Schools are closed and there is still a pandemic brewing in our midst. Some remain unvaccinated and the question of what will come next has arrived. Technology will most likely be on the minds of students who now have more free time and ideas for developing routines and rules around it abound. However, I have another one for you and it came out of the blue in a discussion within the past two weeks.
I asked a parent, as a part of an evaluation that I was conducting about how much screen time their eight-year-old has. The answer was an awesome idea to consider.. the 5K rule “For every 5,000 steps she moves she get a half hour. The most she can get is one hour of time using her tablet”.
You are probably thinking.. how is this measured? That was my question.. and the parent had a marvelous idea. An exercise tracker. They are very easy to get, so click on the green link!
How life has changed!
I recall struggling with the one-hour rule of television unless there was a special program on or one that we had to watch for school. What did my brothers and I think of doing???? Perhaps I can share some ideas with your family. I was raised before computers and summertimes were different, to say the least. It gives me an opportunity to share another way to have fun! We had a different way of talking one another and still do – bringing new experiences to the next generation.
Mom was a librarian …there were always trips to the library. My dad taught us to work in the backyard and we weeded the area where he was growing vegetables. I even had my own area for marigolds. It is heartwarming to me to know that in my own home city of NY that there are Community gardens in New York City (dailykos.com) so that these skills can be learned. Check with the parks department in your area I learned that cat food cans filled with beer attracted slugs and collected a lot of them that way because slugs would ruin the crop. We went to the park and raced after the Good Humour truck to get an ice cream pop down the street as the bell of the truck was heard when we finished dinner. You can have a lemonade stand at a city park in NYC, perhaps in other areas as well. We went to the local pool, drew pictures, and I kept a diary. Playing in the park or backyard was always an idea. The very fondest memories were those that last a lifetime… family vacations. To this very day, we talk about our childhood trips. We still have them and share our memories with a new generation of family members. I hope that they will have the same experience as we did…
Oh! Please don’t forget to take pictures and perhaps write a story about the details so that you can continue with new traditions and remember the old. It will give you more about which to talk and even share virtually during that half or whole hour 🙂
Parents have called me to schedule sessions this week and declined services provided remotely, although insurance companies are providing coverage and many professionals are providing it. THAT is the impetus for this post and I think one that may be of help to you!
Is it worth getting a Virtual High Five???
I think that the novelty of what this actually has been confusing for consumers and we as practitioners are also learning,,,
One of the benefits, of telehealth is that if you are a parent, young adult, adult with any kind of need, virtual intervention enables professionals and patients/clients to have a venue for reaching out to one another. Interstate compacts are in the works which means for consumers that there won’t be in issue if you want to work with someone who is out of state. Check with the person you want to work with and they should be able to tell you if the state they are in has joined “the compact”. I will try and update information periodically as a part of this post. Things are changing quickly,
In my experience of the past year and in reading those of others in the industry on social media the aim of intervention has been met very effectively through remote services. With those of a very young age group, the caveat is that a caregiver MUST be present and actively involved. Indeed, parents have been posting testimonials about the benefits of virtual therapy https://www.understood.org/en/school-learning/learning-at-home/5-skills-my-child-gained-during-virtual-learning
Another byproduct of virtual therapy has been the sense of empowerment and responsibility that is taken on the part of adults assisting students or older ones getting treatment for themselves. I would think that may even make virtual therapy sessions even more valuable,
In reviewing articles on the web related to the topic a good point is raised https://eyaslanding.com/telehealth-in-speech-therapy/ “The American Association of Speech-Language Hearing Association (ASHA) has provided data through over 40 published, peer-reviewed studies to confirm that online speech therapy services produce outcomes that are as good as face-to-face therapy.  There is currently research regarding implementation of teletherapy for articulation therapy, fluency/stuttering therapy, expressive and receptive language therapy, as well as parent coaching and strategy implementation”. Another advantage of the use of telehealth is that
In the area of feeding therapy, the goals are medical in nature and I have been finding feedback from others who tell me that it has been very helpful. Through telehealth families have become much more focused on learning and then practice more with their children. Treatment becomes more meaningful as a result because you partner and to your credit and share the therapeutic experience in a more authentic way. Caregivers are not so much watching therapists; but learning by doing.
