Auditory-Verbal Therapy- Hearing, Listening, Talking, Thinking

Warren_Estabrooks

 

 

By Warren Estabrooks, M.Ed., Dip. Ed. Deaf, LSLS Cert. AVT, co-author of Auditory-Verbal Therapy: For Young Children with Hearing Loss and Their Families, and the Practitioners Who Guide Them

 

 

Globally, there is a great shift towards listening and spoken language for children who are deaf and hard of hearing.

Amazing auditory options, state-of-the-art hearing aids, and a variety of implantable hearing devices and the pursuit of excellent (re)habilitation by highly qualified practitioners working in partnerships with families, will hopefully become the standard of international health care and educational intervention for children with hearing loss around the world.

It is the work of therapists, teachers, audiologists, surgeons, social workers, and allied practitioners in health care and education to guide, navigate, and coach parents on their search for the treasure chest of spoken communication—to help them help their children discover the valued jewels of hearing, listening, and spoken conversation.  Practitioners everywhere form alliances of hope and trust with parents, and together we polish these precious gems until they sparkle and dance with life.

Why would one ever consider compromising when so much is possible?

We hope that one day we will look back and see an abundance of evidence-based outcomes, all barriers to equitable service gone, and a global focus on literacy with a deep understanding of powerful auditory access to the brain provided by state-of-the-art hearing technologies.

Renaissance man and mentor of many of today’s auditory-verbal practitioners, Dr. Daniel Ling, wrote that “auditory-verbal therapy… developed as a result of the natural outcomes of advances in knowledge, skills and technology.  As such advances occurred, new treatment strategies were devised to maximize their applications”.

Auditory-Verbal Therapy is now widely accepted because more children are acquiring, or have already acquired, the abilities to use spoken language, to interact more freely with other members of society, to obtain higher levels of academic education, and to have a more extensive range of careers, a greater security of employment and fewer limitations on the personal and social aspects of their lives” (Estabrooks, 2006).

Continue reading

2016 Awards and Honors

We are thrilled to announce the winners of the 2016 Plural Publishing Research Awards given in honor of the late Dr. Sadanand Singh, Plural’s founder. These two scholarships are awarded by the Council of Academic Programs in Communication Sciences and Disorders and the honorees and their faculty sponsors will be acknowledged at the annual CAPCSD meeting award banquet, in San Antonio, TX on March 31.

At the MS/AuD level, the award went to Chelsea Hull of the University of Nebraska-Lincoln. Working with advisor Dr. Sherri Jones, Chelsea is researching the impact of Sound Field Amplification (SFA) devices, specifically the REDCAT amplification system, on student academic outcomes and teacher perspectives of this amplification system on academic improvement.

CAPCSD Scholarship Chelsea Hull

Chelsea Hull                                                         Au.D. Student                                             University of Nebraska-Lincoln

At the PhD level, the award was given to Nancy Quick of the University of North Carolina. Under advisor Dr. Melody Harrison, the focus of Nancy’s research is on investigating the impact of underlying linguistic sources of knowledge on spelling among children with hearing aids, cochlear implants and normal hearing, utilizing a multilinguistic analytic approach.

CAPCSD Scholarship Nancy Quick

Nancy Quick, M.S. CCC-SLP               University of North Carolina at Chapel Hill PhD Candidate in Speech and Hearing Sciences, Class of 2017

Congratulations Chelsea and Nancy on your achievements!


Continue reading

Healing Voices

Healing Voices (1)By Leda Scearce, MM, MS, CCC-SLP author of Manual of Singing Voice Rehabilitation: A Practical Approach to Vocal Health and Wellness

Singing is a part of virtually every culture and is fundamental to our human experience. In the United States, singing is enormously popular, as evidenced by the vast number of people engaged in all kinds of singing activities. Over 30 million Americans participate in choral singing alone (Chorus America, 2009). Shows such as The Voice, America’s Got Talent, and American Idol illustrate how passionate we are about singing. From the amateur recreational singer to the elite celebrity, we sing as soloists and in ensembles, with instruments and a cappella, in classical and contemporary styles, on stage, in concert, and in the shower.

