The evolving SLP practice with Sienna Bonomolo-Lenoir

We warmly introduce New York based speech and language pathologist and United States Noala ambassador, Sienna Bonomolo-Lenoir. In our recent interview with Sienna, she highlighted the key points in her journey to becoming an SLP, as well as explaining the importance of staying up to date with recent research to best serve your patients.

Our interview consisted of five key questions, starting with how she became an SLP, her challenges, advice and stance on the ever-evolving SLP practice.

How did you decide to become an SLP?

It took me a few years of soul-searching to decide that I wanted to become an SLP. While completing my undergraduate degree at Florida State University, I was a Clinical Psychology major. I had incredible professors that made the major fulfilling and interesting, but something was missing. During the last year of my undergraduate career, I had a few elective courses to take, so I took the same class as my friend, “Introduction to Communicative Science” just to take a class with her. I never thought this would be the class that would change the entire trajectory of my studies, career, and life. This class introduced me to the world of speech, what Speech-Language Pathologist’s treat, and how they do so. This class was a very general introduction to our field, but I thought it was awesome. There was something really creative and experimental about the field, which I loved. I always had a strong interest in the creative arts and science, so to me, this career seemed like the perfect combination of both– it was just what I was looking for.

What's your typical day like as an SLP?

My typical day as an SLP starts off by engaging with my students before their scheduled speech sessions, in natural environments. One environment I absolutely LOVE engaging with them is the cafeteria. There are so many different environments in a child’s day that are packed full of rich communicative opportunities, and the cafeteria is a noteworthy contender. So, you can typically find me in the cafeteria with my students most mornings. I am careful not to place any demands on them in this environment, and leave it up to them as to what they’d like to share and how they’d like to share it. My kids usually opt for a wave or a high-five as they are actively stuffing muffins/pancakes/waffles into their mouths. Others want me to settle early-morning disputes with their classmates, sometimes crying, literally, over spilled milk. Otherwise, I go about my day seeing students either individually or in small groups. The latter part of my day is filled with paperwork and progress notes/charts, which I save until the end of the day, as I am so busy running around the school. My day is definitely action-packed, but I wouldn’t have it any other way.

What was the most challenging and what are you the proudest of?

As a newbie in the speech world, ‘finding’ my own voice was definitely challenging. Meaning, standing up for what I think is fair, impactful, and clinically relevant. Over the course of the year, I’ve had teachers demand certain things from me, with regard to the communication challenges of my students. For example, one teacher simply commanded (yes, commanded) that I should be targeting conversation skills from the very first day of meeting my students. As a newcomer, my instinctive response was to nod my head and agree. Looking back, nearly a year later, I am way more of a firm clinician who speaks up and speaks out on behalf of my students.

With that being said, I am the proudest of my students, because they are beginning to speak up for themselves, too! Even though they are very young (ages 5 and 6), they are starting to let the world know how they truly feel and what they truly think in the form of communication that is the most comfortable for them. It almost makes me emotional thinking about the progress they have made so far, and the genuine enthusiasm they have for speech.

What advice would you give to your younger self?

I would tell my younger self this: when faced with a tricky situation, put yourself in the other person’s shoes, and walk around for a bit. When I first started seeing patients in graduate school, my tone was a little too matter of fact. It was unemotional, vague, and terse. This happens during graduate school, as you are learning how to transfer over jargon-filled clinical writing into “okay, what’s the best (most empathetic yet efficient) way of conveying this message to the client, or the parent?” When I was in graduate school, it was hard for me to convey a message without sounding overly negative. Even when working with the most challenging of cases, it is important to lead with an air of positivity and warmth.

Now, with the experience I have working with parents, teachers, and other related service providers in a wide array of environments, I have a better handle on when, where, what to say and how to say things. This skill comes with time and is ever-evolving, but SLPs always need to remember that they are messengers of (sometimes sensitive) information and they need to be diligent in how they present it.

How do you see the SLP practice evolve in the coming years?

I see the SLP community will place more of an emphasis on advocacy, especially regarding the use of Augmentative and Alternative Communication (AAC)/assistive tech devices. Recently, I have heard an influx of pushback regarding the use of AAC. It’s disheartening to hear that parents, educators, and even administrators, often reject the use of AAC, following bogus claims that use will halt verbal speech production altogether. This will limit a student’s access to AAC, and access to further language development. Research has even shown that students with severe disabilities may have inconsistent access to AAC, even though research has continuously suggested that consistent access is critical (Andzik et al., 2019) . There are numerous research studies that show us this: AAC helps children develop their speech and language skills faster. As SLPs, we have an ethical obligation to stay up-to-date on current research to best serve our patients.

Resources

Andzik, N. R., Chung, Y. C., Doneski-Nicol, J., & Dollarhide, C. T. (2019). AAC services in schools: a special educator’s perspective. International Journal of Developmental Disabilities, 65(2), 89-97.

Barker, R. M., Akaba, S., Brady, N. C., & Thiemann-Bourque, K. (2013). Support for AAC use in preschool, and growth in language skills, for young children with developmental disabilities. Augmentative and Alternative Communication, 29(4), 334-346.

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