کلینیک
توانبخشی ولیعصر
برای اولین بار در کرج بزرگ استفاده از بیو فید بک
و سیمولاتور اسب سواری
در درمان انواع
اختلالات جسمی - ذهنی -حرکتی
د رمان انواع
اختلالات گفتاری بزرگسالان و کودکان
سکته مغزی - فلج
مغزی - لکنت - ناشنوایی - کم شنوایی
کم توانی ذهنی و درمان اختلالات یادگیری
و اوتیسم
تعیین بهره هوشی و
آماده سازی برای تست
با تعیین
وقت قبلی
آدرس مطب
کلیک کنید
Rhythmic Speech
دستگاهی
است قابل حمل باوزنی کم که درقالب شکل ظاهری
موبایل ساخته شده است که جهت ریتم دهی گفتار و حرکت
در درمان افراد مبتلا به لکنت زبان و ضایعات نرولوژیک و
تروماهای ناشی از ضربه مغزی و پارکینسون بکار می رود
دارای
دو سیستم تنظیم کننده یکی جهت کنترل تعداد ریتم ها و دیگری جهت
کم و زیاد کردن حجم صدای خروجی دستگاه که از طریق هد ست ظریفی
در لاله گوش قرار می گیرد می باشد در انواع مختلف بنا به
شدت اختلالات تولید می شود
لطفا در صورت تمایل برای کسب اطلاعات
بیشتر این لینک را کلیک کنید
D.S.A
دستگاه دی
اس ای با پنج واحد کنترل برای
تنظیم حساسیت ورودی - حجم
فرکانس و بلندی تولیدی - تنظیمات زیر و
بمی و واحد کنترل کننده حجم صدای خروجی و تنظیم تغییرات خروجی تاخیری با
ایجاد افزایش گردش خون در لب تمپورال و اکسی پیتال مغز که منجر به در مان
قطعی و کامل لکنت زبان کودکان و بزرگسالان می گردد همراه با ریتم دهنده
گفتار
به منظور درمان
قطعی لکنت
بهمراه بیو فیدبک بینایی بدو صورت پرتابل و کلینیکی
عرضه گشته است و همراهی مطمئن در تمامی مراحل درمان افراد
ناروان می باشد . بدون نیاز به تنظیم توسط متخصص و مراجعات
بعدی بهمراه دستور العمل کامل جهت استفاده و گارانتی قطعات به استثنای باطری و بدنه دستگاه
لطفا در صورت تمایل
برای کسب اطلاعات بیشتر این لینک را کلیک کنید
زبان آموز دیجیتال
تک کاناله
دستگاهی است در جهت
ضبط ، پخش و مقایسه شنیداری آواها کلمات و جملات در مراحل مختلف درمان با
قابلیت ضبط و پخش بیش از یک میلیون بار
ویژه درمان انواع اختلالات گفتاری
بزرگسالان و کودکان ، سکته مغزی - فلج مغزی - ناشنوایی - کم شنوایی ،کم توانی
ذهنی و درمان اختلالات یادگیری و اوتیسم
لطفا در صورت تمایل برای کسب اطلاعات
بیشتر این لینک را کلیک کنید
مجموعه همخوان های فارسی
مصور و سخنگو با قابلیت نمایش خودکار
اختلالات تولیدی از رایجترین
اختلالات گفتاری ، خصوصا در سنین قبل از دبستان می باشد . آسیب شناسان گفتار و
زبان در روند درمان این اختلال ، نیاز به فهرستی از کلمات به منظور آموزش و
تمرین همخوانهای مختلف دارند . ولی ازآنجا که کودکان در این محدوده سنی قادر به
خواندن نیستند و از طرفی هنوز به مراحل رشد انتزاعی نرسیده اند ، تکرار و تمرین
به صورت شفاهی باعث خستگی و کم شدن توجه آنها می گردد . لذا ، نرم افزار مصور
همخوان ها ، با هدف افزایش دقت و جلب همکاری کودکان در محیط های درمانی و
همچنین پیگیری درمان توسط والدین در منزل طراحی و تدوین شده است. این مجموعه
شامل 22 همخوان فارسی و ترکیبات طبقه بندی شده آن ها با شش واکه می باشد . شیوه