Every person’s voice is unique and identifiable, and our voices can be a big part of our identity and how we see ourselves in the world. This is especially true for singers, for whom the voice is not only intricately tied to self-image and self-esteem but also may be a source of income and livelihood, creative expression, spiritual engagement, and quality of life. For a singer, a voice injury represents a crisis. Because of the specialized needs of singers, it takes a team—including a laryngologist, speech-language pathologist, and singing voice rehabilitation specialist—to get a singer back on track following an injury or voice disorder. Singing voice rehabilitation is a hybrid profession, requiring in-depth clinical and scientific knowledge married with excellence in teaching singing.

Voice problems are rarely isolated in etiology—usually multiple factors converge to create an injury. These factors may include poor vocal hygiene, inadequate vocal technique, an imbalance in vocal load and medical problems (allergies and reflux are common in singers, but thyroid, pulmonary, neurologic, and rheumatologic conditions are among the illnesses that may affect the voice). The singing voice rehabilitation process must encompass all elements that may be contributing to the problem: medical factors, vocal hygiene, vocal coordination and conditioning, vocal pacing, and emotional factors. Continue reading

Tinnitus: In the Brain of the Beholder

Marc_Fagelson    Baguley_PTINN    David_Baguley

 

By: Marc Fagelson, BA, MS, PhD and David M. Baguley, BSc, MSc, MBA, PhD

Co-editors of Tinnitus: Clinical and Research Perspectives

Most audiologists and patients understand tinnitus to be the perception of a sound that is not connected in any way to an environmental event. For some patients, the sound produces minimal discomfort and is noticeable only a fraction of the time. Other patients are not so fortunate, and their tinnitus may persist and prove distracting when they are in the presence of other sounds or when they try to communicate. A relatively small proportion of patients with tinnitus, still probably more than 10 million people worldwide, have bothersome tinnitus that consistently reduces their quality of life and affects most routine activities. Such patients often respond to tinnitus as though its presence merits the attention and concern consistent with that demanded by a sound that is recognized as a threat. These patients illustrate some of the more confounding elements of tinnitus: it is a sound experience that may produce, or be associated with, powerful emotions and physiologic responses consistent with those demonstrated in fear-avoidance research.

A person’s experience with tinnitus may be complex and multi-faceted. Some patients link tinnitus to traumatic events, perhaps those that triggered the tinnitus onset. Other patients report psychological conditions such as anxiety and depression appear to exacerbate tinnitus and may be reinforced by tinnitus-related negative associations. Often, tinnitus severity is dictated not by the sound, but by the patient’s interpretation of and response to the sound. In this regard, the power of tinnitus to exert influence over a person’s life is in the eye, or ear, of the beholder.

Tinnitus interventions, then, may be viewed as proceeding along parallel tracks: abolishing or attenuating the sound may be the target of a treatment strategy, or the patient’s response to tinnitus may be the target of a management strategy. Both approaches are considered in detail, and with many examples, in Tinnitus: Clinical and Research Perspectives. Continue reading

The Ineffectiveness of Checklists in Diagnosing Childhood Apraxia of Speech (CAS)

Margaret_Fish  Fish_HHTCASE2E_low res

By Margaret Fish, MS, CCC-SLP, author of Here’s How to Treat Childhood Apraxia of Speech, Second Edition

Sorting through evaluation findings for young children with complex speech sound disorders can be confusing and challenging. As SLPs we strive to complete thorough evaluations and make sense of our evaluation findings to achieve an accurate diagnosis; however, many of the characteristics of CAS overlap with other types of speech sound disorders. Certain key characteristics from a CAS checklist such as inconsistency, atypical prosody, groping, or vowel errors may raise red flags for a diagnosis of CAS, but these characteristics alone should not predetermine the diagnosis until a thorough analysis of the child’s speech productions is completed.

Following are case studies of two children recently seen for consultations. Both children had an incoming diagnosis of CAS, but only one child was given a definitive diagnosis of CAS at the conclusion of the consultation. The other child demonstrated a number of characteristics commonly associated with CAS, but after careful examination of the child’s speech, the underlying nature of the challenges was not consistent with the core impairment of CAS that ASHA (2007) describes as the “planning and/or programming (of) spatiotemporal parameters of movement sequences.”

Case Study 1.

