Speech Therapy

Child speech and language problems are identified and treated by a speech-language pathologist.  The speech-language pathologist (SLP) determines the child's ability to understand and communicate through formal testing, parent interview and skilled observation in different environments.  A child with a language disorder or delay may have trouble understanding what they hear, see, or experience.  He/she may have difficulty expressing their needs, wants, feelings effectively.  If left untreated, language problems may affect the child's school performance, confidence, and behavior.
Children with articulation or "phonological" disorders do not produce their speech sounds appropriately.  They may omit sounds or substitute one sound for another.  Their speech may sound distorted when they speak and you will notice that their speech is not as clear as others their age.  Like language problems, articulation disorders may affect a child's self-confidence as well as their school performance, specifically their ability to read and spell.

Stuttering is a communication disorder that affects the fluency of speech.  It is characterized by repetitions of single sounds, syllables or whole words ("I-I-I need to see the doc-doc-doctor.").  Some individuals who stutter experience hesitations or blocking - in which no sound comes out - or they prolong words within sentences ("I neeeeeeeed to see the doctor.").  Others have difficulty eliminating "filler words" such as "um" or "like" from connected speech.           

The cause of stuttering remains to be determined.  Some researchers believe that there is a genetic predisposition toward stuttering.  Some stuttering, especially around 18-24 months of age in early development - is considered "normal."  If the child becomes aware and self-conscious of their own stuttering, if they develop negative feelings about talking, or if their stuttering worsens or becomes more consistent, parents should talk to their physicians about obtaining a speech therapy order.  Early childhood is a good time to address stuttering, before behaviors become habitual.

Older adolescents and adults who stutter sometimes seek therapy to gain better control of stuttering moments.  The SLP may provide counseling and treatment to reduce the frequency of stuttering moments through changing the timing and tension of speech.  Treatment may also focus on changing the patient's negative attitudes and fears towards speech, avoidance issues, and helping the patient become more confident in themself and their speaking ability.

Voice disorders can occur at all ages and for a variety of reasons.  A person with a voice disorder may experience chronic hoarseness or difficulty changing their pitch or volume.  They may experience a tremor in their voice or get easily fatigued when talking, singing, or working.  Voice disorders can also cause an achy or "lump in the throat" sensation in the voice box.  A child or adult may experience a voice disorder as a result of trauma, head/neck cancer, overuse, or misuse of the vocal mechanism.  Voice disorders may also result from stroke or brain injury.  Many neurological conditions such as Parkinson's disease and multiple sclerosis affect voice production as well.  Vocal change can even occur from acid reflux disease or nodules growing on the vocal cords.  All of the above can be treated by a team of medical professionals - often including the ENT (ear, nose, and throat physician) and a speech-language pathologist.  Our goal, of course, is to restore a more comfortable, functional, and "normal" sounding voice.

Swallowing is as necessary to your life as breathing.  We depend on swallowing in order to get the nutrients we need to live.  If the ability to swallow becomes impaired, it can lead to malnutrition, dehydration, poor oral secretion management, and/or development of pneumonia.  "Dysphagia" is the term we use to refer to swallowing disorders.

Speech pathologists are specifically trained to evaluate feeding and swallowing.  We use information obtained during assessment to plan appropriate treatments.  Although we are often the professionals that take the "lead role" in dysphagia management, many medical specialists and other health care professionals may work together to evaluate and/or treat feeding and swallowing problems.  Our goal is to maintain safe swallowing.  Often times, we are able to do that with therapy alone; however, we sometimes have to make diet modifications to ensure safety.

Swallowing disorders in children accompany many different diagnoses, such as nervous system disorders (cerebral palsy, Down Syndrome), gastrointestinal issues, prematurity/low birth weight, or cleft lip/palate.

Swallowing disorders in adults are often the result of stroke, brain injury, spinal cord injury, degenerative neurological diseases (Parkinson's, ALS, Alzheimer's), cerebral palsy, and muscular dystrophy.  Swallowing disorders may also occur following injury to the head/neck/throat, due to cancer of the mouth/throat/esophagus, or any surgery involving the head and neck.  Oral difficulties can result from poor dentition, oral surgery, and/or poorly fitting dentures.

Cognitive impairment is a broad term that refers to difficulty with brain functions including attention, memory, orientation, problem solving, safety awareness, and executive functioning.  Cognitive impairment is most common following a stroke or traumatic brain injury (injury resulting from trauma to the head), but can also occur as a result of neurological disease processes such as Parkinson's disease, multiple sclerosis, ALS, or Alzheimer's disease. The loss of cognitive functions may cause difficulty in being able to care for yourself, care for others, return to work, pay the bills, or administer/manage medications safely.  Cognitive rehabilitation focuses on restoring independence and safety in natural environments.  It also serves to offer coping strategies so patients can return to work and other daily functions with minimal restrictions.

In addition to cognitive impairment, there are several other specific disorders that may result following a stroke.  Aphasia is a language impairment that often occurs after a stroke.  Aphasia can affect a patient's ability to either understand or express himself.  Patients may be able to produce long strings of words, but the words are meaningless, OR they may have good understanding of everything they hear, but be unable to produce a single word.  There are many different types of aphasia and it is the Speech-Language Pathologist's job to evaluate and plan treatment appropriate to the patient's needs.

Dysarthria is another disorder that often results after a stroke.  Dysarthria can affect a patient's ability to coordinate respiration with speaking.  Patients may complain of being easily "winded" or losing their breath when they talk.  Speech may sound nasal, as if patients are talking through their nose.  Patients may not be able to coordinate their mouth and tongue movements to make clear speech sounds, causing "slurred speech."  Dysarthria, like aphasia, can present differently in every patient and it is the speech-language pathologist who evaluates the patient and develops the treatment plan that will best benefit the patient.

For more information about the hospital's speech therapy services, which are available for children and adults of all ages on both an inpatient and outpatient basis, call Laurel Jones or Lori Windle at 615-3020. For an appointment, see your personal physician; all therapy provided through the OCH Rehab Services Department requires physician referral.