Many individuals will have experience with speech therapy at some point in their life. But what is speech therapy, exactly? Speech therapy is a specialized treatment performed by a speech-language pathologist that helps individuals of all ages improve their speech and communication.

What is Speech Therapy?

Speech therapy prevents, assesses, and treats communication problems, delays, and disorders. It is performed by a communication specialist called a speech-language pathologist (also referred to as a speech pathologist, speech therapist, or SLP).

Speech therapy aims to improve an individual’s speech and/or language skills and treat developmental delays, swallowing disorders, fluency disorders, voice and resonance disorders, and more.

Who Needs Speech Therapy?

Speech therapists help a wide variety of clients from birth to old age. Individuals who might benefit from speech therapy include the following.

• Infants. Speech therapy helps infants and babies with feeding, speech development, and early communication skills.
• Toddlers and Preschoolers. Toddlers and preschoolers receive speech therapy to treat speech delays and disorders and enhance language development (identifying body parts, following simple directions, etc.).
• Children and Adolescents. Speech therapy can help children with a variety of disorders, including speech sound disorders, language delays, stuttering, voice disorders, auditory processing, verbal expression, and much more.
• Adults. Adults can be treated in therapy for the same delays and disorders as those seen in adolescents, as well as for aphasia, dysarthria, memory, cognition, accent reduction, swallowing, and gender-affirming voice therapy.
• Elderly. Speech therapy can be very beneficial for seniors. Therapy may work on improving functional communication skills, safe swallowing techniques, and memory and problem-solving skills.

What Does Speech Therapy Do?

A speech-language pathologist treats a wide range of communication delays and disorders. They provide therapy in the areas of articulation, language, fluency, resonance, cognition, voice, swallowing, dysarthria, auditory rehab, and more.

1. Articulation

A speech sound disorder (also known as an articulation disorder) is the inability to correctly produce speech sounds (called phonemes). These disorders are most common in children and may include an omission, substitution, distortion, or addition of sounds when speaking, often making the child difficult to understand.

• Omissions. Leaving out a sound in a word. (Example: Saying “unny” for “bunny” or “ar” for “car.”).
• Substitutions. When a sound is said in place of another. (Example: A child has a “lisp” and says “thun” for “sun” or when a child substitutes a W for an R and says “wabbit” for “rabbit.”)
• Distortions. A non-typical sound is said in place of the correct sound in a word. (Example: A child has a lateral lisp where the air escapes out the side of the teeth when saying the “S” sound, making it sound “slushy” and hard to understand.)
• Additions. A sound is added to a word, like extra vowels or an extra consonant. (Example: Saying “puhlay” for “play.”)

2. Language

A language disorder is when a person has difficulty understanding written or spoken language or expressing their wants and needs to others. People with a language disorder may have an expressive language disorder, receptive language disorder, or both.

• Expressive Language. Individuals with an expressive language disorder have difficulty communicating their wants and needs to others through speech, writing, or gestures. Individuals with an expressive language disorder may not produce grammatically correct sentences, have a limited vocabulary, and may speak in short phrases instead of full sentences.
• Receptive Language. A receptive language disorder causes difficulty understanding or processing language. Individuals with a receptive language disorder may have difficulty following directions, and answering questions.

3. Fluency

Fluency disorders interrupt the normal rate, rhythm, and speed of speech. Rather than speaking in a smooth, consistent rate of speech, individuals with a fluency disorder will have repetitions, prolongations, and blocks when they speak. They may also experience tension when they speak and have secondary behaviors (like eye blinking or nodding their head) when communicating.

Fluency disorders are divided into two categories: stuttering and cluttering.

• Stuttering. Stuttering is the most common type of disfluency. It is characterized by repetitions of sounds, syllables, words, and phrases, blocks in the flow of speech, and sound prolongations.
• Cluttering. Unlike stuttering, cluttering is a fluency disorder where the individual talks at a fast rate and often combines words or phrases together, making the speech difficult to understand. Cluttered speech is often filled with abnormal pauses, deletion of syllables, abrupt topic changes, and omission of word endings.

