Read the full transcript here

Today, on the All About Audiology Podcast, Dr. Saperstein speaks with Meera Deters, who is a Speech Language Pathologist (SLP) from Texas. Throughout her career she has worked in multiple setting including a cancer hospital, a skilled nursing facility, and an in and outpatient rehab for people with brain injuries and strokes. She also has worked with individuals of different ages. Currently, she works with patients at their own homes through her  own practice, which is called Super Speech Solutions

This week on the All About Audiology podcast:  

• 3:30 – Shadowing a trained professional, within a field of interest, can give you an inside look into the field and allow you to decide if such a field might be suitable for you.

• 7:00 – Students, within the SLP field, who are unsure what they want to specialize in can figure out their exact path as time goes on. One does not even have to technically specialize in anything and can be a generalist.

• 10:00 – For younger clients, in-person therapy is preferred due to the heavy focus on play-based therapy. Although in-person therapy is mainly preferred, Zoom may be a better fit for older children and adults.

• 12:00 – Children with Autism can benefit from working with a SLP on skills such as  receptive language, pragmatics, social language, social skills and non-verbal cues.

• 15:00 – It is important to keep the parents of a younger client in the loop to help them understand what the therapist and their child is working on

• 17:00 – Working on accent modification, or accent reduction, skills allows one to work on their speech and language use with a goal of allowing one to be more intelligible to others

• 23:00 – Working with patients of all ages can make you more marketable as a professional 

For more resources and research visit:

All About Audiology Website 

All About Audiology Facebook group  

All About Audiology Instagram

And the Prodana pay-it-forward platform here: https://prodana.org/practioner/lilach-saperstein/audiology-counseling–dr–lilach-saperstein

(Guest Links)

https://superspeechsolutions.com/

Find Meera on : Instagram

Find Meera on Facebook: Super Speech Solutions, LLC

Find Meera on: LinkedIn

Email Meera at: meera@superspeechsolutions.com

• All About Collaborating with Speech Language Pathologists – Episode 74- with Dr. Leah Beekman
• Episode 56 – All About Early Intervention: Speech and Language Development
• All About Speech Therapy – Episode 19 with MariLouise Nichols

Transcript:

Dr. Lilach Saperstein

Welcome back to the All About Audiology Podcast. I’m your host, Dr. Lilach Saperstein, and this is the show where we talk about Audiology and also related fields, speech pathology—basically anything around communication. And we have many families listening to the show, many professionals, and lots of students as well of communication sciences. So I think this one’s for you, my dear students, listeners of the show. We’ve had podcasts talking about medical SLPs and practice in school and all different things that our amazing Speech Language Pathology colleagues do and I’m excited to continue that conversation with today’s guest. Meera Deters is a speech language pathologist—is gonna give us a lot of information, insight and advice. So welcome to the show, Meera.

Meera Deters

Thank you so much for having me on. I’m happy to be here.

LS

I’m very excited. I’d love to hear first, a little bit about your background and how you even heard about Speech Language Pathology, and what was your kind of journey to become one? 

MD

Sure. So, I’ve been practicing as a speech pathologist for 14 years. I honestly can’t believe it’s been that long. It’s gone by super fast. I actually didn’t know anything about speech pathology, or it’s also called speech therapy. After high school, I had no idea what I wanted to do in college in terms of majoring, in terms of studying. So, my dad actually had been working with speech therapists at the hospital. So, he’s a radiologist, and he’d been working with speech therapists at the hospital. He would consult with them on swallow studies. So, when people have trouble with swallowing, oftentimes, they may get an imaging study, which involves a speech therapist and a radiologist together. So, my dad actually suggested I come to the hospital and said, “Hey, why don’t you see what speech pathologists do? You can figure out if that’s something you’d like or not. Let’s just see what you think,” so I said, “All right.” So, I actually spent a total of two weeks at the hospital just observing what speech pathologists, occupational therapists, and physical therapists all do, and I have so much respect for my colleagues and co-workers, and I’ve met all kinds of cool audiologists, and occupational therapists and physical therapists. But really, I mean, I don’t feel like I’m not strong physically, and I thought, “Wow, to be an occupational therapist, or physical therapist would be personally pretty hard for me. I don’t know if that’s something that I would be good at,” but the second, I saw what a speech therapist does, literally, I just thought it was the coolest thing I’d ever seen, and right away, I thought to myself, “Man, I want to be the person who’s helping someone with their communication,” and I still remember to this day—I mean, this kind of gives me goosebumps even now, because I was actually shadowing a speech therapist at the hospital, and she had gone into some kind of intensive care unit. So I remember we had to gown up to see the patient, and he had suffered some kind of wounds and I remember she was helping him with voice therapy, and so she was helping him figure out how he could use his voice to communicate, and I just found it so fascinating. What I still find fascinating about the field is that there’s just so many different areas you can specialize in, and honestly, you can never get bored. So it’s really just great, and very fascinating.

