Wyoming

Speech Language Hearing Association

March 1, 2015
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Conventions in 2015

2015 ASHA Convention

November 12-14
Denver

2015 Kahn Lecture

June 26
Laramie

2015 WSHA
Convention

Laramie, Wyoming
June 25, 2015

University of Wyoming
Hilton Conference Center

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From the Pen of the President

Getting out of your Comfort Zone

2015 WSHA President

WSHA advocates for Child

Development Centers

I recently read an article by

Douglas F. Parham, PhD, CCC-
SLP, professor at Wichita State
University and our current
CSAP President (CSAP Council
of State Association Presidents)
in which he discusses the
Comfort Zone. By definition,
most folks think of the
comfort zone relating to the
temperature of a room. Am I too
cold? Am I too hot? In essence, a comfort zone is the result
of a comfortable place to be. When you are in your
comfort zone you really dont have to risk anything or feel
uncomfortable. However, staying in your comfort zone can
sometimes result in missed opportunities.

When I think of situations in which I have been out of my
comfort zone, it usually resulted in my learning something
new or something new about myself. If I had stayed in my
comfort zone, I dont think I would have become a speech
language pathologist. I never would have even made it past
my clinical observations! I remember 8 years ago when I first
tried multiple-opposition articulation treatment. This was
not what I was used to. But had I not tried the new
treatment, I wouldnt have discovered the outstanding
effects of using it with severe phonologically disordered
students. Had I not taken the risk of supervising clinic at the
University of Wyoming last summer, I wouldnt have
discovered how much I enjoyed teaching graduate students.
Leaving my comfort zone has caused anxiety at times, but
usually resulted in outstanding outcomes.

I would like to challenge all of our WSHA members to try
to get out of your comfort zone throughout this year. Get
involved with WSHAattend the convention, volunteer to
become a committee member, challenge your fellow speech
pathologists and audiologists to join WSHA. The results will
be outstanding! Our convention is coming up in June. Plan to
attend and become involved!

Sue Torney, M.A., CCC-SLP

In June 2014, the Wyoming Department of Health which is

the agency in Wyoming overseeing early intervention
services implemented a new policy with regard to
assessment instruments that can be used for the
identification of children three to five. All 14 regional Child
Development Centers must use these instruments to
establish eligibility under IDEA and Chapter 7 Rules and
Regulations. The resulting qualifying scores, including the
standard deviation/ Z score(s) must be included in the
evaluation reports. For speech-language pathologists, the
approved assessment instruments are:

Preschool Language Scales, 5th Edition
Peabody Picture Vocabulary III
Clinical Assessment of Artic. & Phonology II
Goldman Fristoe II
Kaufman Speech Praxis Test
Bayley
Clinical Evaluation of Language Fundamentals
Preschool 4th or 5th edition
Structures Photographic Expressive Language Test II or II
Structured Photographic Articulation Test II

Some Wyoming speech-language pathologists find these
limitations frustrating. In most cases, SLPs are able to
establish eligibility with the current list, and then are free to
use other evaluations for further information. There are
times, however, that eligibility is difficult to establish even
though the professional believes services are warranted.
Limited instrument options are also a problem for other
service providers working at the preschool level - the special
ed teachers and OT/PT also have very few choices.

In February 2015, the WSHA Executive Board responded to
WDH with a position statement:

Dear Ms. Walk,
I am writing to you on behalf of the Executive Board of
the Wyoming Speech-Language Hearing Association in
regard to the list of assessments provided by the Wyoming
Department of Healths Early Intervention and Education
Unit to determine eligibility for Early Childhood
speech/language services. This list was brought to our
attention by several early childhood speech language

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pathologists who were concerned about this list interfering
with our professions scope of practice.

It is our position as the WSHA Executive Board that the

Wyoming Eligibility Criteria for speech/language services
should be the only determining factor for eligibility of
services. Determination of such eligibility is the
responsibility of the highly qualified speech-language
pathologist who has underwent years of education and
training of psychometric principles, normal development of
speech-language skills, and identification of atypical speech-
language skills. If a standardized assessment has been given
with fidelity, those assessment results should be what drives
a childs eligibility for services, not what test was used to
determine eligibility.

By creating a list of acceptable assessment tools, the EIEP

department is infringing upon our professional skills in
choosing an appropriate standardized assessment.
Standardized assessments are chosen based on a tests
validity and reliability, not by what is frequently used within
the early childhood community. If a list is mandated, then
the determination of what assessments tools are included on
this list should be based on the input of several SLPs working
in the early childhood setting, as they are the experts.

We hope that you will consider our position regarding

your test selection list. If you have any questions, please feel
free to contact me. Thank you for your time and
consideration of this important matter.

Sincerely,

Sue Torney, M.A., CCC-SLP

2015 WSHA President

Speech-language intervention for
students with Traumatic Brain Injury

By Darcy Regan, M.A., CCC-SLP

Wyoming Institute for Disabilities

Traumatic brain injury
(TBI) in children occurs in
all culturally and
linguistically diverse
populations. In pediatric
traumatic brain injury, a
variety of physical, social,
behavioral, cognitive,
communicative, and
emotional problems are

apparent. According to the Agency for Healthcare Research

and Quality, Seventy five percent of pediatric TBI show
impairments in self-feeding, cognition, and behavior; sixty
seven percent show impairments in speech; twenty- nine
percent with vision, and sixteen percent with hearing
impairments 1 The following components were investigated
in the intervention of children with TBI, and could be applied
in work as a speech language pathologist: narrative skills,
cognitive-communication abilities, social skills, memory, and
services provided in the schools.

Narrative Skills
It is critical to include an evaluation of narrative ability in
the intervention of children with TBI. Narrative skills assess
an individuals cognitive communicative abilities. Research
from Chapman and colleagues (1990), as cited in Biddle, et.
al. (1996),2 used a retelling paradigm in order to investigate
the narrative abilities of children and adolescents with mild,
moderate, or severe TBI. Children with mild and moderate
TBI did not show deficits, while children with severe injuries
were impaired in their abilities to present critical story
information and episodes in narratives. Various other
studies regarding narrative skills found that childrens
deficits were due to memory rather than discourse ability.
When targeting narrative skills during intervention, it is
important to use personal narratives rather than fantasy
narratives as personal narrative are more frequently used in
personal and educational settings.

Cognitive Communication Abilities
The sensory systems in the frontal lobes do not mature
until later in life; so, the higher-level cognitive functions such
as judgment and organization will not be established until
later in adolescence. A five-year old also may undergo
several challenges as the student is confronted with age-
appropriate tasks such as listening and social skills that need
to be established before the brain injury.

A child with a brain injury may function without

presenting deficits during an earlier phase of development;
masking the fact that the developmental process has been
arrested. Deficits resulting from brain injury may surface
when the child reaches a chronological age at which
educators and family members expect performances beyond
the cognitive capabilities of the child1 Therefore, the early
identification of the childs developmental stage is necessary
at the time of the evaluation. This enhances the ability to
predict when problems are likely to surface so that the
educators and family members could use that information to
design interventions that account for damaged cognitive
capabilities and their behavioral characteristics.

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Social Skills
Children with TBI may have a difficult time adjusting to
mainstream education due to their characteristics of social
inappropriateness, lack of awareness, and decreased control
of attention, memory, and strategic thinking 1 Children with
TBI typically receive special education services similar to
those for children with learning disability. The research sets
TBI apart from learning disability by stressing that students
with TBI will need different compensatory strategies because
they will have more extreme problems with generalizing,
integrating, and structuring information3. Children with TBI
may experience difficulty with tasks that require new
learning; but, have less difficulty with tasks based on old
learning. A child with TBI is unlike having a learning disability,
where the disability has been acquired. The child may
remember his or her capabilities before the injury and most
children with TBI do recover some function. It is important
to use other conversational partners besides the clinician
when implementing social skills training. The strategies the
American Speech-Language Hearing Association (ASHA)
recommends for improving social skills include: allowing the
client to participate in the selection of target skills, creating
an awareness of social settings, interactions, and
appropriate modes of behavior and communication. ASHA
also recommends educating and training family members
how to interact with the client and focusing on self-
monitoring and self-evaluation behavior and performance.
The SLP should also use role-playing and scripting to practice
social interactions. Additional evidence-based intervention
strategies are listed on ASHAs Practice Portal: Social
Communication Disorders in School-Age Children:
www.asha.org/PRPSpecificTopic.aspx?folderid=8589934980
&section=Treatment

Memory
Many Speech-Language Pathologists who work with
children with TBI use iPads and computer games that teach
the memory recall of digits or commands. However,
because memory is specific to a task, the ability to recall
numbers or commands does not result in improved
communication skills4. . Further research cites the use of
memory training software to enhance memory performance;
however when retested 15 days later, the gains were not
maintained. Therefore, there is little evidence of the lasting
benefits apart from what is expected from spontaneous
memory improvement. When implementing different
scheduling apps to assist a student with recall of different
timed schedules, look for apps that will allow you to create
ringtones from voice recordings instead of just playing a
generic notification that usually cant be heard clearly. The
website, OTs with Apps, lists apps containing organization

tools such as appointment reminders and chunking daily

information on their website at:
http://otswithapps.com/2012/08/19/how-memory-works-
good-ways-to-improve-your-memory-are-there-apps-for-
that/. When teaching students with memory impairments, it
is important to offer several repetitions, teach in small steps
and supplement your directions with the use of gestures and
facial expressions. It is equally as important to make sure
the child has heard the request; the child could be asked to
paraphrase any verbal commands or oral instructions.
Teaching a student mnemonic techniques is another
evidence-based intervention in assisting a student with
traumatic brain injury with his or her verbal and nonverbal
memory.

It is important to weigh the evidence and take into

consideration the developmental skills of the client when
providing intervention for students with traumatic brain
injury. Early identification of traumatic brain injury in
children is necessary at the time of the evaluation. When we
correctly identify the students mastery of the
developmental skills before the time of injury; we are more
likely to predict when problems are going to surface. By
looking at narrative skills, cognitive-communication abilities,
social skills, and memory, we can more closely align our
interventions that will account for a students damaged
cognitive capabilities and behavioral characteristics resulting
from the traumatic brain injury.

References
2
Biddle, K.R., McCabe, A., & Bliss, L.S. (1996). Narrative skills
following traumatic brain injury in children and adults.
Journal of Communication Disorders, 29, 447-469.
4
Cloud, S.J., & Muma, J.R. (2004). How do you treat patients
with traumatic brain injury? Power point presentation
presented at the Annual ASHA Convention, Philadelphia, PA.
3
Hibbard, Gordon, Martin, Raskin, & Brown (2001). Students
with traumatic brain injury: identification, assessment and
classroom accommodations. New York, NY: National
Institute on Disability and Rehabilitation Research, United
States Department of Education.
Jorgensen, M., & Togher, L. (2009). Narrative after traumatic
brain injury: A comparison of monologic and jointly-
produced discourse. Brain Injury, August 2009: 23 (9) 727-
740.
1
Rehabilitation for traumatic brain injury in children and
adolescents. (1999). (AHCPR) Publication No. 99-EO25).
Rockville, MD. Retrieved January 2, 2015 from
http://archive.ahrq.gov/clinic/epcsums/tbisum2.htm
Traumatic Brain Injury, (n.d.) Retrieved January 11, 2015,
from http://www.asha.org/public/speech/disorders/TBI/

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WSHA 2015 Convention News

By Jessica Waldron, M.S., CCC-SLP

WSHA President-Elect

It's time to start thinking and planning to attend the 2015
WSHA Convention. With ASHA being in Denver this next fall,
the WSHA Convention will be held June 25th in Laramie this
year at the new Hilton Garden Inn Laramie. We are tagging
on to the UW ComDis Kahn Lecture to make the trip to
Laramie more worthwhile! WSHA has

know, Amy has served on the scholarship committee for the

past few years and when I expressed my desire to step-down,
Amy was quick to volunteer her time as chair to maintain
some continuity for the committee and in the selection
process. Joining Amy on this committee are two former UW
graduate students: Jennifer (Jackman) Brown (2001) from
Green River and Estelle (Roland) Baker (2011) from Lander.
Together with Amy, these individuals will serve in selecting
graduate students to receive the WSHA Scholarships. The
winners will be announced at the annual spring awards
reception hosted by the Division of Communication
Disorders and the UW chapter of the National Student
Speech, Language and Hearing Association (NSSLHA) on
March 6, 2015. I look forward to reading about the winners
in next months WSHA Pitch.

continued to contract with Cravens and Associates to help

organize our convention. This year we have several local
experts lined up to present on various topics throughout the
day. Thus far session topics range from Clinical Supervision,
Assessment and Treatment for Traumatic Brain Injury and
Concussion, AAC Assessment and Intervention Across
Settings, Language Sample Analysis for the Busy SLP, and
many more! The day will finish with several round table
discussions to choose from.

As always it is bound to be a fun convention full of great
information and good friends. If you want to join the WSHA
Convention Committee, please contact Jessica Waldron,
2015 WSHA President Elect at jessbrodie30@gmail.com. Our
committee welcomes your input! Hope to see you all in
Laramie!

