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Telepractice Task Force

Task Force Chair: Kenn Staub kstaub@clarion.edu
Co-Chair: Andrew Jinks jinksa@upmc.edu

Telepractice Resource Links

Update from October 28, 2013 Meeting

The telepractice task force met on October 28, 2013.  The following brief summary is provided in order to help our PSHA membership stay current with the rapid changes that technology brings to our practice.
                  

  1. Licensure status is unchanged: SLPs engaging in telepractice must be licensed in the state where they reside AND licensed in the state in which the client is located.   
  2. Members are encouraged to check individual malpractice insurance policies prior to engaging in telepractice.    Do not assume coverage – check that telepractice liability coverage is listed in your policy.  “Marsh” Insurance states specifically in their policy that telepractice is covered, but this cannot be assumed with other companies.   
  3. The task force discussed assessment through telepractice and reached a consensus that while face to face assessment remains best practice, if assessment through telepractice is necessary it should be well documented and clearly stated in the resulting report. 
  4. The task force reminds PSHA membership to be cautious of platforms used in telepractice settings.  Web offerings such as Skype are not considered to be secure for providing therapy in a confidential setting. 

 

4th Telepractice Task Force Meeting: October 25, 2012 (7 attendees)
Actions Items:  general statement was written to be forwarded to PSHA Executive Board for review; members to review Wisconsin Position Statement and provide feedback to the group; work to get other groups involved such as PDE or State School Board; two articles on telepractice to be published in upcoming Keystaters;  Telepractice Panel Discussion offered for PSHA Convention; possibility of training modules and webinars on telepractice and guidelines

 

Update from March 29, 2012 Meeting at PSHA Convention

Progress on goals: Telepractice goals and links to ASHA information have been placed on PSHA website.
New Task Force members have joined
Licensure: currently to engage in telepractice, the professional must be licensed in the client’s state. No definite response about telepractice has been obtained from PDE.  Currently, no regulations to prohibit telepractice in PA.  Task Force will work on Position Paper on Telepractice and reach out to various stakeholders with this information.
Reimbursement:  currently no notice about Medicaid reimbursement, but Leader has lost the contract in Pennsylvania and there will be a new vendor from NJ.

 

Telepractice Task Force Initial Call Minutes
The following is a summary of the initial call with the Telepractice Task Force. These are some of the working goals we discussed:

Educate professionals on the topic of telepractice; link to ASHA resources from PSHA website.

Forthcoming information and training may include:

      • Fact sheet
      • Webinars
      • Journal articles

Develop a list of current issues/questions about the practice of telepractice in Pennsylvania.

Assign current task force members to address questions regarding: licensure, billing/Medical Assistance, technology, materials, training

 

SLP and ABA Task Force

Minutes from the SLP and ABA Task Force - Meeting of 9/12/2013

Minutes from the SLP and ABA Task Force - Meeting #3

Minutes from the SLP and ABA Task Force - Meeting #2

 

 

Dysphagia Task Force

Dysphagia Task Force pshadysphagia@gmail.com

Interested PSHA members are invited to send questions/concerns to the Dysphagia Task Force.

Following are the bios' for the current Dysphagia Task Force

Cesar Ruiz, SLPD., CCC-SLP, BRS-S is an Associate Professor at La Salle University, Philadelphia, Pennsylvania. He is also Board Recognized Specialist in Swallowing and Swallowing Disorders. Dr. Ruiz’s clinical appointments include the Philadelphia VA Hospital, and the Ear Nose Throat Association of Chester County (ENTACC). He is an adjunct doctoral professor and dissertation chair at Nova Southeastern University in Ft. Lauderdale, Florida. His experience includes speech and swallowing rehabilitation following Head & Neck Cancer, as well as other dysphagia, and voice disorders patients, He has published and presented nationally and internationally.

Erin Knoepfel, MS, CCC-SLP, BRS-S, is the Director of Clinical Services in Speech Language Pathology for Genesis Rehab Service (GRS). She is an adjunct professor at Marywood University where she teaches Dysphagia at the graduate school level.  Erin is Advisor to the GRS Dysphagia Special Interest Group and is a member of ASHA’s Special Interest Group #13- Swallowing and Swallowing Disorders. She has over 22 years of extensive experience in the areas of assessment and treatment of swallowing and swallowing disorders with patients across the life span. She has presented at the local, state and national levels in the area of Dysphagia. Erin is a Board Recognized Specialist in Swallowing and Swallowing Disorders.

