EPISODE 37

[INTRODUCTION]

[00:00:07] CL: Hello and welcome to This Speech Life, an audio course and podcast from speechtherapypd.com. Exploring all things related to school-based SLP practice. I'm your host, Caitlin Lopez, MS, CCC-SLP, a school-based SLP with over 10 years of experience. In each episode, we will cover three need to know aspects of the topic, two resources related to the topic and one actionable strategy for tomorrow. 

[INTERVIEW]

[00:00:36] CL: Hello and welcome to this week's episode of This Speech Life. I am Caitlin Lopez, your host for the podcast for school-based SLPs. And I am so excited to have Sara Serota with us today to talk about all things deaf and hard-of-hearing students. And how to best work with our deaf and hard-of-hearing students. 

But before we begin, just a few housekeeping items. Sara Serota has been working for four years as an SLP for the deaf and hard-of-hearing students in the public schools. She worked on a waiver in graduate school. And since then, she has worked with students in early intervention, to high school. And she currently works in middle school and in private practice. In her free time, she enjoys spending time at the beach with her husband and two Boston Terriers, as well as reading romance novels. 

I am Caitlin Lopez. I do receive compensation for this episode from speechtherapypd.com. Sara Serota will receive an honorarium from speechtherapypd.com appearing as a guest on this podcast. 

All right. So now that that stuff is out of the way, Sara, I am just so excited to have you on to discuss deaf and hard-of-hearing students. This is something we haven't really talked about much on the podcast. And there isn't a ton of content out there, especially for newer SLPs that have deaf and hard-of-hearing students on their caseloads. So I'm just really excited that you are going to be bringing your knowledge base to us today. 

[00:02:18] SS: I'm so excited to share. And it is a topic that is near and dear to my heart. 

[00:02:23] CL: Awesome. So why don't we just jump right in? What are three things that we need to know when it comes to working with DHH students? 

[00:02:32] SS: So the first thing you need to know is that you will be challenged as a clinician in the best way and you will grow and you will become a better clinician for both your hearing and non-hearing students. Because you're going to have to learn how to ensure that the therapy you're providing is not just accessible to them at the level of their language ability but also physically accessible to them. Whether that be visual, auditorily, in writing. 

And I also find that I incorporate a lot more written work with my older DHH students, as well. I usually do therapy with the assistance of a certified educational sign language interpreter. So I'll be the one voicing and they will be signing. 

There's a lot of different delivery models. Probably, I would say gold standard would be a deaf or hard-of-hearing SLP giving services to the deaf or hard-of-hearing population. Those people are unicorns and I think some of the coolest people in the universe. I don't think that there's necessarily anything wrong with being an SLP that has to use an educational sign language interpreter. But there is that extra level of abstraction for the student. And you kind of always have to keep that in mind as you're working. 

I am trying to learn sign so that one day I will be able to deliver bilingual services. That's my professional goal. The other one is you don't have to be fluent in ASL. That's like a common misconception. A lot of us are thrown in the deep end so to speak. I know in some of our conversations, Caitlin, you had shared that that happened to you, that you were given this population and told, "Okay. Here you go." And the same thing happened to me. 

So when I started with my current district four years ago, I had transferred from another district where I worked primarily with English language learners predominantly in a Hispanic community and with a lot of students who Spanish was their primary language. 

And then I transferred to my current district. And the school that I was assigned had this program. And so, I felt like a fish out of water. But I was able to find a lot of resources including on my campus. The teacher for the deaf and hard-of-hearing. My school psychologists who had a lot of experience working with the deaf and hard-of-hearing. Many different teachers for the deaf. And also, asking questions to my educational sign language interpreters. And they were always so willing to teach me new signs and explain why they interpreted something a certain way or let me know when something didn't translate really well and allow me to clarify it for my students. 

I think that it's important for SLPs to reach out to the deaf community to provide positive deaf role models for students who are deaf and/or hard-of-hearing. Some of the most impactful professional collaborations I've had are working with the teacher for the deaf and hard-of-hearing and also helping our gen ed teachers for our students who are mainstreamed into their classes teaching them how to help those students access the curriculum given the barriers of hearing levels. 

[00:06:17] CL: Fantastic. Okay. I just want to make sure your three points are you will be challenged. Using Ð let's see. Don't have to be fluent in ASL. And then the third one was collaboration.

[00:06:30] SS: Yes. I added a third point that like most of the students cannot communicate via ASL in their homes. But that might actually be a better question for discussion.

[00:06:41] CL: Okay. ASL, yeah. That's a really Ð I know that that's something that I've seen pop up a lot lately is the statistic is really low of children who are deaf, the statistic of families that learn ASL. 

[00:06:57] SS: My current statistic at the middle school is zero.

[00:07:01] CL: Wow. Wow. 

[00:07:02] SS: My statistic at elementary school is a little bit higher. A little bit. Yeah. Maybe three or four parents.

[00:07:09] CL: Wow. That's really Ð it's heartbreaking to me. But I also am recognizing that the resources to learn is not always super available either. 

[00:07:23] SS: We also have to understand the barriers to those resources. There are lots of resources. However, oftentimes, what I find to be the case is that there's a second language barrier. So it's not just an ASL English language barrier. For instance, I have some parents whose primary language is Mixteco. And so, they speak very little Spanish. And there are so few Mixteco interpreters. And then Mixetco and ASL, somebody that would know both of those would be like a true unicorn, right? Maybe a mythical creature. I have not met one yet. Met a person yet that has expertise in both of those languages. That would be a sight to behold. 

And then there's socioeconomic factors and just the factors that go into childbearing. Raising kids is hard and expensive. And there's just so many factors that would be prohibitive for people learning different language as an adult specifically. But it never ever keeps me from encouraging it.

