Speech and language therapy

Our Role

Our team works with people who have communication and swallowing disorders as inpatients at both hospital sites – Chelsea and Westminster Hospital and West Middlesex Hospital. 

***Please note – From January 2020, the Chelsea and Westminster Hospital site no longer have an outpatient service for voice/communication/swallowing difficulties. Please contact your local community SLT service for more support***

We have specialists who help with: 

  • Dysphagia (swallowing disorders)—we use clinical bedside assessment and videofluoroscopy (video X-rays) to accurately assess and diagnosis swallowing problems
  • Respiratory and tracheostomy management
  • Stroke rehabilitation, and other neurogenic swallowing and communication disorders
  • Care of the elderly
  • Communication and swallowing problems arising from other medical or acute conditions

Our team

Our team is managed by Jessica Newman and includes therapists across both hospital sites. Team members are registered with the Health and Care Professionals Council and the Royal College of Speech and Language Therapists (RCSLT).

Contact

Chelsea and Westminster Hospital

Inpatients: Ward-based
Tel: 020 3315 8458

Email: 

West Middlesex University Hospital

Inpatients: Ward-based
Tel: 020 8321 5487

Email: 

NB: We accept referrals from Community SLTs for outpatient videofluoroscopy. Please use the details above to contact us for a referral form. Please note we will also need a GP sanction before we can book these in. 

More information about swallowing/communication disorders

What is dysphagia?

Dysphagia describes eating, drinking and swallowing difficulties. Dysphagia in adults occurs as a result of a medical problem, such as: Stroke, Dementia, Parkinson’s Disease, Motor Neurone Disease, Head and Neck cancer, Respiratory conditions e.g. COPD, spinal cord injuries and surgery.

Early identification, treatment and management of dysphagia by Speech and Language Therapists improves quality of life and reduces the possibility of further medical complications such as chest infections.

Signs and symptoms of Dysphagia:

  • Takes a long time to chew
  • Difficulties controlling the food/drink in your mouth 
  • The feeling of sticking of food/drink in your throat 
  • A wet voice after eating/drinking
  • Food in the nose
  • Coughing or choking when swallowing
  • Eating slowly/avoiding meals
  • Significant, unintended weight loss
  • Recurrent chest infections or pneumonia

Dysphagia assessment

Speech and Language Therapists will use different assessment techniques to determine the severity and best management of dysphagia:

  • Bedside/Clinical Swallow Assessment: This is where an SLT will examine your swallow by looking, feeling and listening for signs of dysphagia whilst you are eating or drinking. 
  • Videofluoroscopy: This is an x-ray examination of swallowing which is used to provide moving images can be reviewed in detail. During this assessment, you will be asked to swallow different food and drink consistencies that have been mixed with contrast material (e.g. barium or omnipaque) to see exactly what happens when you swallow.
  • FEES (fibreoptic endoscopic evaluation of swallowing): This is a procedure where an endoscope (with a small camera) is inserted through the nose and throat to visualise your larynx (voice box) and airway whilst you swallow. This service is currently not provided at Chelsea and Westminster Hospital or West Middlesex Hospital. 

Dysphagia management

Speech and language therapists can help individuals with swallowing difficulties to eat, drink and swallow more safely. This might be done using one or several of the following:

  • Strategies/Postures: Can sometimes be used to improve the safety of the swallow and may be recommended following assessment.
  • Thickening Fluids: can help to make the fluids move slower and reduce risks of aspiration (drinks going the wrong way in to your lungs). You need to be assessed by a Speech and Language Therapist before commencing thickened fluids. 
  • Diet Modification: Altering your diet (e.g. mashed foods/pureed foods) can help to reduce the risks of choking and make swallowing more comfortable and manageable. 
  • Swallow Rehabilitation: Targeted exercises will sometimes be recommended to help improve the muscles we use to swallow.  Often these exercises require patients to spend at least 30 mins exercising, for 3 times per day, every day for approximately 6 weeks.

Communication Difficulties

Adults can have difficulties with their speech, language, communication or voice due to many different reasons. These can include;  stroke, traumatic brain injury or progressive conditions e.g. Motor Neurone Disease/Multiple Sclerosis, Dementia. 

Types of Communication Difficulties 

  • Aphasia: this is an acquired language disorder which may affect a person’s ability to talk, writeunderstand spoken information and written information (reading). Aphasia is a long-term and life-changing condition that can make every day activities very challenging. It requires the individual as well as their family and friends to adapt to support their communication
  • Apraxia of Speech (AoS): a motor speech disorder that refers to a difficulty in planning, sequencing and coordinating movements needed for speech. It may result in difficulty producing any speech at all, or may have a less severe impact on parts of speech such as articulatory movement, fluency, or inconsistencies with producing longer or more complex words (such as words with several syllables). Some automatic speech (such as counting) may be less affected by AoS
  • Dysarthria: is the umbrella term used to describe a group of motor speech disorders, which affect how well someone can be understood. It often refers to someone who has ‘slurred speech’. It may cause speech to be completely unintelligible or present as more subtle changes such as reduced volume, reduced clarity with mildly slurred speech, changes to usual pitch or intonation patterns
  • Cognitive Communication Disorder (CCD): is an acquired communication disorder that often impacts someone’s use of social communication. Cognitive communication disorders are problems with communication that have an underlying cause in a cognitive deficit rather than a primary language or speech deficit. A cognitive communication disorder results from impaired functioning of one or more cognitive processes, including attention and memory

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