Therapy for all ages with communication and swallowing disorders
SPEECH / LANGUAGE AND ARTICULATION
Improving overall communication
Children who have developmental delays or special needs often need help to improve their language, speech, and communication skills. Children who cannot express their wants and needs can become frustrated and turn to inappropriate behaviors to try and express themselves. A speech therapist (SLP) can help your child to become a successful communicator by working on articulation and language skills, so he/she can more easily share their wants, needs and feelings.
Speech disorders occur when an individual has difficulty producing speech sounds correctly or fluently (e.g., stuttering is a form of disfluency) or has problems with his or her resonance or voice.
Language disorders occur when an individual has difficulty understanding others (receptive language), or sharing thoughts, ideas, and feelings (expressive language). Language disorders may be spoken or in written form and may involve the form (morphology, phonology, syntax), content (semantics), and/or use of language (pragmatics) in functional and socially appropriate ways.
Improving function for daily living
Many people experience cognitive deficits after a stroke, traumatic brain injury, or dementia. This is often experienced as memory loss, slower thinking, problems with remembering the day or time, or difficulty with reasoning and judgment. A speech-language pathologist can assist with compensatory strategy training, memory training, and improving executive function skills to allow for greater independence with daily life.
Cognitive-communication disorders include problems with organizing thoughts, paying attention, remembering, future planning, and/or problem-solving. These disorders usually happen as a result of a traumatic brain injury, stroke, or dementia, although they can be congenital.
Lifespan Therapy provides cognitive rehabilitation therapy (CRT) by essentially rebuilding the brain through neuroplasticity. CRT emphasizes independence in building skills that restore the rhythm of living. Tailored therapy treatments to an individual's needs can focus on the emphasis of improved language skills, increased processing speed, enhanced executive function skills (ie. proficiency in adaptable thinking, planning, self-monitoring, self-control, working memory, time management, and organization), task follow-through, and activity planning.
DYSPHAGIA / SWALLOWING DISORDER
Guided exercises to improve swallow function
Dysphagia is when you experience frequent coughing or choking with eating or drinking, foods sticking in your throat, or inability to swallow. Your doctor will refer you to an SLP for treatment. Swallowing therapy with Lifespan Therapy provides tailored exercises to strengthen swallowing muscles and maintain optimal range of motion to promote safe and efficient swallow with your recommended diet. Your clinician will also advise appropriate diet textures and/or use of compensatory techniques to ensure the safest swallow.
It is often advised for an individual diagnosed with dysphagia to undergo a swallow study ordered by your doctor or recommended by the SLP. Types of swallow studies include a Video Barium Swallow (VBS), also called Modified Barium Swallow (MBS), or Fiberoptic Endoscopic Evaluation of Swallowing (FEES) with an SLP. This provides the SLP with a visual assessment of the swallow function and structures to help determine the appropriate course of therapy/treatment. Because Lifespan Therapy does not perform these studies, it is highly recommended that you have a swallow study before starting therapy if you are receiving services for dysphagia.
Important note: Teletherapy services offered for swallowing are meant to help guide an individual through therapy exercises as an alternative to home health. Swallow evaluations are NOT provided via teletherapy, and should be performed in person with a local SLP.
VITALSTIM / ASPIRE
The VitalStim® Therapy System and the Aspire SwallowStim devices are a non-invasive therapy device to help to swallow through the use of Neuromuscular Electrical Stimulation (NMES). Electrical stimulation is used to aid muscle strengthening and muscle recruitment to rehabilitate the swallow. VitalStim® retrains the muscles needed to complete the swallowing process through specially designed electrodes attached to the patient's neck. The Aspire SwallowStim and biofeedback (sEMG) device provides an opportunity for capturing, measuring and visualizing electrical signals of the targeted musculature.
Both the VitalStim® Therapy System and Aspire SwallowStim devices use small electrical currents to stimulate the muscles responsible for swallowing. At the same time, trained specialists (Speech-Language Pathologists) help patients to re-educate their muscles through rehabilitation therapy.
PICKY EATERS / ARFID
Behavioral Feeding Training / Coaching
Avoidant Restrictive Food Intake Disorder (ARFID) is a diagnosis in the DSM-5, that was previously referred to as “Selective Eating Disorder.” ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness. ARFID can have many causes, but many sufferers feel extreme anxiety and fear around eating.
