Speech therapy helps adults who have trouble speaking, understanding language, using their voice or swallowing. A speech pathologist assesses what’s causing the difficulty and then works on exercises, strategies and tools that make everyday communication and eating easier and safer. It can help after a stroke or brain injury, with progressive conditions like Parkinson’s disease, and with lifelong disabilities such as autism or intellectual disability.
In Australia, speech therapists are usually called speech pathologists. Most belong to Speech Pathology Australia, the national professional body.
What can speech therapy help adults with?
According to healthdirect, speech pathologists treat problems with speaking, voice, listening, understanding language, reading and writing, social communication, stuttering and swallowing. In adults, these problems often come from:
- Stroke or other acquired brain injury
- Progressive neurological conditions, such as Parkinson’s disease, multiple sclerosis, motor neurone disease and dementia
- Head and neck cancer, or surgery to the mouth or throat
- Voice problems caused by overuse, vocal cord nodules or other conditions
- Stuttering that continues into adulthood
- Lifelong disabilities, such as cerebral palsy, autism and intellectual disability
- Hearing loss that affects how clearly someone speaks
What are aphasia, dysarthria and apraxia?
These three terms come up often in adult speech therapy, especially after a stroke or brain injury. They describe different problems, and each needs a different approach:
- Aphasia is difficulty with language itself, such as finding words, understanding what others say, reading or writing, even though thinking and intelligence are unaffected
- Dysarthria is slurred, slow or quiet speech caused by weakness in the muscles used for speaking
- Apraxia of speech is difficulty planning the movements needed to say words, so a person knows what they want to say but their mouth doesn’t cooperate
Someone can have more than one of these at the same time. For example, a stroke might cause both aphasia and dysarthria.
How does speech therapy help with swallowing?
Swallowing difficulty, called dysphagia, is common after stroke and in conditions like Parkinson’s disease and dementia. It can cause coughing or choking at meals, and food or drink going into the lungs, which can lead to pneumonia.
A speech pathologist assesses how a person swallows and recommends ways to make eating and drinking safer. That might include exercises to strengthen the swallowing muscles, changes to posture while eating, or a change in food and drink texture, such as soft foods or thickened drinks. They also train family members and support workers so mealtimes stay safe every day.
What happens in adult speech therapy?
The first appointment usually involves questions about health, daily life and what the person finds hardest, followed by some simple tests of speaking, understanding or swallowing. From there, the speech pathologist and the person agree on goals that matter in real life, such as ordering a coffee, talking on the phone, following a conversation at a family dinner or eating a meal without coughing.
Therapy might include practising words and sentences, strengthening exercises for the lips, tongue and voice, strategies for getting a message across when words won’t come, and practice in real situations. Sessions can happen one-on-one, in groups, by telehealth, at a clinic, in hospital or at home.
For people who can’t rely on speech, a speech pathologist can set up augmentative and alternative communication (AAC), such as a communication board, a speech-generating app or a dedicated device. AAC gives a person a way to be understood straight away while other skills develop.
Can speech therapy help autistic adults and adults with intellectual disability?
Yes. For autistic adults and adults with intellectual disability, speech therapy usually focuses on functional communication: making choices, asking for help, expressing feelings, understanding instructions and taking part in conversations at home, at work or in the community. It isn’t about making someone sound or act like everyone else.
Communication and behaviour are closely linked. When an adult can’t easily say they’re in pain, overwhelmed or don’t want to do something, that message can come out as shouting, hitting or leaving the room. Giving the person a reliable way to communicate, whether through speech, signs, pictures or a device, often reduces this kind of behaviour. Positive Behaviour Support works on the same idea, looking at what a behaviour is communicating and teaching safer ways to meet that need, and it works best alongside speech pathology.
Autistic adults at every ASD support level can benefit, from people who speak fluently but find social conversation exhausting to people who communicate mainly without speech.
How can adults access speech therapy in Australia?
Adults don’t need a referral to see a private speech pathologist, but a referral can unlock funding. The main options are:
- Public hospitals and community health services, which are usually free and often prioritise people after stroke, brain injury or with swallowing problems
- Medicare, through a GP chronic condition management plan, which gives rebates for up to five allied health sessions a year across all eligible professions
- Private health insurance extras cover, depending on the policy
- The NDIS, for participants with speech pathology funded in their plan
Under the NDIS, speech pathology is usually funded from Capacity Building supports. For NDIA-managed and plan-managed participants, the current NDIS price limit for a speech pathologist is $193.99 an hour.
To find a speech pathologist, Speech Pathology Australia has a searchable directory. It’s worth asking about fees, experience with the person’s condition, and whether home visits or telehealth are available before booking.
This article is general information about speech therapy for adults. It isn’t a medical assessment. If you notice sudden changes in speech, such as slurred words, trouble finding words or a drooping face, call 000 immediately, as these can be signs of a stroke.
Communication and behaviour support for adults
When communication is hard, behaviour often carries the message, and Helping Hands Behaviour Support (HHBS) helps adults and their support teams understand what that message is. We’re an NDIS-registered provider of Positive Behaviour Support, ABA therapy and early childhood intervention, working with adults and children at home or at school, alongside their speech pathologists. NDIA-managed, plan-managed and self-managed plans are all welcome.
If you or someone you support has NDIS funding for behaviour support or therapy, call HHBS on 0406 920 296 or send an enquiry to talk about building better ways to communicate. Support coordinators working with an adult participant whose communication difficulties are affecting daily life are welcome to refer them online, and our team will be in touch.
