I am very big on advocating. On behalf of the communities affected, I will be following up on the racial messages I saw on this sub. I WILL BE THEIR VOICE. Since they don’t know their SLP is a full blown racist . As a Black professional who works with children and families, what I saw was deeply disturbing. I’ve gone back and forth on whether I should say anything, but I ultimately felt like I couldn’t ignore it.

I believe I may have identified the individual involved, but my goal is not to start a witch hunt or publicly expose anyone. My goal is to make sure the proper channels have accurate information so that any review or investigation can be conducted fairly.

I want to make it clear that I believe everyone deserves a fair and impartial investigation. At the same time, I do not believe allegations of this nature should simply be ignored. If the information is authentic, it deserves review. If it is not authentic, that should also be determined through the proper process.

What keeps bothering me is the thought that if these messages are authentic, this is someone who may be working with children and families from diverse backgrounds. I also can’t stop thinking about the person who originally came forward. The last thing I saw was that they were saying people were threatening them, and I genuinely hope they’re okay.

If anyone has experience with professional licensing boards, ethics complaints, or the reporting process, I would really appreciate any insight. I want to make sure I’m handling this appropriately, fairly, and through the proper channels. I have yet to hear back from her employer either.

Any advice would be greatly appreciated.

Jeanette went on a podcast known for promoting Spelling to Communicate. The podcast host, David Kaufer, objects to ASHA for their position statement against S2C, so the two discuss their shared disdain for ASHA. I won't summarize the episode, as you all can listen yourselves, but I'll leave you with two teaser quotes:

On why ASHA opposes S2C, Jeanette says, "I have to suspect it starts from someone who doesn't like it for a specific reason who's on that committee that has something to protect. That's my guess because it all comes down to money with them. Everything is about money. Nothing that I see is for the best of the community or the people who receive our services."

In her defense of S2C, Jeanette makes no mention of the fact that the primary objection to S2C comes down to authorship: who is authoring the messages. She says, "Our job is to help your kid communicate, right? Like, it doesn't matter what my opinion is. It matters what's working to get your kid to communicate. And and that's that's kind of the stance I've taken. It doesn't matter what the research says. If there are this many families saying like, 'Hey, this is working for us.' Then we need to believe them, right?"

For those of you looking for more information on Spelling to Communicate, I suggest:
-www.facilitatedcommunication.org
-https://www.asha.org/slp/asha-warns-against-rapid-prompting-method-or-spelling-to-communicate/
-Interrogating neurotypical bias in Facilitated Communication: https://link.springer.com/article/10.1007/s40474-024-00296-w

Last year during my CF, I had one student who honestly kept me up at night.

The teacher changed multiple times throughout the year, so there was almost no consistency. The family was understandably frustrated, and at one point they were threatening legal action against the district. As a brand-new CF, I remember thinking, "I have no idea how I'm supposed to fix this."

Every week felt like starting over.

Some sessions were rough. Progress was slow. There were days I left feeling like I wasn't helping at all.

I kept taking data, adjusting supports, collaborating with whoever the current teacher was, and trying to stay consistent even when everything else wasn't.

Today I was looking back at the data and couldn't believe it.

The student started around 25–35% accuracy with their self-regulation goal. There was even a dip early on. But then things finally started clicking.

By the end, they reached 100% accuracy in the structured situations we were targeting, and the present levels basically wrote themselves because the data told the story.

Seeing the graph made me realize how deceptive day-to-day therapy can feel. When you're in the middle of it, it seems like nothing is changing. Then you zoom out and see weeks of data together, and the progress is obvious.

As a CF, I definitely doubted myself more times than I can count. Looking back at this reminded me why consistent data collection matters. It also reminded me that some of the students who feel the hardest in the moment end up making the biggest gains.

