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A day in the life of a speech pathologist

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photo_sue_steegstra.pngVDEI sat down with Sue Steegstra, speech pathologist at Aurora School.  
Hi Sue. Thanks for agreeing to give us an insight into your job! Can you share with us a little bit about your job?  
Sure! I work as a speech pathologist at Aurora School, which provides early intervention services for deaf children across the state.  Aurora School runs a daily centre-based preschool and Prep program (Early Education) in Blackburn South for children from the south and eastern suburbs who attend the school on a daily basis. The other section of Aurora, the Early Intervention Program, visits children and their families in their home. 
I work in the centre-based Early Education program with deaf children aged between 3 to 7 years of age.  As the most senior of the three speech pathologists in our centre-based program, I have a lot of responsibilities in terms of leadership and coordination. I’m also on the school’s leadership team meaning I have additional roles over and above my speech pathology role. 
 
A typical day involves providing speech pathology to a child, one on one in a ‘withdrawal’ situation (outside of the classroom). The sessions are based around the communication goals that I select for that child and I provide activities to do in the session.  As well as that, the child and I put an activity into the speech activity scrap book which they take home to practice with their family. Every child in the Early Education (centre based) program has individual speech pathology sessions once a week. This is just part of my role. 
 
I’m also involved in assisting with transition for children who are moving on from Aurora to a new placement the following year.  I assist with collating and writing reports that are required by the Education Department and other educational facilities to gain funding for the children and to inform people of where the children are in terms of their communication. This allows the families to make a more informed decision about the future placement for their child.
 
Another area of my role is to assist with the differential diagnosis of children’s difficulties. Children at Aurora are enrolled in the program because they have been identified as being deaf. With the Newborn Infant Screening Program this identification can be at a very early age. But some children have an additional disability such as an intellectual disability or Autism Spectrum Disorder. As a child gets older it becomes clearer that their progress is slower than we would have expected so we assist the family through the process of a second round of assessments and diagnosis. I also identify and refer on children who have facial structural difficulties impacting on their eating or speech production such as a tongue tie.
Twice a week, we have meetings with teachers of the deaf and track our children’s language development on the Cottage Acquisition Scales for Listening Language and Speech or CASLLS, a measure that looks at children’s speech and language development, cognition and play.  Each child is discussed approximately every six months. The classroom teacher and I have a meeting about a specific child where we review the child’s progress and together select goals on where we’d like the child’s language, speech and communication development to be in the next six months. 
There is such a misconception that speech and language pathologists only work on articulation, but we work on so much more than that.  There are two focuses to our work: the first is developing children’s communication through oral language, signing or pictures. The second is working on children’s eating and feeding problems. Some speech pathologists work purely on helping a child swallow or trying to increase their tolerance for textures in order to transition them to regular eating. 
Most of the work that I do is on developing children’s language. I work on children’s vocabulary and sentence structure, without even getting to articulation because unless a child has a language base, being able to say sounds is neither useful nor functional.  A lot of what I do is teaching the child vocabulary for clothes or things in the kitchen and other things they don’t know the names for or can only point to.
I also focus on developing children’s listening skills – making sure they are wearing their hearing devices and helping the child to make sense of the sound that is coming through their devices and giving it meaning. 
What do you find most rewarding about your job? 
I love working with the children. They are an absolute delight! They are so open to learning and I really enjoy the sessions that I have with them.  I also like working with families. I love it when children come back after a few years and you can see how they’ve developed and think that you’ve had a small part in that.  I love being part of watching a child learning to communicate for the first time – a child who may previously have had no communication who is now able to ask for something.  That just blows me away. 
What do you find most challenging about your job? 
The hardest part is the coordination of the services that you are trying to provide.  There are a lot of players in a child’s life: the family, who is the most important; the speech pathologist and the classroom teacher. It’s about trying to get everybody to work together, having a shared understanding of what we would like to do for this child and making sure we are all working in the same direction. Different people come with different understandings: families come with their understanding of the child and their hopes and aspirations for that child and the class teacher and I come with our professional understandings.  It’s about trying to get those three areas in sync. 
Has the role of the speech pathologist changed over the years? 
I’ve been working with deaf children for more than 30 years now and during that time there have been a lot of new developments. The biggest change has been with advances in technology and its effects.  Nowadays children who have cochlear implants and are speaking effectively are the children who 20 years ago I would be trying to get vocalisation from.  There has also been a huge explosion in what’s called ‘Augmentative and Alternative Communication’ or AAC, which is using picture symbols with children as a way of communicating.  That has become much more sophisticated and may allow the child to use an electronic voice output device or even an iPad to communicate.  For a long time my work with deaf children was only a small part of my overall caseload because I was working in regular schools visiting children all over Boroondara and I didn’t have as much knowledge in that area, so for me learning about AAC and how to work with a child with AAC has been a big change. 
Are you able to give a case example – with permission – to demonstrate the value of your/ a speech pathologist’s work i.e. a student who has made significant progress or achieved something special.  It would be great to have a positive story for our readers. 
I can’t say I’ve done anything alone. I’m always working in partnership with people and have been one part of a team where children have made significant progress in learning to speak.  There was one child who had been using picture communication for a long time, but had not made much progress.  We decided to change the way we were doing it so that the child had to give us the picture instead of simply pointing to it.  That made a huge difference.  When one of the staff members, who had worked with this child for a year, returned from holidays she said that she had enjoyed more communication with the child in an hour than she had for a whole year with him prior to her holidays.  That was magic! 
So how useful are PD workshops to you as a speech pathologist?    
It depends on the professional development workshop! I have found the ones for speech pathologists very useful.  I’ve been to several workshops at VDEI and found them to be absolutely fabulous.  I think that VDEI has done a wonderful job in bringing out world-renowned experts and allowing us the opportunity to come and listen to them.  I can’t believe some of the people that we’ve had out here that I’ve only ever read about in journal articles or books!  I choose the ones that I go to on the basis that I think they are going to be relevant to me.  Like everything, I think professional development only works when you take in some questions to be answered. You have to go with a reason to be there and that you think it will be relevant to your work. 
Sue, thank you so much for your time today.  We greatly appreciate it!