LS

That’s so good, and that’s such a good opportunity that you were able to have that shadowing, observing time, and I also always recommend that to anyone who’s considering—should I do audiology or speech or what should I—just go just call up the clinic or hospital and try to figure out how to get a couple hours observation or even longer, and not only that, it gets you kind of relationships and networking, as well, which is also very helpful.

So I do want to give people opportunity to even go on YouTube, or go on Instagram and look up—

MD

Oh, modified barium swallow studies? 

LS

Thank you. Yes, exactly. Yes. So like, yes—

MD

Or MBS for short. Yeah. [Laughs]

LS

And then you can see it’s really cool because it’s an x-ray of someone swallowing. Is it just an x ray? It is right?

MD

It is.

LS 

It is, right? So it is very cool. You can kind of see the tongue moving and [the] swalling. So if you don’t have the opportunity to actually observe it, you could still check it out online. 

MD
Yeah, it is fun. I agree.

LS

That’s another part of the podcast, and what we’re doing here is that you can connect with people all around the world from different professions and kind of do some of this work, especially in a post pandemic life, when a lot of things are online. There’s still so much opportunity for this kind of questioning and looking on Instagram hashtags. Definitely. Instagram is where I hang out @allallaboutaudiologypodcast. I was recently talking about that Facebook can get really overwhelming and maybe rant-y. It’s got a different energy, and then Twitter is so quick and short and you have to be—but put an Instagram is like right in that sweet spot of captions of images, and you can kind of make a full point without it getting out of hand. I don’t know. So, I’m a fan of Instagram.

Anyway, back to [the] journey. So, did you major in speech therapy—is what happened then in college?

MD

Well, technically, yeah. That’s actually an interesting story. I did not. I actually majored in Sociology. So, I went to school in San Antonio, in Texas, and I majored in sociology. And I knew during college that I wanted to become a speech therapist, but the school I went to didn’t have the program. So, what I actually did after that was I went to another school, TCU—it’s a private school in Fort Worth, and I did a year of leveling classes. So essentially, if you don’t do an undergraduate major in communication disorder—yes, like me, you can still become a speech therapist. They require you to take a year of classes. So it’s almost like getting another bachelor’s, but they call it leveling courses, and then once you complete that year of courses, before the end of that you can apply for graduate programs.

LS

Yeah, we had that when I studied at Brooklyn College. They called it post-bach, like people who had finished their bachelor’s and come into classes, but there’s always a major scramble of who can get in and the classes are so competitive to even just get into the classes.

MD

Oh, wow.

LS

Yeah, there was a lot of competition, and there was like a hierarchy. The seniors would have first dibs, because they have to graduate, and then, the post-bach students were kind of last on the list and so it was always tough, but we had big classes anyway.

MD

Gotcha. Yeah, yeah.

LS

Did you have any idea of what you wanted to specialize in? Or which—

MD

No, I really didn’t have that figured out, except until a few months ago, during the pandemic, when I decided, “Hey, I have all this free time on my hands, maybe I should go after certifications,” and that actually eventually led me to start my own practice, which is called Super Speech Solutions. So the interesting thing about that is two things. So one, I’m not someone who knew what they want to specialize in. I only feel like I figured it out in the past few months. So, I know a lot of students probably out there thinking, “Hey, I need to know that.” Well, you can figure it out along in the field as time goes on, and you don’t even have to technically specialize [in] anything. You could be what people call it—generalists. You can still see—some people call it womb to tomb. You could see kids from very early in life until the very end of life. So not to say that you have to specialize.

I personally specialize in language disorders, autism, and accent modification. So, I actually see children as well as adults, which I really like. It’s a nice mix for me.

