Difficult text, lack of time and competing obligations can render it impossible for many clinical (as opposed to academic, research or student) speech-language pathologists (SLPs) to regularly read our professional literature in a focused and meaningful way. As a consequence, the luxury of absorbing and integrating relevant findings and then applying the new knowledge at work is often denied them. It can be argued that part of the role of Continuing Professional Development (CPD) event presenters is to 'distil' the literature for practitioners, but this does not equate to first-hand familiarity with current publications. Because so many SLPs are in this situation, valuable information that is clinically applicable tends to linger in academe, refusing to cross what Duchan (2001) called the research–practice gap. There are rich rewards to be had, however, for those who resolve to develop a research-reading habit (Highman, 2009) as part of a personal learning plan.

Clinical research

Like clinical practice, clinical research in speech-language pathology (SLP) involves people. Among those people are volunteers who agree to participate, or who consent for those in their care to participate, in meticulously conducted ‘laboratory’ investigations. Through a long and exacting process, if things turn out well, the investigations eventually reveal better means of preventing, classifying, assessing, diagnosing, explaining, treating and understanding human communication and swallowing disorders. The other people involved are the researchers themselves, some of whom are clinicians, the clinicians and educators who implement the research, and the beneficiaries of the research: our patients, clients or students and those close to them, and of course, us.

Translational research

Translational research is a process in which findings from laboratory studies (often involving animal subjects) progress to studies in humans (bench to bedside), or in which the implementation of best practices in everyday SLP settings (bedside to practice) is hastened. Its four dynamic phases include:

T1. Bench to Bedside (B2B): a fundamental new discovery is transferred into a clinical application.
T2. Bedside to Practice (B2P): clinical research delivers evidence of the value of T1.
T3. Research that moves the evidence-based guidelines developed in T2 into health practice 
T4. Research to evaluate the ‘real world’, functional outcomes of the novel T1 development.

Another way of conceptualising clinical and translational (C/T) research comes from the people at the Harvard Clinical and Translational Science Center. They think of it as a stepwise progression from basic scientific discovery, to clinical insights, to implications for practice, to implications for population health, to improved global health.

Publications

Every step of the way, C/T research is peer reviewed (‘juried’) and reported in learned journals and evidence reviews (e.g., the Cochrane Reviews), or ‘the literature’. Not forgetting the Journal of Clinical Practice in Speech-Language Pathology (JCPSLP), SLPs have a substantial range of periodicals to choose from, including journals from the Mutual Recognition Agreement signatories, ASHA, IASLT, NZSTA, RCSLT, SAC, and SPA. Also in the areas of SLP and Audiology there are Child Language Teaching and Therapy, Clinical Linguistics and Phonetics, Contemporary Issues in Communication Science and Disorders, Folia Phoniatrica et Logopaedica, the Journal of Child Language, the Journal of Interactional Research in Communication Disorders, Seminars in Speech and Language, Topics in Language Disorders and, new in 2014, the West Asian Journal of Speech-Language Pathology. Special subject journals are numerous with SLP-related topics that include AAC, aphasia, craniofacial issues, dysphagia, fluency, genetics, hearing, intellectual disability, and literacy through to motor speech disorders, TBI, telepractice and voice.

Free and inexpensive access

In addition to the barriers posed by articles that are hard-to-read due to the way they are expressed, restricted time to read, and work-life obligations vying for supremacy, clinicians cite lack of access to the literature, and the high cost of subscriptions as reasons for not reading it. Speech Pathology Australia members are fortunate to have subscriptions to hard copy and electronic versions of the International Journal of Speech-Language Pathology and JCPSLP as a member benefit. There are also free journals available, some discipline specific and some more general. In the first category are the Canadian Journal of Speech Language-Pathology and Audiology, Communication Matters from NZSTA, Contemporary Issues in Communication Science and Disorders the biannual, peer-reviewed journal of National Student Speech Language Hearing Association (NSSLHA). The Journal of Neurodevelopmental Disorders, fully open access and published as part of BioMed Central's portfolio of journals, repays exploration and it is interesting to see some of the 'big names' represented within this format. More generally, there are over 4,000 Free Medical Journals and the PLOS one Journals.

Readers pursuing a particular topic area will find that researchers very often upload their own work, and the work of colleagues and collaborators, to their faculty, institutional or personal web pages. For example, ISAAC Australia has a range of free AAC articles to download; The Phonology Project, and the Learnability Project provide full text articles about child speech, and Susan Rvachew offers to sent reprints of her publications to people who cannot access them via a library.

