Speech and Language Therapy

The Stanmore Speech and Language Therapy (SLT) team are experts in the assessment, diagnosis and management of complex swallowing and communication impairments and aim to optimise function. There is currently a full-time service available to inpatients on the London Spinal Cord Injury Centre. Outpatient follow-up is available, as required.

team provides high quality specialised services to spinal cord injured patients, from acute admissions to the intensive care and high dependency units through to rehabilitation at ward level.

Spinal Cord Injury patients:

SLT team offers a comprehensive service to the unit. We will meet with you/your family if you are experiencing any difficulties eating, drinking, swallowing and/or communicating. We have access to state of the art swallowing equipment which allows us to accurately assess your swallowing function and create tailored rehabilitation programmes to restore safe eating and drinking where possible. We have a strong commitment to research and provide regular teaching, training and advisory roles to other units both nationally and internationally.

Tracheostomy/ventilation:

SLT team are members of the trusts tracheostomy team. Our multi-speciality team carry out comprehensive weekly ward rounds to assess & optimise your respiratory function and plan weaning programmes. SLT team will manage any communication and/or swallowing difficulties which you may experience as a result of having a tracheostomy or being on a ventilator.

Assessment and therapy sessions may include:

Fibre-optic Endoscopic Evaluation of Swallowing (FEES):

A flexible nasendoscopy allows direct visualisation of the pharynx and larynx and to assess swallow function, including secretion management and readiness to commence eating and drinking.

Fibre-optic Endoscopic Evaluation of Swallowing

Videofluoroscopy clinic:

is a moving X-ray that looks at the way your swallowing works and informs swallow rehabilitation and strategies to facilitate safe eating and drinking.

moving X-ray

Mouth-care:

is important to maintain good oral health, especially if you are unable to eat and drink. The SLT and nursing teams will ensure regular assessment and maintenance or your mouth during your stay. This may include the use of oral hydrating gels in addition to regular teeth brushing. Good oral health will facilitate talking and eating and drinking.

Voice therapy:

Voice problems are sometimes reported and this is often due to changes in breathing ability or surgery to the neck area. The SLT team will assess aspects of your voice and plan a program of therapy to maximise voice production. In addition, access to the Voice Clinic and Ear, Nose and Throat (ENT) service at Northwick Park Hospital can be arranged for detailed examination and specialist advice on any voice or laryngeal problems.

Swallow rehabilitation may focus on re-training components of swallow function to include strengthening and skill based tasks to allow safe eating and drinking where possible. This may include:

Surface electromyography (sEMG):

This is a non-invasive therapy targeting muscle contraction. It is used to monitor swallow performance and provide feedback to the clinician and patient during swallow tasks.

Inspiratory and expiratory muscle training:

This treatment aims to strengthen your respiratory muscles, which may help improve cough, voice and swallow. Your SLT and physiotherapist will advise on this treatment and plan a program for you

The Team:

Sarah Morgan – Clinical Lead
Email: sarah.morgan15@nhs.net or sarah.morgan@rnoh.nhs.uk
Contact telephone: 020 8909 5466

Education and research:

The adult SLT team has a strong commitment to research and education. They provide regular teaching to staff on-site at RNOH and also to other hospitals. Recent training days have included;

  • Advanced tracheostomy study day – Northwick Park Hospital
  • Fibre-optic endoscopic evaluation of swallowing (FEES) study day – Northwick Park Hospital
  • Management of the altered airway – Rila Institue, London
  • Nutrition study day – RNOHT
  • Spinal Cord Injury Study day –The role of SLT – RNOHT
  • Respiratory Information for Spinal Cord Injury – The Wellcome Institute, London

Recent publications include:

  • Respiratory Information in Spinal Cord Injury (RISCI) 2016. Sheffield. Oral presentation and prize winner for best clinical presentation: ‘A Novel Approach to Dysphagia Management in Spinal Cord Injury S. Morgan and H. Chalke
  • The UK Swallow Research Group Conference 2016. London. Poster presentation and prize winner: ‘Successful Ventilator Weaning in Dysphagic Spinal Cord Injured Patients –a 12 year Retrospective Study’ J. McRae and S. Morgan
  • Intensive Care Society, State of Art Meeting 2015. The Excel, London. Poster presentation and winner of best clinical practice paper: ‘Restoration of speech and swallowing in dysphagic spinal cord injured patients receiving mechanical ventilation via tracheostomy – a case series’. S. Morgan & J. McRae. 'The DAISY project: identifying dysphagia in acute cervical spinal cord injury’. J. McRae
  • R. Fox, J. McRae & S. Morgan 2015. ‘Feeding patients with tracheostomies’ Journal of Intensive Care Society.
  • International Spinal Cord Society Conference 2014. Maastricht, Netherlands. Poster presentation: ‘Successful Ventilator Weaning in Dysphagic Spinal Cord Injury Patients’ J. McRae & S. Morgan

Useful links:

Speech and language therapy in adult critical care

Respiratory Information for Spinal Cord Injury

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Spinal Cord Injury Centre