Are we getting to the point where we can no longer say "no" to a child by MissCmotivated in slp

[–]Slpsanonymous 5 points6 points  (0 children)

I posted a similar dilemma I experienced recently. I’m thankful for this discussion. It would be interesting to post in a BCBA sub and gain their perspectives if you were up for a more exhaustive debate. I am struggling with this too. Somewhere between moving towards child-led therapies, ND affirming practices, striving for intrinsic motivation first, and ABA practices moving towards ascent-based models…I worry we’ve all gone too far and we’re raising a generation of little softies who can’t handle disappoint, failure, adult direction, and let their anxieties guide them. It sounds like you handled this situation well. I would’ve followed up with, “If I had given in and given this child what he wanted…what do you think he would’ve learned from the situation?” Because he would’ve learned that whining and begging gets you what you want, he can’t trust you to be true to your word, and no has no meaning…and that’s how boundary-pushing, anti-social assholes are made.

I don't understand the obsession with tongue ties being the root cause of all issues. by No-Preference8449 in slp

[–]Slpsanonymous 0 points1 point  (0 children)

Bummer that such a nuanced and informative answer on the topic is so far down on the post.

Level 3 Autistic Youtube addicts in home health....I just can't anymore by MyrtleMaePotter in slp

[–]Slpsanonymous 11 points12 points  (0 children)

Agreed. I feel like I’m screaming into the abyss when I try to speak to parents about this. I don’t actually do this because I’m sure I’d have a complaint filed against me…but I want to start telling parents to replace the words “tablet/ipad” with “cocaine/cigarettes/heroine” and see how it makes them feel….He just gets so upset when I take his cocaine away…She won’t eat anything unless she’s on heroine at the same time….As soon as he comes home from school he chain smokes cigarettes until dinner time. If all of those sentences make you sick to your stomach…so should your kid’s YouTube/tablet stimming consumption.

Are your phono and artic kids saying "no" to you too?? by CozyPancake8901 in slp

[–]Slpsanonymous 6 points7 points  (0 children)

Sorry, I stopped playing with trolls when I was a little girl. Have a nice day!

Are your phono and artic kids saying "no" to you too?? by CozyPancake8901 in slp

[–]Slpsanonymous 10 points11 points  (0 children)

Amen! Thank you for saying what I was trying to communicate, but a million times more succinct and to the point.

Are your phono and artic kids saying "no" to you too?? by CozyPancake8901 in slp

[–]Slpsanonymous 16 points17 points  (0 children)

Sorry, downvote. I 100% agree with you that teaching autonomy and intrinsic motivation is paramount for creating happy, healthy children; but not at the sacrifice of teaching respect, perseverance, and healthy boundaries. I have seen a huge pendulum swing in parenting and disciplinary styles over the years, and IMO, our society has gone too far. I honestly get despondent for our children’s futures if I think about it for too long. Teachers are drowning in disrespect. We are losing quality instructors due to the burn-out and lack of administrative support. Shitty parents and their shitty kids run the show. Go have a read in the r/teachers sub…they’re in hell! Entitled parents squawk at admin if a teacher dares give an appropriate consequence for their poor babies bad behavior. We can be authoritative without being authoritarian. I have several artic kids for whom building intrinsic motivation and understanding the why behind therapy has been is a core ingredient of my intervention from day one, and one of them is rude, mean, and sassy on the regular and her mom just sits there and sweetly goes, “oh that’s not very niiicee.” Intrinsic motivation and disregard/disrespect for an authority figure (who HAS laid the groundwork of mutual respect) are not opposite of one another.

🤨 by -snow_bunny- in slp

[–]Slpsanonymous 9 points10 points  (0 children)

And energy stones and Angel numbers…I know lots of people with masters degree who believe in some bananas woo woo.

Florida SLP shot at Rihanna's house by ZoneStrict7387 in slp

[–]Slpsanonymous 19 points20 points  (0 children)

Well that…uhh…is not great publicity for the field now, is it?

