Speech Therapy Telepractice | Presence TeleCare

Internship Opportunity

Who We Are
Presence TeleCare is an exciting startup that has become the leader in online special education. Our web platform helps children with disabilities ranging from autism to stuttering. With revenue and rapid growth, we have the opportunity to help millions of children in over 70% of U.S. school districts. The company’s founders, both graduates of Stanford Business School, have experience at successful start-ups, venture capital firms and large companies including Disney. We are backed by an experienced group of Silicon Valley investors. We are based in San Francisco just off South Park.

Why Work Here?
This is a rare opportunity to be part of a growing, thriving company and have a positive social impact at the same time. You will be working in a start-up environment and gaining real marketing and operational experience. You will also be part of a team of fun, nice, smart people attacking a pressing problem in U.S. K-12 education.

Ideal Candidate
We are looking for a top-notch candidate to assist with a variety of tasks, supporting our sales, operations, and marketing teams. Our ideal candidate is smart, energetic, friendly, and detail oriented. You are a highly organized self-starter, and you thrive on performing a diverse set of tasks.

Compensation
You will receive a small stipend based on your experience.

Responsibilities
-Work with our Chief Clinical Officer to generate content for therapy sessions
-Work with all company functions (including product, sales, and clinical) to ensure that customer needs are met
-Write copy for email newsletters and blog posts
-Perform general office administration and reception work
-Support move to new office space

Requirements
-Incoming college seniors and recent graduates from top schools only
-Superlative academic record
-High attention to detail, highly organized
-Minimum commitment of 3 months
-Strong connection to Presence TeleCare’s mission
-Desire to flourish in an entrepreneurial environment

Email us today to apply!

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An Unexpected Success

: Image by Getty Images via @daylife

At the end of the school year, professionals working in education often recount their successes. Oh sure, we have the usual student “graduations” from Speech, a new school assignment, a hard-won new or improved employee benefit, or maybe even an expanded supplies budget. As long and as hard as I searched through my various sources, though, I just couldn’t find a report similar to one of my most prized successes, parental anger and derision for a job well-done.

My original success story unfolded in a medical setting – a TBI rehabilitation unit. A popular high school sophomore, actively courted by several prestigious universities for his athletic prowess, sustained life-threatening injuries in an accident with a Highway Department snow plow during a blizzard. Comatose for six weeks, a dedicated, organized and skilled treatment team worked diligently to create a new life for Tory and his courageous family whose entire lives were changed in an instant.

But as progress slowed and inpatient care came to an end, Tory still looked different, walked with an unsteady gait, and processed information at a kindergarten level. It was painfully clear to the family that the service team would not return Tory to his prior state of great expectations. It was at this juncture that the family’s grief manifested as anger toward those who failed to reverse the multiple and debilitating effects of his injuries. Though we did the best we knew to do, we just had not met the family’s expectations – we had not answered their most fervent prayers. The upside to the situation was sharing the experience with my colleagues, all of whom verbalized a conviction that we had served our patient and his family with the utmost professionalism.

But I faced the most recent circumstance with no such loyal and collegial support.

Brittany, a bright, creative 2^nd grade student being served in an educational setting, was dubiously identified as suffering from Reactive Attachment Disorder by the age of two. Sadly, Brittany’s adoptive parents were counseled to follow a verbally confrontational and physically coercive treatment regime that has been denounced by all leading medical associations, which they did with vigor and commitment. Once enrolled in the local school, a timid and ill-informed school team cow-towed to the unusual demands of the parents for unprecedented services and accommodations for Brittany who, quite strangely, was categorized as brain-injured.

Oh, had I known the true folly of contradicting control and fear with reason and evidence!

In both described situations, the emotional discomfort yielded an unexpected sense of success and a renewed commitment to render the best evidence-based, professional service. Our work is a discipline: we do the right thing to do for the right reason. We don’t work to achieve an emotional response.

Have you ever experienced an unexpected success?

