2024 CSHA Conference

Kevin Stuckey, MEd, CCC-SLP, Super Duper Publications

This presentation address how SLPs and parents can help their children ages 4-12 catch up on the basic language and literacy skills they have fallen behind on due to the COVID interruption of in-class learning.  Tens of thousands of students across the country in Grades PreK-4 are very deficient in their ability to follow directions, listen carefully, comprehend and retain information and read.  These children need to improve their skills NOW or they will not be successful in school, and they will more than likely continue to struggle their entire lives.  Unfortunately, most SLPs, teachers and parents do not have time to give these at-risk students all the help they need, nor do they have the specific teaching tools that children need to improve their skills quickly. What can be done? One proven solution is to have these children start using the online programs HearBuilder and the Super Duper Digital Library.  HearBuilder is the only online, research-based, foundational literacy program that address four fundamental learning skills: Following Directions (with Basic Concepts); Auditory Memory (Listening and Comprehension); Phonological Awareness (Sound Recognition); and Sequencing (2-6 Step). Children move through the program gradually at their own pace and work independently without the need for constant adult supervision. Significantly, HearBuilder keeps track of all student progress and has detailed reports for SLPs, educators, principals, administrators and parents.  For those students needing additional help, the Super Duper Digital Library offers support with over 57,000 online educational and literacy-related resources.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Define how students can work independently to improve their basic skills in four critical areas of elementary school learning – following directions, auditory memory and comprehension, phonological awareness and sequencing.
• Identify and utilize over 57,000 online educational resources that they can use daily in their therapy sessions to help their students in topic areas including articulation, phonology and numerous areas of language and communication.
• Determine strategies and receive suggestions as to how to incorporate teaching techniques that were successful in teletherapy into the in-person therapy environment.
• Define the most up-to-date online therapy materials and influential educational bloggers.

Instructional Level: Intermediate   |  Track:  Education

Taylor Seitz, MA, CCC-SLP, Taylor Neuro Specialists

This session will provide education on guidelines for the assessment and treatment of swallowing, AAC and cognitive-communication disorders within the neurodegenerative population.  As SLPs in the medical field, we often become accustomed to our goals of care being rehabilitative in nature to maximize progress, as often reinforced by funding sources. However, when treating a progressive neurological disease, we must think holistically and, therefore, adapt our treatment goals to account for current symptomology and realistic progression of the disease. When we shift our focus to maintenance, prevention and comfort and let the patient/family goals guide our care, we work towards the most functional goals in quality end of life care.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Develop functional goals of care for patients with neurodegenerative conditions.
• Determine when typical dysphagia assessment and treatment methods may be contraindicated.
• Identify candidacy requirements for effective message/voice banking and speech-generated device funding.
• Identify patients with dementia in order to determine an appropriate plan of care.

Instructional Level: Intermediate   |  Track:  Medical

Ally Carrillo, MA, CCC-SLP, University of Colorado at Boulder

What is “trauma,” and how do we, as professionals working with humans across the lifespan, offer our services from a place that is “trauma-informed?” How do we provide speech therapy while also recognizing the traumatic experiences that often lead someone to see SLPs in the first place? How is trauma-informed care related to diversity, equity and inclusion? When is trauma-informed care beyond our scope of practice? And how is working with traumatized individuals related to provider burnout? This presentation will focus on what it means to be trauma-informed as SLPs. We will explore how to consider the past experiences and current emotional needs of clients, students, colleagues and ourselves, while providing speech-language services across settings and populations. Special attention will be paid to providing trauma-informed care that recognizes and acknowledges bias and systems of inequality.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Define the different types of trauma, and what symptoms and behaviors might impact therapeutic relationships and progress in speech-language therapy.
• Identify the principles of trauma-informed care and how it applies to speech-language pathology and our scope of practice.
• Engage with clients, university students (including clinical fellowship year’s) and colleagues from a more trauma-informed perspective.
• Recognize and support symptoms of secondary trauma and burnout in providers.

