Hasbro Children’s Hospital Hasbro Children’s Hospital Speech Pathology and

Audiology Department

Spring 2010

� Resume…………………………………….. 3

� Summary of Experience………………..… 4

� Learning Contract………………………… 5

� Annotation One………………………........ 7� Annotation One………………………........ 7

� Evidence for Annotation One……………..9

� Annotation Two……………………………21

� Evidence for Annotation Two…………….23

� Annotation Three…………………………..27

� Evidence for Annotation Three…………...29

� This semester my internship was at Hasbro Children’s Hospital’s Audiology and Speech Pathology Department. My official title was “Speech Pathology Student Intern.” I know that I am incredibly privileged to have interned at one of the most technologically advanced placement sites in the state of Rhode Island. This setting provided me with a very diverse set of experiences.

� I knew that interning at in a medical setting would offer me many opportunities that could not be found in any other placement setting. For this reason, I wanted to record all of my experiences and the new knowledge I obtained. My ultimate goal was to create a compilation of all the unique treatment techniques and procedures I observed. To achieve this goal, I created informational worksheets to fill out for each patient throughout the semester. On each worksheet, I included the most valuable experience I encountered with the patient. I was able to learn about voice, phonology and language disorders in great detail. I was also given the opportunity to observe a videostroboscopy. I will be able to use my created evidence in the future to assist me in planning observe a videostroboscopy. I will be able to use my created evidence in the future to assist me in planning therapy sessions for my own patients. Reaching this goal was very beneficial to my future.

� Through my previous experiences talking to graduate students, I have become aware that guidance in report writing is limited in graduate school. This fact inspired me to write out a complete videostroboscopy report. To do so, I reviewed previously written reports to learn the proper and professional format. After writing my report, I had it reviewed and edited by a speech pathologist at the clinic to make sure I used all of the correct terminology. I was lucky enough to write the report on my own personal videostroboscopy! I received a flexible endoscope and got to interpret my own results. I was able to focus on indentifying healthy anatomical structures of the larynx due to my adequate vocal hygiene. I also became familiar with the different parts of the equipment and the computer program used to analyze the obtained voice sample. Not only was this experience educational, but I believe that it also enhanced my ability to become a compassionate and empathetic speech pathologist.

� This internship has greatly influenced my plan for the future. I am now confident that I want to work in a medical placement setting for the rest of my career. Observing these speech pathologists, and seeing the rewarding experiences they encounter on a daily basis, has definitely ignited my passion to excel in graduate school. I want to become the best speech pathologist that I can be, so I can positively influence as many lives as possible. This internship really opened my eyes to the crucial need for speech pathologists, and I am absolutely positive that I chose the perfect major to pursue.

� 1. Objective: To increase my knowledge base in the area of treatment methods and techniques, as well as my overall understanding of diseases and disorders relevant to the field of communicative disorders.

� Activities/Resources:� Sit-in on therapy sessions with licensed SLPs� Ask questions to inquire additional information from the speech pathologist� Read any information provided by the clinic� Read and become familiar with client files and patient information � Observe therapy with patients with voice disorders, fluency disorders and hearing loss, as well as a videostroboscopy

(not performed anywhere else in RI)

Evidence: Create a form to fill out during observation sessions so as much information as possible can be retained. These � Evidence: Create a form to fill out during observation sessions so as much information as possible can be retained. These observation forms will be included in the final portfolio. The form includes non-identifying client information, the type of disorder the client exhibits, the primary goals of the therapy session, the tasks performed by both the client and clinician and the method of data collection. This is an effective way to report new information being acquired about both treatment and disorders.

� 2. Objective: To receive a videostroboscopy and write out a professional report with the guidance of an experienced speech pathologist.

� Activities/Resources:� Receive a videostroboscopy from a licensed SLP� Obtain pictures and video of procedure (vocal folds)� Ask questions about the anatomical structures observed during the procedure � Review previously written reports to learn proper format

� Evidence: Include all photographs and videos obtained during the procedure. Also included will be the videostroboscopy report that I create after it has been edited by an experienced professional.

� 3.Objective: Create an effective and innovative therapy material to meet a child client’s communication needs, specifically due to Autistic Disorder and language delay.

