Our goal as speech-language pathologists is to provide the highest quality of care to patients who have speech, language, voice, and swallowing disorders.
We do this by working closely with the ear, nose, and throat physicians in the Department of Otolaryngology at UPMC’s Swallowing Disorders Center and Voice Center.
About Us
UPMC’s team of speech-language pathologists are certified by the American Speech Hearing and Language Association (ASHA) to evaluate and treat individuals who have speech, cognitive, language, voice, and swallowing disorders. All clinicians hold a Master’s degree and are licensed by the state of Pennsylvania.
In addition, the division of Speech Pathology at UPMC has an extensive training program for clinical fellows in the field of speech-language pathology.
Our Experts
Click on the experts' names to read more about their specialties and backgrounds.
- Sara Byers, MA, CCC-SLP
- Danielle Columbe, MA, CCC-SLP
- Tamara Wasserman-Wincko, MS,CCC-SLP
- Joan Bucholtz, MS, CCC-SLP
- Jim Coyle, MA, CCC-SLP
- Erica Dolgoff, MS CCC-SLP
- Brooke Paull, MA CCC-SLP
- Deanna Pasekoff, CCC/SLP
- Denise Vargas-Stump, MA, CCC-SLP
- Nicole Veydt, MA, CCC-SLP
- Jen Wild, MA, CCC-SLP
Patient Services
The Division of Speech-Language Pathology provides inpatient and outpatient services.
Inpatient Service
UPMC’s team of speech-language pathologists provides service to UPMC Presbyterian, UPMC Montefiore (including the Rehabilitation Unit, Transitional Care Unit, and Select Specialty Hospital), UPMC St. Margaret Hospital, and Magee-Womens Hospital of UPMC.
Our diverse patient population includes patients with:
- Head and neck cancer
- Swallowing problems after surgery (head and neck, transplants, cardiac, cardiothoracic, and spinal cord surgeries)
- Tracheostomized and ventilator dependent patients who have difficulty communicating and swallowing
- Neurological disorders (stroke or head injury)
- Geriatric diseases (dementia, Alzheimer's disease)
- Degenerative neuromuscular diseases (Parkinson’s disease, ALS, Multiple Sclerosis, Myasthenia Gravis, Muscular Dystrophy)
- Inability to verbally communicate and require assistive communication devices
Outpatient Service
Voice Rehabilitation Following Total Laryngectomy
UPMC’s dedicated team of speech-language pathologists is certified and highly trained in laryngectomy rehabilitation . Our experts utilize state-of-the-art diagnostics and treatment procedures to provide patients with the best level of care. The goal of this program is to provide high quality care and education to restore verbal communication and improve quality of life for patients who received a total laryngectomy.
What is a Total Laryngectomy?
Approximately 12,500 new cases of laryngeal cancer are diagnosed every year, making it the most common site for head and neck cancer. Often times with advanced cancers, a total laryngectomy, or surgical removal of the entire larynx (voice box), is required to provide the best option for cure. During the surgery, the entire larynx is removed and the trachea (airway) is completely separated from the nose and mouth and re-directed through a permanent hole in the neck called a stoma.
Anatomical and Physiologic Changes after Total Laryngectomy
The disconnection of the nose and mouth from the lungs results in a number of changes. The following is a list of some of these changes:
- Patients will no longer breathe through their noses and mouths and will exhale and inhale air through a hole in the neck.
- Patients will not be able to sniff and blow their noses after the procedure
- Because the patients cannot sniff, their senses of smell may be diminished
- When the patients sneeze or cough, the air and mucous will come out of their stoma rather than their mouth
- After the removal of the larynx the patient will be unable to talk
Restoring Communication after Surgery
There are three methods of restoring voice after a total laryngectomy surgery.
1. Electrolaryngeal Voice
An electrolarynx (EL) is a battery-operated electronic device that provides an artificial vibration to replace vibration of the vocal cords. When the device is placed against the skin or in the mouth, it vibrates the tissue and creates an artificial voice while the patient mouths the words to create speech. Electrolaryngeal voice tends to sound more mechanical than a natural voice and there can be occasional mechanical difficulties with the devices. However, the advantages of an electrolarynx are that patients can achieve immediate voice and the devices are low maintenance and can be independently cared for by the patients.
