Changes in cognition can occur after traumatic brain injury, stroke, dementia, or any other neurological disorder. The following are cognitive domains:

• Memory (problems with short-term, long-term, working, prospective memory, etc)

• Attention/Concentration (difficulty with sustained attention, slow processing, alternating and divided attention)

• Pragmatic Skills (difficulty regulating emotions, decreased insight/awareness towards deficits, reduced ability to maintain conversational topics, etc)

• Visuospatial deficits (neglect objects or words in your left or right field)

• Executive function skills (difficulty with initiation, planning, organization, decision making, problem solving, and/or reasoning)

A person can experience deficits in communication which often times is known as aphasia. Communication deficits can happen due to stroke, PPA (primary progressive aphasia), head injury, brain tumor, or progressive neurological disease. Impairment can be related to:

• Auditory language (how well you process and comprehend language)

• Reading comprehension

• Verbal language (how you express your thoughts and ideas, word retrieval, thought organization).

• Writing language (spelling, organizing thoughts)

Dysphagia refers to difficulty or discomfort in swallowing. Dysphagia can occur after head injury, head/neck cancer, stroke, acid reflux, and any progressive neurological diseases such as Parkinson’s, Multiple Sclerosis, and ALS (Amyotrophic Lateral Sclerosis). Some of the symptoms of dysphagia are:

• cough during or after meals

• change in vocal quality (wet/ gurgle voice)

• globus sensation (feeling there is a lump in the throat)

• throat clearing

• drooling

• food pocketing

• anterior loss (food or liquid spilling out of the mouth)

• weak lip closure (difficulty maintaining lips together to drink from a cup/straw)

Voice problem is often caused by vocal abuses or misuse but there are some disorders that can trigger vocal problems such are stroke, progressive neurological disorders such as Parkinson’s, Multiple Sclerosis and ALS, vocal nodules, tumor, and etc. Some of the symptoms related voice problems are:

• hoarseness

• breathiness

• raspy quality

• strained voice

• muscle tension

• inadequate pitch range (cannot sing, or speaks in a lower or higher pitch compared to your baseline)

• decreased phonatory vs respiratory coordination

• difficulty swallowing

• coughing

• frequent throat clearing

Speech impairment is commonly found in patients who have suffered stroke, head injury, and with different degenerative disorders.

• Dysarthria occurs when there is damage in the nervous system affecting the strength and coordination of speech muscles.

• Apraxia is a motor planning deficit. In this case a person will have difficulty planning the sequence of movements involved in producing speech.

SNA recognizes the importance of preserving your cultural identity when providing rehabilitation services. We proudly create a culturally sensitive and inclusive therapy environment where you feel understood and valued. Assessment and treatment can be provided in English, Portuguese and Spanish.