Better Hearing and Speech Month: Raising Awareness About Communication Disorders

Every May, we like to highlight the hardworking speech-language pathologists we have at the Speech-Language Institute (SLI). They provide life-altering treatment and raise awareness about communication disorders.   

Here’s a Q & A with Robert Serianni, MS, CCC-SLP, FNAP, chair/program director, Speech-Language Pathology and learn more about Better Hearing and Speech Month.

Q: Could you describe what a communication disorder is?

A: Communication crosses multiple channels, from the thoughts that we have through verbally expressing ourselves. A communication disorder would be any breakdown in the understanding of thoughts and words through the expression of those thoughts and words. So it could be a motor speech disorder where the articulators or the structures of your mouth have difficulty forming sounds, though you're really not sure where you are or where you need to go because you have a cognitive problem associated with dementia. Communication really spans many broad aspects of our lives.

Q: How do speech disorders differ from language disorders?

A: Language is the expression or the understanding of the thoughts, we have language when we write, we use language when we read, and we use language when we talk. Speech is the motor aspect or the sounds that come out of our mouths and speech, where my language might be the same as your language, but you might sound like you're from Boston and I might sound like I'm from the south, so our speech might be a little bit different. We call that dialectal variation, but our language is still the same.

Language has those multiple modalities. Speech also does, too. Speech aspects also include your voice. As I always describe it, the voice is sort of the music of your speech. It's what makes you sound like you. We also talk about fluency as it's related to speech and that's commonly known as stuttering. Those aspects, how fluently we talk, what we sound like, are the aspects of speech, and then what we have to say, how we use the words or the way we write the words really becomes our language.

Q: How do communication disorders in infants and young children differ from communication disorders in adults?

A: Although we don't always assume that they have it, we do look to adults that think they've developed communication aspects. Although some argue that you are constantly developing your communication abilities, most of us know how to talk and use our language pretty early in life, so that when an adult has an injury like a stroke or develops something like Parkinson's disease, they are losing a skill that they've acquired. Children, however, they're like blank slates, so they develop speech and language skills. If they're not developing as quickly as their peers or if they're injured early in life so that they have difficulty developing those skills, then we don't have really a basis to judge how well they've talked.

Think about a child that's born with a cleft lip and palate. They don't have the mechanisms to pronounce the sounds, or they'll have difficulty eating and drinking because the structures of their mouths did not form properly. But a person who's gone through life, maybe they've gone to law school and they've had a practice downtown and all of a sudden has a bike accident and hits their head and then has cognitive deficits, we make assumptions that they've been a good communicator before the injuries, so we've got to work that rehabilitation into what they used to have. Kids didn't use to have anything, because they're developing those skills as they grow and mature.

Q: Communication is across the lifetime or lifespan, so at the Speech-Language Institute, do you see yourself working more with adults, more with infants or somewhere in between?

A: My personal practice is with adults, and the way we set up our clinic – the Speech-Language Institute - is that we make sure the students are working with speech pathologists that have deep clinical experiences in their area of expertise. I work and have worked in the adult populations, so the clients I always see are adults, and again they might have had a stroke or a brain injury. Some of them have neurological deficits that develop with age like dementia and Parkinson's disease. 

That being said, our clinic works across the lifespan, so we've had clients that are just a few weeks old that come in because they have feeding difficulties and need a speech pathologist to help mom and dad figure out what are the best ways to feed the baby. We've had school-aged children come in because they have difficulty with learning or they have difficulty in communication or they stutter, through adults and the geriatric population, again, that have some kind of acquired injury such as a stroke or a brain injury. So, the clinic addresses the lifespan, whereas our particular speech pathologists may only work with a piece of the lifespan.

Q:  Can you talk about some of the support groups at SLI that facilitate communication across the lifespan?

A: That's actually one of my favorite topics, because I think especially from the practicing clinician side, these groups are so infrequently done in the community because they're not billable and there's no reimbursement for them, so you have to have agencies and clinicians that are really dedicated to addressing all the needs of the individual and not just the billable needs of an individual. Giving students the opportunities to look at a client outside of the treatment room I think is a really important way to give them the full complement of how a communication disorder impacts their lives.

We have support groups for parents and kids who stutter - the children have stuttering issues and the parents want to be supportive. It's difficult and they want to push, but how hard to push? We work with them in a support group setting, and the kids who stutter get to meet other kids who stutter and share those sorts of social aspects, and, "Hey, I'm not alone," and I think there's empowerment in that.

Q: Yes, communication can only be done between two people really, or more than two people.

A: Right. Another group that I'm really excited to see launch is our dementia support group. Caregivers that provide care to individuals that have dementia really feel isolated, because an individual with dementia needs to be monitored at all points. So it's hard for them to go out into the community and get support because then they have to worry about, "Well, who's going to watch my loved one while I'm out?"

SLI has developed a two-track program where we're going to do a group activity with the individuals that have dementia around a treatment philosophy called reminiscing therapy. Basically you spend a lot of time talking about things from the old days. I'm realizing as I get older, the old days are kind of creeping up on me. But we will talk about things like World War II and music of the era and politics of the era. People with dementia tend to hold onto their oldest memories longer than their newer memories, and that reminiscing therapy sometimes settles behaviors down, it makes individuals less scared because they're more familiar with that information.

So while we're doing the reminiscing therapy with the individuals with dementia, we're going to be working with the caregivers and say, "Here's some tips and tricks for you to do at home to make things more calm or more organized," so that the individual, the caregiver, as well as the individual with dementia have more supports around them so that they age better. We can't stop the decline in dementia, but we can certainly hold off some of the changes with therapy.

Those kinds of groups, from the children's groups through the adult and geriatric groups, really allow our students to again go beyond the treatment room and become more familiar with all the aspects, not just sort of the assessment and treatment aspects of communication disorders.