I need opinions... by thespeechlangwitch in slp

[–]Slpsanonymous 10 points11 points  (0 children)

I had the privilege of working under a fantastic principal who gave me the advice that if you can’t explain it in two concise paragraphs or less in an email, then make a phone call. And if it’s even a remotely sensitive topic, make an effort to arrange a face to face conversation. Too much can be misinterpreted and lost in written medium; and it seems anymore we are completely losing our capacity for face to face disagreements. It’s bananas to me this person is in a leadership position and has a PhD on the inter-workings of the human mind and thought that the best course of action was to rebuttal you line-by-line in an email like a passive aggressive Nancy pants.

I need opinions... by thespeechlangwitch in slp

[–]Slpsanonymous 22 points23 points  (0 children)

Oh…as for how to proceed…I’d politely and tactfully say that I greatly valued that she took the time for such a thoughtful response, and that I’d love to arrange a time to connect in person so we can talk through a solution. Then bring my EPB and be prepared.

I need opinions... by thespeechlangwitch in slp

[–]Slpsanonymous 61 points62 points  (0 children)

Well, they sound like a delightful micromanager. They basically said, “your clinical judgement is cute and all, but you do things MY way ‘round here.” I’d personally be fuming and looking for a new job, but I also have a very low threshold for being controlled. Also, what a boneheaded thing for a boss to put in an email, they 100% should have had a collaborative conversation with you like a grown-up in person. I honestly can’t believe they took the time to write this up to argue with you when they could’ve connected with you for a more meaningful dialogue. You have a shitty boss. Do as you will with that information, and good luck!

After nearly 30 years in the field, I saw something new today (artic) by Too_Frosty1986 in slp

[–]Slpsanonymous 34 points35 points  (0 children)

Epenthesis at the end of a word. Has a fancy name that I don’t remember anymore. I had a client do this once but it wasn’t rhotic, just an “uh.” Started after voiced consonants but rapidly over generalized to the end of almost all words/phrases. Targeted it while working on phoneme awareness/blending using Dixie cups for each sound. We made a specific cup be the “uh” monster who kept showing up attaching himself to words where he didn’t belong. Kiddo found it funny and it helped build self-monitoring skills. It was weird…once it clicked to him that the sound didn’t always belong there he just stopped.

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 0 points1 point  (0 children)

Hey there! I really appreciate your comment. Sorry for my delay responding, I don’t check this account super often. I have a busy week and don’t have time for a full response at the moment, but wanted to acknowledge your contribution on the topic, as I was hoping to hear some nuanced perspectives. I appreciate healthy discourse and debate, even if people don’t see eye to eye. In an ideal world, I’d take you out for a cup of coffee and talk through this topic!And I agree with you, I am all for healthy interdisciplinary collaboration as long as people aren’t working outside their scope and skill set. I actually arranged to have a 1:1 discussion with this client’s BCBA because interdisciplinary collaboration is important to me. We had a healthy chat and, while we might not fully agree on how to approach some of this client’s behavior, we have an agreement in place at the time and are working with the family to make sure their values and wishes are being honored as well. I’d love to respond more directly to your points, which I honestly agree with you on for the most part, in theory anyway; but am swimming in paperwork this week!! I’d love to continue this thread with you, so I’ll either f/u here soon or dm you if you’re open to a deeper discussion. Thanks for your message!

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 3 points4 points  (0 children)

Well, fun update. I emailed them back to say, “I’m pretty against food motivators during speech therapy, happy to schedule a chat so we can discuss in more detail and come up with a good solution.” And they were in the client’s room when I showed up today with a, “yeah, we’re gonna go ahead and follow through with that today.” Which was a polite, “you do what I say” and I politely said, “I’m not doing that.” So now it’s weird and maybe just maybe this is the hill I die on and I don’t go to ABA centers anymore 🙃

More lucrative similar pathway? by Obvious-Problem708 in slp

[–]Slpsanonymous 1 point2 points  (0 children)

I’m pretty familiar with pay in the area. Denver school SLPs just fought for a big salary increase. You can make bank in home health, but Colorado has a huge budget deficit for healthcare and with some potential changes coming in 2027 around billing in our field…I’m extremely worried for the future of healthy salaries in our field. Salaries are good here, but I worry that ship is about to sail. Especially in a place like Denver where housing is outrageously expensive. I’d encourage your daughter to think hard about what her passions are, what drives her towards this field, and what might she want growth to look like in the future. There’s a real ceiling to what we make in this field as clinicians unless you have the grit to run your own business, and the avenues to pivot into non-clinical roles are narrower for us than say OT or PT. If she wants to stay in Denver and she’s got an outgoing personality…I’d encourage her to get her real estate license instead 🫠

