America needs a lot more speech, language, and hearing specialists. The trouble is, there aren’t enough professors to train them. During its most recent survey of communication sciences and disorders educators, the American Speech-Language-Hearing Association found one-third of faculty searches went unfilled. The Bureau of Labor Statistics estimates the number of speech pathologist job openings will jump 18 percent by 2026.

For the students in Sargent’s speech, language, and hearing sciences PhD program, it means a nearly guaranteed job after graduation. Many go straight into tenure-track faculty positions; others decide to take a postdoctoral position to continue their research or explore new fields before starting their academic careers.

“We think of our PhD as the ramp to the next stage in an academic career,” says Swathi Kiran, associate dean for research and director of the program. In 2016, the National Institutes of Health awarded Sargent an institutional training grant (T32) designed to help attract students to disciplines such as speech pathology, flagged as national “shortage areas.”

When Kiran, also a professor of speech, language, and hearing sciences, joined Sargent in 2009, there were two students in the doctoral program; today, there are more than a dozen. They take courses across the University in engineering, medical sciences, neuroscience, and more, and start mentored research projects right away. The current cohort is working with faculty to investigate areas including language recovery after a brain injury, the mechanics of swallowing, and the neural basis of speech.

Kiran says doctoral candidates are encouraged to publish often and to secure federal funding for their work. “That’s what gets them ready to get out there and get great faculty positions.” In the 2017–18 academic year, students presented 26 posters and published 14 papers in journals. Many also landed F31 predoctoral individual national research service awards, a highly competitive NIH fellowship grant.

children at play
For her dissertation, Natalie Gilmore (left) is studying the effectiveness of Swathi Kiran’s Intensive Cognitive and Communication Rehabilitation program. Photo by Michael D. Spencer

Recent alums include Jessica M. Pisegna (’13,’17), director of speech language pathology at Boston Medical Center; William S. Evans (’10,’15), an assistant professor at the University of Pittsburgh; and Victoria McKenna (’18), a clinician and postdoctoral research fellow at Purdue University.

Kiran heads Sargent’s Aphasia Research Lab, which focuses on language processing and recovery after a stroke and other brain injuries. She says her students’ varied interests and clinical backgrounds have helped take her research in unexpected directions. One student, for example, proposed exploring an area of language recovery that had largely been ignored.

“She was interested in looking at fluctuations in attention,” says Kiran. “She started thinking that was one of the reasons why our patients might not improve—it’s not just the fact that they have trouble communicating, it’s that their attention zones in and out more.”

The paper the two wrote on the research was published in a 2015 edition of Neuropsychologia and has been cited more than 30 times (a majority of scientific papers snag less than four citations, according to Nature). After earning her doctorate, the student, Sarah Villard (’12,’16), returned to Sargent as a postdoctoral fellow to continue her work on attention.

Inside Sargent spoke to three speech, language, and hearing sciences doctoral students—who will soon be ready to fill some of those vacant faculty positions—about their research.

Helping kids with voice disorders

Elizabeth Heller Murray
Elizabeth Heller Murray (Photo by Conor Doherty)

When Elizabeth Heller Murray (’19) joined Cara Stepp’s Sensorimotor Rehabilitation Engineering Lab, she studied a range of voice problems, from vocal trauma to laryngeal stiffness. As she moved through the projects, she wondered how what she was learning about adults might apply to kids. Many existing clinical approaches to voice disorders, says Heller Murray, involve “just taking adult therapies and making them fun, but the pediatric mechanism is really different from the adult mechanism.”

Stepp, an associate professor of speech, language, and hearing sciences, encouraged Heller Murray to explore children’s speech mechanisms—how the brain and vocal system work together—helping her successfully apply for an F31 grant to fund her research.

With Stepp’s guidance, Heller Murray began studying children with voice disorders: some sounded different from their peers, others were constantly losing their voices. Their conditions can affect their self-worth, says Heller Murray, who also worked at Boston Children’s Hospital as a speech-language pathologist while studying at Sargent. These children may be less likely to speak up in class; sometimes, they’re labeled as potential troublemakers.

Cara Stepp, an associate professor of speech, language, and hearing sciences, and director of Sargent’s Sensorimotor Rehabilitation Engineering Lab, encouraged Elizabeth Heller Murray to study children’s speech mechanisms.

