At the Center: Addressing Difference vs Disorder through a Multilingual Lens

Thank you for joining us At the Center! In today's episode, host Dean Constantopoulos speaks with Sivan Schondorf, the Chief Communications Officer at CSES, about Speech Language Pathology and how SLP work functions at the Center for Special Education Services. She explains the importance of understanding a student's native language and how these linguistic differences can be misconstrued as "disorder" while highlighting the steps that district leaders, educators, and families can take to ensure that their child receives the best speech services possible. Interested in learning more? Come and join us here, at the Center!  

Transcript

Dean 0:01

Good day to you, whatever time you're listening, and thank you for joining us at the Center, your one-stop shop for all of the hot topics here in special education. Today I'm joined with a special guest. I have with me Sivan Schoendorf. She is the Chief Communications Officer here at the Center for Special Education Services. Sivon, it's great to have you.

SPEAKER_00 0:19

Thank you. Thank you for having me.

Dean 0:21

Of course. So let's go ahead and jump right into our topic today. Today, we're talking a little bit about speech language pathology and the services that they provide, particularly here in the Center for Special Education Services and with our clients. So let's talk a little bit about that. Tell me a little bit about who you are and what is your role here at CSES.

SPEAKER_00 0:48

Sure. So my training is that I'm a speech pathologist, speech language pathologist. I actually started as a theater major.

Dean 0:57

Oh, really?

SPEAKER_00 0:57

Yes. And while that was evolving from a hobby to something else, I wanted to bridge it into something that I was interested in. Um I was in a voice for the actor class and I was learning about breath support and voice. And it made me realize that there were a lot of similarities. I had found out about speech pathology, and there are speech pathologists that work in voice. And so that kind of got me thinking about the career. And then I fell in love with it for all kinds of other reasons because SLPs do all kinds of different things.

Dean 1:29

Interesting. That's really cool. So I didn't even know that they had SLPs like in the the theater and kind of actors' circle. So we can we can come back to that. That's a whole conversation in and of itself. Um, so what uh so, in terms of your role here at the company, what um what is it you do with speech path and how do you incorporate that into CSES?

SPEAKER_00 1:54

So, my role here, besides managing some of the higher level ins and outs of um that are probably boring to all the listeners, in terms of my speech path hat that I wear, I supervise all of our speech pathologists as well as some OT. And we do all kinds of testing, like early childhood assessment, um, ADOS testing. And so I'm in charge of all of those departments and overseeing that things run smoothly and um reviewing reports and whatnot.

Dean 2:23

And you had mentioned earlier, um, just a little bit ago, that there are tons of things that you could do with speech path. Um, so what are some of those like what is a what is a speech path, what's a normal day for a speech path kind of look like? What is uh what do speech pathologists usually do? And what are some things maybe that people didn't know that they can do?

SPEAKER_00 2:46

I think that most people assume that speech therapists work in a school, what a lot of students would call their speech teacher. And that is true. There are many, many speech therapists that work in the school system and they work there doing therapy and assessment, but you can also work in a hospital, in an acute care type of rehab. Um, you can work in a private practice, in a clinic for adults or children. And so some of the areas that hospital speech pathologists would work in could be with patients who've had stroke and they're working on a with patients who have aphasia and um some cognitive decline. They might be working with Parkinson's patients, they might be working on voice for someone that's had their vocal folds damaged in an accident or because of um an upper motor neuron disorder. Um, they might be working with swallowing patients. That's also very common in the hospital setting. And so there are a lot of different avenues you can go into when you're a speech therapist. It's not just a one size fits all.

Dean 3:47

Interesting. So just kind of like keeping with keeping with the theater theme that we talked about earlier. So for example, I've I've got history in choirs and like singing and stuff like that. And people would talk about um vocal folds and vocal nodes and such. Um, I think uh Julie Andrews had vocal nodes, uh the sound of music.

SPEAKER_00 4:11

Even the best singers, you know, after using your voice a lot and maybe not always using it properly, it wears on you. So she did have some kind of vocal pathology.

