Category: Uncategorized

By Kyle Traux, M.S.CCC-SLP, Speech-Language Pathologist Vegas Voice Institute

A common problem for people with aphasia and their caregivers is how to find opportunities to safely practice communication. In normal times, getting this would be relatively effortless: one would have the option of moving freely around one’s environment engaging others at will or joining social groups. For those less outgoing or not quite ready to strike up conversations with strangers or even place an order at a restaurant, there are groups one can join made up of individuals who share similar experiences with language loss and rehabilitation. But with so many of these avenues temporarily blocked because of
restrictions on social gathering, what can one do?

We at Vegas Voice Institute would like to help you find some options for increasing communication and language opportunities:

Chat on the phone or on-line– Communication with friends and family often allows for a less stressful and/or overwhelming experience as these tend to be people who are familiar with your difficulties with communication and can help support the conversation. Schedule recurring phone ‘dates’ with friends and family and use scripts or talking points to aid the conversation.

Practice with Apps- A variety of apps are tailor made for aphasia and offer a wide variety of skills to target. These apps are designed with the person with aphasia in mind and are thus user friendly. Check-in with your Speech-Language Pathologist (SLP) for advice on selecting apps to supplement speech therapy.

Join virtual groups- A few aphasia groups have moved online due to social restrictions. While it may not be the ideal way to satisfy our social needs, it may just be the best option we have for now. Check out Aphasia Recovery Connection on Facebook.

Write, Read and Listen- Pick up a pen and write a letter, keep a journal or practice writing something from memory, such as the Pledge of Allegiance. Try listening: Tune in to an audio book or browse the seemingly infinite library of podcasts. Dust off a favorite book: If your favorite author now appears too complex, pick up a magazine or even a book targeted toward younger readers. You may find support in aphasia friendly material. Check out this news site: http://talkpathnews.aphasia.com/

Ask your SLP for some home practice- If motivation is a problem, request that your SLP give you some home practice. Your SLP will be able to provide tasks that are specific to your area(s) of need.

Though current conditions prevent us from seizing the most optimal rehabilitative opportunities, we don’t have to remain silent. Be creative and take opportunities like welcoming a new neighbor from a safe distance, ordering at the drive thru window or asking the stocker at the grocery store when they expect more toilet paper. Your recovery is not yours to face alone, but it will likely require some initiative. So try something new.

If you or your loved one doesn’t currently have a Speech Language Pathologist to work with, contact us at Vegas Voice Institute and we can guide you through the steps needed to get the support that you need to begin or resume your rehabilitation.

Vegas Voice Institute September 2023

The Cause

As we age, muscles get weak. Vocal folds are no different. The normal aging process can affect vocal folds and cause atrophy in the muscles. While this is considered normal, too much atrophy can cause problems for your voice. When the muscles weaken, the vocal folds will decrease in elasticity and develop a “bowed” look.

Symptoms

Some symptoms that may develop and cause you to need a speech pathologist are the following:

• Hoarse voice
• Coughing
• Throat clearing
• Quiet voice
• Breathy voice
• Swallowing problems (even aspiration)
• Men may notice higher pitched voice and women may develop lower pitched voice

While presbylarynx is part of the normal aging process. Presbyphonia is abnormal. Any time someone experiences poor voice quality, it is abnormal. While some weakening of the vocal cords is to be expected, too much will cause disruptions in the voice. A voice evaluation and voice therapy with a speech pathologist may be necessary if problems with the voice begin to occur.

How Presbyphonia is Diagnosed

In order to find out if you have presbyphonia or presbylarynx, you will have to be evaluated by an otolaryngologist (ENT) and/or speech pathologist. A stroboscopy and voice evaluation will need to take place to assess your vocal cords and your voice quality.

A videostroboscopy is when a camera is inserted into your mouth or nose to look at your vocal cords. It flashes a strobe light onto your vocal cords to slow down the vibration so that each vibration cycle is visible to the human eye. During a stroboscopy, the strength of the vocal cords can be assessed and presbylarynx and other voice disorders can be identified.

