|  

Banner01 Audiology
Banner02 Speech
Banner03 Play
Banner04 Professional
Banner General
Home Testimonials Voice Disorders English Speech Therapy

Voice Disorders

2. Service

Hoarseness can be caused by abnormal growth on the vocal cords, such as Cord Polyps, Nodules, and Paralysis. Persistent hoarseness (lasts for weeks or months) can be caused by a variety of problems.

ENT Laser – A Decade of Excellence

  • Since 2003, our transdisciplinary team of speech therapists and consultant otorhinolaryngologist combined endoscopic evaluation and instrumental analysis to provide one-stop assess,emt and treatment of voice disorders.
  • On 2007, our speech therapists has been appointed as clinical instructor by the Voice Clinic of Division of Speech and Hearing Sciences, The University of Hong Kong.
  • Since 2008, our consultant otorhinolaryngologist has participated in researches contributing to the treatment of voice disorders, conducted by Voice Clinic of Division of Speech and Hearing Sciences, The University of Hong Kong.
  • Our centre is the only speech therapy institution that has invited the founder of Lessac-Madsen Resonant Voice Therapy, and Professor of The University of Pittsburgh, Dr. Verdollini Abbott, for three times, to lecture speech therapists in Hong Kong, Taiwan, and Singapore. About 300 speech therapists attended the lectures.
  • Our centre has introduced from the United States, two empirically supported approach to treatment of voice disorders: Lessac-Madsen Resonant Voice Therapy and Adventures in Voice.

 Introduction

Possible Causes for Hoarseness:

Excessive use of the voice (as in shouting or singing)
  • Allergies & Postnasal drip
  • Excessive use of irritating substances (e.g. alcohol or tobacco)
  • Hearing Loss
  • Developmental disorders (e.g. Autism)
  • Frequent throat clearing and coughing
  • Viral infection
  • Gastric reflux
  • Tonsillitis
  • Ingestion of a caustic liquid
  • Foreign body ingestion
  • Cancer of the voice box (Laryngeal cancer)

Signs and symptoms of voice problems
  • Loses voice (becomes aphonic), pitch breaks voice becomes tired easily
  • Voice either too loud or too soft
  • Compared with same gender and age groups, voice is of too low or too high pitch
  • Voice often sounds raspy, hoarse, or harsh.
  • Voice has unusual nasal quality
  • Feeling of lumpiness in the throat
  • Throat is often too dry
* Voice problems have persisted over a period of time (at least 6 weeks) (add in voice problem clip)


 Assessment

Our speech therapists combined instrumental analysis with perceptual evaluation to assess our clients’ voice. Clients suspected of vocal folds abnormities can also be referred to our otorhinolaryngologist for endoscopic evaluations.


 Treatment

About Lessac-Madsen Resonant Voice Therapy (LMRVT)

Our center is the ONLY speech therapy center who has invited Dr. Verdollini Abbott to conduct voice training workshop. She was the founder of Lessac-Madsen Resonant Voice Therapy (LMRVT). In year 2010, our center has organized LMRVT Asian Tour with other speech therapy associations in Singapore, India and Taiwan. Our center's speech therapists are ALL certified provider of Lessac-Madsen Resonant Voice Therapy (LMRVT).
Lessac-Madsen Resonant Voice Therapy (LMRVT) was widely used in the United States and other countries. The efficacy of resonant voice therapy to improve voice quality was highly evidence-based. Initial and recent studies showed that resonant voice training was useful in helping to improve the signs and symptoms associated with vocal fold nodules and polyps (Verdolini-Marston, Burk, Lessac, Glaze, & Caldwell, 1995).
Dr. Katherine Verdollini Abbott, Professor in the Department of Communication Science and Disorders, has developed a systematic approach of Resonant Voice Therapy called Lessac-Madsen Resonant Voice Therapy (LMRVT). All patients who receive voice training have goals of producing a strong and clear voice over a distance or in background noise as well as to prevent future injury to vocal folds.

The program focuses on:
  • Individualized voice care program by therapist
  • Introduction of resonant voice and explore how it can SOUNDS good and FEELS good
  • Variable practice (i.e. practice on resonant voice on words, phrases, sentences)
Appointment
MoreClient's Sharing
“ My speech therapist was fantastic at listening, observing, and articulating my problems to me. The conversational style of the sessions allows me to acquire the skills in a comfortable, pressure-free, and enjoyable environment. ”
Betty
2. Service


Neurological Communication Disorder is a collective term for acquired neurological language disorders which affects language comprehension and production resulted from brain damages by stroke, encephalitis, traumatic brain injury and brain tumor, etc. Neurological Communication Disorder includes Aphasia, Apraxia and Dysarthria.

ENT Laser – A Decade of Excellence

  • Since 2003, experienced Speech Therapists of ENT Laser have brought intensive clinic and outreach services to clients in need of communication rehabilitation.
  • Besides from in-patient speech therapy services, our Speech Therapist extended our services to public and private hospitals, elderly homes, and households for the past ten years.
  • Speech Therapists from our centre volunteered in regular communication rehabilitation groups of Neuro United (a non-government self-help organization), providing rehabilitation training to patients who suffered from stroke or dementia.

