Opening Plenary Session
PL1 Personal-Professional Balance: Does It Exist? How Do We Find It?
Judy Stone-Goldman, PhD, CCC-SLP
University of Washington and The Reflective Writer
In our lives as health care professionals, we participate in multiple relationships that present demands and stressors. We juggle sometimes-competing needs of institutions, administrators, professionals, colleagues, and clients, as we try to provide accountable service, maintain our boundaries, and get the paperwork done. It is any wonder we sometimes lose our balance? You might wonder whether balance is even a reasonable goal. This talk suggests that the answer is yes...at least some of the time. In this session you'll gain insight into the balance-imbalance continuum, the intersection of personal and professional issues at work, and strategies for achieving balance on a day-to-day basis.
After completing this session, you will be able to:
- Describe common symptoms of imbalance and their effects on your work
- Discuss the importance of interpersonal relationships and boundaries in one's working life
- Identify typical personal and professional variables that crop up to create imbalance
- Describe three boundary states and how they may relate to balance or imbalance
- Describe three strategies for restoring personal-professional balance
ASHA Business Institute
B1 Medicare SLP Private Practice: The Rules Rule
Sponsored by Special Interest Division 15, Gerontology
Mark Kander, MHA
American Speech-Language-Hearing Association
If you have enrolled or are considering enrolling in Medicare, make sure you know the rules! Some professional activities you have been performing for years may require some adjustments to be compliant. This session reviews some of the rules for billing and reimbursement, physician referrals and orders, and documentation. You will learn about enrollment as an individual or group provider, approved locations for providing services, affiliation with managed care Advantage programs, and relationships with inpatient/outpatient health care facilities. A Medicare roadmap to ASHA's Web site is provided, as well as direct links to essential sections of national Medicare policy manuals and tips on access to local coverage determinations (LCDs).
After completing this session, you will be able to:
- Enroll as a Medicare provider electronically or via hard copy
- Comply with Medicare documentation requirements
- Identify local and national scope of coverage descriptions
- Contact your Medicare Administrative Contractor
B2 The Business of Caring: SLP Services in Context
Becky Sutherland Cornett, PhD, CHC
The Ohio State University Medical Center
This session focuses on how a clinician in a helping profession can (and must) demonstrate financial acumen, business process skills, knowledge of health policy issues, and political savvy, while offering patient-focused services. Learn how to enhance your own knowledge and skills in this area, and how to broaden your employees' understanding of the business of caring.
After completing this session, you will be able to:
- Discuss the elements of financial acumen in a health care setting
- Assess your knowledge of your role within the health care business
- Describe how knowledge of current policy issues and political savvy are essential to success in the health care business
B3 Regulatory Compliance Update: HITECH, Red Flags, RAC, and More
Becky Sutherland Cornett, PhD, CHC
The Ohio State University Medical Center
This session focuses on the latest information about regulatory compliance issues that affect speech-language pathologists in health care and private practice environments: HIPAA/HITECH, red flag rules, Medicare's recovery audit (RAC) and other medical review programs, management of the environment/facility, quality of care, accreditation, and human resources. Brief overviews will include pertinent resources for detailed information. Emphasis will be on your questions and concerns.
After completing this session, you will be able to:
- Identify the primary changes to regulatory compliance requirements affecting the practice of speech-language pathology in health care and private practice
- Discuss implications of regulatory requirements for daily management practices
- Access pertinent resources to develop or revise internal policies and procedures
B4 Correct Coding: Your Ticket to Reimbursement
Mark Kander, MHA
American Speech-Language-Hearing Association
Many CPT procedure codes and ICD-9 diagnosis codes can be misread or misapplied unless one is familiar with the official coding guidelines and Medicare rules (many private health plans selectively adopt the Medicare rules). This session addresses, among other topics, untimed vs. timed codes, CCI edits of code pairs, and CPT modifiers. Implementation of ICD-10 in 2013 is also discussed.
