Podcasts about communicative disorders

On this episode we are learning about educational and rehabilitation aspects for children and adults with CVI. Learn why CVI intervention is so critical and what APH products can help those who have been diagnosed.NarratorSara Brown, APH Public Relations ManagerAmanda Lueck, Ph.D., Professor Emerita of Special Education and Communicative Disorders at San Francisco State UniversityTristan Pierce, APH Product Manager for Educational ProductsAdditional LinksCVI ScotlandCVI Companion GuideLED Mini Lite BoxSpinner Overlays for the Light BoxLight Box: Level 1: Plastic TumblersLight Box: Level 1: Threading BeadsLight Box: Level 2: Parquetry Piece SetMini-Lite Box Ledge SetAPH WebinarsYouTube Behind the Scenes of the “Light Box Story Hour”YouTube Light Box Story Hour 2! More literacy activities for students w/ vi & additional disabilitiesSensing and Learning bookSensing and Learning EPUBSensing and Learning: An OverviewSAM – Symbols and Meaning KitVibrating Pad with AdapterTactile Connections: Symbols for CommunicationSTACS: Standardized Tactile Augmentative Communication SymbolsAstro Adventure Balls AppBlast Off with Astro Adventure Balls AppCVI Complexity Sequences Kit

Welcome to the Aphasia Access Conversations Podcast. I'm Jerry Hoepner. I'm a professor at the University of Wisconsin – Eau Claire and co-facilitator of the Chippewa Valley Aphasia Camp, Blugold Brain Injury Group, Mayo Brain Injury Group, Young Person's Brain Injury Group, and Thursday Night Poets.  I'm also a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources. I'm today's host for an episode that will feature my friend and colleague, Dr. Warren Brown. I've been fortunate to work with Dr. Brown for the past two years and I'm excited to share the work he's been doing in service of the LPAA. Warren C. Brown, Ph.D., CCC-SLP is an Assistant Professor in the Department of Communicative Disorders at Jackson State University. His research explores the intersections of traumatic brain injury (TBI), aphasia, and healthcare disparities, with a focus on cultural and linguistic diversity in clinical care. He serves as a facilitator for the Black Aphasia Group at the Aphasia Center of Acadiana and has published on topics related to brain injury, intersectionality, and patient-provider communication. Dr. Brown is an active member of the American Speech-Language and Hearing Association (ASHA), National Black Association for speech Language Pathology (NBASLH), the Academy of Neurogenic Communication Disorders and Sciences (ANCDS), and Alpha Phi Alpha Fraternity Inc. Take Aways: Learn about health disparities faced by Black Americans. Learn about the perceptions of Black Americans towards their healthcare providers. Dr. Brown will continue to facilitate the Black Aphasia Group affiliated with the Aphasia Center of Acadiana. Dr. Brown and his team to are hoping to publish an anthology project featuring entries from Black Americans with aphasia by fall of next year. Dr. Brown plans to organize a symposium on aphasia at Jackson State University with a focus on diversity. Dr. Brown plans to present a poster on the anthology project at the upcoming Aphasia Access Conference.   Interview Transcript:   Jerry Hoepner: Alright. Well, Warren, it's good to see you today. I'm fortunate to see you on a regular basis. So, I think this is the second time we've connected today. For different reasons. But I'm glad to have you here as a part of the Aphasia Access Conversations Podcast. I'm hoping you can share a little bit about yourself. I know that some aphasia access affiliates will know you and know a little bit about your work. But I'd like others to get to know you and your work as well, so can you share a little bit about yourself?   Warren Brown: Yes, sir. Well, thanks for having me. For sure, this is an honor. I'm a recent graduate from the University of Louisiana and Lafayette. With my PhD. I studied under multiple folks. There. I studied under Anthony Salvatore, Dr. Judith Oxley, and Dr. Jamie Azios. My main areas of interest are traumatic brain injury, aphasia, and all neurogenic disorders related to marginalized populations. Prior to my doc program, I was a practicing clinician for 11 years or so I practiced in mainly acute care hospitals long term, acute care, hospitals, home health, and predominantly in Southern Louisiana. So, and I did a little bit of private practice. I did everything but child language disorders. So I prided myself when I started my doc program as being a clinician first, and thinking about clinical issues, first, because I was gracious enough to get a lot of great experience in my timeframe, so I kind of had a better idea about, you know the areas that I was most mostly interested in prior to going into my doc program. So, I'm married. I have 3 kids Wes, Evie, and Wells, which is my newborn and a lovely wife, Tatiana. I'm a new faculty member at Jackson State University in Jackson, Mississippi, and I love my job, and I love my students, and I love my research endeavors that I've done thus far. So, you know I'm fortunate enough to work with you, Dr. Hepner, Dr. Louise Keegan, Dr. Jamie Azios Dr. Judith Oxley. Still Dr. Anthony Salvatory. Still Theresa Gray, a few other folks. I'm just happy that Dr. Brandy Newkirk-Turner as well at Jackson State. I'm happy that I have a great group of mentors to ask questions to and bother from time to time. So, I'm just grateful. So yes, sir.   Jerry Hoepner: Well, yeah, it's been really fun working with you and getting to know you. And certainly, that really strong, diverse group of mentors is something to build upon for sure. That's a great group of people. So privileged to be a part of that a couple of things that we were going to talk about today. I want to get to your work with the black Americans with aphasia group, and I want to get to some of the new work that you've been doing on an anthology. I'll kind of leave it at that, for now you were gracious enough to share a manuscript. That you and Dr. Azios have under review right now. I know it's not quite published, but I'm wondering if you're willing to give us just a little bit of a preview of that work, and I have a few things that I just think were really powerful from reading that manuscript, and I'm interested in your thoughts on it. So, do you want to tell us a little bit about, like the general context of that manuscript?   Warren Brown: Yes, sir, so this was. This was actually a part of my dissertation. My dissertation was a mixed methods. Research project on healthcare encounters of African Americans with aphasia and without aphasia. But I was lucky enough to capture 8 interviews from a qualitative standpoint for that dissertation from African Americans with aphasia from across the United States. Different age ranges different levels of severity and obviously different etiologies from which caused them to acquire aphasia. The paper really came about, because, again, clinically, you know, I always realized that individuals who had aphasia who were black, had a lot of different experiences when it came to healthcare providers and practitioners. And oftentimes, when I would go into a home or see them in a hospital, they would be surprised that I was the individual to see them right. They would think I was a dietary staff member. They would think I was DNA. They would think I was a nurse, everything but a speech pathologist. So, when I had the opportunity to lead or facilitate a group which was the California the conversational group with Dr. Teresa Gray. You know I love to hear the different experiences that those individuals were having, as well coinciding with what I knew what was going on in the field. So that's what spawned this idea about understanding the dynamics of what you know. These encounters were from a deeper perspective. So originally it was going to be just a regular project with Dr. Azios and I, but we felt it'd be better if we made it a larger scale project and added to a portion of my dissertation. So, we did so. We really look to understand those lived experiences of those individuals, how those healthcare encounters went for them before and after they acquired aphasia, and trying to understand, like different strategies and challenges, that you know they may have had to use to overcome some of those issues, and how, you know we could take what they were saying, and make that accessible to practicing clinicians to understand how to work with diverse populations a bit more you know. Yes, sir, so.   Jerry Hoepner: Yeah, I mean, I found a couple of points that well, actually, several within the background. And literature review that really struck me. There's several of these statistics, but a couple that really stood out to me were the percent of deaths among black Americans during the Covid pandemic. And just you know the marked difference between the amount of actual African Americans in those communities and the numbers that died. Which were that was just really striking to me. And then the other one. The other context that you wrote about was the study of 85 black Americans. That were a part of a VA. Study, a veterans affairs study and really just talked about their, you know, their feelings of being stereotyped by the professionals that we're dealing with them, treated and labeled as if they were uneducated, and addicts and angry and poor, and those really set the context for the study. Wondering if you can just kind of weigh in on those and other kinds of striking background pieces of information.   Warren Brown: Yes, sir, so you know, it's known that you know there is racial bias when it comes to African Americans in general, just because of how society is. But you know oftentimes in neurogenic disorders it's unstudied, right? You don't look at race and ethnicity as factors as being contributing factors to some of the issues that the populations that we service are dealing with, you know, looking at Covid alone. You know, we added, that I added that statistic because you know it just kind of highlighted how much racial disparities really are prevalent right and not just individuals with aphasia, but individuals who have a multitude of you call it metabolic issues, right or just issues in general when it comes to healthcare, and how sometimes these issues go unserviced or underserviced, or these individuals are not educated about what they need to do or what they need to accomplish, from a healthcare practitioner which ultimately leads to poorer outcomes across that population. You know. One of the things that we listed in that paper was also about just black women in general, right? Black women are twice as likely to have low birth weights of infants when compared to white women, and they also face lower rates of prenatal care right? Although that doesn't have much to do with aphasia. I think that that speaks to a larger picture than that.   Jerry Hoepner: Yeah.   Warren Brown: You know. Sometimes African Americans are looked down upon the most across our society. And why? That is, you know, it's a multitude of reasons, right? There is no one pinpointed answer for that, and it just kind of paints to the goes to the bigger picture of racial bias, and how patient and provider communication is just poor across the board, and you know, and it could be because of communication styles are different, right? It could be because of the practitioners. You know the old mindset was that the practitioner is always right, so they should. You know the patient should listen to what they're saying, and it's not. It wasn't necessarily a patient center or person-centered approach like it is nowadays. And some practitioners, especially in the South. They still are under that mind, right? Not necessarily in the South, probably across the board in the United States. Right? So, I think that you know those biases, and some of that lack of communication or poor communication it just contributes to the poor perceptions and stereotypes that are out there in African Americans and black people you know, because regardless. When a black person gets sick, you know, they may be scared to go and talk to a practitioner because of where they live. That might be the only practitioner or specialist that they can see, and they are a family member, or a friend might have had a bad experience. Therefore, they're hesitant to go to that person, and they'll just deal with the issue themselves. And that's where you know. I think a lot of the differences are when it comes to African Americans and healthcare providers. And I've seen that as well with individuals who have acquired language disorders. Right? I've had patients particularly. Tell me when I was practicing that. You know, Warren, we want you to come back, but we don't want the other girl to come back, right? Because you're listening to what I'm saying. You actually are educating us about what's going on more so than just what the language issue is right. And I think that points to the picture of just them feeling comfortable with me, because I'm most of the time with the same ethnicity, right? Same race. And I'm genuine, right? I do the same with any patient that I encounter. But obviously, sometimes, when it's African Americans, and I know what the assumption is, and I understand some of those experiences are, you know I try to go a little bit more. I try to. I try to go the extra mile for them. So, this.   Jerry Hoepner: And I think there's it's interesting. And throughout the paper there's parallels to some of the work that you and I and Dr. Keegan have done on healthcare perceptions in traumatic brain injury. That you know you mentioned that idea of providers still following it, falling into that provider centered care rather than person centered care. And I think that's a problem across the board for some providers, because that's evident in our research. But we don't have you know, we're not even representing the black Americans within that group. And I know that the problem is more pervasive when it comes to services for black Americans and other colored people as well. You know the one number that really struck me from the study in Chicago, 70% of.   Warren Brown: 70%.   Jerry Hoepner: From Covid.   Warren Brown: Yeah.   Jerry Hoepner: Were black Americans in Chicago, and only 30% of their populations or population was black Americans. That's just. You can't help but be startled by those kind of disparities, because clearly there's something.   Warren Brown: Up in there.   Jerry Hoepner: Something that.   Warren Brown: And these are these are fairly new studies. Right? I mean, the stat for Louisiana was 70 70.5% of this, and they only represent 33% of the State's population. Right? We're African American people. So that. That's you know. My personally, my dad didn't leave his house for a year and a half during Covid he would not go to church. He didn't leave right, and he was terrified. Terrified. You know. I know he had at least 4 or 5 people that died that he knew. You know. So, I mean, it's daunting right especially if you're not educated, or you're not understanding. I had a great relationship with a practitioner that could educate you on, you know the do's and the don'ts of what you should or shouldn't be doing so. Yes, sir.   Jerry Hoepner: Yeah, absolutely. I kind of broke down the article into 3, like major areas of interest and topics. And I'll just kind of lay out the 1st one being those challenges with healthcare providers. I couldn't help but put down. This one quote was like being put in a damn box, and we had a little conversation about that earlier, but We also talked about this like this lack of knowledge about stroke and that healthcare literacy creating this fear like. And you even mentioned that with your dad, right? This fear that I don't even want to go into that healthcare context. But then this like laundry list of things that we hear in a lot of studies about healthcare perceptions, healthcare providers are dismissive, dismissive, and you feel vulnerable in that context, you don't have control or agency. Those kinds of things that we don't hear in in those other studies about healthcare perceptions are things like. There was a clear. There was a clear prejudice against me. Right? There was this neglect by providers. One lady I had to write this down, wrote. I don't talk to my dog like that, you know, like.   Warren Brown: That's right.   Jerry Hoepner: So.   Warren Brown: That's right.   Jerry Hoepner: And then, you know, just a lack of inclusion in decisions in in the whole entire process. And just feeling that sense of people looking down on you, and that you know that this is kind of the expectation. So I'm really interested to get your thoughts about. You know that that issue of those challenges in terms of working with healthcare providers. How many of those are communication based? And what's kind of bias and kind of sorting some of that out, because we know some happens a little bit to everyone in that context. But certainly, this is different.   Warren Brown: Yeah, I think that you know we all have personal biases that, you know are inherently that we are. You know that we're introduced to that from an environmental standpoint. But you know, one would assume that when you become a healthcare practitioner provider, you know you have to be open-minded because, you understand, you're going to be dealing with so many different types of people from all walks of life. And unfortunately you know, these disparities still are there, and this particular study showed that they're still there, right one of the examples you just gave about the young lady that said, you know I wouldn't let my dog talk to me like that right? I remember in in her Transcript she also stated that you know, in multiple visits that she went to her physician would talk through her or over her, where she just totally felt dismissed, or one interaction she had. She had a friend who was white that brought her to the doctor, and they felt as if the friend was the patient, and she was the patient caregiver right? And I think that really broke her down. She literally stayed out of therapy or avoided therapy for a long time because of that. And obviously that affected her outcomes right. But I think the bigger picture is that it's a little bit of both, Dr. Hoepner. I think it's a lot of bias, and it's also poor communication. You know, I think, and some of that's not on the physicians themselves. Some of them, I'm sure, are compassionate. I think some of that is on the larger system systemic issues that are out there. Right? You know you have. They have insurance deadlines; they have time frames. They have. Probably some of them are overwhelmed with patient care in general. But I still think that you know to be truly compassionate, you know you need to understand what you're getting into as a practitioner, and still with individuals that you know may not understand some of the dynamics of some of the diseases or illnesses that they have. You have to find a way to provide them services that they need. Right? I think the communication is key, because it always goes back to communication. Right individuals who are educated, which a lot of these folks are. Some of these folks in the study. I had PhD. Some of them were medical doctors, right? Some of them have master's degrees. A lot of them still stated that their health literacy was poor when it came to symptomology, of strokes, symptomology of not just strokes, but them acquiring aphasia what that truly meant, and how that might affect their daily lives. Right. One of the individuals she stated that she didn't realize that you know aphasia was a thing until she had it. She didn't realize that she was having multiple strokes right until it happened, and she just felt like she would bounce back and go back to her daily life and be fine and go about her normal business. But you know it's hard to pinpoint exactly how to fix it. But this study is, I guess, one step towards trying to understand the different dynamics from multiple perspectives. And I think what makes it super unique is this qualitative study is really, really, it's very in depth. That's why it's so long right? It's a long paper. But we felt it necessary to put these quotes in, because these individuals, these interviews long and you can't help but be compassionate and understand each individual's perspective on what their experiences were right. You know, because this dynamic, this really changed their lives. And I know aphasia changed the lives of a lot of different people and caregivers right. Anytime you have a failure or even a brain injury. Right? It changes we know that. But I think compounded with the racial and ethnic tension or societal views that these individuals suffered with prior to having those injuries. This acquiring aphasia only makes whatever was going on a bit worse, because the inability to communicate or even comprehend what's going on around you, right being overstimulated, not necessarily being able to do on your own, or do for yourself, especially with a practitioner on something that's unknown to you is again. That's a daunting thing like you really don't know what to do, and if you feel dismissed, or if you feel as if a practitioner is talking down to you, what would make you, as an individual, want to go back? You know the a good example, I can say, is customer service right? If you go to a restaurant and you receive poor customer service from a from a waitress, will you give them a tip probably, maybe, or you might give them a less amount of tip that you would have gave given to a person who gave you better customer service right? This is a good example of what a physician interaction and communication is with a patient right. Sometimes these individuals just won't go back right or might not go back to any practitioner one of the individuals in the interviews. He literally said that you know he had a few poor encounters, so he switches doctors regularly because a lot of them don't understand him and won't try to understand him. So, you know, it's problematic. It's definitely problematic.   Jerry Hoepner: And you hit the customer service thing right on the head, because one of the things that I was struck by, and I've done work kind of parallel to this. And brain injury is that relationship and the importance of starting to build an authentic relationship in terms of mitigating some of the other communication problems, right? Like, if you invest a little bit in like getting to know that human being. You start to humanize them, and you start to, you know, want to have good outcomes for them, and that results in in better care. And it comes right down to that. That patient centered versus provider centered communication. Right? If you open up the door on the front end to investing a little bit in a relationship building, it seems like the goodness follows right like you're saying earlier, like, these physicians aren't bad people right? It's just, you know, they're in a system that says, Go, go. And then they have these biases that they might not even be aware of. And the next thing you know, they're out, you know, on the way out the door, and care hasn't happened in the way that it should. But I'm just struck by the fact that that was like a mitigating factor for people like just a little investment get to know that person. And then everything changes so.   Warren Brown: That's right. I think I think that's what you know. Someone asked me a while back. Why, like our Black aphasia group. Why is it so successful? Right? It's because it's not if I don't. The way that I approached it. I didn't approach it as me, Warren brown as an SLP. Right? I approached it, me, Warren Brown is trying to understand these people's stories and get to know them, and fully. How can I, as an SLP, help you right? And I think that's why our group is so successful, right? And why people keep coming back. Because if they didn't feel like it was a genuine interaction, I can assure you they wouldn't come back. Because I genuinely look forward to the group like the group members do, because I love talking to these folks. These are folks of my family, right? And that's the type of community that you know. Practitioners can make it like that right?   Jerry Hoepner: Okay.   Warren Brown: You know, in certain rehabs. That's what it is. It's a familiar environment. At certain places. I know some of the ones that I used to work at. So, you know, but I definitely understand the dynamics of health care have changed right as time has progressed, and that's due to a multitude of reasons. But care doesn't have to change. Right practitioners can change for the better. If you fully try to understand and invest time and energy and being genuine into the folks that you're seeing right. I truly believe that so.   Jerry Hoepner: Agreed, you know, and when I kind of listed a bunch of priorities, or what black people with aphasia want this? Isn't it an outlandish list by any means like, I've got this big, long list of things that are problems. And then they say they just want to be treated with dignity, compassion, and respect. They want.   Warren Brown: Right.   Jerry Hoepner: Heard, and they want to be treated like human beings. That's not unreasonable. So, it's not like they've got this big, long list of you got to do this. This I just think that's pretty interesting in light of all of the struggles that they're facing like. If you could give us these 4 or 5 things we could. We could work with.   Warren Brown: Yes, sir, and I. And I think even with that the you know, interpretation of respect is different from everyone. But I think ultimately, no matter what race, no matter what ethnicity, what creed you are. Respect is respect, you know, treating people the way you want to be treated right. I mean, that's what it is. And you know, talking to people the way that you want to be spoken to. Right? That's what it is. And I think, like you said, it's so simplistic it should be natural. But obviously it's not for some people right?   Jerry Hoepner: Okay.   Warren Brown: And that's and that's problematic. But hopefully, it's hopefully, we're trying to change that. So you know.   Jerry Hoepner: Yep. yeah. Finding a way to make those priorities on the front end. I think that really makes sense. The other thing I wanted to talk to you about kind of get your take on. This is along with the challenges and along with kind of these desires. What people with aphasia want? I just noticed a lot of strengths that I'm not seeing in some of the other research that's out there from the perspective of survivors of brain injury and so forth. Things that I just saw flowing through like this idea of self-reliance like I learned, I gotta rely on myself, I rely on my faith and my religious beliefs. And then this really struck me, this, this cultural community, where one of the one of the participants said something to the extent of, We always stay in each in each other's business, kind of like, whether we want it or not, whether they want it or not, and that allows them to help each other. I'd just like to get your thoughts on that, because that seems like such a strength of this community.   Warren Brown: Yes, sir, that's a that's a loaded question, but I can definitely break it down. So, I love that question, though I think that you know, from perspective of self-reliance. That's definitely a cultural thing, right? Because, you know, personally, I'm 38. So, I was raised to not be dependent on someone else, because you really can't depend on what someone else can do for you outside of what you can do for yourself. That is something that is instilled at a young age and I went to Southern for my master's right Southern university in Baton Rouge, which is a historically black college or whatnot. And you know, at Southern they taught us the same thing, because, you know, as you know, our field is predominantly white women, right? Less than 5% African Americans, even less percent African American men. And at Southern they always said, You have to work twice as hard in order to be in this field and be successful. And they instilled that in us so much right. Because you really have to understand that you know society has painted this picture that things are against you and these individuals, with aphasia in their own careers, have had this same type of battle and everything that they've gone through. So, they've always had to prevail. And some of these individuals in this group. They went through the Jim Crow South right they went through struggles of individuals, fully talking down to them, having separate everything, having to deal with parents and grandparents that, you know, had to bow down to certain people because of the societal norms at the time, so that self-reliance, you know, always was there, because they always had to work harder in order to achieve what even was fair or normal for other people right? And that paints it to a bigger picture, even goes back to the level of respect. Right? If you work twice if you feel like you working harder than someone else for a job. And you know you're more qualified. Right? That's something that that you feel you're owed. But to some black people you understand that I'm not old. Anything right? That's just how society paints it. It is what it is, and I think that goes back to that point. And I'm sorry. What was the other question? I was trying to.   Jerry Hoepner: So, I think just that that cultural community.   Warren Brown: The cultural. Yes, sir.   Jerry Hoepner: Others, business and.   Warren Brown: So that kind of touched on it, like I think from a cultural standpoint, you know I am my brother's keeper. Right. You may or may not know this, but I'm in a I'm in a predominantly African American fraternity. Right? We're the oldest fraternity, and that's something that we learned right. You. You never go anyplace by yourself. You always have your brother with you. I always have you know I am my brother's keeper, and that goes from, you know, not just African American males, but African American females, and vice versa, because that sense of community, you know. Again, we talked about it earlier with the Speech acts is unspoken, things that we understand inherently, that as an African American or a black person, you're going to endure in life, and you have to just suck it up and swallow your pride and deal with it. But we all are going through that struggle right, and I think some demographic groups can relate to that. But obviously some groups can't as much right. It's harder to you can empathize. But you may not fully understand, just because the dynamics are different, right? And I'm not saying that all black people have that experience. I'm not saying that. But I'm saying that a lot of black people feel like that. And that was inherent in the interviews as well. Because this group, you know, they, we talk about community. We talk about personal experiences and regardless. If some of them had a PhD., a MD a Ms., a BA right behind their names. All of them had the same experiences. Right? I have to highlight one of the folks in the group. He went to Harvard. He was the second African American person to graduate with a PhD. From the State of Mississippi. Right, you could. I could only imagine. And he did this in the seventies. I could only imagine the struggle that he had to go through right to attain a degree like that from a school like that coming from where he came from. So you know something that you know other people's family members may have done, you know, is probably much more meaningful to him because of the struggle he had to go through, and I think that is where the community comes in because African Americans acknowledge that right? I was always told. Like, you know, school is important. Education is important, you know, education to get you a lot further in life than sports and all these other things, because, you know, it was always instilled that in education, you know, knowledge is power and you know these older folks. I call them older folks. No offense, right? No ageism here. But you know the 70 plus right. Those individuals who have doctorates and really are fully educated. Their battle and struggle was much harder than mine coming through school right? And I. And that's a level of respect, a level of community that we all know how to respect. And I think you know, when it comes to community, that's something that we all can recognize as a culture. And with this particular group, that's something that's respected across the board because, regardless of the level of severity of aphasia, they have every individual in that group respects one another. They check on one another. They listen to stories about one another. They know about each other's family right? Milestones. It's phenomenal, right. When I got my doctorate. They were the 1st people to congratulate me right. When someone had another struggle in the group. We were the 1st to say a prayer for them and why? That is cultural. It's a traditional thing. I mean, it probably ties back to slavery before the great migration, right? And folks moved up and all around from the south to different parts of the North. Right? That's something that is always probably going to be there. And that's a cultural thing that you know, is really unspoken a lot of times. So.   Jerry Hoepner: Yeah. You know, you talked about the people in the study, the people with PhDs and master's degrees and physicians. One of the stories I kind of connected with was Ann Story. She was a physician prior to her stroke, and had acknowledged that she had colleagues that she would refer black Americans to, and colleagues she wouldn't and then she had the stroke, and she had this very personal, insider experience. I don't know if you want to just say a couple of things about that.   Warren Brown: Yes, sir, she actually, I'm glad you said that she actually definitely said that she referred people to certain practitioners because she knew certain physicians with had more empathy than others. Right now, her experience was a little bit different, right? She didn't really have any negative experiences with practitioners, but also all of them knew she was a medical doctor, right? And I think that you know that level of information is different, because had they not known who knows what her story would have been right as opposed to the individual with the PhD. They didn't know he had a PhD. Because at the time of his stroke he couldn't talk, so it wasn't until his wife came and alerted them as to who he was and where he worked, that some of that stuff shifted, and obviously it shifted when he went to different facilities as well. But Ann's experience was very, very different than some of the other individuals, but I think that even with that she was much more conscious about her experiences as well, because she kind of had a better anticipation about what she was supposed to receive and how services were supposed to go for her right. And that goes back to the bigger picture of healthcare literacy right? Obviously, her literacy and understanding of how healthcare works was a bit better because she was a medical doctor, and I think even just. Her journey with aphasia was a bit better in a lot of different ways as well. Yes, sir.   Jerry Hoepner: Yeah, that's really important to have that that perspective and that kind of juxtaposition. Well, I do want to make sure we have some time to talk a little bit about your role in running the Black aphasia group, and how that's changed your clinical perspective, your research perspectives kind of what you've learned in that. In that context.   Warren Brown: Absolutely so. Originally, I was gung ho! About brain injury. Only, right? I didn't really necessarily want to go into aphasia as much as I am, because my premise for going to get the PhD. Or really one of the main reasons why was I wanted to study sports, related concussions mostly. But once I got into the program and I learned about some of the different, the different profs, some of their interests, you know. I couldn't help myself, but dip into it some, and I got an opportunity at the last Aphasia conference to meet Teresa Gray and she allowed me to facilitate her group out in California, and then we started our own group through the aphasia center of Acadiana with Dr. Azios and Miss Rose Shelf. So, you know, I still run that group. It's still affiliated with the aphasia center of Acadiana. Although I'm in Jackson State. I asked Dr. Azios if we could continue to do that because I think that that connection to an aphasia center is integral. Because I think that you know with the group, that's what we're known for. And that's what we're going to stay as long as they'll have me. So. You know, with that group I've learned so much more than what I knew before, as far as compassion, as far as empathy. As far as, although you might be the expert or the practitioner, you still need to understand the dynamics of the individuals that you're seeing just hearing some of their stories, and even personally, as a practitioner, some of the things that I used to do right, which were probably wrong, because that's how I was trained originally in the beginning, you know, and I shifted throughout my career as well, because I understood a lot more, but I think even more so now, I really fully understand. And that's kind of what I teach a lot of the students that I have right how to understand the dynamics of people that you're working with and the students at Jackson State. They have an opportunity now where they actually come on with the group, and I allow them to have somewhat of a conversational type of discourse with the members, so they can understand those dynamics, for whenever they get out in the field to understand how to work with diverse people with aphasia. So, one of the things that you know, we were able to start with the group members. And this was all the group members. They wanted to create an anthology, right? Because they stated that they wanted to document right their journeys and journeys for other people who are African Americans or of color to understand. You know what you may or may not go through right that you are not alone, that you aren't in a damn box by yourself. Right? They wanted to understand that also for caregivers what to do, because all of these individuals literally stated, they all were oblivious to aphasia prior to this, prior to acquiring it. So this anthology is serving, as you know, just a guide or tool to use for individuals and for other individuals with aphasia who may or may not be of color to relate with right and for individuals to understand like, Hey, you know, this is what I went through. You know I am black with aphasia. This is also to get other people who are black with aphasia in their caregivers to understand that. Hey? We have a group for us out there that you may or may not want to be a part of and last week we actually added a new member. So that was wonderful. But so far, we have multiple different entries. The group participants have entered essays. They've entered poetry. Some have done checklists, some have done prayers some have even one. We have one from a caregiver. Her husband has aphasia. She comes to the group as well. We love her. She's actually a compound pharmacist. She wrote about her perspective as a caregiver in the anthology as well. So.   Jerry Hoepner: Cool.   Warren Brown: Me. Being in Jackson state. I got lucky enough to talk with Dr. Brandon Newkirk Turner, and Dr. Morris is that the University of Saint Augustine. They connected me with Dr. Mcdaniels, who's over the Humanity Society in Mississippi, and she's gonna help us to get it out there. So.   Jerry Hoepner: Awesome.   Warren Brown: And recently we started a collaboration with one of the art, the Black art History professors at Jackson State, Dr. Brittany, Meinberg. We're actually going to make it aphasia friendly. So, whereas we're gonna have mirrored pictures of the entries and the pictures of those entries from an abstract standpoint for individuals who have aphasia so they can read it and be aphasia friendly as well. So yes, sir, that's the idea, and hopefully we'll have something by the fall of next year. So.   Jerry Hoepner: Because.   Warren Brown: At JSU, we're going to be doing a symposium on aphasia. And obviously, since it's an HBCU we're gonna have some focus on diversity with that as well. So yes, sir.   Jerry Hoepner: Well, I'm excited to see that anthology come to fruition and look forward to kind of keeping an eye out for that and everyone out there who's listening. Keep an eye out for that as well. Just a handful. 2 or 3 more questions I want to ask. Just find out a little bit more about your experience. I know that you've had opportunities to work alongside of some great researchers and clinicians. I want to get your perspectives on that. And yeah, share a little bit about that, and how that's prepared you to be like a brand new professor this year. So.   Warren Brown: Yes, yes, sir, absolutely you know. I can honestly say it's truly been a blessing since I started at UL, and I'm done now to be able to encounter all the folks that I have. You know, from Dr. Salvatore to Dr. Michael Canito to you. Right, Dr. Hoepner to Dr. Louise Keegan, Dr. Azios, Oxley Ryan, Nelson. You know the list goes on right. Everybody that I've worked with and spoken to all have different perspectives of our research, you know, and I and I take pieces from everyone that I've worked with to understand how I want to approach things right, because my love is always going to be diversity right in whatever area that I'm in. And you know, I think that's what makes me a little bit unique, right? Because my perspective is always looking at the population that I mainly care the most about right. And you know understanding the different dynamics about how you all have what you all have done. And from reading, all of you guys work, I call it borderline stalking. You guys work right? I remember the 1st time I met you, Dr. Hoepner, I was terrified to talk to you, man I really was, and then, when you introduce yourself to me, I was quiet, and I was like, he's normal. He's not like, I thought he was. So, I was like, Okay, this, this is cool. So, and Dr. Jamie said, just go talk to him. He's cool. Go talk to him. I was like Okay, but I use it as an example, because, you know we're all human, and I think that you know sometimes, you know, as a new researcher, as a novice researcher, as a student, you know, you get overwhelmed with the people that you're reading about, the books that you're using or books that you're reading. These are the folks that are writing it. And hopefully, one day you can get to that level to impact students like myself, like I was, or students that are out there, up and coming students. So, you know, I think, that all the work that everyone is that I've learned under and still learning under, you know, it's important, because this is all. This is all, how we all are contributing to the field and how we're making the field better. Right? I think that's the ultimate goal ultimately is to serve the population of individuals that we're treating. It's never about me, right? It's never about you. It's never about any of this is about the work that we're doing to improve outcomes, to improve the populations that we serve. And you know, clinically, I've worked with some phenomenal clinicians. When I was a clinic, when I was a clinician when I was a full-time clinician and you know I've had great clinicians that I've worked under and with, and horrible at the same time. I think we all have, and you know, when I was in administration I would fire and hire people left and right. I would let people know if they were horrible, and I would just go on and keep moving. But I think you know now that I've shifted to research and understanding how clinicians think to a certain degree. You know, I can understand why some clinicians practice the way they do or did, because they were ignorant to what's out there, you know. Earlier on in my career I was oblivious to aphasia. I heard nothing about it. I work in acute care hospitals, major acute hospitals because they weren't that popular in the South, right? It wasn't really until I got to Southern, and I taught undergrad for a while. And you know in some of the text that I was reading. I read about it, and I was like, Oh, I never knew that was a thing right, because they weren't offered. We had Parkinson's groups. But we never had aphasia group, right? And I think that you know, and TBI groups that we have that as well. But I think these groups are much more impactful because they do serve as a sense of community for a multitude of people. And these groups are places where individuals can go when they plateau out of therapy. And I want to say something on that, too. That's actually one of the topics we wrote about in the anthology. What does it feel like to be plateaued or told you plateaued in therapy? Right? And it's just amazing how you know as a clinician, you say that to someone right? Or you meet, you met Max level of potential. You say that to someone, but you don't fully understand the mental or the impact that you have on an individual when you say that right? And that was something we talked about. And now they're writing about it. And I'm like man. I never thought about that as a clinician. So I say that to say even I'm still learning right. That's something we should know. But you don't think about it from a clinical standpoint, because that's a standardized thing. But to an individual who's suffering from or had to endure what you're saying to them, it's a totally different perspective. Right? So, you know, I'm learning that. And I'm learning how to be more compassionate, too. So yes, sir, I'm learning a lot. I love it. I love it so.   Jerry Hoepner: We are well on your way, and you will make that impact on a lot of students. I'm sure you already have. Well, just to kind of bring things to a close. I want to end with a lighter note hopefully, a lighter note. What brings you peace in the midst of this sometimes crazy world that we're living in.   Warren Brown: Oh, man, I love! I love my kids and my wife. I love my kids and my wife. They bring me peace. I'm a I'm a classic car collector. I love my classics, too. I have them. Can I share about that?   Jerry Hoepner: Absolutely.   Warren Brown: So, I have a 1969, a 396 Chevelle that I bought years ago. And we're restoring that we're almost done with that. I just have to get it painted. And recently I bought a 1985 K. 5 Chevy Blazer that we started to restore as well. It's a smaller engine. It's a 305, but that's something that brings me peace as well. You know my dad was a jack of all trades. So, I learned at a young age how to construct houses, how to do plumbing electrical fix cars. That's why I went to college, so I didn't want to do that full time. So, but one thing about it is that you know, I learned how to do all those things, so I can teach that to my kids. And hopefully, that's our family time. You know that we do these things together. That's what truly brings me peace, my family, and a lot of my friends. So, for sure. Yes, sir.   Jerry Hoepner: Well, that's fantastic. And obviously you and I could talk all day. We need to wrap things up. Hopefully. We'll get to see you at the Aphasia Access Leadership Summit and connect there.   Warren Brown: I'll be there. Yes, sir.   01:05:02.260 --> 01:05:11.929 Jerry Hoepner: Connect with a whole bunch of new people. That you haven't met yet, too. So, thank you so much. Warren and I look forward to talking to you again soon.   Warren Brown: Thanks, Dr. Hoepner. Thanks for having me. I appreciate it.   Jerry Hoepner: You're so welcome. On behalf of Aphasia Access, thank you for listening to this episode of the Aphasia Access Conversations Podcast. For more information on Aphasia Access and to access our growing library of materials go to www.aphasiaaccess.org. If you have an idea for a future podcast series or topic, email us at info@aphasiaaccess.org. Thanks again for your ongoing support of Aphasia Access.

