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Speech and Language Pathology

Speech and Language Pathology

At Sky Lakes Outpatient Rehabilitation Services, physical therapy, occupational therapy and speech therapy are available in one place.

Our board certified Speech-Language Pathologists help individuals of all ages improve quality of life by maximizing their communication potential. Our SLPs work in collaboration with other members of your rehabilitation team, which may include physical therapists, occupational therapists, physicians, neuropsychologists, and dieticians, to tailor your therapy to your individual needs. We help you and your family members formulate goals for progress, and we develop a plan of care to help you attain your functional goals.

We provide assessment and treatment for the following conditions:

What is Aphasia?
Aphasia is an acquired language disorder that can affect ability to speak, read, write, and understand language. Aphasia can be mild or severe. People may have significant word finding difficulty and may use non-words or real words that don’t make sense when put together in connected speech. Some people with aphasia may be non-verbal and may require Augmentative/Alternative Communication (see AAC section below) methods.

What can cause Aphasia?

  • Stroke
  • Traumatic Brain Injury (TBI)
  • Brain tumors or brain infections
  • Progressive Neurological Diseases

How can Speech Therapy help?
A certified Speech-Language Pathologist (SLP) will conduct a thorough assessment of your language skills. Depending on what your areas of need are, the SLP will formulate a plan of care to address your needs and help you achieve your functional goals. Therapy may include treatment designed to improve language function and/or to compensate for language deficits. Additionally, the SLP can help you implement an Augmentative/Alternative Communication (AAC) system, if necessary. The SLP will also work with your caregivers and loved ones to help them support you in communicating with others.

What is a Cognitive-Communication Disorder?
A cognitive-communication disorder can involve a number of different communication problems, including memory, attention, organization, reasoning, problem solving, safety awareness, decision making, social judgment, planning, and prioritizing. Problems can range from mild to severe. These difficulties can make it hard for a person to independently pay bills, remember appointments, stay on task at home or work, use a calendar or clock, take medications appropriately, maintain personal hygiene, read and follow instructions, complete two tasks at the same time or in succession, etc.

What can cause a Cognitive-Communication Disorder?

  • Stroke
  • Traumatic Brain Injury (TBI)
  • Progressive Neurological Disorders
  • Dementia
  • Brain tumors or brain infections

How can Speech Therapy help?
A certified speech-language pathologist will perform a thorough evaluation of your cognitive-communication skills. Based on the results of the evaluation (and the input of you and your family), the SLP will identify goals and develop a plan of care for treatment. Treatment may be designed to restore function (i.e., improve memory, attention, or other cognitive skill) and/or help you compensate for such difficulties. For example, an SLP can train you to use specific memory strategies and tools to aid your memory, even if you continue to have memory problems.

What is Dysarthria?
Dysarthria is a motor speech disorder characterized by weakness. Speech is a complex process with a lot of coordinated movements and systems involved. Dysarthria can affect one or all of the following systems: respiration (breathing), phonation (producing voice), articulation (how we formulate sounds when talking), resonance (how the sound projects or emanates out), and prosody (rhythm, rate, stress, and intonation of speech). Dysarthria can make it hard for other people to understand you when you are talking. Dysarthria can range from mild to severe. In severe or progressive cases, Augmentative/Alternative Communication (see AAC section below) may be necessary to help a person communicate.

What can cause Dysarthria?

  • Stroke
  • Traumatic Brain Injury
  • Disorders of the Nervous System (examples: Cerebral palsy, Parkinson’s Disease, Lou Gehrig’s disease (ALS), Huntington’s Disease, or multiple sclerosis)
  • Brain tumors or infections

How can Speech Therapy help?
A certified speech-language pathologist will conduct a thorough evaluation of your speech and the systems affected. Together (with the input of you and your family), your speech therapist will develop a treatment plan tailored to meet your specific goals and needs. Therapy may include exercises to strengthen the lips, cheeks, and/or tongue; improve coordination of breathing and speech; increase the intelligibility of your speech (i.e., the ability to be understood by others); improve the way you use your voice; and help you make your sounds clearer and sharper. Therapy may also include instruction in compensatory strategies (i.e., techniques to help you compensate despite having speech difficulty, such as slowing your rate of speech, eliminating background noise, announcing the topic of conversation before talking, etc.) If necessary, a speech therapist can help you implement an AAC system.

What is Apraxia of Speech?
Apraxia is a motor speech disorder in which the brain has difficulty sending the message to your mouth about how to produce, sequence, and coordinate speech sounds. It can be difficult to get speech started, and often longer words and sentences are more difficult to produce than shorter utterances. Often speech comes more easily when it is automatic and spontaneous vs on command. A person with apraxia of speech may make many errors when attempting to produce words and may have difficulty correcting errors, despite the fact that they know the word was not correct. Errors may vary considerably and speech may seem to fluctuate from day to day or even within the same day. (For instance, a person may be able to say a word perfectly one day and not be able to say it at all the next day.) Apraxia of speech can range from mild to severe. In severe cases, Augmentative/Alternative Communication (see AAC section below) may be necessary.

