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Interview with Linda Austein, CCC-SLP

December 18, 2006
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Schreiber: Good Morning Linda. Before we begin this interview, tell me little bit about your professional background.Austein: I'm a Board Recognized Specialist in Child Language. I have a private practice with a focus on assessment of and intervention with children who have language and learning dis
Schreiber: Good Morning Linda. Before we begin this interview, tell me little bit about your professional background.

Austein: I'm a Board Recognized Specialist in Child Language. I have a private practice with a focus on assessment of and intervention with children who have language and learning disabilities. I'm a speech-language pathologist consultant-advocate for children. My private practice serves private school and public school children.

Schreiber: How long have you been in private practice?

Austein: This private practice has been in existence since 1986. Previous to that I was in pediatric private practice in Richmond, VA; founder and head of the speech-language department in Richmond's hospitals; and language development specialist in Richmond City schools and Mayfield City schools in Ohio.

Schreiber: So you have a lot of experience in communication disorders and in the public school setting?

Austein: Right, also working with and consulting with public schools on behalf of my students.

Schreiber: One of the roles you've have in your private practice that I'd like readers to learn about is your role as a consultant advocate. Would you start by defining advocacy and what you do as a consultant-advocate?

Austein: A speech-language pathologist consultant-advocate is a speech-language pathologist who has expertise, most commonly in child language, and who supports a child in obtaining appropriate, educational, speech-language services within the regulations of IDEA and ASHA guidelines.

Schreiber: We all know the definition of advocate but I find it interesting that you attach the title consultant, as in consultant-advocate. This seems like a philosophical statement about advocating.

Austein: It is. The role of a speech-language pathologist consultant-advocate is to support a child who is eligible to receive appropriate educational services under IDEA. Sometimes I'm called in to consult on or to flush out those kinds of educational services and IDEA provisions that ensure that the child is getting an appropriate education. It can be that I'm called in by the parent but I could also be asked to consult by the school system.

Schreiber: When you've been called in to consult-advocate, with what kind of tasks do you find yourself involved?

Austein: I have been called in to help determine whether the IEP "has been" or "will be" appropriate. I also write IEPs along with a special educator that's my number one role. A second role is in the diagnostic area that is, has the child been diagnosed appropriately and given the correct eligibility code? Many times the diagnostic work is inadequate for the purpose of the diagnostic questions. So I do a lot of "forensic" diagnostic work. I also examine the provision of services, the amount of time set for providing services, and then how the services are delivered. I provide information to help teams make decisions about educational placement and educational programming. This is all at the team level, most often done in a collaborative interaction with the school team. I'm another "information giver."

Schreiber: So as a consultant-advocate, you become involved at the ground level?

Austein: That's where I do most of my work. Very few times has the process as an consultant-advocate had to advance from there.

Schreiber: So obviously you try to prevent issues from escalating to the next levels.

Austein: The truth is, when I consult at the ground level, my point is to secure appropriate services. I always have in the back of my mind that the process could take a different route, and it does sometimes. But that's not my primary mind set. Whether it's through presenting information, or adding to discussions, or bringing in another viewpoint, the purpose is to secure appropriate speech-language services and to contribute to the overall educational plan. Very often I work collaboratively with the school team to write the child's IEP goals.

Schreiber: I would guess there have been times when you've advocated for a child, and it required "advocating against" a school district's decision?

Austein: Yes, at times the findings that I'm advocating are in opposition or discrepant with what the school district is suggesting. That's why I call diagnostics "forensic diagnostics." Forensic diagnostics means doing an extraordinarily in-depth diagnostic work-up in areas a school may not have examined. In doing so, I come up with "multi-confirming evidence." This is evidence that we see across the board in testing and in the child's performance in the classroom, which is something the school can relate to.

