Speech Therapy and Self-Advocacy: A Conversation with Sarah Kenny

A conversation with  Sarah Kenny // 

SC: Hello Sarah, thank you for joining us!  Can you tell us a little about Speech Pathology?

Sarah: Sure! I think Speech Pathology is a field that a lot of people don’t quite understand unless they’ve had an interaction with a speech pathologist. We work with speech and language disorders. It’s important to distinguish between speech and language, because they’re different things: a speech disorder is when a person is unable to produce speech sounds correctly or fluidly, or their voice or resonance is off, and then a language disorder is when a person has trouble understanding others or expressing themselves.  

We also work with swallowing, which is actually, according to my professors, a pretty new thing in the field. We can use a barium swallow test to make sure that people can swallow different thickness of food and liquids safely without it going into the trachea, and thus, into the lungs. We work with people throughout the lifespan, so you could be doing swallowing with premature babies, and with geriatric adults in nursing homes. You could be working with stroke patients, with children with autism or other developmental disorders, or with people who stutter; there’s just a huge, huge variety of things. A speech pathologist—all that stuff is within their scope of practice. People specialize, but technically all of us are licensed to do stuff with all of those mini-fields, which is pretty nice. We’re in schools, hospitals, nursing homes, clinics—it’s pretty neat.

SC: What motivated you to become a Speech Pathologist, and what gets you really excited about Speech Pathology?

Sarah: I have always really liked language, and I think in college I was stuck deciding, “Do I want to do education? Do I want to do writing? Do I want to do psychology?” And for me, Speech Pathology was a field that combined a lot of that. There’s a huge psychology aspect, there’s a huge really fun nerdy science, neuroscience aspect, there’s a lot of teaching — and, for me, that was a really good combination.  

I also like to be in a field where I can see the results of my work, where I can see it making a difference in people’s lives. And there’s so much ongoing research that the field is very competitive. It’s a nice healthcare field where everyone is really working toward the end goal that is having that can best serve patients.

SC: That sounds really neat.  Can you tell us a little more about the language aspect, since you mentioned the distinction between speech and language, and how that was a motivator for you?

Sarah: So I really like linguistics, and the idea of learning language and the mechanisms in our brain that allow us to produce language and understand it. We make a distinction in the field between speech disorders, which relate to the production of speech, and language disorders, which relate to understanding speech and being able to express yourself effectively so as to be understood.  And that has nothing to do with intelligibility—intelligibility falls more under speech disorder. For example, one of my classes is on speech sound disorders in children, and so we talk about phonological issues, where the child has trouble planning the motor movements to speak, versus a language disorder, which would be something like pragmatics, where the social aspects of language are something the kid has trouble with.

SC: What do you see as the connection between Speech Pathology and justice?

Sarah: Because we’re working with people in the healthcare setting, we’re usually working with more vulnerable individuals. There’s a huge aspect of the field that’s treating that person and their life experiences with dignity. And because we work towards the ability to communicate, and with the pathologies of that ability, it’s even more important that we are doing justice for our patients. Our organizing body, ASHA (the American Speech and Hearing Association), has a lot of really cool things that they do that I think promote justice without naming it as such.

Take the idea of dialects. There was a big thing in the ‘70’s (and I know there was a lawsuit) where schools were saying that African American English was a deviant form of English, and it was incorrect, and the students would have ‘sound disorders.’ And then ASHA came along and said, “Nope, it’s a dialect, we don’t treat dialects. That’s something that we don’t consider to be a problem.” Which I think is really neat. Part of the practice is not treating any dialect as more important than any other. We also have a lot of growing interest in the field about bilingual speakers, and how we can best serve the patient who speaks multiple languages and make sure they’re making progress in all of their languages.

Another way justice comes up is when we talk about how if a person is not able to express themselves, or if they have no voice, that is unjust. They can’t advocate for themselves, or for their needs. I think it’s cool to be able to be part of working against that. I know a lot of the most important things that we work on with patients come down to functional language—we want to be sure that the person can express their needs and wants, and can advocate for themselves.

There’s a lot of cool ways to do that in the field. For patients who find that speech is completely ineffective, we have augmentative communication devices, like iPads, that they can touch to make them sort of speak for them. And then you have a ton of people in the field who are working to make those culturally appropriate. I had a professor who was able to make changes to a very popular picture program for one of those, and he made it so that the program would understand words in Hindi—I thought that was pretty cool.

SC: I really liked what you said about people being able to advocate for themselves, and that being a core element of justice. To wrap up, can you describe to us what a barium swallow test is?

Essentially, you are swallowing a radioactive tracer that is placed in liquids of varying thicknesses, or in food, and when the person swallows, we have a machine that can pick that up as sort of an X-ray video. The speech pathologist is able to see how much of the swallow is  actually going into the esophagus, where it belongs, and how much of it is ending up in the trachea, which is dangerous, because it can lead to pneumonia. Before that we had that, there were a lot of geriatric patients dying of pneumonia, and they couldn’t figure out why, and then we had the videofluoroscopy machine and they were like “Oh… every time they drink water it’s going into their lungs!” There you go.


Sarah is a connector and communicator. She loves to provide others with the resources they need to succeed. You can find her sharing everything from study guides to recipes to great book recommendations. Though her Bachelors was in writing, she is now in graduate school studying speech-language pathology.

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