Earth, Life and Time - Reflection

The site and site supervisor: When I started thinking about where I would do my practicum project, I knew I wanted to do something that would relate to my major. It was a great opportunity to get hands-on experience to see what being a speech pathologist is really like. I had volunteered at Holy Redeemer Hospital during high school, so I had known about the types of services that the institution offers. One of my peers at the high school I went to was the daughter of the director of St. Joseph's Manor. Her mom was able to give me the contact information for the speech pathologist and I called her to see if she had the time to allow me to shadow her. She was more than accommodating. Especially in speech pathology, it is very important to spend time getting real, applicable experience, and to see how information learned in class is applied. Since clinical experience is a requirement for graduate school in speech pathology, Colleen was very understanding and willing to teach me.

Tasks performed: I watched Colleen do a wide variety of activities. I was able to see her perform evaluations and treatments for a variety of conditions relating to the speech mechanism. A speech pathologist deals with patients who have speech problems, swallowing problems, and cognitive problems. This gives them a very wide variety of patients.

With Colleen, I observed mostly rehabilitation services. For patients with swallowing problems, I saw evaluations performed. Evaluations entailed testing various consistencies of food and evaluating if the patient can consume it safely. In general, for food, there are more and less risky types of textures to eat. By risky, I mean the chance that the patient has of aspirating (getting food or liquid into the lungs, putting the patient at huge risk for pneumonia). The following are listed from most to least risky: Crackers (dry, time consuming to chew), Mixed (such as a fruit cup - it requires an individual to consume 2 types of food textures. It also requires an individual to swallow the thin liquid as they are chewing the chopped fruit), chopped (cottage cheese), and puree (pudding). There are also various consistencies of liquids that are easier or harder to consume. This ease also related to the riskiness involved in possibly aspirating the liquids. The following are the three types of liquid consistencies, listed from most to least risky: thin liquids (like water or juice), nectar thick liquids (the consistency of nectar), and honey thick liquids (the consistency of honey). Colleen would begin by looking at the patient's chart to evaluate their history, why they are being evaluated for their swallowing, and which consistency she should begin with. An important aspect of the process that I learned is that it is better to start with easier foods and liquids and then move up to harder ones if the patient does well. Some symptoms that Colleen and I would look for would be choking, coughing, speech that sounds like they have something in their throat (most likely lingering food).

The cognitive evaluations were to see whether an individual, usually with a form of dementia, is safe to eat or is cognitively functional enough to communicate with others and understand what others are telling them. This type of therapy is crucial - if there is a fire, and someone is told that they must leave, but they do not really understand why or how urgent it is, their condition can be life threatening. The cognitive evaluations would ask patients general questions (like what is your name? Where are you living now?) as well as comprehension type questions (Colleen would read a brief story and ask the patient questions based on the story).

I also observed Colleen do speech therapy on post stroke patients. Speech therapy was also performed on patients with other types of disorders, such as Parkinson's Disease. This would involve helping patients who could not produce language correctly or who could not understand language.

At the hospital, I mostly went with Vicki and Julie to the ICU to see patients who had come in with severe injuries to evaluate their cognitive state and their ability to swallow. An exciting thing that I was able to observe with them is Video Fluoroscopy Evaluations. This is essentially a video x-ray taken of the throat and mouth to see if the food the patients are eating is going down the right "tube." I helped prepare the food and liquid so that it could been seen on the x-ray by adding Barium Sulfate to the food and liquid. Then I got geared up in the lead to protect my organs from the radiation, and watched the radiologist and speech pathologist team up. This was definitely one of my favorite parts of the experience.

I learned SO much at my site. I am so grateful to have gotten such a wonderful experience. I learned about all of the evaluations, about the safety and dangers in swallowing and the proper way to interact with patients.

How doing work at your site has affected you beyond science: The work that I performed at my site had implications far beyond just fulfilling ELT requirements. It really solidified my choice to go into this field. Ever since I was a kid, I knew that I wanted to help people but I did not know what the best avenue would be to accomplish this. With this experience under my belt, I feel more confident that this will be a good way for me to help others. I have not necessarily modified my future plans at UMD as much as excited me for my continuing educations in the field.

Last Modified: 11 May 2010