Speech Pathology Confidential

Bryan Castañeda told me the following:

I was talking to a good friend of mine who’s a speech pathologist. He works for a woman who runs a private practice in Connecticut. Says that a third of his patients require the amount of treatment his boss recommends, a third require treatment but less than she recommends, and a third require no treatment at all. But his boss is skilled at preying on parents’ insecurities (and their clientele has a lot of money), so she makes a killing. He agreed with your advice that people should be more skeptical of the claims of medical professionals and do their own research to evaluate to those claims.

The woman who runs the practice has a Master’s in speech pathology, same as Bryan’s friend. I asked about the treatments. Bryan’s friend replied:

It depends on the diagnosis. If it’s a speech disorder, we do articulation therapy. Articulation therapy usually consists of drills, correcting erred sounds by shaping the articulators appropriately and then having the client produce the sound in isolation, at the word, phrase, and sentence levels, and then in reading aloud and in conversation until they’ve reached 100% or close to 100% accuracy.

If it’s a language disorder, we do language therapy. Language therapy is a little more complicated. We target specific language areas based on the results of previous testing. It can vary a lot, but some of the more common things I do is read passages and have the client answer questions about it, teach grammar, work on formulating sentences appropriately, teach vocabulary, and word classification activities. A lot of worksheets and games too — materials that my boss writes off at tax time. We bill by the hour, so more hours certainly equals more pay for her,” he says. “We are all salaried, so the tighter she crams our schedules the more she gets to keep at the end of the day.

At least the unhelpful treatments are harmless, in contrast to a large fraction of mainstream medicine, where children have their tonsils removed, and so on.

3 Replies to “Speech Pathology Confidential”

  1. So what did cause the long-term doubling of life expectancy in England from 32 in 1680 to 65 in 1942? There is general agreement that medicine was not responsible and that the major factor was better resistance to disease, and that the only thing that could have made this possible was better nutrition.

    How much has modern medicine contributed to the increase in life expectancy? The answer seems to be about 20 per cent, much less than improved nutrition and improved sanitation.

    It is easy to adopt a patronizing attitude to those patients who, from 425 BC to 1865, imagined their doctors were doing them good when they were only doing them harm. But we too are credulous. We owe much less to modern medicine than we can imagine

    Wootton, David (2006-06-22). Bad Medicine : Doctors Doing Harm Since Hippocrates (Kindle Locations 4196-4200). Oxford University Press. Kindle Edition.

    Seth: In addition to better nutrition, there were big improvements in public hygiene, e.g., cleaner water. It became a lot safer to live in a city.

  2. MJB’s remark implies to me that economic historians have grossly underestimated economic growth rates during the Agricultural and Industrial Revolutions: that doubling of life expectancy, after all, was accompanied by large population growth rates.

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