What Does an Adult Speech Therapist Do?
Being told by your doctor that you should see a “speech therapist” can feel strange—especially if you have never been told what a speech-language pathologist actually does. Your first reaction may even be defensive: I can speak. Why would I need speech therapy?
Speech-language pathologists, often called speech therapists, help adults with much more than pronunciation. They evaluate and treat difficulties involving communication, thinking and memory, voice, and swallowing. The specific reason for your referral may be very different from what you first imagine when you hear the words “speech therapy.”
What Does an Adult Speech Therapist Do?
An adult speech therapist helps people communicate and swallow as safely and independently as possible. Depending on the reason for treatment, this may include helping someone:
speak more clearly
find and express words more easily
understand conversations or written information
improve memory, attention, organization, or problem-solving
strengthen or better control the voice
communicate after a stroke or brain injury
manage changes related to Parkinson’s disease or another neurological condition
eat and drink more safely
Some adults need speech therapy after a sudden medical event, such as a stroke, traumatic brain injury, surgery, or hospitalization. Others experience gradual changes related to Parkinson’s disease, dementia, multiple sclerosis, cancer treatment, or another medical condition.
Speech therapy may also help adults who have experienced communication difficulties for many years but are now ready to address them.
What Conditions Does an Adult Speech Therapist Treat?
Adult speech therapy covers several different areas. A person may be referred for one concern or for a combination of difficulties.
Speech Difficulties
Speech refers to how clearly and accurately a person produces sounds and words. An adult may know exactly what they want to say but have trouble making their mouth produce the message clearly.
Speech difficulties can occur because of muscle weakness, difficulty coordinating speech movements, or changes in the brain’s ability to plan those movements.
Common speech disorders treated by an SLP include:
Dysarthria, which occurs when weakness or reduced coordination affects the muscles used for speech
Apraxia of speech, which affects the brain’s ability to plan and sequence the movements needed for speech
Persistent articulation difficulties that have continued into adulthood
Changes in speaking rate, volume, or clarity
Someone with a speech disorder may sound slurred, quiet, slow, effortful, or difficult to understand. Treatment should focus on the situations in which that difficulty matters most.
In everyday life, speech therapy might help someone communicate clearly enough to make a medical appointment by phone, order at a restaurant, participate in a work meeting, or speak with family members without constantly being asked to repeat themselves.
Language and Aphasia
Language is different from speech. Speech is the physical production of words, while language is the ability to understand and express ideas.
Aphasia is a language disorder that commonly occurs after a stroke or other brain injury. It can affect speaking, understanding, reading, and writing.
A person with aphasia may:
know what they want to say but struggle to find the word
substitute one word for another
have difficulty following longer conversations
misunderstand questions
struggle to read forms, messages, or instructions
have difficulty writing texts, emails, or notes
Aphasia does not mean that someone has lost their intelligence. A person may still know exactly what they want to communicate but have difficulty accessing or organizing the language needed to express it.
Speech therapy for aphasia may focus on restoring language skills, developing communication strategies, and helping family members communicate more effectively.
In everyday life, that may mean helping someone tell a family member what they need, understand instructions at a doctor’s appointment, send a text message, read a menu, or participate more fully in a conversation.
Cognitive-Communication Difficulties
Communication depends on more than speaking and language. It also requires attention, memory, organization, reasoning, and self-awareness.
When changes in thinking interfere with communication or daily functioning, they are often described as cognitive-communication difficulties.
An adult may have trouble:
remembering conversations or appointments
staying focused during a discussion
organizing thoughts before speaking
following several steps
solving everyday problems
managing medications, schedules, or finances
recognizing mistakes
returning to work or completing complex tasks
These difficulties can occur after a concussion, stroke, traumatic brain injury, neurological illness, or prolonged hospitalization. They may also develop gradually with conditions that affect cognition.
In everyday life, cognitive-communication therapy might help someone create a reliable medication system, remember what was discussed at a medical appointment, follow a household routine, manage a calendar, organize a work assignment, or communicate more successfully when distracted or overwhelmed.
Cognitive-communication therapy is usually practical and individualized. Rather than completing isolated memory exercises alone, treatment may involve developing systems and strategies that help the person function more successfully in everyday life. The activity should have a clear connection to the person’s actual needs. Although completing worksheets or games that exercise “memory” or “attention” have their benefits, I work with my clients to ensure that they are doing activities that transfer or directly target their goals and needs.
Voice Changes
An adult speech therapist also evaluates and treats voice problems. A voice may become weak, hoarse, strained, breathy, rough, or difficult to hear.
Voice changes may be related to:
Parkinson’s disease
vocal fold injury or weakness
neurological conditions
surgery
prolonged intubation
vocal overuse
head and neck cancer
muscle tension
Some adults do not realize how much their voice has changed until family members frequently ask them to repeat themselves or tell them they are speaking too quietly.
Treatment may focus on improving vocal strength, clarity, endurance, and efficiency. For people with Parkinson’s disease, specialized programs such as LSVT LOUD may be recommended to improve vocal loudness and communication.