After completing this session, you will be able to:
- Access ASHA's speech/hearing/swallowing CPT and ICD-9 code lists
- Differentiate between code pairs that require a modifier and those that do not
- Insert codes and modifiers properly on the standard claim form
B5 Decision Making by the Numbers: Using Financial Projections and Cost Benefit Analyses to Guide Business Decisions in Speech-Language Pathology
Tannus Quatre, PT, MBA
Vantage Clinical Solutions
Whether you're the owner of a small practice or an administrator in a large hospital or rehab center, your ability to effectively use numbers in making key business decisions is critical to the results achieved for your team, your business, and your livelihood. This session introduces some of the same basic techniques of financial analysis taught in business school, simplified in a manner that is both easy-to-understand and practical for use by SLP practice owners, administrators, and decision makers. You'll learn to use financial projections and cost-benefit analyses (CBA) to help you make sound decisions about programs, services, and new ventures. You'll take away access to electronic financial projection and CBA tools that will enhance your performance in program development, managerial, and entrepreneurial roles.
After completing this session, you will be able to:
- Discuss the importance of quantitative analysis in business decision making for the speech-language pathologist
- Create a set of financial projections for the development of new programs, services, or ventures
- Perform a cost-benefit analysis (CBA) for a proposed new program, service, or business
- Access and use electronic financial projection and CBA tools for use in business decision making
B6 Six-Step Marketing for SLPs: A Sustainable Approach to Marketing SLP Services
Tannus Quatre, PT, MBA
Vantage Clinical Solutions
Instructional level: Introductory
Learn a simple and effective framework through which your SLP practice can achieve successful marketing results. This approach has been used to develop successful marketing strategies for health care practices throughout the United States, and combines elements of sound marketing theory with a simple step-by-step approach to the organization of your marketing efforts. You'll get practical concepts, techniques, and tools that can be used quickly and effectively in the marketing of your SLP services, regardless of practice setting. Included in this presentation is access to a "Six-Step Marketing Tool" that can be implemented within your practice immediately following the presentation.
After completing this session, you will be able to:
- Describe how basic principles of marketing apply to SLP services
- Discuss the keys to sustainability with marketing efforts
- Follow a six-step framework through which SLP marketing efforts can be made simple and effective
- Use a "Six-Step Marketing Tool" to organize and bolster the marketing efforts within your SLP practice
B7 Supervision, Ethics, and the Law
Sponsored by Special Interest Division 11, Administration and Supervision
Wren S. Newman, SLPD, CCC-SLP
This session highlights the ethical and legal issues that may present as part of the supervisory process. Topics include vicarious liability, informed consent, confidentiality, and dual relationship, with attention to strategies to address problems in these areas. The implications of ASHA's Code of Ethics for supervisory issues are discussed.
After completing this session, you will be able to:
- Recognize ethical dilemmas in supervisory relationships
- Define the terms "vicarious liability" and "dual relationship"
- Discuss possible strategies to address ethical issues in the supervisory relationship
B8 Reflective Writing for Personal-Professional Balance
Judy Stone-Goldman, PhD, CCC-SLP
University of Washington and The Reflective Writer
Instructional level: Introductory
You want your work time to count, and you want to do your best for each client. But what about the days when frustrations intrude, when you have uncomfortable feelings about yesterday's interactions, or when you can't help but worry about the economy? When stressors push us into imbalance, our rising anxiety or anger may impair our ability to deliver the best professional services. One way to restore balance is reflective writing, a process that has now been shaped to serve the needs of helping professionals. In this session, you will learn how reflective writing can help you be more effective in your work by achieving personal-professional balance. This is a hands-on workshop. You will engage in reflective writing exercises and learn techniques for using reflective writing in response to real-life work situations.
After completing this session, you will be able to:
- Discuss how personal-professional balance affects the quality of service delivery
- Discuss the value of using writing to explore personal-professional stressors and restore balance
- Identify at least three topics for your reflective writing
- List at least three prompts you can use to get started and keep going in reflective writing
- Apply reflective writing techniques in your professional life
B9 What a Great Idea! Brainstorming That Works…for Work
Katie Schwartz, MA, CCC-SLP
Business Speech Improvement, Chattanooga, TN
Learn how to get more—and better—ideas, more easily! Over a 60-year period, researchers and other experts on idea generation have discovered what works, what doesn't, and why. Learn what they know, and then try at least three group and individual brainstorming techniques to see the difference. Use these techniques to engage your employees and co-workers in resolving process problems, exploring new areas of practice, or creating marketing strategies.