Every year, the conventional wisdom about getting into college gives way to painful, new truths and exciting, new opportunities. Amy and Mike invited educational consultant Rebecca Stuart-Orlowski to return to the show with admissions notes for the HS graduating class of 2025. What are five things you will learn in this episode? How are colleges and students using AI and AI detectors in college admissions and college essays? Are more colleges requiring test scores this application cycle? If so, why? Why is there a dearth of SAT centers despite more colleges requiring tests, and what can students do about it?  How will AP's recalibration of scores influence admissions decisions? Will the FAFSA be a disaster like it was for the Class of 2024? MEET OUR GUEST Rebecca Stuart-Orlowski, founder of Orlowski College Consulting, has worked in education for 35 years and has worked as an Independent Educational Consultant for 10+ years. She has a specialized Certificate in College Counseling from UCSD, a BA in Communicative Disorders from San Diego State, and two active teaching credentials. She taught deaf, LD, and 2E students for four years and was a college counselor at a small private school for 3 years. Rebecca specializes in gifted/2E, STEM, creative, homeschooled, and transfer students. Rebecca first appeared on the podcast in episode 369 to discuss ADMISSIONS NOTES FOR THE CLASS OF 2023 and in episode 526 to discuss ADMISSIONS NOTES FOR THE HS GRADUATING CLASS OF 2024. Rebecca can be reached at r.orlowski.consulting@gmail.com. LINKS U.S. Department of Education Announces Schedule and New Process to Launch 2025-26 FAFSA Form Is next year's FAFSA already off the rails? Incorporating AI into the Admissions Process Testing Policies in the Spotlight I live in Northern California. Why do I have to travel hundreds of miles to take the SAT? Colleges are using AI in admissions. How can they do it right? RELATED EPISODES HOW STUDENTS USE GENERATIVE AI WHAT DO TRULY TEST OPTIONAL COLLEGES FOCUS ON? BIG CHANGES TO AP TESTS IN 2025 FIRST IMPRESSIONS OF THE BETTER FAFSA ABOUT THIS PODCAST Tests and the Rest is THE college admissions industry podcast. Explore all of our episodes on the show page. ABOUT YOUR HOSTS Mike Bergin is the president of Chariot Learning and founder of TestBright. Amy Seeley is the president of Seeley Test Pros and LEAP. If you're interested in working with Mike and/or Amy for test preparation, training, or consulting, feel free to get in touch through our contact page.  

Dr. Michael Spagna has a degree in Communicative Disorders from Northwestern, Special Education from UCLA and his PhD from University of California. Now working at California State University Dominguez Hills as the Provost. I heard him talk about dyslexia which I have. If you don't know what Dyslexia is, it's a is a learning disorder that involves difficulty reading due to problems identifying speech sounds and learning how they relate to letters and words (decoding). Also called a reading disability, dyslexia is a result of individual differences in areas of the brain that process language. We talk about why jumping into the family of study and moments that changed his life for the better. --- Support this podcast: https://podcasters.spotify.com/pod/show/matt-brown57/support

Summer Perkins, MS, CCC-SLP, is a certified Pediatric Speech Language Pathologist with a Master's degree in Communicative Disorders. She has held roles as a Clinical Professor at the University of Florida and Director of a Pediatric Outpatient Therapy Clinic in Chicago. Summer specializes in working with Children and Adults who neurodiverse conditions like, Autism, ADHD, […]

Dr Stan Goldberg is author of Preventing Senior Moments: How to Stay Alert into Your 90s and Beyond. Stan has been living with cancer for 25 years. He is Professor Emeritus in Communicative Disorders at San Francisco State University. He has provided therapy, researched, and published in the areas of learning problems, communication disorders, loss, change and end-of-life issues for more than 25 years. Stan offers workshops throughout the world on change, loss, and end-of-life issues. His blog, radio/tv interviews, downloadable articles, and complete resume can be found on StanGoldbergWriter.com. Get Preventing Senior Moments at: amazon.com. #entrepreneurship #Cleveland #branding #SelfEmployment #inspiration #Alzheimer's #dementia #StanGoldberg #Dr.StanGoldberg #PreventingSeniorMoments --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-edwards/support

In this episode, Lisa, Rebecca, David, and Becky discuss:A critique of the information and misinformation of the latest NACAC Annual Survey of Colleges. The role of ACT and SAT scores even beyond the admissions process. The impact of Institutional Priorities in the admission of students.Colleges have differing expectations for various majors, including highly competitive majors. Whether the ability to pay affects students' admission rates.Key Takeaways: To understand what schools seek for admissions, the common data set is more important than the NACAC survey for the colleges your student is considering.The survey does not reflect admission by major but is critical for your student to understand.College is more than just getting in; it is also about affording college. Test-optional admissions help the most wealthy students and the least wealthy students. It hurts those in the middle class the most. Institutional priorities, like the ability to pay, influence admission but are not covered in the survey. “We always have to take these surveys with a grain of salt. I encourage families to do their homework, to work with professionals, or to work closely with their school counselor to really understand the nuances of college admissions because until things change, it continues to be very opaque.” – Rebecca Stuart-OrlowskiAbout Becky Priest: Becky Priest is the College Counselor at The Cambridge School, where she has overseen the design and build-out of their college counseling program. She also has over 20 years of college financial aid experience at all levels. She is currently serving on the Classic Learning Test's Board of Academic Advisors.About David Blobaum: David Blobaum is a nationally recognized expert on standardized exams and college admissions. He graduated from the University of Chicago with honors. He co-founded and runs 1Summit Prep and he is the Director of Outreach for the National Test Prep Association. About Rebecca Stuart-Orlowski: Rebecca Stuart-Orlowski has been an educational consultant specializing in profoundly gifted, 2E, advanced STEM, and homeschooled students for 11 years. She has a Specialized Certificate in College Counseling, a BA in Communicative Disorders, and 2 teaching credentials, Multiple Subjects w/ a Multicultural Emphasis & Communicatively Handicapped. She taught deaf, deaf/blind, LD, and 2E students for 4 years. She's a member of IECA, cochair of the IECA Homeschool Affinity Group, and a member of NACAC and WACAC. Get Lisa's Free on-demand video: How-to guide for your teen to choose the right major, college, & career...(without painting themselves into a corner, missing crucial deadlines, or risking choices you both regret). flourishcoachingco.com/videoConnect with Rebecca:Facebook: facebook.com/OrlowskiCollegeConsulting LinkedIn: linkedin.com/in/rebeccastuartorlowskiEmail: r.orlowski.consulting@gmail.com Connect with David:Website: davidblobaum.comLinkedIn: linkedin.com/in/david-blobaum/X: twitter.com/David_Blobaum Connect with Becky:LinkedIn: linkedin.com/in/becky-priest-458b204b Website: cambridgeclassical.org Connect with Lisa:Website: https://www.flourishcoachingco.com/YouTube: https://www.youtube.com/@flourishcoachingcoInstagram: https://www.instagram.com/flourishcoachingco/LinkedIn: https://www.linkedin.com/company/flourish-coaching-co

University of Alabama Professor Paul Reed, PhD is the Distinguished Teaching Fellow in the Department of Communicative Disorders. Despite the heady title, he's easy to talk to about accents and the impressions they make on others. I read a quote from him in The Economist magazine and had to reach out. As a guy that travels a lot, I hear many accents and I have been told many times "you don't sound like you're from Alabama." Paul explains where my accent may have gone and why, and what we think about people when we hear other's accents. Fun, fun conversation.  Show Sponsors: Mason Hills Farms - True Farm to Table Meats E3 Termite & Pest Control Roy Lewis Construction Trey Langus - Transworld Business Advisors Allison Horner - State Farm Agent Angelo DePaola - The Coastal Connection Realty Persons Services Corp Seth Cherniak - Jeffrey Matthews Financial First Horizon Bank's "Bucket List-ening" Podcast Bill-E's Bacon Find Cam Marston's book - What Works: The Ten Best Ideas from the First Two-Hundred Episodes on Amazon.com. 

Tara Phillips is a speech/language pathologist and has run her own communication based classroom for 25 years. She was at the early elementary level for the first part of her career, and at the early childhood level for the last 10 years.Tara earned her bachelor's and master's degrees in Communicative Disorders at the University of Wisconsin-River Falls. Her minor was in Early Childhood Education. After working exclusively with autistic children at the elementary level for several years, she went on to obtain an Autism Certificate from Hamline University in St. Paul, Minnesota.Check out Tara's PodcastTara's InstagramTara's Facebookhttps://autismlittlelearners.comwww.autismlittlelearners.com/visualsWe'd love to answer your questions on the podcast! Fill out this form -> https://harkla.typeform.com/to/ItWxQNP3Brought To You By HarklaThis podcast is brought to you by Harkla.  Our mission at Harkla is to help those with special needs live happy and healthy lives. We accomplish this through high-quality sensory products, & child development courses.Podcast listeners get 10% off their first order at Harkla with the discount code "sensory". Head to Harkla.co/sensory to start shopping now.LinksAll Things Sensory Podcast Instagram Harkla Website Harkla YouTubeHarkla Instagram

Despite its shared foundation with others who speak the same language, each individual's mental dictionary is intricately shaped by their unique life experiences, education, and cultural influences. Guest: Dr. Nichol Castro, Associate Professor of Communicative Disorders and Sciences at the University of Buffalo Learn more about your ad choices. Visit megaphone.fm/adchoices

Seg 1: Despite its shared foundation with others who speak the same language, each individual's mental dictionary is intricately shaped by their unique life experiences, education, and cultural influences. Guest: Dr. Nichol Castro, Associate Professor of Communicative Disorders and Sciences at the University of Buffalo Seg 2: View From Victoria: Nobody likes to point to Oregon as the model for decriminalization of drugs. It was a well intentioned effort to steer users into treatment but ended up being a total failure. We get a local look at the top political stories with the help of Vancouver Sun columnist Vaughn Palmer. Seg 3: Studies show an unexpected connection between thunderstorms and respiratory issues, particularly asthma. The increasing frequency of severe weather events and the challenge this poses to public health systems in treating respiratory illnesses. Guest: Dr. Chris Worsham, Professor of Pulmonary and Critical Care at Harvard University and Co-Author of “Random Acts of Medicine: The Hidden Forces That Sway Doctors, Impact Patients, and Shape Our Health” Seg 4: Serena noticed a significant gap in resources for younger students when she put together a Remembrance Day bulletin board a few years ago: there were few books addressing the contributions of Black Canadian soldiers during World War I. Guest: Serena Virk, Teacher at Sawmill Valley Public School and Author of "We Remember the Black Battalion" Seg 5: It was a 24-13 Western Final loss in Winnipeg for the Lions. The Offence struggled to get in rhythm most of the day. Now looking ahead to the offseason, when does the building for 2024 start? It'll be a big season next year with another chance to take the next step with Vancouver hosting the Grey Cup. Guest: Rick Campbell, Head Coach of the BC Lions Seg 6: The Harm Reduction Nurses Association has initiated a legal challenge against the province and attorney general in the B.C. Supreme Court, questioning the constitutionality of the recently enacted Restricting Public Consumption of Illegal Substances Act. Guest: Corey Ranger, President of the Harm Reduction Nurses Association Seg 7: While many war memorials focused on honouring individual combatants, a significant group received limited recognition: the millions of conscripted animals, particularly pigeons, who served alongside soldiers. Guest: Dr. Frank Blazich, Museum Curator of Political and Military History at The Smithsonian Institution Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, I am joined by Amy Prince and Amber Ladd. Amy and Amber are Speech-Language Pathologists with over 31 combined years of experience. They are extremely passionate about working with children, and integrating behavioral techniques in speech therapy. Amy and Amber are the co-owners of The TALK Team, a pediatric speech therapy clinic located in Fresno, CA. They each received their Masters of Arts in Communicative Disorders and Deaf Studies, with an emphasis in speech-language pathology from California State University, Fresno.  In addition, they are both Board Certified Behavior Analysts. They have been employed in the public school system as well as private practice. They have extensive experience working with autistic children, with sensory processing disorders, pragmatic language disorders, oral placement, feeding disorders and extensive language needs. Visit Speechie Side Up to learn more about this episode.

