Speech Language Pathology
Speech-Language Pathology specializes in communication disorders.
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. The main components of language include: phonology, the manipulation of sound according to the rules of the language; morphology, the understanding and use of the minimal units of meaning;syntax, the grammar or 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.
National approaches to speech and language pathology
Speech and Language pathology is known by a variety of names in various countries around the world:
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, which may be 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. 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.
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.
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 collaborating in the assessment and providing intervention where there is evidence of speech, language, and/or other cognitive-communication disorders.
The treatment for patients with cleft lip and palate has an obvious interdisciplinary character. The speech therapy outcome is even better as the surgical treatment is performed earlier.
Speech-language pathologists act as case managers and service delivery coordinators as well as manage clinical and academic programs.
Speech and language pathologists can work in a wide range of settings. The clinical environments include both public and private hospitals and home health care. 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.
Subsequent to ASHA’s 2005 approval of the delivery of speech-language pathology via video conference, or telepractice, SLPs have begun delivering services via this service delivery method.
Methods of assessment
There are separate standardized assessment tools administered for infants, school-aged children, adolescents and adults. Assessments primarily examine the form, content, and use of language, as well as reading, writing, and some cognitive functions.
Swallowing assessments often require specialized training. These include formal assessments of Fiberoptic Endoscopic Evaluation of Swallowing (FEES) or Modified Barium Swallow Study (MBS). Informal oral motor assessments review the strength, co-ordination, range of movement, symmetry and speed of cranial nerves V, VII, IX, X and XII. The Australian National Guidelines for Stroke Management state that the presence or absence of a gag reflex in an oro-motor examination is not sufficient evidence to determine if someone has a swallowing disorder.
Individuals may be referred to a speech pathologist 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