Instructional Level: Introductory   |  Track:  Multi-Interest

Amy Graham, MA, CCC-SLP, Graham Speech Therapy

Differential diagnosis of speech sound disorders is key to ensuring that appropriate interventions are chosen. This presentation will address how to differentially diagnose speech sound disorders with a thorough evaluation, including how to dynamically administer articulation assessments, conduct an oral-facial exam, interpret case history information, options for intelligibility measurement, considerations for phonological analysis and phonological awareness skills, as well as when to consider the administration of a dynamic motor speech evaluation when childhood apraxia of speech is suspected.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Identify key components of a thorough speech sound disorder assessment.
• Describe how differential speech sound disorder diagnosis can inform therapy approach.
• Identify reasons to refer to other specialists given various evaluation results.

Instructional Level: Intermediate   |  Track:  Education

Stephanie Barnard, MS, CCC-SLP, Speech Language Pathologist

Primary Progressive Aphasia is getting increasingly diagnosed and visible in medical and lay communities. What do we know about this disease and how it progresses over time? This course will cover the three types of PPA, early/middle/late stage characteristics, treatment ideas and important topics to consider when supporting a patient and their family with this new diagnosis. The focus of this topic will be for the outpatient clinician though many of the principles are applicable across various healthcare settings.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Identify the three types of PPA.
• Identify two or more treatment strategies.
• Identify holistic providers and services that need to be a part of the care team.

Instructional Level: Introductory   |  Track:  Medical

Hillary Cooper, MA, CCC-SLP, Speech-Language Pathologist

Thickeners are pervasively used in dysphagia management and have historically been taught to be benign one-size-fits-all solutions for aspiration. However, current research shows that thickeners may be contraindicated in some circumstances and harmful in others. In this lecture, we discuss the evidence behind the use of thickeners as dysphagia compensation techniques as well as the pros, cons and ingredients of the most commonly used thickeners on the market.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Identify three aspects of thickening which may impact quality of life.
• Demonstrate understanding of the current scientific evidence regarding use of thickeners without instrumentation.
• Describe five types of thickeners and their primary indications and contraindications for use.

Instructional Level: Introductory   |  Track:  Medical

Amy Graham, MA, CCC-SLP, Graham Speech Therapy

Many SLPs find correcting residual /ɹ/ errors to be extremely challenging. This presentation will focus on how to properly assess the speech mechanism for possible underlying structural/functional deficits that could impede progress in therapy and provide practical strategies to help SLPs elicit /ɹ/ using cognitive reframing and multi-sensory cues. Considerations for target selection and strategies to promote generalization will also be addressed.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Identify key components of a speech assessment that can help SLPs understand underlying structural/functional impairments.
• Describe one new method for elicitation of /ɹ/.
• Explain how utilizing principles of motor learning can promote retention and generalization of newly learned speech skills.

Instructional Level: Intermediate   |  Track:  Education

Kimry Schwarz, MS, CCC-SLP, Advanced Dysphagia Diagnostics LLC

This course will cover general classifications of HNC including tumor staging and implications for the SLP. We will discuss the need for pre-radiation SLP diagnostics and therapy. Various therapy approaches and the benefit of ongoing therapy in this patient population will also be reviewed. This course will also cover the need of a multidisciplinary team to best serve patients with HNC.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Discuss the benefits of pre-radiation SLP intervention.
• Discuss EBP therapy approaches in the HNC population.
• Identify beneficial members to a HNC IDT team as well as understand the need for such a team approach.

Instructional Level: Intermediate   |  Track:  Medical

Hillary Cooper, MA, CCC-SLP, Speech-Language Pathologist

Thickeners are pervasively used in dysphagia management and have historically been taught to be benign one-size-fits-all solutions for aspiration. However, current research shows that thickeners may be contraindicated in some circumstances and harmful in others.  In this hand-on lab experience, the participant will be provided with a variety of commercial thickener products to mix and then perform qualitative ratings based on organoleptic properties such as mouthfeel, texture, smell, appearance and more. Additionally, the speaker will guide the participants through a brief science experiment which will highlight the impact that salivary amylase has on thickener viscosity and stability. (DISCLOSURE/ALLERGY WARNING: Participants will be expected to consume small quantities of thickener products mixed with water during this session. Do not participate if you are highly allergic to corn, milk, galactomannans, xanthan gum or erythritol.)

