Health Services: Speech-Language Therapy

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Speech-Language Therapy:

The ability to communicate is essential part of making connections with others and experiencing the world. The ability to hear and understand others and the ability to express thoughts, feelings and ideas can be impacted throughout life by a variety of disorders. Difficulties can be from the inability to communicate to not using appropriate communication skills, such as interacting with others due to issues related to autism or a traumatic brain injury. Speech-language pathologists (SLP) help in variety of ways. The goal of speech-language therapy is to foster the development of social communication skills and improve the individual’s daily living skills. SLPs work to bring communication to all, based on the individual’s situation. This may be through articulation therapy or development of a communication board with pictures or a computer that recognizes eye movement or teaching an alternate means of voice production after surgery.

At a Glance:

  • 40 million Americans have communication disorders
  • 25% to 40% of typically developing children demonstrate feeding and swallowing problems.
  • 31.5 million Americans have reported difficulty hearing.
  • 9 out of 10 individuals with Parkinson’s have a speech or voice disorder, but only 1/3 receive speech or voice treatment.
  • 3 out of 10 Americans over 60 suffer from hearing loss.
  • 1.4 million children age 18 or younger have hearing problems.
  • 2.4 million individuals in the US sustain a traumatic brain injury and another 800,000 individuals sustain an acquired brain injury from non-traumatic causes.

Speech-language pathology services include diagnosis and treatment of swallowing, speech-language skills, and cognitive communication disorders that result in communication disabilities. Many of these disorders may have a neurological basis such as head injury, Parkinson’s diseases, stroke, autism and cerebral palsy. Speech-language pathologists treat disorders of:

  • Speech sound production (articulation, apraxia, dysarthria)
  • Resonance (hypernasality, hyponasality)
  • Voice (phonation, quality, pitch, respiration)
  • Fluency (stuttering)
  • Language (comprehension, expression, pragmatics, semantics, syntax)
  • Cognition (attention, memory, problem solving, executive function)
  • Feeding and swallowing (oral, pharyngeal, and esophageal stages) (ASHA, 2007)

The American Speech-Language Hearing Association (ASHA) has set the Admission/Discharge Criteria as: “Individuals of all ages are eligible for speech-language pathology services:

  • when their ability to communicate and/or swallow effectively is reduced or impaired, or
  • when there is reason to believe that treatment would prevent the development of a speech,
    language, communication or feeding and swallowing disorder;
  • reduce the degree of impairment;
  • lead to improved functional communication and/or swallowing abilities.”

How do does speech-language therapy help the person with a disability or family support system?

In children, speech-language treatment can have profound effects on the overall development of social skills, academic success and future vocational choices. Early treatment for adults with acquired age or noise related hearing loss, injuries to the vocal cords, speech, language or swallowing disorders due to stroke or Parkinson’s, cancer or other medical conditions can reduce the length of and expense of treatment.

How can a parent/caregiver gain access to speech-language therapy?

Prior to treatment a comprehensive speech/language evaluation of the patient and their speech language potential by certified speech-language pathologist is required. Standardized assessments for in the evaluation to see if there is a need for services.

To find a certified private SLP or audiologist ASHA’s ProFind provides a listing by location of certified audiologist and speech-language pathologists Click Here for the ASHA website. Speak with your healthcare provider and insurance company about your concerns to find out the procedures for getting a referral for coverage. Coverage by insurance companies depends on your policy and what specific conditions, course of treatment, age of patient, and other factors are defined in your policy. Insurance policies may have limited coverage for outpatient speech therapy through short-term rehabilitative therapy benefit when the therapy is prescribed by physician. Always check with your health plan before having any services performed.

To learn about Speech/Language IEP services click here Link to Education section subtopic.

Recommended questions or observations to investigate:

  • Review your health plan benefits to ensure speech and hearing services (and specific provider) are covered. When speaking on the phone request any clarification of your coverage in writing.
  • Keep a medical journal with dates, time and contact person of phone calls, conversations, appointments, copies of evaluations, medications taken and other documentation that is specific to the reason for therapy.
  • In the medical journal write down details concerning the difficulty you or your loved one is having. If feeding is a concern, keep a log of meals – what, when and how much is eaten to indicate the problem over time. If speech or language skills are of concern, note how the person communicates verbally – such as how many words the person is able to say, pronunciations, gaps in conversation, how well the person understands others, how well the person interacts with others, and if a child note developmental milestones which have been met.
  • Write down questions (and leave room for answers) to ask during your visit, such as what is the diagnosis? What are treatment options and the pros and cons of each option? How long will the treatment be needed before results are seen?
  • Find out how insurance claims are filed.

Recommended websites, YouTube videos, books:

Nova.edu: NSU Feeding Disorder Clinic Click Here

Asha.org: The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific and credentialing association for audiologists, speech-language pathologists, language, and hearing scientists, audiology and speech-language pathology support personnel and students. Their website provides up to date information for consumers as well as professionals. The links below are provided to help consumers when seeking speech language therapeutic services:

For Private Health Plans Click Here (provides tips and strategies for ensuring speech and hearing services are covered)

For ASHA Pro Find Click Here

For Funding Resources for Speech-Language Pathology Services Click Here

About Health Insurance Click Here

For Private Health Plans Click Here

For Medicaid Click Here

For Medicare Click Here

Schools: IDEA information Click Here

For Speech, Language, and Swallowing Funding Resources Click Here

For Hearing and Balance Funding Resources Click Here

Speak Up: Tips for Talking to Your Doctor

When You Don’t Understand What Your Doctor Says:

References:

American speech-language-hearing association. How do I prepare for my speech-language pathology visit? Document details and concerns.
asha.org/public/How-Do-I-Prepare-for-My-Speech-Language-Pathology-Visit

American speech-language-hearing association. Identify the signs of communication disorders.

American speech-language-hearing association. Private health plans.
asha.org/public/coverage/php

American speech-language-hearing association. Speech-Language Pathology Medical Review Guidelines. 2015.
asha.org/uploadedFiles/SLP-Medical-Review-Guidelines.pdf

Cigna. Medical coverage policy for speech therapy. 2018.
cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medicalmm_0177_coveragepositioncriteria_speech_therapy.pdf

U.S. department of health. Agency for healthcare research and quality. Questions to ask your doctor. September 2018.
ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/index.html

Written by: Iris Neil

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