Archive for the ‘Speech Therapy’ Category
Speech Therapy Activities For Aphasia
To begin with, the primary cause of aphasia should be stabilized or treated. After doing so, that’s the only time that a therapist can work on the rehabilitation of the patient. To recover a person’s language function, he or she should begin undergoing therapy as soon as possible subsequent the injury.
Speech Therapy: As A Treatment For Aphasia
Since there are no surgical or medical procedures that are currently available to treat Aphasia, conditions that result from head injury or stroke can be improved through the treatment of speech therapy.
For majority of Aphasic patients though, the main emphasis is placed upon optimizing the use of the person’s retained language skills and being able to learn to use other ways of communication to be able to compensate for their permanently lost language abilities.
Therapy Activities
The formulation of what activities to use during a speech therapy session is critically done and would highly depend on the therapists’ assessment and diagnosis results on the individual. However, there are some general activities that are done to treat Aphasia.
Exercise
Since most types of Aphasia would include right-sided weakness of the body and sensory loss, it is important for the patient to be able to exercise their body. Regular exercise and practice is needed to strengthen the weak muscles and prevent it from further degeneration.
The exercise activities do not have to be exhilarating. For the purpose of speech function, the therapist can exercise the patient’s weakened muscles through repetitive speaking of certain words, and projecting facial expressions, like smiling and frowning.
The use of food too is helpful, since the patient is able to exercise articulators needed for speech production like the tongue and jaw, which may be weakened due to the condition.
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Picture Cards
One of the tools used for therapy are picture cards. Pictures of daily living and everyday objects can be used to improve and develop word recall skills. Picture cards can act as a visual cue to increase the learning process of an Aphasic. These can also help increase the vocabulary of the patient.
By showing the picture cards and repetitively saying aloud the names of the objects in the picture, the patient will be able to exercise weak muscles and practice vocalization.
Picture Boards
Another tool for therapy are picture boards. Since aphasia can bring about difficulty in recalling names of activities, objects and people, use of material to help recall these names is very helpful. By making use of a board where the therapist places pictures of different everyday activities and objects, the patient can point to specific pictures to express ideas and communicate with other people.
Workbooks
The use of workbooks is also important in the treatment of Aphasia. Since reading and writing skills are affected, this is one way to exercise them. Workbook exercises can be used to sharpen an Aphasic’s word recalling skills and recover reading and writing abilities.
By reading aloud, hearing comprehension can also be exercised and redeveloped through workbook exercises.
Computers
With the development of technology, there are now computer programs that are used to treat Aphasia. Such computer programs can be used to improve an Aphasic’s reading, speech, recall, and hearing comprehension. In fact, the use of computers can bring about optimal results, since it can stimulate senses of vision, and hearing at the same time, helping speed up the learning process.
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By Anders Eriksson, proud owner of this top ranked web hosting reseller site: GVO
The Role of Speech Therapy In Traumatic Brain Injury
So what is Speech Therapy really all about? The following report includes some fascinating information about Speech Therapy–info you can use, not just the old stuff they used to tell you.
Traumatic brain injury can cause about a lot of speech and language disorders that would entail the need of speech therapy. That’s why the role of speech therapy in the rehabilitation process of a traumatic brain injury patient is very vital.
What Speech And Language Problems TBI Brings About
A person may have loss of consciousness after a traumatic brain injury. This loss of consciousness can vary from seconds, minutes, hours, days, months or even years. The longer you are out of consciousness, the more severe your injury is. After a traumatic brain injury, you may suffer secondary consequences, which are considered to be more lethal and dangerous than the primary injury.
Some of these secondary consequences include damage to your brain’s meninges, traumatic hematoma, increased intracranial pressure, herniation, hyperventilation, ischemic brain damage, and cerebral vasospasm. When these brain damages occur, they tend to affect parts of your brain that are responsible for speech and language processing and production, thus you get speech and language problems.
