Thursday, October 22, 2009

Of switches and boards

It's been a pretty tough week at work. For several reasons, but I'm just going to talk about one aspect.

For those of you not in the know, I'm a speech pathologist by profession. I have been doing this for many years in many different capacities. It is a field where ther are so many options and different areas and ages to work in. Overall it has been a rewarding career.

When we moved here I was concerned about work. How could I work with language-delayed or language-disabled children when my language was newly acquired and not up to snuff? (I should point out here that my Hebrew is quite decent. Still it takes years to acquire the richness, subleties and sophistication of language of a native-born speaker. For example, I can probably say "The girl is pretty" in many different in ways in English, but in Hebrew I can say only the basic sentence--"הילדה יפה" [HayalDAH yaFAH]).

And yet, I was lucky enough to find a job at a school in Kiryat Sefer, about 20 minutes travel from Modi'in. It is a chareidi (ultra-orthodox) school and most of the children and all of the teachers and assistants are chareidi. The support staff (speech, physical, occupational ["OT"], music, and vision therapists as well as psychologists and social workers) ranges from not religious at all, to very religious and everything in between.

Because my language skills are not yet up to par, I am working with multi-handicapped children. These children have extreme motoric and cognitive issues, as well as contending with various medical conditions. Like kids everywhere, some are beautiful and some are not, some are likeable and some not so much. They have personalities and feelings and thoughts. They communicate with their eyes and their movements and their smiles and their cries. They are very special children in every sense of the word.

Few if any of these kids will ever communicate by using words spoken by their own mouths. It is my job to help these children express themselves in a more functional, organized way. To show them that by communitating more functionally they can control some things in an environment where they have so little control, where everything is done for them. That they can say yes and no and I want more and stop that and I'd rather do something else and hey, I like that toy. Where they can announce that something smells funny and where they can ask someone else how they are. Where they can tell their parents about what they did in school. Where they can daven (pray) and make brachot (blessings before eating) and say the Shema at night. Where they can make choices.

We have the tools to teach severely handicapped kids to do those things. Or at least to try. It is very hard to know exactly how intelligent a kid who can't speak or move is. But we've all heard and read about people who were "trapped in their own bodies" who have achieved many things with the use of communication tools and devices. I know that this is not the norm. But I also know that I'll never know which kid could achieve these things and which not unless I try. And trying means trying to reach the potential of each kid, whether the child's potential is going out there and making scientific discoveries or whether the potential is the child taking control by saying "yes, I want that" or "No, I don't like that".

These goals of communication are achieved by using what we call switches, and boards.

You start by recording a simple message such as "I want more" on a switch and when the child hits the switch (with his hand or his head or an eye blink--that's where the OT comes in) he gets more, immediately. Same thing if you you are using a board--you start with one or two simple messages, reinforce their use quickly and add more messages. In this way the child learns that the device or board is his means of communication; when he uses it, he has more control of the world around him.* Whatever means of communication the child has, it is crucial that many opportunities are provided throughout his everyday life for him to use it. After all, you and I take our mouths and ears (and laptops!) everywhere we go; these kids need to be given the opportunity to do the same thing with their modes of ocmmunication.

This week, the teacher, occupational therapist (OT) and I arranged a meeting with the classroom staff to review all this stuff. However, the meeting turned into a rap session. The principal of the school had been invited to the meeting, and she told us (the OT and myself) that our expectations are to high. That the classroom staff just doesn't have the time to implement the kinds of things we were asking them to implement. That they felt like we were checking up on them when we came to the classroom. They were to busy feeding and diapering and positioning the children, the principal said. "After all", she added, "you don't really expect these kids to ever be independant, do you? Isn't it enough that they are well-cared for and loved? We give them music and parties and animal therapy, to give them a quality of life, to make them happy. If they're smiling isn't that enough?" (Please note, those weren't her exact words, but they were pretty close).

I was shocked. That's all they want for these children? These children are only 3-5 years old. How could we possibly know what they can achieve if we don't give it our best effort?

The OT sitting next to me, just burst into tears out of anger and frustration and sadness. I said to the principal, "Then exactly what are you paying me for? You have an excellent staff who does those things. You don't me or the OT for that". I felt completely discouraged and disrespected.

The principal then back-pedaled and told us how wonderful and dedicated and professional we were and of course we were key players in the classroom. It's just a difference of expectations.

Let me just say that the principal is an intelligent woman who has dedicated her life to building this school and helping children and their parents. But she is not an educator, or at least a special-educator. Obviously she has some very core beliefs that filter down to the staff. Which is why I feel like I'm fighting an uphill battle, banging my head against a wall.

So we have here a bit of a professional crisis. I can't leave the job for the very practical reason of income. Yet, I need to feel good about what I do and that there is hope of progress, minute as it may be.

Your thoughts are welcome.

*There is alot more that goes into this process, I am giving you the very basic stuff.


Anonymous said...

Hey Baila-

Hi, it's Shari. So, which 'expectations' of yours were too high? Is the classroom staff unwilling to implement ANY augmentative communicative devices? I'm curious to hear what you were asking them to cooperate in doing? If she supports NO devices/alternative communcation systems in the classroom, she's wrong, and unethical. Of course, I'm just surmising here, based on the 'we give them parties, love, and cookies' attitude conveyed in your blog. Did anyone ask her what she believed all the therapies were for? Did anyone mention that there are different degrees of 'dependence', and that every child is entitled to learn in their least restrictive environment (I'm guessing the law in Israel is similar)? Did she expand on what exactly she SEES as the 'key role' that the therapists play within the classroom? I'm disappointed that (it seems) she didn't spend time explaining to the classroom staff that you are, in fact, not coming to 'check up', but rather to share professional knowledge to better the lives of the children. I can go on and on, but I am going to start feeling like I'm preaching to the converted. Of course you know I haven't (yet) experienced how it is to work in the classrooms at *our place of work*, but it is disheartening to hear that this is the attitude of our chief administrator, though not all that surprising; I bet you'd find a similar attitude (if not worse!) elsewhere. Are you thinking of a career switch because it's just too frustrating? Good luck with your thoughts on all this. I'll talk to you soon.


