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Ask the expert: Speech Therapy

TWo women sitting on couch talking

Have you ever been curious about Speech Therapy and if it is right for you? Or has your care team ever suggested you work with a Speech Therapist? Here you will find a brief interview with an oncology-based Speech Therapist who gives an overview of the discipline as well as simple, and realistic changes to help make life a little easier. 

 

What is Speech Therapy and what are the overall goals of care?

Speech therapy is a rehab service that helps people in the areas of speech, communication, cognition, and swallowing with the goal of maximizing functional skills related to these areas to empower people to engage and be present in their lives.  When working in cancer care rehabilitation a speech language pathologist (SLP) will typically focus in areas of language, cognition, and swallowing.   

 
When would Speech Therapy Intervene?

 

  • Speech sound production  
  • Language deficits- including difficulty finding specific words and reading  
  • Social communication 
  • Changes in voice  
  • Fluency  
  • Cognitive deficits- including changes in memory, attention, organization   
  • Feeding and swallowing 

 

What would an initial assessment with a Speech Therapist be like?

An initial SLP assessment would be based on the primary concern or issue that initially brought the person to seek care. Then the SLP and individual would establish mutual goals of care to focus each session on. For example, if a person was reporting difficulty remembering specific words, the session would include spending some time talking about moments words are forgotten and then they would complete a formal cognitive-linguistic evaluation.  Another example is if a person was reporting difficulty with food getting stuck in his or her throat, the session would focus on the specifics of when food is getting stuck and then proceed to a swallowing evaluation. 

Once an evaluation is complete, the SLP will work with the person to develop specific goals to address the areas of need through education and exercises.    

 
How does Speech Therapy support individuals going through BMT, chemotherapy, or radiation?

For the adult population, SLP support depends on the underlying condition.  When a person is going through a BMT, SLP may be asked in to assess for swallow safety and make recommendations for diet modifications to maximize safety and oral intake in the setting of mouth and/or throat pain.  For individuals with head and neck cancer, SLP follows the preventative approach and gets involved as early as possible.  This is because we understand how radiation impacts the muscles of swallowing and there is a lot of evidence supporting the benefits of early intervention and exercise.  For individuals with cognitive changes post chemo, SLP intervention usually occurs later, after a person recognizes these changes and is at a place where he or she is ready to seek out assistance. 

For children, SLP could be involved for reasons beyond underlying condition as these children might be going through treatment when they are also developing their language and speech skills.  Due to this a speech therapist might be involved in supporting this ongoing development.  Another reason for SLP involvement is if a child has a pre-existing condition that requires intervention. Some of these conditions would include:  

Title
Examples of pre-existing conditions

 

  • Apraxia
  • Autism Spectrum Disorder (ASD)
  • Brain injury/concussion
  • Cancer
  • Cerebral palsy
  • Cleft lip and/or palate and craniofacial anomalies
  • Developmental delay
  • Feeding and swallowing difficulties (dysphagia/aspiration)
  • Genetic and chromosomal disorders
  • Hearing impairments
  • Pervasive Developmental Disorder (PDD)
  • Social communication deficits
  • Traumatic brain injury
  • Velopharyngeal dysfunction/insufficiency (VPD/VPI)
  • Many other complex medical conditions

Why should someone be motivated to work with a Speech Therapist?

The areas that we SLP’s support have a huge impact on people’s quality of life and no one should feel as though he or she is alone with these challenges. A SLP is able to provide physical, mental, and emotional support to maximize his or her functioning and reduce frustration related to these deficits. 

How can I make progress on my own?

Cognition

 

  • Pay attention to the moment that you are unable to find the word that you want.  Are you able to describe it in any way? 

  • Use external memory strategies including calendar, notes, lists, and alarms to remind you.   

  • Pace yourself 

    • Slow down to allow yourself time to compensate  

    • Break larger tasks into smaller, manageable ones  

  • Begin journaling 

    • Keep it simple; consider listing 2 positive things from the day and 1 negative thing 

  • Give yourself a routine  

  • Play brain games  

    • Online applications- there are many free brain games  

    • Crosswords  

    • Word searches  

    • Suduko puzzles  

Swallowing

 

  • Always follow your SLP suggestions to maximize safety  

  • Be mindful of the environment, reduce distractions during meals so that you can pay attention and modify your eating behaviors 

  • Go slowly and pace yourself  

  • Know that things that are soft and similar in texture such as oatmeal, yogurt, or puddings may be the easiest, and from there you can progress to softer solids such as mac and cheese, pancakes with syrup, bananas, and crock pot meals.   

  • Adding additional sauces, gravies, and syrups are a great way to maximize the ease of swallow.   

  • Know that dealing with changes in taste are challenging  

    • Expect a slow return of taste with this return being taste specific (i.e., you may only be to taste one flavor such as ‘sweet’) 

    • Give yourself a variety of experiences 

  • Avoid sneaky, highly acidic items which can be painful.  These may include sour/overly sweet candy, red sauces, strawberries, pizza, citrus fruits, salad dressings, and even applesauce.  

  • Balance a craving with what is safe and recommended 

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