Speech Language Pathology Initial Evaluation: Fill & Download for Free

I had taken my fifteen-year-old daughter to Children’s hospital for a dermatology consult for acne, as it was becoming cystic in places on her face and back. Clinic days can be somewhat of a zoo, with a wide range of ages and diagnoses, and cheerful to screaming children waiting anywhere from 30 minutes to two hours. We had entered the line to be seen and began the registration process. My daughter was becoming visibly more and more self-conscious as the head resident is staring at her face.We were accustomed to the stares and questions from people who were unfamiliar with her birthmark. My daughter was born with a port-wine stain. A genetic vascular defect passed down from her paternal grandfather, which happened to skip a generation. All of our children had a one in four chance of having one. In the case of my daughter, hers was nearly a perfect match to her grandfather's as noted by the first dermatologist who looked at it from the Cleveland Clinic when her grandfather chose to have his removed. Rarely are they that similar.Removal of the port-wine stain is accomplished with laser surgery. The pulsing of the laser cauterizes the vessels underneath the skin. The physicians told us it was like being snapped in the face repeatedly with a rubber band. As her parents, we felt she was too young to sit through the repeated treatments. My father-in-law had said it was more painful afterward during the healing process. Our decision was to wait until our daughter wanted to have her birthmark removed. Until then, we approached inquiries with providing people with information. Our daughter had grown up feeling confident and comfortable with her face as it was.Once we were in the examination room, the entire focus of our appointment immediately shifted due to the curiosity of the head resident. Our small exam room suddenly was full of a revolving door of residents looking at my daughter’s face as a learning experience. Initially, I was cooperating with this, in order to accomplish the goal of treating her acne. My daughter was being treated as a medical oddity, and I was not fully comprehending the implications of what that meant. But as the head resident continued to speak, he began to go further and further from our goal, first by asking for an MRI to assess the depth of her port-wine stain, stating that we were not fully informed as to it’s impact on my daughter. He further stated, after glancing at her education being homeschooled at the time, that she could possibly be retarded and I might not be aware. She might need to be assessed by their neuropsychology department.At that outrageous attempt to utilize scare tactics and intimidation, I asked that he be removed and not return. I repeated the purpose of our appointment and stated that if they were unable to oblige, we would pack-up and leave. The head resident abruptly left, returning with the supervising physician hoping for vindication. The supervising physician began by stating this was a teaching hospital and asked that I exercise patience. I smiled at this comment, knowing I had a response that would appease his need to be clear I understood what he was saying. I explained that I had a colleagueal relationship with the Ombudsman of the University of Oklahoma School of Medicine when I worked at Presbyterian Hospital in Oklahoma City. He would send to me some of his most arrogant and green residents, and I would help them learn to be polite and respect ancillary services such as speech-language therapy. I remarked that it had proven to be quite effective, as we conferred frequently over which ones were the slow ones to understand the lesson.The supervising doctor raised his eyebrows and gave a chuckle, and began to ask what had transpired. I gave him my impressions regarding the ambitions of the head resident and then gestured to my now silently crying daughter. I explained how the head resident suggested that my daughter with the 148 IQ was mentally deficient and how I, with a masters degree in speech-language pathology and 20 years of experience couldn't possibly be wise enough to suspect it or have sought for my child to be evaluated. But even more ironic was the fact she was identified as talented and gifted in second grade in the public school she attended. At no time were we asked if she had attended school.As the supervising doctor nodded and began to ask what of the recommendations I would agree to, the head resident would abruptly leave the exam room to seek more exciting and challenging patients. I blatantly refused the recommendations of the MRI, neuropsychological testing, and follow-up visits for her port-wine stain. He made no attempt to apologize to my daughter or myself once he was corrected regarding her academic level and IQ.Ultimately, we were attended by two of the female residents who began to speak only to my daughter and put her at ease. As they began to speak to her, they also acknowledge the rudeness and arrogance of the head resident. They tried for apologize for his behavior. We would not allow them to do so. We thanked them for their compassion and left with the prescription we had sought. It would be our last clinic visit due to the knowledge the resident rotation changed frequently.It would be a short two and a half years later that my daughter would decide she wanted her birthmark removed. We would be delighted to find one of the two young women residents was specializing in pulse dye laser surgery and chose Dr. Jill Waibel, as the physician to remove the port-wine stain. My daughter endured 200-250 laser flashes each treatment on four different occasions to remove her birthmark. Some along her eyelid, some along her lip and cheek. The laser flashes would be black and then scab over for three to six weeks depending on the depth. I know she was glad she did them and glad she waited.After one of her treatments, despite every precaution, she would suffer a secondary infection that would prolong her healing. A quick call to Dr. Waibel, and she saw my daughter. An antibiotic was ordered and we were told to watch it closely for additional complications. We held our breath that the antibiotics would work and not carry the infection into her bloodstream or surround her eye. Our prayers were answered, and within five days, we could see the new skin peeking out and the infection all but gone.My daughter’s relationship with Dr. Waibel would be the high point of her experience, despite the pain and frustration of waiting for the scabs to heal. We would follow Dr. Waibel’s career after she left that practice and continued her research of the uses for the laser. Most recently we saw Dr. Waibel on ”The Today Show” discussing breakthrough treatments in breaking down scar tissue formed after deep scarring from burns in fires, scars on wounded warriors, and car accidents to improve the scars not only esthetically but also any function that can be increased. She was an amazing physician!