 Introduction

  • Aphasic patients might have difficulties in comprehension and expression, speech organization, reading and writing, etc. Symptoms include:
    • Word-finding difficulties: Aphasic patients might not able to find the right word to say. They might circulate around the topic but is unable to tell the exact wordings. Some patients might simply tell you, "I can't remember the word." or "I don't know how to say that."
    • Circumlocution: Some Aphasic patients might be able to speak fluently but you may find that the content lacks coherence or the patient is telling something unrelated. Some patients might have grammatical errors in their speech.
    • Slurred speech: Due to deficient facial and oromusculature, Aphasic patients might have articulation errors. For example, slurred speech, voice too soft like murmuring, speech rate too fast or too slow, hoarse voice.
    • Reading and Writing Difficulties: Aphasic patients' reading and writing ability might be impaired. They might forget how to read and write simple and common words.
  • Apraxia is one kind of motor speech disorder. Apraxic patients have difficulties in motor planning and programming of the speech articulators. Symptoms include: inconsistent articulatory errors, groping oral movements to locate the correct articulatory positions, and increasing errors with increasing word and phrase length.
  • Dysarthria is also one kind of motor speech disorder. Due to weakness/paresis and/or paralysis of the musculature of the oral mechanism, resonance, phonation, respiration, articulation and prosody of the patients could be affected.

 Assessment

Speech Therapist will assess and make accurate diagnosis in the following areas:
  • Language comprehension and production (including word, sentence and passage comprehension, naming, word-finding ability, repetition, speech organization, and reading and writing abilities).
  • Articulation(including assessing the strength, coordination, rate, and range of movement of the muscles of jaw, lips, tongue, palate).
  • Motor speech planning and programming.

 Treatment

Individual therapy will be tailor-made for patients. Speech Therapist will set treatment goals according to the patient’s daily communication needs. Training goals can include strengthening word-retrieval, enhancing speech organization, increasing strength and control over articulator muscles, improving articulation, voice and breathing exercises, etc.
 
Appointment
More Client's Sharing
“ My therapist is professional, tender, patient and experienced, teach her in gradual steps and often encourage her. ”
2. Service


A normal swallowing process comprises several stages as food and liquid move from the mouth, down the back of the throat, through the esophagus and into the stomach. Problems with swallowing can occur at any of these stages, such as oral spillage due to difficulties in controlling liquid in the oral cavity when drinking, and choking due to food entering the airway when swallowed.

ENT Laser – A Decade of Excellence

  • Since 2003, our transdisciplinary team of speech therapists, consultant otorhinolaryngologist provided swallowing assessment using state-of-the-art fiberoptic endoscopic evaluation of swallowing (FEES).
  • First private speech therapy institution providing VITALSTIM dysphagia treatment to a 1-year-old toddler with congenital oropharyngeal dysphagia, in 2005.
  • In 2009, our speech therapist volunteered for Hong Kong Cancer Fund in providing a series of rehabilitation seminars for patients with nasopharyngeal cancer and swallowing disorders.
  • To best meet our clients’ needs, our speech therapist extended our outreach evaluation and rehabilitation services to public and private hospitals, elderly homes, and households for the past ten years.

 Introduction

According to a study released by the Hong Kong Hospital Authority in Year 2005, over 50% of the elderly (>1000 subjects) were diagnosed to have swallowing disorders. Individuals with strokes, dementia and Parkinson’s disease are at high risk. Aspiration pneumonia, reduced body weight, malnutrition, dehydration are the possible consequences of swallowing disorders.
Speech Therapists can provide clinical swallowing assessment and rehabilitative training for individuals with difficulties in swallowing.

Symptoms of Swallowing Disorders:
  • Choking / Hardness to breath when swallowing
  • Gurly voice after swallow
  • Food stuck in throat
  • Frequent oral retention / Prolonged meal time (1 hour+)
  • Frequent drooling / oral spillage when drinking liquids
  • Persisting low-grade fever / Pneumonia
  • Poor appetite
The most common symptom of swallowing difficulties is choking. However, some patients may not show obvious symptoms (e.g. no coughing when aspiration occurs). Please consult your Doctor or Speech Therapist for professional diagnosis.

 Assessment

  • Bedside Assessment
Swallow test with different food consistencies to look for signs of aspiration.
  • Modified Barium Swallow Study (MBS) / Videofluoroscopic Swallow Study (VFSS) / "X-ray"
    • a video X-ray examination procedure that provides objective information on the food bolus transport process from the oral cavity to the esophagus
    • compensatory strategies for more effective swallow may also be assessed
  • Fiberoptic Endoscopic Examination of Swallowing (FEES)
a dynamic laryngopharyngoscopic examination of swallowing abnormalities and aspiration.

