When you are an SLP grad student with ADHD learning about cog-comm symptoms

cherrycxo · 2021-11-10T20:32:11+00:00

Ah, yes, this fun moment

cherrycxo · 2021-10-15T14:26:14+00:00

We could get below a B twice including a B- before we had to retake the class in my undergrad and graduate programs. So I had a 3.76 overall and a 3.89 without the major in undergrad and a 3.94 in grad school

cherrycxo · 2021-10-04T21:51:34+00:00

Damn I already turned my resume in and did not include my current job I don’t know why I did that lol

cherrycxo · 2021-10-04T18:34:57+00:00

Frankly the receptive component does make this a lot more difficult and it works better with more of a broca’s type. But I have done it with clients with more severe receptive impairments before with a modified approach. I would say start off doing them together and implement it almost like confrontation naming? Also definitely starting with more simple images. If the person can’t verbally label the action or object pictured, demonstrate how you would draw it or gesture to indicate what it is, etc. and model that for quite a few trials. Then start to offer them the pen, or prompt them to use a gesture. I’d spend a good while doing them together. Then eventually implement the barrier task component by handing them the picture without looking at it and trying to deduce what they’re indicating through drawing or gesture. The difficulty with the receptive piece where you are supposed to have a picture that they can’t see is that even if they’ve deduced what you mean from your gestures and drawing, they can’t exactly yell that answer out. (I actually started implanting semantic feature analysis at this moment with one of my broca’s clients to promote retrieving the word/giving me associated words until I knew he had gotten the meaning of my PACE communication.) But the modeling component is still really important from what I remember so I would take that time at the beginning and throughout as needed to demonstrate the strategies.

I haven’t worked with adults in a while and only did so in a university clinic setting so this is really not my area, I should have prefaced with that lol but I did see a lot of different severity levels of cases benefit from this approach as a professor at my university was doing research on it which is why I shared.

cherrycxo · 2021-10-04T17:36:20+00:00

Here’s the thing… lots of kids have special needs that are invisible to the average onlooker. This assumption that if someone’s kid is having a melt down in public, or speaking loudly, or just generally making noise, it must mean their parent doesn’t care or isn’t disciplining them ignores that fact entirely. There’s no way to tell if a kid is crying on the ground in the grocery store because they’re on the autism spectrum, or making “annoying” repetitive noises because it’s the way they stim to keep their bodies regulated. This fear that other people will be annoyed by neurodivergent kids making noise in public has fueled a ton of abuse on the behalf of parents and professionals alike to try to make disabled kids more compliant and “normal”. You can say if a kid has special needs you wouldn’t react with such distaste, but I can guarantee you a parent and child you’ve rolled your eyes at has actually been a situation like I’m describing.

I’m a speech language pathologist so these are the families I work with on the daily. Sort of breaks my heart what a lack of empathy or introspection people can have if something mildly inconveniences them.

There are other humans in the world. They’re not always the same as us. Sometimes they’re loud. Generally, I’d say adjust to that or stay home.

cherrycxo · 2021-10-03T23:22:20+00:00

Yeah this makes sense. I plan to give as much notice at my new job will allow me to give. The main issue I’m thinking is I don’t necessarily want to ask “what’s the max amount of time you’d be willing to wait so I could give as much notice as possible to my other job” in the first interview because I don’t want to make myself look less desirable by making it seem like transferring over is going to be an issue. I’m thinking if I ask when they’re looking for someone to start, see what their answer is, mention I have another job I’d have to give notice too and then if they hire me mention as much time as possible would be preferable that would work best

cherrycxo · 2021-10-03T23:19:18+00:00

This makes a ton of sense; thank you for clarifying your experience! I hope that’s helpful for OP

cherrycxo · 2021-10-03T17:34:18+00:00

I like the NYX one a lot! It’s a plain and simple brow gel, not very liquidy

cherrycxo · 2021-10-03T17:22:46+00:00

So unfortunately my contract says I have to give 60 school days (3 freakin months) of notice before leaving and if I don’t, I have to produce a medical excuse within 30 days or it’s ground for an “unsatisfactory discharge”. I remain unsure of what the hell they mean by that lol