What can cause Apraxia of Speech?

  • Stroke
  • Traumatic Brain Injury
  • Brain tumors and infections
  • Diseases of the nervous system
  • Developmental (from birth, in children)

How can Speech Therapy help?
A certified speech-language pathologist will conduct a thorough evaluation of your speech. Based on the evaluation results and input from you and your family, your therapist will develop a treatment plan tailored to meet your individual needs and goals. Therapy may include treatment to improve speech production (i.e., exercises to help you sequence and coordinate sounds and words) and/or instruction regarding compensatory strategies for speech (for example, slowing your rate of speech, using shorter sentences to get your point across, etc.) If necessary, your therapist can help you implement AAC strategies.

What is Dysphagia?
Dysphagia is a swallowing disorder. Dysphagia can affect any one or all of the following phases of swallowing: the oral phase of your swallow (i.e. your ability to hold foods/liquids in your mouth, chew food, move food to the back of the mouth to be swallowed, etc.); the pharyngeal phase of your swallow (i.e., the passage of food/liquid through your throat); and the esophageal phase of the swallow (i.e., when the food/liquid passes through a small sphincter at the top of the esophagus and travels down through the esophagus to your stomach.) Dysphagia can be a dangerous condition because it can lead to choking and/or aspiration pneumonia, which occurs when food/liquid travel into the airway and fall into the lungs. Dysphagia can range from mild to severe. In severe cases, an alternative method of feeding (i.e., temporary or permanent feeding tube) may be necessary.

What can cause Dysphagia?

  • Stroke
  • Traumatic brain injury
  • Head/neck cancer and chemo-radiation therapy
  • Progressive neurological diseases
  • Surgeries that impact the neck/throat
  • Uncontrolled acid reflux
  • Deconditioning/severe weakness

How can Speech Therapy help?
A certified speech-language pathologist will provide an evaluation of your swallowing. This may include: an examination of your lips, cheeks, tongue, and mouth; an interview regarding your swallowing problem; a clinical assessment in which you are observed swallowing foods and liquids of various textures; an X-ray study to observe your swallow under fluoroscopy; and/or an endoscopic swallowing assessment. After your swallowing problem has been thoroughly evaluated, your therapist will make recommendations to help you eat/drink safer, which may include diet modifications (i.e., specific textures of foods that will be easiest and safest for you to eat) and compensatory strategies (example: taking small bites and sips, alternating between bites of solid food and sips of liquid, etc.) If swallowing therapy is recommended, your therapist will develop a treatment plan tailored to address your specific swallowing impairment(s). This may include exercises designed to strengthen your swallowing muscles/structures. Your therapist may refer you to other professionals who may be able to provide assistance for your specific difficulty (i.e., a dietician, an ear/nose/throat physician, and/or a gastroenterologist.)

What is a Voice Disorder?
Dysphonia is the term for when the voice is disordered. Dysphonia may sound like hoarseness/roughness, a breathy voice, a very quiet voice, a strained/strangled voice, or a voice that cuts in and out as a person talks. The voice may feel fatigued with usage. Voice problems may be consistent (the same all the time) or they may come and go.
Voice problems are often complex and involve numerous causes/associations (see below.)

What can cause a Voice Disorder?

  • Abuses and misuses of the voice
  • Lesions on the vocal folds (can be benign or cancerous)
  • Head/neck cancer
  • Damage to the Vagus cranial nerve (often from surgery to the head/neck area)
  • Uncontrolled acid reflux
  • Allergies and post-nasal drip
  • Patterns of strain and muscle tension when speaking
  • Excessive use of the voice (often seen in professions that involve a lot of talking, like a teacher, customer service representative, minister, etc.)
  • Progressive neurological conditions (examples: Parkinson’s Disease; ALS)

How can Speech Therapy help?
A certified speech-language pathologist will conduct a thorough evaluation of your voice. Your therapist will listen to your voice (in various speech tasks, like conversation, and reading); evaluate the manner in which you use your voice; and take data regarding your voice production using a computer program. You may also undergo an assessment of your voice called Videostroboscopy, in which a camera/strobe light on the end of a rigid scope is utilized to observe the manner in which the vocal folds come together and vibrate. After your voice evaluation, your therapist will develop a treatment plan (in accordance with your goals and needs). Voice therapy involves exercises designed to improve the balance between your breathing, voicing, and resonance to train you to use your voice in the most optimal manner possible. Voice therapy also often involves instruction in vocal hygiene (lifestyle habits that promote a good voice, such as drinking a lot of water.)

