Pathologists help patients communicate

Most of us go through our days working, running errands, tending to children, doing chores, and enjoying our hobbies and leisure time, all with little thought to how fortunate we are to be able to speak clearly and hear well. We take for granted that we can communicate with others, much like we take for granted breathing and walking. But not everyone is so fortunate, and for those among us who do suffer with speech and hearing issues, there is help available.

May is Better Hearing and Speech Month, as designated by the American Speech Language Hearing Association. This annual recognition is intended to raise awareness about communication disorders and to educate the public about treatments that are available.

Kevin Keith is a master’s level trained speech-language pathologist at Southwest Memorial Hospital. Once an English teacher, Kevin has been practicing speech therapy for nine years, six of those at SWMH. He says his profession dates back to the 1800s when elocutionists taught both dignitaries and ordinary people to speak properly. This was beautifully illustrated in the Academy Award-winning film “The King’s Speech,” in which therapist Lionel Logue worked with Britain’s King George VI to help him overcome stuttering. Another well-known American elocutionist was Alexander Graham Bell.

As the profession became more formalized, the American Academy of Speech Correction was formed in 1925 and subsequently became the American Speech Language Hearing Association in 1978. The organization currently has more than 150,000 members in the United States and internationally. Speech-language pathologists work in hospitals, long-term care facilities, home health agencies, in schools, in private practices and in academia. Kevin, in this role at SWMH, assesses and treats patients when they are hospitalized and also on an outpatient basis.

Kevin sees patients with a variety of medical problems in the hospital setting, including those who have suffered a stroke. An individual who has had a stroke may have cognitive or language impairment, making it difficult or impossible for them to communicate with doctors, nurses, and family members. Kevin’s role is to evaluate the patient and determine what types of therapy will be needed once the acute phase of the illness is under control. He also assesses a patient’s ability to swallow safely, a common problem with stroke patients. Swallowing problems also occur in individuals with other types of medical issues including chronic obstructive pulmonary disease, or COPD.

“There are sometimes age-related swallowing problems that must be addressed as well,” Kevin said.

“In the hospital setting, I determine what’s changed from an individual’s baseline,” Kevin said. “Then I tailor a program that’s based on their needs.”

Later, in either an outpatient setting at the hospital or sometimes in the home, Kevin works with patients and their caregivers to overcome language, speech, or swallowing deficits caused by a stroke or other medical event.

“With swallowing issues, for example, once I determine what’s safe for a patient, I teach them exercises and techniques and train family members and caregivers to make necessary accommodations, depending on what types of food textures and liquids a patient can manage,” Kevin said.

When it comes to language rehabilitation, the process can be quite long and much of the work is done by patients with the support of their caregivers outside the hospital setting.

“I give them exercises to work on word recall, basic communication, reading, writing, speech clarity — the whole gamut,” Kevin said. “It’s fairly involved and complex because language is brain-based and it takes a while for therapy to run its course and for patients to improve.”

But they do improve if they take their rehabilitation efforts seriously.

Technology can play a role in this type of rehabilitation.

“There are smart computer programs out there that help patients work independently on problem-solving, pattern recognition, and to improve their visuospatial functioning,” Kevin said.

He can help patients and their caregivers set up this type of technology in their homes. “This can be a very cost-effective form of therapy for patients who are able to work on their own,” he added.

“The caregiver is so important because an illness or a stroke never affects only the patient,” Kevin said. “Providing education and support and teaching families how to help is an important part of what speech pathologists do.”

On an outpatient basis, Kevin frequently works with children who are not progressing normally with language or who have specific issues such as stuttering or other speech deficits.

“The intention is to identify these children early and get them into services that will help them develop normally,” Kevin said. “If you wait too long it can impact their education.”

Fortunately, the local school system also has speech pathologists on staff who are trained to identify and intervene when children need support with speech and language development.

“Interestingly, it’s not uncommon for parents to be concerned about a child’s speech development simply because they’re comparing their child to other children,” Kevin said. “In some cases, I need only to reassure parents that their child is within the normal range in terms of developing speech.”

Kevin works under the direction of area physicians who refer their patients for evaluation and treatment.

“Working in our rural area, I get to be a generalist and see a little bit of everything,” he said.

He works with individuals who have traumatic brain injuries, autism, voice disorders, development disorders, fluency disorders, Parkinsonism and a wide variety of neurologic disorders.

The length of therapy varies dramatically, depending on the issue at hand.

“Swallowing disorders can often be dealt with fairly quickly,” Kevin said. “Sometimes it’s just a matter of education.”

Other conditions, such as traumatic brain injury, may involve a lifetime of ongoing work on the part of the patient and caregivers. For stroke patients, the amount of rehab needed depends on the severity of the stroke and the motivation of the patient.

This article has focused on speech and language disorders and treatment. Hearing is the other side of the communication coin, and there are several local audiologists available to help patients with hearing problems. Check the local yellow pages or contact Kevin at 564-2154 about finding a hearing professional in our area.

For more information, visit the American Speech Language Hearing Association website at ahsa.org or go to swhealth.org and click on “Hospital” and then on “Speech Therapy.”

Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal healthcare provider.

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