Focus

Autism is a neurodevelopmental difference characterized by alternative methods of communication, socialization, and behaviors (compared to neurotypical people). This may manifest as preference for routines, stimming while communicating (non-speaking or speaking), and engaging passionately with topics of high interest. We see autism as a whole and valid experience (not a disease!) while recognizing the challenges this different neurological organization faces with the inherent barriers of everyday life.  We offer strengths-based, neurodiversity-affirming approaches for enhancing communication between autistic and non autistic folks including sensorimotor regulation supports to support cognitive balance, self-advocacy skills, and embrace natural language acqusition by using evidence-based techniques to encourage language growth. Speaking, non-speaking and/or alternative augmentative communication (AAC) modalities are honored and embraced. *PLEASE ADVISE: An autism disagnosis does NOT mean a child requires therapy. NEED for therapy is different for each autistic individual and determined through self or specialist evaluation.

Stuttering is a neurologically-based difference in speaking characterized by repetitions in speech sounds, syllables, words, phrases, and sentences, as well as blocks in speech production and prolongation of sounds. Stuttering may also include other behaviors, such as groping or twitching. We affirm and see stuttering as a normal part of speaking diversity per the social model of disability. We also understand the inherent challenges that stuttering presents. We approach stuttering from a neurodiversity-affirming perspective by beginning with the basics of motor speech and fluency mechanics and building an understanding of what stuttering is and is not. We work with patients and their families to build understanding, encourage self-advocacy, and create healthy communication environments in all settings of their daily lives (i.e., home, school). Fluency-enhancing speech strategies are taught if the patient and family opt to learn them.

Following a brain injury (i.e., stroke, traumatic brain injury (TBI)) or neurodegenerative diagnosis (i.e., Parkinson's, Alzheimer's), the brain is changed and may have more difficulty with executive functioning, attention, memory, and language skills. Because all of these abilities are cognitive in nature, they can directly impact communication. We work with individuals and their families to either rehabilitate previous level of cognitive-communication functioning (i.e., internal memory strategies, functional working memory exercises) or maintain current the current level for as long as possible while building in support to prepare for the future (i.e., environmental adaptations, external memory aids).

Aphasia occurs due to problems with receptive or expressive language following neurological changes to specific language centers in the brain. It can be characterized by issues with word finding, sentence formulation, switching or distorting words, and trouble understanding conversations or written language. Acquired neurological conditions impact language function and can result in word-finding issues making it difficult to communicate with others called aphasia. We partner with the patient and family to improve autonomy in day-to-day life by utilizing evidence-based word-finding exercises and communication strategies. Using a range of approaches depending on each individual, treatment plans are tailored specifically to each patient to rehabilitate, maintain, and empower functional communication.

Motor speech functioning skills often change following a neurological event or condition like a TBI, stroke, or Parkinson's disease.  Depending on which part of the brain is affected, speech can become effortful, slow, slurred, quiet, dysrhythmic, rapid, or contain speech sound distortions, among other qualities which can interfere with communication. This is called dysarthria.  Apraxia of speech is caused by difficulty with motor speech planning meaning the brain has trouble planning and coordinating signals to motor and muscle actions to put together speech sounds reproductively. This is can look like groping and sound jumbled and uncoordinated when speaking. We use evidence-based motor speech exercises and communication strategies to optimize communication as well as AAC options for individuals who qualify.

"Speech sound disorders" is an umbrella term for an array of different difficulties producing speech sounds, including but not limited to speech sound omission, substitution, and distortion. For example, using the "wuh" sound for the "er" sound (substitution). These errors are judged by others as "cute" when children are young but sometimes impact communication as they mature, impact self-esteem, and participation in public speaking situations (i.e., reading aloud to the class, acting in a play, giving a presentation). While we do not view speech sound disorders as "wrong," we acknowledge the barriers that others' internal biases may create for these children.  We offer evidence-based treatments that train speech sounds and build phonemic awareness to support children's self-awareness and participation in all settings of their daily life. Hana has experience working with Bjorem Speech and has been trained in the Lindamood Phoneme Sequencing Program (LiPS).

Language development and processing is a vital component of communication. There are different ways to learn language that are unique to each person like neurotype (i.e. autistic vs. neurotypical) and cultural linguistic background (i.e. Spanish vs. English vs. bilingual). We offer evidence-based treatments that are individualized to fit the learning needs of the whole child. Hana is trained in gestlalt language processing, analytic language processing, and bilingual language acquisition.