Google Scholar is a search tool that allows broad searches for scholarly literature: articles, theses, books, and abstracts from academic publishers, professional societies, online repositories and databases, universities and other websites.

The best value for money for those wishing to take out a subscription is International Affiliate Membership of ASHA for less than one hundred Australian dollars per annum. Among other benefits, affiliates receive The ASHA Leader and access to The ASHA Leader online, as well as unlimited access to all four of ASHA's online journals: AJA, AJSLP, JSLHR and LSHSS. There is guidance available for those wanting to adopt the discipline of reading journal articles regularly, including the helpful How to Read a Paper (pdf) by Srinivasan Keshav.

Implications for practice

Nearly every SLP clinical research paper published has one paragraph or more headed ‘implications for practice’ that speaks directly to clinicians – or at least, tries to. Oddly enough, this can be the most clearly written part of an article, with journal style-guides advising authors to address practitioners in clear and simple language. Make of that what you will! This is also the section that can make readers who are not all that well-acquainted with a topic area shake their heads and say, ‘So that’s what it’s meant to be about!’ Each ‘implication’ includes a small number of recommendations that can be operationalised by a specified readership, or that say what that readership should, could or must not do – based on a study’s outcome. ‘Implications’ that truly inform the reader often come with real clinical practice examples (Bartunek & Rynes, 2010).

Increasingly in our field, the implications reflect clinician-researcher partnerships, encouraged by programs such as ASHA’s CLARC, launched in September 2013, which aims to enable clinicians and researchers to identify each other for the purpose of forming research collaborations. What a fine thing it would be if CLARC expanded internationally and the ‘ordinary Australian’ reader of the Journal of Clinical Practice in Speech-Language Pathology could participate.
 

 

 

 

 

References

Bartunek, J. M., & Rynes, S. L. (2010). The construction and contribution of implications for practice: What’s in them and what might they offer? Academy of Management Learning and Education, 9, 100-117.

Duchan, J.F. (2001). History of Speech-Language Pathology in America. Retrieved October 20, 2013 from: http://www.acsu.buffalo.edu/~duchan/history.html

Highman, C. (2009). Keeping abreast of the evidence base. In C. Bowen, Children's speech sound disorders. Oxford: Wiley-Blackwell, pp. 218-223.

Links

Evidence-Based Practice (EBP) Briefs from Pearson

Informa Communication Disorders Journals

ReadCube

Why you shouldn't believe that exciting new medical study

 


"I didn't want to join a Yahoo group, but my professor said I had to for 10% of my mark in this subject."
- Graduate student, USA

"If you don’t wish ‘live’ tweeting during your presentation please advise your chairperson prior to your session."
- Notes for Conference Speakers, Australia

"I was more or less coerced into joining Facebook because a SIG I support could not find a moderator for its FB Group. Hey ho!"
- Professor, UK

"I lurked on the Twitter Chat because I hate that sort of thing. They spent half the time introducing themselves. It was pointless."
- First year speech pathology student, Australia

"I can't avoid being involved in some social media, and I quite like it. But Pinterest? NO WAY."
- Speech and Language Therapist, New Zealand

"Look, if the organizers insist on allowing live tweeting of my Keynote I will simply pull out. Got it?"
- Academic, USA

"I had no notion of the possibilities of social media as a professional resource. Twitter is a revelation. I'm hooked!"
- Academic, Ireland

"Social media is called social media for a reason. It lends itself to sharing rather than horn-tooting."
- Margaret Atwood, Canada

"In the circles I move in, a high proportion of tweets are messages pointing to a weblink, which may be a newspaper or journal article or a blog. This is where Twitter is such a useful resource for the academic: if you follow those who share your academic interests, they will point you to interesting stuff."
- Dorothy Bishop, UK

The push

More than ever before, Speech-Language Pathologists are pushed to engage professionally via social media, whether they want to or not. Disinclined senior and not-so-senior members of the profession report feeling they have been dragooned and thrust into online interaction with fanatics, hell bent on creating, sharing, and exchanging information and ideas in virtual communities and networks; and they resent the time it occupies. Newly appointed chairs, presidents, CEOs, councillors and committee members reluctantly sign on to Twitter and Facebook because it has come to be expected of them, and many of them partake minimally if at all. By contrast, enthusiastic converts 'get' its purpose and utility, integrating near-daily social media involvement into already busy schedules. Speechwoman (@speechwoman) is somewhere in the middle, fascinated by the relentless growth of the current social media platforms, conscious that more is to come, and participating actively but selectively. Nowhere is the push to participate more apparent than in the International Communication Project 2014 (#ICP2014).

