What is speech therapy and who provides it?

Speech therapy is provided for disorders of communication, cognition and swallowing. When speech intervention is necessary it means that one of the most essential human functions is compromised. What could be more important than restoring a means of communication, thinking or eating? Speech-language pathologists are trained professionals with the ability to improve or restore function in these areas. They must have a Master’s degree and state licensure. Most hold clinical certification (CCC) from the American Speech-Language Hearing Association (ASHA). Their expertise and services include, but are not limited to:

• Speech Services –
  • Articulation
  • Voice
  • Resonance
• Language Services –
  • Word-finding
  • Increasing sentence length
  • Comprehension
  • Pragmatics
  • Reading
  • Writing
• Alternative means of Communication –
  • Tablet/Smartphone
  • Computer
  • Dedicated communication devices
  • Eye gaze/non-hand switches for communication devices
  • Low tech picture communication systems
• Swallowing Services –
  • Objective swallow studies (Modified Barium Swallow or FEES)
  • Bedside swallow evaluation
  • Postures/positioning for increased swallow function
  • Modified texture diets
  • Thermal/tactile and swallow-related oral motor exercises
  • Electrical stimulation of swallow, such as VitalStim
• Cognitive-Communicative Services –
  • Memory
  • Problem-solving
  • Planning and initiation
  • Attention

Can effective speech therapy be provided at home?

Whether the need for speech therapy arises from an illness, disease or accident, speech-language pathologists can provide most services at home. Many people in recovery have spent weeks or months in hospitals and are thrilled to return home. Others may not have been hospitalized but do not have a means of transportation to outpatient service facilities. Still others are homebound, receiving all care in their residence. It is still possible to receive high quality, evidence-based speech-language, swallowing or cognitive-communicative therapy. There are actually benefits to receiving therapy at home.

Benefits of in-home speech therapy

People feel most comfortable in their homes and everything they need is nearby. Therapy will be less disruptive for medication, food or bathroom breaks.

Informed Caregivers

In the home, a speech pathologist frequently encounters family members or professional caregivers. They can observe therapy and receive education or counseling about the techniques implemented by the therapist. Continuity of care then improves when the speech pathologist is not present. Family members or professional caregivers are with patients many more hours per week than the visiting therapists. Knowledgeable caregivers can encourage patients to use techniques throughout the week. This extends the therapeutic effect by increasing practice time and intensity. Recent research suggests these parameters improve patient outcomes. Additionally, naturalistic home environments support generalization of techniques to everyday situations, not confining learned behaviors to just the speech pathologist or clinic.

Personally Relevant Materials

Another benefit of in-home speech therapy is that the patient’s own items can be used in therapy. For example, in language or memory therapy family pictures or photo albums can be adapted as stimulus materials. In swallowing therapy, the speech pathologist can use the patient’s actual silverware. This can increase the accuracy of instructions and the safety of the patient during swallowing. A patient’s spoon may be twice the size of a plastic spoon commonly used in outpatient rehabilitation.

Less Stress and Energy Expenditure

Patients experience fatigue with illness or during recovery. In-home speech therapy reduces the burden on the patient for travel time and physical activity, saving energy to put into a meaningful therapy session instead. This improves patient’s stamina and allows a speech-language pathologist to see a patient at his or her best. There are numerous reasons why people elect to have rehabilitation at home. An experienced speech-language pathologist can provide quality therapy in that environment and actually harness the benefits of in-home speech therapy to enhance a patient’s experience within individual therapy sessions and overall outcomes.