WSHA Convention Committee: Jessica Waldron, Sue Torney,
Lindsey Curran, Christiane Dechert.

WSHA Scholarship Committee has new
Chair
by Lynda D. Coyle, M.S., CCC-SLP

After 10 years as the chair of the student scholarship
committee, I am ready to step down and relinquish my role
as chair to my UW colleague, Amy Weaver. As many of you

Since 2003, the Wyoming Speech and Hearing Association

(WSHA) has provided scholarships to graduate students. The
total amount awarded has increased nearly every year with
the latest budgeted amount for scholarships set at $3000.
The money is awarded to graduate students to off-set the
costs of their graduate education. The philosophy behind
the scholarships was to provide graduate students with an
incentive to stay at the University of Wyoming for their
graduate training, or consider conducting either one or both
of their clinical externships in the state and from there,
consider staying in Wyoming to start their SLP careers. Many
of the past recipients have become certified SLPs in the state,
served on the WSHA executive board, and continue to pay it
forward by supervising graduate students for clinical
rotations.

It has been an honor to serve my state association in this

capacity. I look forward to hearing about future scholarship
winners and strongly encourage other members to
participate in other WSHA committees. By doing so, you
contribute to making our organization stronger and help to
ensure its legacy. Thank you for the opportunity to serve!

WSHA student and CF sponsorships

The WSHA Student and CF Sponsorship Program is a

successful WSHA program that integrates students of the
Division of Communication Disorders at the University of
Wyoming or clinical fellows into the state association. With
this program, WSHA members provide sponsorship to
student and clinical fellow candidates. The fee for
sponsoring a student is $20 per year, for a clinical fellow is
$40.00 for two years. To qualify for a sponsored student
membership, a student must be currently enrolled. To

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qualify for a sponsored CF membership, the CF candidate
must be currently employed at a job site in Wyoming.
Clinical fellows must complete a WSHA membership
application and note CF Sponsorship on the application
form. The CF supervisor must sign the application.

Sponsored student and CF memberships depend on
memberships generosity and are assigned on a first-come-
first-served basis. A member may request a specific student
or CF candidate or donate to the pool of student funds. A
member may choose to be publicly acknowledged for the
donations or remain an anonymous sponsor. WSHA would
like to encourage members to mentor students and Clinical
Fellows as a way of encouraging the future of our profession
and our association.

Meet first year

graduate student
Janna Stoutenburg.
She loves playing
music, drawing, and
reading. Her family
has lived in Wyoming
for 8 years, where
she has developed a
love of hiking, having
cook outs, and
floating the Green
River with her brothers
She cant wait for the summer! Janna earned her Bachelors
degree in Communication Disorders at Brigham Young
University. She is excited to pursue her career in Speech-
Language Pathology! Jannas student membership is
donated by WSHA member Nancy Axthelm.

Kelsey T. Mullikin is a first
year graduate student at
the University of Wyoming.
She lived in multiple states
and her family currently
lives in Colorado. Kelsey
attended the University of
Wyoming for her
undergraduate career,
when she served as
NSSLHA President.
Wyoming has been her
home for the past five
years and she says she has
enjoyed every minute of it!

She is looking forward to finishing her education where her

dream began. Kelseys student membership is donated by
WSHA member Kay Munsterteiger.

Brooke ODonnell is
currently in her first
year of graduate
school at the
University of
Wyoming. She is
originally from
Bozeman, Montana
and did her
undergraduate work
at Eastern
Washington
University in Spokane,
Washington. After the
loss of her father at a young age she always wanted to help
people and improve their lives. She didnt know how to do
that until her cousin directed her towards the career of
Speech-language Pathologist. Brooke wants to be that
person in someones life that makes a positive impact. She is
excited to continue to learn and become a Speech-Language
Pathologist and is excited that the University of Wyoming is
giving her that opportunity. Brookes student membership is
donated by WSHA member Cathy Ross.

Graduate student
Stine Turgeon is in
her second year of
grad school at
University of
Wyoming of what
she considers the
most interesting
profession:
Communication
Disorders. Stine
cant wait to get
out and start
working as an SLP.
She has called
Wyoming home for the last 13 years. She has two children
who along with her husband have been incredibly supportive
of her spending most of her free time studying. Stines
student membership is donated by WSHA member Cathy
Ross.

