Speech-Language Pathologists identify and treat communication disorders, conditions that affect 42 million Americans. One in 10 families is affected by a communication disorder. If you stutter, have hoarseness, have trouble remembering words or pronouncing certain sounds you could have a speech or language problem. Young children can have speech and language delays that limit early learning abilities. Speech language pathologist Karen Sheffler, MS, CCC-SLP, answers commonly asked questions about speech impairments.

Q. The field of Speech-Language Pathology seems very broad, what age levels and disorders do you work with?

A. A Speech-Language Pathologist is certified to work with infants through geriatrics. At Caritas Carney, we provide Speech-Language and Swallowing evaluations and treatments to inpatients and also provide services through the Outpatient Clinic. Pediatric Outpatient Services are from age 3 years old and up, and cover disorders of voice, stuttering, and speech and language delays. Adult Outpatient Services include: stuttering therapy, voice therapy, voice prosthesis therapy for laryngectomy patients, speech-language and cognitive therapy for patients with stroke or neurological disorders, and swallowing therapy

Q. When should I be concerned if I think my child is stuttering?

A. Between the ages of two and five almost all children will begin to repeat words and phrases when they are speaking (i.e., “Mommy I, Mommy I, Mommy I”), especially when they are excited. This is not stuttering, but rather, the normal stages that kids go through to learn language. It may disappear then re-appear several months later. Patience and acceptance is important at this time. Allow the child time to talk without feeling rushed or interrupted. Avoid finishing sentences or saying “just relax, slow down, or take a breath.” Speak in a relaxed and smooth way with simple sentences and pauses, and the child will copy this.

Seek a Speech Pathology evaluation immediately if you notice:

• Repetition of sounds more than twice (i.e., “li-li-li-li-like this”), and repetitions are less effortless,
• Tension and struggle in the face and mouth,
• Changes in pitch of the voice or blocks in the airflow,
• Repetitions of sounds and syllables come and go but are now present more often than absent, and
• Child is becoming aware that it is hard to talk.

For more information on this important topic go to www.stutteringhelp.org, and www.westutter.org.

Q. How can I help a person communicate better after a stroke?

A. First of all, if you have any sudden trouble talking, understanding, or if you are slurring your words, you may have had a stroke. Please get to the Emergency Room right away to decrease the lasting problems that a stroke may cause. Then it is important to seek Speech Therapy. It is common to regain the speech and language within the first 3 to 6 months after a stroke, with the help of a speech therapist.

A stroke may cause difficulty understanding speech, naming objects, and making sentences, but the patient is not confused. This is called Aphasia. You can help someone with a stroke understand better by: asking simple yes/no questions, giving one-step directions, adding gestures (hand signals) while you talk, and talking slowly with pauses. You can help someone talk better by allowing him/her extra time to talk, encouraging the use of hand signals and pointing, and giving the patient clues (i.e., “You would like a glass of _______”, or “Are you cold or hot?”).

Q. What are some signs that a person is having trouble swallowing?

A. Criteria to refer for further evaluation of swallowing are:

• Food getting stuck in the throat, discomfort or pain with the swallow, or obvious choking, coughing, or regurgitating during or immediately after taking a drink or eating a meal.
• Wet-gurgly voice during or after drinking.
• Drooling
• Increase in hoarseness in the voice or slurring of speech
• History of neurological disorder (such as Parkinson’s Disease, Dementia, Multiple Sclerosis, ALS/Lou Gehrig’s Disease) or stroke.
• History of head and neck cancer with resection and/or radiation.
• History of repeated pneumonias
• Change in amount or rate of intake of foods and liquids
• Difficulty breathing while eating

Q. How is Swallowing tested?

A. A bedside swallow evaluation consists of an interview to go over symptoms and a review of medical history, as well as testing the strength and function of mouth muscles and observing while eating a variety of textures and liquids. A modified barium swallow study is a motion x-ray used to identify swallowing problems in the mouth, throat, or esophagus (food tube).

Q. Does my insurance cover Speech-Language Pathology visits?

A. Most insurance companies cover the evaluation and therapy. There may be restrictions in the number of visits and the co-pay will vary from each health plan.

Q. How do I make an appointment for a Speech-Language evaluation or a swallowing evaluation?

A. A written doctor’s order that includes the diagnosis and the type of evaluation and treatment is necessary to set up an appointment. Our Speech-Language Pathologist, Karen Sheffler, MS, CCC-SLP is at Caritas Carney Hospital Monday through Friday. Sheffler also speaks Spanish and Caritas Carney provides interpreter services for 18 different languages.

Appointments can be made by calling 617-296-4012, ext 5141. We will be happy to assist you.

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