Speech-language evaluation can help determine difficulty

In a recent parent-teacher conference, your child's teacher expressed concern that your child may have a problem with certain speech or language skills. Or perhaps while talking to your child, you noticed your child is stuttering more frequently. You're not sure that your child has a problem - what should you do?

"Whatever your particular circumstances, it's wise to intervene quickly," said Keely Mead, Speech Therapist at Southwest Medical Center. "A speech-language evaluation can help you determine the nature of your child's difficulties.

The focus of Mead’s duties at SWMC is Speech-Language Therapy and not just for children, but for patients of all ages.

"Speech-language therapy is the treatment with speech and/or language disorders," Mead explained. "A speech disorder refers to a problem with the actual production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas."

SWMC’s Speech Language Therapist Keely Mead goes over testing data in her office at SWMC. Mead says it’s important to intervene quickly whenever someone is experiencing a speech-language difficulty.

Speech disorders include the following problems:

• Articulation disorders include difficulties producing sounds in syllables or saying words incorrectly to the point that other people can't understand what's being said.

Fluency disorders include problems such as stuttering, the condition in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-st-stuttering), or prolonging sounds and syllables (ssssstuttering).

Resonance or voice disorders include problems with the pitch, volume, or quality of a person’s voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort when speaking.

• Language disorders can be either receptive or expressive. Receptive disorders refer to difficulties understanding or processing language. Expressive disorders include difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.

• Swallowing disorders include problems with one of the four stages of swallowing. These include the oral preparation stage, the oral stage, the pharyngeal stage and the esophageal stage. Swallowing disorders can be evaluated through both clinical/bedside evaluation or a moving X-ray may be used to take pictures of the patient’s swallow, called a Modified Barium Swallow Study (MBSS).

"During an MBSS, a patient is given bites and sips of various consistencies of food which have been mixed with barium," Mead said.  "The MBSS usually takes approximately 20 minutes and it provides the clinician with detailed information to best treat the swallowing disorder through compensatory strategies, strengthening exercises and maneuvers and/or diet modification."

The goal, according to Mead, is to provide the patient with the safest swallowing function for the least restrictive diet.

"By assessing the speech, language, cognitive-communication, and swallowing skills of children and adults, we can determine what types of communication problems exist and the best way to treat these challenges," Mead added.

Speech-language therapists typically treat problems in the areas of articulation; dysfluency; oral-motor, speech, and voice; and receptive and expressive language disorders. Speech-language therapy involves working with a patient on a one-to-one basis, to overcome difficulties involved with a specific disorder. Speech-language therapy uses a variety of therapeutic strategies, including:

• language intervention activities - The therapist may use pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills.

• articulation therapy - Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables. Articulation therapy involves physically showing a patient how to make certain sounds, such as the "r" sound. A speech-language therapist may demonstrate how a patient should move his or her tongue to produce specific sounds.

When Is Therapy Needed?

Speech-language therapy may be needed for a variety of reasons, including: hearing impairments, developmental delays, weak oral muscles, birth defects such as cleft lip or cleft palate, autism, motor planning problems, respiratory problems (breathing disorders), swallowing disorders and traumatic brain injuries.

Therapy should begin as soon as possible. When it involves children, they should be enrolled in therapy early in their development.  Those younger than 3 years tend to have better outcomes than children who begin therapy later.

"This does not mean that older children can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be modified or changed," Mead said.

Speech-language experts agree that parental involvement is crucial to the success of a child's progress in speech or language therapy.

"Parents are an extremely important part of their child's therapy program," Mead said. Parents help determine whether their child's experience in speech-language therapy is a success. Children who complete the program most quickly and with the most lasting results are those whose parents have been involved. It is very important that parents help their child use the stimulation activities that their speech-language pathologist suggests at home to ensure continued progress and carry-over of newly learned skills."

The process of overcoming a speech or language disorder may take some time and effort.

"That is why it's so important that all family members be patient and understanding with the one who is dealing with one of these disorders," Mead said.