Irina Brailovski, MS, CCC-SLP, BRS-S
is a Board Recognized Specialist in Swallowing and Swallowing Disorders with over 20 years of experience. She is working full time as a Speech Pathologist/Master Clinician for Genesis Rehab Services as well as Abington Memorial Hospital on a PRN basis. She is currently a doctoral candidate enrolled in the SLPD program at Nova Southeastern University, Florida. Her work focuses on geriatric dysphagia patients in long term care as well as a variety of dysphagia patients in acute care and home care setting. She also provides training and education to clinical fellows and Master’s level students in the long term care environment. As a member of the Genesis Dysphagia Interest Group, Irina has presented on a variety of dysphagia related topics.   She has been a member of the Dysphagia Committee in PA until 2008 and is currently the chair of the Dysphagia Task Force in PA.

James L. Coyle, PhD., CCC-SLP, BRS-S. Dr. Coyle is an Assistant Professor of Communication Science and Disorders at the University of Pittsburgh where he teaches Head and Neck Anatomy, Dysphagia, Medical Speech-Language Pathology Doctoral Research Seminars, as well as training Master’s level students in the University of Pittsburgh Medical Center.  He also provides continuing education nationally and internationally to Speech Language Pathologists seeking advanced knowledge and skills in management of swallowing disorders in adults.  He is a member of the Specialty Recognition Board for Swallowing and Swallowing, has co-authored several peer reviewed studies including investigations validating and establishing the reliability to the Penetration Aspiration Scale.  He reviews manuscripts for Dysphagia, Archives of Physical Medicine and Rehabilitation, The Journal of Speech Language and Hearing Research, Gerontology, Folia Phoniatrica et Logopaedica,  and other journals. His clinical practice at the University of Pittsburgh Medical Center for the past 13 years has focused on oropharyngeal dysphagia assessment and management in adults in acute care hospitals of the Medical Center, ambulatory outpatients and nursing home residents with a variety of neurogenic etiologies, head/neck cancer, iatrogenic conditions and trauma. 

Jill Seidman, MA, CCC-SLP is a speech-language pathologist and supervisor of speech and hearing support services at the Bucks County IU #22. She has a worked in a variety of settings including Easter Seals of Lower Bucks County, BARC and Woods Services. She has provided feeding therapy to children in early intervention settings for many years and currently supervises the feeding team at Bucks County IU.

Judith F. Hengst, MA, CCC-SLP has been working in the field of speech and language for over 30 years.  She has worked with preschool, elementary, middle school and high school students in public & private school settings, and with adults in nursing home settings.  She was a member of a team who developed a feeding protocol for the Bucks, Montgomery, and Philadelphia Counties Easter Seal Society.  In addition, she assisted in designing the feeding protocol for the Bucks County Intermediate Unit (BCIU # 22)  developing teams of OT's and SLP's designated as  assessment teams.  She has presented the feeding protocol at ASHA, PSHA, NESHAP and various school districts in Bucks County.  In addition, she has consulted with other Intermediate Units who have been interested in developing feeding protocols.  Judith has  worked with the Bucks County Intermediate Unit as an SLP in the preschool department,  and has been the Special Education Supervisor for the Speech Department, Special Education supervisor for the Autistic Support Program and currently is the Director of Autistic & Multiple Disabilities Support Services and Nursing Services.  

Katie Hein, MS, CCC-SLP. I currently work as a feeding specialist at an Outpatient Pediatric Rehabilitation Facility in York Hospital.  I work with children ranging in ages from birth to 15 years.  As part of our feeding clinic, we complete multidisciplinary feeding evaluations with the participation of an Occupational Therapist, Certified Dietitian, and Speech-Language Pathologist.  In addition, we have a Pediatric Gastroenterologist who acts as a consult for our feeding team.  I am currently certified in pediatric neuromuscular electrical stimulation (NMES), am formally trained in Sequential Oral Sensory Feeding Approach (SOS), and have over 130 hours of continuing education in the areas of fragile infant feeding and pediatric feeding.  I complete pediatric modified barium swallow studies at York Hospital for children ages premature infants to 15 years of age.  In addition to working in outpatient pediatrics, I  also provide feeding services in our Level III NICU.

