Language disorders negatively affect an individual’s ability to understand and express themselves while conversing to meet social demands in everyday life.

Pediatric

Reasons to have a child evaluated may include, but is not limited to, the following:

1. At risk for language difficulties including

• Prematurity
• NICU graduate
• Other medical diagnoses (i.e. Autism Spectrum Disorder, Attention Deficits, Cerebral Palsy, Down Syndrome, etc).

2. Concerns about not talking on time.
3. Concerns about not responding to name.
4. Concerns about limited vocabulary and not putting words together.
5. Concerns about understanding simple requests.

Screening, evaluation and treatment includes, but is not limited to, the following language diagnoses:

• Developmental Language Delay
• Expressive and/or Receptive Language Disorder
• Social Communication Disorder
• Specific Language Impairment

Adult

Reasons to have an adult evaluated may include, but are not limited to, the following:

1. Language difficulties resulting from the following medical diagnoses: 

• Stroke
• Neurodegenerative Disorders (i.e. Amyotrophic Lateral Sclerosis (ALS), Dementia, Multiple Sclerosis (MS), Parkinson’s Disease, etc.)
• Brain Cancer
• Traumatic Brain Injury

2. Concerns regarding an inability to find words.
3. Concerns regarding an inability to formulate sentences.
4. Concerns about an inability to follow directions, identify, describe and request. 

Evaluation and treatment include, but are not limited to, the following language diagnoses:

• Aphasia
• Expressive Language Deficits
• Receptive Language Deficits

 

Cognitive disorders can negatively affect an individual’s ability to successfully function in their daily life. An individual may have confusion, difficulty thinking, learning, reasoning, remembering and making decisions.

Reasons to be evaluated include, but are not limited to, the following:

1. Cognitive deficits resulting from the following medical diagnoses:

• Stroke
• Neurodegenerative Disorders (i.e. Amyotrophic Lateral Sclerosis (ALS), Dementia, Multiple Sclerosis (MS), Parkinson’s Disease, etc.)
• Brain Cancer
• Seizure Disorder
• Traumatic Brain Injury

2. Difficulty with memory.
3. Difficulty with organization.
4. Difficulty with problem solving.
5. Difficulty with attention/focus.
6. Difficulty with processing visual-spatial information

 

AAC supports those whose needs are not met through spoken language due to deficits in speech clarity or language skills. AAC augments existing spoken messages of an individual or replaces for those unable to verbally meet functional communication demands. AAC can vary in presentation per person by use of picture supports, speech-generating devices, gestures, sign-language and/or tactile objects.

Pediatric Feeding

Evaluate and treat the negative effects of complications for an infant or child during feeding and/or swallowing. Infant feeding evaluations are offered for bottle feeding difficulties. Those who are unable to effectively, efficiently and safely meet hydration and nutritional needs for optimal growth, development and long-term health require specialized intervention for optimal outcomes.

Reasons to have a child evaluated may include, but are not limited to, the following:

1. At risk for feeding difficulties including:

• Prematurity
• Neonatal intensive care unit graduate
• Other medical diagnoses (i.e. Down Syndrome, Cerebral Palsy, Autism Spectrum Disorder, Cleft Lip/Palate, tongue/lip ties, Tracheostomy placement, PEG tube dependent, Reflux, etc.).

2. Bottle feeding difficulties.
3. Difficulty transitioning to solid foods.
4. Poor mealtime behaviors.
5. Reduced oral intake.
6. Coughing/choking while eating or drinking.
7. Refusal, avoiding or spitting out certain foods.
8. Need for diet expansion. 

Evaluation and treatment includes, but are not limited to, the following feeding diagnoses:

• Pediatric Feeding Disorder (PFD)
• Avoidant/Restrictive Food Intake Disorder (ARFID)

Lactation Services

Prenatal: Prenatal lactation consultations are offered as an entryway into breastfeeding education. During prenatal consultations, breastfeeding basics are discussed such as:

• How to establish an effective, comfortable latch.
• Positioning options.
• Maintaining and protecting the milk supply.
• Frequency and duration of feedings.
• Pumping.
• Return to work tips.

Postnatal: Postnatal lactation consultations include the evaluation and treatment of any breastfeeding difficulties that may arise, such as:

• Poor latch.
• Poor weight gain.
• Nipple/breast pain.

