Feature Article: Speech Therapy

Role of the Speech/Language Therapist

Contributed by Jeanne Thomson, CCC-SLP and Yael Manor, CCC-SLP

The speech pathologist has several useful roles to fulfill when evaluating and treating a patient with any movement disorder and educating family and professional carers.

The goal of swallowing assessment and intervention is to assure safe and adequate intake, the latter best accomplished with a nutritionist. A thorough swallowing evaluation includes observation of an entire typical meal of foods and liquids in the presence of the speech pathologist. An instrumental swallowing assessment, such as modified barium swallow study or endoscopic evaluation, may further pinpoint areas of difficulty. The results allow the therapist to determine the best diet consistency and compensatory strategies to assist the patient in completing a meal safely.

Speech assessment and intervention is crucial throughout the life span. It is always a priority for the patient to be able to hold a conversation, share their feelings, preferences and ideas to better cope and participate in life. Treatment typically focuses on voice and articulation as these are the modalities most affected. Lee Silverman Voice Treatment® is one of the most effective treatment methods for individuals with hypophonia or low volume. [1] The main goal of speech intervention is to increase the patient's intelligibility, thereby maintaining good quality of life.

While standard of practice in North America [2], cognitive treatment is not part of the role in Europe or Israel [3], cognitive treatment is offered during the early stage of dementia when the patient is able to learn new information, retain it and adapt to external aides (such as lists, calendars, clocks) which can trigger the desired effect. Equally important is the support, training and education of the family in dementia management.

References

Ramig L, Sapir S, Countryman S, Pawlas A, O'Brien C, Hoehn M, Thompson L (2001) Intensive voice treatment for individuals with Parkinson's disease: A two-year follow-up. JNNP:71,493-498.

American Speech-Language Hearing Association: Scope of Practice in Speech-Language Pathology.

The Israeli Speech and Hearing Association: www.ishla.org.il

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