What is Neurologic Speech Therapy?
Neurologic speech therapy is an allied health profession that deals with the diagnosis and treatment of communication problems/speech disorders, caused by damage to the central nervous system (brain, spinal cord, or nerves) in children and adults. A neurological speech therapist also focuses on feeding therapy in people who have problems with chewing and swallowing food. Neurological speech therapy is intended for individuals whose capability to speak is greatly reduced or lost due to several factors such as injuries, accidents, perinatal and developmental factors, and illnesses. The therapy is always customized to the individual’s abilities, expectations, and needs of each patient.
Neurological issues can be acquired due to unexpected injury to the nervous system or can also be progressive where the issues worsen over time as a result of deterioration of the nervous system. Hence, whether you are struggling with oral and written language disorders as well as swallowing disorders due to traumatic head or brain injury, stroke, aphasia, or neurodegenerative disorder, your neurologic speech therapist has the knowledge to provide you with appropriate tools to progress in your rehabilitation and assist you to develop, maintain, or restore your capacity to communicate and promote your independence and integration into family, school/college, social and professional activities.
Types of Neurological Conditions
Neurological conditions can result in several different difficulties depending on the region of the nervous system that has been affected. Neurological issues can cause difficulties with language (both receptive and expressive), speech, muscle function, swallowing, and social communication. The following are some examples of the neurological conditions which could cause swallowing and communication issues:
- Head injuries and brain tumors
- Parkinson's disease
- Myasthenia Gravis
- Muscular dystrophy
- Muscular Sclerosis
- Amyotrophic Lateral Sclerosis (ALS)
- Bell’s Palsy
Conditions Treated by Neurologic Speech Therapy
There are many speech and language conditions that can be treated with neurologic speech therapy. These include:
- Fluency disorders: Cluttering and stammering are fluency disorders. This condition affects the speed, rhythm, and flow of speech. An individual with stammering has difficulty getting out a sound and may have speech that is interrupted or blocked or may repeat a section of all of a word. An individual with cluttering often merges words together and talks very fast.
- Cognitive-communication disorders: This condition is characterized by difficulty communicating because of a trauma to the area of the brain that controls your ability to think. This can result in issues with problem-solving, memory, and trouble speaking or listening. Cognitive-communication disorder can be caused by a stroke, brain trauma, certain neurological conditions, and abnormal brain development.
- Resonance disorders: This condition occurs when an obstruction or blockage of regular airflow in the nasal or oral cavities changes the vibrations responsible for voice quality. Resonance disorder can also occur if the velopharyngeal valve does not close correctly. This condition is often associated with swollen tonsils, cleft palate, and neurological disorders.
- Expressive disorders: A person with an expressive language disorder has trouble with expressing or conveying information. If you have this condition, you may have difficulty forming correct sentences, such as using the wrong verb tense. It is often associated with developmental impairments, such as hearing loss and Down syndrome. It can also occur from a head injury or a medical condition.
- Articulation disorders: This condition is defined as the inability to correctly form certain word sounds. An individual with this type of speech disorder may distort, swap, drop, or add word sounds. An instance of word distortion would be uttering “thith” instead of “this.”
- Receptive disorders: An individual with a receptive language disorder has difficulty comprehending and processing what others say. This can cause you to appear uninterested when somebody is speaking, have a limited vocabulary, or have difficulty following directions. A head trauma, hearing loss, autism, or other language disorders can cause receptive language disorders.
- Dysarthria: This disorder is defined by slurred or slow speech as a result of weakness or inability to control muscles utilized for speech. Dysarthria most often occurs as a result of nervous system disorders and conditions that cause facial paralysis or tongue and throat weakness, such as stroke, amyotrophic lateral sclerosis (ALS), and multiple sclerosis.
- Aphasia: Aphasia is an acquired communication disorder that affects an individual’s capability to speak and comprehend others. The condition also commonly affects an individual’s capability to write and read. The most common cause of stroke is aphasia, although other brain conditions can also cause it.
- Apraxia: This is a neurological condition characterized by difficulty with specific motor skills even though the muscles appear to be normal. In children, apraxia may manifest as a speech disorder, present from birth, caused by problems with the motor coordination in the muscles used for speech. A child who is born with this disorder will have difficulty pronouncing words and phrases accurately.
- Dysphagia: The difficulty in swallowing food or liquids is known as dysphagia. Swallowing is a set of coordinated muscle movements that control the mouth, the back of the throat (pharynx), and the food tube (esophagus). Dysphagia may result from a lack of coordination of the nerves or muscles due to head and neck trauma, neurologic disorders, or other conditions.
Treatment with Neurologic Speech Therapy
Neurologic speech therapy typically starts with an assessment by a neurologic speech therapist who will determine the type of communication disorder an individual has and the best method to treat it.
Neurologic Speech Therapy for Children
For children with neurologic speech disorders, a neurologic speech therapist will start therapy in the setting of a small group or a classroom or one-on-one, depending upon the speech disorder. Neurologic speech therapy activities and exercises vary depending upon a child’s age, needs, and the disorder. During neurologic speech therapy for a child, the therapist may:
- Provide a plan of action and homework for the child and parent or care provider on how to conduct speech therapy at home
- Model correct syllables and sounds for a child during age-appropriate play in order to educate the child on how to make certain sounds
- Interact through playing and talking, and utilizing pictures, books, or other objects as part of language intervention to assist in stimulating language development
Neurologic Speech Therapy for Adults
Speech therapy for adults also starts with an assessment to identify an individual’s needs and the best possible treatment. Neurologic speech therapy exercises for adults can assist with language, speech, and cognitive-communication.
Therapy may also involve retraining of the swallowing function if trauma or disorder, such as Parkinson’s disease has caused swallowing difficulties.
Treatment may include:
- Breathing exercises for resonance
- Exercises to strengthen oral muscles
- Conversational strategies to improve social communication
- Memory, organization, and problem solving, and other activities geared towards improving cognitive-communication
- Neuromuscular electrical stimulation and electromyographic biofeedback as treatment modalities for oropharyngeal dysphagia to aid in muscle relaxation, coordination, and/or muscle response pattern training