Friday, 8 November 2013

Into the mind of a Speech Therapist

Welcome back,

So today I am going to talk to you a little about what it is we speech and language therapists (SLTs) do.

Usually, the reality of telling someone you are a speech therapist welcomes the notion of surprise combined with discomfort at not knowing what it is we do. If I had a penny for every time a person said 'oh ok,' or 'that’s interesting,' for when I told them I was an SLT, lets just say I think I could open up my own practice. No but seriously, today I thought I would talk very briefly on four disorders/impairments that we help assess and manage. I'll also put up a little background reading in the form of FREE journal papers for anyone interested or looking to find a little more about what we do.   

So first let me talk to you about disorders/problems that young children may face. First off, we have language impairment (LI). As the name states, this is when a child’s language is impaired. A child who has a language impairment may have delayed or disordered language. A delay implies that language is developing along normal lines albeit doing so at a slower rate or with a later start, whereas a disorder is used to imply some deviance from the normal pattern of development. If a child has a language impairment it may not necessarily be their primary problem. For example a child with a language impairment could also have hearing problems or autism. Previous research has shown that school-aged children with LI experience higher risk of social and emotional difficulties. There is limited provision for older teenagers and young adults and little focus on community support for this group. A team of researchers at City University London looked at specialist youth groups for young people with LI. They reported the experiences and views of 19 young people aged 13-23 attending a leisure provision for young people with communication difficulties. Take a look here at what they found.

Secondly, apart from Language Impairment, there is also Specific Language Impairment (SLI). It has been defined as the failure of language ‘to follow a normal developmental course for no apparent reason’. The difference between SLI and LI is that the primary problem is specific to language only when the child is otherwise developmentally normal. Some indicative features of SLI are having difficulty with verbs and word finding difficulties. Due to its nature, researchers have been interested to find out whether children with SLI have difficulties with memory and other cognitive abilities. Dr. Nicola Botting and colleagues researched cognitive abilities in children with specific language impairment. They looked to identify whether children with SLI demonstrated difficulties with visuo- spatial memory as well as verbal short-term memory and to see whether a visuo-spatial processing task without short-term memory requirements was problematic for children with SLI. Click here to see the results.

What is visuo-spatial processing you ask? Click here for more info 


Furthermore, the ability to hear as a child determines how well you can pick up language. For those who are born deaf, if their parents are also deaf and use British Sign Language (BSL), then they will pick up language naturally and easily, just like hearing children pick up spoken language. Yet, this is not the case for most deaf children as the majority of them are born to hearing parents. As a result, their language and communication may be delayed. Some children are not born totally deaf but with mild to moderate hearing loss as a result of recurring infections e.g. glue ear. There is a lot of interest on sign language acquisition among native signers (whose first language is sign language): how does it compare with language acquisition of hearing children exposed to a spoken language in terms of ages and stages of development? One such study undertaken by Dr Ros Herman and colleagues looked at ‘Early Vocabulary Development in Deaf Native Signers.’ Click here to read the article.

Glue ear I hear you say.. 



Many deaf children can also have other concomitant disorders such as developmental delay. They may also have language impairment. A study undertaken by Kathryn Mason and colleagues looked at identifying language impairment in deaf children acquiring British Sign Language. Mason found that the children in her study had significant language delay compared to their peers matched for age and language experience. Click here to read more about this.

As speech therapists we don’t just work with children, there are many adults out there who have acquired problems in their life. One such example is a Stroke. A stroke happens when the blood supply to parts of the brain is cut off and brain cells are damaged or die. This can be from a blood clot or a burst vessel. About a third of people who have a stroke make a significant recovery within a month. But most stroke survivors will have long-term problems. Strokes can vary in terms of severity. About one third of people who have suffered a stroke will get Aphasia. This is a condition that leads to problems understanding and using language. Sadly many people who have had a stroke and have lost their ability to communicate verbally, also lose their friends. Losing friends, having few social contacts and loneliness are linked to depression post-stroke.  It is therefore important to look at what happens to social contacts post-stroke. At City, Dr. Katerina Hilari, a leading researcher into the impact of aphasia and her colleague Sarah Northcott developed a test called Stroke Social Network Scale. Clinicians and rehabilitation professionals can use this test to look at what happens to people’s social contacts after a stroke. Have a look at what they found here.

Aphasia…Sarah Scott was 18 years old when she suffered a stroke. Here she discusses what happened on the BBC 



Some people with aphasia who have trouble speaking may need to use various strategies, such as pointing and gesture to help them get their message across. Professor Jane Marshall and her colleagues at City investigated gesture and naming therapy for people with severe aphasia. They looked at a group of people with severe aphasia and compared their learning of gestures with their learning of words. They found that across the group, improvements in naming were greater than improvements in gesture. For more information about what they did, click here.

Anyway, this is just a flavor of some of the exciting research that takes place at City University London where I study! I know that’s a lot of information to handle, so I'll leave it there for now. I hope you enjoyed reading this blog and learned something new.

Ciao,

H x

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