There is NOT an app for that.

Speech-Language Pathologist.

There is NOT an app for that.

Speech-Language Pathologist. It’s a mouthful. Also known as Speech Therapist, SLP, Speech Teacher, Clinician, or  CCC/SLP. When you see my name scribbled at the bottom of a report, you’ll see some special letters that follow it. That alphabet soup, M.A., CCC/SLP, indicates that I have a Master’s degree in Speech-Language Pathology and my Certificate of Clinical Competence through the American Speech and Hearing Association. I am a certified professional trained to evaluate and treat communication disorders in adults and children. Although technology in our field has come a long way, there is NOT an app, tool, or computer to take my place.

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Recently, a newspaper article in the Wall Street Journal focused on how technology is turning speech therapy into something parents can tackle at home. The article specifically called  it a “do-it-yourself project for parents.” While the article is one reporters poor interpretation of the field, other companies are using similar marketing strategies. Over the last year I saw graphics and articles that compare the cost of an articulation tool to the cost of an SLP. The article from the WSJ reported SLPs were part of a ‘notoriously sleepy and low-tech field.’  The first line,  “Speech therapy for children is becoming a do-it-yourself project for parents”  evoked a visceral reaction to jump out of my seat and yell NO!

Unless parents have been personally involved with an SLP they might not know much about our field. They might see our name on the yearly ‘best jobs’ list. They might connect us to stuttering and problem with the /r/ sound. To most, a ‘do it yourself’ version might sound like a great plan. The problem is that NO technology can take the place a certified SLP. Speech Language Pathologists treat a variety of communication disorders. These include articulation (speech sound errors), phonology (sound pattern errors), language (understanding language and using language), swallowing, fluency (stuttering), pragmatics (social skills) and voice disorders (problems with how your voice sounds). There is no possibility that the general public has the expertise and knowledge to diagnose communication disorders. Recommending that parents try it themselves at home is delaying evaluation and treatment from a qualified professional.

Let’s use an analogy of how technology works in a related field:

Outpatient Physical Therapy is a model of service delivery that more people are familiar with than speech therapy. If you’ve done PT before you might have had a similar experience as me. A Physical Therapist works with you for 30  minutes and  prescribes exercises/stretches  for you to do within the week before you see them again. You might be sent home with those brightly colored exercise bands to work on your shoulders. Did you know you can buy those therapy bands on Amazon? Awesome right? Do-it-yourself physical therapy. Wait… what’s that you say? You can’t imagine anyone thinking she could fix her shoulder muscles by themselves with therapy bands they ordered online? I can’t either.  It just makes sense that the PT has the expertise to evaluate your needs and give detailed instructions on the muscles to target. Even if I knew which muscles were weak, I wouldn’t know which exercises were safe for my injury.

It’s perplexing to me why companies and the media are suggesting that speech therapy can now be replaced with do-it-yourself tools and apps purchased online. Rather than helping parents searching for answers, these reports that suggest parents can remediate errors with the download of an app or purchase of a tool. Instead of showing them the importance of finding a professional who can suggest the appropriate interventions and eventually home programming, they are pointing parents in the other direction.

As I sit and write this, I’m feeling torn. I am one of the tens of thousands of SLPs who highly value parent involvement. When parents download apps, use worksheets, or make up their own games to practice the skills we are targeting in speech therapy I do a happy dance. Parent involvement and carryover is a vital part of treating communication disorders. On my blog Speech Room News, I often write about technology and tools I’m using regularly in speech therapy. Technology is a wonderful thing when used appropriately. I use my iPad, speech generating communication devices, bio-feedback, video modeling, and more. Technology is increasing the quality of my services for many students. Technology however is never going to take my place. An app can’t diagnose apraxia. An app can’t diagnose a language disorder. An app can’t determine if a child’s stuttering is developmental or disordered. Placement tools can’t replace a SLP’s articulation intervention.

To each  journalist considering writing about ‘do-it-yourself’ therapy for parents, let’s take a look at one receptive language goal. “Samantha will follow one-step directions that include positional and temporal concepts.” There is an app for that! Before I can let my student practice using that app I have to explicitly teacher her the skill. Samantha didn’t learn what the concept ‘before’ or ‘behind’ meant through incidental learning like her peers. She has heard the word ‘behind’ dozens and dozens of times by the time she is 6, but does not understand the concept. Direct instruction with corrective feedback, modeling, and repeated practice will be completed as a part of the intervention. Books, apps, toys, and other items can be used to practice once Samantha is ready to practice the skills for generalization. If Samantha was my client, this would be the time I’d introduce the idea of using an app for practice at home with her parent.

As technology continues to increase within the field, let’s all take the time to spread awareness about speech therapy.  The more people know about our job, the more they will make appropriate referrals.  The importance of  thorough evaluation and interventions can be shared in many ways. Discuss your job with friends and family. Give an in-service in your school. Reach out to local pediatricians.  Let’s market ourselves in a way that makes our value obvious. Let’s demonstrate how we can work WITH parents to utilize technology to improve outcomes during speech therapy.

Did you read the same article as me?  What was your reaction?