Welcome to the Aphasia Access Conversations Podcast. I'm Jerry Hoepner. I'm a professor at the University of Wisconsin – Eau Claire and co-facilitator of the Chippewa Valley Aphasia Camp, Blugold Brain Injury Group, Mayo Brain Injury Group, and Thursday Night Poets.  I'm also a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources. I'm today's host for an episode that will feature Lauren Schwabish. In this episode, we'll be discussing Lauren's work on groups for parents with Aphasia and person-centered approaches to primary progressive aphasia interventions. Biosketch: Lauren Schwabish M.S., CCC-SLP is the owner of Neuro Speech Services, a private practice based in Northern Virginia, specializing in person-centered assessment and treatment of cognitive-communicative disorders related to stroke, brain injury, mild cognitive impairment, ADHD, and other neurologic and neurodegenerative conditions. Lauren received her Bachelor of Science degree with Honors in Communicative Disorders from the University of Wisconsin-Madison and holds a master's degree in Communication Sciences from Hunter College of the City University of New York. She is licensed in the Commonwealth of Virginia and state of Maryland and is a certified member of the American Speech Language Hearing Association. She has over 23 years of experience working in hospitals and acute rehabilitation centers and is passionate about providing meaningful and accessible health education about the brain to patients, families, and health care professionals. Lauren is committed to empowering communities with evidence-based information and best practices in brain health behaviors.   Take aways: LPAA is vital to understanding what the client wants and needs from you as a clinician Parents with aphasia encounter many of the same challenges that all parents experience as they're raising small children but this is further complicated by aphasia While work and other community obligations may go on hold after aphasia, parenting doesn't go on hold People with aphasia who are in the process of raising children benefit from peers who understand what they're going through People with PPA are still connected to their family and kids and need support in navigating everyday conversations that are necessary to parenting and participating in their children's lives Group therapy provides a safe and supportive environment for people with PPA to find supports or relate to others that have similar experiences as them Learn how to be “a purveyor of hope” for individuals with PPA and their families Interview Transcript: Jerry Hoepner: Well, welcome, Lauren. I'm really excited to have this conversation with you today. And I thought maybe it would be a good thing. If we kind of begin by introducing our readers to your experience as a speech language pathologist, and kind of what led you along this life path of participation approaches to Aphasia and that person centered approach which is really central to what it sounds like you do in your in your workplace setting. Lauren Schwabish: Yes, thank you so much for having me. I'm a big fan of aphasia access and the podcast is on my it's on my feed routinely. So it's really an honor to be here. I am like I said, a speech language pathologist for 23 years. I started out in I worked in New York City in a really big city hospital. There was, you know 2 campuses, a thousand beds each. It was literally everything under the sun, and I think that was my first experience. In really getting to the heart of what a what drives a person, what a person is all about because I was so different from the population. I came from a different place. I had a different educational trajectory. You know, this was a city hospital that had, mostly an underserved population, and it was in New York City. So it was tremendously, culturally diverse and one of the things I recognized instantly was that the way I would sort of drive compassionate and effective care was to really understand who I was working with and so I think from the from the jump, you know, just really having the humility to say, I need to sit and listen and understand this individual so that I can support their recovery from you know stroke, trauma you know, sort of acute illness. That was something that really just ended up making sense. So that was sort of my foundation. And then I moved into acute rehab into a hospital in Northern Virginia, where I am now and really just found, even though I was in a sort of a very medical setting, that connecting with the individual was absolutely the most important thing, and it was how I really felt that I could you know, show others how to do effective therapy. So I didn't know that it was life participation approach, but it was just really about understanding what the person needed to communicate about and in the hospital it's a different setting than in the community where I am now in private practice. But 21 years later, when I started my own private practice, that's when I really found LPAA as a principal, and could start to put some of the theory behind what I'd been doing all along. Jerry Hoepner: Nice, you know. It's funny. I was just having a conversation before we started this conversation, with Tami Howe, who is going to be doing a future conversation about the role of environment and accessibility in communication with individuals, with aphasia. And one of the things that we kept coming back to is exactly what you said, just getting just spending time listening and getting to know who that individual is as a starting point for really recognizing authentically what that person's wants, needs beliefs, values-  all of those things are and I think that's just a wonderful starting point for thinking about life participation, because it's easy to jump straight into the therapy or the assessment pieces. But what we need most is just to put our listening ears on, and really find out who that individual is and what makes them tick. So wonderful place to start. Lauren Schwabish: Yeah, and I would say that sometimes, especially when you know thinking about that acute rehab or acute care setting when someone's, you know, potentially very limited in their life participation, what they can do getting to understand like you said their beliefs. You know. What were they doing before they got to where you are? What can they teach you about? It's really honoring their strengths and sort of who they are prior to this acute illness. And so you can see them as that individual and they oftentimes can tell you more about that than you could. They may be able to from the from the, you know, sort of compromise place that they're in and it just feels right, you know, that's the one thing I tell. You know, when I was in the hospital, and I was working with therapists were so concerned about productivity and so concerned about billing. And just oh, my gosh! I don't think I have time to do this, and for me it's like you have nothing but time to honor this aspect of it, because once you figure out what makes this person tick, what excites them? What kind of music they wanna listen to what they don't like, you know, that's the foundation. And it shouldn't be something that's an afterthought to the skilled, clinical, hard skills that you have. It's really the first step, and it just when it works, it works well. So I think people just have to know that they have to have the permission, right from their environment, from their you know department, their supervisors, their peers, that this is actually very much the most essential ingredient to being an effective therapist. Jerry Hoepner: Yeah, and what a refreshing way to start. I'd like to say that all therapists in the acute care context and that's the context where I worked for many years. But I'd like to say that they all get that but you're right. People get caught up in the fact that we only have a few days with these people, and we have a little bit of time, and we don't necessarily have time to devote to finding out who that individual is but what you're saying is that's central to being successful in helping them move forward with anything. So I really appreciate that as a grounding starting point and it really makes sense why, we're going to have a conversation today about what we're going to have a conversation about. I know Lauren, we talked about a couple of different topics. One being your passion for working with parents, and the topic of parenting with aphasia and that might seem like a leap to talk about that, and person centered approaches to primary progressive aphasia but when we think about that grounding principle of meaning, the person where they're at finding out what they value, I think it's going to be easy for our listeners to tie those pieces together. Lauren Schwabish: Definitely cause it's ultimately about a family, right? And it's not just a person with aphasia, but the person with aphasia exists in some sort of family unit, whether it's a partner, a friend, neighbors, kids, grandkids. And so, yeah, one of the things I have been privileged to be in is those 2 spaces? So I think I think, yeah, we can tie them together. And also just to hear that what this looks like with kind of 2 different sort of different populations, you know, thinking about parents with aphasia where the prognosis is typically so favorable, right? It's just lots and lots of improvement. They're typically younger, you know, we're seeing gains and everyone feels fairly optimistic, and that person with Ppa is going in a different direction. Right? But person-centered approaches are vital for each. Jerry Hoepner: Yeah, that I totally agree. Family is what ties these topics together, and I'm sure we can think of a whole bunch of other related little niches of therapy that are tied together by family as well. So I'm excited to jump into this conversation. And I'm gonna begin with talking a little bit about the topic of parenting with aphasia, just a really interesting and important topic. So why is it so important to have communication groups or parents with aphasia? Lauren Schwabish: I why, I would say I'm a parent, so I can, I could speak with experience, that parenting itself is a 24/7 situation. And so when you have a parent who's been very suddenly affected by aphasia it is the one task, you know, work goes on hold. And sometimes, you know, operations in the community go on hold because the person's recuperating. But parenting really doesn't ever stop you know, children with, you know, whose parents have had a stroke or brain injury. You know they're up in the hospital. They're part of the therapy process hopefully, and they're in the community, or they're back at home with that individual and so I do think it's really important to give people who are raising children, and I will say, you know, we have lots of people who have raised their children. They're still a parent with aphasia. But this is sort of specifying that these are people who are in the active process of raising younger children and those are the people that are in the communication group that I run through the National Phase Association. When I speak to those parents they really are. They are seeking a safe and compassionate environment to discuss how to raise kids right? And that can range from talking about, how do you discipline a kid when you have aphasia, how do you talk to the teachers that a parent teacher conference? You know, how do you engage? How do you re engage your parenting skills when they've been sort of taken over by family members necessarily. But how do you sort of reenter that role again? And I don't know that for the parents that come to my group. They don't have that in their own parenting community, right? So, the friends that they had who were parents prior to their aphasia. They're not necessarily the same fit as other parents who have aphasia. So, I think that the group environment that we've cultivated is that safe space to talk about, you know, and highs and lows of parenting. Let's face it. Parenting is really hard. So sometimes it's, you know. Everyone just wants a place to kind of vent and again when you're venting with aphasia, it's not always smooth, but it feels really good, just like parents who don't have aphasia. Jerry Hoepner: Yeah, what a what a terrific summary. And in response to that question, I I'm just gonna go back to the one of your earlier statements, because I think this is so true. When we think about someone in the rehabilitation process work stops and the community services, and all of those kinds of things stop, or at least they change significantly. But parenting doesn't stop as a fellow parent I can. I can guarantee I've got kids who are in college and just outside of college, and parenting still doesn't stop, but to be in the thick of raising small children. That that's definitely a a unique challenge so speaking of that, what are the unique challenges and needs of a person with aphasia who's also raising a child. Lauren Schwabish: Yeah, you know, when I think about the things that the parents in my group have raised, it's really I mean, it runs the gamut you know some of it is how do you read a book to your child when you cannot read how do you, you know, manage things like. There's one gentleman who's awesome. He had a stroke when his youngest daughter was out, and I think she was like a newborn, or she was essentially an infant. And you know, how do you navigate watching them start out? He was joking kind of at the same level language wise and then she's just accelerating. And you know, how do you navigate that? So, as the child's language is growing? How do you facilitate your own child's language development. We've had one of our survivors is she's made tremendous progress. Many years since she had her stroke. She had a situation where her daughter within high school, and there was a child who committed suicide, and she said, I don't know how to talk about this with my child, but I know I need to right, and that kind of stopped me and my tracks as a parent of high schoolers to think. Gosh! This isn't so much about the aphasia. But how carefully we have to word a conversation like that. Right? So it's really having those serious high stakes conversations. And then some of it's, you know, not as heavy, not as hard. It's kind of how do you, How do you reintegrate yourself with, you know, kids at the playground. How does your kid explain aphasia to their friend who's coming over for a play date, you know. How do you ween a baby, you know, sort of like all different things. So this is where it's sort of like, is it a group for people with aphasia. Is it a parenting group? Well, it's kind of everything, because sometimes we just wanna kind of talk about stuff. And it's you know, last month we talked about, you know, if I gave you a plane ticket and you could go on vacation, you know, where would you go? And would you bring your kids or not? Which was fun. Some people were like, of course, it bring my kids, and some people are like, Heck! No, I'm leaving them at home. I'm going on vacation by myself. So it's really fun. It kind of is the group itself. We really start out with 2 principles, which is what is I have these little smiley face cards, you know what's making you happy and what's kind of a struggle, or, you know, making you feel sort of mad. And that's just a really nice place to launch from. Jerry Hoepner: Yeah, wow, terrific. And one of the things I kept thinking when you described the loss of kind of kinship or a connection between themselves and other parents who don't have aphasia, who are a parenting, I'm wondering about the relationships between the different parents with aphasia and each other from a peer standpoint. And what that looks like. Lauren Schwabish: Yeah, one of the women. She's in North Carolina, and she found the group after it had been running for a couple of months, and she says every time she's like, I'm just so glad you guys are out here because I did not know that there were other people like me. So, some of it is just seeing that there's young people who also have aphasia, who are also raising kids. So, some of it's just that environment. One of the things that I think was the most incredible was there's a speech pathologist who's in Texas who runs or she's in a program that think it's sort of an inpatient rehab a residential program. It sounds incredible. She had 3 or 4 young parents with aphasia who had recently come there, and she logged on from that facility and those folks were able to see survivors from, you know, one year, 2 years, 5 years, 7 years. And so, some of it is be able to show people who are just learning, you know, just getting a couple of words. You know, may be able to say the name of their child. Maybe you know one or 2 word phrases to see and experience what recovery looks like. And that was amazing. And one of the women who is in the program has since discharged home. And now she logs on, and it's fun to see her recovering quickly. But I just think that sense of like, and you know we hear it all the time like you just have to keep going. It is a marathon, it is. It is arduous right? And so for them to have that support and the spectrum of recovery. I think that's one of the things that is the most meaningful. Because, you know, it's of course, post direct depression, anxiety, especially for a younger survivor who's not only lost you know their language abilities, but probably it's also facing the fact that they can't return to work. That was one of our topics a couple of months ago. It was someone who was like, yeah, I hope I can get back to work and then come to find out the whole group shared, you know what they used to do for work, and a large majority of them. In fact, I think all of them, you know, in addition to parenting being tough, is they've lost their careers. Which is also a challenging topic. But, at the other hand, some of those long-term survivors say, but you know what? Instead of working, I'm able of, you know, volunteer at my kids school. I'm cheering on the sidelines. I'm attending that concert, and she said, I don't know that I would have had that if I was working. So, you know, I think the silver lining aspect is great, too.   Jerry Hoepner: Yeah, absolutely. I think it's so critical. I mean, even outside of the the topic of parenting with aphasia, to have to see people who are at different points along the recovery. And maybe this will come up when we talk about primary, progressive aphasia, too. But, for example, one of the things that we see at aphasia camp is often that people will identify with someone who's a little bit further along in the journey, and they might take sort of a mentorship kind of a role just to be able to say, this is what's coming. And you know, things get better and a little bit easier to handle. It's so positive from that standpoint. But I've seen the reverse true as well to be able to say. You know, this is a person who's longer, or, you know, further along on their primary progressive aphasia journey, and to be able to just know. Okay, so this is coming and I can kind of ground myself and prepare myself for these things. I think there's something really valuable about being able to see that continuum like you described. So Lauren Schwabish: agreed. And just that sense, you're not alone. You're not the only one who has this experience. Jerry Hoepner: I'm interested. So I mentioned that sometimes there's these pairings of people along the continuum. Do you see those relationships growing? And do people connect with each other outside of group or have particularly close connections with someone within the group. Lauren Schwabish: Yeah, well, I think the group is pretty new. So, we're sort of cultivating that I would say, one of the things, though, is, there's one woman shared that now that her kids this was back in, I think August, her kids had gone back to school, and she was like, I don't know what to do with my time. And another survivor basically sent me a list of ideas. She's like a support group Guru. She attends some in the Uk, some here. She really knew of a ton of resources, and she sent those to me to pass on to this other individual. So that's probably a great example of, you know, one person wanting to really cheer on the other one. There's that same woman who offered the resources is lives in the Chicago land area, and we had a one person who moved to that area was really fun. She ended up giving us a tour of her house on our in our group, which is really great. But that was a connection we made where we said, Hey, you know what? What are you know, the the strokes, survivor communities like in that area in Chicago. So that was really neat, too. So I think you know anytime I feel as a facilitator when I have a chance to match someone to either to peer to peer, or just for resources. In general. You know, one woman is like, I really wanna read. She has a 14-year-old, and she's just like there's a lot of reading that goes on with like middle school and high school and so we were just sort of like troubleshooting together, you know, on the side, just hey, you know, here's an audio book that we might want to try or here's something you could pair with an audio book. So, you know, it's it's just we have a space to share how you're feeling resources, I think, become evident when you're in that supportive environment. Jerry Hoepner: Yeah, absolutely. I think those are perfect great examples of that connection between people and that resource and mentorship that they can provide to one another one another. I was kind of internally laughing when you you mentioned the middle schooler with reading, because I was thinking about when your children reach high school and college, and they begin to pass you up in terms of knowledge and intelligence. That's a hard time for any parent. Definitely for someone with aphasia or we're even talking about how to handle like cell phones and social media and technology. And like you think of how fast pace. That is, I can barely keep up. How does someone who has, you know, issues, maybe even with like sensory overload you know where there's video games going on and when you're really at that point, and you have to say something how do you find the words, you know? And so actually, one of our, you know, again, longer term survivors like, you know what? I just text my kids. And we have a couple of emojis where they know what I'm saying, you know. So I think it's really neat. And that way, too. It's just sharing those examples of like modern day parenting. And what does it look like when you have aphasia? Yeah, that's fantastic. One of the things I was going to ask you about is the kinds of topics that come up. But you've shared a few social media and how to support someone with reading and all of those topics. But what other kinds of topics typically come up in these groups.   Lauren Schwabish: I think for the parenting group, it's really about, how do you keep your language skills going? Because I think a lot of these folks are, you know, not necessarily continuing to receive skilled interventions from speech pathologists. And so some of it is. Just try to like, how do I use my environment? Or how do I have strategies to sort of resume participation? There was one woman early on in the group, so it was a smaller group and she was going to meetings with her High School senior about college and graduation. And so we were sort of just coming up with, like, what are some words that you'd wanna have ready, you know, application. And you know, tuition. And so even just kind of brainstorming a way to support her participation in that. So that was something that came up. A lot of it is sort of what are your kids excited about? And I think that that's one of the things I always close that group with is gratitude. Just because it's such a wonderful it's brain, healthy activity. And almost universally the parents are talking about their kids. They're grateful for their kids. They're grateful that they got to you know that their kid was well behaved at school, or they're grateful that they got to go on vacation, or they're grateful that they want to swim meet. So sometimes it's also a chance to brag, you know, to really shine a light on the things that your kid is doing. You know, that's a fun thing to be able to do. And again, in a fast-paced environment, you know, when they're with their neighbors, or they're with the kids at, you know, other parents at school things just go quickly. And so when it's a time to just slow down, and we'll just sort of popcorn it around the Zoom group. Where everyone has a chance to just share something that their kid is up to and that's been really neat to one of our members is from Canada in BC, and so we didn't really know, you know, geographically where he was. So I was. You know we were looking at the map, and we were figuring out where everyone else is from, too. So sometimes it is just it's about that community and some hot topics that are coming up. Weather was one of them where everyone was talking about you know the wildfires where he was, or how do you, parents when it's so hot out. You know, it's really typical struggles. It's just, in a way, it's probably not that different from a normal parenting conversation. We just use language support and give people tools. They need to be successful contributors to that conversation. Jerry Hoepner: That's a pretty strong litmus test for being meaningful and person centered to be able to say, it's just the stuff that every parent talks about. Now, this is just a community that scaffolds that for people with aphasia, so that they are a part of those conversations and can be a part of those conversations I love that that's fantastic. Yeah, really wonderful. Well, knowing what you know now, and other, what other resources would you like to see available? To this community of individuals with aphasia from a parenting standpoint? Your wish list. Lauren Schwabish: We talk about this, my wish list. So one of the things that I'm I'm trying to, you know. It's hard because we only meet once a month. I wish we could meet, you know, more routinely, but is, of course, when you have kids it's really hard to plan, you know and get together. But we've talked about this over. Several different meetings is, what would we like to have available? I think certainly books or resources videos that are for parenting, about parenting that are aphasia friendly. So like, how do you, parent? You know a toddler? I know, I read books when I was raising my kids. You know, I read books currently about like teenagers and mental health. You know what resources are available that are aphasia friendly. And where can we find those books and do those books exist? And can we write those books? So some of it is just typical parenting advice but made aphasia friendly. That's something I would love to see. And we have a couple of different books that people have recommended, and I think we said we could link those in the show notes so people could try to. You know, find those. But of course, this is probably one of those moments where someone will get inspired and create them, you know, create that resource in the future. I would like to have some tip sheets again, based on what my parents in with aphasia, have recommended about how to engage in conversation in the community when it comes to parenting. So, for example, how do you talk to the pediatrician during a checkup? Right? How do you make sure that your voice is heard, that you can fulfill that role of parents versus someone who's just sitting in the room when there's you know, someone else speaking? How do you talk to a teacher at a parent-teacher conference? So some of it I think it'd be again scripts or recommendations or advocacy. I have a like we've all seen them sort of. I have aphasia, you know, cards, and we I've shared that with that group just to try to say, like part of your job is to be a presence in the school community, right? So like, how do you do that? So even like a guide? Again aphasia, friendly, something that would allow them to participate in these pretty routine parenting situations. And then I think, what I'd really love, and I don't know, you know. I hope someone out there is thinking about. This, too, is to think about how to record stories or videos with just those words of support. So that if you're out there and you have a young parent with aphasia on your unit in a hospital where you could go to Youtube, or you could go somewhere and say, Hey, you know what? Here's words of wisdom from people who've been where you are. If I could record a snippet of the conversations that we have, or the words of wisdom that one parent passes on to another. It would be so. I think, reassuring in a really scary time I think it would be inspiring. You know nothing that's too heavy a lift that doesn't need to be, you know, a feature like film, but just something that would be a collection of stories that someone could watch and just gain a little bit of sense of, okay, you know I'm not alone and people have done this before me, and they got better. And I can, too. Jerry Hoepner: Yeah, that seems to be a recurring theme that I'm not alone, and I can connect with people that really get this. Yeah. II love your wish list, and I hope that some of our listeners are inspired to create those resources. And you know, as we were talking, II just couldn't help myself. I jumped on to Google Scholar, and I wanted to see what was out there for research in this area. There's not a lot, and I know that Molly Manning has written a little bit about this, and I think Brooke Ryan has done a little bit of work recently, but there's not a ton out there. So for all of you academics out there, too. Like what a terrific topic! For someone to research into, to learn more about this. So I'd love to get those testimonials and words of parents out there as well. So feel like we're just scratching the surface of this, and a lot of work needs to be done. But what a great kind of call to action! That the need for groups for parents with aphasia. So I really love, love that conversation, and thank you. Anything else that we're missing, or we should add, before we move on. Regarding. Lauren Schwabish: No, it's like, I said, running, the group has been wonderful. And I just think, if you even have 2 people, you know, it doesn't take like we have people from all over the country that come to the National Phase Association meeting once a month, you know, the second Wednesday of the month. But it doesn't take too much to operate it, you know, Zoom Link. And so I think even Matching, or you know, Peer matching someone else just to recognize that this is a very this is a population that's gonna live with aphasia for a long time, and you know they're the needs are high. And so even if you can think about a peer mentor, or some kind of connect in your greater community. You know, this is really a population that's thirsty for it, and they want it, and they will. They will pursue it on their own. Once you sort link them up together, and then hopefully, the rest of us can come up with some great resources to fulfill that. You know that that connection. Jerry Hoepner: Yeah, excellent. And certainly, if there are people listening, thinking, what should I do? I want to do something related to parents. Wow! What an opportunity to step into! There's plenty of plenty of room for that support to go around. So really inspiring. Lauren, if it's okay, I'm gonna shift gears and talk about a very different conversation. But one that, we said, is definitely linked through that kind of family. Principle, family centered principle. And that's the conversation about person centered care for individuals with primary, progressive aphasia. Can you begin by just sharing a little bit about your perspective? What drives you, your underlying theories for this approach? Lauren Schwabish: Yes, and I will say, for my, you know, 23 years of experience. I am very new in the Ppa space, mostly because I was working in the hospital system, and that's not where these individuals are found, you know. So for me. Once I started my practice, and someone said, Do you treat primary, progressive aphasia. The answer was, of course, yes, but then it was very much a well, how right? How do I do this? And so diving into you know, all sorts of education. Looking at, you know, resources that are available. I've really appreciated some of the work on the raise framework in terms of really not thinking so much about all of the testing, but really thinking about what does this individual need to do? And how can I identify as much personally meaningful stimuli as possible, because that's the only thing we should be focusing on, right? So I think to that end also, it really clarifies what my approaches and forces me to be as efficient as possible, and then really be flexible. There's one gentleman in particular I'm thinking about where, you know, we've started out, and he didn't really require too much in the way of language support. So it was more like, what do you want to talk about and maintaining, you know, a multimodal language, practice opportunities. And then, as things have gone on and change, we've really run the gamut from like starting, you know, starting with an iPad, and you know, a higher tech, aac option, and then kind of seeing that that's not really going very well, or it is a little too challenging for this particular family, and then very quickly pivoting to something that's more accessible. So yeah, it's to me. It is it is a family centered situation, and you know it's interesting.I have a wonderful aphasia center near me, and I love them, and I refer everyone to them. But they are very much clear that Ppa and sort of that aphasia community center feeling doesn't really work well in their experience. And so I brought this, you know, again to the aphasia access community to, you know, at the Leadership Summit, and said, You know, how does this work? And it's just really complicated. And what you'd said earlier about, you know a family being able to look ahead and say, okay, this is what I want. I have found in the Ppa clients that I've had. They actually avoid that because I think they don't want to see it. It's too much, they've said, you know. And so I tried to be a little bit of a matchmaker. I had 2 gentlemen, both with primary, progressive aphasia, you know, scientists very loving wives, you know, really like they were so ideally suited to connect and it was almost like they didn't want to see this other individual, even though it would have been wonderful for them to connect there. I just found and this is probably happened in, you know, 75% of the cases I've had so far, they are reluctant to see someone else with. Ppa.   Jerry Hoepner: yeah, interesting and I think that's one of those challenging things where we have to like your principle of matchmaking, and where we have to think about how we get there, right? Because there's always things that we don't want to talk about, or we want to avoid to some extent. But there's always a a bit of us who knows there's a need for that, too, and finding ways to make that threshold of building those bonds and those relationships is definitely a part of that even if it doesn't start out with. Hey, talk about what primary progressive aphasia looks like further down the road, but just to be able to build some of those peer connections? Lauren Schwabish: and not know that, or know that you're not alone. I think that that idea that we talked about with families as well. So yeah. And what I found probably is a more successful avenue is really sustaining those family connections. So that's where I found that sometimes the community of course I want them to be able to see someone who's, you know, just as bright, who also has aphasia where things are changing. But what I found greater success in is looking to the sort of family as a community and saying, What can we really do in this contact, so that you can continue to, you know, ask your grandkids about, you know how school is going, or give advice to your you know newlywed son about you know life nowadays, you know. So, some of it is really trying to figure out how can I use those family connections? And then to me and anyone who knows Ppa knows it's so much about counseling. So really, being a provider of I would say hope and I think that that's one of the things that really is important is to say we can still have participation, meaningful life activities, even though things are getting to look a little different. And so the one family I'm thinking about. They have this beautiful vacation house on the bay in Ver. In Virginia, and you know they love to go on vacations like this is a family that lives a great life and they really feel that they have to kind of reel it in, because, oh, my gosh! You know Dad has aphasia, and you know what if? What if? What if? And my perspective is? No, we need to make sure he's still going on vacation. And here's a communication tool, so that you know we can do that safely. Or here's how we're gonna navigate his communication in that situation so that he can participate. And that's probably been a great source of creativity. And also kind of success. Is the family as community? Jerry Hoepner: Yeah, absolutely involving those family members and allowing them to make those connections, as it, you know, as if they're comfortable. And that principle of hope cannot be overstated right? Just how important that is to keep people engaged, because as soon as you start thinking about the downside that's when you want to just withdraw and kind of close in on yourself. But that hope is the light that people need to see in that moment. So completely agree. From your perspective, why is this person centered approach so crucial for a person with primary, progressive aphasia and their family. Lauren Schwabish: I think, as we see sort of the deterioration that comes. you know there's so many there's so much value. And really looking at who you're you know who you are. Who is this individual? And so, being able to remain connected to things. They are passionate about friendships they've had forever. You know things that really get them excited. I have a gentleman who is like a he was a food researcher, a food scientist, and he actually absolutely loved being in this professor role. And you know, all of a sudden. He's his family is, you know, very attentive, and they're, you know, bustling around and doing all these things for him, and he just lights up when he gets an opportunity to explain a scientific concept or look at a scientific journal, or attend a conference like we encouraged him to go, and he attended a conference, and we practice the names of the researchers he was going to meet. And you know questions he might be able to ask and I think so much of it is. You know we're looking at someone who's essentially fading away, and that's so scary. And so if I can say, who are you? You know what's important about you? What should I know? What should your family maintain? And then we build a communication support system around that I think it allows them to continue to see the individual, even though there's a neurodegenerative process. And so things like I had one client who wrote his own obituary, and in doing that he gathered all of his. You know he was he had a lengthy Cv. He had done all this wonderful work, and so it was a chance for him, and it was of his own request he wanted to do this and I just said, Let's go because it was a chance for him to relive his professional connections. It was a chance for him. Talk about you know, areas of study where he had contributed. So to me, it's really about preserving the identity and recognizing and being able to have a again a tangible communication book, memory book, whatever they want to call it. Practice words. You know, stimuli photos. Anything that really says this is who I am And so that remains a touchstone where families can say, you know, even if the level of support changes over time, we still can have that person and be that person. Jerry Hoepner: Yeah, II think that's just another one of those grounding principles. I I'm not making fun of you. When I say this, you've said who I am or who you are multiple times. And and that focus on identity is so crucial. And I think another piece I've been really into reading work on personhood, and that idea that yep, this person is fading. Their cognitive and language abilities are changing but they're still intelligent human being inside. There's still someone who deserves your time and attention, and still has many of the thoughts and kind of knowledge of their life. I think really important for families, and anyone who interacts with them to just recognize that personhood and and that identity of who they are. Lauren Schwabish: it's also so easy to see what's going wrong or what could go wrong, that I think, also maintaining someone's competency and finding ways to reveal competency to families is so important. So like my one of my clients is much better at writing than he is at initiating verbal language, and so for him we haven't texting people right? And they are sort of like rolling their eyes like he's got his phone out again. And I'm like, yeah, cause that's how he's gonna communicate with you. And he will text me pictures and videos from family gatherings. And you know, it's really become a tool that shows his competence. And so you know, that's another opportunity. And why skilled intervention is so important even in the scheme of neurodegenerative disease is because there's always something that we can do to show that person and show what they're able to do. We just have to think of the way to do it. Jerry Hoepner: Yeah, absolutely. I love that. You came to Aura Kagan's principles of acknowledging and revealing competence in a time when someone is like you said, fading and and losing some abilities even more important that we hold onto those principles. So I'm really interested. What does that look like in a session? What do your sessions? How do they look? Lauren Schwabish: Yeah, it's every session looks a little bit different. Some of it is. I just want them to introduce themselves to me. And that's usually what I'll say is, you know I'm new to you. What can you show me? What can you tell me? And what can I look around in your environment. And I'm so fortunate in the private practice I've constructed is I'm a mobile therapist. And so I get to go to people's homes. And you know, even just being in that space can tell you so much and so you know, trying to really invite opportunities. Knowing how to ask the right questions. You know a lot of those carefully constructed open ended questions and then trying strategies here and there to see what really helps support someone's language. So I have one gentleman who he's he loves cricket and you know there's really no cricket on when I'm at his house but he and I have discovered over working together that having written notes as I'm listening to him, and I'm capturing, you know, content words and keywords he's able to say I write them down, and then he and I kind of have them on the table in front of us And so with cricket, He wanted to tell me. I said, I've you know I've played it like long ago. I really don't ever get to see it. What can you tell me? What can you show me? And then giving him a a vehicle to do? That drawing was a perfect way for him to show. You know, and this is a gentleman who's no longer writing. He's actually not really using any texting, or, you know, ipad, he has all of these devices. Unfortunately, not a lot of them are. Does he really feel comfortable if he could engage with them? But again, it's about what he would like to do. But a pen and paper was so effective and so with that, as he's drawing the sort of circles, and and you know the the lie out of the pitch of cricket. He's suddenly writing numbers, you know, and then he's able to point to those numbers and express those to me. So that's one version. One of the things that I talked about at the aphasia access summit and was really fun is looking at photos on the phone. So another gentleman the one with the big family, and he's always taking pictures. And so what we had discovered was this captioning strategy where I could just swipe up with him, and because his writing is a strength, he's then able to put in the names or events of family members into the photos. And that's been really fun. So that we're really trying to find that strategy where he can continue to use the stronger modality in the context of ample stimuli, because this guy takes pictures of everything. And then, as he's sort of declined a lot of it is trying to meet the needs of the family, so making sure that they know what communication supports are. Some of it's just thinking about safety, too. You know, making sure that right off the bat, this person has some sort of identifier on them. For stuff that's starting to get lost. How do we use technology, you know. Air tags and tiles and all those cool things. How do we maintain his independence and community? And that's been tricky lately is, you know, providing education resources related to driving. And how do we know when it's time to stop driving? You know these are sort of things where I have become just a trusted advisor to the family. And so, if I have a resource, I think that's important that we recognize our roles look so different in these sessions. And that's okay, because what we're doing is we're providing again, person center care trying to highlight what their priorities are and support the family. So that they can make that happen too. Jerry Hoepner: Absolutely. Since the aphasia access summit that swiping up for the captions is something that I do quite a bit lot of my people. So I really appreciate that. I'm glad you brought that up again. Yeah, I feel like this has really brought us full circle, and with that emphasis on the family and the person as the core. Really. I mean family identity, and what that individual wants and needs to do what drives them. Seems to be at the core of these approaches, and that definitely aligns with what aphasia access and the life participation approach is trying to accomplish. So thank you for your insights and and creative ideas about this anything that we missed in terms of the discussion about primary, progressive aphasia or parenting. Lauren Schwabish: I will just say that as someone who's sort of like done this by my gut instinct. It's so wonderful when I can go to the research. Not so much for the parenting is like you said, there's you know I it's not a ton of ample of evidence body of evidence yet, but it is so reassuring to have access to meaningful research that really supports You know just an Lpa approach it as a clinician like boots on the ground. I've really valued that I've loved podcasts and resources. I've had access to in terms of counseling. I think validating that counseling is important. I'm grateful to the fact that you know we even payers like Medicare. You know that there's a space now for the role of a skilled speech pathologist to follow along and to perform therapy over the course of a neuro, degenerative condition. You know, I feel like sometimes I've heard. Oh, you know, I think I'm guilty of this when I was working in the hospital setting, and someone would come in with some sort of acute process but then there would be dementia. I really feel like I was like well, they can't learn, or you know they I was so dismissive of someone's capacity. And I have changed completely in terms of being able to say, you know what there's individuals I work with, whether it's Ppa or another dementia process. Just to be able to say there's always value in finding a communication system or communication tool to really allow that person to connect with whomever they want to and so I think the fact is that I'm in a community that, you know is is interested in that. I have a practice that is, you know, working well because of that I'm able to get paid by payers because of that. So I really think it's important for people to recognize that. We can fulfill such a valuable role and there's actually wonderful resources out there that will justify this approach. Jerry Hoepner: Totally agree. Yeah, there's always value in fostering participation. Whether that's going to help someone recover, or whether that's gonna help them. You know, in their in their decline gracefully, and to remain engaged as long as they can so totally agree. Well, thank you, Lauren, this has been a fantastic conversation. I know our listeners are gonna value your clinical insights. So thank you. And it's been really nice talking with you. Lauren Schwabish: Oh, it's been a joy. Thank you so much.   Jerry Hoepner: On behalf of Aphasia Access, thank you for listening to this episode of the Aphasia Access Conversations Podcast. For more information on Aphasia Access and to access our growing library of materials go to www.aphasiaaccess.org. If you have an idea for a future podcast series or topic, email us at info@aphasiaaccess.org. Thanks again for your ongoing support of Aphasia Access.