Current Professional Research about Effectiveness of Telehealth Services
The current review aimed to determine if telehealth-delivered SLP interventions are as effective as traditional in-person delivery for primary school-age children with speech and language difficulties. The reviewed research was limited and of variable quality, however, the evidence presented showed that telehealth is a promising service delivery method for delivering speech and language intervention services to this population. This alternative service delivery model has the potential to improve access to SLP services for children living in geographically remote areas, reducing travel time and alleviating the detrimental effects of communication difficulties on education, social participation and employment. Although some initial positive findings have been published, there is a need for further research using more rigorous study designs to further investigate the efficacy of telehealth-delivered speech and language intervention.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546562/ and another reference was http://American Speech-Language-Hearing Association. National Outcomes Measurement System (NOMS): K-12 Speech-language pathology user’s guide. Maryland: American Speech Language Hearing Association; 2003. [Google Scholar].
For older students https://pubs.asha.org/doi/10.1044/2017_AJSLP-16-0070 These results suggest comparable treatment outcomes between traditional service delivery and telepractice for treatment of children exhibiting speech sound disorders. The findings provide support for the use of tele practice for school-age children.
In closing (for now): Virtual therapy, tele-health, remote intervention… it goes by a number of names I believe will be here to stay. As a result it is worth learning more about as an option. If you are a professional or parent, please leave comments so that others can benefit from reading this post and I will continue to be updating it as more information is available.. thanks! many are motivated to use it because of its convenience. Telehealth may be more time efficient for an ever evolving world. Children become excited when technology is used and become highly motivated with activities that may be used
A Systematic and Quality Review of Parent-Implemented Language and Communication Interventions Conducted via Telepractice Read ASHA’s Article Summary | Go to Article
We have all been preoccupied with the coronavirus pandemic, but how can we not be. Good news is that this year, one since this post was originally written, we have a vaccine! I’ve re-written it with reflection in mind and the fact that there is concern. April is also Autism Awareness month and April 2nd is World Autism Day. In that spirit, I wanted to start this month off with a post along that theme.
Many have resorted to using more and more technology with their children. The paper, “Association of Early-Life Social and Digital Media Experiences With Development of Autism Spectrum Disorder–Like Symptoms,” was published online in JAMA Pediatrics and is available at this link. Don’t be alarmed, in response to comments about this article, it is noted that there is more need for research.https://jamanetwork.com/journals/jamapediatrics/article-abstract/2772821?resultClick=1. Look at how the spectrum of online relationships has changed us. How does this impact your family and how does it impact development of relationships in which communication is already a challenge?
The impact of COVID19 on development of social skills has not yet been measured yet. This is a significant area of concern for those who live on the autism spectrum. As a result, continued monitoring milestones of your child is imperative, Parents can do so using a screening tool that I have referenced below. There are also resources for adults.
In a matter of speaking … yes! Wow!!! Blended learning students in grades 9-12 return to buildings beginning 03/22 (at least in NYC). Speech-language pathologists help others with organizational skills so in that spirit here are some reminders
Get back into that routine now! Resume the routine bedtime, preparing lunch the night before, laying out clothing etc. Whatever the routine – especially with students who are special needs, that will be important. Since we are talking about older students returning, maybe a chart as below with their routine would be helpful to write out now..
Once your son or daughter is back – in-person..
Please communicate face to face if possible – not through facetime; but in-person and it will be important to show up with your son or daughter’s paperwork in hand. I’d suggest that you hand it to the special education supervisor as soon as your high school student enters the door. They may be pulling away during their adolescent years; which we’d typically expect. However, they won’t tell you – you are needed! Just like at the beginning in September – here is a checklist:
Set up a meeting or call your child’s lead teacher and introduce yourself. If possible go to school in person as it is the parent who makes themselves known that gets the help!
