Frequently Asked Questions

Difficulty swallowing, or dysphagia, falls under the purview of speech-language pathology because all the muscles you speak with are the same muscles you swallow with! SLPs have extensive training in head and neck anatomy (body structure) and physiology (body function). If you have difficulty chewing, producing enough saliva, drooling, getting food to move from your mouth into your throat, or getting your food to go down from your throat into your stomach, an SLP may be able to help.

First, you should look for an SLP who is licensed in their state and who is certified by the American Speech-Language-Hearing Association (ASHA). You can check these credentials by going to the Wyoming State Board of Examiners of Speech-Language Pathology and Audiology. 

You should also ask any SLP whose help you are considering if they have experience with the issue you need addressed. SLPs can evaluate and treat a variety of cognitive, communicative, and swallowing disorders, but not all SLPs have equal amounts of training or experience in all areas. Additionally, some specialties offer their own certifications. For example, SLPs may hold specialty certifications in swallowing (BCS-S), the conducting of videostroboscopic swallowing evaluations (MBS-IMP), or voice treatment in Parkinson’s Disease (LSVT Loud). Websites where you can check for these certifications can be found at:

• American Board of Swallowing and Swallowing Disorders
• Modified Barium Swallow Impairment Profile
• LSVT Certified Clinician

Of course, the number of years in practice (I have 27) may suggest how much experience an SLP has, as will the different types of settings an SLP has as will the different types of settings an SLP has worked in (I have worked in acute care, inpatient rehabilitation centers, nursing homes, and home healthcare. I have also taught at a university.)

worked in (I have worked in acute care, inpatient rehabilitation centers, nursing homes, and home healthcare. I have also taught at a university.)

Different types of knowledge are necessary to evaluate and treat children, who may not have fully developed their speech and language skills yet, and adults, who have learned speech and language normally but had it affected by disease or trauma. I have always worked with adults and have specialized skills and knowledge to reteach speech and language to clients who already learned it normally as children.

Speech is the physical act of moving the muscles of your mouth and throat to make different sounds. It’s not all that different from other muscular movements, like moving your fingers to type or play an instrument or moving your legs to dance or ride a bike.

Language, on the other hand, has more to do with how one expresses oneself. The words one chooses (“excited” versus “satisfied”), the way words are put together to express one’s thoughts, and the facial expressions and body language (leaning in during a conversation versus sitting back and crossing one’s arms and legs in a closed, defensive manner) are all aspects of language.

Voice is another area addressed by many speech-language pathologists. This specialty area has to do with the way someone coordinates their breathing, vocal cord movement, and shaping of their mouth and throat to produce clear, audible sound.

There are many ways to define cognition, but, generally speaking, “cognition” refers to the mental processes involved in learning, retaining, and using or applying information. To get a more detailed idea of what this means, think of all the things that need to happen in your brain to learn something. Your sensory organs (eyes, ears, nose, tongue, and skin/nerves) have to be functioning well enough to see, read, hear, smell, taste, or feel what’s going on around you so that information can get to your brain (sensory perception). Next, you have to be able to attend, or focus for long enough to let the information enter through your eyes, ears, nose, mouth, or skin and get to your brain for processing (attention/concentration). Once the information reaches your brain, you have to be able to hang on to the information long enough to do something with it (memory). Then you’ll probably have to do something with the information—manipulate it in some way, such as deciding if it pertains to you and your situation, or figuring out what exactly to do with the information, how to apply it. This involves judgment, reasoning and problem-solving. Finally, you may then have to carry out an action in response to the information you have received. For example, if a fire alarm goes off, you hear it, you decide it applies to you, and you determine that you should probably exit the building, you will then have to formulate a plan for how to get out of the room or building, and you will have to execute that plan (executive function). ALL of these mental processes—sensory perception, attention, memory, judgment, reasoning, problem-solving, and executive function—make up cognition.

Cognitive impairment is any disruption in one or more of these mental processes, and may result from a stroke, brain injury, concussion, a brain tumor, lack of oxygen to the brain, swelling or inflammation of the brain and/or nervous system (encephalitis, meningitis), “water on the brain” (hydrocephalus), or any number of neurologic diseases and conditions affecting the brain and nervous system, such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, ALS (amyotrophic lateral sclerosis, also known as motor neuron disease or Lou Gehrig’s disease), Huntington’s chorea, and a number of others.

Yes! Although dementia is a progressive condition for which there is currently not a cure, our understanding of what it going on in the brain continues to advance. There are some medical treatments, prescribed by physicians, which can help slow the progression of the disease. Speech-language pathologists and behavioral specialists trained in dementia care can also teach families and caregivers effective ways to help manage challenging behaviors and communicate most effectively with those with dementia.

Evaluations typically take longer than treatment sessions. Depending on what is going on with a client, an evaluation may take anywhere from 60 to 90 minutes, while a typical therapy session is around 50 minutes.

Therapy lasts as long as a client is showing quantifiable progress. I carefully chart client responses to treatment tasks in every session and calculate accuracy at the end of each session. Because progress can have its ups and downs, I don’t worry about “a bad day,” but rather look at trends over several sessions. If the trend is positive progress, we keep going! However, if a client shows signs of reaching a plateau, I am legally and ethically obliged to discharge the client.

For now.  Changes in insurance reimbursement for 2024 may impact this, however.