Speech Language Pathology – Guam Regional Medical City

Rehabilitation Center

About our Speech Language Pathology Services

Swallow Assessment:

Bedside Swallow Assessment: Oral Phase: Lip symmetry, lip range of motion, tongue strength and range of motion are assessed. Pharyngeal and Airway Protection Phase: Airway protection during the swallow, using cervical auscultation is assessed. Penetration and aspiration are examined or rules out when swallowing the different sizes of liquids boluses.
Modified Barium Swallow Study (Hard Visual Evidence of the Swallow):Pt. seated at 90 degrees in a chair and a moving picture x-ray (video-fluoroscopy) from the side view is taken to examine the Pt’s. oral phase, airway protection phase and esophageal screen. Various size thin liquids boluses are used as well as foods, (puree, pudding, cracker). The liquids and foods are mixed with barium sulphate in order that the boluses show up on the video-fluoroscopy. A Barium Sulphate Pill ( 11mm diameter) is given to Pt. in the 90 degree sitting position for an esophageal screen, to watch the esophageal action and pill descent into the stomach. This video is reviewed in slow motion and a report is written outlining normal and abnormal swallowing behaviors. Specific attention is paid to assess presence of penetration / aspiration during the swallow and to assess if maneuvers help prevent this occurrence.
Fiberoptic Endoscopic Evaluation of the Swallow with Sensory Testing (FEESST) (Hard visual evidence of the swallow from the superior view). Pt. sits in a chair at 90 degrees sitting position. An endoscope is inserted through the nostril and guided down to the pharynx to just above the vocal cords. Various size thin liquids boluses are used as well as foods, (puree, pudding, cracker). Descent is watched and recorded for each bolus type. The video is reviewed in slow motion and a report is written outlining normal and abnormal swallowing behaviors. Specific attention is paid to assess presence of penetration / aspiration during the swallow and to assess if maneuvers help prevent this occurrence. Also, vocal cord action is assessed for equal approximation and airway protection status. Vocal cord structure is also assessed for nodules or other abnormalities.
Swallow TherapyIf abnormalities are found in any of the above assessments, swallow therapy is offered to attempt to correct the disorder using Maneuvers, Exercises, Electrical Stimulation or Deep Pharyngeal Nerve Stimulation;

Speech- Language Assessment:

Speech-Articulation Speech-articulation is assessed in children and adults. If errors are found that affect correct production of sounds in sentences or if intelligibility is significantly affected, then Speech Therapy is offered to attempt to correct these errors; • Stuttering is assessed and therapy is offered to reduce or eliminate this disorder;
VoiceVoice is evaluated ( may include endoscopic examination of vocal cord action) and therapy is offered to attempt to restore normal voicing habits during conversational speech;
Fiberoptic Endoscopic Evaluation of the Swallow with Sensory Testing (FEESST) (Hard visual evidence of the swallow from the superior view). Pt. sits in a chair at 90 degrees sitting position. An endoscope is inserted through the nostril and guided down to the pharynx to just above the vocal cords. Various size thin liquids boluses are used as well as foods, (puree, pudding, cracker). Descent is watched and recorded for each bolus type. The video is reviewed in slow motion and a report is written outlining normal and abnormal swallowing behaviors. Specific attention is paid to assess presence of penetration / aspiration during the swallow and to assess if maneuvers help prevent this occurrence. Also, vocal cord action is assessed for equal approximation and airway protection status. Vocal cord structure is also assessed for nodules or other abnormalities.
Receptive / Expressive Language AssessmentUsing normalized tests, children and adults are evaluated for levels of understanding / comprehension of spoken language and ability to express oneself in sentences. Language therapy is offered to attempt to correct disorders identified with the tests given;
Hearing ScreeningUsing an audiometer, hearing is screened bilaterally, in children and adults, for possible hearing loss. If a loss is found, the Pt. is referred out to a Licensed Audiologist for further assessment.

GRMC is committed to enhancing communication and swallowing abilities through our specialized Speech-Language Pathology services. Our team of licensed and experienced Speech-Language Pathologists is dedicated to diagnosing and treating a wide range of speech, language, voice, and swallowing disorders in individuals of all ages.