More Than Words

October 18, 2004

During his undergraduate years at Baylor in the late 1970s, David Garrett reached a critical crossroads in charting his future career path. As a double major in biology and psychology, he struggled with choosing between his love of research and having contact with people. Ultimately, he got both. 
Garrett, associate professor of communication sciences and disorders and director of its graduate program at Baylor, says when he first heard about speech pathology from Gardner Gately, late chair of that department for many years, he knew he'd found his career. Garrett received his master's degree at Baylor, a doctorate from the University of Iowa and a postdoctoral fellowship at Haskins Labs at Yale. He returned to his alma mater in 1998 after teaching at the University of Wisconsin and at Baylor College of Medicine.
"Most people take communication for granted," he says. "Nobody really realizes how significant it is until you start to lose it. Then, at that point, it affects everything in your entire life -- your relationships, your ability to work, your ability to make it through school. Everything." 
In the University's CSD department, established in 1947, nearly 150 undergraduates and between 40 and 50 graduate students are guided by 11 faculty members who teach courses or supervise the University's five clinics. Staffed by faculty members and graduate students, the clinics serve more than 550 patients a year offering screening, diagnosis and treatment for a range of disorders. The cost is $125 a semester, although services are free to Baylor students and employees. 
"When patients come in and they're frustrated because something has gone wrong, I tell them it's amazing that anybody can communicate well because the system is so incredibly complex," Garrett says. "People assume that communication is simple, but it's not."
In the United States, between 6 million and 8 million people have some form of language impairment, according to the National Institute on Deafness and Other Communication Disorders. Communication disorders, or pathologies, run the gamut: articulation (problem with sounds), language (word order), aphasia and dysarthria (neurological problems often associated with strokes), voice (problems with sound production and resonance), dysphagia (swallowing difficulties common in older adults), cleft palates and stuttering. 
"Everything we do in this department is very integrated into our research. Understanding the latest research findings and integrating them in clinical practice is critical for providing the best services to the patients," Garrett says. "It warms my heart to counsel with patients and help them to understand their problem and assure them that it can be either fixed or helped. You can almost see the cloud lifting." 
Michaela Ritter, an assistant professor in the department and clinical supervisor in its speech, language and hearing clinic, shares similar sentiments about her 25 years as a speech pathologist, working primarily with children. 
"I've always loved this field," says Ritter, who joined the department full time in 1996 and earned her EdD at Baylor in 2003. "When you work with a child and you hear a word for the first time and the mom hears a word for the first time, there is nothing like that. You know that what you do makes a difference every day in what's going to happen to that child." 
In 2003 and 2004, the CSD department received more than $70,000 from the Waco Scottish Rite Foundation to provide a free, four-week summer clinic called Camp Success for Central Texas children with literacy and language problems. During the two summers, approximately 80 children benefited from individual and small group language treatments they received from Baylor graduate students during the four days each week of camp. "We looked at both pre- and post-testing," Ritter says. "There was significant progress in all language and literacy areas."
Ritter recently has focused her research on literacy. Many in the field, she says, now believe that approximately 85 percent of reading deficiencies are language-related,'including dyslexia. Speech-language pathologists are ideal to work with children who have language-based reading problems because the pathologists understand the foundational language skills needed to be a good reader, she says.
"Why is that child failing? Why is that seventh-grader not making it in math, chemistry and history? Everything we do in life is based on our ability to read," she says. 
Julie Pennington-Russell's teenage son, Taylor, attended Camp Success last summer and attends a CSD clinic this fall. "I cried on the phone when Mikie Ritter said to me, 'We see enormous potential in your son,'" Pennington-Russell says. "You can't believe how rare it is for kids with profound learning differences to hear those words. Camp Success was a critical turning point for our son."
Research has shown that reading is significantly challenging for about 20 percent of children in schools, although between 30 percent and 40 percent experience some difficulty, Ritter says. "Prevention is huge. The development of the language system in a child is critical, especially between birth and 5 years of age."
In 2000, the National Reading Panel identified five areas from research that were found to be necessary for reading success in children: phonological awareness or sensitivity, phonics, fluency, vocabulary and comprehension. "This becomes a challenge to all educators to identify and remediate these language skills as early as possible so that the child can be successful in school and in life," Ritter says.
Because language skills start at birth, Ritter recommends that parents begin reading to their children when they are infants, at least 10 minutes a day. Typically, developing children need to hear a book read as many as seven times. "But if the child has language difficulties, the book needs to be read at least 30 times in order for the child to get the most benefit from all the language skills," she says. These skills include vocabulary, comprehension, listening, looking at the pictures and following along while looking at the words in the book. 
One way for parents to ascertain if a child struggles with language skills is to study developmental guidelines. For instance, a 3-year-old should be able to rhyme -- "A predictive rhyme is like 'Jack and Jill went up the ... hill,'" she says. "If they can't rhyme, the child may not be hearing all of the parts of the words."
Ritter says she and her colleagues in the department are motivated to keep searching for answers. "We are committed to finding the best ways for children, adolescents and adults to benefit from the best interventions available," she says. 
Speech pathology is just one option for students in CSD; the other emphasis is deaf education, which began in fall 2002. Deborah Zembo-Carnes, an American Sign Language lecturer who has been at Baylor full time since 1999, suggested and now directs the undergraduate program, which has about 20 students. 
"From being in the field, I knew there was such a shortage -- at the crisis level -- of certified deaf ed teachers for the state of Texas," says Zembo-Carnes, who worked for 14 years at Texas School for the Deaf in Austin. 
The numbers support her assertion. In early June, there were more than 35 vacancies listed for deaf educators in Texas, according to the Region 20 Education Service Center Web site; in mid-September there were 37 vacancies. John Bond, an educational specialist with ESC Region 20, says there is a year-round need for new deaf education teachers. "There are some programs that have had the same vacancies posted for years and have never filled them," he says. 
At Baylor, the majority of students in the deaf education track take two years of ASL and one year of interpretation. All are required to take two general education courses, which Zembo-Carnes would like to see increase to four. During their junior year, students work with hard-of-hearing and deaf children in the University's cochlear implant clinic and spend their senior years in off-campus internships. Once they've completed the program -- 37 hours of course work and 18 hours of practicum, in addition to the core courses required by the College of Arts and Sciences -- the state allows them to take the deaf education exit exam for certification. 
For the first time this year, eight seniors will spend two semesters participating in two 16-week internships, student teaching in state school districts in Austin, Round Rock or Bryan.
"These are my pioneers, and they are the students who really pushed for the program. ... They have such a passion for this field," Zembo-Carnes says. "It is our duty to prepare our Baylor graduates to be the best teachers that they can be so that the deaf children of Texas can receive an outstanding education."