EPISODE 28: Over the years, as I parented an autistic child, worked with parents of autistic kids, and met many beautiful and amazing autistic individuals, one thing has always stood out to me:The world doesn't always recognize the wonder in these incredible individuals as I see it.And I've always wished that others could see these humans in their true light. Every moment spent with them has only deepened this desire. This feeling led me to Barry M. Prizant, Ph.D., CCC-SLP, as his book "Uniquely Human" instantly hooked me.And now, I've brought him onto our show. To say I'm thrilled is an understatement.About 50 years ago, as a teenager, Dr. Barry Prizant started his journey helping kids with disabilities at summer camps. Those early years gave him a peek into what these families face daily. Today, he is recognized as among the world's leading scholars on autism and neurodiversity and as an innovator of respectful, person- and family-centered approaches in supporting neurodivergent individuals.He currently serves as the Director of Childhood Communication Services and is an Adjunct Professor of Communicative Disorders at the University of Rhode Island. With fifty years of experience, he has established himself as an international consultant and researcher. He's not just an expert but also a bridge to understanding. Barry co-produces and hosts the Uniquely Human podcast with his friend, Dave Finch, an autistic audio engineer and New York Times best-selling author.He is the author of five books, with “Uniquely Human: A Different Way of Seeing Autism” being notably published in 26 languages. Additionally, he has written more than 140 articles and given close to 1000 presentations at major universities across the US and in over 25 countries.Apparently, he's made it his mission to shed light on the true essence of autism.In this interview, Barry talks about common misunderstandings about autism, how parents can best support their kids, what true understanding looks like, the “it factor” some people have, and more. Join us and see autism through a fresh lens.Key Takeaways:Intro (00:00)Who is Barry Prizant (02:07)Why is Barry so passionate about showing the world a new view of autism? (04:51)The most common misconceptions about stims and non-speaking individuals (07:29)The most common misconceptions about meltdowns (13:48)The it factor (24:25)The one thing struggling parents need to know (32:22)Find Barry's work here (37:01)It's okay to trust your intuition (42:30)Additional resources:Get your copy of Barry Prizant's book Uniquely Human: A Different Way of Seeing AutismCheck out Uniquely Human: The Podcast Visit Barry Prizant's website Check out Barry Prizant's comprehensive educational approach being implemented in more than a dozen countries - The SCERTS Model Check out the websites of these organizations that support non-speaking individuals:CommunicationFIRST Communication 4 ALL I-ASC - - - 

Every year, timeless verities related to getting into college–or even what colleges a student can get into–give way to painful, new truths and exciting, new opportunities. Amy and Mike invited educational consultant Rebecca Stuart-Orlowski to return to the show with admissions notes for the HS graduating class of 2024. What are five things you will learn in this episode? What does it truly mean to build a balanced college list?  What's a good way to help manage expectations for students who are applying to highly selective colleges?  How optional are test scores in the current admissions cycle? What other majors might a Computer Science student consider in light of admissions challenges for those increasingly popular programs?  What should students know about the University of California admissions and what are some alternative ideas for colleges?  MEET OUR GUEST Rebecca Stuart-Orlowski, founder of Orlowski College Consulting, has worked in education for 35 years and has worked as an Independent Educational Consultant for 10+ years. She has a specialized Certificate in College Counseling from UCSD, a BA in Communicative Disorders from San Diego State, and two active teaching credentials. She taught deaf, LD, and 2E students for four years and was a college counselor at a small private school for 3 years. Rebecca specializes in gifted/2E, STEM, creative, homeschooled, and transfer students. Rebecca first appeared on the podcast in episode 369 to discuss ADMISSIONS NOTES FOR THE CLASS OF 2023. Rebecca can be reached at r.orlowski.consulting@gmail.com. LINKS What Are Your Expectations?  Admissions Trends for the HS Class of 2023 College Kickstart How many reach, match, and safety schools should be on your college list? Should Today's Students Take the SAT & ACT? Should You Apply Early Decision? RELATED EPISODES LONG-TERM PLANNING FOR COLLEGE ADMISSIONS COLLEGE ADMISSIONS INSANITY USING THE COMMON DATA SET ABOUT THIS PODCAST Tests and the Rest is THE college admissions industry podcast. Explore all of our episodes on the show page. ABOUT YOUR HOSTS Mike Bergin is the president of Chariot Learning and founder of TestBright. Amy Seeley is the president of Seeley Test Pros. If you're interested in working with Mike and/or Amy for test preparation, training, or consulting, feel free to get in touch through our contact page.

Thinking about starting an adults-focused private practice?In this episode of Private Practice Success Stories, I sat down with one of my Start Your Private Practice students, Lauren Schwabish, to talk about how she started her own private practice during the pandemic and is loving working with adults with brain injuries, aphasia, and executive functioning deficits. Lauren shares where she gets clients, where she sees clients, how she handles billing, and her plans to get more into consulting. Lauren Schwabish M.S., CCC-SLP is the owner of Neuro Speech Services, a private practice based in Northern Virginia, specializing in person-centered assessment and treatment of cognitive-communicative disorders related to stroke, brain injury, concussion, ADHD, and other neurologic and neurodegenerative conditions. Lauren received her Bachelor of Science degree with Honors in Communicative Disorders from the University of Wisconsin-Madison and holds a master's degree in communication sciences from Hunter College of the City University of New York. She is licensed in the Commonwealth of Virginia and is a certified member of the American Speech Language Hearing Association. She has over 22 years of experience working in hospitals and acute rehabilitation centers and is passionate about providing meaningful and accessible health education about the brain to patients, families, and healthcare professionals. In Today's Episode, We Discuss:How Lauren got started in her career and why she decided to start a private practiceWhy Lauren loves being a private practice ownerHow the Start program taught her the business skills she needed to succeedThe importance of building up a referral networkThe freedom private practice gives you to do the work you're passionate aboutThe consulting work that Lauren is doing along with her private practice workLauren's plans for her business in the futureI hope you enjoyed this episode with Lauren! She took her decades of experience and is now fully in control of her life and her clinical practice by having her own private practice. She is an example of someone who wanted something and went for it and I hope you found her story as inspiring as I did. If you want to learn more about how we help SLPs and OTs start their own private practices, just like we helped Lauren, head over to https://independentclinician.com/learn-with-jena/..Whether you want to start a private practice or grow your existing private practice, I can help you get the freedom, flexibility, fulfillment, and financial abundance that you deserve. Visit my website www.independentclinician.com to learn more.Resources Mentioned: Visit Lauren's website: https://www.neurospeechservices.com/Follow Lauren on Instagram: https://www.instagram.com/neurospeechservices/Where We Can Connect: Follow the Podcast: https://podcasts.apple.com/us/podcast/private-practice-success-stories/id1374716199Follow Me on Instagram: https://www.instagram.com/independentclinician/Connect on Facebook:

This week, we are joined by two board members from BABA, Black Applied Behavior Analysts. Dr. danyelle beal is a Clinical Psychologist whose dissertation research focused on resiliency factors in Black women who have survived trauma in their youth. She obtained her undergraduate degree at CSU Long Beach in Child Development and Psychology with a minor in Communicative Disorders and went on to obtain a Master's of Art in Teaching (Deaf and Hard of Hearing Studies) with an emphasis in Applied Behavioral Analysis. Camille "Cammie" Williams is a Black, lesbian, cisgender woman who holds the title Board Certified Behavior Analyst (BCBA). Her work focuses on diversity, equity, and inclusion (DEI), social justice, autism and exceptional needs services, mentorship, advocacy for Ovarian Cancer and systematic self-love & self-care.Today we will talk about Trauma Assumed Care and the need for support for Black Clinicians and the Black Families they service. Dowload lastest episode to learn more! Resources: https://msha.ke/danyellebeal  Instagram: cammiepartonspears Facebook: Cammie Morgan   Why Are All The Black Kids Sitting Together In The Cafeteria, Post Traumatic Slave Syndrome: America's Legacy of Enduring Injury and Healing, The Role of the Behavioral Scientist (written by Dr. Martin Luther King Jr)   White Tears Brown Scars by Ruby Hamad   . . . . . . . . . . . . . . . . . . . . . Autism weekly is now found on all of the major listening apps including apple podcasts, google podcasts, stitcher, Spotify, amazon music, and more. Subscribe to be notified when we post a new podcast. Autism weekly is produced by ABS Kids. ABS Kids is proud to provide diagnostic assessments and ABA therapy to children with developmental delays like Autism Spectrum Disorder. You can learn more about ABS Kids and the Autism Weekly podcast by visiting abskids.com.

