MEMORY & ATTENTION
Holding on to information
Remembering conversations, appointments, instructions, tasks, names and details while sustaining or shifting attention appropriately.
MICHIGAN AUTO NO-FAULT SPEECH-LANGUAGE PATHOLOGY
Cognition. Communication. Swallowing. Independence.
Specialized Speech-Language Pathology for people recovering from traumatic brain injury, neurological impairment and other serious Motor Vehicle Crash injuries throughout Michigan — delivered in the home, office, community or virtually when clinically appropriate.
✓ TBI & Cognitive-Communication Rehab
✓ Memory & Executive Function
✓ AAC & Communication
✓ Michigan Auto No-Fault Since 2014
THE FULL SCOPE OF SLP
Speech Therapy after a serious injury is often about thinking as much as talking.
The central question is not simply “Can the patient speak?” It is: Can the patient communicate, remember, organize, reason and function effectively in daily life?
A patient with traumatic brain injury may speak clearly and still forget conversations, lose track of tasks, struggle to organize information, miss appointments, misunderstand complex instructions, become overwhelmed by cognitive demands or be unable to communicate effectively in work and community settings.
M & M Home Care Speech-Language Pathology addresses those real-world cognitive and communication barriers and builds treatment around functional independence, participation and safety.
Cognitive-CommunicationMemory, attention, executive function, planning, organization, problem solving and information processing.
LanguageExpressive and receptive language, word retrieval, comprehension and functional communication.
Speech & VoiceArticulation, fluency, voice and speech production when clinically indicated.
Social CommunicationConversation, topic maintenance, inference, turn taking, pragmatics and communication in real social settings.
AACTools, devices and strategies that support communication when speech alone is not sufficient.
SwallowingAssessment and treatment of dysphagia and swallowing-related safety when clinically appropriate.
TBI & COGNITIVE-COMMUNICATION REHABILITATION
A patient can sound normal and still have profound cognitive-communication deficits.
Traumatic brain injury can disrupt the mental systems required to understand information, organize thoughts, remember what happened, plan what comes next and communicate effectively with other people.
EXECUTIVE FUNCTION
Organizing what comes next
Planning, prioritizing, sequencing, self-monitoring, managing time, solving problems and adapting when a routine changes.
COMMUNICATION
Turning thought into effective interaction
Organizing ideas, understanding complex information, finding words, maintaining topic and communicating successfully in daily life.
A patient may speak fluently and still be unable to manage a schedule, follow a multi-step plan, remember instructions, organize a conversation or communicate effectively under cognitive load.
MEMORY & ATTENTION
Recovery depends on more than remembering in the therapy session.
The goal is carryover — using strategies in the home, at appointments, in the community and during the routines that actually matter.
Working memory
Short-term recall
Prospective memory
Sustained attention
Selective attention
Divided attention
Task completion
Appointment management
Recall of instructions
Use of external memory systems
Calendars and reminders
Environmental supports
Treatment may use both remediative approaches designed to strengthen cognitive performance and compensatory strategies designed to improve real-world function when a deficit remains.
EXECUTIVE FUNCTION
The ability to do something is different from the ability to manage doing it.
A person may know how to prepare a meal, make a phone call or complete a work task but still struggle to initiate, organize, sequence, monitor or finish the activity.
Executive dysfunction can affect nearly every complex activity of daily living because it interferes with the mental systems used to manage behavior over time.
Planning
Prioritization
Organization
Initiation
Sequencing
Problem solving
Self-monitoring
Cognitive flexibility
Time management
Error recognition
LANGUAGE & COMMUNICATION
Communication is how a patient participates in the world.
Injury-related communication problems may affect relationships, healthcare, work, community participation and the patient’s ability to advocate for themselves.
Expressive LanguageFormulating ideas, word retrieval, sentence generation and conveying information effectively.
Receptive LanguageUnderstanding spoken and written information, directions, questions and complex messages.
Word FindingStrategies to improve access to words and reduce breakdowns that interfere with daily communication.
Speech ProductionArticulation and motor-speech-related needs when clinically indicated.
Voice & FluencyFunctional treatment for voice or fluency impairment when appropriate to the diagnosis and plan of care.
Functional CommunicationCommunicating successfully with family, providers, employers and the community.
SOCIAL COMMUNICATION
A conversation can reveal deficits that formal speech alone does not.
After brain injury, communication may become disorganized, overly literal, impulsive, tangential or poorly matched to the social situation even when grammar and articulation appear normal.
Speech-Language Pathology may address the practical communication skills needed to interact successfully with family, clinicians, employers and the community.
