Speech & Language Therapy Services

Speech & Language Therapy Services Goshen NY Speech and language allow us to communicate with each other. Impairments in these areas prevent us from sending, receiving, and understanding messages. Speech disorders occur when a person is unable to produce speech sounds correctly or fluently, or has problems with voice or resonance. Language disorders occur when a person has trouble understanding others or expressing thoughts, ideas, or feelings. Hearing is also an important factor for successful communication. Hearing disorders make it difficult to detect, recognize, discriminate, comprehend, and perceive auditory information for speech and language. Disorders of speech, language, and hearing are also referred to as communication disorders. Communication disorders can be present at birth or acquired later in life and range in severity.
Voice disorders, or dysphonia, are characterized by problems with pitch, loudness, and quality of the voice. They occur when the vocal folds are not vibrating normally in the larynx, or voice box. Voice disorders can occur from infections, colds and allergies, surgical procedures, excessive throat clearing, vocal misuse and abuse, or neurological disorders. People with dysphonia may demonstrate hoarse or breathy voice quality, loss of voice, painful or effortful speaking, tension in the neck muscles, chronic dry and scratchy throat, loss of voice, coughing or choking while eating, and reduced pitch range. Voice disorders include vocal cord nodules and polyps, vocal cord paralysis, paradoxical vocal fold movement, and spasmodic dysphonia.
  • Vocal cord nodules are callouses that develop over time from vocal abuse and can become harder and larger gradually.
  • Vocal cord polyps are blisters that develop from vocal abuse and misuse and are typically larger than nodules.
  • Vocal cord paralysis occurs when the vocal folds are unable to move, which can cause voice, breathing, and swallowing problems.
  • Paradoxical vocal fold movement occurs when there is abnormal vocal fold movement, such as the vocal folds closing when they should be open.
  • Spasmodic dysphonia is a chronic voice disorder in which vocal fold movement is forced and strained due to involuntary movements of laryngeal muscles.
Treatment depends on the cause and severity of the voice disorder. A medical evaluation by an otolaryngologist (ENT) is recommended to identify the cause to the voice disorder. The ENT will typically perform an endoscopic evaluation by inserting an endoscope into the mouth or nose to look at the larynx and the movement of the vocal folds. Voice disorders are best treated when diagnosed early. Speech-language pathologists can help patients with voice disorders by eliminating vocal abusive behaviors, practicing relaxation techniques, teaching good vocal hygiene, finding optimal positioning, and improving pitch, loudness, and breath support. Severe cases may require surgical intervention if treatment is unsuccessful.
Resonance disorders occur when there are changes in the way that air flows through the oral and nasal cavities as a result of abnormal opening, obstruction, or movement in the cavities. The oral and nasal cavities shape the airflow necessary for making specific speech sounds as it passes through the system. Resonance disorders are typically caused cleft palate, but can also be caused by apraxia, enlarged adenoids, and neurological disorders. People with resonance disorders may demonstrate weak consonant production, short utterance length, muffled speech quality, and too much or too little sound coming from the nose during speech. Speech-language therapy for resonance disorders will focus on targeting correct articulatory placement, teaching speech patterns, establishing oral airflow direction, and maximizing pressure build up for producing speech sounds.
Cognitive disorders affect any area of communication that relates to cognition. Cognition includes the aspects of attention, perception, memory, sequencing, organization, problem solving, and executive functioning. Cognitive disorders can be congenital or acquired. Congenital causes include genetic disorders and neurological diseases. Acquired causes include stroke, head trauma, neurological disease (including dementia), brain tumor, and traumatic brain injury. People with cognitive impairments may experience functional limitations in behavioral self-regulation, social interaction, academic and vocational performance, and daily living activities. These limitations can significantly impact a person’s overall quality of life. The speech-language pathologist can assess, identify, and manage cognitive disorders. Intervention might focus on teaching cognitive processes, training functional living skills, developing compensatory strategies, providing training to caregivers and families, and counseling patients. The speech pathologist may also collaborate with other professionals, such as a neurologists and otolaryngologists, when developing and executing intervention plans.
Dysarthria is a motor speech disorder that occurs after neurological damage. This condition affects the muscles and articulators necessary for making speech sounds. People with dysarthria may demonstrate mumbled speech, varied speech rates, changes in voice quality, and reduced articulator movement. Drooling, chewing, and swallowing issues may also be present. Neurological disorders that can cause dysarthria include:
  • stroke
  • brain injury
  • tumors
  • Parkinson’s disease