Is it really challenging for homeschooled students to get admitted to college? Regardless of whether the student attended a public, private, or homeschool, as long as they have strong communication skills, the student will be fine. In this episode, Rebecca Stuart-Orlowski shares how to positively present homeschooled students through the college application process. HIGHLIGHTS:Strong communication skills by both the parent and student are essential for homeschooled familiesHow to overcome barriers for homeschooled students applying to collegeSpecial considerations in the college application process for homeschool families Advice for college-bound homeschools families around test-optional policiesWhat families with 10th and 11th graders can do to make the future application process easier Meet Our GuestRebecca Stuart-Orlowski has a Specialized Certificate in College Counseling from UCSD, a BA in Communicative Disorders from SDSU, and two active teaching credentials: Multiple Subjects w/ a Multicultural Emphasis and Communicatively Handicapped. She taught deaf, deaf/blind, LD, and twice-exceptional students for four years in Chula Vista and San Diego, and was an educational consultant for a small private Catholic PSP (Private Satellite Program) for three years. She has been an IEC since August 2012. Long before Rebecca moved into her career as an IEC, she was honing her communication skills that currently serve her so well. Rebecca performed professionally as a jazz dancer for over 20 years for the likes of The Beach Boys, Bill Gates and Microsoft, and Visionary Dance Theatre, where she was a choreographer, teacher, and soloist. Her final choreographic piece can be found here: https://www.youtube.com/watch?v=AJ85xnwK0as  Performing and interacting with professionals from all backgrounds lends itself well to her job as an IEC. Rebecca is a professional member of IECA, co-chair of the IECA Homeschool Affinity Group, and a member of NACAC and WACAC. She is the parent of two Davidson Young Scholar Alums and presented at a Davidson Young Scholar Summit on 2E children in 2021. Each fall, she speaks to homeschoolers and their parents on the topic of homeschooling and college admissions for her local homeschool co-op. She has been independently homeschooling for 25 years and will graduate with her third and last child in June 2023.  She specializes in gifted/2E, STEM, creative, homeschooled, and transfer students. Listen on…the Flourish Site, Spotify, Apple, Google, Amazon Music, Stitcher, or your favorite platform. “College & Career Clarity with Lisa is so helpful!”  ← Is that you? If so, please consider rating and Connect with Lisa: Website: https://www.flourishcoachingco.com/ YouTube: https://www.youtube.com/@flourishcoachingco Instagram: https://www.instagram.com/flourishcoachingco/ Facebook: https://www.facebook.com/flourishcoachingco LinkedIn: https://www.linkedin.com/in/lisa-marker-robbins/

Tiffany Anderson is a Master's Degree holder in Communicative Disorders and a former speech therapist with 12 years of experience. She discovered her passion for direct sales eight years ago and became a top performer in the industry, with four years as a top sponsor and ranking in the top 10 in sales for a women's clothing company. In 2020, she began coaching others in direct sales using the BANK methodology, a science of buying behavior that helps sales professionals understand their prospects better. Tiffany's approach to coaching incorporates the BANK methodology, which uses personality coding technology to understand prospects better and increase the chances of making a sale. As a certified practitioner of the BANK methodology, Tiffany has helped many sales professionals gain a deeper understanding of their customers and close more deals.Connect with Tiffany here: https://msha.ke/passionatelylivinglife?mibextid=unz460Send me a text, what questions do you have?Support the Show.Our mission at The Podcast Empire is to help purpose-driven women in business launch a profitable podcast to build their brand and influence WAYS YOU CAN WORK WITH TRACEY LEE COOK:

As a law enforcement spouse, Monda has seen firsthand the devastating effects of a loved-one's battle over depression, PTSD, and attempted suicide. Leveraging a master's degree in Speech-Language Pathology and Communicative Disorders from UCF, Monda helps first responders and their spouses recognize the signs and symptoms of deteriorating mental health so that they can best support each other's needs and live a happy and healthy life together. An accomplished member of the non-profit community, Karen Monda has a long history of fundraising for national and global non-profit organizations including St. Jude's, The Florida Wildlife Hospital, the Humane Society, and the Dystonia Medical Research Foundation. Find out more at https://survivefirst.us/

Welcome to this Aphasia Access Aphasia Conversations Podcast. My name is Janet Patterson. I am a Research Speech-Language Pathologist at the VA Northern California Healthcare System in Martinez, California, and a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their efforts in engaging with persons with aphasia and their families through a variety of educational materials and resources. I am today's host for today's episode that will feature Dr. Nina Simmons-Mackie and Dr. Jamie Azios. These Show Notes accompany the conversation with Dr. Simmons-Mackie and Dr. Azios but are not a verbatim transcript.         In today's episode you will learn about: Lache Pas La Patate! and aphasia The importance of being mindful of gap areas in aphasia service and research Moving aphasia care best practices from knowledge to action Dr. Janet Patterson: Welcome to our listeners. Today I am delighted to be speaking with two individuals who are well known in the field of aphasia rehabilitation, Dr. Nina Simmons-Mackie and Dr. Jamie Azios. Nina and Jamie authored the text, Aphasia in North America, which is also known as the State of Aphasia Report. The original State of Aphasia Report was published by Aphasia Access in 2018, and contains information describing, among other topics, the frequency and demographics of aphasia and its impact on individuals and society, and aphasia services and service gaps. The State of Aphasia Report is a valuable resource for clinicians, researchers, administrators, and third-party funding agencies as we seek to craft a rehabilitation atmosphere that balances the treatment evidence base, the resource support for community aphasia groups, and the principles of client centered care. An updated State of Aphasia Report is forthcoming.   Each of our Podcasts in 2021 and 2022 highlighted at least one of the gap areas in aphasia care mentioned in the original State of Aphasia Report. For more information on the original State of Aphasia report, check out Podcast Episode #62 with Dr. Liz Hoover, as she describes these ten gap areas and their impact on aphasia rehabilitation. Our conversation today takes a broader view of the aphasia service gaps, crossing all ten gap areas. My questions for Nina and Jamie will ask them to reflect on the impetus for the original State of Aphasia Report, as well as the changes that appear in the updated State of Aphasia Report.   My first guest is Dr. Nina Simmons-Mackie, Professor Emeritus at Southeastern Louisiana University in Hammond, Louisiana. She has received the honors of the American Speech-Language-Hearing Association, the Louisiana Speech-Language-Hearing Association, and the Academy of Neurologic Communication Disorders and Sciences. She has published numerous articles and chapters and has had many years of clinical, academic and research experience in the area of adult aphasia. Also joining me today is Dr. Jamie H. Azios. She is the Doris B. Hawthorne Endowed Chair in the Department of Communicative Disorders at the University of Louisiana in Lafayette. Her research interests include qualitative research methodologies, understanding perspectives of people living with communication disabilities, co-constructed conversation and aphasia, and the impact of communicative environments on social participation and inclusion. She has published articles related to client centeredness, communication access, and life participation approaches to aphasia. Welcome Nina and Jamie to Aphasia Access Conversations and our discussion about the State of Aphasia Reports.   Dr. Nina Simmons-Mackie: Thanks Janet, happy to be here.   Dr. Jamie Azios: Really excited and honored to be here. Thanks for having us.   Janet: Good, and I look forward to a great discussion and learning about the State of Aphasia Reports. Nina and Jamie, I would like to begin our chat today by asking about the original State of Aphasia Report. Many of our listeners are familiar with the book, which is a resource published by aphasia access, describing the social, financial and life quality consequences of aphasia. It contains current statistics, compelling stories, and a one-stop report to understand the state of aphasia care in North America. Nina, you were the impetus for this project and oversaw its production. How did you organize a team to think about the need for this project and envision the value it could provide to people with aphasia, clinicians, medical and rehabilitation professionals interested in aphasia, administrators, and organizations who fund aphasia research?   Nina: Well Janet, when I started out in the field of aphasia, it wasn't all that difficult to review the literature on an aspect of aphasia. Now, the amount of information is just overwhelming. A kernel of an idea started forming as I was involved in a variety of projects that required a huge amount of effort gathering statistics and references to justify different types of services for aphasia. As I talked to lots of colleagues floating the idea for a comprehensive report, everybody agreed that it would be immensely helpful to pull data from diverse sources into one document. Something that could be a quick reference for grants or advocacy or program proposals.   I also had some personal experiences at the time that highlighted some gaps in the system of care for aphasia. So, it really struck me as a worthwhile undertaking and the board of Aphasia Access was really supportive of the idea. We succeeded in pulling together a diverse team of experts to serve on an advisory committee to review the chapters and vet the information. The report was originally envisioned as a relatively brief statement of gaps, but as I got into the literature, I realized that it was too much for just a short paper. In fact, it turned into 163 pages in the original document published in 2018. Now, it's been about five years since this publication, and so much has happened in the aphasia world. So, we felt like it was time for an update. Next year, we hope the state of aphasia will be published. Jamie graciously agreed to join me in this project, researching and writing the updated report. Jamie, you might have some comments on the update.   Jamie: Yeah, it's been so fun to work on this project with Nina. I've learned a lot from reviewing all the work in our field, and other fields too. Just getting my feet wet with the kind of experiences that Nina was talking about, pulling together this key information from so many places. It's been really challenging, but it's also been really rewarding.   I didn't realize just how much has changed in the last five years. There're just some amazing things happening in terms of aphasia programming, and technology, and attempts at overcoming gaps and equity and inclusion. That's not even talking about the way stroke and aphasia care has been impacted by our worldwide pandemic. So, in terms of what's new for the update, you can expect us to hit on all those new key areas. We're really going to try to highlight both the gaps and solutions over the last five years.   Janet: You both describe such an exciting project. Time flies, and things happen. And if you get busy in your own little world, sometimes you don't recognize all the things that are going on around you and all the changes. This is a great idea that you had 100 years ago Nina or maybe five or six. I'm glad Jamie, you're part of the current project. One component of the original State of Aphasia in North America is a list of ten gap areas, and you mentioned those a moment ago Jamie, gap areas in aphasia care and aphasia research. In planning our podcasts, we identified at least one of these gap areas to highlight in each interview. The ten gap areas are listed in the show notes for this conversation and discussed in Aphasia Access Podcast Episode #62 with Dr. Liz Hoover. So, Nina and Jamie as well, how did your team identify the gap areas for the original State of Aphasia Report and consider the potential for their influence on aphasia care and research?   Nina: Well, really the gap areas grew directly out of the data. It was similar to a literature review. The main difference is that a typical literature review addresses a specific topic, whereas this report addressed any topic that might be useful to advocate for aphasia services. So, the sources included government statistics, some original surveys of clinicians in North America, and grey literature. Both Jamie and I have a background in qualitative research so our approach has been pretty much like qualitative research. We take a broad-based look at the literature and identify themes that seem like topics that would be important in advocating for aphasia services. And then as we dig in and begin collecting the information, the gap areas become fairly obvious. In other words, we don't just think up gap areas. They represent what is described in the aphasia literature.   Jamie: We mentioned this earlier, but one of the big gap areas that's going to be recognized in the update, likely because of the impact of COVID and our shifts to engaging more digitally, is the idea the inaccessibility that people with aphasia have when it comes to using technology. We know that there has always been a digital divide, but it seems like COVID, and the loss of face-to-face contact has really widened that gap. Also widening that gap is just the fact that older people in general are using technology more and people with aphasia seem to be falling behind when compared to their age-matched peers due to these accessibility issues. The data show that people with aphasia don't text as much as other people their age, they seem to have more difficulty retaining technology skills, they have difficulty using social media platforms. We know that these things are critical for maintaining social connection. So even before COVID, we saw an increasing use of technology to access information, interaction, across a range of activities. But during COVID, and even after COVID, there's an absolute explosion. We do plan to dedicate a chapter to technology and accessibility.   Janet: That's good, which leads me right into my next question for the two of you. I wonder if you would reflect on the original State of Aphasia Report and its contents and describe the changes in the information in the updated State of Aphasia Report? In particular, would you comment on the ten gap areas in the original report, and any changes in the updated report? I know you've alluded to a few of them in the last few minutes, but I'd like you if you will, take a few more minutes to be a little more specific about the nature of the gap areas, and how they're changing as we look forward to the updated State of Aphasia Report.   Nina: I think the original report definitely raised an awareness of the gaps and aphasia services. Those gap areas remain relevant, so it's not like we're going to drop out gap areas. But the good news is that there's been a surge in the research and the literature relative to some of those gaps. It's typical that there is a significant lag from research and publications to implementing research into actual daily practice. This is what's interesting relative to the update, looking at how those gaps have affected actual daily practice. I think there have been two Podcasts on implementation that aphasia access has presented. One was Rob Cavanaugh talking about issues in implementation back in October, and Natalie Douglas talked about implementation science in 2021. That's significant relative to the gaps and aphasia services that we've recognized. I'll give you an example. A very recent Podcast by Sameer Ashaie addressed mental health and people living with aphasia. Mental health services was a big gap identified in the original 2018 report. Now, as we've updated the report, we find that attention to mental health and daily aphasia practice continues to be a significant gap. Not many SLPs are screening for depression and mental health professionals remain relatively uninformed about how to conduct counseling with people with aphasia. But it's been said that approximately seven or eight years is often the time it takes to move from research to implementing research in daily practice. The good news is that the literature in the area of mental health, for example, has surged since the 2018 report. We found 47 new papers on mental health and aphasia published in just the past five years. That's a typical journey that we see from a gap in service to implementation of the services and awareness of the problem and recognition of the need to change have to happen first. I think we've met that requirement of building awareness of a lot of these gap areas.   Now, we have to focus on how to move from knowledge to action, meaning that SLPs and other health care professionals have to figure out how to address things like mental health in daily practice. I see the report as helping us see where we are on that road to best practices, and possibly pushing faster than the seven-to-eight-year gap in research to practice. Also, one of the gap areas was in SLPs addressing participation in daily practice. A very similar thing seems to have happened in that there's an increase in research in participation-oriented activities and therapy. But the actual practice, according to a survey that we've done recently shows that SLPs are about the same as they were in 2018, relative to actually integrating participation-oriented tasks into daily practices. I think it gives us an outline of where we have to move with this current report.   Jamie: Yes, and that makes me think of some of the work that I'm working on now for the updated version in communication access, which was also a gap area in the original version of the State of Aphasia Report. Something that's really struck me is that over the last five years, so far there's been 25 new communication partner training studies in healthcare settings. That includes training healthcare providers or healthcare students that are going to be working, mostly the studies are in hospitals. That's amazing, in the past five years that's a lot of work that's been done in that area.   But the other thing about that work is that has helped us learn more about the complexity of delivering an intervention like that within a health care system. A lot of the studies that have come out have also showed, by interviewing nurses and other health care staff that have been trained, that even after training healthcare providers still seem to have a really narrow understanding of what communication supports are, or there might be a burden for implementing those into their daily routine care tasks and other things that they're doing. In general, nurses have expressed more critical than positive views about the relevance and the usefulness of communication partner training. It seems like healthcare professionals know the strategies are good. They know they need to use the strategies, but then they kind of get stuck in a place of uncertainty about how to switch up when it doesn't quite go the way that they expect it to go in an interaction. I remember one of the quotes from a paper that talked about this was a nurse saying something like, “I went to use a strategy. I know it didn't work. The patient became increasingly frustrated, and I needed to use a different strategy, but I just didn't know what to do.” So, in thinking about moving forward, it's great that we see this work coming out, but it's a continued focus on shaping these programs and understanding the systems that maybe we need to approach it a little bit differently or make some adjustments so that we're really carrying through with the goal of the intervention and the outcomes are as we expect them to be and are positive.   Janet: This is exactly research into practice. Isn't what you just described, Jamie, much like all the human nature that we do? When we first learn something we're not so sure about it, and we don't quite know what to do when things don't go as we anticipate. The more familiar we become, the better we are at switching up as you say or changing or keeping our goal in mind, which is exactly what I'm hoping that we can talk about and the information in this updated State of Aphasia Report will help clinicians and researchers.   Nina, you mentioned two things that are something that I think about a lot and first of all, was your comment about the Podcast with Rob Cavanaugh. That was my Podcast with him, and we had a wonderful conversation. I love his ideas paying attention to, how do we actually deliver the service and are we doing what we think we are doing? And given the specific confines that we are working within, are we able to achieve the effect that we want, or do we have to make some changes? To me that seems like an important line of thinking and of research coming up about how we can make a difference given what we have or given whatever constraints we have.   The other comment that you made is about depression and mental illness. I think back to my Podcast with Rebecca Hunting-Pompon and some work that she's been doing, really looking at depression and the prevalence of it among people with aphasia, and it's greater than we think. So, your comment about identifying it as a gap area and what we're going to do. How are we going to take research into practice so that we can actually address those points that you're making. Which goes into my next question to ask you, as we look forward to the future of aphasia care, and specifically, as we move from research into practice, how might you see the information in the updated State of Aphasia Report and the gap areas that you'll identify within that publication? How do you see that continuing to guide aphasia care and research?   Nina: I think like the first report, the updated report will continue to raise awareness of major areas of need for people living with aphasia. I think it'll continue to serve as an advocacy tool. I know people have told me that they've pulled out parts of the original report to present to administration, and people have borrowed statistics to put into grants and things like that. So, I think those kinds of activities would continue. The report highlights areas where research is desperately needed. For example, there's a whole section on social isolation in aphasia, and we have data that's grown in the past five years verifying that this is a problem. This updated report shows that we haven't really seen very much in the way of intervention research or models for relevant interventions to address social isolation. I think as people read the report, they'll recognize areas where research is needed, and exactly where models need to look at practical ways to implement these different interventions. The report can highlight those kinds of questions so that researchers and clinicians can begin to address those questions in the next five years. It's just kind of a little push to keep the system moving along to be more efficient and more focused on addressing the needs of people living with aphasia.   Jamie: You know, another thing is, I think it's going to be good as Nina said, directing researchers and clinicians into maybe some practices that we need to make sure that we incorporate whenever we're thinking about what research is valuable, and what research is worth doing and the impact of that research on the people with aphasia. Something that's coming up as maybe a new gap area or continued gap area is the idea of stakeholder engaged research and including people with aphasia in that process. That was another Podcast that we just recently, I think, had in the last month or so. Something that Dr. Jackie Hinckley said that really struck me was that research that's produced in collaboration with stakeholders is efficient, even though it's more time consuming. That's because it has a better chance of making it into actual clinical practice. It can also be incorporated much quicker than research that's solely dictated by the interest of the researcher who likely doesn't have a full understanding of the barriers or the institutional problems that exist in a space. So, that's another idea of just thinking forward in ways that we hope that these gap areas are going to be addressed.   Janet: Both of you just in answering this last question and in things that you've said earlier, have touched upon the concept of how do you go from research to practice and most specifically, in the area of clinician work? It's lovely to say things, but how do you actually do it? How do you implement it? How do you get comfortable with a particular action and being able to change course, if that action is not working? I know it's important for aphasia clinicians and researchers to be mindful of the gap areas in aphasia care and to address them in their work, but that is a charge to us that is sometimes easier said than done. During our Aphasia Access Conversations, we've asked guests for their thoughts on how clinicians and researchers can implement actions in their daily activities to address a gap area. Importantly, we've asked our guests to consider actions that are easy to implement yet may have a broad impact on persons with aphasia or the family or the clinical environment.   I wonder if you would each share with our listeners some of your ideas and thoughts on how aphasia clinicians and researchers can remain mindful of the gap areas in the midst of their busy schedules, and feel comfortable incorporating specific actions? I see, and I know you see it as well, you get busy in a clinical life and all the daily activities, and you start to forget, “Oh yes, I should be mindful of the gap, but I forgot because I had a report to write.” So, I wonder if you could give us some very practical ideas, thinking from the perspective of a clinician and how they can bear in mind the gaps and how their actions might relate to them?   Nina: Well, one of the different things in the updated report from the original report is it will include solutions that are drawn from the research literature. But of course, the problem that you alluded to is much of our research is not always feasible in the whirlwind of everyday practices. I think the message for researchers that Jamie alluded to, is to make the interventions that are being trialed more practical by getting the input of stakeholders, of clinicians, of people with aphasia, to see if they're generalizable to everyday practice.   I think the biggest need is for all of us to remain aware of gap areas, so we're not just thinking about language, but thinking about mood, and family needs and daily lives. Awareness of gaps is the first step towards improving those services. One of the things we used to talk about a lot was long-term and short-term goals. The terminology now is sort of moving towards talking about aims and targets of therapy. Using that terminology, we need to be sure that the aims of therapy, that is the ultimate goals, are stated in terms of participation in chosen life roles or activities, not in terms of WAB scores, or how many words a person can name. In other words, the ultimate targets that are worked on in therapy need to lead to meaningful outcomes. To me, one of the most practical things is for us all to envision goal setting in a way that places us in the position of looking at what gets in the way of those big picture aims. It's not always just things like language problems. It may be other things like confidence, depression, poor support for partners, lack of opportunities to communicate with other people. So, thinking more broadly about those ultimate aims or goals for each person with aphasia helps us see what the most efficient targets are for therapy. If a big barrier is depression, then that needs to be addressed or improved, because word finding won't make any difference if the person is too depressed to engage with other people. I guess what I am saying is, being aware of gaps in services and of the domains that impact life with aphasia helps the clinician to orient to what is needed most for that person, rather than what we habitually just go in and do every day.   Another suggestion is to get help. Going back to the example of the mental health needs. Maybe investing initial energy in training some mental health professionals on your rehab team or in your community how to communicate with people with aphasia, and how to do that kind of specialized counseling that's needed for this population. Then, when somebody pops up and you feel that they're depressed, you have a resource there that you can refer the person with aphasia to, so that it doesn't fall on your own shoulders to manage the depression yourself. The same thing goes with using the rehab team to increase participation. So that whole idea of dividing and conquering. As I said, the updated report shows that SLPs don't focus that much on participation-oriented activities. But if the rehab team all identified a participation goal in unison, that interprofessional kind of approach, and then all worked together towards fulfillment of that aim or participation goal, then it takes a little of the burden off the SLP in their daily frenzy of activity.   Janet: You know, Nina, you gave an excellent example. Another good example and an illustration of that was in a conversation with Mary Purdy a little while earlier this year, where she talked about interprofessional education. One of the goals, which is exactly what you said, was how do you get the rehab team thinking about it? The example that she gave was from her own personal experience about everybody was working towards helping an individual. The problem, what got in the way, the individual wanted to knit and couldn't knit. So how do they all work together, from language, from the occupational therapist, and physical therapist, to remove the obstacles and then allow the rehabilitation to consider. So, that's exactly right. And, Jamie, I know you've got some ideas as well.   Jamie: Well, that was just inspiring. It makes me want to go be a clinician every day again in long term care, because it's just really inspiring to think about change in that way of clinical practice. What came to me when you said easy to implement, but have a broad impact, it brought me back to a paper that I was reading. It's by Mia Loft and colleagues, and it's called, Call for Human Contact and Support. It's a paper about stroke survivors and their experiences in inpatient rehabilitation. Essentially, what they communicated was that they just wanted to be treated like humans. They wanted to be asked how they were doing. They wanted to be talked to like they were a person and not a patient. The really interesting thing was that they felt like these negative experiences really derailed their rehabilitation and motivation to get better, because they were so worried about what was going to happen after they left this place, “What happens when I go home? Am I going to go back to work?” These really negative emotional feelings disrupted the very start of their rehabilitation journey. Instead, what they ended up doing was kind of sitting in isolation most of the time and feeling like their interactions with healthcare workers were negative. That made me think back to the tiny habits talk that Linda Worrall gave at IARC. We as SLPs, we're the models for what good communication looks like in those settings. I think it's kind of our responsibility to start building those habits into our own practices. It might change a little bit of a shift in our view about what therapy looks like, and what's our role in that situation. It might take us recognizing the importance of stopping and asking somebody, how are you doing, but really listening. Maybe starting small with some of those tiny habits and being a model can really influence our other colleagues that we're working with of the importance of these small things in the rehab journey for the patient, especially early on when they're dealing with these emotional consequences of diagnosis.   Janet: You mentioned the word motivation, which of course was another previous Podcast with Mike Biel talking about the role of motivation. Everybody says, “oh yes, yes, motivation is important to consider.” But nobody really does much about it. I mean, how do you know if somebody's motivated or not? To your point about sitting in isolation in the care facility, you can't just say that patient is not motivated, therefore, we're not going to do a particular activity. Until you have a discussion, you don't know. You don't know what they want to achieve, which is back to your comment earlier Nina, about what does this patient want to achieve in the long run? What is the aim here? And if you can have those conversations, find out the motivation, I think you have a greater likelihood of a maximum outcome, positive outcome of the rehabilitation journey.   I thought of something and wonder about this idea. Wouldn't it be fun...well, maybe it wouldn't be fun, I don't know, developing a little sort of cheat sheet or a little card that the Aphasia Access might put out that has these gap areas. If it's cute, designed well, it may be something that clinicians could put on their badge or keep on their clipboards. Instead of having to remember it in their brain, it's all right there in front of them - “Remember about these gap areas is you provide a service to an individual with aphasia.”   Nina: That's a great idea. Little infographic that's something people can carry around and remind themselves. Good idea.   Jamie: Yeah, I love it.   Janet: Well, thank you. Let's see if it comes to pass because it truly is, I think very difficult to bear everything in mind when you're in a busy schedule. Anything that we can do to help a clinician have an easier life, like you don't have to remember the gap areas, they're right here in front of you, we'll see. It's an idea.   As we draw this interview to a close, Nina and Jamie, I wonder if you would each reflect on your work and experience in aphasia rehabilitation, and in preparing the State of Aphasia Reports. Are there a few pearls of wisdom, or lessons learned or words of guidance you might offer our listeners, as they interact with persons with aphasia, and approach aphasia care on a daily basis?   Nina: Well, I'm not sure I have any pearls, maybe some grains of sand to irritate the thought process. I think the first point I would make is understanding, or deeply understanding the values of a life participation approach to aphasia, is critical to achieving relevant and meaningful outcomes. I think the most important clinical skill, and I alluded to this earlier, is knowing how to set meaningful participation goals in collaboration with clients. Once we learn this, then the rest sort of falls into place because you're thinking about the big picture and what is important where. I think that's a key thing is learning how to write those big picture goals, and then see how to get there.   I think everyone involved with aphasia should read Linda Worrall's Seven habits of highly successful aphasia therapists. I think her PowerPoint on that topic that she presented is available on the Aphasia Access website. It's a common sense and elegant outline of the Must Do's for any aphasia therapist. It's seven things that make a good aphasia therapist, and if each item on her list were addressed, we could probably scratch off a bunch of gaps in services. I think that's another one of the things that I would recommend.   Jamie: Yeah, that is a great paper. It's been so influential for me and working with people with aphasia, but training clinicians, it's a great paper. I don't have any pearls of wisdom, either. I guess my only advice and Nina you've probably heard this saying before. This is something that is said down here in Cajun country in our French culture. It's “lache pas la patate”. It means, “don't drop the potato”. Essentially what that means is, even when things get really hard, don't give up. So if you're a clinician working in a situation where it's really hard for you to feel like you can achieve some of the things that we're talking about today, don't give up and know that we're all working towards this goal. We are recognizing these issues. I promise you, we're all thinking about these things, and that we're in it together.   Janet: I love that phrase, Jamie. I'm going to learn to have it trickle off my tongue and I'm going to use it frequently. That's a great idea. Doesn't it really describe how we want to be acting as humans. We're all in this together. Be a human. This person with aphasia is another human and we're trying to help this human with aphasia, given the skills that we possess that they perhaps don't. But they possess skills that we perhaps don't so together, we're on the rehab journey. Say it again, the phrase. “lash……”   Jamie: Lache pas la patate   Janet: Lache pas la patate. We're going to remember that phrase.   Thank you, Nina and Jamie for being part of the Aphasia Access Conversations, and for your efforts in creating the State of Aphasia Reports. I look forward to reading the updated version and seeing how its information will influence aphasia rehabilitation, and how it can assist clinicians and researchers as we continually work to improve care for and partnership with persons with aphasia and their families. I especially, am thankful that we had such a fun conversation, and I learned a new term today. The conversation we had continues to make me mindful of how we interact with everyone in our world, especially those people who have aphasia and their family members. And the people who work with or treat those people who have aphasia and their family members. And thank you to our listeners.   For references and resources mentioned in today's show, please see our Show Notes. They're available on our website, www.aphasiaaccess.org. There you can also become a member of our organization, browse our growing library of materials, and find out about the Aphasia Access Academy. If you have an idea for a future podcast episode, email us at info@aphasiaaccess.org. For Aphasia Access Conversations, I'm Janet Patterson. Thanks again for your ongoing support of Aphasia Access.   Conversations, Gap Areas, References, and Words to Live By Aphasia Access Conversations Episode #62 - Identifying gaps in aphasia care and steps toward action: A conversation with Aphasia Access Board President Liz Hoover Episode #77: Voltage drop and aphasia treatment: Thinking about the research- practice dosage gap in aphasia rehabilitation: In conversation with Rob Cavanaugh Episode #72: Implementation Science, Aphasia, and Sauce: A Conversation with Natalie Douglas Episode #67: Considering depression in people who have aphasia and their care partners: In conversation with Rebecca Hunting Pompon Episode #89: Aphasia is a complex disorder: Mental health, language, and more – A conversation with Dr. Sameer Ashaie Episode #84: Interprofessional Practice and Interprofessional Education: In conversation with Mary Purdy Episode #69: Motivation and engagement in aphasia rehabilitation: In conversation with Michael Biel Episode #88: Everyone's an expert: Person-centeredness in the clinic and research - A conversation with Jackie Hinckley   2018 State of Aphasia Report - Gap Areas 1.Insufficient awareness and knowledge of aphasia by health care providers and the wider public    2.Insufficient funding across the continuum of care           3.Insufficient availability of communication intervention for people with aphasia (need for services)  4.Insufficient intensity of aphasia intervention across the continuum of care     5.Insufficient attention to life participation across the continuum of care    6.Insufficient training and protocols or guidelines to aid implementation of participation-oriented intervention across the continuum of care            7.Insufficient or absent communication access for people with aphasia or other communication barriers               8. Insufficient attention to depression and low mood across the continuum of care 9. Lack of a holistic approach to community reintegration       10. Failure to address family/caregiver needs including information, support, counseling, and communication training   References Fogg, B.J. (2019). Tiny habits: The small changes that change everything. Boston: Houghton Mifflin Harcourt. Loft, M.L., Martinsen, B., Esbensen, B, Mathiesen, L.L., Iversen, H.K. Poulsen, I. (2019). Call for human contact and support: An interview study exploring patients' experiences with inpatient stroke rehabilitation and their perception of nurses' and nurse assistants' roles and functions. Disability and Rehabilitation, 41:4, 396-404, DOI: 10.1080/09638288.2017.1393698 Worrall, L. (2022). The why and how of integrating mental health care into aphasia services. Presentation to The International Aphasia Rehabilitation Conference, Philadelphia PA: June. Worrall, L. (2019). The seven habits of highly effective aphasia therapists. Presentation to the Aphasia Access Leadership Summit, Baltimore MD: June.   Words to live by Lache Pas La Patate! (Don't Drop the Potato!) This saying means that even when things get difficult, don't give up. It is a testament to the resiliency and enduring spirit of the Cajun people. Cajuns are known for their strong family and community values. During difficult times everyone comes together and helps each other out.    

