Vivian Topp spins around south Florida in her sports car, taking the opportunity as she glides between her four SLP offices to enjoy the ride.

“I’m very comfortable driving,” Topp explains, talking on her cell phone while traveling from one of her four SLP offices to another for her next appointment.  “My husband calls me a Bedouin, and I’m fine with it.  I drive a little Audi, and it does well with gas mileage.  It’s a convertible … red … it was a mid-life crisis car, the car in the color that your Mom said you should never get!”

Topp laughs with the carefree spirit and ease of a teenager who has just gotten her driver’s license, and it’s clear that she enjoys what she does so much, that driving is an insignificant detail if it gets her closer to her passion.

“I’m 54, and I started as an itinerate Speech Pathologist in the schools,” Topp recalls.  “And we traveled, so I’m used to it.”

Topp, who received her Bachelor’s degree at the University of Georgia in Athens, and her Masters degree at the University of Miami, was born in Cuba and came to United States in 1960 at the age of 7.  She now has four bilingual SLP offices in South Florida: a main office in Hialeah (west central Miami/Dade county); a satellite office is in Ft. Lauderdale; a Boca Raton office (which also covers Ft. Lauderdale), and an office in Coral Gables.  (Topp also has an office in South Miami as well, that is by appointment only.) 

Since her main office in Hialeah is so close to the Miami International Airport, Topp’s SLP practice includes a lot of international clients.  And she says her international clientele often combines their SpeechEasy fitting with a little fun in the Miami sun.

“Usually they’re planning a vacation and they come for their fitting, go on their vacation, and then come back to pick it up,” Topp says, with a light-hearted lilt in her voice.  “Janus is great about expediting the order for people who are not local, and I have clients that come from South America, the Bahamas, Europe, Trinidad and the Caribbean.  We even dispense in Puerto Rico, but we have an SLP there who helps us there.”

Topp has a great, expanding relationship with the University of Puerto Rico and, in fact, with the University’s assistance, Topp just received word that the first vocational rehab approval for a SpeechEasy device in Puerto Rico came through last week.

“We had a nice invitation to come and present to the Master Class at the University of Puerto Rico in San Juan,” she recalls.  “They have a very good ASHA accredited Master’s course.  It was really fun, great to go into the class room to demonstrate the devices and how we program.  Professor Edna Carlo has been a supporter of SpeechEasy, has seen the technical presentation twice and has been at our course in Miami.”

 “The gentleman to receive the first device in Puerto Rico via the vocational rehabilitation program was evaluated by John Haskell in New York, who suggested voc rehab.  The young man had just graduated from law school, knew his fluency was getting in the way of his job, and decided to pursue the approval.  He and I had been corresponding for about a year, during which time I helped him with some of the paperwork. But this gentleman has been so vocal, assertive and persistent, and not given up where other’s would have.  He was the one knocking on the counselor’s door every day.  I wrote and backed him up, but it was really his perseverance that made it happen.”

“I finally spoke to him Monday to tell him that we had received his authorization which means payment is assured.  So in about three weeks I’ll get the device and then I’ll go down and deliver it to him along with two others.  I really want to go deliver his because it’s pretty monumental. He has opened the door for other voc rehab clients.”

“In Florida, voc rehab has really been a smooth process. Every once in a while we will get a counselor who is unclear, but we know who to refer to.  I usually ask a counselor if we can refer others to them if they are clear.”

“Most of the time, they just work their process through their office, and what I’ve found out is you need to let them work through their own mischagaz,”  (a Yiddish word for ‘foolishness’).  “I’m there to offer them assistance or what ever they need, and leave it at that.”

Topp is describes her approach to the voc rehab process, and recalls some of the challenges that can arise when pursuing reimbursement.  “One lady had trouble finding the right people, so, I’m just patient and respectful and never get annoyed.  Sometimes (the counselors at voc rehab) make you jump through hoops that you don’t necessarily feel are necessary, but that’s okay, because we’re there to assist the SpeechEasy client.”

“I’ve never had one turned down (by voc rehab), although I have to say our requests are based on solid, sure data,” she explains.  “I show comparisons with and without the device, and the report we send is based on good data – we ask the client, ‘How would this help you with your job?  What would you do?  How would this help you obtain your goals?’  If we can demonstrate how this device is going to help accomplish that…
We’re good.”

“I had a client, a young man who was a lawyer, and his voc rehab counselor thought his stuttering was psychological.  So, I helped educate the counselor (who was a doctor), and he was so grateful.  The young man was already a lawyer in real estate, but he wanted to be a trial lawyer.  The counselor at first didn’t understand, so I had to rewrite the report and reframe it in a way that he would understand what the young man wanted to accomplish.  In the end, I made a friend for life!  And now the young man is a second-chair trial lawyer, and about to be a first.”

“We also have an accountant who just chose the device through the new leasing program.  It was a no-brainer for him, and he understood it right away.

Topp praises Janus for their design of the leasing program.  “They did a beautiful job in the way they set it up,” she notes.  “My first client to select the leasing program had a response the same day, which he was thrilled about, and that’s very important.”

Topp, who is a regular presenter for SpeechEasy at the annual ASHA convention, says SpeechEasy has been a great experience for her.

“Alan Newton used to present the technical presentation at ASHA, and I’ve been doing it now with Amber Snyder (Clinical Services Manager for SpeechEasy) for awhile.  It’s been very rewarding, and very cool to be able to do it,” Topp says.  “Every time I prepare for it, it changes slightly.  I cover the ongoing research and the evaluation of the device, how we run an evaluation, managing patient expectations, and how to go through the certification process.”

“It’s really neat.  We get great questions every year.  It was standing room only in Miami, and that’s very gratifying.  Dr. Kalinowski is always there, and he’s such a gracious person and teacher.”

Topp reflects on the commonalities in her practice.  “By and large, most of the stutters I work with do well with behavioral strategies.  However, every one of them has to be on their guard, constantly aware of it.  SpeechEasy is like passive assistance, it’s like ‘I’m wearing glasses because with them, I can see.  I feel like it helps me speak.’”

“To be able to hear someone in this class of disorders speak fluently and clearly on a regular basis is awesome.  And dispensing SpeechEasy is one of the coolest things I’ve ever done in 30 years of speech pathology,” says Topp. “It provides a tool to assist an individual to communicate.”

“In the middle of reading with the device, a young lady breaks into a big smile.  That told us what we needed to know: She was reading!!  It’s such a ‘feel good,’ it makes you want to laugh, its so liberating for them.  It’s nice to see them have control for a change – because usually, the therapist or the dysfluency is always in control.  The SpeechEasy, when it works well, gives them the control.”

“I try to keep expectations realistic within the realm of communications and activities of daily living,” Topp explains.  “The SpeechEasy is a device that is facilitative in communicative issues, but it’s not 24-7.  I try to identify where they would like to be fluent in their daily communications.  That’s a good way to present the notion of the device.  That way people don’t have to feel like they have to wear it all the time – and it doesn’t become a hindrance.  It’s important to convince parents their child doesn’t have to wear it all the time, to decide with them or discuss with them where the device is going to be the most effective and useful to them.”

“Also, when we do our tech session at ASHA, I’ve learned to start relinquishing some control to the client or patient right from the beginning.  I let them tell me what changes or differences they notice.  I let them tell me if they feel like its going to make a difference in their lives or not.  Sometimes I don’t see huge changes, but it’s good for them, and vice versa.  I try to listen and assist, rather than report all the time.”

 “Yes,” Topp says, laughing, “I’ve been around for a long time.”

And everyday, there’s one more person in the world seeking fluency who’s glad she is.