Our SLP chat tonight, Monday, Dec. 3rd, 2001, will be hosted by Dr. Nancy
Creaghead who will address the topic of working as a Speech-Language
Pathologist in the schools. Nancy Creaghead, Ph.D., CCC/SLP
is Professor and Head of the Department of Communication
Sciences and Disorders at the University of Cincinnati. 
She is responsible for teaching in the areas of language
acquisition and intervention.  Dr. Creaghead has had previous experience
in preschool classes for language impaired and hearing impaired
children and in a special school for learning disabled children. 
Her research, publications and presentations have been primarily
in the areas of language acquisition and disorders and classroom
communication.  She has lectured at numerous workshops and
meetings at the local, state, national and international levels,
including the 1978 through 1998 ASHA conventions.  Dr. Creaghead is an
ASHA Fellow and has just completed a three-year term as ASHA
Vice President for Professional Practices in Speech-Language Pathology.
She is currently ASHA President-Elect.  References about School Services
and Literacy have been provided by Dr. Creaghead and can be found at the
bottom of this chat transcript.

<Robin> Welcome !  We are so pleased to have Dr. Nancy Creaghead here tonight
     to talk about the topic of working as a Speech-Language Pathologist in the schools.
<Nancy> I'm pleased to be here to talk about school issues.  Hope there are lots of
<Ivonne> I am currently working on a presentation tomorrow on the effectiveness of
    early intervention of hearing impaired children so this will be interesting
<Robert Rimac> congrats Nancy on your ASHA election
<Robin> Welcome everyone!
<Robin> Dr. Creaghead, would you like to start with some general info about working
    in the schools?
<Nancy Creaghead> Thank you.  I hope that there are students on the chat who might have
    questions about what it is like to work in school settings.  I think it is a very
    exciting place to work.
<Nancy Creaghead> Several things that make school settings important and challenging are: the
    variety of disorders that we see there -- and the total range of issues.
<Nancy Creaghead> In order to provide services in the schools, the SLP must be prepared to work
    with any disorders and in many cases a wide range of age groups.
<Ivonne> what do you think about current caseloads?
<Robert Rimac> I haven't been a student in years, but as a former university professor,
    I find the public schools the place to be - caseload size is the biggest issue I know of
<Nancy> The size of caseloads is a big issue for school based clinicians.  ASHA has a
    focused initiative on school issues with caseload as a major focus
<Robin> what does ASHA recommend as the ideal caseload size?
<Nancy> We are working to put the focus on "workload" rather than "caseload" only as
    we have so many responsibilities in the school environment.
<Nancy> ASHA has tried to avoid a number for caseloads as there are so many
    issues regarding severity of students, other responsibilities, etc.
<Nancy> States vary a lot in regard to the stated caseload size so setting a number
    could be bad for states with a low caseload requirement.
<Robin> how then do you determine what a fair "workload" is?
<Nancy> I think we are making some good progress in getting the concept of workload
<Nancy> Workload needs to be based on our roles in collaborating with teachers,
    serving as consultants for the curriculum.  We need to figure out how many hours we
    work and how we fit in all these things
<Anonymous10> I agree with the referral to "workload", not caseload.  I have been in the
    field for 30 years and I am feeling more overworked than ever.  I have had high
    caseloads in the past, but I am now dealing with more severely involved children
<Nancy> We would base work load on whether we are in a preschool or older setting,
    the severity of the caseload, etc.
<Anonymous89> In Colorado we use a severity rating scale to determine eligibility for
    speech and language.  However, all of my lower IQ students qualify.  What do I do?
<Nancy> I understand that -- in many cases, the caseload numbers are really irrelevant
    today with new duties and types of children
<Nancy> In regard to the question about having so many children qualify, I think we
    must make decisions about how best to serve certain students -- must we see them
    directly or collaborate with other members
<Ivonne> How about speech technicians? How do they fit in our workoad?
<Ivonne> I know states such as Arizona and Florida are really pushing for the use of
    speech technicians in the schools
<Nancy> About the technicians, that varies so much from state to state.  If we really
    have technicians or assistants who assist SLPS, then maybe that can help, but in
    some states, Assistants work independently
<Nancy> I think that technicians could help IF they really work under the supervision of
    SLPS -- which many often not really happen
<Robert Rimac> as a member of L'GASP, I find that gay/lesbian public school teachers
    feel threatened....will ASHA take more of a stand with regard to gay/lesbian issues in
    the schools, to enforce our code of ethics?
