What is Speech Therapy? Helping Adults with Communication and Swallowing Disorders
- Donnetta Davis MS, CCC-SLP
- Aug 8
- 8 min read
Speech therapy is a specialized treatment that helps adults facing communication and swallowing difficulties. Whether these challenges arise from neurological disorders such as stroke, Parkinson’s disease, dementia, or other medical conditions, speech therapy can significantly improve an individual’s quality of life. But what exactly does speech therapy involve, and how can it help those dealing with communication and swallowing issues?
In this blog, I’ll break down what speech therapy is, the disorders it addresses, and how it helps patients regain independence and confidence.
What Types of Disorders Does Speech Therapy Address?
Speech therapy covers a wide range of disorders that can affect how individuals speak, understand language, and swallow. These disorders can be caused by various neurological conditions or other health issues. Let’s dive into some of the most common conditions that speech therapy targets:
Cognitive Communication Disorders: Cognitive communication disorders arise from damage to the brain or neurological conditions that impair memory, attention, problem-solving, reasoning, and executive functioning skills. These disorders can make it difficult for individuals to organize their thoughts, recall words, follow conversations, or maintain focus during discussions. Common causes include stroke, traumatic brain injury, and dementia.
Language Disorders: Language disorders refer to difficulties with understanding language (receptive language) or using language to express thoughts (expressive language). These disorders can vary widely in severity and can make daily communication challenging. Some specific types of language disorders include:
Aphasia:Aphasia is one of the most well-known language disorders, often resulting from a stroke or brain injury. It affects a person’s ability to speak, understand language, read, and write. There are different types of aphasia:
Broca’s Aphasia (Non-Fluent Aphasia): This type involves difficulty in speaking and forming sentences, but comprehension generally remains intact. People with Broca’s aphasia may speak in short, broken phrases and omit smaller words like "is" or "the."
Wernicke’s Aphasia (Fluent Aphasia): This type leads to fluent speech that is often nonsensical, with individuals unable to form meaningful sentences. While they can produce speech, their understanding of language may be impaired.
Global Aphasia: A severe form of aphasia, it involves both speech and comprehension difficulties. People with global aphasia may be able to say only a few words or phrases, or none at all.
Reading and Writing Difficulties: Language disorders can also have a profound effect on reading and writing abilities. Individuals with aphasia, for example, may struggle with reading comprehension, making it difficult to understand written material. People with Wernicke’s aphasia might read words correctly but not comprehend the meaning behind them, leading to confusion. Writing abilities can also be affected, with individuals finding it hard to form coherent sentences or even write legibly.
Word-Finding Difficulties: Also known as anomia, word-finding difficulties refer to a person’s trouble recalling specific words during conversation. This can lead to frustration and pauses in speech. Individuals may describe objects by their function (“the thing you write with” instead of “pen”) or use general terms when they can’t recall specific ones.
Motor Speech Disorders: Motor speech disorders occur when the muscles needed for speech are weakened or do not function properly. The most common motor speech disorders include:
Dysarthria: A motor speech disorder caused by weakness or paralysis of the muscles involved in speech, often seen in patients with neurological conditions such as stroke, Parkinson’s disease, or cerebral palsy.
Apraxia of Speech: A disorder affecting the brain's ability to plan and coordinate the movements required for speech, even though the muscles themselves are not weak. It can cause difficulty with articulation, sequencing sounds, and speaking smoothly.
Neurogenic Stuttering: Neurogenic stuttering is a type of speech disorder that arises due to neurological conditions affecting the brain's control over speech production. Unlike developmental stuttering, which typically begins in childhood, neurogenic stuttering occurs in adulthood and is usually linked to brain injury, stroke, or neurological diseases such as Parkinson’s disease or multiple sclerosis. People with neurogenic stuttering often experience disruptions in their speech patterns, including frequent repetitions of sounds, syllables, or words, and sometimes blocks where the flow of speech stops altogether.
Swallowing Disorders (Dysphagia): Swallowing difficulties, also known as dysphagia, can make it hard to eat or drink safely. These disorders are most commonly caused by neurological issues but can also result from structural or psychological problems. Conditions like stroke, Parkinson’s disease, dementia and other neurogenic conditions often lead to dysphagia, which can increase the risk of choking or aspiration (food or liquid entering the lungs).
