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Presence Spotlight for Clinicians: Emily Provenzano, M.A., CCC-SLP

A conversation with Emily Provenzano, speech-language pathologist in the Presence network

From Zero Flexibility to Work-Life Balance

Emily, let’s begin with a little background on your professional journey…

I grew up in Brooklyn, and moved to Staten Island in seventh grade. Beginning from about age 11, I always wanted to be a teacher and to work with children. I actually studied special education at first, and did that for seven years before I got into speech therapy. Having the background in special education and going into speech has been very good because they were so related.

What inspired you to become an SLP?

I was working in special education. I started speaking with some of the speech therapists that worked in the school, and learned about what they do. I was always interested in language and I had the advantage of seeing what the speech therapists did. They would let me watch some of the sessions, or they would tell me some of the things that they did with the students, and I became really interested in it. I realized that this career was more for me. Also, I like individual and small group work. I really saw the impact speech therapists were able to make. As I mentioned, I was always interested in the language arts, so to be able to focus on that specifically was exciting to me.

The inspiration also came through in conversations with colleagues. They’d say ”There’s a good graduate program, and you should just try it out and go.” My initial response was “I already have my Master’s in Special Ed. And now I have to go back to school?” I felt like I was old at the time, but looking back, I was only in my late twenties. So eventually I decided I would go all the way back and work on a second master’s degree. I did it and then realized I was grateful because it really was the right path for me. It was actually great because I had more of a background going into school again. I didn’t feel lost with the classes. I felt like I had experience with this and I knew a lot of things already going into graduate school. So it was definitely really, really helpful.

What made you want to be a teletherapist with Presence?

I have worked 12 years as a speech therapist with elementary school students in New York. I am new to Presence and decided to pursue teletherapy to reach more students and have more flexibility at home for my daughter. I had worked remotely with students previously and loved seeing their positive response and motivation during sessions.

I would say I was thrown into teletherapy in 2020. It was always something I wondered about but I didn’t know if speech therapy could be effective online. I heard that there were some early intervention services that were online where you would speak with and coach the parents but I was a little unsure. Then 2020 came with the pandemic, and basically we all needed to learn teletherapy whether we were ready or not. We taught ourselves. We were using a video platform that was not built for teletherapy. Now I can see that what we were doing was not really teletherapy. There were no materials built in, and we were just scrambling and trying to pull it together the best that we could.

Then I realized that it really could work. To my surprise, some of my students even did better. I had a little girl who barely spoke. She would speak at a very low volume, or she would say just a word here or there. Then seeing her at home, she was speaking like I couldn’t believe. She was in her comfort zone at home, and she totally opened up to me. So I think that’s what convinced me.

I did a job search on teletherapy companies, and Presence came up. I saw that they had very good reviews. People were giving a lot of compliments to the company. So I just took a leap of faith, gave it a try, and I’m glad that I did. Besides what I found on the internet, I researched the website, watched the videos there, and thought it looked like a well organized company. I just decided “Let’s go with it!”

What do you enjoy about being a provider with Presence?

There are so many benefits to being a provider for Presence. Working from home has been a huge time saver. My work and home life balance has definitely improved. I have more flexibility, no commuting, and can reach students who may not have access to therapy services in their area. Presence has been supportive and helped me with all my questions as a new therapist here. I am happy to work for Presence and would recommend this company to anyone looking to make the transition to teletherapy.

What do you consider the most significant benefit to your work/life balance since you joined the Presence Clinical Community?

The flexibility is really great. When I worked full time in a school before, I had zero flexibility. I would miss everything with my daughter. My daughter would have her first day of school, and I wasn’t there to pick her up at the end of the day. We couldn’t pay attention to things the way I wanted to, especially in the mornings rushing out. I was so deep in a routine and just didn’t notice how much time I didn’t have until I was out of it.

What were you most surprised about when you made the transition to be a teletherapist?

It is surprising to see how easy it is to access a variety of materials, including assessments. I can effortlessly stay organized and find a wealth of resources that are easily at my fingertips to meet my students’ needs. Students find the games online motivating and engaging and they perform better.

What do you consider the most impactful features of the Presence platform for therapists?

There are so many materials—it’s really great. I feel like I’m never lacking for anything. I don’t need to really even look for certain things on my own. Everything is right there. What I find the most helpful is the community contribution center where all the other therapists can put their materials too. That has been so helpful. I can put a keyword in and so many different choices come up. I always find something specifically for each student that’s appropriate.