[00:08:33] CL: Absolutely. Absolutely. 

[00:08:34] SS: And trying to find those resources in our community. 

[00:08:39] CL: Yeah. Absolutely. As I was thinking about that caseload that I had when I first signed on to a school district. I was speaking with Sara just before we started recording. And I had a preschool DHH program and then the elementary DHH program. And the preschoolers, about half of them, the parents did not speak English. They were Spanish-speaking. And two were recent immigrants from Mexico and El Salvador. The parents were not speaking English. And the children really weren't either. 

That was kind of a fun challenge. I don't have to get into it. But it was such an interesting case. The family from Mexico, they moved to the US to get their cochlear implant. But he was implanted in I think fifth grade, which is a little late. But anyway, we don't have to get into that now. But they were such a sweet, sweet family to work with. And I really enjoyed the challenge of working with him because he was learning Spanish while he was learning English and ASL. And he was such a bright kid. I had so much fun with him. 

But anyway, like what Sara was saying, this population is so much fun to work with. But I loved your point that you made about making sure that our therapy is accessible. Not just physically. But also, with language. You know, what kind of language we're using? How simple or how complex the language is? I thought that was something that was a huge steep learning curve for me. 

I had fifth and sixth-grade students that I was expecting to Ð you know, there's no intellectual disability. But their language was so low and it was also because Ð as I'm thinking back to one of the girls that I had, she was a sixth grader and the family didn't use ASL with her. She also had an implant. I can't remember when she was implanted. The little girl didn't like to use her cochlear implant. And families were very adamant that that was the mode of communication and not ASL. And so, it impacted her language. 

And it was hard to find materials that were appropriate for her age but also not too complex. I really love that you bring up that point. Because that first year, I was like, "What am I going to do?" I realized I was picking things that were way too hard initially. 

[00:11:09] SS: We run into that issue of language deprivation. And then there's not the complete opposite flip side of that coin, but language over-simplification, too, right? Although deaf children miss their critical period for language development, right? That 18-month statistical learning window. They still require rich language models just like any other human developing language. 

And so, it is a delicate balance between providing them the rich knowledge of whatever language is accessible to them. And then, also making sure that it is at their level and maybe reaching that zone of proximal development just a little bit higher so that we can build the vocabulary and build the syntactic structures. 

Yeah. Like I said, working with the deaf and hard-of-hearing population will do nothing except bring growth and insight into your life. And in my case, just immense joy as well. 

[00:12:16] CL: Awesome. And thank you for making that point of like you don't have to simplify things. You can still provide rich language environment. I think that that's really something that we all need to hear, especially with all of our students, right? That presuming competency, but also meeting them where they're at. I love that point that you made. 

You said so many great things. I'm going to go back and look at my notes. I love that you had access to an educational ASL interpreter. I didn't have access. I was learning from students. But I did have a student that was hard of hearing and had been in the DHH program since preschool. And he was mainstreaming into classes in the gen ed setting. 

And so, he acted as my interpreter a lot of times. I would often pull him when I was working, especially with that student. He also spoke Spanish, too. He was trilingual. And so, I would often pull him when I was working with that student I was talking about that was recently immigrated, recently cochlear implanted. And he was such a huge help. I almost wonder if I relied on him a little bit too much. That's really great. 

And I loved also the gold standard is a DHH SLP. However, they're unicorns. I know that I follow I think one or two on Instagram. And I have questions for you regarding like deaf culture and that kind of thing that we'll probably get into a little bit at the end if there's time. But I did love that you talked about how you don't have to be fluent in ASL to jump into this setting. It's helpful and you will learn as you go. I've lost everything that I learned because I quit using it. 

[00:14:06] SS: When you're a public school speech-language pathologist, not only do you not have to be fluent in SLP. A lot of times you don't have a choice. It's free and appropriate education, right? They don't guarantee that the person working with your child is going to be deaf or hard-of-hearing or fluent in sign. And that piece of it, first of all, there's a dire need for SLPs in general. There's a dire need of bilingual SLPs. And then adding SLPs that are deaf and hard-of-hearing and bilingual, there's just so many different levels there. 

But the ultimate message I think to take home from that is that you can be deaf-affirming and deaf culture positive without being fluent in ASL. I consider myself a student of ASL. I've taken some classes and I continue to take classes to get better. 

I also very, very humbly submit that I have visual-spatial deficits. I struggle with ASL. It's like I've never been able to take a dance class. I can't match my body to do what other people's body are doing well. And it makes ASL a very difficult language for me to learn. 

However, I keep trying. And my students are so gracious. And they are always willing to correct me sometimes nicely. And sometimes I work with pre-teen, so sometimes it's not the nicest. But I always just take it with a grain of salt and learn from it and make it all a learning opportunity. But they will model anything I ask them to. 

And I think that's just so lovely that they're just so willing to share their language and their culture and invite me in. And that's been such a source of Ð how do I says this? It's been such a source of like the good feels. That even though I'm not deaf or hard of hearing and I'm not a CODA, I'm not a direct member of the deaf community, they have been so inviting and at every opportunity have reached out the bridge to welcome me in, and teach me. 

[00:16:35] CL: I love that. I would say that I remember I felt so humbled and grateful when one of my students gave me a sign name, which you can only get from a deaf person. And I just remember thinking like, "Oh, my gosh. Wow." We really are building a relationship here. And, yeah, I agree with you that those points of your students modeling for you and being so welcoming. 

I guess I'll ask you now since we're a little bit on topic. I live very close to California School for the Deaf in Riverside. And we have a huge deaf population. I shouldn't say Ð I mean, it's a bigger one in our area. In fact, just this year, my husband and I, we started counting because we really felt like it was more than just a coincidence. 

