‘Presenting Complaints’

Professional discourse and evaluation in speech and language therapy report writing exemplars

Authors

  • Mary Pat O' Malley-Keighran National University of Ireland Galway

DOI:

https://doi.org/10.1558/jircd.v7i2.29921

Keywords:

professional identity, diagnostic report writing, appraisal analysis, speech and language therapy

Abstract

This paper examines an aspect of speech and language therapy practice that has not been studied extensively: published exemplars of professional report writing for speech and lan-guage therapists (SLTs), both in training and in practice. The research question addressed in this qualitative study is: ‘How are clients’ speech, language, communication, and feeding eating, drinking and swallowing (FEDS) abilities evaluated in diagnostic report writing exemplars? Specifically, the data consists of sample reports from the speech and language therapy educational literature, that is, texts that aim to demonstrate ‘best practice’ in relation to ‘professional’ report writing. Drawing on Critical Discourse Analysis and Systemic Functional Linguistics, the study uses Appraisal Analysis to examine naturalised representations of clients in eighteen sample diagnostic reports. The findings show that the predominant form of evaluation of clients is negative appreciation, as evidenced by lexical choices including terms such as deficits, disorder, difficulties, and adequate, within normal limits, within functional limits. The emphasis in the report exemplars is primarily on problems or presenting complaints/concerns. Positive appreciation lexical items tend to have weak positive valence built into their semantic features. For instance, the strongest positive appreciation can be found in lexical items such as adequate, within normal limits, within functional limits, etc. An additional form of positive appreciation is expressed in the absence of a problem (e.g. There appeared to be no deficit with comprehension of concrete information). Positive evaluations of client communicative competency were not identified in the reports. Inclusion of affect or emotion was rare in the data set. Occasional instances of judgements were identified in the data. The focus of this paper is on appreciation in particular. This aspect of evaluation in the report exemplars results in reports in which the client’s communicative competence and perspectives on his/her communication are excluded. The implications for the profession are discussed and alternative evaluation options which retain the same underlying meanings are explored. This paper contributes originality to the field by exploring an under-researched aspect of professional speech and language therapy practice which has applications for many healthcare professionals both in clinical practice and in clinical education.

Author Biography

Mary Pat O' Malley-Keighran, National University of Ireland Galway

Mary-Pat O’Malley-Keighran is a lecturer in speech and language therapy in NUI Galway. Her research interests are varied and include narrative as an ecologically valid way of measuring language skills in children, representations of people with communication impairments in mass media, interactions in medical settings, among others. Recent Publication: O’Malley-Keighran, M. P. and Coleman, M. (2014). I am not a tragedy. I am full of hope. International Journal of Language and Communication Disorders, 49 (2): 174–188.

References

American Speech and Hearing Association (2007). Scope of Practice in Speech-Language Pathology. http://www.asha.org/uploadedFiles/SP2007-00283.pdf as viewed on 11/7/2015.

Anspach. R. (1988). Notes on the sociology of medical discourse: The language of case presentation. Journal of Health and Social Behaviour 29: 357–375. http://dx.doi.org/10.2307/2136869

Benwell, B. and Stokoe, E. (2006). Discourse and Identity. Edinburgh: Edinburgh University Press.

Burrus, E. A. and Willis, L. B. (2009). Professional Communication in Speech-Language Pathology: How to Write, Talk, and Act like a Clinician. San Diego, CA: Plural Publishing, Inc.

Byng, S., Cairns, D., and Duchan, J. (2002). Values in practice and practising values. Journal of Communication Disorders, 35: 89–106. http://dx.doi.org/10.1016/S0021-9924(02)00059-X

Candlin, C. (1995). General Introduction. In N. Fairclough, Critical Discourse Analysis, vii–xi. London: Longman.

Chivotti, R. and Piran, N. (2003). Rigour and grounded theory research. Journal of Advanced Nursing, 44: 427–435. http://dx.doi.org/10.1046/j.0309-2402.2003.02822.x

Duchan, J. (1999). Reports written by speech-language pathologists: The role of agenda in constructing client competence. In D. Kovarsky, J. Duchan, and M. Maxwell (eds) (1999). Constructing (In)Competence: Disabling Evaluations in Clinical and Social Interaction, 223–244. Mahwah NJ: Lawrence Erlbaum Associates.

