Our guest chat host tonight, Feb. 19, 2001, is Susan Moon-Meyer.
Dr. Meyer is a Professor in the Speech-Language Pathology Program at Kutztown
University in Berks County, Pennsylvania.  She is the author of
guide offers insight into behavioral objectives, writing evaluations,
honing writing skills, professional style, writing progress notes,
clinical accountability, handling paperwork, running therapeutic
sessions and evaluations more smoothly, and self-evaluation. Dr. Moon-Meyer
will chat about tips for the beginning speech-language clinician.


<Dr. Meyer> Hi Robin!  Guess we are off to a good start--we are here!
<Dr. Saras> Hi Dr. Meyer
<Dr. Meyer> Well Hello--Dr. Saras
<Robin> Hi Dr. Meyer!  Glad you could be here with us!  You too, Dr. Saras
<Adrienne> Dr. M- I was looking through your book again before the chat.
<Adrienne> I had forgotten how many tips are in there!!
<Robin> hello, we are chatting with Dr. Meyer, author of SURVIVAL GUIDE
<Dr. Meyer> Probably everytime you look, you'll find something that is more
    relevant to what you are doing now than when you originally looked at it.
<Robin> shall we open up the floor for questions?
<Adrienne> It's a great resource :~)
<Dr. Meyer> What type of students are here tonight (other than good
    ones!)--like undergrad, master's, Ph.D?
<Kim> first year masters from UW-Madison
<Adrienne> let's shout out where we're coming from...
<Adrienne> senior at FSU
<Jessica> Junior at UW
<Kim> madison?
<Erika> senior at Oklahoma State
<Jessica> oh, No not that UW... University of Washington, Seattle
<Julia> Senior - Southern Illinois Univ
<Katz3178> senior at UW-Whitewater
<Anonymous5143> Andrea KU 1st semester Graduate
<Adrienne> does anyone have any questions about clinical practice for Dr.
<Erika> Hello Dr. Meyer...I am looking through your book now. It is a great
<Erika> It made my first clinical experience a little less traumatic :)
<Dr. Meyer> Thank you Erika.  It is currently under contract to come out in a
    revised second edition in time for the 2002 ASHA convention.
<Dr. Meyer> I hope it will even be more useful and have more helpful hints.
<Dr. Meyer> I'm ready for those questions!
<Anonymous5143> What advice can you give to someone who wants to have
    their own clinic?
Dr. Meyer> 5143, go for it!  Just be sure you have the necessary credentials!
<Jessica> Do you have your own practice?
<Dr. Meyer> What kind of problems, if any, are you all having with clinic?
<Anonymous5143> Do you think it is necessary to have your PhD to have your
    own practice?
<Robin> Andrea, we will be having a chat about private practice on april 2nd
<Dr. Meyer> Jessica, been there-done that.  Before I had my children, yes, I
    had a large private practice.
<Adrienne> why did you leave for University?
<Jessica> Why did children change what you do?
<Dr. Meyer> 5143, according to ASHA, no you do not need your doctorate.
    However, I certainly believe it helps when interacting with MD's.
<Erika> that is an interesting fact
<Erika> I guess I always think Ph.D. ---> you teach
<Anonymous5143> Do  you suggest going straight for your PhD after grad.
    school. Or going out into the practice and gaining some experience first?
<Adrienne> good question!
<Dr. Meyer> Adrienne, I did not leave private practice for the university.
    Concurrently I was running and doing private practice, teaching at the
    university and working on my Ph.D.
<Erika> holy mackerel
<Adrienne> wow!
<Kim> impressive!
<Jessica> You must have good time management skills
<Dr. Meyer> 5143, no I do not suggest going straight for the Ph.D.  I don't think
    it is wise to have the doctorate and no CCC.  I think it is best to get the CCC
    between your master's and doctorate and then you will have your CCC
<Adrienne> are there many PhD's that do clinical work?
Dr. Meyer> Adrienne, there are some but I certainly think that more would be
    nice--to really get into the research aspect.
<Adrienne> uuu, let's talk about research in the clinic
<Erika> doesn't one get into the research aspect in a univ setting?
<Adrienne> how do you see research and therapy interacting?