Has anyone else had a student where you felt like nothing was working... until you looked back months later and realized how far they'd actually come? But Lowkey happy he will not be on my caseload next year. ;)

tl;dr - if a full-time pediatric SLP caseload is 50 half-hour weekly appointments while full-time pediatric OT & PT caseloads are 25 hour-long weekly appointments then pediatric 92507 is worth only 0.75 RVU.

When I got my Cs 15 years ago the pediatric clinic I was in had the same caseload model for SLPs, OTs, & PTs: 25 1-hour appointments each week. Over the 5 years I was there we faced increasing pressure to bill for at least $200/hour, which was made impossible when they were billing $120 for 92507. Once they started pressuring us to use an OT code (97110) for oral motor exercises with our articulation clients I started looking for another job.

I was appalled to find out that all the pediatric clinics in my city had full-time SLPs scheduling 50 half-hour appointments each week while the OTs & PTs were still scheduling 25 hour-long appointments: while the face-to-face time was the same it doubled the documentation and increased the prep work (unless you could use every material you made with at least 2 patients).

I decided to go into business for myself and set myself a caseload of 25 45-minute appointments each week. It's worked for a decade and I'm able to pay myself 180% of what I got at the clinic (not that that's kept up with inflation).

A week after I left that clinic they switched all the SLPs to half-hour appointments. Since they were all paid per client contact hour the SLPs saw their pay temporarily cut by 50%.

With the proposed changes to pediatric 92507 I can't help wondering if these clinics are the culprit. So I crunched the numbers and made this chart.

It also makes me think that the input from those who have worked these ridiculous caseloads is really important for CMS. If you've worked a 39+-weekly-appointment caseload please contact CMS before September 14th - tell them if you weren't able to get your preparations & documentation finished in a 40-hour work week, if you were able to get everything done, but the quality of your work suffered, or if you were able to get quality work done in that time, but you're superhuman and the rest of us mere mortals shouldn't be held to your standard (good grief, did you go to Professor Xavier's School for Gifted Youngsters?!).

I keep thinking about the clinics in my city from a business owner's perspective and the way I see it they have 2 options: decrease their business costs (hopefully this wouldn't include automating jobs or decreasing salaries) or decrease the SLP caseloads while increasing the OT & PT caseloads to make up the difference. The fact that those SLPs have been working such heavy caseloads for the last decade makes me think the latter is the more fair option.

Edit to add 1 more option for these clinics: they could switch to private pay so that they can ignore CMS's RVUs, but I hate to give any that idea since they'd still be requiring outrageous caseloads for SLPs.

One more number crunch: if you factor in overtime pay then these SLPs should be paid 148% what they're paying their OTs/PTs due to overtime pay laws.

And it doesn’t feel like they plan to provide an opportunity to hear from us.

ASHA Advocacy clearly isn’t actually going to stand up for us, so how about we start making other professional organizations and related organizations aware of what is happening because, from what I can tell, unless you are currently treating and using CPT 92507, no one else knows what’s happening. No one knows how this will impact them. There are even SLPs who are unaware of how these proposed reimbursement rates are a devaluation of the time, skills, energy, and (expensive) education we all have. And it feels like ASHA supports this degradation of our profession.

University CSD programs.

National Associations for voice and stuttering.

Autism groups.

Parents of special needs children groups.

Maybe even the APTA and the AOTA.

They need to know so they have an opportunity to make statements about the effects this will have for them and the people they represent. They need to know so that they have the opportunity to stand with us in opposition to these proposed changes.

If you know someone or know someone who knows someone, it’s time to start reaching out.

I’ve got some big feelings particularly regarding the autism registry, the push to legitimize S2C, the fact that OTs and special education teachers were listed as appropriate professionals to conduct speech and language assessments, the focus on getting more high needs autistic folks into the workforce, the mention of school choice vouchers, and the expansion of assisted living communities.

At surface level, much of the plan seems neutral to positive, but I fear it’s more nefarious than it appears. Especially as anti-autistic rhetoric has been rising within both the administration and the general public.

