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Speech and Language Services

Services provided for adults include evaluation and treatment of:


Aphasia is a language disorder resulting from an injury to the brain, most often in the left hemisphere that affects all language modalities. Aphasia is not a single disorder, but instead is a family of disorders that involve varying degrees of impairment in four primary areas:

  • spoken language expression
  • spoken language comprehension,
  • written expression, and
  • reading comprehension.

A person with aphasia often has relatively intact memory and executive function skills, although these and other cognitive deficits may co-occur with aphasia. Sensory deficits such as auditory and visual field deficits may also be present.

Signs & Symptoms may include:

  • Difficulty finding words
  • Speaking in single words
  • Omitting smaller words like “the”, “of”, and “was”
  • Putting words in the wrong order
  • Making up words
  • Difficulty understanding others
  • Lacking awareness of others
  • Difficulty comprehending written material
  • Difficulty writing or copying letters, words, and sentence


Dementia is a syndrome resulting from acquired brain disease and characterized by progressive deterioration in memory and other cognitive domains (e.g., language, judgment, abstract thinking, and executive functioning).  The cognitive decline associated with dementia affects an individual's ability to comprehend and produce linguistic information. Additionally, behavioral problems that develop as a result of the neuropathology (e.g., paranoia, hallucinations, and repetitiousness) may interfere with communication.

Signs & Symptoms may include:

  • Easily distracted
  • Episodic memory deficits
  • Difficulty multi-tasking and handling complex tasks
  • Inability to recognize familiar people
  • Difficulty recalling names of family and friends
  • Inappropriate behavior


Dysphagia is a swallowing dysfunction where it takes more time and effort to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain. In some cases, swallowing may be impossible.

Occasional difficulty swallowing, which may occur when you eat too fast or don't chew your food well enough, usually isn't cause for concern. But persistent dysphagia may indicate a serious medical condition requiring treatment.

Dysphagia can occur at any age, but it's more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause.

Signs & Symptoms may include:

  • Difficulty swallowing
  • Pain during swallowing
  • Drooling
  • Unable to swallow
  • Being hoarse
  • Feels like food is stuck in your throat
  • Regurgitation

Traumatic Brain Injury

Traumatic brain injury (TBI) is a form of brain injury caused by sudden damage to the brain. The effects can range from physical, sensory, cognitive-communication, swallowing and behavioral issues. These problems significantly impair the effected person's ability to live independently. The problems vary depending on how widespread the brain damage is and the location of the injury.

Signs & Symptoms may include:

  • Difficulty thinking and understanding
  • Aggression, impulsivity, and lack of restraint
  • Dizziness, fainting, or fatigue
  • Anger, anxiety, or apathy
  • Nausea or vomiting
  • Slurred speech or impaired voice
  • Blurred vision or sensitivity to light
  • Headache, seizure, or ringing in the ears

Voice Disorders

A voice disorder is an abnormal pitch, loudness, or vocal quality resulting from disordered laryngeal function and may cause pain or vocal fatigue. Voice disorders range from mild hoarseness to complete voice loss, and limit the effectiveness of oral communication.

  • Hoarseness
  • Chronic cough or excessive throat clearing
  • Vocal strain or fatigue
  • Loss of voice
  • Reduced pitch range

Voice disorders can be caused by an injury resulting in paralysis of a vocal fold, an improper breathing pattern, or misuse of the voice. Voice disorders can also be due to medical/physical conditions or neurological in nature. The individual with a voice disorder may experience stress, withdrawal, and depression because of an inability to produce normal voice.

Signs & Symptoms can include:

  • Hoarseness
  • Chronic cough or excessive throat clearing
  • Vocal strain or fatigue
  • Loss of voice
  • Reduced pitch range

Services provided for children include evaluation and treatment of:


An articulation disorder is the production of speech sounds spoken with substitutions, omissions, additions or distortions that may interfere with intelligibility.

