Wednesday, June 5, 2013

May WAS Better Hearing and Speech Month

 If you read the “IHP News” you know that in May each year, associations and professionals and patients that care about speech and hearing celebrate these functions.   I have procrastinated on a well-intentioned blog about May being “Better Hearing and Speech Month .  I have lots of excuses:

1.  I already wrote a blog about Nurses Week earlier in the month.

2.     Since I recently have experienced my first personal experience with speech and hearing problems, it’s just too hard to talk about in a blog.

3.    !Having spent the last 30+ years focused on this particular set of conditions, there is just too much to be said

4.    None of the above

Number 4, none of the above, is my reason.   Actually, I have been struggling for weeks.  I have really thought about the personal angle, the life experience and patient experience angle, and the perspective of how important our own Department of Communication Sciences and Disorders is to the Institute.   Each of these topics is particularly meaningful to me.   As I thought and thought about what to write, none of these topics “did it” though.  I just couldn’t become inspired enough to write about them.To be honest, they were too simple and trite.    Writing on these topics, somehow couldn’t touch what I know with great confidence:  The profound impact of the discipline of human communication sciences and disorders is yet to be realized in society.  Let me say that again, this time with italics: The profound impact of the discipline of human communication sciences and disorders is yet to be realized in society.  (Can you hear violins in the background?).

Is this an admonition and a warning?  Is this a cautionary moment? Am I attempting to overstate? 

Think about it for a moment.  160,000 or so speech-language pathologists  and audiologists in the US spend their time studying, thinking about, diagnosing and treating  patients with speech, language, hearing, reading, cognitive, and swallowing problems.   Additionally, basic scientists from CSD, but also from medicine, rehabilitation, engineering, psychology and a myriad of other disciplines devote their work to understanding how it is that people carry out these functions.  Where does communication originate in the brain?   Can it be reorganized in the brain?  What is the genetic basis?  How does something as “simple” as the human voice mechanism produce thousands of different adjustments to produce everything from perfect musical tones to the most primal sounds associated with fear or pain (and everything in between)?  How do blind people learn to read?  How do deaf people learn to speak?  How can a child go from a few vocalizations to adult-like speech in matter of a few years?  How do people, who cannot move, learn to communicate using technology?  

Here in Boston, we are lucky to be surrounded by people who provide wonderful examples of best practice in clinical care for many patients with speech, language, swallowing, and hearing problems.   The legacy of the Boston VA, Boston University, Children’s Hospital, Mass Eye and Ear Infirmary, Spaudling and Mass General ,( and more recently, the IHP)  in developing and applying innovative treatments for people with these conditions is well known in the speech and hearing community.

Similarly the great work of teams of speech and hearing scientists, neurologists, SLPs and audiologists at these institutions, as well as at Harvard and MIT,  have been significant at answering questions about aphasia, voice, swallowing, augmentative communication, hearing loss, head injury, and so forth.   In our MGH Institute community we are honored by the presence of remarkable leaders like Gregg Lof, Howard Shane, Marjorie Nicholas, Bob Hillman, Charlie Haynes and others who have left indelible marks on the timeline of communication sciences and disorders and will continue to do so.

So, given the environment in which we work, why does society continue to undervalue these important contributions?   I have come to believe that the answer is an evolutionary one.   At our most primitive moments we focus on survival and on satisfying those needs that are most basic.   Living in a society where health care and education, the primary environments where SLPs and audiologists work and study, are undervalued is clearly  a piece of the puzzle.   How can one say that the most human of functions (talking/understanding) is vital when  we have trouble identifying these as central to primary care in the health system or see them as non-essential to education?   

I have lots of ideas about why this has happened and how it needs to change in a progressive society.   I hope to hear your ideas as a follow up to this blog.   Let’s talk and listen to each other about speech and hearing.  What are your thoughts? I hope that YOU will take a few moments to comment below.   


  1. Beautiful sentiments Alex. Lesley Maxwell

  2. Thank you Alex for this thought provoking blog. I would love to hear more from you and my colleagues in the Department of Communication Sciences and Disorders about why this is so. Tell me it system based,lack of progress with the science, financial, ignorance, cultural? Linda Evans

    1. Linda, You are so great to comment! Thank you. Your question is a complicated one of course and I think many of your suggested reasons are important to consider. I think that we in SLP have to take some responsibility for not advocating strongly enough about primary communication issues. I also think that we have not been as effective as we need to be in addressing financial issues (i.e. reducing costs). Other systemic issues are the low priority that people with disabilities have within the health care system in general. I wonder if we see some more responses from some SLP colleagues.....

  3. Dear Alex,
    Thank you for your inspiring blog entry. Your comments about the educational setting resonated with me in particular. More often than we would like, SLPs in schools continue to be undervalued in terms of the breadth of their knowledge, and the contributions they can make. With the implementation of the Common Core, and revised versions of No Child Left Behind currently before Congress, the ground is certainly shifting. I think big roadblock are the limited modes of service delivery that are deeply engrained in school systems, including how Individual Education Plans are formatted. The CSD grads from The Institute leave with a broad view of their role in the schools, and the critical thinking and collaborative skills needed to make change. However, educating ourselves as professionals and our students in effective advocacy skills and strategies is something we could give more thought. Bonnie Halvorson

  4. Bonnie, Your thoughts are so valuable and so important. I hope that our new IMPACT curriculum and other efforts will further equip our grads for advocacy in the way that you describe. There are some wonderful leaders about schools advocacy-Barbara Ehren, Maureen Staskowski, Nicki Nelson--all come to mind. Maybe we should think about an advocacy conference for school based SLPs!

  5. As a pediatric provider who regularly saw children 5 and under being refused for community-based speech service reimbursement through private 3rd party payers with the reason, "Speech is not essential to children," I think you describe a multilevel issue. There is ignorance of the importance of communication at all ages, the relative invisibility of aphasia say compared to limb loss, and the reluctance to pour financial resources into an issue that is poorly understood and affects people who cannot speak to advocate aggressively for themselves. When people can't speak for themselves across disabilities, it leaves them especially vulnerable.
    I am continually struck at the wonderful work done here with this clinic and the PT clinics. Giving hope to people is a really special gift.
    Nancy Terres

  6. Nancy, your comment is such a great statement and means so much coming from a valued nursing colleague.

  7. Nancy, your comment is such a great statement and means so much coming from a valued nursing colleague.