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PIVOTING TO MEET THE NEED

Updated: Dec 8, 2023


Pivot

By Rachel Dutil | Photo Supplied



For individuals with communication disorders, the effort it takes to effectively connect with others can be exhausting. In addition, the pandemic has exacerbated communication challenges particularly for people who rely on visual cues for understanding.

“The pandemic has added an entirely new level of difficulty for those with communication difficulties,” said Dr. Ashley Gambino, chair of the Communication Sciences & Disorders Department at SUNY Plattsburgh. Gambino, also the Clinical Director of Audiology at the campus Speech and Hearing Center and an audiologist, was motivated to embrace the career because of her own hearing loss. “I can speak both personally and professionally,” she said.

“The pandemic blew the doors off for audiology,” Gambino said. “Hearing aids and other devices don’t magically give you perfect hearing the way glasses can give you 20/20 vision.” She explained there is often distortion within the auditory system for which the devices cannot compensate. Masks muffle sounds and take away visual cues. Masks can also complicate things further for individuals who wear hearing aids because the mask strap can pull the hearing aids out of the ear when one removes it.

THE PROGRAM The undergraduate program in the Communication Sciences & Disorders department prepares students for graduate programs. Most students major in speech language pathology and the department offers a graduate program for them. Students who aspire to a career in audiology need to do their graduate studies elsewhere.

In addition, SUNY Plattsburgh offers a certificate program for students who have received their Bachelor’s degree in another major, but wish to take the necessary pre-requisite coursework in Communication Sciences to be eligible for a speech language pathology or an audiology graduate program.

One of Gambino’s former students, Rachel Flemming, joined the department in 2016. Flemming is a Speech Language Pathologist (SLP), Clinical Director for the Speech and Language segment of the Center and the Internship Placement Coordinator for graduate students.

Flemming explained, “We work with a diverse population and the more diverse our SLPs are, the stronger the field is going to be.” She added that grit and determination are needed to be successful in the rigorous, challenging program. It is a “very difficult degree and it is a complicated field,” she commented.

The main difference between students who choose speech language pathology and those who choose audiology, Gambino explained is that audiology is black and white, while speech language pathology has more gray areas.

BETTER COMMUNICATION “At the end of the day, we are working to help people communicate better,” Flemming said of the communication science professions. Both audiologists and speech language pathologists work with individuals across the lifespan — from babies in the neonatal intensive care unit to patients at the end of their life.

“Audiologists help individuals with hearing difficulties and balance difficulties,” Gambino explained. “We really want to figure out a way to make life easier for our patients,” she said, adding that if you are expending a lot of effort just to piece together what people around you are saying, then you are exhausted at the end of the day.

There is a strong need for speech language pathologists. “We work in schools, homes for early intervention or home health care, in skilled nursing facilities, hospitals, Neonatal Intensive Care Units (NICUs), hospice centers, colleges. We also do private practice, and we do a lot of telepractice.”

Audiologists work in similar settings, but because audiology is more equipment-based, “There are a lot of unique opportunities on the manufacturing side,” Gambino observed. “We fit patients with devices, and we need devices to fit our patients. We also need devices to test patients to determine if they need devices.” Audiologists also work in research developing equipment, training on how to use equipment and selling equipment.

Another aspect of the profession is industrial audiology or hearing conservation. Audiologists in this field work directly with companies to ensure their employees have the appropriate safeguards in place to protect their hearing and follow federal mandates that protect their workforce. These audiologists evaluate the workspace, determine the appropriate hearing protection and provide hearing assessments for employees.

SPEECH AND HEARING CENTER To graduate, students are required to work a certain number of hours with clients. The on-campus Speech and Hearing Center provides the dual benefit of a valuable healthcare resource for the community while also offering job training and experience for students.

The audiology side of the center offers diagnostics, hearing assessments and intervention. Gambino and her team teach communication strategies for how to manage in difficult listening environments. Audiology services are open year-round for anyone who needs them.

On the speech side of the clinic “We have both a habilitation – where we are trying to develop a skill and a rehabilitation side where we’re trying to bring a skill back that was lost,” Flemming noted. The staff also works with swallowing disorders.

“The system we use to chew and swallow our food is the same system we use to articulate speech and language,” she explained. “Because it is the same biological system, we are very familiar with how those muscles move and how the nerves operate. It makes good sense for us to also help with the biological function of those systems which allow us to eat and swallow safely.”

Swallowing disorders are always a symptom of another condition. Treatment is often oral-motor exercises or sometimes stimulation of the swallowing muscles. Video fluoroscopy can be used to take a swallowing X-ray to see the path food and drink follows. SLPs may teach the patient to use a different posture when swallowing to correct the flow. The aim is to make the entire system as strong and as reactive as possible.

All the patients who visit the clinic for speech language or swallowing concerns are treated by graduate or undergraduate clinicians who are supervised by a licensed speech language pathologist. Speech and swallowing services are offered when the college is in session. Students work in the on-campus clinic for three semesters before obtaining a full-time externship placement in a school, hospital, skilled nursing facility, or an early intervention preschool for their final semester.

“The pandemic has thrown a wrench into our program and our profession as a whole, and our students have had to pivot, but I am pleased to say they have risen to meet the challenges,” Flemming concluded.

Communication Sciences & Disorders Department SUNY Plattsburgh 226 Sibley Hall 101 Broad St. Plattsburgh, NY 12901 518-564-2172 www.plattsburgh.edu

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