Who is a Speech Pathologist?

As I am 6 months into my speech pathology career, it is now time for me to share with you what a speech pathologist does. Coming from Malaysia, a developing country, the field of speech pathology is still in its infancy. There is still a stigma around disability and lack of acceptance of an individual living with a disability. Therefore, it is my passion to share what speech pathology is and advocate for this field.

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The Speech Pathologist

Speech pathology is the study of speech, language, voice, social communication, written communication/literacy, cognitive-communication, and swallowing disorders in people across the lifespan. Speech pathologists play a vital role in assessing, diagnosing and preventing the above disorders and providing intervention/therapy/strategies for individuals of all ages with such disorders.

We see all sorts of individuals come through our doors. Here are some examples:

1. A premature infant who currently has her milk via a tube through her nose. She communicates through body and facial expressions to tell others when she is overwhelmed and not ready to be fed through her mouth.
2. A toddler with a language and speech delay, which impacts on his ability to communicate his wants and needs verbally. He gets frustrated as no one understands him and does not get what he wants.
3. A teenager presenting with dyslexia, impacting his ability to spell and read the text on his Biology. He struggles every day at school as he does not comprehend what he had just read.
4. A 30-year-old man with an intellectual disability who has difficulty making inferences from what others are saying, causing confusion and not knowing that someone was being nasty to him.
5. A woman in her sixties who just had a stroke presenting with aphasia, an acquired language disorder, with characteristics of word-finding difficulties. She often experiences frustration as she “can’t get his words out” and is finding it difficult to understand what everyone around her is saying.

The Many Roles of a Speech Pathologist

Besides those mentioned above, there are many areas in which a speech pathologist could work in, therefore we have a variety of roles that we could play. These are the roles:

1. Speech Pathologist — assess, diagnose, treat, provide intervention
2. Trainer/Educator — to parents, carers, colleagues, other staff members
3. Advocate — for our clients and patients; for our profession
4. Counsellor/Consultant — in providing strategies to be implemented at home; in comforting and encouraging clients and families
5. Team player — speech pathologists work collaboratively with professionals of other disciplines, sometimes in multidisciplinary, interdisciplinary or transdisciplinary teams
6. Trainer/Supervisor — to future speech pathologists
7. Researcher

What are all these disorders?

Speech disorders: difficulties with speech sound production (pronunciation of sounds in a language), fluency of speech (stuttering)or voice problems (quality of voice; e.g. hoarse, croaky, breathy)

Language disorders: difficulties with understanding others (receptive language), or sharing thoughts, ideas, and feelings (expressive language). Language can be either spoken or written has four elements to it. Form (phonology, morphology, syntax), content (semantics), and/or use (pragmatics) of language which is functional and socially appropriate. Breakdown in communication can happen in any of these four areas. Aphasia is an acquired language disorder commonly experienced by individuals who have had a stroke.

Social communication disorders: difficulties with the social use of verbal and nonverbal communication including communication for social purposes (e.g., greeting, commenting, asking questions), talking in certain ways according to the target audience and setting, and following conversation rules and story-telling rules. Social communication disorders present in individuals with Autism Spectrum Disorder (ASD) and can also be acquired as seen in individuals with traumatic brain injury (TBI).

Cognitive-communication disorders: difficulties with attention, memory, planning, organising thoughts, and/or problem-solving, which can be seen in individuals affected by stroke, TBI or dementia but could also be congenital.

Swallowing disorders (dysphagia): difficulties with feeding and swallowing, which can be seen in individuals with an illness, post-surgery, post-stroke, post-injury and prematurity in infants.

Speech pathologists also work with deaf/hard of hearing individuals in providing aural rehabilitation, provide communication options such as augmentative and alternative communication (AAC) systems for individuals who are non-verbal or present with severe/complex communication needs as seen in individuals with progressive neurological disorders, ASD, cerebral palsy etc. Additionally, speech pathologists work with individuals with tracheostomy in airway management and communication options as well as work with infants and young children who are premature and are at high risk of long-standing feeding disorders as well as fussy eaters. Speech pathologists provide literacy (reading, writing and spelling) interventions for people who have low literacy skills in schools or even in the justice systems.

Swallowing? But It Says “SPEECH Pathologist”!

Yes, you read it right — swallowing. This is because speech pathologist study and master the structures in the head and neck as well as areas of the brain in which controls them. The structures used for speech are the same for swallowing, therefore we do have a very important role in managing swallowing disorders.

Client Groups often seen by a Speech Pathologist

• Individuals who have experienced a stroke (Aphasia/Dysphagia/Apraxia)
• Individuals with Traumatic Brain Injury
• Progressive Neurological Disorder (Parkinson’s Disease)
• Dementia
• Pre-school aged children
• School-aged children
• High school students
• Juvenile centres
• Individuals with ASD
• Individuals with Cerebral Palsy
• Premature infants
• Professional voice users (singers, actors, teachers, sports coach, auctioneer etc.)

Where can you find a speech pathologist?

Speech pathologists can be found in various workplace settings, they include but are not limited to:

• Hospitals (ICU, Acute, Sub-acute, Rehabilitation, Outpatients, Neonatal Care Units)
• Community Health Care Settings
• Stuttering Clinics
• Speech and Language Clinics
• Voice Clinics
• Cerebral Palsy and Autism Specialist Centres
• Mainstream Schools (Primary to Secondary)
• Special Education Schools
• Justice System
• Speech and Audiology Clinics
• Universities (as educators & researchers)

The Development of Speech Pathology

Speech pathology is a field that has only existed since around 1925 and is constantly growing, with new findings and research being released every year. It is still a young profession where advocacy is much needed to build awareness of our role as speech pathologists. Only being established in approximately 17 countries, awareness about the profession amongst today’s society is still limited. There are many emerging areas such as working in the justice system and neonatal populations, in which speech pathologists are still trying to make their mark as a profession that will benefit such areas.

If you are in need or know someone who is in need of a speech pathologist, you can go to the Speech Pathology Australia or American Speech and Hearing Association website (or your local speech pathology governing body) to look for more information. Feel free to contact me if you have any questions regarding this.