Speech, Voice & Swallowing Disorders



Speech disorders or speech impediments are a type of communication disorders where 'normal' speech is disrupted. Many disorders can affect our ability to speak and communicate. They range from saying sounds incorrectly to being completely unable to speak or understand speech. Causes may include hearing disorders and deafness; voice problems, such as dysphonia or those caused by cleft lip or palate; speech problems like stuttering; developmental disabilities; learning disorders; autism; brain injury; and stroke.

Voice disorders are medical conditions affecting the production of speech. Vocal cords, located in the larynx (voice box), produce the sound of your voice by vibration as air passes through the cords from the lungs. The sound the vocal cords produce is then sent through the throat, nose, and mouth, giving the sound "resonance." The sound of each individual voice is determined by the size and shape of the vocal cords and the size and shape of the throat, nose, and mouth (the resonating cavities).

Vocal cord disorders are often caused by vocal abuse or misuse, such as excessive use of the voice when singing, talking, smoking, coughing, yelling, or inhaling irritants. Some of the more common vocal cord disorders include laryngitis, vocal nodules, vocal polyps, and vocal cord paralysis. Symptoms may include:

  • Hoarseness lasting for more than two weeks
  • Difficulty projecting your voice
  • Vocal fatigue, or voice gets tired after talking for any length of time
  • Reduced range, breaks or gaps in the range, difficulties through the passagio
  • Clearing the throat or excess throat mucus
  • In general, an inability to do things with your voice that you could once do

Dysphagia (Swallowing Disorders)

Dysphagia is the medical term for the symptom of difficulty in swallowing. It can also be a condition in its own right. People with dysphagia have difficulty swallowing and may also experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.

Symptoms of swallowing disorders may include:

  • drooling
  • a feeling that food or liquid is sticking in the throat
  • discomfort in the throat or chest (when gastro esophageal reflux is present)
  • a sensation of a foreign body or "lump" in the throat
  • weight loss and inadequate nutrition due to prolonged or more significant problems with swallowing
  • coughing or choking caused by bits of food, liquid, or saliva not passing easily during swallowing, and being sucked into the lungs
  • voice change

Swallowing disorders can occur in all age groups, resulting from congenital abnormalities, structural damage, medications and/or medical conditions. It is a common complaint among older individuals and frequently develops in the elderly, in patients that have had strokes and in those who are admitted to hospital and long term care facilities.

Dysphagia is a symptom of many different causes. Our physicians work closely with our licensed speech-language pathologist to conduct a formal evaluation of the patient. Together they employ a variety of tests that examine the parts of the swallowing mechanism. One test, called a fiber optic laryngoscopy, allows our staff to look down the throat with a lighted tube. Other tests, including video fluoroscopy, which takes videotapes of a patient swallowing, and ultrasound, which produces images of internal body organs, can painlessly take pictures of various stages of swallowing.

Once the cause of the dysphagia is found, surgery or medication may help. If treating the cause of the dysphagia does not help, our speech-language pathologist will test the person's ability to eat and drink and may teach the person new ways to swallow.

Treatment may involve muscle exercises to strengthen weak facial muscles or to improve coordination. For others, treatment may involve learning to eat in a special way. For example, some people may have to eat with their head turned to one side or looking straight ahead. Preparing food in a certain way or avoiding certain foods may help other people. For instance, those who cannot swallow liquids may need to add special thickeners to their drinks. Other people may have to avoid hot or cold foods or drinks.

For some, however, consuming foods and liquids by mouth may no longer be possible. These individuals must use other methods to nourish their bodies. Usually this involves a feeding system, such as a feeding tube, that bypasses the part of the swallowing mechanism that is not working normally.

Our Offices: Fairfax · Reston · Chantilly Phone: (703)383-8130 Fax: (703)383-7350