But since January, we've had 10 instances of deaf people coming to us to ask for help, for things when we've been out and about. And we haven't necessarily Ð there's restaurants that are near school for the deaf that like we would notice deaf people signing to each other. But we just were like, "Oh, my goodness. It's not just we're noticing people. They're coming up and asking us for help." And then we feel so inadequate that we can't sign back to them. But luckily, we all have our phones and we have notes on our phones and we can text back and forth. 

But the question that I have for you is I remember I also went to grad school in the community that I live in now and I did observation hours at school for the deaf when I was in either undergrad or grad school. I can't remember. But the speech therapist that was there was saying Ð and I was really intrigued and thought maybe this is the population I want to work with. And I've always had an affinity for ASL. But like you, I also have a really hard time learning it. 

And so, when I went and visited and observed her, she was really negative and she could have just been Ð she was a much older SLP. I think she was on her way to retirement. But she was really negative about, "Well, you need to think twice if this is the population you want to work with. They don't want to work with us. They don't want to talk. They don't want to communicate through mouth [inaudible 00:19:00]." 

And so, I just remember being like really turned off. And not turned off, but just I kind of understood. Like, "Oh, yeah. I don't want to insert myself where I don't need to be." And so, your response right there. What has been your Ð and you also shared that you have a lot of really good feelings and you've had such positive interactions with deaf culture. What are your thoughts when it comes to speech therapy in some of those maybe negative attitudes towards speech? 

[00:19:31] SS: I'm going to kind of actually circle back to something you said earlier. Because we were talking about sign names. One of my most difficult students is the one who gave me my sign name, ultimately. I think that some of that sort of maybe attitude towards hearing SLPs or non-signing SLPs or speech-language pathology in general of the deaf students that we work with is stemmed in educational trauma and therapeutic trauma, to be completely honest with you. 

There is no homogeny among the educational programs. And so, we have oral programs that emphasize only spoken language. And then we have only deaf programs and then the total communication programs. The program that I work in is a total communication program. And we teach deaf students with hard-of-hearing students. And so, the language is always spoken and/or signed or one of the two often times with an interpreter. 

The current teacher for the deaf that I work with is a certified educational sign language interpreter and also a teacher for the deaf. She's an amazing resource and she has really helped me immeasurably specifically learning ASL syntax and helping me with like learn the language development and how to kind of scaffold things for our students. 

When I first came to the district, I had a really rough group of eighth graders. They really resisted speech. And right from day one, they were like, "We don't like you. Speech is bad. We don't want to do it. Why do we have to do it? I hate it." Right? Honestly, if I had to, without being a fly on the wall, come up with the reason why, I would say an emphasis placed on oral language as their primary mode of communication within a speech therapy setting is traumatizing and devaluing. And I would also say that, for a long time, there was some really not great practices. 

For instance, when working on some of the disordered sounds that were outside the students' possible hearing profile, trying to teach it to a deaf kid with a hoop in front of your face. I don't know if you remember the speech hoops of your and treating oral spoken language as if it occurred in a vacuum. As if hearing people didn't have visual cues to decipher language, right? 

Having said that, it took a long time and a lot of collaboration, and research and humility to build our relationship to the point where it became therapeutic. And it didn't happen overnight. But I approach that piece of it with the same attitude that I do my hearing students, with the same approach that I do my geriatric patients, with the same approach that I do the parents that I coach. And that is to focus on our relationship first, right? 

When you care about your students and when they feel that and know that, when you show them that you respect them, and want good things for them, and make therapy fun and engaging and you show up for them, they will let their guard down. But understandably, yes, the guard is up. It is there. And it's there for very valid reasons. 

This particular student, I just adore him. And he actually really put me through the wringer. At some point, I'm not going to lie, there was some sobbing that first year because the kids were kind of hazing me. They were kind of mean to me. But I just cried in private and then reached out to the resources that I had asked how I could be better worked, specifically with that student. 

What ended up working with that student was seeing them individually, and letting them get to know me, and getting their parents involved and saying, like, "Look, this behavior is happening and it's not great. Like, they were calling me names." And there was some refusal, which I do let my kids refuse. But this is a pattern of refusal. And so, we kind of got to address that, right? 

But it ended up just being one of the most powerful therapeutic experiences of my life. Because within three months of starting that individual therapy with this student, we were able to establish a rapport. And he was able to see that while I was doing speech therapy, it wasn't like what he had experienced before. And I was going to honor ASL. And I was going to honor whatever communication attempt he had. And I wasn't going to make him sit for 30 minutes and do a worksheet or whatever. That I cared about his thoughts and his opinions. And it really is the basis of all therapeutic relationships.

I will say it's there. Even still, I work with middle schoolers. And you just have to have a thick skin. Whether they're deaf or not. If you were ever thinking like your outfit wasn't the best, you'll know for sure when you show up at work at a middle school. If you were feeling really good, just be like prepare to be taken down a peg by your very fashionable and savvy students. And just know that, most of the time, it's out of love. Like, they feel like they can tease you like that because they love you and care about you. 

Yeah. That student ended up giving me my sign name and it has stuck. All my students use that sign name. And it's been really meaningful. And like I said, I only had them for a year. And things kind of came to a head at one point and we just really managed to turn it around. And it was one of the most powerful experience I've ever had as a therapist. And I think it will always be that way because it was really that first instance where I had a student that was that resistant. 

And when I kind of did the deeper dive, reached out to my resources, dug deep in my humility and took my ego out of it, we were able to find that common ground and make some really strong progress along the way, too. 

[00:26:32] CL: Do not be sorry. As you were talking, I just loved hearing your story, this particular student. Because I think we've all been there, whether or not it's been a DHH student, of having those students that we just struggle with. And then they always end up being our favorite. 

[00:26:51] SS: It's true. It's true. 