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Changing your lot in life: 4 suggestions to impact caseload size

In our first post on caseload manageability, as proposed by Katz, et al (citation below) in a recent article in Language, Speech, and Hearing Services in the Schools, we discussed the identified factors that impact one’s perceptions of her caseload size and those that contribute to job satisfaction. The authors also shared several proposals to impose some controls on an unrelenting work situation.

Response to Intervention (RTI) – While RTI is inthe early stages of implementation, it holds promise for SLPs, especially those with unreasonable caseload sizes. RTI allows special education professionals to use their knowledge and expertise working with students and teachers not only in remediation,but also with prevention in mind.

Negotiate caseload/workload issues with school administrators -Document job responsibilities and share results fromthe Katz, et al, study and others related to SLP job satisfactionand burnout with your most insightful administrator. Inform administrators about thesignificant relationship between caseload size and perceivedcaseload manageability. Doing so might help SLPs make a case for expanded discipline-specific service and time to complete other workload demands in lieu of unskilledresponsibilities such as lunch or bus duties.

Inform administrators on the benefits and limitations of team collaboration – Mandated classroom collaboration could impactSLPs’ perceptions of caseload manageability. If an SLP is findingcollaboration to be a particularly difficult endeavor in hisor her school, based on substantial resistance among teachers, more reasonable and more familiar service options, such as more pullout services, could be proposed.

Alternately, SLPs could lobby for administratorsto lend visible support for classroom collaboration by allottingtime in SLPs’ and teachers’ schedules for planning meaningful and effective collaboration as well as supporting and encouragingSLPs’ efforts to participate in continuing education in howto create and maintain fulfilling collaborative relationships.

What could you add to the list of proactive solutions to merely succumbing to being perpetually overwhelmed? What has worked for you and your team mates in your district? We’d love to know. Please share!

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Katz LA, Maag A, Fallon KA, Blenkarn K, Smith MK. (2010). What makes a caseload (un)manageable? School-based speech-language pathologists speak. Language Speech and Hearing Services in the Schools, 41(2), 139-151.

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Caseload manageability and job satisfaction: Comments from the field

In an earlier post, we looked at research presented by Lauren Katz, et al, “What makes a caseload (un)manageable? School-based speech-language pathologists speak” (complete citation follows below), a discussion of the variables impacting a speech pathologist’s perception of the manageability of his caseload. Variables were divided into three (3) distinct categories:

demographics: who was more likely to feel like she was managing things well and enjoy a sense of job well-done;
job-setting: where one is more likely to perceive the ability to manage his caseload; and
job characteristics: team and time factors supporting job satisfaction.

Several of my colleagues responded to an invitation to comment on the research presented.

Eric, Director of Special Education (WI): Our team of four SLPs work together to organize the caseloads and work demands. We meet monthly to discuss issues and concerns, with the SLPs proposing the most reasonable options for dealing with the situation. We have two unfilled positions, but our Speech team makes the best of the challenges by actively supporting each other.

Gin, Speech Pathologist (IA): I’m nearing the end of my career in the schools. In my last assignment, no one got along. No matter what you did, it was never enough. Then my supervisor proposed a new assignment and I jumped at the opportunity. I love my new school. The parents are supportive and involved, and I have a chance to use my skills with a community grateful to have a speech pathologist back in the district.

Name withheld by request, Speech Pathologist (MN): As a private practitioner, I provide part-time service in both large and small districts. The larger districts seem to have a more “even” coordination of special education activities. Some of the smaller rural districts seem to be a bit more idiosyncratic. I was considered an “outsider” longer in the rural districts but once I was “in”, I was good to go.

Michelle, a new grad doing her CFY in a small town (MN): I don’t have any contact with the part-time SLP at the high school who’s been there a long time. We never meet to discuss what we do. The special education teachers send the LD kids down to my room and tell me I need to help them complete their worksheets or their homework. XXXX (the Special Education Director) stops by and answers some of my questions but I have so many of them! On top of it all, my husband’s ex- has been a real pain lately! I’m really stressed out.

