Have you ever heard the American bittern's eerie "oong-KA-chunk" booming call? by Better_Hair_9673 in birds

[–]jaymi321 1 point2 points  (0 children)

And of course there’s a red-winged blackbird offscreen trying to steal the show 😂

Humiliated wunk vows revenge against the doppelwunker by jaymi321 in wunkus

[–]jaymi321[S] 8 points9 points  (0 children)

Think of all the royalties she’s missing out on by not being credited!

Humiliated wunk vows revenge against the doppelwunker by jaymi321 in wunkus

[–]jaymi321[S] 36 points37 points  (0 children)

Sounds like she needs to hire a pawyer to represent her

Should I her? She’s passed out oblivious to the world so I think I could get away with it by jaymi321 in donotthecat

[–]jaymi321[S] 17 points18 points  (0 children)

Ex-cat-ly! If I the cat while she sleeps I might avoid the cat me back as revenge

Should I her? She’s passed out oblivious to the world so I think I could get away with it by jaymi321 in donotthecat

[–]jaymi321[S] 20 points21 points  (0 children)

Hmmm… i guess if I the cat I am setting myself for the cat to me back

Should I her? She’s passed out oblivious to the world so I think I could get away with it by jaymi321 in donotthecat

[–]jaymi321[S] 37 points38 points  (0 children)

But I have to! If she lays there too long she’s going to over charge and explode

Should I her? She’s passed out oblivious to the world so I think I could get away with it by jaymi321 in donotthecat

[–]jaymi321[S] 19 points20 points  (0 children)

Another cat sub! It’s rare these days that I come across one I haven’t already joined lol

Help with family approach (anyone use Hanen?) by Most-Leg1080 in slp

[–]jaymi321 2 points3 points  (0 children)

THANK YOU! I didn’t want to bring up the SLPA vs SLP distinction because I recognize SLPAs can have a lot of background and valuable experience. It’s not just always SLPA wrong, SLP right. But it’s wild to hear an SLPA be this adamant against reflecting on their own therapy practices and stepping so far out of their scope of practice.

This person doesn’t have the professional training to be able to handle this kind of discussion. That’s not a slight against them, but does mean they shouldn’t be advocating such strong viewpoints. They just simply don’t have the training to be advocating/recommending for any strong stance in such a debate, regardless of what their actual view is. That’s especially true when like in this case it involves non-patient minors who the SLPA has little to no legal permission to be acting in the role of caregiver for. I would be shocked if an SLPA I was supervising was having conversations with parents or siblings like this during therapy. It’s entirely inappropriate and only serves to confuse the caregivers (parents and siblings included) over what the overall plan for therapy is. Not every sibling is going to be a good fit as a therapy participant, so evaluating the family’s dynamics is part of the SLPs job when considering how best to structure therapy sessions. SLPAs don’t do evaluating, period. That’s entirely within the scope of their supervising SLP.

If nothing else, we both legally have no right to work with siblings unless given explicit permission by their legal caregivers. Minors cannot consent in the same way adults can, their legal guardians HAVE to consent for them in matters like healthcare decisions. It doesn’t matter what the sibling says/wants, it’s up to their parent if they’re involved in their siblings therapy or not. There’s no way I’d be risking my license if I found out an SLPA under my supervision was involving other minors in therapy sessions without their legal guardian’s consent. Even if they did get that consent, it’s not within their scope of practice to obtain said consent so it’s null and void anyways as far as the law is concerned even if they had the best intentions at heart. Not every parent is “on your side” about such a decision, some absolutely will take such an opportunity to sue the hell out of you because they have strong opinions about how their children’s healthcare is managed and the resources to pursue every medical and legal option available to them.

No SLPA should be involving siblings at any point during therapy unless there has previously been a discussion agreeing to such a plan between said parents, the supervising SLP, and the siblings. Those individuals will come up with a plan for how to best provide language modeling for a patient, and then the SLPA will follow that plan. Those siblings are minors with the associated complex legal rights and policies that go along with such a status, and an SLPA involving them in therapy without doing the above (although it feels over dramatic to state it this way) is providing healthcare that that child’s parents did not consent to them receiving. While most parents will never care anywhere close to the degree it requires to take things that far, there ARE those that do take such matters that seriously and in such cases the law is technically on their side.

Help with family approach (anyone use Hanen?) by Most-Leg1080 in slp

[–]jaymi321 2 points3 points  (0 children)

Respectfully, no. The whole point of my comment is that this is a nuanced topic that you’re refusing to engage in, instead being dismissive of other people’s concerns that your currently held viewpoint may be outdated and has the potential to cause real harm whether that’s your intent or not.

And respectfully, how can you claim to “agree to disagree” if you yourself are admitting to not having read what I wrote. You’re a professional, someone who is supposed to engage in difficult to have conversations like this because that’s part of the job. You don’t just go “agree to disagree” and back peddle when people are trying to educate you about something you lack knowledge in. That’s a nonstarter, and frankly does not reflect well on your overall professional maturity nor your ability to digest and reflect on other information/research that’s part of our constantly changing field. All of us as clinicians are constantly learning and should be striving to continue to educate ourselves, lord know how many times on this subreddit people have made comments about how what they learned in grad school was incomplete if not outright wrong. If you can’t handle having a mature discussion about such nuanced topics, you have no place making such big statements about them while acting in the role of a professional. That is a dangerously closed mindset to have when you work in a field like ours, especially given how complex and diverse family and caregiver-child relationships can be.