[00:26:53] CL: Right? Right? As you were talking, I thought, "Man, this story is so universal." 

[BREAK]

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[INTERVIEW CONTINUED]

[00:27:19] CL: Whether or not they are deaf or hard-of-hearing is Ð as you were talking about, I thought how many of our autistic students have educational trauma? How many of our students who are marginalized have had some sort of educational trauma? 

And that one of my favorite principles, she has since retired, but something she would always say to us whenever we were having behaviors Ð because I loved her so much, I would sometimes go to the staff meetings. We didn't have to in our district. And she would start every staff meeting with, "How are you reaching them to teach them?" 

[00:27:58] SS: I love that. I love it. 

[00:28:00] CL: Yeah, that was always her response, was, "Okay, who's going to share reach them to teach them moment?" Or if somebody was struggling with behaviors with a student, "Okay, what are you doing to reach them? What are you doing to reach them?" 

And it comes back to that relationship and how that is so necessary. Because I'm not going to care about what somebody has to say unless I know that they care about me or they care about a particular topic we're going to talk about, you know? We are all that way. And I just love that you brought up that point. 

And you brought up the point of educational trauma. That's something that we really need to think about when we're working with all of our students. But especially, our DHH students. Because, again, so much of what you said. Like, the previous speech therapist that they might have been working with or the previous teacher or anybody that they might have been working with that is not taking them individually into consideration. And how there have been times where we have been harmful as speech therapists. Not meaning to. 

[00:29:05] SS: Right. I don't think that anybody like woke up one day as a speech therapist in the '80s and '90s and was like, "How can I give some educational trauma? But the flip side of that is when we know better, we do better.

[00:29:18] CL: Absolutely. 

[00:29:19] SS: And I know better. So I'm going to do better. And just I think my therapy philosophy in general is never to push kids to do things they don't want to do. It's to get our relationship to the point that they trust me. That whatever I bring up to do, they're going to want to do. And they trust me enough to know that it's going to be fun. It's going to be engaging. Or at the very least, it's not going to be boring.

[00:29:49] CL: Absolutely. And it's going to impact their life in some way that is meaningful to them as opposed to just filling out a worksheet for the sake of filling out a worksheet. Yeah, I know in my last 12 years, I, for sure, have caused educational trauma without meaning to, you know? 

[00:30:06] SS: Same. 

[00:30:07] CL: I think that that's such a good thing to bring up as to the experiences kids have before they get to us. And I've been there, you know? There might be a person that Ð like, the dentist. I don't really want to go to the dentist because I haven't had the greatest experiences at the dentist. 

[00:30:24] SS: It's funny that you say that because that was my previous life. I was a dental assistant for a decade before I became an SLP. 

[00:30:31] CL: Really?

[00:30:32] SS: Yeah. And I had the same opinion that you did. I had terrible dental experiences as a child. Like, painful, and scary and traumatic. And I ended up needing a lot of dental work in my early 20s as a result. And I came across a dentist who just happens to continue to be one of my dear friends and is one of the nicest people I've ever met. 

And he was so gentle, and kind and understanding that I decided to be a dental assistant in that field because he turned it around for me. Because I wanted to turn it around for other people who were afraid of going to the dentist and be that like friendly face to help let them know that, like, "I know you're afraid. But you're in good hands. And it's going to be okay." 

[00:31:17] CL: Oh, I love that. I love that. And now we get to be that for students too. Which is also I think one of the reasons why I just love working in the school setting, is because we're a little different than a teacher. And we can create these safe spaces on campus for kids. And we can hopefully start to spark some curiosity and some love of learning even if we're not necessarily that teacher, that space. I love that. 

Sara, thank you for sharing that little story. Let me see. Did I recap your three things? You will be challenged and you're going to grow. ASL is not necessarily their way of communication at home, which we also touched on. Great. You've given us so many great things to think about when we're stepping into working with our DHH students. Do you have any resources for us that will either help us learn more or things we can use in our practice? 

[00:32:13] SS: Yes. Oh, my gosh. Yes. When I was thrown into the deep end of working with this population, I found Dr. Kim Ofori-Sanzo on Instagram of all places. The true Millennial that I am. Elder as I may be on that population. And she runs a company called Language First. And it is a resource for SLPs or other professionals working with the DHH population. 

And I cannot tell you how immensely grateful and impactful it was. She provides learning opportunities. Puts on a conference. I was able to attend the conference during COVID times. But now it's back in person and out of state. My district won't pay for it. It's a little harder. But I, out of my own pocket, subscribe to Language First. 

For their webinars, they have monthly webinars and ASL chats. Dr. Ofori-Sanzo has been so helpful and so generous with her time. She actually came out and talked to our SELPA, which is our local special education area representation through our county about assessing DHH students. 

She gave a whole presentation about how to use standardized assessments as a component in a non-standardized way. And how to word assessment results so that we're not blaming deaf kids for their language levels, which is something Ð if you want to talk about at the end, I would really love to discuss that because I think it is really important. 

And so, she's amazing. Language First is the name of the organization. I cannot say enough good things about her and her organization. And she has both deaf and hearing people that work for her. And she is amazing. And I'm just constantly in awe of her knowledge and ability. But also, her willingness to share it. And the fact that she has created so much free Ð by the way, free content that she shares through Language First and all the content that she creates online to expose people to deaf culture. To help us understand and bridge the gaps in our profession about honoring sign language as a valid form of communication and prioritizing language learning over all else, including oral language. If ASL is the only language, that's 100% accessible to children with impaired hearing levels, deaf children or hard-of-hearing children. Because even if hard-of-hearing children are aided, there may be sounds outside of their hearing profile that they will just not be able to hear aided or not. 