  • Certain sounds are not produced but omitted or deleted (e.g., “cu” for “cup” and “poon” for “spoon”)
  • One or more sounds are substituted (e.g., “dood” for “good” and “wabbit” for “rabbit”)
  • One or more extra sounds are added or inserted into a word (e.g., “buhlack” for “black”
  • A syllable is repeated or deleted (e.g., “dada” for “dad” or “wawa” for “water”


Stuttering affects the fluency of speech. It begins during childhood and, in some cases, lasts throughout life. The disorder is characterized by disruptions in the production of speech sounds (disfluencies).  Most people produce brief disfluencies from time to time. For instance, some words are repeated and others are preceded by "um" or "uh." Disfluencies are not necessarily a problem; however, they can impede communication when a person produces too many of them.

Signs & Symptoms:

  • Difficulty starting a word, sentence, or phrase
  • Prolonging a word or sounds within a word
  • Repetition of a sound, syllable or word
  • Brief silence or pauses within a word

Receptive Language Disorder

This language disorder affects a child’s ability to understand what is being said to them.  This usually is seen in children prior to age four.  In most cases, children with receptive delays also have expressive language disorder.  Children must be able to understand the spoken language in order to properly speak.

Signs & Symptoms can include:

  • May not listen when being spoken to
  • Inability to follow verbal instructions
  • Inability to understand complicated sentences
  • Language deficits
  • Repeating words that are said to them (echolalia)

Expressive Language Disorder

This language disorder affects a child’s ability to formulate words, speak in complex sentences, and remember words. Most often, the child does understand verbal communication.

Signs & Symptoms can include:

  • Limited vocabulary skills
  • Improper use of tenses (past, present, future)
  • Unable to speak in sentences


Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.

Signs & Symptoms can include:

  • Does not coo or babble as an infant
  • Problems combining sounds
  • Understands language but doesn’t talk
  • Difficulty imitating speech
  • Is hard to understand

Tongue Thrust

A tongue thrust occurs when the tongue pushes against the front teeth or protrudes through the teeth during swallowing and/orspeech, or while the tongue is at rest.  It is commonly referred to as a reverse swallow and is normal during infancy and toddler stages, but should disappear by the time a child starts elementary school.   

Signs & Symptoms can include:

  • Articulation errors can include /s, z, t, d, n, l, sh/
  • Orthodontic issues
  • Mouth breather
  • Messy eater
  • Tongue visible during speech and/or swallowing

Augmentative and Alternative Communication (AAC) includes all forms of non-verbal communication that is used to express thoughts, needs, wants, and ideas.  AAC includes facial expressions, body gestures, use of symbols or pictures as well as the written word.  Many people with severe language deficits rely on AAC to communicate their needs.  The following options are examples of AAC communication:

  • Unaided Communication: Relies on the individual’s body to perform gestures, body language, and/or sign language.
  • Aided Communication: Relies on additional tools to aid in communication such as paper and pencil, communication boards, and electronic speech devices that produce voice output.

Pediatric Feeding and Swallowing Clinic

The ISU Pediatric Feeding and Swallowing Clinic provides diagnostic, treatment, and consultation services for families with children who are experiencing difficulties in feeding, including:

  • Difficulty sucking
  • Swallowing
  • Chewing
  • Children who do not feed themselves at appropriate ages
  • Transition from nasogastric or gastrostomy feedings to oral feedings
  • Neurological impairments
  • Development delays that hinder oral feedings, abnormalities of the mouth and throat that affect eating, difficult transitions from breast-feeding to cup/bottle or pureed foods and behavioral feeding issues.

Early Literacy Program (8 Week Program)

The Early Literacy summer program is an interactive group for children entering Kindergarten (ages 4 to 6).  The program provides a structured environment that fosters early reading skills such as:  beginning sound identification, rhyming and syllables, vocabulary enrichment, alphabet recognition, name writing, and concepts of print.  Parents will learn how to facilitate the development of literacy skills during storybook reading time.  Parents also participate in shared reading parent education sessions with their child directly before/after the interactive group time once weekly.

Program Coordinator:

Program Dates:

Two days per week during June and July.

NW Center for Fluency Disorders Interprofessional Intensive Stuttering Clinic

This residential two-week intensive clinic runs for two weeks at the end of July – August. It includes speech-language pathology and counseling graduate students and professionals working with clients who stutter through Acceptance and Commitment Therapy (ACT). Overt stuttering is treated using individualized methods based on client preferences. The clinic focuses on overcoming obstacles, reframing, understanding the process involved with these changes, and generalization through many community interactions and trips.

Program Coordinator: