Speech & Language Therapy
Communication is central to our lives. It enables us to establish and maintain relationships, it helps us to work, learn, explore and keep in touch with the world. We also understand our past and make plans for our future using communication. Often we connect with others around a meal, with eating and socialising being central to our interaction.
​
The ability to communicate and swallow is something most of us take for granted. Yet when one suffers a neurological insult the value of communication, cognition and swallowing become valuable and treasured commodities.
​
The speech-language therapists at RehabWorx specialise in acquired speech, language, swallowing and/or other cognitive-communication disorders and endeavour to re-connect patients with their communicative partners.
We form an active part of the multidisciplinary treatment team and provide intervention to guide and assist individuals in communicating, eating and drinking in an attempt to enhance the patient and his/ her significant other’s overall quality of life in a social environment.
Communication disorders are often the lasting result of a stroke or brain injury, but may also be caused by other neurological conditions such as dementia or brain tumours. Surgery such as head and neck cancer and the generally weak medical patient may also suffer from swallowing and communication difficulties.
We render a full time speech-language therapy service to our patients. Individual therapy may focus on one or more of the following areas:
LANGUAGE THERAPY
​
Addresses acquired language disorders such as aphasia. Aphasia is a communication disorder and masks the patients inherent competence to communicate. As speech therapists we endeavour to reveal the patient’s competence with an emphasis on increasing overall comprehension of language, and enabling improved ability to express or communicate one’s needs.
​
​
SPEECH THERAPY
​
Addresses motor speech disorders such as apraxia and dysarthria, which may include a focus on disorders of articulation, phonation, resonance, vocal quality, pitch, intensity, rate, fluency and prosody of speech to facilitate improved speech clarity and intelligibility.
Bell’s Palsy is also treated to assist in muscle recruitment as well as the functional use of these muscles needed for eating and talking. This therapy is conducted in collaboration with the physiotherapists.
​
COGNITIVE - COMMUNICATION THERAPY
​
A cognitive -communication disorder may result from impaired functioning of various cognitive processes, which may include the following:
-
Attention
-
Perception (interpretation of sensory information)
-
Memory (recall of facts, procedures and past and future events)
-
Insight and judgement (understanding ones own limitations)
-
Organisation (arranging ideas in a useful order)
-
Orientation (Knowing where, when and who you are)
-
Language (words for communication)
-
Processing speed
-
Problem solving
-
Reasoning
-
Executive functioning (making a plan, acting it out, evaluating success, and adjusting)
-
Metacognition (thinking about how you think)
A problem with integrating these processes can cause difficulty with functioning in society and communicating effectively.
​
AUGMENTATIVE COMMUNICATION
​
The development of an alternate communication system such as the use of gestures, yes/no cards, picture and communication boards to enable the individual to express his/her wants/needs and interact with others. Patient who are non-verbal can greatly benefit form this form of communication.
As speech therapists, swallowing therapy is also an integral part of our service. Swallowing difficulties are a common sequelae following neurological involvement and can cause difficulty with eating or drinking. If not managed, this can result in chest infections, including pneumonia as food or liquid passes into the windpipe and lungs instead of the stomach. Dehydration or constipation may also result.
Head and neck cancers can lead to speech and voice problems and to difficulties with swallowing, eating and drinking. As part of the multi-disciplinary team supporting people with head and neck cancer, speech and language therapists (SLTs) play a crucial role in supporting people’s rehabilitation. This includes helping people to communicate and to eat and drink safely.
The impact of head & neck cancer on communication & swallowing:
Head and neck cancer is used to describe a range of tumours that occur in cavities and glands across the head and neck region. These tumours can lead to problems with communication and swallowing before, during and after treatment. Medical interventions for treatment for these cancers may include surgery, to remove parts of structures essential for functions of speech and swallowing, such as the lips, tongue, pharyngeal muscles, voice box(Laryngectomy), in addition to adjuvant therapies such as radiotherapy, chemoradiotherapy or a combination of treatments. These commonly affect a person’s ability to speak, use their voice, swallow, smell and breathe, significantly affecting quality of life. Left unsupported, these difficulties can also affect a person’s ability to participate in social activities and to return to work.
The Role of the speech and language therapists
​
Speech and language therapists play a unique and essential role in assessing, diagnosing and managing communication, speech, voice and swallowing problems resulting from head and neck cancer. We work in close collaboration with the patient, their families and other members of the multi-disciplinary team.
Our role is to:
-
Assess and provide patients and their families with information regarding the potential impact of treatment on their functioning and assist in multi-disciplinary team treatment decision-making .
-
Help develop and support the communication skills of both the patient and communicative partners post surgery.
-
Identify and treat swallowing difficulties, and manage the associated risks of persistent swallowing problems. Improving function post surgery is imperative to enable the patient to swallow and communicate despite altered anatomy and to find new ways to work with the oral and pharyngeal structures.
-
Assisting with restorative vocal usage in patients with Laryngectomies.
-
Contribute to palliative and end-of-life care, maximising and facilitating communication and managing swallowing problems, promoting quality of life.
Modified Barium Swallows are conducted at our X-ray department. These studies are conducted in collaboration with the Radiologists and radiographers at Groenkloof Hospital. We assess the anatomy and physiology of the swallowing process and based on our findings a treatment plan is developed, to specifically address and remediate the patient’s swallowing difficulties.
​
Why a modified Barium Swallow?
Modified Barium Swallow (MBS) studies are performed by the radiologist and speech-language therapist. The Modified Barium Swallow study is used to determine the efficiency and safety of the swallow. The main intent of the study is not to rule out or confirm aspiration, but rather to understand the functioning of the swallowing mechanism so as to plan an appropriate treatment plan specific to the patient’s needs. In so doing, it also assists in determining the type(s) or texture(s) of food a patient can ingest in a safe and efficient manner. It also helps to determine any postural changes or compensatory techniques which might be needed to allow the patient to eat or drink safely.
FAQ's ABOUT THE MODIFIED BARIUM SWALLOW
Can I eat before the assessment?
Yes. You do NOT have to have an empty stomach for this test.
How long will the study take?
Once you are in the X-ray suite, the study should take no longer than 30 minutes. We will make every effort to keep your waiting time to a minimum. If you are an out-patient, put aside an hour to conduct the entire procedure since you will have to fill in your details at reception. Please arrive 15minutes before your scheduled appointment to complete the forms.
What does the study involve?
You’ll be given small amounts of liquid to drink, a pudding-like texture to eat, and a biscuit to swallow while video x-rays are taken. All the products are immersed in Barium, to enable visibility during the X-ray. If there are particular foods that cause you difficulty like dry foods or pills, you may be asked to try to swallow them. While you are seated, both a side view and a front view will likely be done.
When will I know the results?
A family member is most welcome to accompany you to the study. During the actual study, your significant other will be asked to remain in reception. On completion of the study, we will call your family member and feedback will be given with your family present.
Can my family observe?
We are happy to have one member of your family accompany you and observe the study.