Topic maintenance
Turn taking
Inference
Perspective taking
Reading social cues
Controlling verbosity
Conversation repair
Appropriate communication style
NEUROFATIGUE MANAGEMENT
When the brain tires, cognition and communication can change dramatically.
Patients recovering from brain injury may perform relatively well for a period of time and then experience a sharp decline in attention, processing, memory, communication or emotional regulation as cognitive fatigue develops.
Treatment may help patients recognize fatigue patterns, structure demanding tasks, use pacing strategies and manage cognitive load more effectively throughout the day.
Performance at 9:00 a.m. may not predict performance at 3:00 p.m. Functional rehabilitation has to account for the way cognitive endurance changes over time and under real-world demand.
AUGMENTATIVE & ALTERNATIVE COMMUNICATION
Communication should not depend on speech alone.
When verbal communication is limited or unreliable, Augmentative and Alternative Communication may help the patient express needs, choices, information and identity more effectively.
Low-Tech SupportsWritten choices, communication boards, visual supports and structured systems when appropriate.
High-Tech AACElectronic or device-based communication options when clinically appropriate.
Strategy TrainingHelping the patient and communication partners use the system consistently in daily situations.
Partner TrainingTeaching family and caregivers how to support effective communication without speaking for the patient unnecessarily.
Real-World UseIntegrating communication supports into healthcare, home routines and community participation.
Ongoing AdjustmentRevising tools and strategies as the patient’s abilities, goals and communication needs change.
SWALLOWING & DYSPHAGIA
Swallowing problems require clinical attention because safety matters.
Neurological injury and other serious medical conditions can affect the ability to chew, manage food or liquid and swallow safely and efficiently.
When dysphagia is suspected or diagnosed, Speech-Language Pathology may evaluate and treat swallowing function within the appropriate scope of practice and coordinate with the treating medical team when additional assessment is necessary.
CLINICAL SAFETY
Swallowing is not a generic home exercise program.
Treatment must be based on the patient’s clinical presentation, medical history, current recommendations and the type of swallowing impairment involved.
ACCESSIBLE THERAPY DELIVERY
Speech Therapy can meet the patient where the communication demands actually occur.
M & M Home Care provides Speech-Language Pathology in the home, office, community or virtually when clinically appropriate.
HOME
Real routines
Medication schedules, calendars, conversations, household organization and other real cognitive-communication demands can be addressed in context.
COMMUNITY
Real participation
Functional communication and cognitive strategies can be connected to appointments, errands, community tasks and return to meaningful roles.
VIRTUAL
Access across distance
Virtual Speech Therapy may be useful for rural patients, long travel distances or circumstances where teletherapy is clinically appropriate.
M & M Home Care’s existing virtual Speech Therapy model may incorporate computerized standardized assessments, questionnaires and therapy materials to support structured treatment and progress monitoring when teletherapy is appropriate.
RETURN TO COMPLEX ROLES
Recovery is not complete just because basic conversation improves.
Work, school and community life place much higher demands on cognition and communication than a quiet therapy session.
Following multi-step instructions
Organizing written information
Managing deadlines
Remembering meetings and appointments
Professional communication
Taking notes
Planning and prioritization
Managing distractions
Problem solving
Cognitive endurance
Self-monitoring
Community communication
CAREGIVER & COMMUNICATION PARTNER TRAINING
Good communication support continues after the therapist leaves.
Family members and caregivers often become the people who help a patient carry strategies into daily life. Their communication style can either support independence or unintentionally increase confusion and dependence.
Speech-Language Pathology can help communication partners understand how to cue, structure information, reduce overload and support the patient’s own communication as effectively as possible.
Cueing strategies
Reducing cognitive overload
Supporting memory systems
Breaking information into steps
Communication repair
AAC partner training
Carryover of home strategies
Recognizing meaningful changes
DOCUMENTATION & MEDICAL NECESSITY
Speech Therapy documentation should explain function — not just test scores.
Standardized testing can be valuable, but the clinical record should also explain how cognitive, language, communication or swallowing impairment affects the patient’s real life.
CognitionMemory, attention, executive function, processing and the effect of those deficits on daily tasks.
CommunicationLanguage, speech, social communication and the patient’s ability to exchange information effectively.
Functional ImpactAppointments, routines, work, school, relationships, safety and community participation.
GoalsSpecific treatment goals tied to meaningful cognitive and communication outcomes.
ProgressChanges in performance, carryover, strategy use, level of assistance and remaining impairment.
RecommendationsOngoing treatment, compensatory strategies, caregiver training, additional evaluation or physician follow-up when indicated.
