Wednesday, July 31, 2013

Guest Post: Communication Disorders and Social Security Disability Benefits

Hello everybody!

Occasionally we get requests from people who want to write guest posts. So, we are willing to post them if the content is good and it fits the spirit of the blog.

I recently was contacted by Molly Clarke who wrote a guest post that would be greatly helpful to parents who are looking into applying for Social Security. I hope this information is helpful, if you have any questions for Molly you can contact her at mac@ssdhelp.org or you can go visit her blog:  Social Security Disability Help.

~bob

Childhood Communication Disorders and Disability Benefits

Human communication is a vital component of daily life.  Being able to communicate both verbally and non-verbally allows us to inform others of our wants and needs, it allows us to share our thoughts and ideas, and it allows us to enjoy basic human companionship. Unfortunately, for a significant number of children, communication disorders make it difficult—even impossible—to speak.

Communication disorders can cause issues that impact the affected child as well as his or her parents. While some communication disorders can be corrected with therapy, others are more permanent and require lifelong treatment.  Therapy, assistive devices, and specialty care can cause a significant financial burden.

If your child has been diagnosed with a communication disorder, he or she may be eligible for financial assistance in the form of Social Security Disability (SSD) benefits. Although the SSD application process is known for being lengthy and overly complicated, benefits often provide a necessary lifeline for parents of children with communication disorders.  Continue reading to find out if your family is eligible for assistance.

Childhood Disability

To qualify for any sort of financial assistance through the Social Security Administration (SSA), children must first meet the SSA’s definition of childhood disability. Taken from the SSA’s website, this definition is as follows,

A child under age 18 is disabled if he or she:

  • Is not working at a job that is considered to be substantial work; and
  • Has a physical or mental condition (or a combination of conditions) which results in “marked and severe functional limitations.”  This means that the condition(s) very seriously limits his or her activities; and
  • The condition(s) has lasted, or is expected to last, at least 1 year or is expected to result in death.


Medical Eligibility Requirements

In addition to meeting the SSA’s definition of childhood disability, your child will have to meet very specific medical regulations in order to qualify for SSD benefits. These regulations can be found in the SSA’s blue book. The blue book is an official manual of potentially disabling conditions and the medical criteria that qualifies each condition.

The SSA recognizes the following disorders as disabilities (Although some of these disorders are not traditionally considered to be communication disorders, many are characterized by issues with speech and communication):

  • Autism (112.10)
  • Personality disorders (112.08)
  • Psychotic disorders (112.03)
  • Organic mental disorders (112.02)
  • Mood disorders (112.04)
  • Hearing Impairment (102.10 or 102.11)


Children with communication disorders most commonly meet blue book listing 111.09- Communication Impairment Associated with a Documented Neurological Disorder. This listing requires that your child demonstrate the following symptoms:

  • A documented speech deficit which negatively impacts the content and clarity of his or her speech; or
  • A documented comprehension deficit that has resulted in ineffective verbal communication based on his or her age; or
  • A documented hearing impairment.


It is important to note that if your child does not meet a specific listing he or she may still be able to qualify for SSD benefits if you can prove, using medical documentation, that he or she is not able to perform daily activities due to his or her communication disorder. To access all blue book listings, visit the SSA’s website, here: http://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm

Disability Benefit Programs

Although the SSA offers SSD benefits through two separate programs, children typically only qualify for SSI benefits. SSI stands for Supplemental Security Income and offers benefits to elderly or disabled individuals who earn very little income. Eligibility for SSI is based on an applicant’s income and financial resources. Because children do not earn income, they will undergo something called parental deeming. Essentially, parental deeming is the process of allocating a parent or guardian’s income and resources to the child.

Learn what types of income are counted toward parental deeming, here: http://www.socialsecurity.gov/ssi/spotlights/spot-deeming.htm

Start the Application Process

Because, the application process can take months to complete, you should prepare and apply for SSI as soon as possible—this way, you will receive a decision sooner. Prior to submitting your application, be sure to have copies of all relevant medical records to support your child’s claim.  Without medical proof, the SSA will not approve your child’s claim. In addition to medical documentation, you should also be prepared to submit proof of income and citizenship.

Once you are thoroughly prepared, you can begin the process. This process will include two different forms— the “Application for SSI” and the “Child Disability Report”. Your child will also have to attend an in-person interview.  Although the SSA has made it possible to complete the child disability report online, many parents prefer to fill out both documents at the time of their interview.  Schedule your interview by calling the SSA’s main number: 1-800-772-1213.

After completing and submitting your child’s application, it may be months before you receive a decision and you should be prepared for the possibility of being denied. If your child’s claim is denied, this decision is not final. You can file an appeal within 60 days of receiving your notice of denial.

While this process is not simple, it is often necessary. Parents whose children qualify for SSI find that they can better provide for their children’s special needs with the assistance of Supplemental Security Income.

For more information about SSI, visit Social Security Disability Help or contact Molly Clarke at mac@ssdhelp.org.

Tuesday, July 16, 2013

SLP jokes on tumblr - this made me laugh SO hard!

Can I be honest?  I don't really understand what tumblr is.  Or should I say what A tumblr is?  Not sure of the correct use of the word.  I am starting to learn today, thanks to my lovely graduate student intern.  :)  She showed me this:   http://whatshouldwecallslp.tumblr.com/

It's a series of tumblrs (?) about being in SLP grad school.  And many of them apply to SLPs who are working!  What do you think?  (There are pages and pages of these.  I could watch them for weeks.)

Example #1:

My face when I go to do an assessment on a patient with aphasia and the family assures me they can talk just fine. 

  "I'll just double check anyways."


#2:
When a child is misbehaving in therapy, but the parents are watching, so you just have to be like:



Also, can you please explain to me about Tumblr or at least tell me how to use the word syntactically correctly?  I'm a Speech-Language Pathologist for Pete's sake!

Love,
Kristin

PS:  By the way, I also learned today that there are different tumblrs like this for almost any subject.  Could this be a great therapy task?  My brother sent me this one about Accountants.  I don't get all their jokes, but I had some good laughs.  Google this: #howshouldweaccountforme?

Wednesday, July 10, 2013

More Short-Term Memory Therapy Ideas

Thanks for your comments and requests.  Sounds like a couple of you would like another post about memory task ideas.

Memory is one of my favorite things to work on with patients. I love teaching compensatory strategies. Maybe it's because I need them so badly for myself?

Image courtesy of: http://mainepi.org/ALZ/Cafes.html

I usually start out each session with a quick memory quiz (What did you have for breakfast?  What was you first therapy session this morning?  Who is your nurse?  What was for dinner last night?  What time did your wife leave/arrive?)  We also use the O-log and the Cog-Log protocols around here quite a bit.

Here are a couple of books I use a lot:
  • WALC 10
  • HELP for Memory
  • The Source for Memory Exercises
  • One of my blog commentators recommended: "Memory Rehabilitation: Integrating Theory and Practice" by Barbara Wilson

Apps I like for short-term memory:
  • Calendar App
  • Flick Flag (I have the patient come up with a memory "trick" (association, elaboration, visualization, etc.) for each flag as we study them, then we play the game to see what they can remember.  It's great for learning how to come up with effective "tricks."
  • Simon (remember this memory game from the 80's??  Love it.
  • Brain Baseline has a couple of tasks for memory (and a lot of great tasks for improving processing speed!)

Much of the therapy focuses on compensatory strategy training.   
We practice using the tools they will use in their home: calendars, calendar apps, day planner, notebook, post-its, alarms, association "tricks"/mnemonics, elaboration, chinking, rehearsal, visualization...


Other fun tasks:
  • Index cards with faces on one side and names on the back.  Again, we focus on associations to help remember the names (e.g., Nyla never likes to smile-a).  I make sure they are effective (e.g., she looks like another Allison I know) vs ineffective (Tyler starts with T, tooth starts with T-- Tyler has big teeth!  There are too many names that start with T.)  I also like to try it the first time with no strategies so that they can see what a difference the strategies make.
  • Objects - I'll show a photo or drawing of several objects (or anything!  A magazine picture with a bunch of foods...).  I'll have them study it for 1-2 minutes and remember all they can.  Then we'll list them out.  Then I have them do it again with some strategies and associations (e.g., make up a story using the objects, or group them into meaningful categories).  THEN, I'll do yes no questions to see what they can remember (e.g., Was there a hammer?  Was there a beach ball?  Was there a shoe?).     
  • Sometimes I'll read a story/article/bit of information and have them answer questions afterward.
  • Prospective memory tasks:  Prospective memory involves remembering to do something at a certain time or in a certain situation.  Such as remembering to take a pill or feed your dog.  I will give the patient tasks to remember at a certain time.  This could be anything from remembering to hand my a paperclip every 5 minutes on the clock, to remembering to tell me the 3 facts I taught them about their favorite hobby (I pick facts they don't already know) at the beginning of our next therapy session.  Etc., etc.  There are a million ways to do this one.  I could go on and on but you get the idea.  They key here is that they try to initiate the task without my help.  If needed, we add compensatory strategies or reminders.
Image courtesy of http://cognitivepsyc.tripod.com/id10.html

