Speech and Language Pathology

The Speech and Language Pathology Department at The Northwest Texas Healthcare System focuses on evaluating, treating and managing both adults and children with disorders of speech, voice, language, cognition, memory or swallowing. The staff works with a variety of specialties, including neurology, otolaryngology (ear, nose and throat), radiology, oncology and general medicine. Patients receive individualized treatment plans that focus on establishing or reestablishing optimal communication and swallowing function.

Speech Conditions and Disorders Treated

People with the following conditions may benefit from the expertise of a speech-language pathologist:

• Brain tumor
• Developmental delays and disorders
• Head and neck surgery
• Neurological/Post-neurological condition
• Neuromuscular disease
• Trauma Disorders
• Stroke

Among the disorders treated by Northwest Texas Healthcare System speech and language pathologists include:

• Aphasia – difficulty speaking or understanding speech
• Apraxia – difficulty forming words due to motor condition
• Cognitive disorders – amnesia, dementia, delirium, etc.
• Dysarthria – unclear articulation
• Dysphagia – difficulty swallowing
• Glossectomy – surgical removal of part or all of the tongue
• Laryngectomy – total or partial voice box removal
• Voice disorders – caused by nodules, polyps or sores

Pediatric Speech-Language Outpatient Clinic 

The Pediatric Speech-Language Pathology Outpatient Clinic at Northwest Texas Healthcare System provides physical therapy, occupational therapy and speech pathology services to children. Specific pediatric speech-language disorders that are treated by speech-language pathologists at the clinic are described below.

• Articulation and phonology (production of speech sounds)
• Childhood apraxia of speech
• Dysphagia (modified barium swallow studies)
• Executive functioning and cognitive skills
• Expressive language, including:
  • Answering questions
  • Making requests
  • Vocabulary and basic concepts
• Family education and home programs
• Nonverbal Language
• Receptive Language
  • Comprehension of written and spoken information
  • Following directions
• Social Language/Pragmatics and problem solving
• SOS® (Sequential-Oral-Sensory) feeding therapy

Specialized Swallowing Studies

VitalStim® Therapy

VitalStim® Therapy is an innovative therapy that uses a small current passing through electrodes on the neck to stimulate inactive swallowing muscles. It is the only technology cleared by the FDA for restoring the swallow function.

Stroboscopy

A stroboscopy is an exam in which strobe light is combined with rigid laryngoscopy allowing exam of vocal fold vibration and vocal fold closure.

Modified Barium Swallow Exam

People with swallowing disorders may be asked to take video fluoroscopic swallowing exam (VFSE), also called a modified barium swallow exam (MBS). In this radiologic examination, doctors use a special x-ray called fluoroscopy. The doctor observes the patient swallowing various substances made from barium, a metallic chemical, to evaluate his or her ability to swallow safely and effectively.

A speech-language pathologist is usually present at the exam with the doctor and patient. The speech-language pathologist may then use information from the VFSE to help the patient learn new swallowing techniques and strategies.

Fiberoptic Endoscopic Evaluation of Swallowing

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is an instrumental evaluation provided by specially trained speech-language pathologists to evaluate swallow function in individuals with dysphagia. In the FEES procedure, a flexible endoscope is introduced transnasally to the patient’s pharynx where the clinician can clearly view laryngeal and pharyngeal structures and their functions. FEES can be completed in the patient’s typical eating position at bedside or in a private treatment room.

During the evaluation, the patient is given any type of food or liquid to assess swallow function. A small amount of food coloring is usually added to assist with delineation of tissue, secretions and bolus trials. Upon completion of the FEES we are able to provide recommendations regarding the safest, least restrictive oral diet, appropriate compensations and treatment strategies to improve safety and reduce the risk of aspiration-related illness.

Training of Clinical Staff

The clinical staff includes seven speech-language pathologists certified by the American Speech-Language Hearing Association. As part of an academic medical institution, graduate students majoring in speech-language pathology also provide clinical services under direct supervision from clinical staff.