And that group is so heterogenous that ASL really is truly the only fully accessible language at all times to them. And I think it's really important that we, as the professionals, make that educational point to families when they're choosing how they want to educate their children. I cannot say enough good things about the Language First organization. 

And then there are so many amazing resources in this day and age to learn ASL. And I just urge as many people who are interested in it to do it, from Community College classes, many offer in-person learning, which is the gold standard if you can take in-person ASL because of that spatial component, I do recommend it. ASL is a language that has rich meaning that is carried on the body. So not just the hands. That's a really important thing. 

But that's not to say that things can't be learned if online is the only way that you have to access. I've taken online classes and learned a ton and felt so grateful. The deaf community has voiced that they prefer you learn ASL from deaf people. And so, I will repeat that here. That's not always an option for people. And I understand there may be barriers there.

But I do recommend an outfit called Sign Language Center. It is deaf-owned and operated. And their teachers are deaf. And they offer online classes and in-person classes if you're in the New York City area. I had a wonderful experience taking classes from them. And I also felt that they were somewhat affordable in comparison to some of the other options. So, learn ASL or try. Try your best. Like I said, it's really hard for me. But I try every day. And my goal every day is to learn a new sign. I really take that to heart and do really attempt to learn a new sign every day. 

[00:37:25] CL: I love that. What is your sign for today? 

[00:37:27] SS: You know, it was funny, I was doing yoga with my TK and K summer school students today. And I learned the sign for yoga. And I learned the sign for like partner. We were doing doubles poses. That was good. And I think at some point I had known the sign for like partner but it went away. Those were the two I learned today. And that was a lot of fun. We did a lot of movement. It was good.

[00:38:01] CL: Awesome. Awesome. Thank you so much for Language First. I haven't heard of Language First. I'm really excited to jump in and start learning. I did have a student on my caseload at the end of last year. He had transferred into our program. He was also autistic. And he was hard-of-hearing. Had no hearing in his left ear. And so, we were working on total communication with him anyway. And then he is moving. He's no longer in our district after the summer. 

Yeah, after the summer. But because I had shared that experience of my husband and I just running into, there were just so many different instances where both of us were like, "Okay, we live in this community. We believe in inclusion. And so, we got to do it this summer." And we both tried to get into ASL classes at our community college because our community college was offering all of their classes for free this summer. But we couldn't get in. 

But I said just because we couldn't get in this summer doesn't mean that we have to like put this dream or this idea on hold. I'm definitely going to be looking into more. And especially, Sign Language Center. I really don't know much about ASL. That was I think my fifth year as an SLP. And then I had shared with Sara, working at that particular school, I ended up leaving the district and going working somewhere else. 

And so, I only had those programs for a year. And then after that, I really haven't worked with anybody that was DHH, deaf or hard-of-hearing, since then. And so, this year has been really kind of opening my eyes to like, "Okay, I should learn ASL. This is Ð"

[00:39:56] SS: You've had some sign from the universe. 

[00:39:58] CL: Yeah. Right? That's exactly how we felt. We thought, "Okay. We really Ð" we live in Riverside County. That's where the Ð well, technically, we live in San Bernardino County. But Riverside is where the School for the Deaf for Southern California is. And so, we're like, "Okay, we got to do this." 

And I was really excited at our community college. One of the professors is a deaf woman. And so, that was the course we were trying to get into. And then we didn't get into any of them. But I also have heard to learn ASL from deaf ASL fluent teachers. 

And I also would say that Ð especially, I have a young child. And when we were teaching her sign language, I would look up different signs. And if the hearing people were not necessarily using the right signs. 

[00:40:55] SS: That is a common problem. And I think, too, one of the things that I think some hearing people that are teaching the signs, ASL is a very contextualized language. And so, not having that cultural piece as a part of the education you're receiving can make it challenging. And you might be given incorrect information. 

One place on the body can be interpreted in several different ways. And there's dialects in ASL just like any other language. And so, you really want somebody with that cultural knowledge who is a part of the deaf community to giving you that education along with the learning the language in my opinion. 

Having said that, I've also taken classes from people who are not deaf but are heavily involved in the deaf community. And I felt like that is kind of the next best thing. And don't let me saying like don't learn sign language unless it's from a deaf person, but you can't find that be the barrier. Like, learn it, if you can. 

[00:42:09] CL: Learn it. Absolutely. Absolutely. Absolutely. Thank you so much for those resources, whether it was ASL or Language First, which I'm really excited to dive in especially if there's free content. 

[00:42:22] SS: Tons. Tons, tons, tons of free content. Dr. Sanzo is amazing. And people that want to invite her to come give talk, she, for a small fee, will come and give you guys one of the most useful presentations you'll ever have. It's stuff that you can like implement next day. And for us, it was stuff we could implement for any ELL population. Not just deaf and hard-of-hearing. So there was lots of different applications, which I just loved.

[00:42:53] CL: And that makes sense to me. Because as you were talking about asking your students to model signs for you, I've done that so many times with my Spanish-speaking students. What's the word for this? Or can you teach me to say that? And sometimes I'll say it wrong on purpose just to give them that little like, "Oh, I'm the expert in the room." You know, self-confidence for some of my students that may not have that. 

[BREAK]

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[INTERVIEW CONTINUED]

[00:43:40] CL: And so, as you were talking about that with your deaf and hard-of-hearing students and having them teach you ASL, I thought, "Oh, yeah, we should totally be doing that with our Spanish-speaking students as well." Or whatever language that they speak. I just primarily have Spanish-speaking students on my caseload. 

All right. We've talked about resources. We've talked about three things to know. What is one actionable strategy that we can start doing tomorrow? 

[00:44:09] SS: Inter-professional collaboration. One of the reasons I really, really love being a school-based SLP is because I feel like we are boots on the ground at the forefront. And the stuff we do, we get to see the impact immediately, right? 

