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Published on April 26th, 2021

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Reflections of a Speech-Language Pathologist: Perceptions of our Profession and Unique Opportunities

Written by: Patricia Smith, S-LP(C)

 For over almost 50 years as a speech-language pathologist (S-LP) – graduating in 1972 and a member of SAC for that same amount of time – I have listened to many stories from people whose lives have been touched by those in our profession. I have heard numerous stories of how an S-LP has made a significant difference in the lives of people young and old, coming not only from the individual who received treatment but from also family members. The stories told are less focused on the specific strategies used but rather on the connections made and the dedication of those in our profession.

I have often wondered about the futures of those lives that we have touched. I have asked myself the following questions: what is needed for essential advancements in the areas of communication that would ultimately lead to a happy life and what are the key factors that make this happen?

With this in mind, I reached out to two young adults and their families. The young man, Jake and the young woman, BB, have received extensive S-LP support throughout their lives and are now on their own paths toward achieving their dreams. One received speech and language therapy from me (as well as two other S-LPs), while the other received speech and language therapy from S-LPs in another province.

This is certainly not a scientific study and my results and comments are merely reflective of my life spent as an S-LP. Based on this, my hypothesis would be that positive connections between a professional (in this case, the S-LP) and clients as well as their families is one of the key factors to their success. These connections are not only with our clients. Looking at that person as a “whole” and not just at the separate “parts”, it is equally as important to build connections with the parents, grandparents and others significant in the life of that individual. We do not take a course on this when we are working towards our degrees, but maybe we should.

With this in mind, I drafted a list of “talking points” to use as an outline for my interviews, hoping to find some key turning points to their success. My talking points were:

  • Early developmental milestones
  • First suspicions of learning difficulties
  • Sibling order and effects of birth order
  • Start of school experience
  • Successes and hurdles in early years
  • Time of diagnosis
  • Diagnosis by which professionals
  • Types of therapies
  • Parental involvement
  • Parental frustrations
  • Parental celebrations
  • Elementary years
  • Other interests throughout childhood
  • Social interactions positive and negative
  • Advocacy
  • Middle school
  • High school
  • Notable successes
  • Self esteem
  • Today
  • Reflections on past negative events
  • Reflections on past positive events
  • Future goals and life’s aspirations

Each young person was interviewed, along with their parents. Here are their stories.

The Story of BB

During BB’s early years, her communication difficulties were not apparent to her parents. She developed her own language such as “sticks” for French fries; “flat” for eggs; “circles” for chicken nuggets. She was always happy and charming, willing to try new things, developing motor skills early (walking at 11 months) and responding eagerly to stories read to her. BB’s parents shared that as a young child, she was kind with charming interpersonal skills. They said she was “a delightful child.” BB has one sibling, a sister who is 2 ½ years older. Her sister developed language early and her overall communication skills were advanced. As a result, her sister often acted as BB’s “interpreter.”

BB’s early school years were met with frustration for both herself and her parents. Her grade one teacher told BB’s parents that she was “falling behind” and recommended summer tutoring for reading. By grade two BB was feeling “frustrated and unhappy.” BB’s grade three teacher suggested to her parents that she may have Attention Deficit Disorder (ADD) and possibly a brain tumor. Her teacher recommended she be tested. That year BB received an academic assessment and was referred for further evaluation and placed on a lengthy waiting list.

At home BB’s parents enrolled her in dancing. She did very well and enjoyed it, excelling. Because of this, BB was placed in an advanced class that required good auditory memory skills and an ability to sequence oral directions, which were difficult and frustrating for her so she did not continue this activity.

Remaining on a lengthy waiting list for an assessment was frustrating. Through a friend, a referral to a developmental paediatrician was made with additional psychology, audiology and S-LP evaluations. BB was seen for a complete psychological evaluation as well as speech-language and audiological assessments. According to BB’s parents the report indicated an extraordinary split between verbal and non-verbal skills as well as auditory processing disorder.

Although BB felt others were able to understand what she was saying there were times she felt that her teachers did not like her.

In January of grade three BB’s parents moved her to another school. With her parent’s support she was placed in a grade two classroom with an intuitive and knowledgeable teacher. They felt this was a positive move as they observed BB’s frustrations diminishing.

During this time BB saw a private S-LP twice a week. BB’s parents spoke of this S-LP with great fondness and appreciation. BB’s parents felt that the private S-LP understood their daughter’s needs. After three years of private therapy, this S-LP moved to another province. Unable to provide further S-LP support, and with an in-depth knowledge of BB’s learning needs, she suggested to her parents that they consider moving her to a private school that facilitated learning, primarily for youth and children identified as having a learning disability (LD). This is an example of a professional in our field making a recommendation based on an understanding of this young girl while also having the ability to communicate to her parents what she would need to support her academically. This recommendation would prove to be life changing.

