Pediatric Cases Accepted on a case-by-case basis
Autism Spectrum Disorder • Feeding/Dysphagia • Dysfluency • Articulation
GENTLE. COMPASSIONATE. HUMBLE.
Donnetta Davis, M.S, CCC-SLP, Ampcare ESP™ Certified
Owner, Speech-Language Pathologist
Welcome
HEALTH AND SPEECH PLLC is a Long Island based private practice dedicated to helping adults and seniors with neurogenic communication and swallowing disorders, with a speciality in Parkinson's Disease, Stroke, & Dysphagia. Our mission is to improve the overall quality of life for our patients and their family through fun, functional, and evidence-based interventions. We offer skilled speech therapy services in the comfort of your home, where all of our services are individualized and tailored to meet the specific needs of each patient.
HEALTH AND SPEECH PLLC is owned and operated by Donnetta Davis. Donnetta Davis is a NYS licensed speech-language pathologist and holds a certificate in clinical competence from the American Speech-Language-Hearing Association. She is a graduate of Emerson College with a Master of Science in Communication Disorders and a Bachelor of Science in Biology from SUNY Stony Brook University.
Ms. Davis has an extensive amount of medical experience and has worked with all ages across the lifespan treating a multitude of communication, feeding, and swallowing disorders. Ms. Davis is certified through Ampcare's Effective Swallow Protocol ESP™ to offer Neuromuscular Electrical Stimulation (NMES) as an innovative rehabilitative treatment for dysphagia, "swallowing disorders."
"Rebuilding Communication, Restoring Confidence"
How Speech Therapy Supports Neurological Recovery
DYSPHAGIA
Dysphagia, or difficulty swallowing, can significantly affect a person's everyday life in many ways. It impacts not only physical health but also emotional well-being, social interactions, and overall quality of life.
Harmful affects of a Swallowing Impairment
( Nutritional & Hydration Challenges )
-
Difficulty Eating and Drinking: Trouble swallowing certain foods or liquids make it challenging to maintain a healthy and balanced diet. This might lead to avoidance of certain foods that are harder to swallow, such as meat, bread, or vegetables, leading to a limited variety in one's diet.
-
Risk of Malnutrition: Difficulty swallowing can lead to poor food intake, resulting in malnutrition or weight loss.
-
Dehydration: Dysphagia can make it hard to drink enough liquids, leading to dehydration. This can worsen other health problems, such as kidney issues or urinary tract infections, and can lead to fatigue and weakness.
( Physical Health Risks )
-
Choking Hazards/ Aspiration Pneumonia : One of the most immediate risks of dysphagia is the danger of choking. People with swallowing difficulties are more likely to aspirate (inhale) food or liquids into their lungs, which can lead to serious complications like pneumonia or other respiratory infections.
-
Gastroesophageal Reflux Disease (GERD): Swallowing difficulties may increase the risk of acid reflux, as people may not fully swallow food or liquids, leading to irritation of the esophagus.
( Social Isolation and Embarrassment )
-
Avoiding Social Situations: Eating and drinking are often social activities, and people with dysphagia may avoid social events or meals with family and friends due to embarrassment or fear of choking. This can lead to feelings of isolation and loneliness.
-
Discomfort in Public Settings: Difficulty swallowing can cause people to feel self-conscious or anxious in public settings, such as restaurants or gatherings. They might worry about choking or appearing awkward when eating or drinking in front of others.
-
Frustration and Anxiety: Struggling to swallow can be frustrating and lead to anxiety, especially if individuals fear choking, aspiration, or being unable to eat their favorite foods. They may feel a loss of independence and control, which can contribute to emotional distress.
-
Depression: The emotional toll of dealing with the limitations of dysphagia, such as feeling isolated or losing the ability to enjoy food, can lead to depression or anxiety disorders. Loss of social connections around meals or the inability to enjoy eating can diminish quality of life.
-
Loss of Enjoyment in Food: Eating is not just a physical activity, but also an emotional and social one. Dysphagia can take away the pleasure of eating, as people may have to follow restrictive diets or use special equipment (e.g., thickening liquids), making mealtime a stressful or unappealing experience.
( Impact on Caregivers )
-
Increased Caregiving Responsibilities: Family members or caregivers may need to take on a more active role in meal planning, food preparation, and monitoring during mealtimes. This can be physically and emotionally demanding, and caregivers may experience stress, fatigue, or burnout.
