The Online Conference Experience

by Phil on May 14, 2013

I have been participating in the Dysphagia in Older Adults online conference for the last week. This is my first online conference, and so far it has been a relatively ‘mixed bag’ of an experience. Let’s start with the good.

The Good

  • I was surprised to discover how much I don’t mind the pre-recorded lectures. While I like to see presenters, they did a nice job of having the presenter’s picture posted next to the slides. Even when there are multiple speakers, the picture switches whenever they take turns.
  • One of the biggest perks of a pre-recorded lecture is that you can watch it at your leisure. I can watch it in the morning, then pick up where I left off later on (though I do need to remember which slide I was on, but that’s relatively easy).
  • I love being able to pause a lecture, or rewind to pick up anything I missed. It makes it very easy to take notes. On the other hand, soemtimes it can make the whole thing last much longer.
  • Having the resources so readily available is wonderful. The slides are presented throughout the presentation, and they are also provided as downloadable PDFs. The ease of obtaining resources is vastly different from the experience of the 2012 ASHA Convention, where despite a large number of attendees wanting to go paperless, we were nearly completely unable to do so.
  • It’s rather charming to hear the presentations; I suspect that since they’re pre-recorded, the presenters likely didn’t have an audience (or if they did, perhaps an audience of one). It’s interesting how this changes the dynamics of a presentation; being able to look at attendees surely makes a big difference in how you present, and an engaged audience is always helpful. It must have been challenging to work up these presentations without that benefit, though hopefully they’re finding that we’re all an engaged and attentive bunch.

The Less Than Ideal

  • The philosophy of the online conference seems to be “watch all the lectures, then participate in live chats”. In theory, this isn’t a bad thing. However, it is quite limiting, as the live chats are scheduled at specific times, and depending on your time zone, they’re not necessarily convenient. In my case, literally every single live chat happens during my workday; since I work in acute care, my day is generally unpredictable and so this is a considerable inconvenience for me, as I want to participate as much as possible.
  • Relating to the structure of these chats, they state you can only get credit for attending the full 60 minutes of discussion. I was a few minutes late for one yesterday; I managed to finish an eval in time to start, but the conference website was slow to load. Hopefully I can still get credit for participation.
  • While I love that discussion is encouraged, I don’t much like the “I agree” and “Here’s a twist” style comment system. I also get bogged down in the “this was a great presentation” comments. Like many, I like to express thanks for a good presentation, but it makes having real discussion difficult when there’s so much fluff.

The Takeaway, and Hope for the Future

I’m very happy I took the chance and decided to participate in this conference. It is very applicable to me as a budding SLP, and I feel inspired to keep reaching for the stars and trying to learn as much as I can every day.

I would happily participate in another online conference in a heartbeat. My hope would be that for the future, the goal be to truly harness the power of online dialogue, which should be availability to participate and earn CEUs without specific time constraints. Given that the live chats are all typed and moderated, a moderated forum would be just as useful, if not more so, as it would be less restrictive of when everyone could participate.

Dysphagia in Older Adults

by Phil on May 6, 2013

I’ll be attending the Dysphagia in Older Adults online conference. It starts Wednesday and runs until the 20th of this month. I signed up under the early bird rate of $300, but the regular cost of registration is only $30 more. Given the schedule of events, it should be an interesting and informative conference.

This is my first online conference and I’m eager to see how it goes. I’ve got an awful lot to learn, and I think this conference will be a great place to continue that journey.

For Boston

by Phil on April 15, 2013

I have only ever been there in my dreams, or else seen the city through the lens of a camera. It has always seemed to me an exceptional city, and its people have proven today that it is. My heart goes out to everyone there, and because our only option is to continue to live in this world, I offer first accolades to the runners for a race well done, and condolences second for the tragedy that struck such a celebration of life and accomplishment.

My friend and colleague Sean reminded me that sometimes our own concerns and lives are put into different perspectives by such events. No matter what happens, we only have each other, and one chance for this life. I hope that, however we can manage it, we continue to strive for peace.

In Retrospect

by Phil on March 8, 2013

Every once in a while, I find myself writing in new places. Yesterday was one such day. I wrote my first ever article for ASHAsphere, the official ASHA blog. I wrote a piece I called A Handful of Post-Graduate Retrospection. It was a lot of fun.

One of the hardest things about any new endeavor is getting started. Everyone has to start somewhere, and much as we would prefer to think otherwise, the best place to start is at the beginning. Much as I don’t want to admit it, I hated starting at the beginning. But I did it (and I’m glad I did it), and here’s a handful of things I’ve learned so far.

I would be honored if you go read it. If you already have, I hope you enjoyed reading it as much as I enjoyed writing it.

