← 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.