Most are aware that these fears are irrational, but are unable to control their fears. Although many children go through phases of picky or selective eating, a child with ARFID does not "outgrow" these phases, and significant complications with growth and development may arise. ARFID can also result in problems at school due to difficulties eating with others or needing extended times to eat. In adults, ARFID concerns can cause severe lifestyle challenges, job difficulties, social relationship challenges, and complex medical issues. is when you experience
Tethered Oral Tissues (TOTs)
Tongue Ties and Lip Ties
Tethered Oral Tissues (TOTs) is a term used to describe tight, restrictive connective tissue between oral structures. Tethered oral tissues are congenital formations that restrict the range of motion, which contribute to functional deficits. There are a total of seven frenula in the mouth: one lingual frenulum (tongue), two labial (lip) frenula, and four buccal (cheek) frenula.
What are signs and symptoms of tethered oral tissues?
Shallow or weak latch during
Breastfeeding or bottle feeding
Maternal pain during breastfeeding
Noisy or clicking during breast and
Sleep quality issues such as snoring, mouth breathing, restless sleeping, bedwetting and teeth grinding
Headaches & Migraines
Difficulty chewing and swallowing
GER (Gastroesophageal reflux)
Poor speech intelligibility
Everyone deserves a voice
Voice therapy is like physical therapy for your voice. Sessions include a combination of education for a complete understanding of therapy practices and rationale, instruction for therapeutic exercises, and strategies to apply techniques to the conversation.
Voice therapy sessions consist of evidence-based exercises to heal injured vocal folds and rehabilitate your speaking and singing voice back to its most functional state. It is also valuable to undergo voice therapy to learn techniques and therapeutic exercises to promote an optimal healing environment for your voice after vocal cord surgery. Referrals from a physician and self-referrals are accepted.
Common diagnoses treated include, but are not limited to:
Muscle Tension Dysphonia
Vocal cord nodules, polyps, cysts, granulomas, and other benign vocal cord lesions
Vocal cord paralysis or paresis (weakness)
Vocal fatigue and strain
Age-related voice changes (i.e. vocal cord atrophy or "bowed" vocal cords)
Chronic cough and throat clearing
Vocal Cord Dysfunction (VCD)/Paradoxical Vocal Cord Motion (PVFM)
Spasmodic Dysphonia (SD)
Lee Silverman Voice Treatment
LSVT LOUD is an effective speech treatment for people with Parkinson's disease (PD) and other neurological conditions. LSVT LOUD trains people to use their voice at a more normal loudness level while speaking at home, work, or in the community. It is a standardized treatment protocol that can only be delivered by an LSVT LOUD Certified Clinician and consists of the following:
16 sessions: 4 consecutive days a week for 4 weeks
Individual 1 hour sessions
Daily homework practice
Daily carryover exercises
LSVT LOUD will help you establish a LIFE-LONG HABIT of improved communication.
Communicating one word at a time
Aphasia is an incredibly frustrating communication disorder for stroke survivors. It can affect your independence by limiting how much you can express your thoughts and needs. Whether your aphasia is mild or severe, Lifespan Therapy can help you find a way to effectively communicate your wants/needs with family, peers and healthcare professionals.
Social communication disorders occur when an individual has difficulty with the social use of verbal and nonverbal communication. These disorders may include problems communicating for social purposes (e.g., greeting, asking questions), talking in different ways depending on the listener(s) and setting, and following rules for conversation and story-telling. All individuals on the autism spectrum disorder (ASD) have some level of social communication problems. Social communication disorders are also found in individuals with other conditions, such as a traumatic brain injury.
Treatment for aphasia can be restorative (i.e., aimed at improving or restoring impaired function) and/or compensatory (i.e., aimed at compensating for deficits not amenable to retraining). The treatment approach can be a mix of the following or other methods recognized by ASHA set forth by the evaluating/treating SLP:
Augmentative and Alternative Communication (AAC) Devices
Communication through technology
An augmentative and alternative communication (AAC) device, is a tablet or laptop that helps someone with a speech or language impairment to communicate. The term AAC device is often used interchangeably with terms like speech-generating device (SGD) or assistive communication device or simply communication device.
