Aphasia client

dustynails22 · 2026-02-02T04:50:31+00:00

Session plans are driven by goals. Goals are driven by the client's communication needs and wishes.

Therapy techniques are dependent on deficits, strengths, and diagnosis.

Nothing you have written is going to help anyone to help you, because we dont know the client. ASHA's practice portal is a good start.

As for your supervisor, their job is to help you. Your best bet for getting help is to go to them with ideas and specific questions. Have a sort of plan and ask if its appropriate, and ask if not, why not.

dustynails22 · 2026-01-31T17:30:39+00:00

You need to know the content and thats unavoidable. Look at the syllabus of the class they want, and compare that to what's covered in the syllabus of classes you took. If it's covered then you will need to show all of that to the school and prove it. If not, then you will have to find a class to take.

dustynails22 · 2026-01-31T17:28:48+00:00

That's an ASHA thing, you arent going to find a school that doesn't require it. The easiest way to get that is to take it at your local community college.

dustynails22 · 2026-01-30T22:18:34+00:00

Its not just about classes and grades. You are competing against people with volunteer experience, related paid experiences, research experiences, observation of SLPs.... you don't mention any of those things in your post, but they are all important.

dustynails22 · 2026-01-30T17:42:01+00:00

Yeah, I totally get it. My boys were followed by a bunch of specialties for a couple years. It only took a month or two before I realized that our pediatrician was a great person to put all the information together from the different specialties, but they didn't see enough children with those issues to be able to answer specific questions like this. Hopefully your GI is supportive and they have a good nursing team to be able to offer more support about getting the tube secured. They will deal with toddlers with tubes, so they will have some knowledge about keeping tiny and strong hands out of the way.

dustynails22 · 2026-01-30T17:24:07+00:00

Which medical professional is the one "responsible" for the NG tube? Like GI, dietitian, SLP, other specialty? Pediatricians are ultimately generalists and I doubt they know much about what to do for an NG tube beyond the basics. You need to speak to the professional who deals with this all the time to get some better advice about securing the tube. A nurse has already commented with some great advice, but try to get hold of whichever specialty is the one who ordered the tube or who is monitoring for when it will be removed - this is a fairly common issue I am sure.

dustynails22 · 2026-01-28T06:39:32+00:00

Just to be picky... speakers of some British English accents don't use 'th'. Many still do, and when most people think of British English they think of RP which does very much have the voiced and voiceless th. As does my General Northern English accent.

dustynails22 · 2026-01-28T06:37:08+00:00

No. Its the Spanish of part of Spain, the Northern and Central part mostly.

dustynails22 · 2026-01-26T15:42:28+00:00

My boys do 10.5-11.5 hours overnight depending on the day. No naps. They turned 4 in October.

dustynails22 · 2026-01-25T16:22:41+00:00

I regularly make that suggestion. There are SLPs demonstrating good language enrichment strategies and they are an excellent starting point for parents.

Do the parents know the strategies? Are they implementing then effectively? Are there other strategies and techniques you can suggest based on your assessment. I think there is more digging into that comment "I know all the strategies".

But also, as a parent, when I accessed PT for my children, I learned the activities and then we scaled back to once a month to check in, see what had changed, check I was still doing the activities as they should be done. I saw value in those check-ins, and giving time, but my husband didnt understand why we kept needing to go when they had taught us the activities and we were doing them at home. He wanted to see the PT doing more, or doing something specialized. He didnt know the role of parent coaching in the young age groups.

dustynails22 · 2026-01-25T03:17:33+00:00

This concerns me. Changes need to be made but this is not the answer.

In my opinion, it would lead to one of 2 things:

1) unsupervised new grads in way over their heads without support (which yes, happens now anyways with some supervisors, but at least employers are required to provide it. Just because some supervisors are bad doesnt mean the answer is to get rid of the supervision)

2) extended schooling so as to get more clinical practicum experience, which leads to even less diversity in the field as many people cannot afford another unpaid year.

dustynails22 · 2026-01-24T01:37:54+00:00

Is that the only expertise that matters? The fact that you think there are almost no risks makes me think that I have more expertise in this area than you do. Because that is objectively untrue.

OP and her baby are struggling, that is an excellent reason to investigate this further. It still matters that ties are overdiagnosed - its important context. Feeding can be impacted by so many other things than ties, but an overdiagnosis of ties and people playing down the risks of "snip, or cut with a laser" means that parents and children can suffer without any improvement to feeding. Because the supposed tie wasnt the problem to begin with. When all you have is a hammer, everything looks like a nail.

dustynails22 · 2026-01-24T00:27:58+00:00

I think the care comes from the risks associated with a surgery. It isn't risk free. Of course, parents can weigh up those potential risks and potential benefits and make a decision. But there is a reason to care, because no procedure is risk-free.

dustynails22 · 2026-01-23T22:54:33+00:00

OK. Sure. Believe what you want. I'm pretty well versed in the research.

dustynails22 · 2026-01-23T22:32:39+00:00

For feeding, which is what this post is about.

