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Speech and Language Pathologists: More than Just Talk

Speech and Language Pathologists: More than Just Talk

Hospitalized patients are often surprised when a speech-language pathologist walks into their room, especially if they don't have what they perceive to be a speech problem.

In fact, speech-language pathologists have many responsibilities in acute-care settings, medical inpatient rehabilitation, and outpatient rehabilitation.

They work closely with physician specialists (ENTs, neurologists, neurosurgeons, physiatrists, internists, family practitioners) to diagnose a range of problems, to initiate treatment, and to make referrals to other health-care professionals during and after hospitalization. Speech language pathologists also play a role in hearing conservation. They are qualified to screen patients' hearing to determine if a referral to an audiologist is necessary.

In the diagnosis of neurological conditions, speech-language pathologists are often asked to evaluate both cognitive (thinking, knowing, perceiving) and physiological (physical) problems.

The way in which a person speaks and uses language reveals a great deal about thought-processing skills, memory deficits, and the ability to focus attention. Deficits in these areas can indicate brain injury, stroke, Alzheimer's disease, Parkinson's disease, and a host of other neurologic conditions. Because speech-language pathologists are trained to identify unusual patterns in speech, their assessment can be extremely important to an accurate diagnosis and an effective treatment plan.

In addition to cognitive problems, difficulty in swallowing (dysphagia) is common among patients who have suffered a stroke or who have other neurological diseases, like multiple sclerosis and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). Speech-language pathologists are often asked to diagnose swallowing problems and work with patients to overcome these difficulties. Dysphagia can have serious side effects, including malnourishment, choking, and aspiration pneumonia, and it needs to be aggressively treated.

Speech-language pathologists also work with voice patients prior to and following surgery.

People who have vocal nodules sometimes compensate for the gradual loss of their voice by putting pressure on the laryngeal muscles or by forcing their vocal folds together. By working with a speech-language pathologist, patients may be able to reduce or eliminate the nodules by changing behavior. Those who require surgery can also benefit from speech therapy by breaking bad habits and learning new strategies for using their voices in ways that will prevent the problems from recurring.

People who have suffered a stroke on the left side of their brains can experience a condition called aphasia.

They have difficulty retrieving words, sequencing activities, and understanding what they hear and what they read. Because speech is second nature, these patients often feel confused, angry, and depressed. They need to explore ways in which to regain the language already stored in their brains, but which is less easily accessible as a result of their stroke. Speech-language pathologists can facilitate this process, during the inpatient phase of recovery and on an outpatient basis following discharge. Loss of speech is terrifying, and frequently the communication process begins by helping the patient convey needs and feelings using alternative communication devices. This helps to decrease feelings of isolation and depression, and initiates the recovery process.

Speech-language therapy in the medical rehabilitation setting is really focused on an interdisciplinary approach to care. Patients have a definite advantage when several specialists are working toward the same goals. Speech-language specialists work closely with nurses, family members, other rehabilitation professionals, and caregivers to educate them and to be a resource. Patient education is augmented by community programming and patient support groups, to ensure that the skills of local speech-language pathologists are fully tapped.

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