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Ever Wonder How A Speech Therapist Can Help You or Your Loved One
Ever Wonder How A Speech Therapist Can Help You or Your Loved One with Meera Raval Deters
Speech, language pathologists, and speech therapists actually mean the same thing. In the adult world, there are a lot of areas that we can help with. Sometimes, unfortunately, when people get older, if they have a brain injury or stroke or, something happens to their they have trouble swallowing
About Meera
Meera Raval Deters, M.A., CCC-SLP, BCTS, ACAS is the owner of Super Speech Solutions, a concierge private practice that provides online Speech Therapy to Texans. She received her Master's degree in Speech-Language Pathology from Our Lady of the Lake University in 2006. Meera has worked in a variety of settings including hospitals, skilled nursing facilities, inpatient/outpatient rehabilitation clinics, charter schools, and private practices over the past fourteen years.
Meera specializes in accent modification and child language disorders, with an emphasis on autism.
Certifications/ Awards:
- Completed Phase 1 out of 3 for BCS-CL (Board Certified Specialist in Child Language) through ASHA (the American Speech Language Hearing Association)
- Certified Brain Injury Specialist
- BCTS: Board Certified Telepractice Specialist through IBCCES (International Board of Credentialing and Continuing Education Standards)
- ACAS: Advanced Certified Autism Specialist through IBCCES (International Board of Credentialing and Continuing Education Standards)
- a basic DIR/Floortime provider
- 3 Awards for Continuing Education (ACE) through ASHA (the American Speech Language Hearing Association)
When she is not thinking about speech, Meera loves to spend time with her husband Jeff, cook, watch Hallmark movies, and go on walks with their dog, Daisy.
www.superspeechsolutions.com
www.ageucational.com
Full Transcript Below
Ever Wonder How A Speech Therapist Can Help You or Your Loved One
00:00:14
Roy
Hello and welcome to another episode of educational. I'm your host, Roy I'm Terry. We are the, podcasts that were chronically not only my journey through aging. Of course, Terry is timeless than hasn't aged in many years, but also, our parents are getting to that age where they need more help and guidance in different aspects of life. I think we've got some hard decisions, that are on our horizon. We just felt like, my background has been in aging for the last 20 years and we just felt like there were a lot of people out there that are looking for answers. Unfortunately, we usually wait till we're in an emergency or in a crisis to look for those. Hopefully we can give people some things to think about so we can, at least be a little more prepared. I mean, you can never be totally prepared for the things that happen, but if we have a little knowledge, it'll go a long way.
00:01:05
Roy
We also have professionals on, from time to time. Today is no different Terry I'm going to let you introduce mirror.
00:01:12
Terry
Meera Raval Deter's is the owner of Super Speech Solutions as concierge private practice that provides online speech therapy to Texans. She received her master's degree in speech language pathology from Our Lady of The Lake University. In 2006, she has worked in a variety of settings, including hospitals, skilled nursing facilities, inpatient and outpatient rehabilitation clinics, charter schools, and private practices over the past 14 years. Meera, thank you for coming on and being with us today.
00:01:48
Meera
Thank you so much for having me really happy to be here.
00:01:51
Roy
Yeah. And, it's, I guess that, I can speak for myself. I won't speak for Terry, but I don't even know that we know enough to even start with any intelligent questions for you. It's only late is that the, I put this, put a lot of this back on you, is that well, first off, kind of tell us how you got here, how did you end up in the speech world?
00:02:14
Meera
So my dad is actually a radiologist. He's a doctor by profession and I actually found out was what a speech therapist does because of that. My dad had been working at Hermann hospital in Houston, and I think this was right after I finished high school. I had no idea what I wanted to do. Some people know exactly what they want to do when they go to college, but I had no idea. My dad had the brilliant, of course now I think it's a brilliant idea. Although my dad always has a brilliant mind, but, he had the brilliant idea for me to come to the hospital with him and observe what three different kinds of therapists do. I observed physical therapy, occupational therapy and speech therapy. The second I saw what a speech therapist can do to help adults. In this case, we're in the hospital setting, I was really just taken with being able to help people with communication.
00:03:05
Meera
I still remember, to this day, and this was of course now more than even 14 years ago. Cause I hadn't even started college at the time. I actually saw it at the speech therapist was helping someone who was in an ICU unit. I think they had suffered wounds of some kind and they were actually having trouble with their voice. She was actually helping them communicate in terms of talking. And I just found it so fascinating. I remember asking questions and just thinking, man, this is what I want to do. I want to help people with us. Even though I observed occupational therapy and physical therapy, I'm just not really like I do work out and stuff, but I don't feel like I really have the physical strength to do those kinds of things. I do have a lot of respect for people who are in both those professions is like I said, I don't think I could have done that.
00:03:51
Meera
That's pretty much how my journey started and how I decided I wanted to become a speech therapist.
00:03:57
Roy
Okay. That's cool. I mean, I think that's awesome to be able to expose you to those and it's not my parents' fault. I'll give them credit. They've tried, but I got out of high school. Didn't know what I wanted to do, went to college didn't know and still there's days, I'm not sure what I want to do. So it's still, ever evolving.
00:04:16
Terry
Was very brilliant in that way. That's awesome.
00:04:19
Roy
Tell us what are some things and I know it's, there's a lot to it, but tell us some of the major things that speech therapy that you do for people, things you might can help them with or things that you do to help them.
00:04:35
Meera
Sure. I think a lot of people, honestly, very commonly, I feel like people come to me and they think I help with public speaking, which is not what I do at all, actually. I'm glad you asked that because I feel like a lot of people who have not really had too much exposure to the field really don't know what a speech therapists can do. Just to clarify speech, language pathologists and speech therapists actually mean the same thing. Number one, that's just important to know they mean the exact same thing. In terms of speech therapy, and I know today we're talking more about adults. I do work with both adults and kids, but for our purposes today and the adult world, there are a lot of areas that we can help with. Swallowing is one big area that we can help with. Sometimes, unfortunately, when people get older, if they have a brain injury or stroke or, something happens to their brain could be dementia, could be, they have a bleed in the brain, lots of different things unfortunately can happen.
00:05:32
Meera
They may have difficulty with swallowing. So that can look like someone choking. It could look like someone having that really wet gurgly, voice quality, where it just sounds like, oh my gosh, that doesn't sound right. Something went down the wrong way. Oftentimes we can be consulted to help with swallowing for voice is another whole area we can help with. Sometimes what happens, like I said, due to various injuries, someone can actually trouble with their vocal cords. It actually means that their vocal chords are not opening and closing as they should. It can give their voice a very different quality and a speech therapist can help by prescribing certain vocal cord exercises that can help. Oftentimes, they may have to go to an ENT or ear nose, throat doctor who actually scopes their vocal chords to see if they're opening and closing correctly because speech therapy actually can't even be cleared for speech therapists.
00:06:26
Meera
Can't be cleared to do therapy until, actually knowing the diagnosis of the problem in that case. Cognition and memory is a whole nother area too. If someone is having difficulty with short-term memory, whether it's due to Alzheimer's or dementia, or it could be due to a brain injury, that's definitely an, a big area that we can help with. There can be lots of different things that we can do to help, but I would say mainly a lot of caregiver training, does, is something that we do in that case. It might be recalling names of medications. It might be, recalling daily activities might be helping someone come up with a schedule for what they do during the day. Even with cognition or memory, like there are a lot of different things. I think that we all take for advantage. Our brain is responsible for so many different functions.
00:07:15
Meera
It could be related to problem solving. It could be relating to processing, it could be relating to social skills. I mean, it's a whole host of areas that we can help with even just under the area of cognition or thinking.
00:07:28
Roy
Interesting. Now, and I know that you work with children and on, and let's kind of just back out the, group that you may help due to trauma. This something that as we age that typically, you're, we're going to need to see a speech pathologist or is it that, only certain things like the dementia or other physical ailments will trigger it and I guess, does it con I guess kind of the question is, does it become more common as we age in general?
00:08:01
Meera
Well, I think it can, but I think I really depends on the health of the person. So, I mean, generally speaking, you're not going to see a speech therapist, unless there's a specific reason. Like there's a decline in communication, right? The communication is not happening as much or memory is not as good as it was before or swallowing is not as good as it was before or the way someone's voice sounds. Generally I would say that we're consulted, especially in the cases of Parkinson's dementia or Alzheimer's, brain injury or stroke really are the most common areas that we're oftentimes consulted upon.
00:08:39
Roy
Okay. There's definitely going to be, I guess there's definite game be a trigger mechanism there that sets off the need for you to come in and see people.
00:08:49
Meera
Right, exactly. Thought I, thing I want to mention, that's also a really interesting area in terms of, for the adults. One area that I specialize in and working with adults, now this is not related to injury, but just as an interesting side note to know what speech service can do with adults has something called accent modification. That's an elective, speech, elective, speech therapy service that people will actually seek me out for, to help with improving their speech, improving their pronunciation, to actually help them, go higher up in the workplace. That's a really fascinating whole separate area than what, all the other things we're talking about. And Roy enjoys that because.
00:09:29
Roy
I probably need to sign up for that one there.
00:09:35
Terry
No, I like his accent, but you could teach him not to be, I mean, just speak like, and it just, I was going to say normal tone. That's not what I mean, just like middle of the road, Midwestern ish, no accent.
00:09:52
Roy
Lonnie. I lived in Massachusetts for a while and I had somebody be like, wow, you don't sound like you're from around here. I'd be like, nah, I'm from New Jersey. And they're like, oh, okay. Like, it's really, do you think I sound like I'm from nature.