� Activities/Resources:

� Observe the therapy session so that the clients specific needs are met

� Become familiar with effective treatment methods for an individual with that specific disorder

� Obtain knowledge about the clients specific likes and dislikes from his clinician

� Talk to the clinician about the clients frustrations to try and improve their enthusiasm about the therapy sessionsession

� Evidence: Provide pictures in the portfolio of the therapy material, and pictures of me using the material with a child (not at the speech clinic due to my restrictions). Also included will be a write up discussing obtained client information and how his specific needs were met.

� Objective: To increase my knowledge base in the area of treatment methods and techniques, as well as my overall understanding of diseases and disorders relevant to the field of communicative disorders.

� Activities/Resources:� Sit-in on therapy sessions with licensed SLPs� Ask questions to inquire additional information from the speech pathologist� Read any information provided by the clinic� Read and become familiar with client files and patient information � Read and become familiar with client files and patient information � Observe therapy with patients with voice disorders, fluency disorders and hearing loss,

as well as a videostroboscopy (not performed anywhere else in RI

� Evidence: Create a form to fill out during observation sessions so as much information as possible can be retained. These observation forms will be included in the final portfolio. The form includes non-identifying client information, the type of disorder the client exhibits, the primary goals of the therapy session, the tasks performed by both the client and clinician and the method of data collection. This is an effective way to report new information being acquired about both treatment and disorders.

� The following piece of evidence is a compilation of the patients that I observed this semester. These are the patients that I was able to see progress and develop over a period of time. Due to my limitation of only attending the clinic on Tuesdays and Thursdays, I was unable to observe every Speech Pathologist in the department. I did observe a wide variety of diseases and disorders, including voice, language and phonology therapy. I was also given the opportunity to observe a videostroboscopy and a modified barium swallow (MBS). For each patient, I created a one page piece of paper that gives a description of the different therapy exercises that were used to effectively improve communication abilities. On each sheet, I also mentioned a very meaningful experience that I encountered with each patient. that I encountered with each patient.

� I learned so much from this particular piece of evidence. Not only do I have a personal experience discussed on each sheet, but I also included all of the therapy techniques involved in the success of the patient. This internship directly relates to my previous academic knowledge because I am a communicative disorders undergraduate major. This major not only relates to Speech Pathology, but also audiology, which is included in the same department as my internship. I was able to ask questions and obtain a great deal of knowledge this semester. My previous undergraduate class work explained the different types of disorders treated by Speech Pathologists, but I have not yet learned about treatment techniques formally. This was my first introduction to the actual realm of conducting therapy. I think this piece of evidence is a valid testament of my abilities because I am able to effectively gather and retain relevant information. This is a skill that must be mastered by graduate school, and I now have the experience to truly feel prepared for the future.

Patient Disorder Exhibited / Procedure Observed

R. B. Voice – Videostroboscopy

Demetrius Cerebral Palsy – Feeding Team

Mordy Phonology – Lisp

Elizabeth Phonology – Lisp

Nicholas Phonology – Lisp

Susan Language – Aphasia (Stroke)

James Language – Aphasia (Stroke)

J. L. Voice – Parkinson’s Disease

J. T. D. Voice – Muscle Paralysis (Stroke)

Jimmy Phonology/Language – Autistic Disorder

R. E. W. Dysphagia – Modified Barium Swallow

Session Information

Disorder /Procedure

Primary Goals/ Primary Goals/ Tasks Conducted

Method of Data Collection

Most Meaningful Experience with Patient

Modified Barium

Swallow

� Objective: To receive a videostroboscopy and write out a professional report with the guidance of an experienced speech pathologist.

� Activities/Resources:� Receive a videostroboscopy from a licensed SLPReceive a videostroboscopy from a licensed SLP� Obtain pictures and video of procedure (vocal folds)� Ask questions about the anatomical structures observed

during the procedure � Review previously written reports to learn proper format

� Evidence: Include all photographs and videos obtained during the procedure. Also included will be the videostroboscopy report that I create after it has been edited by an experienced professional.