After completing this session, you will be able to:
- Discuss factors that research finds to be important in effective group brainstorming
- Describe how to run a group brainstorming session
- Apply at least two individual brainstorming techniques to issues relevant to your work
B10 Make Your Practice Shine Online
Tom Jelen, BS
American Speech-Language-Hearing Association
Having a solid online presence has become an essential component of running any small business. The good news is that establishing a professional Web site is easier (and less expensive) than it has ever been. This session provides you with an action plan for establishing your business online and strengthening an existing Web presence.
After completing this session, you will be able to:
- Develop a simple plan for representing your practice online
- Avoid some common mistakes in developing an online presence
- Describe low-cost methods (such as search engine optimization and use of e-mail and social media) to help drive traffic to your practice Web site
B11 Individual Differences and the Supervisory Relationship
Wren S. Newman, SLPD, CCC-SLP
Cultural perspectives are pervasive—they color our perceptions of events and people in ways we may not be consciously aware of. Because the supervisory relationship is central to the development of competent, caring professionals, we should be especially attentive to individual differences and how they may affect supervisor and supervisee. This session reviews literature on individual differences in the context of supervision, and explores strategies for communicating effectively about sensitive, value-based issues.
After completing this session, you will be able to:
- Discuss ways that differences of gender, cultural/linguistic background, social role, age, or other factors may affect the supervisory relationship
- Describe how your unique perspective may influence your approach to supervision
- Describe strategies to communicate effectively and appropriately with supervisees about these issues
B12 The Teaching Clinic in the Working World
Nancy Alarcon, MS, CCC-SLP
The academic clinic is expected to prepare developing professionals to "hit the ground running"—and also meet KASA standards, provide meaningful clinical experiences across a range of competency levels, develop funding sources including community service contracts, and navigate private-pay and third-party insurance billing practices. This roundtable session facilitates discussion of policies, procedures, and critical business strategies that can enable an academic teaching clinic to serve both as an effective contemporary work setting and a model for professional preparation.
After completing this session, you will be able to:
- Identify at least three essential elements of business management requisite for the professional teaching clinic
- Identify at least two methods of fiscal management in the teaching environment
- Articulate practice policies and procedures that bridge a teaching environment and working world clinical practice
- Identify clinical practice teaching tools that exemplify working-world practice standards in a teaching clinic
B13 Marketing Your Practice: Out-of-the-Ordinary Approaches
Katie Schwartz, MA, CCC-SLP
Business Speech Improvement, Chattanooga, TN
Why be content with ordinary marketing techniques? This session offers ways to take a fresh look at your community, prospective patients/clients, services, and referral sources. Explore visualization techniques such as mind mapping, and discuss how to analyze your practice from the perspective of a client or a referral source. You'll hear about different services being offered by innovative private practices. Bring the business, metropolitan, and "help wanted" sections from your local Sunday paper to supply insights into your community. You'll start on a plan to develop a year's worth of out-of-the-ordinary marketing activities.
After completing this session, you will be able to:
- Use mind-mapping to explore marketing options
- Discuss the marketing process from the viewpoint of the referral source and end user
- Describe at least five non-traditional services being offered by innovative private practices today
- Describe how to identify service needs in your community
B14 Coding and Reimbursement Roundtables
Mark Kander, MHA
Janet P. McCarty, MEd, CCC-SLP
American Speech-Language-Hearing Association
Get help with your specific coding and reimbursement questions. In small groups, you'll discuss your challenges with ICD-9 and CPT coding. Each roundtable will present its top questions to the session facilitators for guidance on issues such as primary/secondary diagnosis codes, CPT modifiers, Medicare's impact on private health plan coding, restricted CPT code pairs, physical medicine CPT codes, and understanding time units.
