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Norman Coombs: Welcome to EZ's equal access to software information podcast series; it's about people, not technology. My name is Norman Coombs and I'm pleased to be able to share with you another one of our friends.


EZ is putting on a four part webinar series, on making podcasts and broadcasts that are fully accessible. You should look those up; one is in August, one is in September, each is four weeks long. Go to the EZ.cc page and click on webinars. One of the things that's fun about living in the digital age, with the Internet, the telephone, and all of these things is meeting new people from new places doing new things and today I want to introduce to you one of my new contacts and friends. Her name is Joan Green. Good morning Joan!

Joan Green: Good Morning.

Norm: Or at least, it's morning for me in California. [laughter] I'm in California and Joan is just outside of Washington, D.C. And, Joan, who is the founder of an organization called Innovative Speech Therapy. What is Innovative Speech Therapy?

Joan: Innovative Speech Therapy is a private speech pathology practice. And, right now, I don't have any employees, it's just me. And what I do is provide a few different programs. One is, I work directly with clients, another is I have a number of professional training opportunities and, I have just authored and published a book.

Norm: OK, we'll get to the book after a while. What's innovative about Innovative Speech Therapy?

Joan: What's innovative? I believe that I offer a unique approach to helping people with a wide variety of reading, well, communication and cognitive challenges. I offer very unique programs. I don't think exist anywhere else.

Norm: Now, when the government passed the Americans Disabilities Act, one of the reasons it passed is people found out that almost every senator and congressman had somebody in their extended family with a disability and they were able to find out about that and reach all of them on a personal level. So, it wasn't just some nice lot of help them folks out there. It made it much more personal. Do you have any personal interest in speech therapy?

Joan: Not really.

Norm: So, what got you interested then?

Joan: I had never heard of speech therapy until I was in college. I was pre-med, I thought I might like to be a neuropsychologist, or a teacher, or a child psychologist. I always loved medicine and teaching and helping people. I just happened to be at Northwestern and they had a great speech pathology program and I started taking some courses, and it put all the pieces together for me. I had never known a speech pathologist, or knew anyone that had a stroke or a head injury and needed one.

Norm: One of my best buddies in college went to Northwestern for his Master's, and that was in audiology, which I guess is sort of related to speech pathology. Now, that's interesting.

Joan: It's called the school of communication.

Norm: Yeah. So, I guess Northwestern is pretty good for that.

Joan: Yeah. It's really a great program. So, I ended up doing both my undergraduate and my graduate training there.

Norm: OK. You mentioned that you deal with a number of speech disabilities, or communication problems. Which ones are the most, tie in the best with technology as an aid and which ones need personal help?

Joan: I mean I use technology to help all the clients.

Norm: All of them. OK.

Joan: Yeah. I worked, for many years I worked primarily with adults who had strokes and head injuries, speech problems, reading and writing problems. It really lends itself beautifully to that. And then I also work with a lot of children who have learning disabilities, and speech and language issues. And, it's wonderful for that, also.

Norm: Now, an elderly friend of mine has had a bit of a stroke. It's not too bad, and his speech is slurred. And, they're trying to give him therapy, but I think it's mostly someone just trying to make him speak words, and learn how to think before he says the word and things like that. What kind of ways can technology play a role in that?

Joan: Well, I think technology, you definitely need the speech pathologist to do a good evaluation and help somebody with hands on and in person but technology is a great way to extend the practice sessions and the ability of someone to immerse themselves in a lot more routine.


So, somebody had disarthria, or slurred speech, their learning strategies of slowing down the rate of their speech and increasing the articulation of the sounds, and maybe breathing patterns. There are a lot of software programs that they can use when they're not with the speech pathologist to practice that. They're also, if they're working on word retrieval, there are a lot of programs that offer the ability to somebody to work on word retrieval strategies and then drill and practice but then the software can be set up with whatever kind of assistance or help the person needs so they don't get too frustrated.

Norm: OK, that's...

Joan: In my eyes the computer works to increase the intensity of the treatment so the more you practice the better you get and it works by drill and practice and it also works to compensate for the areas of deficit.