Margaret Payne Shafer, MA, CCC-SLP is Manager of Speech Pathology Services at Abington Memorial Hospital.  She has worked continuously in multiple healthcare and educational settings over the past 35+ years. While at Montgomery County Intermediate Unit, she saw alternative kindergarten through grade 12 regular education and special needs students.  She also provided services to medically fragile S/PMR homebound residents at Lynch Home.  In healthcare, she has worked in both acute and inpatient rehab settings, SNF, homecare and outpatient.  She has multiple certifications for swallowing and voice including L-M RVT, LSVT, VCT, Alaryngeal Speech Instructor and CPR instructor for both healthcare providers and families of dysphagic patients.  Her special interests include dysphagia- NICU through Geriatrics, cervical auscultation and instrumental exams, comorbidities and impact on decision-making in the medically complex patient, trach/vent, HANC, neuropathology and end of life care.  As part of her present responsibilities, she lectures and trains medical residents, attending staff, professional nurses and students.  Abington has an active graduate level practicum site and offers a one year clinical fellow program to allow experience in acute care, inpatient rehab, outpatients from preschool through adult and videofluoroscopy.  She maintains a clinical caseload in addition to her supervisory and administrative responsibilities.

Pamela Smith, PhD received a bachelor's degree from Kutztown University, Master's degree from Ohio University, and Ph.D. from Temple University.  She is an associate professor at Bloomsburg University where she teaches undergraduate and graduate courses in Speech-Language Pathology, including Acquired Disorders, Psycholinguistics, and courses in swallowing. She advises graduate and undergraduate student research projects and is an undergraduate academic advisor. She is also a co-advisor for Bloomsburg University’s NSSLHA Chapter.  Dr. Smith holds privileges in the Department of Radiology, Allied Health, at Geisinger Bloomsburg Hospital where she provides videofluoroscopic swallow studies. Dr. Smith’s research interests are in language processing in adults, normal and disordered swallowing in adults, and clinical training issues. She presents research findings in local, national and international conferences and has published her research in journals such as Journal of Speech, Language and Hearing Research, Contemporary Issues in Communication Sciences and Disorders, Journal of Medical Speech-Language Pathology, and Aphasiology. She is an active member of ASHA’s Special Interest Groups in Swallowing/swallowing Disorders and Gerontology, and is editor of the Perspectives newsletter for the Gerontology group.

Randy Dubin, MA, CCC-SLP is the Speech Pathology Team Leader for Good Shepherd Penn Partners.  He has worked in multiple settings including SNF, outpatient, acute rehab, LTACH and acute care.  He currently evaluates/treats patients at The Hospital of the University of Pennsylvania and Penn Specialty Hospital (LTACH).  He specializes in the management of speech and swallowing disorders in the medically complex patients.  He also serves as a Site Visitor for the ASHA Council for Academic Accreditation (CAA).

Tamara Wasserman-Wincko, MS, CCC-SLP, is the Co-Director of the Speech-Language Pathology Division, Department of Otolaryngology, at the University of Pittsburgh Medical Center (UPMC).  She is responsible for training, supervision, and program development at several UPMC sites.  Her clinical experience of 18 years at UPMC includes, acute care, swallowing rehabilitation following head and neck cancer, and the assessment and treatment of a variety of swallowing disorders.  She is actively involved in the UPMC Swallowing Disorders Center and works closely with the ENT department.  She serves on the Aspiration Prevention Committee at Presbyterian University Hospital and is on the Total Quality Care team in the Department of Otolaryngology.

Joy McGowan

 

Early Intervention Task Force

The following is a summary of the initial call with the Early Intervention Task Force. These are some of the working goals we discussed:

  • Develop strategies to recruit SLPs to work with the birth to three population.
    • Work with universities to promote EI to graduate students.
    • Members of this task force can go to local universities and offer to talk with the students on EI.
  • Develop a presentation on working in EI for both students and potential supervisors of graduate students.
  • Develop a FAQ sheet of regulations/processes for SLPs interested in EI.
    • For current SLPs in EI, link PSHA website to PaTTAN website on PELICAN regulations.
  • Determine if PSHA can help SLPs who work in EI meet the 24 hour training requirements in a more efficient manner.
  • Educate physicians on EI through email blasts or Project CONNECT.