Dean 4:20

So that's what that's so interesting. So that shows just like the wide gamut of different options that an SLP has for work, for opportunities to use their skills to help people out. That's really interesting. So when we are looking for SLP services and we're looking for speech language pathologists here at CSES, um, what does that usually look like when we when we hire a speech language pathologist? They go out to the schools. What are SLPs doing when they work for CSES in particular?

SPEAKER_00 4:54

That's a good question because it's not a typical model that you would think of in the schools. Our speech pathologists, for the most part, are working on assessments. So they're going into the school districts, different ones, and they're doing testing, which is assessment. Um, this can be initial evaluation for a child, a student, that um there are concerns that they might have a language disorder, speech and language disorder, or it could be a three-year re-evaluation. And so we're going in to help out the school district and find out more about a student and give them information that they can use to determine if the child is eligible for speech and language services.

Dean 5:32

Okay.

SPEAKER_00 5:33

Also, a lot of our evaluations are bilingual. So we have a number of bilingual therapists, such as in Spanish, they speak Polish, Gujarati, Arabic, all kinds of languages. And so aside from doing that assessment piece, we have covered minutes. So there are times that districts need extra help when their own district personnel can't be there because of maternity leave or they've moved. We've covered minutes virtually, and we've also covered minutes in person. But for the most part, our speech pathologists are doing testing within our practice. Um, and our students, there's a very wide range because we're doing early childhood assessments. The students can range from age two and a half years old all the way up through 22 years old if they're in a transition program.

Dean 6:19

Oh, that's great. So we are able to cover a wide range of demographics, of ages, of all that good stuff for our districts and families too. And we'll definitely come back to that topic that you had mentioned about um different students speaking different languages, because I imagine that is a large sort of topic to consider when you're thinking about assigning an SLP to a student or to a family, even to help them with services. But before we get to that, um, I do have one question. I'm sure that any district leaders or any partners partnering with us would be interested in finding out. But how do we go about contracting our SLPs for the company? And how is that different from like a typical staffing model that you might see?

SPEAKER_00 7:10

So typical staffing models are that they might send an SLP, that's a speech pathologist. They might send them daily or several days a week to cover a caseload. And the staffing company does not oversee anything related to the therapy, the assessment, supervision, other than doing the billing. So they're kind of the go-between for the district to just get their minutes covered and be in compliance.

Dean 7:33

Okay.

SPEAKER_00 7:34

Um, and so we're very different because our SLPs are supported through the entire process. So they come into the schools, they go and do testing. And so this means that the district SLP might be on site and might even be able to collaborate with our bilingual SLP. Okay. Um, and sometimes we're going in because there's no SLP and we cover that assessment piece completely. Gotcha. Essentially, how we're different is that we support our own staff throughout the whole process, as well as being in communication with the district, which is very atypical. So we know a lot of the superintendents and district heads, we know who they are. We've met with them in person, we've had meetings with them. And so there's much more of a real life relationship. It's not as much of a business interaction. And that way, everyone, there's a mutual trust. Um, the therapists get the kind of support that they need as well as the district.

Dean 8:32

And it seems like that is kind of even from speaking with um previous guests on on the show, um, it seems like that communication piece is a really big part of what makes CSES, what makes us us, is that we really um go in there with that sort of communicative attitude and really get to know the people that we're working with and as instead of uh a more mechanical relationship of we provide the service, you provide the billing, sort of thing.

SPEAKER_00 9:06

Right. And I think that that is what is really different about us too, is that we're this essentially a hybrid model. We're not private practice and we're not a small private clinic, but we're not one of these huge staffing companies that has a bunch of anonymous people and is a lot of people disconnected where one of your supervisors is in New York and you just send somebody your building in California and you're off on your own in your own school world. Right. And we are very connected. We have like a home base in Northbrook, but we're always connected, whether by phone, email, um, text, you know, everybody knows each other and we know that we can rely on each other. So because each assessment that we complete is supervised by an SLP or a psychology supervisor, it's not just that it has more, we have more quality control, but then therapists have another specialist with whom they can collaborate and ask opinions. So in this regard, they have this support system that decision making isn't just on one person. So in this regard, our therapists have support in decision making regarding which tests to administer, the analysis, interpretation. And as therapists, they can continue to grow and evolve as professionals. And then we can also give the best quality product to our clients who are the school districts.

