"Looking at—and Along—Communication Disorders" by Matthew H. Rouse (July 31), encouraging clinicians to relate more empathically, alludes to the key matter of therapeutic presence, our contribution to the tone and functionality of the relationship we cultivate with clients, caregivers, and colleagues. Focusing on being genuinely empathic can help us establish and monitor the extent to which our presence leads to satisfying clinical service. And being so stems from our awareness that what we do has the potential to help others live more personally meaningful and joyous lives, something we are more likely to actualize as we cultivate our ability to calmly and thoughtfully engage as we work together.
We know as patients and clients that we are more likely to relate with candor—sharing aspects of our stories that can help heal us more thoroughly and more efficiently—when we interact with professionals who listen with interest and respect to our expression of need and desire. Our clients, too, are likely to engage more fully to benefit more completely when we display—through grooming, attire, movement, posture, use of personal space, attention, eye contact, physical touch, word, rate of speech, tone of voice, intensity of voice, and silence—a presence that is welcoming, encouraging and healing.
Cultivating our therapeutic presence enhances our ability to be and feel useful and valued as professionals, reducing the likelihood we may succumb to compassion fatigue and jettison a career we sought and worked so hard to establish.
Concerns About Access
Although the Affordable Care Act—the new health law recently enacted by Congress—increases the prevalence of health insurance for the general public, the article "The Health Care Ruling and You" (July 31) expresses concern that the services of speech-language pathologists still may not be accessible to all of those in need.
I am an undergraduate student majoring in communication sciences and disorders and spent the summer interning as a member of the rehabilitation team in an acute inpatient traumatic brain injury unit. By the time I had a chance to interact with the patients, they were medically stable, but many still had a long way to go until recovery. The new buzzword in medicine is quality of life, and although these patients were no longer facing a life-threatening condition at the inception of therapy, such therapy was needed to allow the patients to achieve their optimal quality of life upon discharge from the hospital.
In recent years, there has been a preponderance of therapy developments that allow for remarkable recoveries (as in the case of Gabrielle Giffords). The next few years are expected to be an exciting time for health policy makers, and now, more than ever, it's important for speech-language pathologists (along with other rehabilitation professionals) to ensure that their services are properly recognized and made affordable to ensure that patients experience complete recovery.
New Hyde Park, New York
Listening Is Key
I was delighted to read the recent letter of Susan Cella ("The Importance of Listening," July 31), in which she gave herself permission to listen to a client rather than refer to a mental health professional. We must, as a profession, remember that grief is not pathology. We need to create the conditions, by nonjudgmental listening, to promote the emotional safety that enables our clients to express their grief. We cannot injure clients by listening and validating their pain, but we can potentially harm our clients by needlessly referring clients to mental health professionals because of our own felt inadequacy.
Lions Club Help
As a long-time ASHA member (and Fellow) and a Lion, I very much appreciated your comment about hearing aid help coming from your local Lions club ("Care for Everyone's Ears," July 31). Lions Clubs International has a program called AHAP, the affordable hearing aid program, which offers new aids sold at low cost. Here in the Northwest, there is a program called Audient, which is also a low-cost aid program sponsored by the Northwest Lions Foundation for Sight and Hearing. In many communities, local Lions have a hearing aid bank. In Spokane, we have one for the entire area, which is run by a Lion. It offers refurbished aids collected by Lions clubs and provided to the hearing aid bank. Some clubs charge for these aids; other don't.
Sanford E. Gerber
New California Credential
The California Commission on Teacher Credentialing's (CTC) new language and academic development (LAD) teacher credential regulations were adopted into law August 2011. Search asha.org; there are NO results regarding this major change to our profession. The e-mail response I received from the California Speech-Language-Hearing Association's leaders stated: ASHA and CSHA's leadership were actively involved in all negotiations and deemed this new teacher category to be an acceptable (and best possible) compromise. Wow! We already have a professional crisis with staff shortages nationwide. How much time, energy, and monetary resources are being spent on recruitment campaigns? If teachers begin doing our jobs, why would students pursue a degree in speech-language pathology?
Watch the CTC webinar, read the FAQs, and judge for yourself. There are eight LAD standards: Characteristics of Students with Communication Needs, Language Development, Assessment and Evaluation of Language Skills, Academic Assessment and Instruction, Planning and Implementing Curriculum and Instruction, Literacy Instruction, Social/Pragmatic/Communication Skills, and Behavior Based Teaching Strategies. Anyone else see a conflict? You may think I sound like an alarmist, but four of these eight are in my scope of practice!
It really seems to me, as much as the presenters emphatically state (maybe too much) that these LAD teachers are NOT replacing SLPs, that this entire plan was developed to mitigate the SLP shortage, and in the process, whether intended or not, put SLPs out of work—oh, except for articulation, voice, and fluency (they did say that, over and over again!).
Editor's note: The five-year history of this issue is complex. See the upcoming Oct. 9 issue for a full explanation of efforts by CSHA and ASHA to work with the California Teaching Commission, an independent decision-making body, on this compromise.