Well, I could say more.  But I would LOVE to hear your ideas!  Do you have any to add?  Post them, por favor, in the comments below.

Until next time,
Kristin 

Tuesday, May 28, 2013

SLP Q&A's (from my email) Memory Therapy Task Ideas

Hi guys!

I get a lot of email questions from young SLPs.  I thought it might be fun to start posting their questions and my responses.  Feel free to add your own comments!

-Kristin

Hi Kristin,

I just graduated with my Masters in speech in May from the University of (withheld).  I'm now working for a hospital there where I was previously a student.  I mainly see inpatients, however my outpatient caseload is growing.  Ive been seeing one of my outpatients since I was a student and I was wondering if you had any tips for functional working memory therapy tasks that might spice up my therapy sessions.  Thank you for your time!  I am looking forward to any ideas/tips you may have!

Sincerely,
Haley S.

----------------------------------------
 Hi Haley,

Do you mind if I post your question on the blog?
Ummm, how about the following:

1)  I'll ask them to imagine a 4x4 matrix and I  name 4 letters and 4 categories.  (this is a high level task).
I'll have them mentally fill in the chart.  They have to remember the letters and categories on their own.  (E.g., for slot 1, they'd name an animal that starts with B)

2)  I'll ask them to listen to 3-5 words, and then repeat them back in alphabetical order

3)  Same task as #2, but repeat them back in reverse order

4)  Mental math problems where they have to remember the problem's elements as they work it out.

That's just a quick list.  I'm trying to be working memory-specific here.  I can think of a lot of other short term memory tasks I like (most of which focus on some aspect of compensatory strategy retraining).  Does this help?

Thanks for reading!

Kristin

***note:  Haley did agree to let me post her question.  :)
Can you add some more memory task ideas?  Also see my 2 other memory task posts!

Wednesday, December 19, 2012

Vocabulary Selection for AAC devices

This is Bob, I just thought I'd pop in here real quick and share something our AAC specialist shared with me.

When programming AAC devices one of the things that has always left me stumped was the selection of vocabulary. What do I put on the buttons? I try to be as functional as possible, put in a "more", "help", and "all done". Maybe throw in some nouns in the classroom, but it has always been pulling teeth for me to think of what to add.

So, Gail Van Tatenhove has done some research in the area, and she has a handout that is available on PDF entitled: Normal Language Development, Generative Language & AAC. This hand out briefly reviews normal early language development, then applies it to what we should do with AAC word selection. At the end of the hand out she gives lists of words that you can use when selecting words for your AAC devices that coincide with the first words that children learn in normal language development. I love it! I just thought I'd share that with you guys real quick.

Wednesday, October 24, 2012

Advice for SLPs going to ASHA! or "What I wish I'd known before I went to ASHA..."




Hi, it's Kristin. I’m so jealous of all of you who are going to ASHA!!!  Deeply jealous.

Well, just for fun, I made a list last year of all the things I learned and wanted to do in future years.  Let me know if you have anything to add!!

  • Carry business cards.  There are so many situations where you want to give them out.  You meet new friends and connections.  AND so many booths have contests where you can either fill out their form OR drop a card in the jar!  Duh- why didn’t I bring mine?  Bring a TON. I also saw many people bring a sheet of labels or a stack of small papers with all their info to drop in context and info boxes, etc.    (Include name, workplace, address, and email.)  Smart! 
  • Meet people for lunch each day (It’s a great time to catch up and review what you learned.  It’s so easy not to make plans and then just eat on your own otherwise.  Lame.
  • Pick classes early (beforehand) and bring the “My planner” printouts and the ASHA leader insert.  Write your schedule out including back-up classes with room numbers so you don’t have to look things up throughout the day.
  • Print out your handouts early (via ASHA.org)- or at least as many as you can.
  • Plan on bringing home extra stuff!  Like freebies, SLP garb you buy in the booths and stores, papers papers papers...