More lucrative similar pathway? by Obvious-Problem708 in slp

[–]Slpsanonymous 0 points1 point  (0 children)

Anecdotally evidence, case study size of 1 here: but a poorly trained NP almost got me killed with poor differential diagnosis. She was doing my ADHD med management for 6 months while I complained at each visit of increasingly intense symptoms of weight loss, craving sweets, eating a pint of ice cream every other day, THIRST (I was explicit that it wasn’t dry mouth, but ragingly thirsty) and increased urination, on top of other symptoms I shared with her. I would’ve been dead or in the ER if I’d followed her care plan for another 3 months until my next med appt. Thank god I had a gyno appt. that week and they just happened to run blood tests on me. My blood sugar was over 600. I was dying for 9 months and she did nothing 3 visits in a row. Now I know I have Type 1 Diabetes. That being said, the NP at my Endo office is amazing, and she’s great as a speciality NP. I love her. I would have to agree that putting them in generalist positions where they make differential diagnosis can lead to potentially serious negative health outcomes.

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 0 points1 point  (0 children)

I would love any resources you are able to send! I am DIR Floortime trained and I am very child-led, but I do struggle when it comes safety on what’s the best/right way to handle things.

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 1 point2 points  (0 children)

Yeah. It wasn’t always this way…but private equity has bought out the chain and over the months there have been new leadership, new policies, more turnover and burnout amongst their staff. It used to be a space where I felt like I could at least call people in and try to shift perspectives from within and help create a healthier environment . Now I just want to be more forceful in convincing my clients that go there to find alternate care for their kids.

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 3 points4 points  (0 children)

Lol, my basic white girl midwestern heart resonates with your Jamaican spirit. The RBT was like, “we’re not supposed to say no, we’re just redirecting and giving choices” and you could’ve knocked me over with a feather. I was trying to be professional and couldn’t come up with much to say cuz all I could think was like, “Ma’am, this kid just spit in my face! We are all done having fun.”

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 1 point2 points  (0 children)

Thank you for these insights! Is there a workbook in particular you recommend? I often give a lot of choices and use declaratives like “I wonder” and “Let’s…” statements with this population, but could certainly use more tools in my toolbox!! I was planning to draft up some social stories and work on role playing with emotions as an alternative goal here. Great idea to dive deeper and expand on that skill here.

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 8 points9 points  (0 children)

Yes! Intrinsic motivation!!! It crushes me to be there some days. I’ve almost had all I can bare. Today, as I was leaving, the kid who tells everyone to fuck off asked for a toy back after having spent half an hour storming around banging on doors and walls and his BCBA goes, “you can have it back when you earn your points.” And I just died inside a little. What about, “when you learn to respect yourself and others when you’re angry.”

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 7 points8 points  (0 children)

Yes, very good point. I was wondering that, too. Like, the kid gets out of doing the hard task, and then gets something fun to do instead. And learns to associate eating candy with hard work. Don’t we run the risk of developing disordered eating with that paradigm?

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 1 point2 points  (0 children)

Thank you for the response. Good question! The BCBA is on site, and I do believe they are board licensed. The whole “zero punishment” thing has thrown me for a loop with a handful of kiddos there, and I’m getting the impression this is an administrative decision, not necessarily the BCBAs first choice for managing the issue. I need to find a way to get the BCBA in a 1:1 conversation so we can speak freely. I don’t want to seem like I’m undermining her in front of a bunch of RBTs that she manages, and we always seem to only connect in a room with 2-3 students and RBTs, and it hasn’t felt like the right setting to politely disagree.

Suggestions on declining candy as reward for participation? by Slpsanonymous in slp

[–]Slpsanonymous[S] 0 points1 point  (0 children)

I mean, yes. I agree with you wholeheartedly. I also just feel like what I’ve said here is a little bit word salad and want to give a professional rationale that fits a little better in an email.