BHSM: Raising Awareness about Communication Disorders: Part 1

This is the first of a three-part Q&A series highlighting audiologists and speech-language pathologists.

Every May, we like to highlight the hardworking audiologists and speech-language pathologists we have on campus here at Salus in our clinical facilities – the Pennsylvania Ear Institute and the Speech-Language Institute – and in our programs. 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, to 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, through 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.