By grade seven, BB “claimed her LD.” She reflected that, even now, when she encounters difficulty learning new things and “feels” her learning disability, she will “push against it” in order to achieve her goals.

After graduating High School, BB was accepted to university and her first year studied general arts. Having a learning disability diagnosis, BB received 100% extra time, a private room and a computer during test taking. She did well academically, but (according to BB) not socially, feeling “lost,” having moved from very small high school to first year dorm life. She decided to take a gap year, moving home and working. After her gap year she continued her studies and completed a B.A. with an honour’s degree.

According to BB, she felt science was her field of choice but felt intimidated by the course work. With this in mind she still felt she needed to do this for herself and forged ahead.

BB was accepted in a Master of Science program, receiving a full scholarship for academic merit.

She commented that, in the past, her learning disability would “embarrass her” but this doesn’t happen now. Maybe it’s from summiting the mountain and seeing her future with confidence and strength.

During this interview BB presented herself as a confident young woman with a clear vision of her future. Her parents were, needless to say, very proud of her.

The Story of Jake

Jake’s early developmental milestones were unremarkable except for speech and language development. Although Jake continued struggling with speech and language development as he aged, his parents felt it was his ear infections that delayed his speech and that he would eventually catch up. Jake’s parents noticed a huge improvement in his speech and language abilities after he had tubes inserted in his ears at 18 months old. Unfortunately, Jake’s speech and language did not catch up and at one point the question of autism was raised. He started speech and language therapy through the Children’s Development Center in Kelowna, BC as a preschooler.

Jake is second born with a brother who is 13 months older. Jake’s brother Joel has taken on a parental figure in Jake’s life, continuing to check in on him, offering his guidance and support throughout their lives. Jake has leaned on his older brother for this support recognizing that school comes easy to his older brother.

Jake’s parents delayed his kindergarten entry, giving him the “gift of an extra year.” His kindergarten experience was positive, having an experienced kindergarten and learning assistant teacher as well as good friends and his older brother. It was this year that his parents began to realize how just how delayed his communication and early literacy skills were. 

Jake received speech and language therapy from kindergarten through grade six with myself, Pat Smith, S-LP. Jake’s mother attended all his speech and language sessions and his parents re-enforced therapy at home. This parental partnership was critical to Jake’s progress. Jake’s parents have commented that their S-LP initiated difficult conversations to get “the ball rolling” toward diagnosis. They feel that Jake might have “fallen through the cracks” if the S-LP had not pursued through to the discomfort of diagnosis. After fully understanding Jake through competent assessments as well as diagnostic therapies and developing a trusting relationship with Jake’s parents, I was able to gently push for further assessments.

Jake was diagnosed by the school district psychologist with a learning disability as well as Attention Deficit Disorder in the middle of his Grade 1 year. Jake’s Grade 1 teacher, Learning Assistance Teacher and Speech Pathologist recommended his parents pursue a referral to a pediatrician who diagnosed Jake with Attention Deficit Disorder (ADD).

Middle school was great for Jake. He made an instant connection with his English/social studies teacher in his grade seven year. This teacher became an incredible role model for Jake throughout his middle school years, encouraging him to enter a speech contest, which he won, and continues to enjoy public speaking to this day.

He was the male athlete of the year grades 7-9 which gave him confidence that showed in his academics and social life.

Jake began to struggle academically in his grade 11 year. He didn’t “connect” with his basketball coach and ended up quitting. His classes were getting harder and required a lot more support from his parents. Jake took it upon himself to speak with a councillor who supported him though this time. He joined acting and found a new passion. Jake was able to rejoin his basketball team as they got a new coach (his dad). He joined grad council and was asked to be one of the grad secretaries. Academics were difficult, but with support from mom, dad and his older brother he managed and even made the honour roll! Jake consistently received work ethic and honour roll throughout middle and high school.

Jake’s parents feel that Jake’s greatest hurdles in life were his communication skills, which affected not only academics but friendships as well. He did well in sports and this gave him a lot of confidence moving forward, but even sports were affected when they depended on communication and especially following directions.

Jake’s parents are constantly advocating for Jake saying that he needs to “see” things many times and that he was not trying to be rude or disrespectable. It was difficult for his parents to watch him struggle while trying his hardest. This advocacy has been crucial in so many ways. As Jake moved into middle school, he began advocating for himself.

Completing his high school diploma was celebrated by Jake and his family as a significant success and he has recently been accepted into University of British Columbia, Human Kinetics.

Jake has worked at a retirement home as a server. According to his parents, “he absolutely loves it as he works with some of his friends and he is absolutely amazing with the seniors. It has allowed him to learn different things like multitasking, taking orders and being on time!!! He loves listening to the stories of the residents and he is becoming aware of the fact that there is more to life then basketball”.

