Speech pathology needs

Question 1

What are the adult disorders related to speech pathology?

Answer 1

1. Aphasia/Right Sided Brain Damage - Disorders Associated with Aphasia: Dysarthria, Apraxia, Dysphagia, Visual Field Cuts
2. Cognitive Deficits
3. Stuttering
4. Voice Disorders
5. Laryngectomy
6. Hearing

Question 2

A general impairment of language functioning, not intellectual functioning, associated with localized cerebral pathology

Answer 2

aphasia
- Therapy consists of reprogramming the brain for language function, using strengths to feed the weaknesses, and keeping information relevant to the patient’s needs

Question 3

A general impairment causing inappropriate speech, lack of facial and vocal expression, inattention, orientation/memory disturbances, perceptual problems, flat affect and lack of humor

Answer 3

right-sided brain damage
- Therapy consists of increasing the patient’s ability to orient to person, place, and time, their memory skills, perceptual skills, and ability to socialize

Question 4

What are tips and strategies for auditory comprehension?

Answer 4

1. Make sure that the patient can see and hear you.
2. Make sure background noise is kept to a minimum.
3. Use gestures, pictures, objects or written notes to communicate.
4. Use concrete words, phrases and one step directives.
5. Emphasize key words when speaking to the patient.
6. Speak at a normal conversational level of loudness…the patient’s difficulty is understanding language, not loss of hearing.
7. Watch for signs of understanding…the patient may grimace or say something inappropriate.
8. Repeat information as needed. Repeat information in a different way.
9. Be patient! The patient’s comprehension may fluctuate due to fatigue.

Question 5

What are tips and strategies for reading comprehension?

Answer 5

1. Cover text so that only one line is visible at a time.
2. Encourage the use of an augmentative device.
3. Encourage the use of books on tape.
4. Read printed materials together…discuss newspaper headlines.

Question 6

What are tips and strategies for verbal expressions?

Answer 6

1. Be patient!
2. Treat the patient as an adult, not a child…do not talk down to him/her. Remember intelligence is generally intact, communication is the problem.
3. The main goal is communication, not perfect speech.
4. Repeat what you understand to clarify the patient’s message.
5. Be flexible – if it works use it!

Question 7

What are tips and strategies for vague responses?

Answer 7

1. Repeat what you know and ask yes/no questions.
2. Ask for more information.
3. Encourage use of different modalities.
4. Note facial expressions and intonation.
5. Let the patient know what he is attempting to communicate is important to you.
6. Take a break and try again later.

Question 8

What are tips and strategies for jargon?

Answer 8

1. Ask yes/no questions.

2. Ask the patient to try another method of communication: gesturing, drawing, writing, etc.

Question 9

What are tips and strategies for written expression?

Answer 9

1. Hold the paper in place.
2. Rewrite the parts of the word you know and encourage the patient to continue.
3. Provide the patient with written information he can carry with him…name, address and phone number

Question 10

A weakness of paralysis of the muscles used to produce speech.

Answer 10

dysarthria

- Therapy consists of strengthening the muscles used to produce speech.

Question 11

An inability to produce a word, phrase, or sentence voluntarily, due to an inability to “recall” how to place the tongue, lips, and other parts of the speech mechanism in the correct position; The patient may be speechless, may use unintelligible garbled speech, or may use the same word or phrase for every verbal attempt

Answer 11

apraxia

- Therapy consists of increasing voluntary movements

Question 12

An inability to swallow

Answer 12

dysphagia
- Therapy consists of increasing the patient’s ability to swallow by changing diet texture, method of hydration, head or body positioning, and using various therapy techniques

Question 13

An inability to see a specific visual field

Answer 13

visual field cuts

• Therapy consists of teaching the patient to compensate for the field cut by changing head position and using various therapy techniques
• A referral to the physician may be required

Question 14

An impairment to the brain bilaterally, causing impairments of language and intellect, inattention, orientation/memory disturbances, difficulty with problem solving/abstract reasoning, disorganization, and executive function deficits (ie: inability to plan, initiate, and execute tasks, lack of awareness and inability to self-regulate)

Answer 14

cognitive deficits due to TBI

• Therapy consists of increasing the patient’s ability to orient to person, place, and time, their memory skills, organization and problem solving skills, and ability to self regulate
• If deficits are unlikely to improve the patient’s family and/or caregiver is provided with suggestions on how to adapt the environment

Question 15

An inability to speak fluently due to the use of repetitions, prolongations, blocks, fillers, concomitant behaviors

Answer 15

stuttering

- Therapy consists of increasing the patient’s ability to speak fluently using various therapy techniques

Question 16

Voicing in an inappropriate manner causing hoarseness, harshness, breathiness, hypernasality, hyponasality (too high, too low, never changing, harsh, hoarse, breathy or nasal)

Answer 16

voice disorders

• Therapy consists of increasing the patient’s awareness of abusive behaviors and providing him with alternatives for those behaviors thereby improving his vocal quality
• A referral to the patient’s physician may be required
• laryngoscopy, breathing exercises, see-scape, amplification, LSVT

Question 17

Partial or complete surgical removal of the larynx due to cancer or traumatic accident

Answer 17

Laryngectomy

- Therapy consists of providing an artificial larynx or teaching them to use esophageal speech

Question 18

Inability to hear

Answer 18

hearing deficit

• Therapy consists of teaching aural rehabilitation strategies (ie: lip reading, positioning, lighting, etc.)
• A referral to the patient’s physician and/or audiologist may be required

Question 19

what are guidelines for referral to SLP?

Answer 19

1. No purposeful speech.
2. Agitation when needs are not met.
3. Limited ability to provide biographical information.
4. Difficulty with word finding.
5. Conversation that is tangential.
6. Delayed, perseverative or off-topic responses including inappropriate words.
7. Cannot appropriately initiate, change topic during or end a conversation.
8. Difficulty paying attention while speaking…courtesy and facial expressions.
9. Difficulty understanding abstract information…very concrete.
10. Difficulty anticipating consequences of own actions.
11. Limited awareness of extent of difficulties.
12. Difficulty following directions.
13. Difficulty self monitoring and following rules.
14. Exhibits socially inappropriate behaviors.
15. Missing humor.
16. Poor organization with limited problem solving and judgment.
17. Difficulty analyzing, identifying and applying solutions
18. Impaired attention and memory with impulsivity.
19. Limited memory and knowledge of current events.
20. Difficulty with concepts of time and money.
21. Difficulty planning and completing necessary daily activities.
22. Difficulty managing multiple responsibilities simultaneously.
23. Difficulty changing routine or modifying plans as needed.
24. Difficulty with new learning.
25. Difficulty managing emotions.