A One-Woman Show

Please definitely keep this blog going. I love it!

I have just discovered this blog. I am excited because you have described my work week. I, too, love the autonomy , the variety, and the opportunity to make a difference.  I, too, miss the opportunity to discuss my work with collegues.

Thank you, parents and therapists, for all your wonderful feedback and encouragement. I am so glad people are finding this blog helpful AND I am so grateful to ADVANCE magazine for the opportunity to write about such a valuable topic!

Please continue to write in and share ANY questions you may have regarding challenging speech issues or therapy ideas, suggestions, etc.....and I will do my best to help and I hope other therapists out there will do the same and join our discussions.

That is my hope and goal for this blog - to create an on-line community of therapists and parents involved in EI - to create a place where everyone can come and ask questions, seek answers and offer helpful solutions freely! Thank you for all your support and participation!!

This is my first time looking at the BLOG, and what a great idea!  I too am a self-employed contractor for the Early Start program through our Regional Center.  I juggle my little clients, and my own 2 preschoolers, and I often have questions about the children I see.  Is this a place where I could post a question re: particularly challenging cases, and get feedback from others in the field?

Hi Stephanie ~ I've enjoyed Birth to 3 because of the direct family involvement, the opportunity to (however slightly) change the dynamics. I've experienced all the positive & negative feelings you've described.

I notice that one of your bloggers became uncomfortable with her LTC setting; I can only imagine unpleasant politics. Unfortunately, I ran into that at a couple of the B-3 agencies I worked with. In one, the speech pathologist who was favored by the administrator was paid about $10. higher, something revealed only much later. Experience was identical for each professional. In another agency, SLPs (I was the only one, but not salaried as you are) had to yield implementation of therapy to a salaried LCSW at times. I suppose it was because the agency needed to keep a salaried employee busy. So in effect, the LCSW was doing language therapy! The agency administrator skirted this by stating it wasn't therapy (the LCSW wasn't permitted to use that term,) it was "showing the parent how to interact." Administrators in both of these agencies allowed parents to skirt basic responsibilities, like calling to cancel, keeping a calendar, etc. There was, indeed, a 3 strikes you're out rule, but it wasn't always observed.

I hope your experiences all will be much more positive. Notice that the negatives were usually on the part of administrators who misunderstood their own responsibilities to therapists and parents alike.

Dear Stephanie and therapists,

As a parent of an autistic boy receiving home services, I'd like to thank you for this blog and thread.  Although my wife and I of course really appreciate our sons' therapists, I don't think we've ever considered how hard it would be to go from home to home and from "special needs story" to "special needs story."  Encountering all the emotions, tensions and drama of special needs home visits every day has to be hard.  The fact that you find it draining shows that you're one of the good therapists who genuinely care about their clients and their work.  

It's only natural that anyone working with several per day would need to share with peers.  It's very hard to mentally process an experience unless we can share and discuss it with someone with the background to understand and relate.  If therapists can't get the chance to "compare notes" face to face, maybe blogs like this can be the next best thing.  In any event, thank you for the blog-- it gives my family a new perspective on the therapists we work with.

Dear Stephanie,

  I understanding you feeling lonely since you are the only Speech Pathologist.  Our company teams every monday so we can consult other Speech Therapists as well as the OTs, PTs, Educators.  We have field supervisors as well, that are also therapists.  I work homebased birth-3 as well as preschool 1 day a week so I can keep in the loop with the entire buildings professionals.

  Homebased therapy is my passion.  I believe in teaching/helping parents and caregivers to help their children with their language needs.  I do find it very, very difficult to have graduate students with the homebased population.  As you stated, we are more than therapists.  We are counselors, resources, parents, an ear and a friend.  We are also typically, experienced therapists who truely understand development and should be trans as well as multidisciplinary.  It takes years to be able to have all of these skills and I don't feel that most students have the experience and knowledge base yet to jump into homebased therapy.  I never mind someone tagging along to observe however, we usually suggest that the student get their experience in preschool or outpatient before homebased.  It is more likely that students will get more supervision and observations in a school, hospital or outpatient setting than homebased.

Jennifer - So, are you entering into your CFY now? If you are a CF then you should be supervised the whole next year. Also, I would think you can always ask your boss and fellow SLPs to come out with you to meet children and families you may be unsure of how to treat....and if all else fails....write in and we will help to answer your questions!!

Good Luck to you on your new adventure to NYC and your new job!! Keep us posted!!

I'm just graduating from a master's program in PA and moving to Manhattan on Saturday. I'm interviewing for EI positions because I love working with these age children. One concern - will I get enough supervision since I'm home based? Any thoughts?? Please give me some advice.

Again, I'm so happy to hear the positive voices out there and it is wonderful to hear from so many therapists who love their jobs!! Today was very, very rainy and cold in the Philly area, so homecare is always a little more challenging on days like today! Tomorrow's post is all about holiday crafts, so I hope you find it helpful and cheery with all the rain and snow out there!

p.s. David, great suggestion about the grad students!! I've often thought about teaching at the college level part-time on the side - I love working with students!! Thank you for reminding me!!

