Specialized Speech/Language Services
Specialized Speech/Language Services include:
Voice Disorders
The Voice Center at JFK Johnson Rehabilitation Institute offers evaluation and treatment for patients with hoarseness, vocal cord paralysis and vocal abuse. Adults may have hoarseness or voice changes due to:
- Vocal cord nodules or polyps
- Voice abuse
- Muscle Tension Dysphonia
- Smoking
- Vocal cord dysfunction/paralysis
- Cancer
- Stroke
- Neurological disorders - MS, ALS, Parkinson's Disease, head injury
- Open heart surgery
If you experience hoarseness with or without any of the above medical diagnoses, it is recommended that you schedule an appointment with an otolaryngologist (ear, nose and throat doctor). The physician may refer you for a voice evaluation with a speech language pathologist. The speech pathologist will evaluate your voice using a Digital Videostroboscopy System to assess vocal quality, pitch and loudness. A detailed case history will be obtained to determine any vocal abuses that may affect the voice. A brief period of voice rest may have already been recommended. An individualized voice treatment program will be designed to improve your vocal quality to its maximum potential.
Lee Silverman Voice Treatment is also offered is a specialized, certified therapy program. Videostroboscopy is utilized to visualize the vocal cords. A baseline evaluation and periodic reassessments allow the patient to visualize their progress.
Stroke
Have you or someone you know had a stroke? The staff at JFK Johnson Rehabilitation Institute provide intensive rehabilitation to individuals who have suffered a stroke. If you or someone you know suffers from any of these problems following a stroke, our staff can develop a therapy program that is suited to the specific disabilities. The following are common deficit areas that can occur as a result of a stroke:
- Aphasia
- Difficulty understanding verbal and written information
- Difficulty expressing wants, needs, and ideas verbally and/or graphically
- Difficulty finding the words for common items ("It's on the tip of my tongue")
- Apraxia
- Difficulty formulating sounds and words in an appropriate sequence
- Dysarthia (Slurred Speech)
- Difficulty in pronouncing sounds and words clearly
- May experience weakness in the mouth or have a facial droop
- Cognitive Deficits
- Difficulty remembering recent events
- Difficulty organizing thoughts or sequencing ideas and tasks
- Difficulty in processing information
- Difficulty in reasoning out problems or abstract ideas
- Dysphagia
- Difficulty swallowing food or liquid
- Coughing or choking during meals
- Difficulty chewing food; food gets stuck inside the mouth
- Frequent bouts of pneumonia or other respiratory problems
The department offers a weekly aphasia support group.
Dysphagia Swallowing Disorders
Patients who have Dysphagia may experience some of the following symptoms:
- Frequent respiratory problems or pneumonia
- Coughing or choking while eating or drinking
- Sudden weight loss
- Poor secretion management or drooling
- Pocketing food in the oral cavity with difficulty dislodging it
- "Globus" or feeling like something is "stuck" in your throat
If you or someone you know is experiencing any of the above symptoms, inform your physician, who will refer you for a "Dysphagia Evaluation." A speech/language pathologist will take a detailed case history, assess your mouth and throat movements and ask you to swallow a variety of solid foods and liquids.
JFK Johnson Rehabilitation Institute is home to a regional swallowing center with an interdisciplinary approach to assessment and treatment. This approach includes assistance from a variety of specialties, including radiology, nursing, dietary, physical therapy and other services as needed.
Electromyography (EMG) for visual feedback is also offered. Once the evaluation is complete, specific therapeutic intervention may be recommended, including EMG for visual feedback to increase muscle movement and focus on the "feeling" of the correct swallow to carryover
to daily life. EMG therapy involves placing surface electrodes on the throat to measure adequate muscle movement.
Deep pharyngeal neuromuscular stimulation is a systematized therapeutic method for pharyngeal dysphagia, which utilizes nine specific stimulation techniques with the oral/pharyngeal areas. This specialized training is offered at the JFK Johnson Rehabilitation Institute's speech program.
In addition, following a modified barium swallow procedure, some patients are candidates for electrical stimulation. This is a systematic approach for outpatients who meet the criteria to improve swallowing. The stimulation works to increase activity and coordination of the muscles involved in swallowing.
MBS: Modified Barium Swallow
The modified barium swallow procedure is a test often recommended for an individual with swallowing difficulties. This procedure is performed in conjunction with the radiology department and is often described as an "X-ray of the swallowing mechanism."
During the test, patients are asked to swallow various solids and liquids moxed with barium. The barium acts as an illuminator so that during the X-ray, areas of the swallowing mechanism can be highlighted to determine if they are functioning appropriately.
Results of this test are reviewed by a speech pathologist and radiologist and then forwarded to the patient's physician.
Head Neck Cancer Rehabilitation Program
Speech pathologists at the JFK Johnson Rehabilitation Institute are trained in providing
comprehensive laryngectomy evaluation and treatment including:
- Preoperative Counseling
- Testing to determine prognosis for successful esophageal speech production
- Electro larynx training and
assistance in ordering appropriate device
- Esophageal Speech Training
- Tracheoesophageal Puncture Prosthesis (TEP) Fitting and Training (A very specialized procedure to experience excellent voice quality)
- Monthly support group
- State-of-the-art diagnostic and treatment protocols for those patients who have undergone surgery of the neck or mouth including:
- Total or partial
laryngectomy
- Glossectomy (tongue)
- Mandibulectomy (jaw)
Patients are referred by their physician for pre-operative counseling or speech/swallowing evaluation post surgery.
If a dysphagia evaluation is recommended, the speech pathologist will administer various food/liquid consistencies and observe the swallow for overt signs of aspiration (choking or coughing). A modified barium swallow might be recommended to further assess swallow skills.
A complete laryngeal voice evaluation is conducted on patients who have had their voice box removed.
Other tests may include a transnasal esophageal insufflation test to determine appropriateness for tracheo esophageal puncture or esophageal speech.
The department offers a monthly laryngectomy support group.
Foreign Accent Reduction
The goal of the CLEAR (Clients Learn Effective Accent Remediation) Program is to improve the quality of speech of people who are speaking English as a second language. Our clients may not always be understood on the phone, their dialects may cause miscommunications or the client may not be able to communicate ideas clearly in English.
Participants come from all segments of the workplace: physicians, attorneys, teachers, students, computer programmers, engineers, secretaries, receptionists, salespeople, etc.
What can you expect from the CLEAR Speaking Program?
- An initial interview and tape-recorded session of your speech
- An individualized program based on a phonetic analysis of your tape-recorded speech
- A set of practice tapes from your individual speech analysis
- A manual containing your speech analysis and scripts of the recorded practice materials
- A tape recorder evaluation to measure your success
Types of Programs:
- 13 Week Class
- Small group instruction
- 1 1/2 - 2 hour class once each week
- Training materials
- Total instruction time is 24 hours
- Private Tutoring Programs
- 13 week individual tutoring - for individuals with very strong foreign accents who need close professional guidance
- 7 week individual tutoring - for individuals with mild foreign accents or clients in need of general speech improvement
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