Support can be provided in the form of weighted feeds, assistance with establishing a more effective, comfortable latch and positioning and oral-motor assessment and treatment.

Swallowing

Difficulty swallowing (Dysphagia) affects quality of life and overall health.  Patients who are demonstrating a difficulty in the ability to eat and drink safely, a difficulty achieving adequate nourishment and/or who want to improve their quality of life would benefit from swallowing services.

Evaluation of the swallowing mechanism will be evaluated through one of the following:

1. Modified Barium Swallowing Study (MBSS)
2. Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
3. Clinical Swallowing Assessment

Reasons to be evaluated include, but are not limited to, the following:

1. Swallowing deficits resulting from the following medical diagnoses:

• Stroke
• Neurodegenerative Disorders (i.e. Amyotrophic Lateral Sclerosis (ALS), Dementia, Multiple Sclerosis (MS), Parkinson’s Disease, etc.)
• Head and Neck Cancer
• COPD
• Traumatic Brain Injury

2. Oral motor weakness.
3. Coughing/Choking while eating and/or drinking.
4. Sensation of food sticking in throat.
5. Frequent throat clears when swallowing.
6. Recurrent pneumonia.

The following management and treatment approaches are offered:

• Traditional swallow rehab.
• Expiratory Muscle Strength Training (EMST).
• Chin Tuck Against Resistance (CTAR).
• Alteration of Diet.
• Compensatory Strategies.

Voice disorders (Dysphonia) occur when there is an alteration in normal voice quality, which can be due to structural and/or functional causes. Poor quality can be described as hoarseness, no voice, breathiness, reduced volume and/or poor pitch.

Reasons to be evaluated include, but are not limited to, the following:

1. Voice difficulties resulting from the following medical diagnoses:
   • Stroke
   • Parkinson’s Disease
   • Head and Neck Cancer
   • Vocal Cord Paralysis
   • Vocal Cord Lesion
   • Presbylaryngia
   • Thyroidectomy
   • Traumatic/Lengthy Intubation
2. Hoarseness
3. Vocal Fatigue
4. Voice changes
5. Low volume

Evaluation and treatment include, but are not limited to, the following voice diagnoses:

• Muscle Tension Dysphonia
• Spasmodic Dysphonia
• Aphonia
• Hyperfunction
• Vocal Tremor
• Chronic Cough

 

Head and Neck Cancer: Head and Neck Cancer can negatively affect speech and swallowing. The location of the mass, as well as the effects of radiation therapy on the swallowing mechanism, can cause significant problems. We offer preventative swallowing education, swallowing assessments and swallowing exercises to manage swallowing abilities during radiation therapy and after radiation therapy. An assessment is completed prior to the initiation of radiation therapy. Next, we teach swallowing exercises and follow the patient throughout the treatment.

Swallowing intervention is crucial to the preservation of the swallow mechanism during and following radiation therapy.

Laryngectomy: A total laryngectomy is the removal of the entire larynx (voice box) with the separation of the airway from the mouth, nose and esophagus. This is a major surgery which negatively affects communication and quality of life. We offer pre-laryngectomy consultations to offer education and support before, during and following surgery.

Tracheoesophageal Puncture (TEP):  A total laryngectomee patient may be a candidate for a TEP. During a TEP, a puncture is made between the tracheal wall and esophageal wall surgically and a prosthesis is placed. This TEP prosthesis maintains the open fistula to allow air passage for speech and safe swallowing. We provide TEP changes, treatment and maintenance services.

Our virtual telehealth therapy brings the same high-quality care to students as traditional in-person sessions. We’ve pioneered an effective approach to ensure, regardless of location, the therapy provided meets the highest standards, particularly for students in public schools. By focusing on less severe cases, we offer specialized attention tailored to their needs.

Our strong in-person presence sets us apart. In almost every area we serve, we have local team members on-site who can assist our virtual therapists, ensuring any challenges are quickly addressed. This unique blend of virtual and in-person care allows us to offer seamless, consistent support.

Unlike many virtual services that overpromise and underdeliver, we are committed to redeeming the full potential of telehealth. By leveraging technology thoughtfully, we provide top-tier care for the students of Appalachia, delivering therapy that truly makes a difference.