Speech Therapist/Speech Language Pathologist are the professionals trained for the assessment and treatment of all kinds of communication disorders. For example:1.Voice Disorder: Feminine Voice In males (Puberphonia), Sudden Loss of Voice, Soft Voice, Hoarse Voice,Breathy Voice, Voice Breaks, Dysphonia due to vocal cord paralysis etc.. Watch before and after voice therapy video to know more click on 1. SLP Sanjay Speech and Hearing Therapy Specialist 2. SLP Sanjay Kumar . For more information click: Voice Disorders2.Professionals Voice Care3.Stammering/Stuttering4.Delayed speech in children: Children's speech and language development follows a typical pattern. For example at first birth day the normal children speak at least one meaningful word, at the age of 2 years they should able to combined two words and at the age of 3years expected to speak in sentences .The deviation in such pattern is considered as delayed speech and language.Mostly it is associated with Autism, hearing impairment, mental retardation, inadequate speech and language stimulation at home, cleft lip and palate, ADHD. Early professional help (Speech therapy) can be very much effective for developing the communication skills and achieving academic goal among such children.How is delayed speech and language diagnosed?Speech language pathologist administers some speech and language test on the child .Also take an interview of the parents related to speech language development and case history of the problem and speech mechanism examination of the child. Based on collected information, comparing with the normative for that age group, they will diagnose the problem.What treatments are available for delayed speech and language?Based on diagnostic report the speech language pathologist make a individual therapy plan .Therapy session can be about 45 minutes and 2-4 times in a week based on the severity of the problem. Usually Parents will be asked to observe the speech therapy session so that they can learn and continue the home training program.Here is a checklist (Click on : SLP Sanjay Speech and Hearing Therapy Specialist ) that you can follow to determine if your child's speech and language skills are developing on schedule. Anything that is checked "no "need for the consultation to a Speech Language Pathologist.5.Mispronunciation/Misarticulation: Beginning in the childhood, the person with deviant articulation or phonology (e.g. saying dod for dog, lam for ram , teater for teacher etc.) may experience unfavorable comments, teasing ,ostracism, exclusion, labeling and frustration.Such experience may result in a low sense of personal worth with the accompanying attitudes of feeling different, incompetent, stupid, socially inept, or disliked. As these unfavorable attitudes continue to develop, they may affect academic performance and behavior. The person with atypical articulation may begin to 'play the part' of an atypical person. Grades my begin to drop, and disruptive behavior may become commonplace.How is misarticulation diagnosed?Speech language pathologist/speech therapist will administer an articulation test with a list of pictures/words which is scientifically designed to test the all speech sounds and they will do the video/Audio recording same time. After that they will do the appropriate analysis and diagnose the problem.What treatments are available for misarticulation?The speech language pathologist will teach the place and manner of articulation for the affected/misarticulated speech sounds .They will also work on auditory processing for those sounds. By early intervention we can make the person absolutely normal.6.Speech language Disorders After Stroke: Aphasia is a language disorder that results from damage to the parts of the brain that contain language. Aphasia causes problems with any or all of the following: speaking, listening, reading, and writing.Some people with aphasia have trouble using words and sentences (expressive aphasia). Some have problems understanding others (receptive aphasia). Others with aphasia struggle with both using words and understanding (global aphasia).Damage to the left side of the brain causes aphasia for most right-handers and about half of left-handers. Individuals who experience damage to the right side of the brain may have additional difficulties beyond speech and language.Individuals with aphasia may also have other problems, such as dysarthria, apraxia, or swallowing problems.How is aphasia diagnosed?The speech-language pathologist (SLP) works collaboratively with the person's family and other professionals (doctors, nurses, neuropsychologists, occupational therapists, physical therapists, social workers) to address all of the person's needs. For example, a person who has had a stroke often has physical problems, such as weakness on one side of the body, that require treatment from a physical or occupational therapist.The SLP evaluates the individual and determines the type and severity of aphasia. The evaluation is done by assessing the following areas of communicationSpeechFluency, vocal quality, and loudnessHow clearly the person speaksStrength and coordination of the speech muscles (tongue, lips)UnderstandingUnderstanding and use of vocabulary (semantics) and grammar (syntax)Understanding and answering both yes-no (e.g., Is your name Bob?) and Wh-questions (e.g., What do you do with a hammer?)Understanding extended speech-the person listens to a short story or factual passage and answers fact-based (the answers are in the passage) and inferential (the patient must arrive at a conclusion based on information gathered from the reading) questions about the materialAbility