Making Online Speech Therapy Work: Tips from an Expert

by Beth Finke

Here it is! Part Two of speech-language pathologist Marsha Boyer’s guest blog about teletherapy. The owner of Speech Connections, Inc in Indianapolis, Marsha says she’s seen countless changes in the Speech and Language therapy field over her 27-year career, ”but the year 2020 has brought a new meaning to the word ‘change!’” In Part one of her Education and Parenting guest post, she described how she, the children she serves and their parents made the switch from face-to-face therapy to tele-therapy while sheltering in place. Today she offers tips for speech-language pathologist and parents for the new school year.

by Marsha Boyer, M.A.,CCC-SLP

I believe I speak for most speech-language pathologists and parents when I say that in the early stages of the pandemic we were using what resources we had and trying our best to continue with services. Now that we have had some time to take a step back and assess what we’ve accomplished so far, we can look at making a few adjustments to improve the delivery of services. I’ve learned a lot in the last six months or so, and today I’m sharing my tips to help speech-language pathologists and parents get the most benefit out of your tele-therapy sessions.

Parents:

1. Try to use a large screen device or computer, and check for good internet connection. Tablets and phones are sometimes what are available when parents also have to be online for work, but I have found these devices often do not allow clients to interact with online activities. Also, find websites that help you check your internet speed and quality.
2. Keep nearby distractions to a minimum. Siblings and pets are great topics for us to talk about but sometimes they are doing things that draw attention away from the speech therapist.
3. Finish up those snacks and meals before meeting. Though I would rather have them happy than “hangry”, we lose some quality therapy time while they are eating, leaving me to stand by waiting.
4. Set up your child in front of the camera so that your speech therapist can see their entire face. Hearing their speech through a speaker often does not allow me to hear those subtle changes. If I also have the visual component, the two together help me make a better assessment of how they are doing.

At this point in the year, most speech-language pathologists have had some experience with tele-therapy and most likely have materials and routines all set. My advice to speech pathologists at this point is to stay true to your style of therapy as much as you can to maintain some normality. For instance, though green screen activities are engaging, if that was not part of your skill set before the pandemic you may not want to tackle that yet. Annotating PDFs and using interactive learning games can address goals just as well. Here are a few additional tips to take your online sessions up a notch.

Speech-Language Pathologists:

1. Have an external microphone and use headphones or earbuds while meeting with a child.
2. Plan ahead for creative ways to engage very young children. We all know preschoolers can be unpredictable, but if you have a general idea of how you want to address a particular goal, you reduce the need to scramble for a way to pull in their attention. Even a simple hide and seek game where you ask a parent to help them hide an object while they turn off video, then back on for you to look around and ask them “where did you hide it?” This type of simple activity is great for working on answering questions.
3. Consider a healthy mix of direct therapy from you and parent/child observation. Parents are happy to help facilitate and be a part of the session, but not all parents are at the same readiness level when it comes to being the leader. To a speech therapist, the parent/child interaction can be valuable information, but several parents I’ve spoken with have expressed feelings of stress and lack of confidence when asked to play with their child while the speech therapist watches and adds tips for drawing out specific skills.
4. Go the extra mile now and again. I use a specific program for stuttering which involves the child keeping a set of cards that explain their fluency “tools.” I don’t ask the parent to print out these cards at home. Instead, I laminate the cards and send them by mail to their home. I include some fun stickers as encouragement, too, and discovered that kids get really excited about receiving mail with their name on it. Now I make encouragement packages a part of my practice for all of the clients I see.

Whether you’re a parent or a speech therapist, I hope my tips help you get more out of your therapy sessions!

Today is National Voter Registration Day! Are You Registered?

by Beth Finke

The United States General Election will be here before you know it: Tuesday, Nov. 3, 2020, to be exact. Ballots across the country will be cast and counted that day, and in order to participate, you must be registered to vote.

A healthy democracy requires active citizenship and civic participation from everyone, including those of us with disabilities. We are a vital part of the communities where we live, work and play, and voting is foundational to being an engaged citizen. Every election, whether local, state or federal, helps determine the laws that govern us, the programs and support services available to us and the elected officials who represent us on every level of government. We all need to vote – this year and every year – to make sure we all have a voice in shaping our futures.

