Susan's Super Citizen Showcase

Monday, November 13, 2006

Speech-language therapist gives voice to those who need it most

Being able to speak and be understood is something that most of us take for granted.

When we have to repeat ourselves – especially if it’s more than once – we may feel frustrated and irritated. But for some people, “not being understood” is a part of daily life.

People with degenerative diseases, brain injuries, and strokes can often be cut off from communicating with their families, friends, and caregivers. Other people stutter or are unable to articulate certain letter sounds – making self-expression a constant challenge.

Speech-language pathologists – commonly known as speech therapists – work with individuals to find solutions to their communication barriers. These therapists, who study human communication and its disorders, see their clients in private practices, schools, health units, and hospitals.

Recently I had the privilege of meeting Jayme Carvey, a registered speech-language pathologist consultant with Columbia Speech and Language Services Inc. in Vancouver. Jayme, who completed her Master of Sciences in Speech-Language Pathology at UBC in May, is a good example of someone who loves her job.

“It’s pretty much the best job to have. In my day, I get to play games with little kids and talk with adults and people actually pay me to do that. That’s what I can’t get over!” she says, with a laugh. “I’m always working with people who have communication impairments – providing them some kind of support to be able to communicate again and seeing the impact that it makes on their lives. It’s pretty amazing!”

In some cases she works with people who have degenerative diseases, teaching them to use alphabet boards for communicating.

“That may mean for their last few days or weeks or months, they can point out the words and communicate with their loved ones, where otherwise they wouldn’t be able to. They may be able to tell their home support worker that there’s a throbbing pain in their toe that’s been there for three months,” she says.

Jayme also works with people who stutter or have developmental speech delays – and she sometimes sees hockey moms, teachers, and rock singers who strain their voices from “slamming their vocal chords together so hard.”

She says she sees some of the most profound changes among her stuttering clients, who often make huge gains in their ability to communicate with confidence.

“We see them becoming almost different people than they were. They walk in the door reserved and shy, not being the one who’s going to talk in front of the group because they know they have difficulty talking,” says Jayme. “Then by the end of it, you can’t shut them up. They want to be saying everything they haven’t been saying for so many years. It’s pretty awesome!”

While there are a few theories on the cause of stuttering, the exact cause has not been pinpointed.

“For every paper written on what causes stuttering, there’s another one that says that’s not what causes stuttering. So we tell our clients all the theories and then say: ‘But really we’re not actually interested in what causes stuttering. What we want to do is teach you to be able to control your speech,'” Jayme says, describing how the Columbia therapists get stuttering clients to slow their speech to about 60 syllables per minute, which is “painfully slow” since most of us speak between 180 and 220.

“Essentially we just reshape their fluency. We slow them right down and teach them how to be fluent at that rate and then shape that into something that people actually want to listen to. Over the 10 days we speed them back up.”

The reason I saw Jayme is really quite minor compared to the issues I’ve been describing. I ended up in her office because I wanted to see if there was anything I could (or should) be doing to help my six-year-old son learn to pronounce the letter R. With a passion for conversation and a great vocabulary, Toby has not yet mastered this one sound, which is sometimes frustrating for him.

People sometimes imitate his pronunciation – some mimicking him unkindly, while others seem truly confused about what he is trying to say. Usually he responds by repeating the word-in-question with more emphasis, but occasionally he just stops talking. This happened recently at a birthday party when, with great anticipation and excitement, Toby watched his eight-year-old friend open a gift he had spent extra time wrapping in different coloured layers of tissue paper.

“Look how I did the wapping paper!” Toby exclaimed, clapping his hands together and hopping from one foot to the other.

When the birthday boy laughed and asked: “What’s wapping paper?!” Toby stopped jumping and looked down at his feet, his smile extinguished. That’s when it hit me: I was going to go ahead and book a private appointment with a speech therapist, since it seemed unlikely Toby would get to see the school district therapist within the next couple of years.

Toby’s Grade 1 teacher said she didn’t think “the letter R issue” was a concern at this point. She said the school district’s speech therapist was booked beyond belief with much more severe speech issues queued ahead of him. It might be possible to get some exercises that would help – but even that would take a long time.

I Googled “speech therapists” in Vancouver, made a few phone calls, and asked Toby if he’d like to meet with a professional who could talk with us about the letter R. He loved the idea, so I made an appointment and ended up at the Columbia office, where Jayme asked me lots of questions about Toby’s developmental milestones (which are all fairly typical). Using a variety of games, she gave Toby a Photo Articulation Test in which he identified a series of pictures, testing his use of all the sounds in the English language. His hearing and oral motor skills were within normal limits – and he reports that he particularly enjoyed wearing the headphones because it made him feel like a cool DJ.

In a nutshell, Toby’s speech is within the range of typical sound development. The R sound is one of the last sounds for kids to master; some don’t get it til they are just past the age of 7. Other sounds that come after the age of 7 are: Ssss, Zzzz, “th” as in “this” – and “zh” as in “measure” may not be articulated until the age of 8.

In Toby’s case, speech therapy is optional – but not necessary at this point. If he were very sensitive about teasing, we might go ahead with it. However, in general, he is pretty well-adjusted about it and we have a good line of communication when it comes to “talking about our feelings.” I asked him how he felt when he heard there were other kids his age, and older, who didn’t “have” their letter R sound yet.

“Oh yay! Now I feel better! Before I thought: ‘Some of my friends can pronounce Rs. How come I’m not like one of those kids?’” he said, adding that the best part of the experience was “the games” and Jayme herself. “I think she’s kind of cool.”

We now have some R words to practice at home and will revisit the idea of therapy in a couple of months, if he seems particularly frustrated about the whole issue. Jayme says I’m not the only parent who has come in with this type of minor issue.

“We have a lot of parents who come in and maybe they didn’t really need to come in the first place, but a lot of it is peace of mind. They say: ‘I just want to make sure. I want to get a professional point of view here that everything is okay,’” she says. “I don’t have any kids myself, but my sisters and friends who have kids are always calling me for advice.”

For more information, visit Columbia’s soon-to-be-updated website at:

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At Sat Nov 18, 03:39:00 AM PST , Blogger 42 words/min said...

a chilling comment about the people with degenerative brain diseases and mutely throbbing toes- being left without the ability to communicate would be like being buried alive.. if you can give those people a bell for their grave, you know you are doing something meaningful.

At Thu Apr 03, 01:00:00 PM PDT , Anonymous Anonymous said...

You might find the information on this article about the "R sound" helpful:

or at:

At Thu Apr 03, 01:08:00 PM PDT , Blogger Susan said...

Thanks for your comment - and this reminds me to follow-up. Toby picked up the R sound within about six months of my posting. He just managed to "get it" on his own without any intervention. The speech therapist was bang-on!


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