Next, a voice evaluation is performed to assess acoustic, aerodynamic, and perceptual measurements of the voice. The voice evaluation provides the speech pathologist with information about severity of the voice disorder. It is also when the speech pathologist will be able to see if the patient is stimulable for therapy.

Basically, the speech pathologist wants to make sure that the patient is a good candidate for speech therapy before having the patient start a therapy program.

How Presbyphonia is Treated

Every recommendation is based on the specific patient. Depending on different factors the patients may be recommended for different frequencies and lengths of therapy programs. The severity and longevity of the problem as well as the patient’s success and ability to perform the exercises will ultimately determine how long therapy will take.

What is Voice Therapy

Voice therapy comes in different shapes and sizes and it can look different for everyone. When working with presbyphonia, we typically address strengthening the muscles and decreasing muscle tension. A speech pathologist will curate a plan of care that addresses the specific deficits and needs of each patient.

Where Can I get Voice Therapy

It’s important to see a speech pathologist who is qualified to treat voice disorders. At Vegas Voice Institute, all of our speech pathologists are qualified to evaluate and treat voice disorders. Vegas Voice Institute is speech pathology office specialized in the treatment of voice and swallowing disorders.

Every speech therapy office is different and finding the right speech therapist to treat your voice disorder is important to the success of your therapy. You should ask the person treating you if they treat voice disorders regularly.

Finding a speech pathologist shouldn’t be difficult. Ask your doctor or google voice therapy in your area to find someone. You will have to be referred by your doctor to see a speech pathologist. Start by asking them and do your research!

Vegas Voice Institute

Vegas Voice Institute is a speech therapy clinic located in Las Vegas, Nevada. We offer voice, swallowing, and language therapy. Therapy can be provided in person at the clinic as well as virtually through telepractice, if you live far from the city. If you feel like you are having voice problems, hoarseness, or have developed a quiet voice, have your doctor refer you to Vegas Voice Institute to help you improve your communication today.

Finding a Speech Pathologist in Las Vegas can be daunting. A speech pathologist isn’t as simple as googling “nearest dry cleaners.” There are so many different reasons to need speech therapy, so simply searching speech pathologist may not find your needs. Each speech pathologist can specialize in specific types of therapy, whether that be voice therapy or strokes, children or adults, swallowing or feeding, etc. 

Speech Therapy at Vegas Voice Institute

At Vegas Voice Institute, we specialize in adult speech therapy, focusing on voice and swallowing problems. We also work with adults with neurological disease with speech and cognition difficulties, including dysarthria, aphasia, memory loss, apraxia, and needs for AAC. 

Voice Therapy 

Our speech therapists are trained in a multitude of therapeutic techniques in voice therapy. Voice disorders come in many different shapes and sizes. There are hypofunctional disorders like glottal insufficiency, paralyzed or paretic vocal folds, and sulcus vocalis. We also treat voice disorders that stem from tension and voice misuse, like vocal nodules and polyps, muscle tension dysphonia, and aphonia. 

Voice Therapy Techniques We Use

Some voice therapy techniques that are common with vocal weakness are Lee Silverman Voice Treatment (LSVT) or PhoRTE. With vocal fold paralysis we work closely with Laryngologists in the cases where surgical options may be needed. 

For muscle tension we utilize a combination of semi-occluded vocal tract exercises, vocal hygiene education, myofascial release and voice massage, and resonant voice therapy. 

The thing about voice therapy is you can’t just do every technique on everyone. That can waste the patient’s time and cost a lot of money. Vegas Voice Institute utilizes stroboscopy to accurately diagnose the patient prior to starting therapy and develop an individualized curated therapy plan for each patient to improve patient outcomes. 

Swallowing therapy

Swallowing problems, or dysphagia, can occur at any stage in our lives but can be detrimental to our health when they do. Treating dysphagia early and quickly is important to decrease the risk of aspiration pneumonia. 

Vegas Voice Institute utilizes a combination of neuromuscular electrostimulation, strengthening exercises, and functional swallowing exercises to improve swallowing and decrease risk of aspiration. 