After completing this session, you will be able to:
- Identify new diagnosis codes for 2010
- Use CPT codes with greater accuracy
- Describe official guidelines for ICD-9 codes
- Access resources to answer coding and reimbursement questions in the future
ASHA Health Care
Track 1: Dysphagia
D1 Advanced Issues in Tracheotomy Management
Sponsored by Special Interest Division 13, Swallowing and Swallowing Disorders (Dysphagia)
Susan Brady, MS, CCC-SLP, BRS-S
Marianjoy Rehabilitation Hospital
Instructional level: Advanced
This session explores the use of blue dye during clinical swallow examinations, the impact of tracheotomy tube occlusion status on secretions and swallow function, and the overall effect of the tracheotomy tube on swallow function. Clinical examples of unique or unusual tracheotomy tube complications are presented.
After completing this session, you will be able to:
- Describe the use of blue dye during clinical swallow examinations
- Discuss the possible impact of tracheotomy tube occlusion status on secretion levels and swallow function
- Describe the recent research related to the overall effects of the tracheotomy tube on swallowing function
D2 Implementing a Water Protocol in a Rehabilitation Setting
Caren Carlaw, MA, CCC-SLP
Surrey Memorial Hospital, British Columbia
This session presents an interprofessional process and framework for implementing a water protocol in a rehabilitation setting. You will discuss the rationale for a water protocol, including issues of safety and effects on patient satisfaction, quality of life, and fluid intake. An algorithm for assigning candidates to supervised or independent water access will be demonstrated, including frequency, techniques, and tools for oral care protocols with and without suction.
After completing this session, you will be able to:
- Discuss the rationale for a water protocol, including issues of safety
- Use the GF Strong algorithm to assign clients to supervised or independent access to water, and describe the interdisciplinary plan of care for each
- Use the GF Strong algorithm to assign clients to an oral care protocol with or without suction, and describe the frequency, techniques, and tools for each protocol
- Discuss the effect of the GF Strong water protocol on client satisfaction, quality of life, and fluid intake
D3 Clinical Decision Making in Swallowing: Spinal Cord Injury, Cardiovascular Disease, Feeding Tubes, and VFSS/FEES
Susan Brady, MS, CCC-SLP, BRS-S
Marianjoy Rehabilitation Hospital, Wheaton, IL
Instructional level: Advanced
This session addresses clinical research and decision making for swallowing disorders across different patient populations, including persons with cervical spinal cord injury and cardiovascular disease. It also applies the results of clinical research related to decision making about feeding tubes, stroke outcomes, and comparing VFSS to FEES.
After completing this session, you will be able to:
- Apply the results of clinical research to decision making about the treatment of dysphagia following cervical spinal cord injury
- Apply the results of clinical research to decision making about the treatment of dysphagia in individuals with cardiovascular disease
- Apply the results of clinical research to decision making about the treatment of dysphagia in persons who require feeding tube placement following a stroke
- Apply clinical research on VFSS and FEES to select the most appropriate examination for your patient
D4 Clinical Decision Making in Swallowing: Brain Injury, Brain Tumor, and Viral Illness
Susan Brady, MS, CCC-SLP, BRS-S
Marianjoy Rehabilitation Hospital, Wheaton, IL
Instructional level: Advanced
This session addresses clinical decision making for swallowing disorders in individuals following a severe traumatic brain injury, brain tumors, or a complicating viral illness. Emphasis is on describing and applying results of clinical research as it affects decision making with these populations.
After completing this session, you will be able to:
- Apply the results of clinical research to the treatment of dysphagia in individuals following a severe brain injury
- Apply the results of clinical research to the treatment of dysphagia in individuals with brain tumors
- Apply the results of clinical research to the treatment of dysphagia with individuals following a complicating viral illness
D5 Endoscopy for Evaluation and Treatment Planning: Grand Rounds
Susan Brady, MS, CCC-SLP, BRS-S
Marianjoy Rehabilitation Hospital, Wheaton, IL
This session presents a rating scale for accumulated oropharyngeal secretions. You will review endoscopy studies to apply the secretion rating scale and discuss treatment options. You will also rate swallow function and discuss possible treatment options following a review of endoscopy studies involving the use of ice chips and oral care strips.
