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The 4 Speech Therapy Treatment Routes

You’ve assessed your adult speech therapy patient, you made a solid plan of care, and now it’s time to treat!

But with all the complexity and options out there, how do you even know where to begin?

In this post, you’ll learn the 4 speech therapy treatment routes for every speech therapy patient. Use it as a guide for a strong start to your treatment journey!

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The 4 Speech Therapy Treatment Routes

speech therapy treatment options

Whenever possible, treat the underlying cause of whatever brought your patient to speech therapy.

When you treat the source of their problem—versus just the signs and symptoms—patients are more likely to make functional and lasting changes.

So once you’ve identified the underlying cause, where do you being?

Thankfully, when starting treatment with your adult speech therapy patient, there are only 4 routes to choose from!

  • Route 1: Treat Now. Treat the underlying cause now

  • Route 2: Treat Later. Treat the underlying cause later

  • Route 3: Compensate. Don’t treat the underlying cause but teach compensations instead

  • Route 4: Refer Out. Don’t treat the underlying cause and refer out instead

Each of these routes is perfectly valid. The path you choose will depend on your patient’s unique wants and needs and what you have available to you as a clinician.

Ready to delve deeper into the 4 treatment routes? Keep scrolling!

Route 1: Treat Now

adult speech therapy treatment options

Your first option is to treat the underlying cause now.

Start by asking yourself: What is the underlying cause of my patient’s disorder? If:

  1. It’s something that you, the SLP, can treat and
  2. The patient is ready for treatment now, then go with Route 1!!

Let’s look at a couple of adult speech therapy treatment examples.

“Treat Now” Example: Dysphagia

Underlying Cause of Dysphagia: Muscle weakness due to a stroke

Can You Treat It? Yes!

Can You Treat It Now? Yes!

Treatment Ideas: Swallowing-muscles strengthening exercises

Read our Swallowing Exercises post or check out our Youtube channel for step-by-step dysphagia treatment help!

“Treat Now” Example: Attention

Underlying Cause of Inattention: Divided attention deficit due to mild cognitive impairment

Can You Treat It? Yes!

Can You Treat It Now? Yes!

Treatment Ideas: Treat using functional tasks that require divided attention, like taking notes in real-time or having a conversation while doing another task.

Read Attention Activities for Adults for more treatment ideas.

Route 2: Treat Later

treatment options AAC speech therapy

Some underlying causes will be too acute or the patient won’t otherwise be ready for treatment right away, so you’ll need to wait until they can safely and successfully work on it.

Choose to treat the underlying cause later if:

  1. It’s something that you as an SLP can treat and
  2. It needs to be treated later

“Treat Later” Example: Dysphagia

Underlying Cause of Dysphagia: Esophageal inflammation due to trauma

Can You Treat It? Yes

Can You Treat It Now? Not yet

Treatment Ideas Until They’re Ready: Thinner consistencies and liquid wash

Check out the Dysphagia Pack for EP handouts and treatment guides.

“Treat Later” Example: AAC

Underlying Cause of Disorder: Unable to voice using a speaking valve in their trach

Can You Treat It? Yes

Can You Treat It Now? Not yet

Treatment Ideas Until They’re Ready: Work with a physician and respiratory therapist, do speech trials, introduce a simple needs board

Route 3: Compensate

compensatory treatment options speech therapy

Some underlying causes of our patient’s disorders are permanent or even progressive. Examples are ALS, a permanent trach, and Parkinson’s disease.

Choose compensatory strategies if the underlying cause:

  1. Is something that an SLP can’t directly treat and
  2. You can still help improve their safety and quality of life

“Compensate” Example: Dysphagia

Underlying Cause of Dysphagia: Muscle rigidity due to advanced Parkinson’s disease

Can You Treat It? No

Can You Improve Safety & Quality of Life? Yes!

Compensatory Treatment Ideas: Put the patient on a softer diet and introduce compensatory strategies. Refer to a physician and dietician for eventual feeding tube placement.

Read Swallowing Exercises & Compensatory Strategies for more treatment ideas.

“Compensate” Example: Memory

Underlying Causes of Memory Deficit: Severe memory deficit due to dementia

Can You Treat It? No

Can You Improve Safety & Quality of Life? Yes!

Compensatory Treatment Ideas: Memory book for orientation, environmental modifications, caregiver education

Read Speech Therapy Memory Activities for Adults

Route 4: Refer Out

when to refer out slp

There are some underlying causes that an SLPs can’t treat—but a different specialist can help right now.

A referral may be appropriate for any of the 3 treatment routes above. But let’s go over when the best immediate action is a referral to a different discipline:

  1. You can’t treat the underlying disorder and
  2. Another discipline can treat it now

“Refer Out” Example: Voice

Underlying Causes of Voice Disorder: Unmanaged laryngopharyngeal reflux (LPR)

Can You Treat It? No

Can Another Discipline Treat It Now? Yes!

Who To Refer Out To: An otolaryngologist or gastroenterologist

Read Voice Treatment Ideas for more on treating and referring out patients with voice disorders

“Refer Out” Example: Resonance

Underlying Causes of Disorder: Hypernasality due to velopharyngeal insufficiency

Can You Treat It? No

Can Another Discipline Treat It Now? Yes!

Who To Refer Out To: Otolaryngologist or a qualified prosthodontist, dentist, or plastic surgeon

Read our Resonance Treatment Guide for more on treating and referring out patients with resonance disorders

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