Over the last several years, timeless verities related to getting into college–or even what colleges a student can get into–have given way to painful, new truths. Amy and Mike invited educational consultant Rebecca Stuart-Orlowski to share admissions notes for the HS graduating class of 2023. What are five things you will learn in this episode? Should students in the HS class of 2023 take the SAT or ACT?  How many reach/match/likely schools should be on a student's list?   What is considered a match or likely school for the Class of 2023?  Should students consider applying Early Decision?  How should students and families manage expectations for this admissions cycle? MEET OUR GUEST Rebecca Stuart-Orlowski, founder of Orlowski College Consulting, has worked in education for 35 years and has worked as an Independent Educational Consultant for 10+ years. She has a specialized Certificate in College Counseling from UCSD, a BA in Communicative Disorders from San Diego State, and two active teaching credentials. She taught deaf, LD, and 2E students for four years and was a college counselor at a small private school for 3 years. Rebecca specializes in gifted/2E, STEM, creative, homeschooled, and transfer students. Rebecca can be reached at r.orlowski.consulting@gmail.com. LINKS What Are Your Expectations?  Admissions Trends for the HS Class of 2023 College Kickstart How many reach, match, and safety schools should be on your college list? Should Today's Students Take the SAT & ACT? Should You Apply Early Decision? RELATED EPISODES LONG-TERM PLANNING FOR COLLEGE ADMISSIONS COLLEGE ADMISSIONS INSANITY USING THE COMMON DATA SET ABOUT THIS PODCAST Tests and the Rest is THE college admissions industry podcast. Explore all of our episodes on the show page. ABOUT YOUR HOSTS Mike Bergin is the president of Chariot Learning and founder of TestBright. Amy Seeley is the president of Seeley Test Pros. If you're interested in working with Mike and/or Amy for test preparation, training, or consulting, feel free to get in touch through our contact page.

In today's episode, I sit down with A-Team member Emma as well as Jennifer and Sue of the Student Financial Support here at USU to talk about the different services offered through the new department. We go into some of the specific services offered, why it is important, and what students can expect when visiting.      New Student Orientation: https://www.usu.edu/orientation/locations/logan     Orientation Office Contact Information: 435-797-0283; orientation@usu.edu; Instagram @usuateam   Student Financial Support: https://www.usu.edu/financial-support/   Emails: financialaid@usu.edu; scholarships@usu.edu; smmc@usu.edu   Location: TSC 106 (set to return August 5, 2022 to in-person services)    Guest  Sue Rasmussen – Scholarships Councilor; USU Student Financial Support  Jennifer McGaughey – Assistant Director of Counseling; USU Student Financial Support  Emma Davis – Double Major in Communicative Disorders and Deaf Education & Psychology; Sophomore; Sandy, UT 

In today's episode I sit down with A-Team member Emma as well as Jennifer and Sue of the Student Financial Support here at USU to talk about the different services offered through the new department. We go into some of the specific services offered, why it is important, and what students can expect when visiting.      New Student Orientation: https://www.usu.edu/orientation/locations/logan     Orientation Office Contact Information: 435-797-0283; orientation@usu.edu; Instagram @usuateam   Student Financial Support: https://www.usu.edu/financial-support/   Emails: financialaid@usu.edu; scholarships@usu.edu; smmc@usu.edu   Location: TSC 106 (set to return August 5, 2022 to in-person services)    Guest  Sue Rasmussen – Scholarships Councilor; USU Student Financial Support  Jennifer McGaughey – Assistant Director of Counseling; USU Student Financial Support  Emma Davis – Double Major in Communicative Disorders and Deaf Education & Psychology; Sophomore; Sandy, UT 

https://www.GoodMorningGwinnett.com-This show is made possible by https://www.NoisePodcastNetwork.com Have you ever thought about getting an investor for your company? Would you even know what type of investor to look for? Do you know what it takes for your company to be investible? Well if your answer is no to any of these questions, listen to this episode and take notes. Renee McCalla-Taylor is an investor and entrepreneur who has a passion for helping businesses to grow and flourish. Renee is Co-Founder and Managing Partner of 4C Capital that has investments in IGeneX, Insight Medical Genetics, Stride Tool, and Chicago Switchboard. Mrs. McCalla-Taylor is a strong advocate for Minority and Women Owned Businesses. She has served on the boards of Florida Minority Supplier Development Corporation and as President of the Orlando Chapter of Business and Professional Women (BPW). She holds B.S. and M.A. degrees from the University of Central Florida in Communicative Disorders.In her spare time, she enjoys a great game of golf, traveling, dancing, and hanging out with family and friends.

Visual Schedules Made Easy?!  Yes please!  If anyone has ever told you that your child would benefit from visuals, this episode is for you!  Right?  This episode is for EVERYone… because we can ALL benefit from visuals (hello, grocery list)!  Today I'm talking to the one and only Tara Tuchel of Autism Little Learners, creator of the online course called “Visuals Made Easy” about all things visuals.  Tara, a licensed SLP and early childhood teacher to children with autism, will help us understand exactly what we mean by “visuals,” how to use them, and why so many students benefit from them.  Tara's enthusiasm is contagious, and her ideas are so darn easy to implement.   ________ Tara is a speech/language pathologist who has worked with autistic children for over 20 years. She earned her bachelor's and master's degrees in Communicative Disorders at the University of Wisconsin-River Falls. Her minor was in Early Childhood Education. After working exclusively with autistic children at the elementary level for several years, she went on to obtain an Autism Certificate from Hamline University in St. Paul, Minnesota. She's attended numerous professional development workshops, seminars, and courses over the years, and has been an adjunct professor at Hamline University teaching courses for educators about autism for 10 years. Tara spent several years at the early elementary level in Wisconsin and Colorado.  Now, she is enjoying co-teaching in an autism classroom at the early childhood level (mainly with children ages 2.5 to 5 years) in Minnesota. Another aspect of her job at the early childhood level includes doing initial evaluations, from speech/language evaluations to full autism assessments. The parent connection at the preschool level is something she really loves!   Tara started Autism Little Learners in March of 2019, about 6 weeks after she lost her dad to leukemia. The grief was so deep and so raw after he died that she needed something to distract her mind from the pain. Prior to that, she had been thinking about starting a store on Teachers Pay Teachers. because she already made so many of her own materials for her classroom. It can be so difficult to find good resources that are at the right level. Especially for 3 and 4 year old autistic students! So, she started creating resources and activities for educators and parents of young autistic children.  Tara also does several free trainings each year on Facebook, and has an online course titled "Visual Schedules Made Easy". Website: https://autismlittlelearners.com/autism-little-learners-about/ Teachers Pay Teachers, Autism Little Learners Teaching Resources: https://www.teacherspayteachers.com/Store/Autism-Little-Learners Instagram: https://www.instagram.com/autismlittlelearners/

Paulette attended and received both her Bachelor's and Master's degrees from the University of Redlands in Communicative Disorders as well as a California Lifetime Teaching Credential. She has worked in public schools as a teacher and later as a speech therapist.She is a huge believer that all children deserve a quality education. For years, she has been actively involved both professionally and as a volunteer in public education. Being a mother of two young men who attended public schools and she has been an active volunteer with the PTSA groups and in the classrooms. She was also awarded the Above & Beyond Award from the Fullerton School District for her work with children. Her involvement with Science Olympiad, All the Arts for All the Kids, First Five Orange County, and Legislative Advocacy Groups has given her insight into best practices for quality education. Sound fiscal management is a top priority for quality education. It is vital to ensure that all children benefit from an education system that puts the children's needs first. Children are our future and educating our children is of the utmost importance.

The COMDDE program is one of USU Online's largest programs, and for good reason! We're joined by Kristy Meeks, who is the advisor for first bachelor's students. As a graduate of the program herself, she provides valuable insight into what the curriculum and faculty are like, and where the program can take you. If you are interested in becoming a speech language pathologist or audiology, this is the program for you. You can learn more about the program at comdde.usu.edu.--Connect with USU OnlineWebsite | Facebook | Instagram | LinkedIn | Twitter

Returning to the podcast today is Carol Karp, and this episode is all about the impact a personal narrative has on language development. Many of us love stories and storytelling, but we don't often think of storytelling as a way to develop language skills. The personal narrative helps kids who struggle with language based learning challenges, and Carol is here to explain how. Carol brings her own stories to this episode to truly demonstrate the power the personal narrative can have. The personal narrative is something that can be developed at all different ages, and Carol gives us strategies to start conversing with kids in ways that help promote their language skills, creativity, flexibility, and self-image.   Show Notes: [2:03] - Welcome back, Carol! [3:33] - “Meeting kids where they are” means having conversations with them about their interests and figuring out what they can and can't do. [4:41] - Carol shares a story with a child and how meeting her where she was made the biggest difference. [6:50] - You can't work in a traditional sense all of the time or you will miss out. [8:07] - Some kids have these great continuous stories that go on in their head that can be used to help them communicate. [9:47] - Studies show that children who tell stories well are more accepted by peers. [10:31] - A personal story is the story we have about ourselves in our head. [11:50] - Having a more complicated personal narrative can positively affect writing. [12:49] - Young children tend to tell stories about things that have happened and the older they get the more fiction develops. [14:40] - Narration style is developed by asking questions. [15:30] - A real sense of self can't be replicated through technology. [16:40] - Language develops in a social setting. [18:22] - When a child doesn't tell a story in sequence, parents can direct them to think about the order of events. [19:32] - Sometimes, children develop a negative personal narrative. [22:16] - Carol demonstrates the effect of a negative personal narrative and how to help. [24:01] - When children see improvement in their communication, their personal narrative changes. [27:08] - With language difficulties, slow things down and listen. [29:50] - A common assignment in school is how to relate to the text. Kids have to have a personal narrative to be able to connect. [32:37] - Vocabulary lessons help promote personal narrative and language flexibility. [35:14] - Early intervention is very important. [38:10] - Cultural variations were not taken into account when grammar norms were created. [40:01] - Storytelling is rooted in culture. [41:51] - It is harder to connect with other people without a personal narrative.   About Our Guest: Carol W. Karp, M.S., M.Ed., CCC-SLP, is a pediatric clinical speech-language pathologist. Carol holds two Master's Degrees, one in Education and one in Communicative Disorders. She has two teaching credentials and was an elementary school teacher and training teacher for LAUSD. Upon completion of training in communicative disorders Carol was awarded a clinical fellowship at the Neuropsychiatric Institute Hospital (Semel Institute) at UCLA, where she received advanced training in diagnosis and intervention for children with speech and language difficulties. She is one of only a small number of Speech and Language Pathologists with this unique dual background. Carol has a Certificate of Clinical Competence in Speech-Language Pathology from the American Speech Language Hearing Association (ASHA Number 01099141); as well as licensure as a Speech-Language Pathologist by the California Speech-Language Pathology and Audiology and Hearing Aid Dispenser Board for over twenty years (License Number Sp8297). She is the founder of Westside Speech and Language Pathology Associates, Inc. and has conducted a thriving private practice since 1991.   Connect with Carol Karp: CK Curriculum Coaches Website Phone: (310) 804-7805 ChildNEXUS Profile: Carol W. Karp M.S., M.Ed.   Links and Related Resources: Top 5 Signs You Need a Speech and Language Pathologist Speech and Language Disorders in Children More Than Meets the Mouth Episode 20: How Speech and Language Difficulties Affect a Child's Life with Carol Karp Episode 4: Helping Your Child with Language Based Learning Disabilities with Dr. Daniel Franklin   Cited Research: Clarke, P. J., Snowling, M. J., Truelove, E., & Hulme, C. (2010). Ameliorating children's reading-comprehension difficulties: a randomized controlled trial. Psychological science, 21(8), 1106–1116. https://doi.org/10.1177/0956797610375449   Join our email list so that you can receive information about upcoming webinars - ChildNEXUS.com The Diverse Thinking Different Learning podcast is intended for informational purposes only and is not a substitute for medical or legal advice, diagnosis, or treatment. Additionally, the views and opinions expressed by the host and guests are not considered treatment and do not necessarily reflect those of ChildNEXUS, Inc or the host, Dr. Karen Wilson.

Karla is an award-winning best-selling author, speaker, and licensed marriage and family therapist. Karla's passion is to see individuals, marriages, and families set free from the chains of dysfunction, scriptural misunderstanding, and emotional pain personally and relationally. Her messages provide practical solutions based on biblical truths that bring balance and clarity to life and relationship issues. She also desires to equip ministry leaders and lay counselors to reach out more effectively to those who are struggling with difficult relationships. Karla holds a Master of Arts degree in Marriage and Family Therapy and a Master of Arts degree in Communicative Disorders. She is the author of five books. 10 Lifesaving Principles for Women in Difficult Marriages was a 2004 ECPA Silver Medallion winner. Her second book, When Love Hurts: 10 Principles to Transform Difficult Relationships, applies the same principles to all difficult relationships. Her third book, The Truth in the Mirror: A Guide to Healthy Self-Image, offers a unique and life-changing approach to the topic of self-image. Her fourth book is titled Change My Relationship: 365 Daily Devotions for Christians in Difficult Relationships and her fifth book Boundaries with Adult Children and Rebellious Teens: A Biblical and Practical Guide on What to Do and What Not to Do. Karla is the founder of ChangeMyRelationship.com. She has written hundreds of Internet articles, as well as several resources for Lifeway's Women's Ministry and eight studies she teaches at churches. She has a YouTube channel with over two hundred videos on difficult relationships and a podcast “Change My Relationship.”

Molly is a Speech/Language Pathologist and Certified Auditory Verbal Therapist with a passion for supporting families and their children with hearing loss work toward reaching their individual potential. She earned her Bachelor's degree in Communicative Disorders from the University of Redlands in Southern California, and Master's degree from San Francisco State University. She served as the SLP for the Cochlear Implant Team at Children's Hospital Oakland, and in a lovely twist of fate has returned now that it is called UCSF Benioff Children's Hospital Oakland working specifically as a research SLP on a study focused on the efficacy of telepractice. In the dozen years between these jobs, she worked for BabyTalk Teleintervention, early intervention programs for children with hearing loss in West Contra Costa Unified School District, Center for Early Intervention on Deafness, Regional Center of the East Bay, Utah School for the Deaf and Blind and operated a successful private practice in Salt Lake City prior to returning to sunny California. She lives on a couple acres with her husband, two daughters, two dogs, and three cats outside of Sacramento. Her family loves spending time outside, exploring new areas, trying new restaurants, and listening to podcasts! 