Make sure that your child’s therapy schedule is in place as times may change ..??? perhaps…
If your son or daughter needs any adaptive equipment – communication boards or FM systems and these are typically at school – make sure they are there and also any eyeglasses!
***If your son or daughter can help with the very last item above it may be wonderful so that you guide them in self advocacy skills!
Remember that it is not just your child who needs the help. Your child's teacher needs the support from the school therapist so that they know how to support him or her and they need you too as the "team leader". Your son or daughter needs guidance too!
Resources: The impact that changes in kids since the pandemic necessitated social distancing cannot be understated.
World Hearing Day was March 3rd and I wonder-do we really hear each other???
Well… as a speech language pathologist this topic is near and dear to me. In fact, it is an occupational hazard… Pragmatics refers to the way in which people use language within social situations. Consider that you may use language to greet others, inform people about events, make demand, give directions or make requests. If you find that you are not able to do so and in fact may not have the focus to interact verbally with someone else and really hear, here are some ideas. After all – it is our verbal communication that separates humans from other animals
Movement or vestibular input will help your brain to calm down (this goes for adults too). For adults – think about how calm and energized or focused you may be after a work-out. For kids, consider the fact that movement can promote the use of sound. In the video below, by using a teddy bear or similar item this can be facilitated in young children. This activity promotes counting (in the video) but you can adapt it such that i.e. you sing “twinkle twinkle little star”, reciting ABCs or spelling words. For older people you can adapt a more age-appropriate strategy of using a wiggle seat cushion or exercise ball chairs gives more vestibular stimulation and promotes core strength.
*p.s. this also strengthens the muscles that we use to speak!
If you feel that you need more help in being able to focus attention, concentrate and communicate in a meaningful way, feel free to give me a call or reach out by email.
**Occupational Therapists also provide assistance in addressing these issues
Thanksgiving is coming; but how do you keep safe traditions now in a socially distanced world. Cooking has always been something central to our family. I would think that this is to others as well. In my family, we sometimes share a recipe. Everyone brings something to dinner and one family member makes a main course. This year will be different. We will all be separated. Perhaps we will come together on Zoom, Facetime or someoneyum y uy ittyuyuu other form of technological means to mark a few minutes of the holiday together.
You are most likely going to be cooking anyway, so why not make it into a family happening. The speech-language pathologist in me suggests to you that there is so much that can be blended into this type of activity. For example, if you choose to make a fruit or vegetable salad together you can talk about the colors and categories of fruits or vegetables, with older kids – what makes a fruit a fruit and a vegetable a vegetable, cut with math concepts of quarters, a half or eighths. You could talk about action such as cutting, with shaped fruit/vegetable cutters and fruit picks slicing, spatial concepts such as putting in, taking out, having one next to or in between. Whatever you do, there are guidelines that were developed to keep cooking as a safe activity. According to the CDC, the following guidelines for holidays are noted.
“Currently, there is no evidence to suggest that handling food or eating is associated with directly spreading COVID-19. It is possible that a person can get COVID-19 by touching a surface or object, including food, food packaging, or utensils that have the virus on it and then touching their own mouth, nose, or possibly their eyes. However, this is not thought to be the main way that the virus is spread. Remember, it is always important to follow good hygiene to reduce the risk of illness from common foodborne germs”.
Make sure everyone washes their hands with soap and water for 20 seconds before and after preparing, serving, and eating food. Use hand sanitizer with at least 60% alcohol if soap and water are not available.
Instead of potluck-style gatherings, encourage guests to bring food and drinks for themselves and for members of their own household only.
Limit people going in and out of the areas where food is being prepared or handled, such as in the kitchen or around the grill, if possible.
Wear a mask while preparing or serving food to others who don’t live in your household.
