Speech and Swallowing Therapy

Speech and cognitive communication disorders

Speech and Swallowing Therapy

Speech and swallowing therapy, also called Speech and Language Therapy (SALT), treats all voice, speech, language and swallowing disorders and facial paresis after a neurological disease. The therapy session is administered by specialized therapists, who assess the patient’s condition, develop a personalized treatment plan with individual exercises, single and group therapy sessions, and provide ongoing support and guidance during the patient’s rehabilitation. During each therapy session, the speech and language therapist works closely with patients to improve their ability to communicate or swallow using various techniques or tools.

Speech and swallowing therapy is used to treat a wide range of medical conditions, including:

Aphasia: In aphasia, patients struggle with both the understanding and expression of language. It is a multimodal disorder, typically affecting both oral and written language. Symptoms of the disease commonly occur in the sound or structure of words, word selection, and grammar or syntax.

Non-aphasic central speech disorders: Certain speech disorders that do not primarily affect the language component but are caused by impairments in the patients’ memory, attention, or executive functions.

Dysarthrophonia: This is a neurogenic disorder of speech-motor skills and coordination. The patients’ breathing, vocalization, and articulation are mostly affected.

Apraxia of speech: A disorder of patients that affects the planning and coordination of individual movements into complex sequences of movements when speaking.

Dysphagia: Patients with this disorder have difficulties in swallowing and feeding.

Facial paresis: In this condition, part of the face of patients is paralyzed due to central or peripheral nerve damage, resulting in impaired speech or feeding.

Diagnosis

Given the many systems involved in speech and swallowing – from muscular to neurological – diagnosing these conditions is important to ensure the correct and best treatment is prescribed. Speech and swallowing therapists at Kliniken Schmieder will comprehensively evaluate the patient’s condition, involving various tests and assessments.

The comprehensive evaluation process typically involves a thorough medical history review, examinations of breathing, vocalization and articulation, and various testing procedures. One of the primary diagnostic tools used by speech and language therapists is the modified barium swallow study (MBSS): a patient is asked to swallow various types of liquid or food mixed with barium. The therapist then monitors the patient’s swallowing process using a special X-ray machine to identify any abnormalities or issues causing swallowing difficulties. Blockages or incorrect movements are readily identified through a barium swallow.

Common assessments and tests include:

  • Oral Motor Assessment evaluates the strength and movement of the muscles used in speech and swallowing.
  • Speech Evaluation assesses the patient’s ability to produce speech sounds and communicate effectively.
  • Language Evaluation assesses the patient’s ability to understand and use language effectively.
  • Videofluoroscopy involves the patient consuming various foods and liquids while being monitored by an X-ray machine. This procedure helps to identify any problems with swallowing.
  • Endoscopy involves the insertion of a small camera into the throat to visualize the structures involved in swallowing.

Once a diagnosis is made, the speech and language therapist at Kliniken Schmieder will develop a personalized treatment plan based on the patient’s specific needs and goals. Treatment plans can include exercises to strengthen the muscles involved in speech and swallowing, compensatory techniques to improve the patient’s ability to communicate and swallow safely, and assistive devices such as communication aids or feeding tubes.

Considering the importance of speech and swallowing to daily life, impairments can significantly impact a patient’s quality of life, including their ability to socialize, eat and drink comfortably, and express themselves. Early diagnosis and treatment can, therefore, help minimize the impact of these disorders and improve overall patient outcomes.

How does Speech and Swallow therapy work?

The speech and swallow therapy at Kliniken Schmieder treats the patient’s symptoms and the underlying condition. The fundamental goal is to restore the patient’s prior function, allowing them to communicate effectively and consume food and liquid safely.