Swallowing problems can be caused by neurological disease like strokes, ALS, Parkinson Disease, and can also stem from head and neck cancer or surgery in the neck or larynx. Utilizing the correct evaluation tools can determine the safest diet and best way to treat patients with dysphagia. 

Speech Therapy

This is the one that sometimes gets confusing for people. People often say, “Oh, you do speech therapy, so like, stuttering and stuff?” Well, yes, but more emphasis on the “stuff.” Speech therapy with adults looks more like working with patients with aphasia or loss of language, dysarthria or slurred speech, memory loss and cognition disfunction. 

Treating these disorders means understanding their cause and prognosis. Creating a care plan that is functional for patients with neurological disorders means understanding if the patient can improve or will continue to decline. It doesn’t mean you can’t treat patients who will always have a decline, like a patient with Alzheimer’s Disease. It just means that the care plan for speech therapy with these adults will be based around compensation for deficits and family education instead of improving deficits. Choosing a Speech Pathologist for Adults

When looking for a speech pathologist, or any type of therapist for that matter, we want to feel comfortable wherever we end up. Finding the right type of office for an adult can be important so that you feel comfortable when you go for an appointment. 

Locate an office that works specifically with adults and therapists who specialize in the type of disorder that you are experiencing. 

Telepractice in Speech Therapy

Some speech therapists are continuing to provide telepractice visits. Vegas Voice Institute will continue to provide telepractice visits for their patients when accessible. Teletherapy can be beneficial to patients who are far from the office or live outside of the city. Teletherapy offers accessibility to speech therapy for these patients. Vegas Voice Institute has been utilizing teletherapy for patient long before the Covid-19 Pandemic. 

Vegas Voice Institute

If you are looking for speech therapy, feel free to call Vegas Voice Institute at 702-558-9900 to schedule an appointment with us.

Do you have good vocal hygiene? Its probably not something that many people think about except for singers, performers, and speech-language pathologists. But just like a singer relies on her voice, you rely on yours every day. Whether you’re talking to family, your coworkers, or when you’re calling up the pizzeria to get a pizza on Friday night, you need your voice just as much as anyone else. Everyone should care about vocal hygiene. Here some ways you can make sure to keep your voice clean and healthy.

Hydration

Water. Water. Water. Water is the key to vocal hygiene. If your vocal cords are dry and your mucous is thick, you’re going to be straining all day. Keep your vocal cords moist by keeping your body hydrated. How much is enough water? The US National Academies of Sciences, Engineering, and medicine say women should have 2.7 liters and men should 3.7 liters. Of course, if you are exercising or live in a dry place, like Las Vegas, you have to increase those numbers. A good goal is to take your body weight and divide that number in half and then drink that amount of water per day.

Warming up

There are plenty of exercises to warm your voice up. Humming is a great way to start. Labial trills are another warmup to try. Think about the “raspberries” you give a baby. Now, just turn your voice on and make buzzing sounds trilling your lips. There are so many warmup exercises you can learn on YouTube. If you are having voice difficulties, it would be great to see a Speech Pathologist so you can see how to improve your voice quality!

Sleep

Our vocal cords, just like every other muscle in our body. They need a break at night when we sleep. So, that means we need to get good sleep. Yes, of course we should try to get our 8 hours and such but there are other important factors during our sleep. The main factor having to do with what we eat before we sleep. Acid reflux during sleep is a problem that runs rampant in the United States but most people don’t even know its happening to them. It’s important to remember that gravity helps keep our food down in our stomach. When we lay down its possible for some low levels of acid to travel back up our food pipe (esophagus) to our throat (larynx/pharynx). Although acid is fine in the stomach, it can damage our vocal cords. We must remember to space eating and sleep by 3 hours, so that your stomach isn’t digesting food when we lay down at night. You may notice you wake up in the morning with mucous in your throat. This could be a sign that you are having some level of acid reflux.