Stephanie said...

Beatrice, you did a beautiful job of the describing the difficult work that you do. Having worked with you in the past I know that you are an excellent therapist and an assest to your school and students. I am sorry to hear that others do not see the potential that you (and I) see in some of our most impaired children. I am sure their parents appreciate it. Although you may be frustrated by your situation, you must stay true to yourself and ethical to your students. So you will just do your best you can for them with in the current limitations you are given. That is probably more than many others would do. Thanks for blogging such an interesting and important issue about our profession. All the best from one dedicated SLP to another!

Leora said...

My quick note: it sounds like the job is more the problem than the profession. Hard when you know more (or think differently) than your supervisor. I hear this from other people that work in the public sector.

Anonymous said...

This is so close to home, because we have a mostly nonverbal 5 year old and I think an AAC device is our next step ... scary and exciting at the same time. The issue will be how to get the school district to pay for it and train him. B'h he's not cognitively or physically handicapped, and he is a little stubborn, so I don't know if he would even want to use it.

Anonymous said...

One other thing: I'm also having some professional issues in my corporate-type job -- but over the course of time I've realized that job opportunities come and go, that situations change, that supervisors change, and sometimes it's best to make the best of a bad professional situation because you can't see the future.

Commenter Abbi said...

Baila, that's so frustrating. I would also like to know how principal views your role in the school, given her attitude towards the children's potential?

Maybe try to find some good professional articles in Hebrew to throw her way, to back up what you're saying? Are you in contact with any Israeli speech therapists or special pple?

SuperRaizy said...

I think that the principal's remarks are indicative of a defeatist attitude that is much too prevalent among educators. Too many educators assume that a child with special needs will never be "normal", so we shouldn't expect too much of them.
I work with autistic preschoolers and I encounter that attitude every day. Thankfully, the children themselves don't know that not much is expected of them, and given the right educational and social support, they easily surpass our expectations every day.

Gila said...

I can imagine your frustration--I was infuriated, reading the principal's words.

I am echoing everyone else's sentiments, but nonetheless. My two cents--continue giving this job your all...while looking for a new job. Something will come up.

Toto said...

Hey, I don't think I ever knew you were in this field. anyway.....although teaching Eng. now, my first starts, my first love, has always been Special Ed.

Your story reminds me of a story when I was first class hadn't yet been established so they had me assisting in the established classrooms. I was told one day to "help Annette get her boots on" after OT. Annette was non-verbal, non-mobile....and her mother had dressed her with COWBOY BOOTS that did not zipper open. I tried to get her foot into the boot but it was flexed tight. I turned to the teacher in the room and asked her how I was supposed to do this. Her response: "ANNETTE!!! let her put your shoe on!!!" which was followed by snickers and snorts from Annette!!! To this day I always think of her when people talk about whether or not multiply disabled people have thoughts and feelings and the capacity to advance.

Sorry for the ramble, just wanted to give you a reminder that you are making a difference, and that you need to keep trying for all the Annettes out there. Target the classroom staff one by one, help them to open THEIR eyes to the miracles they are helping to create.....

sending hugs......

mother in israel said...

Great post and interesting comments. I hope you can get through to this principal eventually.

RivkA with a capital A said...

I suggest you schedule a meeting with the principal:
first, recognize and acknowlege her dedication and achievements. then, gently tell her what you have told us in your intro. That some kids can achieve a lot more and we don't know unless we can open some line of communication.

make sure you pause often, allowing her to comment.

Anything she says that you agree with, acknowlege verbally and, if you can refer back to it during your conversation.

remember: you are both on the same side.

Anonymous said...

Do you do mostly push-in or pull-out?

If its pull-out, I would say keep going with using the switches/boards when in speech, and in a couple of weeks, when the issue has died down a bit, ask the teachers if there is something they would like on the board/switch that would be useful in the classroom. That way, hopefully they will feel as if you are helping them...

Its unfortunate that its often such a touchy relationship between the classroom teachers and the SLP. As for the principal, this seems to be her philosophy, and I don't know how much headway you can make in changing it. Of course, we're not expecting miracles, but we definitely do get surprises.

Just remember, its the kids that keep us going!

westbankmama said...

Baila, it seems to me that there are two problems here: one, the supposed lack of time by the regular staff to implement what you want them to do, and two, the attitude of your supervisor.

Perhaps the staff is truly overburdened, and a solution would be to find a volunteer to help in the classroom.

In terms of the attitude of your supervisor, this is unfortunate and very frustrating, but perhaps she needs to "see it to believe it". Finding an example where this technology opened up a child's world would possibly change her mind.

Batya said...

Darling, I'm the one who frequently gets into trouble for big mouth mistakes.
What you do is between you and the kids and their families. YOu may have to build up the families' expectations. Keep at it.

Breda said...

Everyone has the right to communicate and if they are unable it, it is our job as speech pathologists to find a way to enable them. Those children are too young to be written off.

Anonymous said...

First let me tell you how fascinating the explanations about how a child can express her/himself are.
Then I suppose that if you could explain all this to parents they would be reassured to know that their kids could achieve more than they ever thought possible.