Traumatic brain injuries can cause you permanent or temporary memory loss, orientation problems, lesser cognitive performance or slower processing of thought, attention problems, deterioration of skills in basic counting, spelling and writing. You can also have Aphasia, where you have a loss of words.
Traumatic brain injury can also cause you difficulty in reading simple and complex information. Your naming skills, of everyday seen objects, familiar others can also be affected. It can also bring about dysarthria, or problems with movement, that can cause you to have shaky movements leading to difficulty speaking and writing.
Speech Therapy For Traumatic Brain Injury Patients
Treatment for traumatic brain injury patients can be classified into three categories. There are different treatments for early, middle and late stages of a traumatic brain injury. There are also compensatory strategies taught for a TBI patient.
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Early Stage Treatment
Treatment during the early stage of a traumatic brain injury would focus more on medical stabilization. A speech therapist would also deal more on establishing a reliable means of communication between the patient and the therapist. The patient is also taught how to indicate yes or no, when asked.
Another goal is for the patient to be able to make simple requests through gestures, nods, and eye blinks. The behavioral and mental condition of the patient is also treated. During the early stage, sensorimotor stimulation is also done. Where in the therapist would heighten and stimulate the patient’s sense of sight, smell, hearing and touch.
Middle Stage Treatment
The main goal during the middle stage treatment is for the patient to develop an increased control of the environment and independence. The adequacy of patient’s interaction to the environment is also increased. The therapist should also stimulate the patient to have organized and purposeful thinking. The uses of environmental prompts are to be diminished during this phase.
A lot of activities focusing on cognitive skills like perception, attention, memory, abstract thinking, organization and planning, and judgment, are also given.
Late Stage Treatment
During the late stage of treatment, the speech therapists’ goal is for the patient to be able to develop complete independence and functionality. Environment control is eliminated and the patient is taught compensatory strategies to cope with problems that have become permanent.
Some of these compensatory strategies are the use of visual imagery, writing down main ideas, rehearsal of spoken/written material, and asking for clarifications or repetitions when in the state of confusion.
As your knowledge about Speech Therapy continues to grow, you will begin to see how Speech Therapy fits into the overall scheme of things. Knowing how something relates to the rest of the world is important too.
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By Anders Eriksson, feel free to visit his top ranked GVO affiliate site: GVO
Aphasias Speech And Language Problems Targeted For Speech Therapy
The best course of action to take sometimes isn’t clear until you’ve listed and considered your alternatives. The following paragraphs should help clue you in to what the experts think is significant.
Aphasia can bring about a lot of speech and language problems that are to be treated for speech therapy. The kind of speech and language problems brought by Aphasia would highly depend on the kind of Aphasia that you may have.
Broca’s Aphasia
Broca’s Aphasia is also known as motor aphasia. You can obtain this, if you damage your brain’s frontal lobe, particularly at the frontal part of the lobe at your language-dominant side.
If Broca’s Aphasia is your case, then you may have complete mutism or inability to speak. In some cases you may be able to utter single-word statements or a full sentence, but constructing such would entail you great effort.
You may also omit small words, like conjunctions (but, and, or) and articles (a, an, the). Due to these omissions, you may produce a “telegraph” quality of speech. Usually, your hearing comprehension is not affected, so you are able to comprehend conversation, other’s speech and follow commands.
Difficulty in writing is also evident, since you may experience weakness on your body’s right side. You also get an impaired reading ability along with difficulty in finding the right words when speaking. People with this type of aphasia may be depressed and frustrated, because of their awareness of their difficulties.
Wernicke’s Aphasia
When your brain’s language-dominant area’s temporal lobe is damaged, you get Wernicke’s aphasia. If you have this kind of aphasia, you may speak in uninterrupted, long, sentences; the catch is, the words you use are usually unnecessary or at times made-up.
