Speech and language therapy FAQs

Contents

• Will I/my relative get better?
• How long until I/they are back to "normal"?
• When is it best to treat?
• How often should they be treated?
• How do I choose an appropriate Speech and Language Therapist?
• References

Will I/my relative get better?

The nature and severity of the condition causing the speech, language or swallowing difficulty has an impact on likely recovery. The severity of the difficulty itself is also important. There are a number of other factors which can impact on recovery including: depression, age, family support, and motivation. With progressive neurological conditions e.g. Multiple Sclerosis (MS), speech and language therapy is usually aiming to maintain skills and function as opposed to restoring it.

How long until I/they are back to “normal”?

The rate and extent of recovery varies between individuals for many reasons, as outlined above. For example, the site and size of two people’s stroke may be the same but their difficulties and their recovery will be completely different. It is very rare for someone to recover 100%.

When is it best to treat?

The evidence suggests that the earlier treatment begins, the better the outcome. In the early stages following a stroke or head injury many people are very tired and can only manage very short periods of therapy. It is also a time when the brain is recovering and therefore the way someone speaks or swallows can change rapidly at this point. The majority of recovery occurs within the first six months but people can still improve many years after the original injury. For example, there is evidence that some people with non-progressive dysarthria benefit long after the initial onset (1).

How often should I/they be treated?

This is another question for which there is not a definitive answer. It is not always the case that more equals better. A specialised and experienced therapist will be able to advise you on recommended frequency. The Clinical Guidelines for Stroke 2008 state that people should “undergo as much therapy as appropriate to their needs as they are willing and able to tolerate.”

A study into the efficiency of aphasia therapy after stroke revealed that in the first twelve weeks after stroke there was no measurable difference in outcome from those who received 1.6 hours of speech and language therapy per week than those who received three hours a week (2).

How do I choose an appropriate speech and language therapist?

A number of generalist therapists choose to treat all ages and conditions. Other therapists choose to specialise in a particular area, for example adults with neurological conditions. It is important to speak to the therapist to ascertain their skills and experience with the particular condition to be treated. For example through asking the following:

• Are they members of RCSLT (the Royal College of Speech and Language Therapists)?
• Are they registered with the Health Professions Council (HPC)? All registered speech and language therapists are.
• Are they members of the Association of Speech and Language Therapists in Independent Practice (ASLTIP)?
• Are they a member of a special interest group (SIG) in the given condition?

References

1. Bakheit A.M., et al. 2007. A prospective, randomized, parallel group, controlled study of the effect of intensity of speech and language therapy on early recovery from poststroke aphasia. Clinical Rehabilitation; 21:885-894.
2. Palmer R., Enderby P., Hawley M. 2007. Addressing the needs of speakers with longstanding dysarthria: Computerized and traditional therapy compared. International Journal of Language and Communication Disorders; 42, S1: 61-79.

For further information on the author of this article, Speech and Language Therapist, Ms Liz Ackroyd, please click here.