Inbox: Reach Out Across Settings I am writing in response to "Think Outside Your Setting" (Inbox, January 2013). As an SLP practicing in hospitals for 24 years, I understand the frustration expressed by SLPs in communication regarding shared patients or clients. I strongly feel communication is a two-way street. As a medical SLP working ... Inbox
Inbox  |   March 01, 2013
Inbox: Reach Out Across Settings
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School-Based Settings / Healthcare Settings / Professional Issues & Training / Inbox
Inbox   |   March 01, 2013
Inbox: Reach Out Across Settings
The ASHA Leader, March 2013, Vol. 18, 3-4. doi:10.1044/leader.IN3.18032013.3
The ASHA Leader, March 2013, Vol. 18, 3-4. doi:10.1044/leader.IN3.18032013.3
I am writing in response to "Think Outside Your Setting" (Inbox, January 2013). As an SLP practicing in hospitals for 24 years, I understand the frustration expressed by SLPs in communication regarding shared patients or clients. I strongly feel communication is a two-way street.
As a medical SLP working with children in the pediatric ICU and the hematologic/oncology unit, I am involved as early as emergence from coma or just after extubation. Truthfully, many times we are just grateful that the child is alive. I write goals that support the work of the medical team and that are accepted by insurance. I write goals that nursing and child life specialists can support and in which parents can participate. These considerations frequently preclude what is appropriate for a school setting, even though transition back to home and school is foremost in all of our minds.
I have worked with teachers who come in [to the hospital] at night to visit and see what activities to leave, but I cannot remember a school-based SLP doing the same. And frankly, sometimes children are discharged and I am not given time to update goals for home and school.
As a clinical assistant professor, I teach my graduate students to contact their clients' school SLPs to initiate that essential collaboration. But, in the years that I have been practicing, I can count on one hand the number of IEPs that I have been invited to attend by the school or the school clinician. Funding for services is tight, so we must all support the needed services we provide in all settings. The medical home model is becoming more prevalent, and physicians more and more are treating the whole child. I ask all school-based SLPs to invite the medical or private-practice SLP, as well as the pediatrician or family physician, to IEPs as a starting point for collaboration. You will be pleasantly surprised by the results.
Jennifer Casteix
Tucson, Ariz.
This is in response to Corrina Zimmerman-Riggs' letter "Think Outside Your Setting" (January 2013). I empathize and sympathize with her feelings, but I also understand the responsibilities of the nonpublic-school SLPs. Each school setting has mandated guidelines that allow parents to seek second opinions, a situation—that has existed since the 1960s—that puts the local education agency and the outside evaluators into a defensive position. The outside voluminous report reads like a letter to Santa Claus and contradicts that of the LEA [local education agency]. A conflict arises.
There is no simple solution to these predicaments. Each setting has competent ASHA-approved SLPs. Parents who appeal findings naturally lean toward "the hospital said" opinion. In this process the SLPs transgress their role and become a parent advocate, wittingly or unwittingly. The conflicts take on a life of their own!
To reduce the conflict it helps to seek professional unity and to try to see the world through the eyes of the other professionals. An e-mail, tweet, text or old-fashioned phone call before the report is written might improve communication and minimize conflict.
Robert J. Ferullo
Boston, Mass.
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FROM THIS ISSUE
March 2013
Volume 18, Issue 3