Larissa Ramirez | January 13th, 2025
Speech, language, and hearing scientists play a vital role in understanding how we communicate. They delve into the biological, physical, and psychological aspects of speech and hearing, developing evidence-based methods to diagnose and treat communication disorders. While many people might think of them as researchers working in labs, their work goes far beyond that. They also train the next generation of audiologists and speech-language pathologists (SLPs) at universities, collaborate with engineers, doctors, and dentists on product development, and explore assessment and intervention strategies in hospitals and clinics where research is part of patient care.
At Vanderbilt’s Bill Wilkerson Center, adults recovering from illnesses or injuries benefit from comprehensive speech and language services. The center addresses a range of disorders that can arise from brain injuries, strokes, cancers, and conditions like Parkinson’s and ALS. One important focus in the field is augmentative and alternative communication (AAC), which provides tools for individuals who have difficulty speaking or writing. AAC can be as simple as a picture board or as advanced as high-tech speech-generating devices. This approach supports many disabilities, including autism, cerebral palsy, and traumatic brain injuries. For some people, AAC can bridge communication gaps when their speech is hard to understand.
Camille Nuttall, a first-year PhD student, is conducting research on speech sciences and AAC interventions at the Child Language and Literacy Lab. This lab specializes in studying how children acquire language and literacy, both in typical and atypical development.
In a recent interview with The Vanguard, Nuttall shared her experiences in the field of speech sciences and offered her insights into its future within academia and research.
The Vanguard: What inspired you to pursue a career in speech sciences, and what drew you to this specific field?
Nuttall: Ever since my senior year of high school, I’ve known I wanted to be a speech therapist. I had a friend growing up who stuttered, and that really got me interested in how communication works and what it means to connect with people. I love that speech sciences blends working with others, creativity, education, and healthcare — all things I’m passionate about.
The Vanguard: Can you elaborate on your work within the schools and clinic system in Nashville?
Nuttall: I began working in schools in fall 2020 after navigating some challenges during my training. My first externship in Chicago in fall 2019 was disrupted by a public school strike, and another opportunity in March 2020 was canceled due to COVID. Ultimately, I completed a remote externship over Zoom, which, while unconventional, allowed me to connect closely with students’ families as parents participated alongside their children — an invaluable experience highlighting the critical role of family in education.
In the outpatient hospital clinic, I worked with children from birth to age 18, while my school experience focused on elementary students. The clinic involved less paperwork but came with challenges like managing a high caseload and dealing with frequent cancellations, especially during COVID.
The Vanguard: What do you think are some common misconceptions about speech-language pathology as a field?
Nuttall: Speech-language pathology is a field that’s mostly made up of women — about 98% of us are female. Because of this, we sometimes face biases, especially in the hard sciences, where we might not always be taken seriously. One common misconception is that speech-language pathologists only work in schools, helping kids learn how to say the letter “R.”
But our work goes so much deeper than that. We do a lot of important things, like supporting breastfeeding in the NICU, helping adults who struggle with swallowing, and working with individuals on the autism spectrum or those who stutter. It can be really frustrating when people only think of us as teachers focused on phonetic speech, so it’s really important to spread the word about the diverse range of services we provide. Our profession is all about helping people communicate and thrive, and there’s so much more to it than what many people realize.
The Vanguard: What advice would you give to students considering a career in speech sciences or speech-language pathology?
Nuttall: At Vanderbilt, we don’t have an undergraduate program specifically in communication disorders or speech-language pathology, so I recommend getting involved by shadowing professionals in the field. You can reach out to different labs and organizations to find opportunities.
Shadowing an SLP in a hospital or school setting can also be a really eye-opening experience. It’s fascinating to see how they work in different environments and how diverse their roles can be. Each setting offers unique challenges and rewards, and it’s a great way to gain insight into the field before pursuing more education.
The Vanguard: Given your research, could you explain AAC and its role in helping individuals with communication challenges?
Nuttall: AAC really deserves more attention than it gets because it’s so important for helping people communicate. AAC refers to various ways individuals can express themselves beyond just speaking, which is essential for those with limited or no speech.
