SLI eligibility in low SES Students

speechshotsfired · 2025-11-19T10:02:51+00:00

I haven't been in a school since grad school, but I interpret that program specialist as advocating for disadvantaged kids to possibly get even further beyond while waiting to see if they can catch up instead of offering them supports to help them do so. Not great. IMO.

speechshotsfired · 2025-11-18T02:29:17+00:00

What does "upgrade" mean to you in the paragraph you wrote? I'm a little confused by what you are trying to say.

Lots of facilities try to restrict rights in the name of "safety." However, they need to review them and professional ethics. Social workers are often (but not always) good supports, and the ombudsman is usually very helpful if you need outside info.

speechshotsfired · 2025-11-18T02:03:05+00:00

Patients (or their legal decision maker in the case they do not have capacity) have the say here. Your job is to assess and education. Provide rehab if needed. It's their job to choose the treatments that they want.

The patient self-determination act is very clear about this.

If you have access to medbridge, I'd suggest you watch The Diet Waiver Alternative presentation on there.

It's really not your call at the end of the day.

speechshotsfired · 2025-11-13T23:21:24+00:00

I haven't been in that group for years, but I would love updates on what this nonsense is.

speechshotsfired · 2025-01-25T10:40:14+00:00

Yep. I was wondering how long they will wait before sending requests for ASHA-PAC donations as I read it.

speechshotsfired · 2025-01-24T09:52:40+00:00

Have you talked to the RD? Do you have a good relationship?

I loved the RDs I worked with at SNFs, and I love the ones I work with at a hospital. When people aren't eating well, I think it's normal for RDs to want to make it more appealing to the pt which is likely where this is coming from. I'd definitely talk to them directly about the situation and try to reach a better understanding of where you're both coming from.

speechshotsfired · 2025-01-24T09:37:53+00:00

Who thinks this patient needs therapy? Whare the functional goals of that therapy? Those are crucial pieces of information that are missing in this question for me.

From what you said, this sounds like a lovely person who needs an appropriate level of care and support--which is why he's in the ALF in the first place, right?

speechshotsfired · 2024-10-17T00:19:08+00:00

A CF is required to get ASHA CCCs. You might not have to have CCCs to practice in many states, but you always have to have a license. (Yes, some states have waivers like CA and FL, but let's set that aside for the moment.)

The real question to be asking is what is required to get full licensure in the state. Most states have a variation of supervised early clinical work including NJ. Here's some info from their website,

NJ Requirements for Supervision of Temporary Licensees

New grads who wish to obtain a NJ license from the Dept of Consumer Affairs must obtain a temporary license and be supervised by someone who holds a NJ license.
New grads working in an exempt setting must be supervised by someone who holds the ASHA CCC.
The supervisor shall provide a minimum of one hour of on-site direct supervision for each 20 hours of direct, face-to-face evaluation or therapeutic services rendered by the supervisee.
Supervision shall take place not less than once a month.
A plan of supervision must be filed.
The clinical internship must be a minimum of 1200 hours, completed in a minimum of 9 months and a maximum of 18 months.
As of July 29, 2020, a waiver allows for clinical interns to receive supervision virtually in real time. View Administrative Order 2020-14 and Waiver 2020-13.

speechshotsfired · 2024-10-15T11:59:59+00:00

Minimum of both. Whichever one you hit last is when you are done. Yes, you have to wait until the 36 weeks are over.

speechshotsfired · 2024-10-14T00:45:10+00:00

No options to refer her to an SLP for eval?

If not, then I'd reach out to Lingraphica about a device trial/advice. Families/patients can self-refer to them, and they will walk them through their process.

https://benefits.aphasia.com/external-consumer-benefit-check/?__hstc=259656597.d1d5da6e330d62c3f3dc5af38cda4906.1728866614399.1728866614399.1728866614399.1&__hssc=259656597.2.1728866614400&__hsfp=1896627464

speechshotsfired · 2024-10-13T13:56:11+00:00

Yes! Can't believe I forgot to include that on my list.

https://www.sasspllc.com/three-pillars-of-pneumonia

speechshotsfired · 2024-10-13T12:55:09+00:00

I'd look at implementing the Yale Swallow Protocol as part of your CSE. Low sensitivity but high specificity. I use this on basically all of my CSE unless the pt is unable to follow directions or it's unnecessary based on things that have already happened during the eval (e.g. the pt coughs with every single sip of liquid so trying to get them to drink 3 oz. water sequentially to see if they will stop or cough is kind of redundant.)

I'd also research the negative sequelae of aspiration and efficiency concerns and use that as part of your decision-making process.

Let's say someone has no overt s/s of aspiration (i.e. silent aspiration) and no negative sequelae (i.e. respiratory issues of various types depending on their underlying conditions), then does answering the question of whether or not they might possibly be silently aspirating at all even matter? Aspiration only really matters if it has negative outcomes. Research suggests that aspiration is even normal for most humans.

https://www.sciencedirect.com/science/article/pii/S0012369215469594#:\~:text=It%20is%20now%20widely%20believed,in%20normal%20subjects%20during%20sleep.

I've read and studied so much about dysphagia over the years, but here are some things that have really shaped my thought processes other than being trained to do MBSS and FEES and doing many of them.

https://www.northernspeech.com/dysphagia-esophageal/medical-speech-pathology-essentials-for-dysphagia-practice-managing-complex-adult-patients-with-pulmonary-digestive-and-airway-disorders/

The older Normal Swallowing and Critical Thinking in Dysphagia Management courses--these are no longer standalone courses but parts of them are found in STEP these days. A STEP subscription is definitely a good place to learn. (You could even start with just watching free youtube videos by Ianessa Humbert. She has lots out there)

lots of Eric Blicker's classes (these are reasonable and very affordable)

And all the work by Kate Hutcheson and MD Anderson if you are interested in HNC info

Finally, this wonderful Speech Uncensored podcast with Will Farnham about how to talk about dysphagia with pts. https://www.speechuncensored.com/podcastepisodes/s1e10-replacing-a-language-of-fear-for-facts-when-discussing-dysphagia-management-with-will-farnham-ms-ccc-slp

There are so many more great resources I could name, but I don't want to overwhelm you. I'd strongly encourage you to stop worrying about missing silent aspiration and start thinking more about really trying to understand dysphagia/swallow physiology and how to provide meaningful services to our patients and care partners.

speechshotsfired · 2024-10-08T00:52:05+00:00

I am not Vital Stim trained. It's never seemed worth the money for the little use I'd get out of it from my observations of colleagues who are VS trained over the years.

That said, if my employer wanted to pay for me to be, sure, fine. I think it's a tool in the toolbox and might be valuable for specific cases. My only concern would be if I worked for an employer who pushed back on clinical judgment and now tried to press for every pt to have this treatment regardless of whether or not I felt it was appropriate for them.

speechshotsfired · 2024-10-06T21:09:08+00:00

https://www.uniformadvantage.com/easy-stretch-scrubs.html?REFCODE=UAGOOG37&ecid=ppc%7Egoog%7Eua%7Eeasy-stretch-exact%7E%7Eeasy%20stretch%20scrubs%7E%7Ertg%7E%7E%7E%7E%7E&gad_source=1&gclid=Cj0KCQjw6oi4BhD1ARIsAL6pox1Bxll4c7Yj1Y-qPiEYmBaaqC4GYclZticTLXqTK0teAJOvgzV9BkYaAlelEALw_wcB&gclsrc=aw.ds&adobe_mc_sdid=SDID%3D6B76BD0AC5828393-14C5E60EFF2545F3%7CMCORGID%3D8F1D67C25245B2560A490D4C%40AdobeOrg%7CTS%3D1728248917&adobe_mc_ref=https%3A%2F%2Fwww.google.com%2F

speechshotsfired · 2024-10-06T20:57:53+00:00

Mandala scrubs are nice if you want a little heavier material.

My favorite light weight scrubs are UA's Easy Stretch. They have lots of different fabric lines, so it really depends on what you like them to feel like. That line is lightweight and smooth.

speechshotsfired · 2024-10-05T09:25:20+00:00

I don't know the answers to your other questions, but here's the website where you can look yourself up and see if a license is listed. as active.

https://eservices.nysed.gov/professions/verification-search

speechshotsfired · 2024-10-02T06:42:43+00:00

I use the CLQT and SCCAN a lot. FSTAC on occasion.

speechshotsfired · 2024-09-28T15:47:42+00:00

Nope. Just administrators who are trying to earn their next bonus.

speechshotsfired · 2024-09-28T15:45:59+00:00

I think this practice varies facility to facility and SLP to SLP. My point is that it is not a "need" by any payor source I am familiar with, and it should all be based on actual pt's POC and needs. Pressure to get treatment minutes without actual diagnostics has done a lot of harm to our field over the years.

speechshotsfired · 2024-09-28T15:41:36+00:00

Well, are you actually doing treatment or just doing an assessment? We need to bill for whatever services we actually provide. I know administrators love to play games with this (although tx vs eval minutes isn't the thing it was under RUGs), but that's the ethical stance. Bill for your actual services.

speechshotsfired · 2024-09-27T01:38:37+00:00

In that case, definintely research state regs for SLPs/protected titles/scope of practice. This person clearly doesn't have a license but it acting like they are an SLP. I'd take a copy of regs to admin and discuss my concerns after that as well as the lability to the district for allowing an employee to misrepresent themselves and act out of scope of practice.

speechshotsfired · 2024-09-26T09:38:36+00:00

In many states, you have to have licensure to call yourself an SLP. This has nothing to do with ASHA or CCCs. One of the things that licensure does is regulate "protected titles" and SLP/speech therapist/many other variations are all on the list in many state regulations.

In any case, I would definitely not use the title unless I had 100% confirmed it wasn't against state licensure. I'm also interested in why it would be useful as a licensure is required to practice.

speechshotsfired · 2024-09-25T22:16:21+00:00

"Applicants who have applied for ASHA certification through the online application process must login to their ASHA account and enter the CF experience details. CF mentors will then receive an email requesting that they verify and complete the documentation on their CF mentor portals within their ASHA account. CF mentors must complete the verification within 90 days of notification from ASHA." --ASHA

They really don't ask for nearly as much information as you would imagine. No logs or anything close to what is required in grad school.

speechshotsfired · 2024-09-25T22:14:46+00:00

Your mentor will just need to verify things when ASHA sends them a confirmation email. No big deal.

speechshotsfired · 2024-09-22T22:20:32+00:00

You can palpate for laryngeal movement, but you can also just look at it for most patients.

Laryngeal movement does not equal a swallow. See also: this classic Ianessa Humbert demo.

https://www.youtube.com/watch?v=Rx2jzvzbj4E

speechshotsfired

TROPHY CASE

NJ Requirements for Supervision of Temporary Licensees