Licensure Task Force

The following is a summary of the initial calls with the Licensure Task Force. These are some of the working goals we discussed:

  • Getting the bill passed is the ultimate goal.
  • Email blast every other week to PSHA members to provide one piece of information
    about the bill.
  • A “Breaking News” box on the PSHA website to update members on current status of the bill.
  • Develop ways to accomplish grassroots advocacy:
    • Use of ASHA CAPWHIZ
    • Packets of how to interact with legislators
    • Link from PSHA site to ASHA site on advocacy.

Schools Task Force

The following is a summary of the initial call with the Schools Task Force. These are some of the working goals we discussed:

  • Develop information for SLPs in schools to advocate for salary supplement for the CCC
    • PSHA has been working with one SLP on this and can use this model if it proves successful.
    • Determine if other districts in PA have approved salary supplement—there are a couple who are working toward it that we know of at this time.
  • Develop a mechanism where school-based SLPs can connect with each other through commenting/blogging more easily (PSHA Bulletin Board).
  • Begin to discuss what issues are important in developing workload language for the regulations, if the licensure bill passes with the current workload language (to be specified in the regs) intact.

Healthcare Task Force

The following is a summary of the initial call with the Healthcare Task Force. These are some of the working goals we discussed:

  • Have PSHA serve as a resource for promoting and developing clinician-researcher partnerships.
  • Advocate with the PA Department of Health to lift ban on running studies in long-term care facilities.
  • Recruit students to Healthcare through presentations, mentorships, contact with local universities, etc.
  • Continuing education on insurance regulations and regulations by geographic region.

AAC Task Force

The PSHA AAC Task Force was started in late 2012. The AAC Task Force has generated a list of goals related to promoting knowledge and awareness of AAC in Pennsylvania. In the upcoming year, the Task Force plans to help review AAC submissions to the 2015 PSHA Convention, and to provide AAC-related information on the PSHA web site and newsletter. If you would like to join the Task Force, please contact Bruce Wisenburn, Ph.D, CCC-SLP at bwisenburn@marywood.edu.

Task Force Chair - Bruce Wisenburn     bwisenburn@marywood.edu
PSHA Board Liaison - Amy Goldman      amy.goldman@temple.edu

AAC Services in PA
Helpful Links

Statement on the use of Augmentative/Alternative Communication related to speech development

AAC does not hinder the development of speech; rather, it encourages it. The issue of speech development after the implementation of AAC has been addressed in numerous studies. The following website reviews the various myths in regards to speech and AAC: http://aac.unl.edu/yaack/b2.html

Consider the following:

  1. When people repeatedly experience failure, they logistically quit trying. That is what happens when people are expected to speak when their speech is unintelligible. They often reduce their interactions with others because they expect to be unsuccessful. This means that they actually do not practice speech as much as others would hope.
  2. By not interacting as much, people denied a means of communication may also suffer many other consequences. Their language skills will not develop as well, so their vocabulary and grammar skills will be affected. Also, their cognitive, reading, and social skills may not develop as quickly, as they are not interacting with others. Finally, their emotional state may be impacted as they do not have as much human contact and interaction as they withdraw from communicating with others. With AAC, children can engage with others in both academic and play settings, enhancing their education and socialization.
  3. AAC does not encourage “laziness” towards the development of speech skills. In fact, people often talk more when AAC is implemented. AAC may provide context to the topic, which would allow distorted speech productions to be more comprehensible. This would encourage more attempts at speech. Also, speech may be worked on in conjunction with the implementation of AAC.
  4. People have the right to communicate. Imagine not communicating with others for a single day. As human beings, we have an instinct to communicate that should not be denied. By not allowing others to have AAC so “speech will develop,” a person’s right to communicate is being denied.
  5. So, because AAC actually encourages speech, a “wait and see” attitude is harmful. If a person’s speech is not functional, then there is usually no reason to wait. A low-technology AAC system may be implemented immediately at little or no cost, which may allow someone access to effective communication. Waiting to see if speech develops means that more time will pass in which a person does not communicate with others, with all of the associated problems related to language, cognition, socialization, and emotional state.
  6. Behavior may also be improved through AAC. When an effective communication system is denied, people may scream or engage in other inappropriate behaviors to try to get their wants and needs met. By implementing an effective communication system, people can use an appropriate method of requesting what they desire.

