Adult Communication Disorders Treated in a Medical Setting
Communication is a complex process involving hearing, comprehension, cognition, language, voice and speech production. Normal communication relies on the effectiveness of several underlying processes including phonation, respiration, resonance, hearing, brain function, and oral mechanism.
Adult Communication Disorders Treated in a Medical Setting
According to the American Speech Language and Hearing Association a communication impairment is an impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal and graphic symbol systems.
A communication disorder may be evident in the processes of hearing, language, and/or speech. A communication disorder may range in severity from mild to profound. It may be developmental or acquired. Individuals may demonstrate one or any combination of communication disorders.
A communication disorder may result in a primary disability or it may be secondary to other disabilities. Medical problems such as a stroke, brain injury, brain tumor, dementia or neurological disease can affect the processes underlying effective communication and cause a wide variety of communication problems.
Following is a brief description of the major communication disorders that can result from these medical problems.
| Disorder | Description | Cause |
|---|---|---|
| Aphasia | – Impairment in language function affecting ability to understand. – May affect understanding, verbal formulation, reading, writing, and/or gesturing. | – Usually a left sided stroke – Brain Damage – Dementia |
| Dysarthria | – Impairment in the strength, speed, and coordination of muscle movements for speech – Can affect voice quality or loudness, breath support or speech production. – Speech may sound slushy or slurred or may be too fast or too slow. | – Stroke – Neurological Disease |
| Voice Disorders | – Voice may be hoarse, weak, breathy, hypernasal or tremulous. – Loss of voice | – Stroke – Neurological Disease – Cancer, vocal cord pathology – Cleft palate |
| Apraxia | – Impairment in planning, executing and sequencing muscle movements. Not due to muscle weakness | – Usually Left-sided stroke |
| Cognitive Deficits | – Impairment in orientation, attention, memory, problem solving and/or executive functioning | – Stroke – Dementia, – Traumatic brain injury |
| Hearing Loss | – Difficulty discriminating sounds, understanding speech, hearing well in noise – Voice may be too soft or too loud | – Aging – Damage to middle ear – Infection – Tumor |
| Dysphagia* | – Impairment in swallowing – Symptoms may include coughing, choking, drooling, pocketing of food, wet voice quality, excessive chewing or complaining of food “stuck.” | – Stroke – Dementia, – Traumatic brain injury – Neuro-logical disease |
Medical management of the underlying causes of these communication disorders is the first priority in treating these problems.
Once medically stable, an individual can be evaluated by a speech and language pathologist and/or audiologist who will perform a comprehensive evaluation, determine appropriate goals and establish a plan of treatment.
Because deficits vary so widely, treatment is highly individualized and dynamic, changing as the patient progresses. Treatment often involves at team of skilled professionals, including physical therapists, occupational therapists, doctors, nurses, psychologists, audiologists and dietitians.
Family and caregiver training and education is also crucial to recovery. When communication is impaired it can affect all aspects of one’s life. Deficits vary widely as does recovery from these deficits.
Good professional intervention, a supportive environment, a positive attitude and motivation are all factors contributing to recovery.
Author: Barbara Van Dyne
Barbara Van Dyne, M.A., speech-language pathologist has worked for decades in a variety of rehabilitation settings, including inpatient and outpatient rehabilitation, home health, private practice and skilled nursing facilities. She holds a Master's Degree from The University of Kansas in Speech and Language Pathology. She is the author of Memory Chit Chat, a clinical manual with exercises that leverage social themes for therapeutic purposes offers meaningful engagement, repetition, familiarity, personal relevance, and a connection to seasonal and cultural events She has taught memory improvement classes and served on the advisory board of the Stroke Support Group of Northern California. Prior to her retirement she was certified by the American Speech and Hearing Association and licensed as a speech pathologist in the state of California.
Barbara Van Dyne, M.A., speech-language pathologist has worked for decades in a variety of rehabilitation settings, including inpatient and outpatient rehabilitation, home health, private practice and skilled nursing facilities.
She holds a Master's Degree from The University of Kansas in Speech and Language Pathology.
She is the author of Memory Chit Chat, a clinical manual with exercises that leverage social themes for therapeutic purposes offers meaningful engagement, repetition, familiarity, personal relevance, and a connection to seasonal and cultural events
She has taught memory improvement classes and served on the advisory board of the Stroke Support Group of Northern California. Prior to her retirement she was certified by the American Speech and Hearing Association and licensed as a speech pathologist in the state of California.
