Speech-language pathologists can help patients with a wide variety of speech and swallowing disorders caused by illness and injury.
When a communication challenge is brought about by a cognitive issue, they use techniques that help patients restore their abilities or compensate for lost skills.
The goal is to help patients communicate effectively and confidently so they can return to the activities they enjoy.
When communication is challenging, it’s important to seek help from an expert. These issues have a wide variety of causes, and a speech language pathologist has the training and experience to help patients identify and overcome them.
During National Rehab Week, Regional One Health providers are sharing how rehabilitation therapy helps address a variety of concerns. As a speech language pathologist, Michelle Fowke, CCC-SLP works with patients on speech and swallowing disorders: “Many patients express feeling an increased level of confidence after they have completed speech therapy,” she said. “Therapy should give them tools, or strategies, to use in their daily life.”
Fowke treats people who are experiencing both speech and cognitive communication impairments.
Physically, “articulation” is how we make sounds using the mouth, “voice” is how our vocal folds and breath make sounds, and “fluency” is the rhythm of our speech. Cognition, meanwhile, includes components like attention, memory, information processing, problem solving, reasoning and executive functions like planning, organizing and self-regulation.
When communication challenges are based on a cognitive problem, a speech-language pathologist can help by helping patients rebuild skills and find ways to compensate for weaknesses.
“There are many causes of cognitive impairment, such as stroke, traumatic brain injury, dementia and progressive neurological disease like Parkinson’s or Huntington’s disease,” Fowke said. She uses a number of therapies to help patients with cognitive impairments to maintain or regain independence.
Fowke starts each patient’s care by reviewing their medical history and interviewing them to get information about the timing and progression of their concerns and their current goals. If the patient has a severe speech or cognitive impairment, she involves a family member or caregiver.
“This information helps me to determine which assessment tasks will be most appropriate in order to determine the patient’s needs and current level of functioning,” she said.
At that point, she takes an individualized approach to treating each patient.
Some therapies focus on restorative techniques, which involve repeating tasks to target a specific process like memory or problem solving.
The complexity increases over time. For example, Fowke might start treatment in a quiet setting and gradually move to a more distracting setting as the patient improves their ability to attend to selected information while ignoring background noise and activity.
Other therapies focus on compensatory techniques, which use a patient’s residual strengths to accommodate for lost or weak skills. “Often this involves use of internal or external aids such as learning to desensitize to or reduce distractions, writing a to-do list or keeping an appointment book or calendar,” she said.
Assistive technology can help patients improve communication. Smartphones and tablets have features like Siri, screen readers, calendars, contacts, alarms, notes and apps that help with a variety of needs.
Assistive technology can also help, Fowke said. Smartphones and tablets have built-in features such as Siri, a screen reader, a calendar, contacts, alarms and notes. Patients can also download apps for additional assistance with specific needs.
“Education in the use of technology is another part of therapy when it is appropriate and relevant for the patient,” Fowke said. “Other assistive technology includes speech generating devices or low tech communication boards for patients who are unable to communicate verbally. These can be personalized to accommodate a patient’s specific communication needs.”
Treatment is always tailored to a patient’s specific needs, with the goal of helping them regain as much function and independence as possible.
“Therapy can help patients restore weak skills so they can return to work or resume hobbies and socializing they may have discontinued prior to therapy,” Fowke said. “If you’re concerned about speech, language, cognitive functioning or swallowing, share your concerns with your primary care physician, who can contact a speech language pathologist with an order for an evaluation.”