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Allison Geller's Blog

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Identifying the Early Warning Signs of Communication and Swallowing Disorders in Adults

The Facts 

There are many reasons why an adult might have a problem with speech, swallowing, voice or language. Some problems start in childhood. Others happen after an illness or injury, such as stroke, dementia, laryngeal cancer, oral cancer, traumatic brain injury (TBI) or other neurologic conditions such as Parkinson’s disease. Between 6 and 8 million people in the United States have some form of language impairment and an estimated 18 million adults report having had a problem with their voice in the past 12 months. More than three million Americans stutter. Anyone can acquire aphasia (a loss of the ability to use or understand language), but most people who have aphasia are in their middle-to-late years. Dysphagia, or difficulty with swallowing, is a sorely neglected medical disorder that impacts as many as 15 million Americans, with approximately one million people annually receiving a new diagnosis of the condition. 

The Challenges of Communication Disorders

Every day, I see in my work that untreated communication disorders often lead to larger academic and social issues. Early detection of speech and language issues is absolutely critical to improving academic and social outcomes—and improving one’s quality of life.

Early Diagnosis is Key

For people with communication disorders, those closest to them are often their biggest asset. Unfortunately, many family members and caregivers are unable to identify the warning signs or dismiss them too readily. Some misjudge a communication disorder as a problem with the person’s intelligence and some do not understand that many people continue to improve over a period of years and even decades.

Identify the Signs: Communication and Swallowing Disorders Common in Adults Following Stroke and Other Illness

Many people may not appreciate their ability to communicate until it’s lost. From having basic needs met to nurturing relationships and earning a living, communication is at the core.

Speech and language disorders that may be seen in adults include the following:

  • Aphasia. This involves problems speaking, understanding, reading, writing, telling time, and/or using numbers. Often misunderstood, aphasia does not affect a person’s intelligence. The most common cause of aphasia is a stroke.

  • Cognitive-communication disorders. Problems with thinking and communication can affect each other. Some examples are difficulty paying attention, remembering, organizing thoughts, and solving problems.

  • Apraxia of speech. Speech difficulties arise from problems planning motor movements. It is caused by damage to the parts of the brain that are involved in speaking.

  • Dysarthria. Speech difficulties (e.g., slurred speech) due to the weakness of muscles involved in breathing and/or speaking.

  • Voice disorders. Changes in pitch, loudness, and vocal quality that negatively impact communication. These may result from nodules on the vocal cord, overuse/misuse of voice (e.g., yelling), diseases such as Parkinson’s or multiple sclerosis, and other causes. 

  • Dysphagia. Difficulty swallowing.

  • Fluency disorders. Struggles to say sounds or words, or repetition of words or parts of words.

Speech-language pathologists can help adults with these and other communication problems, such as swallowing disorders, also known as dysphagia. Dysphagia is another common side effect of numerous diseases in adults. Each year, according to the Agency for Health Care Policy and Research (AHCPR), over 60,000 Americans die from complications associated with swallowing dysfunctions, most commonly aspiration pneumonia – caused by food or saliva going down the windpipe and into the lungs. A person’s ability to eat and drink is critical to maintaining good health and promoting recovery from illness. Food is also a central part of many social experiences—contributing to an enjoyable and fulfilling life. Treatment can be truly transformative to a person’s quality of life and overall health.

Speech-Language Pathologists Treat Dysphagia in Various Ways:

  • Helping people use their muscles to chew and swallow

  • Finding better positions for people to sit or hold their head while eating

  • Identifying strategies to make swallowing better and safer

  • Advising people on their dietary choices, including softer foods or thicker drinks

Getting Help

Although treatment for communication and swallowing disorders ideally begins early, it is never too late to get treatment. The large majority of individuals report significant improvement after treatment. I encourage you to share the information in this article and investigate other resources you find on ASHA’s “Identify the Signs”site. Above all, though, I hope you will seek help if you suspect that you or a loved one shows signs of having a disorder. If you would like to schedule an assessment, contact me!