Norm: Yes, my impression of things like that, and drill and practice are things the computer is really good at.

Joan: It's also good at compensating. So, for example, word prediction can help people think of words that have trouble with that, or people as you know, can use the text readers. It can help in so many different ways. As your abilities are improving, to help compensate and make life a little bit easier.

Norm: So would word prediction be something they would use just to help them with learning to retrieve words better? I mean, obviously, if my buddy is talking to me, he is not looking at word prediction, to find out the next word he wants to use in talking to me.

Joan: It would help more in the writing.

Norm: OK, OK, yeah.

Joan: But you can also, there's also something by Premiere assistive technology and some other companies. They have the ultimate talking dictionary so there are dictionaries where if you can't think of the word, and you might not be able to remember the initial letter, you can find it, how it's linked to other words. You know, think of categories it might belong to, or parts of it, and by sort of going around it you can think of the word.

Norm: In one of my observations that, oftentimes, when somebody spends a lot of their time and effort trying to help someone with a problem, a disability, in the process of helping somebody else it changes you as well. Can you see any ways that this has impacted your life?

Joan: That's an interesting question. Well, I don't like to let my kids run off the diving board.


[laughter]

Joan: I'm afraid they're going to get a head injury.

Norm: Well, that's reasonable. [laughs]

Joan: Yeah. And I'm a little nervous during all their soccer games if they do too many headers. I have a little trouble with high blood pressure. I make sure to take all my medicine.

Norm: [laughs]

Joan: So I don't know. I really value life. I have four children, and they see my clients and my patients and interact with them, and I think it's important for them to learn about people with disabilities and to treat them with respect. And then so many unforeseen things can happen to somebody injured their life around.


So I think I have a very positive outlook on life that you just, every single day, make it the best that it can be, and you live for the future, but don't put off things for the future because you never know what's in store. People really can't get caught up and get really upset about these little piddly things that don't mean too much. You get in a car accident and you have a terrible head injury, and that really, really...

Norm: Change your perspective on life.

Joan: Right, right. So I think I have a very positive perspective. People wonder how I work with people all the time that have had such tragedy and not get depressed, because I work with so many people with brain tumors and strokes and head injuries and developmental disabilities, and I just look at it like I'm helping them.


And my program, I typically only focus on one person for a week and see them for three to five hours a day, put all my energy into this one person, and by the end of the week, I love to see how it has changed their life. And they have new hope and motivation, and it really paves the way for a much more pleasant future. So I love starting new clients, because by the end of the week, they're a different person. So I love my work. It's much easier than my home life.


[laughter]

Joan: I have four different drop-offs every morning for my kids. My oldest one's in ninth grade and my youngest one's in second grade, and they all have different drop-offs.

Norm: [laughs]

Joan: I get my cup of coffee, and then I go to my office and start working with my clients, and it's just pure enjoyment. I'm just focusing on one person. I have no interruptions. It's just easy and natural and positive. And then I come back, I only work until about 2:00 or 2:30, and then I start picking up all my kids, and that's when the real challenge begins. [laughs]


So I think it gives me a good balance in life. I think everyone has to find that balance, and I'm fortunate that I could create a practice where I work while my kids are in school.

Norm: Well, one of the things I find sad, when you're in a restaurant or in the checkout line some place and somebody's just doing what seems like a routine job, and you find some of them take an interest in the customer and they're cheery and all of that, and there are others that are just... doing the job. [laughs]

Joan: Right.

Norm: And I think it must be so awful if you're stuck doing a job that, to you, is meaningless and boring.

Joan: Right. Unfortunately, there are a lot of people that just haven't been able to find something that makes them happy, or they haven't had that opportunity to develop skills, and they're just able to earn a living.

Norm: Well, I think sometimes it's learning to find something meaningful in what you're already doing.

Joan: Right.

Norm: I was teaching college for 40 years, and people would say, "Well, how could you teach the same history class [laughs] a couple of times a day, month in, month out?" I tried to make it interesting and all of the rest. And there was a point, I remember, where I started getting a little dull and bored about it. And one day, it occurred to me, "You know, I'm not teaching history, I'm teaching students."


