What is speech therapy and when to use it?

Definition: What is speech therapy or speech therapy?

The term speech therapy appeared in Europe in 1828 with the creation of the Orthophonic Institute of Paris founded by Doctor Marc Colombat. This establishment’s mission was to re-educate speech, particularly in cases of stuttering. Speech therapy or speech therapy is a paramedical discipline which covers a very broad field of action.

What pathologies are treated by speech therapy?

Speech therapy is the rehabilitation of everything relating to:

• Oral or written language and communication;
• Oro-myo-facial functions, that is to say linked to the mouth, the tongue, motor skills, sensoriality;
• Cognitive disorders in the context of a disorder acquired after a stroke, head trauma, etc.;
• The treatment of neurodegenerative diseases such as Alzheimer’s, Parkinson’s, etc. where language is lost and cognitive disorders affect memory.

“For example, we work with toddlers who have oral disorders that lead to feeding problems (difficulty sucking due to a tongue that is too short or poor lip closure). We also treat voice disorders: poor vocal behavior when a teacher forces his voice for example, or a problem following an operation or ENT cancer. We also treat disorders linked to deafness whether from birth, linked to an accident or illness or presbycusis.“, adds Emily Benchimol, speech therapist in Ile-de-Europe and vice-president of the National Federation of Speech Therapists (FNO). These patients with deafness are fitted with hearing aids and at the same time speech therapy trains them in lip reading, which is i.e. to read lips better. This makes it possible to compensate for the failures of hearing aids in noisy places.

What is a speech therapist? What is his role ?

The practice of a speech therapist is rich and varied. Depending on the situation, he can take on different roles.

Re-education

One of the roles assigned to the speech therapist is to re-educate. The treatment of certain disorders involves repeated training in order to recover lost or absent function.

L’adaptation

When the patient fails to recover beyond a certain threshold, the speech therapist then has an adaptation role. He seeks to adapt the environment, to think about relevant solutions with the family or school to improve the patient’s living environment and allow him to evolve more easily.

Support for family or caregivers

This professional also has a family support role for parents or caregivers. He can thus provide advice on how to communicate with the patient, how to react if those close to him do not understand what he is saying, if he stutters and turns away, etc.

Prevention

Finally, the speech therapist has a prevention role at the population level. This can involve workshops to teach parents to assimilate the language of toddlers. The “one baby, one book” initiative aims to offer young parents in maternity wards a book and to explain to them the benefit of reading to their baby, how to do it, etc. In partnership with Health Insurance, another prevention action is also organized for children aged 3 to 3 and a half years to detect language disorders in the school environment. This action is carried out in a few cities in collaboration with teachers who check off a grid and send it to speech therapists to determine whether the child is normal, fragile or needs a speech therapy assessment.

Training, diploma: What studies to be a speech therapist?

The profession of speech therapist is relatively recent since it was not until 1955 that the first speech therapy study certificates were issued following the initiatives of Suzanne Borel-Maisonny. The law of July 10, 1964 gave rise to a legal status for the profession and a national diploma was created: the Certificate of Speech Therapy Capacity (CCO). In Europe, to become a speech therapist, training takes place at university. The admission of candidates is selective: it is done on file via Parcoursup and is completed by an oral interview. At the end of the five years of study, the student can obtain their Certificate of Speech Therapist Capacity, Master grade. “The training includes many internships, almost 2000 hours. We really learn in the field through contact with internship supervisors and patients. In the first and second year, these internships take place in schools and nurseries to observe the child’s normal development. From the third year onwards, the internships are focused on assessment and rehabilitation and take place in private settings, in hospital services, in structures, etc..”, précise Emily Benchimol.

Why does a child go to see a speech therapist?

If a child does not begin to say his or her first words at 18 months to 2 years, this already merits a consultation with a speech therapist. No need to wait. Same thing if he does not produce sentences at 3 years old, if he does not begin to read six months after his arrival in first grade, if reading is tedious, slow…”This does not mean that he will need speech therapy follow-up but it deserves an assessment to see if the discrepancy is too significant compared to the norm and if it is indeed speech therapy that is necessary to help him. child“, specifies Emily Benchimol. Sometimes the assessment reveals that the problem is not speech therapy but depends on other health professions. This allows the patient to be referred to the appropriate specialist. The FNO has also set up a platform called “allo ortho” (www.allo-ortho.com) to regulate speech therapy requests, save everyone’s time and free up offices.It is a prevention site with many articles. It also includes a questionnaire to find out whether or not you need speech therapy. A speech therapist regulator calls people back to guide them and tell them if there is a need for a speech therapy assessment or if they should consult another professional“, adds the vice-president of the FNO.

Do you need a prescription to see a speech therapist?

Since the Rist law on improving access to care through trust in health professionals, published in the Official Journal on May 20, 2023, it is possible to consult a speech therapist without a prescription, under certain conditions. The practitioner must therefore practice in a health home or be a member of a CPTS (Territorial Professional Health Community) which has included direct access in its health project. “For patients, it’s a little difficult to know whether or not they need a prescription. It is the speech therapist who will provide information based on their situation. We regret that this is not possible for all speech therapists but it nevertheless concerns a large proportion of them.“, recognizes Emily Benchimol. For specialists who do not meet these conditions, access is by medical prescription.

When to do a speech therapy assessment?

A speech therapy assessment is recommended for children who have a language delay or disorder. In adults, it is systematically performed following a stroke or head trauma. “For people who forget their words, elements, it is more difficult to know when to consult and to distinguish what is ordinary aging or the beginnings of dementia. As a general rule, from the moment there is a complaint, it is justified“, confides Emily Benchimol. In these cases, it is important to speak to your doctor or to contact the “allo ortho” platform to consider a speech therapy assessment. This assessment consists of evaluating a patient by having them undergo standardized tests in one of the different areas covered by speech therapy. It can be to assess degenerative dementia, aphasia, etc. At the end of this assessment, the speech therapist makes a diagnosis. If the patient presents results that are too -below the norm, it is considered pathological.

How does a speech therapy session take place?

The course of a speech therapy session depends on the disorder in question. The session will also be modulated depending on the presence of caregivers, parents or not. Each session usually lasts between 30 and 45 minutes. This can take place in a private practice or at the patient’s home if they are unable to travel or if it is of particular interest to adapt their home for example.

During the session, there is a time for discussion between the patient and the speech therapist, then series of exercises and advice to finish. The patient will have to repeat these exercises very often at home. “It is not with one or two sessions per week that we will change a person’s communication. This usually requires daily training to achieve results.“, affirme Emily Benchimol.

When to stop speech therapy?

Two main scenarios can justify stopping speech therapy monitoring: either the patient has made progress and his new assessment reveals that he has returned to the norm, or he has not returned to this norm but there is no has more noticeable evolution. “In this case, we will instead switch to adaptations of the environment, school adjustments before stopping the sessions. If necessary, nothing prevents you from resuming follow-up later. It’s a break…