When Nick Burriel was 23, he flatlined for nearly 25 minutes after an assault left him in the emergency room clinging to life. When he awoke after nearly three weeks in a coma, Burriel could no longer speak, walk or function the result of anoxic brain injury, which meant he lost oxygen to his brain. Burriel thought his life as he knew it was over. 

Then he began speech-language therapy, first at Community Regional Medical Center in downtown Fresno and later at Fresno State in 2013, when he became a client at the Speech, Language and Hearing Clinic. The services he received, in addition to his strong faith, restored his hope.

Now eight years later, Burriel is thriving. He credits his progress to each of the speech-language pathology graduate student clinicians he’s worked closely with over the years. With careful concentration, he can name all 11 of them in order a nod to his improved cognitive function and also to the impact the students, many of them now seasoned professionals, have made on him.

This semester, he worked with second-year graduate student, Katie Kennedy. Burriel beams as he talks about her and the other student clinicians he’s worked with. 

“Each therapist had their own tools to get my brain better, from reading one semester to public speaking and scanning the next semester,” Burriel said. “It’s never black and white. For anyone who struggles to speak clearly, like me, this is the place to be. This is the place that will give you tools to reach your goals. Coming back each semester has been amazing.”

As this semester comes to a close, Burriel can celebrate. This is the first semester he’s been able to meet all four of the reading goals set for him at the beginning of the semester. For Kennedy, working with Burriel gave her an opportunity to work with an adult population she hadn’t yet encountered those with traumatic brain injury. She said the lessons she’s learned in the classroom on this topic translated seamlessly into her real-world experience. 

Katie Kennedy (right) is one of several student clinicians who have worked with Nick Burriel during his time at the Speech, Language and Hearing Clinic at Fresno State.

Katie Kennedy (right) is one of several student clinicians who have worked with Nick Burriel during his time at the Speech, Language and Hearing Clinic at Fresno State.

“The neatest thing about the clinic is that it really helps us connect coursework to practice,” Kennedy said. “There is not a cookie-cutter definition of what TBI is and how it affects people, so it was really nice to have had a class on it and to practice treating it with Nick. I’ve had a lot of ‘aha’ moments throughout this process.”

Burriel’s mom, Maria, said they went to a couple of different treatment centers before finding Fresno State’s clinic. What she appreciates most about the clinic is the family-centered approach. Through the double-paned windows, Maria is able to hear and see each session, giving her an inside glimpse into the lessons her son is learning. She said this is what makes the clinic unique. 

“Here, they teach you the tools that you can apply to real life, and every clinician he’s worked with has given him their best,” Maria said. “The clinicians never gave up on him, and as his mom, that’s all I want for him.”

Affordable service to the community 

The clinic looks much different than it did just one year ago, when in-person services transitioned to teletherapy during the COVID shutdown. With resilience and creativity, student clinicians and supervisors continued serving clients in the new, virtual format, said clinic director Sabrina Nii. This allowed students to continue completing clinical hours, essential for them staying on track to graduate. 

“There is a profound shortage of speech-language pathologists throughout the country and our Central Valley is no exception,” Nii said. “Having a fully functioning clinic helps our students build skills needed to be successful and for our department to continue to produce well-qualified professionals to serve the Valley.”

This past September the clinic re-opened for in-person services, and now has more availability than usual on its waitlist. The clinic, which serves clients of all ages and a variety of diagnoses and needs, sees up to 80 clients per semester. 

Services are free at the clinic, but Nii said a solid client base and financial support from the campus and community is needed for the clinic to prosper.

“With ongoing financial support from our local community, we can continue to purchase the supplies needed for daily clinic operations and regular maintenance,” Nii said. “Perhaps, more importantly, it will allow us to continue to educate graduate student clinicians and to meet the needs of our community.”

Students typically need 400 hours of clinical experience in order to graduate. During the course of the clinical experience they are matched with two clients per semester who have varying diagnoses. Kennedy said the clinic has been vital to her growth.

“We are getting a lot of experience working with all different types of clients, of different diagnoses and ages,” Kennedy said. “The speech-language pathology field is so broad that you can’t possibly be prepared for every scenario, but Fresno State really tries to prepare you with the tools and foundation to succeed. This experience truly helps us to become more well-rounded clinicians.”

Now with in-person services resuming, Nii has hope even more community members will take advantage of the cost-free services that students provide.

New beginnings 

Client Dylan Blackstone works with graduate student Destiny Gilbreath at the Speech, Language and Hearing Clinic at Fresno State.

Client Dylan Blackstone works with graduate student Destiny Gilbreath at the Speech, Language and Hearing Clinic at Fresno State.

When Dylan Blackstone was 5 years old, the only word  she was able to articulate was “milk.” 

Diagnosed with autism, Dylan faced developmental challenges that affected her communication and behavior. After eight months receiving speech and behavior services at another local clinic, Dylan’s father, Brad Blackstone, realized she was not making progress. 

He enrolled her at the Speech, Language and Hearing Clinic, and said the difference in services was monumental. By the end of that first semester, Dylan’s one-word vocabulary transcended into an entire sentence:Can I have some milk, please?

Blackstone, who is director of Bulldog Vision within the Department of Athletics at Fresno State, said the services have been a gamechanger for his daughter, now 9.

“With Dylan, we saw progress every single semester which was super encouraging,” Blackstone said. “We’re really just trying to engage her in conversation. You know, if you ask her a question, I’m not looking for a simple one- or two-word answer. I want to talk to her about it. Now we are able to do that.”

On this particular afternoon, the clinic is bustling, as both rooms house several clients and clinicians working together. On the other side of the hallway are private rooms that house individualized sessions for older adults. Graduate student Destiny Gilbreath is completing her second clinical experience and said the ability to help Dylan is a two-way street – they both learn from each other through this semester-long process.

“I love Dylan’s personality and seeing her progression is super important to me,” Gilbreath said. “At the start of the semester, we set four goals for her to achieve, including improving on her expressive, receptive and pragmatic (social awareness) and phonetic language. So far, she’s met all her goals. She’s such a quick learner.”

Dylan’s younger sister, Emersyn (3), is also receiving speech therapy at the clinic, and begins her session just after Dylan. Much like Dylan, Emersyn began with very little vocal expression, but has seen immense growth in just a matter of weeks. 

Blackstone said both sisters will continue services in the spring, giving a new set of students an opportunity to learn. 

“For the student clinicians, they see huge strides made over the course of the 10 to 12 weeks in the program,” Blackstone said. “That’s great for us. It’s great for them, and it’s great for the program.”

To support the Speech, Language and Hearing Clinic or to learn more, contact Sabrina Nii at sanii@csufresno.edu, or visit  the clinic website.