Speech therapy

Speech therapy

The speech therapist is an expert in speech, language, voice, and swallowing. A brain tumor, like other forms of acquired brain injury (ABI), can lead to the following disorders:
- Speech disorders: dysarthria, verbal apraxia
- Voice disorders: aphonia, dysphonia
- Swallowing disorders: dysphagia

The nature of the symptoms depends on the location of the lesion in the brain. A speech therapist can be consulted through a physician or neurolinguist. They are familiar with examining the voice, speech, language, and swallowing, as well as with their treatment. Speech therapy aims to inform the patient and their family about the disorder and its treatment. If other cognitive complaints are present, such as memory problems, concentration problems, perceptual disturbances (e.g., neglect), and behavioral changes (e.g., decreased initiative or apathy, disinhibited behavior), the speech therapist, in consultation with the treating physician, will refer the patient for a comprehensive cognitive assessment by a neurolinguist or neuropsychologist.

Dysarthria is a speech disorder in which the function of one or more muscles involved in speech is impaired. Words and sentences can be found, but they are not pronounced clearly. The cause is impaired innervation, and consequently muscle function, due to an organic defect of the motor nervous system. This lesion can be centrally or peripherally located.

Verbal apraxia is also a speech disorder. However, the disorder concerns a problem with programming the speech muscles for the production of phonemes (abstract language units, groupings of sounds) and the sequential muscle movements for the conscious production of words. It is not about the execution of the movement, but about the preceding step: the programming.

Aphasia is an acquired language disorder caused by brain injury in which the comprehension and expression of spoken and written language are impaired (Dharmaperwira, Prins, 1989/1998). Because it is a language disorder, nonverbal memory and thinking are essentially intact. Thought can be retained, but the expression of it through language is impaired.

Aphonia and dysphonia refer to the loss of vocal function and a malfunction of vocal function, respectively. This is caused by unilateral paralysis of the vocal cords.

Dysphagia is a swallowing disorder that can result from a neurological disorder.

It's important to know that there's no one-size-fits-all solution for a specific language, speech, or voice disorder. Therapy is determined individually. A disorder consists of several subtypes, and moreover, a disorder rarely occurs in isolation, but usually coexists with another disorder. Other determining factors are the medical diagnosis and history, the severity of the disorder, and the patient's motivation. The speech therapist will therefore always formulate advice and goals based on an individual case. Therefore, it's important to contact a speech therapist who specializes in and/or has extensive experience with a specific problem. For example, for a voice disorder, it's best to contact a voice therapist. For example, neuromuscular electrophonatory stimulation can be administered for vocal cord paralysis. In the case of aphasia, it's best to contact an expert in that field.

Always seek support for your speech or language problems as soon as possible. This can be done even during the acute phase, namely in the hospital. If necessary, follow-up treatment can also be arranged from the hospital. You always have two options: outpatient therapy or a speech therapist who provides support at home. Your health insurance fund will cover the costs of speech therapy. Ineke Wilssens, Speech Therapist

The Brain Tumor Working Group (Hersentumoren vzw) draws attention to the fact that rehabilitation after a brain injury cannot be limited to a period of three months, but can sometimes take years. For some patients, continuous "maintenance" will be necessary to maintain the achieved level of performance. Speech therapy, physiotherapy, and occupational therapy can also be considered a form of educational stimulation, preventing the patient from falling into a negative spiral that can lead to apathy, depression, and even poverty. Current government policy is to allow rehabilitation only if progress is being made. This perspective is not in line with the needs of people with chronic brain disorders.