SLP Nerdcast Kate Grandbois, MS, CCC-SLP, BCBA, LABA; Amy Wonkka, MA, CCC-SLP.

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When most people think speech and language pathology they think of working on articulation in a tiny treatment room. Not only do SLPs do more than articulation, we also do a lot more than face to face service in a sterile / controlled environment. There are many different kinds of service delivery models available to us as clinicians, and yet somehow the “2x30 direct service” (or what have you) has become the “standard” in many work settings. And yet, indirect service is one of the most powerful service delivery models out there. As clinicians it is important for us to remember the different kinds of service delivery models, what components go into service delivery, and what variables we should consider when choosing a service delivery model for our client.
And just wait till we get started on how service delivery impacts workload.
- Providing direct service? That contributes to workload
- Indirect service? Also contributes to workload.
- Writing assessments? Workload.
- Insurance? Workload.
- Billing? Wrkload.
- Prepping up / breaking down / cleaning after a session? Wrkload.
- Programming SGDs? Wrk ld.
- Bus duty? load.
Loads and loads and loads. Do service delivery models impact our workloads as clinicians and vice versa? You betcha. Should we, as a field, embrace a workload model instead of a caseload model? You. Bet. Cha.
In this episode we review components of service delivery, define direct and indirect service, and discuss how these different variables interact with workload across work settings. Come join us, be our nerdy friends, and have a laugh or two.
This episode is offered for 1 ASHA CMH (equal to .1 ASHA CEU). If you have questions about CEUs or how this works, please see our How It Works or ASHA Professional Development pages.
Learning Outcomes
1. Explain the components that are involved in service delivery within common pediatric treatment environments (e.g., schools)
2. Explain the differences between direct and indirect service and what factors might indicate a need for each type of service?
3. Describe a workload approach to caseload and identify how service delivery components and variables are likely to impact workload

References
Brandel, J., & Loeb, D. F. (2011). Program Intensity and Service Delivery Models in the Schools: SLP Survey Results. Language, Speech, and Hearing Services in Schools, 42(4), 461-490. doi:doi:10.1044/0161-1461(2011/10-0019
Case-Smith, J., & Holland, T. (2009). Making Decisions About Service Delivery in Early Childhood Programs. Language, Speech, and Hearing Services in Schools, 40(4), 416-423. doi:doi:10.1044/0161-1461(2009/08-0023)
Cirrin, F. M., Schooling, T. L., Nelson, N. W., Diehl, S. F., Flynn, P. F., Staskowski, M., . . . Adamczyk, D. F. (2010a). Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School–Age Children. Language, Speech, and Hearing Services in Schools, 41(3), 233-264. doi:doi:10.1044/0161-1461(2009/08-0128)
Cirrin, F. M., Schooling, T. L., Nelson, N. W., Diehl, S. F., Flynn, P. F., Staskowski, M., . . . Adamczyk, D. F. (2010b). Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School–Age Children. Language, Speech, and Hearing Services in Schools, 41(3), 233-264. doi:doi:10.1044/0161-1461(2009/08-0128)
Farquharson, K., Tambyraja, S. R., & Justice, L. M. (2020). Contributions to Gain in Speech Sound Production Accuracy for Children With Speech Sound Disorders: Exploring Child and Therapy Factors. Language, Speech, and Hearing Services in Schools, 51(2), 457-468. doi:doi:10.1044/2019_LSHSS-19-00079
Soto, X., Seven, Y., McKenna, M., Madsen, K., Peters-Sanders, L., Kelley, E. S., & Goldstein, H. (2020). Iterative Development of a Home Review Program to Promote Preschoolers' Vocabulary Skills

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As promised, here is our second episode on AAC Basics. If you have listened to any of our other episodes you already know that we are passionate about AAC Implementation. As we covered in our Implementation Plans episode, you could have the most appropriate set of AAC tools in the universe, but if they aren’t implemented in a way that supports the needs of the client / student then they are at risk for being abandoned. Our goal for this episode was to try and unpack some realistic barriers to effective implementation.
We begin this episode by providing a quick review / discussion of the different personnel roles in AAC based on a great article by Binger et al (2012). We discuss how each of these roles has unique barriers to effective AAC implementation. Finally, we review some strategies for how to overcome the barriers unique to each of these roles. Come join us, be our nerdy friends, and learn a little more about AAC Basics.
Learning objectives:
1. Identify barriers for successful implementation across different environments
2. Identify successful strategies across different environments and profiles