You can also have difficulty understanding other’s speech, to the extent of having the inability to comprehend spoken language in any way. You also have a diminished reading ability. Your writing ability may be retained, but what you write may seem to be abnormal.
In contrast with Broca’s Aphasia, Wernicke’s Aphasia doesn’t manifest physical symptoms like right-sided weakness. Also, with this kind of Aphasia, you are not aware of your language errors.
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Global Aphasia
This kind of aphasia is obtained when you have widespread damage on language areas of your brain’s left hemisphere. Consequently, all your fundamental language functions are affected. However, some areas can be severely affected than other areas of your brain.
It may be the case that you have difficulty speaking but you are able to write well. You may also experience weakness and numbness on the right side of your body.
Conduction Aphasia
This kind is also known as Associative Aphasia. It is a somewhat uncommon kind, in which you have the inability to repeat sentences, phrases and words. Your speech fluency is reasonably unbroken. There are times that you may correct yourself and skip or repeat some words.
Even though you are capable of understanding spoken language, you can still have difficulty finding the right words to use to describe an object or a person. This condition’s effect on your reading and writing skills can also vary. Just like other types of aphasia, you can have sensory loss or right-sided weakness.
Nominal Or Anomic Aphasia
This kind of aphasia would primarily influence your ability to obtain the right name for an object or person. Consequently, rather than naming an object, you may resort to describing it. Your reading skills, writing ability, hearing comprehension, and repetition are not damaged, except by this inability to get the right name.
Your may have fluent speech, except for the moments that you pause to recall the correct name. Physical symptoms like sensory loss and one-sided body weakness, may or may not be present.
Transcortical Aphasia
This kind is caused by the damage of language areas on your left hemisphere just outside your primary language areas. There are three types of this aphasia: transcortical sensory, transcortical motor, and mixed transcortical. All of these types are differentiated from others by your ability to repeat phrases, words, or sentences.
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Speech Therapy For Intermediate Stuttering
This interesting article addresses some of the key issues regarding Speech Therapy. A careful reading of this material could make a big difference in how you think about Speech Therapy.
There are different techniques used for the treatment of intermediate Stuttering. Such techniques are a mix of fluency shaping and stuttering modification techniques. Here are some of the commonly used techniques for treating intermediate stuttering.
Flexible Rate
Flexible rate is slowing down the production of a word, especially the first syllable. This technique is thought to allow more time for language planning and motor execution. In here, only those syllables on which stuttering is expected are slowed, not the surrounding speech.
Flexible rate is taught by having the clinician model production of words in which the first syllable and the transition to the second syllable are said in a way that slows all of the sounds equally. Vowels, fricatives, nasals, sibilants, and glides are lengthened, and plosives and affricates are produced to sound more like fricatives, without stopping the sound or airflow.
After the clinician’s model, the child produces the word with flexible rate, and successive approximations of the target are reinforced.
Easy Onsets
Easy onsets refer to an easy or gentle onset of voicing. Teaching easy onsets is like teaching flexible rate. The clinician models the target behavior by the use of a lot of different sounds and then he makes the child imitate the models. After the child tries to imitate, the therapist should reinforce the child’s successive approximations.
Some children, particular younger ones, may be helped to get the concept by performing an action, such as bringing their hands together slowly, as they produce an easy onset.
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Light Contacts
Producing consonants with light contacts prevents the stoppage of airlow and/ or voicing that can trigger stuttering. Light contacts are taught by modeling a style of producing consonants with relaxed articulators and continuous flow of air or voice, depending on the consonant.
Plosives and affricates should be slightly distorted so that they sound like fricatives but are still intelligible. Modeling a variety of words with initial consonants and reinforcing the child’s successive approximations of the target accomplish teaching a child to use light contacts. The clinician can use a variety of games to make the concept of light contact more interesting.