LS

It’s great. So you are seeing patients privately now, but what were you doing in the last—what was it 13 years before?

MD

Yeah, before that. So I’ve actually worked in a lot of different settings. I actually started out on the medical side, and I was working with adults for the first five years of my career.

So, when I first started, I was in a cancer hospital, and then I went to a skilled nursing facility, and then after that I went to was an in- and outpatient rehab for people with brain injuries and strokes. Then after that, I transitioned to pediatrics, which now I’ve done for nine years. So I’ve worked in a lot of different settings. Even in terms of Pediatrics, I’ve worked in different private practices that other people have owned. Through one of those private practices that we actually contract with charter schools as well. So I feel like I’ve kind of been all over the map, but then of course, a few months ago, I started my own private practice so I almost feel like I’m one of those people who can check off multiple boxes, like What settings have you worked in? I’ve worked in a lot of different ones.

LS

Yeah, that’s so important. Not only do you not have to choose, you can also change later on or throughout our career.

So, are you working mostly on Zoom-based—that to telehealth, or do you have a physical practice?

MD

I mostly—well, actually initially started out mostly working on Zoom because of the pandemic. I actually recently have transitioned to doing in-home sessions. I don’t actually have a physical office right now, and I’m not sure that I’m going to be getting one anytime soon because I think it’s important to keep your overhead costs to a minimum, especially when you’re first starting on the business. So yeah, right now I just started in home sessions now that things are.

Where I am in Texas. Unfortunately, not everywhere in the world are things better with COVID. We hope that continues throughout the course of time. Where I am, things certainly have gotten better. Although surprisingly, not even 40% of the population even here locally is vaccinated but anyhow, things have gotten better. So, now I feel comfortable going in homes within a certain radius from where I am.

I think the good thing about doing that is first of all, I will say that online speech therapy is not something that’s going to be good for everyone. So, especially for kids who, my opinion are five and under or even six and under, they’re not going to participate on the screen. That’s going to be a lot of parent coaching. I think for doing speech therapy on Zoom or any kind of therapy on Zoom, I think it’s easier for kids who are older and certainly for teenagers, adults as you go all the way up in the age range.

I think for younger kids, it’s really important to be face-to-face, because a lot of what you’re doing when kids are young is play-based therapy, and so you really are relying more on cues from the speech therapist or looking at their body language and the added bonus of going in someone’s home is that you really get an idea of what their environment is like. It’s more functional.

LS

Yeah, that’s so important. So I’d love to hear more about the work you do—kids with autism and any other pediatric patients you’re seeing. And specifically, what parents who have speech therapists coming into the home, what you would want them to know about and hear from you?

MD

Sure, yeah.

LS

What are you actually looking at when you come? [Laughs]

MD

Yeah, what do we really do? So, I think it’s great for parents to know what speech therapists do, especially in working with children who are autistic or children who have autism, as we know, that’s a very wide spectrum disorder. So, there’s a whole bunch of things we can do in terms of speech therapy, but I would say the main area that we’re going to be concentrating on when we’re working with autistic children is language.

So even within the area of language, we could be working on receptive language, which is more like answering questions and following directions, or we, oftentimes, work on expressive language, where maybe the child is only using couple words, maybe they’re not using words, but essentially, you’re trying to have them put multiple words together in a phrase or sentence in order to communicate, but if they’re done with all of those areas, typically we could be working a lot on pragmatics, or social language, social skills are really important. A lot of times it can be difficult for autistic children to make friends because they don’t necessarily pick up on  , or they may not be able to rephrase something and understand that someone’s not understanding what they’re saying. So, there are a lot of different things that we could do in speech therapy. I think it’s really important for the parent to know session to session what’s happening—what’s happening with the child in terms of their behavior, but also what the speech therapist is working on—

And private practice—personally, that’s actually my favorite setting now, really, because I have the most contact with parents and typically, if the parent—if I don’t have direct contact with a parent, it might be a nanny, or caregiver or—what I like about that setting is that you have really good communication with a parent or caregiver of the child, and you can constantly know what’s going on. I think the disadvantage of the school setting is that you don’t necessarily have contact with the parent. You have more contact with the teacher, which is just a different source in that sense, but yeah, I think it’s important to, for parents to know what they can work on with their child at home and I really like to give functional ways they can work on things. I think a lot of times you can say, “Oh, well. You can spend—” A lot of parents don’t have time, and we typically do half an hour sessions or longer parents don’t have time to sit there for half an hour, and work with their child on something by itself. So, I really try to tell them something functional. Like let’s say, the child is working on introducing new topics. I tell them something like, “Hey, why don’t you work on that and play this game during mealtime and each person has to introduce a new topic.” So what happens with kids is almost of any age, if you can put things in terms of a game, it’s much more fun, you get much more by it.