If serving any food, consider having one person serve all the food so that multiple people are not handling the serving utensils.
Use single-use options or identify one person to serve sharable items, like salad dressings, food containers, plates and utensils, and condiments.
Avoid any self-serve food or drink options, such as buffets or buffet-style potlucks, salad bars, and condiment or drink stations. Use grab-and-go meal options, if available.
If you choose to use any items that are reusable (e.g., seating covers, tablecloths, linen napkins), wash and disinfect them after the event.
Look for healthy food and beverage options, such as fruits and vegetables, lean proteins, whole grains, and low or no-calorie beverages, at holiday gatherings to help maintain good health.
In terms of our fruit and vegetable – here are some reasons to make this – by color~
My personal favorite addition to the below is to add some sort of seeds for crunch – pomegranate seeds or pepitas; but regardless ……
The traditional trick or treating as we did growing up brings to mind the neighbor who gave out handfuls of peanuts and chocolates. As kids, my parents would search through the bags that my brothers and I brought home to make sure that what we had gathered was safe – unwrapped candy for example. I also recall carving out a pumpkin, drying out seeds and then roasting them. Cupcakes with icing was another thing that we enjoyed eating. As we got older and when I was raising a family there was the house next door that had a fabulous display and my son running out the doorway, coming back to the door saying that there were “customers mommy!!!”. This was in a suburban area of NY and now in an urban setting the “customers” are limited to buildings not so much those on the street OR those in schools who dress up and walk from class to class.
Those are fun memories, but this year things will look a lot different. Going trick or treating by yourself isn’t much fun. What will the memories be of this year’s generation of trick or treaters? Will there be any in an age of social distancing??? How can we be safe and how can it become a memorable one. All is not lost. Here are a few resources that I pulled together.
Masks are certainly in vogue… that will most likely remain in place for those non-sensory challenged people. Costumes and masks can perhaps be homemade.this year so that you don’t have to be shopping for them if you are or are not in a “hot spot”. see how these are. In searching for some ideas to share I came across CDC Guidelines that are for use at Halloween and also include those that will be applicable for the upcoming holiday season. Keep them nearby as you consider celebrations with family and friends.
GAMES
Games to be played?? Google online and you will find a number of them. For older kids or adults
Since the onset of the COVID19 pandemic, there is an increase in drinking. The impact of this on pregnancy is an issue of importance that need not be overlooked at this time. My guest blogger Patrick Baily (bio listed below) provides us with insight into its impact.
FAQS about FADS
Women who are considering having a baby but who also enjoy the occasional drink (or more) shouldlook at more info about fetal alcohol spectrum disorders (FASDs) and how they can affect their offspring.
Here are some important answers to FAQs about FASDs.
What is a Fetal Alcohol Spectrum Disorder?
According to the National Institute on Alcohol Abuse and Alcoholism (NIH), FASDs are not a single condition but rather an umbrella term that includes several disorders caused by prenatal alcohol exposure.
The Institute of Medicine of the National Academies (IOM) recognizes four diagnostic categories that collectively are labeled FASD. They are:
Neurobehavioral disorder linked with prenatal alcohol exposure (ND-PAE)
What Causes FASDs?
When a woman drinks during pregnancy, alcohol in her blood passes through the umbilical cord to her baby. The Centers for Disease Control and Prevention (CDC) advises that no amount of alcohol consumption is safe during pregnancy. This includes all types of alcohol, including beer and wines.
For the safety of the developing fetus, it’s recommended that women who are or who may be pregnant, that they avoid alcohol. In part this is because a woman may not be aware she is pregnant for four to six weeks.
The good news is that it’s never too late to stop drinking during pregnancy. An unborn infant’s brain continues to grow, but the earlier a woman stops drinking the less likely her infant is to sustain FASD later in life.
What Symptoms Can a Person with an FASD Have?