#ICP2014

In 2014, professional associations, Speech-Language Pathologists, and students of communication sciences and disorders unite to increase world awareness of who we are and what we do. The purpose of this extraordinary yearlong international campaign is to publicise the fundamental importance of communication and the crucial difference communication professionals can make – particularly when they are involved early. Australian Nation for Communication champions support this global effort in large and small ways that could snowball to change many people's lives for the better. The champions' message is simple: communication is a human right, since people must be able to communicate to fulfil their social, educational, emotional and vocational potential.

As #ICP2014 participants, SLPs have learned a lot about under-served communities at home and further afield. They have also become more aware of the ever-increasing workload shouldered by the Mutual Recognition Agreement associations: ASHA, IASLT, NZSTA, RCSLT, SAC, and Speech Pathology Australia (Bowen, 2012), the benefits they offer, and their policies.

Policy

A policy is a course or principle of action adopted or proposed by an organisation or individual. The application of a policy, as opposed to facts, opinions, discussion, theories and research relating to it, can be summed up in one word: practice - the customary way of doing something. Professional practice involves the display of competence and specialist expertise anticipated in a professional, or professionalism. Professionalism in any paid occupation that requires prolonged training and a formal qualification is always bound up with other attributes: accountability, clear communication, quality assurance, steady reasoning and decision-making, effective leadership, lifelong learning, respectful workplace etiquette, and appropriate comportment. On top of this, a clinical profession, like speech-language pathology, has its unique occupational standards of practice, ethics, and agreed procedures including professional self regulation. They all reside in the context of the profession's unfolding history and development of expectations for state-of-the-art clinical competence.

Competence is the cornerstone of clinical preparation, and its pursuit is exemplified in COMPASS®. Supremely practical, COMPASS is a tool designed to validly assess the performance of Australian speech pathology students in their placements. It has four Professional Competency Units: Reasoning, Communication, Lifelong Learning, and Professionalism. For individual SLPs and students, one aspect of professionalism is deciding whether to join, support and represent; and be admitted to, supported and represented by, a relevant professional association. In deciding, most will consider the cost benefits and tangible advantages of membership, and what membership says about them.

Benefits

The Journal of Clinical Practice in Speech-Language Pathology (JCPSLP) Webwords column is accessed online by at least 1.5 million readers per month worldwide, while most JCPSLP readers are Speech Pathology Australia members who receive it in print as a magazine, and who can also retrieve it electronically. These are two of many member benefits SPA delivers in its key role as a beneficial resource for its members. It also provides: representation to external bodies and the general community, public relations, several publications in addition to JCPSLP, continuing professional development, member services, and the coordination and drafting of submissions to funding bodies, government departments and research authorities. 

Kelly Cherwin, Communications Editor of HigherEd Jobs reflects on the potential for association membership to enable a professional to further important career goals. She addresses her topic in terms of building a professional network, utilising career-related resources, and developing discipline-specific knowledge. Cherwin's target readership is higher education professionals seeking academic appointments. But if she moseyed on over to the Speech Pathology Australia website, or attended an Association event or online forum in order to gather illustrative examples of what she means, she and her readers would not be disappointed. SPA membership offers many satisfying opportunities to give and receive help and support in reaching professional goals within secure, trustful relationships.

What does association membership say about me?

From a cynical onlooker's perspective, association membership may just say that the member is a conformist or even a pragmatist who knows which side his (3% of SLPs in Australia) or her (97%) bread is buttered. But for most observers it probably sends a message to colleagues and to the public that you care about your profession, value continuing professional education, are in touch with key issues and developments in your discipline. It tells them that you and your profession count for something, that you are active in the field, and in it for the long haul.

Virtual professionalism

Our professionalism is on display virtually all the time in the real world, and all the time in the virtual world. It is represented in everything we post or broadcast in Blogs and Blog comments, Facebook, Google Hangout, Instagram, LinkedIn, Listservs®, ORCID, Podcasts, Pinterest, ResearchGate, Twitter, Yahoo! Groups, YouTube (and whatever comes next in any and all media of expression now known or later developed and in all languages!) (Hemsley, Bowen, & McCabe, 2013). So we have to be mindful of online comportment, whether we are in a gated 'professional' network such as SPA's Member Communities, a 'mixed' network like Speech and Language Therapy where professionals and the general public interact, or Twitter where everyone can see everything, unless you lock your account.

