Speech pathologists provide services to individuals and families. They also provide information and education to staff and the general public.
Speech pathologists provide assessment and diagnosis for communication and swallowing disorders, and may provide advice, intervention, treatment and counselling for the following:
Speech (i.e. articulation, stuttering, acquired or developmental neurological disorders e.g. apraxia)
Language (i.e. acquired or developmental difficulties with word knowledge, syntax, semantics, language processing, listening and the social aspects of communication). This also includes the comprehension and expression of spoken, written, non-verbal (signs symbols and gestures) modalities
Cognitive communication (i.e. attention, memory, problem solving, executive functions)
Oral, pharyngeal, laryngeal and upper oesophageal swallowing function (i.e. infant feeding, acquired dysphagia)
Voice (i.e. abnormal quality or poor volume e.g. rough, breathy and strained)
Tracheostomy management, including facilitation of verbal speech with tracheostomy, swallowing with tracheostomy and decannulation pathways
Augmentative and Alternative Communication (i.e. picture or alphabet boards, voice output technology)
Head and neck management, including surgical laryngectomy voice restoration and swallowing.
The speech pathology goal is to optimise diets and maximise hydration and nutrition. Speech pathology management of 'chronic aspiration' includes diverse strategies beyond diet and fluid modification and these decisions best involve all the caring team (including the speech pathologist) and the family.
Speech Pathology Multidisciplinary Clinics
Videofluoroscopic Swallow Study (Modified Barium Swallow) Clinic
Modified Barium Swallow (MBS) study is a dynamic radiological evaluation of swallowing. It allows visualisation of oropharyngeal structures; examines physiology with different food/fluid types, bolus sizes and delivery methods, and evaluates the effects of compensatory strategies. MBS differs from a barium swallow in that it examines oropharyngeal physiology of swallowing. It is not used to diagnose or investigate oesophageal problems.
Voice and Swallowing Clinic
This multidisciplinary clinic involves both ENT surgeons and speech pathologists. The focus is on assessing dysphonia and dysphagia and developing a management plan.
Speech pathology provides limited inpatient paediatric feeding assessment and management. A fortnightly outpatient multidisciplinary feeding clinic forms part of the paediatric speech pathology service at RNSH. The feeding clinic is conducted in conjunction with a paediatrician and dietitian to provide a holistic client service. The clinic aims to promote and stimulate feeding in children who may have difficulties as a result of medical or behavioural issues.
Radiation Oncology Clinic
Speech pathology provides education, support and therapy for patients undergoing radiation therapy to head and neck structures involved in speech and swallowing. The clinic runs each Wednesday morning.
Head and Neck clinic
Speech pathology participates in team meetings which review new referrals for management of head and neck cancer and provides individual review as part of follow-up after treatment. This clinic meets in the Cancer Care Centre on Tuesday afternoons.
Head and Neck ENT Surgery
Speech pathology provides specialist in and outpatient services for patients presenting with problems such as difficulty with producing a normal voice, speaking clearly and swallowing difficulties secondary to surgery, trauma or dysfunction. This might include patients with tracheostomy, head and neck cancer or other anatomical variation.
Critical Care HDU
Speech pathologists provide swallowing and communication advice and management for patients that are often medically complex and fragile. These patients may be ventilator dependent with a tracheostomy. Communication intervention in patients with tracheostomy can be facilitated by careful assessment of the patient. Swallowing input aims to commence oral intake as soon as safely possible and to reduce reliance on alternative nutrition.
Speech pathologists provide a service to patients with neurological disorders including stroke and degenerative diseases in addition to patients requiring neurosurgical management for vascular disease, traumatic brain injury and brain tumours. These patients are seen on the neurology and neurosurgical wards, in neurosciences ICU and a small number of outpatients.
Speech pathologists assess and manage swallowing and communication in people with tracheostomy, and provide communication options (including phonation valves and non-verbal communication boards). The aim is to promote verbal speech (e.g. Leak speech, phonation valve). If speech is not possible, assessment and training in non-verbal communication methods (e.g. mouthing, alphabet board) may be used. Speech Pathologists may also provide advice on weaning and decannulation pathways.
Speech pathologists provide both generalist and specialist services to inpatients (predominately) with severe burns. Besides managing swallowing and communication issues, they also form part of an allied health team managing facial and neck scarring. They will also provide follow-up to some outpatients when necessary.
Fibreoptic Endoscopic Evaluation of Swallowing (FEES) is an objective swallow assessment that allows for direct visualisation of the structures and physiology of swallowing. This is performed at the patient's bedside, sometimes in conjunction with ENT. This enables assessment of swallow and voice function, compensatory swallow positions or techniques and can be used as biofeedback for the patient in swallow therapy.
Speech pathologists located at the Graythwaite Rehabilitation Centre provide comprehensive assessment, diagnosis and tailored goal-oriented therapy programs for in-patients with acquired communication and/or swallowing problems. Treatment is conducted in a multidisciplinary setting with a patient centred approach. Patients requiring outpatient follow up are referred to other services.
Adults with communication or swallowing disorders who live in the local area. Some adult, child and infant referrals for specialty clinics or services.
- Via letter, phone contact, self-referral or medical referral for outpatients.
- All MBS referrals require a medical referral.
Please contact our administration staff on 02 9463 1622
for urgent referrals.