So because we're on the school campus, we can see the progress happen. And then we can see the progress generalized and applied. And it's one of the reasons I just love being a school-based SLP. And I can say that also owning my own private practice where I'm not a school-based SLP, right? 

And look, both are valid. And one is no more important than the other. And I enjoy both. It's something so special about working in the schools. I have found that my professional growth has been exponential when I form professional learning communities with my teachers for the deaf and hard-of-hearing. When I collaborate with my psychologist. When I ask questions and get feedback from my educational sign language interpreters. When I do that deep dive into how the curriculum is modified for our deaf and hard-of-hearing students and really understand it working with the deaf and hard-of-hearing teacher. 

And then I get to tag team basically, and piggyback off of that and build my lessons that I do with our students do the therapy around what's happening in the classroom. And what I see is explosions of language and growth. And it's like generalizing left and right. And it is one of the just most rewarding relationships on a greater level than just like that individual therapeutic relationship. That inter-professional collaboration has, A, just taught me a lot because I came in without any prior knowledge really. I had some prior knowledge because my grad program did I think a fairly decent job of giving me a solid foundation. I didn't come in without you know one class. I knew some. 

The deaf and hard-of-hearing teacher in my school is an amazing resource. She's actually gone on to become our program specialist. And I'm a little bit sad about that because it has been one of the most special and meaningful professional collaborations I've ever had. But I think it's just going to grow and change in her new role. I'm grateful for that. 

Yeah, honestly, it feels like such a given. But I feel like a lot of times school SLPs, because we're overworked, that's a topic for a different day. And there's so much work to be done and not enough hours in the day to do it. Really overlook that piece and it could not be more critical than for this population. It is of the utmost importance and you must, must, must, must, must do it. You must know what is being taught in their classrooms and you must also target the same goals. You must help those kids to generalize the language skills that they're learning. 

And if you do, your students will be so much more successful and you will feel so much more empowered in that relationship with your professional learning community, but also with the student. Because the student feels successful. And it's just been beautiful. Yeah, sounds kind of like an SLP cliche at this point. Like, inter-professional collaboration, we have to take a course on that in grad school now." But they're not wrong. 

And when those relationships are good and strong, oh, man, does the good stuff happen and the magic. Literally, it's like witnessing real-life magic in our students' growth and my growth.

[00:48:30] CL: Absolutely. Absolutely. And it feels so good to come together and sit down at an IEP team. Because I also feel like when I have a really strong relationship with the people that are also sitting at the table, usually the relationship with the parent is that much stronger. It always feels like a little bit like a family reunion in a sense when you sit Ð 

[00:48:53] SS: I love that. 

[00:48:54] CL: And usually, when that's the case and you're seeing those types of things happening, it's a really good thing to sit at the IEP table and celebrate that student as opposed to times where it's Ð and it's not always that way. But I love the points. I mean, I know you said it's a cliche. But can I ask you Ð well, something that you said earlier on, which kind of clued me in. You were talking about when you first stepped on campus and you were like, "Oh, my gosh. I've got these DHH students. I haven't done this before." 

And so, you started out by reaching out to ask questions. What does that relationship look like a little bit now? Do you guys Ð I know every professional learning community or collaboration looks a little different. Do you have time that you set aside to work together? Is it more just sending emails back and forth? How does it work for you guys? 

[00:49:51] SS: We're next-door neighbors at the school, which is my principal. It was actually my previous principle's doing in her infinite knowledge and wisdom. She's actually moved on to a bigger role in our district. She was a great mentor and a good leader. And I really enjoyed that relationship. And then my current principal has kept it and encouraged it. 

I will say that relationship has done nothing but grow, strengthen and become even better. For instance, this summer, I am working ESY. And our ESY happens in the month of July. And I am working with my middle school students even though I'm assigned to the elementary school. They threw me my carrot and let me keep my deaf and hard-of-hearing middle school students. And I was so grateful. 

And the even better part is that their teacher is the teacher for the deaf and hard-of-hearing, who I adore, that we've been working really closely. And we won't get to work in that same capacity next year. What it looks like is we talk every single day. We do set aside time to meet and develop lessons. I do at least one push-in whole group lesson in her class a month and I piggyback on whatever curriculum that they're using. A lot of times we'll do a science-based lesson. 

For instance, one of the lessons we've done is a couple cooking lessons. The kids love to make slime. They love to make sensory bottles. We talk about the physics and the chemistry behind it. And so, she supports me with the American Sign Language. And then I support the language in general. 

And so, I'll be voicing the lesson. Oftentimes, I won't need an interpreter or I will have an interpreter and she will sign for me. Or they'll both sign or we'll take turns. But she never usually Ð it's not "co-teaching" where I come in the room and then she takes a break. We are teaching the lesson together to the students. 

It takes a little bit of time. Usually, one or the other will come up with a PowerPoint. How we've done it, she'll either already have a PowerPoint that has ASL embedded in it and then I'll kind of add to it. Or I'll make one and she'll embed the ASL into it. We front-load all our vocabulary, which is really important. I do want to highlight that. When you're working with students who have language deprivation or really any language disorder, you really want to make those exposures to vocabulary super meaningful. 

And we know that just exposure is not enough. They need that explicit instruction to learn the word and retain it. We front-load the vocabulary. And then we expose the vocabulary. And then we keep on exposing the vocabulary and then test for knowledge. So, it looks like that. We do have our PLC at our work where we meet. I would say like maybe twice a month. But oftentimes, that kind of takes a back seat because we talk almost every single day. It's very rare that we don't conversate about our students that day. 

