Linguistics Encyclopedia.pdf

A-Z 573
PLACES OF WORK
In 1986 there was the equivalent of approximately two and a half to three thousand
fulltime speech therapists in posts in England and Wales, the large majority of whom are
women. In the USA there are currently 41,000 members of the American Speech,
Language and Hearing Association (ASHA) of whom approximately 70 per cent are
practising clinicians. As in the United Kingdom, most American speech therapists are
women. Most speech therapists practise in local-authority health clinics, schools, or
hospitals. Some are employed by charitable bodies concerned with handicapped children
and an increasing number work in specialized units, for example with physically or
mentally impaired adults and children, or with those with hearing impairments. There are
also units offering intensive rehabilitation to injured adults, mentally handicapped, and
disturbed children.
Speech therapists work closely with a number of other professions, including medical
specialists, nurses, other medical therapists, psychologists, teachers, social workers, and
linguists. They are often part of a rehabilitation team. In all positions, the speech therapist
remains ultimately responsible for the assessment, treatment, and management of the
disorder of communication, although in cases which are secondary to disease or injury, a
doctor will usually retain overall responsibility for patient care.
RANGE OF INTEREST
Communicative disorders may result from abnormalities of the production or resonance
of voice, the fluency of language, language production, including the articulation of
speech sounds, or they may arise from defects of the monitoring system at any level of
production. Disorders at any of these levels can have a number of causes; they may be
secondary to trauma, illness, or degenerative processes, for example acquired disorders of
language such as aphasia and dysarthria; associated with structural abnormalities such as
cleft palate; associated with abnormal developmental patterns, for example delayed
language or phonological development; secondary to or associated with other defects, for
example hearing loss or gross mental retardation; arise from environmental damage, for
example aphonia, loss of voice, or dysphonia, abnormal voice; or they may be idiopathic,
as in stuttering.
A significant number of people in the United Kingdom suffer from some type of
communicative disorder. It has been estimated that approximately 800,000 people suffer
from communication disorders where little or no spontaneous speech is possible and a
further 1.5 million have speech or language which is noticeably disordered (Enderby and
Philip, 1986). Some of these disorders can be alleviated and require remediation, others
are chronic and require management and perhaps counselling. The speech therapist is
responsible for assessing all those with communication disorders and selecting the
appropriate treatment and/or management programme.