The record should answer a functional question: What problem is the patient experiencing, how is it affecting daily life, what are we treating, and is the patient becoming more independent or effective because of therapy?
MICHIGAN AUTO NO-FAULT
Speech Therapy inside a rehabilitation system we understand.
Michigan Auto No-Fault cases often involve long-duration rehabilitation, multiple disciplines, changing cognitive needs, utilization review, return-to-work questions, attendant care, physician follow-up and coordination among Case Managers, attorneys, insurers, families and other providers.
M & M Home Care has extensive experience treating people injured in Motor Vehicle Crashes and working within the Michigan Auto No-Fault environment.
Our role remains clinical. We evaluate, treat, document function and make recommendations within the Speech-Language Pathologist’s scope of practice.
M & M Home Care does not provide legal advice, determine coverage or decide entitlement to benefits.
MULTIDISCIPLINARY REHABILITATION
Cognition and communication affect every other part of rehabilitation.
SLP + OTCognition, executive function, ADLs, routines, community reintegration and strategy carryover.
SLP + PTAttention, dual-task performance, instruction following and safe carryover during mobility.
SLP + NursingMedication understanding, communication of symptoms, safety and changes in cognitive status.
SLP + CounselingCommunication, adjustment, cognitive fatigue and psychological barriers affecting participation.
SLP + Attendant CareCueing, supervision, memory supports and caregiver communication strategies.
SLP + PhysicianClinically meaningful findings that may affect treatment planning and need for additional medical follow-up.
SPEECH-LANGUAGE PATHOLOGY EXPERTISE
A clinical team with brain injury and Speech-Language Pathology expertise.
M & M Home Care’s current Speech Therapy program includes a Certified Brain Injury Specialist among its Speech-Language Pathology staff.
Grace Kuza, MA, CCC-SLP, CBIS
Speech-Language Pathologist · Certified Brain Injury Specialist
Grace brings Speech-Language Pathology expertise together with Certified Brain Injury Specialist credentialing — particularly relevant to cognitive-communication rehabilitation after traumatic brain injury.
MA
CCC-SLP
CBIS
Sophia Carrillo
Speech-Language Pathologist
Sophia is part of M & M Home Care’s Speech Therapy team providing rehabilitation for communication and cognitive-communication needs.
E-E-A-T matters in neurorehabilitation. The page should show actual credentials, actual clinical disciplines and actual expertise rather than relying on vague claims that “our team is highly trained.”
WHO WE HELP
Speech Therapy for complex Motor Vehicle Crash injuries.
TBI
Traumatic Brain Injury
Memory, attention, executive function, language, social communication, neurofatigue and cognitive-communication rehabilitation.
NEUROLOGICAL
Neurological Impairment
Communication, cognition, language, speech production and swallowing needs when clinically indicated.
COMPLEX REHAB
Long-Term Functional Recovery
Patients who need ongoing support to resume household, work, school, community and communication roles after serious injury.
SPEECH THERAPY REFERRALS
What happens after an SLP referral?
1
Contact M & M Home Care.
Call 248.599.2410 or use the referral process and identify Speech-Language Pathology as the requested service.
2
We review the referral.
We discuss the injury, patient location, current setting, cognitive or communication concerns and the reason Speech Therapy is being requested.
3
Required information is coordinated.
Orders, records, demographics, claim information, authorizations and other required materials are identified.
4
The patient is evaluated.
The Speech-Language Pathologist evaluates the relevant cognitive, communication, language, speech or swallowing domains.
5
Goals and recommendations are developed.
The plan is based on actual findings, functional priorities, medical necessity and clinically appropriate rehabilitation goals.
6
Treatment begins when appropriate.
Care proceeds when required orders, approvals and clinical conditions are in place, with progress documented throughout the episode of care.
WHY M & M HOME CARE
This is not generic Speech Therapy.
Our program is built around serious Motor Vehicle Crash injuries, cognitive-communication rehabilitation and the real-world consequences of neurological impairment.
Michigan Auto No-Fault experience
Traumatic brain injury rehabilitation
Certified Brain Injury Specialist expertise
Cognitive-communication rehabilitation
Memory and attention treatment
Executive-function rehabilitation
Language and communication therapy
AAC support
Swallowing treatment when clinically indicated
Neurofatigue management
Home, community and virtual treatment options
Caregiver and partner training
Multidisciplinary coordination
Meaningful clinical documentation
Speech Therapy should help the patient think, communicate and participate more effectively in real life.
Talk with M & M Home Care about Speech-Language Pathology for TBI, cognitive-communication deficits, memory, executive function, language, AAC, swallowing and other complex needs after a serious Motor Vehicle Crash.