Reflections of a KDS Speech-Language Pathologist

This piece was written as a follow up to a popular blog post written in August 2015, Communication without Borders: Speech Language Pathologist Conducts Preeminent Research on Autism in Sri Lanka. As an invaluable member of our Speech-Language Pathology (SLP) team, Nimisha Muttiah has worked closely with our patients and students to help build their communication skills and find ways to express themselves.

Nimisha is leaving Franciscan Children’s to continue her efforts in her home country of Sri Lanka, serving children where resources, therapeutic experts and technology are incredibly limited. We will miss her dearly, but are proud that she will continue to share our unwavering passion for helping each child reach their fullest potential with those families in need. Nimisha wrote the following blog post as a reflection of her time spent as a Speech-Language Pathologist in the Kennedy Day School at Franciscan Children’s.

Nimisha (left) and her Occupational Therapy colleague, Alicia, work with a student in the Kennedy Day School using an augmentative communication device.

With my journey back home to Sri Lanka just around the corner, this is definitely a time of reflection for me. I can’t help but think back to when I first came to the U.S. 10 years ago – I was eager to learn and excited for the freedom! I could never have anticipated the opportunities I was going to have, the children and adults who would touch my life, and the friendships I would make. It has been an amazing journey! I now carry the immense and daunting responsibility of taking all the knowledge I have gained during my time here, the experiences I have had, and thinking about how all of this can be applied in a setting where the needs are so, so many and professionals such as speech-language pathologists (SLPs) so few.

When I first came to Franciscan Children’s I wasn’t sure what to expect. My good friend and colleague, Jess Caron, had said wonderful things about Franciscan and I was excited to be here. I had just completed my Ph.D. specializing in augmentative and alternative communication (AAC), a field that involves individuals with the most severe disabilities and most complex communication needs, often resulting in many of them not being able to produce any speech  at all. Many of the children I was going to be working with at the Kennedy Day School (KDS) had similar complex communication needs – over 95% of them in fact.

This unique population was the main reason I wanted to work at KDS – to  have the opportunity to put into practice all of the theoretical and research knowledge I had gained during my graduate program. My caseload included the youngest students just over the age of 3 years, to students of high school age, with a wide range of abilities. I had never worked with a population with this extent of complex medical, physical and communication needs, and although many of the children didn’t “talk” with their mouths, they communicated in so many other ways! From the 6-year old who was starting to experience the magic of using his eyes to communicate on a high-tech eye-gaze device, which in turn spoke aloud the pictures/symbols he was looking at, to the 19-year old with autism spectrum disorder (ASD) who had just mastered using a communication app on his iPad.

Click the image to watch a video of Nimisha working with a patient.

The children I worked with at Franciscan Children’s and the Kennedy Day School taught me things that no textbook or professor in the world could have. They taught me the importance of believing in their abilities. The belief that a child is going to use a communication tool to change his or her entire world with it! The perseverance my students and patients would exhibit to hit a switch, to look at a symbol on their eye-gaze device or to touch their speech-generating devices was truly inspiring. These children showed me how powerful and empowering it can be to have a voice, to have control over a situation, to have “a say.” Communication is beautiful, and I get to facilitate giving someone a voice!

The team approach to care and education at Franciscan Children’s truly embodies the word “multidisciplinary.” The opportunity to co-treat with my Occupational Therapy and Physical Therapy colleagues was incredibly enlightening. To share, collaborate, learn more about another field and problem solve access points and methods was challenging, but so interesting. Collaborating with wonderful Music Therapists such as Julie, Lyle and Ted has truly been a gift. During our Music Therapy – Speech-Language group co-treat once a week with KDS students, we brainstormed ways to facilitate the children’s communication through the universal language of music and these were some of my favorite sessions. Finally, the special education teachers and paraprofessionals at the Kennedy Day School do an incredible job. They don’t just provide these children access to the curriculum and academics, they also ensure their personal care, feeding, and medical needs are taken care of as well.

Halloween at Franciscan Children’s is a big deal! Here, our Speech-Language-Hearing team dresses up as idioms – can you guess their costumes?

In the Speech-Language Pathology department, I’ve been fortunate to have not just one or two colleagues who are SLPs, but seven! Although our tasks, responsibilities and the settings we work in vary, the one thing we have in common is the population we work with -children who are medically complex and fragile. Often, our lunchtime discussions would revolve around not just about what we did over the weekend, but also about an interesting case someone saw, or what to do about a certain speech impairment a child had, or about a rare syndrome, or if anyone had seen the movie about the rare syndrome! Our collegiality allowed us to have healthy debates about our clinical philosophies, the theoretical frameworks we prescribed to, and our individual clinical approaches. Be it figuring out how to program a certain device, or what paperwork to send in to insurance to get a device funded, or even debating about what situations you would recommend an iPad versus a dedicated speech generating device or vice versa, the discussion we have had have been incredible. My colleagues are ever willing to collaborate and help, and I will miss our conversations and their wonderful friendship terribly!

The children and the families I have worked with, the teachers, paraprofessionals, therapists and other staff at the Kennedy Day School, and my colleagues at Franciscan Children’s have taught me so much in this past year. The journey has been short, but incredible! I have been touched by all of you. I take with me all the lessons learned, the experiences had, the memories, and the laughs! I will carry a piece of each of you as I make my “big move” to my little country of Sri Lanka. I will think of you all fondly, and Franciscan Children’s will always hold a special place in my heart. It has been an honor.

Nimisha Muttiah, Ph.D., CCC-SLP
Speech Language Pathologist

If you have questions, or to refer your child for a speech-language, feeding team, video swallowing study, or augmentative communication evaluation, please call 617-254-3800 x5220 or email info@franciscanchildrens.org.