Speech-Language Pathology
Speech-Language Pathologists (SLPs or speech therapists), accredited by the American Speech-Language-Hearing Association (ASHA), work in various domains from speech sound disorders to feeding or swallowing disorders, to stroke/traumatic brain injury patients. SLPs may work closely with other professionals including teachers, occupational therapists, physical therapists, physicians, nurses, audiologists, psychologists, nutritionists, and other healthcare professionals. Clinicians often work in schools, private practice clinics, hospitals, acute care, inpatient or outpatient care, rehabilitation facilities, or nursing homes. When working with your loved one, a clinician may work on improving his or her memory and cognition, expressive or receptive language skills, articulation or phonological skills, motor speech function, motor speech programming, stutter, or feeding or swallowing deficits.
What domains do SLPs work with?
You may wonder what speech-language pathologists (SLPs) do and how an SLP can assist your loved one. Here is a breakdown of what an SLP does and what areas one may work with. The following domains are some of the many areas we work with. We are not limited to these areas; however, these are mainly focused on the adult population.
01
Expressive and Receptive Language
Expressive Language: Expressive language consists of skills to communicate one's ideas, communicate dangerous situations, seek help in emergency situations, and engage in social interactions, using gestures, sign language, or words.
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Receptive Language: Receptive language skills are comprised of language that is understood or comprehended such as understanding questions, following directions, recognizing items or pictures, and pointing or looking at named objects or people.
02
Augmentative and Alternative Communication
AAC is a form of communication using a low-tech communication device such as picture icons like a picture exchange communication system (PECS), a communication board with icons and functional nouns, verbs, and items, and a technological device that has digital communication boards that may elicit verbal output for each icon to communicate with others. Some children and adults who are non-speaking or have low verbal output may qualify for an AAC device that is appropriate for that individual. AAC devices can promote verbal speech by providing visual and verbal modeling to communicate and can support them while they are practicing to use their voice! SLPs are one of the professionals who may work with your loved one to test if he or she qualifies for a device!
03
Articulation and Phonology
Articulation Disorder: focuses on errors (e.g., distortions and substitutions) in the production of individual speech sounds.
Phonological Disorder: focuses on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound.
It is often difficult to clearly differentiate between articulation and phonological disorders; therefore, many researchers and clinicians prefer to use the broader term, "speech sound disorder," when referring to speech errors of unknown cause.
04
Apraxia of Speech
Apraxia is a motor speech disorder that consists of deficits in motor speech planning or programming.
Three salient features have gained some consensus among investigators in apraxia:
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Inconsistent errors on consonants and vowels in repeated productions of syllables or words
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Lengthened and disrupted co-articulatory transitions between sounds and syllables
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Inappropriate prosody, especially in the realization of lexical or phrasal stress
05
Feeding and Swallowing
Feeding: impacted by difficulty suckling, sucking, latching, spoon feeding, munching, or chewing. Feeding can be caused by conditions such as cerebral palsy, acid reflux, heart disease, cleft lip or cleft palate, asthma, muscle weakness, autism spectrum disorder, sensory issues, or behavioral issues.
Some factors that impact feeding are consistent feeding schedules, eating at the dinner table, and selective or picky eating.
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Swallowing: children and adults may be impacted by swallowing disorders which can greatly impact his or her quality of life. Here are the 3 phases of swallowing:
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Oral phase—sucking, chewing, and moving food or liquid into the throat. Feeding is a part of the oral phase.
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Pharyngeal phase—starting the swallow and squeezing food down the throat. The body needs to close off their airway to keep food or liquid out. Food going into the airway can cause coughing and choking.
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Esophageal phase—opening and closing the esophagus (the tube that goes from the mouth to the stomach). The esophagus squeezes food down to the stomach. Food can get stuck in the esophagus. Or one may throw up a lot if there is a problem with the esophagus.
06
Dysphagia
Swallowing disorder involving the oral cavity, pharynx, esophagus, or gastroesophageal junction. Adults with dysphagia may also experience disinterest, reduced enjoyment, embarrassment, and/or isolation related to eating or drinking.
07
Aphasia
Aphasia is a language disorder that impacts expressive and receptive communication. It can impact comprehension, reading, and writing skills. Aphasia is commonly caused by damages to the language centers of the brain, located on the left side of the brain.
Some causes: stroke, dementia, neurological disorders
08
Fluency
Fluency disorders occur when there is an interruption in the flow of speaking. Some examples are atypical rate, rhythm, and disfluencies (e.g., repetitions of sounds, syllables, words, and phrases, sound prolongations, and blocks). In addition, the individual may display excessive tension, speaking avoidance, struggle behaviors, and secondary behaviors. Psychological, emotional, social, and functional aspects of life may also be negatively impacted due to the communication disorder.
Types of fluency disorders:
- Stuttering is the most common fluency disorder and is an interruption in the flow of speaking.
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​Cluttering consists of a rapid or irregular speech rate, atypical pauses, pragmatic issues, maze behaviors, decreased awareness, excessive disfluencies, collapsing or omitting syllables, and language formation issues.
09
Dysarthria
Dysarthria is a motor speech disorder that consists of deficits in the execution of speech due to weakness of the muscles. Examples of motor speech execution are flaccid, spastic, ataxic, hyperkinetic, hypokinetic, and mixed dysarthrias. Motor speech disorders may result from conditions such as cerebral palsy, multiple sclerosis, muscular dystrophy, myasthenia gravis, Parkinson’s disease, dementia, stroke, or traumatic brain injury.
10
Voice
Voice Disorders: occur when voice quality, pitch, and loudness differ or are inappropriate for an individual’s age, gender, cultural background, or geographic location. A voice disorder is present when an individual expresses concern about having an abnormal voice that does not meet daily needs—even if others do not perceive it as different or deviant.
11
Memory and Cognition
Cognitive communication disorders are the difficulty with any aspect of communication that is affected by the disruption of cognition.
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Some examples of cognitive processes include attention, memory, organization, problem-solving/reasoning, and executive functions. Problems in these areas can affect verbal and nonverbal communication.
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For instance, speaking, listening, reading, writing, and pragmatic (social interaction) skills may be affected negatively. Deficits in cognition can affect activities of daily living, and academic and work performance.