<Nancy> Robert:  I know that ASHA is VERY committed to serving the needs of
    members of our profession from diverse cultures.  As you know we have a focused
    inititave on that.
<Nancy> We need to know from members what is needed and how best to help.
<Nancy> I wonder what students in the chat room have had a school experience
    and if so, what their impressions of the challenges are.
<Anonymous2286> What is the best part about working in the schools?
<Nancy> Well, I think the best part is the opportunity to work with children in
    relationship to what is their "real life" -- school and the curriculum
<Ivonne> I worked as a preschool special ed teacher before returning for my masters,
    and realize the need for extensive collaboration that needs to exist
    between teachers and SLP's if we want to make a "real" difference
<Nancy> If we are in the school, we have the best opportunity to impact change in
    relationship to the child's actual environment -- school!
<Nancy> I agree with Ivonne about the important of collaboration.  I think we are doing
    better in preschool settings than anywhere else in this regard.
<Anonymous89> Don't go into public schools thinking you'll get rich.  The rewards are
    numerous though.  Challenges, variety, great peers, after 25 years I still get
    surprised by new problems.  I love it
<ndlinnen> I agree, although I have never worked in the private sector, I feel that I am
    making an impact in their education.
<Nancy> Ivonne:  I agree so strongly.  Back to caseloads, we are not going to be able
    to serve all children ourselves.  We must work on a team if we are going to serve all
    the children we will see there.
<Nancy> It is possible to be helpful outside the school, but it sure is easier when you
    are right there.  If we can support teachers in helping, we can make an even greater
<Anonymous89> Nancy, how do you see this team working?
<Nancy> I see the team working in a multitude of ways.  Sometimes, the group will
    determine goals together and all work on them
<Nancy> In other cases, the SLP might be a consultant and the teacher takes the main
    role in supporting the student
<Nancy> In another case, the SLP takes the lead if there are specific speech skills to
    be taught
<Anonymous89> Who is in the group?
<Nancy> who is in the collaborative group, 89?  Anyone who is relevant -- teacher, SLP,
    special ed teacher, parent, child, psychologist, reading teacher, etc.
<Robert Rimac> Nancy...you will make a WONDERFUL ASHA President. I have to go,
    but thank you & the sponsor for hosting this innovative forum. Palm Springs, CA, has
    wonderful schools. Come visit anytime. :-)
<Robin> thanks  for joining us Robert
<Ivonne> Nancy, I read you have experience working in settings with children with
    hearing impairments
<Ivonne> any advice with that specific population?
<Nancy> Yes,  I worked with children with hearing impairment a lot early in my
<Nancy> Well,  I guess I really see the issues as the same as other populations --
    except that we have the hearing also to deal with -- but isn't the main problem
    developing lanuage?
<Nancy> and especially with hearing impaired children, we have to have everyone on
    the team understanding the child's needs
<Ivonne> and that of the family as well
<Nancy> The teacher must understand that the child can't hear!!--that sounds
    simplistic, but may not really be easy for the teacher to understand
<Nancy> And you are right that the family is so crucial for these children as well as
    other groups that we serve
<Anonymous89> I am working with a child who received a cochlear implant 1 1/2 years
    ago.  I panicked at first but you're right, you develop language. 
<Ivonne> Do you see the role of an slp tied with that of an early interventionist in the
    case of preschool settings?
<Nancy> Ivonne:  I definitely see that we need to work with the early interventionist in
    preschool settings.  We just have to work with anyone who is in the settings -- and
    one thing we can do is share roles
<Nancy> rather than duplicating them -- that is how we will get the high nubmers of
    children served
<Nancy> Another issue in school settings that is big today is paperwork
<Nancy> That is an area that ASHA is addressing.  School SLPs feel that they spend
    more time on paperwork than seeing children sometimes.
<Robin> what can be done about the paperwork?
<Nancy> We are trying to be sure that the reauthorization of IDEA as well as state and
    local requirements do not add paperwork requirements any more than necessary
<Anonymous89> Yes, there's tons of paperwork and most of it gets done on my own
    time.  I spent most of the weekend doing a report for our governing organization.
