Cognitive-communication therapy may be indicated for those who have experienced a stroke, traumatic brain injury, brain cancer, or various forms of dementia. Interventions may target orientation, immediate/short-term/long-term memory, planning, sequencing, organization of thoughts, financial and medication management, initiation, inhibition, insight, basic to complex attention, visuospatial, problem solving, and reasoning skills. Caregivers also benefit from support and education to help maintain quality of life and independence, avoid burnout, and recognize when transitioning to a further level of care is necessary. Compensatory strategies are commonly beneficial to improve safety and daily functioning.
Swallowing impairments (dysphagia) may be caused by stroke, traumatic brain injury, spinal cord injury, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, muscular dystrophy, Alzheimer's disease, cancer of the mouth/throat/esophagus, head and neck injuries/surgeries, or poor dentition. Dysphagia significantly affects quality of life and can ultimately cause respiratory infections such as aspiration pneumonia. Eating is a social activity, provides pleasure, and can usually be preserved with alternative textures or liquid, compensatory strategies or exercise regimen. We offer intensive VitalStim (neuromuscular electrical stimulation) and Myofascial Release for those who are determined to be appropriate candidates.
Apraxia, Dysarthria, Aphasia
Apraxia occurs when there is a breakdown in motor planning from the brain to the nerves that control coordination of muscles necessary to make speech sounds.
Dysarthria is often described as"slurred" speech caused by muscle weakness often due to brain damage.
Aphasia presents as difficulty understanding language, reading, writing, prolonged searching for words, "broken" or "nonsense speech" often following damage to the left side of brain.
These disorders may occur concurrently and it is important to see a speech-language pathologist to evaluate and treat most appropriately.
Voice disorders occur when vocal quality, pitch, and/or loudness are compromised resulting in alterations to respiratory, laryngeal and vocal tract mechanisms. You may benefit from voice therapy if you have any of the following: spasmodic dysphonia, paradoxical vocal fold movement, muscle tension dysphonia, vocal fold paralysis or paresis, polyps/nodules/cysts, "throat" cancer, recurrent laryngeal nerve damage, Parkinson's disease, multiple sclerosis, pre- and post- laryngectomy. Lee Silverman Voice Treatment coming soon.
Alternative and Augmentative Communication
When communication is difficult as a result of stroke, brain injury, or neurological disease, alternative and augmentative forms of communication (AAC) devices can be utilized. We coordinate evaluations and implementation of AAC devices with local companies and manufacturers, ensuring the most appropriate device is obtained for you and your loved one.
Myofascial Release for TMJ, head/neck cancer, and trigeminal neuralgia
Head and neck cancer commonly affects swallowing function. If surgical intervention has removed parts of the head/neck, if skin grafts have been performed, and if radiation treatment has been completed, tissues can become tight and, sometimes, immobile. Not everyone will experience swallowing difficulty immediately following treatment, though months or years later may notice that eating usual foods is becoming problematic. It is critical to begin the rehabilitative process early. Traditional therapies are not always effective. Myofascial release has become a more widely-accepted therapy, involving manual techniques of improving blood flow to muscles and tissues that are important for mobility, support of head/neck/mouth structures, and increasing safety with eating and drinking.
Myofascial release has also become one of the go-to therapy modalities for treating TMJ. TMJ pain results from dysfunction in the jaw joint, which exacerbates trigger points in the muscles, causing pain. Myofasical release can significantly help, and sometimes completely reduce, TMJ pain.
Trigeminal neuralgia results from suspected nerve entrapment, causing pain in various areas of the face. It can be extremely debilitating, affecting quality of life and social engagements. Traditionally, surgical and medication treatments are recommended, and are widely cited in research. However, Myofascial Release can be a more non-invasive approach to treating nerve pain, prior to more invasive interventions being attempted.