Adelaide Speech Pathology Services - information about speech pathology and communication difficulties

What is a speech and language pathologist?

A speech and language pathologist (sometimes called a speech pathologist, or speech-language pathologist) is a person trained to treat communication and swallowing disorders. A degree in speech and language pathology includes studies in anatomy and physiology, psychology, linguistics, psycholinguistics (the study of the cognitive mechanisms required for language processing), audiology, articulatory phonetics and phonology (the study of the production and characteristics of speech sounds). Studies are also taken in acoustic phonetics (the study of the acoustic characteristics of speech sounds), as well as subjects covering specific pathologies treated by speech and language pathologists.

What is a communication difficulty?

Communication is the most complicated human behaviour, yet it is often taken for granted. Communication involves listening, speaking, reading and writing. Communication difficulties are the result of problems with producing speech sounds (articulation), using and understanding language, voice (i.e. the production of sound in the voice box), fluency (stuttering), hearing, reading and writing. Communication difficulties range from very mild (eg. a seven year old who can not yet produce the sound "r") to very severe (eg. a seventy year old who has suffered a stroke and is no longer able to produce speech or language).

One in seven Australians has some form of communication disability. In Australia approximately:

386,000 children have speech delay problems
577,000 school-aged children have difficulties with language
326,000 people stutter
2.5 million people have hearing impairment
25,000 people have a severe brain injury

(Speech Pathology Australia, 2001)

A person's ability to form and maintain relationships, succeed at school, get a job and attain career goals depends heavily on their communication skills. The role of the speech and language pathologist is to improve the person's ability to communicate through extensive assessment, provision of individualised therapy programmes, and counselling of the parent, family and patient. In addition, the speech and language pathologist may advise other people responsible for the patient (such as carers, school teachers, special education staff etc.) regarding the nature of the patient's difficulties and how to maximise the potential for improvement.

Speech and language pathologists provide treatment for people of all ages. A speech pathologist's caseload may vary as dramatically as treating a four year old with a speech sound development delay followed by a session with a year twelve student who struggles with essay writing due to severe literacy problems.

How do I recognise when a person may have a communication disability?

Any person may seek the services of a speech and language pathologist directly. Patients are usually referred by parents, spouses, teachers and doctors. The following general guidelines may help in determining when a referral to a speech pathologist may be appropriate:

Speech

The patient has difficulty producing speech sounds correctly - speech sounds may be distorted (eg. a "slushy /s/" sound) or substituted for other sounds (eg. "tat" for "cat").
Young children make substitution errors as part of normal speech development, however if it is felt that the child's speech is more "babyish" than the speech of other children their age, the child should be assessed by a speech and language pathologist.
The patient has learnt English as a second language and experiences difficulties producing Australian speech sounds and words to the extent that they feel they are disadvantaged by their accent.

Language

The patient has difficulty understanding what is said compared to other people of the same age, has limited verbal output, and / or struggles to structure sentences correctly compared to other people of the same age.
The patient has limited word knowledge (vocabulary) compared to people of the same age.
The patient has difficulty structuring an argument / telling a story etc. Information does not flow logically.

Pragmatics

The patient has difficulty "following the rules" of conversation, including difficulties with turn-taking, eye contact, topic maintenance, good listening behaviours etc.

Reading

The patient has difficulty decoding written material compared to other people of the same age (eg. a seven year old child who can only read three letter words).
The patient has difficulty understanding written text compared to other people of the same age.
The patient reads at a slow rate compared to other people of the same age.

Writing

The patient has difficulty understanding the relationship between sounds and letters compared to other people of the same age.
The patient has poor spelling compared to other people of the same age.
The patient has difficulty structuring sentences, including the correct use of punctuation compared to other people of the same age.
The patient has difficulty writing a logical piece of connected writing, with a beginning, middle and end.

Fluency (stuttering)

The patient's speech is not "smooth" - the patient hesitates and gropes for words, often prolonging individual speech sounds (eg. "It's a ffffffffrog"), repeating speech sounds (eg. "It's a b-b-b-ball"), repeating syllables (eg. "It's a bu-bu-butterfly") repeating words (eg. "It's-It's-It's a dog") and / or "cluttering" speech sounds, giving the impression that words seem to run into and overlap each other.

Voice

The patient's voice sounds unusual, and may be characterised by difficulty producing voice at all, excessive "breathiness", unusual pitch or volume, "croakiness", frequent loss of voice, difficulty projecting voice etc.

Where do I get more information?

Should you require more detailed information, wish to clarify any part of this information sheet, or discuss a particular patient and their suitability for referral, please do not hesitate to contact us. Further information about speech and language pathology may be found on the Speech Pathology Australia Website (please see our links section for the website address).

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