Most of our consultations are booked at the Sleep & Breathing Specialist Centre at the North Shore Health Hub. For individuals with Head & Neck Cancer seeking treatment through GenesisCare, we will see you at Genesis St Leonards. Your Clinical Nurse Consultant can book you in to see us on one of our Thursday clinics.

If you would like a combined ENT/Speech Pathology assessment please contact us and we will arrange an appointment. Otherwise, we will advise you if this is necessary following our initial assessment.

A referral from your GP or specialist is recommended to ensure the continuity of your medical investigations and intervention/s and to allow correspondence between Danielle and your medical and/or surgical team/s. However, a referral is not always necessary and Danielle is able to contact your team should you prefer to make an appointment without one.

Danielle utilises zoom for telehealth consultations. You will be emailed a link upon confirmation of your appointment. Ideally you will require a desktop or laptop computer however some sessions may be possible from the zoom application on a smartphone. Headphones are preferable, especially for patients requiring voice assessment and therapy. Good lighting is required and ideally, a view of yourself which will allow Danielle to observe your chest/ribcage, shoulders and a full view of your face and head.

Telehealth services are a standard mode of assessment and treatment delivery in speech pathology. Assessments such as endoscopic swallow assessments and functional laryngoscopy and treatments such as laryngeal massage are not able to be delivered via an online platform.

If you are eligible for a chronic disease management plan (CDMP) from your GP, you are eligible to receive approximately $52.00 off the total consultation fee, to a total of 5 consults per calendar year. You will be required to pay the full consultation fee and claim from Medicare with your receipt, following the appointment

For private health funds, NDIS self-managed funds and DVA members, you will be required to pay the full consultation fee and claim with your receipt, following the appointment.

Danielle triages all referrals and prioritises based on time of referral. In some situations, patients presenting with new swallowing problems may be prioritised in consideration of the possible risks associated with delayed assessment and treatment. Individuals requiring voice prosthesis replacement are also prioritised. At present, average wait time is approximately 4-6 weeks.

An acoustic voice assessment is a recording of a range of vocal tasks. The recordings are analysed by voice analysis software to objectively measure different aspects of the voice signal. These measurements are used for assessment and comparison during and after treatment. Examples include include measuring the average pitch or loudness of your voice or the percentage of irregularity in your voice. Danielle is highly experienced in acoustic voice analysis, including training speech pathologists around Australia in their use and clinical application.

Perceptual analysis is a subjective rating of your voice quality. Danielle is highly experienced in the use of evidenced-based perceptual tools to describe the range of voice parameters which may highlight your problem. This may include a rating of vocal strain, breathiness or roughness.

A functional laryngoscopy is a procedure where a Speech Pathologist or Ear Nose & Throat Surgeon inserts a small, flexible endoscope through your nose. The endoscope has a high-definition camera on the tip. The scope is flexible and designed to gently enter the nose to then rest inside the throat, above your voice box (near the “adam’s apple). The procedure is a gold standard assessment enabling full visualisation of the back of the tongue, throat and voice box. You are awake during the procedure and whilst some find it mildly uncomfortable, most people tolerate it very well. The procedure takes around 10 minutes.

You will be fully awake and conscious during the procedure and required to sit in a chair. Many people find it interesting and watch the screen. During the examination you will be asked to breathe and use your voice in different ways. The procedure provides invaluable information regarding your voice and breathing problems and people often find it increases understanding into their symptoms. Highly-trained Speech Pathologists and Ear Nose & Throat Surgeons regularly conduct functional laryngoscopy procedures. Danielle has been conducting this procedure for over 15 years and has trained many speech pathologists in the procedure.

A clinical swallow examination (CSE) is a gold-standard assessment of swallowing. It includes detailed case history, an oral motor and sensory assessment and observation of eating and drinking. Case history involves Danielle asking questions around your swallowing problem. An oral motor and sensory assessment aims to test oral and facial muscles and nerves relevant to speech, chewing and swallowing. Observation of drinking liquid and a range of different food types enables assessment of swallow timing, coordination and strength. Speech Pathologists are highly trained to observe the coordination and efficiency of chewing, the speed of swallow initiation and the start of the swallow reflex and throat movements during the swallow. This provides invaluble information to help determine the degree and extent of swallow dysfunction. The CSE is often followed by an instrumental examination such as the FEES.

Dry, irritable, persistent cough or throat clearing arising from lower airway disease (e.g. asthma), post-covid or respiratory virus/infection, obstructive sleep apnea, chronic reflux, allergy, chronic rhinosinusitis, stress/anxiety, chronic pain and muscular tension. We work closely with respiratory physicians and Ear Nose & Throat specialists to assess the underlying reason for your cough and aim to stop the cough or throat clearing with evidence-based cough suppression therapy. We have successfully treated many long-standing coughs in our patients, some whom have coughed for 40 – 80 years!

Link to Cough Severity Index – To find out if your cough could be helped by Speech Pathology intervention, complete the following questionnaire.

Removal of the larynx/voice box for treatment of advanced larynx cancer.

Laryngectomy care is the comprehensive management alongside your medical and surgical teams, before, during and after surgery, to treat voice, speech and breathing changes related to removal of the larynx.

Danielle has worked with people with laryngectomy for 20 years and is the Australia/New Zealand clinical consultant for Atos Medical, providing clinical education, training and support for speech pathologists around Australia/New Zealand working in Laryngectomy.

Danielle is happy to discuss your questions and concerns, to determine whether you may benefit from speech pathology assessment and/or treatment. Completing these questionnaires may also be helpful. (INSERT HYPERLINK) If these questions highlight any concern, speech pathology advice is highly recommended.

Stroboscopy is use of a stroboscopic light during a videolaryngoscopy, which allows stroboscopic evaluation of vocal fold vibration. The strobe light enables a slow motion image capture of vocal fold vibration, which allows detailed examination of aspects of laryngeal function such as the closure of the vocal folds and regularity of vocal fold vibration. It is the gold standard assessment method for diagnosing vocal fold nerve paralysis and vocal fold lesions.

Speech Pathologists are highly trained in assessing voice, breathing and swallow function, whilst ENT specialists are qualified to diagnose structural and anatomical deficits of the larynx. Danielle and A/Professor David Veivers have worked together for several years in multidisciplinary voice & swallow assessment clinics. Multidisciplinary assessment is a highly effective approach to diagnosing voice, breathing and swallowing concerns. In particular, evidence-based guidelines suggest joint assessment by a Speech Pathologist and Ear Nose & Throat specialist is the gold standard approach to diagnosing inducible laryngeal obstruction.

Danielle prefers to work in multidisciplinary clinical settings rather than provide services in your home. This allows Danielle to have access to necessary equipment, a plinth and laryngoscopy, if needed. However, Danielle is happy to discuss your needs if this is not possible or where there is a reason a home visit is most appropriate. Please call Voice Swallow Medicine to discuss your preference.

Danielle has provided 60-minute sessions for 20 years and believes this is the optimal time for an assessment or treatment session. This length of session enables adequate time for education and counselling, which is often required as part of the treatment program. It also allows time for practice, which is the most effective way to facilitate long-term motor learning.

Shorter sessions of 30 minutes are available and in some situations these work well. Please discuss this with Danielle when booking your appointment or follow up.