After completing this session, you will be able to:
- Describe and use a secretion scale to evaluate the level of accumulated oropharyngeal secretions during endoscopy
- Apply recent research involving the use of endoscopy related to the evaluation and treatment of swallowing and swallowing disorders
- Describe and apply appropriate treatment options for higher levels of accumulated oropharyngeal secretions
D6 Swallowing and Respiration in Neurodegenerative Diseases
Christine Sapienza, PhD, CCC-SLP
University of Florida
This session reviews the major mechanistic causes of symptoms presented by patients with neurological and neurodegenerative diseases such as stroke, multiple sclerosis, and Parkinson's disease. The impact of corticobulbar dysfunction in neurologically based disorders is traced in its effects on the normal function of breathing, speech, swallow, and cough. This session describes management therapies that directly address these functions and modify the course of these diseases.
After completing this session, you will be able to:
- Discuss the impact of neurodegenerative disease on the processes of breathing, speech, swallow, and airway protection
- Identify the airway and swallow symptoms presented by different patient groups
- Describe current treatment options for improving those functions
D7 Dysphagia Screening: Whose Job Is It?
Paula Leslie, PhD, CCC-SLP, CertMRCSLT (UK)
University of Pittsburgh
Dysphagia "screening" is an ill-defined term and a contentious issue. Who should "screen" and how can it be done consistently and reliably? What does it mean in practice for SLPs? How does the clinician decide what will work best for his/her setting, given staffing levels and need for in-service training of other disciplines? In this session we will turn to current research and evaluate the evidence. We will also review real-world attempts by services to initiate a nurse screening program. We will consider existing resources and evaluate some current "screening tools" to guide us in developing strategies for this important area.
After completing this session, you will be able to:
- Discuss the current range of perspectives on "nurse screening"
- Explain the problems experienced by services that have tried a nurse screening initiative
- Identify factors to consider if a service is thinking of using nurse screening
- Identify clinical settings where such an approach is more likely to be successful
D8 Ethics, Risk, and Decisions in Dysphagia
Paula Leslie, PhD, CCC-SLP, CertMRCSLT (UK)
University of Pittsburgh
Theoretically, dysphagia intervention increases safety and reduces risk. In reality, decisions in dysphagia are murky with seemingly little clear evidence. How do we balance clinical experience, evidence, and patient preference to inform our professional input to the complexities we face every day? The best decision for a patient is not necessarily the traditional one learned in training. Acknowledging this will help with those thorny cases where every option is imperfect. In this session we will examine decision making and risk analysis with respect to patients with impaired swallowing and their families. Using the "Ethical Grid" by David Seedhouse, we will establish a framework to help with complex decisions.
After completing this session, you will be able to:
- Explain differences between values, morals, and ethics
- Identify personal biases that affect decision making about dysphagia
- Discuss medical ethical principles
- Balance components of the Seedhouse Ethical Grid to help inform patient-centered decision making
Track 2: Adult Neurogenic Disorders
N1 Direct Attention Training: Procedures and Evidence
McKay Moore Sohlberg, PhD, CCC-SLP
University of Oregon
Attention is fundamental to all cognitive performance and encompasses all the mental processes, operations, and systems requisite for acquiring and applying information. It is also commonly disrupted following many types of brain insult. The session describes an attention intervention, Direct Attention Training, which aims to improve the underlying attention deficits seen in clients with both acquired and developmental cognitive deficits. You will learn the theory and procedures for drill-oriented therapy designed to remediate attention deficits, and discuss methods for promoting generalization.