Mark, age 3 years, 7 months, had recently received a diagnosis of CAS by a diagnostic team at a local hospital. The diagnosis was based primarily on the following factors:

  • Reduced speech intelligibility (judged to be 50% intelligible)
  • A nearly complete repertoire of consonants and vowels
  • Inconsistent productions of the same word
  • Occasional vowel errors
  • Atypical speech prosody

Because of Mark’s limited speech intelligibility, inconsistency, vowel errors, and prosody differences, it was understandable how a diagnosis of CAS was made, as these characteristics often are associated with a positive diagnosis of CAS. Indeed, the use of a checklist of CAS characteristics alone could lead a clinician to conclude that Mark had CAS.

Continue reading

How to Work with Interpreters and Translators

Henriette_Langdon  Langdon_WWIT  Terry_Saenz

By Henriette W. Langdon, Ed.D., FCCC-SLP and Terry I. Saenz, Ph.D., CCC-SLP, authors of Working with Interpreters and Translators: A Guide for Speech-Language Pathologists and Audiologists

Our world is increasingly heterogeneous. English is no longer the only language spoken in the United States, England, or Australia. French is not the only main language spoken in France and neither is German the only language spoken in Germany. Immigration caused by political and economical changes has dispersed many people to other countries in the world in search of better opportunities. Consequently, communication between these individuals and residents of the different countries is often disrupted due to the lack of a common language. This challenge has existed throughout humankind, but it seems that it has increased in the last century or so. There have always been people who knew two languages that needed bridging, but now this urgency is more pronounced. The need for professionally trained interpreters was first noted following the end of WWI when the Unites States was first involved in world peace talks alongside many nations with representatives who all spoke a variety of languages. This historical event eventually led the League of Nations to the foundation of the École d’Intèrpretes in Geneva, Switzerland in 1924. Since that time, many other schools that train bilingual interpreters to participate in international conferences have been established. The AIIC [Association Internationale des Interprètes de Conférence (International Association of Conference Interpreters)] Interpreting Schools directory lists a total of 87 schools worldwide: http://aiic.net/directories/schools/georegions. The reader can gather information on which specific language pairs are emphasized in the various training schools; for example, Arabic-English; French-Spanish, Chinese-English, and so forth. Thus, interpreting for international conferences is a well-established profession today, offering specific training and certificates. However, interpreting is necessary not only for international conferences, but also to assist in bridging the communication in everyday contexts such as medical or health, judicial, educational (schools) and the community at large. Training and certification in areas such as medical and judicial have slowly emerged and are available to those who need them in various states throughout the United States. Legislation has been the primary force in the establishment of certificates in the areas of medical and legal interpreting. However, training in other areas where interpreting is needed such as education, and our professions, speech pathology and audiology, are notoriously lacking. There are some situations where medical interpreters can assist speech-language pathologists (SLPs) and audiologists in a hospital or rehabilitation center, but even those interpreters may not have the specific terminology and practice or procedures to work effectively with our professionals. Working with Interpreters and Translators: A Guide for Speech-Language Pathologists and Audiologists is a second revised and expanded edition on this topic that provides SLPs, audiologists, and interpreters who collaborate with them some concrete tools and strategies on how best to conduct interviews, conferences, and assessments when the client and/or family does not speak English fluently.  The proposed process is based on information gathered from other interpreting professions. The research, and some personal interviews with audiologists in particular that were conducted to assemble this information, indicate that the process is conducted haphazardly at best.  The literature available on the collaboration between SLPs and interpreters indicates that both parties are not secure about procedure and must learn how to work together by trial and error. Often the SLP does not trust the interpreter and the interpreter does not follow suggested procedures, such as failing to interpret all that is being said, conducting a side conversation with a parent during a meeting, and giving the child unnecessary cuing during testing (if tests are available in the child’s language, which is primarily Spanish). Literature on working effectively with audiologists is almost nonexistent; therefore, the first author resorted to several personal interviews with audiologists, a specialist of the deaf and hard of hearing, and professors of audiology throughout the country. Often individuals who perform the duties and responsibilities of the interpreter and who are hired to do this job are not fully bilingual; they may speak the two languages, but may not be able to read or write the language they are using to interpret. These interpreters are often not respected, are not treated as professionals, and their pay is very low.

