Speech-language pathology

Speech Therapy ( from Ancient Greek λόγος lógos " word " and παιδεύειν paideuein "educate"; literally so " elocution ") is the first time in 1913 and 1924 used by the Viennese physician Emil Froschels introduced term for the medical speech therapy. The importance of speech therapy - term changed over time.

Today, speech therapy refers to the fledgling medical-therapeutic discipline that has the restricted by a language, speech, voice, swallowing or hearing impairment in his interpersonal communication skills people to object.

The speech therapy focuses on the theory and practice of prevention, counseling, diagnosis, therapy and rehabilitation, teaching and research in the fields of voice, voice disorders and voice therapy, speech, speech disorder and speech therapy, language, speech disorder and speech therapy, and swallowing, swallowing disorder and swallowing therapy.

History in Germany

First four -week training courses for " language herbalists " there were already 1886 in Potsdam. Five years later, 115 were individual student " trained", also opened one of the first institutions, the Berlin clinic for sick voice, which offered courses for sprachgebrechliche children. These courses lasted about 3-4 months 8-10 children per class daily for a period of 1-2 hours.

After 1918 the working field of speech therapy has been significantly expanded, the customer was speaking academic discipline. Results of psychoanalysis and individual psychology led to new methods.

After 1913, the term speech therapy was first used, was officially introduced in the medical language in 1924 by Emil Froschels in Vienna. He led the first International Congress of Logopedics and Phoniatrics by in Vienna, where it was required to introduce the training of speech therapists on a scientific basis with an academic audit.

In Berlin, Phoniater father and son Gutzmann tried to intensive training of therapists.

Until 1945 there was no separate training. First structured and speech therapy specific educational training opportunities there as needed - usually referred to the main interests of the provider. The work remained selectively limited to individual cases and to large cities such as Berlin, Mainz, Munich and Münster. At the end of two years' training was a test whose certificate of completion had no official character, but was to be regarded merely as a purely private document. The study then demanded a high degree of initiative.

In 1949 Hermann Gutzmann Jr. moved after his departure from the Charité his privately run language ambulance to Berlin -Dahlem, calling them " Centre for Voice and Speech sick ." The professional title of the speech was officially introduced in 1957, and five years later he opened where the first speech - educational institution with the completion of this course was -. government recognition pronounced - after long negotiations with the Senate Department Gutzmanns.

1974, the Rehabilitation Act was adopted approximation, which health insurance obliged to accept the cost of speech therapy. At the same time created the pension insurance institutions a new framework for rehabilitation. Thus, the neurological rehabilitation was a large work area in speech therapy.

1977 training and examination regulations were developed. On this basis the law to the profession of speech therapists was adopted on 1 October 1980.

History of Switzerland

Living in the Netherlands, Swiss physician and the deaf teacher Johann Conrad Ammann (1669-1724) is considered one of the first writers of instructions for deaf education and deaf as the greatest teachers of his time. He taught lip-reading, the use of the laryngoscope and let feel the laryngeal vibrations. He emphasized the importance of speaking as the most essential human characteristic and thus provided the philosophical basis for the Oralists. His books Surdus loquens ( The Learning Pigeon) and his dissertation of 1700 ( Dissertatio de loquela ) have been translated into several languages ​​and had a great influence on the development of deaf education in Germany.

The priest and the deaf teacher Heinrich Keller (1728-1802) founded in 1777 in his rectory in Schlieren the first small deaf school in which he taught the spoken language. In 1786 he published his textbook for the deaf teaching experiment on the best method of teaching to teach deaf-mutes.

The doctor Rudolf Schulthess (1802-1833) published in 1830 his book The stammering and stuttering in which he made a first exact distinction between stammering and stuttering.

The doctor Laubi Otto (1861-1825) practiced from 1889 as the first ENT specialist in Zurich. As a former doctor at the mental institution Rheinau he favored - as later Emil Froschels - the psychogenic view of stuttering. From 1893 he led through regular medical examinations ears at the Zurich school children. In 1918 he led at the ENT clinic in Zurich volunteer the first public consultation for voice and speech defects a, connected to a Ableseunterricht for the hearing impaired.

