Where There’s Crisis, There’s Opportunity
March 15, 2012 4:52 pm
for Speech-Language Pathologists & Audiologists
July 23, 2012 – Vol. 22 – Issue 7 – Page 14
By Stephen Sacks, MA, CCC-SLP
In 1975, I walked into the speech clinic at California State University, Fresno, a 24-year-old with no voice. I had been working as a sound engineer in a recording studio. With the constant noise level, it had become increasingly difficult to talk until I had totally lost my voice.
As I worked with the student clinicians over the next two semesters, a change began to occur. My voice started to come back, and I also became interested in the profession. I began taking classes and pretty soon I was hooked.
My biggest anxiety was not how difficult the classes were but my ongoing speech issues. I was diagnosed with adductor spastic dysphonia with bowed vocal cords which led to lots of breathiness. I also developed significant dysfluency as it was difficult to make the transitions from unvoiced plosives to vowels (e.g., pay). I started avoiding certain words and speaking situations and wondered how I would ever pass the final oral speaking test to become an SLP.
Discouragement & Inspiration
Dr. Robert Brooks, a clinical psychologist and researcher, frequently writes how charismatic adults can change children’s lives.
He often does workshops with adults where they retell their stories from childhood about how some adult (frequently a school employee) said or did something that permanently changed their lives for the better. There are also painful incidents where an uncaring adult left the individual permanently scarred.
In my case, I had both happen.
One of my professors had assigned the class to watch a movie on stuttering. Because of my situation, I had done a lot of reading on stuttering. I thought this film was pretty superficial, and I told that to my professor. Standing in the speech office with other students around, she proceeded to tell me I shouldn’t even be in the department because I didn’t have the voice of a professional SLP.
In the Communicative Disorders Department at that time was an instructor named Bette Baldis whose classes I really enjoyed. One day after my traumatic experience with the professor I asked Bette whether she thought I should continue to become an SLP. Her response was, “Are you kidding Steve? You are going to be terrific!”
Discovering a Passion
I graduated in 1980 and never did pass the speech test but was allowed to continue. The first job I found was working in the schools. I took it and have been in the schools ever since.
In the mid-80s, I began having more voice difficulties. There were white growths on my vocal cords, and I had a surgery called a vocal cord stripping. This involved removing the top layer of skin from my vocal cords leaving them reduced in mass. After my surgery, I plodded along the best I could and then in 2008 decided to have a bilateral thyroplasty. This involved surgically inserting some plastic triangular-shaped devices which pushed the vocal cords closer together making it easier to phonate. My voice is somewhat better than it used to be, but I still find it difficult to talk in many situations, particularly when it is noisy.
As my 32-year career has progressed, several things have stood out over time.
The first was my initial day as an SLP. I took over a caseload with the usual assortment of speech and language problems. As I was working with some kids with no /r/ sounds, it became very clear to me I did not have the skills I needed to remediate their deficits. That day was instrumental in shaping my future. I vowed I would become an expert remediating speech disorders which resulted in doing lots of reading, attending many workshops and experimenting with different techniques.
I felt I continued to be mediocre until I went to several oral-motor workshops. Two significant concepts in oral-motor principles involve stabilization and differentiation. When I began to apply those principles I began to have consistent success. Rather than just telling a student with a frontal lisp to close his teeth to prevent the tongue from sticking out, I could now instruct him to develop the proper foundation for saying a correct /s/ sound.
The student was now instructed to stabilize the back of the tongue on the back molars and differentiate the movement of the back of the tongue which stayed still from the tip of the tongue which lifted up. I incorporated recommended oral placement exercises and developed others which helped get the articulators in the proper position to move into successful speech.
Articulation Fading Away?
Because my special interest is articulation/phonology, I’ve noticed over time it has become less prominent in our profession. As I present my workshops and talk to SLPs, there seems to be a consensus that as in my case when I graduated 32 years ago, new SLPs don’t have the necessary skills to efficiently and effectively remediate articulation/phonology disorders.
In the schools, it appears students with articulation/phonology disorders are the largest group of students we serve. I continue to see students in middle school and high school who have never made a correct /r/ sound, who have been dismissed from speech for lack of progress, and I will consistently get them to produce a correct /r/ in our first session.
In the future, I hope school SLPs and university professors can better partner to study what works best for students.
There is a belief the Chinese symbols for crisis can also be interpreted as opportunity. Whether or not this belief is true, my crisis turned into an incredible opportunity. I feel so lucky to have stumbled into what has been a terrific and rewarding career that was unimaginable when I walked into the CSU Fresno speech clinic 36 years ago.
Stephen Sacks is program creator at SATPAC Speech, LLC. The American Speech-Language-Hearing Association presented him with the 2011 Rolland J. Van Hattum Award for school-based professionals. He can be contacted at info@satpac.com.
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July 23, 2012 – Page 14