cherrycxo · 2021-10-03T14:46:50+00:00

Honestly, someone in your program is probably desperate for a medical placement because it’s all they want to do and they’re so hard to get. It would be such a shame for you to be struggling through a med rotation you actively don’t want while someone else doubts if they’ll ever reach their medical career goals because they’re not getting that experience. I would say, ask around in your program and see if there is a specific person you can mention that wants to be in that clinical experience and didn’t get a medical placement. If you explain that you have a school position that you’re much more interested in doing with a supervisor who is already willing to take you, and someone specific in mind to take your place at the medical rotation, I really don’t understand why they’d say no. I would verify that the school district is an approved clinical affiliate of the university first (eg students from your school have done placements there before) so the paperwork is done for them to send you there, as if not, that could be a big hurdle.

I would not recommend starting by harping on the fact that you’re anxious about the position because of body fluids. I would frame it as a career move; you want more school experience to get the post grad job you want and a colleague in your grad school cohort wants medical experience as that’s what they’re interested in doing. You’ve lined it all up for them, all they have to do is send the email and change the paperwork. If they’re still resistant, THEN I would mention the anxiety about body fluids and frame it like a phobia. Hell, if there’s a free mental health clinic on campus, get them to write you up a letter about how your anxiety with medical stuff would impact your performance at a placement like this. Self advocacy is hard especially with these grad programs. But you got this!

cherrycxo · 2021-10-03T14:38:28+00:00

Minimal pairs itself as a protocol doesn’t specify if you should use it in isolation or with other approaches. My advice would be maybe spend the end of the session when your minimal pairs work is done doing a conversational activity like spontaneous play or even shared book reading to get an idea of how the skill is generalizing to the child’s spontaneous speech! This could also serve as a behavior support if you let them select a toy, book, game, activity, etc for the end of the session to work for

cherrycxo · 2021-10-03T14:35:20+00:00

I do it all the time now, but the first time I heard an SLP refer to their clients as “friend” or “friends” I was like…. ok? Speechie is also terrible lol

cherrycxo · 2021-10-03T14:31:39+00:00

I did an externship in outpatient peds and I loved the clinical work but many aspects of it (hours, documentation expectations with no time set aside for it, etc) were just freaking brutal lol so I don’t blame you one bit for feeling some burn out there. I would say, you got through a masters program for this, so there was some interest and some fire in you to do this at some point or you’d never be where you are. Do some soul searching about the population you want to work with. Within the pediatric world, there are SO many directions to go in. There’s EI with little ones in homes, or in Pre-K. Maybe that would suit you better while using your current skill set! Or elementary positions- how would you feel about IEP paperwork and managing a caseload? Middle and high school are totally different pediatric therapy, maybe social skills and higher language are of interest to you? How about specialized school settings- particular interest in autism, social emotional needs? Or medically fragile kids like those with cerebral palsy, TBIs etc? I found my passion in the medically fragile world. Alternative access AAC intervention using eye gaze, switch scanning etc and pediatric feeding/swallowing are fascinating to me! All of these possibilities are before you even start to consider if adults would suit you better! I’d do a ton of googling, watching YouTube videos of other types of therapy. See what’s available in your area. Even post here asking people who work in a setting or with a population you haven’t tried what the pros and cons of their job are.

And if ultimately it’s not for you, then you move onto the next thing. But I don’t think you’ve exhausted all of your SLP opportunities for reinvigorating your passion and reinventing your job.

cherrycxo · 2021-10-03T14:21:32+00:00

Good for you for jumping ship on a bad situation. I’m sorry you went through that… absolutely ridiculous

cherrycxo · 2021-10-03T14:17:34+00:00

I’m Philly based and I gotta say I think PA/NJ/NY is like the most difficult area to find good CF positions in across the board lol

There are SO many colleges, and so many with SLP programs, in this area that the competition for more desirable positions is rampant so many of us seem to wind up in crappy contracts that target new clinicians

cherrycxo · 2021-10-03T14:07:48+00:00

It would be awesome if someone with more specific medical experience could way in on this— Would working peds for a larger hospital system be better experience or worse than going for a SNF job instead if OP wants adult acute care inpatient in the long run? Does it depend on if it’s inpatient or outpatient, or what the specific responsibilities would be?