There is concern this year that because of COVID-19, many people with disabilities risk not having their voices heard in the 2020 election. To ensure that people with disabilities are a powerful force in our democracy, we need to register!

National Voter Registration Day is a nonpartisan civic holiday celebrating democracy. This year, it is important to register early and vote early if you can! Go to the National Voter Registration Day‘s voter help page to learn about voter registration deadlines by state, voting times and locations, whether or not you’re eligible, and more. To learn about voting rights for people with disabilities, election information and how to encourage your friends and family to vote, visit Easterseals’ voting resource page.

Education and Parenting: Online Speech and Language Therapy, Part one

by Beth Finke

I am pleased to introduce speech-language pathologist Marsha Boyer as today’s “Education and Parenting” guest blogger. The owner of Speech Connections, Inc in Indianapolis, Marsha has seen countless Changes in the Speech and Language therapy field over her 27-year career. ”But the year 2020 has brought a new meaning to the word ‘change,’” she says, describing in this guest post how she, the children she serves and their parents are managing the switch from face-to-face therapy to tele-therapy.

by Marsha Boyer, M.A.,CCC-SLP

After Governor Eric Holcomb directed Indiana schools to close back in March, I got to work structuring online sessions that would be as close to the face-to-face appointment structure as possible. The number of children in my private practice caseload pales compared to my counter parts in the school setting, but I do encounter young children with hearing loss and hearing aids, children with genetic syndromes, Apraxia, stuttering, and Autism, to name a few.

These children typically have an Individualized Education Plan (IEP) identifying deficits their speech language pathologist have determined are impacting the child’s education. Things were changing so quickly in March that I only had one short weekend to plan for the switch from face-to-face therapy style to online. Granted,one weekend is not enough time to wrap your head around providing quality services under a completely new structure, but I felt compelled to do what I could. School therapy was non-existent while school systems drew up policies and procedures for tele-therapy, and my clients needed to keep momentum going with their speech and language goals.

Many face to face therapy routines I’ve used for years vanished into thin air when we switched to tele-therapy. Without being able to work together physically and manipulate objects together, what would we talk about? How would I help clients who need tactile guidance to show them how to make a sound or to explore a toy? I needed high-interest lessons and activities. Educational videos and songs, too.

Where to find these? Go to the experts: fellow speech-language pathologists!

While searching for online therapy materials and creative lessons, I came across a Facebook group of speech-language pathologists who had been tele-therapists even before the pandemic. To be successful in this field, you must learn to come up with creative, adaptive ways to teach a skill or engage a child. Their tips and resources were extremely helpful when I was trying to hit the ground running. Thanks in large part to them –and to the children I serve and their parents — I’ve been leading tele-therapy sessions for months now.

Stay tuned for part two of this post, where speech language-pathologist Marsha Boyer shares tips to help parents make the most of their child’s tele-therapy sessions.

Educating and Parenting: The Struggle to Learn Remotely

by Beth Finke

In his introduction to a story on NPR a few weeks back, Morning Edition host David Greene pointed out that here in the United States, more than 7 million school children receive special education services. “But this spring, many of those vital services, like physical therapy, simply stopped,” he said. “So what happens now with some districts planning to continue remote learning in the fall?” To answer that question, NPR took an approach like we’ve been taking with our Education and Parenting blogs lately. Just like us, they went to experts: the parents of the children with disabilities.

The story features a Minnesota mom with a third grader who struggles with auditory processing, and a mom in Rhode Island whose son has cerebral palsy and a cluster of other conditions.

The mom with the third-grader said her daughter had a hard time keeping up with teacher’s using an iPad. “They’d tell her, you know, look at this problem, look at that problem, no, show me your worksheet…” she said. “I mean, the teachers were doing the best they could, but all those rapid verbal directions just overwhelmed her.” The result? Her daughter has gone from loving school to dreading it.

The boy in Rhode Island who has cerebral palsy loves school but got little of the therapy he needed last spring while school was online only. His mother, a single parent, needs him to be in school this fall so she can work. But how can she send him to school if it’s going to be a health risk? “One more mistake could land him in the hospital,” she says, worrying that a hospital stay like that could be fatal.