Dean 10:28

Absolutely. We we do seem to go the extra mile when it comes to providing services, being communicative with the districts.

SPEAKER_00 10:37

So, fun fact about how our business got started many years ago before I was a professional. My father, Paul Credo, is a retired clinical psychologist. And in the early 90s, one of the very large western suburban school districts of Chicago was becoming very out of compliance. They did not have enough psychologist coverage. Okay. And through networking and whatnot, they knew that my father had a private practice. And they contacted him and said, Hey, in the next month, can you cover a hundred evaluations?

Dean 11:14

Jeez.

SPEAKER_00 11:15

And I mean, that's if you've never done it before and you don't have the staff, that's asking quite a lot. You're not going to be able to do it all on your own. And my father said, Yes, we can do that. And they did it.

Dean 11:28

Nice.

SPEAKER_00 11:28

And that is how this model started. And so for the most part, we try never to say no. We always want to help a school district fill a need. That's kind of what we pride ourselves on is that a district can call us with the most unheard of obscure dialectal language. And we try to cover it. I mean, granted, we don't always have every dialect from every corner of the earth, but we really try our best to fill in those gaps because um we pride ourselves on that and that we can be very flexible.

Dean 11:59

Based on what you're saying, it sounds like CSES can really provide any sort of like any sort of provide for any sort of need that a student might have or a district might have. So kind of going off of that idea, what are some right from the start, what are some signs that a student might need services that a district employee or a classroom teacher might see to begin this whole process of services for the kiddos?

SPEAKER_00 12:30

Sure. So oftentimes the school team will notice that a student isn't following directions or isn't following classroom routines. Um, they don't volunteer, raise their hand, maybe they're quiet if there's something going on expressively. Uh, the student might might appear confused. Um, sometimes this is even demonstrated by behavior, like acting out. So a misbehaving, quote unquote, child doesn't mean that they're naughty or bad. There's a reason. Why is this happening? So sussing out, is this because of some something social emotional going on, or is there a communication issue? Because there are children, especially those little, those little, little guys in pre-K that might not have a lot of language, but they know what they want and they're getting frustrated. And so you might see behavior going on, and that can indicate a communication delay.

Dean 13:29

Yeah. So in even going, touching back on what you had mentioned earlier about just language differences, I can't, I can't imagine what it would be like for a kiddo who didn't even have the language skills in whichever uh whichever country you happen to be in here. It's the US, of course, but um a kiddo who comes from a different country, who does not have the English skills, um, does that happen where sometimes a a student might be misdiagnosed or they might uh there might be an issue just based on language barriers?

SPEAKER_00 14:07

Yeah, definitely. There are some cases where um a student comes from another country or they're being raised in their house, um, their home language is not English, and and that's okay. But what can happen is that that can get a little mixed up when their language is developing. And at times it might look like they have a language disorder or they're delayed in language, but it's really because they're learning two languages at the same time, or they're catching up with their English language learning because maybe at home they're only speaking their home language and then they're thrown into the school system at four or five years old and are learning a completely new language. So when there are concerns from the school team, it's up to the bilingual speech pathologist to determine is this a true language disorder? Are they having difficulty communicating, understanding language, following directions, speaking in their home language as well as English or the, you know, the language of the country that they're in?

Dean 15:10

Right.

SPEAKER_00 15:10

Or is this a language difference where at home and communicating with the community that they speak that language in, or you might see something called a language difference, and that would be where a child is developing at a typical rate, but it appears that they might have a communication disorder because they're English language learning, they're speaking two languages at the same time. And so sometimes they need a little extra time to develop that second language, it's the second language acquisition. Right. And there are no concerns in their home language. And so it's up to the speech pathologist to determine because there sometimes is a lot of overlap in gray areas because there might be gaps because of learning two languages at the same time, or maybe their household uses two languages. And so it might look like their vocabulary is delayed, but really they know some words, let's say in Spanish for home items and some words in English. And so when you ask them only in English, it's going to look like they're delayed. Right. But they're not.

