BULLHEAD CITY — It’s something that doesn’t always seem apparent, but speech pathologists have helped many people and will continue to help even more.
“In speech pathology, we can diagnose communication, speech, language and swallowing disorders,” said Hannah Abbott, a speech pathologist at The Legacy Rehab and Care Center. “From birth to the end stages of life, it’s helping of all ages learn how to improve their speech, language, communication and swallowing skills.”
“Speech pathologist works with a variety of disorders and populations depending on what route they go,” said Abbott. “For example, they can go through pediatrics and work with schools or go through the medical field. They can also work with mothers who have newborns and teach their families the baby’s communication signals.”
Abbott herself had to see a speech pathologist after sustaining a mild traumatic brain injury, which is one reason she chose her career path.
“I went into therapy to help with time management skills and executive functions,” said Abbott. “My speech therapist’s compassion for me, and how she helped me meet my goals to get back into school full time, inspired me to do the same thing for other people.”
According to the National Institute on Deafness and other Communication Disorders (NIDCD) in 2016, about one in 12 (7.7 percent) children ages 3-17 years old in the United States had a disorder related to voice, speech, language or swallowing.
“In the Colorado River Union High School District, 59 out of the 220 special needs students are in speech therapy,” said Geoff Tubbs, director of special services for CRUSHD. “In the elementary district we have 232 students that require speech therapy and that includes pre-school students.”
According to the American Speech-Language-Hearing Association (ASHA), about 40 million Americans have a communication disorder.
Abbott said that her caseload fluctuates but for the most part can be anywhere from nine to 18 patients for a given week. On average, Abbott sees patients about three to five times per week for about 15 to 45 minutes per session.
“The top three disorders that we see in this setting are dysphagia, aphasia and the third is cognitive impairment from traumatic brain injury or dementia,” said Abbott.
According to the NIDCD in 2016 dysphagia affected 0.9 percent of children and ASHA said it affects about one in 25 adults in the U.S.
“Dysphagia is evaluating and treating swallowing disorders,” said Abbott. “It’s helping patients figure out what’s the safest food texture and liquid consistency they can have so they can safely swallow. One thing I enjoy is collaborating with the hospital to have them perform what’s called modified barium swallow studies. Which is using X-rays to look at their swallow functions when they eat and drink different textures and liquid consistencies.”
According to the NIDCD, aphasia — the loss of being able to use or understand language — affects about 1 million people, with nearly 180,000 Americans acquiring the disorder each year.
“This happens when people suffer a stroke and it can affect them very little or it can have a profound effect on their ability to use and understand language,” said Abbott. “When I have a patient with aphasia, I assess their writing and reading skills as well as monitor their receptive language skills. I want to make sure that they are understanding what they are hearing and able to get their words out.”
Throughout CRUSHD, Tubbs said, the most common speech issue they see is articulation.
“We work on pronunciation of words so they are understood because it can be very frustrating if they are not getting their needs met because they are having a hard time getting their words out,” said Tubbs. “We try to get the students who need help into speech therapy as soon as possible to be able to correct the mistakes that are there. The younger that a student is, the easier they are to shape as far as knowledge and information go. So the earlier we get them started on speech services, the easier it is to get the issue corrected.”
Being a speech pathologist does have its challenges in working with adults and children ranging from pre-schoolers to seniors in high school.
“Probably the hardest part is making recommendations and seeing a patient choose not to do that and decline in their health status,” said Abbott. “But, at the same time, it’s an honor to be able to make recommendations and give them that choice of whether they want to implement it or not. Another hard part is getting attached to patients since they become like family, so you’re happy to see them go but sad to see them go.”
“I think it’s easier to work with younger children, especially if you can include some play into the therapy because it seems a little bit more natural,” said Tubbs. “When a student becomes socially aware that they have a speech disability, the less likely they are going to want to meet with a speech therapist because they might be afraid of getting made fun of. So actually, getting the older students to go and meet with a speech therapist and have a session can be a little bit more of a challenge.”
When people are in speech pathology, the overall objective is to make sure they are getting better and overcoming the issue for which they sought help.
For Abbott, she writes a plan of care for her patients that spans a month. When the month is over, she does another evaluation.
“If they have met their long-term goals I will discharge them early, but in other circumstances I will make an updated plan for another month to see if there are more things we can address,” said Abbott. “It fluctuates per person — how severe their injury was and how motivated they are to get better. Some patients see results in a week others need to take the more long-term route. Cognitive functioning is important as well because if they can’t remember the strategies to use and are only doing it with me in the session then it’ll take much longer.”
Tubbs said that at CRUSHD a student is assessed when found eligible and that initial test is used as a baseline.
“When we determine what are the type of speech therapy they need, we write an individualized education for the student,” said Tubbs. “The student will have baseline data that shows at what level they are functioning and the therapist will add speech goals for that student. We will take data — based on the goal and their baseline data — to see what kind of progress the student is making by being in speech therapy. If we see that they are not improving, or if they aren’t where they should be, we will alter our method of teaching or we will alter our goal but it depends on the team and what will benefit the child. Ideally, when the student achieves their goals we will move to the next part, but if there isn’t another area they struggle with then we can say they don’t need speech therapy anymore.”
Sometimes the only time that patients who are in speech pathology get help is when they meet with their therapist, which is why getting help from people close to the person is a great help.
“Mentoring families and giving them simple exercises to do with their family member goes a long way in the patient’s recovery,” said Abbott. “For patients with decreased breath support, I encourage diaphragmatic breathing in order to get enough air to speak clearer. For swallowing, I encourage them to sit up straight during their eating or drinking and to take small bites and sips to swallow easier. For those patients who need brain exercise, I love to give compensatory memory strategies. Those are things that help our brains compensate, such as writing information down while it’s fresh in their memory, placing objects in the same place, making lists and others.”
“What I really like is when a therapist will work with a student in their natural setting, such as the classroom and the cafeteria,” said Tubbs. “Those are the natural areas where the students typically struggle because that’s when they are spending most of their time, so when they work on it that way the language becomes more natural. It also helps when the teachers see some of the techniques that the speech therapists are doing because they might do something similar. So their therapy becomes more than just 30 minutes each week. The speech therapists that we have here are very caring and loving of the student and do a great job in helping them achieve their speech therapy goal.”