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Let’s talk about speech therapy

Created date

April 24th, 2012

When you hear speech therapist, what comes to mind? Most people know what a speech therapist is, but many are not aware of the scope of services we provide, says Michelle Vitelli, M.S., C.C.C.-S.L.P., a speech-language pathologist and peer team leader for speech therapy at Living. Along with speech, we also deal with voice quality and vocal loudness, swallowing, language, and cognitive problems. The preferred title for these professionals is speech-language pathologist (SLP), which better describes their scope of practice. There are over 120,000 SLPs working in the U.S., according to the American Speech-Language-Hearing Association (ASHA). SLPs have a minimum of a master s degree and take a national exam to obtain a certificate of clinical competence, says Mary Wagner, corporate director of rehabilitation services for Erickson Living. Each is licensed by their respective state. SLPs have a thorough knowledge of oral motor anatomy and physiology, neurology, and hearing science, Wagner continues. They also have the most effective evaluation and treatment tools available and know how to use the most current approaches to therapy. There are problems that people may need help with, but because they aren t aware of what we do, they may not discuss certain areas of concern with their doctor, Vitelli says. Someone might think that minor swallowing difficulties or cognitive issues may be due to aging and can t be helped.

Helping you communicate better

According to ASHA, about one million people in the U.S. have aphasia (a partial or total inability to understand or express language). The most common cause of aphasia is stroke, says Leslie Rigali, D.O., medical director for, an Erickson Living community in Peabody, Mass. SLP s can teach people with aphasia how to improve expressive language skills by working on tasks such as naming objects or teaching them how to put sentences together, Vitelli explains. We also may work on receptive language skills understanding information that you hear. SLPs can help anyone who has speech problems, not just stroke patients. Neurological problems such as Parkinson s disease can affect speech, Rigali says. People with cognitive problems, hearing difficulties, or who have had surgery on their mouth or throat may also need an SLP s services. What an SLP can do for you depends upon the severity of the problem, and how much you are able to participate in therapy. SLPs are skilled in working with people with all levels of disability and can also help your family and friends communicate with you better. Along with teaching better speaking skills, SLPs assist people in improving reading and writing skills and teach the proper use of assistive devices or systems that can help you interact with others.

The sound of your voice

SLPs can work with you if your speaking voice has been affected by surgery or another medical problem. The biggest voice problem with older adults is the inability to speak loudly enough, Vitelli says. This is a particular problem in loud environments or when talking on the phone. To help your vocal volume, SLPs work with your breathing and vocal system. Some therapists are certified in the Lee Silverman Voice Treatment program, Vitelli explains. This involves a series of voice exercises to help enhance the sound of your voice. It s especially helpful for people with Parkinson s disease.

The swallowing experts

Being unable to swallow correctly not only interferes with your nutrition but also puts you at risk for developing pneumonia because food and liquids can get into your airway, Rigali says. Strokes and practically any neurological condition can interfere with your swallowing ability, Vitelli says. Cognitive problems can also contribute, as can rare conditions such as severe osteoarthritis of the neck, Rigali adds. SLPs teach swallowing techniques, such as head and body positioning, Vitelli says. We also recommend food textures and eating strategies that may facilitate better swallowing. If it s necessary for you to have a swallowing test, an SLP will be there to observe and make recommendations.

Working with cognitive problems

Your cognitive functioning is your thinking ability, Vitelli explains. People with cognitive problems may have trouble with memory, attention, reasoning, or safety awareness. A little-known fact is that SLPs are experts at helping people with cognitive problems. We perform memory screenings to help detect deficits before they affect someone s functioning, Vitelli says. We look at short- and long-term memory, and problem-solving ability. We evaluate your ability to do day-to-day tasks and see what skills you can work on, such as balancing your checkbook or keeping track of your medications, Vitelli adds. Helping you improve your thinking skills may mean you can stay independent longer.

Working with your therapist

Some people have trouble dealing with the changes in their lives that come with speech, voice, swallowing, or cognitive problems. This can be a hindrance in therapy. You have to acknowledge that a problem exists in order to be open to solutions, Vitelli says. Give your therapy a chance, Vitelli continues. Different techniques work for different people, and it s not easy to learn a new way of doing things. Keep in mind that even small changes can help you become more independent.

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