تنظیم و طبقه بندی کلمات بر مبنای جایگاه ظهور آوای هدف ( اول ، وسط ،آخر ) ،
تعداد هجا ، ساختمان هجا ، مرز نشینی با واجهای دیگر، و برخی موارد هم
ارائه خوشه های دو همخوانی یا واژه هایی با بیش از یک آوای هدف بوده است
ویژه
درمان انواع اختلالات گفتاری بزرگسالان و کودکان ، سکته
مغزی - فلج مغزی - ناشنوایی - کم شنوایی
،کم
توانی ذهنی و درمان اختلالات یادگیری و اوتیسم
لکنت زبان کودکان و درمان
نرم افزاری
روشهای درمان لکنت زبان در کودکان
بارها شما سعی کرده اید که از لکنت رهایی یابید اما ممکن است موفقیت کمی بدست
آورده باشید
اگر این مورد در شما هم رخ داده است ، شاید ما بتوانیم به شما کمک کنیم
ما یک روش موثر و جدید در درمان لکنت زبان معرفی می کنیم که حتی می تواند در
درمان اختلال گفتاری دیز آرتری نیز به کار رود
برای درمان لکنت زبان کودکان ( 3 الی 10 سال ) این برنامه مفید و موثر است و
فورا گفتار فرزند شما را روان خواهد ساخت
بعد از دو الی چهار هفته تمرین با برنامه لکنت شکن روانی گفتار افزایش خواهد
یافت
لکنت زبان با مراکز حرکتی گفتاری و هیجانات و تنشها که منتهی می گردد با اسپاسم
در ارتباط است ، گاهی برای درمان لکنت ممکن است از داروها و مهار کننده های
سیستم عصبی مرکزی بهمراه مدیتیشن و هیپنوتیزم استفاده شود ولی هنگامیکه کارهای
بدنی و فعالیتهای ذهنی افزایش می یابد لکنت دوباره بروز پیدا می کند
با بکار بردن این برنامه راهی یافته شد که در آن عملکرد سیستم عصبی مهار نمی
گردد و در طول مدت اصلاح گفتار دوباره سازماندهی انتخابی رخ می دهد
پس از تجزیه و تحلیل طیف گفتاری تعدادی از افراد لکنتی پس از استفاده از نرم
افزار مشخص شد که مناطقی از طیف که در آنها اسپاسم و تونوسیته بیش از حد لکنت
وجود داشت ناپدید شده است . این یافته توسط گروههای بین المللی بیماران نیز
تایید می گردد
لطفا در صورت تمایل برای کسب اطلاعات
بیشتر
و دیدن فیلم مربوطه این لینک را کلیک کنید
vibra total
ویبراتور oral
با هدف تحریک منطقه دهان وحلق دهانی در بیماران دیسفاژی و بازآموزی عصبی
عضلانی عضلات دچار پارزی و یا پلژی و کلیه بیماران اختلالات تولیدی به منظور
تحریک و آموزش جایگاه تولید
توضیحات بیشتر راجع به
ویبراتور توتال
Amyotrophic Lateral Sclerosis
A Challenge for Speech-Language Pathology
By Pamela Mathy
Amyotrophic Lateral Sclerosis (ALS), first identified in 1869 by the French
neurologist, Jean-Martin Charcot, is a relentlessly progressive degenerative
motor neuron disease that primarily affects the motor neurons of the brain and
spinal cord. Lou Gehrig, with whom the disease is often associated, brought
international attention to ALS in 1939, when it caused him to retire from
baseball. More recently, a variety of public figures from actors (Michael
Zaslow) to physicists (Stephen W. Hawking) to retired university professors
interviewed on Nightline (Morrie Schwartz) to senators (Jacob Javits) have
focused attention on this-devastating disease.