Fairclough, N. (1996). Critical analysis of media discourse. In P. Morris and S. Thornborrow (eds) Media Studies, 308–328. Edinburgh: Edinburgh University Press.

Fang, Z. (2004). Scientific Literacy: A Systemic Functional Linguistics Perspective. Science Education 89 (2): 335–347. http://dx.doi.org/10.1002/sce.20050

Ferguson, A. (2008). Expert Practice: A Critical Discourse. San Diego, CA: Plural Publishing.

Ferguson, A. (2009). The discourse of speech-language pathology. International Journal of Speech-Language Pathology 11 (2): 104–112. http://dx.doi.org/10.1080/17549500802412651

Finn, G, Garner, J., and Sawdon, M. (2010). ‘You’re judged all the time!’ Students’ views on professionalism: A multi-center study. Medical Education 44: 814–825. http://dx.doi.org/10.1111/j.1365-2923.2010.03743.x

Fowler, R. (1991). Language in the News: Discourse, Ideology and the Press. London: Routledge.

Hall, P. (2005). Inter-professional team work: Professional cultures as barriers. Journal of Inter-professional Care S1: 188–196. http://dx.doi.org/10.1080/13561820500081745

Halliday, M. A. K. (1993). Towards a language-based theory of learning. Linguistics and Education 5: 93–116. http://dx.doi.org/10.1016/0898-5898(93)90026-7

Halliday, M. A. K. (1994). An Introduction to Functional Grammar (2nd edn). London: Edward Arnold.

Hepworth, D. and Larsen, J. (1982). Direct Social Work Practice: Theory and Skills. Belmont, CA: Dorsey Press.

Holloway, I. (2005). Qualitative Research in Health Care. Buckingham: Open University Press.

Howe, T. (2008). The ICF Contextual Factors related to speech-language pathology. International Journal of Speech- Language Pathology, 10 (1–2): 27–37. http://dx.doi.org/10.1080/14417040701774824

Hutchby, I. (2006). Power in discourse: tThe case of arguments on a British talk radio show. In A. Jaworksi and N. Coupland (eds) The Discourse Reader, 521–531 London: Routledge.

Jaworksi, A. and Coupland, N. (eds) (2006). The Discourse Reader. London: Routledge.

Ma, E. P. M., Threats, T. and Worrall, L. (2008). An introduction to the International Classification of Functioning, Disability and Health (ICF) for speech-language pathology: Its past, present and future. International Journal of Speech Language Pathology, 10 (1–2): 2–8. http://dx.doi.org/10.1080/14417040701772612

Macdonald, M. E. and Murray, M. A. (2007). The appropriateness of appropriate: Smuggling values into clinical practice. Canadian Journal of Nursing Research, 39 (4): 58–73.

Martin, J. R. and Rose, D. (2003). Working with Discourse: Meaning Beyond the Clause. London: Continuum.

Martin, J. R. and Rose, D. (2007). Working with Discourse: Meaning Beyond the Clause (2nd edn). London: Continuum.

Mills, S. (1997). Discourse. London: Routledge.

Monrouxe, L. (2010). Identity, identification and medical education: Why should we care? Medical Education 44: 40–49. http://dx.doi.org/10.1111/j.1365-2923.2009.03440.x

?hlén, J. and Segesten, K. (1998). The professional identity of the nurse: Concept analysis and development. Journal of Advanced Nursing, 28 (4): 720–727. http://dx.doi.org/10.1046/j.1365-2648.1998.00704.x

O’Malley-Keighran, M. P. (2012). To feel good you have to look good: Representing women’s experiences of cosmetic surgery and dermatology in Irish print and television media. Unpublished Ph.D. Thesis, Trinity College, Dublin.