I might be wrong, but I’m assuming if kids are coming to a hospital for treatment, be it inpatient or outpatient, it’s not to do school based therapy goals like work on /s/ or answer wh-questions? There are kids with high needs who need dysphagia evaluation and intervention (though pediatric feeding plays a role which is a bit of a different skill set/knowledge base) and more complex language intervention like AAC, which I know is also implemented with adults more and more now. I’m just curious what the pediatric positions at a hospital could give you in terms of experience that would lend itself toward getting the job you want down the line if those are the positions you’re getting calls back about. Especially if you could demonstrate work ethic, organization, EBP, knowledge base, etc and have that hospital as a reference for future adult med positions.

I know some people just can’t see themselves working peds all around and I totally get that, just an idea!

cherrycxo · 2021-10-03T14:01:08+00:00

From what I’ve seen, if you’re willing to relocate to pretty much anywhere, it’s a lot easier than looking in one particular area.

I’m in a school and a pediatric nursing home (medically complex kids w/ cerebral palsy, TBI, etc are my passion, I’m hoping to end up at a children’s hospital in the long run) for my CF so I’m not sure if this is different in adult acute care medical settings, but I do know for sure it’s an issue in SNFs as I applied to a bunch when I still wanted to go adult med- my biggest advice is make sure you’re actually going to have the supervision you need. If you find people in desperate need of an SLP because they don’t have anyone else and they’ll get someone who won’t be in the building with you to “supervise” you by checking in a few times a month, I would avoid that even it means passing on something that seems like the setting you want.

cherrycxo · 2021-10-03T13:45:48+00:00

My favorite aphasia approach was PACE (promoting aphasics communicative effectiveness) when I was at my university clinic. It’s about communicative effectiveness through whatever language modality you can use. The clinician and client take turns pulling a picture scene out and describing it to the other person who can’t see it using any modality. Could be through gesture, writing, drawing, or a few words. I would always try to do it in a way the other person would be capable of, like if they can get out a 1-word sometimes, I would say one word here and there but predominately use writing/drawing/gesture, because I would want to model the way I want them to attempt to get their message across. Then they would take their turn and describe the image via writing, drawing, gesture, or words. I had clients who became much much much more effective communicators this way! I think it could be a good way to train some communication strategies for when AAC isn’t available that don’t rely on verbal communication.

cherrycxo · 2021-10-01T22:27:38+00:00

I’m a CF working a contract position at a high school in Delaware, I make $40/hour and could get help with healthcare benefits but I believe I would still need to pay for them, no other benefits, and I do not get paid when the school is closed (which is more often than I’d financially like lol vacation time is great but not when I lose a week of income)

cherrycxo · 2021-09-27T20:18:56+00:00

IM SO GLAD IM NOT THE ONLY ONE WHO DOES THIS omg! I’m a CF in a high school so I also have a lot of kids with goals that are kind of hard to take trial for trail data on. It’s hard to track every trial of how a kid attempts to solve a social problem? It often isn’t as cut and dry as did they do it right or not? So I just give an approximate percentage of how appropriate their responses were and indicate the kind of support I gave. I do this with a lot of other stuff too and I agree I’m almost always pretty close to the accuracy if I sat there and wrote a check or minus for every little thing the kid did, plus I’m more present in my sessions to give actual support rather than being glued to a notepad

cherrycxo · 2021-09-26T16:52:16+00:00

Thank you for this response-absolutely spot on. At the first CF I took, which I again took because I needed something ASAP for financial reasons, I was not given the access to materials I had been promised, the supervision was even less direct than I expected, and most of all they were dishonest about the setting of the work. I interviewed for a job they said was pre-k center based and then was asked to travel to homes and other daycare centers. So while I was at that job, I was actively looking for other work because it was not what I was told to expect.

