Speech Language Pathology

Speech language pathology focuses on three major areas:

Dysphagia or Difficulty Swallowing

  • After an injury to the brain (stroke, traumatic brain injury) or as a neurological disease such as Parkinson’s disease or Multiple Sclerosis progresses, individuals can have difficulty with swallowing food or liquid.  The person may begin to cough when eating and experience the sensation of food going down the wrong tube or may have the sensation that food is stuck in their throat and just won’t go down.
  • Difficulty with swallowing can be seen at one or more than one of the following steps:
    • Chewing and controlling the food in the mouth, and moving it back in your mouth.
    • Triggering the swallow, and obtaining airway protection
    • Food entering the esophagus
  • Therapy may consist of doing a variety of oral motor exercises to increase the strength and coordination of the muscles involved in the swallowing process.  A videofluroscopy (moving x-ray) of the swallow may be performed to obtain an objective view of what is occurring in the mouth and the esophagus that is contributing to the difficulty.

Speech and Language

  • This area consists of both expressive and receptive communication
  • Expressive communication refers to:
    • The ability to make individual speech sounds and the ability to get words out to communicate with others.
      • If appropriate the individual may be evaluated and trained for the use of an augmentative or assistive communication device.
    • Identifying if the words that are being spoken are accurate and correct and if listeners can understand what the speaker is saying.
    • The quality of an individual’s voice; ensuring that the speaker is using the appropriate volume and pitch.  Speech therapy also addresses a variety of other vocal disorders.
  • Receptive communication refers to :
    • An individual’s understanding of what is being said to them during a conversation.
    • The ability to follow directions (written and spoken directions) and answer questions.

Cognition

  • Cognition focuses on the following areas:
    • Comprehension: does the individual understand what is being said to them, can the individual follow directions, complete tasks independently, answer questions?
    • Problem Solving/Home Management: this includes identifying and solving functional problems that relate to safety at home and with activities of daily living, sequencing items involved in completing a task.  It also includes money management tasks such as writing out checks and balancing a check book.
    • Higher Functional/Executive Functioning: this includes deductive reasoning tasks, working on the use of a daily planner, and a variety of attention activities.
    • Memory: this area may focus on improving orientation to time and place and working to improve both auditory and visual memory skills.  Speech therapy can aid in implementing different compensatory strategies such as a memory book to aid in recalling events of the day and personal and emergency information.  Therapy can also help in developing techniques for individuals with early stages of dementia.