Speech Therapy for Children with SMA

I am a speech pathologist. My daughter had spinal muscular atrophy.

One of my daughter’s needs was speech therapy services. Since I was too close to this situation, I chose not to self-treat her. Instead, I asked one of my colleagues to evaluate and treat her for voice and swallowing issues.

The role of the speech pathologist

Speech pathologists (SLPs) work with individuals experiencing communication difficulties, swallowing dysfunction, and respiratory issues involving swallowing liquid and solid foods in coordination with breathing.

Speech pathologists evaluate and do therapy with spinal muscular atrophy (SMA). A speech pathologist can help people with SMA overcome problems with speech and swallowing that develop due to weakness in the tongue, throat, and respiratory muscles. They teach safe swallowing techniques, conserving breath support for speaking, or using adaptive language techniques if communication becomes difficult.

Speech pathologists are key members of a multidisciplinary team which also includes occupational and physical therapists treating individuals with SMA.

What does the speech pathologist do?

Help with swallowing A speech pathologist may perform tests to evaluate swallowing and speaking. One test is called a modified barium swallow study or videofluoroscopy. The patient is given different food and drink consistencies. X-rays let the SLP observe as the food and liquids pass through the different phases of swallowing, [oral, pharyngeal, and esophageal stages].

The speech pathologist observes the food and liquids which involves taking X-rays while a person eats a barium-infused cookie and foods of other consistencies including liquids, which helps the speech pathologist diagnose issues and prescribe the proper treatment plan. In addition, the safest meal consistencies are recommended to avoid aspiration

Speech and language therapy treatments may also include:

• Language strategies. Slowing down communication by enunciating syllables, or pausing between words and phrases, is a strategy speech pathologists may use to improve communication in people with weak speaking muscles.
• Vocalization. Speech pathologists may activate rib cage muscles when there isn’t enough breath to speak. Therapy involves blowing exercises to expand lung capacity for vocal loudness. In addition, exercises are given to improve breathing abilities and expand lung capacity upon inhalation.
• Augmentative and alternative communication devices (AAC). These are devices that improve, support, or replace speech and writing. They can range from a set of pictures to electronic speech systems. Speech pathologists can evaluate the need for an AAC, which along with other tools, can help people with ventilators and tracheostomies communicate. In addition, a Passy Muir Speaking Valve can be added to regain speech. The valve stops air from flowing out through a tracheostomy tube while a person is trying to speak.

Aid communication for people with difficulty speaking

The goal of speech and language therapy is to offer aid in communication skills for people who have difficulty speaking using a range of exercises and devices that strengthen speech muscles.

Speech therapists also provided breathing exercises for respiratory support interventions. Many people with SMA can have difficulties with speech intelligibility, vocal intensity, and respiration to maintain voice quality. These symptoms are due to the brain’s inability to regulate tongue strength and movement of oro-facial muscles.

The speech pathologist identifies weaknesses in the oro-facial musculature and develops a plan of treatment to work on the muscles used in speech and swallowing. In addition, they work on helping those who have secretion management difficulties. They are part of a multi-disciplinary team that manages SMA patient care.

Speech pathologists are a vital part of the treatment team for people with spinal muscular atrophy. They treat speech, voice, swallowing, respiration, and assistive communication devices to make everyday activities of daily living safer and more functional. Speech pathologists also provide training and support to caregivers in managing those living safely at home with spinal muscular atrophy.