inpatient rehab main line
Seven days a week
8:00am – 5:00pm
outpatient rehab main line
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 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.