4. Resonance

Resonance disorders occur when there is too much or too little sound energy through the nasal and/or oral cavities. This is often caused by neurological disorders, cleft palate, and other structural conditions like enlarged tonsils. Resonance disorders can be broken down into the following four categories.

• Hypernasality. Hypernasality occurs when there is too much sound energy in the nasal cavity (nose) when speaking. A person with hypernasality may sound like they are talking through their nose.
• Hyponasality. Hyponasalaity occurs when there is not enough sound energy resonating in the nasal cavity (nose) when speaking. A person with hyponasality will sound like they are speaking with a severely stuffed nose.
• Cul-de-sac resonance. A person with cul-de-sac resonance has speech that resonates in their throat, nose, or mouth but it is unable to escape due to an obstruction. They may sound like they are mumbling when speaking or like the sound is muffled in their throat or nose.
• Mixed resonance. This type of resonance disorder occurs when one or more of the previous types of disorders are present at the same time during speech.

5. Voice

Voice therapy is used to improve the quality of a person’s voice and provide treatment for conditions such as vocal fold nodules, polyps, or cysts. It can also be used to improve the speech of someone with spasmodic dysphonia, tremor, and vocal fold paralysis.

Voice therapy aims to improve phonation quality, pitch, and loudness, and helps decrease harmful vocal behavior.

6. Cognition

Speech therapy can assist individuals with acquired cognition deficits. These often occur following a stroke, brain damage, tumor, or neurological damage. Damage to the brain can greatly affect a person’s ability to communicate, and speech therapy provides help in the following areas.

• Attention.
• Memory.
• Problem solving.
• Executive functioning.

7. Feeding and Swallowing

Speech therapists are swallowing specialists and provide therapy for a number of feeding and swallowing conditions and disorders. They work with infants, children, adults, and the elderly to ensure the safe transition of food through all four stages of swallowing.

9. Auditory Habilitation/Rehabilitation

Auditory habilitation/rehabilitation helps individuals with hearing loss improve their ability to communicate with others. It can also assist children and adolescents with dyslexia, autism, and other auditory processing disorders and deficits.

A speech therapist works with a team of specialists to improve speech, language, and hearing skills through a variety of devices and materials.

10. Other Services

In addition to these areas of expertise, speech therapy can also provide elective services including, but not limited to the following.

• Accent modification. Whether a person wants to decrease the severity of their accent or master an accent for acting or other purposes, speech therapy can help train a client on the characteristics of specific accents and dialects.
• Gender-affirming therapy. Speech therapy can help an individual train their voice and nonverbal communication to best match their authentic self.
• Professional communication skills. Speech therapists are experts in communication, and they can help improve public speaking skills and help manage anxiety when speaking to large groups.

Where Does Speech Therapy Take Place?

Speech therapy can be done in many locations based on a client’s needs.

• Private and public schools.
• Clinics.
• Private practice.
• Hospitals.
• Skilled nursing facilities.
• Inpatient rehabilitation facilities.
• Long-term care facilities.
• Telepractice.

Speech therapy can also be provided within a client’s home for infants and toddlers receiving early intervention services or for the elderly with limited mobility.

How Long Does Speech Therapy Take?

There is no set time limit for speech therapy as therapy duration will be different for each person. While some children in therapy working on fixing their lisp (correctly saying the S sound) will take 1-2 years, other children with a severe form of childhood apraxia of speech (CAS) will need therapy for many, many years.

Prognosis and how long someone will be receiving speech therapy services is dependent on a number of factors including, but not limited to:

• Patient age.
• Type of disorder.
• Severity of the disorder.
• Frequency and duration of speech therapy.
• Family support and assistance with at-home therapy “homework.”
• Prognosis of any medical conditions contributing to the speech or language disorder.

Does Speech Therapy Work?

Speech therapy is proven to be very successful at improving speech and communication in a variety of individuals.

Keep in mind that the progress and success of speech therapy vary from person to person. The more consistent the therapy, the higher likelihood of success.

In addition to consistency, the earlier therapy is started (especially in children with delays), the better the prognosis.

Please reach out to a speech therapist if you are concerned about your or your loved one’s speech or communication. You can also email general questions to priscilla@thespeechguide.com.