I highly recommend reading the ‘comments’ section of that online article. Elizabeth McCrea, PhD, CCC-SLP, ASHA President wrote in with a comment. See if you reaction was similar to hers.

 

Lovely comments

  1. 1

    Judy Hale says

    Thank you for your post–I was thinking the same thing as many of the things you said. When I first saw the article, I was reading it on my iPad, so I did not see the comments. I went back to it on my computer, and I totally agree with the comments that were well thought out and made many valid points about needing professional involvement as soon as a problem is suspected. I liked your analogy about the physical therapy–it really helped illustrate the point. As for the journalist who wrote that article–I hope he/she gives some serious thought to his/her future articles or that person could be out of a job!

  2. 2

    The Speech Bubble says

    Excellent post Jenna, very well said! While technology may assist us, it can never replace our knowledge, professional instincts, and skills.

    • 4

      Joan Pasqua says

      Jenna, yours is such a well-written response to a somewhat ignorant slant on speech-language services. Our parents work well with us because they are guided by our suggestions and therapy interventions, not because they can purchase the latest app. I do use apps in therapy, but they often don’t address exactly what I need to work on. Thank you for putting it out there!! I hope your comment gets picked up by the Wall Street Journal as a thoughtful and courteous response to that article!!
      Thank you for ALL you do for our field!

  3. 6

    says

    This was my thought: If I (with my 30 years’ experience) have difficulty getting a child to correctly produce /r/, what makes someone think a parent going it alone with just a computer program can do it? There are so many factors that go into the treatment for a child with an articulation disorder; no way would a program take the place of what we do!
    Good post, Jenna! :)

  4. 7

    says

    There’s no way and app can replace my SLP but I can reason with the journalist. I am very involved with my kids’ speech issues and have pursued many avenues to therapy and getting help. The therapists I have worked with have been great, but only one has actually provided tools, both guides and technology, that enable my kids to practice therapy outside of our sessions, and it’s showing results that we didn’t get in school or our private therapy alone.

    • 8

      adminSRN says

      Thanks for your response! Of course I agree that parents and SLPs as a team work best! I’m so glad you’ve been proactive for your students!

  5. 9

    Chris Cowgill, OSSPEAC Past President says

    Thank you Jenna for writing this post. I too was offended when reading the Wall Street Journal article. I am so glad many people, including the ASHA president, chose to respond to the article. In this technology age, our “low tech field” actually teaches children to put down the technology and learn how to interact with others, have a conversation, take turns, and learn the lost art of playing games. I am so glad your post emphasizes we need to advocate for ourselves and our profession. Thank you again.

  6. 14

    Erin M says

    Jenna,

    Thank you for writing such a thoughtful response to this article! I couldn’t agree more!

  7. 16

    Speechercize and Gluten Free says

    I just read the full article and I’m surprised. As I read it I was thinking to myself that I work in low income schools with students who are mostly bilingual. Not only can these parents not afford to buy expensive machines or apps, but they also cannot teach their children language skills they themselves do not have. As a SLPA (and hopefully soon to be grad student) this article makes me feel like I need to get my C’s and prove the author wrong.

    How did the Wall Street Journal allow this article to be published?

  8. 17

    says

    Great response! My son has moderate to severe hearing loss and wears bilateral hearing aids. If it weren’t for the SLPs we have had in our lives, I don’t know where we would be. I can’t imagine trying to do speech-therapy at home, and I also have a real difficulty with giving all this technology in our lives so much power over us. My son misses social cues all the time. It’s part of living with hearing loss. Sitting around a table with other children and a trained professional goes a long way to helping him understand these cues – along with other skills. I can see use apps occasionally at home to help supplement, but really reading books, talking to my son, asking him questions, having him play with his sister and his friends are really so much more valuable. Keep on with your great work!

    • 18

      adminSRN says

      Hi Krysty! Well, let’s just say that you sound like a very informed parent! I think the point you made about social cues is right on! I can tell you’re a great advocate and support for your son’s communication! Thanks for commenting!

  9. 19

    Amanda says

    Hi Jenna,

    Thank you for writing this. I didn’t even know that article existed until you posted your response. After reading it, I agree, it does paint our field in a ‘replaceable by technology’ light even though it may not say that directly. I have shared the original article and your response with the SLPs in my school district, as I think it is important, especially with the tight school budgets and cuts districts are making today, that SLPs know this is out there. Who knows how many administrators, parents and community members read this article and how they interpreted it? I appreciate you spreading the word.

  10. 21

    Michele Bombardier says

    Thank you for this excellent article. I posted my response on PresenseLearning’s FB page as well as ASHA’s and was surprised more SLPs didn’t respond. I am not against the use of technology in therapy or at home in coordination with a SLP but it hurts families when fear and misinformation is promoted about our field. To describe speech therapy as sitting at a table with flash cards is outrageous and to describe an assessment by an SLP as full of stigma and “doubt” as the CEO of that company did, is absolutely unethical; it is promoting false information for their financial gain.

