Autism Therapist Spotlight with Sarah-Jane Schwabb

Lexington Therapy Services has many dedicated therapists and providers who work day in and day out to provide members and students with exceptional service to help them reach their goals. Provider Sarah-Jane wears many hats, but believes the “light bulb” moment a child has when accomplishing a task makes it all worthwhile.

• What is your full title?
• I am a Speech Language Pathologist. We use the title Head Speech Language Pathologist for the Speech Language Pathologists that are supervising other SLPAs who are the assistants.
• When did you start at Lexington?
• I started at Lexington, I believe in May. May was when I started with clients. I actually interviewed and accepted the position in January. I was still working at another company and then coronavirus hit. So, we delayed things a bit and I started in May.
• What does your job entail?

• I do in-home sessions with clients, anywhere from age three until adults, who have disabilities that impact their life long term and need continued therapy.

  I also supervise two SLPAs assistants who have their own caseloads. I’ll come and supervise their weekly session at the clinic. I do training, help them with their sessions, sign off their notes and do all the paperwork.

  I also do the evaluations for new kiddos who have not had an evaluation in a long time or they have never had one. The initial eval will figure out what specifically they need.

• What skills do you believe are necessary for your position?

• I think that as a SLP you have to have patience. One day you might have a fantastic session and the next day they say they don’t want to participate and you must work a little harder. You must be flexible and adapt because without that, you won’t ever have a successful session.

  Communication with the family is also very important because then they have an open line in regards to the therapy their child is receiving.

  As a supervisor, you need to have excellent writing skills because you are doing the evals and the paperwork. You need to create concise, clear reports that parents, doctors and other therapists can understand.

  You also need to have clinical judgment skills to turn information into a plan of care.

• How long does it take to figure out the curriculum for a child?

• An initial eval takes me about an hour and a half to two hours with the child doing standardized testing. We will use pictures and ask questions. These questions will have a right or wrong answer so that we can score and compare them to kids their age. It then takes me about four hours to integrate all that information and write the report.

  After, I will touch base with the family about the goals and areas I believe need to be worked through. I will also ask if the report sounds appropriate and is consistent with what they see at home. Sometimes that two hours we spend with that child might not reflect their actual abilities.

• Do you ever complete an evaluation then realize this may not be the right care plan?

• I usually make the most adjustments when I touch base with the family again, but we also make them when we start working with the child. Sometimes we pick up on another area that didn’t show up in the evaluation. We then adjust the plan, add the goal and sign it off. The doctor will also view the update and we move forward with that plan.

  We also adjust the plan of care when they meet goals. At the end of every quarter, we look at their progress. Then, we determine the next step or we continue to target a specific set of goals. Eventually, they will have met all of their goals, making them more independent.

• How do you feel when your clients reach their first goal?

• You get so proud of them. It’s just that pride and that joy, especially with that light bulb moment. You will be working with them and practicing a skill for a while and it clicks, but the best part is when it generalizes.

  For example, if you’re practicing a speech sound. You practice that “L”. You do it ten times and they get it right, but they are sitting at the table looking at pictures. Then you go on the floor and you’re playing a game and they start saying that “L” sound while you’re playing the game. They aren’t having to think about it anymore and you’re thinking “YES!” That is the win.

• Would you say that would wrap into why you chose this career path?

• I would say yes. I always loved working with kids. I worked at summer camps and as a nanny. I knew that is what I wanted to do. My sister is an occupational therapist and tried very hard to recruit me. She would take me to work with her and I would watch her, but I would take interest in the speech therapist.

  I started observing sessions with Speech Language Pathologists and I really loved the connection with communication. Communication has always been a passion of mine, along with writing. I was an English major in college. I discovered this path is everything I love plus helping kids be able to communicate. So the helping bucket was filled, the working with kids bucket was filled and the communication bucket was filled.

• Why did you choose Lexington?

• I worked in California when I first became a Speech Language Pathologist in early intervention, which you’re only working with kids under the age of three. It’s so much fun but it is only focused on one kind of kid. Speech Language Pathologists are usually working in groups of about five kids during a session but I really loved working in the home and working closely with families.

  We moved to Arizona and I started working with a company that did home health, which was similar to what Lexington does, but they did not have a clinic. So, everything was in-home and I was driving a lot. Unfortunately that company had shut down and I was pregnant, meaning I needed health care fast. As a result, I switched to the schools and came to Lexington because I missed that home health and that 1-on-1 time in the school setting.

  I remember during my interview meeting Harrison and loved his vision for the larger picture. I just felt like it was the right place with the right people and the right mission.

• What does the motto “So They Can” mean to you and your work?
• I think that it’s feeding back into that independence. We want them to eventually grow up and be independent and there’s this kind of stigma that if you have a disability you will depend on others your whole life and that’s not true. It is finding the things that they can do and helping them do them on a consistent basis, so they’re more independent in their life overall.
• What is your favorite type of therapy or technique?

• I think it ties back to the blog you just did about play based therapy. It’s the most fun because kids are engaged and it’s fun for me because it’s fun to role play. It gives a chance to work on social goals and to learn how to problem solve in certain situations. You also see how they would respond in certain situations outside your classroom.

  So while it is important to sit at a table and do a worksheet or practice grammar, it is also important to have that play based, unstructured therapy. This is another great thing about Lexington. We can work directly with the schools in their natural environment.

• Has there been a client, where though your kindness and patience, has overcome a struggle or difficult task and reached their goal?

• There’s definitely a lot of cases like that. I think Wyatt is one of those. I worked with him two years ago before I worked with Lexington. When my previous company dissolved, he went from therapist to therapist and never found a good fit. When I started with Lexington, I reached out.

  It was interesting to see the foundation of the work I had done with him, but he wasn’t able to do it on his own. He doesn’t want to show interest in other people. He wants to talk about what he wants and as soon as you start talking about something else, he sighs. So, I just kept chipping away.

  I remember the first time I came back, he didn’t even acknowledge he hadn’t seen me in two years. I had to initiate a conversation and bring up my new baby. Another time I asked him how I thought about the current conversation. He responded by saying I probably wanted to talk about my baby and asked about her. It was tough for him, but I kept chipping away.

  Then I heard a story from his mother where he saw a friend and he asked how he was doing and acknowledged he hadn’t seen him in a while. His mom was excited because it was the first time he had ever done that without being prompted. It’s just cool to see that process and that application of skills.

• Anything you would like others to know?

• I think it might be important to help people understand all the areas that SLP works on, because sometimes parents don’t think their child needs speech therapy when they struggle.

  If a child is not socially having relationships and conversations that are meaningful, we can help with that. We work with the emotional piece when kids have a hard time expressing themselves. If we give them communication, we often eliminate certain behaviors. Parents may think their kid is out of control, but if we get to the root of that, it is often communication.

  Yes, we work on speech and speaking clearly, but we do so much more. We work on telling stories, answering and asking questions. Some kids will have a whole conversation just responding and not asking their own questions. It makes a big difference in their lives.

Lexington is one of kind as their staff aims to provide the best service in a multitude of areas. Head Speech Language Pathologist, Sarah-Jane shows this through her many roles and through her clients. Her kindness and patience brings change and independence to many kids as they work with her.