For new readers, welcome! Though I rarely have comments open on this site, I still welcome feedback and love to interact with you all. My favorite way to interact is on Twitter. Shoot me an “@ reply” and I always aim to respond. I also welcome email correspondence. If you would like to receive the articles I post here via email, you can subscribe from the sidebar to the right. If would like to subscribe via a feed reader, you can click the link above that says “RSS” or just click the link right here.

First Impressions of Speech FlipBook

by Phil on March 3, 2013

Speech-centric developer Tactus Therapy has released their latest new app, Speech FlipBook. From their description:

Speech FlipBook is an essential and affordable tool for all Speech-Language Pathologists, teachers, and parents. It’s as easy as 1-2-3 to practice speech, phonics, and reading in this 3-part flip book with onset, nucleus, and coda to create nearly any single-syllable word in English! Apraxia of speech, articulation disorders, dysarthria, and phonological awareness are just a few of the targets of this app perfect for children and adults.

I downloaded it shortly after release last Friday. Though acute care doesn’t normally lend itself well to the use of apps, I do use them from time to time and am quite fond of Tactus Therapy.

First Impressions

Playing with Speech FlipBook so far, I’ve found it to have a welcoming design interface. As a general rule, I don’t like page-turning animations (it’s personal preference; I still respect the amount of work it takes to accomplish said animation). Fortunately, Speech FlipBook includes a settings page that makes it easy to adjust the app to your liking.

After turning the page-flipping animation off, I fleetingly thought it might be nice to have a “tap to flip” gesture control. However, upon further consideration, I decided I actually like that the upward swipe gesture is still required, as I could see myself tapping the screen at or below the letter as a visual cue.

One of the app’s best features is the way all the sounds are organized in specific tables. This makes it easy to design a therapy session. For example, if I wanted to work only on vowel productions between bilabial sounds, I could select /p/ and /b/ for my initial sounds, turn off clusters and R-controlled vowels, and /p/ and /b/ for final sounds. This wasn’t completely intuitive for me at first, but a quick view of this introductory video was all it took to get the hang of it. The touch targets are usually easy to hit, though on the Initial Sounds tab I’ve found that the voiced and voiceless touch contacts are close enough for frequent error upon contact.

Finally, I love the Record feature. I’m a big fan of biofeedback, and love that I could use this potentially for homework, especially knowing that patients could record themselves and then compare it to the model.

Future Ideas

While I don’t yet have a complete use case for this app in my own work, I like the way it’s making me think so far. For my own uses, one thing I would find helpful would be a way to track a session. I love this feature in other Tactus Therapy apps, as I find it useful to track progress.

Perhaps different “modes”, such as Practice Mode and Scored Mode might be a nice option. I have a patient I’m working with right now who would love the chance to practice for a while and then try out a scored version so he could see how he does.

Along those same lines, I would love to be able to limit the number of flips at any given time. Progress could be shown both in terms of number of cards flipped as well as time elapsed.

The Takeaway

Speech FlipBook is a great addition to an already excellent line of apps by Tactus Therapy. Though brand new, it has much to offer already. I expect Speech FlipBook will carry on the Tactus tradition of quality improvements, regular updates, and support. You can download it today for a mere $5 in the app store.

Chronic Traumatic Encephalopathy

by Phil on February 3, 2013

Since today is Super Bowl Sunday, and I cringe every time I watch football, it seems appropriate to discuss some of the long-term ramifications of chronic head trauma.

Though many people know what a concussion is, many don’t think of it as a head injury, per se. Certainly, it’s easy to dismiss a lone concussion. When I was 16, I was mountain biking with my brother and a friend. After having some fun coursing over a fun hill that naturally gave us air time, we were about to call it a night when, on our last run, I watched my friend soar through the air before flipping over and landing helmet-first on the ground.

At first relieved that he got up and started talking, it was fast apparent that he was not okay. He started repeating himself. Even his laugh was repetitive. We insisted on walking the rest of the way home, and by the time he had been to the emergency room, he was diagnosed with a concussion and sent home. Before long, he seemed to be back to normal.

In my friend’s case, he was lucky; his concussion was a one-time thing, and he had little difficulty recovering.

Imagine, then, that this happened to him multiple times every year. Imagine that my friend was right back out on the trails, biking away, and flipping his bike over again just like before. Every time he’d hit his head, it would take a little bit longer to recover. But over time, he might think “I’ve done this so much, I can shake it off.”

Now replace my friend with a football player. The reality was that my friend was wise enough to be more careful about things. A football player, by contrast, is considerably less likely to do so. Whether it’s hope for getting into college, hoping to go pro, or winning a Super Bowl, the football player will stay the course, repeatedly subjecting himself to more trauma. Helmet or no, the brain is still fragile. Damage it enough times, and there’s bound to be less and less resiliency.

