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Speech Pathology

Gentry White

2013-03-25 16:18:24

Q-Can speech therapy help with autism? My 2 year old is showing some signs, though not yet formally diagnosed.

A-It is good to never get “hung up” on the diagnosis of any particular patient. Behaviors and symptoms that the child is exhibiting is what constitutes a treatment plan after the intial evaluation. Autism is a broad area and in the last 10 years has become a familiar term. There are certain language and speech milestones that a two-year-old should be meeting in his development that I would use as a guideline for whether an evaluation is warranted for your son. By two-years of age, your child should be in a language “boom” of learning from his caregivers as well as from his environment. There are two types of language forms; receptive language, which means understanding verbal and nonverbal communication and expressive language, which means his speech output and this includes gestures and signs. I will give several examples of language understanding below. Children this age should be able to follow commands within their environment such as, “please bring me your red shoes.” He should be pointing to around 5-10 parts of his body when asked. During story reading, a typical two-year-old should be able to identify familiar objects in the story (show me the cow, the house, etc.). He should demonstrate an understanding of “no” to protect him within his environment and should demonstrate an understanding of familiar songs/rhymes during play activities. There should be more awareness of social skills and your son’s receptive language should be higher at this age before his expressive language can catch up because of his physical development of his articulatory system. Expressive language is getting ready to catch up to receptive language by this point in a child’s development. By two years, your son should be utilizing two-word phrases such as, “black cat” or “dog jumps” to describe an appropriate activity. He should be utilizing gestures or signs to identify his own needs/wants within his environment. He should be naming body parts following identification when pointing to himself during activities. At this point, he may have unintelligible speech but should begin clarifying information when caregivers indicate that they do not understand what he said during communicative attempts. If you are concerned that there is difficulty with language development in his receptive or expressive language, please visit with your physician about obtaining a speech and language evaluation. It never hurts to have an evaluation to see where his skills are compared to his peers. Thank you for your inquiry.

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Speech Pathology

Gentry White

2013-03-01 14:50:21

Q-My husband had a stroke and the doctor gave him a referral for speech therapy. What can we expect in the process?

A-The rehabilitation process following a stroke largely depends on what type of stroke that your husband had. The two most common reasons behind a person having a stroke are from a thrombosis and cerebral embolism. This occurs when there has been a block in an artery in the head or the neck area and prevents blood flow to the brain. The other two are forms of hemorrhage, where the vessel bursts in the head or neck area. Subarachnoid and intracerebral hemorrhage results from a burst of an aneurysm or from trauma sustained in an accident or from excess internal pressure. The most important step in a positive recovery is immediate medical treatment when the symptoms begin their onset. Most Hospital ER’s have a stroke protocol when a patient presents to their facility with stroke-type symptoms (blurred vision, slurred speech, headache, weakness on one side of the body and/or dizziness) to assist with immediate diagnosis and prompt treatment action. After the patient is deemed medically stable in the hospital, the patient’s Primary Care Physician (PCP) will order a series of screens and/or assessments to determine what areas are affected following his stroke. A Speech Pathologist is trained to look at the patient’s ability to swallow and determine if he is at risk for choking or aspiration as well as speech and language skills. The patient’s deglutition is of primary importance to his health because it is a basis for how he is taking nutrition and hydration to swallow medications as well as eating healthy to work through the healing process. A Speech-Language Pathologist (SLP) will also look at the way the patient is communicating his wants/needs, memory and his ability to retain new information. This will allow the patient to be able to make requests and explain pain levels, in regards to how he is feeling on a particular day. Early rehabilitation will get that patient’s tolerance for new/different activity following his stroke event. He may then transfer to home care or outpatient therapy services to continue his healing process. In my particular case, the patient is seen as an outpatient in the office. Specific diagnostics are utilized during the evaluation session to determine what areas are still affecting positive communication and clear speech. After the initial evaluation visit, a plan of care is implemented to determine if the patient is ready to establish and work towards his specific goals. It is important for the patient and his family to work together for goal establishment as well as utilizing the cueing hierarchy for word-finding errors to reduce frustration with the patient. Depending on the areas of need, a specific plan of care (POC) is established to meet those goals. The POC will establish frequency of visits and length of visits based on the patient’s need. No two people have the same experiences and those two persons will rehabilitate differently in their recovery process, even with the same stroke diagnosis. It is imperative that the patient and his family be patient with communication and work with a trained SLP who can assist with the rehabilitative process that is tailored to meet his individual needs and personal background.

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Speech Pathology

Gentry White

2013-02-01 08:59:57

Q-I did not know that speech pathology was part of Parkinson's treatment. What are the recommendations for speech pathology for someone with early onset Parkinson's?

A-Parkinson's Disease, or PD, is a degenerative disease of the central nervous system. Early in the disease, the most obvious symptoms include diminished facial expressions, shaking, rigidity, and slowness. As the disease progresses patients may demonstrate difficulty with swallowing and speech. Difficulties in speech are particularly noticeable early in the onset of the disease. According to the Mayo Clinic, persons with Parkinson's may lose volume (hypophonia), have reduced pitch range (monotone) and because of problems initiating purposeful movement, have difficulty forming words and may slur their speech (dysathria). As you might imagine, difficulty in speech is one of the most frustrating aspects of the disease as it affects how you relate to others. Combined with the diminished ability to express emotions through facial expressions, individuals with PD may tend to retreat from activities they once enjoyed and be more inclined to experience depression. While around 89% of people with PD will have some form of speech difficulty, only around 5% ever seek treatment. This is very unfortunate, as research shows that speech therapy is very effective in improving the speech, voice, and swallowing problems associated with PD. There are many potential treatments in speech, voice, and language problems that include medication, behavioral therapies, and surgery. I would suggest that anyone having PD and experiencing speech difficulty talk to their doctor about their options, including being evaluated by a speech pathologist. A qualified professional can help provide tools in the management of the areas of deficit so that the individual can continue to enjoy effective communication and meals with family and friends.