Proprioception
Proprioception refers to sensory feedback from mechanoreceptors in muscles of the lips, jaw, and tongue. The effectiveness of teaching proprioception may be that it promotes conscious attention to sensory information from the articulators, perhaps bypassing inefficient automatic sensory monitoring systems and thereby normalizing sensory-motor control.
Children can be taught to use proprioception by having a child first hold a raisin in his mouth and report on its taste, shape, size, and other attributes. Children can also learn proprioception by picking a word from a list and then closing their eyes and silently moving their articulators for this word and being rewarded when the clinician guesses the word.
Children can be coached to feel the movements of their lips, tongue, and jaw as they say a word. Proprioceptive awareness can also be enhanced by using masking noise or delayed auditory feedback to interfere with self-hearing. In this, the clinician must look for slightly exaggerated, slow movements to verify that a child is trying to feel the movement of his articulators.
Scaffolding
It is useful with some children to scaffold their use of superfluency by letting the listener/s know that we are working on our speech and sometimes by coaching the child in that fluency-friendly environment. This can be exhibited for example telling a stranger in a mall that the child and the clinician are working on their speech and would like to ask him some questions, another example would be when the child makes telephone calls.
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By Anders Eriksson, proud owner of this top ranked web hosting reseller site: GVO
Delineating Speech And Language Therapy
The field of speech and language therapy is somewhat a vague body of knowledge that only a few people understand. What most people don’t know is that there is a difference between speech therapy as a whole and language therapy. Although the term speech and language’ therapy is widely used, since speech and language problems coexist most of the time.
Differentiating Speech And Language Therapy
The truth of the matter is, that speech therapy and language therapy differ in some key areas. First off, they differ on the problems that they are targeting. The techniques and activities used during therapy are also different. Although there are times that these activities are done simultaneously, to target two problems at a time.
Speech Therapy
Speech therapy is done to treat speech problems. Such speech problems deal with how or the manner a person speaks. These speech problems are categorized into three general kinds. First, is voice or resonation disorders. Second, is articulation disorders. And, lastly, fluency disorders.
Voice disorders mainly deals on problems with the voice box or the larynx itself. These may be due to physiological malfunction, anatomical differences, fatigue, or neurological problems. Some voice disorders present problems in pitch, volume, and tone. The presence of breathy, raspy, nasal and weak voice is viable too.
Articulation disorders, on the other hand, deal with the manner a person speaks. The problem is rooted from the articulators themselves. Articulators are composed of the tongue, teeth, hard palate, soft palate, jaw, and cheeks. Articulation disorders may be due to weakness or physiological malfunction in any of the articulators, which results to distorted or incomprehensible speech.
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Fluency disorders would deal on problems regarding the fluency of the person. It may be the case that he talks too fast or too slow. Stuttering and Cluttering are two of the major fluency problems that speech therapists deal with.
Speech therapy activities would likely include different exercises to practice speaking. Since most of the time, weak muscles are present; the therapy proper would usually include activities that can help strengthen these muscles. Different compensatory strategies are also taught, so that the patient can compensate for lost speaking skills.
Language Therapy
Language therapy mainly deals with problems regarding your inner language, receptive language and expressive language. Cognition skills can be the main cause of language problems. Unlike speech disorders, that manifest physical differences, most language disorders are due to problems the brain’s language processing.
Receptive language problems mainly deals on difficulties understanding received language, like what other people are telling you and comprehending written data. Expressive language problems on the other hand are difficulties on expressing oneself. You may have a hard time knowing which words to use verbally or even through writing.
Language based problems are usually treated through mental exercises. Workbooks are often used to practice and develop language skills. For very young children, play therapy is used to develop inner language, so that the therapist could later on target improving receptive and expressive language, respectively.
In some cases, speech and language problems are both present. This is especially true for individuals that had traumatic brain injuries or accidents that had an effect on the brain. They may manifest physiological problems due to damaged nerves that result to articulation or voice problems.
The can also have language problems like aphasia, especially if their brain was hit on its language areas.