Dean 16:14

So has this from what you're aware of, has this, do you know if this ever causes problems with maybe kiddos who are ELL who maybe are just fine, um, who haven't experienced any delays or anything like that, but are just learning a different language, but uh are then categorized as a learning delay or something like that.

SPEAKER_00 16:38

Well, and so the school cannot determine if they're delayed or have a language disorder unless that formal testing takes place. And that's why it's so important. If there is a question mark about is this a language difference, are they just learning the English language or is this a disorder? That's where the SLPs come in and it's very handy information.

Dean 16:58

That's great. So it so the SLP then really is like the stopgap between the this the district and this kiddo being uh diagnosed for lack of a better term. So then how do our SLPs approach these situations when um in ways that are both accurate to what the student needs and then also to be culturally appropriate? Um, for example, if a family is a little bit hesitant about getting services from a school or from an outside clinic or something like that.

SPEAKER_00 17:36

You know, in order to do testing, the families have to consent. So they have to be buying into wanting to know more information about their child and agreeing to it. So I think it's important that the process is explained. There are some communities in which they are a little more fearful about obtaining special education services because they think there might be some kind of stigma. Um, I actually used to work in California in a district in Glendale, California, and there's a very large Armenian population there. And in the early to mid-2000s, um, it was at the time, a lot of the community was very, very worried about special education because they thought that that would follow their child on their record through college.

Dean 18:26

Gotcha.

SPEAKER_00 18:27

Um, and for some some reason or another, that rumor had spread. And so, in certain situations where I had a family that had heard that, we I would talk with them and the school team would talk with them and say that this is to help their child. This will not stay on some kind of permanent record. It's not looked at like it's a fault. Um, but there are some cultural differences. And ultimately at the end of the day, it's the parents' decision um if they want to seek out speech and language services. Um, I would say that most families, if their child is having frustration and communication challenges, most families do want to know what's going on. Right. Um, and I think when it's explained to them, then they understand and they understand the process and they feel comfortable with it. And so I think transparency is the biggest thing. If we're transparent with the families, then they're not going to be worried about what's going on.

Dean 19:21

Absolutely. And I'm and I'm sure that the families really appreciate the time that our SLPs put into making sure that they feel comfortable, making sure that they understand all of the processes, um, which it would be huge for any family, but especially I imagine families who um whose native language isn't English.

SPEAKER_00 19:41

Right. Um and and in the old days, um, schools used to tell families, you know, stop speaking that language. They got to learn English. And I'm talking about like old old days, you know, like when my father was a kid, as soon as he went to kindergarten, like you better be speaking English. Like, don't speak your native language or your home language anymore, or speak it minimally, speak English to your child so that they learn. And I understand the idea behind it, you know, and and the way they looked at it back then. But now we understand that some cases are different and it's not always the case, but for the majority of the time, having more than one language is actually a wonderful thing. Yeah, not only to maintain culture, but just for all uh cognitive and communication development. So we still encourage families to speak their home language with their child and not give that up because that's part of who they are, that's part of their identity. And in the long run, you know, once their child is catching up with their language skills, having two languages can be a benefit for them.

Dean 20:44

So the process of getting these kiddos all of the services that they need can't just be a one-person job, I imagine. So it's it's gotta be more than just the SLP getting all these services provided and such. So I imagine the SLP from CSES, when they're meeting with a kiddo at a school district or some such, uh, they'll be working with a variety of other team members, either through CSES or with the school district, for example, um OTs, school psychologists, um, uh social workers, things like that. So how do SLPs collaborate with these other team members, either through the CSES model or just in general?