Symptoms
The early symptoms of ALS are varied. For some it begins with speech slurring,
difficulties with swallowing, and/or hoarseness. Others may experience
uncharacteristic clumsiness or tripping. Difficulty lifting may be the initial
symptom for others. Clinically, the signs and symptoms are divided into two
areas-spinal functions and bulbar functions. Three-quarters of people report
initial spinal symptoms (weakness in the upper and/or lower extremities) and
about one-quarter present with bulbar symptoms (weakness with changes in both
speech and swallowing). Both upper and lower motor neurons characteristically
become involved as the disease progresses.
Incidence
ALS strikes in the prime of life. The average age of diagnosis is 55 years with
a range of 40 to 70 years. It is possible, however, to find individuals in their
20s and 30s diagnosed with ALS. Men are 20% more likely to develop ALS than
women. Population studies estimate two cases per 100,000 population. In the
U.S., approximately 5,000 individuals per year receive a diagnosis of ALS and
nearly 30,000 people residing in the U.S. at any time are living with ALS.
Cause
The vast majority of ALS cases diagnosed in the U.S. each year (90%-95%) are not
associated with genetic inheritance. Results of worldwide epidemiological
research examining the population-based risk factors for ALS suggest increasing
incidence (Yorkston, Strand, & Miller, 1995). There is also a positive trend
linking ALS with occupations involving heavy labor, exposure to heavy metals, or
a history of traumatic injury. With the exception of an unusually high frequency
of cases occurring in specific regions of the western Pacific, particularly
Guam, there is no pattern of geographic clustering of ALS. Nor is ALS associated
with a particular race or educational level.
Prognosis
The prognosis for individuals diagnosed with ALS varies from person to person.
Small percentages of people show very slow disease progression and may live 10
to 20 years following diagnosis. However, the average life span from the time of
diagnosis is three to five years. In their review of the literature on survival
duration, Mathy, Yorkston, and Gutmann (in press) found a number of predictors
including age at time of onset, classification of initial symptoms (spinal,
bulbar), and pulmonary function. The older the individual at the time of
diagnosis the shorter the life span with the disease. Patients who present with
initial spinal symptoms have a three times greater survival rate at the end of
five years than those with initial bulbar symptoms. Respiratory status is an
important predictor of survival duration.
Although current published data indicate that only between 5% and 20% of
individuals choose to prolong their lives using mechanical ventilation,
anecdotal evidence suggests that this proportion may be rising. The suggested
reasons for this trend include the greater feasibility of home ventilation, the
increasing number of people opting for non-invasive ventilatory support, and
progress in the field of augmentative and alternative communication (AAC).
Diagnosis
There is no specific laboratory test for ALS, making it complex to diagnose. The
diagnosis is made using clinical findings in conjunction with results of
electrodiagnostic studies and the absence of evidence of other disorders.
According to the diagnostic guidelines of the World Federation of Neurology
(1994), there must be lower motor neuron (LMN) degeneration detected by clinical
electrophysiological or neuropathologic examination, signs of upper motor neuron
(UMN) degeneration by clinical examination, and progressive spread of signs
within a region of the body or to other regions.
Treatment
Presently there is no cure for ALS. However, the accelerated pace of research in
the neurosciences over the last decade has yielded several promising theories
regarding its pathogenesis. These include autoimmunity, glutamate
excitotoxicity, free radical oxidative stress, and neurofilament accumulation
(Jackson & Bryan, 1998). Increased understanding of the neuropathology of ALS
has yielded numerous clinical trials of drugs such as antiexcitotoxic agents,
antioxidants, immunosuppressants, and neurotrophic factors (Louvel, Hugon, &
Doble, 1997). Riluzole, an antiglutamate agent, is the first FDA-approved drug
for the treatment of patients with ALS. Although Riluzole is not a cure, results
of clinical trials indicate some promise in prolonging life, especially with
bulbar patients. The current trend is to evaluate potential additive or
synergistic effects of drug combinations.
As with any incurable disease, the state of the art in treatment for ALS is
symptom management (also referred to as "palliative care"). According to the
World Health Organization, palliative care is active care of the total patient.