Like so many other COVID-related stories these days, this one offered few solutions. That said, I was pleased that NPR found the issue important enough to give it air time. The reporter ended the story by explaining that a handful of lawsuits have been filed by parents and advocates around the country arguing that schools broke federal disability law by providing insufficient services in the spring. “Disability rights experts say this fall, schools have to do better for the parents who are angry or ready to give up, for the schools that know they could face legal consequences if they don’t, and, most importantly, for the kids for whom remote learning wasn’t just inconvenient or boring, but a painful absence of vital care for months that could set them back for years.”

Stay tuned to the Easterseals National blog for a two-part Education and Parenting post by a speech-language pathologist doing all she can to treat the young children in her practice remotely.

Education and Parenting: We Don’t Have to Operate by the Old Rules Anymore

by Beth Finke

I am pleased to introduce Deana Herrman as our featured Education and Parenting guest blogger today. The mother of two, Deana is a disability advocate and healthcare worker who is working on a PhD in disability studies at University of Illinois Chicago. Her daughter Anja uses a wheelchair and started her freshman year of high school last week. “In her bedroom,” Deana explains. “Her school is full remote.” In her guest post today, Deana welcomes parents of non-disabled children to a world of uncertainty when it comes to having their kids back in school.

Deana Herrman with her daughter Anja

An Open Letter to Parents of Non-Disabled Kids

by Deana Herrman

Dear parents of non-disabled kids frustrated about school reopening plans,

Welcome.

COVID-19 school re-opening plans are challenging for parents. Maybe school has always been a safe and fun space for your child before this. Light and productive interactions with teachers got students exactly what they needed, and relationships with fellow parents were easy.

Now, everything is different.

Fear that school is not going to do what’s best for student learning, not having a way to appropriately interact with students or not having the right equipment to promote learning are new worries.
School is this weird mess of tech that may or may not work, and quick ins-and-outs of the building for check-ins, supplies, and visits are not guaranteed. Enrolling a kid in school now is a new and unpaved path to form relationships between educators, administrators and communities.

Parents are left to manage it all. Parents don’t know what to tell kids to expect. Parents aren’t sure where and when to push on administrators, school boards and teachers and when to back off. Parents don’t get immediate answers from schools or get answers they don’t like; answers filled with uncertainty or a “we’re doing our best” assurances.

Welcome to our world.

For parents of kids with disabilities, this uncertainty isn’t so new. Navigating a school system with a kid with a disability, particularly if you are not disabled, means you cannot really tell your kid what school will be like for them. You can never tell them with all honesty that it’s going to be okay and that school is a safe space for them. How would we know? We have never experienced school as a disabled person. And parents of non-disabled children have never gone to school during a pandemic, either.

Those of us who have children with disabilities are likely to have dealt with conversations of loneliness and strained relationships as a result of school policies before. We’ve been working around limited access to technology long before COVID. Not knowing what is around the corner for your kid, feeling like the school may not be doing what’s best, wrestling with feelings of anger or distrust at the district while still trying to show support when the school gets it right — we have been there. Knowing when to let your child handle school challenges with teachers, policies or course work on their own and when to jump in is not easy.

COVID has made the environment impossible for a school to operate as it did previously, affecting the majority of students now, not just a minority of disabled students. The majority of our kids are now subject to an imperfect environment and policies that are confusing. No one can function optimally in it.

Students with disabilities have been operating in an imperfect school environment for years. Parents of children with disabilities have been making it up since our kids entered school. But… we don’t have to operate by the old rules anymore.

Reopen, hybrid, full remote? Who knows? Can we start over? Let’s throw out what didn’t work & put new guidelines and expectations in place. Let’s bring in all the voices and perspectives so we are not continuing to ignore those who don’t always have a seat at the table. As everything is restructured, let’s consider students with disabilities alongside their peers right from the start, not afterwards like was done before. Now, with everything in flux, this is an opportunity for parents of children with all abilities to work together, look at what we were doing before & re-imagine how we can do it better.

Education and Parenting: What eLearning Taught Me About Our Daughter

by Beth Finke

The new school year is starting, and this one is going to be a doozy. With that in mind, we’re centering our blog posts this month on education. You might recognize our first featured guest blogger: Patty O’Machel is a writer, special needs advocate and mom who has been writing guest posts for Easterseals for years now.

Our New Normal – E-Learning

by Patty O’Machel

Patty (right) and her daughter (left)

The new normal is a challenge for everyone, not just parents like myself who are raising children with disabilities. And in this disability parenting club, I have found our new normals do not look like everyone else’s.