The perceived lack of regulation and well thought out policies governing its professional use may partly explain the reluctance of many leaders, bright, thinking newcomers, and experienced clinicians in our field to embrace social media as a regular practice. The future of social media as a powerful vehicle for knowledge dissemination and positive change is in our hands. We need to talk about it, and we need to talk about it soon.

References

Bowen, C. (2012). Webwords 42: Professional issues. Journal of Clinical Practice in Speech-Language Pathology, 14(1),42-43.

Hemsley, B., Bowen, C. & McCabe, P. (2013, November). Speech Language Pathologists navigating Twitter: Everyday ethical decisions in publishing, exchanging information, and engaging across multiple blurred boundaries. Paper (30 minute oral presentation) presented at American Speech-Language-Hearing Association Convention, Chicago, IL, USA.

 

 

 

 

Links

How to behave professionally on social media
Markkula Center for Applied Ethics: Articles about Internet/Social Media Ethics

The Power of Professional Associations

As a speech therapist/pathologist I enjoyed The King’s Speech greatly, but was totally unprepared for the tremendous interest shown by almost everyone else, not only those of my age with a childhood memory of the solemnity of the wartime speeches, but younger people too, some of them committed republicans, have been asking me about speech therapy practice. “Is that what you did when you treated stammerers / stutterers?”

When I thought about this I realized, with surprise, that my graduation in Speech Therapy in Melbourne, Australia in 1951 was closer in time to Lionel Logue than to today’s speech pathologists. So close that we, with our new diplomas at the end of our three year’s study, were very careful to distinguish ourselves from elocutionists, whom we thought unscientific and unprofessional, and guarded our status by accepting for “treatment” only “patients” referred to us by medical doctors.

Some elocutionists or speech and voice teachers, like Logue, had however trained as actors or singers and would have had good information available to them in what was then known about The Anatomy, Physiology, and Hygiene of the Vocal Organs --- the title of a chapter by Lennox Browne FRCS in Miles’s Standard Elocution, already into its ninth edition in the second decade of the twentieth century (no publication date given). In an earlier chapter the “earnest attention of the student” is drawn to “pitch, articulation, pronunciation, emphasis, modulation, punctuation or phrasing, pace and pause”. We forget now how large a part the spoken word played in entertainment in this period, in recitation , as well as in plays. Many people with speech problems had been helped by practitioners from such a background, and indeed it was from amongst those practitioners, aware of the limitations of their knowledge, that many of the founders of our own profession came. Lionel Logue was one of them.

Margaret (Peggy) Eldridge, who came to initiate Speech Therapy training in Melbourne in 1945, was a Founder Fellow of the College of Speech Therapists, London, and told a story of a wartime meeting of the founding committee in rooms in Harley St. where the members present continued their meeting under a board room table during an air-raid. Among members of this founding group were Lionel Logue and Leopold Stein, an Austrian psychiatrist with a particular interest in voice and speech. When the all clear siren sounded and Peggy went off to drive an ambulance, Lionel would have gone to his air raid warden duties.

It was Peggy who introduced my class to the problem of stammering. Unlike the problems of resonance and articulation caused by cleft palate, or of language after stroke, it seemed to me vague and mysterious. There were many theories about what caused it; there were methods of treatment which focused almost entirely on the speech mechanism, others that were based on general relaxation and suggestion, and some that seemed close to psychotherapy. As most combined all of these, when patients improved we didn’t really know what had worked and why, or how to measure it. Research now provides sound evidence to guide therapists and information about this can be found elsewhere on this website.

Why did Lionel Logue’s methods work? From the little evidence we have I believe that his confidence, his empathy with his clients, and his understanding of the profoundly traumatic nature of a serious impediment to communication, combined with techniques to reduce inappropriate muscle tension and respiratory patterns, and to demonstrate to patients that there were many ways of producing fluent speech were all important.

Some of his ways of doing this are surprising, but there are more ways than one to sieve a thistle!

PDF version of this article

Read another article by Ruth Porteous

Many hits and many questions

Launched in June 1998 this site welcomes many visitors, often receiving 180,000 to 200,000 or more hits in a single day. Thousands of these visitors have enquiries, questions and requests for information, most of which arrive by email in  numbers so overwhelming that it became necessary to instate a policy on questions from SLPs/SLTs on child speech assessment and intervention.