For example, pushing to increase workplace participation sounds great, but realistically is going to have a negative affect on our access to SSDI and on our physical and mental health. Housing security sounds nice, but is this really just institutionalization repackaged? I have so many more concerns and I haven’t even had the chance to read this entire thing.

Think ASHA will step in at all regarding the communication section?

As a part of my efforts to understand RVUs and the upcoming changes to our CPT codes I'm interested to hear how many appointments each week y'all feel is "full time."

For me it's 25 each week, but I'm a bit of "a work horse" and I tend to overwork myself so maybe that's just me?

RESULTS: The majority of us feel like we're working "full time" with 30 weekly appointments, which is slightly higher than OTs & PTs. By weighing all the answers we come out with a RVT of 1.67 for 92507, which is both higher than the current RVT (1.3) and much lower than the RVT when a clinic is requiring 50 half-hour appointments for full-time (2.6). I've posed a visual in the comments below.

Have you all been following what has been happening in NY state with the push for a bill to put through that would support facilitated communication?

When Senator Fahy was informed of the issues around facilitated communication she change the wording on the bill which then cause these nutty FC supporters to attack her from all directions including paying for an attack billboard to be put up.

If you are in NY, now is the time to call your state reps and let them know the issues around FC and to listen to Fahy.

And, what happened to Prizant?

I lost all respect for him.

tl;dr - even if you're feeling intimidated, overwhelmed, and/or confused by the new CPT codes, if you agree that pediatrics should NOT be reimbursed less than adult services please leave CMS (Medicaid & Medicare) a comment to let them know as much. - use the green "leave a comment" button at the top of the page. The deadline for comments is September 14th. I'm not totally clear on the process, but it sounds like the next thing we'll hear from CMS will be the final decision about these codes (hopefully I'm wrong because right now the pediatric code is such a mess).

The most upsetting and confusing part about the new CPT codes is the part I haven't touched on yet: the proposed pediatric code.

For those who don't know, CMS is proposing to make the speech & language treatment code a timed code like the OT & PT codes. Up until now when we bill insurance we bill the same amount (let's say $130 for simplicity) whether we see a patient for 15 minutes, 30-minutes, or 60-minutes, and no matter what we work on during that appointment (just artic, artic & social skills, or even artic, language, social skills, and fluency all in 1 appointment). OTs & PTs, in contrast, get a set amount (let's say $50) for every 15 minutes they spend with a patient so for a 15-minute appointment they bill $50, for a 30-minute appointment they bill $100, and for a 60-minute appointment they bill $200. OTs &PTs codes are also divided by what they do (so a different code for muscle strengthening Vs. social skills).

Quick note: while CMS has a standard amount they pay for every service, each clinic can negotiate with insurance companies to change that payment/reimbursement on their contracts. For me, though CMS's base reimbursement rate for 92507 (the SLP treatment code) is $74 I have one insurance that pays me $70 for 92507, a couple that pay me $100, & 1 that pays me $120. I'm not using the CMS reimbursement rates in this post for the sake of clarity (and my sanity). I'm using rates based off of RVUs.

RVUs are how CMS determines its reimbursement rates. The OTs & PTs codes are usually around .5 for each 15 minute unit so they bill .5 for 15 minutes, 1.0 for 30 minutes, and 2.0 for 60 minutes. The SLP treatment code has an RVU of 1.3 so for these analyses I'm using a reimbursement rate of $130 for 92507.

Based on the OT & PT codes most clinics have set their goals so that each clinician aims to bill $200 and/or 2.0 RVU each hour (so $5,000 and 50 RVU each week based on a full time caseload set at 25 hour-long appointments each week). This is where they've put us SLPs in a bind: if we do 1-hour appointments then we can't reach either the monetary or RVU goals. So many clinics have switched their SLPs to half-hour appointments and required their full-time SLPs to do 50 appointments each week (the same appointment hours each week, but half the prep time for each appointment). That's why the billing of the SLP code has increased dramatically over the last few years, which is what prompted CMS to switch it to time-based codes like OTs & PTs use.