Vocal Hygiene

It is important that everyone have good vocal hygiene, not just professional voice users. Poor vocal hygiene and voice misuse can lead to dysphonia, or hoarseness, in anyone. If you do feel like your having hoarseness, it would be a great idea for you to see a speech pathologist especially someone who specializes in voice. Ask your ENT for a referral to a speech pathologist and if you’re in Las Vegas, ask for a referral to Vegas Voice Institute.

This month, Vegas Voice Institute celebrates Better Speech and Hearing Month. Each May, Better Speech and Hearing Month allows Speech Pathologists to raise awareness about communication disorders and the role Speech Language Pathologists have in treatment. Whether it be communication or eating, speech pathologists help those who can no longer take those two simple tasks for granted.

Speech therapy comes in all shapes and sizes. Speech Therapy can be provided for those with strokes, dementia, Parkinson Disease, and others. In speech, you might see us helping people learn how to use language again, improve their speech, or improve their memory and cognition.

Vegas Voice Institute also has speech pathologists who specialize in working with patients who have swallowing and voice disorders. Helping people relearn how to eat and swallow is a life-altering therapy that allows patients to join the dining table with their family again.

We don’t realize how much of our day is spent at a table where we eat or at events like weddings or family parties. We work with patients who have recently had pneumonia or breathing problems causing problems such as aspiration pneumonia or choking when eating in speech therapy. We also work with patients after radiation who have had cancer of the head and neck. These patients often are unable to use their muscles to eat and have a tube in their stomach for nutrition. Our NMES Vital Stim treatments and dysphagia treatments help restore their function so they can eat and drink again. Providing speech therapy to allow patients to rejoin the family dinner is challenging and rewarding work.

Voice therapy includes working with professional voice users, singers, or people who just have a hoarse voice. You don’t have to be a famous singer or tv analyst for the Vegas Golden Knights or the Las Vegas Raiders to need voice therapy. Having a hoarse voice isn’t “typical” and we can usually help with reducing hoarseness in your voice.

Many of our patients have difficulty controlling their breath when exercising or cough often requiring speech therapy to increase their voice and breath control which is called vocal cord dysfunction. We also help patients who are experiencing voice weakness after COVID-19 when they have trouble projecting their voice or getting air in when speaking.

Speech language pathologists work in many different settings including acute hospitals, inpatient rehab, schools, and nursing homes. There are also outpatient rehab centers, like Vegas Voice Institute, where patients come for treatment. Speech therapy can now be provided through a combination of telehealth and in-person therapy for most areas.

If you or someone you know needs speech therapy, you can ask your doctor for a recommendation for a local speech language pathologist. Payment for speech therapy services can be covered by private insurances like Aetna, Blue Cross, P3, Medicare, and others or can be paid out-of-pocket.

Better Speech and Hearing Month isn’t about celebrating speech pathologists even though our team of speech-language pathologists are fabulous, highly trained, and effective in their jobs. It’s about raising awareness about how quality of life can be improved through speech therapy. Everyone deserves to be able to communicate effectively and eat safely.

Improving Interactions with People with Traumatic Brain Injuries

By Vincent M. DelGiudice, M.S.CCC-SLP
Speech-Language Pathologist
Vegas Voice Institute

Traumatic Brain Injury (TBI) is when a person has a physical injury to their head or neck resulting in a disruption of normal function. This can be caused by a blow to the head, penetrating injuries, assault or motor vehicle accidents. The injury to the head may affect cognition, attention, memory, a person’s movements, and their emotions. With these deficits, any high stress situation can escalate quickly. So, it is important to understand what the signs of a TBI are and how to best interact with a person to decrease the chance of escalating the situation.

Being aware of these signs or symptoms is an important first step to interacting with someone with a TBI. TBI survivors sometimes have difficulty with controlling emotions and/or overreacting. Identifying these signs or knowing that someone had a TBI can be the difference between a safe interaction and a crisis. These tools can help de-escalate situations to make it safer for the first responders and law enforcement.

