Name of the Procedure:

Motor Speech Functional Limitation, Projected Goal Status at Therapy Episode Outset, at Reporting Intervals, and at Discharge or to End Reporting (G9186)

Summary

In this procedure, a speech therapist evaluates and documents a patient's motor speech abilities to establish a baseline, set goals, monitor progress, and assess outcomes at discharge.

Purpose

The medical conditions or problems it addresses: The procedure targets motor speech disorders, which can arise from conditions like stroke, brain injury, Parkinson's disease, multiple sclerosis, and other neurological disorders.

The goals or expected outcomes of the procedure: The main goal is to improve the patient’s motor speech functions and communication abilities by setting realistic therapy goals and tracking progress.

Indications

Specific symptoms or conditions that warrant the procedure:

• Slurred or slow speech
• Difficulty articulating words
• Hoarse or breathy voice
• Conditions like dysarthria and apraxia of speech

Patient criteria or factors that make the procedure appropriate:

• Diagnosis of a motor speech disorder
• Physician referral for speech therapy
• Patient consent and willingness to participate in therapy

Preparation

Pre-procedure instructions for the patient:

• No specific fasting or medication adjustments usually required.
• Bring any existing speech assessments or medical history documents.

Any diagnostic tests or assessments required beforehand:

• Comprehensive speech and language evaluation
• Neurological examination
• Imaging studies (e.g., MRI or CT scans) if indicated

Procedure Description

Detailed step-by-step explanation of what the procedure involves:

1. Initial Evaluation: The therapist conducts a motor speech evaluation to establish a baseline.
2. Goal setting: Based on evaluation findings, the therapist sets short-term and long-term goals.
3. Therapy sessions: Regular intervals of therapy are used to practice motor speech exercises.
4. Progress Monitoring: The therapist reviews progress at set intervals and adjusts goals as needed.
5. Final Evaluation: A concluding assessment is performed at discharge or the end of therapy.

Tools, equipment, or technology used:

• Speech therapy software
• Audio/visual recording devices
• Articulation tools (e.g., mirrors, tongue depressors)

Anesthesia or sedation details, if applicable:

• Not applicable

Duration

How long the procedure typically takes: Initial evaluations and goal-setting sessions typically last 60-90 minutes. Ongoing therapy sessions range from 30-45 minutes each, conducted weekly or bi-weekly depending on the patient’s needs.

Setting

Where the procedure is performed:

• Outpatient clinics
• Hospital therapy departments
• Rehabilitation centers

Personnel

Healthcare professionals involved:

• Licensed Speech-Language Pathologists (SLPs)
• Occasionally, physical therapists, occupational therapists, or neurologists may collaborate.

Risks and Complications

Common and rare risks associated with the procedure:

• Fatigue from repeated sessions
• Frustration or emotional distress due to slow progress
• Rare incidents of vocal strain

Possible complications and their management:

• Reduced motivation: Managed through goal adjustment and patient encouragement.
• Vocal fatigue: Managed by adjusting exercise intensity and providing adequate rest.

Benefits

Expected benefits and how soon they might be realized:

• Enhanced speech clarity and communication abilities
• Improved quality of life
• Benefits may start to be realized within a few weeks, with significant improvements observable over several months.

Recovery

Post-procedure care and instructions:

• Continue practicing exercises at home as prescribed.
• Attend all follow-up appointments with the therapist.

Expected recovery time and any restrictions or follow-up appointments:

• Recovery and improvement vary; regular follow-up sessions typically occur every 4-6 weeks.

Alternatives

Other treatment options available:

• Alternative therapies like occupational or physical therapy for related motor skills.
• Augmentative and alternative communication (AAC) devices.
• Medications for underlying neurological conditions.

Pros and cons of alternatives compared to the described procedure:

• AAC devices can be beneficial but may not address the underlying motor speech issues.
• Physical therapies may improve overall motor function but not specifically target speech capabilities.

Patient Experience

What the patient might feel or experience during and after the procedure:

• During: Active participation in therapy sessions involving speaking and articulation exercises.
• After: Possible mild fatigue or hoarseness. Generally, patients feel a sense of progress and accomplishment.

Pain management and comfort measures:

• The procedure is non-invasive and typically painless.
• Comfort measures include regular breaks and adjustments in therapy intensity based on patient feedback.