Speech Therapy

What is speech therapy?

If you are having problems with speaking, thinking, or other language skills, speech therapy is a treatment program that can help you. Speech therapists also help people with swallowing problems. Speech therapy helps people learn new ways to:

• communicate
• breathe or swallow
• concentrate, remember, and process new information.

When is speech therapy needed?

Speech therapy may be prescribed for conditions such as:

• a stroke
• brain injuries
• feeling a lump in the throat due to an emotional or anxiety disorder (globus hystericus)
• cancer or other growths on the vocal cords
• chronic laryngitis (a hoarse voice, loss of voice, or sore throat that keeps coming back)
• diseases such as multiple sclerosis, Alzheimer's disease, Parkinson's disease, or Lou Gehrig's disease
• dysphagia (trouble swallowing)
• speech disorders such as stuttering
• vocal cords paralyzed or severely weakened after a viral infection of the throat, an injury, or after surgery in the neck.

What does a speech therapist do to help me?

Depending on the nature and severity of the problem, common treatments may include physical exercises, practice and drilling, and using audio-visual aids.

A speech therapist will test you and find out the speech and language skills that you need to work on. Speech therapy includes training, repetitive exercises, and the use of devices that can make it easier to communicate. The therapist may work with you one-on-one or in a small group. Speech therapists may also work closely with family members who are helping to care for a person getting the therapy.

Types of exercises that may be used are:

• Language exercises: During these exercises the therapist may model the correct way to say words and have you repeat words and sentences.
• Articulation exercises: Articulation means the making of sounds. The therapist will do sound exercises with you by speaking the correct sound or syllable of a word for you to repeat. You are shown how to make the sound with your mouth and tongue. You may use a mirror to watch how your mouth and tongue are moving.
• Relaxation and breathing exercises: Breathing techniques and relaxation exercises can help you relax your face and mouth muscles.

Speech therapy often is used along with physical therapy, occupational therapy, and assistive devices such as voice-synthesizing computers and language boards.

Where can I get speech therapy?

You can get these services as an outpatient of a hospital or skilled nursing facility, or from a home health agency, rehab agency, or public health agency. Medicare does not pay for services given by a speech therapist in private practice.

To find a speech therapist, call your local hospital, ask your primary care physician, or ask people you know for recommendations. Many otolaryngologists (ear, nos, and throat specialists) work closely with speech therapists. To help choose a speech therapist, ask:

• Are you a licensed speech therapist in my state?
• How much experience do you have treating people with my condition?
• How often will I need to have speech therapy?
• What types of therapy do you think I need?
• Will you accept Medicare and what are your payment policies?

What is the Medicare coverage for speech therapy?

Medicare helps pay for medically necessary outpatient speech therapy when:

• Your doctor sets up the plan of treatment.
• Your doctor periodically reviews the plan to see how long you will get therapy.

Medicare pays a percentage of speech therapy bills that it approves. You are responsible for deductibles and parts of the bills not covered by Medicare. If you have a Medicare supplemental plan, the plan may cover these charges. The amounts you must pay may be higher if a speech therapist does not accept Medicare assignment.