00:10:11
Meera
Yeah. That's an interesting thing about accents. Even wherever you go in the U S people can sound different, let alone all other countries in the world. Like I said, that's a specific service that people will come to me for because they feel like they're not being very well understood at work. For purposes of, that they feel like it's actually hindering their progress, how far they can go up in the workplace.
00:10:34
Roy
Yeah. It's unfortunate because I, I've made peace with this at my age by now, but people think that, you're from the south and you sound that way that you're probably not too intelligent or you're just kind of slow on the uptakes, but, it's just, learn to, go.
00:10:52
Terry
With it and use it to your advantage.
00:10:55
Roy
It's a thing I actually, I mean, and, it, I, I see where that could be very beneficial, especially, if you're younger and wanting to try to move up in a company. Very interesting. Another thing I don't want to dwell on that too long, but it's just funny you brought that up because the other thing was that as I stayed there longer, I think my accent kind of started going away, but they said that whenever I would pick up the phone and talk to somebody in Texas, they said that my accent would immediately go back to, the deeper Southern accent that I used to have. So.
00:11:33
Terry
Yeah, we used to do that with my cousins in west Texas, man, we used to make fun of them. Cause you couldn't understand a word that they said, and there were five or six words that were strung together to make one. We're just like, what are you talking about? So anyway, let's get back to the.
00:11:53
Meera
Roy. What you're saying about the stereotypes are unfortunate. Yeah. That to me is a really negative piece of it. I mean, I feel like everybody just needs to respect it. People of all different ethnicities races and from all different areas, geographically are going to speak different. Sometimes I feel like that's not something that happens, unfortunately.
00:12:12
Roy
Yeah, no, it doesn't. Well, let's go back to the aging. The Swallowing is an interesting piece that, I don't think a lot of people would know that you actually deal with that, but it just, I guess for a lot of different reasons, it can be hard to just swallow your own saliva. Also if we have a food or drink that people get where they just can't, swallow like normal, or they start aspirating, I guess, of some kind,
00:12:45
Meera
Right. Exactly what you're saying. What happens is there can be weakness of the muscles involved for swallowing. Like I said, due to different, incidents that could happen or injuries as such. Yes, oftentimes there can be a risk for aspiration. Aspiration being that things could potentially have the possibility of dumping into your lungs, which of course we want to completely avoid because aspiration pneumonia is a serious thing. We don't want that to happen to anyone. Oftentimes when a speech therapist is consulted, like I was mentioning before, if there's signs of, choking, certainly, and if they're drinking water or they're coughing quite a bit, like not someone who has a chronic cough outside of, eating or swung, but let's say subtle, like someone starts choking, they start coughing, or they just have that really wet, gurgly, vocal quality. Those are really the biggest signs that we see, or if they have like a spike in their temperature after eating or drinking, that can oftentimes indicate that there's a potential possibility of aspiration pneumonia.
00:13:49
Meera
Now, if we suspect that there's a possibility of aspiration, then we'd actually do a diagnostic test. A radiologist is actually called a modified barium swallow study. That's actually an extra eight X, three study that's done. Like, you do have to do it in consultation with a physician or an MD of some kind. You're actually looking at your client and you're having them drink, water. You're looking to see, you're actually looking at the x-ray as it's happening. You're looking on the screen to see, Hey, where is that water going? Oh, and then you do that with different consistencies. You might do that with like something that's harder to chew, like a cracker versus something that's pure, right. Like apple sauce. Basically all that to say, if you look at an instrumental evaluation like that, you can actually make a very specific, safe diagnosis terms of, and recommendation in terms of what that person is safe to be eating and drinking.
00:14:56
Roy
Yeah. Okay. Let's kind of staying on that path for a minute. Do you go in and let's just say, somebody has had a market marked change that they used to could eat and drink. No problem. Now they're kind of coffin hacking, choking more. So, we call you in, I guess you go to the ear, nose and throat doctor first, you get a diagnosis and then you come in and work with them. So do you are there? Right.
00:15:23
Meera
So, so the order would come from some kind of position. I'm sorry, before I was just saying ear nose and throat, that was specifically for vocal cord, but a doctor, their MD has to write the order for speech therapy. Correct.
00:15:34
Roy
Then, are there exercises or things that you can do to help make it better? Or do you have to think about adjusting the diet to where they're at or some combination of both of those?
00:15:50
Meera
Yeah, that's a great question. So it actually depends on the individual. Sometimes there are strategies that they can use that may help them, what swelling. Sometimes we might recommend something like a chin tuck, which is like I did right now, which is actually where you're bringing your chin all the way down before you swallow. Typically if we're recommending a strategy, we'll actually try that during the instrumental evaluation, the modified barium swallow study, to make sure that actually helps. And, sometimes we might recommend using a straws. Okay. Or it's not. Like I said, all of the recommendations we're making are based exactly on what we're seeing. It's all, based off of the information that we're getting from the diagnostic imaging.
00:16:32
Roy
Yeah. That's awesome. It's not really, just guesswork like, well, I've seen this before. Maybe we'll try this. It sounds like there's real time information to say, this is what's happening. Also to say, this is what we've tried, it's helped or not.
00:16:50
Meera
One of the biggest things we do is, again, staff training comes in, caregiver training. Lot of times we'll post swollen precautions, in a hospital room. Or if we're in a skilled nursing facility, we'll post them bedside. We'll talk to the nursing staff, the nursing aides, and we'll train everyone on the swamp cautions, for example, the person needs to be sitting upright at 90 degrees every time they're eating and drinking. That's okay. If they're on a feeding tube, et cetera, that's still the case. So there's some general precautions like that. You want to make sure the person is alert while they're eating and drinking. Again, that's another general precaution. Then, the specific diet recommendations and strategies, after that they are done tailored to the individual. Yeah.
00:17:35
Terry
Do you, I'm going to dike sorta digress but, do anything about Schatzki's rings? Like it's like, no, my mom has, what's called Schatzki's rings and they're just that, enclose upon her, swallow. I mean, it has something to do with her swallowing mechanism and it's not working properly at the same time to where, she gets things down in the same, the way that she swallows it. And, so I just was wondering if that, I mean, he's never, she's had it for like 20 years and she has to go in and get scoped and they have to expand her throat, ? So I just, I, sorry, I just was, I was wondering, well, he's no, that's okay.
00:18:25
Meera
No problem. I haven't heard about it, so, yeah.
00:18:28
Terry
Okay. What kind of caregiver, I mean, w what would, what kind of caregiver strategies, do you talk about or suggest, I mean, what could we, what can caregivers do to look to see if they may or may not need a speech therapist?
00:18:48
Meera
Yeah, I think that's important to know. I think if you see that someone's not communicating as well as they were before, that's definitely a time that we would want to be consulted. The caregiver, I want to reassure anyone who's listening, especially the caregiver, s a lot of what's going on. It's definitely good for them to go directly to the MD or to the doctor and say, Hey, something's not right here. Like, what can we do? Because the doctor is the one you want to keep the, keep really good in touch with, because like I said, they write all the orders, they write orders for, occupational and physical therapy as well as speech therapy. So, like I said, we can't do anything unless we have the order just to emphasize that. Beyond that, I would say, if you notice that they're having more trouble with their memory, maybe they're not able to remember daily life activities, or, their communication sounds different.
00:19:41
Meera
Like sometimes, your voice can sound slurred, right? So that can happen as a result of, potential, mini stroke or, schemic stroke or, a full on stroke. If you notice anything that's different with swallowing or with communication or with memory, I would say those are the biggest ones, to look at consulting a speech therapist, as well as, if there's a progressive, disorder or disease that we're talking about. Oftentimes, we do work with people, have Parkinson's and dementia. There are of course different phases to those specific diagnoses that I'm talking about, but oftentimes those are things we can help with. I know with Parkinson's, a lot of people will think, oh, well, physical therapist is involved. Well, sure. Certainly they are, because a lot of times they will need help with walking. More of these speech therapy side would be helping with the voice, and a lot of times I'm talking at like the volume that you and I wouldn't be talking about as a challenge.
00:20:47
Meera
There are some exercises that a speech therapist, can actually show, the individual patient or client. That's also where caregiver training would come in. If there exercises that we're recommending, as a home exercise program, then that is a person who could help, their loved one and complete them on a daily basis, if that's what we're recommending.
00:21:11
Roy
What about getting you involved sooner rather than later? And I realize we need to be cognitive of what's going on so we can go to the doctor to keep them involved, but, what's the benefit of recognizing the signs earlier sooner rather than later, getting to the doctor where you can get involved before, is there a point that there's just no return or it just takes you longer to get them back to a better place?
00:21:41
Meera
Well, I think that's important information. I think it kind of depends on the setting because what happens is, if I'm a speech therapist working in acute care in a hospital, I'm going to see that patient sooner than if I'm working in a rehab center, right. Or if I'm working in a skilled nursing facility or a nursing home. I would say me personally, having worked in different settings, in the hospital, if someone's in acute care, you're going to be seeing a speech therapist. You're going to be seeing them sooner. Just because, the nature of like, for example, working in a stroke unit, you're going to be consulted a lot sooner, because there's a lot more medical involvement at a hospital. If I'm a speech therapist at a rehab center, like when I worked at one in Houston, a while back, I did work with people, but it was after they had been through the hospital and they came to us and they were an inpatient or outpatient, but they were fairly medically stable at that point.
00:22:40
Meera
I think that really depends more on the setting. Also, similar to a hospital, if I'm a speech therapist working in a skilled nursing facility or nursing home, I'm going to be, again, consulted more, I'm going to be consulted sooner because they do have doctors that are making rounds on a regular basis. I probably am seeing someone who's going to have more medical involvement. They may not be as stable, but really then it depends. Cause there was, a skilled nursing facility I worked in that one side actually was a nursing home. The other side was a skilled nursing facility and I saw people who are on both ends. In the skilled nursing facility, I actually saw a lady for example, who was living by herself and she was fairly high functioning, but then I also saw someone on the other side, who had really serious Alzheimer's and, had a lot of trouble with swallowing.
