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Speech–language pathology

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Speech and language pathology is concerned with issues surrounding human speech and language communication disorders and swallowing disorders. There are multiple methods of human communication both nonverbal communication (such as facial expression, posture and gesture), written, and verbal communication. Speech and language pathology is concerned with disorders of verbal communication, including expressive language (the production of effective communication) and receptive language (the understanding of presented communication). Speech results from voice production, and the manipulation of speech sounds creates language. They also specialize in disorders of swallowing.

Speech

See also: Speech disorder

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.

Language

See also: Language disorder

The main components of language include: phonology, the manipulation of sound; morphology, the identification, analysis and description of the structure of morphemes and other units of meaning in a language; syntax, the 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.

National approaches to qualification

United States of America

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.

National approaches to the costs of provision

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

Further information: Speech and language 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. Oral motor and swallowing assessments often require specialized training. These include the use of bedside examination tools and endoscopic/modified barium radiology procedures.

Individuals may be referred to an SLP 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

Children and adults

Adults

See also

References

  1. ^ Block, Frances K. (1993), "Definitions of Communication Disorders and Variations", Ad Hoc Committee on Service Delivery in the Schools, ASHA, doi:10.1044/policy.RP1993-00208, retrieved 2010-08-07 {{citation}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  2. ^ "2005 SLP Standards". 2005 Standards and Implementation Procedures for the Certificate of Clinical Competence in Speech-Language Pathology.
  3. ^ DeBonis DA, Moncrieff D (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. {{cite journal}}: Unknown parameter |month= ignored (help)
  4. ^ "What is speech and language therapy?".
  5. ^ "ASHA Telepractice Position Statement". Asha.org. Retrieved 2010-04-15.

Further reading

Template:Speech and voice symptoms and signs

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