A humorous and educational look at speech pathology.

As part of my efforts to start regularly blogging again, I’m branching out a little beyond what games I use in speech therapy sessions and spending some space discussing why I use games in speech therapy. This conversation is going to occur over a few months, one topic a month, and will be rooted in my study of communication theory as well as my experience as a speech pathologist. I’m starting out with the theory that is something of the background of my perspective in both communication theory and speech pathology – Walter Fisher’s model of the Narrative Paradigm.

Prior to Fisher’s development of the narrative paradigm, research in human communication focused on logic. It assumed that people used rational argument and discussion to develop their beliefs and perspectives. As a result, communication relied upon developing knowledge and understanding and reaching conclusions based on that understanding that the way the topic was discussed – scientifically, philosophically, legally, etc.

Fisher found purely logical constructs of human communication to be too limited and inconsistent with how people actually behaved. Recent examples of human communication and persuasion – one notable example being the Daisy ad from the 1964 US Presidential campaign – didn’t use appeals rooted in logical or philosophical thought, and were extremely effective in motivating action. What these acts of communication did, Fisher argued, was appeal to a more fundamental nature in human communication – our nature as storytellers. Instead of placing evidence into a structure of logical arguments, people instead experience and interpret their lives and others’ as a series of ongoing stories or narratives, each with their own characters, scenes, and plots with beginnings, middles, and ends. Using the example above, the Daisy ad didn’t appeal to any sort of evidence to construct a logical argument. It created a powerful narrative that began with an idyllic scene of a young girl picking flowers, transitioned to a sinister countdown, and ended with a literal end – of everything – followed by a statement that not “standing together” behind President Johnson would make this dreadful narrative become reality.

Core elements of the narrative paradigm include:

  • Values/Beliefs – The narratives we experience throughout our lives define our values and beliefs. Additionally, values and beliefs we’ve already formed tend to influence which of conflicting narratives we accept or reject in the future. If my father was a hardworking electrician whose union membership allowed him to gain access to better wages and benefits, I’ll develop a belief that unions are good. If your father was an independent contractor who couldn’t find work because local businesses use non-union labor, you’ll develop a belief that unions are bad. Those beliefs will greatly influence whether or not we believe the conservative politician who says that right-to-work laws protect workers from union bullying or the progressive politician who says they’ll hurt worker wages and benefits, regardless of whether the statistical evidence supports either narrative.
  • Good Reasons – We develop our own “good reasons” for accepting and interpreting information and evidence in the manner we do. In contrast to evidence and logic, which are objective and the same for all people, good reasons are based on our own history, culture, and perspectives about the character of the others involved – measures that are more subjective and less completely understood by a communication partner. When a new student enters your school from a neighboring school or district, your opinion of the quality of the students’ goals is influenced by your previous experience with that student’s school and the service providers at that school, even though those previous experiences provide no actual evidence regarding the quality of this student’s goals.
  • Test of narrative rationality – When we experience a new narrative, we assess, and then accept or reject, that narrative based on the narrative’s coherence, probability, and fidelity. Coherence refers to whether or not the characters in a narrative act reliably or consistently – someone who is kind to his neighbors will be deemed unlikely to rob them. Probability Fidelity refers to accepting a narrative that matches our own beliefs and experiences – if our experience and belief is that there is no God, we are unlikely to believe a story of miraculous healing and instead search for a scientific rationale.

Where does Fisher’s narrative paradigm become useful to speech pathologists?

1. The narrative paradigm does much to explain why it’s difficult for the field of speech pathology to move from treatment and assessment based on anecdote to evidence-based practice. As the more natural communicative form, it’s difficult to switch from the anecdote to something more structured.

2. The narrative paradigm suggests that our clients will respond better to treatment methods that present tasks in the form of a narrative or require responses in the form of a narrative. By using a natural communication form, we are asking clients to take fewer steps in developing their communication.

3. We must be mindful of cultural and social factors when developing treatment plans. If we present treatment activities or assessment items that are outside a client’s values, beliefs, or experiences, they’re not going to do as well on them. This is why students in low-income urban areas tend to do poorly on the Understanding Paragraphs section of the CELF – attending double features at movies and getting positive attention from emergency workers tends to be wildly inconsistent with their experiences.

4. We need to acknowledge that, even in the face of direct evidence to the contrary, our predisposition to use “good reasons” is likely to influence our therapy or assessment decisions – and the input of other professionals. Considering the influence of these narratives is critical (and the narratives may not necessarily be wrong – standardized assessments frequently do not present information in narrative form or ask students to respond that way).

Using the Narrative Paradigm in Therapy

Many games I’ve suggested in previous blog posts either present information in narrative form or require students to produce narratives in responses:

Games that present information in narrative: Dixit (a narrative in image form is still a narrative), Telestrations, Snake Oil, Storyteller Cards.

Games that require a narrative response: Apples to Apples (a great example of how values, beliefs, and “good reasons” influence choices), Rory’s Story Cubes, The Storybook Game, Who Would Win.

I hope this brief exploration of communication theory was useful. This kind of blog post is new for me, so I’d love to hear any feedback regarding what could use better explanation or what portions simply weren’t useful to you. At the end of next month, I’ll cover another communication theory, and you’ll see a couple more posts covering board games between now and then.



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