Speech Therapy: More than "Just Speech"

When we think of speech therapy, we often associate it with children who are learning to speak or addressing speech impediments. However, speech therapy also plays a crucial role in assisting adults as well. As we age, or after an event like a stroke or brain injury, various factors can affect our ability to communicate and think effectively. In this blog post, we will delve into what speech therapy for adults can look like, with a special focus on the cognitive aspects that go beyond "just speech."

The Intersection of Cognition, Communication, and Speech Therapy

In adulthood, challenges may arise due to a range of conditions or life events, such as strokes, traumatic brain injuries, concussion, neurodegenerative diseases like Alzheimer's or Parkinson's, or even psychological issues like anxiety and depression. These conditions can significantly impact cognitive abilities related to language, memory, attention, and problem-solving. Speech therapy at Blossom Neuro Speech & Wellness in Louisville involves a holistic approach that addresses these and supports individuals in returning to participating in their desired goals.

Cognitive functions play a fundamental role in higher-level language skills, shaping our ability to comprehend, process, and produce complex and meaningful communication. These functions are the underlying mental processes that enable us to gather, store, manipulate, and use information. When it comes to language and communication, several cognitive functions are particularly relevant:

• Attention is the ability to focus on specific stimuli while filtering out distractions. Higher-level language skills, such as reading comprehension or participating in a complex conversation, require sustained attention.

• Memory is the ability to hold on to information. There are many different types of memory—all contribute to our communication abilities.

• Mental flexibility involves the ability to adapt to new information or ideas and shift between different mental sets. In language, mental flexibility allows individuals to adjust their communication based on their audience and the context of the conversation. A lack of mental flexibility may lead to communication breakdowns.

• Working memory is responsible for temporarily holding and manipulating information during complex cognitive tasks. In language, working memory allows individuals to process and integrate multiple pieces of information, such as understanding sentences or comprehending longer narratives. A limited working memory capacity may lead to difficulty following conversations or understanding texts.

• Initiation is the ability to begin a task, conversation, or interaction. In the context of cognitive communication, initiation impacts various aspects of social communication, language expression, and participation in everyday interactions.

• Sequencing refers to the ability to organize information, thoughts, and actions in a logical and coherent order. Difficulties with sequencing can manifest as trouble understanding stories or instructions or organizing one’s own speech. It can also make time-management, planning, and organization burdensome.

• Impulse control is the ability to know what to say or do, and understanding the consequences of inappropriately timed words or actions. Impulse control plays a crucial role in regulating behaviors and responses during social interactions and language expression.

• Planning & organization skills allow us to think systematically consider all that is involved in completing a task and identify and efficient approach to reaching that goal.

• Problem-solving & reasoning is the ability to consider multiple solutions to an issue to determine what techniques might help to work around barriers.

Higher-level language skills rely heavily on various cognitive functions, working in harmony to facilitate comprehension, expression, and effective communication. From attention and memory to executive functions and mental flexibility, each cognitive aspect plays a critical role in shaping how we use language to connect with others, share ideas, and express our needs. Brain injuries, including stroke and concussion, can change individual’s cognitive aspects, and therefore, their communication. Our speech therapists at Blossom Neuro Speech & Wellness understand the interplay between cognitive functions and language skills and can help identify and address communication challenges.

What might adult speech therapy treatment look like?

• Assessment and goal setting: During an initial evaluation, the goal is to get to know the individual, and assess speech and cognitive abilities (e.g., language skills, speech production, comprehension, memory, and attention). Based on the evaluation, and each individual’s goals and self-reports, personalized therapy goals are set, which often include improving language expression, enhancing memory, and enhancing overall communication. These goals often evolve over time based on patient needs.

• Communication exercises: Treatment includes various language and cognitive exercises tailored to meet individual needs. These exercises may aim to improve word association, vocabulary, semantic connections, memory, recall abilities, and problem-solving to enhance cognitive flexibility.

• Communication strategies: Therapy sessions equip individuals with communication strategies to compensate during communication breakdown. Strategies can include learning to speak more slowly and clearly, using visual aids like drawings or gestures to support communication, and employing techniques to improve active listening and comprehension.

• Social communication skills: As individuals face difficulties in expressing themselves and understanding others, they may encounter social isolation and reduced self-confidence. Speech therapy can work on improving conversational skills, interpreting nonverbal cues, and understanding social context to enable more meaningful interactions.

• Emotional regulation: Psychological challenges can significantly impact speech and cognitive aspects. In speech therapy, adults learn emotional regulation techniques to manage stress, anxiety, or depression, which can often hinder effective communication. By addressing these underlying emotional factors, speech therapy helps individuals communicate more confidently and coherently.

• Technology integration: In today's digital age, technology can play a transformative role in speech therapy for adults. Specialized apps, software, and assistive devices can facilitate communication and cognitive exercises. These tools not only make therapy engaging but also provide opportunities for individuals to practice skills independently outside the therapy sessions.

• Real-life situational practice: Effective adult speech therapy goes beyond the confines of the clinic. We often integrate real-life situational practice into our sessions, such as visiting public spaces, engaging in group conversations, or making phone calls. This hands-on experience helps individuals adapt their learned skills to real-world scenarios and gain confidence in their communication abilities.

Speech therapy for adults encompasses far more than just working on speech sounds. At Blossom Neuro Speech & Wellness in Louisville, we use a comprehensive and multifaceted approach that addresses the cognitive aspects of communication, emotional well-being, and social skills. Through personalized assessment, targeted exercises, and real-life meaningful practice, speech therapy empowers adults to overcome challenges and regain control over their communication and thinking abilities.