Thursday, May 12, 2011

An Inside Look at Speech Therapy from the Folks at KidsCare Therapy

In May, KidsCare Therapy continues to celebrate our amazing therapists by partnering with Avant Garde Parenting for Better Hearing and Speech Month! Over the coming weeks, we’ll be featuring—you guessed it—speech therapy services. You’ll learn about a speech therapist’s scope of treatment and the various ways they help children overcome a wide range of developmental delays. By the end of the month, we hope you are equipped with the tools to identify a child that could benefit from speech therapy services.

Just as with occupational therapy, speech therapy’s scope of treatment is very broad and contains some surprises. As their title suggests, speech therapists treat speech and language disorders. What might surprise you is that speech therapists also treat feeding and swallowing disorders, called “dysphagia”. This is the same for both adult and pediatric patients, although the focus of treatment will likely vary. Speech therapy in adults is typically more rehabilitation-based, where as pediatric patients are typically learning skills for the first time.

As in occupational therapy, the goal is to help children develop into fully-functioning independent adults by developing necessary life skills—in this case, communication and feeding skills. By giving a child effective communication skills, he or she is able to express their needs and wants, especially those that are medical. Feeding skills are vital in allowing a child to gain nutrition for appropriate weight gain and growth.

It’s important to understand the difference between speech and language. Speech is literally how words are said. Children with speech disorders have trouble with the physical act of speaking. They might substitute sounds (“tat” for “cat”), leave sounds out (“ca” instead of “cat”), stutter (“c-c-cat” for “cat”), or simply say sounds incorrectly (“wat” for “rat”). The causes of speech disorders are wide-spread and vary from child to child; regardless, early intervention is key to ensure proper development in all other areas of a child’s life. 

A language disorder is a disruption in comprehending the meaning of what is being said or in how an individual expresses their thoughts or needs. An individual with a language disorder has trouble with processing the meaning of words, difficulty with the social skills that accompany communication, the grammatical structure of their thoughts, and rules of language. This individual’s brain’s ability to process language is delayed. Remember: speech is HOW you say it, language is WHAT you say.

Play is commonly used as a tool toward developing language and cognitive skills. Games, puzzles and other interactive activities are used to encourage better communication. Feeding and swallowing disorders address issues with the physical act of eating (chewing, sucking, drinking, tongue movement, muscle weakness), food aversion (reflux, constipation, food allergies, behavioral issues), sensory issues (hypersensitivity of the mouth, excessive gagging, avoidance of food groups) and dysphagia (difficulty or the inability to swallow as the result of a injury to related parts of the brain). Dysphagia can lead to malnutrition, weight loss, dehydration, choking, and even death. Sometimes the treatment is as simple as introducing a thickening agent or modifying the diet, but can also be as complex as having a feeding tube surgically inserted. In some cases, physical and occupational therapy services are also administered. Consider the following success story, where a KidsCare Therapy patient received VitalStim® to overcome a feeding disorder. 
When Samantha was born, she was given a rare diagnosis of VATER syndrome, a non-random association of birth defects caused by unknown genes or sets of genes. VATER syndrome can cause neurological disorders, which resulted in difficulty swallowing for Samantha. When she would try to eat, she would choke, and food would get into her lungs. This would cause pneumonia, which was especially dangerous in her already fragile condition.

Samantha’s doctor had recommended surgery in order to place a gastronomy tube (g-tube), but wanted to try speech therapy first. He knew that speech therapists treat feeding and swallowing disorders, thereby circumventing the need for a g-tube. While a g-tube can be a wonderful device in cases of dysphagia and other severe feeding and swallowing disorders, transitioning away from it once it is no longer needed is a long and difficult process for children. Therefore, her parents were willing to try and avoid it if at all possible.

Samantha was a perfect candidate for a therapy called Neuromuscular Electrical Stimulation (NMES), a new treatment approved by the FDA that applies an electrical current to the muscles of the neck to improve swallowing function. KidsCare Therapy had a speech therapist trained and certified in VitalStim® for the application of NMES. Samantha underwent treatments of VitalStim®, and over time, the need to thicken her formula began to decrease until she needed no thickener at all. She steadily gained weight and her lungs were clear.  Samantha eventually transitioned to Gerber Stage One foods and soon became a healthy little girl with an insatiable appetite for carrots and bananas—who no longer needed VitalStim© services.

Because Samantha was able to receive services in the home, she wasn’t exposed to additional health threats that come from repeatedly leaving the house and traveling to a clinic.  She was also able to develop good eating habits in the home, where she would be eating the majority of her meals in the future. Most importantly, she never had to use a g-tube which would have required a costly medical procedure, equipment, and treatment to transition away from it once it became unnecessary.
In our next posting, we’ll talk about some of the conditions a speech therapist commonly sees and developmental red flags of which you should be aware. In addition, our in-office speech therapists will be chiming in with some of their tips for continued speech, language, and feeding development. And of course, we’ll be bringing you another success story from KidsCare Therapy; this one will be about how a child was finally able to communicate with her parents thanks to speech therapy services and a high-tech device. We hope you’ll check back to continue celebrating Better Hearing and Speech Month with us!


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