← Rehabilitation


inpatient rehab main line
(307) 755-4728

Seven days a week

8:00am – 5:00pm

outpatient rehab main line
(307) 755-4730

Monday – Friday except holidays

8:00am – 5:00pm by appointment only

This Inpa­tient and Out­pa­tient based health ser­vice eval­u­ates, treats, and works to pre­vent many med­ical con­di­tions relat­ed to a per­son­’s abil­i­ty to speak. 


Cog­ni­tive Com­mu­ni­ca­tion Impair­ments
Cog­ni­tive Com­mu­ni­ca­tion impair­ments include any changes in com­mu­ni­ca­tion that are caused by the dis­rup­tion of think­ing abil­i­ty. These changes may include word find­ing dif­fi­cul­ty, mem­o­ry changes, atten­tion issues, and exec­u­tive func­tions such as prob­lem solv­ing, plan­ning, and orga­ni­za­tion. Severe changes may occur includ­ing a total loss of speech and lan­guage. Caus­es of cog­ni­tive impair­ment include con­cus­sions, strokes, trau­mat­ic brain injury (TBI) , anox­ic brain injury, tumors, the nat­ur­al aging process, degen­er­a­tive dis­eases, and neu­ro­log­i­cal changes. These changes can have a sig­nif­i­cant impact on activ­i­ties of dai­ly liv­ing includ­ing work, school, rela­tion­ships and social sit­u­a­tions. Diag­no­sis and treat­ment of these changes are tai­lored to the indi­vid­ual.

Swal­low­ing Prob­lems (Dys­pha­gia)
Swal­low­ing prob­lems (Dys­pha­gia) include any com­plaints or issues with han­dling and mov­ing foods and or liq­uids from the mouth and trav­el­ling to the stom­ach. Com­mon swal­low­ing com­plaints include: feel­ing like food gets stuck’; cough­ing before, dur­ing, or after drink­ing or eat­ing; chok­ing; fre­quent res­pi­ra­to­ry infec­tions includ­ing pneu­mo­nia; wet sound­ing vocal qual­i­ty; avoid­ing cer­tain foods that used to be enjoyed; tak­ing longer to eat; weight loss; throw­ing up after eat­ing. If you have any of these issues and they are new, unex­plained, or are get­ting worse please see your reg­u­lar physi­cian. If war­rant­ed, a refer­ral will be made to our Speech Lan­guage Pathol­o­gist or anoth­er spe­cial­ist to eval­u­ate your swal­low.
There are two gen­er­al types of swal­low­ing eval­u­a­tions per­formed by our Speech Lan­guage Pathol­o­gist: a Clin­i­cal Swal­low­ing Eval­u­a­tion and a Mod­i­fied Bar­i­um Swal­low Eval­u­a­tion.

Clin­ic Swal­low­ing Eval­u­a­tion
Clin­i­cal swal­low­ing eval­u­a­tions usu­al­ly take place in the out­pa­tient reha­bil­i­ta­tion clin­ic. This eval­u­a­tion includes a his­to­ry, inter­view, and con­sul­ta­tion with a Speech Lan­guage Pathol­o­gist, as well as an oral-motor exam­i­na­tion and swal­low­ing tri­als, if appro­pri­ate. The swal­low­ing tri­als may include eval­u­a­tion of a vari­ety of liq­uids and foods such as ice chips, water, juice, apple­sauce, pud­ding, canned fruit, crack­ers, and bread. If you have a par­tic­u­lar food that you have dif­fi­cul­ty swal­low­ing, it is rec­om­mend­ed that you bring a small amount of this food to your appoint­ment to be includ­ed in the swal­low­ing eval­u­a­tion. The results of the clin­i­cal eval­u­a­tion, a plan of care, and rec­om­men­da­tions from the Speech Lan­guage Pathol­o­gist for fol­low-up will be dis­cussed. This eval­u­a­tion is con­duct­ed pri­or to sched­ul­ing a Mod­i­fied Bar­i­um Swal­low Eval­u­a­tion. You should allow 60 – 90 min­utes for this eval­u­a­tion.

