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
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
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
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.