The Gebbie Speech-Language Clinic provides quality diagnostic and therapy services in-person and via telepractice for children and adults with a variety of communication differences, disorders, and needs. Please see the list below for more detailed information on specific communication areas.

We currently participate with Medicare (Non-Supplemental), POMCO/UMR, NYS Employees Empire Plan, Aetna, Humana, and Excellus BCBS. Anyone is welcome to come to the Gebbie Clinic for services; however, if you are not insured with one of these companies, payment is the client's responsibility.

Accent Addition

"Accent addition" is basically the process of adding another "accent" or set of phonological rules, patterns or processes to one's own accent repertoire. So, a speaker may speak in heavily accented English that is effective or intelligible enough in conversations, especially with those listeners who are themselves nonnative or nonstandard speakers of English. Sometimes a speaker needs to add an accent, such as Received Pronunciation of British English or the idealized Standard American English accent, in order to increase overall intelligibility or even to minimize prejudice, depending on their listeners. Speakers can add an accent without reducing or removing the accent that they continue to use in other contexts. The term "accent reduction" infers that a person should lose one's own non-standard accent, for example a so-called "foreign accent," and that simply is not the case for a speaker whose accent is intelligible and even charming. Accent addition, then, focuses on the use of compensatory strategies when needed for the listener and the speaker, such as use of a slower rate or use of geminate sounds, instead of focusing on reducing or eliminating an accent that a speaker owns and uses effectively in other contexts. http://www.speechpathology.com/ask-the-experts/accent-addition-1584.

The Gebbie Clinic offers individual therapy services for persons who wish to increase their speaking intelligibility.

Aphasia

Aphasia is an “acquired communication disorder that impairs a person's ability to process language, but does not affect intelligence. Aphasia impairs the ability to speak and understand others, and most people with aphasia experience difficulty reading and writing.” (National Aphasia Association) https://www.aphasia.org/

The Gebbie Clinic offers individual and group therapy for clients with Aphasia.

Articulation and Phonological Disorders

The Gebbie Clinic offers therapy for children and adults with articulation and phonological disorders. Articulation therapy involves treating a few specific sound errors, typically with a motor-learning focus. Phonological therapy involves teaching children new sound patterns. We also have access to speech perception training software that can supplement speech sound production training.

The Gebbie Clinic also has available an ultrasound for visualization of the tongue during speech. This technology is relatively new in speech therapy, and the Gebbie Clinic is one of few locations in upstate New York with an ultrasound available for speech therapy. Ultrasound can be used for school-age and adult clients who have speech sound errors involving incorrect tongue movements. It can be used in speech therapy as a visual feedback tool to show clients their tongue position and instruct them to move the tongue differently to achieve a clearer speech sound. It can help with remediation of errors on sounds such as /r, l, k, g, s/. Ultrasound is appropriate for individuals approximately ages 8 years and up with articulation errors.

http://www.asha.org/public/speech/disorders/SpeechSoundDisorders.htm

Autism Spectrum Disorders

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and social interaction and the presence of restricted, repetitive behaviors. Social communication deficits include impairments in aspects of joint attention and social reciprocity, as well as challenges in the use of verbal and nonverbal communicative behaviors for social interaction. Restricted, repetitive behaviors, interests, or activities are manifested by stereotyped, repetitive speech, motor movement, or use of objects; inflexible adherence to routines; restricted interests; and hyper- and/or hypo-sensitivity to sensory input. (ASHA) http://www.asha.org/Practice-Portal/Clinical-Topics/Autism/

The Gebbie Clinic offers individual and group therapy. Social skills groups are available for children and young adults.

Child Language Delay or Disorders

When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.

Preschool children (3 to 5 years old) with language disorders may have trouble understanding and talking. (ASHA)

http://www.asha.org/public/speech/disorders/Preschool-Language-Disorders/

Language-based learning disabilities are problems with age-appropriate reading, spelling, and/or writing. This disorder is not about how smart a person is. Most people diagnosed with learning disabilities have average to superior intelligence. (ASHA)

http://www.asha.org/public/speech/disorders/LBLD/

Selective mutism (formerly known as elective mutism) usually happens during childhood. A child with selective mutism does not speak in certain situations, like at school, but speaks at other times, like at home or with friends. Selective mutism often starts before a child is 5 years old. It is usually first noticed when the child starts school. (ASHA)

http://www.asha.org/public/speech/disorders/SelectiveMutism/

The Gebbie Clinic offers individual and group therapy services for children with language disorders.

