We’re excited to introduce you to the always interesting and insightful Breanna Waldrup. We hope you’ll enjoy our conversation with Breanna below.
Breanna, thanks for taking the time to share your stories with us today If you had a defining moment that you feel really changed the trajectory of your career, we’d love to hear the story and details.
In the fall of 2011 I began to realize that I needed to make a job change. My first three and a half years of practicing as a speech-language pathologist had been providing services to children ages birth to three through an Early Childhood Intervention (ECI) program. ECI programs are mandated by IDEA, the special education law, and thus receive some government funding. The Texas legislature had met that summer and decided to make some significant cuts to ECI funding. The program for which I had worked had been fantastic and supportive, prioritizing the needs of the children it served, as well as its employees. After the funding cuts, the program had to start letting people go out of necessity. As a therapist, I generated income for the program, which meant my position was safe. However, I knew that it would only be a matter of time before there would be increased caseload demands – it was a matter of money, and there wouldn’t be a way around it. At that time I started paying attention to job listings and looking for the right opportunity. In December 2011 I saw a job posting at Apraxia Dallas, a small private practice that specialized in treating a rare speech sound disorder, childhood apraxia of speech (CAS). CAS is a motor planning and programming disorder, which means that the child knows what they want to say but are not able to efficiently coordinate the muscles required to speak. Like most speech-language pathologists, I knew very little about this disorder, but had treated several children that I suspected might have it. I went on an interview and observed therapy provided by the owner. The therapy seemed challenging but like a good fit; a mix of the skills I had acquired in my career thus far plus opportunities to build on those skills and take them to the next level to help a group of children that definitely needed it. The next year was one of the toughest of my career, as I rapidly expanded my knowledge and skill set in order to provide this specialized type of therapy. While most speech therapy is language-based, effective therapy for CAS is based on movement and motor learning. Shifting from thinking about speech from a linguistic perspective to a motor perspective was a major change. Over the next few years, I attended numerous continuing education courses on childhood apraxia of speech and began collaborating and sharing that knowledge with other speech-language pathologists.
In 2015, the owner of Apraxia Dallas decided to move away from the Dallas area and we decided at that point that I would take over the practice. We hired a new speech-language pathologist and trained her together. In January 2016, I took over ownership of Apraxia Dallas, with myself and one speech-language pathologist as the only employees. Later that same year I presented my first continuing education course on childhood apraxia of speech. Since that time, the practice has continued to grow and I have continued to expand my knowledge and share that knowledge with others. In 2016 I applied for and was selected to attend an intensive three-day training on CAS. Then in 2018 I was selected as one of about twenty speech-language pathologists from across the country to attend a week-long intensive training on CAS. After completing follow-up assignments, I am now recognized for Advanced Training and Experience in Childhood Apraxia of Speech. Apraxia Dallas now employs six speech-language pathologists, including myself. I have presented at the state and national levels multiple times a year since 2016 and during the pandemic, pivoted to both providing teletherapy and virtual presentations.
In 2017, I began to serve as the Volunteer Walk Coordinator for the North Texas Walk for Apraxia. The “Walk,” as it is called, is really a family fun day in which children with CAS are recognized for their hard work learning to speak. In addition, it serves as a fundraiser for Apraxia Kids, the leading nonprofit for children with childhood apraxia of speech. Although the Walk takes a great deal of time and effort each year, it is one of the most meaningful parts of my year.
At this point, a huge portion of my life revolves around childhood apraxia of speech – providing therapy to children with this disorder, educating families and professionals about it, and raising awareness and funds to help these children. When I went on that interview over ten years ago, I had no idea that this is where it would lead! I wouldn’t have it any other way.
Awesome – so before we get into the rest of our questions, can you briefly introduce yourself to our readers.
