Cognitive Communcation Episodes

Ever feel like you’re fighting your patient just to get through a session? Explore Acceptance and Commitment Therapy (ACT) as a framework for speech therapy—not psychotherapy, but a way to rethink how we approach resistance, engagement, and progress. Using the metaphor of “the river and the rock,” Eva and Emily unpack how ACT shifts us away from power struggles and toward flexibility, values-based care, and meeting patients where they are. They break down the research on ACT in post-stroke depression and emerging work in aphasia, showing how emotional adjustment and communication recovery are deeply connected. Plus, we translate ACT concepts into real clinical scenarios—from dysphagia refusals to cognitive pushback to aphasia shutdowns—and walk through how to respond without arguing, forcing, or “fixing.” Because sometimes the most effective therapy isn’t pushing harder—it’s learning how to flow.

When we talk about dysphagia, “choking” is often used as a worst-case scenario—but how often does it actually happen, who’s really at risk, and what can we actually do about it? This week on Speech Talk, Emily and Eva dive into the research article “Dying for a Meal” to unpack the realities of choking across populations. From defining what “choking” really means (hint: it’s not always what we think), to exploring who’s most at risk, they break down the evidence behind one of the most feared complications in swallowing. They also get into the messy, real-world side of things: the emotional impact of choking, the unintended consequences of diet modifications, and why person-centered care is often missing from the conversation. Plus, practical strategies SLPs can actually use—like pacing, environmental supports, interdisciplinary collaboration, and staff education—to reduce risk without over-restricting patients. And, as always, they keep it real with clinical stories, ethical d…

Setting the stage for dementia care: aka staging! Emily and Eva to examine dementia staging and its impact on care. We share our personal experiences in acute care/SNF/LTC and emphasize the importance of adaptation and effective communication for patients and families. Discussing the mild, moderate, and severe stages, we highlight care strategies tailored to each level, including compensatory techniques for early-stage patients and Montessori-inspired approaches for those in severe stages. We refer to the article "Staging and Treatment Frameworks for Dementia Management" to underscore the need for ongoing education in dementia care. I also reflect on my efforts to develop a dementia staging program, encouraging listeners to engage further in these vital discussions

A very Geri Problem: TBI (traumatic brain injury) in Aging. In this episode of we share insights on the trends of traumatic brain injuries (TBIs) among older adults and their implications for our practice as speech-language pathologists. Our discussion includes an exploration of various TBI types, with a focus on cases like a motor vehicle accidents and falls. We examine statistics, highlight the importance of interdisciplinary collaboration in assessing and managing TBI symptoms, as well as practical strategies for rehabilitation focused on cognitive, linguistic, and emotional challenges.

You've tested your patient and they are sitting at a 25/30 on the MoCA. They have an MCI.. now what? In this episode, we explore mild cognitive impairment (MCI), a condition that sits between normal aging and dementia. We discuss the nuances of MCI, its subtypes, and the critical need for early identification to prevent progression to dementia. Personal anecdotes highlight the emotional challenges patients face, as we share strategies for sensitive discussions around diagnosis and care. Our conversation also includes insights from recent research on identifying high-risk MCI cases, advocating for tailored approaches to support cognitive health.

This week, we’re diving into one of the murkiest waters of SLP practice: cognitive interventions for people with dementia. When you hear “Well, can’t you just work on following directions?”—do you cry inside? Same. That’s why we’re unpacking a meta-analysis to give you the research-backed confidence to stand your ground. We reviewed “Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression” by Huntley et al. to understand what works, what doesn’t, and what’s still unclear when it comes to treating dementia in a meaningful way. Spoiler alert: only treatment shown to have a positive impact on standardized testing, but there’s still a long way to go when it comes to proving quality-of-life improvements. You’ll learn: The difference between Cognitive Therapy (CT), Cognitive Stimulation (CS), and Cognitive Rehabilitation (CR) What type of cognitive intervention showed the most promise in research Why “following directions” is not a val…

Mild Cognitive Impairment (MCI): what it is, how it shows up, and what SLPs can actually do about it. In this episode, Emily and Eva break down how MCI differs from moderate and advanced dementia, how to approach screening, and how to design meaningful therapy when patients are still “too high” for traditional treatment plans. They share practical ideas for early intervention, motivational interviewing, and supporting independence—all with their signature mix of science and sass. This episode is your crash course on being a better advocate for patients who fall through the cracks.

Training medication management? In this episode, we address the challenges of medication management for older adults with cognitive impairments, sharing our insights from high-turnover facilities. We review the research on medication self-management skills, revealing significant difficulties these individuals face. Our discussion highlights the importance of comprehensive education, cognitive screenings, and family involvement in medication management. We brainstorm effective strategies, such as hands-on kits and tailored assessments, while exploring cognitive errors and minimizing distractions during tasks. Our hope is that this will empower you in your practice to break out some medication bottles and challenge those clients!