� The following piece of evidence is a complete videostroboscopy report. This report includes detailed patient information, patient history comments, past medical history, perceptual voice evaluation, impressions and recommendations. Also included are exam details, an exam summary and stills (photographs). I wrote this report from the results of my own personal videostroboscopy. I received this procedure for the simple reason of increasing my experiences and knowledge about the field. I received a flexible endoscope which is inserted through the nasal cavity and passed through the pharyngeal cavity to see the vocal cords. A strobe light is flashed so that individual movements of the vocal folds can be recorded. After my procedure, I used the information I gathered to write a professional videostroboscopy report. I obtained the format from the Speech Pathologist that performed the procedure. She also reviewed and edited the final copy of the report. After the report, I also included an actual video clip of the procedure. This particular piece of evidence relates to my current classes because every anatomical picture I have � This particular piece of evidence relates to my current classes because every anatomical picture I have seen of live vocal cords in textbooks is taken by doing this procedure. I was able to relate all my previous knowledge from anatomy to this experience. In graduate school I will obtain more information about diagnosing different disorders and diseases of the vocal cords. I believe this piece of evidence is a strong testament of my abilities because as an undergraduate student, I am not introduced to writing this type of report at all. Every piece of preparation for writing the actual report was information that I obtained on my own (not from previous professors). I am a very curious and capable individual. My desire to know more led me to having a flexible endoscope inserted into my nasal cavity. I feel that this experience has made me more prepared to be a Speech Pathologist. I can now empathetically relate to each patient in the future that experiences the same procedure. I feel that it makes me a stronger candidate in the field of communicative disorders.

AdductedVocal Cords

Abducted Vocal Cords

� These are my vocal cords! ☺

http://www.youtube.com/watch?v=fMTv2xLa8ys

� Objective: Create an effective and innovative therapy material to meet a child client’s communication needs, specifically due to Autistic Disorder and language delay.

� Activities/Resources:� Observe the therapy session so that the clients specific needs are met� Become familiar with effective treatment methods for an individual with

that specific disorderthat specific disorder� Obtain knowledge about the clients specific likes and dislikes from his

clinician� Talk to the clinician about the clients frustrations to try and improve their

enthusiasm about the therapy session

� Evidence: Provide pictures in the portfolio of the therapy material, and pictures of me using the material with a child (not at the speech clinic due to my restrictions). Also included will be a write up discussing obtained client information and how his specific needs were met.

� This piece of evidence is a therapy material that I created myself to enhance the clinical experience of an eleven year old boy with severe Autistic Disorder and language delay. I designed a material to keep the child thoroughly engaged in the therapy session, while still effectively working on the necessary expressive vocabulary skills. Included in this portfolio are pictures of the material, as well as a very detailed description of the instructions to play and the specific needs of the child that were met. Also included are pictures of the material being demonstrated (not at the clinic because of my restrictions due to the medical placement setting).

� The disorder portrayed by the child has been discussed briefly in many of my classes throughout the past two years. I was also introduced to treatment techniques in this area throughout the past two years. I was also introduced to treatment techniques in this area last semester while observing for Clinical Methods in Communicative Disorders, but only minimally, so this was a great chance to increase my knowledge. I think this piece of evidence is the greatest testament to my abilities as a future Speech Pathologist. I used my own creativity and innovation to create this material. I received no assistance from anyone when designing and planning how to successfully improve this child’s communication abilites. I believe my skills to both individualize and generalize therapy materials were showcased through this piece of evidence. I was able to go through the entire thought process of making something to motivate the patient, while still effectively and intricately treating each aspect of the individual’s disorder.

� This therapy material was created for an eleven year old boy with Autistic Disorder. The material was designed to improve his social interaction skills, cognitive abilities and also increase his use of expressive language. This material includes picture cards that make sequences of three. The cards are placed face down at the beginning of the activity and the matches of three are obtained by playing the memory game. Each turn allows for three cards to be flipped over before it becomes the next participant’s turn. When a sequence of three is found, the cards are placed by Velcro adhesive on a colorful presentation board. The matches are by Velcro adhesive on a colorful presentation board. The matches are permanently numbered from 1 to 3. The client is then required to create a story coinciding with the provided pictures. (Questions are provided on the back of each card if there is too much difficultly trying to initiate a sentence.) This therapy material improves social skills by providing a turn taking situation. Cognitive abilities are challenged due to the memory aspect of the game, and expressive language is practiced each time a new sentence is created. This material is also fun and interactive for the client. He has a brother and enjoys learning about dinosaurs, so these specific topics were included on the picture cards for the client’s enjoyment. (New picture cards could be created at any time for various clients.)

Display Board for Picture Cards

Picture Cards I Created (Matches of 3)

Questions Located on the Back of Each Card

Turn Taking to Obtain Matches

Presenting a Match on the Display Board