During this episode, Dr. Janet Patterson, Chief of Audiology & Speech-Language Pathology Service at the VA Northern California Health Care System, talks with Dr. Michael Biel about theories of motivation and their application and value in aphasia rehabilitation.  Guest Bio: Michael Biel is an Associate Professor in the Communication Disorders and Sciences department of California State University, Northridge and senior speech-language pathologist at UCLA Medical Center.  From 1993 to 2012, Michael was a full-time speech-language pathologist working in the Los Angeles and Pittsburgh VA healthcare systems.  Michael is board certified in neurologic communication disorders from the Academy of Neurologic Communication Disorders and Sciences and specializes in working with persons with aphasia. In today’s episode you will hear about: Self-Determination Theory, and Flow, and Aphasia rehabilitation Psychological nutrients of competency, autonomy, and relatedness, including a short list of actions one can take to satisfy these nutrients Intrinsic and extrinsic motivation, and therapeutic engagement as a process. Interview Transcript Dr. Janet Patterson:  Welcome to Aphasia Access Conversations. Today, I am delighted to be speaking with my dear friend, research partner, and pioneer in the study of engagement, motivation and aphasia. Dr. Michael Biel. Dr. Biel earned his master's degree in Communicative Disorders from California State University Northridge, and clinical doctorate degree in medical speech language pathology from the University of Pittsburgh. Mike dedicates much of his clinical practice and research efforts to understanding the science of motivation, and how to translate well established theories in the psychology literature to clinical practice and research in aphasia rehabilitation. He also has an interest in the role of the arts and humanities in adult neurorehabilitation, and with his wife, Francie Schwarz, started a book club for persons with aphasia. You can hear about that book club in Aphasia Access Podversation # 12, where Francie describes the aphasia book club within the Los Angeles Public Library System.  Before joining the faculty at CSUN, Dr. Biel worked as a speech-language pathologist for the VA Healthcare System, and the UCLA Medical Center. Mike is Board Certified in Neurologic Communication Disorders from the Academy of Neurologic Communication Disorders and Sciences or ANCDS.  Welcome, Mike. I am pleased to have a conversation with you today, and to turn the tables on you so to speak, as you are typically a podcast interviewer with ANCDS. Today you are our aphasia expert on motivation and engagement. Thank you for talking with me today about aphasia, rehabilitation, motivation, and engaging patients, family and clinicians in the treatment enterprise. Dr. Michael Biel: Great, thank you so much for having me. Janet: Mike, I would like to start our conversation by asking you about motivation, and how we might think about it as a concept in rehabilitation. People scatter their conversations with the word motivation, attributing all sorts of their actions and reactions to motivation or the lack thereof. Knowing that this is a vast topic, can you help our listeners develop a frame of reference for thinking about how motivation fits into aphasia rehabilitation? Mike: Well, Janet, you're right. Motivation is a broad term. I think one author said that motivation is the why behind all human behavior. Some years ago, a paper was published, exploring the definition of motivation, and I think the author catalogued something like 200 different definitions. In its simplest form, I think we could say that motivation is the energy that causes us to do something, to act. Typically, whether motivation is effective, the many theories of motivation, are regarding its strength. The stronger the motivation, the more someone's going to pursue their goals and, and persist. Another way to think about motivation, one that I've kind of subscribed to comes from Self-determination Theory, and they focus more on the quality of motivation. They acknowledge that the strength is important, but they argue that more than the strength the quality is important and in its simplest terms, they define motivation as being either intrinsic or extrinsic. Intrinsic motivation is motivation where we're moved to act, because the activity itself is enjoyable, interesting, or satisfying. When people play video games that would probably be an example of intrinsic motivation. I use the example of going dancing, right, we dance because we'd like to dance not because we're expecting some kind of outcome after we're done. And so, if we are expecting an outcome, or if we have a goal in mind, then that would be considered extrinsic motivation. When I teach my students about motivation, they are in some ways, very tied to this notion that intrinsic motivation is good, an extrinsic motivation is bad. Extrinsic motivation is not necessarily bad. Much of adult life is characterized by us having to do things that we don't always enjoy. But if we're working towards a valued goal, and we're doing something because we desire to achieve that goal, then we're in a positive state of motivation, I guess you could say. Self-determination Theory divides extrinsic motivation into controlled and autonomous forms. In controlled forms of motivation, we’re acting out of some pressure to act. That can be due to some external threat, such as the client in acute rehab, who's told that if they don't participate, more, there'll be discharged, or even the pressure to secure a reward. And in this case, the care and the positive regard of a health care provider. Even we can put pressure on ourselves, wherein we have this “should” voice in our head. In Self-Determination Theory, this is thought of as some recommendation, or belief or value or goal that's been internalized, but to a shallow degree. In a better way of saying it, the authentic self is not really integrated and identified with this goal, and so it simply remains kind of a “should” voice in our head. Janet: That's fascinating, all the ways to think about motivation, several different perspectives. As I was listening to you, I was thinking about all of them, or at least, most, I think, have in common, that you're motivated to engage in something behavior, whether it's intrinsically motivated, or extrinsically motivated. But let me ask you a little bit about motivation from the perspective of engagement in the rehab process, because you mentioned that as an example of using motivation to keep people engaged in that process. I looked at the definition of engagement and found these two examples. One is, the fact of being involved with something. And another that adds a psychosocial component specifically says emotional involvement or commitment, which is exactly what I think you were talking about in differentiating the kinds of motivation.  I also found this interesting description of how engagement feels when riding a horse. Now, I am not a horse person. However, this description resonates with me, and I wonder if it does with you as well. I think it has application in how we think about aphasia rehabilitation. Paraphrasing from the site, Happy-HorseTraining.com, and I bet you never thought that aphasia and happy horse training would be in the same sentence, but there they are. “There are different degrees of engagement, and it can come and go when we are writing in itself. It is a particular gymnastic state when the horse brings into action, a specific set of postural muscles, which fundamentally alter the dynamic of how he carries himself. It is only in this state that the horse is able to carry the rider in balance, and without the damaging effects that otherwise a rider inevitably has on the horse. This is why any educated rider who cares about their horse’s well-being will make engagement a priority when they ride. Apart from the fact that an unbalanced horse is never a pleasure to ride, nor is it safe. The engagement of the horse gives you the following sensations: you feel the power from the hind legs feeding underneath your seat, instead of pushing out behind, and you feel lifted up by the horse’s back underneath the saddle, instead of dropped into a hollow. Above all, engagement is an incredibly good feeling for both the horse and the rider, because we instinctively enjoy the feeling of balance and power. Instead of always focusing on what you are doing when you ride, start to become aware of the moments when it simply feels good. This is the most reliable way of finding the direction towards a correct engagement.” Several phrases in this description such as being engaged is a good feeling for both patient and clinicians (those are my words, replacing horse and rider) they resonate with me because I think we instinctively enjoy the feeling of balance and power. What do you think, Mike? Mike: I completely agree, I think we all have a sense of what that feels like. Some people might call it flow. And in fact, there's a theory of flow and in that theory, they say, essentially, that we get into a flow state, when there is a particular balance between our skills and ability, and the degree of challenge that we're facing such that if the challenge is too great for our skills, then flow is lost. If there isn't enough challenge to capture our attention, then we're not going to have the kind of absorption that we might have in that flow state. I certainly think most of us have had that experience working with a client where, particularly after we get to know them for a while, and we've developed some skill at facilitating their communication abilities, or some aspect of a treatment that we're working on and things are starting to flow. I know that when I was at the VA in Pittsburgh, working in their Intensive Aphasia Treatment Program, one of the things I noticed was that, we worked with people for a whole month, and after about a week or two, I felt as if I was really dialed in. I was like an instrument that was being tuned, so that I could really exquisitely cue my client and facilitate their production. When we think about engagement, people have written about engagement as an experience that is co-constructed, it is a process. People have also talked about it as a state, and flow state would be an example. In going back to Self-Determination Theory, intrinsic motivation would probably be very closely related to this idea of a flow state in the sense that when we're intrinsically motivated, we're drawn to do something because we get some satisfaction out of the very act of doing it. In Self-Determination Theory, the ingredients that contribute to intrinsic motivation are that our sense of competency is being satisfied, we're feeling effective. In fact, one of the details of that competency satisfaction is that there's an optimal challenge, that we're meeting, a challenge that is not too hard, not too easy. The other ingredient that's being addressed is we're it we're doing it truly out of our own choice freely, without a sense of pressure, because we genuinely want to. Janet: That makes a lot of sense to me as you talk about engagement and motivation, and how we can apply it in the aphasia rehabilitation sessions that we do in in our program planning. I wonder if you had any other additional thoughts you might want to share at the moment about how we can think theoretically, the theories of motivation and how we can apply those to our aphasia rehabilitation practice? Mike: Sure, you know, when I started off as a therapist, and I was thinking about ways to motivate my clients and to increase their engagement, I think I often thought about the stimulus. I thought about making the activity more interesting to them. I thought about incorporating their hobbies, or something like that. And I think that practices is fairly common. But again, it tends to be focused on the interesting aspects of the stimuli. I think when we look at theories of motivation, we realize that there are deeper needs, that people have needs that are going to provide more of this motivational energy and provide a kind of energy that sustains itself for longer. I think when we focus on some of these more superficial aspects, quite honestly, of therapy, they just don't have the staying power. And at least in Self-Determination Theory, there's a concept of basic psychological needs. In this theory, they've identified three, (1) the need to feel autonomous, to feel that what we're doing is truly of our own choice that we desire to do it, (2) the need to feel competent at doing those things that we want to do, and (3) the need to feel connected to other people, what's called the need for relatedness, to feel that there are people who care about us, there are people we care about, and that this care is unconditional. I think if therapy and rehabilitation is constructed in a way where these needs are satisfied, then we're going to have a lot more fuel for engagement, and particularly when we hit the different challenges that people have to cope with.  Now, the listener may be wondering, well, exactly how did these needs influence motivation, and, to be honest, I probably don't have time to go into that in much detail, but essentially, it contributes to motivation in two ways. Number one is, at least according to Self-Determination Theory, these needs are innate. We tend to be drawn towards activities, goals and contacts, where these needs are being satisfied. These needs fuel a process called internalization, which is the human tendency to kick in the recommendations that belief, the values, the practices of important people around us, and to identify with them and to make them our own beliefs and practices and what not.  I think in rehabilitation, we do a fair amount of teaching in one way or another and recommending and espousing certain beliefs and values that we think will serve people in positive ways. In the dynamics of a relationship and satisfying these needs, there is a kind of a security and a trust, and a nurturance that our clients feel and that increases the likelihood that they do take on what we have to offer and make it their own and, develop some ownership over it. Of course, that really is going to form the foundation of a more persistent engagement. Janet: Mike, in the past year during the pandemic, and its requirement for social isolation, which perhaps may continue for several months into the future, increased mental health challenges, such as depression, have appeared in the general population, and likely also in persons with aphasia. How do you think that fostering engagement in aphasia rehabilitation and in communication interaction can help persons with aphasia cope and indeed thrive during these challenging times? Mike: Yeah, that's a that's a really interesting question. Staying on this notion of a psychological need. Self-Determination Theory is not the only psychological theory that proposes that humans have psychological needs. What these theories tend to have in common, these needs-based theories, is that it's the satisfaction of these needs that is necessary for us to be psychologically healthy. In fact, in Self-Determination Theory, these needs for autonomy, competence and relatedness are sometimes referred to as psychological nutrients, communicating the idea that just like physical, dietary nutrition, that these elements really do need to be addressed for us to be optimally healthy. I think that as therapists, of course, we have our limits. In my sessions with clients and the dynamics of our interaction, I do the best I can to address and satisfy these needs. That would also include the kind of goals, collaborative goal setting that we might do, and, and I will frankly discuss these needs with clients and family members, too, and people seem to get it. Other examples are, let's take the need for relatedness, which is not just satisfied between individuals, a client-clinician relationship, or a romantic relationship, or a parent child relationship, but it's also satisfied when people have a sense of belongingness to community. I think, right now, I've noticed that a couple of the aphasia groups that I belong to and facilitate seem to be playing a really important role in helping people feel connected to a community. Hopefully that is having a prophylactic effect in terms of helping people stay psychologically well. Janet: Which again makes sense. But as you are interacting with people, both patients with aphasia and their caregivers, what are some of the indicators you see, that suggest a client is engaged in rehabilitation, or not engaged? How do you measure engagement or feel confident in identifying when a patient is engaged with you in the rehab process? Mike: There are some measurements of engagement out there. Off the top of my head I don't know how valid they are. There are most definitely a number of measurements of motivation and Self-Determination Theory related measures of intrinsic motivation, of autonomous versus controlled forms of motivation, and need satisfaction. I don't administer those tests myself in my clinical practice, although I sometimes pull one aside to guide the kind of conversation that I might have with a client so that I can kind of get a sense for whether they're really struggling with this need for autonomy. In other words, they're not feeling as if they're having much choice over their life, that they have a sense of doing what is important to them, or steering the conversation towards getting a sense of how competent they feel, doing the things that are important to them, how connected they are to friends and family, etc. In general, I guess I rely more on my interactions with people and my observations. I think in terms of kind of markers of engagement, I think it does look different at different stages of rehabilitation. Early after a stroke, for example, or early in a clinical relationship, our clients often don't understand enough about their disorder, about the process of rehabilitation, to be real engaged the collaborators. At that point engagement is more focused on them being engaged in wanting to learn about aphasia, and the options for rehabilitation and whatnot. In so in the beginning, I'm spending more effort supporting people developing some competencies that will help them become more true collaborators, so that later on engagement is manifest much more in the sense of them participating in decision making and sharing their opinions on different treatment approaches, for example, then sharing their observations of what's going on with them and their progress towards their goals. So, I guess, overall, my experience has been when things are going well, that people start off most definitely curious and engaged in that way. Over time, they develop more ownership over the process and become, if not collaborators, maybe even more than that, for lack of a better word, become their own therapist. Then, of course, there are, I guess you could say, the more traditional observation observations of engagement, adherence to treatment schedules, home practice schedules, following up on recommendations, things of that nature. As a kind of an example, I think of the way one can use a theory of motivation to maybe start to think about some of the patterns of behavior that we see. I'll sometimes see clients who are using an app on their iPad and so I can monitor their practice how often they're practicing, when they're practicing. I might see that they kind of don't practice much until the day before their scheduled session with me. And to me, that's really one example of someone being in a more controlled form of motivation, wherein the reason for them to be motivated is perhaps the desire to maintain my approval of them. When our motives are external to us they don't really exert much influence until they're in proximity. And so, as we get closer to the scheduled appointment, all of a sudden, this external motivator starts to kick in, and they'll do some practice. I might look at that and realize that there's something missing in terms of addressing goals, etc. so that people are more truly, the genuinely autonomously motivated, in which case, the pattern would be more like, not just that people are more persistent on their own, but at times, they're even asking for more. Janet: That is a good place to leave it because you've been helping me visualize this picture of engagement as a process. Everything's so new in the beginning of a person's journey through aphasia. And as the clinician, you are helping them become more comfortable with that and take more of an active role, if you will, owning the aphasia and what to do about it. Let me ask from your experience and research, what advice or techniques or suggestions can you give to our listeners that they can take and incorporate into their clinical practice? I know you've described a little bit about how you use your observations, but are there some specific pieces of information you can impart to our listeners? Mike: Sure. I think engagement starts with me. If I am truly engaged, then that tends to facilitate the engagement of my clients. If we think about when someone listens to us, let's say and listens to our story, in a manner in which they genuinely seem to be trying to understand our perspective, that tends to cause us to be a little bit more interested in in it ourselves. I think engagement is contagious. You will read in in qualitative studies, rehab patients particularly in the acute phase, talk about this need to kind of draw on the positive energy of their clinicians to carry them through this difficult time. Now, there are some specific practices that have been described that are focused on satisfying these basic psychological needs, which are kind of the ingredients of motivation, and therefore, engagement. Maybe it would be helpful for me to just go through the list of them, or the short list, so people can kind of get a flavor for what this might look like.  The need for a satisfying people's autonomy is often achieved through first doing what is called perspective taking, listening to people, their concerns, their stories, with the particular intention to try and see the world through their eyes. That kind of listening interest is an acknowledgement of a person's autonomy, and therefore, its autonomy satisfying. Providing choice has been studied quite a bit in terms of satisfying the need for autonomy. I think most of us are familiar with that, because it plays a role in shared decision-making and client-centered goal setting, providing rationales for any of the recommendations we make, rationales that are meaningful, from the client’s perspective, that allow people to genuinely self-endorse them and to kind of take ownership of them. That's believed to be autonomy supportive. Finally, establishing an environment that is not pressuring. In other words, that we don't set up contingencies either explicitly or implicitly. What I mean by that, specifically, is that people don't feel that they need to be a certain way, or behave in a certain way, in order to secure our approval, and our energy, and also to some degree, that means paying attention to the language that we use. Those people who are familiar with motivational interviewing will know that, in motivational interviewing, you pay quite close attention to the language your client is using, the language you're using. For example, you may make an extra effort to stay away from controlling language such as “you should”, “you must”, “you need to”, etc. As far as satisfying the need for competency, that starts by providing the kind of structure that makes people feel secure, that makes them feel supported in making progress. It’s not chaotic, therapy is not a chaotic experience, it's somewhat predictable. I mentioned previously optimal challenge, such as finding tasks, goals that are optimally challenging. The nature of the feedback that we give can support people's needs to feel competent, in other words, that our feedback is more informational than evaluative. It's informational in the sense that, once we give it people have a sense of how to do better next time. It's useful a feedback. And then of course, monitoring progress is an important component of satisfying people's needs to feel competency within rehabilitation and measuring progress in a way that is meaningful to clients. As far as the need for relatedness. In general, it means that we do not send any overt or covert signals that our positive regard for our clients is in any way dependent on what they say or do. Let them know that our care for them is unconditional, and that our motivation is autonomous. In other words, that they are not an object to us. What I mean by that is, they are not a means to an end for us they are not a productivity requirement, they are not a means of generating income, they are not a means of stroking our egos, that we genuinely empathize with them and want to help. And they that is their experience of us. Janet: It does sound to me like you've spent a lot of time thinking about motivation and engagement, and also applying it in your everyday work with patients and their family members. Would you describe for us one of the successful experiences you've had and engaging patients and family members in your rehab process? Mike: Sure. I can honestly say that all of my clients now and in recent memory, or I think, successes. One of the things, as I mentioned before, that I've been experimenting with more is working with caregivers and talking about these basic psychological needs and how we, the people around the person with aphasia, can sometimes out of good intention, thwart those needs, and how they can do some simple things, to help people feel autonomous, to help them feel competent, to help them feel connected to others. I've gotten a lot of good feedback from starting to do that. Another thing I've been experimenting with are very, very short term goals. In goal setting theory, which is referenced now and then in rehab literature, proximal goals, very short term goals are thought to be more motivating than long term goals. My PT colleagues are fortunate in the sense that the kinds of goals their clients are working towards her so much more concrete and tangible. A person could not transfer from their bed to their wheelchair independently. Now, they can. It's easy to observe. Communication improvements are more abstract. To some degree, I think my patients suffer from struggling more to have a tangible, concrete sense that they're making improvements towards their goal. And so I've been working with super short term goals. In other words, goals, like,” Okay, what would you like to achieve by next week.” What's been really interesting about that process is that when we think about a goal in that short of a term, it tends to focus the mind in ways that longer term goals, one month, two months, three months, just don't. It seems to cause people to really reflect carefully on their strengths, what they can do. Then there’s this heightened sense of expectation that people have, because they're going to experience meeting a goal in a very short timeframe. Now, of course if we can link these one week goals up towards some longer term valued goal, all the better. But that's been a very interesting process, and really helpful not just for my clients, but for me as a as a clinician, too. Janet: I can imagine it has. It must, again, thinking back to the definitions we talked about earlier on engagement, make you feel good, help you and your client feel good that you're in balance with each other. You're working together, little steps, baby steps to achieve some larger goal in future time. Mike: Yeah, I think setting goals and thinking about goals is, is difficult for all of us. And by really shortening the distance. It makes it easier to conceptualize, Janet: I can imagine. Well Mike, as we bring this conversation to a close, and quite frankly, I would rather not. I'd rather go on talking to you for hours and hours because I know that you've spent a good deal of time studying this topic, and practicing this topic, and can talk for days with us about motivation and engagement and its value and importance in our rehabilitation activities. But we are limited on time, so as we bring this conversation to a close, are there any last comments on engagement or motivation? Or in particular Self-Determination Theory, that you would like to share with us?  Mike: Yeah, I think there may be two things. First is that we don't motivate people. We support people's motivation. We support people in ways that contributes to their need for motivation to show up. I want to make that statement because I know that earlier in my career, I spent a lot of time trying to persuade people to believe certain things, to do certain things, and whatnot. In a related way, you know, for me, motivation was a thorn in my side, because I often felt that my clients were not as engaged in a persistent way as they needed to be to kind of reap the benefits that treatment had to offer. That wasn't just my perspective, they felt the same way, and they often didn't know why. It was some time before it dawned on me that there was this factor - motivation - that I put a lot of emphasis on, but I essentially knew nothing about it, I followed my intuition. Learning some theories of motivation, not just Self-Determination Theory, although I think that's my favorite one, I think it's the best fit for the people that I see in my practice, but I draw from other theories, too, this has really transformed my practice and made me more comfortable in my skin, as well as I think more effective. I'd suggest that people who are interested in this topic to start to read about it. One thing about motivation is that the factors that influence motivation tend to be universal, so that we can read about motivation in the context of education or even the workplace, and I think with some confidence, translate that into our own practice. So even though their research is really not there, in speech pathology land, there is a lot of useful research that we can draw upon. Janet: Thank you, that's a good recommendation. I hope that our listeners will take that recommendation, and I hope they will to learn from a project, Mike, that I know you and I with some other people are working on to really examine how people in speech language pathology are reporting motivation when they report their clinical work. We look forward to disseminating that information in a future venue. I want to thank you so much for your time today, Mike, and for chatting with me about motivation and engagement in aphasia rehabilitation.    This is Janet Patterson speaking from the VA in Northern California, and along with Aphasia Access, I would like to thank my guest, Mike Biel for sharing his knowledge, wisdom and experience in studying and practicing principles of motivation, and engagement in aphasia rehabilitation. You can find references and links in the Show Notes from today's podcast interview with Dr. Michael Biel, at Aphasia Access under the Resource Tab on the Homepage. On behalf of Aphasia Access, we thank you for listening to this episode of The Aphasia Access Conversation Podcast project. For more information on Aphasia Access, and to access our growing library of materials, please go to www.aphasiaaccess.org. If you have an idea for a future podcast topic, please email us at info@aphasiaaccess.org  Thank you again for your ongoing support of Aphasia Access. Resources   @mebiel  https://twitter.com/Mebiel  Self-Determination Theory http://selfdeterminationtheory.org/  VA Pittsburgh Program for Intensive Residential Aphasia Treatment & Education (PIRATE) https://www.va.gov/pittsburgh-health-care/programs/pirate/

Today's guest is a podcast first for us here at Diverse Thinking · Different Learning. Carol Karp is a pediatric clinical speech-language pathologist with a vast knowledge in how speech and language difficulties can affect a child's life. Carol and I have known each other and have worked together for many years and she does absolutely incredible and important work. Carol's work is strength-based and throughout this episode she shares stories, experiences, and most importantly, her emphasis on building a relationship to have a lasting impact on the children she works with. Show Notes: [1:59] - Carol and Karen have worked together for many years and they look back on the growth the children they have helped together have made. [2:56] - The model Carol uses is strength-based and she shares how she trained in the field of Speech and Language Pathology. [3:51] - A lot of times through testing for Speech and Language, Carol doesn't immediately see a lot of strengths, but she works together with a team to find the other strengths the child has. [4:25] - Building a relationship with the child is crucial and helping the child rid themselves of shame. [5:37] - Carol emphasizes to students that it isn't their fault if they aren't learning something, but rather hers as a teacher. She explains to them that their job is to tell her when they don't understand and she will work with them in as many ways as is needed. [6:36] - Carol shares an impactful story about working with a student whose parent experienced shame.  [8:10] - Through online learning, Carol initially thought she would struggle reaching students, but instead shares a story about a student who was a dancer. She used his strengths to build a relationship. [9:41] - Speech and Language Pathologists are language experts and that makes them stand out from other types of therapists. Carol describes the difference between speech and language. [11:09] - Oftentimes students are referred for speech issues, but Carol finds that they also have issues understanding and communicating language. [12:40] - Carol describes the things that are looked at through initial speech and language assessments. [13:04] - Carol points out the Speech and Language Pathologists are not the ones who diagnose auditory processing disorders. An audiologist is the one that makes that referral. [14:19] - Receptive language is one's understanding of language. Carol describes how she looks at this step by step with a student and where to start. [16:14] - Expressive language is how children communicate using language. Are they having difficulty finding the words they need? Carol describes the different types of difficulties this can cause. [17:50] - Language issues, especially figurative language and multiple-meaning words can impact friendships and relationships with peers and teachers. [19:12] - This can also impact self-advocacy.  [20:17] - Carol shares the story about a parent who expressed that he never thought he would have a conversation with his child until he worked with her and was taught how to communicate. [22:21] - Carol explains how creativity in reaching students at their strength and modality has been the key in student success. [24:22] - Collaborating with educational therapists is something that Carol likes to do because creating a team working together for the child is significant. [26:09] - Carol lists some of the strategies she uses with students and how each child has different needs. [27:58] - There are a lot of programs that Speech and Language Pathologists use and while Carol will use bits and pieces of some programs together, she doesn't use a specific program. She tailors her therapy for each child and their strengths and interests. [29:40] - When children are engaged and interested in the intervention, they are more willing to participate in the intervention. [30:18] - Carol explains that children who are consistently asked “why” and “how” rather than just “what,” “when,” and “where” are stronger in expressive language. [32:12] - Parents can help by asking questions that prompt students to be more detailed in their expression to further develop their language and higher level thinking skills. [34:14] - The most important thing parents can do is to be great listeners. Some parents tend to talk too much. [35:24] - Carol also shares that keeping a diary, even when the child doesn't write yet (but can draw pictures), is a great idea to help children express themselves. [36:24] - By taking cues from the child rather than trying to change them and their strengths, you will learn so much about your child and how to help them. About Our Guest: Carol W. Karp, M.S., M.Ed., CCC-SLP, is a pediatric clinical speech-language pathologist. Carol holds two Master's Degrees, one in Education and one in Communicative Disorders. She has two teaching credentials and was an elementary school teacher and training teacher for LAUSD. Upon completion of training in communicative disorders Carol was awarded a clinical fellowship at the Neuropsychiatric Institute Hospital (Semel Institute) at UCLA, where she received advanced training in diagnosis and intervention for children with speech and language difficulties. She is one of only a small number Speech and Language Pathologists with this unique dual background. Carol has a Certificate of Clinical Competence in Speech-Language Pathology from the American Speech Language Hearing Association (ASHA Number 01099141); as well as licensure as a Speech-Language Pathologist by the California Speech-Language Pathology and Audiology and Hearing Aid Dispenser Board for over twenty years (License Number Sp8297). She is the founder of Westside Speech and Language Pathology Associates, Inc. and has conducted a thriving private practice since 1991.   Connect with Carol Karp: CK Curriculum Coaches Website Phone: (310) 804-7805 ChildNEXUS Profile: Carol W. Karp M.S., M.Ed.   Links and Related Resources: ChildNEXUS Home Page ChildNEXUS Instagram Top 5 Signs You Need a Speech and Language Pathologist Supporting Parents of Children with Language-Based Learning Difficulties Writing Disorders in Children: The Language Link SLP Search Join our email list so that you can receive information about upcoming webinars - ChildNEXUS.com

Tara is a speech language pathologist with a master's degree in Communicative Disorders plus a minor in Early Childhood Education with an Autism Certificate from Hamline University. She has 21 years of experience and she took that experience and began to create resources for teachers and families with autistic students and children. You can follow her on @autismlittlelearners on Instagram and gain access to many helpful and creative resources such as communication boards and potty training picture sequences. Tara is passionate about what she is doing inside the classroom as well as with Autism Little Learners. She is creative, generous, and inspiring and I feel grateful to have had the chance to get to know her just a little better. She is a woman with a heart of pure gold. Take a listen and enjoy! --- Support this podcast: https://anchor.fm/michele-portlock/support

Learn from Communicative Disorders & Sciences faculty Marcella McCollum as she discusses the progress on the development of an Education Leadership Minor, which is a collaboration among a group of SJSU faculty and will create an opportunity for undergraduate students of all academic backgrounds to develop their transformational leadership capacities. The goal is for this minor to become available beginning Fall 2021. This initiative has been initially funded through the SJSU Lurie College of Education Strategic Plan grants - learn more about our strategic plan at http://sjsu.edu/education/community/strategic-plan Connect with Lurie College at https://linktr.ee/sjsulurie to receive more news about academic and student life!

