Key points

  • Speech and language therapy services for people with respiratory care needs are provided within an integrated, multidisciplinary context
  • All people with idiopathic or refractory chronic cough and inducible laryngeal obstruction (vocal cord dysfunction) should have access to an appropriate respiratory speech and language therapy service
  • Services can engage in evolving the respiratory speech and language therapy role, through continuous appraisal of service provision and skill mix

Role of speech and language therapy in adult respiratory care

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Speech and language therapists are specialists in the assessment, diagnosis and treatment of upper airway disorders. These include inducible laryngeal obstruction (e.g. vocal cord dysfunction), chronic cough and heightened laryngeal sensitivity. Specialised speech and language therapy has been proved to be beneficial for people with these conditions.

Chronic cough

The aim of the treatment is to increase awareness of cough control and reduce the irritation that triggers coughing. Therapy sessions include giving techniques to voluntarily control cough and reduce irritations in the throat.

A speech and language therapist will take a detailed case history, as this is essential to diagnosis and getting a clear description of symptoms from the patient is key.

The components of the successful treatment programme include:

  • Education about the cough
  • Psycho-educational counselling
  • Strategies to control cough
  • Upper airway health training to reduce laryngeal irritation

It is vital therapy does not commence until a patient has been seen and diagnosed with a chronic cough by a respiratory physician.

Inducible Laryngeal Obstruction (vocal cord dysfunction)

The potential irregularity and inconsistency of VCD attacks mean that a detailed case history is essential to diagnosis and getting a clear description of symptoms from the patient is key.

Therapy teaches patients to relax the upper airway and control the laryngeal area utilising techniques commonly used in voice therapy. The emphasis should be on readily identifying and reducing excessive tension associated with respiration, during a variety of activities and in a variety of settings.

By learning to detect increased tension, the patient can implement easier breathing behaviours before an acute VCD attack occurs. This empowers a patient to gain laryngeal airway control.

Speech and language therapy in adult Respiratory Support Units

Following guidance developed by The British Thoracic Society (BTS) and Intensive Care Society (ICS) the RCSLT have developed a position statement, to highlight the role that SLTs play in adult Respiratory Support Units (RSUs).

The statement also provides guidance for multiprofessional colleagues and service managers.

This guidance is intended for patients aged 18 or older who are being treated in an RSU or who would qualify under the criteria as an acute respiratory patient.

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