University expands speech therapy services on and off campus

There aren’t enough speech language pathologists to meet the needs of the community.

That’s what Rodney Gabel learned upon his arrival at Binghamton University in 2020 after speaking with local speech language pathologists and leaders of organizations that provide speech services.

Gabel, a speech language pathologist who specializes in stuttering, joined Decker College of Nursing and Health Sciences tasked with creating the Division of Speech and Language Pathology (he is founding director and a professor in the division) and developing a master’s-level program in the discipline.

“There’s a shortage of speech language pathologists nationwide, so the need didn’t surprise me, but the severity of the need did,” Gabel says.

About 60% of the organizations he spoke with didn’t have enough therapists to care for the adults and children with speech and swallowing disorders who were requesting services.

“For children who need early intervention speech therapy [those up to 3 years old], there are still more than 100 kids in the county who aren’t getting seen at all because of the lack of clinical providers,” Gabel adds.

Augmenting care in the community

The scarcity of speech therapy providers in the region presented an additional problem: There wouldn’t be enough clinical placement sites for the approximately 45 students the division aims to have in each cohort of the master’s program in speech and language pathology (SLP). That program has been approved by the University and the State University of New York; the New York State Education Department (NYSED) is reviewing the program application. Once NYSED approval is granted, the program will apply to the American Speech, Language and Hearing Association’s Council of Academic Affairs.

To help fill these gaps in the community, Gabel accelerated the hiring of the division’s clinical faculty. Two years later, they are providing services throughout the area on a contract basis.

At present, the division has eight contracts with a combination of school districts, nonprofit organizations and a health system. The division performs swallowing evaluations for the hospital system, helping that organization reduce a backlog of individuals waiting for this service. Most of the contracts, however, are to provide early intervention services for children such as language screenings and assessments, speech therapy and program development.

GiGi’s Playhouse Southern Tier, which supports individuals with Down syndrome, contracts with the division to deliver individual and group speech therapy. With this 15-hour-per-week contract, GiGi’s can aid 15 to 20 individuals.

“Many of our younger participants end up on huge waiting lists until they enter school, and then, many times, are only offered group sessions that do not always target their specific needs,” says Anna Bruce, GiGi’s board vice president and program coordinator. “Many of our adults have an ongoing need for continued language support, but all services end at age 21 when participants age out of school programs and families are left floundering, trying to fill in the gaps.

“Through this partnership, we are providing hope, increased communication, independence and the gift of language for so many of our families, so they no longer have to fear the end of services or being placed on long waiting lists. Without these services, many of our families would have to go without these critical therapies. There are no alternatives for many families and certainly no free alternatives.”

At the Family Enrichment Network (FEN), which provides a variety of programs for children through adults, up to four therapists from the University deliver 40 hours of speech therapy a week.

“Having this contract with the University meant we could continue to offer quality speech and language services to our children and families,” says Tamara Ivan, director of special education services at FEN. “The University also offered professional development sessions to our staff to keep them up-to-date on SLP developments.”

Clinical faculty spend about half their time providing contract services, while also teaching students in the speech and hearing science minor the division began in fall 2021. They’re also helping create the graduate program in SLP.

Tina Caswell, director of clinical education and a clinical assistant professor in the SLP division, believes the contracts are a win-win-win for the University, the community partners and students.

“Students in our undergraduate minor need clinical observation hours if they want to go into a graduate program in SLP, so we’re hoping to offer them the opportunity to gain those hours in these organizations where we have contracts,” she says. “For our graduate students, those community sites will be internship placements sites, enabling us to keep these students in our community.”

“We’re helping organizations by delivering services they couldn’t provide with their existing staff,” Gabel adds. “More people in the community are being served now, and our students will have quality clinical placements, so it’s a really good setup for the community and for us.”

Ivan concurs: “This has been one of the best possible collaborations for our department and the children.”

On-campus clinic increases available services

In September, the division opened the Binghamton University Speech, Language and Hearing Clinic at the Health Sciences Building in Johnson City, N.Y. The clinic significantly increases access to speech and language therapy services in the region, while also serving as a clinical training site for undergraduate students in the minor. Future graduate students will complete some of their clinical training at the location, as well.

The following services are available in the clinic by appointment only; no referrals are necessary. Most services are provided in person and via telehealth.

• The Early Intervention and Preschool Program helps preschool-age children develop speech and language skills needed for literacy development and academic success. The program includes individual therapy sessions and parent consultation and support.
• The After School Program provides individual and group therapy at the end of the traditional school day for children with a variety of communication disorders.
• The Aphasia Program offers group and individual therapy services for people living with aphasia, a loss of speech due to brain injury.
• The Parkinson’s SPEAK OUT! ® & The LOUD Crowd® Program addresses the communication and swallowing needs for those living with Parkinson’s disease. The program combines individual and group therapy.
• The Stuttering Program provides individual and group therapy for adults, adolescents and children who stutter. It also includes support and resources for families.
• The Social Skills Program prepares adolescents and young adults with autism spectrum disorder, social communication disorder or neurodiversity for successful transitions into adulthood. It offers a framework for teaching social communication skills and provides opportunities to practice skills learned in natural settings. Parents and caregivers attend weekly group support sessions.
• The Augmentative and Alternative Communication (AAC) Program delivers services to children and adults who are nonverbal or low verbal. The clinic offers evaluations and intervention, focusing on language, literacy and social-communication development. In addition to individual therapy sessions, the program includes a parent and caregiver participation program that uses a telehealth format.

Demand for clinic services has already been high, and Gabel is working to increase access. “While we develop the clinic program for the community, we’re trying to serve all those who are interested in receiving speech and language therapy services,” he says. “When we can’t provide services immediately, we’re keeping a waiting list and will provide services as soon as possible.”

Decker’s Speech, Language and Hearing Clinic is a private pay clinic that doesn’t accept insurance. It operates under a reduced-fee structure (individual therapy is $25 per hour, group therapy is $10 per hour and evaluations are $100).