Better Hearing and Speech




If you didn’t already know, May is Better Hearing and Speech Month. Speech and language pathologists who work with children and adults to improve their capacity for communication highlight the importance of human communication during this month. Our ability to communicate impacts well-being and happiness – in other words, our quality of life, and one of the most important aspects of this communication is discourse.




Discourse is all aspects of communication that are beyond the level of a single sentence, including:

  • Conversation
  • Narrative
  • Descriptive procedures
  • Arguments


Understanding and formulating discourse can be extremely difficult for individuals with language impairments, autism (even high-functioning autism), social communication disorders, and brain injuries. This can limit academic, career, and social effectiveness, which has a significant effect on quality of life.




Many facets of discourse are particularly difficult for people with language impairments or social communication difficulties because they require integrating diverse strands of perception.




Understanding the communicative intent of a speaker requires watching facial expressions, noticing tone of voice, and incorporating context. Understanding other people’s perspective is so critical, and can be so difficult.




Furthermore, the language and communication faculties that we use while processing discourse draw on all areas of the brain, which are then orchestrated and coordinated in the prefrontal cortex. Because it is such a “high level” faculty, requiring sensitive connections and real-time processing from all parts of the cortex, it is fragile.




The ability to successfully engage in discourse can break down in all of us when we are tired, hungry, sleep deprived, anxious, or angry.




In children, this can be apparent even when their ability to speak single sentences is normal, it shows up as difficulty with:

  • reading comprehension
  • following multi-step directions
  • heightened inter-personal dynamics


As you can imagine, struggling in these areas can have long-term consequences at school, at work, and when building and maintaining relationships.




Of course, the science and mechanics of the process of discourse can also be looked at from the perspective of more than just one-to-one interactions. Breakdowns in discourse are also visible in many areas of human society. Currently in national politics, it is a subject of irritation or amusement for many ordinary citizens that there is so little civil (i.e., respectful, functional) discourse among politicians. In the national arena there is even a tone of impatience or contempt with the idea of an arena dependent on civil discourse.




Likewise, in online discussions and comments, and across social media, there are countless examples of a breakdown in discourse. Perhaps the anonymity of online communication discourages the mental effort that is required for functional discourse and results in ordinarily good, thoughtful people becoming “trolls” that insult people and post inflammatory messages to provoke readers. Thus, we see practical discourse fall apart.




A pressing question for our time is how to re-establish true discourse: to listen with respect and good will and to formulate our thoughts with recognition of the audience.




We all want our children to succeed in school and in life, which means among other things understanding and formulating discourse, but we all know that children do what we model. Now is our opportunity to put some sweat equity into the worthwhile task of engaging in discourse, if nothing else, for the sake of our children. With the arrival of May and Better Speech and Hearing Month, the need to be able to communicate well through true discourse is highlighted. Effective and thoughtful discourse is essential to us all.


Shaun Stephens, M.S., CCC-SLP

Speech-Language Pathologist, Instructor

Shaun Stephens, M.S., CCC-SLP, Evaluator and Instructor, provides speech and language services in the areas of social cognition, fluency (stuttering), motor speech, language, and alternative and augmentative communication (AAC) to learners of all ages. His areas of expertise include social communication, language impairments, speech fluency disorders and discourse impairments in children and adults. Prior to joining the Stern Center, Shaun worked extensively in schools, medical centers, skilled nursing facilities and in private practice.

He received his Master of Science degree from the University of Vermont. Currently, Shaun is enrolled in the Ph.D. program at UVM through the College of Medicine’s Clinical and Translational Science program, where he is researching discourse impairments in individuals with traumatic brain injury. Published articles include:

  • Prefrontal cortical activity during discourse processing: An observational fNIRS study, Topics in Language Disorders, 36(1): 65-79.
  • Discourse characteristics and neurovascular activation in four genres. In submission, Journal of Neurolinguistics.

He lives in central Vermont and enjoys hiking, biking, playing fiddle, and cooking with his family.

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