Speech-Language+Pathology

=Speech-Language Pathologists: More than “Speech Correctionists“=

By: Brittany A. Hill
Almost all of us have heard the term Speech-Language Pathologist, but do you really know what the career entails? I have come across many people who have not even heard of the term “Speech Pathologist,” and they only know what I am referring to when I tell them “We’re also known as Speech Therapists.” While it’s not necessary for everyone in the world to know what a Speech-Language Pathologist does, it is important that those working in an educational setting do. At times, SLPs in the school setting work very closely with teachers and other staff to ensure that a child is getting what they need to succeed. This is why it is essential we understand each other.

What exactly is a Speech-Language Pathologist?
As with all things, there are a range of definitions. But let’s concentrate on the legit. The National Student Speech Language and Hearing Association (2004) defines SLPs as the following: “Working with a full range of human communication and its disorders, SLPs treat speech, language and swallowing disorders in individuals of all ages, from infants to the elderly, and evaluate and diagnose speech, language, and swallowing disorders.” NSSLHA goes on to say, “In addition, SLPs may: train future professionals in colleges and universities; manage agencies, clinics, or private practices; engage in research to enhance knowledge about human communication processes; develop new methods and equipment to evaluate problems; establish more effective treatments; and investigate behavioral patterns associated with communication disorders.”

Where might I find a SLP?
If you think SLPs can only be found in the school system, think again. The practice and work of a speech-language pathologist is likely to take place in public and private schools, hospitals, rehabililitation centers, nursing care facilities, community clinics, colleges and universities, private practices, state and local health departments, government agencies (including prisons), home health care, adult day care centers, and research laboratories (ASHA 2009). This is one great thing about the field of SLP-there are opportunities everywhere. They are never limited to one environment through the course of their career.

What types of services does a school-based SLP provide?
At an average sized school, you can expect an SLP to have a caseload that ranges between 30-100 students per week. The average is somewhere around 40-50 (Homer, 2009). SLPs serve on several multidisciplinary teams that are student goal oriented. In addition to SLPs, these teams usually consists of general education teachers, special education teachers, administrators, and even the school nurse when necessary. The SLP participates in meetings with other educational professionals to evaluate and review student progress and make recommendations for appropriate academic goals. While SLPs have an array of roles and responsibilities, the majority of their time is usually spent on providing direct services to students. (Annett, 2003)

Here is a brief overview of the main categories of services provided by the school-based Speech-Language Pathologist (Merkel-Piccini, 2008):

//Articulation Therapy and Assessment:// This type of therapy is provided to students who have difficulty producing speech sounds. This is the most common school age problem.

//Voice Therapy and Assessment:// Some children may have problems with their voice due to things like prolonged vocal hoarseness. These children may come to therapy to learn how to use their voice appropriately and to prevent future damage to the vocal cords. In some cases, an SLP will refer a child to an ear, nose, and throat doctor to make sure the child does not have any growths (such as nodules) on their vocal cords from prolonged abuse.

//Language Therapy and Assessment:// Children who have things such as delayed vocabulary and syntax issues receive this type of therapy. There are an array of other language disorders as well that benefit from language therapy.

//Auditory Processing and Comprehension Deficits:// This type of service is provided to children who have problems in the area of receptive language. These children have problems understanding spoken language. If their lack of understanding is the result of an auditory processing deficit, then they will have problems distinguishing and discriminating speech sounds. With comprehension deficits, the child will have difficulty with word meaning, sequencing skills, and problem solving.

//Pragmatic Language Disorders:// Some children do not have any problem with spoken language; rather, they have trouble using language properly in social contexts. Children with autism often receive therapy under this category. During therapy they learn things such as how to greet others, initiate conversation, make eye contact, use proper body language, and other meaningful social skills.

//Hearing Impairment and the Hearing Handicapped:// Some children who have hearing loss participate in aural rehabilitation. This type of therapy addresses skills revolving around topics such as lip reading, articulation, and voice. SLPs also screen hearing in many school systems. They can check hearing aids and other hearing devices to ensure they are working properly.

//Oral-Motor Disorders:// These children receive therapy for weak tongue and/or lip muscles. A child with this type of disorder often has trouble with the clarity of speech. SLPs use strategies that involve oral activities such as whistling, bubble blowing, using straws, and chewing gum to strengthen the weak muscles. Other children that fall under this category have trouble coordinating the movement of their mouth and the parts surrounding it during speech (known as apraxia). These children are treated by an SLP through structured practice of speech movements.

//Myofunctional Disorders:// Children who demonstrate a tongue thrust when eating and a lisp when producing sounds such as /s/ fall under this category. A flat, weak tongue that always pushes against the front teeth characterizes these disorders. When working with a child who presents such a problem, the SLP will focus on tongue thrust reduction, which will result in less difficulty when speaking.

