Career Story: Speech Language Pathologist At A State Institution

Speech Language Pathologist At A State Institution

Job Title: Speech Language Pathologist

Type of Company: I work for the Massachusetts Department of Public Health providing speech and language supports to children who live at a central hospital that also offers education services.

Education: BA, Communication Disorders, Douglass College, Rutgers University •• MA, Speech and Language Science, UMass-Amherst •• MA, Speech Language Pathology •• certificate of Clinical Competence, American Speech Language Association

Previous Experience: I have worked in many different settings over the last two decades, in state institutions working with retarded adults, in various collaborative associations servicing moderate to severe special needs children in various school settings and in private practice consulting to various day habilitation programs that service adults with severe special needs.

Job Tasks: I try to determine how a patient's verbal and cognitive skills affect his day-to-day functioning in a residential hospital during the school year. I have to ascertain, for example, what a patient can understand and what the best ways are to approach him (spoken words, written words, pictures, combinations of these stimuli etc). Can the patient speak? Can she write or type? If so at what level? Can she use sign language? Can she point to pictures if she can't read? Can he create messages using a word or several words? Many of my patients were born with a disability: cerebral palsy, spina bifida or muscular dystrophy. But can they use their hands to access a writing or typing or speaking system (if they can cognitively handle such a thing)? If not, can I work with other professionals to provide them with access to a system such as switch that they use to start and stop a system? (OT, PT etc.) My primary responsibility is increasing their active participation in their education and their ability to stand up for themselves as hospital residents and direct our staff to care for them.

The cognitive level of a patient is critical to providing for his needs but it can be hard to determine if he can't respond to a question by speaking or pointing. All my current patients are between 14 and 22 years old, but some have the mental abilities of a two-year old. So I have to use technology to help them: computer software for learning and dedicated communication devices that allow a person to speak by touching a screen. I have patients who use their fingers to touch a screen or type, patients who can't use their hands but who use a switch instead, scanning information on a computer screen and then activating the switch. I also have patients who are using cutting-edge gaze technology to look at a computer screen and activate it using infrared light beams. Very cool!

Best and Worst Parts of the Job: The best part of my job is being able to help patients who cannot use speech effectively to become better communicators using a communication book, a computer or a designated speaking device. These allow patients to establish relationships with other people and can change their lives. I have seen kids go to college after learning to use a communication device! I love it when a patient who has learned to communicate is seen differently by the world ... and no longer thought stupid. Far from it, in fact!!!

The worst part is watching patients with certain diagnoses degenerate and sometimes die.

Job Tips: Work in different settings until you find your niche. It is impossible to become a great therapist doing a little of everything. Our field licenses us to "do it all" but the reality is that you can only know what you have experience doing. Work with other professionals who have a better understanding of an area that you would like to learn or excel in. And don't be afraid to ask questions.

Don't provide clinical advice you are not comfortable with. Establish a network of other professionals to "bounce ideas" off of. Don't be intimidated when you are not sure how to approach a new case. Our career is all learn-on-the-job and that is just the way it is.

Additional Thoughts: I love what I do. There are many different settings and different career opportunities. I successfully work part-time allowing me to provide time for my family and my job, allowing me balance in my life which is key to success at both!

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