00:23:32
Meera
Yeah. I think even within each setting, there can be variation. It just depends on where you are. Okay.
00:23:39
Roy
Okay. Yeah. That's something, just talking about the eating act. Cause I will say I am a fast eater and the bigger the bank, the better, just to move it. I think once we get to a certain age and then we're in our, as a caregiver, we're in a hurry to let's, we got to get this done so we can move on. I think maybe just taking that time to slow down smaller bites, give them time to really process it if they're having some troubles anyway, I'm sure it takes longer to chew. Just patience, I guess, is what I'm trying to say.
00:24:17
Meera
Patience is a virtue. I absolutely agree. You did bring up an important point to really, take time with eating and swelling is really important and take really small bites. If you try to cram your mouth and you're already having trouble with swallowing and unfortunately won't do anything good. That's another general swelling precaution we do recommend, like I said, having the person sit up right. Making sure they're alert and making sure they're just eating really small pieces of food. A lot of times we may also recommend, that they're alternating the liquid with the solid meaning. Every time they're eating a bite of food, they're, drinking water for coffee or tea or whatever it is after to kind of wash it down.
00:25:00
Roy
Yeah. What are, what are some success stories that you've seen? What's the, kind of one of your favorite episodes that you can remember where you feel like that you've just brought somebody back from a bad place to, a better place for them and their families?
00:25:18
Meera
Well, there's one individual that I've been working with and he suffered from a more minor brain injury. And, unfortunately because I left that position and after a while working with him, I didn't get to completely see, what he was doing after, but all that to say it was pretty great to actually have him work on math and we did get to go out in the community, he and I would go out one-to-one outings. I worked at a place called mentise in Houston, were responsible for community reintegration, meaning we actually took our clients out, who had a brain injury, a stroke out into the community. We would go shopping at the mall, we would go to target. He and I was great because he and I would go on individual outings. We had this like 16 passenger van, my God, it was so hard to drive.
00:26:08
Meera
That's a whole nother story telling you, but it was really fun because he and I would go on outings. I remember one time I took them to a popular area in Houston and I literally told him, I need you to do the following 10 things and meet me back at two 30. I gave him a certain amount of time. Well, he was actually, really good at, all the stuff I gave him. The thing I really enjoyed about working with this particular individual is barely highly motivated. He would come to me, even if I just had my door open and I was working on other stuff. He would come to me with homework. I'd given him earlier in the week and say, Hey, miss Mira, I'm done with this. Can you check with this? I'm ready for more. Were actually training him to go back to work.
00:26:49
Meera
I don't remember where he worked. We did have a vocational rehab therapist at momentous as well. She was also a of helping with that. It was cool because, he and I were actually working on a PowerPoint and he actually presented it to all of the staff. I mean, he was doing pretty well, like even when I left. Like I said, unfortunately I wasn't able to keep in touch to find out what he was doing, but I was pretty impressed with where he was. To give you an idea when he first started, I remember he wasn't even completely oriented. Like he couldn't even tell me, I mean, I think he knew his name, but like he, wasn't completely sure about the place and the time. So, I mean, the brain really has a remarkable ability to recover. How.
00:27:34
Terry
Long of a period did that take that you.
00:27:38
Meera
Were working a month? Couple of months.
00:27:41
Roy
Yeah. That's, that was the next thing I was going to ask too, is about typically, once you start seeing, and I know it's based on their severity, but what's the average interaction that you have with your clients?
00:27:55
Meera
I would say, for brain injuries, what I know from research and what I've heard it working with my coworkers from before is that most of the progress you see is within the first year and sometimes up to the first two years. Oftentimes, the individuals that I'm talking about I've worked with on a daily basis. The interesting thing about like I was saying, the job I was at before is all of us did group sessions and individual sessions. We're talking couple of hours, a day of intensive therapy. My man, it's no joke. I mean, we're signing up for like intensive, like I said, for purposes of what I'm talking about, the rehab program that I was in there signing up for, quite a few hours of therapy. These are people who could, I wouldn't say they could tolerate a hundred percent, but they would get to the point where they could basically.
00:28:43
Roy
Wow. Yeah. That's a lot, it's a lot more intensive. Yeah. The length of time is much more than what I expected. Interesting. Yeah. And it's got, you know, yeah, right. But.
00:28:56
Meera
You know, if someone's no, you're fine. Go ahead. Oh, oh, I'm just going to say if someone's at a hospital, still as a speech therapist, you're seeing them on a daily basis. I would say at a hospital though, therapy is not going to be as intense obviously, but typically still there's occupational therapy, speech therapy, as well as physical therapy, but you're not probably going to be doing as much therapy, still therapy is there. The intensity level of course can only be higher once you're out of the hospital because you're more medically stable.
00:29:30
Roy
Right. So, let's talk about the psychological, aspects of this for just a moment, because I can only imagine as, the, that you're helping not being able to communicate or not being able to eat very much, I guess, makes you feel kind of defeated and, are we ever going to get through this? And I'm sure there's, some desperation and directness with the actual client, but then also, with the, caregivers and families surrounding them with them being uncommunicative or hard to communicate or having these troubles. I imagine that, it can be kind of tense or, and maybe that's not the best word, but maybe I'll let you explain. Yeah. Frustrating for sure.
00:30:21
Meera
Well, I think it can be a large mixed emotions, especially depending on where the caregiver is in their journey. I think it's a very difficult process. It's, there is, I would say some grieving involved in the sense that even though that person is still physically alive, unfortunately after something happens to your brain, you're not exactly the same person. So, a lot of times I would hear stories from, husbands or wives where they would tell me, oh, they used to function at this level. They used to be in this high level job. And things are just really different. I mean, I can't imagine that is, I think empathy goes a long way. It really just understanding that, these are people who are used to their loved one functioning very differently. They're here because they have a problem and they're relying on you for help and support.
00:31:10
Meera
They want to know how they can help, but they're going to be days where they're frustrated, they want to hit their head against a wall. It's something they have to deal with day in, day out. It's not something that, there's not really an easy fix. I mean, time heals. All right. It takes a lot of time, takes a lot of patients. I think that's important to remember, I think it's really important to realize where they're at and, not to take things personally, I think can be hard because I think that's something all of us want to do, but I think sometimes, the caregiver may lash out, but it's because they're frustrated. Because they're going to do that with everyone, they have not singled you out individually. It's not you, it's the experience of what they're going through is that they're frustrated.
00:31:56
Terry
Yeah. And, and for caregivers, I mean, how anybody who's in a caregiving situation, how it's so hard not to do whatever task is at hand, let alone let somebody, I mean, that's what your whole business is based on helping people, but you have to know how much to help them. How much is too much because they need to do it themselves. Right.
00:32:23
Meera
Exactly. I think one of the challenges is that you want the person to become more independent and so you don't want the caregiver to be doing everything for them. There is a fine line and, let's be honest, sometimes there can be friction and frustration, but there's also, the positive side of that, where their relationship evolves over time and people understand each other better. People understand that, Hey, even though I want to do everything for my loved one, I'm not going to help them by doing that. I need to actually do less for them so that they feel better, they become more independent and they feel more confident.
00:33:02
Roy
Yeah. There's a lot of that masking that goes on, I guess, with couples, because just like us, I mean, I may at times be incommunicable, but Terry knows my thoughts and can finish it or go do something for me. Well, while I understand that dynamic, I think, as loved ones, caregivers, whatever, I think we have to kind of realize the longer we put this off, either the less chance they have of getting some back to normalcy or the longer road that we're going to put them on to do that, which was kind of leading into my next question about, so, on average, how far can you bring people back usually? I mean, is it like you get them pretty much back to normal with their speech and swallowing, or is it just usually some improvement from where they were, what does that, what does the end product usually look like?
00:33:58
Meera
I think it depends on the nature of their injury. Definitely for someone who has a more severe brain injury, it's hard to predict how much they're going to recover. Like I said, the first year is really crucial up to the first few years, but I would say generally speaking, their prognosis may not be as good just because there was a much larger injury or bleed in their brain. I think those conversations can be difficult because, you're looking at someone who ends up going home where home has to be much more structured. For example, they need to have a schedule what they're doing every day, like they did with us in rehab, versus someone who might be ready to go back to work like the individual I was talking about before he was getting there. I mean, he was probably pretty close. Like he may have gone back to work okay.
00:34:44
Meera
In a modified position. Probably not exactly what he's doing before. I think it just depends on, I think it depends on a lot of things. I think it depends on where the bleed is in your brain and the nature of how severe the bleed is. I think it also depends on, unfortunately, some of the things we're looking at are progressive, like Parkinson's and dementia. Unfortunately we know that those things change over time. There is some deterioration that happens with that, which again is really difficult to process. Because you're used to seeing someone one way and then, over time things get worse. I think it just depends on the individual. Okay.
00:35:25
Roy
Yeah. It's always good to, manage expectations sometimes as loved ones. We, we're always hopeful that things will be back to normal, but sometimes they want, and so we have to, good to understand that we accept just some norm. Yeah, yeah.
00:35:42
Meera
All right. Those are the really difficult conversations. Right, right. Oh, for sure.
00:35:47
Terry
Yeah. You had, some advice about, iPad apps. Maybe that might be helpful.
