This is the second 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: At Salus University, we have the Pennsylvania Ear Institute, which is associated with the hearing part of Better Hearing and Speech Month. Do you ever find yourself working with any of the audiologists there when you have a client who has both hearing and speech language disorders?
A: Absolutely. So much of how we learn speech and language is through what we hear, and if an infant or an adult loses that ability to hear the input, we have to partner with our audiologists to figure out the best way to get the messages from the outside world to the communication partner. We work hand in hand with audiologists, not just in the spirit of Better Hearing and Speech Month, but as partners in the community.
Q: In the field of health science and audiology, as well as speech language?
A: Yes. I also should probably give a shout out to our optometry fellows, because what we don't hear, we see, and those two channels, those two senses, really help understand communication. I always give the example of being able to see an expression on one's face that might not match the words coming out of their mouth. For example, I'll have one of my kids answer me and say fine, but I know by how their face looks that they really don't mean fine, they're just telling me fine. And, if I didn't have that ability to sort of witness that their body language doesn't meet their words, then I would miss the actual communication. So, vision is very important to communication, as well as hearing.
Q: It's obviously easier to diagnose an adult who can tell you what issues they're facing, but with infants in terms of hearing and speech, they probably don't have those skills yet. What signs identify a disorder?
A: We really rely on parents to give us that information. They're the first teachers, and they're the ones that know their children the best, so they know. I had a nephew that had a speech and language delay, and we went to visit them. They live in Atlanta. He used to point at a cabinet in their kitchen and my sister-in-law would know that he wanted Cheerios in his favorite superhero bowl, and they would sit him in the chair with the TV on, and all he did was point. I would've never known what he was pointing at, but, his mom did because she was very in tune to his communication abilities.
When we work with young children, we spend a lot of time interviewing the parents. If they're in preschool, we want to know what they're doing from the eyes of the preschool teacher. They have a really deep understanding of what the child needs to do and how they get it done. And, through interviews and observations, we then begin to understand developmentally where the child is in their speech and language skills. A lot of times when we're working with young children, it looks like play, but really that's their occupation, that's what they're doing at that point in their lives. So to see what they need to get done, that might be a meal time, that might be turn on the iPad, that might be to stack the blocks, and by having the students and the supervisors get down on the floor and really get into play, then we can see, "Oh, these are the skills the child has or doesn't have," and that gives us a sense of where do we need to start with therapy?
Or we might meet a parent that says, "My three-year-old can't say these sounds," and we can explain to them that's developmentally appropriate because they haven't acquired those structures yet, or they're complex movements that their little bodies just can't do as of yet. So, come back to us in a year or two if they're still not able to do it.
Q: So obviously the Speech-Language Institute is kind of special to Salus, and not everyone in every area has access to an SLP like we do here. So how would parents who think their child possibly has a disorder get in contact with an SLP?
A: One point of access for parents is pediatricians. Parents are really good about taking their kids every three months for the first few years of life, and that's a great place to sort of say to the physician or the nurse practitioner or the Physician Assistant that you're working with, "Hey, my kid's different." Maybe there is a sibling, an older child that moved quickly through the developmental steps, and this child doesn't appear to be doing that same thing. My child walked when she was about nine months and we're now at 15 months and my second child isn't walking, and the pediatrician would be a person to have that discussion with.
The second way is through your local education agency. Early Intervention, which houses the birth to three populations, would come to your home and provide these services. So whether it's an agency that contracts with the county or the county itself would come out and do a full evaluation. That might be someone to address the mobility issues, so an OT (Occupational Therapist) or a PT (Physical Therapist). Certainly a speech-language pathologist would be on that team, an educator would probably be on that team, maybe even a social worker. But those individuals would again come out and interview and observe and assess in your home, and that's across the United States. It's certainly easier in a more suburban, urban area like we are here in Salus, in the Philadelphia market, but even in rural areas SLPs exist and are accessible.