Search This Blog

Sunday, April 3, 2016

What is a Medical Speech-Language Pathologist?

"Oh, you're a speech pathologist? Huh. So are you judging my speech right now?"

I get that question a lot. Someone asked me that this week and I said "Yep," and laughed, because I'm awkward like that and I was trying to make a joke but actually it came out more like an insult. Whoops. So now I'm over-compensating with a blog post.

The reality is that I'm most likely not analyzing your speech, partly because most of you do not have speech disorders, and partly because speech is one of the smallest parts of what I do.

My job title is confusing, and not just to people unfamiliar with speech-language pathologists, or speech therapists, as we're sometimes called. I regularly overhear families asking my patients, "So what do you work on in speech therapy?" Sometimes, if I haven't done a good enough job of collaborative goal-setting and education regarding my role, my patients respond that they are working on "speech," when in fact they are mostly working on something else altogether.

To help you understand what medical speech-language pathologists actually do, I am going to give you three things: a picture, a new name, and a pro tip.

First, a picture:

Basically, I tell people that we are involved in therapy related to lots of things from the neck on up, including the functions of your voice box, throat, mouth, nose, and brain!

Next, I have a proposed job title that reflects what medical speech pathologists generally actually do. I probably spend less than an hour a day working on speech accuracy with my patients. I find that the bulk of my patients have intelligible speech but need help with other communication, cognition, or swallowing issues. So when you are confused about the role of the "speech therapist," it might be helpful to think of us as "communication, cognition, and swallowing specialists," or maybe just "communication and swallowing specialists" since most of our work with cognition (thinking skills) is directly related to how those skills impact communication.

Finally, a pro tip. Swallowing disorders are confusing. How could someone not be able to eat? Sometimes, because the entrance to the airway and the entrance to the esophagus (food tube) are right next to each other in the throat, weakness or poor coordination of the swallow puts people at risk for things going down the wrong pipe. This can be life-threatening in the cases of pneumonia or choking. Another potential problem might be that the person's swallowing is so weak, effortful, or inefficient that they can't sustain adequate nutrition and hydration by mouth. Some patients may not even be able to elicit a swallow at all.

Sometimes a speech therapist will collaborate with a radiologist to do an X-ray swallow test, which goes by a lot of different names (videoswallow, cookie swallow, videofluoroscopic swallow study, etc.) in order to get more information about the disordered swallow. So here's my public service announcement of the day. I often, often, often have people ask me if So-and-So "passed" his videoswallow. But you can't "pass" or "fail" an X-ray; instead, the test gives us a lot of valuable information about what is going on inside the throat that helps guide our treatment and recommendations. Instead, you can ask, "What did the videoswallow show?"

So there you go! My job in a nutshell. :)

This was taken in my days as a baby speech therapist at the University Hospital

I'd love to hear from you. Have you or your loved ones ever worked with a speech therapist? What did they do? Any related questions for me?


LisaM said...

Yes! They were awesome in the NICU. But I have to be honest... at first I thought, "a speech pathologist? for babies?" And then I realized how much had to do with suck, swallow and coordination with all it was super eye opening! The possibilities in your field are much wider than the average person realizes. :-) Thanks for doing what you do!!

Alison said...

Thanks for the comment! All the NICU speech pathologists I've come across are incredibly knowledgable and dedicated. I think some of the best people working in our field find their way to that setting. I followed one for a while when I worked at the hospital and was so intimidated by all the wires and tubes!