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When visiting a speech pathologist for the first time, as you might guess, one of the first questions your clinician will ask you is what the reason for the visit is. If you are seeing a dysphagia specialist, then your concern will most likely be due to difficulties swallowing. Swallowing difficulties can occur with food or solids, drinks or liquids and even with saliva. These difficulties can arise due to a number of reasons such as physiological changes to the throat, stroke, Parkinson’s disease and other neurological aetiologies. Once you have established what your concerns are, there are a few key components that the assessment is composed of, including:

Case History

This includes any background history such as the initial occurrence of the swallowing concern, any previous illnesses, injuries or episodes in hospital that may serve to explain the reason for your swallowing concerns and help to determine what strategies are used to tackle the issues. Any previous investigations such as modified barium swallow or functional X-ray while you swallow will also be discussed and help guide treatment. Your current diet should also be discussed to determine a baseline from where the investigation will begin.

Oromotor Examination

This is often the first part of the physical examination where you will be asked to copy an array of facial movements such as poking out your tongue and spreading your lips to determine the strength, speed and coordination of the muscles of the head and neck. Any deviations noted in these movements can help pre-empt any possible swallowing difficulties and determine the direction of swallow management.

Food and Fluid Trial

During this component, you will be asked to eat and drink a range of food and drinks. While you are swallowing, your speech pathologist will be feeling and listening out for signs that food or fluid may be going down the wrong way into your lungs. It is essential to ensure this does not happen, as food or fluid in the lungs can cause Aspiration Pneumonia which can be life threatening.

After the assessment has been completed, your speech pathologist will provide you with the results, which will include a diagnosis and education about swallowing and the treatment programs available. Each diagnosis is different and based on the individuals presenting symptoms, which guide the type of therapy provided. For this reason, it is essential that your swallowing be assessed properly by a qualified speech pathologist prior to commencing therapy.

Contact us for results focused on speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post What to expect in an initial adult swallowing assessment appeared first on ENT Wellbeing Sydney.

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If you have visited a speech pathologist before for either yourself or your child, they may have talked about the ‘traditional’ approach to ‘articulation therapy’ and you may have wondered what this actually means. There is no single definition for this approach as it often includes a number of techniques and what the term encompasses differs from clinician to clinician, however there are a few general principles that are commonly seen through this approach.

Procedures

The speech pathologist guides the individual through a series of carefully sequenced and graded steps, usually one sound at a time (e.g. the ‘s’ sound) and in one place at a time (e.g. at the start of a word such as ‘star’) . The procedure starts with sound training where the individual is required to recognise the sound and differentiate between the target sound and the error sound, and increases in complexity until finally, the phoneme is used in spontaneous conversational speech, and the emphasis moves to self-monitoring.

While the steps in-between sometimes vary, most versions of the traditional approach place discrimination of sounds produced by another individual as the first step, as seen in Berry and Eisenson (1956), Carrell (1968), Garrett (1973), Sloane and Macaulay (1968) and of course, Van Riper (1978), who wrote:
“The hallmark of traditional therapy lies in its sequence of activities for: (1) identifying the standard sound, (2) discriminating it from its error through scanning and comparing, (3) varying and correcting the various productions until it is produced correctly, and finally, (4) strengthening and stabilizing it in all contexts and speaking situations.” Van Riper, 1978 p. 179

Techniques

The techniques used to elicit a sound vary from verbal prompting which can include modelling of the sound or specific instruction on where to place the structures of the mouth all the way through to physical prompting which can include physical movement of the articulators into the correct position for sound production. Powers (1971) describes some of the procedures that have characterised traditional speech-language pathology assessment and intervention for functional speech disorders (articulation disorders). Powers states that the ‘stimulus methods’ developed and described by Travis (1931) remains at the core of most treatment methodologies used by speech-language pathologists to date.

Many resources for the traditional articulation therapy approach continue to be designed and published today and can easily be accessed on websites such as Dr Caroline Bowen’s www.speech-language-therapy.com.

Contact us for results focused on speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have questions about language activities, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post What is Articulation Therapy? appeared first on ENT Wellbeing Sydney.

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When visiting a speech pathologist for the first time, as you might guess, one of the first questions your clinician will ask you is what the reason for the visit is. If you are seeing a voice specialist, then most your concern will most likely be due to changes or issue that you have noticed with your voice. Once you have established what your concerns are your speech therapist may then ask you some questions about your voice.

Some examples of questions that your speech therapist may ask include:

  • How often you use your voice (teachers and singers have a lot more chance of vocal strain and fatigue due to the amount of voice use required in their profession)
  • When did you first notice the change in your voice?
  • Do you have any lifestyle or medical concerns that may impact your voice (e.g. mouth breathing, allergies or smoking)

Next, your clinician will assess your voice while you speak and listen out for qualities such as vocal strain, roughness and breathiness.