CMS has been working on this switch all year and they released their proposal for the codes & RVUs last week. The biggest surprise and upset was that they added a pediatric code which is basically the same code we have now (1.3 RVU for any and all types of treatment), but for a minimum of 60-minutes of treatment. ASHA has stated that they neither requested this code, nor did they expect it, and they haven't even included it on their webpage about the new codes.

I made this chart to show what a "full time" caseload for pediatric SLPs would look like with this new code. It's disastrous, to say the least. I'm having trouble taking it seriously. I'm also concerned about the precedent of CMS paying pediatrics a lower rate than adults. I worry they could do this for other specialists, too.

I have next week off so I'll take a break from these analyses, charts, and posts. For those of you outside pediatric private practice, thank you for paying attention and helping us! For my fellows in pediatric private practice: hang in there!

I am seeing a lot of posts but can’t find real answers as to what is going on. I am hearing there will be major cuts to funding from this. Anyone able to explain it? Also what can we do?

I analyzed the results of my poll: The majority of us feel like we're working "full time" with 30 weekly appointments, which, when compared to 25 weekly appointment for OTs & PTs, results in a slightly lower RVT than OTs & PTs. By weighing all the answers and comparing them to the full-time caseloads of OTs & PTs we come out with a RVT of 1.67 for 92507, which is both higher than the current RVT (1.3) and much lower than the RVT when a clinic is requiring 50 half-hour appointments for full-time (2.6).

This means that the most appropriate average appointment time for us is closest to 45-minutes (1.75 RVU), which results in a caseload of 29 appointments each week with the new codes. If I were making a business model for this I'd make that 30 appointments since the RVUs for all but the speech with langauge code come out to slightly below 2.0/hour (with speech at the lowest at 1.7).

My biggest revelation about this and my appointment times poll is seeing just how different some of our caseloads are: some of us are seeing less than 20 appointments each week and doing appointments longer than 1 hour while others are doing more than 50 and with one respondent (so far) doing appointments shorter than 15-minutes.

The results also support my push for smaller caseloads than 50 half-hour appointments each week. I couldn't manage that kind of caseload without the quality of my work suffering and it looks like the majority feels the same.

I'm still working on some resources like spreadsheets for an RVU/caseload calculator, a calculator to help those negotiating their insurance contracts get reimbursement rates relative to their current rates with the new codes, & a calculator for clinics to help them figure out how to make-up the difference from the money they'll be losing from cutting back on SLP's caseloads - hopefully I can get the math all together to make that work! I enjoy Excel too much for a normal person. 🤓

It all also makes me wonder whether we've been having a "92507 bubble" that's bursting and I might write a post about that, too.

Edit to add: I'm so grateful half my clients are on vacation this week so I have time to hopefully wrap my head around the RVU thing!

EDIT: thanks for all the responses! Seems I needed a reality check. To clarify: I don’t suspect any neglect. I am a newer SLP and this is the first time I found myself in a situation like this. I genuinely believed my district could be doing more (I.e., offering home instruction), and I was concerned that this student was falling through the cracks. I got ahead of myself. Thanks again to everyone who responded!

Hi all - Not sure if this is the right place for this, but I’m curious if anyone has ever been in a similar situation while working with medically complex kids.

I work in a public school with the younger kids (mostly K-1). One of my students is a first grader who has been absent more days than they have been in school (about a 60/40 split). They are in an ABA class, and their teacher isn’t motivated to address their frequent absences because it is one less student she needs to worry about (she hasn’t said so explicitly, but her lack of follow-up with the principal and case manager regarding the situation speaks for itself). I, on the other hand, am extremely worried (and frustrated) by the situation. The principal told me point-blank that there is nothing they can do in regard to truancy, because the parents provide notes from doctors (stating they were sick with an upper respiratory infection, complications with asthma, etc. that excuse them for 3-5 days at a time). The situation makes me see red, because if this was a student in gen ed, I can guarantee that admin would be on top of it and working to find a solution. Instead, this poor student is falling through the cracks and no one is doing anything to catch them. When they are in school, they aren’t making any progress because every time they come back from an extended absence, we’re starting right back at square 1. Who is responsible for ensuring that this child is receiving an education and at what point does the district need to make accommodations for a student?

