The “Therapy Voice”

In grad school way back when, SLP majors were partnered with a classmate and sent out to observe SLPs in a variety of workplace settings.  We observed in a nursing home, a rehab center, a public elementary school, a hospital, a residential facility for clients with multiple disabilities, and a state school for the deaf.  Of course, the goal was to gain insight into each of these settings, into the types of clients who were served, how treatment was delivered, and personal reflections of each of the practitioners.  Following each visit, we were to write up our impressions.  This exercise was one of the most valuable experiences of my education, as it helped me to determine my future goals — the type of setting in which I did or did not want to work and how I envisioned my future self delivering services.  Much of this experience has faded from memory, having taken place over 25 years ago, but one observation has never left me:  the “therapy voice.”

It was in a hospital that my partner and I first heard the “therapy voice.”  The SLP met us in her office and we had a lovely conversation about the profession and her experiences with inpatient and outpatient therapy.  Then we followed her to bedsides and into the clinic.  While her therapy activities seemed appropriate to our novice eyes, what really struck us was the way her voice changed whenever she addressed her clients.  Louder, slower, and higher pitched, her voice took on a whole different persona — one that signaled, to us at least, the message that “you are so impaired, you don’t know what I’m saying so I will shout it at you.”  My partner and I looked at each in disbelief, that her friendly, conversational voice could immediately become so seemingly condescending.  Now, mind you, I fully understand that she had years of communicating with people who presented with strokes, brain tumors, neurological disorders, hearing loss, and dementia, and I fully understand that one’s communication style has to accommodate those conditions.  But we observed this same “therapy voice” when she was treating outpatient children and adults in the clinic for articulation, language, and fluency.  It was amazing to us, the way she could switch back and forth when treating clients with the “therapy voice,” then turning to us with comments in a conversational manner.  This wasn’t the last time I heard the “therapy voice” but it certainly was the first, most dramatic, and most memorable.  My partner and I vowed, as we walked out of the hospital, to never, EVER, use the “therapy voice” in our practice.

The bulk of my 25-year career as a public school SLP has been spent with students who have moderate to profound disabilities.  Obviously, I have had to adjust my language level with these students — shorter sentences, simplified vocabulary — but I have held to my promise and ALWAYS speak in a conversational tone of voice, one that presumes that “I know you understand what I am saying,” even when there is little or no outward sign of this.  In other words, presume competence!

Two books I read recently bear out my intuitive use of conversational tone:  “My Stroke of Insight” by Jill Bolte Taylor, and “Ghost Boy” by Martin Pistorius (reviewed on this blog HERE).  Both authors were suddenly stricken with profound injury to the brain, one by stroke, one by an unidentified virus, and were essentially trapped inside bodies that would not, could not respond or be controlled.  Both eventually recovered to a remarkable degree, thanks in no small part to their own strong will and the support of therapists, caregivers, and family.  Both relate horror stories of how they were sometimes spoken to by people (family and medical staff) who didn’t think they could hear or understand.  Jill Bolte Taylor includes a list of “do’s and don’ts” in her book, including the importance of communicating presumed competence and respect through words, but also through tone of voice and body language.  I highly recommend these two books to all SLPs in any treatment setting, as they provide a rare, detailed, and highly personal account from people who experienced traumatic loss of communication.

Beyond reading these books, I really haven’t given much thought to the “therapy voice” in years, but this spring, I saw how damaging it can be.  On May 10, my dear father suffered the first of several strokes.  He was flown by helicopter to a nationally ranked medical center and was given the “clot-buster” drug within the “golden hour.”  The stroke was on the left side of his brain, which initially caused right side paralysis and the inability to speak.  Twenty-four hours, he had regained movement on his right side and could speak, although aphasia was obvious in the “word salad” and word-finding problems he exhibited.  Within a few days, the aphasia lessened, and he was able to speak in longer, more accurate sentences.  We were so encouraged by this and assured him that progress would continue.  Unfortunately, less than a week after the first stroke, he had a second that required emergency surgery to clear a blocked carotid artery and to remove some of the new clots in his brain.  Clots from the first stroke were left in place, due to the risk of bleeding.  Dad again regained movement on his right side, albeit with weakness, and again could talk, but the second stroke wiped out the progress he had made and he was back to being more significantly aphasic.  One only had to look in his eyes to know that he was fully aware of what had happened and was very afraid.

