Speech-Language Pathology

Speech-Language Pathology in Burlington, VT

Speech-Language Pathologists evaluate and treat a large range of communication and swallowing disorders. These include problems with speech, voice, language, thinking and swallowing. These problems can result from neurological conditions such as stroke, traumatic brain injury head and neck cancer, Parkinson’s disease , swallowing complications from birth – or from infections and other causes.

Speech-Language Pathologists at Fletcher Allen are experienced, highly skilled health care professionals who have national certification from the American Speech-Language-Hearing Association and are licensed by the State of Vermont.

They provide inpatient, outpatient and rehabilitation services for patients of all ages -- from premature infants to the elderly – with a focus on the whole patient. They work closely with clinicians from all disciplines and provide services throughout Fletcher Allen, caring for patients wherever there is a need.

As part of a university hospital, our Speech-Language Pathologists are also actively involved in national conferences and research, with access to the latest medical knowledge and innovations in the field.

Frequently Treated Conditions

• Aphasia – loss of language, including difficulty with talking, understanding language, reading or writing.
  
• Cognitive-Communication Disorders – a wide range of communication problems that affect your ability to think effectively and efficiently.
  
• Difficulty with memory or recall
  
• Dysarthria - slurred speech
  
• Dysphagia – difficulty swallowing
  
• Verbal/Oral Apraxia - a condition that affects the ability to consistently make sounds or words following the same pattern -- not related to muscle weakness. The condition also involves problems with oral-motor functioning (movement of the lips, tongue, jaw and cheeks).  
  
• Voice disorders – Loss of voice quality, or problems with pitch, loudness and other aspects of the voice.
  
• Word-finding problems – tip-of-tongue syndrome: the person knows what he or she wants to say, but is having trouble coming up with the word.

Speech-Language Evaluations and Treatment

Speech-Language Pathologists at Fletcher Allen offer the latest diagnostic tests and procedures.  We help patients regain and improve speech and communication skills, so they can function as independently as possible. In cases where it may not be possible for patients to perform certain skills, we focus on patient and family education and work to compensate for the loss of ability or function. 

We provide:

• Aphasia evaluation and treatment – This involves using evaluation tools specially designed for aphasia to evaluate the patient’s loss of language. Speech-language treatment focuses on helping to improve the patient’s ability to communicate.
   
• Augmentative-Alternative Communication (AAC) -- Patients are evaluated to determine the benefit of using aids such as picture boards, as well as devices designed to help those with severe speech and/or language problems communicate such as speech-generating devices.
  
• Communication and swallowing evaluation and treatment for tracheotomy or ventilator-dependent patients
• Communication-Cognitive evaluation and treatment – A wide range of evaluations and treatment for cognitive communication disorders. These are communication problems that result from damage to the part of the brain that controls the ability to think.

Our services include:

Testing for cognitive-linguistic problems, which can include problems with attention, memory, organizing thoughts, logical sequencing, anticipating outcomes and adapting to changing situations, social interaction, problem-solving skills, awareness and judgment.

Direct teaching and training to improve these abilities, using strategies based on how people learn best.

• Dysphagia evaluation and treatment for swallowing disorders Treatment for adults and children with stroke,  traumatic brain injury, structural anomalies such as cleft palate, respiratory disorders, swallowing coordination, head and neck cancer or neurodegenerative diseases.

Protocols include:

Clinical Swallow Evaluations

Modified Barium Swallow or video fluoroscopic swallow studies for adults and pediatric patients. These studies involve taking a videotaped x-ray of the swallowing process while the patient is eating. These tests help Speech-Language Pathologists determine what changes can be made to improve the patient’s ability to swallow safely.

Pediatric Feeding Team evaluations and treatment. A team including a Speech-Language Pathologist, occupational therapist and dietitian provides evaluation and treatment for children with feeding difficulties.

Dysphagia Treatment- Speech Language Pathologists provide exercises to improve coordination and strengthen the swallowing muscles – including exercises for the tongue, jaw and larynx. We also train patients on new swallowing techniques, and strategies to compensate for loss of functioning.

