Northwestern's Comprehensive Care Model - Speech and Swallow Therapy

Speech Therapy

In the movement disorders clinic, the Speech and Language Pathologist evaluates the speech pattern of a patient, and designs treatment for that person's unique pattern. The speech therapist first assesses the degree of one's speech changes and difficulties, whether mild, moderate, or severe.

In the clinic setting, the speech therapist can:

• Make recommendations of vocal exercises to improve muscle function and guard against further speech decline
• Instruct the patient in strategies to compensate for deficits
• Recommend alternative methods of communication
• Refer patient to a therapist who is certified in Lee Silverman Voice Treatment (LSVT)

Swallow Therapy

The Speech and Language Pathologist also assesses for dysphagia, or swallow problems, in patients with Parkinson's disease and other movement disorders. As many as 50% of people with PD develop swallowing difficulties. These problems may worsen as the disease progresses. Dysphagia can present with a variety of symptoms: coughing, choking, throat-clearing, or gurgly voice when eating or drinking; drooling; complaints of food “sticking;” increased time required for meals (not related to manual dexterity); unintentional weight loss. In the office, the speech therapist can do a clinical, or “bedside,” swallow screening. In addition, a videofluoroscopy (Modified Barium Swallow study) can be scheduled.

Depending on the symptom and severity, the therapist's treatment recommendations might include:

• Diet modifications: thickened liquids and pureed foods
• Range of motion exercises for lips, tongue, larynx
• Other "maneuvers," e.g. "effortful swallow," "breath-hold swallow"