This week, Chris interviews Tami Altschuler, a medical-based SLP and graduate instructor who focuses on supporting AAC and communication in the hospital setting. She shares about her journey helping the doctors and nurses understand that communication is a medical necessity, and the patient and employee satisfaction improvements that have come from better supporting communication and AAC access for every patient that needs it. 
 
Before the interview, Rachel and Chris discuss one of Rachel’s clients who has optical nerve damage that makes visual processing difficult. The family is concerned that he is not able to access his coursework and reading materials due to his visual difficulties.  Rachel shares some of the assistive technology strategies she suggested, including voice typing in Google Docs, using Read & Write for Google Chrome, using text-to-voice using a camera, making text high contrast, and more! 
 
Key ideas this week: 
 
 
? It was difficult to get initial buy in from physicians at her hospital to order SLP services for AAC and communication.Tami needs a doctor’s order to work with the patients - she can’t just work with a patient on her own initative. When Tami started at her hospital, the doctors didn’t know an SLP could help with a patient who can’t communicate (e.g. they are intubated). 
 
? SLPs in the medical setting often focus more on feeding and swallowing than on AAC and communication. It took a lot of working through “barriers to participation” (Beukelman & Mirenda (2013)) - i.e. resources, attitude, skill, and knowledge. Had to break through those barriers to help the other medical SLPs understand the need to support AAC. 
 
? The “Great Resignation” impacted the medical field in several ways, including the amount of knowledge nurses in Tami’s hospital have about AAC and communication. There was a mass exodus of pediatric nurses who had a lot of communication training, and the newer nurses were not as familiar. Tami’s hospital now has a process that trains nurses right away during new hire orientation about communication and AAC.
 
? Writing a patient’s communication tools and strategies on the door outside the patient’s room can help the nurses know how a patient communicates before the enter the room. 
 
You can reach Tami on Twitter @tami_altschuler
 
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