I know mine doesn’t!

During this past spring of online learning from home, I discovered so, so much about this girl I am raising: things that, prior to this, were hidden in her relationships at school. Her relationships with her teachers and her aides are incredibly special and she had surrounded herself with people who see her potential and made her thrive with independence.

She and I never had this relationship. As much as I try, I am always her safe place. Her person to reach for for help, even when she doesn’t need it.

We started that new journey with me making her cry several times a day, as I didn’t know the rhythm yet or the dance we needed to do. She would look at me with her big, brown eyes silently pleading for me to help her and I would get frustrated because I knew she could do it herself.

She is so smart, and so competent. I struggled for a way to change our mom/daughter relationship into the new teacher/aide/student one. Even with her teachers explaining over and over that her current straight A’s as a Freshman could not go down in this corona home learning situation, she still wanted to be at the table by 9:00 and work diligently to get every piece of work done — sometimes turning in work early. Some things I realized from all of this:

• • She is incredibly smart
  • She can do the work — if she would just see herself through the lenses of everyone around her
  • She LOVES to learn
  • She NEEDS to feel she has a purpose and that things are expected of her
  • She wants to use her brain
  • She is great at algebra and physics which she did not get from me!

By far the most important lesson I learned? That before this past spring, I’d been holding her back. I am holding her back. I should have asked more of her at home. I should have given her responsibilities like her siblings. I should have expected her to be a contributing member of this family. She wants and craves being needed like everyone else does.

E-Learning is long, and I have to write for her and sometimes type for her if her voice to text technology doesn’t work. I have to watch the teachers algebra and physics videos to understand even a bit of what she is trying to do. I have to go back and be a freshman in high school, and believe me, I never wanted to do that again!

But I have also learned to see my capable, smart, inquisitive daughter in a whole new way. So another win for this tricky time we are now living in.

As this new school year begins, Patty O’Machel is gearing up to bring her company, Educating Outside The Lines, to more schools through eLearning. Educating Outside the Lines promotes the idea that children with all abilities need to be accepted and seen for their unique gifts, as varied as they are. To see Educating Outside The Lines in action, this link has a short video of programming.

Show Them We Count: Census 2020 Cuts Deadline Back to September 30

by Beth Finke

After years of being overlooked and disregarded, we’re going in the right direction: Diversity has become a buzz word this past year. When people talk about “diversity,” though, the conversation is often limited to ethnicity, race, religion and sexuality.

Let’s use the census as an example. Early this year, the U.S. Census Bureau expanded its massive multimedia advertising campaign on television, radio, newspapers, online – even billboards and bus stops. A press release claims the Census Bureau is “committed to reaching those people who are historically undercounted,” but if that’s true, where are the ads reaching out to people with disabilities?

The U. S. Census Bureau press release says they tested their 2020 ad campaign in over 120 focus groups in their target audiences across the country “to ensure relatability, understanding, cultural relevance, and language interpretation.” Link here to view Examples of 2020 Census ads. I could only listen to the ads — blindness prevents me from taking them in completely,so I might be missing something. So you tell me: are any of them directed to people with disabilities? Does the U.S. Census care if we respond? Do we matter?

In 2010, the official census form every American received in the mail was not available in an accessible format. People who were blind or had visual impairments were told to ask someone we know to help us fill out a census questionnaire, visit a Questionnaire Assistance Center where a paid Census Bureau staff member could help us, or call a toll free number that was available between 8:00 a.m. and 9:00 p.m. 7 days a week.

My husband can see, and he filled out the form for us in 2010.

This year I was able to fill our form out on my own. You can do so too by visiting https://my2020census.gov. The 2020 Census Fact Sheet reports that the 2020 online questionnaire follows the latest Website Accessibility Content Guidelines (WACG) and that Braille and large print guides can also be provided for those who prefer responding by U.S. mail.