While my colleagues report a range of experiences, interpersonal relationships seem to hold great value to each. It appears that even when work conditions are difficult or challenging, if you work with professionals who support you in explicit and ongoing ways, a speech pathologist could feel that the situation is almost quite manageable! Without that support, life can be miserable.

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Git ‘er done: Factors impacting perception of caseload manageability

In a recent LSHSS article by Lauren Katz, et al, “What makes a caseload (un)manageable? School-based speech-language pathologists speak” (complete citation follows below), the authors examined variables that contribute to a clinician’s perception of her ability to enjoy a job well-done.

Through an extensive literature search, the authors uncovered a few demographic variables for predictingjob satisfaction including:

the SLP’s highest degree achieved (thehigher the better),
gender (females over males), and
years ofexperience (the more years the better).

The most important job-settingcharacteristics for predicting job satisfaction included:

caseloadsize (in favor of smaller caseloads),
geographic setting (infavor of suburban settings),
permanent status (vs. itinerantstatus),
number of students served per day (in favor of servingfewer students), and
age level served (in favor of elementaryschools).

Finally, the job characteristics most important for predicting job satisfaction included

having friendly coworkers
having enough time to get the job done, and
working with a friendly supervisor.

Survey respondents to the authors’ questionnaire reported an average caseload of 49 students, with 60% of the participants finding caseloads of 41-50 students unmanageable.

How does this compare with your experience? We invite your comments!

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A Few More Summer Suggestions

We recently discussed creating a parent tip list to successfully navigate the unique rigors of summer break. Involving the special needs student in planning her summer of fun could build “buy-in” and yield some interesting ideas. Consider some of these additions to your parent guide:

Tips to Help Kids with Learning and/or Attention Problems:

1. Revamp — but don’t eliminate — your child’s daily routine. A daily routine provides a sense of structure and security. While certain tasks (like doing homework) may be dropped during the summer, new ones (like packing for daily swim lessons) may be added. Create a visual organizer to enable the young vacationer to track his activities throughout the day.

2. Prepare your child for her scheduled activities. If possible, visit the locations where she’ll be during day camp or day care in advance. Encourage your child to talk to camp counselors, caregivers, as well as other kids, asking them questions of interest about the site.

3. Have your child contribute to the family calendar. Together, highlight key summer events (e.g., community pool opens for recreation swim, July Fourth barbeque). Encourage your child mark these on the calendar, decorating the date field with theme-based cartoons.

4. Involve your child when preparing for family trips and activities. Depending on her age, she can help you map out driving routes, preparing a Google map or Mapquest directions from the Web. She could make a list of the clothing and recreational gear the family will need.

5. Encourage summertime learning. Summer outings may present opportunities for your child to learn about history, geography, and nature. Look for “teachable moments” and encourage her to listen, read, take photographs, collect postcards, and keep a journal of her adventures. This type of learning can boost the self-esteem of a child who struggles in school.

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The Good Ol’ Summertime

It’s important to recognize that the shift from the school year to summer vacation, regardless how welcome, can pose some challenges for the families of the special needs children you serve. Consider creating a “Sweet Summer of Success” handout for the parents of the kids on your caseload, including some of these ideas:

Tips to Help Parents:

1. Review the summer plans you’ve made to date. Where there are gaps in the schedule, brainstorm ways to address them, such as parents rotating days off work to stay home with younger kids on unscheduled days.

2. Post the family’s summer schedule. Mark activities (day camp, vacations, your teenager’s work schedule, etc.) on a “family size” calendar posted in a central location. Be sure to note blocks of unscheduled time as well; that way, you can anticipate free time to use as you wish – even if it’s just to enjoy a break in the action.

3. Plan to be spontaneous. Create a list of places and people to visit when time permits and the mood strikes. Summer — free from homework and tutors — is a good time to stop by the science museum, bike trail, or concert-in-the-park you can’t seem to get to during the school year.

4. If you and/or your child thrive on routine, build as much of it in to your summer schedule as possible. Even so, your routine may change every week or so; find ways to prepare for these transitions. This may be as simple as mentally rehearsing the new routine (including daily wake-up time and preparation) with your child before the week begins. Don’t forget to record those changes in routine on the family calendar.