Boston University’s Center for the Study of Traumatic Encephalopathy describes a condition called Chronic Traumatic Encephalopathy (CTE):

CTE is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.

And further:

This trauma triggers progressive degeneration of the brain tissue, including the build-up of an abnormal protein called tau. These changes in the brain can begin months, years, or even decades after the last brain trauma or end of active athletic involvement. The brain degeneration is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia.

So where does this leave us? Though I am no fan of football, the game won’t stop being played. My hope is that, with education and outreach, more people learn about the very real consequences of head injuries. While we may not be able to fully prevent them, people need to know that support is available for them, and that they should seek it. While awareness is growing, it’s too often after the fact.

What can you do to increase awareness? Talk about head injuries with your friends and family. Share resources. Get involved.

The Centers for Disease Control has some great information. The Sports Legacy Institute has information about CTE and information on how to get involved. Boston University does as well.

With enough awareness, maybe someday we can even move beyond rehabilitation and work toward prevention. Every little bit helps.

Curious Diagnostics

by Phil on January 20, 2013

One thing I love about working in the acute hospital setting is being part of the medical team and aiding in the process of differential diagnosis. In some ways, working with people with swallowing disorders is its own process of differential diagnosis. SLPs are presented with a patient complaining of difficulty swallowing, and it’s our job to narrow down what type of difficulty that is, and how we might help remediate it. This applies to more than swallowing, of course. Acquired or developmental speech and language disorders, fluency disorders, and cognitive communicative disorders are all things we assess and can potentially treat.

During any given day or week, I encounter a variety of diagnoses. I’ve recently taken to writing them down, as I have been curious about what I encounter and doing research as I am able. I will present them here, in no particular order or sequence, but rather as I encounter them and/or see fit.

The more I work in this setting, the more curious I have become about the human body and how it works. I’m looking forward to learning more and seeing where this journey takes me.

Aiming to Please

by Phil on January 13, 2013

Though many people don’t think about it, there are plenty of similarities between working with adults and working with children. Just as pediatric SLPs note the periodic need for incentives in order to make progress in therapy, there are plenty of adults who do as well. I frequently work with patients who are very confused and, as a result, can be less than inclined to work with a guy like me. “Speech pathologist?”, I often hear, “I can talk just fine, what are you doing here?”

In addition to the often-seen challenge of helping someone acknowledge that they’re having difficulty swallowing, an added bonus is that such difficulty is often coupled with poor appetite. It’s the ultimate paradox: when you feel bad, you don’t feel hungry; but, the best way to heal is to get some good nutrition.

Recently, I worked with a patient who had a poor appetite and wasn’t eating enough as a result. She was refusing most food and was not inclined to drink liquid supplements, citing that they were never cold enough to properly enjoy them. I excused myself, ran to the nutrition room on the floor, and returned with a cup of ice. “Ensure on the rocks, then?”, I asked as I began to pour. She had a good chuckle and agreed.

Though it lacked the punch of a good mixed drink, it did the trick to make her day just a little bit brighter.

New Year, New Goals

by Phil on January 2, 2013

A lot of changes are afoot for me right now. I’m rotating from a primarily neuro caseload to one that incorporates more trauma and surgery. I’m excited to learn new things, and to have the chance to learn more about ENT aspects of speech pathology.

I have other goals as well, listed in no particular order:

  • Simplify my computing experience – I have come to the conclusion that I was at my most productive when I had only one device to work from. Having spread myself too thin, I long for that simplicity. My ideal set-up might be to have one home base computer (iMac) and two peripherals to be mobile components (iPhone and iPad).
  • Turn my iPad into a laptop replacement – The original iPad was the first product I ever purchased on the day it was released. It was my last semester of grad school, and I bought it as an early graduation/post-comps gift to myself. It quickly replaced my laptop in my bag, and I found myself using it to take notes in class and even write some assignments. Also, my current third-generation iPad is actually a more powerful computing device than my trusty old iBook G4 (still my favorite computer I have ever owned).
  • Write, write, write – I think about a lot of things. Since October 15, I have made it a point to sit down and write at least once a day. I haven’t missed a day since, and plan to keep it up for the foreseeable future. My next step is to write more on this website. As far as what I’ll be writing here, I think it will be a mix of speech things, resources I find useful, stories I like to tell, and technology I like to use.

I’m looking forward to the year ahead. It should be interesting, challenging, and fun. And I hope that at this time next year I look back and think about how much I learned and grew, and how much more I hunger to know.

Borderline TMI

by Phil on January 1, 2013

Twitter friend and fellow medical SLP Rachel Wynn interviewed me on her website this week. I wax poetic, feel nostalgic, and preface it with “an abundance of formatting instructions” because that’s how I roll. Go read the whole thing.

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