Speech-Language Pathologists: Role and Scope through Cinema!

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What do the titles "Brain Nurse", "Talking Doctor", "Swallow Coach", and "Pudding Lady" have in common? Why, they are all nicknames for Speech-Language Pathologists, of course!

What comes to mind when you hear the term: Speech-Language Pathologist? I gathered some research from the internet (see the comical titles mentioned above) and polled members of my family to answer the question: What is an SLP and what do they do? Their responses are below:

•    "SLPs help people with their fine motor skills and speech."

•    "They help people do different activities and exercises to work on speech."

•    "SLPs assess, diagnose, and treat speech related problems."

•    "They learn about speech and the ways to correct speech problems and work with people who lack the ability to speak."

•    "SLPs work with speech impediments and teach people how to communicate when their speech is impaired."

While these statements are not entirely untrue, they mainly focus only on the "speech" part and leave out the "language" and the "pathology".

When completing a videostrobe evaluation for voice, or a dysphagia evaluation for swallowing, the question that I get asked almost every time is, "what field is your degree in so you can do this (meaning the evaluation)? When I say "Speech-Language Pathology" the person's face assumes a confused look, followed by the statement: "I thought that field just helps people talk".

It is quite unclear to most people how versatile the field of Speech-Language Pathology actually is and how much it has to offer. According to the American Speech-Language-Hearing Association (ASHA), "Speech-Language Pathologists (SLPs) work to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults."

Let's break this down further, shall we? And, because I like movies, I will be including some examples from the cinema!

SLPs work on speech related disorders, true, but this goes beyond articulation and the ability to speak clearly. Speech also includes fluency and voice. You've probably heard of stuttering, which is a common fluency disorder and very accurately represented in the film, The Kings Speech, portraying King George VI. While King George VI is a well known famous person who stutters, did you know that celebrities: Tiger Woods, Julia Roberts, and Emily Blunt also stutter?

When addressing voice, we look at things related to vocal quality: volume, pitch, rate, resonance, etc. As mentioned above with the videostrobe evaluation, we use a strobe light to look at the movement of the vocal cords and assess if everything looks to be functioning normally. The SLP is able to diagnose things like chronic laryngitis, polyps, and vocal nodules. When you read the words "vocal nodules" did you immediately think of Pitch Perfect? I hope so because that is my movie example for voice! Even though the nodules are only mentioned a couple of times throughout the film, when Chloe shares with the group that she has "nodes", she most likely went to an SLP for that diagnosis! 

Another area that SLPs target is language. There are two main types of language: receptive (the ability to understand) and expressive (the ability to share thoughts and feelings) and these can be in either spoken or written form. The most common diagnosis for difficulty with either receptive or expressive language is aphasia, which is common after a stroke. My movie examples for language are: The Possibilities are Endless, and The Diving Bell and the Butterfly. While I unfortunately have not seen either of these, they sound like they accurately portray aphasia after the character experiences a hemorrhagic stroke.

SLPs are able to provide treatment for social communication disorders as well. These occur when the person has trouble with pragmatics, the social use of verbal and nonverbal communication. The person may have difficulty with greetings, taking turns/following rules for conversation, asking questions, explaining stories in ways that their listener will understand, etc. When you read that description, perhaps you thought of Sheldon Cooper from The Big Bang Theory. While this is not a movie, it does provide a pretty accurate representation of difficulties with social communication, albeit a comedic one. 

Cognitive communication disorders can occur after a stroke, traumatic brain injury (TBI), or with dementia and SLPs address these types of disorders as well. These include trouble with organizing, paying attention, planning, problem solving, and memory. I have two movie examples for difficulties with recall: The Notebook, and 50 First Dates. In The Notebook, Noah uses a love story to help Allie remember who she is, despite her dementia, and in 50 First Dates, we see Drew Barrymore's character wake up each day with no recollection of the previous days events after she sustained a TBI in a car accident. 

SLPs also have the knowledge and skill set to address swallowing disorders (dysphagia). This may involve the need for a Modified Barium Swallow Study, use of thickener for modifying diets/liquids to make intake safer for patients, strengthening exercises and yes, lots of pudding for all of those swallow treatments and trials. While I don't have any movie examples for dysphagia, as SLPs we get numerous pseudo-titles when working on swallowing including, but not limited to: "pudding lady", "swallow coach", and "throat doctor".

So, that is the role and scope of Speech-Language Pathologists in a very small nutshell. There is still so much more that we, as SLPs, are able to do, like aural rehabilitation, augmentative and alternative communication, accent modification, etc. but that will be a post for another day!

Needless to say, the field of SLP is very versatile and offers a lot in terms of variety. So next time you are watching a movie, perhaps you will be able to use the knowledge gained from this post and pick out some examples for the disorders mentioned above. Thanks for reading!