What is a Fluency Disorder?
A fluency disorder is more commonly known as stuttering. A person with a fluency disorder may exhibit repetitions of sounds, prolongations of sounds (in which a sound is held out longer than normal), and/or blocks (in which a person finds it difficult to start a word or continue speaking and seems “stuck” on that word.) People who stutter sometimes develop secondary behaviors (things they do with their mouth, eyes, hands, or body) when they are in a stuttering moment (example: blinking their eyes rapidly). People who stutter may experience embarrassment and anxiety about their stuttering. Stuttering can occur in both children and adults, and sometimes people recover from stuttering without any treatment at all.

What can cause a Fluency Disorder?

  • Exact cause unknown
  • Genetics are thought to play a role

How can Speech Therapy help?
A certified speech-language pathologist will conduct a thorough evaluation of your speech, including the type, frequency, and severity of stuttering during a variety of speech tasks (including reciting things, reading, conversation, etc.) The therapist will create a treatment plan, with input from you and your family about what your specific goals are. The therapist may train you to use stuttering prevention techniques (i.e., how to anticipate and avoid stuttering) and rescue strategies (i.e., how to stop stuttering once you are in a stuttering moment.) You may practice using stuttering techniques in a variety of speaking situations and settings, with your therapist providing feedback and encouragement as needed. Therapy does not always cure stuttering, but it can help you learn to manage it and lessen the impact of stuttering on your ability to communicate.

What is Augmentative/Alternative Communication?
When a person is not able to speak effectively (or can not be understood), he or she may benefit from Augmentative/Alternative Communication (AAC). AAC involves a number of different systems and strategies to help a person communicate in other ways than speaking. (For example, use of gestures, pointing to pictures or words in a communication book, using the assistance of a trained partner to communicate, etc.) AAC can be low tech or high tech. An example of a high tech AAC system is a speech generating device (SGD), which is similar to a computer and can speak a desired message for a person when the person activates buttons on the device. Some people are unable to use their fingers/hands or other body parts to push buttons and must use eye gaze technology to select buttons on an SGD.

Who May Benefit From Augmentative/Alternative Communication?

  • People who are non-verbal (i.e, can’t talk)
  • People who attempt to talk but are very difficult to understand
  • People with progressive neurological conditions that impact speech (example: ALS)
  • Caregiver training for loved ones of people who need AAC

How can Speech Therapy help?
A certified speech-language pathologist will conduct a thorough evaluation of your current method(s) of communication, including how you communicate with others and how effective your current method of communication is. The therapist will take into consideration many different factors that can impact a person’s ability to use AAC (for example: fine motor skills, vision and hearing status, ability to learn and remember, positional issues, etc.) An AAC evaluation involves trialing a variety of AAC systems/strategies to determine which option(s) are best for you and your family. Your therapist will develop a treatment plan to address your individual goals and will help you obtain, set-up, and learn to use any needed equipment (for example, communication books, speech-generating devices, etc.) Insurance funding can often be obtained to help a person acquire necessary equipment.

What is an Orofacial Myofunctional Disorder?
An orofacial myofunctional disorder occurs when there is an imbalance of the oral and facial muscles and an abnormal swallowing pattern. This is often characterized by a “tongue thrust,” which occurs when the tongue pushes forward against or between the teeth at rest, when swallowing, and/or during speech. A thrusting tongue pattern during swallowing is normal during infancy but usually disappears as a child ages. If this pattern does not disappear, an orofacial myofunctional disorder can occur. Tongue thrusting can push the teeth out of alignment and cause the person to look, speak, and swallow differently than other people. Some speech sounds may be produced incorrectly and sound lisp-like.

What can cause/contribute to an Orofacial Myofunctional Disorder?

  • Allergies
  • Enlarged tonsils and adenoids
  • Family heredity
  • Excessive thumb sucking, lip and fingernail biting, teeth clenching and grinding

How can Speech Therapy help?
A certified speech-language pathologist will conduct a thorough evaluation of your speech and swallowing patterns. This includes getting a history about your current and past feeding behaviors, oral habits, and other related medical information. You may require treatment for allergies and/or enlarged tonsils or adenoids prior to beginning speech therapy. Your speech therapist will make any necessary referrals to other medical professionals who may be able to assist with your problem (i.e., an ear/nose/throat physician or an orthodontist.) When you are ready for speech/swallowing therapy, your therapist will develop a plan of care to help you learn to eliminate your abnormal speech and/or swallowing behaviors, including tongue thrusting. Other goals may include increasing orofacial muscle strength and coordination, increasing awareness of mouth/tongue postures, and improving speech sound productions.