Teaching the persons that you serve in CSD programs - THAT would seem to be embarrassingly self-evident. Well, doesn't it?! Aren't you teaching these skills for communicating, thinking and swallowing to the people you serve? Don't you instruct their families, the caregivers, your colleagues, the referral sources and third party payers in the plan of care? When it becomes time for completion of the plan of care, doesn't the SLP lead the person served through the home exercise program? Well, yes, you might answer - but that is not all the teaching that might be done.
SLP's teach when they want the person served and her/his stakeholders, to understand what it all means. With the "Fantastic Four" movie coming later this summer, I think of Sue Storm Richards, alias Invisible Woman (what a commentary). Sue would often ask her husband during a mission: "Reed, what does it all mean?". My middle school peers and I (late 60's) would often make Sue jokes when reading the latest comic - but Sue was onto something.
That is why: you tell a mother of a child on the autistic spectrum, how communication may begin with the coding of behaviors that may occur regularly. For example, shaking both hands in the air may mean "I am afraid". If you are working with an intubated adult in the hospital's intensive care unit, that same gesture might mean "please come look at my bandage". A person with a severe stutter can show that same behavior, and it can be a learned behavior that at one time, helped extinguish the stuttering moment. For still another person, the evaluation findings of nonfluent aphasia may require you describe your decision making that came to the diagnosis. How does her performance on word repetition tasks, impact the impressions of her disability?
This is teaching's goal: to help the persons served use data obtained in the clinical setting. They then may feel full partners in the plan of care. When the person served has information that totally keeps them in the loop, she/he has greater focus upon treatment activities, and is possibly more efficient for completing the treatment program. What else can happen as a result of continual teaching?
Teaching the patient and stakeholders bolsters their skills for advocacy. Self-advocacy - "please approve my request for this speech generating device, Mr. Insurance Company"; stakeholder advocacy - " my husband can still do his job, after his brain injury, with the accommodation of wearing tinted glasses in the workplace"; system advocacy - "if cigarette taxes are kept high in states with the highest rates of head/neck cancer, rates of cancers which may lead to communication and swallowing impairments could come down".
Teaching is also essential to all aspects of preventing communication and swallowing problems. Treatment of these problems (tertiary prevention) is done to prevent permanent disability. Secondary prevention, or surveillance, includes teaching the person served and any stakeholder the implications os screening clinic data - or giving answers to questions after a community lecture. The quantum leap beyond teaching persons of their risk for communication and swallowing disorders, is to help people minimize their risk of impairment - or directly control factors that may bring on disease. Primary prevention activities remain undiscovered country to professionals in CSD. They may still hold the strongest hope for answering the question posed by our consumers: what does it all mean?