Dr. Meyer> Adrienne, anyone in the field can do research.  Yes, research is
    done also at the univ. level.  Erika, I meant that if there were more practicing
    Ph.D's we might have more, perhaps better research. 
<Dr. Meyer> For example, the SLPs in the schools certainly have easy
    access to a wide variety of problems.
<Anonymous5143> Where do you see the research and tx going for those
    with cochlear implants and hearing loss?
<Dr. Meyer> 5143, I believe we are making significant gains in that area.  I
    believe that many people with severe and profound hearing losses will receive
    the implants earlier--particularly children.
<Adrienne> why don't more clinician's do research then?
<Andrea> Does there need to be a lot of research done in this area before we
    can "specialize" in the area?
<Dr. Meyer> Something related, the research on the blind population
    receiving implants and being able to see is another extremely interesting
<Erika> no way!
<Erika> wow
<Adrienne> what?
<Adrienne> implants of what?
<Erika> people who are blind receiving implants to see again?
<Erika> amazing
<Erika> will the wonders never cease
<Dr. Meyer> Andrea, it is just at this point in time that there does not appear to
    be alot of this population in one location--therefore, it is not a good area to
    specialize in yet, however, it certainly does not hurt to learn all you possibly
    can about it.
<Adrienne> I have a questions about classes prior to clinical expereinces...
<Adrienne> at FSU, we don't get our own client til Grad school...
<Adrienne> I know other places do it differently...
<Dr. Meyer> Adrienne, go ahead with your question.
<Adrienne> how much experience/knowledge do you feel is necessary before
    working with a "real live client"
<Dr. Meyer> Adrienne, at KU (Kutztown University) where I am a professor, we
    have a very strong undergraduate clinical program.
<Dr. Meyer> Our students also do 30 hrs. of observation prior to the time they
    reach 64 credits.
<Rhonda> How soon will we see clients when we enter grad school?
<Erika> I think that depends on the program you attend Rhonda
<Adrienne> at FSU I think it's first semester... any one else know?
<Julia> At SIU it's immediately
<Jan> I think that undergrad practicum is an essential part of the UG
    experience.  But many programs are getting away from it.
<Katy@OleMiss> Dr. Meyer, do I understand correctly you have a new book
    out for the emerging graduate?
<Dr. Meyer> Katy, my book is not new--it is 1998--but a new revised second
    edition will be coming out in 2002
<Adrienne> Dr. M- do you do an observation class?... We do, that's where I
    used your book
<Katy@OleMiss> Many programs do have you see clients the first semester,
    we did with in the first three weeks of school.
<Erika> I had an observation class also...but there were no books...
<Jan> I'd like to know what students (who have done a semester of therapy)
    think was the BEST thing that prepared them for the experience.
<Rhonda> Scary to see clients right away!
<Dr. Meyer> Adrienne, we do not have an observation class.  However, if a
    student is having difficulty in therapy, we may show and watch some videos
    of therapy sessions with the student to help her get the idea.
<Katy@OleMiss> Dr. Meyer, I am looking to begin a library of books that
    would be very beneficial to the clinician just beginning their CFY, which I will
    do this summer/fall.
<Katy@OleMiss> Any suggestions?
<Erika> My observations class and the clinical methods class went hand in
    hand on being the best thing
<Andrea> I would have to say reading the clients file and becoming familiar
    with them on paper.  When you see the client for the first time, take the
    session to get to know them in person.  Ask some questions
<Katy@OleMiss> Jan, the best thing that prepared me was knowing my
    basics from undergrad and the fact that I did three semesters of supervised
    therapy in undergrad.
<Dr. Meyer> Jan, I would say read the introduction to my book and you will
    see that you are not alone.  The majority of students look at clinic as being
<Dr. Meyer> Jan, and it is understandable because often you are not really
    prepared.  You are expected to be able to do "stuff" that you were never
    "directly" taught.
<Rhonda> how often, as a practicing SLP does one need to remember all the
    speech science/anatomy/physiology?
<Adrienne> Even if I remember everything I'm taught (HA), I worry I won't be
    creative enough to make up therapy tools
Jessica> What sort of things would you be expected to do that you might not
    have been taught?
