Speech Pathology Information

Speech and language pathology specialize in Speech disorders and Language disorders.

The main components of speech production include: phonation, the process of sound production; resonance, opening and closing of the vocal folds; intonation, the variation of pitch; and voice, including aeromechanical components of respiration.

The main components of language include: phonology, the manipulation of sound according to the rules of the language; morphology, the understanding and use of the minimal units of meaning; syntax, the grammar or principles and rules for constructing sentences in language; semantics, the interpretation of meaning from the signs or symbols of communication; and pragmatics the social aspects of communication.^[1]

National approaches speech and language pathology

Speech and Language pathology is known by a variety of names in various countries around the world:

• Speech-language pathology (SLP) in the United States and Canada
• Speech and language therapy (SLTs) in the United Kingdom, Ireland and South Africa. Within the United Kingdom a Speech and Language Therapy team is often referred to by clinicians as the "SALT" team.
• Speech pathology in Australia and the Philippines
• Speech-language therapy in New Zealand
• Speech therapy in India, Hong Kong and other Asian countries.

Speech and Language Pathology is also known as logopaedics and phoniatrics.

Prior to 2006, speech and language pathology in the United States was regulated by the individual states. Since January 2006, the 2005 "Standards and Implementation Procedures for the Certificate of Clinical Competence in Speech-Language Pathology" guidelines as set out by The American Speech-Language-Hearing Association (ASHA) have determined the qualification requirements to obtain "Speech-Language Pathology Clinical Fellowship". First, the individual must obtain an undergraduate degree, preferably in a field related to speech-language-hearing sciences. Second, the individual must graduate from an accredited master's program in speech language pathology. Many graduate programs will allow coursework not done in undergraduate years to be completed during graduate study. Various states have different regulations regarding licensure. The Certificate of Clinical Competence (CCC) is granted after the clinical fellowship year (CFY) when the individual provides services under the supervision of an experienced SLP. After a Certificate of Clinical Competence in Speech-Language Pathology is acquired, there is a mandatory 3 year "maintenance" or renewal required to demonstrate continued professional development.^[2] Post graduate work for a speech pathologist will include both academic study and practical work supervised by a practicing speech and language pathologist. A Ph.D. in speech language pathology is currently optional for clinicians wishing to serve the public.

In the United States, the cost of speech therapy for children ages birth-three years old is usually covered by a state early- intervention program.

The speech and language pathology vocation

Speech and language pathologists provide a wide range of services, mainly on an individual basis, but also as support for individuals families, support groups, and providing information for the general public. Speech services begin with initial screening for communication and swallowing disorders and continue with assessment and diagnosis, consultation for the provision of advice regarding management, intervention and treatment, and provision counselling and other follow up services for these disorders.

• cognitive aspects of communication (e.g., attention, memory, problem solving, executive functions).
• speech (i.e., phonation, articulation, fluency, resonance, and voice including aeromechanical components of respiration);
• language (i.e., phonology, morphology, syntax, semantics, and pragmatic/social aspects of communication) including comprehension and expression in oral, written, graphic, and manual modalities; language processing; preliteracy and language-based literacy skills, phonological awareness.
• swallowing or other upper aerodigestive functions such as infant feeding and aeromechanical events (evaluation of esophageal function is for the purpose of referral to medical professionals);
• sensory awareness related to communication, swallowing, or other upper aerodigestive functions.

Multi-discipline collaboration

Speech-language pathologists collaborate with other health care professionals often working as part of a multidisciplinary team, providing referrals to audiologists and other medical consultants; providing information to health care professionals (including doctors, nurses, occupational therapist, and dietitians), educators, and parents as dictated by the individual client's needs.

In relation to Auditory Processing Disorders^[3] collaborating in the assessment and providing intervention where there is evidence of speech, language, and/or other cognitive-communication disorders.

Administration

Speech-language pathologists act as case managers and service delivery coordinators; as well as managing clinical and academic programs.

Healthcare

• Promote healthy lifestyle practices for the prevention of communication, hearing, swallowing, or other upper aerodigestive disorders.
• Recognizing the need to provide and appropriately accommodate diagnostic and treatment services to individuals from diverse cultural backgrounds and adjust treatment and assessment services accordingly.
• Advocating for individuals through community awareness, education, and training programs to promote and facilitate access to full participation in communication, including the elimination of societal barriers.

Research

• Conduct research related to communication sciences and disorders, swallowing disorders, or other upper aerodigestive functions.

Training

• Educate, supervise, and mentor future speech-language pathologists.
• Educate and provide in-service training to families, caregivers, and other professionals.
• Train, supervise, and manage speech-language pathology assistants and other support personnel.
• Educating and counseling individuals, families, co-workers, educators, and other persons in the community regarding acceptance, adaptation, and decisions about communication and swallowing.

Working environments

Speech and language pathologists can work in a wide range of settings. The clinical environments both public and private hospitals. As part of the support structure in the education system working in both public and private schools, colleges, and universities. And some community support services in community health and day centers, and the judicial and penal services such as courts, prisons, and young offenders' institutions.^[4]

Subsequent to ASHA's 2005 approval of the delivery of speech-language pathology via video conference, or telepractice,^[5] SLPs have begun delivering services via this service delivery method.

Methods of assessment

There are separate standardized assessment tools administered for infants, school-aged children, adolescents and adults. Assessments primarily examine the form, content, understanding and use of language, as well as articulation, and phonology.