-
Training and Support Needs: Caregivers often require training to manage feeding safely, such as how to properly prepare food textures, handle feeding tubes (if applicable), and recognize signs of aspiration. The lack of support or guidance can increase caregivers’ anxiety and stress.
Stroke and Communication
A stroke occurs when blood flow to part of the brain is interrupted, leading to damage. This can affect the areas of the brain responsible for language, speech, and cognition, leading to various types of communication difficulties. The impact depends on the location of the stroke (e.g., left hemisphere vs. right hemisphere of the brain).
( APHASIA )
"When the stroke affects the language centers of the brain (often on the left hemisphere)"
Common types of Aphasia include:
-
Broca's Aphasia (non-fluent): This type affects speech production. A person may have difficulty forming sentences, speaking in short phrases, or finding the right words to say. They typically have good comprehension.
-
Wernicke's Aphasia (fluent): This type affects language comprehension. A person may speak in long, rambling sentences that don't make sense, or they may use the incorrect words.
-
Global Aphasia: A severe form of aphasia where both receptive and expressive language are significantly impaired.
( DYSARTHRIA )
"A motor speech disorder caused by weakness or paralysis of the muscles used for speaking"
This affects the clarity and articulation of speech, making it slurred or difficult to understand.
( APRAXIA OF SPEECH )
"A motor speech disorder where the brain has difficulty coordinating the muscles needed for speech, despite the muscles themselves being intact." This results in difficulty pronouncing words correctly or consistently.
( COGNITIVE COMMUNICATION IMPAIRMENTS )
"Impairment of memory, attention, problem-solving, and executive functioning, all of which contribute to the ability to communicate effectively." A person may struggle to organize their thoughts, find the right words, or follow conversations.
Types of Communication Problems after a Stroke
Dementia and Communication
Dementia is a progressive neurological condition that causes a decline in cognitive function, including memory, reasoning, and language. Over time, dementia can affect various aspects of communication as it progresses. Alzheimer's disease is the most common form of dementia, but there are others, such as vascular dementia and frontotemporal dementia, each affecting communication in different ways.
Types of Communication Problems in Dementia
( Word-Finding Difficulties )
One of the most common communication problems in dementia is difficulty finding the right words (called anomia). As dementia progresses, individuals may frequently pause to search for words, substitute words incorrectly, or use vague terms like "thing" or "stuff."
( Impaired Comprehension )
People with dementia may have difficulty understanding spoken or written language, particularly as the disease advances. They may not fully understand complex sentences, abstract concepts, or instructions, and they may struggle with following conversations.
( Decreased Ability to Form Coherent Speech )
In the later stages of dementia, individuals may speak in short, incomplete sentences or become unable to speak at all. Their speech may become repetitive, and they may struggle to express ideas clearly.
( Loss of Pragmatic Skills )
Dementia can impact social communication skills, leading to difficulty with turn-taking in conversations, understanding social cues, or maintaining appropriate topics of conversation. This can make interactions socially awkward or frustrating.
( Reduced Memory for Recent Conversations )
A hallmark of dementia is memory loss, particularly short-term memory. Individuals may forget what they’ve just said or ask the same questions repeatedly without recalling the previous response.
Parkinson's Disease and Communication
Dementia is a progressive neurological condition that causes a decline in cognitive function, including memory, reasoning, and language. Over time, dementia can affect various aspects of communication as it progresses. Alzheimer's disease is the most common form of dementia, but there are others, such as vascular dementia and frontotemporal dementia, each affecting communication in different ways.
( Word-Finding Difficulties )
One of the most common communication problems in dementia is difficulty finding the right words (called anomia). As dementia progresses, individuals may frequently pause to search for words, substitute words incorrectly, or use vague terms like "thing" or "stuff."
( Impaired Comprehension )
People with dementia may have difficulty understanding spoken or written language, particularly as the disease advances. They may not fully understand complex sentences, abstract concepts, or instructions, and they may struggle with following conversations.
( Decreased Ability to Form Coherent Speech )
In the later stages of dementia, individuals may speak in short, incomplete sentences or become unable to speak at all. Their speech may become repetitive, and they may struggle to express ideas clearly.
( Loss of Pragmatic Skills )
Dementia can impact social communication skills, leading to difficulty with turn-taking in conversations, understanding social cues, or maintaining appropriate topics of conversation. This can make interactions socially awkward or frustrating.
( Reduced Memory for Recent Conversations )
A hallmark of dementia is memory loss, particularly short-term memory. Individuals may forget what they’ve just said or ask the same questions repeatedly without recalling the previous response.
