What is voice, speech, or language therapy? Voice therapy is used to entrain healthier voicing patterns when patterns have become less than efficient. Speech therapy is designed to strengthen or recoordinate the muscles and motor patterns required for efficient speech production. Language therapy requires learning how to more easily find words through self-cueing strategies to more easily get to words, to structure sentences, to read written words, or to understand spoken language. Many speech rehabilitation focuses on neuroplasticity, or "rewiring the brain" to re-establish functional communication. What can I expect from sessions? Sessions will take a collaborative approach and will make clients feel comfortable every step of the way. I will never have a patient do something that makes him/her feel uncomfortable or too challenged. I make sure to challenge patients to successfully reach their goals, but never to the point of any frustration. We build on goals step by step. Some problems may be resolved in just a few quick sessions (i.e. some non-chronic voice disorders), whereas others may require far longer services for a chronic problem (i.e. aphasia). I make sessions engaging for clients and incorporate functional tasks into sessions (i.e. giving a presentation, practicing routine phrases, making a telephone call). I give patients the tools to help get their communication back and then provide at-home carryover practice for techniques or activities to work on at home to carryover these skills to conversation or day to day life (note: this will NEVER consist of busywork, worksheets, or rote tasks and will ALWAYS have a real-life application). It is expected that the client recognizes the work he/she needs to put in, not just in therapy sessions, but at home and in real-life communicative situations in order to make a noticable change in his/her communication. We will discuss how to reduce obstacles to practice, how to stay motivated, and how to use real communication as at-home practice.

How many sessions will I need? That largely depends on several factors; what the disorder is, the severity, and the response to treatment. Each disorder is different, as is each individual presentation of the disorder and the individuals themselves. Voice and upper airway disorders typically can be treated in 4-6 sessions (typically over the course of 4-8 weeks), accent modification can be achieved in about 10-12 sessions, whereas neurogenic conditions may take a bit longer. LSVT treatment follows the structured treatment protocol of 4 sessions per week for 4 weeks. Each treatment plan is individualized and based on the results of the initial evaluation, along with client goals, and quantified progress. What is the frequency and duration of sessions? Sessions are 45 minutes to 1 hour (depending on diagnosis) and are typically once or twice a week. Voice disorders and accent modification clients will typically be seen 1x/week, whereas a client with aphasia or neurogenic communication disorder may be seen 2x/week for more intensive care. Lee Silverman Voice Treatment (LSVT) for Parksinson's Disease is intensive 4x/week treatment.

Sessions are currently only provided via teletherapy. See below for more information on teletherapy services.

What is teletherapy and how does it work? Teletherapy is receiving services virtually through a computer, tablet, or smart phone. It is essentially like a “Skype” session, but more advanced and compliant with HIPAA privacy standards. You can participate in the session from anywhere (most easily from home or at work!). Many platforms offer the option to share documents between the client and clinician and have a “whiteboard feature” to be able to write. What do I need to be able to do teletherapy? You will need a functioning smart device (laptop, desktop computer, tablet, iphone) and a good Wifi connection (you may connect your ethernet cord to your modem to get better connection). Is teletherapy as effective as in person? Yes! There are studies that show that services provided via teletherapy are just as effective as those in person. The American Speech Language Hearing Association (ASHA), recognizes telethearpy as an effective method of therapy delivery. See links below: http://www.asha.org/Practice-Portal/Professional-Issues/Telepractice/ https://thejournal.com/articles/2011/02/02/speech-language-clinicians-connect-with-telepractice.aspx https://www.theraplatform.com/blog/237/effectiveness-of-telepractice Why would I want to do teletherapy? There are many benefits to teletherapy. To start, convenience is at the forefront! You can receive therapy without leaving your home - have kids and don't want to leave them? You don't have to! Feeling tired or sick or don't want to deal with the traffic? Don't want to waste travel time heading to a session? Teletherapy to the rescue! Teletherapy is also great to receive quality care you may not be able to get in your hometown, including across state lines. I am licensed in MA, CT, and NY and am permitted to provide services from my home to individuals in MA to any of these states. Is it private and secure when I do teletherapy? Yes, we make sure we are only using a secure, HIPAA compliant platform.