Continue reading

ASHA 2015 Preview

The 2015 ASHA Convention starts November 12 in Denver and is shaping up to be one of the largest ever. If you are attending this year’s meeting, please stop by our booth (#804) for the following:

  • Save 20% with free shipping!
  • Connect with experts at one of our Meet the Author sessions (schedule to be announced November 11)
  • Browse our new textbooks and request a review copy for your course
  • Meet with Valerie Johns, Executive Editor, about any ideas for a new book

Attend the session, then buy the book!
We have many new books debuting by authors that are presenting at ASHA 2015 on their book topics.

Session Title: Drawing from Different Settings: A Panel Presentation on School-Based Swallowing & Feeding
Presenter(s):  Emily Homer (presenting author); Lisa Mabry-Price (presenting author); Kim Priola (presenting author); Gayla Lutz (presenting author); Donna Edwards  (presenting author); Lissa Power-deFur (presenting author)
Day: Thursday, November 12, 2015 Time: 10:30 AM – 12:30 PM                                     Book title(s): Management of Swallowing and Feeding Disorders in Schools and Common Core State Standards and the Speech-Language Pathologist: Standards-Based Intervention for Special Populations

Session Title: Assessing the Validity of Remote MAPping for Children With Cochlear Implants
Presenter(s): Emma Rushbrooke (presenting author); Louise Hickson; Belinda Henry; Wendy Arnott
Day: Thursday, November 12, 2015 Time: 11:00 AM – 11:30 AM
Book title(s): Telepractice in Audiology and Evidence-Based Practice in Audiology: Evaluating Interventions for Children and Adults with Hearing Impairment 

Session Title: Trauma & Tinnitus
Presenter(s): Marc Fagelson (presenting author)
Day: Thursday, November 12, 2015 Time: 1:30 PM – 2:30 PM
Book title: Tinnitus: Clinical and Research Perspectives 

Continue reading

Brain-Based Listening and Spoken Language: The Focus of the Third Edition of Cole and Flexer (2016)

Elizabeth_ColeCarol_Flexer

By Elizabeth B. Cole and Carol Flexer, author of Children With Hearing Loss: Developing Listening and Talking, Birth to Six, Third Edition

Spoken language is acoustically based. When the expectation is that a child will learn spoken language, hearing loss presents a critical spoken language-information-accessing obstacle to the child’s brain. When, through the miracle of modern technology and expertise, the audiologist provides the child’s ears with appropriately selected and programmed hearing aids or cochlear implants, the child’s brain now has access to the acoustic information encoded in spoken language. Looking at it this way, for the child who is learning spoken language, untreated hearing loss presents not only an ear problem, but also a brain access problem. Luckily, given sufficient acoustic access to spoken language in meaningful, varied-but-repetitive contexts, the child’s brain learns to make sense of the auditory input and learns to understand and produce spoken language. That process can be described in just one sentence, but is far from simple. The process of helping a child with hearing loss learn to listen and talk fluently requires a great deal of time, commitment, and sustained effort from all those who care for the child.

In recent years, there has been a veritable explosion of information and technology about testing for and managing hearing loss in infants and children, thereby enhancing their opportunities for auditory brain access. The vanguard of this explosion has been newborn hearing screening. As a result, in this day and age, we are dealing with a vastly different population of children with hearing loss, a population that we’ve never had before in our history. With this new population whose hearing loss is identified at birth, we can facilitate access of enriched auditory/linguistic information to the baby’s brain. The miracle is that we can prevent the negative developmental and communicative effects of hearing loss (such as delayed speech, language, reading and social skills) that were so common just a few years ago. With these babies and young children, we can now work from a neurological, developmental, and preventative perspective rather than a remedial, corrective approach. As we implement brain-based science, the effects on the field of hearing loss are truly revolutionary.

The following are some suggestions for families and practitioners who want to grow the baby/child’s brain for listening and spoken language. Many of the suggestions describe things that any devoted parent would likely do with a child. Beyond the technology, what is different for the parent of a child with hearing loss is the requirement for constant vigilance for decreasing noise and distance, and the requirement for sustained effort at increasing appropriate and meaningful verbal interactions with the child. These are the so simple, yet so difficult, keys for successfully laying the spoken language foundation that the child needs for the rest of his or her life. The authors take their hats off to all of the thousands of parents who have internalized all of the strategies and accomplished just exactly that!