 Treatment

  • Recommendations on feeding mode, posture, food consistency and swallowing techniques
  • Training on the strength and coordination of oral and laryngeal muscles for swallowing
  • Training on swallowing reflex through Deep Pharyngeal Neuromuscular Stimulation (DPNS) techniques
  • Electrical stimulation on muscles responsible fore swallowing through Vitalstim Therapy
Appointment
MoreClient's Sharing
“ 1-year-6-month-old pre-term baby failed to be oral-fed, acquired 60% success rate in oral feeding trials after 28 sessions of Vitalstim therapy sessions. ”
2. Service

Errors in speech sounds due to various causes can happen in people of all ages, including distortions & substitution, slurred speech, non-native accent, and “lazy sounds”.

ENT Laser – A Decade of Excellence

  • Published three articulation training material sets in 2013.
  • Provided services to thousands of clients, including preschoolers, school-aged children and adults) in the past 10 years.
  • Being invited by different parties, including Job Market, Longman, Learning Plus, TVB, Road Show, Metro Radio, to share our experience on articulation therapy.

 Introduction

A child may not learn how to produce sounds correctly on his or her own. Delayed phonological development leads to unclear speech in these children. Speech sounds errors in adults, which persist from childhood, are also considered as Speech Sounds Disorders.
 

Cause

Factors that may lead to Speech Sounds Disorders include:
  • Weak oro-motor ability/ other oro-motor deficit, e.g. Cleft lip and/or palate
  • Multi-lingual environment
  • Hearing Loss
  • Developmental disorders (e.g. Autism)
  • Genetic syndromes (e.g. Down Syndrome)
  • Neurological disorders (e.g. Cerebral palsy)

 Assessment

Our Speech Therapists will conduct an articulation assessment with the client using Hong Kong Cantonese Articulation Test (for Cantonese), The Goldman-Fristoe Test of Articulation (for English) or other standardized or non-standardized assessment tools under playful or relaxed environment. Integrating findings from oro-motor examinations and consultation, our Speech Therapists will diagnose the severity and possible causes of the problem. Our Speech Therapists will provide recommendations and devise treatment goals specific to each client.
 

 Treatment

Training for pre-school children will be carried out under playful environment, in a stepwise-manner (progressing through articulation placements of speech sounds, words, sentences, to conversations). Our Speech Therapists will utilize different tools, exercises and cueing methods to facilitate the correct production of speech sounds. Parental training will also be given through observation and participation in the lesson so as to ensure the parents can acquire the parental skills to help training the child’s speech at home. Home practice will also be given.
 
Adult
Our Speech Therapists will provide personalized individual training to adult clients, in a stepwise-manner (progressing through articulation placements of speech sounds, words, sentences, to conversations). Our Speech Therapists will utilize different tools, exercises and cueing methods to facilitate the correct production of speech sounds. Personalized to our clients’ daily needs, our training program ensures success in daily communication.
 
Appointment
MoreClient's Sharing
“ My speech therapist used cards and assistive tools, such as straws and tongue depressors, to help my child develop speech clarity. ”
2. Service


Intact oral structures and movement are essential for normal speech clarity and swallowing ability. Reduced mobility, precision and endurance of any of the oral structures and musculature, a condition termed as oral-motor weakness (aka “oromotor weakness), could adversely affect speech and swallowing ability.

ENT Laser – A Decade of Excellence

  • In 2003, we introduced Beckman Oral Motor Assessment and Intervention to provide more options to children and adults with oral motor weakness, in addition to traditional oral motor exercises.
  • In 2008, we introduced Talktools® Oral Placement Therapy (OPT), to systematically train clients with oral motor weakness, in order to improve strength and coordination of the jaw, lip, and tongue.
  • In 2013, we introduced Iowa Oral Performance Instrument (IOPI), to assess and train clients with reduced strength and durance of lip and tongue muscles.

 Introduction

  • Hypersensitive to touch on face or inside mouth
  • Excessive drooling
  • Unclear speech
  • Weakness in chewing (e.g. prolonged time or even failure in chewing meat)
  • Food faddism (e.g. rejecting the intake of certain taste or texture of food)

 Assessment

Speech therapist will assess the oral motor ability of an individual in the areas of:
  • Sensory perception of facial and oral areas: sensitivity and reaction to stimulation of the face and oral musculatures, for any signs of hyper- or hypo-sensitivity.
  • The range of motion, strength and endurance, control and coordination of oral musculatures, including: upper and lower jaws, lips, tongue and facial muscles.

 Treatment

Oral-motor therapy aims at facilitating the improvement in oral movements. It is used in conjunction with speech, language and feeding interventions for the remediation of speech and swallowing difficulties.
In an oral-motor therapy program, active and passive exercises, as well as sensory stimulation, would be performed on oral musculatures including the jaw, lips, tongue, soft palate, larynx and respiratory muscles. Examples of oral-motor therapy programs include:
    • Oral motor exercises
    • Beckman Oral Motor Therapy
    • Sara-Rosenfeld Johnson's Oral Placement Therapy (“Talktools Therapy”)
 
Appointment
MoreClient's Sharing
“ With detailed explanation and patient guidiance, I am confident that I can carry out practices at home with my child. ”