Guest Bio: Mr. Reeves is currently involved in To Be Like Me, a program created to educate school-aged children about disabilities and differences… including stuttering. Mr. Reeves is the recipient of the Distinguished Alumnus Award from the Texas A&M College of Veterinary Medicine, the Distinguished Service Award from the American Speech-Language Hearing Association, the Public Service Award from the Texas State Speech and Hearing Association, the Distinguished Consumer Award from the International Fluency Association, the Hall of Fame Award form the National Stuttering Association, and the Charles Van Riper Award from the National Council on Communicative Disorders.  Links: www.stutteringtherapyresources.com Host Bio: Uri Schneider, M.A. CCC -SLP passionately explores and develops practical ways for us to create our own success story. Delivering personalized experiences of communication care informed by leading professionals and influencers, Uri is re-imagining the next-level of speech-language therapy for people to benefit in real life. Uri Schneider, M.A. CCC -SLP is co-founder and leader at Schneider Speech Pathology and faculty at the University of California, Riverside School of Medicine. For more, visit www.schneiderspeech.com

Congratulations to our Department of Communicative Disorders and Sciences, who earned a $333,000 grant from the CSU Chancellor's Office earlier this year! This grant couldn't have come at a better time as there are so many priorities that have arisen in recent months in response to COVID-19 and ongoing acts of racial injustice. We spoke with Department Chair Nidhi Mahendra to learn more about the grant and the impact it will have on the Communicative Disorders & Sciences program and beyond. Connect with Lurie College at https://linktr.ee/sjsulurie to receive more news about academic and student life! Audio recorded and edited by Brian Cheung Dooley.

Have you ever sent a text asking someone how they’re doing and received the reply “great.” You may have interpreted it as your friend is having a wonderful day. However, they might have actually been having a horrible day and meant “great” sarcastically. Understanding a person’s meaning behind their words (otherwise known as pragmatic language ability) often requires knowing a lot of contextual clues, including tone of voice, body language and facial expressions. “Great” with an eye roll is vastly different from “great” with a smile. These subtle clues can be difficult to detect in many pragmatic language assessments, yet they are a large factor in determining if a person has a social communication disorder and pragmatic language difficulties. In this episode, we speak with Dr. Adriana Lavi about her new video-based pragmatic language assessment, the Clinical Assessment of Pragmatics (CAPs). She discusses her clinical background, what led her to develop the assessment tool, and why this assessment can be more accurate in detecting pragmatic language disorders. This interview can help parents and educators understand why their child may have scored well on other language assessments, yet they struggle with reading these ever-important social cues in real situations. About Dr. LaviAdriana Lavi, PhD, CCC-SLP, is a practicing licensed school-based speech-language pathologist with more than 15 years of experience working with children and young adults who present with a variety of communication disorders. She currently supervises speech-language pathologists in three school districts in Southern California. Dr. Lavi developed the Clinical Assessment of Pragmatics (CAPs) and founded the Lavi Institute for Research and Professional Development, where she completes research and develops a variety of treatment programs. She has also served as an assistant professor at the Department of Communicative Disorders at Loma Linda University. Her primary research interests focus on pragmatics, and the assessment and treatment of culturally and linguistically diverse students with communication disorders. Dr. Lavi is also a mother of four young, highly energetic little boys, ages 6, 5, 4 and 18 months. Related links: The Lavi Institute for Research and Professional Development - Lavi Institute Lavi Institute Video Resources - Lavi Institute on YouTube Lavi Institute Instagram Where to find the CAPs - Clinical Assessment of Pragmatics Support the show (https://donatenow.networkforgood.org/supportTPS?code=New%20Website)

Dr. Rebecca Berger is the Clinical Director of MindWell NYC that is a group practice utilizing evidence-based treatments in Manhattan, NY.  Dr. Berger is a licensed clinical psychologist in New York State. She earned her B.A. at SUNY Geneseo in Psychology and Communicative Disorders and Sciences, and earned her Ph.D. in Clinical Psychology at Hofstra University. Dr. Berger specializes in Cognitive Behavioral (CBT) Therapy and Dialectical Behavior Therapy (DBT) and has particular expertise in exposure therapies for anxiety, obsessive compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). Dr. Berger has significant experience treating college students and young adults and has helped to develop campus policy regarding medical leave of absences and suicide prevention. Dr. Berger provides individual, couples, and group therapy to adolescents, young adults, and adults Be sure to check out this article that was the stimulus for this interview. Also check out this video clip of Lady GaGa speaking with Oprah as an advocate for mental health and DBT.

Learn about Communicative Disorders and Sciences Undergraduate students Kyah Cobb & Robert Abarca who are studying connecting communication strategies between Dementia and Down Syndrome for adults living with a dual diagnosis. Hear about how their research is going and how their learning experience at the Connie L. Lurie College of Education has supported them in their academic research endeavors. Connect with Lurie College at https://linktr.ee/sjsulurie to receive more news about academic and student life! Audio recorded and edited by Brian Cheung Dooley. Edited by Sydney Ahmadian. Music by Patrick Patrikios.

Chris interviews ToniAnn Loftus,MS, CCC-SLP/TSSLD, and Liza Bernabeo, MS, CCC-SLP/TSSLD, about their recent Journal Article "Food for Thought: Preparing the Brain to Eat New Foods through "Messy" Play." The article was originally a presentation that won "best presentation" at the London Conference. Want to read the article? You can find it here: https://publications.waset.org/10010994/pdf Liza Bernabeo MS, CCC-SLP/TSSLD was born in Stony Brook, New York. She received a B.S. in Communicative Disorders and Sciences from the State University of New York College at Geneseo in Geneseo, New York, USA in 2008 and her masters in Speech-Language Pathology from Adelphi University, in Garden City, New York, USA in 2010. She is currently a full time employee of the Rebecca School in New York , New York, USA. Liza is also a paid training leader for the Interdisciplinary Council on Developmental Learning. She is also expertly trained in DIR/Floortime and has been working with in model since 2011. Her special interests include expressive and receptive language disorders, oral motor & feeding, DIR/Floortime, and neurodevelopmental communication disorders. Ms. Bernabeo is a is an active member of the American Speech Language and Hearing Association. ToniAnn Gambella Loftus, MS. CCC-SLP/TSSLD was born in Goldsboro, North Carolina, USA. She received her bachelors degree from Meredith College in Raleigh, North Carolina, USA in 2008 and her master's degree in speech language pathology from Seton Hall University in South Orange New Jersey, USA in 2010. She is currently a full time employee of the Rebecca School in New York , New York, USA. ToniAnn is also a paid training leading for the Interdisciplinary Counsel on Developmental Learning. She is also expertly trained in DIR/Floortime and has been working with in model since 2011. ToniAnn has a special interest in neurodevelopment, feeding and hearing. Mrs. Loftus is an active member of the American Speech Language and Hearing Association.

The wonders of math can be found in daily life. Robin Chapman is the author of ten books of poetry, most recently The Only Home we Know (Tebot Bach, 2019) Her many awards include; a Wisconsin Arts Board Literary Arts Fellowship, 2007, Posner Poetry Award From Council for Wisconsin Writers, 2000, 2006; Honorable mention, 2012; Outstanding Achievement in Poetry Award from the Wisconsin Library Association 2008, 2017; Helen Howe Poetry Prize, Appalachia, 2010. She is professor emeritus of Communicative Disorders at the University of Wisconsin-Madison. “Mary Laycock,” is copyright by Robin Chapman and originally appeared in Journal of Humanistic Mathematics, 2015, and in her book of poems Six True Things (Tebot Back, 2016) by Robin Chapman.

Learn about Communicative Disorders and Sciences students Alexandra (Ali) Murueta, Liz Cagle, and Michelle Ballou, who recently received grants from the Lurie College of Education to attend the annual American Speech-Language-Hearing Association (ASHA) Convention! Connect with Lurie College at https://linktr.ee/sjsulurie to receive more news about academic and student life! Audio recorded and edited by Brian Cheung Dooley. "Adventure" provided royalty free by bensound.com.

How will chaos theorists respond to a changed lecture schedule? Robin Chapman is the author of ten books of poetry, most recently The Only Home We Know (Tebot Bach, 2019) Her many awards include; a Wisconsin Arts Board Literary Arts Fellowship, 2007, Posner Poetry Award from Council for Wisconsin Writers, 2000, 2006; Honorable Mention, 2012; Outstanding Achievement in Poetry Award from the Wisconsin Library Association 2008, 2017; Helen Howe Poetry Prize, Appalachia, 2010. She is Professor Emeritus of Communicative Disorders at the University of Wisconsin-Madison. “The Chaos Theorists Discuss Poetry,” is copyright by Robin Chapman and originally appeared in Verse Wisconsin, 2012, and in the book of poems Six True Things (Tebot Bach, 2016) by Robin Chapman.

In this episode of the Road To Growth podcast, we are pleased to introduce you to Crystal Sanford. Crystal has over 20 years of experience supporting families, children and young adults with unique needs. She has provided services to individuals with a variety of needs, including ADHD, Autism, Asperger’s Syndrome and Learning Differences. However, forthe past 12 years, Autism has been her passion. In addition, she has gained hands-on experience while parenting her own daughter with High-Functioning Autism. Crystal now serves as a Special Education Consultant throughout California, with a specialty in advocating with Autism families through the IEP (Individual Education Program) process. Crystal’s goal is to move fellow families from overwhelm and frustration to confidence and hope. In her advocacy role, she has successfully helped numerous families to persistently pursue what’s best for their children at school. Crystal holds an M.A. in Communicative Disorders from California State University, Northridge and an M.A. in Education from San Diego State University. When she is not supporting families of Autism or speaking life into the hearts of children and young adults, Crystal enjoys gardening, reading, and spending “non-technology” time with her husband and two daughters in San Diego, CA. Learn more and connect with Crystal Sanford by visiting her on Instagram: @sanfordautism on Facebook: @sdautismhelp   Be sure to follow us on Twitter: Twitter.com/to_growth  Facebook: facebook.com/Road2Growth  Subscribe to our podcast all across the web: Spotify: https://spoti.fi/2Cdmacc iTunes: https://apple.co/2F4zAcn Castbox: http://bit.ly/2F4NfQq Google Play: http://bit.ly/2TxUYQ2

In this first episode, Leslie Gustafson is joined by 5 of her closest, courageous, smart girlfriends willing to talk openly about their own sexual education and sexual experiences. Through much laughter (brace yourself, it can be loud for those wearing headphones) and deep moments, you will hear the truth of what many women live through to learn about sex and become sexual in our Western culture. Talking about sex openly and becoming sexually knowledgeable creates power, protection, prevention and opens the door to pleasure and empowerment while releasing hindering shame and fear.In the United States, only 12% of people over the age of 60 have received some form of sex education in school. Only 33% or people between 18-29 have.When shown a diagram of female genitalia, only 50% of college aged women can accurately identify the anatomical structures, and only 25% of men can.1 in 3 women will have lasting sexual difficulties that cannot be attributed to a short-term stressor, illness or medication side effect – a problem more commonplace than chronic pain, diabetes or depression.About ½ of women who have sex report persisting through pain.The Girlfriends: Kristen Wheeler - Mother of two and wife of 16 years to her high school sweetheart. A self-described, “hot mess of coffee and dry shampoo,” she seeks to encourage and inspire women through speaking, writing, and her podcast, Confessions of a Super Mom Wannabe.Laurel Avrin - After a stint in the United States Air Force, Laurel spent 20 years raising her 2 children. With the end in sight, she went back to school and earned a degree in Psychology and is currently working on her Masters in Industrial and Organizational Psychology. Recently remarried, Laurel is embarking on an exciting new chapter in her life. Educated and intuitive, Laurel is working closely with her husband David creating organizational behavioral content and building his speaking and consulting business.Maria Miller – Founder of KMALCO Group, a PR firm and whose work has generated numerous awards from the Public Relations Society in her 25 years in the field. Maria is a pro at expertly navigating the media and is a highly sought after for media counsel. Her clients look to her as an extension of their team for expert positioning, spokesperson training, community relations, social media and content creation. Maria earned her bachelor's degrees in Spanish and Journalism from Indiana University. Maria has been married 23 years and is a mother of 2 children and has 2 dogs.Lori Makkai - Lori has over 25 years experience in the Health and Fitness Industry as an instructor, trainer, manager and brand developer. In the past 2 years, she has partnered with her husband in the financial and securities industry as a small business owner. She also works part time as an Auction Expert for a mobile bidding company, Handbid, where she gets to fulfill her passion for helping non-profits. She is an apprentice of Jesus and The Way, loves to teach bible studies, and mentor Moms in the local MOPS group. Lori has been married to the love of her life for 24 years and has 2 sons.Jamie Miller - Jamie is a Speech-Language Pathologist and Executive Speech and Voice Coach in Colorado. She holds a Master of Sciences degree in Communicative Disorders from the University of Texas at Dallas. Whether the barrier is neurological, physical, social, or emotional in nature, she has coached clients to communicate their wants, needs, and ideas with clarity and confidence. Jamie has three children aged tween to teen and has been happily married to her husband, Jason, for 21 years. Jason and Jamie have traveled the world and have lived in 7 cities across the country following Jason's career as a U.S. Navy Seal and in the private sector. Jamie has a passion for marriage, through all of its highs and lows, and hopes to encourage other women and couples to grow through open dialogue about all aspects of marriage, including sex!FYI - Have a question you'd liked answered by Leslie. She can be found on all major social media platforms particularly Facebook and Instagram @LeslieGustafson!

Learn about Jessica Doushgounian, an undergraduate studying Communicative Disorders & Sciences at the SJSU Lurie College of Education. Jessica is also the recipient of the College of Education Scholarship Endowment award for the 2019-2020 academic year! Connect with Lurie College at https://linktr.ee/sjsulurie to receive more news about academic and student life! Video and audio recorded by Brian Cheung Dooley - http://brianpdooley.com - and edited by Sydney Torrens.

Congratulations to Lurie College Department of Communicative Disorders and Sciences faculty member Michael Kimbarow, who was recently recognized by San Jose State University for teaching for 15 years at SJSU!

Join Doug and Karen Monda as we discuss their story and the foundation they created, Survive First.Doug is the Founder of Survive First, Inc. and has a long standing history in law enforcement. He retired from law enforcement as an undercover narcotics agent with the Cocoa Police Department, a city in Brevard County, Florida in 2017. He began his career in public safety in 2001. In his second year of service, Doug joined the S.W.A.T. team, and subsequently attended Marine Scout Sniper Training, earning his certification with Blackwater. He spent 15 years on the Cocoa Police Department S.W.A.T. team. During his service on S.W.A.T., his experience as a sniper and team leader played a critical role in the safety of teammates and success of countless missions. During his career he has also worked with agencies consisting of D.E.A., F.B.I., ATF, Border Patrol, U.S. Marshalls Office, Department of Homeland Security and NASA.Doug’s training has earned him extraordinary success in the field. Recently, he was named 2016 Officer of the Year. Additionally, throughout his career, he earned many other awards for his hard work and dedication to the City of Cocoa.In 2013, Doug’s own mental health became impacted from his long career in law enforcement. His own experience with treatment for PTSD, depression, and attempted suicide was the catalyst that drove the founding of Survive First Foundation. Doug is now a national keynote speaker. He speaks on the impacts of a first responders job on mental health and family. His mission is to spread awareness of PTSD, depression, and suicide in first responders, hoping to break the stigma, so that help may be received before it is too late. In his spare time, Doug enjoys spending time with his family, surfing and competing in the sport of triathlon. he has competed in the national and world championships and is a four-time Ironman triathlon finisher. Doug was a former professional soccer player and coached several teams for the YMCA, as well as youth and high school soccer teams. He currently serves as a board member for the YMCA of Cocoa and chairs their Youth Scholarship Fund. As a member of the Board of Directors for Survive First, Doug helps set the strategic goals and objectives for the foundation.Karen is the wife of Survive First Foundation’s founder, Douglas Monda, and a proud step mother of five. She received both her Master of Arts degree and Bachelor of Arts degree in Speech-Language Pathology and Communicative Disorders, from the University of Central Florida. Karen has a long history of fundraising for national and global non-profit organizations, including St. Jude Children’s Research Hospital, The Florida Wildlife Hospital, the Humane Society of the United Stated, and the Dystonia Medical Research Foundation. She has a long-standing passion for helping others in need and currently co-chairs the YMCA of Cocoa Youth Scholarship Fund.Karen’s personal experience as a law enforcement spouse, who has fought alongside her husband to win the battle over depression, PTSD, and attempted suicide, has been the drive behind her passion for Survive First Foundation and ensuring that all first responders and their families receive the support and treatment they need when mental health becomes a daily struggle. In her spare time, Karen enjoys spending time on the beach with her family. She maintains a healthy lifestyle by running. Karen enjoys running the marathon distance, and has been honored to qualify for and run the Boston Marathon. She believes in physical fitness as a catalyst for a healthy and happy life and encourages people to find a physical activity they can enjoy.Karen oversees all communications and media content for Survive First Foundation. She also coordinates and plans fundraising events and drives for the foundation. As a member of the Board of Directors, Karen helps set the strategic goals and objectives for the foundation

Dr. Jacqueline Laures-Gore is an Associate Professor of Communication Sciences and Disorders at Georgia State University. She received her PhD in Communicative Disorders from the University of Wisconsin-Madison. She directs the Aphasia and Motor Speech Disorders Research Lab at Georgia State University (esc.education.gsu.edu/aphasia). Her research interests include aphasia, stress, depression, and integrative health. Her work has been funded by the NIH, ANCDS, as well as other entities. Rebecca Shisler Marshall, PhD (CCC-SLP) is an Associate Professor in the Department of Communication Sciences & Special Education at the University of Georgia. She is also a mindfulness instructor, certified life coach and yoga instructor, reiki master, and shamanic practitioner. Her primary research interests include integrative treatments such as mindfulness for aphasia, attention, and aging. Dr. Marshall's Aphasia and Aging Research Lab - aphasiauga.wixsite.com/aphasiauga Dr. Marshall's Profile - https://coe.uga.edu/directory/profiles/rshisler

Join host Amy Zellmer as she chats with Darryl L. Powe Darryl Powe is a speech-language pathologist with more than 20 years of experience. He has worked in a variety of settings including acute and rehabilitation hospitals, university clinics and outpatient offices. He has also taught on the undergraduate level both on campus and developed distance learning classes in communicative disorders. He holds a MS in Communicative Disorders from UNC-Chapel Hill and a BS in Speech Pathology and Audiology from Shaw University in Raleigh, NC. He specific research interests include evidenced-based practice and interdisciplinary team building. His primary clinical interests are in treatments for Parkinson’s diseases and concussion. He holds certification in both LSVT and SPEAK OUT. HealthSouth is one of the nation’s largest providers of post-acute healthcare services, offering both facility-based and home-based post-acute services in 34 states and Puerto Rico through its network of inpatient rehabilitation hospitals, home health agencies, and hospice agencies. Episode sponsored by: Minnesota Functional Neurology DC 

On this episode, Stan Goldberg, PhD, will discuss what to do when a loved one says "I have cancer." Dr. Goldberg, who is the author of the new book, Loving, Supporting, and Caring for the Cancer Patient, provides practical advice for caregivers.He is Professor Emeritus of Communicative Disorders at San Francisco State University and a recognized expert in the areas of cancer support, end-of-life issues, caregiving, chronic illnesses and aging.This show is broadcast live on Tuesday's at 7PM ET on W4CS – The Cancer Support Network (www.w4cs.com) part of Talk 4 Radio (http://www.talk4radio.com/) on the Talk 4 Media Network (http://www.talk4media.com/).

Stan Goldberg, PhD, is Professor Emeritus of Communicative Disorders at San Francisco State University, and author of the new book, Loving, Supporting, and Caring for the Cancer Patient (Roman & Littlefield, October 2016). He is a prolific award-winning writer, editorial consultant and recognized expert in the area of cancer support, end-of-life issues, caregiving, chronic illnesses, aging and change.

Stan Goldberg, PhD, is Professor Emeritus of Communicative Disorders at San Francisco State University, and author of the new book, Loving, Supporting, and Caring for the Cancer Patient (Roman & Littlefield, October 2016). He is a prolific award-winning writer, editorial consultant and recognized expert in the area of cancer support, end-of-life issues, caregiving, chronic illnesses, aging and change.

Episode 3 highlights 5 Element Acupuncture and how it differs from traditional Chinese acupuncture. Kim interviews Mieko Sie, a 5 Element Acupuncture specialist. Mieko explains how 5 Element can be used for emotional healing (a.k.a. "spiritual" acupuncture). Each of us is associated with a particular element; specific organs and acupuncture points are associated with that element. Mieko also tells about her experiences with clients, using 5 Element for things such as pregnancy, in vitro, and depression. Mieko was born and raised in San Diego, CA. She attended San Diego State and received a Bachelor of Science in Communicative Disorders (speech pathology/audiology) in 2001. In 2004, she became a Massage and Holistic Health Practitioner. In 2008, Mieko graduated from Pacific College of Oriental Medicine, in San Diego, and is CA board certified. Also in 2008, she finished her certification in Classical Five Element Acupuncture. Today, Mieko is also an energy worker and most recently got certified in Huna energy work.  Mieko's website: http://mieko-sie.com  Podcast website: http://woowoofortheskeptic.com Facebook: https://www.facebook.com/woowoo4ts  Kim Polinder's website: http://kimpolinder.com