The pathology of speech and language is a field of experience practiced by a doctor known as speech therapist and linguist, sometimes called speech language pathologist or speech therapist. 

The SLP specializes in the assessment, diagnosis and treatment of communication disorders (speech and language disorders, cognitive communication disorders, voice disorders and swallowing disorders). SLP also play an important role in the diagnosis and treatment of autism spectrum disorders (often in a team with pediatricians and psychologists) [1].

The pathology of speech as a recognized field of study had its origins in the early part of the 20th century. From 1945 to 1965, the pathology of speech and language began to evolve. Between 1965 and 1975, linguistic advances prompted researchers to begin to distinguish language disorders from language disorders. Today, the pathology of speech and language continues to evolve as the evidence of high quality research is integrated into professional experience and clinical decision making. The increase in national and international exchange of professionals knowledge [2]. A common misunderstanding is that the pathology of language and language is limited to regulating the articulation of a speaker's vocal sound to satisfy the normal expected pronunciation [3]. Speech language pathologist and speech   therapist   manage   language  disorders,   speech disorders, voice disorders and dysphagia [4]. The components of speech are: Phonation, Resonance, Fluency, Intonation, Pitch, and Voice. The components of language are:

• Phonology

• Morphology

• Syntax

• Semantics

• Pragmatics [5]

Primary pediatric disorders include Speech sound disorders, sensorimotor disorders, Apraxia of speech, Stuttering, Learning based disabilities, Dysphagia. Speech and language pathologist not only work with the adolescent’s speech and language disorders but also with the older [6]. Speech sound disorders involve difficulty in producing specific speech sounds. Articulation disorders are characterized by difficulty learning to produce sounds physically [7]. Voice disorders are impairments, often physical, that involve the function of the larynx or vocal resonance [8]. Language disorders or language impairments involve impairment in exchange of information to others. Language disorder or language impairment involves receptive language, expressive language or both. Language disorder includes Aphasia, learning disabilities and even Sign language typically, all forms of language will be compromised [9]. 

Language disorders tend to manifest themselves in two different ways disorders of receptive language where language is not understood correctly and disorders of expressive language in which the desired message cannot be adequately communicated [10].         

Treatment options include: language therapy, special education classes for children at school and a psychologist, if behavioral problems go with it [11].  Speech language disorders are treated by the speech pathologist and the audiologist [12]. Swallowing disorder includes difficulty in any swallowing system, i.e. oral, pharyngeal, esophageal, as well as functional dysphagia and feeding problems. It can occur at any age and can be due to multiple causes.

The speech therapist [13] offers a wide range of services, mainly on an individual basis, but also as a support for individuals, families, support groups and to provide information to the general public [14]. SLPs work to prevent, evaluate, diagnose and treat speech, social communication, cognitive communication and swallowing disorders in children and adults. Voice services begin with the initial assessment of swallowing and communication disorders and continue with assessment and diagnosis, counseling to provide advice on management, intervention and treatment, counseling and other services. follow-up for these disorders [15]. 

The areas in which the speech pathologist provides services are the cognitive aspects of communication, language disorders, language disorders, problems with swallowing,         speech        disorders,      etc         [16]. 

SLPs work with healthcare professionals as a multidisciplinary team, exchanging information and references to audiologists, doctors, neonatology specialists, dentists, nurses, nurses, health professionals, occupational therapists, dieticians, educators, behavioral consultants (behavior analysis applied) [17]. In 2014 a probe was conducted by Mahmoud, Hana and Aljazi, Aya and Alkhamra, Rana capital of Jordan. The aim of this study was to analyze the extent of public awareness regarding the speech and language pathology and information regarding the communication disorders. The study was dispensed through inquirer that was distributed to 1203 participants. They complete that awareness and information was restricted in Amman-Jordan. Participant which has females WHO have kids or bachelor’s degree in medical field have information and awareness regarding speech and language pathology. Moreover, results indicated lack of familiarity with differing types of communication disorders apart from inarticulate [18]. In 2016 Shemjazz and Arrakal to work out the notice and information of physiatrics in medical internees. The aim of this was to guage the notice and information regarding the physiotherapy among the medical internees. solely forty five of medical interns had awareness and forty two had information regarding physiotherapy [19].  The aim of this is to give awareness of speech language pathology/speech therapy to the medical students as speech therapy is emerging field in the medical fields so professionals have knowledge about speech therapy as patients with speech, language and swallowing issues will be referred to speech therapist for proper assessment, diagnosis and treatment.