Once medically stable, Dad was released to the local hospital in a small town near his home for two weeks of rehab — OT, PT, Speech.  Dad was evaluated by the SLP and therapy began immediately.  Due to work obligations and distance (85 miles from my home), I could not be with my dad during these first few days, but I did get out there on day 4 so I could meet with the SLP and observe therapy.  This observation was welcomed by the SLP and the rehab director, and I had a good conversation with the SLP about Dad’s status and goals.  Then, when we walked into his room, I heard it — the “therapy voice.”  “HELLO, RICHARD!  DO YOU REMEMBER ME? I AM HERE TO HELP YOUR SPEECH.”  This was said just inches from his face.  Dad immediately recoiled and looked stricken — facial expression, eyes, and body language all expressed this.  After a few minutes of this, I gently told the SLP that Dad’s hearing was fine and that his intellect had not been affected, only his ability to produce spoken language, and said that she could speak to him conversationally.  I also said he was having trouble with yes/no questions, but I was sure that he understood.  Dad shot me a grateful glance, but it didn’t change her approach.  She opened up a book of aphasia therapy exercises and asked him “WHAT GOES WITH —” questions.  When he couldn’t answer, she said, “YOU CAN’T DO THIS SO WE’LL DO SOMETHING ELSE.” She moved on a series of yes/no questions.  When he answered “yes” to “ARE YOU A WOMAN?,” she answered, “NO, YOU ARE NOT.  YOU ARE A MAN” and closed the book.  Dad looked even more stricken.  The next activity was naming photographs. He failed on the first three, so that activity ended, again with “YOU CAN’T DO THIS NOW SO WE WILL TRY AGAIN ANOTHER DAY.”  By this point, it was all I could do to keep from taking the cards from her and modeling, “Look at this picture, Dad.  What is this?  I’ll help you, it’s a ball.  What do you do with a ball?  Can you show me?   Yes, you can throw a ball like this; now you do it. You throw a ball.  You can kick a ball, too, like this. Now you show me, kick a ball.  Look at the picture again — see it is a ball, a red ball.  Can you say that with me?  Ball.”  But I didn’t.  After a few more failed activities, Dad watching all the time as data was collected, the session ended with Dad looking devastated and Mom in tears.  I left the room with the SLP and repeated, very calmly, that Dad’s hearing was fine and suggested that he’d respond better to a conversational tone of voice and instruction, rather than just data collecting (the eval had already been done, remember) to show what he couldn’t do, and perhaps she could be more instructive when he couldn’t name pictures. Dad was a very intelligent and proud man, and failure at questions a toddler could answer cut him to the core.  When speaking with the SLP,  I was very aware that I am NOT a hospital/rehab SLP and did not want to say or do anything that would make Dad’s next two weeks more difficult.  But I know how I would teach my students with disabilities — key word is “teach,” not just collect data.  It’s very easy when people have impairment to only focus on what they can’t do.  My approach is always to focus on abilities, no matter how limited, and build from there.

Well, according to my mom, nothing changed in those two weeks.  Dad responded very well to the OT and PT, gaining skills and trying again with positive effort when he didn’t perform to his highest level, but became increasingly despondent as speech therapy time approached.  After two weeks, he was sent home with in-home therapy.  Because I was up to my eyeballs in the crazy end of the school year, I was not able to get out to their home during the week when the new SLP was there, but after a few frustrating sessions, Mom told her I was an SLP and she immediately asked for my phone number.  We had a very good discussion in which she revealed that Dad would become emotional and even hostile when she was taking data on the same kind of tasks that he had been exposed to in the hospital.  Mom had already told me this, saying that the OT and PT did not take data in front of him and worked on skills that were functional in his home and related to his personal interests and goals, whereas speech therapy was limited to drilling him with questions.  I suggested that she put away the aphasia therapy book and cards for a while, and instead engage him in conversation about his family, his career, his hobbies, his dog, etc.  I told her that Mom had many photo albums of family members, present and past, and brochures from many places that they had traveled;  these would be great conversation starters for him.  Dad was an accomplished woodworker, so I suggested that she take him to his workshop and talk about the tools and the things he had built.  Dad lost the ability to read due to the strokes, but he was still able to put together jigsaw puzzles, an activity that he and Mom did every winter to pass the time;  that would be another way to work on language skills in a relaxed context. And I stressed that, although Dad was 85 years old, he was 100% independent in all areas of life prior to the strokes — drove a car, cut his own grass, handled affairs without any difficulty.  When I visited Dad weekly throughout this time, we had many great conversations about people and events in the past, conversations that he initiated and participated in fully, even if a word or two was wrong here and there.  He talked about his concerns for my mom and the future.  He could tell time and knew when his favorite shows were on.  I’ve never seen so many episodes of “American Pickers” as I did this past spring and summer, and Dad was always able to make insightful and relevant comments about this and other shows we watched together each evening.  I did not evaluate my dad and did not want to be his therapist, but it was very evident to me that his intellect was not affected. When we went out for a drive in their rural area, Dad was able to give me directions all over the countryside to point out places of interest, to get to a farm stand he particularly liked, and always found our way home — an errorless and most enjoyable change of scenery for him that gave him a sense of control.  All of this, I shared with the SLP, giving lots of therapy suggestions that Dad would respond favorably to.  I said I totally understood about the need for data (the bane of my school-based therapy existence), but suggested it could be done more discreetly.  The conversation ended very well, with the SLP expressing her gratitude for my suggestions, as it was clear that she wanted to do her best with Dad and that she was as frustrated as he was.