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Speech Pathology

Jordan Easterwood

2013-01-02 15:49:49

Q-If my child is referred to a speech-language pathologist (speech therapist), what would an evaluation entail?

A-There are several different reasons a child or adult may benefit from speech therapy. When a child or adult is experiencing difficulty understanding or using language, correctly producing speech sounds, feeding or swallowing difficulties, voice problems, or demonstrating stuttering characteristics a speech-language pathologist (speech therapist) may be consulted. A speech therapist will perform an evaluation to diagnose the problem and design treatment procedures in an effort to improve functional ability. Your first step is to acquire orders from your physician for a speech therapy evaluation. Then, select an ASHA-certified speech-language pathologist for early identification and treatment. After the appointment has been set up the therapy office staff will typically mail out information forms for you to complete prior to the evaluation The next step is the evaluation. At the start of the evaluation the speech therapist will typically take a few minutes to establish rapport with your child to help him or her to feel comfortable during the evaluation. A case history will be obtained in order to determine various developmental milestones the child has reached thus far. From that it will be determined what kind of evaluation will take place, whether speech, language or feeding difficulties. Informal play routines designed to encourage interaction with the examiner and elicit language from the child are an important part of the evaluation. A language sample may also be obtained during these interactions. An oral motor examination is also performed during most evaluations to determine if oral structures and function are within normal limits. For a speech evaluation, the child’s development of sounds will be determined and whether or not they are age appropriate. A language evaluation might include the assessment of a child’s ability to understand and express language. Expressive Language is verbal and written expression which may be with the use of words, sentences and writing to convey meaning and message to others. Depending on the child’s age the following may be assessed within your child’s expressive language: * Label objects in the environment * Describe actions and events * Put words together, use grammar correctly (e.g. “I had a drink” not “me drinked”) * Ability to retell a story * Answer questions appropriately * Write a short story. Receptive Language is the comprehension of language and the ability to process language – listening and understanding what is being said. Comprehension of language begins at infancy, a sign of comprehension of speech is a simple smile from your baby. It is never too early to assess the development of your child. Here are a few concepts that may be assessed: * Understands spatial concepts (above, beside, between) * Understands size and quantity * Understands use of objects * Identifies familiar objects * Understands verbal in context * Follows commands * Understands pronouns Feeding and/or swallowing difficulties may occur as early as birth. Adults may also have swallowing difficulties that can lead to serious complications. Various reasons for a feeding assessment with a child may include: * reflux with vomiting * behavior/aversive reactions to food * poor intake of food * respiratory symptoms and cough * sensory/texture issues * oral-motor coordination and difficulties * swallowing difficulties * choking * possible aspiration

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Speech Pathology

Alisha Young

2013-01-02 15:48:14

Q-If my child is referred to a speech-language pathologist (speech therapist), what would an evaluation entail?

A-There are several different reasons a child or adult may benefit from speech therapy. When a child or adult is experiencing difficulty understanding or using language, correctly producing speech sounds, feeding or swallowing difficulties, voice problems, or demonstrating stuttering characteristics a speech-language pathologist (speech therapist) may be consulted. A speech therapist will perform an evaluation to diagnose the problem and design treatment procedures in an effort to improve functional ability. Your first step is to acquire orders from your physician for a speech therapy evaluation. Then, select an ASHA-certified speech-language pathologist for early identification and treatment. After the appointment has been set up the therapy office staff will typically mail out information forms for you to complete prior to the evaluation The next step is the evaluation. At the start of the evaluation the speech therapist will typically take a few minutes to establish rapport with your child to help him or her to feel comfortable during the evaluation. A case history will be obtained in order to determine various developmental milestones the child has reached thus far. From that it will be determined what kind of evaluation will take place, whether speech, language or feeding difficulties. Informal play routines designed to encourage interaction with the examiner and elicit language from the child are an important part of the evaluation. A language sample may also be obtained during these interactions. An oral motor examination is also performed during most evaluations to determine if oral structures and function are within normal limits. For a speech evaluation, the child’s development of sounds will be determined and whether or not they are age appropriate. A language evaluation might include the assessment of a child’s ability to understand and express language. Expressive Language is verbal and written expression which may be with the use of words, sentences and writing to convey meaning and message to others. Depending on the child’s age the following may be assessed within your child’s expressive language: * Label objects in the environment * Describe actions and events * Put words together, use grammar correctly (e.g. “I had a drink” not “me drinked”) * Ability to retell a story * Answer questions appropriately * Write a short story. Receptive Language is the comprehension of language and the ability to process language – listening and understanding what is being said. Comprehension of language begins at infancy, a sign of comprehension of speech is a simple smile from your baby. It is never too early to assess the development of your child. Here are a few concepts that may be assessed: * Understands spatial concepts (above, beside, between) * Understands size and quantity * Understands use of objects * Identifies familiar objects * Understands verbal in context * Follows commands * Understands pronouns Feeding and/or swallowing difficulties may occur as early as birth. Adults may also have swallowing difficulties that can lead to serious complications. Various reasons for a feeding assessment with a child may include: * reflux with vomiting * behavior/aversive reactions to food * poor intake of food * respiratory symptoms and cough * sensory/texture issues * oral-motor coordination and difficulties * swallowing difficulties * choking * possible aspiration