Speech Language Pathologist vs. Audiologist

Often times, people confuse Speech Language Pathologists and Audiologists or simply believe they are one in the same. Although they may work together, their roles are completely different. They deal with different disorders and problems and offer different kinds of diagnosis, assessments, and treatments.

A Speech Language Pathologist, or Speech Therapist, is a clinician who specializes in evaluating and treating communication disorders, voice disorders, and swallowing disorders, as well as the understanding of language. An audiologist evaluates, diagnoses, treats, and manages hearing loss, tinnitus, and balance disorders. They also deal with hearing aids and cochlear implants.

Speech pathology and audiology also deal with different parts of the body. A speech pathologist usually works with the tongue, lips, mouth, and throat, the organs that are related to speech production.  An audiologist, on the other hand, mainly assesses the outer, middle, and inner ear and the pathway from the ear to the brain.

Another difference between speech pathology and audiology is that audiology is more of a black-and-white field. A hearing loss is usually easier to diagnose than a speech problem, and the cause of hearing loss is usually a result of problems with the hearing organs. An audiologist performs a series of tests to determine the presence, severity, and cause of a hearing loss. However, speech problems are harder to diagnose and can result from a number of factors. These include: brain injuries, cleft palates, learning disorders, developmental delays, or weakness of  the speech muscles. A speech pathologist will typically perform an evaluation that assesses both receptive and expressive language.

Both disciplines deal with problems related to communication. Speech and language problems affect how a person is understood by others. Hearing problems affect how a person can understand others. Speech pathology and audiology deal with different parts of the body and treat different kinds of problems, yet they are often tied together when it comes to assessment and treatment. A hearing impairment commonly leads to speech problems in communicating or comprehending.  For this reason, a person who has been diagnosed with speech problems may be referred for an assessment in both speech pathology and audiology.

If you think you or your child is having trouble with speech, or if you are looking for treatment, contact Christine Wilson today!

Cleft Lip/Palate

Children with cleft lip and palate do not represent a homogenous population, and the signs and symptoms associated with clefting depend on a variety of factors. Common issues that children with a history of cleft palate can encounter include problems related to:

• Feeding
• Dental and occlusal deviations
• Hearing and middle ear function
• Psychosocial development
• Speech sound acquisition and language development

Brief Definitions of Key Terminology

• Hypernasality: excessive nasal resonance or too much nasality during speech
• Hyponasality/denasality: too little nasal resonance during speech
• Cul-de-sac resonance: speech sounds muffled due to obstruction and inability for air to resonate appropriately in the oral or nasal cavities
• Mixed resonance: inconsistent resonance and/or combination of hypernasality and hyponasality during speech
• Nasal air emission: audible or inaudible release of air through the nose during production of high pressure consonants—the stops, fricatives, and affricates
• Compensatory articulation errors: learned articulation errors that require speech therapy to teach correct placement. Common types of compensatory articulation errors are glottal stops, mid-dorsum palatal stops, pharyngeal fricatives, and nasal fricatives.

Evaluation

The goal of the speech evaluation of a child with cleft palate or suspected velopharyngeal dysfunction is to answer two simple questions: What is the child doing now? What is the child capable of doing? The answers to these questions will help determine whether and/or when a child would benefit from speech therapy and if further physical management is warranted.

Treatment

Partnership between the community or school-based SLP, cleft/craniofacial team SLP, and parents/caregivers typifies best practice for intervention. Making sure a child is referred and being followed by a cleft palate-craniofacial team is a critical step in the process of developing collaboration for treatment planning and specific therapy activities. A listing of cleft palate-craniofacial teams can be found through the American Cleft Palate Craniofacial Association (ACPA).

Speech therapy cannot correct hyper- or hyponasality, and therapy instead focuses on treating compensatory (learned) errors by targeting correct oral placement of the articulators and establishing oral airflow direction and pressure build-up. General therapy goals for children with cleft palate speech sound disorders include:

1. Establish correct oral articulatory placement and/or airflow direction and pressure build up at the target place, using behavioral, articulation (motor-phonetic) therapy.
2. Maximize the intra-oral air pressure build up during speech sound production.
3. Teach new motor speech patterns to replace compensatory maladaptive articulation errors.

http://www.asha.org/SLP/clinical/Cleft-Lip-and-Cleft-Palate/

Cochlear Implants

What is a cochlear implant? 

A cochlear implant is a device that provides stimulation directly to the auditory nerve, bypassing damaged hair cells in the cochlea that prevent sound from reaching the nerve. An implant does not result in “restored” hearing for the recipient, but does allow him or her to perceive sounds.

Who is eligible to receive an implant? 

In general, adults who have severe to profound hearing loss in both ears and have benefited only minimally from hearing aids may qualify as candidates for cochlear implantation. Children as young as 12 months of age who have severe to profound hearing loss in both ears and who demonstrate little progress in the development of auditory skills may also be considered candidates for some implant devices. It is very important that the implant recipient (and the family, in the case of a young child) have an understanding of cochlear implants and realistic expectations regarding the use of the device.

Once an individual receives an implant, is she finished with the process? 

Wearing a cochlear implant is a lifetime commitment, and requires the recipient to maintain and care for the implant. After an individual receives the implant, he or she must return to the center for a number of follow-up services, including the fitting of the external components of the implant; activating and programming of the implant and its microphone, speech processor and transmitter; necessary adjustments and reprogramming, and annual check-ups. In addition, recipients must undergo rehabilitation services with members of the team. Children often require years of extensive aural rehabilitation whereas adults who have been implanted due to acquired deafness may need fewer aural rehabilitation sessions.

What role do audiologists and speech-language pathologists perform in the implant process? 

Audiologists are involved in many of the components of the cochlear implant program, including determining the candidacy of an individual for implantation, as well as activating and programming of the speech processor after surgery. Both audiologists and speech-language pathologists provide aural rehabilitation services to implant recipients to facilitate their ability to detect and understand speech with the cochlear implant. Aural rehabilitation services may include processes to enhance communication, auditory training and speechreading, training on the use and care of the implant, and support of the needs of the recipient and family.

Where can I find more information about cochlear implants? 

Additional information on cochlear implants can also be found through the Alexander Graham Bell Association for the Deaf and Hard of Hearing, American Cochlear Implant Alliance, Hearing Loss Association of America, and the National Institute on Deafness and Other Communication Disorders.

http://www.asha.org/public/hearing/Cochlear-Implant-Frequently-Asked-Questions/