Speech therapy

Speech-language pathologists work with individuals who may have cognitive-communication disorders, aphasia, dysarthria, swallowing difficulties, and voice disorders due to illness, injury, or changes associated with aging. SLPs assess an individual's ability to communicate in the areas of speaking, understanding, reading, and writing.

In addition, cognition including memory, orientation, safety, judgment, problem solving, and reasoning with every day activities may be tested. Speech-language treatment is directed at helping the person communicate and function as safely and independently as possible when carrying out his/her daily tasks.

  • Articulation or dysarthria from CVAs or other progressive neurological diseases (Parkinsons, MS, ALS)
  • Swallowing/dysphagia (NMES, VitalStim certified, Traditional)
  • Language expressive or receptive (aphasia therapy, traumatic brain injury, progressive neurological)
  • Voice (LSVT LOUD certified, abuses, misuses, and anatomical/structural abnormalities)
  • Oral Motor
  • Cognitive therapy for TBI, stroke, brain resection
  • Augmentative communication (communication boards or devices to provide functional communication)
  • Speech and language delays for children including tongue thrust, articulation, and language development
  • Laryngectomy (alaryngeal devices)
  • Tracheostomy (Passy Muir Speaking Valves)
  • Head and neck cancer

Evaluation and assessment 

Evaluations and assessments are provided to determine what the individual needs to do to improve his communication skills. The assessment is the initial phase of the treatment process. It provides information about the strengths, weaknesses and the most effective point for therapy to begin. The evaluation can include testing of articulation, language, oral motor, swallowing, voice, fluency, and higher-level thinking skills. In fact, assessing skills and performance is an ongoing process during therapy. Initial assessments provide information regarding the individual's strengths and how to use that to benefit therapy. 


Articulation refers to speech sound production. Misarticulated sounds call attention to how the speaker sounds rather than to what he is discussing. Misarticulations are characterized by substitutions (when one sound is produced instead of the correct sound), distortions (the sound is produced with improper use of airflow or oral mechanics), or omissions (the sound is left out of the word). Articulation disorders can vary from mild substitutions to multiple sound misarticulations. Speaker intelligibility plays a major role in the focus of the therapy process. 


Language therapy can and does cover a wide range of services. Adults may have a need for therapy following a stroke, which has impaired their ability to use language and speech in the manner prior to the stroke. Language therapy may also be necessary for individuals as a result of closed head injury, adult neurogenic communication disorders, or traumatic brain injury. All aspects of language therapy cannot possibly be covered in this brief overview. 


The oral mechanism and its functions are addressed in therapy for articulation improvement and swallowing disorders in adults. Persons may experience difficulty chewing and swallowing as a result of an illness, stroke, or progressive medical condition. In all these instances oral motor training or retraining is a vital part of the therapy process. Normal swallowing function achieves two goals: moving food from the mouth to the stomach and protecting the airway. The oral phase (mouth), pharyngeal phase (throat), and the esophageal phase are the three phases of swallowing. 

The oral phase of the swallow is voluntary and food is chewed and mixed with saliva. Once the food is mixed with saliva it moves to the back of the mouth. Next, the pharyngeal phase of the swallow begins, which is involuntary. In this phase, the swallow function is stimulated by reflexes which propels the food down toward the esophagus. This reflex in a normal swallow prevents food from going up the nasal passage or down in to the lungs. Food that enters the lungs is called aspiration and can result in pneumonia or other serious illnesses. Finally, the food enters into the third phase of the swallow, the esophageal phase. Once food moves into the esophagus it is propelled down towards the stomach. 

A normal swallow function requires the coordination of the brain, brainstems, nerves, and muscles. Impairment in any of these areas can cause impairment of the swallow, resulting in dysphagia or difficulty swallowing. 

Common causes of swallowing problems include, but are not limited to: poor fitting dentures; dry mouth; acid reflux; neurologic disease such as stroke, Parkinson's disease, Alzheimer's disease, and amyotrophic lateral sclerosis (ALS); vocal fold paralysis; infection; strictures; tumors; surgery; esophageal motility problems; cricopharyngeal spasm; Zenchers diverticulum; medications; and aging. If you are experiencing difficulty swallowing or persistent swallowing problems, please seek treatment to avoid malnutrition, dehydration or illness. 


A fluency disorder is a speech disorder characterized by disruptions in smoothness, rhythm, and continuity of sounds, syllables, words, or syntactic language units during speaking. Disfluencies in speech are more commonly referred to as stuttering. Prolongations, repetitions, and/or blocks are the most common disfluencies. The rate, frequency and the duration of these disruptions are noted during the assessment. The therapy process then focuses on reduction and control of these disruptions. Each individual has attitudes toward their speech disfluencies that are discussed and evaluated as part of the therapy process. The goal is to help the individual manage and/or control their speech to gain fluency. Secondary characteristics during speaking are also addressed to reduce or eliminate their occurrence. Some identified characteristics may be tongue clicks, loss of eye contact, facial grimaces, hand movements, lip tension, jaw tension, and other body and facial movements. All aspects of the disorder are carefully addressed in therapy and in the evaluation process. 


Voice disorders refer to abnormal pitch, loudness, or vocal quality for the sex and age of the speaker. The cause of the disorder may be organic or functional. The fact that it may have an organic origin requires a medical examination and referral prior to initiating therapy. Any medical condition must be considered before any therapy is implemented.