The following article was written in 1999. Nothing much has changed with regard to the questions the site generates, except that the number of them increases constantly. I also receive some very entertaining feedback from empathic colleagues who have had similar experiences. For example, "A" wrote: "As an SLP in the US, your page of examples of questions your receive made me laugh out loud! To that end, I was wondering if you had a good recipe for pea soup. Not too thick, but not too thin either ... and please be sure to send all the info you can!"

Made me smile.


Questions from colleagues


As you can see I have made extensive use of the Question and Answer format as a means of presenting speech-language pathology information. Maybe the presence of these Q&A and pages encourages visitors to ask me more questions. Whatever the reason - I am asked hundreds and hundreds of questions by consumers, professionals and students. This article is about the level of questioning by professional and student colleagues.

Don't get me wrong! Many of the questions I am asked by SLPs and students are interesting and stimulating, and they often provide the impetus for me to develop new sections on this site. They also provide feedback about how accessible the site is. If, for example, I am asked for information that is already available here, it may mean that the site is not well sign posted, and that I need to improve it.

BUT...some of the questions make me wonder whether there is a fundamental change occurring in the way professionals seek out work-related information, and in the way that students approach assignments.


Questions from me


With the increasing availability of Internet resources, is the responsibility for researching professional topics shifting? Is there an increasing expectation that others will (happily!) do the donkey work for us? Is the notion of "independent research" different in the Internet era?

That is how it sometimes feels when I open my Inbox and find requests for information that the writer could have found very quickly by using a little effort with a search engine or directory.


Rude


Some of the requests are so impertinent that I put them in a folder labeled "rude". Like these:

"This site is completely useless to SALTS needing information about expressive language disorder. What do you plan to do about it?" UK/SALT

"Send info on myofunctional tx". SLP

"I need email addresses for ---- and ----" [Names of two prominent language researchers] Graduate Student

"I need info on starting a private practice. Please send to This email address is being protected from spambots. You need JavaScript enabled to view it." SLP


Audacious


Why bother to keep them? Call me systematic, call me obsessional - but I like to keep track of these things. And I find it interesting that some of these correspondents write to me quite frequently, using different "identities" but the same email address! For example, the person who wrote:

"Send info on myofunctional tx". SLP

wrote this (or at least, had the same email address as the person who wrote this) about two weeks later:

"Dear Dr Bowen, I have been reading your excellent web site with awe! My daughter Katie, aged 11, was recently assessed by a speech and language professional who advised myofunctional therapy. I was not so sure that this was a good idea, and saw a private SLP who said that myofunctional therapy was not held in high regard by your profession. Now I am confused and I want what is best for my daughter. Please send the arguments for and against this form of therapy, how assessments are performed, what the treatment entails, and the current controversies. Concerned Father"

Hmmmm!


Ask a busy person


If I have a moment to spare I do sometimes respond to people who want me to do their searching for them (though less often than I used to). For example, an SLP wrote:

Hi Caroline...I know you must be very busy and receive lots of requests, but I REALLY need this info. Do you have any sites which explain the speech banana?? SLP

Well, I wasn't terribly busy at the time, and I did know of one. I had listed included it on my site. I wrote back:

Dear SLP: There is a speech banana information here Caroline

Some minutes later I received this:

Hi Caroline...I looked on the page you sent but I could not see the link. Please send the URL ASAP. SLP :-)

Oh dear!


Nice site, but are your credentials up to scratch?


Hi Caroline,
My name is X and I am a senior at the University of X studying Communication Disorders. I am doing a final project on Developmental Apraxia of Speech and would like to use your website as a reference, however, even though you are a SLP, I need to make sure you are ASHA certified and have your CCCs. I also wanted to thank you for creating such a wonderful resource! I found it very helpful. Thank you. Sincerely, X

Dear X,
I am glad you find my web site helpful. I was surprised by the tone of your e-mail, and suspect that you are taking a rather "local" view of our profession. Are you really taking it upon yourself to check my credentials? And to what end?

There are properly qualified SLPs all over the world who are not ASHA members, and who do not have their CCCs. As it happens, I have been an International Affiliate Member of ASHA for many years. But, as an Australian, I am a Certified Practising Member of Speech Pathology Australia (CPSP). Having ASHA C's would not automatically entitle an SLP to practice in Australia.