<Nancy> In the reauthorization of IDEA, we are really trying to be sure that nothing is
    added, but the real problem is at the state and local level.  It just gets layered onto
    what IDEA requires
<Nancy> Each of us must take on the task of advocating for the minimum necesary
<Anonymous89> I have kept 1/2 hour each day for planning, paperwork, etc. and can
    see how easily I could fit in a few more students.  BUT I REFUSE to give up that
    dab of time.
<Nancy> 89, you are right that you need to reserve that time -- for paperwork or meeting
    with teachers, or whatever other collaborative efforts are needed.
<Nancy> A survey of special education teachers recently showed that those who had
    more than 5 hours of paperwork per week felt that the job was overwhelming
<ndlinnen> I too am frustrated with the amount of paperwork.  My colleague returned
    to school and became certified in elementary education. She is now teaching first
    grade because she was frustrated with the paperwork
<Anonymous4219> I am getting that message in a lot of my classes dealing with
    schools but have not been at my educational placement yet...
<Robin> 4219, what classes are you taking ?
<Nancy> 4219:  What message are you getting?  That you need to reserve time for
    these activities -- or that paperwork is overwhelming?
<Anonymous4219> oh, both, but in a good way...that paperwork is necessary to
    document what needs to be documented by law
<Anonymous4219> I am currently in a course called SLP in the schools.  So much
    good information, I think it could be three classes
<Anonymous9563> I'm planning to enter the field and hope there is a course dealing the
    practical aspects of dealing with paperwork
<Anonymous89> There are times I feel overwhelmed but have accepted that, getting to
    work an hour early and spending weekend time doing paperwork.  Right now I'll have
    to cancel my students for a day just to take nine kids up for testing.
<Nancy> Yes -- it IS necessary -- and what WE need to do is to be sure that SLPs are
    involved in the decision making about how and what needs to be done -- in regard to
    paperwork or anything we do
<Ivonne> In my case, we only spent about 3 hours on the issue of paperwork- IEP's
<Ivonne> that is the other issue, thank you for bringing it up 89, what about testing
<Nancy> These are the issues that lead us to say that we have to consider workload
    rather than caseload
<Ivonne> Is there any time left for therapy?
<Anonymous4219> We have to meet therapy times designated in IEP, correct...
<Nancy> One question is how we define therapy -- thinking of it as intervention in a
    larger perspective, maybe testing is a critical part
<Anonymous89> I have testing time on Thursday PMs when there are no staffings. Ha
    ha.  Thus I have to cancel to test.
<Nancy> What I mean is maybe IF there is only so much time, our time is best spent in
    assessment and intervention planning -- with the teacher carrying out the intervention
<Ivonne> Do you mean servicing the children in their classrooms?
<Anonymous89> I like this last idea, Nancy.  I tend to put the whole responsibility on
    me and haven't yet turned it over to others.
<Nancy> OH  IEPS writing!!!  that's another of my concerns
<Nancy> I think we have to advocate for and implement VERY flexible IEPS that do not
    specificy who, when and where intervention will occur
<Anonymous4219> But then you have to have time to collaborate with the team in order
    to carry out what was planned for intervention
<Anonymous89> And when do we have time to collaborate.  We joke about Sunday
<Nancy> 4219,  I understand that is a problem, but again, I think the time we spend in
    collaborative planning can mean more services for children if all team members are
    part of the intervention, especially the teacher
<Anonymous89> and we have 4 sections of each grade level.  I have to collaborate
    with all of those teachers since my kids are spread out
<Nancy> I understand the "spread out issue".  One thing is to be a part of the
    placement team to try to get children grouped in one classroom
<Ivonne> sounds very nice, but what about the different needs of children in the same
<Ivonne> One technique might not work for all 5 children with Sp/lang problems?
<ndlinnen> If I suggest to the teacher to implement some strategies, I receive an
    exasperated look and comment that it is my job to provide therapy.  This is by some,
    not all.
<Nancy> What I was saying was that what we want is strategic individualized
    instruction by teachers, isn't it?
<Nancy> so maybe our main job is to support that rather than seeing children in
    pullout ourselves
<Anonymous89> The teachers will die if they think they have to do individualized
    instruction for my kids too
<Anonymous4219> but won't our strategies and support be for all students, can we
    really expect the teacher to become that individualized?
<Nancy> 89: I know, but if teachers think we can do the job for them, that is just not
    true and if we let them think that, then children are not going to get the best services.
    We just can't do it.
<Anonymous84> in my experience, teachers don't like it when you cluster special ed.
    students in their classroom
<Nancy> 4219:  I think I know what you mean -- that if we provide strategies for
    teachers, all children will be helped?  Yes, but there must be some individualization.
