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speech therapy

Alternative Names 
speech/language pathology

Definition
Speech therapy is a service provided by a health care professional that helps a person improve his or her ability to communicate. This includes both speech, which is how sounds are made, and language, which involves understanding and choosing the correct words to use.

What is the information for this topic? 
Who provides speech therapy?

Speech therapy services are provided by a speech therapist, also known as a speech and language pathologist. A speech therapist has a university degree. A speech therapist may specialise in certain kinds of problems, so it is important to choose a speech therapist carefully.

What kinds of patients and problems does speech therapy treat?

There are four kinds of problems that speech therapy can treat.
  • speech
  • language
  • cognition, or thinking skills
  • swallowing
A person with speech problems has difficulty producing sounds so that others can understand him or her. Examples of speech problems include stuttering, a lisp, garbled speech after a stroke, or loss of the voice box, or larynx, after a laryngectomy.

Language is the use of symbols, such as words, numbers, or gestures, that have meaning. A person may have trouble understanding or accurately choosing words or numbers or gestures.

The third kind of problem is cognition, or thinking skills. In order to communicate accurately with others, a person must be able to pay attention, concentrate, and use various thinking skills. In order to treat certain language problems, the speech therapist may need to work on these thinking skills.

The fourth kind of problem is swallowing difficulties. A person may have difficulty controlling the tongue and safely swallowing food or liquid. The muscles in the tongue and throat are the same ones used in making sounds. Therefore, the therapy that helps speech can also help swallowing. A person may have swallowing problems if there is an injury or illness that affects the nerves or muscles in the mouth and throat. Swallowing problems can also happen if there has been surgery to remove parts of the mouth or throat.

What are the goals of speech therapy?

The main goal of speech therapy is to restore the ability to communicate accurately. This can be through talking, reading, or writing. It may mean correctly using numbers as well as words. It may mean using and understanding gestures.

Specific goals must be identified for each person. These goals will depend on which of the four kinds of problems need to be improved. Some typical goals include improving:
  • the clarity of speech
  • the ability to understand simple sentences
  • the ability to pay attention
  • the ability to chew and swallow solid foods

What are the treatments given in speech therapy?

The specific treatment depends on the exact problems that need to be improved. First, a speech therapist needs to do a thorough examination. This is necessary to accurately identify the problem and what may be causing it, and to determine the best approach to treatment.

Speech problems may be treated with exercises to strengthen mouth and throat muscles. Or treatment may involve practicing making different sounds. A person may also need to learn to use devices to make sounds. For example, a person may need to hold an artificial larynx up to the throat to create sounds after a laryngectomy. Or a person may use a computer that has been programmed to say words on command.

Language problems may be treated with exercises that help retrain the brain to understand words, numbers, or gestures. An individual can also be trained to use other ways to communicate. For example, if someone has trouble understanding written words, it may be useful to use a communication board.

Cognitive, or thinking, problems are treated with specially designed activities to retrain the brain. Teaching ways to compensate for problems is important. For example, if a person cannot learn to concentrate when it is noisy, that person learns to create a quiet place when it is time to balance a cheque book. If a person forgets names of people, a small book of photographs with names written on the pictures can be carried in a pocket.

Swallowing problems are treated in several ways. Exercises may improve control of mouth and throat muscles. Carefully holding the head in a certain position while chewing and swallowing may help. Eating and drinking foods and liquids of a certain thickness may be needed. For example, water may be hard to control in the mouth, but a thick milk shake is easier to control.

Does Medical Insurance cover speech therapy?

Speech therapy can be given in a hospital, a rehabilitation facility, public school, private agency, an outpatient clinic, or at home. Insurance policies may have limits on where speech therapy will be covered. There are often limitations on how much speech therapy will be covered. A doctor's referral is usually needed to get insurance coverage.

Author: Karen Preston, PHN, MS, CRRN
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 15/02/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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