Angie's LIST Guide to
Speech Therapy

Speech therapy involves evaluating, diagnosing and treating patients who are working through speech disorders. Practitioners are referred to as speech therapists or speech language pathologists.
 

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young man in wheelchair working with speech therapist
A speech therapist works with a young man who suffered a traumatic brain injury. (Photo by Brandon Smith)
 
 

What is a speech therapist?

A speech therapist is a specialist with training in the diagnosis and treatment of a variety of speech, communication, voice and language disorders. A speech disorder refers to a problem with the production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas. A speech therapist may work with all age groups, from young children to older adults.

There are a number of causes for speech difficulties that would require a speech therapist. Speech difficulties can be the result of an underlying health condition, such as cerebral palsy, or they may occur after someone experiences a debilitating incident, such as a stroke. Brain injuries that result from an accident can directly affect your speech and communication ability. Stuttering is another example of a communication disorder that a therapist can address.

Speech therapists use various methods and techniques during treatment. The patient's specific speech disorder and the underlying causes that contributed to the condition will determine the length and type of treatment. For example, a patient suffering from a stroke with no prior speech difficulties may not need as lengthy a treatment plan as perhaps a patient suffering from cerebral palsy. Depending on the severity of the difficulty, some patients may eventually regain normal language ability.

Types of speech disorders

There are a number of different speech impediments that can occur. The most common include:

Articulation disorders: When an individual has difficulties producing sounds and syllables or he/she is saying words incorrectly to the extent that listeners can't understand what's being said. There are three types of articulation disorders, "omissions," "distortions" or "substitutions." Omission is when the speaker leaves something out, for instance saying "oo" for "shoe." Distortion is when the speaker has most of the correct parts, but it's still a bit off. For instance saying "swilmming" instead of "swimming." Substitution occurs when the speaker substitutes one thing for something else, such as saying "wabbit" instead of "rabbit."

It's important not to confuse articulation disorders with baby talk. Young children may mispronounce words, but are expected to grow out of it. As a general rule, a child should be able to make all the sounds of English by the time he or she is 8 years old.

Fluency disorders: These include stuttering, in which the flow of speech is interrupted by abnormal stoppages, repetitions, or prolonged sounds and syllables. Most children stutter a little bit when they learn to talk and most children grow out of it. Stuttering is most common in children between the ages of 2 and 6, and boys are three times more likely to stutter than girls.

Voice disorders: When a speaker has problems with the pitch, volume or voice quality so much that it distracts listeners from what's being said. These types of disorders may also cause pain or discomfort to the speaker. Oftentimes, this is a result of damaged vocal cords, and in many cases is temporary.

Aphasia: A type of language disorder, aphasia is caused by an injury to the parts of the brain responsible for language. It may be caused suddenly, from a stroke or head injury, or it may develop slowly, perhaps from a brain tumor.

Speech therapy treatments

If you suspect a speech disorder, you aren't alone. Research by the National Institute on Deafness and Other Communication Disorders reports that there are an estimated 7.5 million people in the United States that have difficulty speaking, including 3 million who stutter. If you are one of them, plan to meet with a speech therapist for an initial evaluation and assessment. Your visit may also include an accompanying family member or close friend if you need help getting to the therapist's office and have difficulties communicating.

If the speech disorder has resulted from an underlying medical or psychological condition, the therapist will work in conjunction with your primary care physician or some other health provider, such as a counselor, psychologist or psychiatrist.

Therapists can customize treatment plans to meet your unique needs. Examples include such activities as reading aloud, making vocal sounds and working facial muscles to regain strength and flexibility when speaking. A speech therapist may use a variety of tools (such as a mirror) or games to help the process.

For patients with hearing problems, therapists may use a combination of sign language and writing out words and phrases. The length of time treatment takes depends entirely on the individual's situation — some treatments are short, others can take much longer. Therapists will work closely with their patients to help them develop their speech and language skills so they can communicate more effectively.

Choose a speech therapist

There are several key factors to keep in mind when deciding to see a speech therapist. It's important to verify with your health insurance provider that your policy covers these services. Your policy may limit you to a practitioner from the list of providers that your insurance company agrees to cover. Use the provider directory when selecting a practitioner for speech therapy treatment. Consider asking your primary care physician for recommendations.

Most insurance companies give their customers a directory of providers that details their area of medical specialty and credentials. Be sure to check a potential speech therapist's qualifications, education, accepted insurance plans and affiliated hospitals, as well as searching Angie's List for member reviews and rankings from other patients.

Look for a speech therapist who provides services related to your particular needs. If, for example, the underlying cause is a stroke, seek out a professional who has experience in this area. Is the therapist's office located within a short commute? Does the office provide handicapped access, if needed? What are the operating hours of the therapist's office, and is an emergency phone number available?

If you have the opportunity to meet with a speech therapist in advance, make sure that you or the patient seeking treatment feels at ease. The doctor-patient relationship will be an important factor in the success of the treatment provided. Take the opportunity to set up an initial appointment to better gauge if the therapist is a good fit. You shouldn't feel unduly stressed, and ideally the speech therapist should offer a supportive environment so that treatment will be as beneficial as possible.

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