<Andrea> The paperwork and deadlines are what will really get you caught
    up.  Just be on top of it, discuss questions with your supervisor
<Jan> Best that I clarify myself...I am an instructor at OSU and actually use
    your text in my Clinical Methods and Issues class.  It's been many years
    since I was an "official" student.
<Dr. Meyer> Rhoda, I am certain many of your professors would not like this
    response--but let me say that you need to know where to find the information.
    Our field is soooooo broad, that you can not possible know everything or have
    everything right at your fingertips.
<Erika> Jan is one of my instructors...
<Julia> Keep in mind, you are going to make mistakes.  That is why you have
    prof's to guide you.  Don't be so nervous!
<Dr. Meyer> Andrea, Yes, the paperwork can be a real stumbling block.  And I
    agree to stay on top of it.
<Dr. Meyer> However, attack it intelligently.  Think about what you are
    going to do the next session as immediately after the previous session as
    possible--while you are in the mind set.
<Dr. Meyer> otherwise, you "waste" some time getting back into the
    mind set and you have to refresh your memory re what went on in that
    previous session
<Rhonda> Anat/Phys of the speech and hearing mechanisms is a class that
    is killing me! I can't imagine seeing a client and saying (off the top of my
    head) "oh, your arytenoid cartilege seems to have a problem"
<Adrienne> LOL
<Erika> I agree with Julia. I depend on my clinical supervisors to help me
    learn things every session.
<Erika> They know you are just learning
<Jessica> Isn't it a slow process anyway?  Wouldn't that mean that as
    you recognise what needs to be worked on, you can "brush up on it" before
    your session?
<Andrea> You do not want to talk to a client that way.  You want them to know
    what you are talking about.  Use terms that you knew before you started this
<Katy@OleMiss> rhonda, as long as you know how that can affect the voice
    and artic patterns of a client, then it is easier to know how to treat them.
<Erika> yeah, you kind of have to gage the level at which to speak to your
<Adrienne> plus, I probably wouldn't remember as well
<Erika> I have an accent reduction client now, and I have to use basic
    vocabulary...I want to use words like "Productions" but that isn't really clear to
    the client
Erika> same principle
<Erika> it's helpful to know how everything works (anatomically)
<Adrienne> Dr. M- how do you ascertain the client's level of understanding?
<Rhonda> does it seem more diffficult to work with Phonologic disorders
    than artic?
<Dr. Meyer> Another important area as I see it--is the good old
    self-evaluation.  Learn to evaluate your own performance in a realistic and
    in-depth fashion.  Learn this early on in the clinical process.
<Katy@OleMiss> I find phonological disorders to be more challenging
<Dr. Meyer> Rhonda,  I don't believe it is more difficult to work with phonologic
    problems than artic. problems.  I personally find phonol. more fun and more
    challenging. I also find much more generalization when working on
<Katy@OleMiss> Artic patterns of development are relatively easy to
    remember, but phonological disorders can be more complicated, especially
    when trying to assess what processes they are using.
<Adrienne> Dr. Meyer- how do you feel about evaluating each other?... and
    what is the most constructive way to do that
<Dr. Meyer> Adrienne, do you mean students evaluating other students?
<Adrienne> yes
Kim> I don't think we are trained enough to do that
<Erika> we don't do that at OSU
<Rhonda> my mom was in speech therapy after a severe stroke, she had
    group therapy 2x's a week
<Rhonda> how do you feel about group therapy sessions?
<Dr. Meyer> Adrienne, that is a starting point.  Perhaps a delicate way of
    handling that would be if a list of things to comment on were provided.
    that way everyone would have to comment on certain important aspects
    and it would not look like one student was "picking" on another.
<Adrienne> ok
<Kim> I find group therapy more fun but I had two clients at one time in a
    group so it was harder to keep data and focus on both
<Adrienne> I know sometimes it is easier to see how to do things differently
    when you are watching behind glass than doing it yourself
<Katy@OleMiss> Groups are what I work with at school two days a week, and
    the bigger the group, the harder it is to keep data and stay focused,
    especially the younger ones.
<Dr. Meyer> Kim, there are some helpful hints about keeping data in my
<Kim> thanks I'll have to check it out
<Robin> learning how to set goals and record data were key in my
    development as a clinician
<Kim> we're learning goal writing now and it is so hard!