Communication is key when encountering anyone who may have poor short-term recall. Try to include family in the conversation when obtaining details or information as they can help fill in gaps if memory is an issue. Try to give the person breaks if they are looking fatigued from trying to remember information. Try to avoid patronizing or asking them to “calm down.” Suggest using deep breaths to help them calm down if they are becoming frustrated or aggravated. Allow more time than usual for the person to respond. Processing time for information can be slower and they may need more time to think about the question.

If you or someone you know has recently suffered from a traumatic brain injury and you think they may need help, we, at Vegas Voice Institute, are here to help. Speech/Language Pathology can be a way for you to improve some cognitive and processing deficits as well as learn how to cope with new deficits. Vegas Voice Institute can work with you and your family to help develop strategies specific to the problems you or a loved one may have. Don’t hesitate to call to find out how speech pathology can help you.

By Vincent M. DelGiudice, M.S.CCC-SLP

Speech-Language Pathologist

Here at Vegas Voice Institute, our team of Speech Pathologists has been serving the Greater Las Vegas area since 2003. As speech pathologists we serve a variety of patients. As the name of our business suggests, we treat and educate those in the community who have been affected with voice disorders. But that is not where we stop. Our team of speech pathologists is trained to treat disorders that affect your swallowing, speech, ability to communicate with others, and memory.

At our clinic, we are equipped to perform most of our assessments right in the office. If you are having difficulty with swallowing, we can provide a dysphagia (difficulty swallowing) assessment right here in our office. When a patient comes to us with a voice disorder, we are able to perform a Stroboscopy right in our office as well. A Stroboscopy is an assessment of your vocal cords. Your vocal cords move so fast that we need a strobe light to slow down the movement of your vocal cords to assess what is causing your voice disorder.

Vegas Voice Institute treats all kinds of voice disorders including hoarseness, vocal nodules, muscle tension, quiet or weak voices and vocal cord dysfunction. But we don’t just treat singers with voice disorders. We treat all professional voice users, including teachers, preachers, real estate agents, attorneys, coaches and more recently, all professionals who have begun working remotely. But professional voice users aren’t the only people who have difficulty with their voice. As you get older, it is possible that your vocal cords and voice may weaken and people can have difficulty hearing you. At Vegas Voice Institute we feel it is of the utmost importance to used research-based therapeutic approaches. This means that the therapy has been researched over and over again before we try it out on you. For example, if you have a weak voice, we may use the Lee Silverman Voice Treatment or PhoRTE voice treatment because they are some of the most well researched types of therapy available. That means we know it works.

Vegas Voice Institute can provide you with therapy and exercises to help you improve your ability to communicate whether you are singing on the Las Vegas Strip or you just want to be able to hear your husband from across the room. Feel free to click on the Services tab to discover the therapeutic approaches we use for voice therapy.

Unfortunately, your voice isn’t the only thing that can cause problems with communication. There are a LOT of reasons you may have difficulty with communication. Have you had as stroke? Do you know someone who has suffered from a stroke? At Vegas Voice Institute we treat neurological disorders with different therapeutic approaches to improve language, memory, processing, and speech. These disorders can be caused by a stroke, or other diseases such as dementia, aphasia, brain injuries, and brain tumors.

Although there are certain deficits that may be progressive or permanent, our team is always willing to work with patients and family to find the best ways for you to communicate.

Vegas Voice Institute proudly serves the community of Las Vegas. We appreciate all of our patients, as we feel it is a privilege to have been treating patients here since 2003.

By Kyle Traux, M.S.CCC-SLP, Speech-Language Pathologist

A common problem for people with aphasia and their caregivers is how to find opportunities to safely practice communication during the time of COVID-19. In normal times, getting this would be relatively effortless: one would have the option of moving freely around one’s environment engaging others at will or joining social groups. For those less outgoing or not quite ready to strike up conversations with strangers or even place an order at a restaurant, there are groups one can join made up of individuals who share similar experiences with language loss and rehabilitation. But with so many of these avenues temporarily blocked because of restrictions on social gathering, what can one do?

