Speech Therapy

Speech Therapy deals with prevention, evaluation, treatment and scientific study of human communication and related disorders.

Vocal Health

Dra. Ana Gonçalves, Speech Therapist 

Vocal Health is prevention and rehabilitation of vocal disorders, and consists in adopting healthy vocal habits. The goal is to reduce or eliminate behavior which causes vocal disturbances, improving vibration patterns of the vocal folds.

Therefore the following should be avoided:  

• Speaking excessively loudly (e.g.: screaming );
• Speaking very quickly;
• Speaking very softly (e.g.: whispering);
• Making vocal sounds (e.g.: imitating voices);
• Drinking very hot or very cold drinks;
• Clearing the throat frequently;
• Speaking for long periods of time;
• Smoking and alcohol abuse.

Recommendations for healthy habits:

• Vocal hydration, drinking water at room temperature;
• Eating varied and healty food;
• Adopting a correct posture, as well as physical exercise;

- Speak slowly, breathing correctly;

• Implement vocal rest periods throughout the day;
• Practice "vocal warm-up" before using your voice more intensely;
• -  At the end of the day, practice “vocal cool-down”, so that your voice returns to normal.

A Speech Therapist should be consisted if:

1. Become hoarse frequently;
2. Persistent hoarseness for over 2 weeks;
3. Feeling tired when speaking;
4. Making an effort when speaking;
5. The need for frequent clearing of the throat or a throat irritation;
6. Pain, discomfort and/or burning of the throat;
7. A constant sensation such as a “ball” in the throat;  
8. Vocal breaks/sudden voice loss; 
9. Voice alterations during the day;
10. Difficulty with vocal projection.

Dysphagia

Dysphagia or difficulty in swallowing can be explained as gagging when eating or drinking; the sensation of food stuck in the throat; pain during swallowing and/or breathing difficulties during meals.

In most cases, dysphagia can lead to dehydration, malnutrition and/or aspiration pneumonia.

Dysphagia, among other causes, can arise as a result of neurological diseases, oncological diseases (head and neck cancer), as a result of aging (presbyphagia) and/or due to prolonged immobility, either due to aging or prolonged hospitalization.

The most common signs and symptoms are coughing, choking, weight loss, altered vocal quality, dribbling food/saliva from the mouth.

One of the most innovative techniques for treating dysphagia is electro stimulation or VitalStim Therapy.

Electro stimulation involves the application of electrodes to the anterior part of the neck  simultaneously with traditional therapy.

This technique allows re-education of the larynx muscles so that motor and sensory levels are restored and swallowing can take place safely.

Electro stimulation creates additional and intense contraction of the muscles so that muscle movement occurs more quickly in order to regain normality.

In addition to improving swallowing capacity, this therapy will result in an increased vocal intensity and improvement in vocal quality.

Electro stimulation and/or VitalStim Therapy is a new form of therapy and is used to enhance the techniques already used.

The application of VitalStim Therapy needs specialized and certified training, in order to guarantee its correct application.

Areas of intervention

The Speech Therapist Works with a interdisciplinary team of professionals (ENT Specialist, Pediarician, Neurologist, Physiatrist, Orthodontist, among others.

• Word articulation disorders (difficulty in pronouncing sounds and words, lack of sound among others);
• Fluency disorders (stuttering);
• Interactions and communication disorders (autism);
• Written language disorders (dislexia, dysgraphia, disorthographia, among others);
• Early intervention in children with disabilities  (Down Syndrome, Cerebral palsy, deafness, among others;
• Eating difficulties (in respect with chewing, swallowing, retaining saliva, babies with suction difficulties, among others);
• Language or/and speech difficulty  due to brain injury (Stroke, Traumatic Brain Injury);
• Developing and maintaining communication strategies in patients with language disabilities  (Amyotrophic Lateral Sclerosis, Cerebral Palsy);
• Changes in motor and / or ora-facial sensitivity  (facial paralysis, degenerative diseases, among others).
• Voice alterations  (frequent hoarseness, effort in speaking, among other symptoms - vocal fold nodules, polyps, and other pathologies).

Warning signs 

Children

• At 8 weeks does not react to normal sounds and shows inactivity;
• At 18 months doesn’t speak any words;
• At 24 – 30 months does not execute simple commands;
• At 36 months does not speak comprehensible sentences for an outsider;
• The child is older than 4 years and stutters;
• Has a hoarse voice or effort in speaking;
• Changes / omits some sounds when speaking;
• Eye contact is absent or reduced;
• Difficulty in relation or interaction with other children;
• Difficulty in chewing food;
• Breathes mainly through the mouth;
• Difficulty in reading and writing.

 
Adults

• Frequently hoarse, effort in speaking  (nodules, polyps in the vocal folds, laryngeal carcinoma, among others);
• Difficulty in speaking and understanding due to brain injury, degenerative diseases (stroke, traumatic brain injury, amyotrophic lateral sclerosis, among others);
• Eating difficulties (in chewing, swallowing, retaining saliva, among others);
• Changes in motor or oro-facial sensitivity (Facial paralysis , among others).