Writing Stories of Success

Communication disorders are no respecter of persons, and have penetrated humanity since the beginning (some evidence even suggests Moses had such struggles). Ultimately, we are social beings, and there are negative consequences when we are unable to effectively communicate in any way. Thankfully, we live in a time where there is professional help available to those afflicted with such disorders, and they are called Speech Language Pathologists (or speech therapists).

A Shift in Society

Historically, there were not “professionals” for individuals to see when they were having problems communicating. But surely there were cases of individuals working out in the field or learning a trade who had limitations when it came to speaking with others. Early humanity was most concerned with what these limitations meant. The ancient Greeks thought it was a cursing of sorts. Even the scriptures reference numerous accounts of Jesus being asked questions regarding this very suspicion regarding such disorders. With these negative connotations in regards to disordered communication, individuals were predominantly left to the mercy of self-help or questionable surgeries[6]. Today we know these disorders to be rooted in very diverse, natural (rather than supernatural) causes. Specifically, today we investigate structural, functional, cognitive, behavioral, and environmental causation factors. With the shift that has taken place in our society from labor intensive roles (blacksmiths, seamstresses, farmers) to more communicative centered roles (customer service, public relations, advertising), this field was born. Functioning in our present day society is nearly impossible for those whose speech draws negative attention to the speaker. Thus, speech pathologists combine their knowledge of human development, psychology, sociology, science, and medicine to develop personalized therapies that target the root problem and dissipate secondary adverse effects as much as possible. Language is not a secondary function in our modern world. We know that the lack thereof is not evidence of supernatural root or punishment by God; and because of this, we place high emphasis on helping individuals learn to communicate effectively; and the way in which we do this is by communicating effectively ourselves.

I’ve Decided to Study Speech Language Pathology- What Should I Expect?

To prepare for this major requires completion of prerequisite classes, specific anatomy and language development courses in the major, and some field work. For more specifics as to how best prepare or what you need to do now that you have decided to pursue this path, consult the audience profile in this blog post or the PDF version of this complete paper. 

Required Skill Development- Communicating to Different Audiences

Therapist - Client: Therapist to client communication has a very low style. The goal is to increase the individual’s basic communication and eliminate any negative attention or secondary behaviors associated with the impediment, to increase the individual’s quality of life. The most important skill to have is to be able to connect with each individual with his or her unique situation. What works with one client will not work with another; however, in all cases, clarity needs to be priority. This will be the most effective tool whether the patient has the cognitive ability of a seven-year-old, has ADD, had a tracheotomy, or a lisp—directions need to be concise and precise to persuade them to compliance. There will also be client to therapist communication. And a therapist needs to be aware of client strengths in order to magnify them.

Therapist - Family: Another group that speech therapists will constantly communicate with is the family of the client. With this group, it is extremely important to convince them of the necessity of treatment. Treatments can be expensive and often times insurance doesn’t cover all of the sessions necessary. So as the speech pathologist, it is important to design a routine that actually helps the individual progress in a way significant to the person and their family. But, before treatment can be implemented at all, the family needs to be guided through the grieving process. It is very hard to learn that a loved one has any sort of condition, mild or severe, that inhibits their ability to lead a normal life. So, SLPs need to be emotionally available and be able to read the family members to know when it is appropriate to suggest a course of action. It is important to effectively communicate with the family so that their support and encouragement of the client will be based on a clear understanding of the issue, the program, and the expectation.

Reference 1 

Therapist - Insurance: This is the group in which the most technical written and oral communication, heavy in use of medical terms, is used. Therapist need to persuade the insurance companies that the disorder interferes with the individual’s ability to function, and consequently, an expensive treatment could improve the individual’s quality of life in very specific ways. These documents are saturated with lists of the advantages of treatment and the disadvantages of not proceeding on this course of action. It is very important for the speech therapist to effectively communicate to the insurance company exactly what course of action is necessary, and who all needs to be involved (other doctors and specialists). If successful in this, the client will receive the care they need to progress.

So I am sure by this point you have taken notice of the photos on the right. From top to bottom you see Isaac Newton, Marilyn Monroe, Winston Churchill, Helen Keller, and Beethoven.(Websites for more information about famous stutters.) Looking at these people you may have several words come to mind. For example: talent, intelligence, music, determination, inspiration, and leadership. One word that may not come to mind is disorder; and yet, these are just a couple of the faces of various communication disorders. Their disorders cover everything from lisping, to stuttering, to hearing loss. Like all these historical people, our clients too can be remembered in a positive light that focuses on their successes. It is our job to disintegrate these negative concepts associated with such disorders and communicate our own stories of success. Success in this field takes an understanding of communication, respecting communication, and maintaining control over your own communication. One way in which we as speech pathologist showcase control over our communication is by successfully identifying our different audiences and adapting to what will be most persuasive for who we are talking to. It is important to remember that language production in no way indicates intelligence or potential. In this field, we maximize the positive influence of effective communication to improve another’s ability to communicate. They may never get to the point where they are 100% effective in their use of language; but, this will be a field in which you help facilitate individuals growth, improvement, and success.

