Treatment of Communication Disorders Unit

Prof. Aviah Gvion- Director, Communication Disorders Unit

The treatment of Communication Disorders Unit at Reuth TLV Rehabilitation Hospital diagnoses and treats patients with language, speech, voice, and swallowing difficulties resulting from various brain injuries. The unit’s goal is to enable those who require these services to return to full activity, as much as possible, in their ability to communicate with their environment and to regain functional swallowing ability.

Patients

The Unit treats individuals suffering from defects in communication abilities that could be derived due to various causes, including CVA, brain traumas as a result of an accident, brain tumours, and degenerative diseases.

The disorders are divided into four types:

Language disorder (aphasia): brain damage, for the most part in the left hemisphere of the brain that could be expressed by various degrees of severity of disorders in speech, comprehension, reading and/or writing.
Speech disorder (dysarthria): injury to areas of the brain controlling the facial muscles, the tongue and other areas required for speech. The difficulty could be expressed by pronunciation, by the speed of speech and the vocal quality.
Harm to the quality of the voice (dysphonia): brain damage or direct damage to the vocal cords which could cause a decrease in the vocal quality going so far as inability to produce sounds.
Difficulties with swallowing (dysphagia): brain damage that could harm the swallowing system. This is a complex system which obligates coordinated activity of various muscle systems. Difficulty in swallowing could harm the patient’s nutrition and sometimes even endanger his life.

Treatments

A range of treatments are provided in the Treatment of Communication Disorders Unit:

Treatment for language disorders: the treatment has two main objectives: reduction of the linguistic difficulty thus the patient is able to return to communicate as closely as possible to his previous ability, and simultaneously to focus on provision of strategies and additional non-verbal means that will enable the patient to communicate with his environment notwithstanding his linguistic restriction.
Treatment for Speech and Voice Disorders: The treatment includes a variety of exercises aimed at improving movement and sensation of the speech organs to improve articulation and vocal quality. The staff also specializes in unique methods for voice disorders such as LSVT and Speak-out, which are also unique for treating voice and speech disorders characteristic of patients with degenerative disorders such as Parkinson’s.
Treatment of swallowing disorders: the treatment includes exercises for strengthening and improvement of the swallowing mechanism, alongside learning safe swallowing techniques. Furthermore, each patient receives customized nutritional textures which he can swallow without risk. If necessary it is also possible to receive nutritional advice from the hospital’s dietary unit.

The treatments in the unit are provided in a full inpatient setting, in a day hospitalization framework, and also through three specialized clinics: speech and language therapy, voice, and swallowing.

Technologies Used in the Unit

Swallowing: The unit performs Fiber Endoscopic Evaluation of Swallowing (FEES) tests to provide an accurate assessment of swallowing function in patients with swallowing difficulties.

Communication: Assistive communication technologies are used to help patients who require support in their ability to communicate with their environment. These include Gaze focusing systems and various applications on tablets and iPads.

Communication systems for patients with reduced levels of consciousness: The EyeCon system, developed by Dr. Gudad Shachaf at Rambam Medical Center in collaboration with Reuth Tel Aviv Hospital, is designed to identify and promote means of communication for patients in such conditions.

The CEI system, also developed by Dr. Gudad Shachaf at Rambam Medical Center in collaboration with Reuth Tel Aviv Hospital, is used to identify levels of attentional engagement in patients under various care conditions.

Research and academic activity

Student Training: The unit is recognized as a training center for students from various institutions of higher education, who are at different stages of their studies, and is also involved in supervising advanced degree students in MA and PhD theses.
Research and Academic Publications: The unit conducts extensive research activities and carries out studies in collaboration with researchers from Tel Aviv University, Haifa University, Ariel University, and Ono Academic College, and from Rambam Hospital and Beit Loewenstein Hospital.

The team

The unit’s team includes 13 speech therapists with extensive experience in rehabilitation, dyslexia and dysgraphia, and specialization in unique treatment methods for voice therapy, as well as an ENT physician specializing in performing FEES examinations. The team works in full collaboration with the various relevant departments in the hospital.