Why is measuring communication difficult? A critical review of current speech pathology concepts and measures

ABSTRACT

Human society is organised through communicative interactions between co-present people. Speech pathology (SP) assessment and intervention strategies aim to access these sites of communication in order to facilitate participation in life situations for people with communication disorders. Surprisingly, however, there is no explicit theory of communication underpinning SP practice and research. As a result, the conceptual and practical basis for rigorous, empirical measurement of communication remains limited, which is a significant challenge for professional practice and research. This critical review discusses the prevailing ways that co-present communication has been conceptualised and measured in SP. In particular, we examine how models of health have informed current ideas and measurement practices. We argue that although patently valuable for SP, they are largely incommensurate with the realities of co-present communication. Drawing on current empirical research in Sociology and Linguistics, we specify the properties of real-time co-present communication and discuss their relationship to current SP concepts and measurement practices. We conclude by suggesting directions for conceptual development and empirical research that will draw SP assessment and intervention strategies closer to real-time co-present communication.

KEYWORDS:

• Communication
• speech pathology
• enchrony

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Notes

¹ This ‘gatheringʼ may of course be technology mediated (e.g. via video-conferencing). Nonetheless, technology-mediated communication can still be meaningfully considered as ‘co-presentʼ in the sense that a set of embodied individuals is communicating in real time.

² For many linguists, of course, this is the foundational casting point of their discipline. Others reject this notion wholeheartedly (e.g. Evans & Levinson, 2009).

³ We should note that many authors have recognised, and correctly addressed, this issue (e.g. Dykstra, Hakel, & Adams, 2007; Westby & Washington, 2017). However, others have persisted with the category error. For example, McLeod and McCormack (2007, p. 255) case for assigning speech intelligibility to Body Functions and Structures is particularly underwhelming.

⁴ This is an acronym for the different causal frames Enfield (2014) has proposed for studying language; namely Microgenetic, Ontogenentic, Phylogenetic, Enchronic, Diachronic and Synchronic.

⁵ The properties we have specified are suggestive of theories and measurement practices that are relevant for enchrony. Although we cannot detail them here, interested readers should consult, for example, Enfield (2013), Barnes and Ferguson (2013) and Higginbotham and Engelke (2013).

⁶ Walsh (2011) and Hartley and Wirz (2002) offer models of communication disability, but they remain removed from the properties of communication and retain the underlying semantics of the ICF.

⁷ The contrast here is with more generic outcome sets/procedures that span the SP scope of practice, such as the AusTOMs (Perry & Skeat, 2004).