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By Anders Eriksson, feel free to visit his top ranked GVO affiliate site: GVO
Speech Therapy: An Overview
The following paragraphs summarize the work of Speech Therapy experts who are completely familiar with all the aspects of Speech Therapy. Heed their advice to avoid any Speech Therapy surprises.
One of the not so noticed areas of rehabilitation medicine is Speech Therapy. In fact, a lot of people may not even know that something like this existed. It may be the case that this is your first time to encounter the field or you may have heard it somewhere, but don’t fully understand what the practice is all about.
The sad truth about Speech Therapy is that you may not encounter it unless the situation calls for it. However, getting to know what the practice is can be very beneficial information.
What Is Speech Therapy?
As the name suggests, speech therapy deals with speech problems that an individual may encounter. However, the field of Speech Pathology doesn’t only tackle speech, but also language and other communication problems that people may already have due to birth, or people acquired due to accidents or other misfortunes.
Speech therapy is basically a treatment that people of all ages can undergo through, to fix their speech. Although speech therapy alone would focus on fixing speech related problems like treating one’s vocal pitch, volume, tone, rhythm and articulation.
Goals Of Speech Therapy
Speech Therapy aims for an individual to develop or get back effective communication skills at its optimal level. Recovery mainly depends on the case and severity of your problem, especially if your speech problem is acquired, meaning you had normal speech skills before then you had an accident or abrupt incident that caused your current speech problem; thus, you may or may not get back your old level of speech function.
Speech Problems
Speech problems are mainly categorized into three namely: Articulation Disorders, Resonance or Voice Disorders and Fluency Disorders. Each disorder deals with a different pathology and uses different techniques for therapy.
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Articulation Disorders
Articulation Disorders are basically problems with physical features used for articulation. These features include lips, tongue, teeth, hard and soft palate, jaws and inner cheeks. If you have an Articulation Disorder, then you may have a problem producing words or syllables correctly to the point that people you communicate to can’t understand what you are saying.
Resonance or Voice Disorders
Resonance, more popularly known as, Voice Disorders mainly deal with problems regarding phonation or the production of the raw sound itself. Most probably, you have a Voice Disorder when the sound that your larynx or voice box produces comes out to be muffled, nasal, intermittent, weak, too loud or any other characteristic not pertaining to normal.
Fluency Disorders
Fluency Disorders are speech problems with regard to the fluency of your speech. There are some cases that you talk too fast, in which people can’t understand you, thus, you have a Fluency Disorder of Cluttering. The most common Fluency Disorder however, is Stuttering, which is a disorder of fluency where your speech is constantly interrupted by blocks, fillers, stoppages, repetitions or sound prolongations.
Who Gives Speech Therapy?
A highly trained professional, called a SLP or a Speech and Language Pathologist, gives Speech Therapy. Speech and Language Pathologists are informally more popularly known as Speech Therapists. They are professionals who have education and training with human communication development and disorders.
Speech and Language pathologists assess, diagnose and treat people with speech, communication and language disorders. However, they are not doctors, but are considered to be specialists on the field of medical rehabilitation.
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Speech Therapy: PROLAM-GM Approach
PROLAM-GM is an acronym for the various intervention and transfer strategies used in the management of stuttering. PROLAM, which stands for physiological adjustments, rate manipulation, operant controls, length and complexity of utterance, attitude changes, and monitoring, are the intervention strategies. GM, which stands for generalization and maintenance, are the transfer strategies.
Physiological Adjustments
Physiological adjustment strategies include tactics that manipulate bodily components known or thought to be involved in the production of stuttered speech. An example of this would be the attempt to use gentle contact between the articulators when talking.
The rationale behind this approach is that the physiological components necessary for the production of normal fluent speech are in some way used inappropriately when stuttering occurs. Therefore, the therapy tactics used will result in a readjustment of the disordered component, or in use of compensatory behaviors and strategies.