Types of Communication Problems in Parkinson's Disease
How a Speech-Language Pathologist can Help
Stroke, Dementia, and Parkinson’s disease each affect communication in different ways but often lead to significant challenges in speech, language, and social interactions. Treatment, often provided by a speech-language pathologist (SLP), can help manage these difficulties and improve communication abilities. Interventions may include strategies for improving speech clarity, language comprehension, social communication skills, and use of augmentative communication devices. Early identification and intervention are key to improving outcomes and quality of life for individuals affected by these conditions
Dysphagia affects much more than just the physical act of swallowing. It can create challenges in nutrition, hydration, socialization, and mental health, making daily life more difficult and affecting both the individual and their caregivers. People with dysphagia may face emotional struggles, physical health risks, and a loss of independence, all of which can contribute to a diminished quality of life. Early intervention, speech therapy, dietary modifications, and support systems are critical to managing the effects of dysphagia and improving the overall well-being of individuals affected by the condition.
Evidenced-Based Therapeutic Intervention:
DYSPHAGIA
Comprehensive evaluation of swallowing function & therapy to reduce the risk of aspiration
-
Swallowing Assessments: Recommendation & Review of an objective Swallowing Study test to effectively devise a Plan of Care
-
NMES + Swallowing exercises: Use of Neuromuscular Electrical Stimulation to strengthen the muscles used for swallowing
-
Dietary modifications: Adjusting food textures and liquid consistencies (e.g., thickened liquids) to make swallowing safer.
-
Postural Strategies: Teaching patients how to position themselves while eating to reduce the risk of choking (e.g., chin-tuck technique)
-
Compensatory strategies: Teaching techniques used to help individuals swallow more safely and effectively, particularly when they are at risk for aspiration (food or liquid entering the airway).
DEMENTIA
Comprehensive evaluation and therapy to improve
& maintain safety and effective communication with loved ones
-
Cognitive-Communication Therapy: Exercises to improve memory (ie; recalling names, dates, instructions), orientation (ie; strategies to remain oriented to time, place, & identity), word-finding, conversational skills, simplified communication, and behavioral strategies (ie; establishing routines, visual aids, reminders, and AAC devices for severely impaired verbal communication).
-
Dysphagia "Swallowing" Therapy: In later stages of dementia, individuals often experience dysphagia.
STROKE
Comprehensive evaluation and therapy to improve communication with loved ones
& to address dysphagia if present
-
Aphasia Treatment: Exercises to improve language compression, conversational skills, reading comprehension, writing fluency.
-
Cognitive-Communication Therapy: Exercises to improve memory (ie; recalling names, dates, instructions), orientation (ie; strategies to remain oriented to time, place, & identity), word-finding, conversational skills, problem solving, simplified communication, and behavioral strategies (ie; establishing routines, visual aids, reminders, and AAC devices for severely impaired verbal communication).
-
Motor planning therapy (to address Apraxia of Speech): Techniques to improve the planning and coordination needed to produce clear speech.
-
Therapy for Dysarthria: NMES, techniques & exercises to strengthen speech muscles, improve breath control, increase speech clarity/ intelligibility, and improve the pacing of speech.
-
Dysphagia "Swallowing" Therapy: Therapy to address dysphagia if present.
PARKINSON'S DISEASE
Comprehensive evaluation and therapy to improve communication with loved ones
& to address dysphagia if present
-
Cognitive-Communication Therapy: Exercises to improve memory (ie; recalling names, dates, instructions), orientation (ie; strategies to remain oriented to time, place, & identity), word-finding, conversational skills, problem solving, simplified communication, and behavioral strategies (ie; establishing routines, visual aids, reminders, and AAC devices for severely impaired verbal communication).
-
Voice Therapy: Exercises to help strengthen the muscles of the vocal cords, improving loudness and quality of speech.
-
Breathing Exercises: Exercises to improve breath control to increase voice projection and fluency in speech.
-
Articulation Exercises: Exercises to improve the clarity of speech, tone of voice, and speech intelligibility
-
Non-Verbal Communication: Strategies to maintain non-verbal communication, such as using facial expressions, gestures, and body language to convey meaning.
-
Dysphagia "Swallowing" Therapy: There is a high prevalence of dysphagia amongst individuals diagnosed with Parkinson's Disease. "More than 80 % of patients with Parkinson's disease (PD) develop dysphagia during the course of their disease."
-
Social Communication: Strategies to help with turn-taking and maintaining focus on topics
