Speech Therapy

What is speech therapy?

Speech therapy is used to assess and treat language and speech disorders in children and speech impairments in adults caused by brain injury or stroke. Speech-language pathology is practiced by speech-language pathologists, also known as speech therapists SLP’s evaluate, diagnose and treat speech disorders, language disorders, voice disorders, and swallowing disorders. They also play a great role in the diagnosis and treatment of autism spectrum disorder along with pediatricians and psychologists. 

Types of speech disorders

Speech-language pathologists diagnose what kind of language or speech problem the patient has and then decide what will be the best treatment. There are many speech and language disorder some of which are discussed below:

Speech disorders

• Articulation disorders: Inability to speak clearly or properly form certain word sounds. The patient may drop, swap, distort, or add sounds. Example: a patient may distort a word by saying “thith” instead of “this”.
• Fluency disorders: They affect the flow, speed, and rhythm of speech such as in stuttering and cluttering. 
• Resonance disorders: This disorder occurs when there is a problem with voice pitch, volume, and quality. It is due to an obstruction of regular airflow in the nasal or oral cavities that changes the vibrations that make up the quality of voice. 
• Dysarthria: It is a speech disorder that occurs due to neurological injury that causes weakness, paralysis, or lack of coordination of the motor-speech system. The patient suffers from slow or slurred speech because of problems in the muscles used for speech.

Language disorders

• Receptive disorders: The patient has trouble understanding and processing language. This can cause the patient to seem uninterested when spoken to, have trouble following what is being said, or have a limited vocabulary. 
• Expressive disorders: The patient has difficulty putting words together to form correct sentences and conveying information. Expressive disorders can be due to head trauma or other medical conditions or can be associated with developmental disorders such as Down’s syndrome and hearing loss.
• Cognitive communication disorders: The patient faces difficulties in communication skills that involve the use of memory, attention, perception, organization, regulation, and problem-solving. This is caused by trauma to the part of the brain that regulates the ability to think which can be due to abnormal brain development, some neurological conditions, trauma to the brain, or a stroke.

Apart from speech and language problems, SLP’s also deal with swallowing disorders which may include problems in any part of the swallowing process.

• Dysphagia/oral feeding problems: These include difficulty eating, swallowing, and drooling. The patient may gag or have other strong reactions to some types of food, or they may not feel food when it’s in their mouth and it may drop out of their mouth without them realizing it.

Speech therapy techniques 

There are many speech therapy techniques that can be used to improve communication depending on the type of speech or language disorder.

Speech therapy for children:

Speech therapy for children may be in a classroom setting, in a small group or an individual session. A speech-language pathologist will determine what kind of speech therapy the child needs according to the child’s age, disorder, and needs. The different strategies used by SLP’s include:

• Language intervention activities: These include activities such as talking and playing with the child, using books, pictures, and play-based therapy to stimulate language development. The SLP may use language drills, repetition exercises, and model correct vocabulary and grammar to build and improve the child’s language skills. 
• Articulation therapy: These include articulation and sound production exercises in which the therapist demonstrates the correct sounds and syllables for the words and sentences with which the child faces difficulty. The SLP can do this by showing the child how to move the tongue and lips to make specific sounds. This is done during play activities and is specific for the age and needs of the child.
• Oral-motor/feeding and swallowing therapy: The SLP’s use exercises that strengthen the muscles used for eating, drinking, and swallowing. These include facial massage, and several exercises involving the tongue, lip, and jaw. To increase a child’s awareness and tolerance while eating and swallowing, the therapist may introduce them to new food flavors, textures, and temperatures.

Speech therapy for adults

Speech therapy for adults also starts with the identification of the needs of the patient and the specific treatment that they will require. SLP’s help adult patients by using exercises and strategies that will help them with speech, language, and cognitive problems. They also help them with feeding or swallowing disabilities as are seen with Parkinson’s disease or oral cancer. These exercises and strategies include:

• Activities that help with problem solving, organization, memory, and other exercises that help improve cognitive function.
• Teach them and practice conversation tactics to help improve social communication skills
• Breathing exercises to help them with speech disorders such as resonance disorder
• Teach them oral exercises such as facial massage, tongue, lip and jaw exercises to improve the muscles of the mouth used for eating, drinking, and swallowing

How long does one need speech therapy

It is better to begin speech therapy as soon as possible. Starting therapy early in childhood (before 5 years of age) has shown better results than when it is started later. However, this does not mean that therapy will not prove beneficial to older kids. They might progress slower as they will have to unlearn some of the patterns that need to be changed. Some disorders of childhood improve with increasing age but others continue into adult life and need long-term therapy for improvement. Communication disorders due to medical conditions like a stroke may get better with treatment for the causative condition.

The length of time a patient requires speech therapy varies and depends on certain factors, such as:

• Age
• Type and severity of the disorder
• Frequency of therapy
• Pre-existing medical condition and its treatment

A patient’s speech therapy may last for months or even years depending on the patient’s needs. One has to remember that speech therapy is not a cure for speech or language disorder but it will only help improve the disabilities and that the underlying speech or language disorder will still exist.

Role of parents/caretakers

The success of a child’s progress in speech therapy also depends on the involvement of the parents. Children whose parents are involved in their process of speech therapy have shown to finish the program in a shorter period of time and with long-lasting results. SLP’s can involve parents and caretakers by giving them and the patient strategies to deal with problems at home. Parents can help children by practicing with them at home to improve the skills that they are learning. This ensures continuous improvement and training of new skills. The parent or caretaker must keep in mind that overcoming a speech or language problem can be difficult and requires a lot of time and effort so they must be calm and understanding with the patient.

References

1. Backus A, Beasley J. Speech therapy with children.
2. VAN DEMARK PH, Hardin MA. Effectiveness of Intensive Articulation Therapy for. Cleft Palate Journal. 1986 Jul;23(3).
3. Nelson RO, Evans IM. The combinations of learning principles and speech therapy techniques in the treatment of non-communicating children. Child Psychology & Psychiatry & Allied Disciplines. 1968.
4. Scott S, Caird FI. Speech therapy for Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry. 1983 Feb 1;46(2):140-4.