Speech therapy can be life-changing for professional voice users and cancer patients. Whether a patient has suffered a stroke, an injury or cancer, the inability to communicate with others can be one of the biggest challenges in the recovery process. Speech-language pathologists (SLPs) are experts who work with patients on both an inpatient and outpatient basis to help them regain their ability to speak with confidence again.  

“We focus on swallowing, communication, cognition and voice issues,” says Laura Aleshire, M.A., CCC-SLP, an inpatient and outpatient speech-language pathologist at Piedmont Atlanta Hospital. Speech-language pathologists undergo a significant amount of training and must complete a four-year undergraduate degree and a master’s program, followed by a yearlong clinical fellowship.

SLPs can work in a variety of settings, from schools to hospitals to outpatient clinics. While speech therapy can continue for months after a patient has been treated for his or her condition, it often begins while the patient is in the hospital. The therapy administered depends on a patient’s diagnosis and level of care.

For example, an inpatient with a brain injury may be treated for swallowing issues, while an outpatient recovering from stroke may work on word-finding exercises. “Difficulty speaking can mean a lot of different things, whether it’s slurred speech, the quality of sound coming out or language issues,” Aleshire says. “Therapy is tailored toward an individual’s needs.”

Inpatient speech therapy

“Inpatient SLPs are more focused on diagnostics and functional ability,” says Natasha Peacock, MCD, CCC-SLP, an inpatient speech pathologist at Piedmont Newnan Hospital. “Ninety percent of what I do is working with patients who have trouble swallowing.” 

When patients – from premature babies to stroke victims – are acutely ill, they can suffer from swallowing disorders, making eating and drinking difficult or even impossible. Therapists like Aleshire and Peacock work with their patients on positioning and swallowing techniques to improve the recovery process. Inpatient SLPs work with a wide variety of people in many areas of the hospital. Cases include neurological issues, such as stroke or progressive disorders; general weakness; voice disorders; nodules on their vocal cords; a weakening of the vocal cords; or head and neck cancers.

Patients usually spend one to two weeks maximum in an inpatient setting. “Because the patients we work with on the inpatient side tend to be more ill, our role can differ a bit from that of an outpatient therapist,” Aleshire says. “Sometimes we see patients with an altered mental status, so we want to get them back to their baseline functioning,” Peacock says. “We can then assess if they are a viable candidate for outpatient speech rehabilitation.”

Outpatient speech therapy

Outpatients are usually not as ill as inpatients, so speech and voice rehabilitation, rather than swallowing therapy, can be more intensive. Typically, speech therapy occurs several times a week for about 45 minutes to an hour per session.

In an outpatient setting, the SLP will conduct an evaluation, discuss the patient’s symptoms and areas of difficulty, and then perform testing based on areas that have changed since a patient’s medical diagnosis. “If a person has difficulty with word finding, we might show them photos or train them on strategies to use when learning to name photos or items,” Aleshire says. “At higher levels, we might have them engage in conversational tasks, using these strategies at a conversation level.”

A number of patients are considered “professional voice users,” such as sales representatives, teachers, singers and actors. “They will come in extremely frustrated and worry they won’t be able to continue the job they love,” Aleshire explains. “When they’ve gone through a therapy program, they leave feeling confident with their voice and if they maintain it, they’ll be able to stay in their jobs way down the road.”

Aleshire’s favorite part of her job is seeing patients leave with a renewed sense of confidence in their ability to communicate. “My favorite part of my job is being able to follow someone and see success,” she says. “It is extremely rewarding to see people come in speaking very softly and leave with a nice, strong, healthy voice.”

For more information on speech-language pathology, visit Piedmont Rehabilitation.

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