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Speech Therapy

Lake Regional's Speech Therapy Department evaluates and treats speech, language, cognitive, voice and swallowing disorders. Our experienced speech therapists treat all of these areas for patients of all ages, from pediatric through senior living.

Adult Services

Speech therapy services for adults include a variety of diagnoses and treatment approaches. Commonly, speech therapists treat people who have had a stroke or brain injury. Other neurological diseases and processes that affect these areas include myasthenia gravis, multiple sclerosis, cerebral palsy, ALS, Parkinson's disease and dementia, among others.

Our goal is to assist each patient in regaining and optimizing skills for participation in all daily activities. Lake Regional offers speech therapy services for adults across multiple settings, including Lake Regional Hospital, Home Health and Skilled Nursing. Lake Regional speech therapists also have office hours for outpatients at Lake Regional Hospital and provide outreach to Lake Regional's Eldon and Laurie clinics.

Adult Conditions We Treat


Aphasia is a language impairment typically caused by injury to the left hemisphere of the brain. It affects all areas of language function, including speaking, understanding spoken speech, writing and reading. Aphasia can have many different presentations depending on which area of the left hemisphere was affected.

Some common symptoms of aphasia include:

  • Difficulty retrieving the correct word, substituting a word for the needed word. Sometimes these substitutions make sense, but often they change the meaning of what is intended to be said.
  • Use of words that are not real and do not make sense. A patient's language may show occasional use of strange words, or may be almost entirely nonsensical, depending on the severity of the aphasia.
  • Difficulty making a point, excessive talking to make a vague point, or using a lot of words with very little resulting meaning at the end of speaking—"empty" speech.
  • Difficulty understanding what is being said. Some patients may say "yes" to every question, or answer with irrelevant statements.
  • Difficulty initiating speech, or near complete inability to talk.
  • Effortful speech that is difficult to produce, is missing words (telegraphic speech), or has many sound errors.
  • Inability or decreased ability to write.
  • Impaired reading comprehension. Some patients may not recognize letters, while others may struggle with single words or short sentences.

Lake Regional's speech therapy team uses a unique, comprehensive approach to treating aphasia. Although many approaches to aphasia treatment target only a single modality (speaking, listening, reading or writing), Lake Regional therapists use a treatment approach that targets all language modalities for every task of language in a sequenced hierarchy of difficulty. We are proud of all of our patients' successes in their recovery of language.

Cognitive Impairment

Cognitive impairment is comprised of deficits in one or more areas of cognitive functioning:

  • Memory: recalling either long-term (happened in the near to far past) or short-term (happened very recently) information
  • Attention: ability to attend to a single task over a sustained period of time, flex attention between tasks or pay attention to more than one task at a time
  • Problem-solving: ability to solve both simple, routine daily problems (what to wear or eat for breakfast), or complex problems (pay bills, plan a vacation)
  • Organization: ability to sequence thoughts to maintain progression from one task to another to accomplish a goal
  • Executive function: overlying ability to coordinate all of the above cognitive areas to function independently in tasks of daily living

Cognitive impairment can be caused by a specific brain injury, such as stroke or traumatic brain injury from an accident. It also occurs as a result of degenerative brain diseases, such as dementia, Parkinson's disease, multiple sclerosis and others.

The speech therapy team at Lake Regional offers formal evaluation and assessment of cognitive deficits resulting from any cause. We have had success treating individuals who have cognitive deficits as a result of specific brain injury and also offer family and caregiver education for improved management and care of individuals with degenerative cognitive impairment.


Dysphagia is defined as difficulty swallowing. Difficulty swallowing can occur in the oral stage (chewing, sucking, controlling food or liquid), in the pharyngeal stage (moving food or liquid through the throat efficiently), or in the esophageal stage (moving food and liquid through the esophagus to the stomach). Patients with dysphagia are at risk for safety and nutritional deficits and should be evaluated and treated by a speech therapist.

Specific signs of dysphagia include the following:

  • Difficulty chewing, loss of food or liquid from the mouth, or excessive residue in the mouth
  • Frequent coughing while eating or drinking
  • Wet or gurgly vocal quality after drinking
  • Recurring pneumonia
  • Chronic weight loss or dehydration
  • Reflux, or symptoms of heartburn, associated with a feeling of food or liquid "coming back up"

At Lake Regional, assessment of swallowing disorders can be completed by a modified barium swallow study (X-ray video) or tableside clinical assessment. Lake Regional's speech therapy team has superior clinical experience in evaluating and treating swallowing disorders and customizes each treatment plan to each individual's unique needs for optimal outcomes in swallowing and eating.

For more information about dysphagia, please visit the American Speech-Language-Hearing Association (ASHA) website.

Motor Speech Disorders

Dysarthria is a speech disorder caused by specific or general weakness of the articulators in the mouth: lips, tongue, soft palate, vocal folds and diaphragm. Patients with dysarthria may sound like their speech is slurred and difficult to understand. They may also speak too fast or too softly to be well understood or have poor respiratory support or resonance of sound.

Dysarthria is caused by damage to the brain or nerves descending from the brain. Speech will sound different depending on where the damage occurred in the neurological system, as different speech systems will be affected.

Apraxia is another motor speech disorder that is caused by neurological damage to the brain. It is different than dysarthria, however, because apraxia is not caused by weakness of the oral structures. Instead, the message from the brain to the mouth to plan the movement of each speech sound is disrupted, making it difficult to initiate speech or resulting in groping to achieve the right oral movement to form a word. Apraxia can occur with dysarthria and aphasia.

At Lake Regional, our speech therapy team has many years of experience evaluating and treating motor speech disorders through use of direct training to the affected muscles or neurological deficit and compensations to improve intelligibility and ease of speech production.

Voice Impairment

Voice changes in adults can occur for several reasons, including neurological (in the brain) changes, injury, infection, hyperfunctional use and unusual growths. Contact your physician for an evaluation if you notice a change in your voice. After the evaluation, you may be sent to an ear, nose, and throat (ENT) doctor. An ENT can see your vocal folds by fitting a small camera through the nose and throat and then viewing the voice box.

Voice difficulty that might require therapy includes:

  • Hyperfunctional voice disorder (overusing the voice)
  • Paradoxical vocal fold motion (closing the airway during breathing)
  • Paralyzed vocal fold
  • Vocal nodules (small bumps on the vocal folds caused by overuse)

The voice evaluation will include completion of a case history, perceptual voice measures and instrumental voice measures.

Voice treatment will include:

  • Education about how the voice works
  • Recommendations for lifestyle changes that can improve the structure or the function of the voice
  • Recommendations and treatment activities for changing how the voice is used
  • Exercises to improve the strength and efficiency of vocal fold movement

Lake Regional's speech pathologists have years of experience treating voice and work with ENTs throughout the region. Through continuing education, they are able to use up-to-date voice treatment protocols.

Please note: If you have a change in the sound of your voice that lasts more than three weeks, you should always go to your physician for an evaluation. If the treatment prescribed by your physician does not help your voice return to normal, you should schedule an ENT evaluation.