SPEAKER_00 21:29

Yeah, it's a good question. Um, every assessment is like putting a puzzle together about the child, about the student. And so you want to get pieces from their past reports, if they were in early intervention, if they had any kind of diagnoses, medical diagnoses, um, parent interview, as well as what is the teacher's input? The teacher is the one that is with them in school most of the day. What are they seeing? So the teacher's input is so valuable. And then if the student is also having a cognitive or academic assessment, that would be the psychoeducational assessment, it's really important to also gather information from that person that does the testing, whether it's a district employee or one of our other colleagues at CSES. It's important because let's say they have difficulty with memory. Well, there's a subtest on one of our global language tests that deals with recalling sentences. And a lot of it is connected to memory. So if there are challenges with memory that the psychologist has commented on, it would, it would be important for the speech pathologist to know it too. So it really benefits not only the therapists and having a more full report, but the whole team and the parents, it benefits everybody for there to be as much collaboration as possible and as much information about past diagnoses and whatever else is going on at the school for our therapists to know because it all influences what could be going on and what their recommendation might be. Gotcha.

Dean 23:03

And I'm sure that's really helpful for the other, for the other service providers and especially for the parents that they have all the information clear cut right in front of them from all these different service providers. You had mentioned challenges. Uh so let's talk a little bit about that. Uh, what are some of the challenges that you would say um SLPs are facing right now, just in the school setting?

SPEAKER_00 23:27

Sure. Yeah. I there are definitely a lot of challenges overall in the schools with staffing. Right. So SLPs are often now, because there are less per district than there used to be, or there, or rather, you could also say there are growing needs and caseloads are bigger. SLPs are now taking on too much. I see. Same with school psychs and other therapists. So a caseload, it should be capped. There are guidelines for how large a caseload can be, but sometimes what ends up happening is the caseload is bigger than it really should be because there's nothing you can do. They don't have the staff and they need to service the student. And so what ends up happening is um the speech therapist will be taking a lot of work home with them. So doing reports and planning, um, IEP stuff all at home, which that that really can lead to a lot of burnout.

Dean 24:26

Yeah.

SPEAKER_00 24:27

Um, and then it also results in making larger groups. So when a speech pathologist sees a group of uh, usually groups are two to three students, sometimes there's individual sessions, but there have been times where an SLP will have to create a group that's four or five kids in order to be able to service everyone. And so, are you getting as much quality um therapy done? Not really.

Dean 24:52

Yeah.

SPEAKER_00 24:52

Um, and so where we come in and we try to help is that we can help alleviate that load. So we take on that assessment piece so that the school-based SLP can do the therapy and provide the quality minutes and not burn out and then completely quit and then they have no SLP.

Dean 25:10

Right, right.

SPEAKER_00 25:11

Um so it is this balance. So, like we've said to all kinds of schools before like, we are not here to completely replace your staff. We're here to support your staff.

Dean 25:20

And that's good to know because I'm sure when you hear staffing agency, uh, maybe some schools immediately get a cringy feeling, like, oh no, that somebody's coming to replace me.

SPEAKER_00 25:31

Monster is coming in and we're like, no, we're just like you, just kind of, you know, in another we don't like I'm into school eight to four with you, but we're in our own little bubbles of trying to get the same kind of work done.

Dean 25:45

Absolutely.

SPEAKER_00 25:46

Another way that we collaborate here is that we have a mobile ECAT team. So an ECAT is an early childhood assessment team. And they have those teams all around the country. They can be within the school district, but we have one that we contract into different schools. And essentially what it is is when children are in preschool and a delay is suspected, um, a team will collaborate and come in and look at the child as a whole. Like we talked about those puzzle pieces and fitting them together. But instead of having three or four different assessments, the whole team is with the child at one point. So that would be a psychologist, a speech pathologist, an occupational therapist, and sometimes a social worker. The psychologist can sometimes cover what the social worker does too, because some of that bleeds into one thing and another with social emotional. So it's been really exciting because for almost a decade, we've added this other part of our branch of our practice on is that we go into the schools, we do these ECAT assessments, and it's really fun and it's a great way to collaborate. You're working with other therapists and you see how, for example, when I was a speech pathologist on the team, um, I used to be the one sitting on the floor with the kids. Uh, it was a lot of fun because you meet all different kinds of fun, little, rascally little kids. They can be around age two years, nine months, all the way up through six years old. And it can be they're a lot of fun to play with and it's all play-based. Um, but what's really cool also is that you are looking at the same child at the same time, but you're with other therapists who have a different lens on. So when I see a kid on the floor that's um struggling to connect um verbally, and they're lying on the floor, I might think, well, that's because they're frustrated about their communication. And the OT might say, Well, you know, the child also has a very weak core and really just can't sit for that long and maybe needs some time to move around.