The Role of Speech Therapy in Communication and Swallowing Disorders
Speech therapy involves a systematic, evidence-based approach to diagnosing and treating communication and swallowing disorders. Clinicians utilize a comprehensive assessment process, tailored therapeutic techniques, and objective measurement tools to address the specific needs of patients with neurological, cognitive, or structural impairments. The goal is to maximize functional communication and ensure safe swallowing, ultimately improving the patient’s quality of life.
Cognitive Communication Disorders
Cognitive communication disorders, often associated with brain injuries, strokes, or neurodegenerative conditions like Alzheimer's disease or dementia, are addressed through strategies designed to improve cognitive-linguistic function. These include:
Memory and Attention Training: Techniques such as spaced retrieval, errorless learning, and external memory aids (e.g., calendars, notebooks, or electronic devices) help improve attention and memory for functional communication tasks.
Executive Functioning Therapy: SLPs use cognitive training exercises to improve problem-solving, reasoning, and decision-making. These exercises include tasks like planning, organizing, and prioritizing information, aimed at improving real-world functionality in daily communication.
Compensatory Strategies: For individuals with cognitive impairments, therapists teach compensatory strategies, such as using cues or reminders, to support conversational coherence and ensure the patient can manage tasks requiring higher-level cognitive function.
Language Disorders (Aphasia)
Aphasia, a disorder typically caused by stroke or brain injury, affects language comprehension and expression. There are several types of aphasia, each requiring tailored therapy protocols. Some common types of aphasia include:
Broca’s Aphasia (Non-Fluent Aphasia): Involves difficulty in speech production due to damage to the frontal lobe. Treatment focuses on improving expressive language through exercises that focus on word retrieval, sentence formation, and motor planning. SLPs use techniques such as melodic intonation therapy and phonemic cueing to facilitate spontaneous speech.
Wernicke’s Aphasia (Fluent Aphasia): While patients can produce speech with normal fluency, the speech often lacks meaning. Treatment focuses on improving auditory comprehension and the ability to identify relevant words and phrases in context. SLPs utilize semantic feature analysis and constraint-induced language therapy to improve the patient’s understanding and appropriate use of language.
Global Aphasia: A severe form of aphasia affecting both speech and comprehension. Treatment for global aphasia focuses on restoring basic communication, often using augmentative and alternative communication (AAC) methods such as communication boards or voice output devices.
Motor Speech Disorders
Motor speech disorders, including dysarthria and apraxia of speech, result from damage to the motor control systems in the brain. Dysarthria affects the muscles involved in speech production, while apraxia is a disorder of speech planning and coordination.
Dysarthria Treatment: SLPs implement techniques designed to strengthen the speech muscles, such as Lee Silverman Voice Treatment (LSVT LOUD), which focuses on increasing vocal loudness and speech intelligibility. Therapy may also involve articulation exercises and respiratory control techniques to improve speech clarity and breath support.
Apraxia Treatment: Involves motor planning exercises to improve the coordination of speech movements. SLPs use integral stimulation techniques such as the "watch me, listen to me, say it with me" method, as well as phonetic cueing to guide patients in the accurate production of words and phrases.
Neurogenic Stuttering
Neurogenic stuttering occurs as a result of neurological events, such as a stroke, brain injury, or neurodegenerative diseases. Unlike developmental stuttering, which tends to occur in childhood and may be exacerbated by anxiety or social situations, neurogenic stuttering is usually present in all speaking contexts and is often associated with other motor or cognitive deficits.
Therapeutic Approach: Treatment focuses on fluency-enhancing techniques, including pacing strategies (slowing down speech rate), controlled breathing exercises, and delayed auditory feedback to reduce stuttering frequency and improve speech fluency. SLPs may also use volitional control techniques, where patients practice managing speech fluency through deliberate control of their breath and articulation.