Rate of Speech Manipulations
Use of a reduced speech rate to modify stuttering operates in the belief that: (a) reduction of rate results in simplification of the physiological speech processes, thus allowing easier synchronization or; (b) reduction in the rate of speech prevents the stutterer from anticipating feared stimuli that result in the production of the stuttering response.
The rate of the stutterer’s speech may be reduced by: prolongation, combining prolongation with continuous phonation, and using an instructional rate control method.
Operant Controls
Use of operant controls in the management of stuttering believes that if stuttering is an operant behavior (behaviors whose frequency or probability of occurrence are influenced by the consequences they generate), then its frequency will increase if it is reinforced, and its frequency of occurrence will decrease if it is punished.
Two of the most frequently used operant procedures for treating stuttering are positive reinforcement of fluency and punishment of stuttering.
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Length and Complexity of Utterance
Controlling the length and complexity of the stutterer’s utterance reduces stuttering and increases fluency. This technique is often used to increase fluent speech. Most of the approaches utilizing this technique combine manipulation of length and complexity of the client’s language with operant controls (punishment of stuttering and reinforcement of fluency).
Attitude
There are two components of stuttering namely: the feelings accompanying it and the speaking behaviors that are resulted from it. It is believed by some that to have a successful therapy, a balance of treating both factors should be done. That’s why attitude manipulation is done in some approaches while in other approaches it can be optional depending on the case of the client.
Monitoring
In the science of Speech Pathology, especially in the field of stuttering, there are a lot of meanings for the term monitoring’. Some say it’s a process in which the PWS becomes aware of what he is doing at the time he is doing it. Some say it is a specific form of consciousness where the act of speaking is raised from an automatic level to a purposeful level. Basically, it has three key components: self-awareness, deliberate control and self-feedback.
Generalization
The technical term for generalization is the occurrence of a relevant behavior under different nontraining conditions. The term generalization is usually interchanged with transfer’ or carryover’.
Maintenance
Sometimes, when clients are able to achieve fluency, they think the fight is over. They forget to maintain their skills and in result they have a relapse with their stuttering. Maintenance refers to different after-treatment activities to help clients keep the skills they learned from therapy intact.
Some activities to help maintain skills are daily self-monitoring activities, regular clinic contacts, refresher programs and having self-help groups.
Take time to consider the points presented above. What you learn may help you overcome your hesitation to take action.
About the Author
By Anders Eriksson, proud owner of this top ranked web hosting reseller site: GVO
Therapy Procedures for Speech Disorders
The terminal goal of speech therapy is for the client to spontaneously use the appropriate speech sounds of his or her linguistic culture in connected speech. In this context, therapy becomes a continuum of short-term goals designed to meet the terminal goal. And therapy procedures may either use the motor or traditional approach or the cognitive-linguistic approach.
Motor or Traditional Approach
This approach is structure-based and uses drills more. Drills are activities that have rapid rates of stimulus presentation and which puts much stress on accuracy of the patient’s response to the stimulus and the said response reaching various set criteria.
Under this approach is auditory training. Its proponent is Charles Van Riper. This procedure uses pictures and games as motivational events or events that serve as a way of presenting stimuli. Activities are mainly about speech sound discrimination. It highlights the awareness and detection of sound.
Another procedure is the exercise of the oral motor structures. It is used when an oral motor assessment shows muscle weakness or spasticity. For children, it should be made fun and functional. It also uses mirrors for visual feedback.
One other procedure under this approach is phonetic placement. Van Riper was also the proponent of this procedure. It provides clients with verbal descriptions or instructions regarding articulatory position and movements for target sound. It is usually used together with visual, auditory, tactile and kinesthetic cues.
Weiner’s contribution to this field is his modified sensory motor approach. It is where a word in which the target sound is correct in the final position is paired with a word in which the same sound is in error in the initial position. The words are produced without a pause to facilitate assimilation of the incorrectly produced sound.