2. Tracheoesophageal Voice
A tracheoesophageal puncture is a surgical procedure that can be completed at the time of the total laryngectomy or anytime after the surgery. The procedure involves a surgical puncture between the airway (trachea) and the food pipe (esophagus). Once the procedure is completed, a voice prosthesis is placed in the puncture tract which allows air from the trachea to move into the esophagus to vibrate a muscle to create voice. To talk, the patient takes a breath, and puts their finger or thumb over their stoma. The sound of the voice is more natural than the electrolaryngeal voice and patients are generally able to use their voice immediately. The voice prostheses needs to be changed on a routine basis and can be maintained by the patient.
3. Esophageal Voice
Esophageal voice involves the patient injecting or swallowing air into the esophagus. Once the patient has forced the air into their esophagus, the air vibrates a muscle and creates esophageal voice. Esophageal voice tends to be difficult to learn and patients are often only able to talk in short phrases with a quiet voice. However, the sound of the voice is more natural compared to the electrolarynx and it does not require purchasing of any devices.
Our speech-language pathology team provides services following laryngectomy procedures:
Evaluation for a communication method after surgery
- Training in electrolaryngeal voice
- Training in esophageal voice
- Placement of voice prostheses, training in tracheoesophageal voice, training in self-placement of voice prostheses
- Advanced management of tracheoesophageal puncture – customizing voice prostheses, management of leaking around voice prostheses, assessment and treatment of cricopharyngeal dysfunction
- Training in hands-free devices
- Training in stoma care and maintenance
Local support groups
Other web links
Speech-Language and Cognitive Therapy
Have you had a stroke and are experiencing difficulty with any of the following?
- Finding words or getting words out when speaking
- Putting words together to make phrases and sentences
- Pronouncing your words because the muscles in your face, tongue, and lips are weak
- Being able to perform the motor-planning necessary for producing speech
- With the rhythm of speech
- Understanding what others are saying
- With your reading ability or understanding what you read
- Understanding television shows
- Writing
Have you had a traumatic brain injury or a stroke on the right side of the brain or have multiple sclerosis and are experiencing difficulty with any of the following?
- Paying attention or maintaining attention
- Remembering the day, date, month, year or time
- Remembering appointments and important dates
- Remembering where you put things
- Remembering how to get from one place to another
- With short-term memory
- Learning and remembering new information
- Organizing thoughts
- Organizing tasks in the home and sequencing the steps to complete tasks
- Switching from one task to another
- Staying on a topic in conversation
- Taking turns with others in conversation
- Problem solving
- With impulse control
You may have been told you have one, all, or any combination of the acquired speech-language impairments below:
- Aphasia- an acquired communicative impairment that may affect the ability to understand others, speak, read and/or write.
- Dysarthria- a general term to describe several motor speech disorders caused by muscle weakness, paralysis, slowness, dyscoordination or sensory loss. Dysarthria may produce “slurred speech”.
- Apraxia- a disturbance of speech resulting from impairment of the ability to program commands for the positioning and movement of muscles for the voluntary production of speech in the absence of muscle weakness.
You may have been told you you have something called, “Cognitive-Linguistic” or “Cognitive” deficits.
Cognitive-linguistic deficits may include experiencing difficulty with:
- Attention
- Memory
- Visuo-spatial skills
- Executive function (cognitive abilities that control and regulate other abilities and behaviors, including the ability to initiate and stop actions, to monitor and change behavior appropriately, and to plan future behavior when faced with novel tasks and situations. Executive functions allow us to anticipate outcomes and adapt to changing situations)
- Social interaction
- Problem solving skills
- Awareness/insight/judgment
What are outpatient adult speech-language pathology services?
Outpatient adult speech-language pathology services include the evaluation and treatment of the deficits and difficulties noted above. Services are provided by or under the supervision of a Certified Speech-Language Pathologist.
Patients must be referred for Outpatient Adult Speech-Language Pathology Services by their doctor. Patients may be referred for Outpatient Adult Speech-Language Pathology Services following a hospital stay or after a visit to their physician.
The goal of Outpatient Adult Speech-Language Pathology Services is to provide the patient with skills necessary to communicate effectively in his or her environment. Work re-entry may serve as another goal of Outpatient Speech-Language Pathology Services.
Program Focus:
- Improvement in overall ability to speak and understand spoken language
- Improvement of memory and other cognitive-linguistic areas via direct treatment and via the use of compensatory strategies which are meaningful, functional and appropriate to each patient.
- Patient focused treatment is established with the patient and his or her family/caregivers
Our commitment is to help you develop skills necessary to optimize communicative functioning in your environment.