00:35:56
Meera
Oh yes. I'm glad you reminded me about that. I have a few actually, that would be helpful. One thing I wanted to mention that we haven't really talked about is, something called a phasia. Aphasia is a loss of language, when you have a brain injury or stroke. The reason I mentioned that is because, that's oftentimes when you have difficulty with communication and that can look different, it can be, the person can sound really fluent, but they're not making sense. Or it could be that, they're using limited words. I mean, there are a lot of different types. Basically I would say overall, the person has difficulty using a complete sentence. They might speak in phrases. They might not be able to use words at all. They might not be gesturing. One thing before we get to the iPad apps, I want to mention that's important for someone like that is having a communication board.
00:36:48
Meera
There are actually some really great ones you can get online. You can kind of even make one your own, but essentially the purpose of a communication board is having that person point to, things that are really important. Like they can point to yes or no, or they can point to how old. They can point to points for their basic wants and needs. Typically I would say in acute care, in a hospital, that's something, a speech therapist will bring on day one. If someone has had a, if someone's having that kind of trouble with their communication. That's a really important one because what happens is since communication is so vital, people are relying on, even the person who, is in the hospital to be able to communicate, but if they're not able to, it's really frustrating for that person and for the whole family and the caregiver.
00:37:36
Meera
That's just a really good thing in general to keep in mind. Like I said, there are a lot, you can get online or a speech service can bring you one. Really it can also be just, having pictures of family members available, close to the bedside and just having the person be able to point or, having the names written out. Basically you have a lot of visual aids in front of you that can be helpful. You're not relying on the person being able to use their words. You're relying more on, I would say nonverbal communication in that case now, is that,
00:38:05
Roy
That typically brought, is that typically brought on by some kind of a traumatic brain injury or stroke as well? Or is there other things that cause the effect?
00:38:16
Meera
Okay. Yeah. Correct. What happens is, yeah, if the side of your brain, the left side of your brain is responsible for language, so entering injury to that side of the brain typically will involve, loss of language or loss of communication that we're talking about in this case. One of the good series of act apps for aphasia or loss of language is Tactus T a C T U S. They have a whole host of apps that are really awesome. There's a series that I've actually used before, but it can help with lots of different things, naming pictures. One of the things I like about it is that it can be really interactive. If a patient or client is using it can give you the first letter for example of the word. It'll give you like hints for you to come up with what the actual word of the picture is, or the name of the picture.
00:39:08
Meera
Okay, cool. They're higher level ones where you're working on reading comprehension and stuff like that. They're also two other good apps that I want to mention as well. Grocery IQ is a really good one, honestly, whether someone has had a brain injury or stroke, if I was personally, so going into a grocery store, which I'm not because I don't miss doing it because of probate. This one is a really helpful way to keep track of a grocery list and you can even personalize it to the store that you go to. The coupons and everything is actually really cool. I would totally use it if I was still going to the grocery store. Okay. So that one's really handy. There's also one called dose test, which helps with, keeping track of medications, which I know it can be important, especially when people are on multiple medications, because they know they have to be taken at different times.
00:40:00
Meera
They look, the purpose for each one is different. They might look different to be able to keep track of that. I would say definitely, that's also an area that we can help with in terms of speech therapy. Oftentimes if someone, is that the level where they can cognitively, like from a brain standpoint, work on learning their medications. We have actually worked in conjunction with nursing staff and gone through all the different medications and written out a list, okay, you're on this medication for blood pressure, you're on this one for, whatever it is. Actually taking pictures of the medications and written down the dose of everything, so that you can help, that person be more responsible and know what they're getting. I remember we would actually have some people trained to the point where nursing staff would show up and that person would like open their checklist and say, okay, so I'm getting such and such right now.
00:40:53
Meera
Right? Like it was actually really cool. And what was.
00:40:55
Terry
That called again? It's dose pest.
00:40:59
Meera
Dose CAS, D O S E C a S D.
00:41:03
Roy
Okay. That brings up a good point too. We always talk about, having these conversations before this traumatic event, if possible, is that, it's, sometimes you can find the medications laying around, but there are times when you can't and this is why it's good to talk to loved ones, especially to get those lists of what are you taking, what's it for when he taken it was the doctor that prescribed it. So, because, just, let's just say in the event, I'm out of medicine, I threw the bottle away and waiting on something and something bad happens. Then, nobody knows that I was really taking that medicine. Anyway, I just feel like we can never have that conversation soon enough, get it documented, can save us all and save you and your loved one, a lot of heartache as well.
00:41:53
Meera
Absolutely. I think using a pillbox also is helpful too. Yeah. Yes. Like the daily ones where you're actually opening it. You can open it later and see, oh yeah, I already took that. Yeah. Oh yeah.
00:42:05
Roy
Yeah. We have to do that even just for our vitamins and supplements. Cause it's only easier because I'll take them in the morning and then about mid-morning I'm like, Ugh, did I even take that yet or not? So, yeah. Right.
00:42:16
Meera
So it's like a visual reminder. Right. It's helpful for anyone really know taking medications, you can look and see, Hey, I took it or I didn't. Yeah. Yeah.
00:42:25
Roy
When I don't take it, first thing, then a Terry sets it out on the counter top where I have to trip over it next time.
00:42:32
Terry
Yeah. You take it.
00:42:36
Roy
I'm sorry. I didn't mean to interrupt you. Do you have any more apps or is that okay?
00:42:40
Meera
No, I think those are the main ones I was thinking of. Yeah. Those are all the really good ones.
00:42:46
Roy
Yeah. Well, thanks so much for taking time out of your day. A couple of questions before we go. What is, an, what is an app or a habit? What is something that you use every day in your personal or professional life that you feel adds a lot of value?
00:43:01
Meera
Oh, I like that question. We actually meditate every morning that just helps me stay focused and stay grounded. I've been doing it for a while and now for some reason I don't do it in the morning. It really throws me off and I really don't like it. So I definitely try to do that. That just helps me. It just helps me focus really. Yeah.
00:43:23
Roy
Okay, great. Yeah. That's a good, we hear that more and more about this and that I've tried it. I just need to get in the habit of making myself do it. Cause I know, like yesterday were talking, I was a little scattered and I told Terry I'm like, I just need to maybe meditate for like five minutes to kind of, recenter and get my mind from being so scattered. So yeah. Thanks for, they.
00:43:45
Meera
Have a lot of apps. I don't actually use one myself. Well, I do use some inconsistently, but in general, if you search apps, there are a lot of cool ones that will run you through a guided meditation. One thing I want to say about meditation is that think a lot of people think you have to sit there and silence. I have a series of what I go through in my own head, but guided meditation is still meditating. I think meditation, people just think, you're sitting there like this exact, but it doesn't have to be that.
00:44:15
Terry
Whatever your catchphrases or you're a little,
00:44:19
Meera
Yeah. It can look all kinds of different ways that for some people, honestly, their meditation is walking out doors. So, I mean, I think you just kind of have to know what works for you. That's something I enjoy just going for in nature. Yeah. The plan is going to do, I don't do that every day, but that's something I try to do at least once a week.
00:44:39
Roy
That is such a good mechanism to clear my head. I think that's more of my meditation is just having that quiet time walking through the nature. Anyway. Yeah. It's it's good to clear our head. We need that for our creative energies and also, for me problem solving, if I'm bumping up against something, I'm having a little trouble solving, sometimes getting away from it, clearing my head. I come back with a whole different perspective on that as well. So that's good advice. Tell everybody, so who can you help? And I realize that we have to have doctor's orders, but basically who is your clientele? How can you help them? And then how could they reach out and get ahold of you?
00:45:22
Meera
Sure. The name of my company is Super Speech Solutions, LLC. That's actually the name of my Facebook business page. It's also the name of my LinkedIn page. My Instagram handle is also a Super Speech Solutions. So I tried to keep everything easy. My website also is the same, it's SuperSpeechSolutions.com. My email is [email protected]. In terms of helping people, they're actually a whole host of people I can help. Like I mentioned, I do work with children. I can help children, especially I specialize in helping children, build their language skills. I specifically specialize in working with children who are autistic, in terms of adults, more of the piece I can do with adults is caregiver training. Because right now I'm not accepting insurance. Because of that, I can only see people who are 65 and under, but if someone wants to do a caregiver training, it doesn't matter what age they are.
00:46:25
Meera
And I can help in that area. Like I, like we mentioned before, if there are challenges with, swallowing or challenges with memory, and things of that nature, definitely I can help with that. I just can't do the individual, one-on-one therapy. Like I said, because I'm not an insurance provider, people over a certain age then I, but then I can definitely refer them out in that case. Yeah. If someone has had a brain injury or stroke, as long as they're able to pay out of pocket, I would still be able to help them for one-on-one therapy. Like I said, if they're just under yeah.
00:46:59
Roy
It's important, I can talk to the child perspective for just a minute. Cause our son had, one of his adenoids grew, I don't know if it grew or swollen, but somehow it became very enlarged and block the drainage tube of his ear. This went on for some period of time. We finally found out that he had lost some hearing, temporarily, once it got cleaned out, it came back, but he, what it didn't really affect his, he's still able to verbalize, but he was like in second or third grade, first or second grade is very young. It kind of put him a little behind. We, saw out speech therapy, in order to get him caught back up on that learning scale. Definitely, all kinds of things can lead to, things that you wouldn't even think about can lead you down that path in a hurry.
00:47:54
Meera
Yeah. Actually commonly in children who have trouble with hearing and have trouble with pronouncing their sounds because they're not able to hear everything clearly. That's actually a really common reason that people would come see a speech therapist as a child. Yeah. Yeah.