The other forensic evidence is called "inter-examiner confirming evidence," where for example, a psychologist who administered a battery of tests, identifies a specific reading disability or a specific written language disability, which supports my findings. And when all the multi-confirming evidence from my study of the child is backed up by the inter-examiner confirming evidence, sometimes (hopefully) it gives a different picture of the child. This kind of forensic diagnosing, or in-depth study of the child, requires more time than the school typically has. And I do hope the school recognizes the new picture of the child and explores that road and focuses services on what they have learned.

Schreiber: Would you say then the new insight changes the child's program?

Austein: Some of the time, not all of the time.

Schreiber: You said sometimes you advocate for the school district.

Austein: There have been several cases where a parent has wanted to go to due process and I looked at the information and the data and I said, "Don't even think it."

Schreiber: So there are times when you are looking at whether or not the child even needs services.

Austein: Right, or what type of service is needed. What it really comes down to is ethics. I don't take a case just because someone called meever. There are times when the school is totally correct but I might throw in a few suggestions. At times, it has been inappropriate for the parent to request the servicesthat happens.

Schreiber: You mentioned to me earlier that we are all advocates for our clients, whether we call ourselves that or not. What do you mean by that?

Austein: I think it's our job as speech-language pathologists to conduct proper diagnostic work and draw conclusions from the information; then to take the conclusions, determinations, and diagnoses and develop an appropriate educational plan and/or provide appropriate related services for that child. You know, being too busy or too overloaded is a very real problem for school speech-language pathologists. But we all maybe need to advocate for our clients and find a way to manage the overload so that in the end the child receives what the child needs.

Schreiber: Do you sense that some speech-language pathologists are pressured to make certain placement decisions in their districts?

Austein: In some school districts. I see kids from a variety of school districts so I'm not pointing at any particular one. I think it varies from school to school and I think it varies from team to team. The bottom line is and this is known nationally school speech-language pathologists are way overloaded. And I appreciate that they've just got a whole lot to do and they've got too many kids in many districts. And that's why I think that speech-language pathologists as a group need to problem solve this for everybody.

Schreiber: Have any speech-language pathologists called you to advocate for them?

Austein: I've worked collaboratively with private speech-language pathologists who recognize they don't have the skill set or background knowledge for a particular problem. Several times, I've collaborated with a family, the speech-language pathologist who was providing services, and the school district. That happens quite a bit actually.

Schreiber: So what kind of skill set does it take to be an consultant-advocate?

Austein: An consultant-advocate has to be analytical. He or she needs to do a very detailed breakdown of every bit of information one can get one's hands on, even beyond diagnostic informationmeeting notes, past IEP documents, parent information, and teacher information (which always is very critical). And the consultant-advocate has to give some mindful thought to what is being read and how the data all breaks down. The consultant-advocate then synthesizes all this information puts it all back together to come up with a plan. It's a very different skill set than just completing a diagnostic evaluation. And I think the ability to teach as one brainstorms when you come to the table with other ideas being able to effectively explain them is important. I worked with a school system where the principal and I meshed well. There were three special educators working with the team and I taught them, for this child, how to implement the IEP and why we as a team formed the particular set of objectives. In that case, the principal called me, I called her back, and this went back and forth between us trying to get the objectives to a place where they were meaningful and appropriate. So that's a wonderful example of even the top-level person on the team working directly and positively with the consultant-advocate.

Schreiber: So if you were going to give any advice to practicing speech-language pathologists in the schools, who don't want to be in a situation where someone like you has been hired by a parent to advocate, what would you say to them in terms of tips?

Austein: I think they need to know the regulations that are required under IDEA 2004. Just do a proper diagnostic job and then sit down with the results and come up with an appropriate educational plan for the related service of speech-language pathology. And I'd say not to fear an advocate because people from the outside have a very positive way of bringing in new ideas and brainstorming together collaboratively.

Schreiber: Well, what you do is very important for children, families, speech-language pathologists, and school districts. Thank you for spending time with me this morning, Linda.



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