And so, as I walked out the door on the way to class every day, I'd stop with my hand on the doorknob and say, "I'm going to teach students, people." And I would focus on relating to people, rather than teaching a topic, and that helped breathe all kinds of new, fresh life back into something that was getting to be dull and routine.


I suspect there are lots of ways, with many boring jobs, [laughs] to find something meaningful if you've got that kind of outlook on life. But it really is exciting when you get a job that's fun. [laughs]

Joan: Yeah. And I guess I've become very disillusioned with the educational and medical systems. I have these clients come to me, and I have one right now who had a stroke 11 years ago. And she's gone through 10 years of therapy, and she really hasn't made that much progress in, let's say, the last six or seven years. And I made an exception, I continued with her after my intensive TWIST program, because she lives locally and I just felt so bad for her.


She's 60 years old and she really cannot communicate very well at all. I put her through the TWIST program, and then now I continue to see her a couple times a week. I only do two hour visits, two or three hour visits. I don't do anything shorter. And the family says she's made more progress in the last month than in maybe the last five years. And that just shows you that, you know.

Norm: You talk about this being two different models. Well, for those of us who are pretty ignorant, can you explain a little bit the difference?

Joan: Well, normally, what happens is that if you're going to be getting speech therapy, either as an inpatient or as an outpatient, it's usually 30 or 45 or 50 minute sessions, once or twice, three times a week. It's ongoing. And when I first started, I worked at Fairfax Hospital, which I loved. That was the first place I worked at in Northern Virginia.


And I could see clients for years. I had some for two, three, four years as outpatients, as long as I could document progress. And the world has changed, and now you get a certain number of visits [inaudible], it's going to be 30 minutes long--and it's just not conducive to therapy, and you have to discharge your patients even with untapped potential.

Norm: Yeah.

Joan: And they're just left in a lurch. And so I've created my own practice because I became increasingly frustrated with the whole system, and I believed that group therapy and computers were the way to go so that people could help themselves and continue to learn in an affordable way.


I had an aphasia group for about 10 years, and then I finally stopped. And I had about eight therapists at once who worked for me in the whole greater Washington area, but I turned more into an administrator and a businessperson.

Norm: [laughing] Yeah.

Joan: I don't know. I just wanted to get back. I was losing touch with my ability...

Norm: Yeah, yeah. Yeah, if you like teaching, the administration won't cut it. [laughs]

Joan: Yeah, so I do all the therapy now, and I only do this TWIST program, and some other things. I think it's so much more effective to really empower people to help themselves. That's my whole purpose. Give them the tools that they need to help themselves with guidance, because people just can't pick up the software and know what to do with it. You have to...


There's so much to choose from. I read this book. I have one hundred pages of what to choose from. It's hard to zero in, so you need to really be familiar with the different choices.


Once you set somebody up, and you set the options on their computer, and you teach them, and you write the instructions down, it's not hard. So, they can practice for two or three hours a day if they choose to, instead of waiting to go to a 45 minute session a hour drive away.

Norm: You mentioned you have a book. Do you want to give us the title of the book and tell us a little bit about it?

Joan: I would love to. I worked on it for three years. I rewrote it twice. It's called "Technology for Communication and Cognitive Treatment: A Clinician's Guide."

Norm: Run that by us one more time.

Joan: OK. "Technology for Communication and Cognitive Treatment: A Clinician's Guide." And then the subtitle is "A Revolutionary Approach to Enhance Treatment Outcomes for People with Speech, Language, Learning, and Cognitive Disabilities."

Norm: That's a mouthful.

Joan: Yeah. It's good for the website. I've got a lot of keywords there.


Originally, I was going to write a book for speech pathologists about how to help adults who have had strokes and head injuries. Then I expanded it for speech pathologists who work with all ages. And then I expanded it again to all education, rehabilitation, and wellness professionals who help people with a wide range of communication and cognitive problems.


So now, a lot of neuropsychologists have purchased it, and assistive technology coordinators, and occupational therapists, tutors, special ed teachers. It's got a wide audience, so hopefully it's more marketable. I've had offers from several publishers, but they all wanted the copyright, and I'd get this little royalty.


