplace behaviors (ASHA).

Responsibilities –

A SLPP also works under the direct supervision of a certified SLP and follows the student’s IEP.  The SLPPs roles and responsibilities can include those listed for an SLPA but can also include direct therapy services (once trained), screenings without interpretation once trained, meeting with parents without interpreting goals or making judgments regarding prognosis, collaborating with teachers to provide services, assisting in diagnostic evaluations, documenting student performance and progress, scheduling students, and act as an interpreter for non-English speaking students and their families when appropriate, trained, and competent to do so.

A SLPP may be considered for a position once completing coursework to either receive an associate’s degree from a speech-language pathology paraprofessional training program or a bachelor’s degree in Communication Disorders.  State laws vary pertaining to the approval and certification of SLPPs who have received an associate degree in a technical training program specific to SLPP jobs.  It is equally important to note that as of Spring 2003, ASHA discontinued its registration program for SLPPs receiving an associate’s degree as well as its approval process for such training programs in December of 2003 for financial reasons.  Despite these decisions, ASHA continues to provide guidelines for the training, use, and supervision of SLPPs as many states across the country continue to hire paraprofessionals to alleviate the work load of a certified speech-language pathologist.

Supervising Speech-Language Pathologist –

It is the supervising speech –language pathologist’s responsibility to ensure that they as well as their supervisees are working within state and ASHA guidelines and Code of Ethics.  It is the responsibility of the supervising SLP to research, review, and abide by these guidelines and to delegate responsibilities that are in accordance to the level of training each supervisee has received.  As previously mentioned, ASHA provides guidelines for supervising and training speech-language paraprofessionals. State educational departments provide clear descriptions of allowed and prohibited duties of SLPAs and SLPPs.

Supervising Bilingual Speech-Language Pathologist –

For the bilingual speech-language pathologist who works with a linguistically diverse population and supervises bilingual SLPAs and SLPPs the roles and responsibilities are expanded.  Overseeing bilingual SLPAs and SLPPs requires additional supervision, collaboration, training and support in order to provide appropriate services to this population.  Supervisors are responsible for researching and educating both themselves and their supervisees on best practices for servicing ELLs.

The following are suggested guidelines for supervising bilingual SLPAs and SLPPs:

1. Keep printed copies of:
   1. All state guidelines
   2. ASHA guidelines.
   3. Recommendations for best practices in working with ELLs.
2. Follow ASHA’s guidelines and Code of Ethics
3. Follow state guidelines
4. Discuss areas of strength and areas in need of improvement before delegating responsibilities.
5. Ensure that the SLPA or SLPP has a clear understanding of:
   1. their role/s and responsibilities
   2. direct vs. indirect supervision
   3. at least a basic understanding of similarities and differences in working with a linguistically and culturally diverse population vs. mainstream culture and monolingual English speaking population
6. Check the supervisee’s levels of proficiency in the non-English language in speaking, reading, and writing.
7. Delegate appropriate responsibilities according to all guidelines, the supervisee’s level of training, and proficiency in the second language
8. Develop a plan and schedule for:
   1. Direct and indirect supervision according to state guidelines
   2. Training
   3. Observations
   4. Reviewing progress for areas in need of improvement
   5. Planning and prep time to develop task lists for the following week or as needed.
   6. When tasks/skills/responsibilities will be observed and/or completed
   7. Process and procedure for providing:
      1. Instructions
      2. Feedback pertaining to
         1. Professional behaviors
         2. General communication
         3. Planning and work completion
         4. Therapeutic skills if applicable
         5. Management of therapy sessions if applicable
         6. Student progress if applicable
         7. Data collection and therapy notes/logs if applicable
         8. Language usage
      3. Recommendations
      4. Documenting direct and indirect supervision dates, times, skill/task observed, and student/s observed.
9. Provide
   1. Additional training pertaining to working with ELLs
   2. Accessible information regarding working with ELLs as a reference
   3. Clear descriptions and instructions for carrying out tasks and therapeutic services
   4. Clear models and examples of therapy strategies, techniques, and cues
   5. Clear instructions for language usage and language models for both the first and second language
   6. Clear instructions for modifying English materials to fit the language needs of each student
   7. Verbal and written instructions for the proper documentation of data collected and progress logs. Progress logs should include qualitative information (if applicable to the supervisee). Examples of such information are:
      1. Activities/materials, models, cues, techniques, strategies, modifications, reinforcement/s, and language/s used.
      2. A brief statement regarding the student’s participation, behavior, or health that may have positively or negatively impacted the outcome of a therapy session.
   8. Recommendations for translating materials and interpreting for non-English speaking students and their families.

Overseeing bilingual SLPAs and SLPPs is rewarding for both the supervisor and supervisee as there is much to be learned from each other. Keeping an open-mind will facilitate the learning process and allow for an efficient working environment.  The experience can be a positive one keeping in mind that this responsibility is a valuable part of the process of servicing not only ELLs but all students requiring speech-language services in school districts across the country.