In the peer reviewed literature, that is, in journals such as JSLHR, many of the authors are not ASHA members - nor indeed SLPs. This does not make their contribution to the field of human communication disorders any the less worthwhile.

Caroline


Please send goals and objectives for articulation


I am a new speech pathologist and was interested in trying to find some goals and objectives for articulation. I was wondering if you had any ideas in this area. I would appreciate it if you had any input for me. Please feel free to e-mail me if you think you can help. Thank you for your time. SLP


Send as much info about dysarthria as possible! TQ


Hello, I am a student at X. I recently chose dysarthria as a topic for a research paper as well as for our Disability Awareness Day. The only problem is that I am having troubling finding information on it. So could you please send as much information about dysarthria as possible to me. I need your answer ASAP.


Can't find any web sites on phonological disorders


I am a graduate student and I have a research project that I am working on for my Disorders class. Our assignment was to pick a speech disorder and write a research paper on treatment efficacy (for the chosen disorder). I have chosen phonological disorders and the minimal pairs approach. We must have 6 journal articles and two websites. I have found the journal articles, but I can't seem to find any websites. I would love some help if you know of any. Thanks~


Only send PRACTICAL techniques


Hello! I am in great need of some practical techniques for an SLP to use when increasing the range and form of communicative intentions. I have searched your web site extensively under "pragmatics," "language use," "language function" etc. Do you have any suggestions? Only send PRACTICAL techniques.


Any suggestions for communication temptations?


Hi -- I'm a student clinician enjoying your website. These ideas all sound great, but the kids I'm working with right now are very delayed 4-year olds who just don't seem to want to talk at all, no matter how simple I make a task. I haven't managed to come up with any communication temptations that are tempting enough! Do you have any suggestions?


Send unique therapy idea sites ASAP


Just wondering if you know of sites that have unique therapy ideas. Send as many as possible ASAP - Thanks


Looking for articles urgently


I am looking for articles specifically about oral sensory feeding problems. I need them urgently for a paper. Please do not send journal citations as I am a busy clinician and do not have time. Just send as many web sites as possible. I appreciate your efforts. Thanks in advance. SLP


What are your thoughts?


I have a few students on my caseload that after 2 years of therapy still tongue thrust. No amount of tongue exercises seems to help keep that tongue from pushing out between the teeth. What are your thoughts? SLP


Need specific activities for a client


I am currently an undergraduate studying speech-language pathology at XX in the USA. This semester I am working with a 6 1/2 year old boy. My client is missing many teeth including his upper incisors. He is 70% intelligible and exhibits many of the phonological processes. Could you direct me to a website that offers specific activities and or minimal pair word lists that I could use with him. So far the word lists on your website have been helpful, but I was hoping to find more. Will you be adding more?


Help: I can't understand this quote!


Help! I can't understand this quote. I am a student in Speech Lang. Pathology. I am reading a text by M. Lahey ("Language Disorders and Language Development") and have a question about a quote... "The developmental sequence in the use of complement constructions is...infinitival complements with the co-referential subjects before the sentential complements with non co-referential subjects." If you can help me with this one, please do ASAP. I thank you for your help - if you cannot help me, could you show me where else to direct my question. Thank you for your time. GRAD STUDENT


Help: I can't think!


I am doing a project researching how music helps to help a child's speech. I know that for stutterer's, music can help them to obtain smooth speech. Do you know how else music may help a child with a speech-language problem? If you could get back to me I would appreciate it. SALT


Help: I've forgotten!


Hi Do you know the name or where to find a program for teaching k-3 vocal hygiene, pragmatics.. in the classroom. I know it is out there I have seen it but cant remember where. Thanks, SLP


Send all the info you can...


Hi Caroline...I was wondering if you had some info or URL's regarding selective mutism. Send all the info you can...Thanks. SLP


Any fun suggested ideas?


I am working with a student who has difficulty with producing the "r" sound. He substitutes w/r and has difficulty with type of therapy for L to R production. Any fun suggested ideas? This student is a 3rd grader enrolled in SBH class- gets frustrated easily and loves to play games. SLP

Aaaahhh! It feels better now I've got that off my chest!

Any questions?!
 @speechwoman

Aviator oyna cox olk?l?rd? h?r gun daha cox populyarlasan maraql? pul oyunudur. Sad?liyi v? yuks?k qazanma nisb?ti il? cox qumarbaz?n ur?yini qazand?.