More of . . .

I once read that speech pathology is a combination of science, linguistics, medicine, psychology, and teaching. I'd have to add counseling in there as well. For my undergrad I double majored in creative writing and communicative disorders, which to me made perfect sense. I got a lot of quizzical looks whenever I told people my majors, as if there wasn't much in common between the two. But really, it was all about a love of language.

And it still is. Language takes so many forms -- nonverbals, speech, gestures, writing, laughter. I forget the exact number, but it's something like 60% of communication is nonverbal. Some people do really well with this, and if they're having trouble putting sentences together after a stroke, the family will say that they're still doing a decent job communicating. Other people seem paralyzed without their spoken words, and will sit there helplessly wondering how to convey something.

That's one (of the many) reason why "speech therapy" is somewhat of a misnomer. Sometimes a session consists of helping people exaggerate their facial expressions, learn the value of pointing, and encouraging them to become animated with their gestures. A 19-year old girl I worked with who had a severe head injury was at first refusing to try to communicate if she couldn't speak. She eventually went on to string 2 and 3 gestures together to convey a variety of basic needs -- Put the bed down, Close the drapes, Turn on the TV, to name a few. It was so empowering for her, and really gave her a sense of hope. She went on to start speaking again, but that was three years after her injury. Three years is a long time to go without communicating, and fortunately she found a way around that.

I was just sharing a minor victory with my husband, regarding a 50-ish year old woman who is recovering from a brain tumor surgery. I knew she had made significant gains, but I was feeling like my therapy wasn't focused enough. Much of our sessions are spent in counseling to help her and her husband deal with some of the frustrations of everyday life. At our most recent meeting I had to refer to the original evaluation report to answer a question for them, and I was pleasantly surprised to re-read the details of her original skills. It made me realize that she had, in fact, made TREMENDOUS gains. This realization helped me to see that while our treatments were often a series of curvy, intersecting lines rather than a single straight line from point A to point B, this was entirely appropriate to serve this patient's needs. She is progressing fabulously and is in much better spirits overall.

That, I think, is exactly why I do what I do.

So, WHAT do you do?

What I do for my job, is speech pathology. Or more specifically, speech-language pathology (SLP). Which also includes swallowing disorders, since swallowing is in the head and throat area.

And still you probably don't know what I do. You're not alone, oftentimes it seems that no one really understands what a speech pathologist does. My mom doesn't get it, my non-SLP friends don't get it, one of my sisters doesn't get it. My relatives don't get it, my nanny is fuzzy, my neighbors think I'm either a teacher or a nurse. As a matter of fact, there are doctors who could be referring patients to speech pathology don't really understand what it's about either.

My husband, ever willing to listen to my rants and aspirations, does get it. When a glassy-eyed stare follows my remark that I work a lot with swallowing disorders, he jumps in and says, "Quick, try not to swallow for the next minute. You can't do it, can you? Now imagine that you couldn't swallow if you wanted to, pretty freaky, right?"

Back in the day, speech pathology was more commonly known as "speech therapy." But that didn't help people understand what SLP's did, so our big accrediting organization (ASHA, the American Speech-Language Hearing Association, www.asha.org) decided to officially change our job title. The big difference is that therapists do treatment, whereas speech-language pathologists diagnose and do treatment.

"But diagnose and treat what?!?" you may ask. True, that was the original point of this entry. SLP's are known for being rather chatty. So, to get to the point, a clinical description of my job is that I diagnose and treat communication, cognitive-communication, and swallowing disorders in all ages.

Some people think of stuttering, and others think of correcting a slushy s-lisp or an Elmer Fudd "R." That's certainly part of it, SLP's do dysfluency (aka stuttering) and articulation (speech sounds, including the S and R). We also do language therapy for children with delayed language development and social language therapy for individuals on the autism spectrum. Some speech pathologists are also pediatric feeding specialists.

Beyond the pediatric side of speech pathology, there are adults who benefit from speech therapy as well. People who have suffered a stroke or head injury, people with progressive neurological diseases such as Parkinson disease or multiple sclerosis, and people with head and neck cancers may require interventions for the way their speech sounds, difficulty understanding or communicating with others, difficulty with memory and mental organization, or problems with eating and swallowing.

Then there are the voice patients. This group includes people who overuse their voice such as teachers and singers, people with poor vocal habits such as smoking and dehydration, and people who use their breath and vocal cords inefficiently. You know Stevie Nicks' signature raspy singing voice? It was from recurrent vocal nodules, which are basically calluses on the vocal cords.

So what do I do? I interview patients and their caregivers to help determine the areas of difficulty, I play on the floor with toddlers, I administer tests to score strengths and weaknesses, and I educate families about relevant diagnoses and work with them to set goals for treatment. I play card games and board games, I pull out the Legos and Barbies, I discuss current events and upcoming vacation plans. I blow bubbles, instruct patients in oral care, recommend food textures and swallowing postures, and provide recipes to make eating safer. I counsel patients and caregivers through frustrations and provide encouragement and strategies to try to make life a little easier. I help to shape and reinforce correct responses and train families to implement home programs so that the skills carry over into the real world.

In short, I help children learn how to interact with the world and I help adults regain parts of their lives back.

I'm a speech pathologist, and I have an awesome job.

Completely unrelated to speech pathology is my beautiful daughter Cleo.