Mod­i­fied Bar­i­um Swal­low Eval­u­a­tion
Mod­i­fied Bar­i­um Swal­low Eval­u­a­tions take place in the X‑Ray depart­ment. This study uses video flu­o­ro­scop­ic imaging‑a con­tin­u­ous video image- and is con­duct­ed by both the Radi­ol­o­gist and the Speech Lan­guage Pathol­o­gist. Your vis­it will include a med­ical his­to­ry, inter­view, con­sul­ta­tion with a Speech Pathol­o­gist, and vide­o­flu­o­ro­scop­ic exam­i­na­tion of your swal­low­ing. You will be sit­ting or stand­ing and giv­en a vari­ety of foods and liq­uids mixed with bar­i­um. Dur­ing the exam the patient swal­lows liq­uids and foods marked with bar­i­um. These are mon­i­tored as they move through the mouth and into the phar­ynx and down into the esoph­a­gus. If you have a par­tic­u­lar food that you have dif­fi­cul­ty swal­low­ing, it is rec­om­mend­ed that you bring a small amount of this food to your appoint­ment. Please allow 60 – 90 min­utes for this eval­u­a­tion.

Dys­pha­gia Treat­ment
Dys­pha­gia treat­ment is tai­lored to the indi­vid­ual needs of the patient. The goal of treat­ment is to make the swal­low as safe and effec­tive as pos­si­ble. Exer­cis­es designed to increase the range of motion; speed and strength of the mus­cles involved in swal­low­ing may be imple­ment­ed in ther­a­py ses­sions and incor­po­rat­ed into a home exer­cise pro­gram.

Treat­ment after Head and Neck Can­cer
Speech and swal­low­ing ther­a­py may be nec­es­sary to resume an oral diet after treat­ment for head or neck can­cer. Strength­en­ing and range-of motion exer­cis­es may be help­ful to regain full use of the mus­cles of the mouth and throat which have been affect­ed by the can­cer treat­ment. Some indi­vid­u­als with laryn­geal can­cer may require reha­bil­i­ta­tion of the voice or, when the laryn­geal can­cer has been exten­sive, assis­tance in devel­op­ing a dif­fer­ent method of com­mu­ni­ca­tion such as after laryn­gec­to­my (removal of the lar­ynx).

Voice or Speech Changes
Voice changes include hoarse­ness or poor vocal qual­i­ty, tired­ness, effort­ful voic­ing, weak or qui­et voice. The pri­ma­ry goal of voice ther­a­py is to achieve the best pos­si­ble voice with the least amount of effort. Voice ther­a­py ses­sions may include edu­ca­tion about how the voice works, how to take care of your voice (vocal hygiene), exer­cis­es to strength­en your voice, find­ing spe­cif­ic vocal tech­niques that will improve the vocal qual­i­ty.
Speech (artic­u­la­tion) may change after a stroke, injury, or oth­er inci­dent that affects the brain’s func­tion or how the artic­u­la­tors (jaw, lips, tongue, etc.) work to form sounds. Ther­a­py will work towards improv­ing the clar­i­ty and under­stand­abil­i­ty of the affect­ed speech.

Spe­cial­ty Ser­vices for Voice
Our Speech Lan­guage Pathol­o­gist is cer­ti­fied to offer the Lee Sil­ver­man Voice Treat­ment (LSVT® LOUD), a treat­ment for speech dis­or­ders relat­ed to Parkin­son’s and oth­er neu­ro­log­i­cal dis­eases. Left untreat­ed, per­sons with Parkin­son’s dis­ease will grad­u­al­ly lose vocal vol­ume and intel­li­gi­bil­i­ty. With these changes the abil­i­ty to com­mu­ni­cate with friends and fam­i­ly, con­tin­ue careers, and par­tic­i­pate in com­mu­ni­ty pro­gres­sive­ly dimin­ish­es. This inter­ven­tion uti­lizes high res­pi­ra­to­ry (breath­ing) and phona­to­ry (sound pro­duc­tion) effort to improve voice and speech func­tion with­out pro­mot­ing hyper­func­tion (overuse or strain). Research shows 90% of patients who com­plet­ed the LSVT® LOUD improved vocal ampli­tude (vol­ume) from pre to post-treat­ment.

Aug­men­ta­tive and Alter­na­tive Com­mu­ni­ca­tion AAC
When a per­son­’s abil­i­ty to com­mu­ni­cate ver­bal­ly is lim­it­ed, an alter­na­tive form of com­mu­ni­ca­tion can help the per­son main­tain their com­mu­ni­ca­tion in rela­tion­ships, in their employ­ment, and with­in their com­mu­ni­ty. Lim­i­ta­tions on ver­bal com­mu­ni­ca­tion may be life-long or they may devel­op with pro­gres­sive dis­eases, or as a result of injuries. We pro­vide eval­u­a­tion for the use of AAC, devel­op­ment and train­ing of low tech AAC, and tri­al­ing, obtain­ing, train­ing, and sup­port on high-tech AAC devices.