Also known as Speech-Language Therapy, Speech-Language Pathology is the assessment and treatment of speech (articulation, prosody, intonation and rate), language (reading, writing, talking, understanding and the alternative communication systems), cognition (thinking skills), voice, swallowing and social communication skills (social interactions). Evaluation and treatment by a Speech-Language Pathologist (SLP) involves education and training to remediate, improve and/or learn skills and strategies to compensate so that individuals can be more independent in daily tasks and functional communication abilities.
Speech-Language Pathologists work with individuals of all ages, from infancy through adulthood. Some of the clinical roles involved include education, training, collaborating, prevention, screening, advocacy and research.
Who Can Speech and Language Therapy Benefit?
Speech and language therapy can benefit individuals with a wide range of difficulties and challenges stemming from various illnesses, accidents or developmental disabilities. While speech-language therapy often implies that this therapy is only for those who have speech and language issues, voice, swallowing, social communication skills and cognition are also skills directly addressed.
According to ASHA (American Speech-Language and Hearing Association), SLPs serve individuals, families and groups from diverse linguistic and cultural backgrounds and provide services that include:
- Speech sound production:
articulation, apraxia of speech, dysarthria, ataxia, dyskinesia
hypernasality, hyponasality, cul-de-sac resonance, mixed resonance
- Voice: phonation quality, pitch, loudness, respiration
- Language (comprehension and expression):
phonology, morphology, syntax, semantics, pragmatics (language use, social aspects of communication), literacy (reading, writing, spelling), prelinguistic communication (e.g., joint attention, intentionality, communicative signaling), paralinguistic communication
attention, memory, problem solving, executive functioning
- Feeding and swallowing:
oral, pharyngeal, laryngeal, esophageal, orofacial myology (including tongue thrust), oral-motor functions.
My doctor thinks I need speech therapy… now what?
When you refer yourself or a loved one for speech-language therapy, the first step is to think about what you are hoping to change, modify or improve. You will then be screened or evaluated for services. During the evaluation, the SLP will discuss and assess the areas of need and develop a treatment plan to improve or restore skills. Each evaluation will result in a unique, carefully designed plan of care, including short and long term goals, frequency of visits and estimated length of stay.
The number of weekly sessions and length of stay vary with each individual, based on the outcome or long-term goal. For example, adolescents struggling with homework will focus on strategies to improve school success, where an adult who suffered a stroke will work on modified skills to live alone and manage personal affairs and an adult with Aspergers or other social communication disorder will benefit from learning “social communication rules” to resume work.
Similarly, the treatment, or therapy with a SLP varies and may include exploring and utilizing a variety of tools, strategies and internal systems. The systems and strategies developed vary based on the individual’s skill level and prior and current level of functioning. For example, to improve memory some individuals benefit from notebooks, planners, calendars, and/ or alarms. To improve attention, some people benefit from written checklists, while others need more environmental strategies to reduce distractions and help stay on task.
Another successful method that can sometimes be brought into treatment is the implementation of routines, through checklists, structure and repetition. This promotes proceduralized learning and can often improve participation and independence with important daily tasks. With language skills, sessions may include developing language strategies, role play, rehearsal and written templates. Implementing computerized programs or trialing an alternative communication device may also be explored to supplement or replace language skills. With social communication skills, individuals with Aspergers or other social communication difficulties learn and implement social communication “rules” and establish boundaries as needed.