• Amyotrophic Lateral Sclerosis (ALS), often referred to as "Lou Gehrig's Disease" – Speech-Language Pathologists are part of Fletcher Allen’s multidisciplinary ALS Clinic which brings a team approach to evaluating patients with ALS.  In addition to Speech-Language Pathologists, the team consists of a neurologist and neurology nurse who specialize in neuromuscular diseases, a respiratory therapist, physical therapist, occupational therapist, social worker, palliative care specialist, dietician and spiritual services support. Representatives from the national ALS Association and Muscular Dystrophy Association are also involved.
   
• Aerodigestive clinic -- Speech-Language Pathologists are part of Fletcher Allen’s Aerodigestive clinic, which offers patients and families an integrated model of care for swallowing disorders. The clinic provides a multi-disciplinary approach for children with complex conditions. The child is seen by the pediatric pulmonologist, pediatric gastroenterologist, pediatric otorhinolaryngologist and Speech-Language Pathologist. Clinics are scheduled through Pulmonary Medicine.
   
• Voice evaluations and treatment – Speech-Language Pathologists at Fletcher Allen participate in a voice clinic with ear, nose and throat physicians who specialize in voice disorders.  Evaluation may include videostroboscopy, where movement of the vocal cords is visualized.  We provide treatment for a range of conditions, including:   

  Hoarseness
  Chronic Cough
  Vocal Cord Dysfunction
  Hypernasality -- a disorder that occurs when air leaks from the nose and affects the quality of speech.
  Hyponasality – a disorder that occurs when too little air is released through the nose; the person may sound as if they have a cold. 
  Hypophonia – a weak voice related to lack of coordination of the vocal muscles.
  Laryngectomy – surgery to remove the larynx.
  Muscle tension dysphonia – occurs when the muscles around the larynx become too tight during speech and the voice may feel and sound strained.
  Spasmodic dysphonia -- when muscles inside the larynx spasm or move involuntarily, making it difficult to talk.

Tools for these problems can include:

Visi-Pitch – a diagnostic tool used to provide precise measurements of vocal characteristics, such as pitch and decibel levels.

Videostroboscopy – a procedure that uses a scope and strobe light to examine the vocal folds.

The Lee Silverman Voice Treatment Program – a program designed to help Parkinson’s disease patients by helping to increase the loudness of their voice.

In addition, we evaluate and manage patients for tracheoesophageal prosthesis (TEP) following larynx removal surgery, and provide training for esophageal speech.

Developmental Speech and Language Conditions

Fletcher Allen Speech-Language Pathologists focus mainly on medically based conditions. Individuals with speech-language difficulties related to developmental issues are often served best when they receive services through the school system. If you or a loved one has an issue that is developmental in nature, please contact your local school district.

 

Insurance coverage questions

• Insurance coverage for speech-language pathology services may vary by insurance company. If you are unsure whether your insurance will cover treatment for your specific condition, please check with your carrier prior to your visit.
  
• All evaluations require a referral from your doctor. Referrals should include your name, date of birth, medical history, diagnosis, medications and reason for referral.

Contact Speech-Language Pathology

To contact Speech-Language Pathology, please call (802) 847-3970. If you are a provider or need to make a referral, please call Provider Access Service, (800) 639-2480.

Patient Resources

www.vsha.us – Vermont Speech-Language Hearing Association

www.asha.org  -- The American Speech-Language and Hearing Association

www.aphasia.org --  National Aphasia Association

www.parkinson.org -- The National Parkinson Foundation

www.BIAUSA.org – Brain Injury Association of America

www.BIAVT.org – Brain Injury Association of Vermont

www.ninds.gov   -- The National Institute of Neurological Diseases and Stroke

www.strokeassociation.org   – The American Stroke Association

www.alsa.org  – The ALS Association

www.nationalmssociety.org  – National MS Society

www.cochrane.org  -- A group that provides reviews of scientific research studies. Cochrane Reviews provide information about whether certain treatments are effective for certain conditions, and assesses the accuracy of diagnostic tests for certain conditions.