The field of speech therapy specializes in the treatment of disorders of speech communication in speech and comprehension, as well as swallowing disorders. Within this framework, speech-language pathologists attend to the prevention, treatment, practice, and development of primary oral functions (sucking, swallowing, and chewing) in the interplay between the ear, voice, speech, and comprehension.
What is speech therapy?
The field of speech therapy specializes in the treatment of disorders of speech communication in speech and comprehension, as well as swallowing disorders. Speech therapy (from the Greek logo/ speech and paideia/ education) focuses on receptive language, the ability to receive and understand spoken words, and expressive language, the ability to use words to express oneself. Similarly, speech therapy addresses the mechanics of shaping words, such as articulation, pitch, or volume. Adults will seek speech therapy after a stroke or traumatic accident that claims their ability to express themselves through language. When treating children, speech therapy generally aims more to compensate for developmental language difficulties or delays. The job description of a speech-language pathology specialist therefore includes many exercises to strengthen the tongue and lips. Developmental games for word finding or word comprehension can be used to stimulate language skills to the point of enabling conversation.
Treatments and therapies
The speech-language pathology specialty primarily serves individuals whose swallowing, cognitive-linguistic skills, or language skills have been affected or impeded by a neurological event, disease, debilitation, or possibly related to an underlying serious medical condition. This includes individuals with:
- Difficulty with articulation (e.g., stuttering, lisping).
- Voice problems, such as inappropriate volume or a raspy voice, for example, as a result of voice abuse or related to cancer
- Cognitive-communicative impairments in the flow of speech as a result of impaired ability to concentrate, memory, or ability to think abstractly and problem-solve due to stroke, brain injury, or underlying disease processes
- Aphasia or movement disorders
- Oropharyngeal weakness
The treatment spectrum of speech therapy offers a wide range of services, mainly on an individual basis, but also as support families or groups. As a rule, an individual treatment plan, tailored to the needs of the individual patient. At the same time, treatment approaches have an educational nature to enable the patient to fully participate in speech communication through community education. Patients with cleft lip and palate or patients in a persistent vegetative state (tracheal cannula management) are also cared for within the scope of speech therapy. The treatment field of speech therapy equally extends to patients suffering from injuries due to birth or feeding complications, genetic disorders that negatively affect speech and language, ADHD, autism, hearing loss, Alzheimer’s disease, dementia, or multiple sclerosis.
Diagnosis and examination methods
In speech-language pathology, physical examinations, technical instruments, and standardized cognitive-linguistic language tests are used to diagnose and assess speech fluency, language, cognition, and swallowing, in addition to nonformal assessments based on experience. Formal standardized tests are used in speech therapy to measure abilities relative to peers (language screening procedures) or the effects of brain damage, e.g., as a result of a stroke. In the so-called Aachen Aphasia Test (AAT), linguistic levels are assessed mainly by behavior during spontaneous speech and are supplemented by tests in re-talking, reading and writing or in language comprehension. Other test procedures are the Heidelberg Language Development Test, the Psycholinguistic Development Test, tests for grammar comprehension or various intelligence tests.If no findings are available from previous examinations by appropriate specialists, the speech therapy diagnostic procedure includes a hearing examination and, in more difficult cases, a phoniatric-pediatric examination. Instrumental tests, such as the use of a nasometer, check for physiological or anatomical impairments. Here, speech therapy brings to bear examination procedures such as imaging swallowing diagnostics via X-ray examinations to a fiberendoscopic analysis of the swallowing process. Modern technology enables fine diagnostic examinations, which include procedures such as voice range profiling, voice field measurement or signal analysis. The Göttingen Hoarseness Diagram can be used to accurately determine vocal sound. Motor tests in speech therapy check strength, coordination, range of motion, symmetry and speed of the cranial nerves. In the case of complex disorders of speech development or Landau-Kleffner syndrome, speech therapy uses a sleep EEG.
