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Otolaryngology (ENT)

UR Medicine Speech Pathology

UR Medicine / Otolaryngology (ENT) / Speech Pathology / Our Services / Inpatient Rehab Services

 

Inpatient Acute Rehabilitation

Inpatient Acute Rehabilitation is a 20-bed unit that is located within Strong Memorial Hospital. The inpatient rehabilitation unit is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and Magnet accredited and includes an interdisciplinary team of specialists, including Physical Medicine and Rehabilitation physicians, a neuropsychologist, physical therapy, occupational therapy, speech-language pathology, recreational therapy, and social workers.

The Inpatient Acute Rehabilitation program includes the following specialty programs:

  • Spinal Cord Injury Rehabilitation
  • Brain Injury Rehabilitation
  • Stroke Rehabilitation
  • Pediatric Rehabilitation
  • Multi-specialty Rehabilitation
    • Multiple trauma
    • Neurological disease
    • Cardiac disease
    • Organ transplants
    • Amputations

Our speech-language pathologists have specialty training in working with complex patients who have multiple areas of rehabilitation need. Our SLPs work closely within the acute rehabilitation team to provide high quality, interdisciplinary, patient-centered care. While on the acute rehabilitation unit, patients participate in at least 3 hours of rehabilitation services per day, six to seven days per week.

What SLP services are provided in acute rehabilitation?

  • Swallowing evaluation and treatment
  • Modified Barium Swallow Study/Videofluoroscopic Swallow Study (MBSS/VFSS) or can be referred to as Pharyngogram within this organization. 
  • Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
  • Communication (Speech and Language) evaluation and treatment
  • Cognitive-Linguistic evaluation and treatment

Speech-Language Pathology Evaluation & Therapy

Our Speech-Language Pathologists have specialty training and expertise in evaluating and treating swallowing, communication and cognitive impairments.

A swallowing evaluation may include:

  • A detailed history collection / medical chart review
  • An oral motor examination to assess cranial nerve function that impacts swallowing
  • Trials of foods and liquids, including observation and assessment by the Speech-Language Pathologist during these trials

Swallowing therapy may include:

  • Swallowing exercises
  • Changes to diet and liquid consistency and / or use of swallowing strategies to improve swallowing safety, reduce risks for aspiration and maximize nutrition
  • Use of biofeedback to increase effort with exercises
  • Use of electrical stimulation as a treatment modality to improve swallowing function

Modified Barium Swallow Study/Videofluoroscopic Swallow Study (MBSS/VFSS) / Pharyngogram

  • This is a video x-ray study used to assess your ability to swallow food and liquids.  The study is completed by Speech-Language Pathologist, Radiologist, and a Radiology Technologist. During the study you will eat and drink different food and liquid items containing barium.  Barium allows the SLP and Radiologist to see the food and liquid as you swallow under x-ray.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

  • The procedure involves the Speech-Language Pathologist passing a flexible endoscope across the floor of your nasal passage into the throat, voice box and upper airway can be viewed from above. Once the scope is place, the SLP gives the patient food, dyed green to contrast against the tissues in the throat, and assesses the function of the swallowing mechanism.

Communication (Speech / Language) Evaluations

Your speech / language assessment may include some of the following tasks:

  • A detailed history collection / medical chart review
  • Initial informal assessment of communication abilities

Language:

  • Stating personal information (name, birthdate, etc.)
  • Answering yes / no questions
  • Following single and multi-step directions
  • Naming pictures or objects
  • Answering open ended questions
  • Participating in conversation
  • Reading
  • Writing
  • Trials of supportive, multi-modal or alternative / augmentative communication (AAC) methods to identify a reliable method of communication during inpatient admission.
    • AAC may be low-tech, such as the use of a communication page, or high-tech, such as an electronic device (i.e., Lingraphica, Tobii-Dynavox) that facilitates communication.

Speech:

  • An oral motor examination to assess cranial nerve function that impacts speech production
  • Evaluation of articulation, phonation, respiration, resonance and prosody
  • Production of sounds, single syllable words, multi-syllabic words and sentences by imitation, in reading and spontaneously
  • Evaluation of intelligibility of speech
  • Trials of supportive, multi-modal or alternative / augmentative communication (AAC) methods to identify a reliable method of communication during inpatient admission.
    • AAC may be low-tech, such as the use of a communication page, or high-tech, such as an electronic device (i.e., Lingraphica, Tobii-Dynavox) that facilitates communication.

Using this information, your SLP will identify your areas of speech and language strength and weakness, and develop a tailored therapy plan to help maximize and improve your communication skills. Your SLP will implement a person-centered approach and focus on maximizing life participation.

Cognitive-Linguistic Evaluations

Your cognitive-linguistic assessment may include:

  • A detailed history collection / medical chart review
  • Initial informal assessment of functional cognitive abilities

Tasks to assess the following areas may be completed:

  • Attention
  • Memory
  • Executive functioning
  • Language
  • Visuospatial skills

Using this information, your SLP will identify your areas of cognitive strength and weakness, and develop a tailored therapy plan to help maximize and improve your daily functional skills. Your SLP will implement a person-centered approach and focus on maximizing life participation.

Upper Airway and Voice Evaluations

Your upper airway / voice evaluation may include:

  • A detailed history collection / medical chart review
  • Informal assessment of voice and breathing function

Should your speech-language pathologist determine that you have a new voice impairment, a referral to ENT may be made in order to assess and visualize airway patency and vocal fold mobility / function.

Using this information, a treatment plan will be developed between ENT and your SLP to maximize your voice and breathing function.