Speech and Swallowing Therapist

01/16/2010

What is a Speech-Language and Swallowing Pathologist?

A speech-language pathologist (SLP) is a master’s level trained professional who provides therapy services in the areas of speech, language, voice, reading/writing, as well as swallowing.

How can speech and swallowing therapy help people with PD?

For some people with PD, speech can get softer, faster, monotone or slurred. Sometimes, people have concerns about memory, concentration changes or words getting harder to remember. Swallowing problems can arise, as well. A speech and swallowing therapist can provide treatment for any of these concerns.

Sometimes, the recommended treatment will be designed to eliminate concerns. Lee Silverman Voice Technique (LSVT) Loud is one example of this type of treatment. LSVT Loud is a well-researched therapy technique that focuses on increasing vocal volume. With increased vocal volume, breathing becomes stronger and articulation becomes more precise. As a result, speech is easier to understand. Research shows that even swallowing improves after LSVT Loud therapy. LSVT Loud is an intense treatment routine that is very successful.

Some people may prefer less intense treatments with a focus on compensating for changes in speech. These can include using pacing strategies to slow speech down or practicing enunciating words more clearly. It could even involve using an amplifier to make speech louder.

With swallowing, a clinical swallow evaluation can be completed to see what aspect of the eating/swallowing process is creating a problem. Based on the results, changes can be recommended to keep people eating their favorite foods safely. Sometimes a modified barium swallow (MBS) study is recommended. This is a moving x-ray that is taken while a person is eating or drinking. This procedure allows the SLP to view the specific function of the swallow and to try strategies to improve the swallow during the test.

The most important part of speech or swallowing therapy is making sure your SLP knows and understands your specific goals. The SLP can recommend a plan for therapy but the plan must make sense to the patient and be one that they can use in everyday life.

How can I find a speech and swallowing therapist in my area?

To receive therapy from an SLP, you will need an order from a physician. Your neurologist can often make recommendations. Speech-Language Pathologists must be licensed by the state in which they practice. In addition, the SLP should be certified by the American Speech and Hearing Association (ASHA). ASHA is a national professional organization that set professional standards for the profession of Speech-Language Pathology. In addition to licensing and certification, an SLP should also have experience working with people with Parkinson’s. Your neurologist will likely be able to help you with a suggestion. The LSVT Global website has a helpful ‘find a clinician’ feature that you can use to find a therapist. Even if you are not planning to complete LSVT treatment, an SLP who has gone through that treatment will be more knowledgeable about Parkinson’s disease. Word of mouth is an excellent way to find a good SLP in your area; ask at your local PD support group if someone can make a recommendation.

What questions should I ask an SLP?

If you are considering participating in therapy, you will first have an evaluation. During the evaluation you should have time to ask questions. Go to the appointment with a clear history of your concerns and what goals you hope for. You could ask some or all of the following questions:

1. How am I doing with regard to my speech and/or swallowing?

2. What are the SLP’s recommendations for me?

3. What strengths do I have?

4. What prevention strategies might work for me?

5. What can I do right away to make the biggest difference?

6. What are realistic goals for me?

7. What will I do in therapy to reach those goals?

8. How many sessions will I need to accomplish my goals?

9. Will my insurance cover my treatment sessions?

10. How much do I need to practice at home to reach my goals?

11. How long will the gains I make in therapy last?

12. Is there research to support these treatments?

13. What if I have other questions, how can I contact the SLP?

You will likely have other questions to ask the SLP. You should always feel comfortable asking your questions. If you don’t, perhaps it is not the right match for you.

How can I learn more?

Log onto the following websites for more information:

LSVT Loud website - www.lsvtglobal.com

American Speech and Hearing Association (ASHA) – www.asha.org

Author: Lisa Ireland holds a doctorate in Education Administration from the College of William and Mary in Virginia. She began her career as a school speech pathologist but found her real calling working in medical settings. She enjoys working with people with Parkinson’s disease, is licensed by the State of Washington, holds a Certificate of Clinical Competency from the American Speech and Hearing Association, is LSVT certified, and has participated in the Allied Team Training Program sponsored by the National Parkinson’s Foundation.

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