1928-1932 took over Arnold Karl Kistler phoniatric clinic at the ENT Clinic Zurich. He founded in 1934 with the Schwyzerhüsli the first speech therapy home in Zurich.

1942, the Swiss Group for Sprachgebrechliche (SAS ) was in Zurich (from 1960: Swiss Group for Speech Therapy SAL) as a professional association per Infirmis founded. The founding members were Karl Kistler, Hans Petersen, Hedwig Sulser, Hans Ammann, Ernst Bieri, Melanie log as well as members of the French-speaking Switzerland and Ticino. Karl Kistler served as the first president from 1942 to 1962.

The SAS began in 1947 as the first institution of Switzerland systematically train speech therapists. The deaf teachers and speech-language pathologist Hans Petersen was 1947-1973 Head of Training. The primary and speech therapy teacher / speech therapist Hedwig Sulser Bachmann founded in 1947 the first Sprachheilkindergarten on the Egg in Zurich -Wollishofen. 1979-1984 she headed the designed of their SAS courses for group leaders to Sprachheilkindergarten gardens.

1949 launched the Special Education Department of the Université de Fribourg his first training course for academic speech training.

Interdisciplinary Society of Phoniatrics, Speech Therapy and Audiology was founded in 1953. In 1960, the founding of the Société Romande d' also interdisciplinary Audiophonie de pathology du Language (now Société Romande d' Audiology, Phoniatrics de et de Logopédie SRAPL ).

1961 was built at the Institute of Special Pedagogy and Psychology Basel a speech therapy training and 1973 such on Special Education seminar in Zurich (today Interkantonale College of Special Education HfH ).

Opened in 1967, the Department of speech and voice disorders of the university Throat Clinic in Zurich, which was founded in 1917 by Felix R. Nager, a three-year training leading to a diploma in clinical speech therapy, which built on the SLT Basic Training of 3 years. The speech therapy and Pädoadiologie is established in 1971 by Christian hero bar at the Children's Hospital Zurich.

In 1971 the Speech therapy center ( Unit ) was founded in the city of Zurich with a primary school teacher and speech therapist Eva Guldenschuh as an educational leader. She gave lectures for speech therapists and speech therapists organized the training on Special Education Seminar ( HPS), which began in 1973.

1978 was the Swiss Professional Association of Speech Therapists (SBL ) on whose foundation the SAL was significantly involved. The SBL was founded in 1985 in Swiss German regional language groups professional associations Speech Therapists Association (DLV ), Association Romande des Logopédistes Diplomés ( ARLD ), Associazione della Svizzera Italiana Logopedisti ( Alosi ) split.

1979 saw the establishment of the Conference of Heads of speech therapy schools with the purpose for the authorities to be a point of contact and to regulate matters relating to the interns and the Fort or training of teachers on speech therapy classes. First time in 1980, the magazine speech therapy was published in Zurich and 1981 resulted in the first frame order for the training of speech therapists in Switzerland. The Swiss German speech therapists and speech therapists DLV Association was founded in 1998.

Speech therapy as an action science bzw.Therapie

The interest of the speech therapy is directed toward concrete action (prevention, counseling, detection, treatment). The clientele includes all age groups.

In early childhood, the treatments of disorders of language development outweigh the linguistic levels vocabulary, grammar and phonology. In addition to the expressive abnormalities especially disorders of language comprehension are discussed. During the kindergarten age and preschool age are found heaped problems in the context of a language delay or disorder. These include, for example with grammar ( disturbances of sentence structure and disorders of Wortflexion, eg use of the plural ), dyslalia (pure articulation disorder ), omissions, substitutions and changes in individual sounds and sound combinations ( Phonological disorder). Speech therapists also treat balbuties ( stuttering ), rumble, a myofunktionelles muscle imbalance and voice disorders. Likewise, speech therapists treat patients with

• Dysarthria (impaired execution of articulatory movements due to a neurological impairment, such as injury to a nerve, usually more accurate than Dysarthropneumophonie called because in most cases the speech breathing and / or the vocal sound is concerned)
• Dysphagia
• Speech disorders after a stroke or other neurological impairments or the consequences of accidents (aphasia )
• Apraxia (impaired planning of articulation movement without damage to the Fazialnerves ).