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In this line also is syllabication. It uses the syllable-by-syllable production of words. It is used in addressing weak syllable deletion or the deletion of the syllable in a word which is the least stressed.
One procedure that is closely related to syllabication is chaining. The client is first asked to say the whole word. If he says a syllable incorrectly, the therapist instructs the patient to look at his lips while he produces the word syllable by syllable with the patient following him after every syllable until he produces the word the same way that the therapist did.
Cognitive-Linguistic Approach
The first procedure under this approach is auditory bombardment, also known as cycles approach. There are treatment cycles which have their designated phonemes, taught in a span of 2-4 weeks. Auditory bombardment requires that the patient be bombarded with the phonemes that he needs to learn without him being aware of it.
Another procedure is auditory bombarding with PACT (Parents and Children Together). Here, production should not be over-emphasized. It may use funny, perceptually salient make-up words like ker-plunk, boing, shilly-shally or kaboom. All that matters is that the words contain the phonemes that are being targeted.
Modified cycles approach is also under this group. It requires the clinician to make purposeful and obvious lexical errors in words that contain target phonemes to make the patient correct the clinician, thus producing the target sound. Parental involvement is important for explanations of goals, procedures, and assignments.
Minimal contrast therapy, on the other hand, contrasts presence and absence of phonemes, establishing also the difference between phonemes. This procedure can be utilized in addressing perceptual or production difficulties when it comes to final sounds of words, establishing the difference between words like fee and feet.
It never hurts to be well-informed with the latest on Speech Therapy. Compare what you’ve learned here to future articles so that you can stay alert to changes in the area of Speech Therapy.
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Roles Of Speech Therapist In Laryngectomy Management
There are three phases of management for laryngectomy: pre-operative, operative, and post-operative management. Each phase has its advantage and goals. A speech therapist plays vital roles in the first and last phase. Consulting a speech therapist during the first phase is equally important with seeing a therapist during the last phase, which is when voice rehabilitation really begins.
A speech therapist also has different roles in each phase, that’s why it is vital for a therapist to know the two phases he plays a role in.
Pre-operative Management
Pre-operative management includes informing the patient of the anatomical changes, and expectations regarding swallowing, voice, and the family as a part of the team. The therapist also informs the patient on the different speech options he has after the operation.
During this phase, the speech therapist should initiate ordering of the hardware or alternative means of communication. The therapist should also be open to questions that the patient may come up with. This is also the time for him to establish rapport with the patient.
The therapist can also offer re-assuring consultation with appropriate laryngectomee volunteers. This is also the time where he assesses the pre-laryngectomy speech and cognition of the patient. The laryngectomee is also informed with his prognosis, where the potential for recovery and long-term rehabilitation is discussed.
The advantages of this phase would be the evaluation of preoperative speaking skills such as speaking rate, articulation errors, accent patterns, oral opening degree when speaking, and vocal parameters. Cognition and hearing is also evaluated, along with oral-peripheral-mouth strength and sensation. The family can also get emotional support in this phase.
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Assessment is done by the use of modified barium swallowing or Fiberoptic Endoscopic Evaluation of Swallowing. The patient’s communication needs are also assessed where living situation, occupation, social requirements and hobbies are looked at.
Postoperative Management
During this phase, the therapist is given an opportunity to help lessen the patient’s fears, and depression. He should also help the patient to accept the loss of voice and swallowing difficulties. The motivation of the patient should be increased, so that he can easily learn how to use alternative speech. Social implications are also addressed. Arrangements for voice rehabilitation are also done during the early parts of this phase.
Firs off, the therapist should confirm if the patient is already medically cleared for therapy. Then he should review the treatment procedure, re-evaluate the patient’s swallowing function then give diet recommendations, and create a treatment plan.