Cara Stepp, an associate professor of speech, language, and hearing sciences, and director of Sargent’s Sensorimotor Rehabilitation Engineering Lab, encouraged Elizabeth Heller Murray to study children’s speech mechanisms. Photo by Scott Nobles

For her dissertation, Heller Murray watched children without voice disorders as they made or listened to certain repetitive sounds, examining how they responded to changes in pitch to better understand voice control. For those making the sounds, she wanted to see how they reacted if they thought their pitch was too high or too low: How quickly would they shift their pitch? Would they adjust it by too much or too little?

Some kids, like most adults, made effective adjustments, but one group didn’t; Heller Murray, who has published six articles and been asked to contribute to a textbook on pediatric voice disorders, thinks it’s because they’re still in a learning phase.

“Once we understand more about how voice develops over time,” she says, “we can figure out where it’s breaking down for kids with voice disorders.”

What makes someone stutter?

Saul Frankford
Saul Frankford (Photo by Conor Doherty)

In Frank Guenther’s Speech Neuroscience Lab, researchers are studying what happens in the brain when we speak—and how the process can sometimes go awry. Their work could help illuminate the roots of disorders such as dysarthria, a muscle weakness that impacts speech, and stuttering. That makes the lab a good fit for Saul Frankford (’20), whose goal is to zero in on “the break in the chain”—the misfiring part of the brain—in a range of speech disorders.

Frankford, an undergraduate music major, has long been interested in sound. Working with Guenther, renowned for developing a computer model that simulates speech development and speech production called the DIVA model, has shown him how to use computational and mathematical methods to work through a problem. In one recent study, Guenther, a professor of speech, language, and hearing sciences, and Frankford tested the role of auditory feedback—listening to yourself speak—in stuttering.

Frank Guenther, professor and director of Sargent’s Speech Neuroscience Lab

Frank Guenther, professor and director of Sargent’s Speech Neuroscience Lab, collaborated with Saul Frankford on a study of the role auditory feedback plays in stuttering. Photo by Kalman Zabarsky

Frankford placed test subjects in a sound-deadening booth and, as they read sentences from a screen, played their voices back to them through headphones—but with a few tweaks. By toying with how people heard themselves—turning an “eh” into “ah” or speeding and slowing their speech—he could monitor how they reacted to apparent errors.

He found that people who do not stutter tend to do a good job of adjusting—speeding up, changing their pitch—when it seems their speech has erred, “but people who stutter respond to a lesser extent,” says Frankford. “This might have to do with the ability of people who stutter to use auditory feedback to help with sequencing or timing their own speech.”

Watching the brain recover

Natalie Gilmore
Natalie Gilmore (Photo by Conor Doherty)

Since 2016, Swathi Kiran’s Intensive Cognitive and Communication Rehabilitation (ICCR) program has given young people with brain injuries a route to college. The participants all have issues that can make it tough to participate in class or keep up with lessons: some have difficulty with attention or problem solving after a traumatic injury, others have aphasia, a language disorder common after a stroke. Kiran’s program mixes intensive individual therapy with introductory college courses to help ease them back into the classroom. Natalie Gilmore (’21) helped coordinate the program and, with support from an F31 grant, is testing its effectiveness for her dissertation project.

“I plan to investigate which specific cognitive-linguistic domains important for college success, such as attention, verbal expression, and memory, improve over time as a function of this intensive program and the neuroplasticity—changes in the brain—underpinning those improvements,” she says.

Swathi Kiran, professor and director of Sargent’s Aphasia Research Laboratory

Swathi Kiran, professor and director of Sargent’s Aphasia Research Laboratory, has encouraged Natalie Gilmore’s study of the effectiveness of a program that helps young people with brain injuries return to college. Photo by Kalman Zabarsky

To track those changes, Gilmore will work with David Boas, a professor of biomedical engineering and a pioneer in functional near-infrared spectroscopy (fNIRS). The technology allows researchers to watch and map neural activity noninvasively, monitoring changes in oxygen levels in the brain with infrared light. It will enable Gilmore to see how the students in Kiran’s program react to therapy and to their college classes, then follow their progress across multiple semesters.

Kiran says the fNIRS project, “measuring data on young adults who are receiving therapy at different time points, is not something I’d thought about.” She adds that Gilmore, who already has four published papers, has been a driving force for the ICCR program: “It was completely fueled by her energy and her contributions.”

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