SERVICES FOR ADULTS

DYSARTHRIA

What is dysarthria?

Dysarthria is a speech disorder. It results from impaired movement of the muscles used for speech production, including the lips, tongue, vocal folds, and/or diaphragm.

What are some signs or symptoms of dysarthria?

Slurred speech, slow rate of speech, rapid rate of speech with a "mumbling" quality, reduced tongue, lip, and jaw movement, abnormal pitch and rhythm when speaking.

What causes dysarthria?

Dysarthria is caused by damage to the brain. This may occur at birth, as in cerebral palsy, or may occur later in life due to stroke, brain injury or neurological diseases such as Parkinson's disease.

How can we help?

We will examine the movements of the lips, tongue, and jaw, as well as breath support for speaking to determine the nature and severity of the problem .   Following assessment, we will recommend appropriate exercises to treat the dysarthria.  Our therapy programme includes:

Increasing tongue, lip and jaw movements, Improving articulation/ clarity of speech production, Improving breath support to speak louder, Learning to speak at appropriate speech rate, Teaching family members strategies to communicate better with their loved ones with dysarthria

How effective are speech-language pathology treatments for dysarthria?

ASHA produced a treatment efficacy summary on dysarthria [http://www.asha.org/uploadedFiles/public/TESDysarthria.pdf] that describes evidence about how well treatment works.

APHASIA

What is aphasia?

Aphasia is a communication disorder that results from damage to the parts of the brain that contain language .  Aphasia may causes difficulties in speaking, listening, reading, and writing.

What causes aphasia?

Aphasia is most often caused by stroke. However, any disease or damage to the parts of the brain that control language can cause aphasia. These include brain tumors, traumatic brain injury, and progressive neurological disorders.

What are some signs or symptoms of aphasia?

The specific symptoms and severity of aphasia vary depending on the location and extent of brain damage. Individuals with aphasia may have one or more of the following problems:

Difficulty producing language: Difficulty coming up with the words they want to say, substitute the intended word with another word (e.g., "chicken" for "fish" or "radio" for "ball"), switch sounds within words (e.g., "wish dasher" for "dishwasher"), use made-up words (e.g., "frigilin"), have difficulty putting words together to form sentences, string together words fluently but without making sense

Difficulty understanding language: Misunderstand what others say, especially when they speak fast or in long sentences, find it hard to understand speech in background noise or in group situations, misinterpret jokes and take the literal meaning of figurative speech (e.g., "it's raining cats and dogs")

Difficulty reading and writing: Difficulty reading, problems spelling and putting words together to write sentences, difficulty understanding number concepts (e.g., telling time, counting money, adding/subtracting)

How can we help?

We will evaluate our client with a variety tools to determine the type and severity of aphasia.   We will then customize a therapy programme with activities to improve specific language skills affected by damage to the brain. Our therapy programmes are specially designed to be functional, relavant and enjoyable for the individual client. 

In addition, we will help our client use strategies to improve overall communication in different situations.  We will also teach family members how to communicate better with their loved ones with aphasia.  

How effective are speech-language pathology treatments for aphasia?

ASHA produced a treatment efficacy summary on aphasia [http://www.asha.org/uploadedFiles/public/speech/disorders/TESAphasiaFromLeftHemisphereStroke.pdf] that describes evidence about how well treatment works.

DYSPHONIA

What is dysphonia?

Dysphonia refers to a disorder of the voice. 

What are some signs or symptoms of dysphonia?

Hoarse voice, breathy voice, strained/strangled voicd, reduced pitch range, reduced loudness

What causes dysphonia?

The cause of dysphonia is generally multifactorial. They include:

Vocal cord nodules/cysts, voice misuse, vocal cord palsy (from surgery or other medical conditions such as cancer), psychological - voice changes are not uncommon when people are under stress.  The voice may be lost suddenly, usually overnight or following a cold.

How can we help?

Our voice therapy services includes: clinical examination of voice, counselling on healthy voice usage and voice therapy exercises to improve vocal function.  We work closely with the ENT doctor to ensure optimal management of the voice disorder. 

How effective is therapy for dysphonia?

Research data and expert clinical experience support the use of voice therapy in the management of patients with acute and chronic voice disorders. Voice therapy contributes to increased effectiveness and efficiency in the treatment of voice disorders. When surgery is necessary, adjuvant voice therapy can improve surgical outcomes, prevent additional injury, and limit additional treatment costs. 


COGNITIVE COMMUNICATION DEFICIT

What is cognitive communication deficit?

Cognitive-communication deficit refers to difficulties with communication that have an underlying cause in a cognitive deficit more than a language or speech deficit.

What are some signs or symptoms of cognitive communication deficit?

Reduced attention to task, impaired memory, reduced insight and judgement, poor reasoning and problem solving skills, reduced planning and organization skills, trouble communicating in a socially acceptable manner

What causes cognitive communication deficit?

Cognitive communication deficit is usually caused by damage to the right side of the brain, especially in the frontal lobe.  Some causes include stroke, traumatic brain injury, brain tumor and progessive neurological disorders.

How can we help?

We will use both formal and informal screening tools to understand more about our client's deficits.  We will then prepare a personalized treatment plan to help meet our client’s functional needs. This includes:

Using specific tasks to improve functions that has been affected, such as memory and problem solving. Teaching strategies on how to compensate for impaired functions, e.g. using a detailed plan or checklist. Teaching family members strategies to communicate better with their loved ones with cognitive communication deficit.

How effective are speech-language pathology treatments for dysarthria?

ASHA produced a treatment efficacy summary on cognitive commmunication [http://www.asha.org/uploadedFiles/public/TESCognitiveCommunicationDisordersfromRightHemisphereBrainDamage.pdf] that describes evidence about how well treatment works. 

 

APRAXIA OF SPEECH

What is apraxia of speech?

Apraxia of speech is a motor speech disorder. The messages from the brain to the mouth are disrupted, and the person cannot move his lips or tongue to the right place to say sounds correctly, even though the muscles are not weak.  The severity of apraxia depends on the nature of the brain damage.

What are some signs of apraxia of speech?

Individuals with apraxia of speech know what words they want to say, but their brains have difficulty coordinating the muscle movements necessary to say all the sounds in the words or move smoothly between sounds.

Individuals with apraxia may demonstrate: difficulty imitating and producing speech sounds, make up words (e.g. "pidem" for "kitchen"), difficulty self-correcting to produce the right word, inconsistent speech errors, groping of the tongue and lips to make specific sounds, slow speech rate, better automatic speech (e.g., counting, greetings) than purposeful speech, inability to produce any sound at all in severe cases.

What causes apraxia of speech?

Apraxia of speech is caused by damage to the parts of the brain that control coordinated muscle movement, such as stroke, traumatic brain injury, brain tumors, and progressive neurological disorders.

How can we help?

We can diagnose apraxia of speech and determine the nature and severity of the condition using a varity of assessment methods. We will then plan a programe to help our client improve the planning, sequencing, and coordination of muscle movements for speech production. The muscles of speech often need to be "retrained" to produce sounds correctly and sequence sounds into words.  In severe cases, augmentative and alternative communication (AAC) such as electronic picture or word devices may be necessary to help our client communicate.