Massage Therapy Journal Fall 2024

60 • Massage Therapy Journal

AMTA Continuing Education

example of a 5-point pressure scale ranging from very light to very deep. • 1 – Very light to no pressure • 2 – Light pressure • 3 – Medium or moderate pressure • 4 – Deep or strong pressure • 5 – Very deep or uncomfortable pressure • Avoid moving your hands close to the ears if the client is wearing hearing aids. • Objects near these devices may produce an uncomfortable squealing noise or feedback. • If a client has a bone conduction hearing aid, be careful when massaging around the apparatus. The skin around the surgery may be sensitive to touch. It is best to obtain permission before palpating that area and may be best to avoid it all together. • Let the client know when the massage session is complete instead of leaving the room unannounced. This is true for any client. Working With Clients With Speech Impairment A speech impairment is a reduction in the ability to produce speech sounds needed to communicate with others. Sometimes, the term speech impediment is used instead of speech impairment. However, a speech impairment may include problems with one or a combination of the following: • Articulation disorder is characterized by omissions or distortions of specific speech sounds, sometimes called a lisp. • Fluency disorder is an atypical flow, rhythm and repetition of speech sounds. The most common type of disfluency is stuttering. 63 • Phonology disorder is difficulty in organizing patterns of speech sounds, causing errors in how word sounds are vocalized. • Voice disorder is the inability to speak clearly due to abnormal pitch, volume, resonance, vocal quality or duration. Examples are hoarseness or a voice that sounds raspy, weak or breathy sometimes due to polyps on the vocal cords or a paralyzed vocal cord. Speech disorders are different from language disorders. A speech disorder means a person has

trouble producing certain sounds accurately. A language disorder means a person has difficulty understanding the meaning of language—trouble understanding what was said, called receptive language , or communicating their thoughts and ideas to others, called expressive language . 64 There are several causes of speech impairments that include: • Loss of hearing. • Neurological conditions, such as cerebral palsy, muscular dystrophy or autism. • Neurological trauma to the brain, including stroke. • Degenerative diseases, such as Parkinson’s disease, Lou Gehrig’s disease (amyotrophic lateral sclerosis), or Alzheimer’s disease. • Cancerous diseases or polyps that affect the mouth or throat. Other causes of speech impairments are physical abnormalities such as cleft lip, cleft palate or a short frenulum (tissue fold under the tongue). Others include damage to the vocal cords from excessive screaming, singing, excessive throat clearing, smoking or stomach acids from digestive conditions such as gastroesophageal reflux disease or GERD. Other causes are a genetic condition such as Down syndrome, preterm birth and traumatic life events. Speech impairment can profoundly affect a person’s life, from their self-esteem to a reduced overall quality of life to feelings of frustration, anger, depression and isolation. An estimated five to 10 percent of individuals in the United States have speech impairments. That is approximately 18.5 million people. About three million adults struggle with stuttering alone. 65,66 Assistive Technologies for Clients with Speech Impairments People with severe speech impairments may use various augmentative and alternative communication (AAC) methods instead of talking. Augmentative means something added to speech and alternative means something used in place of speech. Examples of AACs are writing or drawing on paper, a white board, or an electronic device such as a teletypewriter or a

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