What is a Speech-Language Pathologist?

They work with “r,” right? They work with “s,” right? They are in the schools, right?

Yes, we do work with “r” and “s,” and yes, we are found in schools, but that is only the beginning. Speech-language pathologists work in hospitals, skilled nursing facilities, rehabilitation facilities and private practice. Let’s talk about who might need a speech-language pathologist.

Children who are difficult to understand is the first thing that usually comes to mind. When should you consult a speech-language pathologist? Broadly speaking, a 3-year-old should be understood by a total stranger 75-90% of the time. There is more to it than just speech sounds, though 3-year-olds should speak in complete sentences, with pretty good grammar, on a wide variety of topics. They should ask a lot of questions and answer many questions. If your child is not talking like others his same age, consult with a speech-language pathologist. A speech and language evaluation will reveal whether your child is behind others or not.

Another speech problem that children (and adults) present is stuttering. Stuttering is difficulty getting the words out; they feel “stuck.” It may sound like repetition of the first sound in a word or sentence or repeating whole words. It may sound like silence as they struggle to get the word out. They may hold onto a sound before getting the rest of the word out. Stuttering is not a result of something you did or did not do; it is neurological. There is no “cure,” but speech therapy can teach some control techniques. Many children will “outgrow” stuttering by 17 years of age; the problem is, we don’t have a way of predicting which ones will or will not “outgrow” it. Between the ages of two and four years, stuttering is very common, particularly when they are excited, and is probably nothing to worry about. If, however, the child appears to be struggling, if the stuttering is “most of the time,” or if their language use seems immature compared to other children, a consult with a speech-language pathologist may be valuable. In the meantime, just let them talk, don’t finish their sentences, and don’t act concerned. Tell everyone in their life (sitters, daycare, grandparents) how to handle the stuttering.

Some children appear to talk normally, but do not seem to understand complex language. They may not follow directions correctly, but think that they did. These children may get into trouble at school for not following directions, but do not understand why they are in trouble. These difficulties may be due to a receptive language problem, or difficulty understanding language.

Children who are struggling to learn to read may benefit from a language evaluation. Reading is a complex skill involving vision, hearing, memory, vocabulary, verbal reasoning, background knowledge, and language structures. Language therapy with a speech-language pathologist may help with reading difficulties.

Speech can be difficult for children with cerebral palsy, autism spectrum disorder, head-neck cancers, hearing loss and a number of syndromes. Speech therapy is often helpful; but if clear speech is not improving, there are computerized, augmentative communication devices that can provide communication for these children.

Adults can experience speech and/or language problems, as well. Stuttering can continue into adulthood. Speech/language may be lost or impaired as a result of head injury, stroke, head-neck cancer, and neuro-muscular diseases such as ALS. Speech therapy may result in improvement, but if not, as mentioned previously, there are several computerized, augmentative communication devices that can provide communication for individuals who are unable to speak.

Communication connects us. An inability to communicate or difficulty communicating isolates us. If you or a loved one has any difficulty with understanding or using speech and/or language, I encourage you to consult with a speech-language pathologist. Most will be happy to discuss your concerns before you schedule an evaluation, and will not recommend therapy if test results indicate “normal” or “average” speech and/or language skills.

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