00:48:09
Roy
All right. Well, thanks again for taking time out of your day. We certainly do appreciate it and that's gonna do it for another episode of educational. Of course, I'm Roy Terry, and you can find us at www.ageucational.com. We're also on all the major social media platforms, as well as all the major podcast platforms. A video of this interview will go up on YouTube when the episode does go live. Until next time, take care of yourself and take care of your family.
www.superspeechsolutions.com
www.ageucational.com
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By Roy Barker
5
22 ratings
Ever Wonder How A Speech Therapist Can Help You or Your Loved One with Meera Raval Deters
Speech, language pathologists, and speech therapists actually mean the same thing. In the adult world, there are a lot of areas that we can help with. Sometimes, unfortunately, when people get older, if they have a brain injury or stroke or, something happens to their they have trouble swallowing
About Meera
Meera Raval Deters, M.A., CCC-SLP, BCTS, ACAS is the owner of Super Speech Solutions, a concierge private practice that provides online Speech Therapy to Texans. She received her Master's degree in Speech-Language Pathology from Our Lady of the Lake University in 2006. Meera has worked in a variety of settings including hospitals, skilled nursing facilities, inpatient/outpatient rehabilitation clinics, charter schools, and private practices over the past fourteen years.
Meera specializes in accent modification and child language disorders, with an emphasis on autism.
Certifications/ Awards:
- Completed Phase 1 out of 3 for BCS-CL (Board Certified Specialist in Child Language) through ASHA (the American Speech Language Hearing Association)
- Certified Brain Injury Specialist
- BCTS: Board Certified Telepractice Specialist through IBCCES (International Board of Credentialing and Continuing Education Standards)
- ACAS: Advanced Certified Autism Specialist through IBCCES (International Board of Credentialing and Continuing Education Standards)
- a basic DIR/Floortime provider
- 3 Awards for Continuing Education (ACE) through ASHA (the American Speech Language Hearing Association)
When she is not thinking about speech, Meera loves to spend time with her husband Jeff, cook, watch Hallmark movies, and go on walks with their dog, Daisy.
www.superspeechsolutions.com
www.ageucational.com
Full Transcript Below
Ever Wonder How A Speech Therapist Can Help You or Your Loved One
00:00:14
Roy
Hello and welcome to another episode of educational. I'm your host, Roy I'm Terry. We are the, podcasts that were chronically not only my journey through aging. Of course, Terry is timeless than hasn't aged in many years, but also, our parents are getting to that age where they need more help and guidance in different aspects of life. I think we've got some hard decisions, that are on our horizon. We just felt like, my background has been in aging for the last 20 years and we just felt like there were a lot of people out there that are looking for answers. Unfortunately, we usually wait till we're in an emergency or in a crisis to look for those. Hopefully we can give people some things to think about so we can, at least be a little more prepared. I mean, you can never be totally prepared for the things that happen, but if we have a little knowledge, it'll go a long way.
00:01:05
Roy
We also have professionals on, from time to time. Today is no different Terry I'm going to let you introduce mirror.
00:01:12
Terry
Meera Raval Deter's is the owner of Super Speech Solutions as concierge private practice that provides online speech therapy to Texans. She received her master's degree in speech language pathology from Our Lady of The Lake University. In 2006, she has worked in a variety of settings, including hospitals, skilled nursing facilities, inpatient and outpatient rehabilitation clinics, charter schools, and private practices over the past 14 years. Meera, thank you for coming on and being with us today.
00:01:48
Meera
Thank you so much for having me really happy to be here.
00:01:51
Roy
Yeah. And, it's, I guess that, I can speak for myself. I won't speak for Terry, but I don't even know that we know enough to even start with any intelligent questions for you. It's only late is that the, I put this, put a lot of this back on you, is that well, first off, kind of tell us how you got here, how did you end up in the speech world?
00:02:14
Meera
So my dad is actually a radiologist. He's a doctor by profession and I actually found out was what a speech therapist does because of that. My dad had been working at Hermann hospital in Houston, and I think this was right after I finished high school. I had no idea what I wanted to do. Some people know exactly what they want to do when they go to college, but I had no idea. My dad had the brilliant, of course now I think it's a brilliant idea. Although my dad always has a brilliant mind, but, he had the brilliant idea for me to come to the hospital with him and observe what three different kinds of therapists do. I observed physical therapy, occupational therapy and speech therapy. The second I saw what a speech therapist can do to help adults. In this case, we're in the hospital setting, I was really just taken with being able to help people with communication.
00:03:05
Meera
I still remember, to this day, and this was of course now more than even 14 years ago. Cause I hadn't even started college at the time. I actually saw it at the speech therapist was helping someone who was in an ICU unit. I think they had suffered wounds of some kind and they were actually having trouble with their voice. She was actually helping them communicate in terms of talking. And I just found it so fascinating. I remember asking questions and just thinking, man, this is what I want to do. I want to help people with us. Even though I observed occupational therapy and physical therapy, I'm just not really like I do work out and stuff, but I don't feel like I really have the physical strength to do those kinds of things. I do have a lot of respect for people who are in both those professions is like I said, I don't think I could have done that.
00:03:51
Meera
That's pretty much how my journey started and how I decided I wanted to become a speech therapist.
00:03:57
Roy
Okay. That's cool. I mean, I think that's awesome to be able to expose you to those and it's not my parents' fault. I'll give them credit. They've tried, but I got out of high school. Didn't know what I wanted to do, went to college didn't know and still there's days, I'm not sure what I want to do. So it's still, ever evolving.
00:04:16
Terry
Was very brilliant in that way. That's awesome.
00:04:19
Roy
Tell us what are some things and I know it's, there's a lot to it, but tell us some of the major things that speech therapy that you do for people, things you might can help them with or things that you do to help them.
00:04:35
Meera
Sure. I think a lot of people, honestly, very commonly, I feel like people come to me and they think I help with public speaking, which is not what I do at all, actually. I'm glad you asked that because I feel like a lot of people who have not really had too much exposure to the field really don't know what a speech therapists can do. Just to clarify speech, language pathologists and speech therapists actually mean the same thing. Number one, that's just important to know they mean the exact same thing. In terms of speech therapy, and I know today we're talking more about adults. I do work with both adults and kids, but for our purposes today and the adult world, there are a lot of areas that we can help with. Swallowing is one big area that we can help with. Sometimes, unfortunately, when people get older, if they have a brain injury or stroke or, something happens to their brain could be dementia, could be, they have a bleed in the brain, lots of different things unfortunately can happen.
00:05:32
Meera
They may have difficulty with swallowing. So that can look like someone choking. It could look like someone having that really wet gurgly, voice quality, where it just sounds like, oh my gosh, that doesn't sound right. Something went down the wrong way. Oftentimes we can be consulted to help with swallowing for voice is another whole area we can help with. Sometimes what happens, like I said, due to various injuries, someone can actually trouble with their vocal cords. It actually means that their vocal chords are not opening and closing as they should. It can give their voice a very different quality and a speech therapist can help by prescribing certain vocal cord exercises that can help. Oftentimes, they may have to go to an ENT or ear nose, throat doctor who actually scopes their vocal chords to see if they're opening and closing correctly because speech therapy actually can't even be cleared for speech therapists.
00:06:26
Meera
Can't be cleared to do therapy until, actually knowing the diagnosis of the problem in that case. Cognition and memory is a whole nother area too. If someone is having difficulty with short-term memory, whether it's due to Alzheimer's or dementia, or it could be due to a brain injury, that's definitely an, a big area that we can help with. There can be lots of different things that we can do to help, but I would say mainly a lot of caregiver training, does, is something that we do in that case. It might be recalling names of medications. It might be, recalling daily activities might be helping someone come up with a schedule for what they do during the day. Even with cognition or memory, like there are a lot of different things. I think that we all take for advantage. Our brain is responsible for so many different functions.
00:07:15
Meera
It could be related to problem solving. It could be relating to processing, it could be relating to social skills. I mean, it's a whole host of areas that we can help with even just under the area of cognition or thinking.
00:07:28
Roy
Interesting. Now, and I know that you work with children and on, and let's kind of just back out the, group that you may help due to trauma. This something that as we age that typically, you're, we're going to need to see a speech pathologist or is it that, only certain things like the dementia or other physical ailments will trigger it and I guess, does it con I guess kind of the question is, does it become more common as we age in general?
00:08:01
Meera
Well, I think it can, but I think I really depends on the health of the person. So, I mean, generally speaking, you're not going to see a speech therapist, unless there's a specific reason. Like there's a decline in communication, right? The communication is not happening as much or memory is not as good as it was before or swallowing is not as good as it was before or the way someone's voice sounds. Generally I would say that we're consulted, especially in the cases of Parkinson's dementia or Alzheimer's, brain injury or stroke really are the most common areas that we're oftentimes consulted upon.
00:08:39
Roy
Okay. There's definitely going to be, I guess there's definite game be a trigger mechanism there that sets off the need for you to come in and see people.
00:08:49
Meera
Right, exactly. Thought I, thing I want to mention, that's also a really interesting area in terms of, for the adults. One area that I specialize in and working with adults, now this is not related to injury, but just as an interesting side note to know what speech service can do with adults has something called accent modification. That's an elective, speech, elective, speech therapy service that people will actually seek me out for, to help with improving their speech, improving their pronunciation, to actually help them, go higher up in the workplace. That's a really fascinating whole separate area than what, all the other things we're talking about. And Roy enjoys that because.
00:09:29
Roy
I probably need to sign up for that one there.
00:09:35
Terry
No, I like his accent, but you could teach him not to be, I mean, just speak like, and it just, I was going to say normal tone. That's not what I mean, just like middle of the road, Midwestern ish, no accent.
00:09:52
Roy
Lonnie. I lived in Massachusetts for a while and I had somebody be like, wow, you don't sound like you're from around here. I'd be like, nah, I'm from New Jersey. And they're like, oh, okay. Like, it's really, do you think I sound like I'm from nature.
00:10:11
Meera
Yeah. That's an interesting thing about accents. Even wherever you go in the U S people can sound different, let alone all other countries in the world. Like I said, that's a specific service that people will come to me for because they feel like they're not being very well understood at work. For purposes of, that they feel like it's actually hindering their progress, how far they can go up in the workplace.