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[1] "Hearing Beethoven – Part I." Hearing International Bob Traynor International Perspectives on Hearing Health Audiology HearingHealthMattersorgHearingInternational. HHTM, 04 May 2011. Web. 09 Dec. 2014. <http://hearinghealthmatters.org/hearinginternational/2011/hearing-beethoven-part-i/>.

[2] "Famous People." Stuttering Foundation: A Nonprofit Organization Helping Those Who Stutter. Stuttering Foundation of America, n.d. Web. 09 Dec. 2014. <http://www.stutteringhelp.org/famous-people/>.

[3] Doty, Laura. "Famous People Who Stutter." Famous People. N.p., n.d. Web. 09 Dec. 2014. <http://www.d.umn.edu/~cspiller/stutteringpage/famous.htm>.

[4] "Knowing Your Disability - The History of Deafness." Knowing Your Disability - The History of Deafness. N.p., n.d. Web. 09 Dec. 2014.

[5] John 9:1-3

[6] Brosch, S., & Pirsig, W. (2001). Stuttering in history and culture. International Journal of Pediatric  Otorhinolaryngology, 59(2), 81-87. Retrieved from http://search.proquest.com/docview/85358528?  accountid=4488 

Different Approaches to the Same Disorders

People of old stuttered and lisped much as we do today. They had structural malformations and functional problems that affected their speech. These aren't new issues unique to our generation. However, it is because they have penetrated throughout humanity that we have speech pathologist today.

Distant Past
Way back when, there were not professionals to consult with in regards to communication issues, so there were many approaches. Some tried to help themselves. For example, Demosthenes, a Greek orator, battled his stutter by placing pebbles in his mouth and practicing talking (presumably to build up control of those muscles). Others, consulted surgeons to snip their lingual frenulum, remove portions of the tongue, or mess with their nerves in hopes to gain control over their various speech impediments.

Recent Past
More recently, there has been more emphasis placed on finding the root of the problem. For example, the source of a communication disorder could be because of:

• a structural malformation (something anatomically preventing the production of correct and intelligible speech such as hearing loss)
• a behavioral disorder that secondarily affects speech
• a traumatic experience (an environmental deprivation)
• any sort of cognitive impairment 

Identifying the source of the problem is the key to successful treatment. As I researched it became obvious to me that the reason why my field has recently developed is because our world is shifting. In earlier times, society was more labor intensive. People were blacksmiths, seamstresses, and so forth. As long as you could work with your hands, you were okay. Today, our work force has shifted into communicative centered roles. Without the ability to effectively and clearly communicate without drawing negative attention to yourself, functioning in this present day society will be very difficult for you.

During Reconnaissance times, in plays and artwork, a person with a stutter was often identified via large glasses. This was because it was common for those with a stutter to squint and distort their facial features as if they couldn't see. Thus, they would wear glasses. 

Brosch, S., & Pirsig, W. (2001). Stuttering in history and culture. International Journal of Pediatric          Otorhinolaryngology, 59(2), 81-87. Retrieved from http://search.proquest.com/docview/85358528?  accountid=4488 

Law, J., Reilly, S., & Snow, P. C. (2013). Child speech, language and communication need re-examined in a public health context: a new direction for the speech and language therapy profession. International Journal Of Language & Communication Disorders,48(5), 486-496. doi:10.1111/1460-6984.12027

Style and Delivery in Speech Pathology

The goal of a speech pathologist is to teach others how to communicate. In class, we have studied that style is the how of speech. So really, you could say that speech pathology is a low style of communication (between patients and therapists) focused on improving an individual's ability to apply style while communicating. The situation of the client determines the method used to increase style application and thus improve quality of life. Though each therapy is unique, there are a couple of constants I have identified in regards to style on the part of the speech pathologist:

1. Low Style

Speech therapists must maintain a low level of style while communicating with clients. The goal is to teach effectively so that the individual can learn the skills they lack. For example, individuals on the autistic spectrum often have a hard time interpreting facial expressions. Thus, a therapist can use appropriate facial expressions to try and reinforce what is being taught. For example, picture flashcards depicting different emotions may be shown to help teach the principle, and then reinforced by the therapist through smiling when answered correctly.

      2.  Clarity

This is highly emphasized by speech pathologist. Not only clear, informative expression  with families and insurance companies, but clarity when interacting with the individual. A medical vocabulary is very necessary when communicating for insurance needs; but, to an individual with the cognitive ability of a seven year old,  simpler terms and instructions will be more effective.