Well, I’d like to say it ended well, but it didn’t.  The picture cards came out again;  Dad blew up and refused any more therapy from anyone — no OT, PT, or speech.  We hoped after this meltdown that he would relent, and we encouraged him as much as we could to try again, but it was clear to him, and to Mom and I, that he was actually going to make more progress on his own, engaging in daily functional activities, having conversations about things that interested him, commenting during his TV shows, giving us directions when driving or about how to change the water filter, than he would be getting from an aphasia therapy book. And so, I started giving my mom strategies to help Dad that didn’t feel like therapy.  That Dad was so soured on speech therapy, right from the beginning, just killed me, as you can imagine, and I have to think that a more conversational approach that presumed competence would have yielded a more positive outcome.  I completely understood and explained to both of my parents that Dad’s anger and frustration was a very common bi-product of stroke and that it would ease with time and healing.  However, Dad was too demoralized by his experience with speech therapy, and then extended that to all therapies and medical interventions.  He didn’t feel any of it was helping him, and he was done with it all.  Once he made this decision, his anxiety level dropped noticeably and he had a good month of small steps forward.  I could see a positive change in his abilities and attitude every week and we were all greatly encouraged.  Unfortunately, Dad suffered additional TIAs and complications from which he could not recover.  On August 14, this proud, wonderful, admirable, and loving husband and father passed away.

Please understand that I write this not as an indictment of the SLPs who treated Dad.  SLPs are the most caring, compassionate people I know.  These SLPs were no exception. Both seemed to be genuinely nice and caring people, and I’m sure they have helped many patients in their careers. I especially appreciated the home-based SLP who reached out for ideas when she saw Dad shutting down.  As stated earlier, I’m not a rehab therapist, so my practice is not shaped by years of dealing with adults with strokes, dementia, etc.  Maybe rehab SLPs are more strictly bound to certain therapy materials and lessons;  as a school-based SLP, I have free reign to do whatever I think will be helpful to my students, be it traditional therapy or materials/strategies that are highly personalized and even unconventional.  That didn’t seem to be the case with the SLPs who treated Dad. I acknowledge that data must be collected to satisfy insurance requirements; it drives the IEP in schools, and I work hard to keep a balance between measuring progress and actually teaching.  I certainly acknowledge that Dad’s strong personality and damage caused by the strokes also contributed to his very negative reactions.  All that said, I guess I felt the need to write this for a few reasons.  I am still very much hurting over the loss of my dad.  I’m very saddened to know that he wasn’t helped by speech therapy and, in fact, was turned off to all therapies and medical treatment as a result.

