Text 7. Speech-Language Services

The provision of services to children and adults who have speech and / or language disorders is a complex problem.

According to Cleland and Swartz (1982), delivery of services includes such factors as funding, transportation, and consumer resistance, in addition to problems of keeping service providers up to date in the latest techniques and tools. Speech and language services are provided in a variety of settings but always by professionals trained as speech pathologists having appropriate certification or a state license. All clinically certified speech- language pathologists are capable of providing a complete range of services. Some choose to specialize, but all have knowledge across a variety of speech and language disorders. The greatest number of speech pathologists are employed in school settings, ranging from pre-school through high school. Services provided include screening for speech and hearing disorders, diagnosis, treatment, and referral for more complex disorders. Since children make up the caseload in public schools, the majority of disorders treated are those concerning speech, language, voice, and stuttering. Many hospitals provide speech and language services. Speech clinics are usually established in rehabilitation departments. Speech- language pathologists work with occupational and physical therapists to treat people with physical disorders. Sometimes hospitals also provide services for children, thus offering an alternative to the free services of public schools.

There are speech-language clinics in many large metropolitan areas. Some of these clinics are private; others are associated with hospitals or universities. These clinics usually provide a wide range of services while at the same time being used as a training base for future speech language professionals. Privately funded or publicly funded health service agencies may also provide speech-language services. These agencies provide speech-language services to people from less privileged socioeconomic backgrounds.

Speech clinicians employed by these agencies usually are itinerant: They go to the home of the client to provide the speech- language service. Clinics run by these agencies also provide a wide range of clinical services. There is a trend for speech- language pathologists to establish their own speechlanguage services rather than work for a school, hospital, clinic, or public agency. These individuals set up offices and see clients there. Occasionally, they hire other speech pathologists and enlarge their caseloads to the point where they can call their practice a clinic. Again, services are provided across the full range of speech and hearing disorders. Occasionally, speech- language pathologists are employed by industry. In these settings, the pathologists usually serve a diagnostic function only. In summary, speech-language services cover a wide range of diagnostic and therapeutic treatments in a variety of settings. These settings include public schools, hospitals, private speech clinics, university speech clinics, health service agencies, and private practices.

(Source: Encyclopedia of Special Education, THIRD EDITION
Cecil R. Reynolds and Elaine Fletcher-Janzen, Editors, 2007)

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Text 8. Speech Therapy

Speech therapy includes all efforts to ameliorate disordered speech. Treatment activities include attempts to improve the speech of persons who have never spoken normally (habilitation) as well as to improve the speech of persons who formerly had normal speech (rehabilitation). A variety of treatment approaches are used, depending on the speaker’s age, speech disorder, and the professional training and experience of the speech pathologist. Speech therapy usually includes teaching a person with a speech disorder to speak differently. Concerning adults and older children, however, therapy may consist of play activities during which treatment is indirect.

Although many research investigations have been conducted into the nature and treatment of speech (and language) disorders, much remains unknown. Therapy remains, therefore, often more of an art than a science.

The speech pathologist must often rely more on intuition and experience than on research results. Often, no attempt is made to determine the cause of the speech disorder because, in most cases, the cause(s) cannot be found. Although some speech disorders can be completely cured so that no traces of the original behavior remain, some speech disorders cannot be completely eradicated. For instance, some children and adults who stutter will continue to have vestiges of stuttering despite successful speech therapy.

Clients receive therapy in group and /or individual sessions, and therapy may be short-term (a few sessions) or long- term (several years), depending on the nature and severity of the disorder. The length and frequency of therapy sessions also depend on a variety of factors. (The terms client, patient, and student are all variously used to refer to the person being treated for a speech disorder, depending on the treatment setting).

Speech-language pathologists typically assess clients before therapy actually begins, although a period of diagnostic therapy may also be used to help determine the nature of the disorder. Sometimes clients are referred to other professionals by the speech- language pathologist (e.g., audiologists, dentists, physicians).

(Source: Encyclopedia of Special Education, THIRD EDITION
Cecil R. Reynolds and Elaine Fletcher-Janzen, Editors, 2007)

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