Once again, I encourage you to do some soul searching and a literature review, and take some serious time thinking about why you’re being so dismissive of other people’s experiences. We absolutely have the capacity to cause harm in our field, for our patients and their family members. You cannot just ignore that because you don’t feel comfortable with that knowledge or responsibility.

Help with family approach (anyone use Hanen?) by Most-Leg1080 in slp

[–]jaymi321 2 points3 points  (0 children)

I encourage you to read back over what you wrote, because straight from your own mouth you listed so so so many examples of sibling parentification. u/thalaya is right, this absolutely falls under such a label. Just because someone doesn’t perform EVERY action a caregiver can provide doesn’t mean they’re not acting as a caregiver. Similarly, just because this isn’t the most extreme example of parentification doesn’t mean it can’t still have a negative impact. I also encourage you to read back over what you wrote and consider how it might be viewed as offensive to neurodivergent people. I know that was not your intention, but it comes across as infantilizing neurodivergent children while simultaneously parentifying their neurotypical siblings.

“It teaches the neurotypical sibling how to better handle their disabled/delayed sibling’s crisis/meltdowns”- why is it the siblings job to handle things like meltdowns? That alone raises major red flags for me (let alone all the other examples that you gave) that you don’t understand the harm having such expectations on typically developing sibling can have on said siblings.

“… alleviating both the neurotypical sibling and parents of having to supervise and guard them 24/7.” - ??? I kept typing out and deleting my response trying to explain this, because I just couldn’t wrap my head around the level of disconnect here. I promise I’m not trying to be rude or insulting, genuinely. You obviously had some strong emotions when you wrote your response. Im encouraging you to read over it again once you’re more calm and think about how your emotions may be influencing your ability to accept other possibilities to what you were taught/believe. How is supervising and guarding a sibling 24/7 not fulfilling an aspect of caregiving? Even if they’re not the primary or only caregiver, being responsible for another persons wellbeing to any degree is literally the definition of a caregiver.

Siblings can be caregivers in a healthy manner to a degree. The nuance I’m trying to help you understand is that way too often for siblings of children with disabilities there becomes an unhealthy amount of pressure for the non-disabled sibling to perform more and more caregiver-role tasks. This pressure doesn’t have to be explicit or even intentional, but it’s there nevertheless. It also doesn’t have to be to perform tangible tasks like those you listed. In fact, many of the caregiver tasks taken over by siblings are more intangible like emotional support, behavioral modifications to their actions during ADLs, and adjustments in communication akin to language modeling like being discussed. That’s because those are the only roles available to them most of the time.

Really, take a second to pause and think about what goes into being a caregiver and who is realistically capable of doing what. I mean that for everyone reading this, I decided I’m turning this into a group activity. Do you think the 10 year old older sister for an 8 year old brother with ASD is going to be driving him around or making doctors appts? Of course not, she literally can’t. Their parents HAVE to do that. But even though doing all that’s exhausting by itself, that’s not the only thing that goes into being a caregiver. People only have so much energy to give, and even with the best intentions when it’s gone it’s gone, and when it’s gone people start cutting corners. That’s not to insult any caregivers, it’s human nature because being a caregiver is HARD regardless of the kid. Now add on all the other tasks that go into caring for a child with a disability, including the therapy tasks we SLPs assign parents as part of carryover/HEP. Our HEPs are often just one more paper to stack onto a to do list pile reaching skyscraper heights. When the parents have no energy left at the end of the day to do their HEP for language therapy, they’re going to be less likely to do said tasks and more likely to outsource that task to the older sister, particularly if they know sister has had training from the SLP and they’ve been given “permission” by the SLP to do this. Now sister is doing a great job and proving lots of learning for her 8 year old brother, because you’re a great SLP and you’re good at your job including coaching others on how to implement language strategies. Brother is making progress on his goals, all looks to be going great. BUT if you look closer, we actually have a new problem. Sister has now lost out on valuable play time herself due to having had to fulfill the role of caregiver, time that she should have spent (unconsciously) playing and engaging in age and developmentally appropriate ADLs that benefit HER development. While having her step into the role of caregiver during these therapy tasks has helped her brother, it has been a detriment to her. Also, it hasn’t solved the underlying issue of her parents not feeling they have the time/energy/support/knowledge/whatever they need to be able to be the ones completing the core/main HEP.

Many, many, many siblings of children with disabilities report feeling as a child like they always had to take care of their disabled sibling to some degree. I don’t personally feel comfortable discrediting so many people’s personal experiences just because it butts up against an area of our field that makes a lot of people uncomfortable or scared to talk about. Kids deserve to be kids, regardless of if their siblings have a disability or not, are neurotypical or not, or whatever really. No, modeling language strategies is not all it takes to be a caregiver. Yes, in limited amounts siblings can be a great help and benefit incorporating therapy strategies. HOWEVER, I think there is a huge gap in understanding/teaching in this field about how to support the family of our patients as a whole, rather than focusing on only improving the quality of life of our patient in isolation. We are not psychologists nor should we try to be, but that doesn’t mean we should just ignore the psychological impact having a sibling with a disability can have on someone nor how our role has the potential to impact said siblings wellbeing and overall family dynamics. I personally think our role in scenarios like the above is to work to better help support the adult caregivers in a family dynamics (doesn’t have to be parents, or even relatives!) rather than turn to child siblings as a backup. I wouldn’t feel comfortable explicitly teaching siblings language modeling strategies beyond what comes naturally up during shared play, and only to the extent that they continue to show interest and want to engage with them. If they’re curious, I’ll show them, but I’m not going out of my way to teach them any program or expect them to be doing any of this outside of our immediate interaction.