//Swallowing/Feeding Issues:// While this type of therapy is most common in the hospital or nursing home setting, there are children in the school system that have difficulty with chewing and swallowing. The SLP can provide techniques that will help the child eat safely (i.e. modifying food texture, positioning of body). The SLP can also help set up a feeding program that is appropriate for the child indicating what foods are safe and unsafe for the child.

//Fluency Disorders:// Often referred to as “stuttering,” dysfluency is characterized by repetition or prolongation of sounds, words, or phrases during speech. SLPs provide children/adolescents with strategies to overcome these difficulties.

While this list is not comprehensive, the majority of students receive SLP services under one of the categories mentioned.

Do SLPs and teachers work together?
Absolutely. There are many instances in which SLPs work with classroom teachers in developing strategies to maximize a child’s classroom performance. (Merkel-Piccini, 2008) SLPs can provide teachers with evidence-based approaches to implement in the classroom. For example, an SLP may provide a kindergarten teacher with evidence-based approaches for emergent literacy development strategies. (Bowell, 2008) While it has always been imperative that teachers and SLPs work together for the benefit of the student, the need for collaboration has grown even more since the Individuals with Disabilities Education Act (IDEA) Amendments of 1997. (Straub, 2004) Students need to access the general education curriculum, as well as carry over individual education plan (IEP) goals in therapy to the classroom successfully. (Straub, 2004) This can only be done successfully if the SLP and general education teacher work together. Straub makes a good point when discussing the collaboration between the two; “Teachers and speech-language pathologists form an equal partnership, each bringing different but equally important expertise to the table. Given the amount of time classroom teachers spend with student’s daily, they have a strong awareness of their development and needs in all areas. Teachers also are rooted in the content standards of the curriculum, the daily routines, and how best to serve student needs. Speech-language pathologists have expertise in the many areas of speech and language development that are not part of the general educator's training.” Moore-Brown (1991) sums up the importance of collaboration: “The bottom line is the children we continue to pull out for isolated special services are the very students most needing the structure and consistency of remaining all day in the general education classroom.”

Do SLPs use technology to support students in their therapy?
There are a great number of technologies and tools used by the school SLP for both diagnosis and therapy, and the SLP must keep abreast of constantly evolving technologies. Three very different examples of these are classroom amplification, speech-generating devices, and teletherapy. Classroom amplification is a classification of many technologies that help students who are hearing impaired to better understand the speech of others in their classrooms. One example is an individual FM system, in which the teacher wears a microphone/transmitter, and the student wears a receiver. (Lewis, 2008) Assistive technologies are helpful in assisting autistic children or children with little ability to speak to learn to spell. For instance, electronic speech-generating devices can be used to provide instant feedback (print and sound) to students after they type a letter or a word. (Schlosser & Blischak, 2004) Through teletherapy, SLPs use videoconferencing or teleconferencing to provide live, real-time diagnostic or therapy services to students at schools, usually rural, that may be hours away from the SLP. (Forducey, 2006)

Bibliography American Speech-Language and Hearing Association. (1997-2009). Retrieved May 2nd, 2009, from www.asha.org Annett, M. (2003, April-June). Beyond School Caseloads:Looking at Total Workload. The ASHA Leader. Bowell, S. (2008, May 6). Schools 2008: Power in partnership: Speech-language pathologists, audiologists join forces at schools conference. The ASHA Leader, 13(6), 1, 9. Forducey, P. (2006). Speech telepractice program expands options for rural oklahoma schools. The ASHA Leader, 11(10), 12-13. Homer, E. (2009). Envisioning the Future SLPs in the. Covington, LA. Retrieved from http://search.asha.org/query.html?col=asha&col=ashaprod&col=ashfoun&col=ebp&col=journals&col=nsslha&col=perspect&col=policy&qt=school+based+slp&charset=iso-8859-1 Lewis, D. (2008) Trends in classroom amplification. Contemporary Issues in Communication Sciences and Disorder. 35(3), 122-129. Merkel-Piccini, R. (2008). "I know you're a speech pathologist...but what do you do?". Super Duper Publications. Moore-Brown, B.J. (1991). Moving in the direction of change: Thoughts for administrators and speech-language pathologists. Language, Speech and Hearing Services in Schools, 22: 148-49 National Student Speech-Language Hearing Assoiciation. (2004). Retrieved May 3, 2009, from www.nsslha.org/nsslha/ Schlosser, R. W., & Blischak, D. M. (2004). Effects of speech and print feedback on spelling in children with autism. Journal of Speech, Language and Hearing Research, 47, 848-862. Straub, C. (2004). Clinicians in the classroom: Collaborating with first grade teachers. Retrieved May 3rd, 2009, from http://speech-language-pathology-audiology.advanceweb.com/Editorial/Content/Editorial.aspx?CC=36511.