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Clinics Treat Swallowing Disorders, Other Disabilities

September 18, 2007 | by Pat Vaughan Tremmel

EVANSTON, Ill. --- Leonard Ellis couldn't swallow.

A brain tumor had left the retired construction superintendent without this ability, one the rest of us take for granted.

Ellis, who lives in Kansas City, sought medical help and was given a set of exercises to do. They didn't provide relief.

Finally his doctor referred him to the swallowing center at Northwestern that is part of the Roxelyn and Richard Pepper Department of Communication Sciences and Disorders.

He was given a new set of exercises--"I had been exercising the wrong parts of my throat," he said. Last month he started swallowing again, and the feeding tube he'd been using more than two years was removed.

"It sure feels good to eat again," Ellis said.

He is among the upwards of 1,000 patients who are seen by the department's clinics each year.

In addition to swallowing problems, there is also help for those with learning disabilities and difficulties speaking or understanding language.

This clinical work comes out of a department that offers more than 100 courses to undergraduates and master's and Ph.D. candidates. U.S. News & World Report consistently ranks its programs among the top five in the nation.

"We are a mini-medical school," said department chairman Charles Larson. "Many of our undergrads are here because they want to go to medical school. Others want to be audiologists or speech and language professionals."

The clinic and lab run by Nina Kraus works with children whose brains are not processing sound waves properly.

"It's something that shows up in noisy classrooms," said Kraus, a professor in three departments: Communications Sciences, Neurobiology and Physiology, and Otolaryngology. Thirty percent of children with learning difficulties have this problem.

"We put scalp electrodes on kids and distract them with a movie, so that in one ear they're hearing the movie and the other, speech and music sounds, and check how the brain responds," she said.

The 20-minute test is known as BioMAP, short for Biological Marker of Auditory Processing. Some adults are given the test as well.

If it shows a sound processing problem, "they can be very much helped by auditory training programs," Kraus said. Supported by the National Institutes of Health, her clinic has tested more than 1,000 children over the last 15 years.

The speech and language clinic, directed by Paula McGuire, diagnoses and treats a wide range of disorders. Patients include stutterers, children and adults who are not making sounds correctly, professional voice users such as singers, actors and teachers, and foreign-born people who want to modify their accents, among others.

"Children who are screaming too much, like a cheerleader who is chronically hoarse, learn to use their voices more appropriately," McGuire said.

The audiology clinic, where Marla Andrews got her new hearing aids, has three audiologists who see about 10 patients a day, said director Lowery Mayo. They also spend three days a week working with students training to be audiologists.

"A majority of our patients are retirees, but we also have some pediatric patients and plenty of younger patients," Mayo said. "We are trying to recruit a pediatric audiologist."

The learning clinic diagnoses and teaches patients ages 6 to 16 whose disabilities make reading, writing or mathematics difficult. Nine are assessed each quarter for the 14 or 15 slots that are open.

About half the children are diagnosed as having learning disabilities. As for the others, "Someone may say, 'My child is 4 and has a hard time reading'-that's normal," said clinic director Frank Van Santen.

Grad students who work with the young patients "get experience with a good range of disabilities," he said.

At the swallowing center, where Leonard Ellis was successfully treated, center director Jeri Logemann noted that injury and diseases such as Parkinson's or ALS can affect the ability to swallow.

Treatment begins with an X-ray to see which muscles aren't working properly. Then the patient is treated, most likely with exercises. "No medications are known to improve swallowing," Logemann said.

Swallowing problems can make it hard to either eat or talk, and Logemann worked recently with a woman who had lost 65 pounds in the last eight months.

"People care more about eating than talking," the director said. "Witness that we are a fat society."