Individuals with ALS receive the best treatment from multidisciplinary clinical
teams that specialize in neuromuscular disorders. Intervention deals with
symptoms that occur over the course of the disease process. The ALS Association
(ALSA) and the Muscular Dystrophy Association (MDA) sponsor clinics in many U.
S. cities (information can be obtained from their Web sites-see reference list).
Role of Speech-Language Pathology
Individuals with ALS and their families must face the challenge of adjusting to
an avalanche of losses. The diagnosis of a rapidly progressive disease with no
cure presents the loss of control of one's future. The loss of control of
movement brings the realization of the need to depend on others for even the
most basic of life's functions. Perhaps most devastating is the prospect of
losing the ability to speak. Although current medical and rehabilitation
technology cannot offer a way to prevent any of these losses, speech-language
pathologists can assist individuals with ALS to maintain their ability to
communicate using compensatory strategies and AAC aids and techniques.
As speech intelligibility begins to decline, intervention focuses on maintaining
functional communication versus attempting to reduce speech impairment
(Yorkston, Miller, & Strand, 1995). Direct speech intervention is not
recommended for a number of reasons. First, exercise to fatigue may hasten
neurological deterioration. Speech drills may be so tiring that speech adequacy
for functional use in other settings would be compromised. Finally, speech
exercises emphasizing optimum performance can only prove to be a discouraging
reminder of increasing loss of ability.
Cognitive Functioning
Because ALS is classified as a motor neuron disease, the typical assumption is
that cognitive functioning is spared. However, studies examining the results of
neuropsychological functioning have found that as many as one-third of
individuals with ALS show clinically significant cognitive impairments. Unlike
the diffuse cognitive changes associated with Alzheimer's disease, the pattern
of deficits in some individuals with ALS is consistent with frontal lobe
involvement (e.g., impairments in tasks demanding sustained attention and the
ability to shift quickly from topic to topic, confrontation naming, judgment,
insight, verbal fluency).
Our understanding of the timing of cognitive changes as the disease progresses,
the extent of changes based on individual characteristics, and the implications
of these changes on functional abilities is in its infancy. Speech-language
pathologists (SLPs) who work with these individuals should be aware of the
potential cognitive deficits in their patients with ALS as they plan their
treatment. For example, complex AAC devices that require extensive new learning
may be a poor choice for some individuals.
Speech Functioning
Due to the effects of upper and lower motor neuron changes, the speech of
individuals with ALS is classified as mixed (spastic and flaccid) dysarthria
(Duffy, 1995). In addition to the perceptual features observed in both types of
dysarthria (imprecise consonants, hypernasality, harsh voice), features
associated primarily with spastic dysarthria (low pitch, reduced stress, and
strained-strangled voice quality) and indicators of flaccid dysarthria (audible
inspiration and nasal emission) are evident in some speakers with ALS. With
disease progression and increased muscle wasting and atrophy, flaccidity
symptoms predominate.
The literature examining changes in speech functioning in ALS reveals two major
thrusts. One area focuses on measuring how the progression of ALS impairs the
components of the speech mechanism including respiratory, laryngeal, and lingual
function (see Duffy, 1995; and Mathy, Yorkston, & Gutmann, in press). Although
knowledge regarding the underlying impairment is important, effective
intervention planning in ALS requires an understanding of the impact of speech
impairment on speech/communicative functioning. Work by Yorkston and her
colleagues (see references) has described five stages of speech decline in ALS.
For each stage, interventions are provided to deal with immediate needs, and
suggestions for future planning are given. Research delineating predictors of
changes in speech functioning is also important. Yorkston, Strand, Miller,
Hillel, and Smith (1993) found reduction in speaking rate to be the strongest
predictor of decreases in speech intelligibility.
Augmentative and Alternative Communication
AAC aids ranging from light-tech alphabet boards to high-tech micro
computer-based systems that provide speech and writing augmentation offer means
for people with ALS to maintain their communicative functioning. Because most
individuals with ALS are adults with intact literacy skills, they benefit most
from AAC aids and strategies that provide the ability to generate messages
through spelling.
