The Mechanics of Speech and Language
The beginning of speech and/or language
therapy involves gathering and analyzing information about a person’s
linguistic, speech and physical abilities (as related to speech/communication).
It also looks at the ways in which the individual’s environment
influences these abilities. The brain and body interact to produce speech
and language, as well as a vast number of other behaviors and automatic
processes (e.g,. heartbeat, breathing). A speech-language pathologist’s
body of knowledge is based on two key ideas: the different, yet overlapping,
areas of speech and language. These terms are defined in other sections
(i.e. overview, glossary of terms) as concepts in and of themselves,
without consideration of the areas of the brain and body that create
speech and language. Please refer to these sections for more general
definitions of these terms. The paragraph below will describe the anatomical (location/identity of a body part) and physiological (functions of body
parts) sources of speech and language.
Language occurs within the brain, and involves the ability to understand what we hear or read and express our ideas in words (spoken or written). Speech also originates in the brain, and is the audible output of language. For speech to occur, the brain must program components of the oral cavity such as the lips, tongue, jaw, and components of the larynx, or “voice box,” such as the vocal cords, for movement. These anatomical structures (body parts) are the “hardware” for speech, whereas the actions of these parts constitute the “software” for speech. For example, the respiratory system (lungs, trachea or windpipe, ribcage) allows us to breathe, but it also helps us speak by providing air to make the vocal cords vibrate, producing sound. Another important system is our auditory system (outer and inner ear, auditory canal, auditory nerve, auditory receptors within the brain). This system allows us to monitor our own speech and understand and respond to others’ speech. In sum, the brain is essential in both speech and language. It is the interpreter of language and helps us generate language. It also programs bodily organs and muscles to act together to generate clear, well-articulated speech.
In evaluating a person in need of speech and/or language therapy, the speech-language pathologist must examine the individual’s anatomical and physiological state, either directly or through the reports of other health professionals (e.g., audiologists, psychiatrists, physicians, neurologists, etc.). Physicians and neurologists are examples of medical professionals who treat certain physiological or structural (e.g., deformities) problems with medication or surgery. Speech-language pathologists, audiologists, physical therapists, and other such professionals specifically treat problems of physiology, or function, of bodily systems. For example, a speech-language pathologist may learn about a client seeking help by reading his/her physician’s reports to learn about anatomically based problems and treatments, but the speech-language pathologist will conduct direct observations of the client to determine his/her functioning. Sometimes a client’s difficulties do not have any clear pathological (e.g., disease, physical deformity, etc.) origin. These problems are functional in nature. This means that the impairment has occurred without any detectable anatomical or physiological abnormality or dysfunction.
learning about a client through talking with and/or gathering documentation
from other professionals, and then conducting direct observations through
an assessment process, the speech-language pathologist makes a diagnosis,
labeling the client’s condition. Speech and language impairments
are often named with codes for clarity among professionals (e.g., for
insurance coverage, for other health professionals’ evaluations,
etc.). The level of severity is also noted. Next, the speech-language
pathologist plans treatment.