This is the first time I’ve been a close observer of therapy with a loved one — very different from being the SLP treating other people’s loved ones.  It was an eye-opening experience;  I viewed the therapy professionally and my dad’s reactions to it personally, and found that very hard to reconcile.  While a person’s prosody may seem inconsequential, Jill Bolte Taylor and Martin Pistorius would disagree, and so would Dad and I. Even if he hadn’t been able to understand the words that were spoken to him, he immediately sensed that the “therapy voice” was an affront to his status as a successful, intelligent, dignified man, and that was his introduction to speech therapy.  I witnessed how Dad perceived each session as a series of tests on which he was found deficient, and saw how badly this wounded his pride and confidence. And I have to agree with him — the activities were rote and without instruction, strategies, or prompts to help him succeed.  No amount of encouragement from me could convince him that he would improve if he would just cooperate and try. This was heartbreaking for my parents and for me;  more than anything, I wanted to do whatever it took to help my dad recover his independence and dignity, and obviously, my mom desperately wanted that, too.   Mom and I saw how Dad watched data being collected after every question, visibly wincing and withdrawing more and more with each tally mark, and that has made me much more aware of the way I keep data with my students. I feel guilty that I didn’t speak up more strongly with the rehab SLP when I saw how offended and saddened my dad was by her approach and tone of voice.  I am not good at confrontation, I never pass judgment on a colleague, and I was in a very fragile place myself.  As a result, I feel that I was overly cautious in expressing my concerns. I also knew that the SLP was not trying to do any harm;  she was just unaware of the effect her manner was having on Dad.  If I had been more clear about my observations, would therapy activities and the relationship have improved?  Would Dad have been more accepting and willing to go along with therapy?  That’s all water under the bridge now for Dad, but maybe by voicing my concerns now in this post, an SLP somewhere might rethink his/her approach and somebody else’s loved one will benefit.  Indeed, shouldn’t we always engage in self-reflection about our practice and do our best to adapt our manner and therapy to each individual? That’s the first lesson in speech 101:  “Establish rapport.”  Right?  If nothing else, maybe the reason I felt compelled to write this post is to finally release some of the feelings that have been bottled up all summer.  It’s been a tough one.

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Making Many PDFs into ONE!

pdfjoin-com-logoWhile entrenched in the arduous task of moving all of the materials on the Materials Exchange to a new platform this summer, I became painfully aware that many materials had many pages, some up to 20 (gulp!), because if you don’t know the trick to making multiple pages at once in Boardmaker, each page you create will be saved separately.  For example, a Go Fish game about fruit for 12 players would be saved “Fruit1, Fruit2, Fruit3,” etc.  That meant 12 downloads, 12 titles typed into the new site, and 12 links to be made for uploading. If you take a look at the many pages on the Materials Exchange, you’ll see this process had to be repeated over and over and over….I’m starting to feel faint, just recalling the experience.  No wonder my family started fearing for my sanity.

Having taken a couple of months off from the site to focus on the new school year (which also induces lightheadedness, I must admit), I am ready to start adding new contributions to the Materials Exchange.  Some new /r/ materials were just posted, and a number of core language stories for AAC users will be posted in the next few days.  I welcome YOUR materials for the Materials Exchange because, as I’ve been saying for over 15 years, sharing is what Speaking of Speech.com is all about. It’s a wonderful way to pay back for all of the materials that you’ve used from others. (Clicking the “donate” button on the top of the site is another way to show your appreciation for the new site and to help keep it going.  So far, 23 SLPs and teachers have kindly donated $5 or more to help defray the considerable out-of-pocket costs for this site, and I send my heartfelt thanks to each one).

Now for today’s tech tip — an answer to the problem!  There is a wonderful site called PDF Join that will allow you — for free! — to join multiple PDFs together to create one multi-page document!  This works with Windows or Mac.  Had this technology been available years ago when files were initially uploaded, my summer would have been much easier. Given the sheer volume of work I had to do with thousands upon thousands of files to organize and go through, I simply couldn’t use this tool on existing materials — the volume and chance for error were too great, and I was battling against a looming deadline.  However, I will certainly be using it with all new materials that are contributed.  But, hey!  You can use it, too!  You don’t even have to download any software;  simply follow the instructions on the website.  How awesome is THAT?!  This is just one such tool that I’m sure you’ll find helpful.  Like Dorothy in “The Wizard of Oz,” you may discover that you’ve had this power all along! Here are instructions for using Preview on Macs.  And here on instructions for using a PDF merge tool in Windows 10.  Do you have another easy resource to share?  Please add to the Comments so we all enhance our knowledge.

Checklist for ASHA!

