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Don’t Take my Tongue

How impairment of our strongest muscle limits speech and swallowing

Nick Bollinger works with a patient on a swallow test.

A lot can go through someone’s head when they are first diagnosed with a stroke, injury or disorder of the brain, digestive disease or lung disease.

The last thing on your mind might be if you will be able to communicate or swallow. After all, conversing with friends, enjoying a beverage, and being understood are all things that we take for granted. When these skills are taken away from you, frustration can be at an all-time high.

At Beebe Healthcare, speech language pathologists (SLPs) work with patients while they are admitted in the hospital and once they are discharged to address communication and swallowing problems that may result from one of the medical conditions mentioned earlier.

We are experts in treating a variety of communication disorders, motor speech disorders, voice disorders and swallowing disorders. Though the profession is closely associated with treating childhood speech disorders in schools, which it does, SLPs are much more diverse in their practice than just working with children.

At Beebe, a team of nine SLPs provides services at the medical center in Lewes and at satellite locations in Millville, Rehoboth Beach, and Georgetown. After receiving an order from your physician, SLPs will assess your comprehension, expression, voicing, speech coordination, swallowing, or cognition. Depending on which concerns you have, different types of formal standardized testing and informal measures will be used to evaluate you, track your progress, and determine a home exercise program.

Our goal is to help patients return to eating and drinking safely and communicating independently so they can enjoy life as they always have.

The first part of identifying a communication, swallowing, or cognitive disorder is having awareness of the problem. “They can’t hear me,” “I can’t get the words out,” or “food goes down the wrong pipe,” are all common complaints SLPs hear. Once you have awareness of a problem, you should let your primary care physician know as soon as possible. They will order the appropriate test to be performed by a SLP.

X-rays reveal swallowing issues

One of the tests SLPs perform at the hospital is a modified barium swallow study.

It’s a fancy term for an X-ray of the swallow function. We give patients different consistencies of food to eat and liquids to drink. We take a video while you are eating and we look at all the structures in your throat to monitor how the food and liquid goes down.

Based on functions we see and the severity of any swallowing impairments, we will recommend the appropriate diet and/or treatment.

Following a modified barium swallow, patients may follow up with SLPs in a location that is convenient to them to have therapy.

Watching patients go from being unable to eat to enjoying their favorite food safely is very rewarding.

Being understood as we age

As we age, we may think it is natural for other people to have difficulty understanding what we say. This does not have to be the case.

If you are often asked to repeat yourself or speak louder, you should consider meeting with an SLP for a motor speech evaluation.

Speaking at a lower volume, slower speed, slurring your speech, or using a monotone voice is not a normal part of aging. These difficulties can result from diseases like Parkinson’s disease, ALS, brain injury, multiple sclerosis, Guillain-Barre syndrome or stroke. Untreated speech disorders can lead to social isolation and inhibit a patient’s quality of life.

A motor speech evaluation will look at a patient’s coordination of speaking and breathing, enunciating and other elements of speech. Once specific impairments are identified, a patient-specific plan will be developed to optimize a patient’s speech intelligibility to ensure they are heard.

When you see a patient smile because they were understood and they did not need to repeat themselves, you get a true sense of fulfillment in what we do as SLPs.

We don’t often think of our mouth and voice as muscles, but they are. Just as people go to physical therapy to help strengthen muscles involved with walking, people should go to speech therapy for problems communicating or swallowing.
The tongue is the strongest muscle in the body. It creates the words we speak and carves concepts out of experiences. It tells family members you love them. It helps you to swallow your favorite chocolate cake. Taking away a human being’s tongue function can be detrimental throughout all aspects of life.

For more information on Beebe Healthcare and services provided in the community, go to

Nick Bollinger, Lead Speech Pathologist
Nicholas P. Bollinger, M.S. CCC-SLP, is the Lead Speech Language Pathologist at Beebe Healthcare. He believes in honesty, integrity, transparency and perseverance to address communication, cognitive and swallowing deficits. To learn more about the services offered there, call (302) 645-3235 or visit