  1. Your child must wear his or her hearing aid or cochlear implant every waking moment and every day of the week—“eyes open, technology on” (even when bathing or swimming, use technology that is water resistant/proof). The brain needs constant, detailed auditory information in order to develop. The technology is your access to the brain and your child’s access to full knowledge of the world around him or her. If your child pulls off the devices, promptly, persistently, and calmly replace them.
  2. Check your child’s technology regularly. Equipment malfunctions often. Become proficient at troubleshooting.
  3. The quieter the room and the closer you are to your child, the better you will be heard. The child may have difficulty overhearing conversations and hearing you from a distance. You need to be close to your child when you speak, and noise in the environment (especially from nonstop TV or other electronics) needs to be greatly reduced or eliminated. Keep the TV, computer/tablet, and CD player off when not actively listening to them.
  4. Use an FM system at home to facilitate distance hearing and incidental learning. An FM system can also be used when the child is reading out loud to improve the signal-to-noise ratio and to facilitate the development of auditory self-monitoring. Place the FM microphone on the child so that he or she can clearly hear his or her own speech, thereby facilitating the development of the “auditory feedback loop.”
  5. Focus on listening, not just watching. Call attention to sounds and to conversations in the room. Point to your ear and smile, and talk about the sounds you just heard and what they mean. Use listening words such as “You heard that,” “You were listening,” and “I heard you.”
  6. Maintain a joint focus of attention when reading and when engaged in activities. That is, the child should be looking at the book or at the activity while listening to you so that he or she has a chance to gain confidence in his or her ability to listen and understand without watching.
  7. Speak in sentences and phrases, not single words, with clear speech and correct grammar using lots of melody. Speak a bit slower to allow the child time to process the words, but be careful not to exaggerate your mouth movements. Many adults speak faster than most children can listen.
  8. Read aloud to your child daily. Even infants can be read to, as can older children. Try to read at least ten books to your baby or child each day. You should be reading chapter books by preschool.
  9. Sing and read nursery rhymes to your baby or young child every day. Fill his or her days with all kinds of music and songs to promote interhemispheric transfer. Singing is a whole brain workout!
  10. Constantly be mindful of expanding your child’s vocabulary. Deliberately use new words (in appropriate phrases and sentences) with the child for objects, foods, activities, and people as you encounter them in the environment during daily routines.
  11. Talk about and describe how things sound, look, and feel.
  12. Talk about where objects are located. You will use many prepositions such as in, on, under, behind, beside, next to, and between. Prepositions are the bridge between concrete and abstract thinking.
  13. Compare how objects or actions are similar and different in size, shape, quantity, smell, color, and texture.
  14. Describe sequences. Talk about the steps involved in activities as you are doing the activity. Sequencing is necessary for organization and for the successful completion of any task.
  15. Tell familiar stories or stories about events from your day or from your past. Keep narratives simpler for younger children, and increase complexity as your child grows.

Above all, love, play, and have fun with your child!

cole

Please read Dr. Cole and Dr. Flexer’s Children With Hearing Loss: Developing Listening and Talking, Birth to Six, Third Edition for detailed information about audiology, technology, parent coaching, and listening and spoken language development.

7 Tips for Landing Your First SLP Job

Guest post by Erica L. Fener, PhD, vice president, strategic growth, at Progressus Therapy

There has never been a better time to be a speech-language pathologist (SLP). According to the U.S. Department of Labor (2014), SLP jobs will grow at a rate of 19% between 2012 and 2022, which translates to an additional 26,000 jobs over the course of the decade. The median pay in 2012 was $69,870 per year, and the current number of jobs—more than 134,000—indicates plenty of opportunity, even before projected growth.

If you just finished graduate school in this field, congratulations! Now all you have to do is ensure you find the right job to begin building your long-term career. Consider these seven tips to help you land your first SLP job:

1. Apply for Your Temporary State License
Every state is different, but most require you to hold a temporary license before becoming an SLP clinical fellow—the first step to being a full-time SLP. Depending on your state, you may be able to apply for the license during your degree program. Your professors can help you figure out how.

2. Land a Professional Clinical Fellowship
Your clinical fellowship year (CFY) is a crucial step on the path to working as a full-time SLP. The purpose of the CFY is to transition from theoretical knowledge to practical application. The experience you gain will be invaluable, if it is the right kind.

The American Speech-Language-Hearing Association (2015a) recommends choosing a setting that provides a full range of speech pathology services, rather than one that solely performs screenings, and treats you as a member of the staff. Also, aim to do your CFY in a setting that you would eventually like to work in, such as a school or a nursing home, so that you will get the training you need to be successful in your future career.

