Who does speech therapy evaluate?

Speech Therapy Evaluation Process and Patient Populations

Speech-language pathologists evaluate patients with communication, swallowing, cough, and related disorders across the lifespan, with assessment tailored to the specific presenting symptoms and underlying conditions.

Patient Populations Evaluated by Speech Therapy

Speech-language pathologists (SLPs) evaluate a wide range of patients with various conditions:

Communication Disorders

• Voice disorders: Patients with dysphonia (hoarseness) require laryngoscopy by an otolaryngologist before speech therapy begins 1
• Speech disorders: Including articulation disorders, motor speech disorders (dysarthria, apraxia) 2
• Language disorders: Including developmental delays in children and acquired disorders in adults 3
• Functional communication disorders: Patients with functional neurological disorders affecting speech, language, swallowing, and cough 1
• Cognitive-communication impairments: Patients with neurological conditions affecting cognition 4

Swallowing and Related Disorders

• Dysphagia: Patients with difficulty swallowing
• Globus: Sensation of something stuck in the throat
• Cough disorders: Including functional cough and laryngeal hypersensitivity 1

Specific Patient Populations

• Children: With developmental speech and language delays or disorders 3
• Adults with neurological conditions: Including stroke, traumatic brain injury, Parkinson's disease, multiple sclerosis, and dementia 1, 5, 4
• Patients with functional neurological disorders: Requiring specialized assessment approaches 1

Assessment Process

Initial Assessment Components

1. Information gathering and diagnostic formulation 1

   • Comprehensive case history
   • Determination of symptom onset, pattern, and impact on daily life

2. Rapport building 1

   • Critical for establishing therapeutic relationship
   • Important since many patients may only attend one session

3. Assessment of illness beliefs and expectations 1

   • Understanding patient's perception of their condition
   • Identifying factors that may maintain symptoms

Specific Assessment Procedures

1. For voice disorders:

   • Laryngoscopy must be performed by physician before therapy 1
   • Results must be documented and communicated to the SLP 1

2. For communication disorders:

   • Standardized performance-based tests 1
   • Parent/patient rating scales 1
   • Speech and language sampling (single-word and connected speech) 6
   • Stimulability testing 6
   • Intelligibility estimation 6

3. For cognitive-communication disorders:

   • Comprehensive neuropsychological assessment 1
   • Specific cognitive assessments for different neurological conditions 4

4. For multilingual patients:

   • May require assistance from interpreters or family members 6
   • Often uses informal assessment procedures 6

Analysis Techniques

• Phonological process analysis
• Substitutions-omissions-distortions-additions (SODA)
• Phonetic inventory analysis 6
• Discourse-level communication assessment for stroke patients 1

Interdisciplinary Collaboration

Speech therapy evaluation often occurs within a multidisciplinary framework:

• Collaboration with otolaryngologists: Required before voice therapy 1
• Coordination with neuropsychologists: For cognitive assessment 1
• Integration with social work: For psychosocial assessment 1

Important Considerations

• Early intervention is critical: Particularly for children with speech and language delays 3
• Regular re-evaluation: Needed for progressive conditions like neurodegenerative diseases 5
• Communication partner inclusion: Essential from the onset of therapy 5
• Individualized assessment: Must consider the specific condition and patient characteristics

Common Pitfalls to Avoid

• Failure to obtain laryngoscopy before voice therapy: Can lead to inappropriate therapy or delayed diagnosis of conditions not amenable to voice therapy 1
• Overreliance on informal assessment: May compromise reliability and validity of cognitive assessments 4
• Inadequate assessment of multilingual patients: May require specialized approaches and interpreter services 6
• Delayed referral: Can negatively impact outcomes, especially for progressive conditions 5

Speech therapy evaluation is a comprehensive process that requires specialized training and expertise to identify and address the specific communication, swallowing, or related disorders affecting each patient.