Power, E., Anderson, A., Togher, L. (2011). Applying the WHO ICF framework to communication assessment and goal setting in Huntingdon’s Disease: A case discussion. Journal of Communication Disorders, 44: 262–275. http://dx.doi.org/10.1016/j.jcomdis.2010.12.004

Ritchie, J. and Lewis, J. (2008) Qualitative Research Practice: A Guide for Social Science Students. London: Sage.

Schleppegrell, M. J. (2004). Linguistic features of the language of schooling. Linguistics and Education, 12 (4): 431–459. http://dx.doi.org/10.1016/S0898-5898(01)00073-0

Semino, E., Demjén, Z., and Koller, V. (2014). ‘Good’ and ‘bad’ deaths: Narratives and professional identities in interviews with hospice managers.’ Discourse Studies, 16 (5): 667–685. http://dx.doi.org/10.1177/1461445614538566

Shipley, K. G. and McAfee, J. G. (2009). Assessment in Speech-Language Pathology: A Resource Manual. New York: Delmar Publications.

Silverman, D. (2005). Doing Qualitative Research. London: Sage.

Starks, H. and Brown Trinidad, S. (2007). Choose your method: a comparison of phenomenology, discourse analysis, and grounded theory. Qualitative Health Research, 17 (10): 1372–1380. http://dx.doi.org/10.1177/1049732307307031

Stein-Rubin, C. and Fabus, R. (2012). A Guide to Clinical Assessment and Professional Report Writing in Speech-Language Pathology. New York: Cengage Learning.

Thompson, G. and Hunston, S. (eds) (2000). Evaluation in Text: Authorial Stance and the Construction of Discourse. Oxford: Oxford University Press.

Van de Camp, K., Vernooij-Dassen, V. Grol, R., and Bottema, B. (2004). How to conceptualise professionalism: A qualitative study. Medical Teacher, 26 (8): 696–702. http://dx.doi.org/10.1080/01421590400019518

Van Dijk, T. (2001). Multidisciplinary CDA: A plea for diversity. In R. Wodak and M. Meyer (eds) Methods of Critical Discourse Analysis, 95–120. London: Sage. http://dx.doi.org/10.4135/9780857028020.n5

Wetherell, M., Taylor, S. and Yates, S. (2001). Discourse as Data: A Guide for Analysis. London: Sage.

White, P.R. (2005). ‘An introductory tour through appraisal theory’, Appraisal Website: The Language of Attitude, Arguability, and Interpersonal Positioning. www.grammatics.com/appraisal (Accessed on 02/07/2015).

Widdicombe, S. (2006) Identity as an analysts’ and participants’ resource. In C. Antaki and S. Widdicombe (eds) Identities in Talk, 191–206. London: Sage.

Wodak, R. (2001a). The discourse-historical approach. In R. Wodak and M. Meyer (eds) Methods of Critical Discourse Analysis, 63–94. London: Sage. http://dx.doi.org/10.4135/9780857028020.n4

Wodak, R. (2001b). What CDA is about – A summary of its history, concepts and its developments. In R. Wodak and M. Meyer (eds) Methods of Critical Discourse Analysis, 1–13. London: Sage.

World Health Organization (2001). International Classification of Functioning, Disability, and Health (ICF). Geneva: Word Health Organization.

World Health Organization (2002) Towards a Common Language for Disability, Functioning and Health. Geneva: World Health Organization.

Worrall, L. Sherratt, S., Rogers, P., Howe, T., Hersh, D., Ferguson, A., and Davidson, B. (2011). What people with aphasia want: Their goals according to the ICF. Aphasiology, 25 (3): 309–322. http://dx.doi.org/10.1080/02687038.2010.508530

Wylie, K. McAllister, L, Davidson, B., and Marshall (2013). Changing practice: Implications of the World Report on Disability for responding to communication disability in under-served populations. International Journal of Speech-Language Pathology, 15 (1): 1–13. http://dx.doi.org/10.3109/17549507.2012.745164

Published

2016-01-17

How to Cite

O’ Malley-Keighran, M. P. (2016). ‘Presenting Complaints’: Professional discourse and evaluation in speech and language therapy report writing exemplars. Journal of Interactional Research in Communication Disorders, 7(2), 213–242. https://doi.org/10.1558/jircd.v7i2.29921