3. Complete Your Fellowship
Successful completion of the clinical fellow requires you to work at least 35 hours a week for 36 weeks, totaling 1,260 hours. You may also work part time, at least five hours a week, until you hit the total. Note that your mentor must be a verified SLP, which you can check through the ASHA Certification Verification page (ASHA, 2015b).

4. Reflect on Your Experience
After you complete your hours, it is time to move forward and look for a real job, which requires reflection. This step might seem a little overwhelming, but thinking through your experience can make a world of difference in your professional career. What did you like? What would you prefer to avoid? How did the setting suit your nature? The answers to these questions will help you determine where you apply.

5. Start Searching for a Job
In rare cases, the setting where you completed your fellowship may choose to hire you. Typically, however, you should not expect your mentoring facility to offer you a job. If it does, wonderful, but you must be prepared to look for work elsewhere, so it is time to start the job search. Check out career fairs and job boards, look online, and utilize your network for prospects.

6. Look Outside the Box
Not all SLP jobs will be specifically labeled as such. Some might be called “speech therapist” or “speech-language pathologist and children’s therapist.” If you are working with older people, your duties might be split between speech-language pathology and physical therapy. The specific job you land depends on your setting and your skills. To get a better idea, do your research and review job boards to see what types of jobs are available.

7. Nail the Interview
In your interview, be personable and honest about your experience and your desires. If you are worried about it, read a few articles detailing some tricks for performing well in the interview. According to Business Insider (2014), these can be as simple as warming up your hands, mirroring your interviewer’s body language, and reading facial cues. Your expert knowledge, good humor, and attention to detail will eventually land you the job you are looking for.

Now that you have that job offer, it is time to take a little break and celebrate—but not for too long, of course. Soon enough it will be time to pack your supplies and start your new career as a professional SLP, helping improve the lives of others.

References

American Speech-Language-Hearing Association. (2015a). ASHA certification verification. Retrieved from http://www.asha.org/eweb/ashadynamicpage.aspx?site=ashacms&webcode=ccchome

American Speech-Language-Hearing Association. (2015b). Selecting a clinical fellowship (CF) setting. Retrieved from http://www.asha.org/certification/SelectingCFSetting/

Business Insider. (2014). Retrieved from http://www.businessinsider.com/psychological-interviewing-tricks-2014-9

U.S. Department of Labor. (2014). Speech-language pathologists. Retrieved from http://www.bls.gov/ooh/healthcare/speech-language-pathologists.htm

About the Author

Erica L. Fener, PhD, is vice president, strategic growth, at Progressus Therapy, a leading provider of therapy employment, including school-based therapy and early intervention services. Progressus Therapy connects speech-language pathologists with schools across the United States.

Insight into the Significance of Supporting Caregivers from Dr. Payne’s New Book

Joan_Payne Payne_SFC

By Joan C. Payne, PhD

Author of the new Supporting Family Caregivers of Adults With Communication Disorders: A Resource Guide for Speech-Language Pathologists and Audiologists

In the United States, there are nearly 44,443, 800 family caregivers over the age of 18 who are caring for someone aged 50 years and older (Alzheimer’s Association, 2011; National Alliance of Caregivers in collaboration with AARP, 2009). Family, or informal, caregivers are family members and friends who provide unpaid care and advocacy for a chronically ill or disabled person for 20 hours a week or more. As such, family caregivers are the nexus between the formal health care system and the community for many individuals. Family caregivers, also called informal caregivers as opposed to those who are paid to render care, are vital extensions of the health care system. Without them, many persons discharged from acute and rehabilitative hospitals would not be able to care for themselves. The efforts of family caregivers are so important to the health, positive mental outlook, and indeed, survival of care recipients that their services are invaluable and predicted to be needed more and more as the 21st century continues.

This is why I am so excited about my book! Supporting Family Caregivers of Adult with Communication Disorders. A Resource Guide for Speech-Language Pathologists and Audiologists represents the first time that caregiver issues and resources have been organized and put in one place for the benefit of health professionals and the families of their patients. Much of my passion for the topic of caregivers comes from my remembering how stressful caregiving was because I really did not know what to do 20 years ago even though I had advanced degrees in speech-language pathology. The purpose of putting this information in one place where it is readily accessible is to empower speech-language pathologists and audiologists and other health professionals to support family caregivers of adults with disorders of communication and swallowing.