<Dr. Meyer> Kim, alot of goal writing is also in my book
<Dr. Meyer> Katy, you don't have to keep data on every child during every
    session.  You can target perhaps 2 children during one session and 3
    others (or whatever) during the next session.
<Rhonda> there was an older man in her group who had simply given up and
    had no desire for therapy. How does an SLP deal with a situation like that?
Katy@OleMiss> Rhonda, counseling is one way to go.
<Dr. Meyer> Rhonda, a person must be somewhat motivated or there will be
    no progress.  In reality, did the person have anything to "live" for--what were
    the extent of his problems?
<Rhonda> stroke victim, just too depressed to continue trying, I think
<Kim> it sounds like in that case the SLP should not recommended therapy
    because we learned that motivation is a key factor to prognosis
Rhonda> I agree completely, my mother was motivated and therapy made
    all the difference in returning to normal
<Adrienne> would "increasing motivation" be ok for a goal?
<Adrienne> (with stated criteria and condition of course)
<Dr. Meyer> Adrienne, third party insurance payors would not like it!
<Dr. Meyer> OK though in the university setting--for a trial basis
<Kim> Dr. Meyer-do you think that if you are seeing a client in a one-on-one
    setting that you should keep data every session?
<Dr. Meyer> Kim, yes, if only seeing one client, I believe it is realistic to keep
    data every session.
<Dr. Meyer> One thing regarding data keeping is that it should not interfere
    with the flow of the session.  If it does, then you have to figure out a system
    where it won't interfere.
<Jessica> is it inappropriate to record a session for later review?
<Dr. Meyer> Jessica, it is OK to record a session for later review as long as
    all parties agree--your clinical supervisor, the patient, etc.
<Kim> the thing I find to be hard is that in my university clinic we don't really
    set percentages in our goals and then when we go out to work in a hospital
    setting we are required to do so
<Erika> Kim, we live on percentages in goals at my Univ
<Adrienne> why don't you do percentages?
<Kim>  I don't know, the clinical supervisors don't require it
<Dr. Meyer> Kim--wow--in this day of accountability I am surprised that you
    don't need %.
<Erika> we do percents, rates, anything with a number
<Adrienne> here too
<Rhonda> how do you calc a % (Im still undergrad)
<Dr. Meyer> Erika--that sounds more like SLP!
<Kim> I'm surpised too
<Robin> %s are more important now than ever to justify progress in therapy
<Erika> yeah
<Adrienne> like saying he will do it correctly 8 out of 10 times (80%)
<Dr. Meyer> Rhonda--total number of correct response divided by total
    number of responses
<Rhonda> that seems simple enough
Adrienne> gets kinda hairy when you're deciding if it was "close enough" to
    count as a success
<Adrienne> I've always wondered how you decide what percent to aim for?
<Dr. Meyer> Adrienne, sometimes to have to account approximations.
<Adrienne> does it depend on the target or the pt?
<Kim> we're being taught 80%
<Dr. Meyer> Adrienne, usually we shoot for 90%; 80% if the patient is
    cognitively involved
<Dr. Meyer> The schools usually shoot for 80% on two consecutive days
<Dr. Meyer> Adrienne--can depend on either pt. or target
<Adrienne> ok
<Rhonda> do you use phonetic alphabet often in clinical setting?
<Erika> every session!
<Erika> I do with one of my clients anyway
<Dr. Meyer> the phonetic alphabet becomes automatic!
<Adrienne> I wish
<Rhonda> I have mastered transcription for average speakers but now the
    class is over and I still have TROUBLE with accents and distortions
Dr. Meyer> Rhonda, that's the hard stuff.
<Rhonda> all with practice I suppose
<Adrienne> we should let Dr. Meyer go, it's late
<Adrienne> Thanks for chatting with us Dr. Meyer!
<Kim> yes, thank you
<Dr. Meyer> You are very welcome.  It was fun!
<Erika> Thank you Dr. Meyer
<Rhonda> It was great chatting with you
<Rhonda> thanks for your time
<Dr. Meyer> You also are welcome.
<Robin> Thank you for joining us, Dr. Meyer...I hope you will come back in the