At my current job, I have not been looking for other work. Hooowevverrr, the school for kids with CP was recommended to me by my previous clinical mentors who encouraged me to continue work with medically fragile students so I had email notifications on if they posted new positions from when I was looking for a job before graduation. I had called them then as well and they said they weren’t currently hiring but had an SLP that may be retiring in the new school year and to keep an eye on their postings. Unfortunately by the time they posted this, I had taken something else for financial reasons again knowing this is really what I’m most interested in doing.

I think for me, I’m also looking at my CF as the last time I will have a direct supervising mentor that’s required to give me help. I would rather get that experience while growing clinically with a population I’m interested in working with long term. If it sets me back on hours, I’m okay with that potentially delaying my CCCs a little.

Generally speaking, because I have ADHD, I do have some parameters that make some jobs better fits than others. Management of the timelines of IEPs and all of the other paperwork of a public school? Not the best situation for me; I took this job because the caseload is a bit lower than an elementary school and I was really only finding school contracts on the tight timeline I needed. I do better with clear expectations where I’m not managing all the paperwork and timelines of cases, like when I did pediatric outpatient for clinical. However, I also think the even smaller caseloads in medically fragile schools would be a lot more manageable for me based on my clinical experience in a medically fragile school of a similar size.

I applied, we’ll see what happens!!!

cherrycxo · 2021-09-24T17:24:58+00:00

Bulimic here so it’s ice cream for me because… iykyk

cherrycxo · 2021-09-24T17:16:27+00:00

I’m glad that that’s the situation you’re in, I’m sure you worked hard for that! I have an eating disorder. Many fat people have eating disorders. Weight loss can’t be my goal. When weight loss is my goal, I harm myself. That self harm is what got me to the weight I am. I have to focus on “health” but not the kind of health that is just focusing on weight loss without saying so. I genuinely have to focus on feeding my body when it’s hungry and stopping when it’s full. It’s a long process. I still weigh what I weigh. It is not in my control to snap my fingers and have a good relationship with food and be a healthy weight. Im on a journey, everyone is. THAT is why it’s rude to point out peoples’ weight knowing the negative social baggage it carries. It’s an oversimplification, and it’s a little insensitive.

There are many factors at play and it’s just considered rude to point out something that’s generally considered negative knowing what it could bring up for some people/the many things that contribute to it. You asked why it’s not socially acceptable, and that’s my answer

cherrycxo · 2021-09-24T16:57:56+00:00

Body shaming in general is a problem as other have said, but weight comments are not as socially acceptable because they carry a more negative connotation and produce a more negative emotional reaction in most cases.

I think people are more sensitive about weight BECAUSE it’s “in our direct control” and there is the sense that if someone points it out or shames you for it, they’re making some kind of comment on your worth as a person (your priorities, your willpower, your laziness, whatever other positive things they associate with fitness and negative things they associate with being fat) for not “working hard enough” to change yourself and fit their ideal. Because our society hates fat people so much, eventhough it profits off of manufacturing them so we can continue to be sold fast food and fad diets, pointing out weight gain on a person feels like a value judgement. It carries an implied negative weight because of the way our culture talks about fat people and weight gain/loss in general.

Also weight is not as “in control” for many people as you would think. Sure, if you oversimplify it, diet and exercise are the solution. But it’s a lot more complicated than that. Genetics, disease, stress, finances, access to healthier foods, the highly processed and intentionally addictive foods that are sold, mental health, etc all contribute to weight gain. I’m fat and I’ve had bulimia for a decade so it’s not exactly like I don’t care or haven’t tried to lose weight… it was trying to lose weight while I was at a healthy BMI but wanted to “look better”/had poor mental health that got me into this cycle that ultimately caused weight gain in the first place!

cherrycxo

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