LS

I think that’s true for everybody across the lifespan. Yeah, try to gamify the productivity. That’s one thing I’ve been looking at.

MD

Gamify. I love that word. That’s exactly it.

LS

Yeah, incentivize good VA, like even Fitbit–everybody like trying to track their steps. At a certain point. It’s like, we shouldn’t be tracking everything but it’s very motivating to kind of see that calendar go up. Although after a few months, I take breaks from the Fitbit and then say, “Actually, I had a good day,” and then I look at the Fitbit and I’m like, “Did I? Did I walk enough?” and it’s like, this is not the worth of my day, but it’s a tool. It’s a tool. So, there I go on my tangents.

But I think it’s another question I’m thinking parents might have is: you’re coming into my home, and maybe I didn’t clean up from breakfast, and maybe there’s a thousand toys everywhere. Is it pressure that sometimes parents feel like you’re coming into the home and I have to prepare or make sure things are in order?

MD

Yeah, I think there could be. I mean, I can see that because firstly, if I think about [it] from their perspective—when my husband and I have people come into our own house, we’re very particular about cleaning and things like that. So, I can see how someone, a parent especially, may have that in the back of their mind, but honestly, that kind of stuff doesn’t bother me. I mean, home environment is the home environment, and typically a lot of the people that I’m working with have more than one kid. It’s not going to be nice and clean and pretty. That’s not the reality of what having kids looks like. So, I think for all the parents who are listening, any speech therapist, including myself, we’re really not concerned about that. We know that real life happens. We don’t expect homes to look a certain way. We really just want to go in and help the child and help the parent understand what we’re working on as best we can. That’s really our goal.

LS

Okay, good. Phew. I can relax. [MD laughs]

I have a few questions about accent modification. In that part of your work, I think there’s like a certain element of the person who has to be motivated and want their accent to change for this to kind of be ethical, and the other side of it might be like oppressive, like, “Oh, your accent isn’t good,” or whatever. So, there’s also a lot of other conversations around that. How do you handle that?

MD

I think it’s hard for someone to come see a speech therapist and say, “Hey, I really want to work on my communication. I’m having trouble with people understanding me.” What I find is that because it’s an elective service, people will come and seek me out for that particular area, number one. Number two, what I think is amazing is—the very last client I had, his employer was actually reimbursing him for the services, and I just thought it was so cool that his employer who was working at an oil and gas company at the time, his employer—I just thought it was so cool that they found the importance of that. [He] obviously understood what we were doing, understood how important it was, and we’re actually paying him back, and because he was paying out of pocket, because of course, insurance doesn’t cover an elective service like that. 

LS

And that’s only for adults? Have you ever seen these kids—

MD

I usually haven’t. It’s usually more for adults, I mean, not to say that children or teenagers will not come for that, but typically, I find that more adults will come for that, and usually, I find that these are very high performing individuals in the workplace, and they are coming for accent modification, or sometimes it’s called accent reduction. They mean the same thing, because they want to be able to move up in the workplace, and they feel like not being understood is actually holding them back. Number one at work, and number two, sometimes socially, as well as what I’ve heard, too.

LS

That’s very interesting. What’s coming to mind for me in the conversations of anti-racism and not infringing on people’s cultural—an accent is not a bad thing, and then reduction to what—to a different kind of standard, how accents are different across the world. I can see how some people might view that as problematic, but [I’m] not trying to stir up controversy and just kind of having this thought.

MD

Well, I agree with what you’re saying because I think generally, if you’re talking about modification or reduction, it’s like, “Oh, you have to alter what you’re currently doing.” So yeah, there could be. I can see how there could be a stigma associated with that.

