Speech is a communicative skill that enables us to understand each other and to interact. It becomes a means of communication, allowing us to share ideas, beliefs, and opinions. When this process is disrupted, and the normal flow of receptive and expressive aspects of speech is compromised, a speech assessment is carried out to assess the disturbance. Disturbances of speech can come in the form of content formation (i.e., the patient has difficulty expressing the desired ideas in the form of spoken words) or of articulation (i.e., the patient can express their ideas in spoken form but has one or more problems physically producing the sounds necessary for intelligible speech). A speech assessment, together with a formal neurological evaluation, can identify specific speech problems or patterns of speech problems, as well as propose solutions. Speech assessment is a method to evaluate and diagnose problems in adults and children of speaking, swallowing, comprehension, and writing. Such evaluation may be warranted due to neurological diseases, stroke, trauma, injury, tumors, cerebral palsy, cleft palate, orofacial musculature, hearing impairment, stammering, articulation errors, motor speech disorders, and many other conditions. Formal speech assessment is performed by a trained speech and language pathologist, and begins with a consultation in the office with the patient and potentially with family members. Reviews of prior records and treatment will be conducted, and formal characterization of receptive and expressive speech will be conducted, including articulation, fluency, content, and clarity of speech, and potentially evaluate breathing and swallowing. Objective testing such as video stroboscopy, nasometry, or rhinomanometry may be obtained, depending on the specific disorder under investigation.
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