A cross-sectional study was designed to evaluate the awareness of speech and language pathology/speech therapy among the final year students of MBBS through purposive sampling technique.155 students of final year MBBS were included in this study that was doing internships and externship in different hospitals. Most of them were in OPD’s where they assess and diagnose different patients with different diseases. An inclusion criterion includes the students of final year MBBS, Exclusion criteria includes students of Allied Health Sciences, 3rd and 4th year students of MBBS, BDS and nursing students. The data were analyzed through SPSS version 21.0 and pressed through Frequencies and Percentages. A self-structured questioner with 24 items was given to the participants and All the data were primary. and presented through frequencies and percentages. Data was collected from two different medical colleges including Allama Iqbal Medical College and the university college of Medicine and Dentistry. The study duration was 6 months

RESULTS

Out of 155 students 50.6% were males and 49.4% were females, number of students who met speech therapist were 20.8%   and 79.2%   not met  any  speech   therapist, 49.4% know about the treatments given by the speech therapist and 50.6% don’t know, 31.2% marked yes and 68.8% marked no about the modalities used by speech therapist, 7.8% marked yes and 92.2% marked NO about the problems treated by speech therapist, on a question about the effectiveness of speech therapy in community based rehabilitation 85.7% were YES 6.5% NO and 7.8% don’t    know    about  it as   shown  in table 1 and table 2.

Table 1: Demographics

Table 2: Know About the Speech Therapy

Table 3: Knowledge About Speech Therapy

It was concluded from the study that the Awareness and knowledge of speech language pathology/speech therapy among the MBBS students is limited due to unawareness of role of speech therapy in the community-based rehabilitation and diagnosis and treatment of disorders associated with speech language pathology/ speech therapy because as it is a growing domain in medical field of Pakistan. It was also concluded that the lack of awareness might be due to the awareness programs in medical colleges and also in public. Thereby there is a need of educating medical students about speech language pathology/speech therapy for better patient care.

The aim of the study was to find out the Awareness and knowledge of speech language pathology/speech therapy among the final year students of MBBS. The study shows that there is a need to give proper awareness and knowledge about speech language pathology/speech therapy to the medical students. The results indicates that out of 155 students 50.6% were males and 49.4% were females, the number of students who have a knowledge about the modalities of speech therapy were 31.2%, the final year students of MBBS who know about the treatment given by speech therapist in speech therapy was 49.4%, the number of students of final year MBBS who met any Speech language pathologist or speech therapist in their clinical rotation or in internship was 20.8%. The percentage of students who think there is a role of Speech language pathology/speech therapy in community based rehabilitation were 85.7%, In 2016 a pilot study was conducted by Arakkal Maniyat Shemjaz and Memman Hussain Saddam on the Awareness of Physical Therapy among the medical internies and the same items were assessed of physical therapy by medical internees  as by speech therapist and the  results were 30% modalities, the role of physical therapy in rehabilitation is 86% [19]. The number of sudents who marked Good to speech therapy professions was 46% and other marked 20.8% excellent, 19.5% marked very good, 13.0% marked not good to the speech profession. 39% have no source of information about the speech therapy, 57.1% thinks that speech therapist work in hospital settings. 41.9%  of final year students knows that the condition treated by speech therapist is voice disorder [18] awareness among the final year students about the treatments of disorders by speech therapist are stammering that was 24.7% [20]. But a study was conducted in 2007 in primary school of autralia about the prevelance of stammering, voice disorders and speech disorders by MCkinnen DH and MC Leod and  the results were the 57%. The voice disorders is 41.6% but the study that was conducted U.S in 2004 by RoyN, Merill RM about the prevelance of voice disorders in tearchers and general population it was 57.7% [21], speech disorders are 23.4% but in 1997 a study was conducted by Bruce Tomblin, Records NL, Buckwalter P, about the language impairements in kindergarten students it was 29% [22] and in Japan in 2004 by Fuji Moto K,dysphagic prevalence was 16% but in Pakistan it is 10.4% [23].

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