The answer to this is complex. I rarely ever tell a patient with a communication disorder or persisting deficits related to their communication disorder that there's nothing I can do for them or that I can no longer help them anymore. Y What are some reasons you may have been told this? -Perhaps the clinician you saw was not specialized or an expert in your disorder and did not know how to make further progress with you. -Perhaps insurance limitations prevented you from moving forward - Maybe you were seen in a busy hospital or clinic where the number of sessions per day was more imporant than the individual patients - Perhaps your prior clinician focused mostly on the outward symptoms but failed to ask you what you feel? How you are still possibly affected by even what may appear to others as "mild"? - Maybe you have a neurological disorder (i.e. like aphaisa or spasmodic dysphonia) and you were told that speech or voice therapy can't help. I tend to disagree. I think there is usually always something that we can work on if the patient is still experiencing real quality of life detremients due to the communication disorder. This is not true for all cases but for most that are still seeking services, there is typically something more functional that has not been fully addressed. There is always an appropriate discharge for patients for but patients with chronic disorders I find that individuals often require long term services to manage ongoing difficulties related to their communication disorder (beyond even just speech sounds or words). For instance, how do you tell others about your disorder, do you have the knowledge to explain it to others, how are you going to fare giving that complex presentation at work, speaking at a noisy restaurant or in other "real" life situations? This is where the "functional" treatment comes in. We work on quality of life detrmients. For spasmodic dysphonia and vocal tremor I believe that voice therapy can help to better manage symptoms (not to cure it).

1. Personalized care: Receiving services through private practice allows for more personalized care - extended sessions if needed, without as many time constraints. Care is based on only the client, and not based on factor such as producitivity standards, that many major hospitals, skilled nurising facilities or rehabilitation centers have. As I mention in an earier question, I don't end services and work with a client to get them to where they need to be functionally. 2. Flexibility: We understand you are busy, possibly working a full time job, dealing with a lot of challanges and possibly other health concerns. This requires flexibility to schedule session. We also understand that things come up. One of the great things about private practice in the flexibility if offers. With session availability for early morning, evening hours and for weekend hours you can find what works for your schedule. If patients have to cancel, reschedule, or change sessions, we understand. You are not penalized like you may be in a large hospital and have the option to schedule flexibly. 3. Specialization: One of the benefits of private practice is the high degree of specialization it offers. I'm specialized in adult neurogenic and voice disorders and offer highly tailored care to that niche population. 4. Ease of sessions: We offer teletherapy so you can choose to do therapy from the comfort and ease of your own home without frequent need for cancellations due to traffic, work, taking care of kids etc.

Currently, only patients who wish to pay privately may be seen. If a patient has Medicare, unfortunately I cannot see the patient without billing Medicare, regardless of whether the patient would still like to pay out of pocket. Invoices or superbills are provided to clients as requested, to be able to be submitted to insurance for a request for reimbursement for services (with included evaluation and treatment codes and modifiers). Evaluations and progress notes can also be provided at request, for documentation to submit to insurance companies. You may also call your insurance ahead of time to see if they offer "out of network" benefits for reimbursement from an out of network provider. All initial consultations are free to determine if my services are a good fit for your needs. Evaluations following the initial consultation will often be more than the price of individual sessions due to extra work and documentation required to approiprately and thoroughly assess impairments, conduct trial therapy, educate, and to follow up with your referring physician or provider as necessary. Payment is due at least 24 hours before the time of the session and collected through through a secure electronic payment servicce. Rates and payment schedule are provided and agreed upon by the client prior to the first visit. Please contact for rates and more details.