What IS Speech Pathology?

What IS Speech Pathology?

Speech pathology is the name of the allied health profession which deals with communication disorders and associated oral movement issues such as swallowing. Speech pathology was previously known as speech therapy and practitioners are frequently known as Speech and Language Pathologists or SLP’s. In a typical Aussie fashion, they are also referred to at times as ‘speechies’.

Speech pathologists are trained at Universities in degrees which include subjects such as psychology (a major area of study), anatomy, physiology, neurology and other medical and dental subjects, education, and linguistics. They also participate in ‘on the job’ training throughout the four years, with clinical placements in schools, hospitals and nursing homes.

The core business of a speech pathologist is to assist clients to have ‘normal’ communication and other oral motor skills such as swallowing. Where this is not possible, they will strive to help the person gain as much skill as they are able to and want to, and offer help with other strategies including sign language and alternative communication methods.

Speech pathologists are not elocution, or speech and drama teachers, or voice and singing coaches, although Wendy actually is a qualified Speech and Drama teacher in addition to her speech pathology training.

Speech pathologists are trained to work with all age groups across many types of difficulty including voice, speech, language, fluency and associated oro-motor activities. However they may elect to work with only certain age-groups and with particular difficulties.

Initially, speech pathologists assess all factors affecting the person’s difficulty and determine ways to help them to gain or regain skills. There are vast numbers of activities that can be utilised to address these issues, depending on the age, interests and skills of the client. Every client’s treatment plan will be individual and may be modified as their progress is assessed. However, Wendy will choose activities which have the following key elements:

The client enjoys and finds the activity meaningful.

The activity has some relevance to the client’s everyday life and needs.

Tasks will be carefully graded to ensure a lot of success, and encouragement on occasional difficulty.

The client or his family/carers will have as much as possible explained to them and be invited to participate actively in the process.

Below are just some examples. More information can be found in ‘Services for Children’ and ‘Services for Adults’

James, a toddler who is not yet talking and finds it hard to imitate speech may be involved in toys and games that provide opportunities for the repetitive use of very simple words. His parents will join in or watch and later hear advice on what types of words and sounds to target, and how best to encourage their child. Wendy believes working with parents is an essential part of treatment, as they are the child’s main teachers. She also shows them some helpful techniques such as Cued Articulation to assist James in learning to speak. as James’ behaviour is a problem at times (and it often is where a child is unable to understand or express themselves) Wendy can provides practical advice based on her many years experience and knowledge. James’ parents attend two extra evening appointments without James, in order to discuss and plan ways to modify his behaviour so that he can be happier and learn more quickly. See services for children for more detailed information.

Jade, a school-aged child who is not grasping how to read or spell will also be treated with great care and lots of positive assurances, as her confidence has been seriously dented by her difficulties. Initially she will be assessed for her level of understanding about sounds, words and letters, and for the misunderstandings and confusion she is likely to be experiencing as she struggles to work it out. Samples of her attempts at writing and spelling will be considered where available, and she will be taken back to basics to learn or clarify what has not been understood previously. This will be done with lots of fun, at times play-acting being some letters, in order to relax and learn. Again, Jade’s Mum will observe each session closely so that she can understand how to help, and remind and explain again at home.

Melissa is a new graduate teacher and has lost her voice for the third time in five months. She is getting worried, as her voice has not returned properly this time. It has a very husky, rasping sound and it is very effortful to speak. Wendy carefully investigates all possible causative factors; history of the problem, general health, background noise issues, dental health, stress levels, and inadequate voice projection ability, amongst many other things. She enquiries about what medical investigation has been done and recommends a visit to an Ear, Nose and Throat specialist to assist her in finding any physical causes of Melissa’s problem. Meanwhile she provides advice on ways to relax the throat, avoid competing noise and what factors such as coughing, whispering and constant throat-clearing are doing to exacerbate the problem.

Tau is an elderly gentleman in a nursing home. He is coughing frequently during eating and drinking and staff have noticed he is losing weight and experiencing ongoing urinary tract infections, probably due to his reluctance to drink. Wendy assesses Tau’s swallowing and finds firstly that Tau is not enjoying the food that he is offered as he is used to food from an Asian culture. She also notes he has a few remnant teeth that are not healthy and that his swallow is weak. She liaises with Tau’s family and the nursing home, and organises for his children to bring in home-cooked meals using ingredients he enjoys, to be provided once a day for him. The nursing home staff also consider what meals they can modify and provide that will appeal to Tau. She also arranges for Tau to have a dental check up and requests for his GP to check on him and make a referral to a dietician. On her subsequent visits to Tau, Wendy finds that he is now looking forward to his meals which has changed his mental state, with the flow-on effect that he is putting more energy in to swallowing. This has assisted him in stronger lip closure and tongue movements which are vital to initiating a good swallowing reflex. His dentist has removed his decayed teeth which were causing pain especially when he ate and Tau is now happily waiting for new dentures. His weight is improving due to supplements recommended by the dietician, and he is being offered drinks with a slightly thickened consistency which he swallows well. Wendy and his GP will both monitor Tau for any further issues with swallowing.