People on the Move – Speech Pathologist Helps with Technology

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Speech Pathologist Helps with Technology
Joan Green uses computers to help patients overcome communication impairments.
By Mary Vause/The Almanac
August 9, 2006

Joan Green always enjoyed tinkering with technology and computer software. One day her hobby led to a career revelation.
“I’ve always been really interested in computers and technology,” said Green, a speech pathologist who lives in Potomac with her husband Mark and their four children. “I started using software with my children, and I realized that it’s all about communication and learning and cognition.”
Thirteen years ago, after hundreds of hours researching computer software and hardware, Green created Technology with Innovative Speech Therapy (TWIST). It is an 18-hour, intensive therapy program that incorporates technology as the key to the successful rehabilitation of patients with communication disabilities, particularly survivors of strokes, head injuries and brain tumors.
Some of Green’s patients in TWIST have severe communication impairments that make it difficult to carry on a conversation. Others have minor deficits that pose challenges at work and in school.
Green’s patients engage in computer activities that are selected and adapted to their communication strengths and weaknesses. Participants leave the program with an individualized “Action Plan” for continued rehabilitation on their own. Green provides software and other materials and trains the patient and family members how to use the programs on their home computers.
For example, If patients have trouble understanding what they read, a text reader or read-aloud program can assist them in their rehabilitation. If a patient has difficulty thinking of words, Green sets him or her up with word prediction software.
TWIST costs about $3,600. Patients and family members from out of town can board as guests at Summerville Assisted Living for the duration of the treatment. Green estimates that about half of her patients are from this area with the rest traveling from across the country and as far away as South Africa. Shorter, more specialized treatment programs are also available.

TECHNOLOGY-AIDED REHABILITATION is not yet taught in speech pathology school, though the results suggest it should be, Green said.
“My clients would be upset that they’d never been exposed to this before,” she said.
Initially, she wondered if sharing the secret to her practice’s success was a poor business move.
“At first I worried I’d put myself out of business,” she said. “Then I realized that I wanted to help move my profession forward into the world of technology so more people could be helped.”
Now she spends half of her work hours showing specialists how to incorporate technology into their patients’ recovery.
Over the last few years, Green has given seminars at speech pathology conferences across the country, and at graduate schools like Loyola University and George Washington University.
Speech pathologists and other professionals are typically too busy working with patients to take the time to learn which types of software are best for their patients.
“By having someone like me tell them what the best software is for the best value, it cuts the learning curve immensely, so people can get up and running pretty fast,” she said.
Green is concerned by health care cutbacks and the trend toward fewer reimbursable speech sessions. Some patients who stopped improving in traditional speech therapy have found success with Green’s technology-centered treatment long after their insurance-paid sessions ended. Patients can go on to use the program at home without additional cost.
“One guy had had a stroke five years before I saw him, and everyone said he couldn’t get better,” she said. “I get a lot of people who others give up on or whose insurance cuts them off. After coming to me, many people are able to make great progress, or at least improve the quality of their life.”

JOHN IS a partner at a local hotel company who requested that his last name be withheld. He had a brain tumor 16 years ago and a stroke in March, which left him with some communication difficulties.
“I could speak but I would have to speak like this to make sure I pronounced all my words correctly,” he said, speaking slowly and enunciating his words ponderously to demonstrate. “I didn’t want to speak like that.”
After a three-hour assessment, Green targeted John’s cognitive deficits and arranged for an intense, 2.5-hour session to address them. She also assisted him with minor memory problems.
“One of the things that many people who are my age, 55, have trouble with is remembering the names of new people,” he said. “She’s given me some help on that, like at a meeting having everybody sign in so you get to know their names.”
“The most impressive thing about [Green] is she could spot things that another therapist could not,” he said. “They’d say, ‘You’re so high-level you’re normal, you’re fine.’ Most people don’t know I’ve had a stroke or a brain tumor.”
Darlene Williamson is the executive director of the Stroke Comeback Center, a nonprofit located in Oakton, Va. Williamson founded the Stroke Comeback Center in 2005 to provide long-term rehabilitation services at reduced cost to people with communication impairments. Williamson turned to Green for technology recommendations and to set up the computer lab.
“There’s no question that she’s the expert in what she does,” said Williamson. Having access to Green’s expertise allows Williamson’s organization to provide technology-based therapy without having to develop programs from scratch for each patient.
Williamson is also concerned that many health insurance plans no longer fund speech therapy adequately for stroke survivors.
“These individuals who survive strokes need long-term care for their communication, and insurance simply doesn’t pay for it anymore,” she said. “They’re cut off after three to six weeks. There are still gains to be made and really nowhere for them to go that doesn’t cost an arm and a leg.”
Green is in the process of publishing a book about technology for communication disorders. The book is designed as a practical resource for speech pathologists, occupational therapists, special education teachers, neuropsychologists and other professionals in the field “who want to maximize progress for stroke and head injury survivors, people with developmental and learning disabilities, and individuals learning English as a second language.”

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