Speech-language therapy

What is speech-language therapy?

Speech-language therapy involves the evaluation and treatment of communication and swallowing disorders for adults and children.

Speech therapists assist individuals who have the following problems:

Children with speech and language delay or disorder

Children acquire speech and language gradually through interaction with people and their environment. A child with speech or language delay will still develop the usual pattern of speech or language skills, but at a slower rate compared to other children of the same age.

Children with speech or language disorders may have difficulties developing skills that follow the typical pattern. A speech impairment may present as difficulty with phonology, articulation, or dyspraxia.

These difficulties and delays may be caused by developmental delay or disorders, cerebral palsy, head injury, cleft lip/palate, hearing impairment, or Down syndrome.

Children with stuttering or stammering issues

Stuttering is a speech coordination problem where there is interruption to the fluency of speech. The flow of speech may be interrupted by the repetition of words or part of words, interjections, or involuntary silent pauses or blocks.

These speech disruptions may be accompanied by secondary behaviour, such as word substitution, eye blinking, grunting, facial contortions and other bodily movements.

Such speech impediments can interfere with a person’s communication ability and affect their quality of life.

Your child may be experiencing communication difficulties if he or she:

• Has unclear speech which the listener has difficulty understanding
• Struggles to get words out fluently
• Has difficulty following instructions
• Has difficulty learning concepts (e.g. shapes and colours)
• Has difficulty interacting with peers
• Has to repeat words or parts of words
• Gets frustrated when they are unable to communicate their wants and needs

Childhood apraxia of speech (CAS)

Childhood apraxia of speech is a speech disorder in which a child's brain has difficulty coordinating the movements needed when speaking.

Children with CAS may have:

• Late onset of first words and sounds
• Difficulty getting their mouths to the correct positions to make a sound
• Language problems such as reduced vocabulary, and errors with word order and sounds

If CAS is diagnosed, treatment often involves teaching children to practice the correct way to say sounds, words and phrases with the help of a speech therapist.

Adults with acquired communication disorders

Communication difficulties may arise from a range of conditions, such as:

• Stroke
• Acquired brain injury
• Brain tumour
• Neurological diseases such as Parkinson’s disease, muscular dystrophy, motor neuron disease, Alzheimer’s and dementia

Communication impairments in the adult population include:

Language difficulties (aphasia/dysphasia)

Adults with language impairment face difficulty understanding what others are saying to them or finding the right words to express their needs, thoughts and feelings.

They may also experience difficulties with reading or writing.

Speech difficulties (dysarthria/dyspraxia)

A speech disorder is an impairment in the articulation or coordination of speech sounds. This may result in unclear or slurred speech.

People with voice disorders

Voice disorders develop from the overuse or misuse of the voice, changes during puberty, paresis of the vocal cords or other medical conditions.

Patients with voice problems may present with a hoarse or rough/breathy/raspy voice, a chronically dry and scratchy throat, an inability to control loudness or experience periods of voice loss.

Types of voice disorders include:

• Vocal cord nodules and polyps, which are growths on the vocal cords
• Vocal fold paralysis or paresis, the total or partial disruption of nerve impulses to the larynx (voice box) muscles
• Muscle tension dysphonia, when the quality of your voice changes as a result of tightness in the muscles around the larynx
• Spasmodic dysphonia, involuntary spasms in the muscles of the larynx
• Puberphonia, the persistence of a high-pitched voice beyond puberty

People with swallowing difficulties (dysphagia)

People with dysphagia have difficulty moving food or liquid safely from the mouth to the stomach. This makes it hard for them to consume enough calories and fluids to stay healthy and maintain an ideal weight.

Dysphagia can lead to many serious medical conditions such as malnutrition, dehydration and aspiration pneumonia.

Swallowing difficulties may be a result of:

• Damage to the nervous system due to stroke
• Brain injury, spinal cord injury
• Cerebral palsy
• Progressive neurological diseases such as Parkinson’s disease, amyotrophic lateral sclerosis, multiple sclerosis, and Alzheimer’s disease
• A cleft lip or cleft palate
• Cancer in the mouth, throat or oesophagus
• Injury or surgery involving the head and neck

Signs and symptoms of dysphagia include:

• Dribbling of saliva, food or liquid
• Difficulty chewing food
• Food remaining in the mouth after swallowing
• The sensation of food stuck in the throat
• Gurgling or wet sounding voice after swallowing
• Coughing or choking during or after eating and drinking
• Unexplained weight loss or dehydration
• Frequent chest infections

What can you expect in speech-language therapy?

Speech-language therapy consists of 2 components:

Assessment

An ENT specialist or speech therapist (also known as a speech pathologist) will need to conduct an objective assessment of the patient.

They may use methods such as:

• A fiberoptic endoscopic evaluation of swallowing (FEES)
• Video fluoroscopy (VFS/VFSS), also known as modified barium swallow
• Swallowing and communication assessment

Therapy

After an assessment of the patient has been completed, a treatment plan is customised to meet the needs of the patient and his or her family.

Services provided by our speech therapy team include:

• Management of patients with a tracheostomy (the practice and use of speaking valves)
• Vitalstim® therapy (electrical stimulation for swallowing)
• Swallowing therapy
• Caregiver training
• Home therapy