Cap Guard Meets Shannon Wooten, M.A., CCC-SLIP, CBIS
Tell me about your professional background and experience. I have been a Speech-Language Pathologist for six years and have worked a wide variety of settings including schools, post-acute rehabilitation, acute care hospital setting, inpatient rehabilitation, Neonatal Intensive Care Unit, private outpatient clinic, and home and communication rehabilitation for patients with brain injuries. I am a Certified Brain Injury Specialist. I have worked with all ages and a plethora of diagnoses. I specialized in NICU feeding and neurodevelopmental therapy and adult brain injury rehabilitation.
What concerns do you have about working as an SLP and the risks of COVID-19 transmission? A lot of what we do as an SLP involves putting ourselves and our patients in a high-risk situation for COVID-19 transmission. We are typically in a relatively small space, in close proximity and are talking loudly, or singing, or working very close to the patient's mouth for dysphagia therapy for an extended amount of time. This is a perfect storm for COVID-19 transmission for both the patient and the therapist. The last thing we want to do is spread this illness to our, oftentimes, sick and vulnerable patients or to our families.
SLP’s who are wearing masks all day have already complained about chapped faces and lips, hoarse voices, facial breakouts, and dehydration from not drinking enough as it’s hard to sip water while wearing a mask. Which of these (one, some, or all) present concerns to you? I find that I am significantly less hydrated when I have to wear a mask. I have also experienced increased mouth breathing, dry mouth, chapped lips and face breakouts.
How do you feel about the risk of face touching and possibly self-infecting as a result? In general, people touch their face so often without thinking about it. I've learned to wear my hair back and make sure my glasses fit snugly in order to reduce my tendency to touch my face, but it is certainly an easy way to self-infect without even thinking about it.
Describe your experiences thus far with evaluations and therapy sessions in which patients came to your session wearing masks. At the clinic I currently work at, I treat both adult and pediatric clients. My adult clients usually wear a mask, unless we are working on swallowing therapy, but most of my pediatric clients do not. I wear a surgical mask at all times. I have had to get creative on how to give my clients the visual cues that I normally give when I say, "Watch my mouth." I do not feel that it is as effective to use pictures or videos for modeling, but everyone's safety is the highest priority right now.
Did the patients eventually fidget with and/or remove their masks, and how did you feel when patients removed their masks or touched their faces? The clients who are wearing masks when they come in, often remove them because they become frustrated with trying to keep it in place as they are talking. I know that the risk of spreading disease is higher when one or more parties is not wearing a face covering, so it does make me feel a little more anxious when they take their mask off. However, I clean my therapy room and surfaces before and after each client so I feel slightly less worried about touch contamination when they are touching surfaces and then their mask or visa versa.
Why is it so critical for you to be able to see a patient’s mouth movement and facial expressions? Almost every aspect of what SLPs evaluate and treat is directly related to the mouth. It is crucial to examine a patient's mouth to look for structural and functional differences and to be able to evaluate feeding skills, articulation skills, and much more. There is so much visual information that we are analyzing in a patient's mouth and face.
Why is it so critical for a patient to be able to see your mouth movement and facial expressions? It is equally important for the patient to see our mouth and face when we provide treatment. We often model tongue, lip, and teeth placement for particular sounds or demonstrate exercises with our mouths for dysphagia therapy. This is even more important when we are working with patients who also have language deficits and need the visual cues to help with comprehension.
If both SLP and patients wore face shields, describe how this would improve assessments and treatment plans. If both patient and therapist wore a face shield, speech therapy would essentially function the same as before the pandemic, which is the most ideal, but would also allow for some protection from the spread of COVID-19.