Treatment of Communication Disorders Unit

The objective of the Treatment of Communication Disorders Unit at the Reuth Rehabilitation Hospital Tel Aviv is to take action to improve the ability of patients to express themselves by means of language and speech and to communicate with their environment, and to treat individuals experiencing difficulties with swallowing. The treatment is adapted to each patient personally, pursuant to his condition and needs. Treatment may be received in Hebrew, Arabic, Russian, English, French, Spanish and Portuguese. Patients speaking other languages can be assisted by an interpreter.

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 of speech and voice disorders: the treatment includes exercises to strengthen the muscles and improve feeling, pronunciation and the vocal quality. If necessary the patient is encouraged to write down messages using various methods. When appropriate, treatment is given using the LSVT method, a unique method for treatment of speech disorders which characterize Parkinson’s patients and also patients with voice disorders based on other neurological backgrounds.
• 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 given within the framework of three designated clinics: the swallowing clinic, the LSVT method voice treatment clinic and the dyslexia and dysgraphia clinic, designed for both children and adults.

Research and academic activity

• Training students: the Unit is recognized as a center for training students from various institutions of higher learning, at various stages of their studies.
• Development of diagnostic tools: the team has developed two specific diagnostic tools in collaboration with the Tel Aviv University:

1. Taltan battery for assessment of reading and writing (Friedman, N & Gevion, A. “The Taltan” battery for assessment of dyslexia, Tel Aviv University (2003))
2. Assessment for short term verbal memory (Friedman, N & Gevion, A. “Freegaby”: battery for assessment of verbal memory work, Tel Aviv University (2002)).

• Academic research and publications: the Unit conducts comprehensive research activity and conducts research in collaboration with researchers from the Tel Aviv University, from Haifa University, from Bar Ilan University and from the Ono Academic College.

Active research:

1. Aphasia: lexical extraction, treatment interventions, verbal work memory and the connection between it and language comprehension, syntax disorders in aphasia and more (collaborations with Tel Aviv University, Haifa University and the Ono Academic College).
2. Use of the BEI (EEG) system as a means for examination of treatment efficacy, in collaboration with Dr Goded Shachaf from the Physiotherapy Unit.
3. Acquired dyslexia and dysgraphia and the developments (collaboration with Tel Aviv University and the Ono Academic College).

The team

The team at the Unit includes 14 speech therapists with extensive experience in the field of rehabilitation, dyslexia and dysgraphia, and expertise in the treatment using the LSVT method and an EEC physician who specializes in execution of FEES tests. The team works in full collaboration with the various relevant units in the hospital including the team of dieticians and nursing personnel.

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