Recently, speech therapists treat and more often children of school age, due to an earlier developmental language disorder as a result of symptoms difficulty in reading acquisition development ( acquisition of written language disorder; formerly dyslexia, dyslexia, dyslexia or Dysgrafie called ).

The speech therapy measures include creating a diagnosis, counseling and treatment of disorders of language comprehension, the spoken and written language, speaking, breathing, voice, oral function, hearing, swallowing, and perception. In addition, preventive measures are offered mainly in the field of voice. The regular and detailed advice of relatives (parents, partner, children ) is especially in children and in severely disturbed adults for activity, since only such a change in the ability to communicate can be achieved in everyday life.

Application fields (selection)

• Aphasia ( eg after a stroke, accidents / craniocerebral trauma)
• Dysarthria: Coordination disorders of voice, articulation, breathing and tone (eg, cerebral palsy, Parkinson's disease, ALS ( amiotrofical lateral sclerosis), multiple sclerosis, stroke and traumatic brain injury)
• With grammar (limited grammatical skills )
• Dyslalien (phonetic ): voice and articulation errors, lisping
• Dysphagia ( swallowing therapy ): neurological dysphagia ( eg after a stroke or cerebral palsy ), postoperative dysphagia (eg after removal of the throat or tongue parts due to tumors)
• Dysphonia: voice disorders
• Limited vocabulary, both actively and passively
• Myofunctional disorder ( orofacial )
• Phonological disorders: the correct use of sound (eg, substitutions, deletions, additions )
• Fluency disorders: stuttering, cluttering
• Selective Mutism, mutism and autism
• Speech and language disorders in the context of dementia (eg Alzheimer's)
• Developmental language disorders and delays in children (SES, specific language impairment )
• Sprechtonänderung in the context of gender reassignment treatments (see also transsexuality )
• Disorders of hearing and auditory perception

End of the treatment

Depending on requirements, articulation, vocabulary, comprehension, writing, reading and computing power, breath, voice or swallowing function to be tested. Together with the medical findings are the results of this diagnosis, the basis for the selection of treatment methods. Together with the patient and / or their caregivers, the treatment goals are set. The treatment consists of specific exercises, discussions about the course of treatment and guidance for independent practice.

Speech therapy as an integration Science

Speech therapists integrate into their work various scientific disciplines, including linguistics (see also psycholinguistics ), phonetics (the study of the sounds ), psychology, medicine and education, special education, special education.

Professions in the voice, speech and language therapy

In therapy, both speech therapists, and speech scientist Clinical ( Clinical Speech Science ), respiratory, speech and voice teacher, clinical linguists ( Clinical linguistics ) and a graduate in speech therapy speech therapy educators and a registered educators operate. However, the difference between these last two professional groups is largely unknown. A certain special position Specialists in voice, speech and hearing disorders childhood (formerly: Specialists in Phoniatrics and Pediatric Audiology ) a. In addition to the medical diagnosis but also therapy belongs to specialist training.

The field of activity of all these professional groups is congruent. For the members of the non-medical healthcare professions, the activity extends into the free practices on diagnosis, treatment and advice for voice, speech, language, hearing and swallowing disorders in patients of all ages.

A significant difference, however, in the training and the possibility of allowing the two occupational groups:

• Graduate speech therapy educators and examined speech therapy educators to complete a five-year university degree. Thus, it is an academic education. In order to obtain a social security scheme, several hundred hours therapy under supervision in individual clinical pictures are ( be issued for each part approvals) to prove.

• Speech therapists to complete either a three-year course at a vocational school for speech therapy, a four-year undergraduate degree at a Fach-/Hochschule or a dual degree of 7 semesters, with the acquisition of vocational certificate and a degree of Bachelor, as at the University of Bamberg. The training for this health care profession can be started with a high-school or secondary school, as well as a completed at least two years of vocational training; for the study is at least the diploma requirement. Following the training of speech-language pathologist or speech therapist may ask the insurance approved at the RVO and VDAK POS and make themselves immediately in their own practice independently, without having been previously worked under the supervision of employed persons. Practicing free speech have no pension insurance, because they are acting based on their own diagnosis and their own treatment plan.