Swallowing assessments often require specialized training. These include formal assessments of Fiberoptic Endoscopic Evaluation of Swallowing (FEES) or Modified Barium Swallow Study (MBS). Informal oral motor assessments review the strength, co-ordination, range of movement, symmetry and speed of cranial nerves V, VII, IX, X and XII. The Australian National Guidelines for Stroke Management state that the presence or absence of a gag reflex in an oro-motor examination is not sufficient evidence to determine if someone has a swallowing disorder.

Individuals may be referred to a speech pathologist for Augmentative Alternative Communication needs.

There are myriad Speech and Language Assessment tools used for children and adults, depending on the area of need.

Clients and patients requiring speech and language pathology services

Speech and language pathologists work with clients and patients who can present a wide range of issues.

Infants and children

• Infants with injuries due to complications at birth, feeding and swallowing difficulties, including dysphagia
• Children with mild, moderate or severe:
  • Genetic disorders that adversely affect speech, language and/or cognitive development including autism and social interaction difficulties including Asperger's, cleft palate
  • Developmental delay
  • Cranial nerve damage
  • Craniofacial anomalies that adversely affect speech, language and/or cognitive development
  • Language delay
  • Specific difficulties in producing sounds (including vocalic /r/ and lisps)
    • some infants with injuries due to paralysis of brain.

Children and adults

• Cerebral Palsy
• Head Injury (Traumatic brain injury)
• Hearing Loss and Impairments
• Learning Difficulties including Dyslexia, Specific Language Impairment (SLI), Auditory Processing Disorder
• Physical Disabilities
• Speech Disorders
• Stammering, Stuttering (dysfluency)
• Stroke
• Voice Disorders (dysphonia)
• Language disorders (dysphasia)
• Motor speech disorders (dysarthria or dyspraxia)
• Naming difficulties (anomia)
• Cognitive communication disorders
• Pragmatics
• Laryngectomies
• Tracheostomies
• Oncology (Ear, nose or throat cancer)

Adults

• Adults with mild, moderate, or severe eating, feeding and swallowing difficulties, including dysphagia
• Adults with mild, moderate, or severe language difficulties as a result of:
  • Progressive neurological conditions (Alzheimer's disease, dementia, Huntington's disease, Multiple Sclerosis, Motor Neuron Diseases, Parkinson's disease, etc.)
  • cancer of the head, neck and throat (including laryngectomy)
  • mental health issues
  • transgender voice therapy (usually for male-to-female individuals)

See also

• Applied linguistics
• Auditory Processing Disorder
• Augmentative and alternative communication
• Esophageal speech
• Language delay
• List of university speech-language pathology departments
• List of voice disorders
• Motor theory of speech perception
• Neurolinguistics
• Oral myology
• Phonation
• Specific language impairment
• Speech and language pathology in school settings
• Speech perception
• Speech processing
• Speech repetition

References

1. ^ Block, Frances K.; Amie Amiot, Cheryl Deconde Johnson; Gina E. Nimmo; Peggy G. Von Almen; Deborah W. White; and Sara Hodge Zeno (1993), "Definitions of Communication Disorders and Variations", Ad Hoc Committee on Service Delivery in the Schools, ASHA, doi:10.1044/policy.RP1993-00208, http://www.asha.org/docs/html/RP1993-00208.html, retrieved 2010-08-07
2. ^ "2005 SLP Standards". 2005 Standards and Implementation Procedures for the Certificate of Clinical Competence in Speech-Language Pathology. http://www.asha.org/certification/slp_standards.htm.
3. ^ DeBonis DA, Moncrieff D (February 2008). "Auditory processing disorders: an update for speech-language pathologists". Am J Speech Lang Pathol 17 (1): 4–18. doi:10.1044/1058-0360(2008/002). PMID 18230810. http://ajslp.asha.org/cgi/content/abstract/17/1/4.
4. ^ "What is speech and language therapy?". http://www.rcslt.org/speech_and_language_therapy/what_is_an_slt.
5. ^ "ASHA Telepractice Position Statement". Asha.org. http://asha.org/telepractice/. Retrieved 2010-04-15.

External links

• American Speech-Language-Hearing Association
• Canadian Association of Speech-Language Pathologists and Audiologists
• Royal College of Speech and Language Therapists. (UK)
• Irish Association of Speech & Language Therapists
• The National Student Speech Language and Hearing Association
• Association of Speech Language Pathologists Malta
• Indian Speech and Hearing Association
• South African Speech Language Hearing Association
• Speech Pathology Australia
• The Hong Kong association of Speech Therapists
• Playworks Speech Therapy (in Arlington VA)
• Fisher SE, Scharff C (April 2009). "FOXP2 as a molecular window into speech and language". Trends Genet. 25 (4): 166–77. doi:10.1016/j.tig.2009.03.002. PMID 19304338. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TCY-4VWGVG8-1&_user=10&_coverDate=04%2F30%2F2009&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=a40988a1d7dcbe434bf39246fae802af.
• Nelson HD, Nygren P, Walker M, Panoscha R (February 2006). "Screening for speech and language delay in preschool children: systematic evidence review for the US Preventive Services Task Force". Pediatrics 117 (2): e298–319. doi:10.1542/peds.2005-1467. PMID 16452337. http://pediatrics.aappublications.org/cgi/content/full/117/2/e298#R8.

Categories: Speech and language pathology | Applied linguistics | Dyslexia | Healthcare occupations | Medical terms | Rehabilitation medicine | Rehabilitation team | Special education | Vocal skills

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