Speech Therapy
These professionals are educated to assess speech and language development along with swallowing disorders. They are commonly referred to as speech therapist.
Language is made up of socially shared rules that include the following:
- What words mean (e.g., "star" can refer to a bright object in the night sky or a celebrity)
- How to make new words (e.g., friend, friendly, unfriendly)
- How to put words together (e.g., "Peg walked to the new store" rather than "Peg walk store new")
- What word combinations are best in what situations ("Would you mind moving your foot?" could quickly change to "Get off my foot, please!" if the first request did not produce results)
Speech is the verbal means of communicating. Speech consists of the following:
- Articulation
- How speech sounds are made (e.g., children must learn how to produce the "r" sound in order to say "rabbit" instead of "wabbit").
- Voice
- Use of the vocal folds and breathing to produce sound (e.g., the voice can be abused from overuse or misuse and can lead to hoarseness or loss of voice).
- Fluency
- The rhythm of speech (e.g., hesitations or stuttering can affect fluency).
When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.
When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder.
Feeding disorders include problems gathering food and getting ready to suck, chew, or swallow it. For example, a person may have difficulty getting the food to the mouth or once the food is in the mouth the motor control for how to swallow.
Swallowing disorders, also called dysphagia (dis-FAY-juh), can occur at different stages in the swallowing process:
- Oral phase – sucking, chewing, and moving food or liquid into the throat
- Pharyngeal phase – starting the swallow, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking
- Esophageal phase – relaxing and tightening the openings at the top and bottom of the feeding tube in the throat (esophagus) and squeezing food through the esophagus into the stomach
A speech-language pathologist (SLP) who specializes in treating feeding and swallowing disorders can evaluate the patient and will:
- ask questions about their medical history, development, and symptoms
- look at the strength and movement of the muscles involved in swallowing
- observe feeding to assess posture, behavior, and oral movements during eating and drinking
- perform special tests, if necessary, to evaluate swallowing, such as:
- video swallow assessment – the patient eats or drinks food or liquid with barium in it, and then the swallowing process is viewed on an X-ray.
- endoscopic assessment – a lighted scope is inserted through the nose, and the patient's swallow can be observed on a screen. A physician performs this test.
The SLP may work as part of a feeding team. Other team members may include:
- an occupational therapist
- a physician or nurse
- a dietitian or nutritionist