After completing this session, you will be able to:
- Describe the different components that make up attention
- Discuss the principles of neuroplasticity that account for benefits from direct attention training
- Discuss principles for implementing direct attention training
- Describe methods of measurement when conducting attention training
N2 Strategy Instruction for Managing Cognitive Impairment
McKay Moore Sohlberg, PhD, CCC-SLP
University of Oregon
Strategy instruction teaches clients to self-regulate their behavior or thinking. A robust literature supports the efficacy of training clients with impairments in attention, memory, and executive functions to self-regulate. This session provides evidence-based procedures for systematically selecting and training strategies that improve functional outcomes for clients with cognitive impairments. A broad range of strategies is reviewed, including metacognitive and task-specific strategies. Tools for instructing clients and documenting treatment outcomes are also shared.
After completing this session, you will be able to:
- Discuss a range of metacognitive and task-specific strategies for managing cognitive impairment
- Conduct a needs assessment for selecting strategies matched to client profiles
- Describe a systematic training model for teaching clients with cognitive impairments to implement strategies in naturalistic contexts
- Describe methods for measuring strategy learning and implementation
N3 Diagnosis and Management of Benign Vocal Fold Lesions: A Multidisciplinary Approach
Tanya Eadie, PhD, CCC-SLP
University of Washington
Albert Merati, MD, FACS
University of Washington Medical Center
Persons with benign mucosal lesions of the vocal folds, such as nodules, polyps, and cysts, often complain of poorer voice quality, greater speaking effort, and other negative effects on everyday activities. Accurate diagnosis and appropriate management are required to restore the voice. This session describes a variety of benign mucosal lesions of the vocal folds and outlines a multidisciplinary approach to diagnosis and decision making. A range of approaches to management, including surgical, medical, and behavioral techniques are presented.
After completing this session, you will be able to:
- Distinguish the roles of otolaryngologists and speech-language pathologists who diagnose and treat individuals with benign vocal fold lesions
- Describe the effects of benign vocal fold lesions on vocal function, including psychosocial impact
- Differentiate among diagnostic and assessment procedures used in evaluating vocal fold lesions, including videostroboscopy, auditory-perceptual, acoustic measures, and functional measures
- Describe a multidisciplinary approach to managing benign vocal fold lesions, including contemporary behavioral, surgical, and medical approaches
N4 Benign Vocal Fold Lesions: Grand Rounds
Tanya Eadie, PhD, CCC-SLP
University of Washington
Albert Merati, MD, FACS
University of Washington Medical Center
The session presents a number of case studies involving benign vocal fold lesions. For each case, you'll be given background information and discuss in small groups ideas for diagnosis, assessment, and treatment methods and alternatives. Actual approaches and outcomes developed by an otolaryngologist/speech-language pathologist team will be shared. Completion of session N3, Diagnosis and Management of Benign Vocal Fold Lesions: A Multidisciplinary Approach, is recommended as a prerequisite to this session.
After completing this session, you will be able to:
- Describe characteristics that help in the differential diagnosis of benign vocal fold lesions
- Discuss videostroboscopy, auditory-perceptual, acoustic, and functional measures of voice in relation to specific cases of benign vocal fold lesions
- Compare the benefits and drawbacks of different methods of managing benign vocal fold lesions in specific cases
N5 Assistive Technology for Cognition
McKay Moore Sohlberg, PhD, CCC-SLP
University of Oregon
Assistive technology for cognition is a class of tools designed to increase, maintain, or compensate for diminished cognitive function. This session reviews a range of tools that have been shown to be beneficial in improving everyday function in individuals with impairments in memory and executive functions. You will also learn protocols and principles for conducting needs assessments and training clients to use technologies. The session focuses on intervention methods that lead to long-term adoption of assistive technology.
After completing this program, you will be able to:
- Describe the evidence supporting the efficacy of assistive technology for cognition
- Discuss a range of tools and a systematic process for matching clients to technology
- Describe a systematic method for training people with cognitive impairments to use and maintain use of technology
- Describe methods to measure technology use, and the impact of using the technology
N6 A Cognitive Approach to Aphasia Management: Rationale and Assessment
Sponsored by Special Interest Division 2, Neurophysiology and Neurogenic Speech and Language Disorders
Laura L. Murray, PhD, CCC-SLP
Indiana University
Cognitive deficits in attention, memory, and executive function commonly co-exist with aphasia in adults. This session explores how these impairments interact with the communicative symptoms and outcomes of adults with acute or chronic aphasia. Recently-developed standardized tests and informal assessment procedures are discussed as ways to quantify and qualitatively describe cognitive symptoms of adults with aphasia.