It looks like me being invited when something special is happening. And if they're doing a special lesson, I pop in so they can show me and practice their language skills with me either in sign or in English. Whatever their preference is. But, yeah, it kind of is loosey-goosey because we happen to be next door to each other. I'll be next door to the new teacher for the deaf. And I hope to continue this sort of collaborative relationship. Because, like I said, it's been so meaningful and impactful. But we do also purposefully and intentionally set aside time to plan together to make sure that we're delivering the highest level that we can. 

Additionally, we constantly collaborate on our goals. And I think that I've talked for a while. So I'm going to touch on that though. Because it is so important that when you are making goals, specifically, if you are not a fluent ASL signer, that you consult somebody who is. And you have a deep and thorough understanding of ASL syntax when you're making syntactic goals in ASL. 

Every single IEP, we do together. And we talk about the goals. And she looks over my goals and gives me feedback. And vice versa. I'll look over her reading or writing goal and give her feedback on that as well. And when we do the IEP meetings, a lot of times it's kind of more of a team approach because we do collaborate so closely together.

[00:54:49] CL: Awesome. I love that. And thank you so much for just painting that picture for us. Because I think sometimes when we hear collaboration, you should be doing it. It's like, "Well, how does that start? What does that look like?" And so, you mentioned earlier about going and asking questions. But I loved how you just really painted the picture of your co-teaching together. She's signing while you're teaching. 

And then, also, I really loved how you painted. You just made it very clear of what that vocabulary instruction looks like. You're giving them exposure to it. You're explicitly teaching them the word. Then you're giving them practice of the words through the lesson and then testing of knowledge afterwards. I think that that is especially helpful for those of us that may not be collaborating. Or our collaboration looks more like, "Okay, IEP is coming up. Let me meet with the teacher." But not necessarily talking day-in and day-out. And of course, how lovely that you guys are right next to each other. That makes it so easy. 

[00:55:47] SS: It does. It does. And not every professional relationship you have is going to be like Ð I consider it to be a perfect match because we get along so well and we deeply enjoy each other's expertise in company. But it's important even if those pieces aren't there to do the work. Because the proof's in the pudding or the progress as it were in IEP world, right? 

I just think it is so important. And I have to say that I do this not quite as close. But I am fortunate to have strong collaborative relationships with my whole special education team and general education team. I'm really fortunate in that way to work at an amazing school and just have great relationships. 

[00:56:38] CL: Fantastic. How many years have you been at your current school? 

[00:56:41] SS: I'm going into my fifth year. I just finished up my fourth year at this school. I was part-time at this school and in elementary school. And then I begged, begged, begged because I feel like middle school is kind of my place. And no one's more surprised than I am by my love of middle school. 

I have done, as you said in my introduction, every level now. At some point or another in my not that long career, I have done early intervention all the way through high school, gen ed elementary, mod severe preschool, speech only preschool, mild mod elementary, mod severe high school, gen ed high school, mild mod high school. 

Mild mod middle school, ED Middle School, which is in California for those of you who don't know. The term emotionally disturbed is still our eligibility category. So that is what they call it. I have some students in that program. And on my campus, we have the deaf and hard-of-hearing program. Kind of really like every level I've picked, right? Hard to have this like niche focus. But I'm really glad that I have. 

[00:57:54] CL: Yeah. That's awesome. I love hearing that. All right. So I want to Ð we have a few minutes left. And I want to come back to something that you mentioned earlier that you'd really want to touch on. And that is language levels. What Ð do you want to just give it to us? Tell us what we need to know about language levels when it comes to deaf and hard-of-hearing.

[00:58:15] SS: Oh, wow. I could talk for hours and hours. I'm actually working on my board certification in childhood language development, and language disorders. It is just so heterogeneous. And there are going to be so many factors that play into this. The age at which the child was found to have impaired hearing levels. The age at which interventions to help prevent language deprivation were implemented. What those interventions were? And in what language they were delivered? 

The amount of access to sound is always going to be a huge factor in how we shape our lessons. But also, when we think about the level at which we're going to have to make visual support the focus of our session. 

Let's see. What are some other factors? Whether or not they have a cochlear implant. Cochlear implants are pretty divisive in the deaf culture and community. But I will say, so many factors come into play here. And it's really important to know that a cochlear implant, the message that goes into our brain does not sound like what you or I are hearing. And so, that's just Ð there's some abstraction there and that's a really important thing to note. 

Some other factors, are there other languages spoken in the home? How much input are they getting at home? Is school the only place they have a fully accessible language? For many of my students, that answer is yes. And that was never more profoundly evident than in COVID. 

Many of my students struggled immeasurably because they lost that community and they lost that ability to communicate on a somewhat daily basis. And it was really tough, to be honest. What are some other factors? Let me think. Obviously, the way the curriculum is modified for these students, there's not a whole lot of great deaf and hard-of-hearing curriculum. And literacy is also going to be our huge, huge, huge focus. For those listeners who aren't aware, there is no written form of ASL. 

Basically, written English becomes the default in American schools. However, the structure and syntax of ASL is very, very different from the structure and syntax of English. You almost get Ð not almost get. It is like an English as a second language, ELL, English language learner, type of instruction that goes into literacy instruction for teachers in deaf and hard-of-hearing. 

And SLPs can absolutely play a critical role in helping develop those skills. And in fact, it might be even more important with this population that we do help support and bring written communication into our sessions. At least in California schools and some schools may differ in this. But most of the ones that I've encountered, most of SLPs I've talked to in California schools, don't focus on literacy as the role of the SLP. Although, it is within our scope of practice. It's not the focus in the schools. 

But I love literacy-based intervention and I do focus very heavily on that with my deaf and hard-of-hearing students. Because they're only written ability is going to be in English. And so, as the person structuring their English instruction and language access, it's a default to go to written, right? Because that's accessible to them also. That's the other piece. Written language, they can at least see it. And so, you start to build that literacy as early as possible, right? Did I answer that question? 

