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Speech Therapy

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We offer assessments, therapies and advice for young and adult patients, on both an inpatient and outpatient basis. In the following areas:

In addition to severe paraplegia caused by accidents, a wide range of diseases can also affect language, speech, swallowing, and the voice, e.g.: strokes (CVI: cerebrovascular insult), craniocerebral trauma (CCT), Guillain-Barré syndrome (GBS), amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Parkinson's disease, locked-in syndrome, various muscle diseases, polyneuropathies or tumours in the ears, nose and throat area (as well as the consequences of their treatment).
The Speech Therapy Department at SPC Nottwil offers assessments, therapy and advice for young and adult patients, on both an inpatient and outpatient basis, with language, speech, swallowing and voice defects. The main focus of our inpatient work lies in the diagnosis of and therapy for dysphagia.

Therapy areas

DysphagiaThe act of swallowing is divided into a variety of phases which can be affected individually or by a combination of problems.
In addition to clinical examinations, diagnostics also involve the use of imaging processes (transnasal, fibre-optic endoscopic checks or video fluoroscopy).
Serious dysphaghia can lead to aspiration pneumonia (saliva, liquids or food getting into the air way) and can also result in malnutrition. Eating and drinking play a pivotal role in lots of social contact situations; as a result, dysphagia may cause the person to become withdrawn and to experience social isolation.
The treatment is individually tailored to the person's particular difficulties, aimed at all times at enabling him to eat and drink again as soon as possible and as much as possible without experiencing any complications.   

Cannula management
Tracheal cannulas may be required if serious problems develop with breathing and/or swallowing. They affect breathing, swallowing and speech. In order to achieve the best possible conditions for the treatment of these three areas, tracheal cannulas must be selected according to the specific needs of the individual patients. Successful tracheal cannula management requires close inter-disciplinary cooperation between all the specialists involved. 
AphasiaSpeech disorders are frequently acquired as a result of a stroke or brain injury. All aspects of speech may be affected, i.e. speech production (speaking, writing) and understanding speech (understanding verbal language, reading). The aim of speech therapy is to restore the best possible communication skills in everyday situations.
DysarthrophoniaSpeech impairments mainly result from brain damage. They are characterised by unclear speech, also often referred to as "slurred speech".  Since the areas of breathing, voice and articulation can be impaired in different combinations and degrees of severity, individual focuses are set in therapy. 
DysphoniaVoice impairments can be caused, among other things, by a non-physiological use of the voice or through organic changes. Roughness is the most common feature of voice impairment. It can be treated by means of voice therapy, surgery or by a combination of the two. We strive to achieve physiological use of the voice where possible and to avoid overstraining, as well as over-compensating.
Paresis of the facial nerveParalysis of the facial nerve may be caused by accidents or by neurological illnesses, although it is also not uncommon for it to occur spontaneously. The paralysis of the muscles of the face generally only affects one side. A variety of measures are used to stimulate the facial nerve and, thus, to stimulate the recovery of the muscles.

Practical placement
The Swiss Paraplegic Centre offers students of Speech Therapy the opportunity to complete a practical placement. The requirement for this is that the placement must run for at least twelve weeks and involve at least four days work a week.

Courses / Further training
We offer courses and workshops on dysphagia and cannula management to speech therapists, nurses and doctors that are interested. The scope and content can be tailored towards individual needs.


The magazine "Paraplegie" Issued No. 108 from December 2003 contains a brief report on the wrk of the speech therapists at the SPC focusing on dysphagia.

The book entitled "Paraplegie" (ed. Guido A. Zäch/Hans Georg Koch; publ. Karger, 2006) devoted one chapter each to dysphagia and to tracheotomy cannula management in the rehabilitation of spinal paralysis patients.

The following article was published in the magazine "Clinicum, Issue 03/07" by the speech therapist Hans Schwegler, Head of Speech Therapy at the Swiss Paraplegic Centre Nottwil: "What to do if first aid is required during eating?"

Another article by Mr. Schwegler also appeared in "Clinicum, Issue 06/07", pages 58 to 63. It deals with: "Tracheotomy cannulas: A blessing or a curse? "

Additional information


Swiss Paraplegic Centre
Speech Therapy
CH-6207 Nottwil

Hans Schwegler
Asst.: Elisabeth Achermann

T +41 41 939 58 92
F +41 41 939 54 40

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