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Undergraduate student
Hannah Cimburek is
originally from
Rapid City, South
Dakota. She is
currently a senior in
the process of
gaining a degree in
Speech-Language
and Hearing
Sciences and hopes
to attend graduate
school for Speech
Language Pathology in the
fall. She the National Student Speech Language and Hearing
Association President for this academic year and has enjoyed
being part of this wonderful group of motivated students
while advocating for those with speech, language, or hearing
difficulties and the professions of Speech Language
Pathology and Audiology. Hannahs student membership is
donated by an anonymous WSHA member.

Undergraduate
student Mikala
McCool is from
Casper, Wyoming.
She is a senior at
the University of
Wyoming studying
Speech Language
Pathology and
very excited to
hopefully attend
graduate school in
the fall. She is the
Vice President of
NSSLHA this academic
year
and loves being involved in this group and getting the
groups name out in the community. Mikalas student
membership is donated by
WSHA member TiAnn
Poloncic.

Undergraduate
student Theresa
Poloncic is originally
from Rapid City, SD.
Currently she is a
senior in the
Communication
Disorders program at
the University of

Wyoming. Theresa is excited to see where the future takes

her. Theresas student membership is donated by WSHA
member TiAnn Poloncic.

On behalf of these students (and there are more to be
introduced in the next newsletter), THANK YOU, WSHA
members for your generous welcome to the state
association.

Wont you consider sponsoring a student, graduate or

undergraduate, or clinical fellow for a WSHA 2014
membership?

You can do so easily at:
http://www.wyomingspeechlanguagehearingassociation.org
/paying-for-your-membership.html

Welcome Wyomings new STAR

by TiAnn Poloncic
WY State Advocate for Reimbursement

Happy March fellow WSHA members! I would like to
introduce myself as your new ASHA State Advocate for
Reimbursement or STAR, so here it goes! My name is TiAnn
Poloncic and I graduated from high school in a small town
in northern South Dakota. I attended the University of South
Dakota and graduated with a B.A. in Communication
Sciences and Disorders then immediately started graduate
school and finished with my M.A. in Speech Language
Pathology. I have my Cs from ASHA well as an SLP license
from the Wyoming Board of SLP and Audiology, I also have
my teaching certificate with an SLP/SpEd endorsement from
PTSB. I have lived in Glenrock for 4 years with my husband,
(almost) 2 year old daughter, pug, and chocolate lab. I
gained work experience in the Wyoming school setting and
skilled nursing facility setting before I began my own practice,
Wyoming SLP. I see kiddos from 9 months and above mainly
for swallowing, articulation, language, pragmatics, and
phonological awareness/reading. I currently do not have any
adult patients.

On to my duties as your STAR. As found on ASHAs STAR

website: The State Advocates for Reimbursement (STARs)
are ASHA-member audiologists and speech-language
pathologists who advocate in their states for improved
health care coverage and reasonable reimbursement. Their
targets are key decision-makers in private corporations,
public agencies, and the local legislature. Examples are
health care insurance executives, benefits administrators,
state insurance department officials, and state congress

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members. STARs create advocacy strategies and share skills
with the state speech-language-hearing associations that
appoint them.

As your STAR, I have already attended conference calls

with other STARS, I attended a conference concerning
Effective Advocacy through Wyoming Community Service
Providers, and I have been in contact with the new provider
services manager for Medicaid, Amy Buxton. Throughout our
conversations we discussed why CPT code 92610 (swallow
evaluation) was not open to be billed by the SLP taxonomy
code. Upon research, she could not find a reason - so she
was able to open up the code to SLPs. As of January 23,
Wyoming SLPs are able to bill Medicaid for swallow
evaluations. This amazing change is important for 2 reasons
beyond the increased reimbursement opportunities. The
first highlights what the STAR representatives can
accomplish once we are made aware of an issue (so please
be sure to bring them up to me!). The second reason really
shows why its so important for SLPs to be involved with

their state association. Those who are not WSHA members

are not likely to know about this new development, so
please spread the news and ask them to join WSHA while
you are at it!

As mentioned before, in order for me to be an effective

STAR I will need your help; I need to know what issues are
important to WSHA members! I am keeping an eye on
legislation and will update you all soon on whats been
happening, but if something needs my attention sooner
please let me know. I am here to help WSHA members with
reimbursement issues with Medicaid and private insurance
providers, so please forward any and all questions my way.
My e-mail address is tiann.poloncic@gmail.com and my
phone number is (307) 337-7799 - feel free to text or call. I
am most responsive to e-mail and text but do eventually
check my voicemail. I want to thank you all for the
opportunity to represent Wyoming at ASHA and look
forward to helping each of you!

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