I am a licensed speech-language pathologist and the owner of Apraxia Dallas, PLLC. I hold a license to practice speech-language pathology in the states of Texas, Pennsylvania and Oklahoma as well as the ASHA Certificate of Clinical Competence. My primary area of expertise is motor planning disorders, especially childhood apraxia of speech (CAS). I have attended numerous continuing education courses on motor planning disorders including the Apraxia Kids Intensive Training Institute (aka “Boot Camp”) in 2018 and am recognized by Apraxia Kids for Advanced Training and Expertise in Childhood Apraxia of Speech. I also attended an invitation-only intensive three-day workshop with Edythe Strand, PhD and completed the Advanced Course in Critical Thinking in the Diagnosis and Management of CAS by Edythe Strand, PhD. I have attended the 2015-2019 and 2021 Apraxia Kids conferences. I have presented at a number of conferences on the diagnosis and treatment of CAS and on reading intervention, including the 2017, 2018, 2019 and 2021 Apraxia Kids conferences, the 2016 ASHA conference, and the 2016-2020 and 2022 TSHA conferences. I have received training in PROMPT, verbal behavior and PECS. Since 2017, I have served as the Volunteer Walk Coordinator for the North Texas Walk for Apraxia, benefiting Apraxia Kids. I strongly believe that every child has the right to communicate and strive to help each child with whom I work find their voice. Childhood apraxia of speech is a rare speech sound disorder in which the motor planning and/or programming for speech is disrupted. Since it is a motor speech disorder, it requires specialized treatment based on the principles of motor learning. Most speech-language pathologists receive little to no instruction during their graduate education on how to effectively treat this disorder. With proper treatment, many of these children make significant progress with their speech, and many are able to resolve the disorder over time. However, if the disorder is treated from a traditional speech therapy approach, these children make very slow progress. Since speech-language pathologists do not receive adequate training in the treatment of apraxia in graduate school, I have to train any therapist I hire on the job. In most settings, a business can hire a speech-language pathologist and have them takeover a caseload in a matter of days. In contrast, when I hire a speech-language pathologist, we meet and pair in therapy regularly, often for months. In addition, I pay for therapists to attend a variety of continuing education opportunities to learn more about research-based methods for treating childhood apraxia of speech.
I would say this dedication to providing the highest level of therapy has been a big challenge, since it requires a lot of time and effort. At times it has meant that we have had a wait list of clients, since we did not have enough therapists with the required level of training and expertise.
We become very devoted to the children we treat and while this is wonderful, it also takes its emotional toll on us, the therapists. Balancing the emotional demands of being a therapist treating children with a severe disorder has also been a big challenge both for me and the speech-language pathologists I employ. I allow my therapists to determine their own schedule and caseload to help find balance in their lives between the needs of the children they treat and their own. We strive to find the appropriate boundaries so that everyone, therapist and client, can thrive.
Can you tell us about a time you’ve had to pivot?
Like most of the world, I had to pivot due to the COVID-19 pandemic. In March 2020 we had planned to close for spring break in order to move to a new, larger office. I had just signed a new commercial lease. Spring break started, we moved, and the world shut-down. That week I frantically scheduled a few speech therapy sessions on telehealth to figure out how it would work, then quickly set-up my employees to be able to provide telehealth to their clients. The following week when we were supposed to be opening at our new office, we started telehealth with any clients that were willing to try it. For us in apraxia therapy, this was a big change. Of course we had to think of different activities and were scouring the internet for new resources. We learned about Boom Cards quickly! But in apraxia therapy we use a lot of multisensory cueing, including simultaneous production (saying the target as the same time as the child) and touch cueing. Neither of these were possible in online sessions – both parties can’t talk at the same time and obviously touch cues were not possible. At this point it was amazing to see parents and caregivers step-in to fill this gap. I always strongly believed in having parents and caregivers in therapy sessions so that they could see and hear the entire session. Once we started telehealth, I was so glad that we had this practice, as many of our parents and caregivers already knew what to do to help cue their child with our guidance. It was amazing to see. We ended up conducting all services via telehealth for two months. Finally, in May 2020, we were able to start seeing clients in-person in our new office, with COVID protocols in place. We slowly transitioned clients back to in-person services, although we still see certain clients, at least some of the time, on telehealth. I think telehealth will always be a part of our practice going forward.
How do you keep your team’s morale high?
When I became the owner of Apraxia Dallas in 2016, I knew that I wanted to be thoughtful and mindful about creating a positive work environment and culture for my employees. I am a big fan of Brene Brown and her work and used her information, especially about leadership, as a guide. I established goals for my practice – 1. provide excellent therapy for children, 2. provide a wonderful work environment for my employees, and 3. make enough money to pay my employees well and make a livable income myself. Establishing and maintaining work/life balance has been an ongoing struggle for me, and burn-out occurs a lot in the therapy professions. I do my best to support my employees so that they can achieve work/life balance. This means that I do not place caseload requirements on them and have structured the practice to minimize paperwork, since that’s a huge time and energy drain for most therapists. I also believe that each employee is a person-first and employee second. I value them as people, not as resources or tools. Each person has inherent worth and has important contributions to make to our team. I value and respect each employee. We all learn from each other. We all make mistakes but strive to do better. These beliefs extend to our clients, as well. Each child that we treat is a person-first and deserves to be seen and heard. Each parent and caregiver has a story. I have a fantastic team that shares these beliefs and it shapes how we interact with our clients and their families. It’s a positive cycle that we strive for at Apraxia Dallas.
Contact Info:
- Website: www.apraxiadallas.com
- Facebook: www.facebook.com/apraxiadallas
Image Credits
Headshot: SolVista Photography