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Demonstrate correct mixing techniques for a variety of thickener products.
• Identify the impact that salivary amylase has on the viscosity of commercial thickener products.
• Demonstrate understanding of the importance of organoleptic properties of thickeners on quality of life and patient compliance with thickener use.

Instructional Level: Introductory   |  Track:  Medical

Patty Walton, MA, CCC-SLP, BCS-F, Chelsea Blanchard, MA, CCC-SLP, Whitney Noven, MS, CCC-SLP, Bethany Tileston, MA, CCC-SLP, Meghan Walton, MA, CCC-SLP, Emily Figliomeni, MA, CCC-SLP; Center for Stuttering Therapy

Stuttering is an area in the field of Speech Pathology that can be difficult to navigate due to the lack of homogeneity across clients and the lack of agreement regarding treatment strategies and approaches.  As specialists who treat stuttering, we often have questions during presentations that always begin with “I have this kid …” SLP’s come to talks with specific kids in mind that they are looking for answers to, or perhaps are looking for validation that they are on the best therapeutic path for the child.  This talk will provide attendees the opportunity to discuss specific cases and ask questions about diagnosis and treatment with the speech language pathologists at the Center for Stuttering Therapy in a roundtable fashion, divided into preschool, school age, teen and adult age groups. This format will encourage

 in-depth discussion, sharing  and problem solving for both assessment and treatment, as well as discussion about current trends in the field.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Determine strategies to enhance their therapy with children and adults who stutter. Strategies from a variety of approaches will be discussed including fluency shaping, modification, acceptance and commitment therapy and cognitive behavioral approaches.
• Identify new trends in the field of stuttering therapy including focusing only on acceptance, stuttering pride, neurodiversity and issues surrounding speech change.
• Explain aspects of counseling important to support positive and long term changes in therapy, including parent and teacher counseling, how to talk to kids about stuttering , how to send positive messages about communication versus fluency, and how too much of a focus on fluency can inadvertently send the wrong message to our clients.

Instructional Level: Intermediate   |  Track:  Education

Irene H. Kim, MA, CCC-SLP, CBIS, Post Acute Medical (PAM) Specialty Hospital of Denver

This program delves into the vast topic of neurological injuries, seeking to further knowledge and understanding of various types.  There is a brief review of anatomy and recent studies highlighting neural interconnectedness.  The discussion is then divided into injuries from the external forces (Traumatic Brain Injury) and those from the internal damage (non-traumatic)/ Focusing on TBI, there will be a review of common mechanisms of injury, the continuum of care and the Rancho Levels of Cognitive Functioning.  Complicated non-traumatic disorders such as Anoxia, CVA and Meningitis will then be discussed.  There are moments of mindfulness and examples of specific patients throughout.  Finally, descriptions of how to promote teamwork and brain injury programs are presented, including staff orientation/education on aphasia and neurobehavioral management, as well as ideas for team communication.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Describe how interconnectedness is an important consideration in brain function and damage.
• Demonstrate understanding of the Rancho Levels of Cognitive Recovery in traumatic brain injury.
• Identify suggestions for teamwork in their facilities to promote brain injury recovery.
• Identify additional factors that may impact neurological patients and their recoveries.

Instructional Level: Intermediate   |  Track:  Medical

Charlie Lenell, PhD, CCC-SLP, University of Northern Colorado

Vocal health is influenced by many factors such as age, sex, occupation and overall physiological condition.  Common key components to maintaining adequate vocal health include the elimination of vocally damaging habits (e.g., screaming, habitual coughing or throat clearing, etc.), ensuring proper breath support (e.g., diaphragmatic breathing) and adequate hydration.  However, certain special populations may benefit from additional vocal techniques or habits to ensure a healthy voice.  For example, vocal disuse is relatively common for elderly individuals; therefore, suggesting vocal use throughout the day such as humming may help prevent or reverse laryngeal changes associated with disuse. This presentation will discuss the theoretical principles and core features of vocal health programs as well as discussing the implementation and customization of these services for special populations. Special populations will include the following:  professional voice users (teachers and singers), transgender individuals, aged individuals and individuals with Parkinson’s Disease.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• List common elements of vocal health programs.
• Describe three special considerations of vocal health for professional voice users.
• Describe three special considerations of vocal health for transgender clients.
• Describe three special considerations of vocal health for aged clients.

