Speech Language Therapy - Whitby
|Monday||8:30am - 4:30pm|
|Tuesday||8:30am - 4:30pm|
|Wednesday||8:30am - 4:30pm|
|Thursday||8:30am - 4:30pm|
|Friday||8:30am - 4:30pm|
[ click each service below for more information ]
Areas Served by This Location
CBI Home Health provides Speech-Language Pathology services across the GTA, in regions including, but not limited to, Durham region, Scarborough, York region, Toronto, Mississauga, Brampton, and Whitby.
Communication – the process of being able to understand and be understood – is something most of us take for granted. Communication disabilities are the result of problems with: speech, using and understanding language, voice, fluency, hearing, reading or writing.
The following is a list of communication or swallowing disorders treated by CBI Home Health.
Articulation Disorder Therapy
Articulation refers to the way in which a sound is made when you are talking. Sounds that are pronounced incorrectly call attention to how you sound rather than to the message that you are relaying. Articulation disorders can vary from mild substitutions to multiple sound errors. A major focus of therapy is to increase the amount of speech that a listener can understand.
Speech sound errors can include:
- Substitutions (when a different sound is produced instead of the correct sound – for example, “fum” for “thumb”)
- Distortions (the sound is produced with improper use of airflow or oral mechanics – for example, a lisp) Omissions (the sound is left out of the word – for example, “um” for “thumb” or “ca” for “cat”)
- Modeling (giving a demonstration of the sound), cueing (giving “hints”), and repetition combined with visual aids are ways we will help you say the appropriate speech sound.
Phonology Disorder Therapy
Every language has rules about how sounds can be combined to make words. Phonological disorders arise when an individual has trouble with the specific sound rules of a language and develops unique patterns of their own. For example, the child may have their own rule for sounds produced at the back of the mouth and instead may make them at the front of the mouth. For example, the child may say “tup” instead of “cup” or “go” instead of “doe” – the child is following the rule that when they hear a sound at the back of their mouth, they make the sound at the front of their mouth.
Examples of processes that can occur as part of a phonological disorder include:
- Final consonant deletion (when all end sounds of words are omitted – “dog” becomes “daw”);
- Fronting (when sounds made at the back of the mouth are made at the front of the mouth – “cup” becomes “tup”)
- Stopping (where sounds that require a continuous flow of air are stopped – “zipper” becomes “tipper”)
- Gliding (when sounds like /l/ and /r/ are replaced with a /w/ or /y/ - lips become “yips” or “red” becomes “wed”)
Fluency Disorder (Stuttering) Therapy
A fluency disorder (“stuttering”) is characterized by disruptions in smoothness, rhythm, and continuity of sounds, syllables, words or language during speaking. All speakers experience dysfluent speech on occasion. The dysfluencies become a disorder when the number and type of dysfluencies interfere with communication.
The most common types of dysfluencies are:
- Prolongations (a drawing out a sound or syllable)
- Repetitions (repeating a sound, syllable, word or phrase)
- Blocks (unable to make the intended sound)
Often a person who stutters will also experience “secondary behaviours” that occur during the dysfluency such as:
- reduced eye contact,
- hand or arm movements,
- facial grimaces,
- lip tension, and
- other facial movements
If a person experiences dysfluency over a period of time, he may feel anxious and emotionally challenged during communication. Therapy focuses on reducing and controlling the dysfluencies, as well as discussing the individual’s attitudes toward their dysfluencies. Early results may be seen when dysfluencies, secondary behaviours and attitudes/emotions are addressed properly. Continued therapy helps the individual manage and control speech to gain and maintain fluency.
Voice Disorder Therapy
Voice is produced when the vocal cords come close together and air from the lungs vibrates the vocal cords.
A voice disorder may include:
- Inappropriate pitch (e.g. a voice that is too high or too low, considering the client’s age and gender)
- Inappropriate loudness (e.g. too loud or too soft)
- Inappropriate quality (e.g. a hoarse voice)
- Total voice loss
- A voice disorder may result from damage to the vocal cords due to misuse (e.g. yelling, talking too much or talking too -loudly)
- Abuse (e.g. excessive throat clearing, coughing, or smoking).
Misuse and abuse causes changes to the vocal cords that may result in vocal nodules, polyps, or contact ulcers.
A voice disorder can also result from diseases including cancer, vocal fold paralysis, or chronic laryngitis. Some conditions that occur at birth such as cleft palate, cerebral palsy or a hearing impairment, can cause voice disorders.
Resonance Disorder Therapy
Resonance is the quality of the voice that is determined by the balance of sound vibration in the mouth, nose, and throat during speech. Resonance disorders may be related to too much airflow leaving the nose while speaking (hypernasality), or not enough airflow leaving the nose while speaking (hyponasality). Disorders such as Cleft Palate, Cerebral Palsy or hearing loss can also cause resonance disorders.
Aphasia Speech Therapy
(a.k.a. dysphasia) is a disorder that results from damage to the language centres of the brain (typically on the left side of the brain). This damage is generally the result of a stroke, but can also be caused by gun shot wounds, tumours, and other forms of brain injury/damage. Some people with aphasia have problems understanding what is being said (receptive language), while others have difficulty producing speech (expressive language); some have difficulty in both aspects of language. There may also be impairments in reading and writing. Word finding problems are common in individuals with aphasia; individuals experience of the feeling of having a word “on the tip of the tongue” but not being able to remember it. Individuals with aphasia may speak only in single words, omit smaller words (e.g. “the” or “of”), put words in the wrong order, use incorrect grammar, or switch sounds and words (e.g. calling a “bed” a “table”, or saying “wish dasher” for “dish washer”). Individuals may string together “made up” words that make no sense to the listener. The person with aphasia may also find it difficult to understand more subtle aspects of language (e.g. not understanding expressions like “it’s raining cats and dogs”, understanding sarcasm or humour).