  • Lou Gehrig’s disease/amyotrophic lateral sclerosis (ALS)
  • Huntington’s disease
  • multiple sclerosis
Speech-language pathologists can help patients with dysarthria by improving speech rates, using louder speech methods, and practicing safe swallowing techniques. Alternative methods to communicating may also be explored, including various technological devices. Our speech-language pathologists are LSVT LOUD and PROMPT certified. LSVT LOUD is a proven treatment method used for patients with Parkinson’s disease and other neurological disorders to improve the loudness of speech. PROMPT is an effective treatment approach that improves motor control of the articulators and the development of oral muscular movements necessary for speech.
Apraxia is disorder caused by damage to the brain that affects a person’s ability to produce speech sounds and perform volitional movements. Apraxia can be either developmental or acquired. Developmental apraxia is present at birth and is also called Childhood Apraxia of Speech. Acquired apraxia occurs later in life, typically from injury to the brain. People with apraxia may experience difficulty performing tasks from the incoordination of required muscular movement. Speech-language pathologists can help patients with apraxia by creating treatment programs that target the improvement of planning, sequencing, and coordination of muscular movements.
Speech sound disorders occur when people have trouble producing sounds or sound patterns. Children are expected to produce speech sounds correctly when they reach a certain age. Making mistakes when saying new words is a normal process as children learn language, but continuing to produce speech sounds incorrectly after reaching specific age levels is characteristic of a speech sound disorder. Speech sound errors can occur as a result of hearing loss, chronic ear infections, developmental disorders, genetic syndromes, or neurological disorders. Adults can also have speech sound disorders as a result of stroke, head injury, or an untreated speech sound disorder from childhood. Speech-language pathologists can evaluate children or adults who have concerns of speech sound disorders with formal tests of articulation and oral motor examinations to determine if there is a problem with the muscles for speech. Treatment for speech sound disorders includes modeling correct sound production, teaching the rules of speech, practicing sound production, and learning to recognize correct and incorrect speech sounds.
Stuttering is a disorder that affects the fluency of speech. Stuttered speech is characterized by prolonged word production, difficulty starting a sentence, sound or word repetition, and struggling to produce conversational speech. Stuttering can affect people of all ages and falls into two categories: developmental and neurogenic. Developmental stuttering is more common in boys than in girls who are learning how to speak. Neurogenic stuttering typically occurs in adults following a stroke or head trauma. Although there is not a cure for stuttering, treatment from speech-language pathologists can help. Treatment techniques include learning how to speak more slowly, minimizing stressful triggers for stuttering, regulating breathing, and developing strategies to improve speech fluency.
Aphasia is a disorder that affects a person’s expressive or receptive language. People with aphasia may find it difficult to read, write, speak and comprehend language. Aphasia occurs from damage to the language centers of the brain, usually as a result of stroke. There are multiple types of aphasia, including expressive, receptive, anomic, and global aphasia.
  • Expressive aphasia occurs when a person knows what he or she wants to say, but is unable to express thought by speaking or writing.
  • Receptive aphasia is the opposite, and happens when a person can hear words and see text but cannot understand the message.
  • Anomic aphasia occurs when a person has difficulty naming objects, places, or events.
  • Global aphasia is a combination of the aphasias.
In most cases, patients diagnosed with aphasia benefit from language therapy as early as possible. The speech-language pathologist will provide treatment based on the individual needs of the patient. Treatment exercises include reading, writing, following directions, and imitating speech. Some instances of aphasia can be resolved without treatment.
Aural rehabilitation is a therapy process that can be used for children and adults which focuses on adjusting to diagnosed hearing losses, optimizing the use of hearing aids, and developing compensatory strategies for participating in conversations. Aural rehabilitation for children focuses on developing auditory perception skills, developing language skills, and learning how to manage hearing aids and assistive listening devices. Aural rehabilitation for adults targets understanding hearing loss and hearing aids, learning to listen again and control conversations, and developing communication enhancement strategies. Speech-language pathologists often collaborate with audiologists to provide the best possible treatment outcome for patients during the aural rehabilitation process.

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  • Anne S.

    Kaitlyn is a smart, astute and wonderful clinician. After a year of trying to figure out what was wrong with my ears, ...

  • Earl L.

    Dr. Emanuele is wonderful because she really explained everything. She addressed my problems more than any other doctor has.

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