Another thing, too, is sometimes in some of the courses that I’ve done, they might talk about the American way of talking or speaking, and, I mean it is what it is. America is a melting pot. I mean, I myself grew up in Canada. I’m third generation Indian. I also live in the United States, sure, too, but I have family that’s all over the world, including in India, England, everywhere, and I think lots of people are very international in nature. So, I don’t really like that term. I mean, I feel like we need to call it something else.

So if you look on my website, I don’t have accent modification, accent reduction. I try to term it differently, because to me, it just sounds very—kind of demeaning. That’s not what I’m really doing. I’m trying to help someone, not trying to make them sound better, or trying to make them sound different. That’s not it.

LS

And I liked the way that you also framed it before about helping someone be intelligible. So that would be the goal, rather, I guess, than the Hollywood version of like, “Oh, I’m doing a movie and I need a different accent.”

MD

Right. I mean, that’s something separate. Of course, people can see speech therapists out for that, too but that’s not really what you’re talking about right now.

LS

Exactly. Yeah. I think that’s so interesting, and so, so much fun.

MD

It is. It is pretty fun.

LS

My phonetics class in undergrad was one of my favorite because I just thought it was basically word games, and learning the International Phonetic Alphabet—it was like puzzles, and I was all over it. It was my favorite class. 

MD

Yeah, I thought it was a cool class to me. I didn’t get it in college. I did take it in my level in courses after to get into grad school, and yeah, I still actually from one of the conferences I went to, I have a mug that says I’m a speech therapist, but it’s written in IPA, the International Phonetic Alphabet. So, it just looks cool because you can’t read it unless you know how to read that stuff.

LS

Yeah, and then I saw an Instagram post once that said, You’ll read anything if it’s written in IPA.

MD

Pretty much, yeah.

LS

And you’re like, “Yup.” By the time you get to the end, you’re like, “oh man, I fell for it.” You’re right.

MD

Yeah, that was a pretty fun class. It’s pretty interesting.

LS

And I think it’s also important for students to hear that, of course, college and any studies you do are taxing and difficult and take a lot of effort, but maybe you could find some fun in there. We’re back to gamifying your studies. [Laughs]

MD

There you go. Yeah. That is one of the things I learned in grad school. So honestly, in grad school, I think no matter what program you’re in, it’s really hard. It’s more intense. You definitely have more reading, more studying, but similar to what you’re saying, if you can come up with those cool acronyms to remember, like the 12 cranial nerves, or whatever you’re learning, it’s so much more fun and so much easier to remember them too.

LS

So should I put you on the spot? [Laughter]

MD

I don’t remember what the phrase is anymore. I was trying to think, “I wonder if she’s gonna ask me that.”

LS

Sorry. We can cut that out if you prefer.

MD

But no, I sort of remember it. There was something about—oh my gosh, it was something about like a fin and a German somehow ended up on like [a] mountain. I don’t remember. It was really random. I didn’t make it up. Someone else did.

LS

Well, it worked with the test.

MD

It did, it did but clearly not after, but I mean, I haven’t been in school in like 15 years, so—

LS

That’s quite all right.

I was just talking with my seven year old today. On the way home from school, she told me about her spelling test. She had a spelling test with five words. This is in first grade, and I asked her to spell one of the words and she’s like, “You think I remember? The test is over.” [Laughter]

MD

Out of sight, out of mind.

LS

I was like, “Uh oh.” You gotta get out of this mindset real quick—

MD

Oh, man. Yeah, that could happen.

LS

So I think that’s gonna be our listener questions. So the listeners, if you will send a message to me on Instagram with the 12 cranial nerves and the sentence you use to remember that then I will do a giveaway for the winner. I don’t know what I’m giving away but that’ll be a fun one.

MD

Yeah, I’m actually curious myself now to look at that and remember what it is too.

LS

Great, and then I’ll compile everyone’s answers and make a post. It’s gonna be perfect. This is awesome.

MD

And I’m sure there are lots of different ones, right? Because everybody tends to come up with a different acronym that works for them, so—

LS

Exactly. I’m really looking forward to that. Perfect. Okay, would there be anything else that you would like to say for all of our listeners? Any advice?