I did my first assessment recently. I was a little nervous about it, doing the assessment online, but it was great. The assessments are all online—everything that I used to have to scramble for in my building. There were tests that we wouldn’t have in the building. I would ask the supervisor about it, and they would say, “Oh, I’ll try to bring it from another school.” It was like an exchange of all these tests going on. Who has what test? And then you have to get it back. Now all of that is taken out of the equation. I type in the name of the test and it’s there and the protocol is there for the test. You don’t have to worry that you’re missing anything.  Everything is just there. So even the assessments on the platform are so convenient for me. I found exactly the two tests that the student needed. Everything is organized and at my fingertips.

The Presence clinician network that meets online in The Lounge has been really helpful too. Since that was my first time giving an assessment in the platform, I wanted to make sure I was doing everything correctly, and there was always somebody answering my questions. There is so much support. I never feel like I’m alone. I was used to having colleagues right there physically in the room with me but I still feel like there is this regular contact with people in the field who understand my concerns and my questions. And I try to help as much as I can, too.

What are the most impactful features of the platform for students?

I would say, definitely, whenever they can interact. I can control whether their mouse is off or on. If they’re getting a little too distracted or I feel like they’re clicking right away without listening to what I’m saying, I can control that—I can say, “Okay, we’re going to listen for a minute” and turn off their mouse. I found that really, really helpful. They have to listen and then I enable the mouse, and they’re able to go on and click. Anything that’s interactive like that my students have loved. I find that’s what motivates them the most.

Could you walk us through your daily routine? A “day in the life of a Presence therapist,” if you will?

I start off the day by bringing my daughter to school (I was unable to have this flexibility when working in a school building). I come back home, have some breakfast and coffee, get a few errands done around the house first, and then I begin my day. I usually start by reading emails or getting some paperwork done. Then I work with students until it is time to go pick my daughter up from school. I love that I now have the time to drop her off and pick her up. I work on my notes for the day at a time that works best. I make sure to get my paperwork done each day so I don’t overwhelm myself. I schedule little 20 minute breaks for myself during the day to get up out of my chair. Then to unwind at the end of the day, I like seeing friends whenever I can, or just going outside, sitting in the yard, listening to music.

I have a six-year-old daughter who loves to bake. She has her own cookbook. I like to cook, too. We like to find recipes and try different things. So we’ve been baking together—that’s our weekly thing now.

Describe how you work with the Primary Support Person to support your students during therapy sessions, particularly those with more significant needs.

I’m in an all remote school, so the children are home. If it’s a younger student, the parent stays there. I find with my older students, they usually just have the headphones on and the parents are in the background. They don’t really need the parent or caregiver there as much. But each student has a case manager so that’s like their support person. Regular email is usually the best way that we get in touch with each other. So if anything needs to be updated with the IEP, or if we need to touch base about anything, I go to the case manager.

Can you tell us a little about how you collaborate with teachers and other school staff members?

Primarily email is the way that we communicate. We are able to touch base with each other about IEPs, concerns, progress reports, and any other important information regarding each student.

How do you build trust and rapport with parents?

I call parents to introduce myself, send them an introductory letter about myself, and then communicate about ways to help their child reach their goals. Typically email is the main way that we communicate.

How would you address any questions or concerns from a clinician considering teletherapy about how to successfully address goal areas like apraxia of speech, or students with more severe needs?

I’m a visual person. What helped me the most was really seeing a lot of the demonstrations and the videos so just seeing teletherapy in action, seeing the features and all the things that you could do.

With a lot of my articulation students when I was working in person, I would use a mirror for them to see how their lips are being placed. Let’s just say they’re doing the sound for /f/—the mirror helped them to see if their teeth were going to their bottom lip for /f/ like they’re supposed to. I would call their attention to how they are articulating the sound with the mirror. Now, we have the camera that lets them see themselves. So honestly, it’s like having a little mirror right there.

There are so many things that you don’t realize until you actually see it, or do it. In the training, the clips and videos we watched were really helpful. Seeing a demonstration of all the different things you can do really helps. I feel like that really enhances your therapy. The platform is so well planned out and organized. If a student is getting distracted by the camera, you can turn that off, too, so you can really tailor it to each child. And there are so many resources—I can always find what I need. I’ll look at what their goal is and then I find a resource that matches that all the time.

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