Though no two cases are alike, people suffering from FASD often have difficulties in:
Learning and remembering
Understanding and following directions
Maintaining attention
Controlling impulsivity and emotions
Communicating and socializing
Doing daily life skills such as bathing, feeding, telling time, counting money, and watching personal safety
Low body weight
Poor coordination
Poor memory
Language and speech delays
Low IQ or intellectual disability
Poor judgment and reasoning skills
Sucking and sleep problems as a baby
Hearing and/or vision problems
Problems with the kidneys, heart, or bones
Shorter-than-average height
Small head size
Abnormal facial features, such as a smooth ridge between the upper lip and nose (called the philtrum).
People with FASD are also more likely to exhibit mental disorders such as:
Attention Deficit Hyperactivity Disorder (ADHD
Anxiety and/or depression
Problems with impulse control, hyperactivity, and conduct
Increased prevalence of substance use disorders
Are Fetal Alcohol Spectrum Disorders Common?
It is difficult to determine the exact number of children who have an FASD, but experts estimate at least 40,000 children are born with an FASD each year in the United States. Based on studies of the Centers for Disease Control and Prevention (CDC), up to 8,000 babies may be born with FASDs each year.
Can FASDs Be Treated?
Yes. However, there is no cure. Fetal Alcohol Spectrum Disorders last a lifetime, though early intervention treatments often improve a child’s cognitive and physical development.
Protective factors are:
Early diagnosis before six years of age. When children are diagnosed at an early age, they can be placed in suitable educational classes and receive the social services needed to help both them and their families.
A nurturing, loving, and stable home environment throughout the school years. Children with FASDs tend to be more sensitive than other children to changes in routines or lifestyle and damaging relationships. Family and community support can work together to prevent secondary conditions, incomplete education, unemployment, and criminal behavior.
Absence of violence. A stable, non-abusive household that encourages children to avoid youth violence is essential to positive development. Children who have FASDs require being taught other ways of demonstrating their frustration and/or anger.
Involvement in social services and special education. Children are more likely to reach their full potential when placed in special education that is geared towards their specific needs and learning style. There is a large range of learning needs in children with FASDs, and education closely geared to their particular symptoms is essential.
What Types of Treatments are Needed for Those with FASDs?
Children and adults who suffer from an FASD have the same medical and health needs as anyone else. They need early well-baby care, good nutrition, hygiene, vaccinations, and exercise. In addition, they should be monitored for concerns specific to their condition.
Some needed medical specialists might include:
Primary care provider
Pediatrician
Nutritionist
Audiologist
Physical therapist
Neurologist
Mental health professionals such as a child psychologist and psychiatrist, and behavior management specialist.
Ophthalmologist
Gastroenterologist
Immunologist
Endocrinologist
Speech-language pathologist
Medications that are often prescribed for those with FASDs include stimulants, antidepressants, neuroleptics, and anti-anxiety drugs.
Behavior and education therapies tend to be most effective. Some of those are:
Good Buddies
Families Moving Forward (FMF)
Math Interactive Learning Experience (MILE)
Parents and Children Together (PACT)
Author Bio:Patrick Bailey is a professional writer mainly in the fields of mental health, addiction, and living in recovery. He attempts to stay on top of the latest news in the addiction and the mental health world and enjoy writing about these topics to break the stigma associated with them.
FAQS about FADS
Women who are considering having a baby but who also enjoy the occasional drink (or more) shouldlook at more info about fetal alcohol spectrum disorders (FASDs) and how they can affect their offspring.
Here are some important answers to FAQs about FASDs.
What is a Fetal Alcohol Spectrum Disorder?
According to the National Institute on Alcohol Abuse and Alcoholism (NIH), FASDs are not a single condition but rather an umbrella term that includes several disorders caused by prenatal alcohol exposure.
The Institute of Medicine of the National Academies (IOM) recognizes four diagnostic categories that collectively are labeled FASD. They are:
Neurobehavioral disorder linked with prenatal alcohol exposure (ND-PAE)
What Causes FASDs?
