Adults with Communication and Swallowing Disorders: A Medical Speech-Language Pathologist Can Help

By Amy Pestreich, M.A. CCC-SLP

When will I be able to eat and drink normally again? What caused my swallowing problem? Why is my loved-one having difficulty communicating? Will my speech improve? These are some of the concerns my patients and their families face. 

I’ve been a Medical Speech-Language Pathologist for 29 years. When I tell people what I do, they typically assume that I work with children. Once I tell them that I have spent my entire 29-year career working with adults, they usually have many questions. (Please note: Some medical SLP’s do work with children.) It is my job, as a medical SLP to evaluate, diagnose, and treat people with speech-language/cognitive and swallowing disorders. 

Medical SLP’s see people with a wide range of medical diagnoses, including, but not limited to: stroke (CVA,) Parkinson’s disease, chronic obstructive pulmonary disease (COPD,) multiple sclerosis, Amyotrophic lateral sclerosis (ALS,) dementia, mouth/throat cancer, and traumatic brain injury. SLP’s are found in a variety of settings such as acute care hospitals, long-term care facilities (nursing homes,) outpatient rehabilitation, and private practice. More recently, telepractice (telehealth, online) has become more prevalent due to COVID-19 safety concerns. 

Medical SLPs can help with the following problems described below:

A swallowing disorder is called dysphagia. The weakness of the lips, tongue, or muscles in the throat and/or incoordination or impaired timing can impact swallow safety and efficiency. A wide range of diagnoses can cause dysphagia. An SLP will evaluate functional swallowing abilities, select appropriate maneuvers, strategies, exercises that improve function and make diet consistency recommendations.

A language impairment most often seen following stroke (CVA or cerebral vascular accident) is aphasia. All forms of language can be affected: verbal expression, auditory comprehension (understanding of language,) writing, and reading comprehension. There can be other causes of aphasia as well.

Sometimes, stroke, TBI, or other degenerative neurological diseases can cause a motor speech disorder. Apraxia is difficulty starting and producing voluntary speech movement patterns when there is no weakness/paralysis of the speech muscles. Dysarthria is a weakness of the muscles of the mouth, face, and respiratory system that may result in imprecise articulation, soft voice, rapid or slow speech, and/or reduced intonation. 

Cognitive-linguistic impairment refers to problems with memory, attention, orientation (to time, place, and person,) problem solving, and abstract reasoning. We use these functions to successfully recall new information, plan events, multi-task, and much more. 

Symptoms of voice disorders can include hoarseness, breathiness, harshness, and reduced loudness. There are various causes. An SLP will likely recommend a referral to an otolaryngologist (ear, nose, and throat) physician prior to starting voice therapy. SLPs also help people with voicing and swallowing following tracheostomy placement (a tube placed in the neck, directly into the trachea to help with breathing.) In addition, SLPs provide therapy for people who have a diagnosis of mouth or throat cancer after surgery.

SLP’s also treat adults who begin to exhibit dysfluent speech (neurogenic stuttering) following an injury or disease that impacts the brain and spinal cord (such as stroke, head trauma, Parkinson’s disease, and others.) Someone with dysfluent speech may exhibit unexpected pausing or hesitation, repetitions, and/or prolongations of sounds, syllables, and words. 

If verbal communication is not possible, speech-language therapy may address augmentative and alternative communication (AAC,) which refers to the use of gestures, facial expressions, picture or word communication books, and/or an electronic device that generates speech. In general, therapy targets areas of impairment that teach strategies and exercises to improve communication and or swallowing function. The goals of the client are a priority.        

To find an SLP clinician in your area: here is a link to the American Speech-Language-Hearing Association’s ProFind (ASHA):

https://find.asha.org/pro#f:@Provider=[Speech-Language%20Pathologist]

To find a Speech-Language Pathologist to provide treatment for individuals with speech disorders related to Parkinson’s Disease and other neurological disorders using Lee Silverman Voice Treatment (LSVT®) modalities. 

https://www.lsvtglobal.com/LSVTFindClinicians

Amy Pestreich, M.A. CCC-SLP is a Speech-Language Pathologist and Private Practice Owner in Westchester County, NY. She is available to see clients in New York State via Telepractice (online.)  

Contact Information: Web: https://www.Amypestreichslp.com Email: apestreichslp@protonmail.com  Phone: (914) 627-8552

© 2020, Amy Pestreich, M.A. CCC-SLP. All rights reserved.