References
Beukelman, D., Ball, L., & Fager, S. (2008). An AAC personnel framework: Adults with acquired complex communication needs. Augmentative and Alternative Communication, 24, 255–267
Binger, C., Ball, L., Dietz, A., Kent-Walsh, J., Lasker, J., Lund, S., … Quach, W. (2012). Personnel Roles in the AAC Assessment Process. Augmentative and Alternative Communication, 28(4), 278–288. doi: 10.3109/07434618.2012.716079
Hunt, P., Soto, G., Maier, J., Müller, E., & Goetz, L. (2002). Collaborative teaming to support students with augmentative and alternative communication needs in general education classrooms. Augmentative and Alternative Communication, 18(1), 20–35. doi: 10.1080/aac.18.1.20.35
Janice Light & David McNaughton (2014) Communicative Competence for Individuals who require Augmentative and Alternative Communication: A New Definition for a New Era of Communication?, Augmentative and Alternative Communication, 30:1, 1-18, DOI: 10.3109/07434618.2014.885080

Online Resources
Augmentative and Alternative Communication: https://www.asha.org/public/speech/disorders/AAC/
Augmentative and Alternative Communication: A Glossary: https://www.asha.org/public/speech/disorders/AAC-Glossary/
Information for AAC Users: https://www.asha.org/public/speech/disorders/Information-for-AAC-Users/
ISAAC: What is AAC? https://www.isaac-online.org/english/what-is-aac/
Iconicity - Libby Rush’s ASHA presentation 2007: file:///home/chronos/u-7131d381df49d87e032b826afd4ed96b8fc99eef/MyFiles/Downloads/0914_Rush_Elizabeth_2%20(1).pdf
Communication Matrix Handbook: file:///home/chronos/u-7131d381df49d87e032b826afd4ed96b8fc99eef/MyFiles/Downloads/handbook.pdf
Communication Matrix 7-Levels of Communication Handout: https://www.gadoe.org/Curriculum-Instruction-and-Assessment/Special-Education-Services/Documents/Vision/VI%20Consortia%205-8-15/Seven%20Levels%20of%20Communication%20in%20the%20Communication%20Matrix.pdf
Core Vocabulary: Making Sense of Symbols: https://praacticalaac.org/praactical/core-vocabulary-making-sense-of-symbols/
AAC Communication Decisions: https://www.asha.org/public/speech/disorders/communicationdecisions/

Disclosures:
Financial: Kate Grandbois is the owner / founder of Grandbois Therapy + Consulting, LLC and co-founder of SLP Nerdcast. Amy Wonkka is an employee of a public school system and co-founder of SLP Nerdcast.
Non-financial: Kate and Amy are both members of ASHA, SIG 12, and both serve on the AAC Advisory Group for Massachusetts Advocates for Children. Kate is a member of the Berkshire Association for Behavior Analysis and Therapy (BABAT), MassABA, the Association for Behavior Analysis International (ABAI) and the corresponding Speech Pathology and Applied Behavior Analysis SIG.

Time Orde

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You just found out you have an AAC user on your caseload - congratulations, get ready to have some fun! If it has been a while since you’ve worked with somebody with complex communication needs (CCN), if you’ve never worked with somebody with CCN, or if you just want a review of the basics - this episode is for you! In this episode we will provide a quick overview of some key terminology and intervention strategies - as well as load you up with resources where you can learn more. This episode won’t cover the AAC assessment process, but will give you information about what questions you might want to ask yourself when designing and providing ongoing treatment for somebody who uses AAC. Communication partners are a big piece of the puzzle when developing a plan for optimal communication for the AAC users in your life. We’ll also point you in the direction of some great partner training literature, as well as give you tips for where you might want to start right now with your service delivery.
As is the way sometimes, we have a lot to say about this topic, so we couldn’t fit it all into one episode. Stay tuned for Part 2, where we will identify barriers for successful implementation and strategies for success across different environments. We will also put all this new knowledge into practice and discuss several clinical cases as examples.
Come join us, be our nerdy friend, listen, learn, and earn ASHA CMHs (other providers check with your credentialing organization to find out if our quiz and certificate of participation counts toward the professional development requirements for your license, email us with any questions!).
ASHA Professional Development hours are offered for this course (1 certification maintenance hour). Visit our ASHA Professional Development page for more information.
Learning objectives include:
1. Identify some key terms used in AAC and what do they mean
2. Identify some of the different personnel roles and responsibilities involved with AAC assessment and intervention

References
Ratcliff A, Koul R, Lloyd LL. Preparation in augmentative and alternative communication: an update for speech-language pathology training. Am J Speech Lang Pathol. 2008;17(1):48‐59. doi:10.1044/1058-0360(2008/005)
Cathy Binger, Laura Ball, Aimee Dietz, Jennifer Kent-Walsh, Joanne Lasker, Shelley Lund, Miechelle McKelvey & Wendy Quach (2012) Personnel Roles in the AAC Assessment Process, Augmentative and Alternative Communication, 28:4, 278-288, DOI: 10.3109/07434618.2012.716079