There are two main types of AAC: unaided and aided. Unaided communication includes things like nodding, pointing, and using gestures, while aided communication involves tools like iPads or communication boards. These methods not only give people a way to communicate but also help them build social relationships. It’s crucial to spread the word about AAC so that more people can appreciate how it enhances communication and connects individuals with their communities.
The Vanguard: How has your work with AAC in schools impacted students’ communication abilities?
Nuttall: In 2020, I worked with a student to secure her first AAC device, a deeply rewarding experience. We connected over Zoom while she was out of school, and in 2021, when she returned and received her device, it was a joyful moment. Watching her light up as she used it to request toys and activities — and later type her name for the first time — was unforgettable.
This was my first time navigating the complex and time-intensive process of AAC evaluations, which included working with an interpreter to support her Vietnamese-speaking family. Seeing her communication flourish and the positive impact on her family dynamic reinforced the transformative power of AAC in fostering connection.
The Vanguard: What are some of the challenges in implementing AAC in educational settings, whether it be in Nashville or nationally?
Nuttall: Funding and resources for AAC are definitely top concerns. It’s also really important for teachers and SLP to feel confident in helping students use their devices effectively. A lot of newer clinicians and teachers may not have had much exposure to AAC, which can make it challenging for them to get up to speed.
Teachers and SLPs are the main support for students using AAC in schools, so understanding each other’s roles and collaborating is crucial. However, this can be tricky at times, especially if some practices have fallen behind what’s currently recommended. It’s essential for everyone involved to stay updated on the best practices in AAC.
We’re lucky at Vanderbilt to have experts like Dr. Biggs and Dr. Da Fonte in the Peabody School who specialize in AAC within special education. Having two specialists in this field is a real advantage, and it means we can provide even better support for our students.
The Vanguard: Are there any new AAC technologies that you’re particularly excited about?
Nuttall: iPads and tablets have really become game-changers in AAC. A lot of students are using eye gaze devices that let them communicate just by looking at the screen, which is pretty amazing. There are several companies that offer tablets specifically for AAC, but you can choose between dedicated devices and apps. Dedicated devices usually come with a higher price tag, while iPads are generally more user-friendly and easier to get your hands on.
Eye gaze technology can be used on iPads, but there are also specialized eye gaze devices out there for people with limited motor skills, like those who have trouble isolating their index finger. These devices are fantastic because they cater to a variety of communication needs, helping individuals express themselves in a way that works for them.
The Vanguard: What do you find most rewarding about working with AAC devices and techniques in your research?
Nuttall: When working with AAC, it’s really important to start by figuring out what the student or client truly needs. That means listening to them and their families to understand what’s most important to them. This approach is all about cultural humility, which helps us respect and prioritize their unique backgrounds and preferences. For instance, when we’re setting up an AAC device, we can pre-program it with specific foods or even add custom pictures for icons—like the snacks they love or what they typically eat at home. This personal touch really helps make the device more meaningful and useful for the child.
Even though we’ve come a long way in the disability field, there’s still so much more to do. We need to keep pushing for more resources and support so that we can better serve individuals with a variety of needs.
The future of the speech sciences
The field of speech sciences and AAC plays a key role in helping individuals communicate effectively and build connections. It’s important to remember that this work is about much more than just teaching sounds; it’s about understanding the unique needs of each person we support. By collaborating with families and educators, we can create customized solutions that empower students to express themselves fully. While challenges like funding and training exist, they are not insurmountable. By remaining open to learning and prioritizing the voices of those we serve, we can make a significant impact. Ultimately, the goal is to ensure that everyone has the opportunity to communicate and connect with others, enriching their lives in the process.
References
American Speech-Language-Hearing Association. (n.d.). About speech, language, and hearing scientist careers. Retrieved from https://www.asha.org/students/about-speech-language-and-hearing-scientist-careers/
Kitchener, C. (2007). Speech-language pathology: Helping people to communicate. Journal of Rehabilitation, 73(2), 40–44. Retrieved from https://go.gale.com/ps/i.do?id=GALE%7CA159645094&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00469157&p=AONE&sw=w
Vanderbilt University Medical Center. (n.d.). Hearing and speech sciences. Retrieved from https://medschool.vanderbilt.edu/hearing-speech/
Vanderbilt University Medical Center. (n.d.). Child language and literacy lab: Current projects. Retrieved from https://www.vumc.org/child-language-lab/current-projects