Speech-language pathologists can help patients with both communication disorders and swallowing disorders.

They treat a wide variety of diagnoses, and often work with patients after a stroke or traumatic brain injury, or those with neurological conditions like Parkinson’s disease.

At Regional One Health, our speech-language pathologists develop individualized treatment plans aimed at achieving each patient’s specific goals.

Speech and swallowing disorders can disrupt daily life, but patients can find new hope and regain independence by working with a speech-language pathologist.

Michelle Fowke, CCC-SLP and Dianne Hightower, M.A., CCC-SLP treat speech, language, cognition and swallowing disorders. Fowke sees patients at our East Campus Center for Rehabilitative Medicine and Hightower sees patients at our downtown Outpatient Rehabilitation Center. Both take a person-centered approach to providing care for a wide range of diagnoses.

“It’s important to listen to the patient’s perspective and concerns, and how it’s affecting their daily life,” Fowke said.  “When a patient comes in for evaluation, my initial question is, ‘What brings you here today?’ That’s the best way to get a good picture of their needs. Then, I can follow up with more direct questions about the effect on their speech, swallowing or memory.”

“When I first meet a patient, we talk about the areas where they’re having difficulty, their goals and what they’d like to work on,” Hightower said. “We work together so the treatment focuses on their functional needs and what’s meaningful to them.”

That individualized approach lets them create treatment plans based on each patient’s evaluation, test results and needs. While every care plan is different, here are some ways a speech-language pathologist can help with communication or swallowing issues:


When a stroke damages the language center of the brain, speech language pathologists can help patients address a variety of diagnoses.

Aphasia is a language disorder that affects the patient’s ability to put their thoughts into words in speech and/or writing as well as their ability to comprehend spoken and written information. A speech-language pathologist helps patients improve language skills by assisting them with word-finding, comprehension and personalizing and using assistive technology.

Speech-language pathologists can help patients by strengthening the muscles involved in speech and swallowing, improving cognition, using assistive technology and more.

Stroke patients can also deal with apraxia, a condition in which they have trouble putting words together or finding the right word. Treatment involves practicing words, syllables and sentences as well as cognitive therapies that help with word recall, memory, etc.

Dysarthria is another stroke-related diagnosis in which a person may slur words because they can’t control the muscles in their voice box and tongue. Therapists use medical devices to strengthen respiratory muscles, and also work on oral motor coordination, strength and function to improve articulation and rate of speech.


Fowke said she’s seeing patients who recovered from COVID-19 and have trouble with stamina, cognition and weakness in the respiratory muscles. Along with providing exercises that rebuild strength, she helps patients with memory, concentration and focus.

Traumatic Brain Injury

Patients with traumatic brain injuries can have cognitive issues and slurred, slow speech that is hard to understand. Because Regional One Health is a Level 1 Trauma Center, Hightower said, its speech language pathologists have a lot of experience working with TBI patients.

Therapists help patients relearn how to form words and communicate effectively. They also work on compensation strategies to improve function – patients may not be able to do things the way they used to, but they can learn skills and use assistive technology to communicate in new ways.

For example, Hightower said, if a patient has trouble with memory, she helps them use a calendar or alarms on their cellphone, or maybe a day planner, to keep track of information.

Parkinson’s disease and other neurological disorders

Many patients with these conditions have a hard time speaking clearly and at a proper volume. In some cases, they feel like they’re shouting when their voice is actually barely audible.

Our speech-language pathologists take a patient-focused approach. They work with patients and their caregivers to evaluate whether their treatment is working and make sure they aren’t facing any barriers to recovery.

Hightower and Fowke are certified in Lee Silverman Voice Treatment LOUD, a leading therapy for patients with Parkinson’s, ALS, multiple sclerosis and stroke. The four-week program uses tailored strengthening exercises and training to help patients speak clearly at a normal volume.


Communication difficulties can become pronounced as a dementia patient’s function declines. Hightower and Fowke offer caregiver education to help loved ones find meaningful ways of communicating, like developing memory books to use when talking with the patient.

Swallow disorders

Speech-language pathologists don’t only focus on communication disorders, they help with dysphagia, or trouble swallowing. Dysphagia patients may have pain when they swallow, feel like something is stuck in their throat, or lose the ability to swallow. There are strengthening exercises that help with function, strategies to improve safety, and diet or texture modifications.

A collaborative approach

No matter what the diagnosis, listening and adjusting to respond to patient needs is essential. “I always ask my patients whether the treatment is making a difference and what barriers they’re facing,” Fowke said. “I encourage them to participate in the future planning of their treatment.”

“We want patients to work on things where they can have success but also feel challenged, so they make progress but don’t get discouraged,” Hightower said. “We provide a lot of positive feedback. Therapy is incremental and improvement can be gradual. We encourage them to think about where they were a month ago and how much they’ve gained.”

For an appointment downtown, call 901-545-6877. For the East Campus, call 901-515-5900.