Communication Disorders

This page highlights my approach to supporting clients with communication disorders, including advocacy for client autonomy, clinical experience across diverse settings, and augmentative and alternative communication (AAC). While guiding you through my evaluation methods, and evidence-based treatment strategies.

"Communication disorders affect how individuals understand, express, and interact with language. These challenges can occur across the lifespan and may involve expressive, receptive, cognitive-communication, or motor speech difficulties."

~ Alexa Noseworthy ~

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My Experience

Communication Advocacy
& Client Autonomy

I strive to support each client in expressing their independent thoughts, preferences, and desires. This includes utilizing multimodal forms of communication (e.i., gestures, writing, low/high-tech AAC, yes/no systems, facial expressions, and vocalizations. Programming devices alongside the client, incorporating their personal interests, allowing informal language, and reflecting who they are.

I have shadowed, received training, and provided; cognitive, expressive, and receptive communication evaluations and treatment plans across the lifespan including in a school-based setting, a private practice, and a skilled nursing facility.

Clinical

Types of Evaluations: BNT • WAB • ABCD • PLS • TOLD • TELD • CASTLE • OME

Evaluations

I conduct comprehensive evaluations using standardized and non-standardized screeners, structured observation, and dynamic assessment to determine each client’s current abilities and learning potential. This includes reviewing case history, medical charts, caregiver input, and interdisciplinary team feedback.

I assess performance across structured tasks and real-world activities. I often include trial therapy to see how clients respond to cues and strategies. I also consider processing time, cognitive load, fatigue, safety, and task endurance to help guide goal setting.

Evaluation Example PDF File

Augmentative Alternative
Communication (AAC)

I have implemented low-tech AAC systems including PECS, sentence strips, written communication, and personalized communication binders. I have also utilized high-tech AAC devices and applications including LAMP, GoTalk, Tobii Dynavox, Lingraphica, and Proloquo to support functional communication.

I have experience training individuals in gestural and multimodal communication including requesting “more,” head nods/shakes, facial expressions, pointing gestures, and intentional vocalizations to express needs and responses.

Motor Speech Intervention: Apraxia of Speech

My Clinical Treatment Experience

For apraxia of speech, I used motor-based planning approaches grounded in principles of motor learning. This included high-frequency repetition, Dynamic Temporal and Tactile Cueing (DTTC), simultaneous production, immediate and delayed repetition, and systematic fading of cues to promote motor planning independence.

I incorporated mirrors for visual feedback, modeling, and multimodal cueing (visual, tactile, verbal), with structured progression from automatic language to volitional speech. Therapy involved phonemic placement tasks, familiar and functional words, and practice within meaningful phrases to support generalization.

Assessment and Intervention (AAC)

I conducted AAC assessment and training, including device personalization with meaningful content such as family trees, important contacts, daily routines, and personally relevant vocabulary to support identity and real-world communication. I have received training in AAC book companion tasks and have provided family education/caregiver training to promote carryover across environments.

Language Comprehension: Receptive Language

For receptive language deficits, I targeted comprehension through functional, real-world tasks using concrete objects and activities of daily living (ADLs). I implemented strategies such as following multi-step directions, identifying objects in immediate and delayed visual fields, and gradually increasing the complexity of linguistic demands.

Cognitive-Communication Intervention

For cognitive-communication deficits, I focused on thought organization, sequencing of functional tasks, chunking information, and use of visual supports to enhance processing and executive functioning. Therapy was rooted in functional, real-life scenarios to promote independence and generalization.

Motor Speech: Dysarthria

For dysarthria, I implemented motor speech interventions similar to the Speak OUT! approach, emphasizing intentional speech, increased vocal intensity, breath support, and over-articulation to improve intelligibility. Treatment included structured drill practice, functional carryover tasks, and education on strategies for communication.

Attention-Based Intervention

I targeted selective attention, sustained attention, alternating attention, and divided attention within structured and functional tasks to improve safety, task completion, and communicative effectiveness.

Language Rehabilitation: Aphasia

I provided intervention for individuals with aphasia using evidence-based approaches such as Semantic Feature Analysis (SFA), categorical inclusion tasks, object recall, and identifying the function of objects. I incorporated multimodal cueing (verbal, visual, written, gestural) and picture stimuli to support word retrieval. Therapy emphasized safety awareness, functional communication, and participation in ADLs.

Functional Communication & Real-World Skills

I incorporated script training and role-playing functional scenarios to support real-world communication. These interventions addressed executive functioning skills, including attention, working memory, processing speed, thought organization, recognition/identification for safety awareness, and engagement in ADLs.

All interventions were aimed at improving quality of life, measured using the Quality of Life in Communication (QLC) Scale, to demonstrate functional improvements in daily life.

"Interprofessional communication and caregiver education are essential for advocating that clients have access to and consistently use their AAC devices across all ADLs.

~ Alexa Noseworthy ~

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