    That is what good teaching is.
<Anonymous4219> I understand that, but if the teachers know the children's IEP goals
    and see that you are helping him/her to adapt/modify the curriculum already being
    used to address the children with special needs goals, isn't that the objective,
    to have the children access the general curriculum?
<Anonymous89> There is no way one teacher will want all 13 of my 1st grade
<Nancy> Well 13 is a lot -- but maybe 6 and 7?  And maybe some teacher is more
    willing if it is not every year?   Perhaps alternate years -- one year they have them
    and the next not?  I think that in some cases, the willing teacher is the best one to have
<Anonymous89> Good idea.  It's not like my kids are the most difficult like the SLIc kids
<Anonymous84> But is that fair to the other teachers to have that extra responsiblity?
    Teachers are responsible for a lot now.
<Ivonne> You are right 89, but that is why we have to keep good PR's with all teachers
<Nancy> I know one place where there were two 3rd grade teachers and they alternated
    with the lower kids and the highest kids because they both were willing to take them,
    but not both ends in one class
<Ivonne> Having good communication with the principal also helps the issue
<Anonymous84> I like Nancy's idea
<Anonymous89> Definitely the willing teacher would be best and if I came into the
    room to help that would be an added incentive
<Nancy> 84:  Yes you are right, but is fair the issue?  it is the children who must be
    treated fairly -- and again, I think it is OUR JOB to make it as easy as possible for
    teachers to do this
<Anonymous89> But sometimes I feel like a tutor in the general classroom
<ndlinnen> so do I
<Nancy> 89:  isn't that all right -- IF you are a tutor who has special expertise in
    language and can use that for lots of kids?
<Nancy> I would really like our job to be supporting teachers in doing this.
<Anonymous84> beware of the teacher who doesn't want you in the classroom
<Anonymous89> amen
<Robin> Do any of our anonymous listeners have a question for Dr. Creaghead, or any
    general questions about working in the schools?
<Anonymous9563> Does anyone know anything about LiPS, directed by Linda
    Mood/Bell? All I know about it is that it is a program for dyslexia
<Ivonne> I have heard about it, but does it really work?
<ndlinnen> we are using it in our school district
<Anonymous84> how is the training?
<ndlinnen> Our kindergarten and first grade teacher, title teachers were trained this
<Anonymous89> Our Title Reading program is based on the Lindamood.  I use it as
    does the resource teacher at the middle sclool
<Nancy> Yes, I do know about Lindamood/Bell.  It is a pretty structured approach to
    reading/phonological awareness -- and really has been around a long time
<Anonymous84> I just wonder how many districts are ready to fund the training and
<ndlinnen> we are also going to receive training in Visualizing and Verbalizing in the
    next several weeks
<Nancy> Are those of you who are using it using only that or also comprehension
    based reading activities? I think a combination is important
<Anonymous89> Genuine Lindamood training is very expensive but there are modified
    "Multisensory" approaches to it
<Nancy> Certainly there is lots of evidence that some children need direct decoding
    instruction, but also children need authentic reading experiences.
<Anonymous84> do you have to be certificated in it to provide therapy in LindaMood?
<ndlinnen> we are using both approaches--comprehension based activities and Lips
<Anonymous89> You can not call what you do LindaMood unless you have the real
    material and training is what I understand
<Nancy> But I understand that we cannot call it by that name.  I certainly think that
    training in any of these approaches is valuable for us.  The more we know about
    literacy the better.
<Nancy> The training that Lindamood Bell (LB hereafter) provides can be done without
    following the exact methods.  There are sound parts of it that good decoding
    instruction includes
<Anonymous84> I've always wanted to try at least an intro. training
<Mona> where can you get trained?
<Anonymous84> I think its great schools are using it
<ndlinnen> you can buy training tapes
<Bob> Is LB substantiated by mainstream research or is it something very
    independent and tightly controlled?
<ndlinnen> that is what the reading specialist and I did the first year we piloted the
<ndlinnen> I am leaving the implementation of the program to the teachers and title
    people because they are able to use the program daily with the children.  I may see a
    child once or twice a week.
<Nancy> Unfortauntely we really do not have any strong research that tells us which
    approaches work.  WE need that but it is "messy!!