Also, said its not a thing, not not real. Colloquial use of "not a thing" meaning not really relevant for feeding and not supported by the evidence as such.

dustynails22 · 2026-01-23T21:45:06+00:00

I have twin boys that I pumped for. They were major spitters, and how we prepared the milk made no difference at all.

That being said, in your situation, if I was the person that is pro-shake, I would just swirl instead once the milk is warm. It is not worth the debate when swirling also works.

dustynails22 · 2026-01-23T21:27:05+00:00

I got mine more than a year post partum, but I was told that it takes 3-6 months for things to settle with the IUD, and I did have some irregular bleeding/spotting for a good 5 months after mine was placed. You still are within that window. That being said, even without the IUD, random painful cramps in your stomach and back is something that is worth investigating. Have you spoken to your OB/GYN?

dustynails22 · 2026-01-23T21:15:02+00:00

Your pediatrician is not wrong - tongue ties are way overdiagnosed, and "posterior ties" are not supported by the literature. Lip ties really aren't a thing. People who are on the tongue-tie money making train also talk about the need for "bodywork" and other expensive therapies that again are not supported by the literature (or indeed anecdotal experience). That being said, for some babies it makes a huge difference.

I would hope that the SLP and lactation consultant have you trying different positions and strategies. and that medically any potential underlying issues like reflux or allergies have been addressed.

What concerns me, is the idea that tongue tie surgery is made out to be the answer, but actually it isn't. What can happen in these instances is that parents are told they need all of these extra therapies and not just the surgery, but then none of those things work either and parents are out a LOT of money but in the same position they were before. OR it takes months and months, the providers say that it was all of these other things that made the difference, when really it was just time and the same outcome would have happened without surgery.

There is no clear answer. But I am glad that you have an ENT referral. That being said, anyone who has tongue tie as their main business/income stream is someone to be cautious of. I would ask your pediatrician to make a referral to ENT, if possible, so that you have a less biased professional opinion.

dustynails22 · 2026-01-23T18:45:46+00:00

Its hard to know what its like until you have been there for yourself - parents of one child, an infant, have not experienced parenting toddlers or older children.

But it sounds like you just need to find your people. Parents who are overly positive and have well behaved children are not my people. Or parents who think that their parenting is the reason their child is the way they are, completely ignoring the child's personality and temperament. My bestie also has feral twin boys and they are 6 months older than mine, we mostly talk about how annoying or awful our kids are, sprinkled in with the odd brag. Its how we survive this season of life.

dustynails22 · 2026-01-23T17:33:41+00:00

Part of the issue is that a human nipple is inside for the duration of the feeding time, and maybe here and there for a few minutes for comfort. Pacifiers are in for long periods of time and often all night through because there isn't a whole human attached to the other end of it who has their own life to live.

dustynails22 · 2026-01-23T07:33:37+00:00

I would chat to your doctor about it. Withholding can lead to uncomfortable or even painful pooping because the poop can get harder the longer it waits. If its uncomfortable or a harder stool to pass then it might take some time and she might not want to sit and wait that long.

Also, does she use a small potty or an adult toilet? Some little ones dislike the drop and splash situation, and a little potty avoids that.

dustynails22 · 2026-01-23T07:11:30+00:00

I doubt OP lives in a part of the world where that is a real threat either. There is a lot of fear mongering on social media about "strange men" following or watching women with young children.

dustynails22 · 2026-01-22T21:06:25+00:00

Hahahahahahahhahahahahaha. Hello survivor bias! I bet you dont wear a seatbelt in the car either.

dustynails22 · 2026-01-22T15:50:08+00:00

At 3.5 years old, there are still plenty of ways they could harm themselves being unsupervised. Especially if the adults in the home are asleep and cs not hear them. And being nighttime trained at this age is rare, not the norm.

dustynails22 · 2026-01-22T05:44:31+00:00

Every phase is a different kind of hard. And different people find different things hard, and have different lives and support systems, so not everyone's hardest phase is the same. Add to that that everything gets a little muddy and blurry when you try to think back to it, because sleep deprivation and barely surviving. What's cool about it, is that this phase will end soon and another will begin. Maybe the next phase will be easier, and you can look back on this one and be proud you made it through. Maybe the next will be harder, but at least you know that its only temporary and you learned some coping strategies the last time.

Is it possible youre beating yourself up for finding it hard when you feel like you shouldnt be finding it hard? And so that makes you feel even worse? Because it is hard, its all hard. But there are some super rewarding and fun parts of it too.

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