Patterns of AAC technology use by individuals with ALS are just beginning to be
examined. Differences in use have been found based on such factors as initial
symptom presentation (bulbar, spinal), communicative activity (e.g.,
face-to-face conversation, indication of basic wants or needs, indication of
detailed wants or needs, etc.), and partner familiarity. For example, both
individuals with initial bulbar presentation and those with initial spinal
presentation preferred light tech AAC aids (e.g., handwriting, alphabet board,
gesture, vocalization) to convey basic needs or wants to familiar caregivers
whereas they used high-tech aids to communicate detailed needs or wants
(messages requiring extensive explanation). Further, when communicating with
unfamiliar partners, both groups preferred to use high-tech aids to communicate
basic as well as detailed needs. People with ALS, therefore, need access to both
light- and high-tech systems to best maintain their communicative functioning.
Future Direction
Over the last decade, the level of hope of individuals with ALS, their families,
and advocates has been bolstered by an increased understanding of the disease
and by the results of initial clinical drug trials. Many hurdles remain to be
overcome, however, for the dream of a cure to become reality. In the meantime,
individuals with ALS and their families need SLPs with expertise in AAC to
assist them to maintain vital human communication.
. . . . . . . . . .
Pamela Mathy is director of Clinical Services in the Department of Speech and
Hearing Science at Arizona State University. In addition to her administrative
duties, she engages in clinical teaching, with a focus on adults and children
with neurogenic and neuromuscular disorders, and she teaches the graduate course
in AAC. Before moving to Arizona, she directed the AAC clinical program at
Munroe Meyer Institute, University of Nebraska Medical Center.
References
ALS Association Web page.
Duffy, J. R. (1995). Motor speech disorders: Substrates, differential diagnosis,
and management. St. Louis: Mosby.
Jackson, C. E., & Bryan, W. W. (1998). Amyotrophic lateral sclerosis. Seminars
in Neurology, 18 (1), 27-39.
Louvel, E., Hugon, J., & Doble, A. (1997). Therapeutic advances in amyotrophic
lateral sclerosis. Trends in Pharmacological Sciences, 18 (6), 196-203.
Mathy, P., Yorkston, K. M., & Gutmann, M. (in press). Augmentative communication
for individuals with amyotrophic lateral sclerosis. In D. R. Beukelman, K .M.
Yorkston, & J. Reichle (Eds.). Augmentative communication for adults with
neurogenic and neuromotor disabilities (Vol. 2). Baltimore: Paul H. Brookes.
Muscular Dystrophy Association
World Federation of Neurology Research Group on Neuromuscular Disease. (1994).
El Escorial World Federation of Neurology criteria for the diagnosis of
amyotrophic lateral sclerosis. Journal of the Neurological Sciences, 124
(Suppl.), 96-107.
World Health Organization of Palliative Care
Yorkston, K. M., Miller, R. M., & Strand, E. A. (1995). Management of speech and
swallowing disorders in degenerative disease . Tucson, AZ: Communication Skill
Builders.
Yorkston, K. M., Strand, E. A., & Hume, J. (1998). The relationship between
motor function and speech -function in amyotrophic lateral sclerosis. In M.
Cannito, K. M. Yorkston, & D. R. Beukelman (Eds.), Neuromotor speech disorders:
Nature, assessment, and management (pp. 85-98). Baltimore: Paul H. Brookes.
Yorkston, K. M., Strand, E. A., & Kennedy, M. R. T. (1996). Comprehensibility of
dysarthric speech: Implications for assessment and treatment planning. American
Journal of Speech-Language Pathology, 5 (1), 55- 66.
Yorkston, K. M., Strand, E., Miller, R., Hillel, A., & Smith, K. (1993). Speech
deterioration in amyotrophic lateral sclerosis: Implications for the timing of
intervention. Journal of Medical Speech-Language Pathology, 1 (1), 35-46.
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