Written by Jessica Lewandoski, MS, CCC-SLP
Speech-language pathologists (SLPs) work with people that have difficulty in the areas of speech and language. Speech and language disorders differ from each other, although the terms may be used interchangeably at times. Speech disorders include the inability to produce speech sounds correctly or fluently, or problems with voice. Language disorders are broken down further into receptive and expressive language disorders. If someone has difficulty understanding others they may have a receptive language disorder, whereas if someone has trouble with sharing thoughts, ideas or feelings effectively, they may have an expressive language disorder.
In the realm of speech and language disorders, there are various types of speech disorders. One speech disorder that SLPs may work with includes Apraxia of speech. There are two types of Apraxia of Speech; Childhood Apraxia of Speech (CAS) and Apraxia of Speech in adults. CAS is a motor speech disorder where children have difficulty saying sounds, syllables and words and is not due to any type of muscle weakness. Children have difficulty with motor planning and although children know what they want to say, their brain cannot coordinate the muscle movements that are necessary to produce speech sounds, syllables, or words effectively. A SLP works with these children to help with sequencing, coordination, and planning of speech sounds. Apraxia of Speech in adults differs because it is caused by damage to the parts of the brain that help produce speech sounds. Common causes of Apraxia of Speech include stroke, dementia, traumatic brain injury, or progressive neurological disorders. Similar to CAS, people have difficulty sequencing and coordinating speech sounds. They know what they want to say but have difficulty coordinating movements to produce the sounds. SLPs help by working on coordinating sounds and/or help with the pacing of sounds and words.
Speech therapists can also work with children that have speech sound disorders, where they have difficulty producing speech sounds, which is referred to as articulation disorders or phonological processes. When a child has an articulation disorder they have difficulty making speech sounds. This differs from a phonological process because phonological processes follow a pattern. As children learn to develop speech there are sounds that are distorted, changed, or left out. This makes speech difficult for others to understand. There are developmental guidelines for learning sounds, and if a child cannot produce speech sounds correctly by a certain age, they may have an articulation disorder. For example, they may produce “biwd” for “bird.” A phonological disorder differs because rather than misarticultion of specific sounds, individuals present with patterns in their misarticultions. For example, they may substitute all sounds that are produced in the back of the mouth with sounds that are made in the front of the mouth, such as /k/ and /g/ substituted for /t/ and /d/. SLPs would evaluate the child to identify the exact sounds that are not produced correctly and look at the oral mechanism to be sure that all articulators are able to move correctly for appropriate speech production. Therefore, SLPs work with children to differentiate correct/incorrect speech production, demonstrate how to create the sounds correctly, and practice making the sound correctly for both articulation disorders and phonological processes.
Another speech disorder that SLPs can work with is fluency disorders or stuttering. Stuttering is a communication disorder where speech may be comprised of repetitions (b-b-ball), prolongations (bbbball), fillers (um, like), or instances of stoppages where no sound is produced. Secondary characteristics of stuttering may include groping or unusual facial or body movements during this time. SLPs work with people by helping to identify when they stutter so that they can monitor their dysfluencies, slowing down their rate of speech, teaching to produce speech sounds gently, and/or breathing techniques.
In the scope of speech and language disorders, the next area is language disorders. Types of language disorders may include Aphasia. Aphasia results from damage to the parts of the brain that contain language. It can affect speaking, listening, reading, and writing. It can be caused by a stroke, traumatic brain injury, illness, or a progressive neurological disorder. People may have difficulty understanding others (receptive aphasia), expressing their ideas (expressive aphasia), or both (global aphasia). SLPs work with people to help with their ability to understand vocabulary, follow directions, create sentences, use words correctly, or use strategies to strengthen their language skills. SLPs can work with various ages including young children through adulthood to help with a language disorder. Language is comprised of five parts; phonology, morphology, syntax, semantics, and pragmatics. SLPs may work with people in any of these areas. SLPs work on either one or combinations of all of the parts of language. It is the SLP’s job to find where the breakdown is occurring and help remediate the area(s) of deficit.
Language can also be broken down into two parts: receptive and expressive language. Receptive language is the understanding of language and may include difficulty in the ability to follow directions, understanding what others are saying, understanding figurative language, or understanding word relationships. SLPs work to help people by teaching strategies or frequent practices of the skill deficit. Expressive language includes the ability to convey a message orally. People with an expressive language disorder often know what they want to say, however, cannot form the words or ideas completely to express themselves. Areas of difficulty may include sentence structure, vocabulary, grammatical forms, or conversational skills. SLPs can help by modeling correct language forms, teaching strategies, and consistently working with people to improve their language based on the specific skill deficit. People can have a mixed language disorder consisting of both receptive and expressive language difficulties.
A SLP chooses what to work on with their clients based on a comprehensive evaluation of the specific areas of strengths and weaknesses. SLPs should work closely with families, other specialists, doctors or teachers collaboratively to formulate the best plan to help with each specific case. Each person presenting with a speech and language disorder has individual needs, therefore, each person requires their own individual evaluation and plan to help with their specific needs.
About the Author: Jessica Lewandowski,MS, CCC-SLP is a certified speech pathologist living in New York State.