Oh my! You have so eloquently expressed my feelings about our jobs.  I could not have put it better.  I have often said to my husband that I feel a bit "lonely" during my work week and I miss the camaraderie of co-workers.  It is ironic because the co-workers were the very reason I hated LTC and rehab settings!  However, the reward of success is so much sweeter here too.  I have been doing this for just over a year and I can't imagine working in any other setting.

Happy Holidays to all.  Hope you all get a holiday!

I've been working in EI for 18 years.  There are two things that have saved my sanity re:  having other SLP's to consult with.

The first is that our team (the county Birth-to-Three Coordinator, Case Manager, OT, PT, and myself) have weekly staff meetings.  This is a real luxury, I know, for many people.  For us, though, it immeasurably improves our services to our clients.  It also helps us keep up with each other's lives, which is a very important thing in any human services field.  If there is any way to have regular staff meetings, I would strongly recommend it.

The second is that I regularly have internship students.  I'm fortunate that there is a program in the town where I work, so it is easy to set one up.  Even remote sites, however, are potentially places where students could work.  Contact the nearest grad school for more information -- many of them are constantly looking for other placements.  I learn new things every time I have a student, whether s/he is a first or second-year grad.

This blog is also a wonderful way to share information.  Thanks so much for doing it, Stephanie -- it's a link we all need.

David

Hi Stephanie. What a delight to read your notes (as well as to read all the comments!). I too work in EI - for about 5 years now. I tell people I have the best job in the universe, and am always amazed to remember that there is a shortage of SLP's in the field. Go figure!! I experience it all a little differently however; I work with a specialty service provider, running in-house playgroups for kids on the spectrum or with social communicative issues - so I DO have the pleasure and benefit of really working with my team.  And how awesome they are!! We have worked together for so long, sharing our observations and expertise that I can't imagine giving it up.  In addition, I have a small private practice. As exciting as that work is, I find it very isolating, and my appreciation of team is only further reinforced.  I believe I share a similar response to the job - there are days of laughter and tears and not enough words and too many words and elation and exaustion, and it always always gives more than it takes, and it is good work to be doing!

Thank you for all your encouragement and supportive comments! It seems as though this post "hit home" with several of you out there, which is great. I was a little nervous because this post was more personal than what I usually write, but I felt as though it needed to be expressed. I plan on writing more reflective pieces like this and I hope therapists will continue to write in and share their own thoughts - it's boring if I'm the only one writing!!

Being in EI these past two and a half years has been the most challenging but also the most rewarding position I have ever had as a therapist. It is so inspiring to know that I am not alone! Thank you again and I plan on using some of the comments/questions you raised to help formulate future post topics.

Also, to answer your questions below about cancellations....I work full time and receive a salary so I am paid even when clients cancel. Our county has a policy that if a family cancels 3x in a row (unexcused absences, etc.) then services can be terminated. I always explain this to families when I first meet them so that they understand their responsibility and role in tx. By doing this and reminding them frequently if they are headed in that direction, I have rarely had a problem, but it is definitely still a struggle for some families faced with many challenges.  Hope that helps....good question!!

Hi Stephanie, Merry Christmas.  I look forward to the EI blog and all of your input.  Please keep at it. I have been at this 'job' for 5 years now, but I agree that it can be very lonely.  The school system at least had some occasional 'get-togethers' to share information. At least I have a reference base in order to guide parents of what to expect from the school system once the child turns 3. I have found that I have to become firm with the parents of continual 'no-shows' and since our group of highly trained and tremendously devoted co-ordinators are trying to please their 'clients', they are not always happy about my decisions.

Stephanie, I, too, LOVE my job.  It has so many rewards.    I miss talking with other professionals too.  The thing that gets under my skin though is the inconsistency of the work/pay:  the cancellations, the aging out, the inability to schedule many clients because they live so far apart, the need to drop a client because mom/dad/caregiver changes their schedule and no longer fits in my schedule, and the client dropping EI after you have put them in your schedule. How do you deal with these challenges?

I absolutely LOVE my job with "special" infants and toddlers.  I see a need to recruit more SLPs into this area of service.  Thank you for starting your blog.  I watch for it each week.

I am so glad to find your blog.  I saw the brief about it in Advance magazine.  I LOVE my job!  Yes, I do cycle between crying and laughing each day.  I will post again soon!

I just wanted to let you know that it is a delight reading your insight.  I will finish my CFY in Jan. and I am going to do EI per diem after my full-time job. I love to read your thoughts and ideas.  I can definitely see how the job is a one-woman show but know that you are making a difference in a child's ability to communicate. Please keep the blog going.

Hi Stephanie, Merry Christmas.  I look forward to the EI blog and all of your input.  Please keep at it.  Little Bradley (NG tube, failure to thrive, Prune Belly syndrome) is coming back in to my life, so I will be blogging.  This is a very busy time and to cap it all off Wisconsin is having a good old fashioned snowstorm, cancellations everywhere.  We're snowed in!  Thnk you.  Take care, Cheryl

Hi Stephanie, Merry Christmas.  I look forward to the EI blog and all of your input.  Please keep at it.  Little Bradley (NG tube, failure to thrive, Prune Belly syndrome) is coming back in to my life, so I will be blogging.  This is a very busy time and to cap it all off Wisconsin is having a good old fashioned snowstorm, cancellations everywhere.  We're snowed in!  Thnk you.  Take care, Cheryl