Introduction
Adult speech therapy and paediatric speech therapy can look very different. While paediatric speech and language disorders are largely developmental, adult speech and language disorders are usually acquired later, due to injury or illness. There are several common types of conditions and causes that may render an adult patient in need of support through speech therapy.
Common Conditions
Aphasia
Aphasia is a condition in which an individual has suffered brain damage (usually from a stroke or traumatic brain injury) in regions associated with language. Aphasia can affect an individual’s ability to understand language, speak, as well as read and write. A speech therapist can help an aphasic patient communicate more effectively by making the most of the abilities that are retained, and by introducing compensatory strategies for the language functions that might have been lost.
Dysarthria
Dysarthria is a condition in which an individual has difficulty producing speech due to muscle weakness or incoordination. The act of speaking involves many different muscles – facial muscles, the lips, tongue, throat, and muscles for breathing. It becomes difficult to talk when these muscles are weakened or are unable to coordinate with each other. Dysarthria may be caused by damages to the muscles from trauma or weakening after suffering from a stroke. A speech therapist can help assess and introduce strategies and activities to work on voice and speech clarity to improve overall communication.
Dysphagia
Dysphagia is a swallowing disorder which can be characterised by painful swallowing, feeling of food stuck in the throat, and/or coughing or gagging when swallowing. It is more common in older adults, though it can occur at any age. Individuals with dysphagia may consequently be malnutritioned or dehydrated, and may suffer from aspiration pneumonia or chronic lung disease, alongside reduced enjoyment for eating, embarrassment, and isolation related to eating or drinking. A speech therapist can diagnose and manage dysphagia, with treatment typically including the restoration of normal swallowing functions and introduction of some compensatory strategies to assist in swallowing (diet changes, exercises). This can help the patient restore as much function as possible and maximise their quality of life.
Common Causes
Traumatic Brain Injury
Traumatic brain injury (TBI) causes damage to the brain which can result in speech, language, thinking, and swallowing difficulties. A speech therapist can support individuals with TBI from the early stages of recovery, helping to improve clear speech, effective expression and comprehension, attention, memory, problem-solving and organisational skills, social communication, and safe swallowing, using practical strategies and tools tailored to each person’s needs.
Parkinson’s Disease
Progressive neurological conditions such as Parkinson’s can result in speech problems such as having a soft or hoarse voice, mumbling or unclear speech, and monotonous speech, as well as swallowing difficulties such as drooling, difficulty chewing, coughing or choking on food and drinks, and the feeling of food stuck in the throat. These can cause frustration and discomfort in the individual. Speech therapy can help address the discomfort during mealtimes and also introduce and monitor new strategies and exercises for improving speech and voice.
Dementia
Dementia is a condition that causes memory loss and other thinking problems that make it difficult for an individual to remember things and carry out daily tasks. Most types of dementia deteriorate over time, and the patient might gradually develop more signs and symptoms. Speech therapy can support patients with dementia maintain their quality of life for as long as possible through supporting attention, memory, problem-solving, and thinking skills. Speech therapists may teach practical strategies such as using visual supports, memory aids, structured routines, and effective communication approaches for both individuals and their caregivers.
Laryngeal and Oral Cancer
The larynx, commonly referred to as the voice box, contains the vocal cords, which vibrate to produce sound. Cancer affecting the larynx, such as forming on the vocal folds or other parts of the larynx, can lead to speech and swallowing problems. Laryngeal cancer treatment often involves a laryngectomy, where the larynx is either partially or completely removed, leaving a hole in the neck. As such, there will be communication and feeding changes to get used to, and a speech therapist has a crucial role in supporting the patient before, during, and after the cancer treatment. After a laryngectomy, the patient will likely not be able to speak immediately, and will require alternative forms of communication, which a speech therapist can assist in adopting. The speech therapist will then discuss with the patient and their caregiver on options for producing voice (i.e. artificial larynx/ electrolarynx, esophageal speech, or tracheoesophageal puncture), and work on strategies for speech and swallowing.
Oral cancer, on the other hand, is cancer that forms on areas in or around the mouth (lips, tongue, gums, cheek, jaw). It can also affect speech and lead to problems with swallowing. A speech therapist can help support the patient during and after treatment in getting used to the changes in their mouth and introduce strategies to manage their speech and swallowing.
Conclusion:
Most of us take speaking, eating, and drinking for granted. To us, they are activities that do not require much effort. However, when these abilities are lost, it can be very frustrating and isolating. With adult speech therapy, speech therapists mostly work on rehabilitation and maximising the quality of life for their patients. If you or your loved ones are finding daily communication challenging or having a stressful mealtime due to swallowing difficulties, do not hesitate to reach out to a speech therapist. Our team at Ohana Therapy believes in individualised, family-centred care, where each client is at the heart of what we do.
References
American Speech-Language-Hearing Association. (n.d.). Adult dysphagia.
https://www.asha.org/practice-portal/clinical-topics/adult-dysphagia/?srsltid=AfmBOoo6CVX3lmh-4NuPQzw5uW1gB67AE2NW72nL9zBDXWt-c0BXvEtX#collapse_6
American Speech-Language-Hearing Association. (n.d.). Dementia. https://www.asha.org/public/speech/disorders/dementia/
American Speech-Language-Hearing Association. (n.d.). Dysarthria. https://www.asha.org/public/speech/disorders/dysarthria/
American Speech-Language-Hearing Association. (n.d.). Laryngeal cancer. https://www.asha.org/public/speech/disorders/laryngeal-cancer/
American Speech-Language-Hearing Association. (n.d.). Oral cancer. https://www.asha.org/public/speech/disorders/oral-cancer/
American Speech-Language-Hearing Association. (n.d.). Traumatic brain injury. https://www.asha.org/public/speech/disorders/traumatic-brain-injury/?srsltid=AfmBOorDV5uVGAM0NYpLI-y2GQKlCFKAgzHIa0g2lCZCMyIOX7ggTO75
HealthHub. (n.d.). Aphasia. Ministry of Health Singapore.
https://www.healthhub.sg/health-conditions/aphasia
Mayo Clinic. (n.d.). Dysphagia: Symptoms & causes.
https://www.mayoclinic.org/diseases-conditions/dysphagia/symptoms-causes/syc-20372028
Singapore General Hospital. (n.d.). Adult language clinic. Singapore General Hospital. https://www.sgh.com.sg/our-specialties/speech-therapy/adult-language-clinic
Tan Tock Seng Hospital. (n.d.). Parkinson’s disease: Impact on swallowing and communication. https://www.ttsh.com.sg/Patients-and-Visitors/Pages/Find-Conditions-and-Treatments-Details.aspx?condition=Parkinsons-Disease-Impact-on-Swallowing-and-Communication