Caregiving is a deeply personal and intensive enterprise. Many caregivers report that they have appreciated the time to forge more intimate and caring relationships with their loved ones. At the same time, a significant body of research indicates that caregiving is also costly in terms of time, effort and financial sacrifice. Many caregivers are placed in the primary role of helping others without adequate resources with which to provide the best care. Caregiving can be so stressful that caregivers can themselves develop diseases and disabling conditions which affect their caregiving and those who depend upon them. For some, the stress can be so crippling that some caregivers are forced to abandon providing care altogether, or they become terminally ill.

To that end, each chapter addresses the issues of caregiving of adults with communication and swallowing disorders. Chapter 2 gives an overview of statistics on family caregivers, caregiver responsibilities for care, the economics of family caregiving, and concepts of caregiver burden, strain and stress. In addition, information on the effects of caregiving on physical, mental and emotional health of those who provide care is also provided. Caregiving has been recognized as an important national resource. There are laws that protect and support caregivers at the local and national levels, and Chapter 2 also includes national and state legislation that supports family caregivers when they deliver care. Chapter 3 describes the diversity of caregivers and how culture and tradition prescribe who will care for disabled adults as well as how caregivers use both internal and external resources. There are important differences in how caregivers perceive and accept caregiving responsibilities across ethnic and cultural groups. These differences have implications for how caregivers manage when the responsibilities becomes stressful. There are also some differences in how caregivers may accept and comply with counseling and referrals. Chapter 4 discusses basic characteristics of various brain-based diseases and disorders that affect communication and swallowing with a focus on how these disabling conditions affect communication and swallowing disorders and to assist caregivers in minimizing communication breakdowns.

Chapter 5 is developed from the perspective of audiologists and includes basic information on hearing loss, auditory processing disorders, balance disorders, cochlear implants and hearing aids, as well as the impact on caregivers. Included in this chapter is information on helping caregivers with hearing aid upkeep. A major portion of the chapter is devoted to assistive and augmentative technologies which audiologists can use to educate caregivers of adults with hearing loss who can benefit from these devices. Perceptions of burden, strain and stress interfere with a caregiver’s ability to provide quality and sustained care.

Chapter 6 describes assessments that measure caregiver strain, burden, stress and coping with caring responsibilities. Chapter 7 introduces concepts of education and counseling caregivers within the clinical setting and within the scope of practice. Educating and training caregivers can be helpful in improving communication and providing a continuum of therapy outside of the clinical setting. Although speech-language pathologists do not provide counseling in many areas of need, resource information is provided that can be shared with caregivers that will empower them to find answers to their most important questions, like respite or hospice care, elder law, and insurance. Chapter 8 provides information on other health care professionals and their areas of expertise. It is designed to inform speech-language pathologists and audiologists about the most appropriate professionals to whom caregivers should be referred when they need counseling in specific areas outside of the scope of practice.

Chapter 9, the final chapter, describes a case of a newly-wed husband who suffers a stroke and how his stroke affects his wife and their relationship. Without support from health professionals, his wife flounders in her caregiving role. Their story ends tragically, but questions are presented to guide clinicians to avoid missing caregiver needs.

It is hoped that this book will serve as a resource for health professionals and students in speech-language pathology and audiology and that it will become part of the toolkit for assisting caregivers. It is also the intent that this resource book will be helpful to those who are involved in caregiving now and in the future.

References

Alzheimer’s Association (2011). Alzheimer’s disease facts and figures. Retrieved from http://www.alz.org/downloads/facts_figures_2011.pdf

National Alliance for Caregiving and AARP (2009). Caregiving in the U.S. Retrieved from http://www.caregiving.org/data/Caregiving_in_the_US_2009_full_report.pdf

About the Author

Joan C. Payne, PhD, is a Fellow of the American Speech-Language-Hearing Association (ASHA) and is a professor of communication disorders at Howard University in Washington, DC, where she has been a member of the faculty for more than 40 years. She is nationally and internationally recognized for her work in neurogenic language disorders from an ethnobiological perspective and is the 2014 recipient of the Scholar-Mentor Award from the National Black Association for Speech-Language and Hearing.