to follow directions that increase in both length and complexAbility to tell an extended story (language sample) both verbally and in written formExpressingCan the person tell the steps needed to complete a task or can he or she tell a story, centering on a topic and chaining a sequence of events together?Can he or she describe the "plot" in an action picture?Is his or her narrative coherent or is it difficult to follow?Can the person recall the words he or she needs to express ideas?Is the person expressing himself or herself in complete sentences, telegraphic sentences or phrases, or single words?Social CommunicationSocial communication skills (pragmatic language)Ability to interpret or explain jokes, sarcastic comments, absurdities in stories or pictures (e.g., What is strange about a person using an umbrella on a sunny day?)Ability to initiate conversation, take turns during a discussion, and express thoughts clearly using a variety of words and sentencesAbility to clarify or restate when his or her conversational partner does not understandReading and WritingReading and writing of letters, words, phrases, sentences, and paragraphsOtherSwallowing (as needed)Ability to use an augmentative or alternative communication aid (as needed) This information is gathered through both structured observations and formal testsWhat treatments are available for people with aphasia?There are many types of treatment available for individuals with aphasia. The type of treatment depends on the needs and goals of the person with aphasia. There are specialized programs using computers or other published materials. There are also less formal approaches available. For many, a combination of formal and informal tasks is most appropriate. Speech language pathologists are trained for such treatment.RegardsSLP Sanjay kumar,http://B.Sc. (Hons.) Speech and Hearing, AIIMS New. Delhihttp://M.Sc. Speech Language Pathology, AIISH MysoreChief Consultant Speech Language Pathologist & AudiologistSanjay Speech Hearing and Rehabilitation Center(A venture of an AIIMS Delhi Alumnus)# 363 SSA Road, Near Sumangali Seva Aashram, Cholanayakanahalli,R.T.Nagar Post, Bangalore-560032Ph: 08042041980, Web: www.speechtherapyindia.inFB: https://www.facebook.com/SanjaySpeechHearingAndRehabilitationCenter/You Tube: https://www.youtube.com/user/sanjay1774/featured

Google "stuttering treatment for adults" and up will pop thousands of links to websites alleging "the best" or "latest" or "groundbreaking" treatments for stuttering. Among other things, you'll find pages recommending acupuncture, cognitive behaviour therapy, regulated breathing techniques, delayed auditory feedback devices, EMG feedback, video self-modelling, time outs, and prolonged or smooth speech techniques.So how do you know which treatments are backed up by peer-reviewed, published research evidence? What types of treatments should adults who stutter seek out when looking for evidence-based treatments to achieve their fluency goals?Fortunately for all of us, in 2006, a group of researchers led by Anne Bothe in the United States published a systematic review of peer-reviewed stuttering treatment studies, including all the techniques listed above. After reviewing 39 relatively high quality stuttering articles, covering 16 treatment categories, Bothe and her colleagues concluded as follows:"For adults who stutter, many of the articles that met this review's trial quality criterion support the use of prolonged-speech-type procedures within a comprehensive treatment framework that includes initial intensive work, practice in front of groups, specific transfer or generalization tasks, self-evaluation of speech and/or self-management of program steps, a focus on speech naturalness and feedback of naturalness measurements, and an active contingent management program that continues to address not only stuttering but also speech naturalness and self-evaluation skills." (My emphasis)The Australian Stuttering Research Centre, affiliated with Sydney University, has developed an evidence-based treatment that includes all of the elements highlighted above. It's called the Camperdown Program.The Camperdown Program is a speech restructuring program that includes prolonged-speech-type procedures. Treatment requires the client to learn a new speech pattern that is incompatible with stuttering. The main aim of the program is to reduce stuttering in everyday speech situations (i.e. not just in the clinic). It also helps clients develop the skills to self-manage their stuttering over time and to reduce the risk of relapse. The Program is composed of four stages:Client training to use the speech pattern and to self-rate the severity of their stuttering and the naturalness of their speech.Training in the clinic to attain stutter-free, natural sounding speech.Training to use the new technique in the real world.Problem-solving skills training to manage stuttering and to minimise the risk of relapse.To date, the Camperdown Program has been tested clinically on over 100 participants in 8 published clinical trials. It's been tested on adults and teenagers, in intensive and non-intensive formats, and via the phone and web-cam (Skype). More information about the program can be found here.For more information about stuttering and stuttering treatments for adults and children, check out our articles at Banter Speech & Language.Key Reference: Bothe, K., Davidow, J.H., Bramlett, R.E., & Ingham, R.J. (2006). Stuttering Treatment Research 1970-2005: I. Systematic Review Incorporating Trial Quality Assessment of Behavioural, Cognitive and Related Approaches. American Journal of Speech-Language Pathology, 15(4) 321.