Letters to the Editor

Formula for Sound Economic Sense

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To the Editor:

The phrase du jour in Washington is "economic recovery." Through all the headlines about rampant unemployment, foreclosure forcing people from their homes, and people's future plans on hold, little has been said about who's supporting children in these difficult times. Little has been said about the key institution that affects children daily, which-when bolstered by significant investment-could result in long-term economic growth.

That institution is our education system. With many states and local school districts teetering on the financial brink, a major infusion of federal support must come now to strengthen this critical institution in supporting our children to become productive citizens. It's easy to see how shoring up the automotive industry is critical, with the many individuals and families whose livelihoods are jeopardized. It takes more creative thought and long-range planning to understand how investing now in education and education-related services is a down payment on the future.

What more important role does the federal government have than investing in the education of our youth to become both the productive workers of tomorrow and the protectors of our national security? Children must be successful in school. Our nation depends on it. Success in school means post-graduation readiness for higher education, training or immediate employment that helps grow the economy. The nation can no longer tolerate a graduation rate of just 75 percent or, in a major city like Detroit, 25 percent.

The employability and earning potential of students who do not attain a high school diploma are significantly lower than those who do. In turn, poor employment and earning outcomes seriously impede economic growth and development.

We know how children can be successful. The nation has well-trained professionals specializing in support services for schoolchildren. They understand the barriers to school success that children are facing. These are often the "invisible" professionals in the schools that students come to rely on and parents assume are available to their children, such as the speech-language pathologists, audiologists, school counselor, social worker, psychologist, nurse, physical and occupational therapists, and art, music and dance therapists.

Children react with stress and anxiety, just as the adults around them do, to the dire news reports and to the specific circumstances of their own families. This stress and anxiety impedes their ability to pay attention in class and causes them to act out, adding another layer to the already difficult day-to-day of just being a kid. Highly qualified teachers are critical. However, their training is for teaching, not for addressing these barriers to learning.

Investment in a strong complement of school-employed specialized instructional support personnel who are trained to provide social, emotional and health services and essential academic support is more critical than ever. Having a team of specialized instructional support personnel readily available is a cost-effective way of not only addressing current problems but identifying problems early on and preventing future problems. Both students and teachers deserve to be in a school environment that values the end goal of student success. It is clear that when the needs of the whole child are not met, optimum learning cannot occur.

Congress must seize this opportunity to ensure that we have a strong educational system with qualified teachers, administrators and specialized instructional support personnel. Bankrupting schools will permanently undermine our economic security. Cuts in personnel will create larger class and caseload sizes and result in less time and support for individualized instruction, which has proved to help students succeed in school. School districts affected by budget cuts have already begun to lay off specialized instructional support personnel-the professionals best trained to help children through these trying times and assist students to optimally benefit from classroom instruction.

Thus far, the discussion has focused solely on investing in repairing and improving the school buildings and technology. However, educational infrastructure must include a sufficient number of strong, dedicated professionals available and ready to develop the potential of our nation's very precious cargo. Reducing the investment in our children's future is a missed opportunity that will have serious repercussions for years to come. Having improved facilities are meaningless without the right complement of personnel shaping the educational potential of the students. That's the formula for sound economic sense.

Neil Snyder
nsnyder@asha.org
National Alliance of Pupil Services Organizations (NAPSO)
www.napso.org


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I always knew that speech-language pathologists were pretty intelligent people with strong self-concepts. We are trained to work in any academic setting and medical setting, with all age groups, with all levels of difficulty, and with all diagnoses of communication challenges. But now we are being challenged to help to diagnose not only children who have Asperger’s Syndrome, but those with Asperger’s Syndrome and Bipolar disorders. Is there nothing we can’t do? Although this article says many of the right things. . .we are not qualified to diagnose bipolar disorders. . .we are all part of a multidisciplinary team. . .the biggest obstacle in diagnosing co-morbid conditions accurately is the overlap in symptomatology. . .the details in the article do not support these truisms. This article suggests very mixed messages for the clinician. Although the article states that speech pathologists are not qualified to make these diagnoses, it goes on to say,”Before jumping to conclusions, though, it’s important to rule out other diagnoses. ‘Anxiety is one of the first things I would try to rule out before I thought, Are we looking now at anxiety coupled with Asperger’s or is it mainly just bipolar? If you are seeing bouts of depression, you might want to start thinking about bipolar,’ she advised. A good rule of thumb is to wait a year for signs of cycling and to see if bipolar symptoms subside.”

What in our training or the background in Dr. Baker’ training entitles us to have any say in the diagnosing of these two most difficult areas of mental health. Yes we can provide highly detailed behavioral observations and we can report on the communication needs of the client. We can even have personal opinions about a person’s mental health diagnosis, but to even suggest that our personal opinions have any bearing on the final diagnosis does the client a disservice and the profession a disservice. We may look to a mental health professional to rule out anxiety, depression, Asperger’s etc., but that is not our responsibility.

Dr. Baker says, “We don’t really have a good indication of what bipolar is in children.” Yes, even psychiatrists and clinical psychologists find this area challenging. Of course WE don’t have a good indication because we are not trained in diagnosing mental health problems. To suggest that our training needs to include “all types of diagnostic categories” because we provide so many psychosocial interventions for individuals,” is to suggest that we get another degree in psychiatry or psychology.

It is time for speech pathologist to have a little humility, step back and see what is reasonable for us to do well and that which we are professionally trained to do. We must be willing to share in the treatment of individuals who are becoming more and more difficult to diagnose and treat. We can be a valuable team member and maybe that is what the current training in speech pathology needs to emphasize. We need to have enough background knowledge to effectively communicate with professionals in mental health and contribute information in our own areas of expertise. This does not include” waiting a year while we decide whether the signs of cycling are in fact bipolar” or whether they subside. If I were a parent with a child demonstrating manic and/or depressed behaviors, I would suggest that waiting a year, without input from a mental health professional, borders on unethical decision making.


Karen December 08, 2010
Fairfax County, VA




     

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