Speech Therapy

Individuals encountering problems with their communication, language and swallowing may benefit from the specialized attention of TIRR Memorial Hermann's Speech Therapy. Our certified speech therapists and language pathologists diagnose and treat a variety of disorders resulting from stroke, brain injury or other neurological conditions.

Therapy usually entails individual therapy training, and education to help an individual overcome or compensate for any of their difficulties. TIRR Memorial Hermann's speech therapists address the individual needs of patients diagnosed with a wide range of disorders, including, but not limited to:

• Aphasia is the impairment or absence of comprehension and/or communication skills as a result of an injury to the brain's language center. It can apply to spoken or written words and numbers and is most commonly associated with stroke and brain injury.
• Apraxia is the inability to execute purposeful and coordinated movements even though muscular strength and mental capacity remain intact.
• Dysarthria is difficulty in articulating words due to a disturbance in the central nervous system. Speech is characteristically slow and slurred. It is most commonly associated with stroke and traumatic brain injury. Treatment involves intensive speech therapy with the focus on oral-motor skill development.
• Dysphagia is difficulty in swallowing food, liquids, and even saliva, due to muscle weakness or paralysis. It is most commonly associated with stroke, traumatic brain injury or spinal cord injury. Individuals may experience mild to severe difficulties when swallowing, including:
  • Coughing, choking or throat-clearing while eating or drinking
  • Throat pain or discomfort
  • A sensation of food sticking the mouth, throat or upper chest
  • Gurgling noises when speaking
• Speech therapists offer a variety of specialized treatments to address needs of individuals with Orofacial Myofunctional Disorders, the impaired function of the muscles of the face, jaw and neck.

A harmonized plan of treatment for each individual is developed by a team of doctors and specialists in order to ensure the best possible care and a return to independence.

Speech and Augmentative Communications

There are a wide range of treatments, techniques and technologies being used to enhance speech skills, including melodic intonation therapy, Visi-Pitch® and Bungalow software programs.

As appropriate, we work closely with each client to find alternative methods of communication. There are many different kinds of devices that meet different needs from the simple, non-electronic variety to the complex, computerized device. Devices may be controlled by a puff of air, a blink of an eye, typing on a keyboard, or a synthesized voice.

Swallowing Therapy

For those with swallowing problems, the department utilizes a number of special diagnostic tools, including non-invasive x-ray procedures, to help evaluate the nature and extent of the condition. Various electronic devices and computers, if appropriate, may also be used both in assessment and treatment.

Most swallowing problems can be diagnosed upon examination of speech, oral function and by observation of the swallowing mechanisms but sometimes it is necessary to confirm this by videofluoroscopy. This is a video x-ray to show exactly what is happening when food and drink of different consistencies is swallowed. From the results of the video swallow, appropriate treatment recommendations are made.

Vital Stim® Therapy

With the guidance of a speech pathologist, treatment may involve incorporating compensatory strategies when eating (including chin tuck, frequent swallows or checking mouth), altering food consistencies (including soft, pureed or chopped) and specialized eating/drinking equipment.

Lee Silverman Voice Treatment (LSVT)

LSVT is a proven effective treatment program that restores oral communication in individuals with Parkinson disease (PD) beyond what current pharmacological and surgical interventions can offer.

The development of LSVT was motivated by the recognition that the reduced ability to communicate is one of the most difficult aspects of PD. Soft voice, monotone, hoarse voice quality, and imprecise articulation, together with lessened facial expression, contribute to limitations in communication.

The LSVT approach centers on a very specific therapeutic target: increased vocal loudness. This key target acts as a trigger to increase effort and coordination across the speech production system.

Speech therapists also work to improve cognitive function, helping individuals with attention to tasks, memory, reasoning, problem solving, and executive functioning, such as goal setting, planning, initiating, self-awareness, self-monitoring and evaluation.

Improving Imaging and Analysis with the KayPENTAX Digital Swallowing Workstation

TIRR Memorial Hermann offers a new swallowing workstation technology that helps medical professionals assess and improve a patient's swallowing. Housed on a mobile cart that can be rolled to radiology or to the bedside, the swallow station can be used for imaging studies, therapy, patient and family education and further evaluation.

The workstation has three components:

• digital recording
• a swallow signals lab
• fiber endoscopic evaluation of swallowing (FEES)

Digital Recording

Digital recording allows for visualization and recording of modified barium swallow studies without exposing the patient to additional radiation. Studies are stored and can be retrieved and analyzed in real time, either frame by frame or in slow motion. Multiple swallow studies can be compared side by side to evaluate a patient's improvement.

Swallow Signals Lab

The swallow signals lab can be used to enhance therapy by giving patients visual feedback on a screen, which facilitates learning during swallowing exercises. Patients are able to see how they're breathing in relation to each swallow and see the timing of each swallow.

Fiber Endoscopic Evaluation of Swallowing (FEES)

FEES is an endoscopic technique used to evaluation patients with dysphagia. During the procedure a flexible tube is passed through the nose, allowing clinicians to see internal structures during swallowing and non-swallowing tasks.

FEES advantages over fluoroscopy include:

• No exposure to radiation
• Test is portable
• Good for repeat evaluations
• Lower cost
• Suitable for patients on a ventilator or those with physical impairments

To make a referral or to schedule an appointment, please call 1 (800) 44-REHAB (73422), (713) 797-5942, fax (713) 797-5988 or fill out our online forms by clicking the buttons below.

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