Sunday, October 16

The Things (That Make Us Who We Are)

Since 2007 our family has lost three very special people: grandparents to me, parents to my parents, a brother to my great aunts and uncles.  For each of them I wrote a post trying to summarize a life: Nonno, Nana, and Grandpa Les.  But before this blog our family lost Grandma Maggie.  She was one of the toughest woman I've known - she could hunt and fish, she raised 6 kids, and she could really bake.  One of the biggest impacts she has had on me though, she'll never know.

2007, after finishing my undergrad in business and realizing that it was the last thing I wanted to do with my life I took a year off.  I worked at an employment office.  I save money.  I used all of that money to travel to South America for three months on my own and learn Spanish.  I shadowed an SLP and decided then that I could do that and I could like it.  4 years since - I worked to save money, spent a year at UWO getting the prerequisites and applying for the program, and after, thankfully, getting in on my first try, I spent two years in Toronto earning a Masters of Health Science.  Now I can put things like MHSc., R.SLP and SLP(C) after my name.  I collect letters.

The program at the University of Toronto is set up so that the first year lays a foundation and centres around child language development; the second year addresses acquired communication disorders and focuses primarily on adults.  From my Grandma Maggie I already knew two things:  1) I wanted to help adults with communication disorders; 2) I was terrified that I would not be able to do it.

When my grandmother was still quite young a despicable disease started to slowly steal things from her - balance, coordination, the ability to walk, care for herself and even her speech.  We eventually found out that she suffered from Progressive Supranuclear Palsy or PSP.  Her speech became increasingly difficult to understand and, while they tried communication devices, the technology at the time was not as advanced and she had limited control of her hands with which to use the devices.  After two years of study I now know that her speech was a mixture of Hypokinetic, Spastic and Ataxic* dysarthrias; all three fighting against her intelligibility.  At the time, as a 10 year old, all I knew was that I couldn't understand what she was saying and I felt so guilty for not understanding her and too afraid to ask her to repeat herself for fear of hurting her feelings that I was afraid to talk to my own grandmother.  That isn't easy to admit and I'm not saying it to hurt anyone's feelings but to be honest.  To this day I feel badly about my 10 year old self and wish that I had spent more time with her being patient and admitting when I couldn't understand.

So that is where both my fear and motivation came from.  I so badly wanted (and still want) to help adults with language and speech disorders communicate with their loved ones and improve their quality of life.  I was also apprehensive that as soon as I was met with a client with a significant speech disorder I would discover that I could not understand them and that conversations would be exercises in frustration for both of us.  That didn't happen.  It didn't happen because I now knew to take the time to listen.  I know now strategies to help people get their message across.  And I discovered that I am often quite good at deciphering difficult speech.  Now when I have clients with nearly-unintelligible speech my initial reaction is still a lump in my stomach but I remind myself that I now know what to do and set out to help them in any way I can.  Thanks Grandma Maggie.

*Almost all speech disorders distort the pronunciation of speech sounds.  On top of this, each unique type of dysarthria impact different subsections of the speech system to decrease intelligibility.
Hypokinetic Dysarthria:  Often associated with Parkinson's Disease, this speech disorder makes it difficult to initiate speech and often causes people to speak in short, fast bursts at low volumes.
Spastic Dysarthria:  This type of dysarthria causes a strained or strangled voice quality, slow speech, and a monotonous prosody.
Ataxic Dysarthria: this is a result of damage to the cerebellar system.  Speech is often reported to sound "drunk".  Sufferers have a difficult time coordinating speaking and breathing (something we take for granted all the time) and develop a tremor to the voice.  Speech sounds become further distorted and speakers often have pitch breaks and uncontrolled volume changes.

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