When the child came in for an evaluation, the grown-ups in the room assumed there was a learning disability. But when doctoral student Yvette Bean realized the child had a high degree of hearing loss, it changed her focus—and required additional expertise.
Luckily, all Bean had to do was go up a few flights of stairs.
Bean, a student in the school psychology program in the University of Georgia College of Education, is one of many graduate students learning how to conduct evaluations at the College's School Psychology Clinic. Housed in Aderhold Hall on the UGA campus, faculty and students work to detect and diagnose intellectual or behavioral difficulties for children and young adults.
But the clinic also partners with faculty in the College's Speech and Hearing Clinic, housed just two floors above in the department of communication sciences and special education. By working together, students like Bean gain access to expertise in the area of communication sciences and disorders, learn new terminology not often used in their own area of study, and gain a fuller understanding of what issues children may be facing. It also benefits the children who come to the clinic, as a speech or hearing difficulty may be what was holding them back in other areas—yet had gone undetected until their visit.
"We have families who come in and they have concerns, and they feel their child has a learning disability or some kind of problem. Our graduate students go through the process of an assessment and come up with an idea of what's behind the problem," said Chitra Pidaparti, clinical assistant professor and supervisor at the School Psychology Clinic. "We also collaborate with the speech faculty because often we come up with some sort of speech problem or language processing-related issue."
Language and communication also play a large role in autism evaluations, which is another way the College's Speech and Hearing Clinic can play a role.
"Sometimes a child is on the spectrum, but they just need mild interventions—if you gave them these helps at school, they'd be fine," said Holly Kaplan, clinical professor and coordinator of the UGA Speech and Hearing Clinic. "That's our overlap."
A lot of this cross-training happens behind the scenes, and is only apparent to families at the clinic when additional interventions or evaluations are needed. But for the students involved in the evaluations, the consultations with Kaplan, as well as Linda Hughes, a faculty member in the UGA School of Pharmacy, these interactions are a key part of their learning.
"It's nice when you can have interdisciplinary teams when you're in a clinic," said Bean. "But oftentimes (in other clinical settings) you don't get that opportunity. The fact that I can go upstairs and get those questions answered is awesome."
Graduate students in the department of educational psychology, which houses the school psychology program, work at the School Psychology Clinic as part of their first practicum experience. Students oversee duties such as patient intake and scheduling, managing cases and evaluating initial information—for example, intake questionnaires from parents, caregivers and teachers.
Every student is assigned a case—one a week in the fall semester and two a week in the spring—and they discuss upcoming evaluations at weekly group supervision meetings, said Pidaparti.
"Tuesday is our testing day—it takes a day because we try to be comprehensive—but before we do anything, we have a group supervision meeting where we talk about upcoming cases, what the situation is, the appropriate testing battery, and walk through scenarios to make sure everyone is ready," she said. "Then, they do the testing, gather all their information, score everything, and come back and we all talk about that. We talk about recommendations and impressions and any additional areas for follow up."
Typical assessments include an IQ test, an achievement test, questionnaires focusing on social-emotional behavior, executive functioning, measures of visual and auditory sustained attention and interviews with the child and parents.
But, if Pidaparti sees a red flag among the results, she may turn to Kaplan for additional insight—and that's where students get to experience the collaboration between the professionals. By being a part of Pidaparti and Kaplan's interactions, students gain an understanding of the terminology used by professionals in communication sciences and disorders, and also the signs that pointed to the additional consultation to begin with.
"They'll usually make an appointment with me and say, 'This is why I think it's auditory in nature,'" said Kaplan. "Usually at that time they've already met with me and I'll say, 'Yes, this does look auditory in nature' and we'll schedule an auditory evaluation for the child if it's recommended and the family wants to continue on. A learning disability is not an inexpensive thing to have."
Because the School Psychology Clinic and the UGA Speech and Hearing Clinic don't accept insurance, evaluations are paid out-of-pocket (although the Speech and Hearing Clinic does accept patients on a sliding scale). In general, though, evaluations for intellectual or behavioral concerns are not typically covered by private health insurance.
Overall, students move on to other clinical experiences confident in their ability to talk with specialists in other disciplines.
"I feel like our students, especially in school psychology, are out in the schools and are part of an IEP (individualized education plan) team with speech pathologists and occupational therapists," said Pidaparti. "And if you have some idea of how to communicate with and understand what other professionals do, you are in better shape to explain to parents why you're referring them on to somebody else. That interdisciplinary knowledge is so important to have before you graduate."
Bean said the partnership between the two departments made an impression on her. When she was evaluating the child with hearing loss, it was difficult to determine what was a learning disability and what was connected to what they couldn't hear. "We worked with Holly Kaplan and she could explain things to us that were outside of our field," Bean added. "She was able to not only tell me what she thought was best for the child, but also gave me her contact information to share with the family, and reading materials for them. She's very willing to collaborate."
Pidaparti and Kaplan acknowledge there's still more room to collaborate with other offices and departments in the College, but for now, they're happy with the direction it's taken them and their students.
"It's my hope that one day we'll have a collaborative clinic and people can come in and see speech and hearing, educational psychology and ABA (applied behavior analysis) therapy all at the same time," Pidaparti added. "Our fields are so complex, we don't have all the answers. We have to work with other people. It makes the most sense and it's best practice."