Instructional Level: Intermediate   |  Track:  Multi-Interest

Theresa Snelling, MA, CCC-SLP and  Jocelyn Parson, MA, CCC-SLP

Children with tonsil and adenoid hypertrophy and other associated obstructing conditions can result in hyponasal resonance, speech/articulation disorders and airway obstruction.  Sleep apnea and disrupted sleep symptoms are often seen in children with pharyngeal and/or nasal obstruction impacting speech and intelligibility.  This session will cover anatomy of these conditions and differential diagnosis of hypernasality, hyponasality, cul de sac and mixed resonance (hypernasal/hyponasal).  Accurately diagnosing resonance disorders, which may be seen in conjunction with speech/articulation disorders, is needed to correctly identify the type of medical management needed.  The specific intervention strategies related to speech therapy for children with resonance disorders, medical management options and when to refer for medical management, will be covered.  Preschool/school age children may show chronic obstructing airway conditions that affect both speech and academic performance. Specific surgical management of cleft palate conditions can result in abnormal resonance patterns. When hypernasal and hyponasal resonance patterns are seen in same client, at same time, it is critical to identify the underlying causes to drive correct surgical/medical management as well as speech therapy targets.  Differential diagnosis of the resonance disorder, which must include a comprehensive oral mechanism exam (OME), drives the correct interventions. The impact of airway obstruction on special populations, including children with Down Syndrome and Cleft Palate, will be presented.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Differentially diagnosis Resonance Disorders in children related to anatomical conditions of the pharynx, oronasal cavity and nose.
• Identify the symptoms of sleep obstruction/sleep apnea in children, as is relates to oronasal obstruction.
• Identify special populations at risk for Resonance Disorders including children with cleft palate, Down syndrome, and apraxia.

Instructional Level: Intermediate   |  Track:  Multi-Interest

John Ashford,  PhD

Flexible Endoscopic Evaluation of Swallowing (FEES) is a well-recognized and highly-utilized clinical tool in the assessment of swallowing functions.  FEES is more than inserting the endoscope through the nose and into the pharynx to observe swallowing functions.  It allows review of the pharynx and larynx for possible abnormalities, but also observation of the consequences associated with dysphagia, including residue, laryngeal penetration and tracheal aspiration. Scoring and quantifying these consequential observations allows construction of a picture of the swallowing behaviors over multiple trials using varied food consistencies.  Further analysis provides insight into the biomechanical problems underlying swallowing problems and gives direction for intervention.  This presentation will introduce a FEES scoring system and the audience will actively score and analyze actual swallowing trials.  There will be discussion and it will be fun.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Identify and name the surface structures of the larynx and pharynx, as seen endoscopically.
• Apply a 5-point scoring scale to assess and record laryngeal penetration and tracheal aspiration events, and similar scales to assess pharyngeal residue.
• Summarize scored swallowing events to determine the characteristics and severity of swallowing impairment.

Instructional Level: Advanced   |  Track:  Medical

Hannah Glick, PhD, AuD, University of Northern Colorado

Hearing loss is a leading chronic health condition in adults worldwide and has been independently associated with cognitive decline, including increased risk for dementia and other co-morbid health conditions such as social isolation and depression.  Despite these statistics, there exists no universal hearing screening for adults and less than 20% of adults have ever received a hearing test.  Furthermore, intervention rates with hearing aids and cochlear implants remain low for adults and there exists many barriers preventing access to and affordability of hearing healthcare services.  This presentation details current research findings on the effects of age-related hearing loss on neurocognitive function and well-being and its implications on screening, identification, intervention and rehabilitation for this population.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Explain current scientific understanding of the effects of untreated hearing loss on neurocognitive function and possible mechanisms driving this association.
• Appraise current research evidence on the effects of hearing treatment on neurocognitive function and well-being.
• Analyze the potential value of employing cognitive screening in the audiology clinical setting.
• Analyze the potential value of employing hearing screening in the non-audiology clinical settings.