When a woman drinks during pregnancy, alcohol in her blood passes through the umbilical cord to her baby. The Centers for Disease Control and Prevention (CDC) advises that no amount of alcohol consumption is safe during pregnancy. This includes all types of alcohol, including beer and wines.
For the safety of the developing fetus, it’s recommended that women who are or who may be pregnant, that they avoid alcohol. In part this is because a woman may not be aware she is pregnant for four to six weeks.
The good news is that it’s never too late to stop drinking during pregnancy. An unborn infant’s brain continues to grow, but the earlier a woman stops drinking the less likely her infant is to sustain FASD later in life.
What Symptoms Can a Person with an FASD Have?
Though no two cases are alike, people suffering from FASD often have difficulties in:
Learning and remembering
Understanding and following directions
Maintaining attention
Controlling impulsivity and emotions
Communicating and socializing
Doing daily life skills such as bathing, feeding, telling time, counting money, and watching personal safety
Low body weight
Poor coordination
Poor memory
Language and speech delays
Low IQ or intellectual disability
Poor judgment and reasoning skills
Sucking and sleep problems as a baby
Hearing and/or vision problems
Problems with the kidneys, heart, or bones
Shorter-than-average height
Small head size
Abnormal facial features, such as a smooth ridge between the upper lip and nose (called the philtrum).
People with FASD are also more likely to exhibit mental disorders such as:
Attention Deficit Hyperactivity Disorder (ADHD
Anxiety and/or depression
Problems with impulse control, hyperactivity, and conduct
Increased prevalence of substance use disorders
Are Fetal Alcohol Spectrum Disorders Common?
It is difficult to determine the exact number of children who have an FASD, but experts estimate at least 40,000 children are born with an FASD each year in the United States. Based on studies of the Centers for Disease Control and Prevention (CDC), up to 8,000 babies may be born with FASDs each year.
Can FASDs Be Treated?
Yes. However, there is no cure. Fetal Alcohol Spectrum Disorders last a lifetime, though early intervention treatments often improve a child’s cognitive and physical development.
Protective factors are:
Early diagnosis before six years of age. When children are diagnosed at an early age, they can be placed in suitable educational classes and receive the social services needed to help both them and their families.
A nurturing, loving, and stable home environment throughout the school years. Children with FASDs tend to be more sensitive than other children to changes in routines or lifestyle and damaging relationships. Family and community support can work together to prevent secondary conditions, incomplete education, unemployment, and criminal behavior.
Absence of violence. A stable, non-abusive household that encourages children to avoid youth violence is essential to positive development. Children who have FASDs require being taught other ways of demonstrating their frustration and/or anger.
Involvement in social services and special education. Children are more likely to reach their full potential when placed in special education that is geared towards their specific needs and learning style. There is a large range of learning needs in children with FASDs, and education closely geared to their particular symptoms is essential.
What Types of Treatments are Needed for Those with FASDs?
Children and adults who suffer from an FASD have the same medical and health needs as anyone else. They need early well-baby care, good nutrition, hygiene, vaccinations, and exercise. In addition, they should be monitored for concerns specific to their condition.
Some needed medical specialists might include:
Primary care provider
Pediatrician
Nutritionist
Audiologist
Physical therapist
Neurologist
Mental health professionals such as a child psychologist and psychiatrist, and behavior management specialist.
Ophthalmologist
Gastroenterologist
Immunologist
Endocrinologist
Speech-language pathologist
Medications that are often prescribed for those with FASDs include stimulants, antidepressants, neuroleptics, and anti-anxiety drugs.
Behavior and education therapies tend to be most effective. Some of those are:
Good Buddies
Families Moving Forward (FMF)
Math Interactive Learning Experience (MILE)
Parents and Children Together (PACT)
Author Bio:Patrick Bailey is a professional writer mainly in the fields of mental health, addiction, and living in recovery. He attempts to stay on top of the latest news in the addiction and the mental health world and enjoy writing about these topics to break the stigma associated with them.
