Adult neurologic speech, language, cognitive and swallowing rehabilitation

Stroke, aphasia and apraxia

A stroke can affect your ability to understand or produce language. You may struggle to find the right word, or speak in incomplete sentences. This is called aphasia, and it is not a loss of intelligence — the thoughts are still there, the route to the words is damaged.

Two other things often show up alongside it. Dysarthria is slurred or slow speech caused by weakness in the muscles that control speech. Apraxia of speech is different again: the muscles work, but the brain has trouble planning and sequencing the movements, so you know exactly what you want to say and it comes out wrong.

Therapy addresses word finding, sentence building, understanding, reading, writing and speech clarity — and, just as importantly, the strategies that let you have a conversation while you are still working on all of that.

Read more about stroke and aphasia therapy, including primary progressive aphasia.

Parkinson’s disease

Parkinson’s affects the dopamine system, and as movements get smaller everywhere else in the body, they get smaller in speech too. The usual result is a voice that has gone quiet and speech that is harder to make out — often without the person realizing how much it has changed.

Parkinson’s can also affect memory and processing speed, and it can change chewing and swallowing.

We are certified in both LSVT LOUD® and SPEAK OUT!®, the two best-established programs for speech in Parkinson’s. It is worth starting before things get difficult rather than after.

Read more about Parkinson’s speech therapy.

Swallowing problems (dysphagia)

Dysphagia is difficulty or pain when swallowing food, liquid, medication or even saliva. It can involve the mouth, the throat, the food pipe, or more than one of those at once.

It matters more than people expect. Swallowing problems affect nutrition, hydration, chest infections, and whether eating with other people is still enjoyable or has become something to dread.

Our clinicians are trained in the Ampcare Effective Swallowing Protocol™, neuromuscular electrical stimulation (NMES), the McNeill Dysphagia Therapy Program (MDTP) and expiratory muscle strength training (EMST).

Read more about swallowing and dysphagia therapy.

Brain injury and concussion

A brain injury’s effects depend on where it happened and how severe it was. It can change speech clarity, understanding, word finding, attention, memory, problem solving, social communication, voice, and swallowing — in any combination.

Cognitive rehabilitation after acquired or traumatic brain injury targets memory and attention, processing speed, executive functioning and language, with the aim of getting back to daily life, work or study.

If you or someone you love is still struggling with everyday tasks, or with returning to school or work, that is the point at which to get assessed — not after another year of hoping it settles.

Memory, attention and executive function

Executive function is the set of higher-level skills that let you actually get things done: planning, organizing, starting a task, holding information in mind, switching between things, and solving problems as they come up.

These are the skills that get hit by brain injury, stroke, Parkinson’s, multiple sclerosis and the early stages of dementia. They are also the skills people describe as “I just feel slower” without being able to name what has changed.

Therapy here is deliberately practical. It works on the things that have got hard: remembering medication, following a recipe, managing appointments, returning to work, keeping track of a conversation, staying safe at home and in the community.

Dementia and mild cognitive impairment

We work with people from mild cognitive impairment right through dementia and Alzheimer’s disease, and we work with the families around them. One of our clinicians is a Certified Dementia Practitioner.

The work is about function and connection. External memory aids — calendars, timers, memory books, written routines — can hold independence in place for a long time. Communication strategies help families keep talking to each other rather than around each other.

We also run dedicated memory caregiver consultations for families who want time to plan.

Voice disorders

Voice therapy uses exercises and strategies to change how the vocal mechanism works. That can mean active physical exercise targeting vocal production, and it can mean reducing the things that are wearing your voice out.

Signs it is worth getting assessed: hoarseness, vocal fatigue, reduced volume, losing your pitch range, difficulty being heard or projecting, poor breath support, chronic cough, pain or tension, and frequent throat clearing.

We treat neurologic voice disorders, vocal changes, vocal nodules, polyps, muscle tension dysphonia, chronic cough, and the demands of professional voice users.

Augmentative and alternative communication (AAC) for adults

When speech is not reliable enough on its own, AAC gives you another way through. That might be a speech-generating device, a tablet app, or something as simple as a written word bank or a communication book.

AAC is not giving up on speech, and it does not stop speech coming back. It means you can say what you need to say today, while therapy continues.

Our owner is a certified Lingraphica technology specialist and has taught continuing education on integrating AAC into traditional speech therapy.

Stuttering

We work with teenagers and adults who stutter. Therapy covers techniques for managing the flow of speech, and — just as importantly — education and counselling, because how you feel about your speech shapes how much you use it.