Has aphasia therapy been swallowed up?

Objective: To review the change in number of referrals to speech and language therapy for dysphasia and dysphagia over one decade.

Design: This retrospective study analyses data collected on an information system developed specifically for the use of speech and language therapists in the management of their services.

Setting: Eleven health care providers used the system between 1985 and 1995 and recorded details of 73758 patients referred to speech and language therapy during that period.

Results: Whilst there were 12 times as many dysphasic patients as dysphagic patients referred to speech and language therapy in 1987, the position was reversed by 1995 with twice as many dysphagic as dysphasic patients being referred to these services. Dysphagia in 1987 accounted for less than 1% of the referrals to speech and language therapy. This percentage increased, until in 1995 20% of referrals were for dysphagia.

Conclusion: No causal relationship between the changes in referral to speech and language therapy for these two groups has been established in this study. However, there has been a significant increase in referral to speech and language therapy of people with dysphagia. Whilst referrals for dysphasia have increased, they represent a lower percentage increase and now receive less treatment per case than in 1987.