Those with hearing challenges may need to be able to lip-read and for that reason, a different type of mask is available to them. It is called a mask with a “mouth expression shield”. As a speech-language pathologist, I see real benefits for the use of this mask when children are in school be they diagnosed with learning challenges, intellectual differences, with diagnoses as being on the autism spectrum or just neuro-typical. It’s also a wonderful tool in the age of COVID19 when you are an adult with communication challenges.
If your child is in school-a teacher would be more likely to interpret the reaction of a student to the information being presented and visa-versa
A parent may be able to bond more effectively with an infant and visa versa.
An adult with compromised communication function may be able to communicate more effectively with a significant another person, a caregiver, friend, or family member.
A person with cognitive deficits who may not be able to recognize others may be scared if they see a part of the face that is blocked; but unable to express this and become emotional – thinking they are alone. They may perseverate on a remark such as “where is…..?”
A newborn may more easilly bond with you if you are visible to them.
The need for discussions about the Black Lives Matter movement and racism is a very real and saddening sign of our times. How do you start this discussion? How do you discuss if remarks are racist or not? In the presence of higher-level language deficits in those with a non-verbal language disorder or social communication disorder, there may be a need for consideration. Helping them to differentiate if remarks are or are not will be important.
Middle school-aged youngsters through college-aged years will need special help for their own protection and well being. because of the fact that from a neurological standpoint. higher-level reasoning, problem-solving, and self-regulation of your own behavior is developing at this time. The baseline functioning of those with nonverbal language disorders (NVLD) or Social Communication Disorder (SCD) will already be below what is typical.
If you are talking about the movement and concept of racism with an individual who has been diagnosed with They may not perceive what has actually occurred if they feel that they have been a victim of racist remarks and behavior. Maybe it was and maybe not. I say this because, those diagnosed with NVLD display problems in understanding communication that is not verbal which includes body language, tone of voice, and facial expression.
For example, I recently had a discussion with a college-aged male adult of Mexican-American descent who felt he had been a victim of racism in an interaction with a healthcare professional. He was accused of being a “drug seeker” when asking for a narcotic that had previously been prescribed and found effective for him in alleviating pain on a short term basis. The stakes were higher now and he felt that he would need the same medication over a three or four week period to tolerate pain from a post-operative dental procedure. He had been told that it would heal within that time frame, but could not tolerate the pain. He could not work, sleep, and was in pain when eating, drinking, or breathing because of this. The healthcare provider hung on him, after hearing his request for the drug. He was left in a situation with no solution for pain relief. This may not have been an ideal way in which to end a discussion with a patient; but, there were lessons when actions spoke volumes. This man felt that his feelings were not validated, he had taken a risk in talking with the doctor – needed help and felt very badly that there was no satisfactory answer or solution to his problem at that time.
In processing this interaction through discussion, great insight was obtained. Regardless of his racial or ethnic background, he had not perceived why this professional may have expressed himself by referring to him as a “drug seeker”. The followings issues arose:
The fact that a narcotic taken over a month-long period could be highly addictive needed to be discussed.
Talking about the need to consider other options was not at that moment on his mind, but was really necessary.
We processed together how the tone of voice and behavior may have had a negative impact on the outcome of this discussion. After all – he had wanted only one thing, saying nothing else would work and essentially made a demand.
At the time that the surgical procedure had been performed was there another factor visually in terms of his appearance when he initially went for treatment. It made him stop and think. His hair was mid-back length, uncombed and he had old clothes on that were very worn out when he initially had met the doctor.
Wonderful that in our discussion, he was able to share really being shaken up by the fact that someone had perceived him and put a label on it “drug seeking”. He said in response, “That’s really bad..being a drug addict is a label that sticks with you and it is not a good thing”. He said that he “just want to feel better so I can sleep, eat and work without pain”.
The discussion was closed by asking him if he now thought that his initial interpretation of the doctor’s remark was truly racist. Something to think about….