Sometimes as a speech pathologist, written communication will be necessary. Because in my field there is a high emphasis on oral communication, I am still learning and identifying ways in which I will rely on written communication. In previous posts, I have mentioned documentation and insurance as possible sources of written communication. I'm not entirely familiar just yet with how that all works or is structured. So, for the purpose of this post, I have focused on the use of written communication in therapy. First of all, literacy is one means of assessment speech therapists use to identify an individual who may need therapy (where there are reading and writing problems, speech problems are likely to follow). There is also one type of therapy that I know for sure relies on written cues:

1. Aphaisa

Aphasia refers to the language displacement suffered by individuals recovering from a stroke. After a stroke, these individuals have varying degrees of ability to comprehend language and also produce it. They rely heavily on verbal cues (often needing another person to be able to fill in the blanks or suggest keywords to help them express their ideas, very similar to the tip-of-the-tongue phenomenon). However, the girl in the video, Sarah, who suffered a stroke at the age of 18, writes down the first letter of the word she knows she wants to say and the visual of seeing the first letter helps her locate and produce the word. Pictures (I consider written communication) are another means used to help these individuals increase their speech output and understanding. In the video, Sarah shows just how difficult it is for her to describe what is going on in the picture.  (4:10-7:52 relate to what I was talking about in this post with written cues and describing a picture)   

Conflict Issues and Special Topics of Invention in Speech Pathology

A Point of Conflict in Speech Pathology

The main point of conflict I foresee as a speech pathologist is the argument over "necessary and proper". While many of us are familiar with this phrase in terms of our government, I'm using it to identify the cases speech therapists make throughout  their careers in regards to whether or not therapy is necessary and will be effective for individuals struggling to communicate in any way. 

Topics of Invention in Law

There are many opportunities for persuasion when dealing with communication disorders. I want to quickly describe two different scenarios that will in one way or another affect each of us. 

Scenario One: 

Imagine sometime in the near future. You're graduated, working, and you have one beautiful child. They are three years old and what you would describe as "extremely shy" Usual communication consists of pointing and making noises rather than word formation. The preschool teacher has noted that your child has a hard time joining other kids and often paces the room and simply watches. You're the parent and need to decide, is this behavior normal or is there an underlying problem?  

Scenario Two:

It is much further into the future. Your parent or grandparent is aging and activities of daily living are becoming more laborious for them. They require extra care now, but the decline you are most concerned with is their ability to chew and swallow. What do you do? 

Analysis

My field deals with highly charged, emotional situations such as these. Health of loved ones is something that is sensitive and dear to all of us. You want to do what is beneficial for those who are in your charge, you feel responsible. As a speech pathologist, I would take your concerns and do a little research. In order to identify the problem, I need to know the composition of the situation. For example, does the child have hearing loss or have an intellectual disability? Is the parent/ grandparent losing their teeth or had a stroke? Identifying these little parts help expose the whole problem. I would need to then compare these observations to what I know is standard or expected from someone in this age group. (You need to have a knowledge of what is "regular" in order to identify atypical behaviors.) Finally, I would help you see how therapy would be advantageous in improving the quality of life for the individual (helping your child eventually be able to interact with other children, or how therapy will help your parent/ grandparent safely be able to maintain independence and avoid a potentially harmful situation). The special topics of invention (parts/ whole, similarities and differences, and advantageous vs disadvantageous), will also then be used to help persuade your insurance that such interventions are necessary and proper. Those are the three topics of invention that are very common in my field.   

Communication and Persuasion in Speech Pathology

At the end of this BYU road, I hope to be a speech pathologist, or one who studies communicative disorders. My entire field of study is rooted in how individuals communicate, discovering why their methods of communication may be ineffective, and designing and implementing therapies to improve their ability to communicate with others. If it isn't already obvious from my use of the word communicate four times in two sentences, my major deals pretty heavily with communication and persuasion, in fact that is the major!The attractive aspects of this major are that it is a blend of social science and the medical field, there are various settings for employment (hospitals, schools, nursing homes, and private practice to name a few), and we deal with a wide range of individuals. We work with babies, the elderly, and everything in between. Because we deal with such a large populous, this includes a variety of disorders such as: stroke recovery, physical malformations, swallowing problems, emotional problems, learning disabilities, etc. These are some of the things that really excite me about the Communication Disorders major.

Because this is the science of communicating effectively, all types of communication are utilized. It my understanding from the discussions I have had with professors that as a speech pathologist, I will be utilizing various methods to communicate with insurance companies/ doctors, clients, and their families. Professionally, I will utilize paperwork and documenting to reach persuasive ends with third parties. Recording observations and also improvements will allow me to use logos to properly advocate services for my clients and their families. It is part of my job to prove that action is necessary. With the clients, paperwork and documentation will not be persuasive in the slightest. With this audience, my goal is to establish independence, a sense of capability, and motivation within the individual. Since this job will include helping those on the autistic spectrum, those recovering from strokes, those with physical malformations, and so forth, no single intervention program will be exactly like the program used for another person (even for another person with a similar primary problem). Finally, to communicate persuasively with the family members of clients will also require a different approach. The goal in communicating with the family is to aid with the grieving process and convince them that intervention is necessary and can only be beneficial. The grieving process requires a very sensitive, understanding form of communication. It is extremely hard to learn that someone you love has a disorder, and a speech pathologist needs to be sympathetic to that and need to be able to evaluate when it will be appropriate to suggest an intervention program.