00:10:34
Roy
Yeah. It's unfortunate because I, I've made peace with this at my age by now, but people think that, you're from the south and you sound that way that you're probably not too intelligent or you're just kind of slow on the uptakes, but, it's just, learn to, go.
00:10:52
Terry
With it and use it to your advantage.
00:10:55
Roy
It's a thing I actually, I mean, and, it, I, I see where that could be very beneficial, especially, if you're younger and wanting to try to move up in a company. Very interesting. Another thing I don't want to dwell on that too long, but it's just funny you brought that up because the other thing was that as I stayed there longer, I think my accent kind of started going away, but they said that whenever I would pick up the phone and talk to somebody in Texas, they said that my accent would immediately go back to, the deeper Southern accent that I used to have. So.
00:11:33
Terry
Yeah, we used to do that with my cousins in west Texas, man, we used to make fun of them. Cause you couldn't understand a word that they said, and there were five or six words that were strung together to make one. We're just like, what are you talking about? So anyway, let's get back to the.
00:11:53
Meera
Roy. What you're saying about the stereotypes are unfortunate. Yeah. That to me is a really negative piece of it. I mean, I feel like everybody just needs to respect it. People of all different ethnicities races and from all different areas, geographically are going to speak different. Sometimes I feel like that's not something that happens, unfortunately.
00:12:12
Roy
Yeah, no, it doesn't. Well, let's go back to the aging. The Swallowing is an interesting piece that, I don't think a lot of people would know that you actually deal with that, but it just, I guess for a lot of different reasons, it can be hard to just swallow your own saliva. Also if we have a food or drink that people get where they just can't, swallow like normal, or they start aspirating, I guess, of some kind,
00:12:45
Meera
Right. Exactly what you're saying. What happens is there can be weakness of the muscles involved for swallowing. Like I said, due to different, incidents that could happen or injuries as such. Yes, oftentimes there can be a risk for aspiration. Aspiration being that things could potentially have the possibility of dumping into your lungs, which of course we want to completely avoid because aspiration pneumonia is a serious thing. We don't want that to happen to anyone. Oftentimes when a speech therapist is consulted, like I was mentioning before, if there's signs of, choking, certainly, and if they're drinking water or they're coughing quite a bit, like not someone who has a chronic cough outside of, eating or swung, but let's say subtle, like someone starts choking, they start coughing, or they just have that really wet, gurgly, vocal quality. Those are really the biggest signs that we see, or if they have like a spike in their temperature after eating or drinking, that can oftentimes indicate that there's a potential possibility of aspiration pneumonia.
00:13:49
Meera
Now, if we suspect that there's a possibility of aspiration, then we'd actually do a diagnostic test. A radiologist is actually called a modified barium swallow study. That's actually an extra eight X, three study that's done. Like, you do have to do it in consultation with a physician or an MD of some kind. You're actually looking at your client and you're having them drink, water. You're looking to see, you're actually looking at the x-ray as it's happening. You're looking on the screen to see, Hey, where is that water going? Oh, and then you do that with different consistencies. You might do that with like something that's harder to chew, like a cracker versus something that's pure, right. Like apple sauce. Basically all that to say, if you look at an instrumental evaluation like that, you can actually make a very specific, safe diagnosis terms of, and recommendation in terms of what that person is safe to be eating and drinking.
00:14:56
Roy
Yeah. Okay. Let's kind of staying on that path for a minute. Do you go in and let's just say, somebody has had a market marked change that they used to could eat and drink. No problem. Now they're kind of coffin hacking, choking more. So, we call you in, I guess you go to the ear, nose and throat doctor first, you get a diagnosis and then you come in and work with them. So do you are there? Right.
00:15:23
Meera
So, so the order would come from some kind of position. I'm sorry, before I was just saying ear nose and throat, that was specifically for vocal cord, but a doctor, their MD has to write the order for speech therapy. Correct.
00:15:34
Roy
Then, are there exercises or things that you can do to help make it better? Or do you have to think about adjusting the diet to where they're at or some combination of both of those?
00:15:50
Meera
Yeah, that's a great question. So it actually depends on the individual. Sometimes there are strategies that they can use that may help them, what swelling. Sometimes we might recommend something like a chin tuck, which is like I did right now, which is actually where you're bringing your chin all the way down before you swallow. Typically if we're recommending a strategy, we'll actually try that during the instrumental evaluation, the modified barium swallow study, to make sure that actually helps. And, sometimes we might recommend using a straws. Okay. Or it's not. Like I said, all of the recommendations we're making are based exactly on what we're seeing. It's all, based off of the information that we're getting from the diagnostic imaging.
00:16:32
Roy
Yeah. That's awesome. It's not really, just guesswork like, well, I've seen this before. Maybe we'll try this. It sounds like there's real time information to say, this is what's happening. Also to say, this is what we've tried, it's helped or not.
00:16:50
Meera
One of the biggest things we do is, again, staff training comes in, caregiver training. Lot of times we'll post swollen precautions, in a hospital room. Or if we're in a skilled nursing facility, we'll post them bedside. We'll talk to the nursing staff, the nursing aides, and we'll train everyone on the swamp cautions, for example, the person needs to be sitting upright at 90 degrees every time they're eating and drinking. That's okay. If they're on a feeding tube, et cetera, that's still the case. So there's some general precautions like that. You want to make sure the person is alert while they're eating and drinking. Again, that's another general precaution. Then, the specific diet recommendations and strategies, after that they are done tailored to the individual. Yeah.
00:17:35
Terry
Do you, I'm going to dike sorta digress but, do anything about Schatzki's rings? Like it's like, no, my mom has, what's called Schatzki's rings and they're just that, enclose upon her, swallow. I mean, it has something to do with her swallowing mechanism and it's not working properly at the same time to where, she gets things down in the same, the way that she swallows it. And, so I just was wondering if that, I mean, he's never, she's had it for like 20 years and she has to go in and get scoped and they have to expand her throat, ? So I just, I, sorry, I just was, I was wondering, well, he's no, that's okay.
00:18:25
Meera
No problem. I haven't heard about it, so, yeah.
00:18:28
Terry
Okay. What kind of caregiver, I mean, w what would, what kind of caregiver strategies, do you talk about or suggest, I mean, what could we, what can caregivers do to look to see if they may or may not need a speech therapist?
00:18:48
Meera
Yeah, I think that's important to know. I think if you see that someone's not communicating as well as they were before, that's definitely a time that we would want to be consulted. The caregiver, I want to reassure anyone who's listening, especially the caregiver, s a lot of what's going on. It's definitely good for them to go directly to the MD or to the doctor and say, Hey, something's not right here. Like, what can we do? Because the doctor is the one you want to keep the, keep really good in touch with, because like I said, they write all the orders, they write orders for, occupational and physical therapy as well as speech therapy. So, like I said, we can't do anything unless we have the order just to emphasize that. Beyond that, I would say, if you notice that they're having more trouble with their memory, maybe they're not able to remember daily life activities, or, their communication sounds different.
00:19:41
Meera
Like sometimes, your voice can sound slurred, right? So that can happen as a result of, potential, mini stroke or, schemic stroke or, a full on stroke. If you notice anything that's different with swallowing or with communication or with memory, I would say those are the biggest ones, to look at consulting a speech therapist, as well as, if there's a progressive, disorder or disease that we're talking about. Oftentimes, we do work with people, have Parkinson's and dementia. There are of course different phases to those specific diagnoses that I'm talking about, but oftentimes those are things we can help with. I know with Parkinson's, a lot of people will think, oh, well, physical therapist is involved. Well, sure. Certainly they are, because a lot of times they will need help with walking. More of these speech therapy side would be helping with the voice, and a lot of times I'm talking at like the volume that you and I wouldn't be talking about as a challenge.
00:20:47
Meera
There are some exercises that a speech therapist, can actually show, the individual patient or client. That's also where caregiver training would come in. If there exercises that we're recommending, as a home exercise program, then that is a person who could help, their loved one and complete them on a daily basis, if that's what we're recommending.
00:21:11
Roy
What about getting you involved sooner rather than later? And I realize we need to be cognitive of what's going on so we can go to the doctor to keep them involved, but, what's the benefit of recognizing the signs earlier sooner rather than later, getting to the doctor where you can get involved before, is there a point that there's just no return or it just takes you longer to get them back to a better place?
00:21:41
Meera
Well, I think that's important information. I think it kind of depends on the setting because what happens is, if I'm a speech therapist working in acute care in a hospital, I'm going to see that patient sooner than if I'm working in a rehab center, right. Or if I'm working in a skilled nursing facility or a nursing home. I would say me personally, having worked in different settings, in the hospital, if someone's in acute care, you're going to be seeing a speech therapist. You're going to be seeing them sooner. Just because, the nature of like, for example, working in a stroke unit, you're going to be consulted a lot sooner, because there's a lot more medical involvement at a hospital. If I'm a speech therapist at a rehab center, like when I worked at one in Houston, a while back, I did work with people, but it was after they had been through the hospital and they came to us and they were an inpatient or outpatient, but they were fairly medically stable at that point.
00:22:40
Meera
I think that really depends more on the setting. Also, similar to a hospital, if I'm a speech therapist working in a skilled nursing facility or nursing home, I'm going to be, again, consulted more, I'm going to be consulted sooner because they do have doctors that are making rounds on a regular basis. I probably am seeing someone who's going to have more medical involvement. They may not be as stable, but really then it depends. Cause there was, a skilled nursing facility I worked in that one side actually was a nursing home. The other side was a skilled nursing facility and I saw people who are on both ends. In the skilled nursing facility, I actually saw a lady for example, who was living by herself and she was fairly high functioning, but then I also saw someone on the other side, who had really serious Alzheimer's and, had a lot of trouble with swallowing.