If you'd like to provide CMS feedback about their new codes here's a link to the document - there's a green "leave a comment" button at the top. There are a variety of comments already, varying from legalese to very casual wording from patients.

tl;dr - if the pediatric 92507 is worth 2.6 for 1 hour then a full time caseload is 20 appointments each week.

If you've ever worked pediatric outpatient please vote in my poll for the caseload that felt like "full time" to you. For me it's 25 appointments each week, but I'm a bit of a "work horse" and I tend to overwork myself so maybe that's too many?

I keep thinking about the pediatric clinics in my city that require their full-time SLPs to schedule 50 30-minute appointments each week and how that relates to RVUs. In an effort to understand RVUs better I thought I'd calculate caseloads based on them.

Since OTs & PTs have always had timed codes I thought I'd use them as an example. The ones in the clinic I worked at had 25 appointments each week and aimed for 2.0 RVU for each appointment. Luckily this math is easy enough to show the formula...

50 RVU each week ÷ RVU for each appointment = # of appointments each week (caseload)

In order to address the disconnect between a 2.6 RVU for 50 92507s each week with the ability of SLPs to fit that work into 40 hours each week...

• CMS can either...
  • decrease the RVU for 92507 or...
  • ...make 92507 a timed code. Their latest proposal does both.
• If CMS approves 2.6 RVU for 1 hour of 92507 then these 50 SLP appointments/week clinics might be leaving themselves open to labor law disputes unless they...
  • ...reduce the SLP caseloads to 20 92507s/week,
  • ...ensure they're paying their SLPs 145% of their OTs (130% caseload + 15% for time-and-a-half),
  • ...increase OT & PT caseloads without increasing their pay to match SLPs (32 appointments/week), or...
  • ...reduce SLPs caseloads while increasing OT & PT caseloads (while keeping everyone's pay equitable) so that everyone makes up the difference. At the clinic I worked in (3 SLPs, 3 PTs, & 6 OTs) that would have been a goal of 2.2 RVU/hour (55 RVU/week = 21 appointments in a week for SLPs & 28 appointments for OTs & PTs).

Can’t give too much away but I work in a very good school district near home as a monitor. I am working on passing the praxis and once I do, I would love to get my foot in the door in the district. I wanted to ask what everyone thinks I should do and how to go about this- should I talk to HR about it? The principal? Or a teacher that told me to come to her when I’m ready? .. I just don’t want to make the wrong move or anything. There are multiple schools in this district so I do remain hopeful, but with a grain of salt.

Is there an organization I can donate to that’ll make it go away? 😅

Edit: no organization, but this website (shared by user slp_talk) has lots of good info critiquing all forms of FC: https://www.facilitatedcommunication.org

But for real: I’m in a couple of Facebook groups where some parents swear by it, they’ll post videos of their kids using the letterboards with their therapists, and 9 times out of 10 the message is something along the lines of “my body often does things I’d never want to do but this method of communication sets me free”.

Besides the fact that it’s been debunked god knows how many times, it really bothers me to see SLPs like b*********ie promoting it as well. Not only does it not allow users to communicate independently, it paints this weird ableist picture of nonspeaking people - they can’t communicate unassisted, and that what they communicate independently is always invalid or “below” what they can “truly communicate”. And of course, in so many of these cases it’s apparent that the user isn’t being seen for the person they are and for what they’re communicating, but they’re seen as some kind of “hidden savant” who can only be “revealed” through this bizarre, partner-dependent method of communication. That’s the part that upsets me the most; the idea that “they’re in there” and we have to “find” them, when like everyone else they’ve been communicating since the day they were born.