AAC devices also provide therapeutic benefits. Simply using a device has been shown to improve language skills and many individuals experience an increase in verbal speech.
Finally, AAC devices are beneficial to the user’s caregiver and family members since it allows the user to be more independent and reduces the burden on others.
Assessing your swallow function
Fiberoptic Endoscopic Evaluation of the Swallow (FEES)
What is FEES?
Fiberoptic Endoscopic Evaluation of the swallow (FEES) is a well-established technique that has revolutionized the field of dysphagia diagnostics. FEES is a sensitive, accurate, portable, and safe examination that yields clinically useful information relative to swallowing physiology and swallowing safety. The procedure involves passing a flexible endoscope across the floor of a patient’s nasal passage into the pharynx so that the larynx, pharynx and upper esophageal opening are viewed directly from above. Then the patient is administered food or liquids mixed with food coloring in order to determine safe swallowing function and integrity. FEES can be done at the bedside, in an office, intensive care unit or in a long-term facility in under 20 minutes with regular food and liquids. Since there is absolutely no radiation administered the studies are able to be sustained for longer time intervals, allowing the clinicians the ability to tell if a patient’s swallowing technique is impacted by fatigue.
How does FEES compare to the Modified Barium Swallow Study(MBSS)?
Vocal Pathology Screener
No need to coordinate time with the radiology department for scheduling
No radiation exposure with FEES
No unpleasant barium-tainted food and no barium-associated constipation for patients
No waiting to be cleared from isolation precautions
FEES can be used with patients on mechanical ventilation and tracheostomized patients
Normal food is given to patients
FEES can be performed while a patient is sitting upright or in bed
FEES can be performed easily on morbidly obese patients as opposed to the MBS where a C-ARM would have to be used for fluoro.
FEES can be given to medically complex patients who otherwise would not tolerate the transfer to the radiology suite
The physician does not have to be present during a FEES exam
FEES is shown in High Definition digital color as both a still and a video
The use of the term “gold standard” as previously applied to the MBSS is no longer the case
Minimal to no complications
Used for biofeedback for voice and swallow
Videotape recording of endoscopies objectively discover and document details that cannot be appreciated by the unaided eye in real-time
Gender-Affirming Voice Therapy
Find your Voice
Adjusting your pitch will likely be a primary focus during therapy. Still, the specific training you receive depends on your unique goals. You may develop skills in:
Pitch modification: Lowering or raising your pitch. You’ll start with a slight pitch change before gradually progressing to higher or lower pitches. You may begin with vowel sounds before gradually progressing to words, phrases, sentences, and conversations in your desired pitch.
Vocal hygiene: Practicing good habits to keep your vocal cords healthy and free from injury. This includes doing vocal warm-ups, practicing good posture, and performing breathing and relaxation exercises.
Articulation: Using your speaking muscles to form sounds in a way that accurately reflects your gender identity. This may mean lightening the constriction between your lips, tongue, and teeth/palate or even using greater intensity, depending on your goals.
Resonance: Using the air-filled cavities in your throat, mouth, and nose to color the sounds your vocal cords make. Working on your resonance can help create a unique tone that feels authentic to you. Training may involve learning how to control your vocal muscles better to anchor sounds in your chest (chest voice) or in your head (head voice).
Prosody: Modifying the tone and emphasis you place on sounds, words, and phrases, creating a rhythmic quality (or flow) to your speech.
Word choice: Choosing words that reflect gendered ways of speaking.
Pragmatics: Adjusting your communication style to fit changing social situations.
Nonverbal communication: Using visual cues like body language and facial expressions to convey messages without speaking.
Orofacial Myofunctional Therapy
Facial muscle therapy
Orofacial Myofunctional Therapy (OMT) focuses on the muscles of the face and mouth and teaches clients how to breathe, posture, swallow, and speak correctly. Its main focus is creating a healthy balance between orofacial structure and function. When these functions are impaired, an Orofacial Myofunctional Disorder (OMD) exists.
Myofunctional therapy service includes (but is not limited to) everything from mouth breathing, tongue-tie, lip-tie, tongue thrust, thumb sucking, and feeding difficulties.
Myofunctional therapy is an exercise training program for the muscles around your face, mouth, and tongue. These exercises are designed to improve issues with talking, eating, or breathing.