<Anonymous89> Thanks, Nancy.  Nothing new here tonight but I needed to hear some
    of this again so I can manage my growing load more easily.  Possibly next year
    will be different
<Anonymous84> I agree w/ the Anon. 89, we have to deal w/ our growing caseloads
    before we shoulder more responsibility
<Nancy> But, 84, I really think we will never be able to deal with our caseloads if we try
    to do it all ourselves.  They are just going to get bigger and we have to share the task
<Anonymous84> share it w/whom?
<Nancy> I just do not think there are going to be dollars for more SLPs and there will
    be more children
<Nancy> Share it with the whole team -- like maybe we see some children and the LD
    tutor sees others and we don't see the same ones.
<Mona> How about changes occuring on the other side? Regular teachers can benefit
    from greater instruction in the whole special ed curriculum.
<Nancy> Are we talking about taking on literacy here?  I understand how that seems
    an addon-- and we can't take on all the children with reading problems, but we can
    share what we know about language to contribute to reading instruction for children,
    especially those with language problems.
<Nancy> Mona:  I agree that teachers can learn a lot from what special ed teachers and
    we do.
<Anonymous84> Sometimes I wish we had something between DIS and SDC
<Nancy> Wouldn't the ideal be for all teachers to be able to provide individualized
    instruction for all students?
<Mona> A good friend of mine, a regular ed teacher, shared with me her concern about
    the need for more classes covering the topics of language development and other
<Nancy> What is DIS and SDC ?
<Anonymous84> I'm sorry I mean something non-intensive but more preventional in
    nature, DIS is pull-out services and SDC is a special day class
<Nancy> Does this mean something between qualifying children and just typical
    classrooms?  If so, I agree.  I wish we could serve children that are qualified
    but need help more easily
<Anonymous84> exactly
Nancy> Ok  84:  I agree and think that we must move to that -- to being able to serve
    children in any model that is needed for that child
<Anonymous65> I am in a private school and do not have to do inclusion, but I think I
    should anyway for carryover
<Anonymous84> agreed
<Anonymous84> if we made ourselves more invaluable could it mean more of a
    demand for us?
<Nancy> 84:  I think so -- and I think that is the only way for more funding -- to show
    what we can do for the regular edcucation curriculum  to become indispensable there
<Nancy> I honestly do not think that we can really do our job in a pullout setting --
    children just can't make the transition from pullout to the classroom.
<Nancy> it isn't fair of us to expect them to do that.
<Anonymous84> but how do we check to see if they're making their goals?
<Nancy>  I think we have to have very simple evaluative measures for teachers --
    not percentages, but observing that it happened?
<Anonymous65> Guess I have to get busy and educate my private teachers
<Nancy> We're getting there -- and are providing lots of high quality services for
    children in the schools -- we just have to keep making it better and better
<Mona> Thank you for all your feedback Nancy
<Robin> Thank you so much, Nancy, for joining us tonight....
<Anonymous84> Thanks Nancy!!
<Robin> we appreciate you sharing your expertise
<Nancy> Thanks..I loved it~!!`
<Bob> bye
<Nancy> Bye everyone.  Thanks for your great questions and ideas
<Anonymous84> bye
<Robin> we are hoping to start a regular chat for school slps starting in Jan.
<ndlinnen> bye
<Robin> Thank you all for coming!
<Anonymous84> looking forward to it
<Mona> thank you
<Nancy> It would be great to have a chat for SLPS in schools
<Anonymous84> regularly
<Robin> Nancy, perhaps you will join us again!
<Nancy> I would definitely like to do that -- and also on the new School SLP chat
<Anonymous65> Thanks from 65
<Robin> yes, I think there is a real need for a chat to exchange ideas and provide
    support for one another
<Anonymous84> I know a lot of us feel isolated
<Robin> Nancy, thank you again!
<Nancy> I agree.  There are so many school issues.  This is a great way to share
    ideas and concerns.  Thanks
<Anonymous65> Am I the only one private here?
<Nancy> GREAT!  65 do you mean you work in a private school?  Aren't the issues really
    the same?
<Anonymous65> yes
<Anonymous65> The private schools are way behind on inclusion
<Nancy> I can see that, but maybe you are the one to lead the way!!!
<Anonymous65> hope so
<Nancy> go for it
<Nancy> Anyone who wants to talk with me more can email me at
    nancy.creaghead@uc.edu  Bye everyone
<Nancy> thanks Robin, for hosting this chat
<Robin> Good night and thanks again!


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