Question what we do; Keep learning more

As I write more and more snippets, I keep reminiscing back to the good ol' grad school days.  There were classes in articulation, classes in early language, classes in fluency, classes in voice.  I guess at the time I thought each potential client fit neatly into the specific category that each class prepared me for.
     Was I ever in for a surprise!   

• How about the child (only Spanish) at home with a complex seizure disorder, cerebral palsy, intellectual delay, cortical visual impairment, and no speech?
• How about a child with normal receptive language (in Burmese) who appears to have selective mutism?
• How about the child with repeated surgeries and radiation for a brain tumor leaving him with severe language deficits among a multitude of other difficulties?
• How about the child with a fluency disorder known as cluttering---totally not mentioned in the NC speech pathology guidelines?
• How about the laryngectomy patient who subsequently had a stroke?  (from my grad school days)

I find as I'm called on to offer expert advice, what I actually do is attempt to dynamically problem-solve, brainstorm ideas, work with other team members, try different therapy or teaching techniques, and with a team, hopefully slowly converge on a way to help.

In our school system, I'm blessed to have both a strong Professional Learning Community (composed of all the speech pathologists in the district) to help with this process.  When I have a particularly challenging case, I make phone calls, and drive to another school to discuss the particulars with my friends--other SLPs.  I can also make a referral to our assistive technology team---a brilliant duo that often assist with some needy and confusing children. 

 The final decisions on therapy fall on me, however.  I feel that my personal strength is that I often, very often, reflect on what I do and whether I have the data to continue with the current course.  I hope that graduate schools now discuss problem-solving and self reflection, and teach their future SLPs to question their own therapy and past therapies in order to make the lives of their clients better.