A speech-language therapist (SLT), speech-language pathologist (SLP), or simply language therapist is someone who specializes in human communication and how it impacts individuals at school, home, and work. It is a licensed field governed by the state. To become a licensed SLP, one must complete a masters in Communicative Disorders, pass a national examination, and complete a Clinical Fellowship Year. Many people don’t realize the breadth and scope of what SLPs do. Some SLPs are also trained in bilingualism and multilingualism. A speech-language therapist’s main responsibility is to prevent, assess, diagnose, and treat speech, language, cognitive-communication, social communication as well as voice and swallowing disorders.
Speech-language therapy involves evaluation, assessment, and treatment of communication and speech and language disorders in young children, school age students, including working with teenagers, and adults. Speech language disorders may begin during infancy and progress into adulthood. In other instances, certain impairments may have resulted from a sudden injury or illness.
A speech disorder is characterized by difficulties with speech production, including articulation and enunciation. These include:
- Articulation disorders - Difficulties producing the correct sounds, such as consonants or vowels, in the beginning, middle, or end of words.
- Phonological disorders - Refers to systematic speech production error. A common example of this in children is the dropping of the /p/ sound at the beginning of words or substituting sounds, like /w/ for /r/.
On the other hand, communication disorders, which are not considered speech disorders, include:
- Fluency disorders also referred to as stuttering: These difficulties include partial-word repetitions (“t-t-two”) in which the flow of speech is interrupted by unusual stops, prolonging syllables and sounds (s-s-s-s-shape), and sometimes blocks.
- Voice resonance disorders: Problems with voice resonance make it challenging for someone to be understood by listeners. These involve difficulties with pitch, volume, or quality of the voice.
WHAT ARE LANGUAGE DISORDERS?
A language disorder refers to difficulties or problems in understanding spoken language compared to peers. It also involves trouble with putting words or sentences together to communicate ideas. A language disorder can impact individuals at various levels such as slow acquisition of grammar, word-finding difficulties, and telling less coherent narratives.
Language disorders involve vocabulary, grammar (verbs and sentence construction), and social language use. They are classified as:
- Expressive language disorder – Refers to difficulties with finding the right words and using age-appropriate grammar when speaking with others or expressing oneself compared to peers. It can also include children who produce less robust narratives, have reduced vocabulary, and demonstrate difficulties with social language.
- Mixed expressive-receptive disorder – A combination of expressive and receptive language disorders characterized by difficulties in listening, understanding, and expression. Someone with a mixed expressive-receptive disorder will typically have trouble, compared to peers, following directions, listening to stories, and understanding sequential information.
- Cognitive communication disorders – These are difficulties in communication skills that involve attention, memory, perception, regulation, organization, and problem-solving.
Someone with a developmental disability is born with it and it is hopefully discovered in early childhood development. Developmental disorders become more apparent when a child has a significant delay compared to peers and doesn’t seem to outgrow it. Some of the most common developmental disabilities are:
- Autism spectrum disorders (ASD) – A neurodevelopmental disorder that affects social communication and interaction and involves restricted and repetitive behaviors. People with autism will often have trouble with joint attention, responding to social situations, and using verbal and nonverbal communication compared to peers.
- Attention-deficit Hyperactivity Disorder (ADHD) – A neurodevelopmental disorder characterized by lack of attention, hyperactivity, and impulsiveness, ADHD is diagnosed in childhood but also occurs in adults. ADHD interferes with how a student regulates their attention in a variety of settings.
A speech-language therapist provides speech-language therapy to individuals of all ages, from babies to adults. They conduct therapy sessions on a one-on-one basis as well as provide information to families, support groups, and the public.
A speech-language pathologist is equipped and licensed to perform a variety of therapies or treatments to address a patient’s difficulties. These include:
- Language Intervention Practices: For younger patients, the SLP uses play, casual conversation, illustrations (such as pictures, books, objects), or on-going events to stimulate language development. A speech language therapist will teach and model the proper use of grammar and vocabulary and use repetition exercises to build up language skills. These interventions are targeted at students who struggle with their language skills.
- Literacy: SLPs help students with all aspects of literacy: reading comprehension, decoding, spelling, and writing skills. Many students who need help with their reading comprehension and writing skills also receive executive function support from their SLPs as well.
- Articulation Treatment: Articulation or sound production exercises involve having the therapist teach and model the correct sounds in sounds, syllables and words during play activities. The level of conditioning and exercises is individualized, age-appropriate, and targeted.
- Swallowing and Feeding Therapy: The SLP teaches how to use the lips, tongue, and jaw to handle food and liquids. The SLP can also introduce different food textures and temperatures to extend a child’s oral awareness during eating and swallowing.
An individual with the following conditions may consider speech language therapy:
- Learning difficulties
- Difficulties with producing age-appropriate vocabulary, sentences, stories, social language use.
- Difficulties with understanding age-appropriate vocabulary, directions, understanding stories, misinterpreting social language cues.
- Students who struggle with reading comprehension and their expressive writing skills.
- Articulation issues
- Cleft lip or cleft palate
- Fluency e.g. stuttering
- Cognitive (intellectual, thinking) or other developmental delays
- Hearing impairments
- Traumatic brain injury
- Feeding and swallowing disorders
- Respiratory problems (breathing disorders)
- Chronic hoarseness (voice)
Many students with speech language disorders also demonstrate co-morbity with other disorder, such as ADHD.
Therapy should begin as soon as possible. Children who receive speech language therapy early on (before five years old) demonstrate more progress or results than those who begin therapy at a later stage.
Parents and family members play a vital role in the success of a child’s speech or language therapy. When parents are actively involved, children will progress more than when parents are less involved in speech language therapy.
With the SLP’s guidance, parents can further support their children by doing exercises and activities at home. Finally, it’s essential for parents and household members to understand that overcoming speech and language disorders will take time, effort, and patience. Many students with language disorders will struggle with language throughout their lifespan but language therapy will offer strategies to help overcome these language challenges.
Finally, parents who are concerned about their child’s speech, language, and communication development can seek the help of a speech-language therapist.
To learn more about speech language therapy, contact the American Speech Language Association (ASHA) for more information. You can also contact your insurance for in-network and out-of-network options as well. Each state also offers free Early Intervention services (birth-3 years of age). For children three and older, find out about free services can be provided through your child's school for children who have IEP's or Section 504 Plans.