Speech Language Pathology Specializing in 

Neurological Rehabilitation

 

APHASIA

Aphasia treatment is individualized to address the specific areas of need identified during assessment, including specific goals identified by the person with aphasia and his or her family. The goal of intervention is to help the individual achieve the highest level of independent function for participation in daily living. Alison is trained in a wide variety of therapeutic approaches to address all domains of communication.

Intervention is designed to 

  • capitalize on strengths and address weaknesses related to underlying structures and functions that affect communication across partners, activities, and settings.

  • facilitate the individual’s activities and participation by teaching new skills and compensatory strategies to both the individual with aphasia and his or her partner(s).

  • modify contextual factors that serve as barriers and enhance those that facilitate successful communication and participation, including accommodations such as large print, pictures, and aphasia-friendly formatting to support comprehension of written materials.

MOTOR

SPEECH

DISORDERS

Treatment for Dysarthria depends both on the type of dysarthria, the underlying cause of impairment, and coexisting deficits that may impact intervention.  Alison is highly trained in various interventions to address dysarthric speech, and is certified in both LSVT Loud and  eLoud (teletherapy), a  highly successful treatment approach for individuals with Parkinson's disease.

 

​Treatment for Apraxia of speech (AOS) focuses on facilitating the efficiency, effectiveness, and naturalness of communication.  When designing a treatment program for an individual with acquired apraxia of speech the speech language pathologist must consider:

Target selection

  • Stimulability - often used to determine initial therapy targets

  • Motivation – can use words and phrases that are motivating and functional

Task hierarchy 

  • Consistent with the principles of motor learning, practice is hierarchical, and selection of stimulus targets promotes success at each step.

  • Tasks typically begin at the syllable level—unless the individual has some success at the word or phrase level. 

  • Single sounds or nonspeech oral-motor movement patterns that approximate speech gestures (e.g., lip rounding and tongue elevation) might be targeted initially if the individual is not yet capable of meaningful speech.

Alison is also trained in PROMPT therapy.  PROMPT, an acronym for PROMPTS Oral Musculature Phonetic Targets, is an approach using tactile kinesthetic cues to achieve production of speech.

 
 

Treatment of swallowing disorders (dysphagia) depends heavily on the problems that your loved one has (e.g. difficulty chewing, coughing while drinking).  A speech language pathologist can complete a clinical assessment using various foods/liquids to identify the difficulties your loved one is experiencing, as well as assess stimulability for intervention.  If needed, objective testing measures, including Modified Barium Swallow Studies (MBS) and/or Fiberoptic endoscopic evaluation of swallowing (FEES) test, can be recommended prior to intervention.  Treatment of swallowing disorders may include exercises to help your loved one strengthen his/her muscles used for mastication (chewing) and swallowing, incorporate postural changes to allow for safer eating/drinking, strategies and techniques to facilitate a safer and more effective swallow, and diet texture modifications.

Alison is trained in several evidence-based treatment modalities and protocols, many of which are utilized in conjunction with traditional swallowing exercises.

McNeill Dysphagia Treatment Protocol (MDTP): a systematic exercise-based approach to dysphagia using various foods as resistance and weight.

Expiratory Muscle Strength Trainer (EMST): implemented by a handheld device based on the principles of exercise physiology to help strengthen a persons cough and improve airway protection.  Shown to benefit those with progressive neurodegenerative disease processes. 

AmpCare ESP: Therapeutic neuromuscular electrical stimulation (FDA-cleared) targeting the muscles utilized in swallowing paired with resistive exercises.

Swallowing

Disorders

Cognitive-

linguistic

disorders

A problem with one or more cognitive functions can cause difficulty performing activities of daily living safely and efficiently as well as communicating effectively. An evaluation by a speech-language pathologist can determine where impairments exist and how to treat them.

A person with a cognitive-communication disorder may have difficulty paying attention to a conversation, staying on topic, remembering information, responding accurately, understanding jokes or metaphors, or following directions.

Cognitive-communication disorders vary in severity. Someone with a mild deficit may simply have difficulty concentrating in a loud environment, whereas a person with a more severe impairment may be unable to communicate at all.  Regardless of the level of impairment, treatment approaches for cognitive-linguistic deficits are best when patient-centered and functional.    Intervention may target sustaining attention to conversation for a person with significant impairments, to managing personal finances for a person with more mild impairments.  

 

After the initial assessment, together we will generate functional and achievable goals for therapy to facilitate functional independence at home and in the community. 

 

Neurogenic

voice

disorders

Neurogenic voice disorders may occur when there is damage to the peripheral or central nervous system.  Some neurogenic voice disorders occur in isolation, however often they are part of a larger disease process.  As a result of impairment, voice may be breathy, hoarse, spasmodic, weak, strained, etc.  Significant changes in vocal quality can be debilitating, resulting in reduced communicative attempts and withdrawal from social interactions.  

Depending on both the etiology and the impairment, medical intervention may be recommended prior to therapeutic intervention.  A speech language pathologist is able to evaluate voice in relation to clinical presentation and etiology (e.g. stroke, Parkinson's disease, etc), and generate an appropriate treatment plan.  Some popular treatment options include pushing techniques, resonant voice therapy, vocal function exercises, expiratory muscle strength training (EMST), Lee Silverman Voice Therapy (LSVT), and various behavioral voice therapies. 

 

Tracheostomy

&

LARYNGECTOMY

Whether you have a tracheostomy tube following your recent hospitalization, or a stoma post laryngectomy, a Speech Language Pathologist can help you safely transition to your home environment.  For patients with a tracheostomy tube, this means safely eating/drinking, incorporating swallowing exercises and compensatory techniques to reduce the risk of aspiration, as well as help successfully utilizing a speaking valve in order to facilitate voicing/communication.  For patients post laryngectomy, a Speech Language Pathologist can help establish the best method of communication, including ongoing training in successful utilization of an electrolarynx or esophageal voice.   Additionally, training and instruction may be provided on stoma care and maintenance, self-placement of a voice prostheses, as well as tracheostomy management in the home environment, including cleaning, maintenance and use of the speaking valve.

 

Certifications:

Please click the icon for more information

about a few of Alison's advanced certifications.

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Certified Brain Injury Specialist (CBIS)

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Certified Provider

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EMST150™

Expiratory Muscle Strength Trainer

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Certified Clinician

LSVT Loud & eLoud

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PROMPT Trained- level 1