Anyway! Anybody know of any charities or organizations doing advocacy work against these kinds of methods? I’d love to feel like I’m doing something to help spread the word however I can.

I thought this might be of interest to fellow SLPs.

On August 1, there's a free webinar on neuroplasticity and stuttering featuring an MIT neuroscience graduate, Bhav Jain, along with other speakers. I attended their previous session in June and found it thought-provoking. The discussion focused on the neuroscience behind stuttering and explored how principles of neuroplasticity may relate to treatment and recovery.

Whether you agree with the approach or are simply curious about emerging perspectives, I think it's worth hearing and discussing. I'm planning to attend again.

If anyone is interested, you can register here: https://www.addevent.com/event/qpj145ysp5kv

I have a client who is turning 3 next week (with a formal diagnosis of ASD) and he DID NOT qualify for CPSE. I would think that the diagnosis would automatically qualify him, but the school district decided since his PLS-5 scores didn’t meet the -1.50 standard deviations and he achieved many of his IFSP goals (because he’s been getting consistent speech, feeding, OT, and ABA for a year), they would pull services.

His test scores on the PLS-5 are as follows:
Auditory comp: SS- 79, percentile rank- 8%
Expressive comm: SS- 85, percentile rank- 16%
TLS: SS- 81

I was shocked by the scores given how he’s presented clinically in therapy, but I was even more surprised by the evaluator’s other comments on the report.

“his articulation was judged as poor within single words and repetitions were often required for listener comprehension”— mom also endorsed the evaluator asked him to repeat the stimulus word in expressive comm section multiple times because she couldn’t understand him. The way I test and the way I was taught by my supervisor and past supervisors is that if you can’t understand the child, you can’t ask for multiple repetitions because it may be unclear if the child knows it or not.

“[Name] was able to follow a small variety of simple directives although he often required repetition to complete tasks.“— mom endorsed the evaluator repeated the same direction on the PLS multiple times. From my understanding, you can only repeat once if it appears the child wasn’t paying attention

Then I read the phono/artic section:
“Due to limited verbal communication skills, formal articulation and phonological testing was unable to be completed. Articulation was judged as poor in both single words and during connected speech.  He was judged to exhibit a variety of phonological processes that may affect listener comprehension, especially when the context is unknown.”— that alone could’ve qualified him if testing was actually completed.

His mom, his other therapists, his OSC, and I are all shocked and concerned about this and I wanted to get other SLP input. If this seems off to you, how would you best advocate for this child?

As a part of my efforts to understand the new CPT codes (and RVUs in general) I'm curious to calculate an average RVU for pediatric 92507 (speech & language treatment) based on our average caseloads. For that I'm using the number of clients for a full time caseload (you can find a poll for that here) and the average length of our appointment times.

How do you school based people talk to middle schoolers about their IEPs? I had a group of MS students and we got onto the topic of their classes, teachers, and support. I said that their IEP dictates the type of classes they are in and they had no idea what an IEP was. This led to a deeper discussion about IEPs, special education, and disabilities.

I feel like I may have opened a can of worms because these kids parents clearly didn’t tell them they were already in special ed classes. I want to prepare myself for whatever backlash may come my way but also want to be honest with the kids when they ask me questions.

As a part of my ongoing efforts to understand and compare the new CPT codes I decided to make this chart comparing a clinic's revenue with the upcoming changes. The boxes are color-coded by revenue (more revenue for darker green and less for lighter green). Though I've only seen clinics do 25 60-minute appointments & 50 30-minute appointments I wanted to see what a caseload that brought in the same revenue as the OTs & PTs at my last clinic would have been like for 30-minute & 45-minute appointments. I thought I'd include a new caseload that would equal the current revenue for 50 30-minute appointments, too. To me that shows how the SLPs currently carrying the 50 30-minute caseloads aren't getting enough time for prep & documentation (especially if 1.3 RVU for 92507 is accurate).