• Respiratory, speech and voice teacher (method Schlaffhorst and Andersen ) complete a three-year training at the only specialist school for certified respiratory, speech and voice teachers in Germany bath nominal village near Hanover. This training can be started with a high-school diploma after passing the qualifying examination. Following this training, the health insurance license can be applied for the RVO and VDAK POS and be made immediately in private practice independently.

• Phoniater and audiologists need to provide the treatment at the expense of the statutory health insurance approval as a doctor.

Germany is the only European country in which non-academic professions in the field of this therapy may be active. Meanwhile, the promotion of training at university level in the professional associations and speech therapists is discussed intensively. Even the Federation of speech calls this a long time. Additional background is the harmonizing education at EU level. In connection with the reorganization study with master's and bachelor's degree programs is sought at various levels for ways to implement the EU harmonization. In Austria the training of speech therapists since 2006 is now possible only to the colleges and thus raised to university level.

Professional associations

There are in the Federal Republic of Germany several associations:

• Active professional association speech therapy speech therapy ( ABLS ) eV based in Cologne ( 2011). He represents all funds approvable speech, voice, speech, language, swallowing and respiratory therapists.

• German -speaking Society for speech and voice medicine ( DGSS ), the interdisciplinary various professionals ( speech and language sciences, medicine, music, science, speech therapy, education, psychology ) has as members. It represents scientific, diagnostic and therapeutic issues as " umbrella organization ".

• German Federal Association of academic language therapist ( dbs ) eV based in Moers (2007), which represents the speech therapy educators, clinical linguists, speech scientists and Clinical Patholinguisten.

• German Federal Association of respiratory, speech and voice teacher / inside - Teachers Association Schlaffhorst -Andersen ( dba) eV based in Hamburg.

• German Federal Association for Speech Therapy ( dbl ) eV based in Frechen (2007). This represents around 12,000 (as of 2013) employed speech therapists in hospitals, specialists and rehabilitation clinics, medical and speech therapy clinics and special facilities for the hearing - and speech-impaired children, speech therapists in early intervention area health authorities and special schools for the hearing - and speech-impaired children, qualified speech therapists from teaching, science and research, as well as the professional speech therapist in private practice in group practices and in interdisciplinary partnership companies.

In Switzerland, you do not know the distinction between a speech therapist and speech Heilpädagogin. The job description of the Swiss speech therapist is roughly equivalent to that of the German-speaking remedial teacher. The original terms " speech therapists / speech therapy educator " were replaced with the creation of the first Switzerland -wide professional association, the Swiss professional association for speech therapy, SBL ( 1978), definitely by speech therapist / speech therapist. The speech therapists are professionally settled in special education. The study includes the specialized medical, psychological and socio-legal components in addition to the special education.

• Swiss German speech therapists and speech therapists Federation (DLV ), headquartered in Zurich (2007). He sees himself as an independent umbrella organization of the German Swiss professional organizations of speech and represents this as well as their members. At national level, the DLV partner is the conference of the Swiss professional organizations of speech therapists (K / SBL). The DLV is claimed to have determined, responsible and forward-looking. He stands up for the interests of both a speech therapist spoke regionally and throughout Switzerland. It represents the interests of its members in particular against the Confederation, cantons, municipalities and institutions. The DLV is keen to promote the speech therapy in the various professional fields and anchor. The DLV aims to promote speech and language therapy as a vital service in a variety of institutions and evolve. He supports its members in their professional activity and development. The DLV is committed to maintaining a comprehensive basic training and promotes continuous professional development. He participates in work-related discussions at technical and political level. Members are 15 regional German Swiss professional associations graduate speech therapists as well as the professional association of speech therapists in Liechtenstein. The individual members of the DLV member associations are also members of the DLV. The DLV has currently (2007) around 1860 members.