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Programs & Services
Common Conditions
From infancy through older adulthood, a variety of speech, language and/or swallowing conditions can arise. Some typical problems include:
Aphasia: A language disorder caused by a stroke, brain injury or illness. A person with aphasia may truly be at a loss for words - unable to say even his or her name. This may also include difficulty reading, writing and/or understanding spoken language.
Articulation/Phonological Disorders: Difficulty making speech sounds correctly.
Cognitive - Communication Disorders: Common in individuals after a traumatic brain injury, these disorders make it difficult to think clearly, remember or solve problems.
Dysarthria: Difficulty producing speech due to muscle difficulties such as muscle weakness or paresis.
Executive Function Disabilities: A term used to describe the ability to initiate, plan, organize and prioritize tasks while shifting attention in response to various environmental stimuli. Difficulty with executive understanding information when listening and/or reading and organizing thoughts for speaking and/or writing. Executive function difficulties may be associated with learning disabilities and/or deficits in attention
Feeding Disorders: Often seen in infants and young children who have difficulty sucking, biting, chewing, and swallowing; also seen in children who have been fed through a tube.
Language-Learning Disorders: Difficulty understanding or using spoken and/or written language to communicate thoughts, feelings, and experiences. Often children have learning disabilities that affect their ability to participate in regular classroom instruction despite average intelligence.
Non-verbal Learning Disabilities: A disorder that impacts the ability to effectively process information through the right hemisphere. Difficulties with nonverbal learning impact visual-spatial processing, organization, comprehension and expression of language, and social skills, despite strengths in vocabulary, rote memory skills for listening, speaking, reading, and writing, comprehension of abstract language (e.g., inferences, idioms, ambiguous language) and social skills.
Stuttering: An involuntary repetition, prolongation or blockage of a word or part of a word that a person is trying to say. Stuttering often starts in childhood and may become a life long challenge.
Voice Disorders: Hoarse, breathy, harsh or nasal voice quality as a result of mistreatment of overuse of the voice (screaming or yelling) or due to structural abnormalities (cleft palate, enlarged adenoids).
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Special Programs and Services
Inpatient Services
At Mass General, Speech-Language Pathologists function as part of a multidisciplinary medical team, providing consultation and treatment services in the areas of feeding and swallowing, speech, language, cognition and memory, as indicated during an individual's hospitalization. Acute care patients receive full diagnostic assessments and treatments, with recommendations for further services upon discharge from the hospital as needed.
Cognitive Rehabilitation Program
Individuals who have suffered a brain injury from a traumatic event, stroke or neurological disorder or other related causes are treated in one-on-one sessions to improve cognitive skills related to attention, memory and problem-solving. The treatment program is designed to work on organization and language capabilities, including reading and writing for individuals in whom these skills are negatively impacted.
Learning Disabilities
The Speech-Language Pathology Learning Disabilities team provides evaluations and treatment for school-aged children with spoken and written language difficulties. Students learn to develop academic based skills (i.e. study skills and note-taking strategies) in addition to traditional language-based intervention for overall communication skills. A diagnostic patient evaluation will determine each patient's individual needs and treatment plan.
In order to provide students and parents with an overview of strategies to facilitate success both at school and at home, patients will address topics such as organization and writing through direct individual or peer group instruction.
Pediatric Therapy Team (PTT)
An interdisciplinary Pediatric Therapy Team of clinicians from Speech, Language and Swallowing Disorders, Occupational Therapy and Physical Therapy performs same-day, personalized, comprehensive evaluation of children, ages 3 to 17 years old, who have medical, developmental and learning needs. The PTT provides assessments in a variety of areas, including: receptive & expressive language skills, speech, reading and writing (SLP); sensory integration, fine motor skills and visual perceptual skills (OT); gross motor skills: balance, strength and coordination (PT).
Feeding Team
A multidisciplinary feeding team that includes a dietician, speech-language pathologist, and a clinical nurse specialist or nurse practitioner, evaluates and treats children who have developed or are at risk for developing complex feeding problems. Children who have dysphagia, congenital heart disease, craniofacial disorders, gastrointestinal conditions, neurological disorders, pulmonary compromise or are born prematurely are among those typically evaluated.
Modified Barium Swallow (MBS)
A speech-language pathologist works with a radiologist from the Radiology Department during radiographic studies to assess patient with suspected dysphagia (swallowing problem) and/or those with risk for oral-pharyngeal aspiration. During this study, the patient is evaluated and images are taken as the individual sits upright and swallows various consistencies of barium. This procedure is provided for both adults and children.
For specific information regarding pediatric MBS, please see the website for the Airway/Swallow Clinic at Mass Eye and Ear Infirmary: www.meei.harvard.edu/shared/oto/pediairway.php
Fiberoptic Endoscopic Exam of Swallow (FEES)
Speech-language pathologists perform FEES in both the  inpatient and outpatient settings to assess individuals with suspected decreased airway protection for swallowing. During the study, the patient sits upright and ingests various consistencies for food while being evaluated. This exam also enables the visualization of pharyngeal clearance after swallowing, as well as the evaluation of compensating strategies that might be used to increase airway protection/swallow efficiency.
Velopharyngeal Insufficiency Studies
A velopharyngeal insufficiency (VPI) study is a multiview radiographic study preformed with the speech-language pathologist and pediatric radiologist. VPI studies evaluate the movement of the muscles for speech to determine why a child may be experiencing nasal speech.
Fluency Programs
Individual therapy is provided for children and adults who stutter. They learn ways to modify or change speech patterns, explore attitudes and improve social and academic interactions.
Bilingual Services for Children with Hispanic Background
Bilingual speech-language pathologists offer comprehensive evaluations and therapy to children of all ages. Spanish-speaking clinicians assess language dominance, delays and disorders across various domains in both languages as needed. Suggestions for direct intervention, classroom accommodations, additional services, academic consultation and ideas for language stimulation in the home environment are made available.
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