Why do I care about all this? Why is it so important for me, a person with a disability, to be counted? Why do I want the government to think we matter enough to come up with an ad encouraging us to make sure we’re counted, too? Here’s why:

• Transportation. My community uses census data when planning for public transit routes, upgrades and changes. Billions of dollars in federal funds are distributed for transportation projects, including public transit, accessible pedestrian signals, and truncated domes at intersections. I need all of those things to get around the city safely. The funding our state gets is based on census data. If I am not counted, that could mean less money for my city and state for these projects. I need to be counted.
• Health and Social Services. My state receives billions of federal dollars to support a wide variety of programs, including funding for services I use that are specifically for people with blindness and vision loss. I need to be counted.
• Representation. The number of people who respond in my community and state will determine the number of Electoral votes we get to help choose who becomes president, the number of seats our state gets in the U.S. House of Representatives, and how the congressional and state legislative districts are drawn. I need to be counted.

After previously stating the census would run through October 31, last week the bureau announced it was cutting the count short by a month, moving the deadline for responding to the 2020 Census up to September 30, 2020. We may not be included in the U.S. Census Bureau’s ad campaign, but This year, while the world faces the impact of COVID-19, people with disabilities need to be counted. More than ever.

Face Masks: Does the ADA Give You Permission Not to Wear One?

by Beth Finke

More and more states and cities in America are implementing executive orders mandating the use of face coverings in public spaces — research has shown that the use of face coverings can significantly reduce the chance of exposure to COVID-19 and slow the spread of the virus. Exceptions can be made for people unable to use a mask due to their age and/or medical conditions, but how does that work, exactly? Do we need to carry cards proving our medical condition?

A lot of misinformation regarding the use of face coverings has been shared via social media, press and broadcast media. A couple of weeks ago, the Great Lakes ADA Center (in collaboration with the Southwest and Northwest ADA Centers) offered a session called “Face Coverings and the ADA” to discuss the application of the ADA to this issue as well as the various scenarios as they are playing out on the ground. The recording of the session is available, free of charge, and closed captioning and sign language interpreters were available.

View the recording here. 

Here’s an excerpt of what the session was all about: “Many states and local entities have implemented executive orders or mandates for the use of Face Coverings in both indoor and outdoor public spaces…The number of calls for technical assistance related to the use of Face Coverings to the ADA National Network have steadily risen over the past weeks as more mandates are issued and economies start to reopen. Join us for this session where we will discuss the application of the ADA to this issue as well as the various scenarios as they are playing out on the ground.”

The ADA Generation Speaks: Demanding Better Access to Mental Health

by Beth Finke

I am pleased to introduce Kit Aronoff as a guest blogger today. Kit is an Assistive Technology Coordinator at Temple University. She has a passion for inclusive technology, she advocates for disability rights issues centering on education, and she works part-time as a freelance tech journalist under the name Kit Englard — follow her on twitter @mathnskating.

by Kit Aronoff

When people ask me, “How old is the ADA?” It’s easy for me to come up with a number. The ADA and I are the exact same age. I’ve nicknamed anyone born in the 90’s as “ADA babies,” because we’ve had the unique privilege of never living in a world where we weren’t protected by this groundbreaking civil rights law.

The ADA has fundamentally changed the way disabled people are able to navigate society. Ask anyone you know who is older and his been disabled for a long time, they will tell you about the “pre-ADA days” when accessible transportation, employment, housing, education and social life was difficult — or impossible — to find. We ADA Babies have no idea, they’ll say.

In many ways, they’re right: when I went to college I was supported by a staff at the disability office, an office that hadn’t existed before the 1990s. The ADA changed the world, laying the groundwork and foundation which future generations can continue to build upon and one day, hopefully, achieve equality for people with disabilities. This aspect is often misunderstood. Like many civil rights issues, the common belief is that “Well, we passed the law. Nothing more to be done here.” Which is misguided.

The ADA starts to get murky when you introduce the idea of intersectionality. That intersection can be with race, ethnicity, religion, sexual orientation, and so on. But it can also be with other disability types. People who are blind and are a wheelchair user, or someone with chronic health conditions who is also deaf. A common, and often overlooked, aspect of this crossroads is mental health. Specifically, access to mental health services as a person with a physical disability. I can tell you firsthand: it isn’t easy.

It’s difficult to explain the complex systemic problems that can prevent access to mental health. Some of these include transportation, lack of medical insurance, and lack of providers with knowledge of issues that directly relate to disabilities.

