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As a school-based clinician, I read with interest the article "Pediatric Speech-Language Pathology in Health Care." The nature and scope of practice within settings changes over the years, and the school setting is no exception. The article fails to accurately represent "The Good and the Bad" of working in the school setting as well as the "typical population" served today. School practice does give the clinician an opportunity to specialize in language and literacy, work closely with fellow SLPs, and develop relationships with parents over years of contact. In fact, the 10 differences suggested between the pediatric health care and school settings are actually similarities. The need to acknowledge developmental differences; be "up" all the time; use play as an intervention context; tailor the physical surroundings to individual needs; vary session length; manage behavior so it fosters cooperation; deal with sadness, fear, and grief; and expect brutal honesty are all part of school practice.
Since virtually every child seen for speech, language, and hearing services in a pediatric health care setting attends or will attend school, perhaps an article focusing on collaboration between clinicians in each setting would be helpful for readers.
Deborah R. Harman
Bloomington, IN
dharmanslp@aol.com
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