[01:02:40] CL: I think so. Well, I wasn't quite sure what you wanted to talk about when it came to language levels. But I think that you really did just talk about all the different things that we need to take into consideration when we start to work with deaf and hard-of-hearing students. 

And literacy, to me, that was the biggest eye-opener that year that I had the DHH programs. That. And then also just diving in a little bit deeper into Cochlear implants. But back to the literacy piece. I mean, my sixth grader was reading at a first-grade level and I was shocked because Ð and then it made sense the more that I dove into, "Oh, yeah. I mean, in grad school, we had to take just one quarter of Ð it was ASL and deaf culture." And the professor focused Ð she was hearing. And she focused more on deaf culture, which I think was when you only have one quarter, I'm grateful that she focused on that because that really is kind of what we needed to know a little bit more I feel like. Those were things that would stick with us a little bit longer than ASL. 

But she did talk about ASL syntax. And so, I was like, "Oh, yeah. That's right. It's completely different." This was also my student that was not getting any input at home and would often take off her cochlear at home because she was tired of wearing it all day. 

[01:04:07] SS: Listening fatigue is a big issue with our deaf and hard-of-hearing population. And honestly, I think this bleeds over into all areas of speech-language pathology. But it goes in line with bodily autonomy. And I teach bodily autonomy constantly. You have the right to remove your hearing aid in my speech room. We're talking about safe spaces, right? Like, I will make this language accessible to you visually if you don't want to wear your hearing device. 

Some of my students are profoundly deaf and they don't have any hearing aid technology. Some of my students prefer to wear it. They're comfortable with it. They appreciate the aided levels. Some of my students fluctuate. And it's all accepted, honored and welcomed knowing that they will always have a visual model for whatever is being presented. And that's that part to really, really consider. Like, listening fatigue can be just exhausting for these kids. 

And the scenario you were talking about where your kid gets home and takes their cochlear off is very common. They're just exhausted. It's uncomfortable. It's heavy. There's pressure on the back of your head and possibly on your ear. Like I said, the feedback isn't identical to what a typically hearing person might experience. And so, yeah, there's so many factors that could impact their desire to use that technology. And it's really important to honor that as a facet of bodily autonomy.

[01:05:52] CL: Absolutely. Thank you for bringing up that point of bodily autonomy and what that looks like in your therapy room. I think it's validating for those of us to hear that when we might think, "Well, I don't know. Is this the right Ð is this affirming of this student?" And then to hear how you are being affirming in your therapy room is giving us permission to do the same if we come across those similar situations. I really appreciate that. 

Sara, I feel like we could talk for another two hours at least. 

[01:06:26] SS: I know. I mean, it's like one of my favorite topics in the whole world. And so, we could. And there's just so much to cover. I say all of this by saying I am still a student as well to all of this. And I am constantly seeking out new information. Like, Language First, I have my subscription. I take the webinars. I read their publications. I still do deep literature dives because so much of this research is in its infancy, as in most of our profession. 

But additionally, I always have more to learn. And it's important that we learn the research and we learn Ð and not just the research based on like what's coming out of the university. But what's the research on our students' experience? Right? What's the research on how the previous interventions have impacted them? And how can we take that knowledge and make it better and be the best clinician that we can be for the students that we have? 

And I feel like when we stop doing that, like you probably need to retire. Like, don't do this career anymore. Because it's always changing. The way I practice six years out is almost a complete 180 from year one on a waiver in grad school still learning and doing my best to meet the needs in a rural district without resources that desperately needed somebody. They still have openings for SLPs in that district, which is tough. 

And so, all of that to say is I consider myself a lifelong learning SLP. And just because I know all of this stuff about working with deaf students doesn't mean that, in 10 years, I won't have different opinions on a lot of it. But I like to think that when I keep my students at that center and offer student-centered interventions that honors their culture and their community, hopefully, in 10 years I won't look back and think about the what-ifs. I think if you're always reflecting on that and keeping that at the center of your therapeutic practices, that you'll be doing a lot of good regardless of what the research comes out and says. 

[01:08:46] CL: Absolutely. Thank you. Thank you so much for just that reassurance for those of us that do try to keep our students and that relationship at the center. We're going to mess up but we're also going to grow from failing, too. Thank you for that.

[01:09:03] SS: Failing up, Caitlin. 

[01:09:06] CL: Failing up. I like it. Failing up. Feeling up. Thank you. Thank you. Thank you, Sara, for just providing such a warm introduction for some of us to the deaf and hard-of-hearing population and just your wealth of knowledge. But also, I love how when you are talking about these things, you're also lifting up all the resources and you're lifting up your experiences of how you've grown and learned. And I really do see you as a lifelong learner. And I'm so grateful that you're a colleague of mine and that I get to go from you. 

And I'm really excited that I got to meet you at California Speech and Hearing Association and that you know I get to follow you from here on out and just see how you uplift not only your students but our professions. Thank you so much, Sara. 

[01:09:56] SS: It has been my sincere pleasure. As you said, I could talk for hours about this. It's been great in any opportunity I have to share the wealth, share the knowledge. I'm so happy to do so. 

[01:10:09] CL: Awesome. All right, everyone. Thank you so much for joining us. Sara, how can they reach out to you if they have any other questions? What's the best way to get a hold of you? 

[01:10:20] SS: Probably my email for my private practice, which is Sara, spelled S-A-R-A.serota, spelled S as in Sam, E-R-O T as in Tom, A .slp@gmail.com. 

[01:10:39] CL: Awesome. Thank you so much, Sara. And please reach out to Sara if you have any other questions. And we hope to see you here again soon. 

[OUTRO]

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[END]

SpeechLife 37		Transcript

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