Problems Encountered During Postoperative Management
After the operation some problems may still occur. With regards to Tracheostomy, the patient and therapist should always be watchful of stoma hygiene, cannula hygiene, stoma covers, excessive mucus in the trachea, mucus encrustations in the stoma, and stoma safety and first aid.
There could also be problems related to taste, swallowing, smell and digestion. The patient may find it difficult to trap air within the lungs. This can lead to difficulties in creating internal subglottic pressure, elimination of body waste and childbirth.
Problems of social adjustment may also be present. The patient may find it hard or embarrassing to use alaryngeal speech in public. The altered physical appearance of the patient may also be an issue. Sometimes, the laryngectomee also has unrealistic expectations regarding acquisition of alaryngeal speech.
Is there really any information about Speech Therapy that is nonessential? We all see things from different angles, so something relatively insignificant to one may be crucial to another.
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By Anders Eriksson, feel free to visit his top ranked GVO affiliate site: GVO
Speech Therapy Assessment Tips For Fluency Disorders
During the assessment of an individual with suspected fluency disorder, there are some things to remember to make the assessment more comprehensive and useful. Here are some of those critical points to take note of during assessment.
Benefits Of Obtaining Both Reading and Conversation Sample
It is more beneficial to obtain both reading and conversation sample from school children and adults because this would give more reliability and credibility to the samples taken.
Since stuttering varies in different situations, a reading and conversation sample would allow the clinician to see the behaviors of the person in two different tasks. A conversational speech sample is likely to have more variability, while a reading passage would likely have less variability.
Information To Assess Motivation
Through interview, a therapist can learn a lot from his client. In fact, insight about the client’s motivation could be seen by asking the following questions like What do you believe caused you to stutter?, Has you stuttering changed or caused you more problems recently?, Why did you come in for help at the present time?, Are there times or situations when you stutter more? Less? What are they?.
Benefits Of Continuing Evaluation
No individual could be understood in an hour or two; that’s why continuing of evaluation is recommended. The clinician might overlook an important element at times and some times a vital clue will not be present in the samples of behavior taken from the limited time of the evaluation period.
Note The Difference When Assessing Feelings and Attitudes
I trust that what you’ve read so far has been informative. The following section should go a long way toward clearing up any uncertainty that may remain.
Assessing a school-age child’s feelings and attitudes would require the clinician to establish rapport and to get to know the child much better after some time, because the clinician’s judgment is also a fair measurement in the case of school-age children.
Talking to the child and observing his behaviors would be necessary. When the clinician has known the child much better, he could administer the A-19 Scale to the child. Other methods could also be used such as Worry Ladder and Hands Down that could be found in the workbook, The School-Age Child Who Stutters: Working Effectively with Attitudes and Emotions.
For adults and adolescents assessment of feelings and attitudes are usually done by administering tools such as, the Modified Erickson Scale of Communication Attitudes, the Stutterer’s Self-Rating of Reactions to Speech Situations, the Perceptions of Stuttering Inventory and the Locus of Control of Behavior Scale.
Remember The Role Of The IEP Team
An Individualized Education Program (IEP) team is appointed to a child to be the ones to consider reports by the clinician and other information. They decide if the child meets the state’s eligibility standards and if the child’s stuttering has a negative effect on his education.
If a child is eligible for services measurable, the IEP team sets goals and short-term objectives for the child. They also provide services needed by the child for improvement in the educational setting.
Goals Of Trial Therapy
Trial therapy for a school-age child is done to understand what approach might work and what might be difficult for him. This could increase the child’s motivation and positive outlook for the treatment. In the case of adults and adolescents, trial therapy is done for 3 main reasons.
First, is to get an idea of how a client would respond to different therapy approaches. Second, is to make a differential diagnosis between developmental, neurological or psychological stuttering. Third, it gives a preview to the client of what to expect during therapy sessions, in effect it would give them motivation to go on their treatment.
About the Author
By Anders Eriksson, feel free to visit his top ranked GVO affiliate site: GVO