In everyday life, voice therapy might help someone speak loudly enough to be heard across the dinner table, participate in a group conversation, communicate on the phone, give a presentation, or make it through the day without vocal strain.
Swallowing Difficulties
Speech-language pathologists also evaluate and treat swallowing disorders, known as dysphagia.
A swallowing problem may affect food, liquids, pills, or saliva. It may occur after a stroke, surgery, neurological diagnosis, cancer treatment, or prolonged illness.
Possible signs of dysphagia include:
coughing or choking while eating or drinking
a wet or gurgly voice after swallowing
food feeling stuck
difficulty chewing
taking much longer to finish meals
avoiding certain foods or liquids
unexplained weight loss
repeated respiratory infections
difficulty swallowing pills
Swallowing therapy is not simply a matter of “strengthening the throat.” An SLP evaluates how swallowing is functioning and determines which strategies, exercises, referrals, or additional testing may be appropriate.
In everyday life, swallowing therapy may help someone drink from a cup with greater confidence, manage medications more safely, eat a wider variety of foods, complete meals more comfortably, or participate in family meals with less fear and frustration.
Because swallowing problems can sometimes be medically serious, new or worsening symptoms should be discussed with a physician.
What Happens During an Adult Speech Therapy Evaluation?
An adult speech therapy evaluation begins with understanding what has changed and how those changes affect daily life.
The SLP may ask about:
medical history
the reason for the referral
when the problem began
current medications and diagnoses
communication or swallowing concerns
work, home, and social demands
the person’s goals for treatment
The evaluation itself depends on the concern. It may include assessment of speech clarity, language, memory, attention, voice, oral movement, or swallowing.
The goal is not simply to assign a diagnosis. It is to understand how the difficulty affects the person’s independence, relationships, safety, confidence, and quality of life.
How Can Adult Speech Therapy Help?
Adult speech therapy should produce meaningful changes outside the therapy session. The goal is not to become better at worksheets, card games, or exercises that have little connection to the person’s actual life.
Some adults and families have had disappointing experiences with therapy in the past. They may remember completing the same activity week after week without understanding why they were doing it or how it would help at home. A person may have practiced sorting cards or recalling unrelated words, for example, while still struggling to remember medications, communicate basic needs, or follow the routine required to live more independently.
An activity is not functional simply because it involves memory, language, or problem-solving. It should be selected because the skill can reasonably carry over to something the person needs or wants to do.
At Savannah Speech Therapy, treatment is built around the individual’s real communication, cognitive, voice, or swallowing needs. That may include:
practicing the language needed for medical appointments
developing a system for medications, schedules, or daily responsibilities
improving speech clarity during phone calls
creating strategies for word-finding during conversation
increasing vocal loudness for communication with family
practicing reading or writing tasks the person actually uses
teaching caregivers how to support communication
working toward safer and more comfortable meals
adapting routines or environments to increase independence
There may still be times when a structured activity or game is useful. However, there should always be a clear reason for using it and a plan for connecting that skill to everyday life.
For one person, success may mean returning to work after a brain injury. For another, it may mean ordering a meal independently after a stroke, remembering the steps of a morning routine, speaking loudly enough for a spouse to hear, or continuing to participate in familiar family activities as dementia progresses.
The goals should reflect what matters to the person—not simply what can be measured easily in a therapy session.
What Does Functional Speech Therapy Look Like for Dementia?
For someone living with dementia, therapy may not be about improving a score on a memory activity. It may be more helpful to determine what communication breakdowns are occurring in daily life and what changes could make those moments easier.
Depending on the person and stage of the condition, therapy might focus on:
creating visual reminders for frequently needed information
simplifying a daily routine
helping the person communicate basic choices
identifying ways caregivers can reduce confusion
organizing important personal information in an accessible format
making familiar activities easier to participate in
supporting safety, comfort, and connection with family
Playing a card game may be meaningful when the person enjoys cards, wants to return to a familiar pastime, or the activity directly supports an identified goal. But playing the same card game simply to “work on cognition” may have little value if it does not improve or support the person’s everyday life. At Savannah Speech Therapy, we work together to develop a plan that is truly individualized and supportive of YOU and your family and lifestyle.
When Should an Adult See a Speech-Language Pathologist?
An evaluation may be helpful when an adult experiences a new or ongoing change in:
speech clarity
word finding
understanding language
memory or organization
voice
swallowing
communication following a medical event
the ability to manage daily responsibilities
A referral does not automatically mean that something is severely wrong. It means that a trained professional can evaluate the concern, explain what may be happening, and determine whether treatment or additional assessment is appropriate.
Adult Speech Therapy in Savannah
Savannah Speech Therapy provides individualized services for adults experiencing changes in speech, language, cognition, voice, or swallowing. Services may be provided in the home in the Savannah area or through teletherapy for appropriate clients located in Georgia or California.
Adult speech therapy is not about being taught how to talk. It is about helping people maintain or regain the skills they need to communicate, participate, and function as independently as possible.
