This might be controversial; I’m not sure. But to me, it feels important.
In my placements, I work alone two days a week and have the opportunity to cross paths with other SLPs one day a week at the pre-k to 1st grade school. Being mostly in upper grade schools, I’m scarcely involved in identifying students in our district who have an SLP – I’m usually tackling the hard work of determining when a student no longer needs our services instead. Because of this, conversations with the SLPs working in the younger population can be sometimes confusing, often frustrating, as we discuss the disheartening increase in referrals, assessments, and caseload sizes. As I comb threads in various Facebook groups for school-based SLPs, I see a similar sentiment: our caseload sizes are growing at an alarming rate and we’re struggling to stay afloat.
I’ve been interested in holistic health for years now, long before I was actually an SLP. I believe in treating the root cause of diseases rather than just masking symptoms and I believe in implementing lifestyle changes that will aim to prevent those diseases in the first place. Real food, exercise, stress management – all of these things are sprinkled through my own lifestyle and I’m consistently seeking ways to make them even more prevalent, especially as I age and notice more “problems” with how my body is functioning. This isn’t a sidebar, I promise.
Last week, I listened to a fascinating conversation between one of the self-contained teachers at my high school and her students. Most of her students are identified as Intellectually Disabled or on the Autism Spectrum, but all are pretty high-functioning (most of them have had, but none of them still receive speech therapy at this point). They were discussing possible jobs after they graduate and disability checks. All of them live in low socioeconomic situations. The variety of thoughts and opinions on these subjects was enlightening at times, disturbing at others.
Today, as I sat pondering the subject, I did a quick search for rising incidence of SLI and quickly found research between poverty and various developmental disorders, including speech and language. I know this; I didn’t really need to see the studies. But still, it made something click in my brain.
One of the reasons I often feel stressed and disheartened as an SLP is because I can only treat the symptoms.
That may seem obvious or even foolish; of course, that’s what I’m trained to do. But I mean more than what that statement seems to say.
I’m disheartened because there’s little I can do about the lack of access to books my student has had since he were little.
I’m disheartened because there’s little I can do about the semantically poor language models my student has received since his little brain began to develop a lexicon.
I’m disheartened because there’s little I can do about my student having to worry more about eating or having heat during the winter than applying himself to his school work.
I’m disheartened because there’s little I can do about my student being forced into adulthood long before it’s time because there are younger siblings to take care of while their parents are out of the house.
I don’t mean any of this to seem accusatory or like I’m creating stereotypes; I’ve met each of these students, many times over. Because of “the way the world works,” many of my students have had significantly fewer opportunities to develop the speech and language than I or my siblings had growing up – and my family was by no means well off. But, I recognize the blessing and privilege to have had two parents working salary jobs, raising children with the assistance of retired, self-sustaining grandparents. I recognize the blessing and privilege of not having had designer clothes or the latest gadget, but of always having a stocked snack drawer and dinner on the table each night. I recognize the blessing and privilege of having parents to help with my homework, attend school events, and send me to school clean, with a lunch box or lunch money in hand. As much as I sometimes condemn it now, I even recognize the blessing and privilege of having parents who bore the weight of school tuition so that we could attend a school with small classroom sizes and without the weight of testing.
More and more, I recognize that what I do at work, while of incredible importance, is only going to go so far. Until the root cause is addressed, there are some students (not all, by any stretch, but some) for whom I will only ever be masking symptoms with my vocabulary games and reading strategies.
In order to effect real change, it will take more than speech therapy, more than strategies. It will take an upheaval of systems and mindsets and lifestyles that deny the opportunity of normal speech and language development to children.
Does that sound political or partisan? Gosh, I hope not. I don’t know of a single political or political party who has the answers or solutions to what we’re facing. And, to be honest, I reject the idea that there is one. What I don’t reject is the idea that we, as a people, can’t effect change with our choices and actions, each and every day. I don’t reject the idea that our choices and actions can create a ripple effect that promotes happy families, happy homes, and happy children.
And while I’m not really offering any ideas or solutions, I hope I at least offer food for thought. I hope I at least cast a small pebble into the pond that will get us thinking beyond the therapy room and into our communities and our world.