One Bite At A Time: Swallowing and Speech Services Inc.

Adult Swallowing Assessment – Includes Flexible Endoscopic Evaluation of Swallow Function (FEES)

Each adult assessment will be comprised of the following components to ensure a comprehensive and individualized approach to treatment planning. Components of each adult assessment will include:

• A phone intake & case history to learn more about your swallowing goals, and any relevant medical history
• An oral-mechanism exam is a crucial part of any swallowing assessment, and allows us to evaluate the structure and function of the parts of our body that are important for eating and swallowing
• A Flexible Endoscopic Evaluation of Swallowing (FEES) assessment allows our speech-language pathologist to objectively assess swallow function. A flexible tube with a camera attached is inserted through the nose, looking down at the throat. Then you are given a variety of foods to eat and drink, and the physiology of your swallow is assessed. Compensatory strategies and maneuvers to make your swallow safer may be tried.
• A review of results/next steps will be provided to every patient, both verbally and in writing. This will include any treatments to maintain or rehabilitate swallow function

Cost: $500 inclusive of all direct components and indirect components (swallow analysis, treatment plan creation)

Adult Swallowing Follow-Up and Treatment Sessions

Following a FEES assessment and intake, a treatment plan will be created by the speech-language pathologist to meet each patient’s unique swallowing goals.

This will include the following options as indicated by the patient’s swallow physiology, and goals:

• Dysphagia rehabilitation exercises such as the Shaker, Chin Tuck Against Resistance, Tongue Strengthening
• Bolus based dysphagia treatment programs including the MacNeil Dysphagia Treatment Program MDTP
• Sensory-motor interventions such as modifying food temperature and taste
• Education for patients and caregivers regarding protective factors such as oral health
• Diet texture recommendations

All treatments will align with several foundational clinical approaches that are key to evidence-based dysphagia care:

• Principles of motor learning
• Principles of exercise science
• Patient-centred and functional goals

Cost: $130/clinical hour (45 minutes of direct service, 15 minutes indirect services like planning and documentation)

Adult Voice, Speech & Language Assessment and Treatment

We do offer speech and language assessment and treatment for adults! We welcome inquiries about all types of communication difficulties, including difficulties with voice, language and speech.

Cost: $300 for assessments (inclusive of direct service, and indirect services like documentation)

$130/clinical hour (45 minutes of direct service, 15 minutes indirect services like planning and documentation) for treatment sessions

Gender Affirming Voice Services

We offer gender-affirming voice services for those who wish to gain skills and strategies to achieve a voice that feels right for them. Our personalized services can help you increase vocal control and flexibility, meet your voice goals, and express yourself in a way that feels authentic to you.

As with all of our services, our gender affirming voice services include access to multidisciplinary assessment with an otolaryngologist and/or visualization of the larynx to help you achieve your voice goals

Cost: $300 for assessments (inclusive of direct service, and indirect services like documentation)

$130/clinical hour (45 minutes of direct service, 15 minutes indirect services like planning and documentation) for treatment sessions

Pediatric Feeding Skill Assessment

Some children need extra support with feeding skill development. The goal of this assessment is to evaluate your child’s current skill, and support you in helping your child progress along their feeding journey. A feeding assessment for pediatric patients will include:

• A phone intake & case history to learn more about your child’s overall development, including feeding, any goals you have regarding feeding, and any relevant medical history
• A functional oral-mechanism exam appropriate for the child’s developmental level will be completed with a speech-language pathologist.
• A feeding observation will occur in-person or virtually to assess each child’s feeding skill. This will include observation of a variety of textures. Changes to positioning, and techniques such as pacing, lateral bolus placement, and more can be tried during the assessment to determine if there is a positive impact on the child’s feeding skill development.
• A review of results/next steps will be provided to every patient, both verbally and in writing. This will include any treatments or recommendations to support feeding skill development.

Cost: $300 inclusive of all direct components and any indirect components (report & treatment plan creation)

Pediatric Feeding Skill Development Follow-Up and Treatment Sessions

Following a feeding assessment and intake, a treatment plan will be created by the speech-language pathologist to meet each patient’s unique swallowing goals.

This will include the following options as indicated by the patient’s feeding skills, and goals:

• Interventions to support oral-motor skill development like crunchy dissolvables, lateral bolus placement
• Sensory-motor interventions such as modifying food temperature and taste
• Education for parents and caregivers regarding protective factors such as oral health
• Diet texture recommendations

All treatments will align with several foundational clinical approaches that are key to evidence-based dysphagia care:

• Principles of motor learning
• Principles of exercise science
• Family-centred and functional goals

Cost: $130/clinical hour (45 minutes of direct service, 15 minutes indirect services like planning and documentation)

Pediatric Speech & Language Assessment and Treatment

We do offer speech and language assessment and treatment for children! This includes children with developmental delays in speech & language development, as well as children with communication changes related to an accident or injury. We welcome all inquiries.

Cost: $300 for assessments (inclusive of direct service, and indirect services like documentation)

$130/clinical hour (45 minutes of direct service, 15 minutes indirect services like planning and documentation) for treatment sessions

Communication Intermediary Services

“Communication intermediaries (CIs) are individuals eligible to be registered speech language pathologists (SLPs), who are trained to facilitate two-way communication between individuals with speech, language and/or cognitive-communication disabilities and justice professionals” (Communication Access to Justice, n.d., https://www.cajust.ca/what-are-cis). Juliana has completed the communication intermediary training through Communication Access to Justice and is available for Communication Intermediary services in Nova Scotia.

Consulting Services

Do you want to learn more about how to support individuals with communication or swallowing disorders in your organization or business? We can help! Nova Scotia passed the Accessibility Act in 2017 which includes a goal of an accessible Nova Scotia by 2030. Accessibility of course includes physical accessibility, but also includes communication accessibility. You may wish to inquire about our consulting services if you want to learn more to ensure your business or organization is inclusive to people with communication disorders.

We also offer presentations, and education for other professionals. This can include information about risk factors for feeding and swallowing disorders, information about when to refer someone for further management, and other topics. These presentations are customizable for your organization’s needs.