5. Ask other people (spouse, family members, and neighbors) for help shuttling kids to activities and supervising them on their “days off.” Trade carpooling and kid-watching duties with other parents in your neighborhood.

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Good, Better, Best

Good, Better, Best

According to the American Speech-Language-Hearing Association (ASHA), May is Better Hearing and Speech Month. Better Hearing and Speech Month. Better than what? And, better how?

Many of us are blessed with “normal” speech, language, and/or hearing abilities. We chat with or text loved ones on our cells. We hear the baby wheezing or breathing peacefully in the crib. We understand a good joke and show our amusement with loud, guttural guffaws or with a raspy snort. We engage in life fully, calling on our “native” communication skills to serve us across our experiences.

So how can we “ramp up” our communication skills; how can we “better” them? Consider the following challenges:

- Understand how cultural differences might impact communication.

- Take a “vocal nap” every day, especially during periods of extended use. For instance, teachers could limit speaking during the breaks between classes and find quiet ways to spend their lunch break rather than talking in a noisy staff room with colleagues.

- Improve your vocabulary. Sign-up to be e-mailed the “Word of the Day” at any or all of the online dictionaries.

- Protect your hearing. The iPod/TV/car stereo system is too loud if you have to raise your voice to be heard.

- To enhance your own listening skills, tell your conversation partner, “I’m listening to you because I really want to understand what you’re saying.” Follow-up with questions on anything that still isn’t clear to you.

- Be attentive to the needs of users of assistive communication or mobility devices (hearing aids, communication boards, wheelchairs, etc). Ask what you can do to communicate effectively with them (e.g. “Stand to my preferred right side,” “Don’t make me look into the sun/overhead lights; please sit,” “Confirm that you understand what I’m saying.”).

Remember: Good communication skills – while completely acceptable — can always be better!

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New Kid on the Blog

Well, this is interesting. If someone had told me two months ago that I would be writing a blog for the premier tele-speech and language service provider, I would have encouraged them to check their sources! But, here I am, happily ensconced in my new “situation”, doing what I love to do — moving words around in whatever format I have available!

I’m Jeanne Juenger (YENG’er), a speech-language pathologist with 33 years of experience who’s having more fun now than ever before in my career! Every day is a day bursting with opportunities to question, to learn, to study, to labor over and/or to just plain ol’ enjoy as I wear a name badge identifying me as a speech-language pathologist.

I’ve worked in a number of settings but find the virtual setting (telepractice in speech-language) to be the niche in which I thrive. Since 2002, I’ve been on a quest to understand how we deliver dynamic, engaging and efficacious professional services at a distance to those individuals with speech/language impairments who are under- served or unserved.

When I’m not thinking about tele-speech, I’m kayaking on one of our many lovely State waterways, enjoying a cup of fine coffee, taking dominion over the organization of my house or coordinating the publishing team for my local church.

Meet me here often as we explore the wonderful world of human communication!

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(Belated) Happy Mother’s Day!

Moms, you are loved and appreciated! Thank you for multi-tasking your way through each and every day, keeping any number of plates spinning for your families, all the while making sure everyone has clean underwear on in case they’re in an accident and have to go to the hospital!

While there are days — or years! – you wear the same uniform (running shoes and a T-shirt that reads, “Who are these kids and why do they keep calling me “Mom”?), when you invest in your own mental, emotional, and physical health, you foster improved communication in your family life. Research has demonstrated that a mother’s well-being (just think about that concept, well-being) enhances a toddler’s exposure to a more diverse language experience – more vocabulary, more learning engagement, more interesting speech patterns. A constricted life for Mom severely limits a child’s access to language experiences that create the foundation for future success.

So, Mom, give yourself permission to be a healthy you every day. Take opportunities to slip away to a relaxing place – or state of mind – to refresh and rejuvenate yourself. Your kids, who may be calling for you all the while you’re “gone”, will benefit from your little vacation.

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