Medical Speech Pathology

Curiosity, Dialogue, and Knowledge

Serving Our Patients by Studying Our Numbers


Whenever someone participates in an activity and enjoys it, they seek to justify their participation by employing reason, invoking emotional pleas, disparaging the quality of other competing activities (regardless of their worth), or by simply extolling the numerous virtues of that given activity (regardless of the actual virtues).  I now plan to do some of this for math.

That being said, consider the title of this post.  If we become more connected to math, I believe that we (Speech Language Pathologists) will become  better at the following:  1. tutoring our patients with basic math drills, 2. analyzing data and charts in the research literature, 3. bolstering speech and language finesse with actual data, 4. balancing our budgets at home or in a small business, 5. developing sound scientific treatment methods based on numerical data, and 6. convincing management to support ideas based on sound numbers.  If you can already do number 1 with ease, then you’re 1/6th of the way there, and you already know it.

Why should it be important for a speech therapist to be comfortable with calculations and abstract mathematics?  This is a reasonable question.  I admit that I had little interest and no special talent for mathematics before I entered graduate school for speech pathology.  I chose to study Speech Pathology, in part, because I had no fear of stumbling across a slew of incomprehensible equations that made little sense to me.  I studied English for my undergraduate degree.  I only took Algebra 1 and 2 in high school, and scored low enough on the ACT in math that I had to take a remedial Algebra class in college (a bit humiliating for me at the time).  Few if any of my formative experiences with math were pleasant, and like many people who are “terrible” at math, I tried my hardest to believe that I simply wasn’t any good at it.  The question then is what changed?  Why do I, of all people, suddenly believe that math is such a good thing?

The mathematical answer is that there was always a probability that I would start liking math given my other scientific interests, but even with those interests it wasn’t all that probable.  The truth is that I don’t know why I stumbled across a love of numbers later in life with a career that focuses on language, articulation, and swallowing. I do believe, however, that numbers can help us do more with our profession than we currently do.  I believe that many of our weaknesses come from too much heart and not enough facts.  I challenge you to look at your practice or your current studies in school and see what you could do if you made numbers a more prominent feature in your treatment sessions.  Show me the data sheet with 100+ swallow trials/exercises per session, and I’ll show you patients that likely have better outcomes.  Why?  Because when you count, analyze, and sort data, you are invested in the outcome of your patients in a very focused way.  You are making them work a lot harder compared to the therapist who discusses random personal information for a quarter of every session.  (-25 swallows a session 5x/week is 125 less swallows a week, or 250 less in 2 weeks, or 400 less in three weeks ~ an average length of stay for a neuro patient in the rehab hospital I work at).

One of the better parts about the McNeil Dysphagia Therapy Program I went to was its emphasis on data.  At the conference there was reference to several studies that found what seems to be emerging as a pattern in our field: frequency and intensity of therapy = big gains.  As a comparison that comes to mind, do you remember the formula for distance? (Distance = rate X time) You go farther in whatever you pursue when you apply this formula.  The rate or frequency of practice, multiplied by the number of days you practice it, is going to equal your level of success with the given pursuit.  Also, read the article in the ASHA Leader on Gabrielle Giffords if you haven’t already.  Talk about an intense level of intervention.

If that sort of intense level of therapy is so successful, then why don’t we do it more often?  The answer, in part, is that we don’t have the numbers to back it up.  We haven’t put enough backbone into that argument.  Another part of the answer, of course, is money.  Demanding more resources, when we have little data to back up our claims at efficacy of treatment intensity is a tough sell.  I believe our profession will need to get more number savvy to demonstrate the importance of what we do to others.  We have all seen phenomenal change in our patients.  We know in our guts that what we do makes a difference.  There are even a few research articles floating around out there that back us up (See Robey’s article here).  We need to get better at this.  Many of us have a Masters of Science degree.  Science and numbers are as closely linked as blood and bone.

How should you, if you have a background somewhat comparable to my own, start learning (or re-learning) mathematics?  My suggestion is to start with Khan Academy.  You can check it out here:  http://www.khanacademy.org/.  This is a free, fun, do-it-yourself, website that has interactive math drills and videos produced from a Harvard/MIT graduate with a passion for math and science.

As a father of two little children, I look forward to the time when they have math homework I can help out with.  I don’t want it to be mysterious and cold for them like it was for me.  If I keep working at it, I might even be able to help with the tricky subjects.

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2 comments on “Serving Our Patients by Studying Our Numbers

  1. Jaye
    July 27, 2015

    Hi there! May I know who wrote this article? I’m going to cite this for a school paper. Thank you!

    • Admin
      July 27, 2015

      I wrote all the opinion pieces except for those few that have an author listed at the start of the piece.
      -Walt Greenslade, M.S., CCC-SLP

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