2016_convention_750x338To all the lucky SLPs who will be attending the ASHA Convention next week, WELCOME TO PHILADELPHIA!  You’ll be right in my backyard!  I can promise that you’ll love the City of Brotherly Love.  I’ll be there all three days, and will be doing a poster session on the SETT Process for assistive technology on Friday.  While the sessions are generally awesome, I find the most valuable part of the convention is the opportunity to network with SLPs from all over the world — similar to what happens on the SLP Message Center of Speaking of Speech.com, but LIVE and IN PERSON!!  I am so looking forward to meeting as many of you as I can!!  If you can’t get to the poster session, please keep an eye out for me around Convention Hall and at the Art Museum party, although, at 4’9″ and 100 lbs soaking wet, I can be a little hard to spot in a crowd, ha, ha.  That being said, it will be much easier for you to find ME than for me to find YOU, so please come up to say hello, or as we say in Philly, “Yo!”

As a veteran of previous ASHA Conventions, I have a few tips for newbies who are starting to pack for the trip:

  1.  Take your most comfortable shoes!!  Really, no one cares if you show up in sneakers.  You’ll still be smiling by Saturday, while those with fancy footwear will be sidelined with bunions.  And sneakers will give you an advantage as you dash from one session to another.  You’ll get there in time to get a seat, but those struggling with heels or boots — or worse, boots with heels! — will be locked out or forced to stand against the wall for the entire session, which won’t be making their feet feel any better for the next dash.
  2. Get the free Program Planner app right now!  Survey the offerings, prioritize those sessions that interest you most, download the handouts, and study the map so you know where you are going next. There’s no time to waste between sessions.
  3. If you are traveling with colleagues, lucky you!  Put your heads together and figure out how to cover the most sessions possible, then take good notes and share them.
  4. Dress in layers.  The ASHA team must have paid off the Weather Channel, because sunny days are forecasted Thursday, Friday, and Saturday, with temperatures ranging from around 60 during the day to around 40 at night.  That means you are not going to need a winter coat during the day, so leave it at the hotel, use the coat check room at Convention Hall, or leave it at home and layer up with a sweater and jacket if you’ll be going outside a lot.  But do be sure to bring a light sweater or jacket into Convention Hall.  I’ve been in there when it is freezing and, guaranteed, you’ll find the temps uneven from place to place.
  5. Empty out your purse of all but the most essential items! You won’t need a pen — you’ll be getting dozens of them in the Exhibit Hall.  Tissues, a small bottle of hand sanitizer, your wallet and ID are the basics. And a painkiller, if you didn’t heed my warning in #1.  Take your smallest purse and wear it across your body.  This reduces back strain and gives you another advantage in the dash to the next session. Backpacks can be a nuisance to stow in crowded session rooms.
  6. Bring a sheet of address labels. While there are online entries for prizes, you’ll likely be filling out a bunch of raffle entries and postcards for more info.  Slapping on your address label will save you time and reduce hand-cramps.
  7. Bring your appetite!  You simply can’t leave Philly without wolfing down at least one Philly cheesesteak, a hoagie, a soft pretzel with mustard, Bassett’s Ice Cream with jimmies, anything from DiBruno’s, and water ice (pronounced “wooder ice”).  Many gastronomic delights can be found at the Reading Terminal Market, but be prepared to wait in line.  A quicker and just as satisfying solution is to eat at some of Philly’s gourmet food trucks!
  8. Resist the urge to sign up Philadelphians for artic therapy. Our native son, Bradley Cooper, will help you to understand our regional speech and language.

Looking forward to a wonderful convention!!  Wishing you all safe travels!!

Some FAQs about SOS.com

Since the “new and improved” Speaking of Speech.com went live last week, I’ve been getting lots of emails expressing delight with the new format, and also some questions.  Here is some info you might find helpful:

