Why Do I Need Speech Therapy?

Speech therapy helps a broad range of conditions, including cognitive and swallowing disorders.

What comes to mind when you hear the term “speech therapy”? A professional who sees a kid with a lisp or treats a person who stutters — or helps a person who can’t pronounce certain sounds? Those are indeed areas that speech therapists address.

Many people without these problems may be surprised when their doctor recommends that they seek speech therapy. Often, patients protest, “But my speech is just fine!”

There are many reasons, however, that speech therapy is recommended. Let’s explore a few.

Many reasons for speech therapy

While it’s true that speech-language pathologists (SLPs) treat childhood speech disorders, they also treat a variety of areas that at first glance may not seem associated with speech.

According to the American Speech-Language-Hearing Association (ASHA), the scope of practice for SLPs — also known as speech therapists — includes:

• Speech (how we say the sounds that make up words)
• Language (understanding and expressing words and ideas)
• Fluency (stuttering)
• Voice (pitch, loudness and vocal quality)
• Swallowing
• Cognition (memory, problem solving and decision making)

While those first few areas on the list may seem obvious, many people are surprised to learn that speech therapy can also help with swallowing and cognition.

Assisting swallowing disorders

Many of the patients whom medical speech-language pathologists treat are adults with swallowing disorders, a condition known as dysphagia. The same anatomical structures that produce speech — vocal folds, tongue, lips and jaw — are also involved in chewing food, pushing food through the mouth and protecting the airway when swallowing. In fact, the primary biologic function of the vocal folds is to protect the airway when we swallow.

Speech therapists are trained to assess and treat swallowing disorders. These disorders can be the result of a stroke, a brain injury, head and neck cancer or many progressive neurological disorders such as Parkinson’s disease and Alzheimer’s disease.

Signs that you may have a swallowing problem include coughing or a change in vocal quality when eating or drinking (especially a “wet” vocal quality), a feeling of something being stuck in your throat or unintended weight loss. Problems with swallowing can be life-threatening, leading to choking or aspiration pneumonia.

The good news is that there are many treatments available to patients with swallowing problems. If you suspect you have a swallowing problem, it may warrant a discussion with your doctor and a referral to a speech therapist for assessment and treatment.

Assisting cognition

Another area people are often surprised to learn speech therapists support is cognition. According to the Britannica Dictionary, cognition comprises “conscious mental activities: the activities of thinking, understanding, learning and remembering.” It includes the mental processes of attention, memory and planning — or, in simple terms, how we think, remember, pay attention and learn.

Language, speech and swallowing all are controlled by the brain, which is why brain injuries can lead to problems in these areas. Speech therapists are trained to know how different areas of the brain impact speech, language and cognition.

Problems with cognition can be mild and age-related, or they may be early signs of a progressive neurological disorder such as Alzheimer’s disease. People can also experience cognitive impairments after a stroke or brain injury. A neurologist can diagnose cognitive impairments and guide treatment, while speech therapists provide education regarding brain health, cognitive exercises to restore or maintain function and strategies to compensate for any difficulties.

Of course, speech therapists also treat problems with speech, language and voice.
In adults, these problems can arise due to a variety of issues, including stroke, brain injury, progressive neurological diseases or aging.

After a stroke or brain injury, the language center, typically located in the left hemisphere, may be damaged. This could result in difficulty thinking of the words you want to say, or it may become harder for you to understand what is being said to you. It may be difficult to articulate clearly due to weakened muscles and the brain’s impaired ability to tell the muscles how to move to produce words. Speech therapists can help patients learn how to communicate effectively again.

Discuss options with your doctor

Speech therapy’s scope is broad, encompassing some of the most important aspects of people’s lives: the ability to speak, think, or share a meal with friends and family. If you are having difficulty in any of these areas, talk to your doctor about a referral to speech therapy. Remember, speech therapy is not just about speech.

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