00:23:32
Meera
Yeah. I think even within each setting, there can be variation. It just depends on where you are. Okay.
00:23:39
Roy
Okay. Yeah. That's something, just talking about the eating act. Cause I will say I am a fast eater and the bigger the bank, the better, just to move it. I think once we get to a certain age and then we're in our, as a caregiver, we're in a hurry to let's, we got to get this done so we can move on. I think maybe just taking that time to slow down smaller bites, give them time to really process it if they're having some troubles anyway, I'm sure it takes longer to chew. Just patience, I guess, is what I'm trying to say.
00:24:17
Meera
Patience is a virtue. I absolutely agree. You did bring up an important point to really, take time with eating and swelling is really important and take really small bites. If you try to cram your mouth and you're already having trouble with swallowing and unfortunately won't do anything good. That's another general swelling precaution we do recommend, like I said, having the person sit up right. Making sure they're alert and making sure they're just eating really small pieces of food. A lot of times we may also recommend, that they're alternating the liquid with the solid meaning. Every time they're eating a bite of food, they're, drinking water for coffee or tea or whatever it is after to kind of wash it down.
00:25:00
Roy
Yeah. What are, what are some success stories that you've seen? What's the, kind of one of your favorite episodes that you can remember where you feel like that you've just brought somebody back from a bad place to, a better place for them and their families?
00:25:18
Meera
Well, there's one individual that I've been working with and he suffered from a more minor brain injury. And, unfortunately because I left that position and after a while working with him, I didn't get to completely see, what he was doing after, but all that to say it was pretty great to actually have him work on math and we did get to go out in the community, he and I would go out one-to-one outings. I worked at a place called mentise in Houston, were responsible for community reintegration, meaning we actually took our clients out, who had a brain injury, a stroke out into the community. We would go shopping at the mall, we would go to target. He and I was great because he and I would go on individual outings. We had this like 16 passenger van, my God, it was so hard to drive.
00:26:08
Meera
That's a whole nother story telling you, but it was really fun because he and I would go on outings. I remember one time I took them to a popular area in Houston and I literally told him, I need you to do the following 10 things and meet me back at two 30. I gave him a certain amount of time. Well, he was actually, really good at, all the stuff I gave him. The thing I really enjoyed about working with this particular individual is barely highly motivated. He would come to me, even if I just had my door open and I was working on other stuff. He would come to me with homework. I'd given him earlier in the week and say, Hey, miss Mira, I'm done with this. Can you check with this? I'm ready for more. Were actually training him to go back to work.
00:26:49
Meera
I don't remember where he worked. We did have a vocational rehab therapist at momentous as well. She was also a of helping with that. It was cool because, he and I were actually working on a PowerPoint and he actually presented it to all of the staff. I mean, he was doing pretty well, like even when I left. Like I said, unfortunately I wasn't able to keep in touch to find out what he was doing, but I was pretty impressed with where he was. To give you an idea when he first started, I remember he wasn't even completely oriented. Like he couldn't even tell me, I mean, I think he knew his name, but like he, wasn't completely sure about the place and the time. So, I mean, the brain really has a remarkable ability to recover. How.
00:27:34
Terry
Long of a period did that take that you.
00:27:38
Meera
Were working a month? Couple of months.
00:27:41
Roy
Yeah. That's, that was the next thing I was going to ask too, is about typically, once you start seeing, and I know it's based on their severity, but what's the average interaction that you have with your clients?
00:27:55
Meera
I would say, for brain injuries, what I know from research and what I've heard it working with my coworkers from before is that most of the progress you see is within the first year and sometimes up to the first two years. Oftentimes, the individuals that I'm talking about I've worked with on a daily basis. The interesting thing about like I was saying, the job I was at before is all of us did group sessions and individual sessions. We're talking couple of hours, a day of intensive therapy. My man, it's no joke. I mean, we're signing up for like intensive, like I said, for purposes of what I'm talking about, the rehab program that I was in there signing up for, quite a few hours of therapy. These are people who could, I wouldn't say they could tolerate a hundred percent, but they would get to the point where they could basically.
00:28:43
Roy
Wow. Yeah. That's a lot, it's a lot more intensive. Yeah. The length of time is much more than what I expected. Interesting. Yeah. And it's got, you know, yeah, right. But.
00:28:56
Meera
You know, if someone's no, you're fine. Go ahead. Oh, oh, I'm just going to say if someone's at a hospital, still as a speech therapist, you're seeing them on a daily basis. I would say at a hospital though, therapy is not going to be as intense obviously, but typically still there's occupational therapy, speech therapy, as well as physical therapy, but you're not probably going to be doing as much therapy, still therapy is there. The intensity level of course can only be higher once you're out of the hospital because you're more medically stable.
00:29:30
Roy
Right. So, let's talk about the psychological, aspects of this for just a moment, because I can only imagine as, the, that you're helping not being able to communicate or not being able to eat very much, I guess, makes you feel kind of defeated and, are we ever going to get through this? And I'm sure there's, some desperation and directness with the actual client, but then also, with the, caregivers and families surrounding them with them being uncommunicative or hard to communicate or having these troubles. I imagine that, it can be kind of tense or, and maybe that's not the best word, but maybe I'll let you explain. Yeah. Frustrating for sure.
00:30:21
Meera
Well, I think it can be a large mixed emotions, especially depending on where the caregiver is in their journey. I think it's a very difficult process. It's, there is, I would say some grieving involved in the sense that even though that person is still physically alive, unfortunately after something happens to your brain, you're not exactly the same person. So, a lot of times I would hear stories from, husbands or wives where they would tell me, oh, they used to function at this level. They used to be in this high level job. And things are just really different. I mean, I can't imagine that is, I think empathy goes a long way. It really just understanding that, these are people who are used to their loved one functioning very differently. They're here because they have a problem and they're relying on you for help and support.
00:31:10
Meera
They want to know how they can help, but they're going to be days where they're frustrated, they want to hit their head against a wall. It's something they have to deal with day in, day out. It's not something that, there's not really an easy fix. I mean, time heals. All right. It takes a lot of time, takes a lot of patients. I think that's important to remember, I think it's really important to realize where they're at and, not to take things personally, I think can be hard because I think that's something all of us want to do, but I think sometimes, the caregiver may lash out, but it's because they're frustrated. Because they're going to do that with everyone, they have not singled you out individually. It's not you, it's the experience of what they're going through is that they're frustrated.
00:31:56
Terry
Yeah. And, and for caregivers, I mean, how anybody who's in a caregiving situation, how it's so hard not to do whatever task is at hand, let alone let somebody, I mean, that's what your whole business is based on helping people, but you have to know how much to help them. How much is too much because they need to do it themselves. Right.
00:32:23
Meera
Exactly. I think one of the challenges is that you want the person to become more independent and so you don't want the caregiver to be doing everything for them. There is a fine line and, let's be honest, sometimes there can be friction and frustration, but there's also, the positive side of that, where their relationship evolves over time and people understand each other better. People understand that, Hey, even though I want to do everything for my loved one, I'm not going to help them by doing that. I need to actually do less for them so that they feel better, they become more independent and they feel more confident.
00:33:02
Roy
Yeah. There's a lot of that masking that goes on, I guess, with couples, because just like us, I mean, I may at times be incommunicable, but Terry knows my thoughts and can finish it or go do something for me. Well, while I understand that dynamic, I think, as loved ones, caregivers, whatever, I think we have to kind of realize the longer we put this off, either the less chance they have of getting some back to normalcy or the longer road that we're going to put them on to do that, which was kind of leading into my next question about, so, on average, how far can you bring people back usually? I mean, is it like you get them pretty much back to normal with their speech and swallowing, or is it just usually some improvement from where they were, what does that, what does the end product usually look like?
00:33:58
Meera
I think it depends on the nature of their injury. Definitely for someone who has a more severe brain injury, it's hard to predict how much they're going to recover. Like I said, the first year is really crucial up to the first few years, but I would say generally speaking, their prognosis may not be as good just because there was a much larger injury or bleed in their brain. I think those conversations can be difficult because, you're looking at someone who ends up going home where home has to be much more structured. For example, they need to have a schedule what they're doing every day, like they did with us in rehab, versus someone who might be ready to go back to work like the individual I was talking about before he was getting there. I mean, he was probably pretty close. Like he may have gone back to work okay.
00:34:44
Meera
In a modified position. Probably not exactly what he's doing before. I think it just depends on, I think it depends on a lot of things. I think it depends on where the bleed is in your brain and the nature of how severe the bleed is. I think it also depends on, unfortunately, some of the things we're looking at are progressive, like Parkinson's and dementia. Unfortunately we know that those things change over time. There is some deterioration that happens with that, which again is really difficult to process. Because you're used to seeing someone one way and then, over time things get worse. I think it just depends on the individual. Okay.
00:35:25
Roy
Yeah. It's always good to, manage expectations sometimes as loved ones. We, we're always hopeful that things will be back to normal, but sometimes they want, and so we have to, good to understand that we accept just some norm. Yeah, yeah.
00:35:42
Meera
All right. Those are the really difficult conversations. Right, right. Oh, for sure.
00:35:47
Terry
Yeah. You had, some advice about, iPad apps. Maybe that might be helpful.