After completing this session, you will be able to:
- Summarize deficits of attention, memory, and executive function commonly associated with aphasia
- Explain how cognitive deficits may negatively affect communication abilities and outcomes in adults with aphasia
- Describe standardized tests and informal assessment procedures for quantifying and qualifying the cognitive symptoms of adults with aphasia
N7 Treatment Issues and Procedures for Cognitive Impairments of Adults With Aphasia
Laura L. Murray, PhD, CCC-SLP
Indiana University
This session is a critical review of a range of therapy procedures for cognitive impairments of adults with aphasia. Approaches discussed include direct remediation or compensation, linguistic approaches to target symptoms indirectly, and alternative and holistic approaches. Recently-developed therapy procedures are emphasized, along with strategies for caregiver education and training.
After completing this session, you will be able to:
- Summarize recently-developed therapy procedures for directly remediating or compensating for cognitive symptoms of adults with aphasia
- Describe recently-developed linguistic intervention approaches that indirectly target or accommodate cognitive symptoms of adults with aphasia
- List alternative and holistic approaches for addressing cognitive issues in adults with aphasia
- Discuss strategies for educating and training caregivers about cognitive symptoms in individuals with aphasia
N8 Respiratory Muscle Strength Training: Who, How, and Why?
Christine Sapienza, PhD, CCC-SLP
University of Florida
Strength, endurance, and skill training represent three different types of exercise with distinct neuroplastic effects. This presentation reviews the neural and myogenic adaptations that occur with different exercise types, and introduces a training paradigm called respiratory muscle strength training. The speaker explores the implications of inspiratory and expiratory muscle strength training for neurological and neurodegenerative diseases, and discusses treatment dosage and patterns of strength gain and loss.
After completing this session, you will be able to:
- Describe the concepts and mechanisms associated with strength training
- List functional outcomes associated with expiratory muscle strength training
- Implement the intervention protocol of expiratory muscle strength training
- Describe the respiratory mechanical effects of expiratory pressure threshold loading
Track 3: Pediatrics and Early Intervention
P1 AAC Domains of Assessment and Feature Matching: An Overview
John Costello, MA, CCC-SLP
Children's Hospital Boston
There are many high-tech, low-tech, and no-tech AAC options. There are also many assessment considerations to match the strengths, needs, and skills of a person with complex communication needs to the features of AAC tools and strategies. This presentation provides an overview of the many domains of assessment in AAC, offers considerations for feature matching and system selection, and discusses the importance of evidence-based clinical trials.
After completing this session, you will be able to:
- Identify multiple domains that must be considered in an AAC assessment
- Detail the impact of assessment findings on selection of AAC tools and strategies
- Discuss strategies to implement evidence-based trials
P2 Make Me WANT to Be Assessed: Select Strategies in AAC Assessment
John Costello, MA, CCC-SLP
Children's Hospital Boston
Many children with complex communication needs have participated in so many doctor's appointments and assessments of various skills that they have little interest or investment in demonstrating true competence. The clinical team of the Augmentative Communication Program at Children's Hospital Boston has developed informal assessment tools and procedures that motivate children to "show their stuff." This session presents high-tech and low-tech assessment strategies that engage children in assessment and generate information pertinent to feature matching and IEP goal development.
After completing this session, you will be able to:
- Describe computer-based strategies to engage children in AAC assessment
- Detail strategies to assess operational skill through vocabulary selection and organization
- Discuss potential strategies and modifications to support participation in assessment
P3 Pediatric Feeding and Swallowing: Grand Rounds
Donna Scarborough, PhD, CCC-SLP
Miami University, Ohio
The session presents several case studies involving pediatric feeding/swallowing issues, Including a child with severe apraxia, a selective eater with sensory issues, and a child with complex medical issues who is being weaned off a g-tube. For each case you will be given initial assessment information, and generate treatment options and remaining questions in small groups. As new information is revealed, you'll discuss how to adapt your plan appropriately. At the end of each case, actual treatment approaches and outcomes are shared.