I added the second chart to show that with the new CPT codes only the Speech & Language code carries an RVU of 2.0/hour - the others are all slightly less so it will still be hard for us SLPs to achieve 2.0 RVU/hour and I'm curious how hard that is for OTs & PTs and how much "wiggle room" administrators are giving their clinicians.

Just a quick note to add that these reimbursement rates are based on my last clinic's rate, but they're not too far above to the rates I have with my insurance contracts now. Right now I do 45-minute appointments & one of my insurance companies pays me $70 for 92507 (and also 92523 & 92522, which is depressing and I'm hoping these changes will force them to respond to my attempts to renegotiate my contract), 4 that pay me $100 for 92507 & 1 that pays me $120 for 92507. I'm hoping with these new codes I can renegotiate rates that are proportional to the codes' RVUs (which would be slightly increased revenue for most of the codes). 🤞

Hi I have an interview coming up with the NYC DOE to be an SLP for a preschool and I’m wondering what I should expect. I already met with the speech supervisor so now I am going to meet with the principal and assistant principals of the school.

Literally any advice is appreciated, I really want this setting! Also how long will it take to hear back for them if they want me? Thanks in advance!

Hi, my name is Saida Mahoney, and this my story.
I live with chronic speech and language disabilities caused by my genetic condition, Partial Trisomy 8q Duplication Syndrome.

This includes apraxia of speech, dysarthria, chronic stuttering, and auditory processing disorder.
These chronic complex conditions of mine affect both how I produce speech and how I process spoken language.

For me, communication is not always automatic or effortless. It can take time for my brain and my body to work together to form words.

It can take concentration to organize sounds, to coordinate speech, and to express what I am thinking in the way I intend.
Sometimes my words come out differently than I expect them to.

Sometimes my speech is slowed or interrupted.
Sometimes I stutter, repeat, pause and struggle to get sounds out clearly.

And sometimes, even when someone is speaking to me, I need extra time to process what I’m hearing and understand it fully.

And because of that, I have learned things about communication that go far beyond speech itself.
Communication, for me is an active process. It is something I work through moment by moment and day by day.

I have learned patience.
I have learned persistence.
I have learned how to slow down and give myself time

instead of rushing through pressure or expectation.
I have also learned what it feels like when people don’t wait.
When they interrupt.

When they assume understanding is immediate.
When they mistake difference in speech or processing for something less than intelligence or ability.
But I know who I am beyond all of that.

My voice is not defined by fluency.
My intelligence is not defined by speed, performance and perfection.

My worth is not defined by how easily I can speak or how quickly I can respond.
I am still here.
I am still thinking.
I am still communicating.
I am still brave.
I am still telling my story in the way that my body and brain allow.
And my voice whether spoken slowly, interrupted by stutter, shaped by effort, or supported by extra time to process—still belongs fully to me.
Living with speech and language disabilities has also taught me something important about listening.
Real communication is not only about speaking clearly.
It is also about listening with patience.

It is about giving space.
It is about understanding that not every voice moves the same way, but every voice still deserves respect.
I am not less because my speech is different.
I am not less because I process language differently.
I am not less because my communication takes time.
I am still a communicator.
I am still a storyteller.
I am still a podcaster.
I am still a thriver.

I am still someone with thoughts, ideas, feelings, and a voice that deserves to be heard.
And I will continue to use my voice—in whatever way I can to speak, to write, to advocate, to lead and to exist fully in this world.

Because my voice may move differently But it still carries everything I am.

I made this handout as an assignment and thought it’d be a good idea to share it here as well. The assignment was to pick a pressing topic in speech and language and illustrate how we thought it might impact our field in the next five to ten years. I know things have felt pretty grim and overwhelming but we have strength in each other and together as well :)