Your fair discourse hath been as sugar, Making the hard way sweet and delectable. - William Shakespeare (1564-1616), in Richard II, act 2, sc. 3, l. 6-71
In this issue of Topics in Language Disorders (TLD), Dana Kovarsky has assembled contributions from outstanding authors who share evidence from "Explorations in Clinical Discourse" that can inform clinical practice. Although you may not agree that these discourse samples make the hard way "sweet and delectable" in the Shakespearean sense, we think that you will find them to make it deeper and richer.
This is an issue full of multiple perspectives. As Issue Editor Kovarsky indicates in his Foreword, he invited contributions from individuals and research teams who could shed light on qualitative evidence regarding client and family values by offering samples of discourse in the clients' own voices. A fascinating element of these articles is the way that authors use discourse to focus on discourse about discourse. It reminds one of those intriguing double-mirror images in which each reflection embeds another.
The practice of speech-language pathology is conducted primarily through clinical discourse. Master clinicians use mediational discourse to establish supportive contexts in which clients can be more successful than they would be on their own. As important as discourse is to the practice the profession, several authors in this issue point out the irony of how little attention is paid the science of doing it well. The first three articles, in fact, address questions about what clinicians say and do to enhance the discourse possibilities for their clients. At the same time, these articles reflect how client discourse is the essential material of the therapeutic process, not only in the context of group therapy (as in the article by Simmons-Mackie, Elman, Holland, & Damico) but also in the dyadic interactions of client-clinician discourse (in articles by Hengst and Duff and by Walsh). Mastergeorge offers a slightly different slant on the question of intervention discourse. She brings in the voices of mothers who are working to understand their roles in supporting their children's learning, whether or not the children have developmental disabilities.
Other important questions addressed in these pages relate to power differentials and how they are worked out in the words and styles of discourse choices. In her innovative article, Duchan draws on historical discourse to illuminate how discourse has been and can be used to subvert power relationships and to moderate discourse standards to make them more inclusive. Kovarsky and Curran take on the question of establishment discourse on what constitutes research evidence of value.
In thinking about who decides what counts as evidence, a nagging question is-what if no one has looked in the right places? What if only highly structured programs are investigated because they are relatively easy to investigate even though they do not allow much latitude for client-negotiated discourse? Who should decide what constitutes a high quality outcome? Should counts of convergent responses to known-answer questions carry more weight than original contributions to a conversation co-constructed by the participants rather than being predetermined by the clinician?
Elizabeth Bates (1979) offered a metaphoric story of a similar dilemma in some of her early writings on the question of how symbols emerge among language learners. This passage was quoted by Marchman and Thal (2005) in their essay honoring Bates in the book Beyond Nature and Nurture: Essays in Honor of Elizabeth Bates (Tomasello & Slobin, 1979):
There is a very, very old joke about a drunk who loses his keys in the bushes late one night. A passerby finds him on his hands and knees, searching a bare piece of pavement directly under a streetlight. "What happened?" asks the stranger. "I lost my keys in the bushes," replied the drunk. "Then why are you looking here?" the stranger asked in bewilderment. The response was one we can all sympathize with: "Because it's so much easier to look out here in the light." (p. 370)
The question is not whether quantitative or qualitative research methods are easier to implement, but where to find the keys. The authors of the articles in this issue have applied qualitative research methods to look for keys in some original but highly relevant places. That is, they have looked for evidence in the voices of those most concerned with the results-adult clients and mothers of children with developmental disabilities who are best suited to understand the messages in their learning styles. Where better to find the keys?
Nickola Wolf Nelson, PhD, Editor
Katharine G. Butler, PhD, Editor Emerita
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