As a DeafBlind woman who has a diagnosis of complex post traumatic stress disorder, I struggle with an eating disorder as well as an anxiety disorder. Finding a therapist that is confident in working with eating disorders and trauma can be challenging enough. Adding my DeafBlindness to the mix makes it nearly impossible. And try finding full access to materials used for in-patient or other structured treatment programs! That’s the area that’s been by far the hardest for me to navigate: in-patient or other structured treatment programs are very reluctant to provide full access to the materials used in groups and classes in an accessible format.

The reason I was given at one point when I was denied a request for accommodation was “intellectual property.” They claimed that by their producing it electronically or in braille for me would make it possible for me to steal their program. The second place cited that they didn’t really understand why I needed it. The worst was my most recent experience. I requested interpreters as well as braille, and I was denied on the basis of a HIPPA violation — which was a wildly incorrect assertion.

When something is inaccessible, we’re advised to “Self advocate!” I’ve spent my whole life — that’s 30 years now, remember — advocating for access to everything from the grocery store to my local synagogue. The long term toll of constantly self-advocating is burnout. Each time I’m denied feels like a little chip of my self-worth is falling away.

But what happens when you can’t self advocate? What if you’re in the ER for a psychiatric hospital, and you simply don’t have the mental or emotional energy to spare on self advocating? The truth is, people give up. They stop asking for help. Worse, they can start believing that they aren’t worth helping.

The first time my husband witnessed a horrible denial of accommodations, I started sobbing uncontrollably when we got home. He was shocked at my strong reaction. I had to walk myself back to a place of feeling worthy of friendship and care.

But to do that I, and anyone, needs to be in a good head space. When one is deep into a mental health condition that isn’t something they can rely on. A denial of accommodations is a huge neon billboard saying, “You’re not welcome here!” I struggle with self worth. I take rejection of accommodations hard. This isn’t a hypothetical, this can literally be life or death.

Society is judged by how we treat our most vulnerable. In the United States we deeply undervalue the worth of mental health professionals, and also the lives of people with disabilities. It is here where we must speak up for those who cannot do so themselves, and demand that accommodation requests be met in treatment centers and clinicians’ offices.

Everyone deserves equal access to mental health treatment, regardless of disability. It is my sincerest hope that this is an area where, 30 years from now, we can look back and say, “See? We did it.”

Celebrating 30 Years of the Americans with Disabilities Act and Beyond

by Angela F. Williams

As we head into the ADA’s 30^th anniversary, I would like to reflect on how we ensure we continue on the right path forward for people with disabilities. On July 26^th, 1990, the Americans with Disabilities Act signed into law the equality of opportunity and full participation in society for disabled individuals; this went a long way in furthering the rights of this marginalized group, including access to buildings, education, employment, and government services. This law changed disability rights immensely, as now there was legal backing for so many who faced discrimination.

But the ADA did not cover everything, and the law did not eradicate microaggressions, prejudice, and violence against people with disabilities. There is still discrimination in hiring and receiving accommodations at work, and only 19% of disabled people are employed, compared to 66% of nondisabled people. People with disabilities are twice as likely to experience violence. Establishments often look for loopholes in the ADA to exclude disabled people from their business. And it wasn’t until the Affordable Care Act that insurers could not deny a person with a disability from signing up for healthcare.

There is hope that these injustices will become a memory as disabled people advocate for their rights and come together to enact change, as they always do. It was because of this activism that we have the Americans with Disabilities Act to begin with, and why we have the Affordable Care Act. It’s why we have the ADA Amendments Act of 2008, which broadened the definition of disability in the context of the law to make sure more folks were protected under it. Advocates like Anita Cameron, Haben Girma, Dominick Evans, Alice Wong, and others bring activism to the forefront for a new generation online.

As leaders, both disabled and not, I passionately believe it is our duty to stand with those who stand for justice, and to lend our voice and platform for the betterment of all disabled people. Celebrating the ADA includes recognizing the work that went into the law and how many human rights groups came together to get it passed; we see human rights groups come together now in the fight for social justice. Celebrating is more than recognizing a victory – it’s about looking ahead to the next hurdle, and ensuring we go over it united.

Resources

• Easterseals Celebrates the ADA
• ADA Anniversary Toolkit: https://www.adaanniversary.org/
• Why I Wrote the Americans with Disabilities Act: Washington Post
• Employment Rights Under the ADA
• The History of the ADA from DREDF
• About the ADA Amendments Act of 2008