Instructional Level: Intermediate   |  Track:  Medical

Jennifer A. Clark, MA, CCC-SLP, Inspiring Talkers

Providing augmentative and alternative communication intervention can be intimidating and overwhelming.  This presentation will focus on how to take what participants already know about language therapy into intervention with AAC.  Pragmatic and realistic strategies that work in pediatric and school settings will be shared.  Common problems and misconceptions will be discussed as well as strategies to complete effective assessment and finding the best technology match for individual clients and students.  Participants will leave this session empowered with strategies and tips to make AAC intervention and assessment more approachable in the educational and pediatric settings.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Identify multiple access methods and when they may be appropriate for users.
• Implement effective theraputic techniques with AAC in their next session.
• Identify and address common barrier to quality augmentative and alernative communication intervention in the listed settings.

Instructional Level: Introductory   |  Track:  Education

John Ashford, PhD

The level of patient frailty is often overlooked when a patient is referred for a swallowing assessment. Valuable clinical clues relating to the cause and severity of possible dysphagia, malnutrition, and eating problems may be found during the frailty assessment. Frailty is characterized by an increased vulnerability resulting from aging-associated declines in reserve and functions across multiple physiological systems affecting the ability to cope with everyday or acute stressors. Muscle weakness is the primary cause of dysphagia and the most common first indication of frailty onset. Sarcopenia is a major component of frailty and is directly related to swallowing disorders. This presentation will examine aging, frailty, malnutrition, and the associated link with dysphagia.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• Define human frailty as a medical term.
• Define sarcopenia and contrast it with Frailty.
• Describe why dysphagia is a major symptom and disorder found in the Frail elderly.
• Describe why dysphagia is a major symptom and disorder found in the Frail elderly.

Instructional Level: Advanced   |  Track:  Medical

Kathy Tucker, MA, CCC-SLP; Tammy Frederickson, PhD, AuD; Sierra Morrow, BS; Hannah Sake, BS; Hayley Ratzan-Wank, BA, University of Colorado

While auditory processing disorder (APD) is a controversial subject among clinicians, determining a common language and criteria for diagnosis, along with the use of a multidisciplinary team, can bring more insight and clarity to this complex issue.  In this interactive session, we will introduce you to  different models of auditory processing, the complex standards for diagnosis, guidelines for assessment and intervention based on evidence and the importance of a multidisciplinary team approach when diagnosing APD.  We will also explore functional recommendations and evidence-based interventions for APD. We will discuss the multidisciplinary team approach used at the University of Colorado Boulder Speech, Language and Hearing Clinic, as well as potential ways to adapt testing and intervention to various settings.  Case studies will be presented to further underscore the importance of a team approach and a comprehensive view of auditory processing concerns.  By utilizing the expertise of various healthcare professionals, the team can provide a comprehensive evaluation, evidence-based interventions and support for individuals with auditory processing concerns and their families.  We will also encourage attendees to share their experiences diagnosing and providing intervention to individuals with APD.  Our goal is for you to walk away with a more comprehensive understanding of APD, guidelines for comprehensive assessment and evidence-based intervention strategies to help individuals with APD in your clinical setting. There will be a question and answer period at the end of the presentation.

Learner Outcomes:  At the end of this presentation, participants will be able to:

• List different models used in the approach to auditory processing disorder assessment.
• Describe how auditory processing disorder is defined and what criteria is used to diagnose audiroty processing disorder.
• Describe why using a multidisciplinary team is the best practice in the diagnosis of auditory processing disorder.
• Identify the next steps and evidence-based intervention for individuals diagnosed with auditory processing disorder.

Instructional Level: Introductory   |  Track:  Multi-Interest