It's all that I know and do, so I really want to spread the word about how technology can be used by professionals, because there's too many people out there who have not been exposed to it and their lives would be so much better.

Norm: So, you're...

Joan: I do speak a lot. I've spoken around the country to a lot of professional groups, but it's really hard for me to travel with four kids.

Norm: Oh, I guess.

Joan: This is much more affordable, for people to just buy a book. It's organized. It's all indexed and organized based on your work setting, so if you work in acute care, or outpatient, or assisted living, there's different sections. It's also grouped according to the deficit area. There's a whole, huge chapter on talking. Speech and language are separated out.


I go through... I purchased so many... absolutely everything that I could get my hands on to try over the last three years, I have. I picked what I perceived to be the best. I have top picks for each work setting and goal area.

Norm: You mentioned a website for the book?

Joan: That's ITTSGuides.com.

Norm: ITTSGuides.com.

Joan: Right, for Innovative Technology Treatment Solutions. That's the name of the series. This is the first book in a series that I'm going to be writing.

Norm: Oh, you're ambitious!

Joan: I have a lot.


One of the next books is going to be for family members who want to help a loved one who has aphasia or a cognitive problem. Then, I want to write one for parents who have children with speech, language, and learning issues and try to help them learn what they can do at home.

Norm: I think support people and support groups are really important, so if you can give them tools, that's great.

Joan: Absolutely. I've talked a lot about adults, but I also have a program called "TWIST" for parents. In addition for this real intensive program for adults who have had strokes and head injuries, I have something that's just half the intensity. It's nine hours instead of 18, and it's where I really help parents. A lot of it's over the phone. We do reports and review what services are being provided in the schools, and then I try to help them learn what they can do in terms of technology. How to tap into other resources.

Norm: You keep referring to TWIST. I assume that's an acronym.

Joan: Yes, that's Technology With Innovative Speech Therapy.

Norm: OK, TWIST.

Joan: It's on my website at InnovativeSpeech.com under Individual Therapy.

Norm: OK, you have another website? InnovativeSpeech.com?

Joan: Right. That was my original website. That's my philosophy, and my mission, and the different services that I offer. TWIST is when I work directly with clients, and then I have something called Fast Tech, which I offer intensive training programs.


Historically, people have come to me. I used to have big classes. I found that people really want it individualized for their... Everybody's busy, and they want to come and learn what will help them.


So now, I do this program where one to three people who work in the same setting come. Ahead of time, I talk to them and find out what technology they have, how experienced they are, how much money they have, what their setting is, who their clients are, and then I try to pick out what I think would give them the best bang for the buck, and then train them with hands on how to use it.


After two days they can go back and hopefully start pretty much immediately using it with their clients. Then they can really expand their practice, because a lot of places don't do this. I think it's really a great way to increase revenue.

Norm: Speech therapy is a whole area in which I know almost zero. I want to thank you for helping me learn something I didn't know before. It really sounds interesting, but the thing that impressed me was your enthusiasm. I think that's a good mark, and a guarantee of a good therapist and teacher.


I'm glad to have had this opportunity to talk with you and learn what you're doing and highlight some of it for people.

Joan: Thank you for contacting me. I really do want to spread the word about how much people can have their lives improved with the use of technology. Thanks for doing that...

Norm: So, the title of the book one more time?

Joan: It's "Technology for Communication and Cognitive Treatment: A Clinician's Guide."

Norm: And the website is www.ITTSGuides.com?

Joan: That's right. It's $89.95.

Norm: OK.

Joan: At this point it's only available on my website. I might go with Amazon at some point, but right now I'm just starting slow. There are a lot of testimonials on the site. About 40 or 50 professionals have reviewed chapters. There are psychologists and OT's and assistive people. It's been really widely reviewed.


I wanted to make sure I wasn't leaving anything out. Let all these professionals get a chance to tell me if I was missing something, so I think it's pretty complete.

Norm: Thank you very much. I'm glad to have had the opportunity to share one friend with my other friends.

Joan: Thank you very much.

Norm: OK. Goodbye.