MD

Oh, another thing I wanted to mention to students. I know another thing that I thought was really key for me, was I actually, from another speech service, got the advice to start working with adults and then transition to working with kids later, and the reason I really appreciate that advice is because number one, I think it would be hard if you do want to transition going from pediatrics to adults, because they’re two completely different worlds, but I also think that if you can do both, you are more marketable as a speech therapist or really, as any therapist, because most people don’t work with both populations. So I think it’s fun because you have even much more variety, but also because like I said, a lot of people can’t do both. So you can step into both worlds. I think that’s a big advantage, too.

LS

Can you say more about why it’s harder to go from kids up to adults rather than the other way around? So you said—

MD

That’s really interesting that you asked. I mean, honestly, I haven’t given it too much though but I really think that’s because—well, each population is so specialized.

Firstly, I think the way I did it was easy, because I think working with adults, in some ways is harder, and of course, your paperwork is gonna look different. The tests and everything you’re doing is different. The nature of the therapy you’re doing is really different. To me, it’s really rewarding, but I think it can also be more intense depending on what you’re working on, especially on the medical side. So, I think from a mental standpoint, you might find it more challenging in terms of being—at least that’s what it was, for me. I mean, as much as I loved it, after working with people [with] brain injuries and strokes for almost three years. I said, “Wow, I really enjoy this, and I love my co-workers, and I love the field, but I can’t keep doing this.” I would come home exhausted because you see so much, and a lot of times you’re coaching people, right? Unfortunately, their loved one has experienced a very—they’ve become a very different person, and they may not eventually go back to who they were before. It’s very difficult, very challenging to see but I had like I said, I have so much respect for and I still keep in touch with my co-workers from that particular job, and then for me, I guess -because I think it’s different if you’re on the medical pediatric side, but since I’m not on the medical pediatric side, I’m speaking more to the side of school-aged kids and middle school, high schoolers—

Like I said, because I’m not really on the medical side, to me, it’s more, it’s very rewarding as well. I think I just love working with kids more. I think it just kind of comes down to that. I enjoy it. I think to me, it’s more like playing games, and I found it harder to see as playing games when I was working with adults. It’s a bit more focus to what they want to achieve.

LS

Yeah, I felt the same when I was seeing adults and children in audiology clinics. Definitely the time just goes faster when you’re trying to do a circus show and get the kids’ attention. You’re becoming really animated and doing less—

MD

And you’re part of the entertainment, and I like doing that so I’m like, “Hey, this is fun! Teach me about video games. I still don’t know.” [Laughs]

LS

Yeah, I learned so much from our patients.

And then with adults, I feel like what you mentioned before is that it can also be so difficult because they have changed, or they’re experiencing—in terms of the hearing loss, and coming to accept that and come to terms with it and learn how to deal with the hearing aid, some of that rehab—it’s a different energy, definitely. And the appointments, and you need a lot of patience and a lot of finesse to be able to also—especially as a young audiologist. I felt that there was—it was much easier for me to be young and excited with young kids and their families than older patients sometimes looking at me, like, “You’re the doctor? I don’t know. You look 12.” [Laughs]

MD

Right. Yeah, no, I can understand that feeling. I know what you mean.

LS

That’s really, really interesting advice and so encouraging. Thank you so much.

MD

Sure.

LS

If any of our listeners want to learn more about your work, or where you know, be in touch with you, where can they find you online?

MD

So I am on social media and I know we’re mentioning Instagram, so first I will say I’m on Instagram, and also on Facebook, my business page is Super Speech Solutions, LLC. I’m also on LinkedIn—same, Super Speech Solutions, LLC, and then the best way to reach me is my email address. It’s my first name Meera, M-E-E-R-A @ super speech solutsions dot com [meera@superspeechsolutions.com]. So, feel free to send me a message if you have any questions.

LS

Awesome. Thanks so much for coming on the show today, and I really look forward to hearing people’s acronyms for the 12 cranial nerves, as well as any other feedback from today’s conversation. So you can find us also on Facebook and Instagram and allaboutaudiology.com, where you will also find a full transcript of today’s conversation and all the previous episodes of The all about audiology podcasts.

Thank you to our patrons and supporters. If you’d like to become a patron, please visit patreon.com/allaboutaudiology and I will talk to you all very soon. Take care. Thank you. Bye.

The post All About a Career as an SLP with Meera Deters- Episode 81 appeared first on All About Audiology.