00:35:56
Meera
Oh yes. I'm glad you reminded me about that. I have a few actually, that would be helpful. One thing I wanted to mention that we haven't really talked about is, something called a phasia. Aphasia is a loss of language, when you have a brain injury or stroke. The reason I mentioned that is because, that's oftentimes when you have difficulty with communication and that can look different, it can be, the person can sound really fluent, but they're not making sense. Or it could be that, they're using limited words. I mean, there are a lot of different types. Basically I would say overall, the person has difficulty using a complete sentence. They might speak in phrases. They might not be able to use words at all. They might not be gesturing. One thing before we get to the iPad apps, I want to mention that's important for someone like that is having a communication board.
00:36:48
Meera
There are actually some really great ones you can get online. You can kind of even make one your own, but essentially the purpose of a communication board is having that person point to, things that are really important. Like they can point to yes or no, or they can point to how old. They can point to points for their basic wants and needs. Typically I would say in acute care, in a hospital, that's something, a speech therapist will bring on day one. If someone has had a, if someone's having that kind of trouble with their communication. That's a really important one because what happens is since communication is so vital, people are relying on, even the person who, is in the hospital to be able to communicate, but if they're not able to, it's really frustrating for that person and for the whole family and the caregiver.
00:37:36
Meera
That's just a really good thing in general to keep in mind. Like I said, there are a lot, you can get online or a speech service can bring you one. Really it can also be just, having pictures of family members available, close to the bedside and just having the person be able to point or, having the names written out. Basically you have a lot of visual aids in front of you that can be helpful. You're not relying on the person being able to use their words. You're relying more on, I would say nonverbal communication in that case now, is that,
00:38:05
Roy
That typically brought, is that typically brought on by some kind of a traumatic brain injury or stroke as well? Or is there other things that cause the effect?
00:38:16
Meera
Okay. Yeah. Correct. What happens is, yeah, if the side of your brain, the left side of your brain is responsible for language, so entering injury to that side of the brain typically will involve, loss of language or loss of communication that we're talking about in this case. One of the good series of act apps for aphasia or loss of language is Tactus T a C T U S. They have a whole host of apps that are really awesome. There's a series that I've actually used before, but it can help with lots of different things, naming pictures. One of the things I like about it is that it can be really interactive. If a patient or client is using it can give you the first letter for example of the word. It'll give you like hints for you to come up with what the actual word of the picture is, or the name of the picture.
00:39:08
Meera
Okay, cool. They're higher level ones where you're working on reading comprehension and stuff like that. They're also two other good apps that I want to mention as well. Grocery IQ is a really good one, honestly, whether someone has had a brain injury or stroke, if I was personally, so going into a grocery store, which I'm not because I don't miss doing it because of probate. This one is a really helpful way to keep track of a grocery list and you can even personalize it to the store that you go to. The coupons and everything is actually really cool. I would totally use it if I was still going to the grocery store. Okay. So that one's really handy. There's also one called dose test, which helps with, keeping track of medications, which I know it can be important, especially when people are on multiple medications, because they know they have to be taken at different times.
00:40:00
Meera
They look, the purpose for each one is different. They might look different to be able to keep track of that. I would say definitely, that's also an area that we can help with in terms of speech therapy. Oftentimes if someone, is that the level where they can cognitively, like from a brain standpoint, work on learning their medications. We have actually worked in conjunction with nursing staff and gone through all the different medications and written out a list, okay, you're on this medication for blood pressure, you're on this one for, whatever it is. Actually taking pictures of the medications and written down the dose of everything, so that you can help, that person be more responsible and know what they're getting. I remember we would actually have some people trained to the point where nursing staff would show up and that person would like open their checklist and say, okay, so I'm getting such and such right now.
00:40:53
Meera
Right? Like it was actually really cool. And what was.
00:40:55
Terry
That called again? It's dose pest.
00:40:59
Meera
Dose CAS, D O S E C a S D.
00:41:03
Roy
Okay. That brings up a good point too. We always talk about, having these conversations before this traumatic event, if possible, is that, it's, sometimes you can find the medications laying around, but there are times when you can't and this is why it's good to talk to loved ones, especially to get those lists of what are you taking, what's it for when he taken it was the doctor that prescribed it. So, because, just, let's just say in the event, I'm out of medicine, I threw the bottle away and waiting on something and something bad happens. Then, nobody knows that I was really taking that medicine. Anyway, I just feel like we can never have that conversation soon enough, get it documented, can save us all and save you and your loved one, a lot of heartache as well.
00:41:53
Meera
Absolutely. I think using a pillbox also is helpful too. Yeah. Yes. Like the daily ones where you're actually opening it. You can open it later and see, oh yeah, I already took that. Yeah. Oh yeah.
00:42:05
Roy
Yeah. We have to do that even just for our vitamins and supplements. Cause it's only easier because I'll take them in the morning and then about mid-morning I'm like, Ugh, did I even take that yet or not? So, yeah. Right.
00:42:16
Meera
So it's like a visual reminder. Right. It's helpful for anyone really know taking medications, you can look and see, Hey, I took it or I didn't. Yeah. Yeah.
00:42:25
Roy
When I don't take it, first thing, then a Terry sets it out on the counter top where I have to trip over it next time.
00:42:32
Terry
Yeah. You take it.
00:42:36
Roy
I'm sorry. I didn't mean to interrupt you. Do you have any more apps or is that okay?
00:42:40
Meera
No, I think those are the main ones I was thinking of. Yeah. Those are all the really good ones.
00:42:46
Roy
Yeah. Well, thanks so much for taking time out of your day. A couple of questions before we go. What is, an, what is an app or a habit? What is something that you use every day in your personal or professional life that you feel adds a lot of value?
00:43:01
Meera
Oh, I like that question. We actually meditate every morning that just helps me stay focused and stay grounded. I've been doing it for a while and now for some reason I don't do it in the morning. It really throws me off and I really don't like it. So I definitely try to do that. That just helps me. It just helps me focus really. Yeah.
00:43:23
Roy
Okay, great. Yeah. That's a good, we hear that more and more about this and that I've tried it. I just need to get in the habit of making myself do it. Cause I know, like yesterday were talking, I was a little scattered and I told Terry I'm like, I just need to maybe meditate for like five minutes to kind of, recenter and get my mind from being so scattered. So yeah. Thanks for, they.
00:43:45
Meera
Have a lot of apps. I don't actually use one myself. Well, I do use some inconsistently, but in general, if you search apps, there are a lot of cool ones that will run you through a guided meditation. One thing I want to say about meditation is that think a lot of people think you have to sit there and silence. I have a series of what I go through in my own head, but guided meditation is still meditating. I think meditation, people just think, you're sitting there like this exact, but it doesn't have to be that.
00:44:15
Terry
Whatever your catchphrases or you're a little,
00:44:19
Meera
Yeah. It can look all kinds of different ways that for some people, honestly, their meditation is walking out doors. So, I mean, I think you just kind of have to know what works for you. That's something I enjoy just going for in nature. Yeah. The plan is going to do, I don't do that every day, but that's something I try to do at least once a week.
00:44:39
Roy
That is such a good mechanism to clear my head. I think that's more of my meditation is just having that quiet time walking through the nature. Anyway. Yeah. It's it's good to clear our head. We need that for our creative energies and also, for me problem solving, if I'm bumping up against something, I'm having a little trouble solving, sometimes getting away from it, clearing my head. I come back with a whole different perspective on that as well. So that's good advice. Tell everybody, so who can you help? And I realize that we have to have doctor's orders, but basically who is your clientele? How can you help them? And then how could they reach out and get ahold of you?
00:45:22
Meera
Sure. The name of my company is Super Speech Solutions, LLC. That's actually the name of my Facebook business page. It's also the name of my LinkedIn page. My Instagram handle is also a Super Speech Solutions. So I tried to keep everything easy. My website also is the same, it's SuperSpeechSolutions.com. My email is [email protected]. In terms of helping people, they're actually a whole host of people I can help. Like I mentioned, I do work with children. I can help children, especially I specialize in helping children, build their language skills. I specifically specialize in working with children who are autistic, in terms of adults, more of the piece I can do with adults is caregiver training. Because right now I'm not accepting insurance. Because of that, I can only see people who are 65 and under, but if someone wants to do a caregiver training, it doesn't matter what age they are.
00:46:25
Meera
And I can help in that area. Like I, like we mentioned before, if there are challenges with, swallowing or challenges with memory, and things of that nature, definitely I can help with that. I just can't do the individual, one-on-one therapy. Like I said, because I'm not an insurance provider, people over a certain age then I, but then I can definitely refer them out in that case. Yeah. If someone has had a brain injury or stroke, as long as they're able to pay out of pocket, I would still be able to help them for one-on-one therapy. Like I said, if they're just under yeah.
00:46:59
Roy
It's important, I can talk to the child perspective for just a minute. Cause our son had, one of his adenoids grew, I don't know if it grew or swollen, but somehow it became very enlarged and block the drainage tube of his ear. This went on for some period of time. We finally found out that he had lost some hearing, temporarily, once it got cleaned out, it came back, but he, what it didn't really affect his, he's still able to verbalize, but he was like in second or third grade, first or second grade is very young. It kind of put him a little behind. We, saw out speech therapy, in order to get him caught back up on that learning scale. Definitely, all kinds of things can lead to, things that you wouldn't even think about can lead you down that path in a hurry.
00:47:54
Meera
Yeah. Actually commonly in children who have trouble with hearing and have trouble with pronouncing their sounds because they're not able to hear everything clearly. That's actually a really common reason that people would come see a speech therapist as a child. Yeah. Yeah.
00:48:09
Roy
All right. Well, thanks again for taking time out of your day. We certainly do appreciate it and that's gonna do it for another episode of educational. Of course, I'm Roy Terry, and you can find us at www.ageucational.com. We're also on all the major social media platforms, as well as all the major podcast platforms. A video of this interview will go up on YouTube when the episode does go live. Until next time, take care of yourself and take care of your family.
www.superspeechsolutions.com
www.ageucational.com