After completing this session, you will be able to:
- Design a treatment plan appropriate for specific cases
- Discuss alternative approaches to treatment
- Respond to new information with appropriate modifications of a treatment plan
P4 Managing the Medically Fragile Child in Early Intervention
Donna Scarborough, PhD, CCC-SLP
Miami University, Ohio
This session focuses on management issues for young children with medically complex conditions who have been discharged into a home or clinic setting. Particular emphasis is placed on children in early intervention programs, and those who have continued respiratory complications requiring tracheostomies.
After completing this session, you will be able to:
- Describe the hierarchy of ventilator weaning through decannulation
- List factors that determine candidacy for ventilator weaning and decannulation
- Design a comprehensive treatment plan that responds to each child's unique circumstances and meets the needs of the family
P5 Why Not to Use Nonspeech Oral Motor Exercises for Childhood Speech Sound Disorders: Logic, Theory, and Evidence
Gregory Lof, PhD, CCC-SLP
MGH Institute of Health Professions
The use of nonspeech oral motor exercises (NSOME) to change speech productions for children with speech sound disorders continues to be discussed and debated by researchers and clinicians. This session presents an update on the controversy and provides information on the logic, theory, and evidence against using NSOME in therapy for these disorders.
After completing this session, you will be able to:
- Discuss logical reasons why NSOME are ineffective
- Describe the theoretical concepts that are inconsistent with using NSOME
- Critically discuss the empirical evidence against the use of NSOME
P6 Pediatric SLP Services and Health Plan Coverage
Janet P. McCarty, MEd
American Speech-Language-Hearing Association
Code your services for pediatric clients, file claims, and develop appeal strategies with confidence. You'll get information on assigning Current Procedural Terminology (CPT) treatment codes and International Classification of Diseases–9th Revision (ICD) diagnostic codes. We will analyze the concept of "medical necessity," discuss how to code normal results, and list common reasons for pediatric claims denials. Learn to develop claim filing policies, and when and how to appeal a denial. Strategies for improving pediatric coverage by focusing on employers, consumers, and legislators will be addressed, along with resources to help you with coding, appeals, and advocacy.
After completing this session, you will be able to:
- Identify coding dos and don'ts for pediatric cases
- Describe typical reasons for pediatric denials
- Prepare appeals using appropriate terminology
- Develop strategies to improve health plan coverage of pediatric services
P7 Hot Topics in Pediatrics: Speech Sound Norms and Childhood Apraxia of Speech
Gregory Lof, PhD, CCC-SLP
MGH Institute of Health Professions
In a discussion format, this session addresses two current hot topics in pediatric speech-language pathology. First we will question the use of norms for determining either eligibility for therapy or target selection. Second, we'll interpret and discuss issues in the identification, assessment, and treatment of CAS, based on ASHA's 2004 position paper and technical report.
After completing this session, you will be able to:
- List reasons why speech sound norms are a questionable basis for eligibility for services or target selection
- Discuss the controversies surrounding the diagnostic label of CAS
- Apply concepts from ASHA's 2004 papers on CAS to current questions and issues about assessment and treatment
P8 Cortical Vision Impairment (CVI), Complex Communication Needs, and AAC
John Costello, MA, CCC-SLP
Children's Hospital Boston
Many children with CVI and complex communication and motor needs are described as being "pre-symbolic," "unable to attend," "unable to be engaged," "easily distractible," "behaviorally involved," "emerging communicators," or simply "inconsistent." In reality, these observations are often related to characteristics of CVI and may not reflect true competence. This session presents characteristics of CVI as well as AAC intervention strategies, illustrated with clinical case videos.
After completing this session, you will be able to:
- Identify characteristics of CVI
- Discuss why typical intervention goals are often not appropriate for children with CVI
- Detail strategies to support success and increased language learning opportunities for children with CVI
To register for Health Care 2010 and Business Institute, download our registration form [PDF].