  1.  Where is the — material that I found several years ago on your site?  Oh, I get this question a lot!  Please note that, with probably less than a dozen exceptions of files that had become corrupted, every single document that was on the old site has been transferred to the new site, and they have been kept under the same headings as before.  The materials are all there;  only the menus have changed in appearance!  If you haven’t scrolled through the lists of materials lately, you really should. It’s astounding to see how much is on there — and it is still all FREE!
  2. How do I contribute to the Materials Exchange?  I’m happy to get that question and would be happy to add new materials.  In recreating the site, I noticed a startling trend.  Contributions of materials were very strong until TeachersPayTeachers came along, then there was a very steep decline.  New materials are always welcome on the Materials Exchange.  Guidelines for sharing materials are found HERE.  Send your original materials to pat@speakingofspeech.com, and I’ll be happy to post them.  It’s an easy way to share your hard work with colleagues all over the world.  Just think of how many students might benefit!
  3. Why don’t my old bookmarks work?  Every page on the site had to be rebuilt from the ground up.  That means each page has a new name and a new URL.  If your old bookmarks are not functioning, you’ll have to go to the home page of the site and bookmark it anew.
  4. How much does it cost to run a website?  Well, most SLP sites can be up and running at minimal cost, but Speaking of Speech.com is different because of the huge volume of free materials that are stored on it.  It is, in fact, one website that you see and a new hosting site with cloud storage that you don’t.  There are many additional yearly costs, including the domain names, my email account, and the newsletter service.  This particular upgrade cost me several thousand dollars (we won’t even talk about the time devoted to it!), and I estimate that I’ve spent upwards of $25,000 to maintain the site in its lifetime.
  5. Will there be a membership fee to use the site?  No, I have always wanted the site to be free to all SLPs, teachers, college students, and parents, and I intend to keep it that way.  However, many SLPs urged me to add a “donate” button on the site and said they’d gladly make a one-time contribution to its upkeep.  Faced with the increasing expense of the site, I took that advice and added the button at the top of each page.  If you value the site and want to express your appreciation, I can assure you that even a $5 donation would be met with my sincere gratitude!  To the 10 SLPs who have made a donation — thank you!!!

 

It’s LIVE! Check out the new Speaking of Speech.com!!

Screen Shot 2016-08-27 at 2.33.19 PM  After many months of mind-numbing work, the “new and improved” Speaking of Speech.com is finally done!  If you’ve been following the saga on this blog and on Facebook, you’ll know that I was forced to recreate the entire site, including the HUGE Materials Exchange, or risk the site being lost when the web host upgraded.  Having been in this same position 10 years when the first web host went out of business, I knew how much time and effort it would take and, frankly, very seriously considered just shutting down the site.  I put out a survey to see if the site was still of any value to SLPs.  After all, times have changed since the site was first developed many years ago. The response was overwhelming!  Well over 3000 SLPs responded in the first few days;  92% said the Materials Exchange was the feature they used most.  Half of the respondents took the time to write comments, all in the vein of “PLEASE DON’T SHUT DOWN THE SITE!”  I can’t tell you how much I appreciate all of the very kind words of support and encouragement.  Quite honestly, that’s what gave me the motivation to save the site. (I only regret that I am unable to answer each comment personally, as every one truly touched my heart).  Attempts to hire someone to redo the site fell through, so I took on the project myself. Ugh.

Saving the site turned out to be quite an adventure. I did a bare-bones recreation of the site on 5 different platforms to see which was most suitable.  Four platforms turned out to be insufficient for one reason or another, so I canceled those and went with the fifth.  I built one entire page of materials on the Materials Exchange, only to find out that when the user downloaded the material, the document names change from the original, descriptive titles to a crazy string of numbers!  This threw me into panic mode, and necessitated multiple phone calls to the host’s tech support to figure out a work-around.  I also wanted to be sure that I’d never, EVER have to go through this “download, upload, type, and link” routine again.  The solution was for me to purchase a second site used for Cloud storage of the thousands of materials.  Files stored on that site retained their names when downloaded.  Whew!  I had to purchase a few additional upgrades so that the site would work better than ever.  It is now 51 pages long (not including all of the message boards!), but you’ll it very easy to navigate.

After thinking very long and hard about it, I took the suggestion of many SLPs and added a “donate” button to the top of the site.  It has always been my intention that the site would be free for all to use, and that is still the case.  However, if anyone wants to donate any amount to help with the expenses of keeping the site running, I would be ever so grateful.   I did add some advertising to the site as unobtrusively as possible; that generates pennies a day, but every little bit helps.

My goal was to have the new site up and running before the start of my new school year, AND I DID IT!!!  (I go back to school on Monday).  I truly hope that you enjoy the new format and that you continue to use it often.  If you haven’t checked out the boards in the SLP Message Center, please do!  The message boards provide a great way to dialogue with colleagues around the world.  The HELP LINE message board is such a lively place that you can sign up for a daily digest of new posts.  I check this and the other boards daily and always learn something new.  I hope you’ll join in the conversations!  I also hope you’ll contribute some new materials to the MATERIALS EXCHANGE.  Directions are on the site.

I’ll be doing some tweaking here and there over the next few weeks, but hope that, overall, the site works well for you just as it is, because I really need a break! 🙂 Many thanks again to all for your support and encouragement!  I hope you all have a happy, healthy, rewarding new school year!!!