Dean 27:57

Right.

SPEAKER_00 27:58

And so you're you're filling, it helps fill in all those gaps of where I don't have training, um, master's level training in gross motor and fine motor. Right. And so that process has been so fun for me to get to understand those early childhood assessments. And so we've been doing them for a very long time, and districts really appreciate that and really need that. Um, those students they come in through child fine programs like community screenings, and then the district will go, oh, we need to test these students that have come in. Their parents bring them in because of parent concern. Um, and sometimes they're already in a district preschool, and the district will see, okay, they're not progressing at the level that we would think they need to be progressing. And so then they refer them for these types of assessments. And so it's been a wonderful way to collaborate with other therapists within our group, within CSES, as well as with school districts.

Dean 28:55

That's amazing. So, and like you said, it it sounds like it's the perfect way to have all of these experts at like in their prospective fields collaborate to really benefit a kiddo and their family. So, and you had said the district themselves can request this sort of ECAT evaluation for a kiddo.

SPEAKER_00 29:14

Yeah, district would put in a request for an evaluation like this, the same way that they would request an individual speech and language evaluation or a psychology evaluation. There's more coordinating on our end because we need to make sure that we have multiple people available on the same day. But that's our problem to worry about in schools.

Dean 29:34

And that's that's a good problem to have, right? Uh, I love that. So if we are thinking about district leaders that are going to be listening to this podcast, what is one major takeaway that you think they could take from this episode when it comes to SLP services provided by CSES?

SPEAKER_00 29:54

Okay, sure. Yeah. We know that in the schools there can be a revolving door of therapists because of the heavy caseload, a tough environment, burnout. So we are really here to support all of those needs, to keep your current employees happy, committed, and to keep you in compliance. We know the value of building relationships. And so we want your own therapists to be able to stay in their buildings, build relationships with the staff and the students. And then when we come in and help with our assessments, we would also like to we send often the same people and their familiar faces. Oh, great. And so we like to maintain relationships as well. So we're a friendly face that the staff recognizes, that students begin to recognize we're not strangers. I think another key point is that trust is so important and we want to build trust with our school districts. And so that means sending quality therapists, having quality reports and a quality product, getting everything to you on time and staying in compliance. We know that is so important and valuable. And so we always want to exceed everybody's expectations and go above and beyond.

Dean 31:11

Absolutely. And just to talk about one last time to bring in the language piece, uh, we have so many contractors here that speak a multitude of different languages that could potentially assist many different families who speak many different languages. So could you give us a glimpse of uh the languages that we speak here at CSES?

SPEAKER_00 31:36

Yeah, I can remember all of them, but I know we have I know we have English.

Dean 31:41

Well, that's good.

SPEAKER_00 31:42

I hope so. Um, we have Spanish, Arabic, Polish, Mandarin, French. We even have French Creole, Ukrainian, Hebrew, Farsi, Romanian, um, Mandarin, and Russian Serbian.

Dean 32:00

Excellent.

unknown 32:01

Yeah.

Dean 32:01

So and I imagine as we continue to grow and continue to meet new talented service providers, those uh the amount of languages that we'll know will only increase as the years go on.

SPEAKER_00 32:13

Oh, yeah, I would hope so.

Dean 32:15

Absolutely. So, Sivan, thank you so much for joining us today. If let's so let's just say a listener is uh they want to know more about C S E S or they want to know more about the speech language uh services that we provide. What's the best way that a listener could get in touch with you?

SPEAKER_00 32:32

Sure. You can always email me. My name is it's kind of a mouthful, but it's S isn't Sam, Schoendorf, S-C-H-O-N-D-O-R-F is in Frank at C S E Sgroup.com. And there's more on the website about that. You can connect to me through there, csesgroup.com online. And I'm always happy to have a conversation, have a coffee, have a podcast, you name it.

Dean 32:59

Perfect. Well, thank you so much for your time today. I really appreciate it. And for everybody listening, stay tuned for next time.