Swallowing Disorders (Dysphagia)
Dysphagia is a swallowing disorder that can result from various neurological, structural, or functional causes. In cases of neurological dysphagia, the underlying issue typically involves a breakdown in the brain's ability to coordinate the swallowing process, making it difficult for individuals to swallow safely.
Assessment and DiagnosisSLPs perform thorough assessments to identify the type and severity of swallowing dysfunction. This includes:
Bedside Swallowing Evaluation: A clinical evaluation where the therapist observes the patient swallowing different consistencies of food and liquid to identify signs of aspiration (food or liquid entering the airway) and determine the safest eating strategies.
Modified Barium Swallow Study (MBSS): A radiological procedure where the patient swallows food or liquid mixed with barium, allowing the therapist to observe the swallowing process in real-time through X-ray images. This helps identify anatomical or functional issues that contribute to swallowing difficulties.
Fiberoptic Endoscopic Evaluation of Swallowing (FEES): A procedure where a flexible endoscope is inserted through the nose to directly observe the throat and laryngeal structures during swallowing, helping the clinician identify problems in the upper airway or swallowing muscles.
Treatment Approaches: Once a swallowing disorder is diagnosed, the SLP develops a personalized treatment plan, often incorporating:
Diet Modifications: Patients may be advised to alter the consistency of food and liquids (e.g., pureed foods, thickened liquids) to reduce the risk of aspiration.
Swallowing Exercises: A variety of techniques are used to strengthen the swallowing muscles and improve coordination. Some include:
Shaker Exercise (Head Lift Exercise): A targeted exercise that improves the strength and mobility of the muscles involved in swallowing.
Masako Maneuver: This technique involves the patient holding their tongue between their teeth while swallowing to strengthen the tongue base and pharyngeal muscles. The Masako maneuver helps improve the coordination between the tongue and the rest of the swallowing mechanism, which is particularly beneficial for individuals with swallowing difficulty due to poor tongue base movement.
Compensatory Techniques: These include changing head or body positions during swallowing to improve the safety and efficiency of the swallowing process (e.g., chin tuck).
Electrical Stimulation (E-Stim): Electrical stimulation is used to promote muscle contraction and improve strength and coordination of the swallowing muscles. It is often combined with traditional swallowing exercises.
Swallowing Techniques: Therapists teach patients specific strategies to swallow food and liquids safely, improving their ability to eat without risk.
SLPs may also incorporate oral motor exercises to target muscle weakness in the lips, tongue, and jaw, which are essential for both swallowing and speech.
The Impact of Speech Therapy on Quality of Life
Speech therapy can make a tremendous difference in the lives of individuals with communication and swallowing disorders. By improving communication, patients are better able to express their needs and connect with others, which can enhance emotional well-being and reduce feelings of isolation.
Similarly, by addressing swallowing difficulties, speech therapists can help prevent dangerous complications like aspiration pneumonia and ensure that patients can eat and drink safely. With proper therapy, patients can regain confidence in their ability to speak and eat, which directly improves their overall quality of life.
When to Seek Speech Therapy
If you or a loved one is experiencing difficulties with speech or swallowing, it’s important to seek the help of a speech therapist as soon as possible. Early intervention can lead to better outcomes and prevent the worsening of symptoms.
Some signs that speech therapy may be needed include:
Difficulty speaking clearly or being understood
Trouble understanding spoken or written language
Frequent forgetfulness
Problems with swallowing, such as choking or coughing while eating or drinking
Unexplained weight loss due to difficulty eating or swallowing
Helpful Products for Safe Mealtimes
While we strengthen the swallow with Ampcare, I also recommend supportive tools that make daily eating safer:
Dysphagia Cup for Adults: Helps control flow and reduce risk of aspiration.
Spill-Proof Scoop Plate & Bowl Set: Ideal for individuals with poor coordination or one-handed use.
Spill-Proof Scoop Plate, 9" (2 Pack): Durable and designed for safe, independent eating.
Looking to add respiratory strengthening into your plan?
The Breather Device: A favorite tool for training the muscles involved in breathing and airway protection.
Learn More
Visit my YouTube channel to explore caregiver tips and dysphagia support videos.
If you’re in need of speech therapy services, contact me here to schedule a free consultation.
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