  •            Carry snacks, gum, sunglasses!
  •       Go to the presentations by the “famous” presenters.  It makes a difference.
  •       Do the “Short Courses.”  They tend to be excellent. 
  •        Do the ASHA boxed lunches (on your registration sheet).
  •       Keep a list of attended courses as you attend for easy CEU entry afterward.
  •       Schedule time for exhibit hall browsing. 
  •       AND save time for poster sessions.  Did you know you can get CEUs for time in poster sessions?
  •       However, you don’t have to go to poster sessions while the presentation is actually being given.
  •       Grab a “Daily Update” each morning from the info booths to learn about fun events and cancelled sessions. 
  •             Bring your iPad or smart phone for contests, etc.  There are sessions ABOUT therapeutic apps.  You’ll want to have your device there to practice IN-session. 
  •             Wear shoes AND socks.  Seriously, there is a LOT of walking.  I got blisters.
  •       Dress nice.  Jeans are ok, but wear a nice shirt.  I think about these things…  
  •       The classrooms were chilly.  Wear a jacket and long sleeves.
Hotels:


  •       Stay somewhere nice (I tried to save a buck and stay in a really cheap place.  Bad idea in more ways than one),
  •       Stay near the Convention Center
  •       Need to be frugal?  Get a room then post on the roommate forum so others can join you and split the cost.
  •       Watch out for flaky people on the roommate forum!  I got ditched by someone at the last minute (it was she who had the hotel room) and that’s why nothing was left and I had to go to that crappy motel.
  •       Consider getting a group together and renting a condo (search “rental by owner.”)  My friends did this – genius!!
  •       You can also stay with a local person (roommate forum)?  I had fun doing this for part of my stay, and I made a new friend.
  •       Bring workout clothes and go running in an awesome place in the city!

 Do you have suggestions of your own, ASHA-savvy folks?  Post your comments.  Have fun at ASHA.  Tell me what you learn!

XOXO,
Kristin

Tuesday, October 16, 2012

Guided Access Feature for iPads

One of the greatest features about the new operating system for iPads (and ipodtouchs/iphones) is the new Guided Access feature. Basically Apple has finally listened to educators everywhere who have been screaming for restricted access. We can finally lock a child into the app that we want them to use. 

Gone are the days where you can't leave a student with your iPad for more than 2 minutes before they have changed your background, rearranged all of your app folders and changed your password. It seems like this would happen especially when I was using the device for AAC. Why would the kid bother if they knew that somewhere on this device there was Angry Birds?

You do have to have one of the newest devices to be able to have access to this feature along with all of the other iOS 6 features. The oldest iPad that you can update is the iPad 2 (sorry all of you iPad 1 users, time for an upgrade?), the iPodtouch 4, and iPhone 3GS. Sad, because some of our old devices could have really used this feature.

So, here is how the Guided Access Feature works.

How to set it up (assuming you already have put iOS 6 on, if not go here).

Open settings -> General -> Accessibility


At this point you'll see some options, basically you can then turn on Guided Access as well as set a password. I would strongly suggest that you do set the password.


And that's it, you are all set up. Now when you want to turn on Guided Access you triple click on your home button and it will open up to give you several options (see picture below).


You can turn off "touch" and/or "motion" or you can just leave them on. I can see this being useful if you have some kind of video you are having your students watch and you don't want them to easily interrupt it. I'm not so sure about the motion feature, but I know many apps have motion functions. 

If you want to get back out, triple click again and then you can enter your password to exit Guided Access mode.


And there you have it. You can now lock down your iPad so that a student cannot go messing around with everything else on your iPad. 

If your iPad is stuck in Guided Access mode.

There is a bug out there where sometimes you are unable to triple click your home button and you are seemingly stuck in guided access forever! 

Or.... you have forgotten your password and there is no apparent way to get out, there is no "forgot my password" button.

This is what you have to do. 

Hard Reset (hold down both buttons down for about 5 seconds). You have a few seconds after the iPad comes back online before the Guided Access turns back on (which is will). You can then go to your settings and turn off the feature.

This is pretty important to know. I've already had to do this twice, good times.