Childhood Apraxia of Speech

Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. 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. (ASHA) https://www.asha.org/practice-portal/clinical-topics/childhood-apraxia-of-speech/

The Gebbie Clinic offers individual therapy services for children with Childhood Apraxia of Speech.

Cognitive Disorder Secondary to Traumatic Brain Injury

Cognitive deficits (impairments in thinking skills) may involve changes in awareness of one's surroundings, attention to tasks, reasoning, problem solving, and executive functioning (e.g., goal setting, planning, initiating, self-awareness, self-monitoring, and evaluation). Although new learning is impacted by memory deficits, long-term memory for events and things that occurred before the injury, however, is generally unaffected (e.g., the person will remember names of friends and family). The person may have trouble starting tasks and setting goals to complete them. Planning and organizing a task is an effort, and it is difficult to self-evaluate work. The individual often seems disorganized and needs the assistance of family and friends. He or she also may have difficulty solving problems and may react impulsively (without thinking first) to situations. (ASHA) https://www.asha.org/public/speech/disorders/traumatic-brain-injury/

The Gebbie Clinic offers individual therapy services for persons with cognitive disorders secondary to Traumatic Brain Injury.

Language and Reading Disabilities

School age language disabilities and reading disabilities can occur alone but can also present together. Because most learning in school takes place through the medium of spoken and written language, students with language and/or reading disabilities can fall short of meeting academic expectations.

Areas of difficulty for individuals with language and/or reading disabilities vary widely but can include:

• Understanding details and directions
• Understanding books and stories that are read out loud or by oneself (reading comprehension)
• Learning letter names and letter sounds
• Sounding out words while reading
• Reading at an adequate pace with fluency
• Spelling words
• Expressing ideas clearly through speaking and/or writing

The Gebbie Clinic offers evaluation and treatment for children who have language and/or reading disabilities

https://www.asha.org/public/speech/development/literacy/

http://www.readingrockets.org/sites/default/files/empparents_guide.pdf

Neuromotor Disorders (Parkinson's, Multiple Sclerosis, Dysarthia, Apraxia)

Dysarthria is a motor speech disorder. It results from impaired movement of the muscles used for speech production, including the lips, tongue, vocal folds, and/or diaphragm. The type and severity of dysarthria depend on which area of the nervous system is affected. (ASHA) http://www.asha.org/public/speech/disorders/dysarthria/

Apraxia of speech is a motor speech disorder. The messages from the brain to the mouth are disrupted, and the person cannot move his or her lips or tongue to the right place to say sounds correctly, even though the muscles are not weak. The severity of apraxia depends on the nature of the brain damage. Apraxia can occur in conjunction with dysarthria (muscle weakness affecting speech production) or aphasia (language difficulties related to neurological damage). Apraxia of speech is also known as acquired apraxia of speech, verbal apraxia, and dyspraxia. (ASHA) https://www.asha.org/practice-portal/clinical-topics/acquired-apraxia-of-speech/

The Gebbie Clinic offers individual therapy services for adults with neuromotor disorders. We also offer the Lee Silverman Voice Treatment (LSVT) program, one of the only speech/voice treatment approaches with demonstrated efficacy for people with Parkinson’s diseas

http://www.parkinsons.org/

http://mymsaa.org/

Stuttering

Fluency Groups

The Gebbie clinic offers individual therapy services to individuals of any age who stutter or have another type of fluency disorder. Group therapy is available to children  3 – 17 years old. All groups offered allow both individual and group practice. A student clinician sees children individually for thirty minutes and in a group session for thirty minutes during their appointment. The groups are organized based on the child’s age: (1) younger school-age fluency group for children between 7 and 10 years of age; (2) older school-age fluency group for children between 11 and 14 years of age; and (3) teen fluency group for high-school age students. Adults may be seen individually for a 60-minute session.  Adults who stutter and   family members of children who stutter can also attend a free monthly support group hosted by the Gebbie clinic and conducted by the Syracuse Chapter of the National Stuttering Association (NSA).

