ABSTRACT
The child patient is generally referred to the speech therapy department because of speech symptoms that reveal some deficiency. The adult patient more frequently comes to the speech therapist as the result of a change of state concerning his physical or psychological condition. The speech assessment must be based upon full comprehension of the factors that have brought about the change whether physical or psychological and it is carried out with a view to establishing a treatment-principle. The patient usually comes to the speech clinic, not as the result of a recently acquired disorder, nor of any discomfort or distress of his own about his speech performance, but because other people find him difficult to understand and think it necessary that he should improve. The patient, eighteen years of age, was referred to the speech therapist from the E.N.T. department.