Looking back, Jake’s parents feel that the most negative event was explaining to Jake that he had a learning disability. They didn’t tell him until he was in Grade seven because they felt it would not “serve him to know at such a young age”. When he was younger, they explained to him that everyone learns differently and that he had to work a little harder. In middle school, Jake had a teacher who took it upon himself to explain to Jake in very poor terms that he had a learning disability. Jake came home obviously very upset and his parents had to navigate this with sensitivity as they did want him to define himself in this negative manner. Jake’s parents regret this event as they felt they should have explained this to him on their own terms.

Today, Jake’s first goal is to train and compete in CrossFit games. He is hoping this will create a platform for him to eventually start his own business in personal training and health and wellness. He is currently completing online certification to become a personal trainer. He is grateful to have an Individual Education Plan to allow him extra time and re-writes.

Reflecting on my time spent with this young man I was always impressed with his intuitiveness. He was especially able to pick up on others emotions and reflect them back to himself. This he expressed well.

Comparisons

When comparing both case studies there are similarities, both positive and negative.

  • Diagnosis frustration – where to go to get diagnosis and by whom.
  • Misdiagnosis early in life – parents heard the terms “brain tumor” and “autism” needlessly.
  • Self esteem affected by communication difficulties.
  • Need for ongoing support though out school years.
  • Continued support post-high school graduation.
  • Being the second child with the sibling offering support but also a comparison.
  • Significant parental support and advocacy.
  • Excellent work ethic.
  • Finding a “hook”.
  • Making the right decision for future career.
  • A positive interpersonal connection between S-LP and the client. They felt that we “liked them”.
  • Positive communication between S-LP and parents.
  • S-LP providing not only therapy but guidance through diagnosis and then support and advocacy with overall direction of education.

Perceptions of our Profession

Once my interviews were complete, I returned to these young adults and their families with two more questions:

  1. How do you feel your involvement with S-LPs have contributed success?
  2. What do you feel make S-LPs unique to this involvement?

These are the responses:

  1. “We have been very fortunate to have had S-LPs in our child’s early development. It was an S-LP that first realized he needed extra help and encouraged us as parents to seek one on one help with his speech delays. They always made it fun through games so that he didn’t even realize he was working! His participation in therapy was always 100% for this reason. Individual traits that made my son special determined the most effective therapy plan which maximized the benefits. Early intervention and one on one support have contributed to his success. With the addition of including parents in the sessions allowed work at home to continue. We were also guided to make the right decisions with the knowledge from our S-LPs and for that we are forever thankful.”
  2. “S-LPs are unique in that they can connect with children on a whole different level. The learning that happens in therapy builds self-esteem. My son who is now 19 still talks about his S-LPs! As parents it is hard to see that your child might not be reaching milestones and they (S-LPs) are able to provide insight in difficult situations. S-LPs not only guide children, they also guide parents.”

Summary and Reflections

Once again this is not a scientific study and my comments are mostly reflective. This discussion is not only about these two young people and their families I interviewed, but it is also reflective of almost 50 years practicing speech and language therapy with young people and their families.

The parental involvement with each of these young people was exceptional. This, I would suggest is one of the top factors in success. The other, I feel, would be each client’s work ethic and drive as well their ability to understand how they learned and what they needed in order to move forward. Their ability to self advocate was shown to be imperative in each case to change direction from a negative experience to a positive experience. They are remarkable young people.

Over the years, I have witnessed this type of parental involvement and work ethic encompassing not just individuals with the potential to attend post secondary studies, but those individuals whose success is measured at all different levels of achievement.

It has always been apparent to me, an S-LP, that parental involvement is a major factor attributing to the success of therapy. Personally, as a parent, I have experienced my desire to support my own children throughout their education and have felt frustrated when the partnership between myself and the significant professional failed. With this is mind, I feel that our profession offers a unique opportunity to create a partnership like few other professions. We are able to provide positive interpersonal relationships with our clients and their families that often pre-empts diagnosis and continues through to adulthood. We are often “first on the scene” when speech development (or lack thereof) is most obvious. We often have to inform parents of our “worries” about their child recommending further assessment. This is our chance to provide our expertise in a gentle and kind manner, reflecting empathy and support as we interact with parents along with their child on a regular basis.

We are there to celebrate numerous milestones as well as roadblocks. It is through this relationship that we as S-LPs can or cannot connect in a positive manner.

I have found, over the years, there are parents that are not able to provide this type of support for numerous reasons. In those cases, I have invited grandparents, siblings or significant others to step in and help, developing similar relationships. This has proven to be another positive avenue of support.

Providing speech and language therapy has allowed us all to develop these positive relationships and I believe it is why we are often so highly thought of by those we have worked with, along with their families.

What we do, as speech-language pathologists, is based on our training, current research and our experience. But more important than what we do, it is how we do it and it is who we are.



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