HLAA Convention 2011 Special: Worshops - Communication Therapy

[Guest guest]

NVRC News - June 23, 2011

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Communication Therapy: An Integrated Approach

By Bonnie O'Leary, 6/23/11

This workshop was led by Jimmy Lee, MS, CCC-SLP, who is a Speech Pathologist

in the Hearing and Speech Center of the Department of Hearing, Speech and

Language Sciences at Gallaudet University. He introduced his program with a

quote from Bernard Shaw which most of us in the audience seemed to

relate to with subdued chuckles around the room: " The single biggest

problem in communication is the illusion that it has taken place. " (This

will be duly incorporated into my future outreach presentations!)

Communication model

When communication takes place, there are components to that event: the

sender, the receiver, the environment, and the message. The sender

" speaks " , assigning meaning to the information; the receiver (or the person

listening) decodes that information and assigns meaning, giving feedback by

answering the speaker. But as many of us know, a breakdown can occur

anywhere along the line, creating threats to the success of the

communication. Some of these include noise, distance, reverberation, shared

language, and speaking skills.

For many years, Gallaudet has used a communication therapy model for

students with hearing loss and speech challenges that focuses on global

areas: informational and adjustment counseling, technology, and strategies.

Integrated therapies include auditory, language, speech/voice,

pronunciation, and speechreading skills. (These services have also been

available to anyone in the area who needs them, especially late-deafened

adults.)

Informational and adjustment counseling

Many areas are addressed in this segment. These include hearing loss,

grief, and relationships at home, at school, and at work. An understanding

of these areas helps form the basis for recommending options in

amplification and communication strategies. Grief is a very important

element in the adjustment counseling. Particularly for those who struggle

with late-onset deafness, grief is a multi-faceted response to that loss.

It has emotional ramifications as well as physical, cognitive, behavioral,

and social dimensions, and it is important to understand the impact of grief

on the person needing these therapies. Many people who lose their hearing

go through the five stages of grief: denial, anger, bargaining, depression,

and acceptance, but not necessarily in that order.

Technology

There are many technology options for people seeking solutions to their

communication needs. Hearing aids and cochlear implants are usually a first

consideration, but depending on the level of hearing loss it could also be

advisable to start with assistive hearing technologies such as FM or

Infrared systems, hard-wired devices such as PockeTalkers, and alerting

devices.

Strategies

Communication strategies are broad and varied, and it takes time to learn to

use them. I remember how many months I spent trying to hone my own strategy

skills after I had learned the basics in speechreading classes.

Anticipatory strategies are useful prior to a communication event; by

preparing yourself for possible conversations and what vocabulary might be

used, it's easier to focus. Repair strategies are helpful during a

communication breakdown; for instance, instead of asking someone to repeat

what you didn't understand, you would ask them to rephrase it, or ask for a

key word, or how to spell a word you simply cannot understand. Maintenance

strategies are simple techniques used during communication, ensuring the

speaker that you are continuing to understand what he or she is saying, such

as confirming the information every few sentences.

How well we handle strategies is often dependent upon our personality. If

we are passive ( " Oh, that's okay. " ), the likelihood of communicating our

needs is more diminished than if we are assertive. If we are aggressive

(demanding!) we risk not having our communication needs met because we've

managed to make everyone around us defensive and irritated. Being assertive

means we are stating our needs in a polite but firm manner, validating the

feelings of the person we are speaking to, and making it clear that we want

to negotiate so it's a win-win for everyone. Generally, an assertive

approach assures a successful outcome for our communication needs.

Areas for assessment

The integrated approach also identifies skill areas that need to be

assessed. Auditory skills are evaluated, such as the person's ability to

communicate one on one and in a group. Speechreading skills include both

visual and auditory. An evaluation of expressive skills covers the areas of

speech, voice and pronunciation. Overall language skills assessment focuses

on everything from grammatical usage to vocabulary and written language

abilities.

If you would like to learn more about Gallaudet's integrated approach to

communication therapy, contact Jimmy Lee at james.lee@....

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