You may then be asked to complete a number of exercises that assess how long you can produce a sound such as ‘ahh’, your pitch range as well as your volume range. Measures taken during these exercises can help to determine the extent and reason for the changes you may have noticed in your voice.

You may also be asked to fill out a self-rating scale where you will provide feedback about the extent of your voice changes and the impact they have had on your daily life. All of these measures serve as a baseline to measure change against, once you have completed therapy.

After the assessment has been completed, your therapist will provide you with the results, which will include a diagnosis and education about the likely causes of the diagnosis. You should also be provided with education about how to improve your voice such as through voice therapy exercises or vocal hygiene recommendation. Each diagnosis is different and based on the individuals presenting symptoms which guide the type of therapy provided. For this reason, it is essential that your voice be assessed properly by a qualifies voice therapist prior to commencing therapy.

Contact us for results focused on speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have questions about language activities, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post What to expect in an initial voice therapy session appeared first on ENT Wellbeing Sydney.

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There many possible areas of difficulty that lead to a literacy delay, and while this should not be taken as an exhaustive list, here are some of the most likely possibilities that would affect a child’s literacy development, specifically with reading.

Poor letter to sound correspondence

This one is the most obvious and is often easily picked up at school, however not as easily rectified. Understanding the link between the letters and their paired sounds or letter to sound correspondence is common in individuals with dyslexia. For these individuals, it takes a lot more intervention that the amount provided at school. For these children especially, specialised techniques such as The Spalding Program are recommended.

Poor phonological awareness

Phonological awareness refers to the representation of sounds in our brain and the ability to manipulate these sounds. For example, in the word ‘CLAP’, there are 4 sounds the ‘C’, ‘L’, ‘A’ and ‘P’. For a child with poor phonological awareness, it may be hard to distinguish the ‘CL’ cluster into two different sounds and therefore they may leave of one sound and instead read the word as CAP instead. For these children, phonological awareness training is recommended to improve their ability to read and spell a range of word types.

Poor verbal comprehension

When reading a passage, a child is expected to not only decode (sound out individual sounds to make a word) but also string each word together to understand a sentence, which they must then tie together to understand the story in its entirety. Underpinning all of this is the child’s ability to understand verbal language. This is because if a child is not able to understand a spoken passage then even if they are able to decode the symbols into the words and sentences, if they are unable to process these words and sentences, then they cannot decipher meaning from it. For these children we recommend specific receptive language therapy, depending on the level where understanding has broken down.

These are some of the areas a speech pathologist assesses, in order to determine the individuals area of weakness. This allows us to provide the correct intervention that will have the greatest benefit for literacy development.

Contact us for results focused on speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have questions about language activities, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Possible causes for literacy delays – Part 1: Reading appeared first on ENT Wellbeing Sydney.

By

There many possible areas of difficulty that lead to a literacy delay, and while this should not be taken as an exhaustive list, here are some of the most likely possibilities that would affect a child’s literacy development, specifically with reading.

Poor letter to sound correspondence

This one is the most obvious and is often easily picked up at school, however not as easily rectified. Understanding the link between the letters and their paired sounds or letter to sound correspondence is common in individuals with dyslexia. For these individuals, it takes a lot more intervention that the amount provided at school. For these children especially, specialised techniques such as The Spalding Program are recommended.

Poor phonological awareness

Phonological awareness refers to the representation of sounds in our brain and the ability to manipulate these sounds. For example, in the word ‘CLAP’, there are 4 sounds the ‘C’, ‘L’, ‘A’ and ‘P’. For a child with poor phonological awareness, it may be hard to distinguish the ‘CL’ cluster into two different sounds and therefore they may leave of one sound and instead read the word as CAP instead. For these children, phonological awareness training is recommended to improve their ability to read and spell a range of word types.

Poor verbal comprehension

When reading a passage, a child is expected to not only decode (sound out individual sounds to make a word) but also string each word together to understand a sentence, which they must then tie together to understand the story in its entirety. Underpinning all of this is the child’s ability to understand verbal language. This is because if a child is not able to understand a spoken passage then even if they are able to decode the symbols into the words and sentences, if they are unable to process these words and sentences, then they cannot decipher meaning from it. For these children we recommend specific receptive language therapy, depending on the level where understanding has broken down.

These are some of the areas a speech pathologist assesses, in order to determine the individuals area of weakness. This allows us to provide the correct intervention that will have the greatest benefit for literacy development.

Contact us for results focused on speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have questions about language activities, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Possible causes for literacy delays – Part 1: Reading appeared first on ENT Wellbeing Sydney.

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