In all three of our groups we use a combined approach to stuttering therapy, which includes such components as exploring talking, exploring stuttering, changing talking (“fluency shaping”) and changing stuttering (“stuttering modification”).  For our young clients who stutter and their families the Gebbie clinic now offers a group therapy for stuttering, The Preschool-age Fluency Group. Preschool-age children who stutter and their parents participate in the fluency therapy together. The preschool-age fluency group uses an indirect therapy approach to help our youngest clients establish fluent speech without asking them to change anything they do (e.g., "slow down"), which may be difficult for a preschooler to control. This approach focuses on working with the parents; we work with each family individually, discover some interaction patterns that may not be supportive of their child's fluency and discuss ways to help their children increase fluency. We also work as a group. The kids have fun playing and exploring talking with their peers and student clinicians while their parents share ideas, find answers to their questions about stuttering and provide support to one another through group discussions. In short, we educate parents about the nature of childhood stuttering and work with them to develop an interaction style that supports their child's fluency.

The younger school-age fluency group provides practice of fluency enhancing strategies for children 7 – 10 years of age.  Children learn about the parts of the body that help them produce speech, what happens during fluent speech and how we may interfere with talking leading to disfluencies. We further explore stuttering by talking about where children may feel tension during moments of stuttering and ways for them to reduce tension and struggle during speech. Children also learn speaking strategies, “fluency tools”, that allow them to control their speech and to improve their fluency.  Parents are invited to observe the group activities and are counseled about ways to change their speech to facilitate their child’s fluency and other factors that may contribute to their child’s stuttering. The children learn through cooperative games and activities how they can make conscious changes to their stuttering to make speaking and stuttering easier. Parents have an opportunity to learn information, ask questions and exchange ideas about stuttering while conversing among themselves and with a clinical instructor or faculty member.

To address the needs of older school age children, we offer a fluency group to children aged 11 – 14 years of age.    The same therapy components described above are also applied to this age group. However, for this age group, a bigger focus is placed on exploring thoughts and feeling about speaking and stuttering. Children participate in therapy activities that help their identification and desensitization of feared speaking situations. Parents are encouraged to observe the therapy sessions, talk with one another  and the clinicians to share their experiences of being parents of children with chronic stuttering.  

A teen fluency group is provided to address the specific needs of high school students who desire practice of fluency enhancing strategies, a safe place to discuss some challenges they may face with speaking and stuttering, and opportunities to learn more about factors and situations that may trigger stuttering. They also learn how to manage their speech and their reactions to stuttering and learn how to eliminate unhelpful thoughts and attitudes about speaking and stuttering.

The Stuttering Association of America, http://www.stutteringhelp.org/

The National Stuttering Association http://www.westutter.org/

Swallowing Disorders

Gebbie Clinic offers therapy for children and adults who have problems swallowing.

https://www.asha.org/practice-portal/clinical-topics/adult-dysphagia/

https://www.asha.org/public/speech/swallowing/Feeding-and-Swallowing-Disorders-in-Children/

Voice Disorders

We have all experienced problems with our voices, times when the voice is hoarse or when sound will not come out at all! Colds, allergies, bronchitis, exposure to irritants such as ammonia, or cheering for your favorite sports team can result in a loss of voice. Learn more about different types of voice disorders. (ASHA) https://www.asha.org/practice-portal/clinical-topics/voice-disorders/

http://voicefoundation.org/

The Gebbie Clinic offers individual therapy services for individuals with voice disorders.

Communication modalities

Augmentative and Alternative Communication (AAC) uses a variety of techniques and tools to help the individual express thoughts, wants and needs, feelings, and ideas, including the following:

• manual signs
• gestures
• finger spelling
• tangible objects
• line drawings
• picture communication boards and letter boards
• speech-generating devices

https://www.asha.org/practice-portal/professional-issues/augmentative-and-alternative-communication/

* We do not support the use of Facilitated Communication. The American Speech-Language Hearing Association (ASHA) has a position statement which states that “Facilitated Communication is a discredited technique that should not be used.” https://www.asha.org/policy/ps2018-00352/