The position that AAC should be strongly considered for individuals with severe speech deficits is supported by the American Speech-Language Hearing Association:

National Joint Committee for the Communication Needs of Persons With Severe Disabilities. (2003). Position statement on access to communication services and supports: Concerns regarding the application of restrictive "eligibility" policies.
Available at: http://www.asha.org/policy/TR2002-00233.htm

References:

Blischak, D. M. (1999). Increases in natural speech production following experience with synthetic speech. Journal of Special Education Technology, 14, 44–53.

Blischak, D. M. (2003). Use of speech-generating devices: In support of natural speech. Augmentative and Alternative Communication, 19, 29–35

Charlop-Christy, M. H., Carpenter, M., Loc, L., LeBlanc, L. A., & Kellet, K. (2002). Using the picture exchange communication system (PECS) with children with autism: Assessment of PECS acquisition, speech, social-communicative behavior, and problem behavior. Journal of Applied Behavior Analysis, 35, 213–231

Cregan, A. (1993). Sigsymbol system in a multimodal approach to speech elicitation: Classroom project involving an adolescent with severe mental retardation. Augmentative and Alternative Communication, 9, 146–160.

Foley, B. (1993). The development of literacy in individuals with severe congenital speech and motor impairments. Topics in Language Disorders, 13, 16–32

Ganz, J., & Simpson, R. L. (2004). Effects on communicative requesting and speech development of Picture Exchange Communication System in children with characteristics of autism. Journal of Autism and Developmental Disorders, 34, 395–409

Johnston, S., Nelson, C., Evans, J., & Palazolo, K. (2003). The use of visual supports in teaching young children with autism spectrum disorder to initiate interactions. Augmentative and Alternative Communication, 19, 86–103.

Millar D. C., Light J. C., Schlosser R. W. (2006) The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review. Journal of Speech Language Hearing Research, 49, 248–264.

Schlosser, R. W., & Wendt, O. (2008).Effects of augmentative and alternative communication intervention on speech production in children with autism: A systematic review. American Journal of Speech-Language Pathology. 17, 212-230.

AAC Services in Pennsylvania

List of Assistive Technology Resource Centers in PA: https://www.temple.edu/instituteondisabilities/programs/assistive/atlend/atrc.shtml

Pennsylvania Initiative on Assistive Technology (PIAT): http://disabilities.temple.edu/programs/assistive/piat/

Pennsylvania Training and Technical Assistance Network (PaTTAN): http://www.pattan.net/

United Cerebral Palsy affiliates in Pennsylvania:
                Alleghenies: http://www.alucp.org
                Central PA: http://www.ucpcentralpa.org
                Northeast PA: http://www.ucpnepa.org
                Philadelphia: http://www.ucpphila.org
                South Central PA: http://www.ucpsouthcentral.org

Helpful Links

International Society for AAC: https://www.isaac-online.org/english/home/

United States Society for AAC: http://www.ussaac.org/

Website of Gail Van Tatenhove, Speech-Language Pathologist and AAC Specialist, containing a variety of information on AAC, including products and resources.
http://www.vantatenhove.com/index.shtml

Information on Mobile Technologies and AAC
http://aac-rerc.psu.edu/index.php/pages/show/id/46

AAC information from the American Speech-Language Hearing Association (ASHA)
http://www.asha.org/slp/clinical/aac/

ASHA Position Statements on AAC
http://www.asha.org/policy/PS2005-00113.htm

 

PDE Task Force

Update: Char Molrine--met twice with the PDE work group working on the certification staffing guidelines for School SLPs. The first fruit of their labors, the certification staffing assignment document, is available at by clicking here.

Because of the work of PSHA, your state association, PDE is now apparently ready to develop an Educational Specialist certificate for Speech-Language Pathology.  While SLPs have clearly been able to practice successfully in the schools, the preparation and ongoing development and evaluation of our professionals would certainly be enhanced if we didn't have to force our requirements into classroom teacher-like boxes.

PSHA has asked me to continue the involvement in this area.  Other educational specialist certificates are tied to holding a license in the respective area (e.g., School Nurses).
 
With the collaboration of Char Molrine, I am pleased to chair the newly formed PSHA Task Force on Education! 

Interested in becoming involved?  Respond to the PSHA office at psha@psha.org

David Stein

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