  11. 23

    Stephanie says

    Thank you for addressing this. I was so amped up after hearing about the WSJ article. You did a great job explaining our field and correcting the WSJ article. It takes a big person to not write a nasty review of the article. Good work!!

  12. 24

    says

    Hi Jenna,

    As the manufacturer of several speech therapy tools (the Z-Vibe, Grabber, Probe, etc.), we cannot agree with you more. Our tools have helped countless children over the years for a variety of different goals. But they are in no way to be considered a replacement for an SLP or OT, for the exact reasons you described above.

    They are meant to AUGMENT therapy sessions, and only when appropriate. Not everyone needs these tools, and therapists have the skill to know if, when, where, and how to use them. To quote the description on one of our product pages, “The Z-Vibe is recommended for individuals of all ages and abilities under the guidance of a therapist or a parent trained in its use by their therapist.”

    Granted, not all of these parents have access to a therapist, either because of monetary restraints, or because they live in a part of the world where there are no therapists. In these cases, we try to provide as much guidance as we can, but we still say to take everything with a grain of salt, as there is no substitute to seeing a trained professional in person. We feel that to suggest otherwise would be a disservice to the child.

    Both us as a company, and my mom as the SLP behind ARK with over 35 years of experience as a practicing clinician, thank you for your wonderful response to this article.

    Rebecca
    http://www.ARKTherapeutic.com

    • 25

      adminSRN says

      Hi Rebecca.
      Thanks for your perspective as a parents clinician, and business woman! I think ARK has always done a respectful job of promoting and being appropriate. It is sickening when other companies (mentioned in the article) create ads that recommend no therapy before 3 years old. They have also created a graphic to compare the cost of their device to the cost of therapy. It’s intentionally sending parents the wrong message. I appreciate the steps ARK has taken and included in your instructions! I know businesses sell to both SLPs and to parents. In many cases it is a wonderful team approach to therapy and results in the best outcomes. This article was less than stellar and I wish they would have interviewed and presented the information in a different way!

      Jenna

      • 26

        says

        Thank you for your kind words! I’ve seen one of the ads that you’re talking about and I’m not a fan. However, I do want to mention that although I’m not familiar with the marketing efforts of all of the companies in the article, I think some of them may also disagree with the article. For instance, I know Heidi Hanks (Articulation Station) has a wonderful website full of great information, but cautions that it is not intended to replace the expertise of professionals.

        In any event, the WSJ missed a great opportunity here to share how amazing and beneficial it can be when parents, therapists, and technology work together. I can only hope that any parents reading that article also read through the very informative comments there.

  13. 27

    says

    My name is Dan Smith, I am the COO of CompleteSpeech. I feel a responsibility and obligation to voice my own comments as one of the technology providers featured in this WSJ article.

    I cannot speak for the author’s choice of words regarding the industry or any other technology provider whose products or comments were featured, but I can speak for my own contribution to the article and our company’s stance on technology within our industry.

    Our Student SmartPalate Membership program that was referenced in the article as a “lease” to parents was developed through the contributions, feedback and insight from our network of licensed and practicing Speech-Language Pathologists as a way to improve home practice between therapy sessions, not serve as an independent therapy model. Many comments have mentioned the need for parents, SLPs and technology providers to work together, that is exactly what we have done.

    Our visual reinforcement tools empower our SLPs and their students, not pit them against each other. The opening image of this article is a licensed SLP using our technology to guide a young boy to what appears to be an /s/ sound. They are mutually focused and engaged. Equipped with this feedback at home, this boy can now self-monitor his own practice before his next session. With practice, he will move on to greater complexities of words, sentences, etc. Habits are formed through consistent repetition; therefore, it is critical for students to practice effectively at home as well as in therapy.

    There will always be a need for qualified and experienced Speech-Language Pathologists. As a technology provider, we seek your help to create tools that enhance understanding and maximize the results for each individual student. As technologies continue to develop in all industries, I would encourage us all to keep an open mind. What may seem as a threat can be the very solution we have been seeking.

    If you would like to contact me, please email me at dsmith@completespeech.com or visit http://www.completespeech.com.

  14. 28

    Crystal VanMarter says

    This is so dead on! As someone with a pretty severe stutter, and who has seen a SLP, the knowledge the SLP gave me was invaluable. She taught me the dynamics of my stutter and clued me in as to why I was doing certain things when I stutter. It’s great to know why and an at home app could never give me that information. An at home app can’t see hear every breath I take and see every twitch I make. It would never be personalized enough.

  15. 30

    erin says

    I don’t know if this has been mentioned in the comments or not but as the parent of a completely nonverbal autistic child I can tell you firsthand that not all SLPs are created equally. I have tremendous respect for those that continue to gain skill in their areas of expertise but frankly I feel we wasted valuable time with our first therapist. Probably through no fault if her own but really considering our therapist now, I cannot believe the difference she has made in our lives. She has actually taught us alternate means of communication. We use the iPad some but I am thrilled for apps that can actually illustrate concepts and show me ways we can get sounds out of my son. I know there is a need for both especially because all therapists are not created equally, especially within different school systems. Parents have got to take an active role in therapies and if the technology piece helps them to do that then make it happen.

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