Online Resources
Augmentative and Alternative Communication: https://www.asha.org/public/speech/disorders/AAC/
Augmentative and Alternative Communication: A Glossary: https://www.asha.org/public/speech/disorders/AAC-Glossary/
Information for AAC Users: https://www.asha.org/public/speech/disorders/Information-for-AAC-Users/
ISAAC: What is AAC? https://www.isaac-online.org/english/what-is-aac/
Iconicity - Libby Rush’s ASHA presentation 2007: file:///home/chronos/u-7131d381df49d87e032b826afd4ed96b8fc99eef/MyFiles/Downloads/0914_Rush_Elizabeth_2%20(1).pdf
Communication Matrix Handbook: file:///home/chronos/u-7131d381df49d87e032b826afd4ed96b8fc99eef/MyFiles/Downloads/handbook.pdf
Communication Matrix 7-Levels of Communication Handout: https://www.gadoe.org/Curriculum-Instruction-and-Assessment/Special-Education-Services/Documents/Vision/VI%20Consortia%205-8-15/Seven%20Levels%20of%20Communication%20in%20the%20Communication%20Matrix.pdf
Core Vocabulary: Making Sense of Symbols: https://praacticalaac.org/praactical/core-vocabulary-making-sense-of-symbols/
AAC Communication Decisions: https://www.asha.org/public/speech/disorders/communicationdecisions/
Communication Community Blog: www.communicationcommunity.com
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SLP Nerdcast is a podcast for busy SLPs and teachers who need ASHA continuing education credits, CMHs, or professiona

Get 1 ASHA CMH here
No matter your work environment, writing goals and objectives is probably part of your job. Why? There are a few reasons, one of which is that the ASHA Code of Ethics includes several components connecting goals and objectives to effective services. And you can’t have goals and objective without our dear friend, data.
Data is a common thread that weaves itself throughout the crafting, implementation, and analysis of whether or not somebody met their goals and objectives. You need data about what a person can currently do in order to write goals that are achievable and meaningful, you need to collect data to assess the efficacy of your treatment, and data helps you determine whether or not those goals were met.
There are a few guidelines to help us in this goal and objective writing process. Enter the SMART goal. An acronym referring to certain components that should be included within your goal - spoiler alert, there are at least 5 of them.
Come join us as we talk through the components we should consider when writing goals, including how we are going to collect our data. Learn more about SMART goals to find out if they could help make the process of goal writing a bit easier, a bit better, and maybe even a bit more enjoyable.__
SLP Nerdcast is a podcast for busy SLPs and teachers who need ASHA continuing education credits, CMHs, or professional development. We do the reading so you don’t have to! Leave us a review if you feel so inclined!
We love hearing from our listeners. Email us at info@slpnerdcast.com anytime! You can also:
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We are thrilled to be listed in the Top 25 SLP Podcasts! Thank you FeedSpot!

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Everyone has had the awful and awkward experience of receiving critical feedback about their job performance from a supervisor or mentor. Sometimes it can leave you feeling driven towards your professional goals. Sometimes it can make you feel awful about your professional performance. Most of the time it just leads to lots of icky feelings.
Since we work as clinicians who are required to continue learning throughout our career, it’s safe to assume that receiving critical feedback will always be part of our work experience. But does it always have to come with icky feelings? Are there different kinds of feedback? Are there ways to make the experience better? We wanted to know, so we went to the literature to find out.
Join us in this episode to learn more about why receiving critical feedback can feel so icky. We review several articles from the fields of psychology and organization behavior management (OBM). Take a listen, be our nerdy friends, and learn a little bit about what you can do to make those icky feelings a little more tolerable.
Learning Outcomes
1. Identify the feedback landscape: supervision, mentorship, and the benefits of each
2. Describe the importance of critical feedback
3. Identify several strategies for receiving critical feedback
References
Blosser, J. (Medbridge) Supervision and Mentoring Throughout the Career Journey [video]. https://www.medbridgeeducation.com/courses/details/supervision-and-mentoring-throughout-the-career-journey-jean-blosser-slp-school
Cook, T. & Dixon, M. (2006) Performance Feedback and Probabilistic Bonus Contingencies Among Employees in a Human Service Organization, Journal of Organizational Behavior Management, 25:3, 45-63, DOI: 10.1300/J075v25n03_04
Fabricio Balcazar, Bill L. Hopkins & Yolanda Suarez (1985) A Critical, Objective Review of Performance Feedback, Journal of Organizational Behavior Management, 7:3-4, 65-89, DOI: 10.1300/J075v07n03_05
Arco, L. (1997) Improving Program Outcome with Process-Based Performance Feedback, Journal of Organizational Behavior Management, 17:1, 37-64, DOI: 10.1300/J075v17n01_03
McCready, V., Flynn, P., (2013). The Supervision Iceberg: More than Meets the Eye. [PowerPoint Slides]
https://www.z2systems.com/neon/resource/msha/files/MCCREADY_-_Supervision_Iceburg.pdf
Palmer, M., Johnson, C., & Johnson, D. (2015) Objective Performance Feedback: Is Numerical Accuracy Necessary?, Journal of Organizational Behavior Management, 35:3-4, 206-239, DOI: 10.1080/01608061.2015.1093059
Steelman, L. & Levy, P. & Snell, Andrea. (2004). The Feedback Environment Scale: Construct Definition, Measurement, and Validation. Educational and Psychological Measurement - EDUC PSYCHOL MEAS. 64. 165-184. 10.1177/0013164403258440.
Steelman, L.A. & Rutkowski, K.A. (2004), "Moderators of employee reactions to negative feedback", Journal of Managerial Psychology, Vol. 19 No. 1, pp. 6-18. https://doi.org/10.1108/02683940410520637
Online Resources
ASHA S.T.E.P. Program: https://www.asha.org/students/mentoring/step/
Disclosures:
Financial: Kate Grandbois is the owner / founder of Grandbois Therapy + Consulting, LLC and co-founder of SLP Nerdcast. Amy Wonkka is an employee of a public school system and co-founder of SLP Nerdcast.
Non-financial: Kate and Amy are both members of ASHA, SIG 12, and both serve on the AAC Advisory Group for Massachusetts Advocates for Children. Kate is a member of the Berkshire Association for Behavior Analysis and Therapy (BABAT), MassABA, the Association for Behavior Analysis International (ABAI) and the corresponding Speech Pathology and Applied Behavior Analysis SIG.
Time Ordered Agenda:
Introduction: 5 minutes
Learning objective 1: 15 minutes
Learning objective 2: 20 minutes
Learning objective 3: 15 minutes
Summary and closing: 5 minutes
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SLP Nerdcast is a podcast for busy SLPs and teachers who need ASHA continuing education