Dysarthria results from paralysis, weakness, or lack of coordination of the muscles required for speech. In children, dysarthria can occur from birth or can occur as a result of a disease (e.g. Cerebral Palsy, Bells Palsy, or head injury). In adults, dysarthria can be caused by a stroke, degenerative disease (e.g. Parkinson’s, Huntington’s, or Multiple Sclerosis), infection, brain tumour, or toxins (e.g. drugs or alcohol).
A person with dysarthria may experience a different symptoms depending on the extent and location of the damage to the nervous system, such as:
- “Slurred” speech
- Speaking softly
- Slow or rapid speech
- Limited movement of the tongue or lips or jaw
A Speech-Language Pathologist determines the cause of the Dysarthria as well as the type and severity of symptoms and then focuses on improving the specific abilities during therapy.
Childhood Apraxia Therapy
Childhood apraxia of speech is a motor speech disorder that affects your child’s ability to sequence and say sounds, syllables and words. It is not due to muscular weakness or paralysis.
Your child will know what they want to say, but the brain does not send the correct instructions to move the body parts of speech the way they need to be moved. Refer to: http://www.apraxia-kids.org for more information.
Adult Apraxia Therapy
Apraxia in Adults (a.k.a. apraxia of speech, verbal apraxia, dyspraxia) : In adults, apraxia is a motor speech disorder that results from damage to the parts of the nervous system that control speech.
The person experiences difficulty sequencing the sounds in syllables and words. Severity of the disorder is related to the degree of damage to the nervous system.
Like children, the adult with apraxia will know what they wish to say and the individual muscles will have normal strength but the person’s brain will have difficulty coordinating the muscle movements necessary and they may say something completely different, even nonsensical.
For example, a person may try to say “kitchen”, but it may come out “bipem”. The person will recognize the error and trying again, sometimes getting it right, but sometimes saying something else entirely.
This can become frustrating for the person with apraxia.
At CBI Home Health we understand how difficult it can be dealing with apraxia and build our therapy with that in mind.
Dysphagia (Swallowing Disorder) Therapy
People with dysphagia have difficulty swallowing and may also experience pain while swallowing.
Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva.
Eating then becomes a challenge.
Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.
Infants may have developmental delays causing difficulty in learning to suck, chew and/or swallow. Neonatal care is provided to infant populations who fail to thrive through typical feeding programs.
Adults may experience difficulty chewing and swallowing as a result of an illness, stroke or progressive medical condition.
Therapy may focus on retraining the swallow or teaching strategies to compensate for the swallowing disorder.
Cognitive-communication disorders are communication impairments resulting from underlying cognitive deficits due to neurological impairment.
These disorders are commonly associated with traumatic brain injury but can also occur as a result of other brain injuries such as haemorrhages, stroke, meningitis, encephalitis, anoxia or tumours.
This can lead to difficulty in your:
- Ability to pay attention
- Organization skills
- Information processing (understanding)
- Executive functions (e.g. planning)
You might have a cognitive-communication disorders if you have difficulties in everyday communication:
- Participating in a conversation
- Social interaction
Cognitive-communication disorders vary widely between individuals and a therapy program will be tailored specifically to your individual needs, skills and impairments.
Impact of Communication Disorders
For children with a communication disorder, socializing with other children can be a major challenge.
The first step in therapy is the speech and language or swallowing assessment. During the assessment, the Speech-Language Pathologist observes and measures the client’s speech and language abilities or swallowing abilities.
The therapist uses these observations and measurements to develop a plan for care that is tailored specifically to that client. During the therapy process, the S-LP continues to measure progress with selected goals. The S-LP will also revise goals or set new goals as appropriate.
A plan of care consists of a series of goals and a set of activities to meet each goal. Only rarely can a goal be reached within one therapy session. Meeting goals is a slow process that takes place over time.
The length of time that a client will need therapy is individual and cannot be predicted. Generally the more serious the speech, language or swallowing problem, the longer the process. Clients may improve steadily over the course of therapy or they might show sudden spurts of growth toward goals. The rate and pattern of improvement varies for each client.
There are many successful ways to treat speech and language disorders.
Communication skills are taught by teaching the client to produce a goal behaviour (e.g. saying the “s” sound), then gradually increasing the difficulty of the behaviour over time. A child learning articulation may be required to say “s” by itself for a period of time, then to say in a syllable (e.g. “saw”), then in a word, then in a phrase, then sentence, and then connected sentences, then in conversation within the therapy session, and finally in everyday speech. The therapist gives the client the specific directions on how to accomplish the goal, provides feedback on how successful the client was in accomplishing the goal, and encourages the client to move on to the next level of difficulty. When therapists are working with children, the therapist will use games and rewards to motivate the child. Adults are generally motivated by progressing toward the goal in itself.
A client who has a swallowing impairment is usually provided with a set of recommendations to make swallowing easier. These recommendations may include: information on how to prepare food (e.g. puree solids or thicken liquids) to make them easier and safer to swallow, information on normal swallowing and the client’s specific swallowing disorder, how to sit to make swallowing easier, special swallowing techniques, etc. These recommendations will help the client compensate for a swallowing disorder. Some clients may be appropriate for therapy to improve their swallowing ability.
The frequency of the therapy sessions will depend upon the client’s age, ability to pay attention and focus without getting tired, nature and severity of the communication disorder, and practical considerations such as the cost and availability of therapy.
The support the client receives from their family is essential to success in speech-language therapy. The client will learn activities and techniques during therapy sessions that must be reinforced between therapy sessions in order to maximize the benefits of the therapy visit; as well as to encourage the client to carryover skills learned in the therapy session to their everyday conversation.