Speech and language therapists use various techniques and tools to treat patients. Some of the standard techniques during therapy sessions include:

  • Oral Motor Exercises are prescribed for strengthening the muscles used in speech and swallowing. The therapist may demonstrate specific actions, such as tongue presses or lip pucker exercises, to target specific muscle groups and improve muscle strength and coordination.
  • Articulation Therapy enhances the patient’s ability to produce speech sounds accurately. Techniques such as repetition, phonetic placement, and shaping help patients produce sounds correctly and increase their speech intelligibility.
  • Language Therapy can help improve the patient’s understanding and use of language effectively. Exercises aim to improve the patient’s vocabulary, sentence structure, and communication skills.
  • Swallowing Therapy helps improve the patient’s ability to swallow safely and effectively, reducing the risk of aspiration and related complications. If aspiration occurs, there is a significant risk of chest infections and pneumonia. Experienced therapists, therefore, work closely with patients to ensure that their actions are performed correctly. Techniques like postural adjustments and dietary modifications, e.g., softer foods, can reduce the risk of swallowing complications and alleviate discomfort.
  • Assistive Devices: In some cases, the therapist at Kliniken Schmieder may recommend using assistive devices, such as communication aids or feeding tubes, to help the patient communicate or consume food and liquid safely. While the restoration of prior functions is always the goal, in many cases, this isn’t possible. Assistive devices are used to accommodate these remaining difficulties.

Swallowing disorder treatment follows the three pillars of restoration:

  • Restitution: return of normal function
  • Compensation: learning replacement strategies, and
  • Adaptation: Dietary adjustment

All therapy is aimed at aspiration prophylaxis.

All treatments with Kliniken Schmieder follow the guidelines established in the Germany Society of Neurology for treating aphasic disorders after a stroke, neurogenic speech and voice disorders, and the guidelines for neurogenic dysphagia.

In addition to these specific aspects, patients may require help with speech-modifying behaviour (loudness, speech, and intelligibility), deficit compensation, independent error correction, and more. For some patients, such as individuals with a tracheostomy, the therapy at Kliniken Schmieder will follow specific guidance to remove the cannula and restore independent ventilation.

At Kliniken Schmieder, speech and swallowing therapy is a collaborative process involving the patient, their family members, and the therapist. During therapy sessions, the patient will work with the therapist to practice various exercises and techniques designed to improve their communication and swallowing abilities. The therapist will provide guidance and feedback, helping the patient to refine their skills and achieve their goals.

After each in-person therapy session, the therapist may also provide the patient exercises and activities to practice at home. These activities reinforce the skills learned during therapy sessions and help patients progress toward their goals.

The duration and frequency of speech and swallowing therapy at Kliniken Schmieder will vary depending on the patient’s needs and goals. Some patients may require only a few weeks of treatment, while others may require several months or longer.

Expected Results

Speech and swallowing disorders significantly impact a patient’s quality of life, affecting their ability to communicate effectively and consume food and liquid safely. However, speech and swallowing therapy can be highly effective in improving these abilities and reducing related complications.

Some of the expected results and benefits of speech and swallowing therapy include:

  • Improved Speech Intelligibility:
    Speech therapy can help patients produce speech sounds more accurately, improving their speech intelligibility and communication ability.
  • Enhanced Communication Skills:
    Language therapy can help patients improve their vocabulary, sentence structure, and communication skills, allowing them to express themselves more clearly and effectively.
  • Increased Swallowing Safety:
    Swallowing therapy can help patients swallow safely and effectively, reducing the risk of aspiration and related complications.
  • Reduced Risk of Malnutrition and Dehydration:
    Speech and swallowing therapy can improve swallowing function and help patients consume food and liquid more effectively, reducing the risk of malnutrition and dehydration.
  • Improved Quality of Life:
    Speech and swallowing therapy can improve communication and swallowing abilities, helping patients feel more confident, connected, and independent and improving their overall quality of life.
  • Greater Independence:
    Speech and swallowing therapy can help patients regain their ability to communicate and consume food and liquid safely, reducing their reliance on caregivers and increasing their independence.

The benefits of speech and swallowing therapy can be long-lasting, improving a patient’s quality of life for years. However, it is important to note that therapy outcomes vary depending on the individual patient’s needs and goals, as well as the severity and underlying cause of their speech and swallowing disorder.

In addition, speech and swallowing therapy is not a quick fix and requires time and patience. During a rehabilitation stay at Kliniken Schmieder, our patients have the best possible conditions for achieving the desired positive results with the help of this therapy: our experienced and compassionate team of speech therapists, in combination with an individually tailored therapy plan to meet each patient’s unique needs and goals. The team of Kliniken Schmieder look forward to helping you or your loved one achieve improved communication and swallowing abilities and a better quality of life.