Get 1 ASHA CMH here
SETT = Student, Environment, Tasks, and Tools. If you aren’t already using this framework to guide your AAC Assessments and service provision, get ready to get really, really excited!
If you’ve listened to our podcasts, you know we are such powernerds that certain people in the field are sort of like professional celebrities for us, the nerd equivalent of a movie star if you will. In this podcast we had the lovely experience of interviewing one of these people, Joy Zabala. If you aren’t familiar with Joy’s work, you are in for a treat! She has achieved her professional “movie star” status for a couple of reasons. She developed the SETT Framework, has consistently been open and willing to share this tool with educators and allied health providers free of charge, and is by far one of the best speakers we have ever had the pleasure of seeing.
We initially reached out to Joy, because we both work in the field of AAC, and utilize her framework on a daily basis. We also both did not learn about the SETT framework as undergraduates or graduate students - but later in our professional careers. It revolutionized our practice in such a positive way that we really wanted to get the word out to others - particularly those working in the field of AAC. SETT is a way of thinking about assistive technology (and quite possibly, life). Since AAC is a type of assistive technology the SETT Framework applied to AAC in schools is a perfect fit. But regardless of your work environment, we’d encourage you to consider the positive impact a SETT approach can have on your assessment and ongoing services.
Having worked in outpatient and private practice settings for years, our AAC assessment and feature matching process was weighed very heavily in “Patient/Client” and “Tools” parameters. Two inputs of data. What is this individual currently doing expressively, pragmatically, receptively, what is happening with their sensory system, their motor system, what features do they need in a device, etc.? What tool has these features? While all of this data is important, and should definitely be factored into the equation, the reality is, it is not enough information. Particularly when we are thinking about pediatric clients who will also be using these tools across a range of environments to do a number of different tasks. The environment and the tasks must also be considered.
Tune in to this episode and learn all about the SETT Framework - from the creator of the framework herself! Find out about important considerations within the environment and tasks that should be considered before you even get to feature matching tools. Be reminded that tools are only one piece of successful AT implementation, and that related strategies and environmental modifications should be given equal emphasis. Learn about the importance of a collaborative process that involves multiple stakeholders, and get ready to realize the benefits for your students, clients, patients, and teams!
This is by far our favorite episode yet. Thank you Dr. Zabala!
ASHA professional development hours are offered for this course (1 CMH). Visit our ASHA Professional Development page for more information. Joy Smiley Zabala, Ed.D., is a general and special educator who has spent over 25 years conducting professional development and training for students, families, education agencies, organizations, companies, and others across the U.S.A. and abroad to expand the use of assistive technology (AT) as a means to increase the communication, participation and productivity of people with disabilities. You can learn more about her here or on her website, http://joyzabala.com/.
Learning objectives include:
1. Describe the origins of the SETT Framework
2. Describe the different components of the SETT Framework and how the framework is used
3. Describe how to use the SETT F