We at Vegas Voice Institute would like to help you find some options for increasing communication and language opportunities:

• Chat on the phone or on-line- Communication with friends and family often allows for a less stressful and/or overwhelming experience as these tend to be people who are familiar with your difficulties with communication and can help support the conversation. Schedule recurring phone ‘dates’ with friends and family and use scripts or talking points to aid the conversation.
• Practice with Apps- A variety of apps are tailor made for aphasia and offer a wide variety of skills to target. These apps are designed with the person with aphasia in mind and are thus user friendly. Check in with your Speech-Language Pathologist (SLP) for advice on selecting apps to supplement speech therapy.
• Join virtual groups- A few aphasia groups have moved online due to social restrictions. While it may not be the ideal way to satisfy our social needs, it may just be the best option we have for now. Check out Aphasia Recovery Connection on Facebook.
• Write, Read and Listen- Pick up a pen and write a letter, keep a journal or practice writing something from memory, such as the Pledge of Allegiance. Try listening: Tune in to an audio book or browse the seemingly infinite library of podcasts.
• Dust off a favorite book: If your favorite author now appears too complex, pick up a magazine or even a book targeted toward younger readers. You may find support in aphasia friendly material. Check out this news site: http://talkpathnews.aphasia.com/
• Ask your SLP for some home practice- If motivation is a problem, request that your SLP give you some home practice. Your SLP will be able to provide tasks that are specific to your area(s) of need.

Though current conditions prevent us from seizing the most optimal rehabilitative opportunities, we don’t have to remain silent. Be creative and take opportunities like welcoming a new neighbor from a safe distance, ordering at the drive thru window or asking the stocker at the grocery store when they expect more toilet paper. Your recovery is not yours to face alone, but it will likely require some initiative. So try something new.

If you or your loved one doesn’t currently have a Speech Language Pathologist to work with, contact us at Vegas Voice Institute and we can guide you through the steps needed to get the support that you need to begin or resume your rehabilitation.

This year has been a crazy ride for all of us. Whether you work full-time, or you are retired, whether you work in healthcare or the service industry, we have all been experiencing changes in our life because of Covid-19. Unfortunately, we must learn to adapt to this new world we are living in.

At Vegas Voice Institute, we have been doing our best to provide a safe, sanitized, and clean environment for our patients to be seen in the office. Our team sanitizes each room after a patient was seen to ensure the patient and the staff is entering a clean sanitized treatment or procedure room. Our staff wears a mask, our rooms are outfitted with UV filters and we provide plenty of space for patients to socially distance. We also offer Telepractice sessions for most types of treatments when patients would prefer not to come into the office. Telepractice means that we offer therapy via video chat instead of having to come to the office. We want our patients to feel as safe as they do in their own homes.

There are some exams and treatments that we do need to see you in the office. For example, if we are going to evaluate your swallow to make sure that you are eating and drinking safely, we need to see you in the office so that we can be absolutely sure your swallow is safe. But for certain treatments, such as voice therapy or cognitive therapy, we can provide patients with the ability to be seen from home via Telepractice or video chat. If you are thinking about sending your patients to us or if you are a patient and prefer to stay home, we would be more than happy to set up your appointments to be seen from home.

Vegas Voice Institute has been doing therapy sessions for patients by utilizing Telepractice for years before Covid-19 first began. We are not new to Telepractice, so the transition has been going smoothly. Fortunately, we have a great team who can provide you with support if technology is not your strong suit. Of course, we would prefer to see our patients face-to-face, but we want to continue providing service for the people of the Greater Las Vegas Area and this virus is not going to stop us.

Now, Vincent DelGiudice M.S. CCC-SLP is returning to our team, and he will be solely providing therapy via Telepractice. You can check out his bio at this link.

If you have more questions about the precautions, we are taking here at Vegas Voice Institute, feel free to call us anytime. We can also provide you with more information on our ability to do Telepractice with you or your patients. Whether you or your patients are located too far from the office or you feel you or your patients are still not feeling safe because of the Coronavirus, we would be happy to discuss options to provide therapy to you in the safest way possible.