Speech Therapy Service
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Speech, Language and Voice DisordersNeurogenic speech & language disorders
Neurogenic speech and language disorders result from damage to the brain, which may be caused by diseases such as stroke or head injury. A person with such a disorder may have problems speaking, comprehending, reading, and/or writing. They may be unable to express one’s needs or thoughts, or produce brief speech, or slurred speech that may be difficult to understand.
Treatment varies according to individual needs which may improve the strength and coordination of the muscles used in speech, re-learning how to produce sounds, words or sentences correctly, or in more severe cases, how to appropriately use gestures or electronic communication devices to aid overall communication.
Speech disorders related to head and neck cancer
People with cancer of the mouth, tongue, larynx or nasopharynx may have undergone surgery and/ or radiotherapy. Owing to changes in the normal head and neck structures or due to the late effects of radiotherapy (e.g. tissue hardening), speech, as well as swallowing problems may arise.
Pre-operative counseling is essential to prepare the individual for the potential changes in speech and/or swallowing function, and the likely rehabilitation that will be needed after surgery and / or other treatments.
After surgery, timely alaryngeal speech rehabilitation using devices such as electrolarynx or tracheo-oesophageal speech prosthesis, may be introduced and speech exercises may be delivered to optimize the individual’s speech intelligibility.
Speech for people with tracheostomy or ventilator
A tracheostomy is a surgical opening made in the trachea. A tracheostomy tube is generally placed through the opening to aid breathing and the removal of secretions. A tracheostomy may be short term or permanent depending on the person’s condition. A person with a tracheostomy may find it difficult to speak, or will not be able to speak at all.
The speech therapist will assess whether a speaking valve or other speech devices can be used. Exercises to improve the coordination of breathing for speech may also be taught
Voice problems may result from misuse of the voice or from other underlying medical problems. People who use their voice often in their occupation may be more prone to voice disorders. Other, including children, who use their voice often, may also develop voice disorders. An ENT specialist may confirm the presence of vocal cord nodules or polyps, or nerve damage that give rise to voice problems although sometimes voice problem can occur without any apparent illness.
Common signs and symptoms of voice disorders may include hoarseness or breathiness of voice, easy vocal fatigue or unable to control the pitch of the voice.
Voice therapy may consist of a variety of tasks designed to eliminate harmful vocal behaviors, shape healthy vocal behavior, and assist vocal fold wound healing after surgery or injury. Treatment may include voice therapy alone, or voice therapy in conjunction with ENT management. Therefore, you are advised also to consult an ENT specialist for a detailed examination of the vocal cords and management plan.
Developmental speech and language disorders in children
Children master speech sounds, words, and grammar in stages. When a child has difficulty speaking clearly or saying particular sounds or words, problems to follow directions, or unable put words together into sentences, then he/ she may have a developmental speech and/or language delay or disorder. There may not be a definite cause to a developmental speech or language disorder. However, some conditions that may affect speech and language development in children include cleft lip and/or palate, global developmental delay, intellectual impairment, autistic spectrum disorders, hearing impairment or children with a lack of facilitative language stimulation/ environment.
The speech therapist will conduct appropriate tests to determine the need for therapy depending on the age and nature of the disorder identified
Stuttering is a disorder that affects the fluency of speech. Stuttering typically begins in childhood, but can also occur later in life drue to injury of the brain. Stuttering may affect an individual’s self esteem, educational, vocational, or social participation. The severity of the stuttering for an individual may vary from situation. For example, one may be more dysfluent when speaking to a large audience. Some features of a person who have stuttering may have part or whole word repetitions e.g. “h-h-how are you?” or “how how how are you?” , or sound prolongation e.g. “sss…sit down please”
Various approaches may be used such as controlling the rate of speech, easy onset, relaxation techniques, and regulation of breathing.
Swallowing and Feeding DisordersAdult Swallowing Disorders
People with difficulties swallowing are at risk of poor nutrition, dehydration, pneumonia or suffocation. Swallowing disorders may result from a number of medical conditions. These include:
After a swallowing evaluation, the speech therapist may recommend specific swallowing treatment. Treatment may be in the form of exercises, recommendations on optimal feeding positioning, swallowing strategies or modify food and liquid textures to allow for safer swallowing. The recommended treatment is based on the cause and presenting symptoms of the swallowing problem
Feeding and swallowing disorders in Children
Feeding and swallowing problems may occur in infants and young children for various reasons. Causes of swallowing problems in children may be congenital (e.g. malformations present at birth such as cleft lips and palate), may be due to prematurity or neurological damage.
Treatment recommended by the speech therapist generally aims to increase the strength of the oral muscles, improve chewing, and coordinate the suck-swallow-breath pattern. The speech therapist may introduce safe textures and advise on postural changes or special feeding bottles and aids. Treatment is based on the cause and presenting symptoms of the swallowing problem
Videofluoroscopic Study of Swallowing (VFSS)
VFSS is an objective assessment used to assess swallowing function. VFSS is conducted under x-ray and is typically done in conjunction with a radiologist. During VFSS, the individual with the swallowing problem is given food and liquid mixed or coated with barium, so that it can be seen under x-ray. The swallowing process is seen and the cause of the problem, presence or absence of aspiration, and whether possible compensatory techniques can be used to improve swallowing may be explored during the procedure. Based on the VFSS findings, the speech therapist may discuss treatment and recommendations that may aid safe swallowing.
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
FEES is an objective assessment used to assess swallowing. The assessment uses endoscopy and is typically conducted with a specialist doctor. A flexible endoscope is inserted through the nose while food and liquids are swallowed. This is so that the swallowing process can be visualized. Food and liquid given during the procedure may be of varying textures and food coloring may be added to improve visibility. Finding the cause of the swallowing problem, assessing the presence or absence of aspiration, and identifying possible compensatory techniques are the goals of the procedure.
|For enquiries and appointments, please contact us at:|
|Speech Therapy Service|
|Address:||5/F, Li Shu Pui Block|
Hong Kong Sanatorium & Hospital
2 Village Road, Happy Valley, Hong Kong
|Monday to Friday:||9:00am - 5:00pm|
|Saturday:||9:00am - 1:00pm|
|Closed on Sundays and Public Holidays|