Ascension Wisconsin - Elmbrook Medical Office Building

Cognition refers to the ability of our brains to learn, process, and remember information. At Ascension Wisconsin, our neuro rehabilitation care team includes occupational therapists, physical therapists, and speech-language pathologists. We provide one-on-one care to patients, individualizing treatment plans to help reach your goals.

Components of cognition include:

• Memory
• Attention and concentration
• Information processing
• Planning and organizing
• Problem solving
• Visual perception and processing
• Understanding and using language

Many neurologic conditions can lead to difficulties with cognition, including:

• Dementia
• Alzheimer’s Disease
• Mild Cognitive Impairments
• Stroke
• Head/brain injuries
• Post-concussive Syndrome
• Multiple Sclerosis

Occupational Therapy Functional Cognition Program

Living life to your fullest potential when experiencing changes in mentation

• An evaluation from an Occupational Therapist to help identify how your specific cognitive changes may be affecting independence and safety with daily activities such as meal preparation, finances, dressing, bathing, medication management, sleep, driving, etc
• Education and training on strategy use to compensate for cognitive changes as appropriate
• Education on recommendations to increase safety and independence with daily tasks
• Assistance in identifying and supporting participation in leisure, hobby, social, and cognitive stimulation activities for a healthy active lifestyle. 
• Caregiver education on a patient's abilities, assistance needs, environmental set up and routine needs, and communication styles to best assist patients.

Speech Therapy for Cognitive changes 

• A person can have changes in communication due to a cognitive decline, together with behavioral changes which can result in considerable frustration. Speech can help with person centered communication goals by teaching compensatory strategies and educating caregivers.
• Individuals with cognitive deficits may have behavioral challenges at meal time or develop swallowing problems such as coughing or choking. Speech can make suggestions and offer modifications for the patient and caregiver while taking into consideration health risks and quality of life.
• Family or caregiver are expected to be present for treatment sessions to receive education on how to use a patient's strengths to improve cognitive and communication abilities.

Do I need physical therapy?

• Are having problems rolling over or getting in and out of bed?
• Have you had any falls during standing activities (putting on pants, moving around the home)?
• Do you find your walking has become more unsteady?
• Do you avoid walking outside or alone? Do you feel less confident with your mobility?
• Are you having more difficulty getting up and down stairs?

A patient would need neurorehabilitation services after noticing a decline in function from any nervous system condition or neurological disorder, including the following:

• ALS (Lou Gherig's disease)
• Cerebral palsy
• Huntington's disease
• Multiple sclerosis (MS)
• Muscular dystrophy
• Parkinson's disease
• Spinal cord injury
• Stroke
• Traumatic brain injury

Neurorehabilitation focuses on the patient as a whole incorporating Occupational, physical and speech therapies to increase function, reduce debilitating symptoms, and improve a patient’s quality of life.

Driving provides freedom and independence, adds quality of life, and allows for social and community engagement. Our driver readiness program is an evidenced-based assessment provided by an occupational therapist. Our therapist evaluates individuals who have experienced medical illness, injury, physical challenges from aging, and progressive neurological conditions, such as Parkinson's disease, Alzheimer's disease and cognitive challenges. We assess the skills required to safely operate a vehicle in the community.

In-clinic driving assessment: A licensed occupational therapist evaluates the following required skills to determine your potential to drive:

• Cognitive skills
• Coordination
• Reaction time
• Strength
• Visual scanning
• Visual perception

The driver readiness assessment also includes recommendations for additional therapy and the need for driver compensations or adaptive equipment. We may also recommend behind-the-wheel training, if needed, to help make your driving safer and easier for you. The results from your driver readiness assessment will be shared with your referring doctor who makes the final decision about your ability to drive.

To schedule a driver's readiness assessment, call 262-641-4280.

Vestibular rehabilitation can be helpful for treating vertigo, dizziness, and conditions that make you unsteady. Lauren Doyle, DPT,  is a doctor of physical therapy certified in vestibular therapy. Dr. Doyle has specialized training to evaluate vestibular system disorders: benign paroxysmal positional vertigo (BPPV), persistent postural perceptual dizziness (PPPD), vestibular neuritis, vestibular labyrinthitis, and vestibular migraines. She uses infrared goggles, along with clinical testing, to determine if an individual’s dizziness and imbalance are coming from the vestibular system or the brain. 

Vestibular rehabilitation may include an evaluation of symptoms related to a concussion. Our clinic team evaluates symptoms and provides treatments using exercises, manual therapy for the neck and head, and specialized balance training equipment to help you improve your quality of life. 

A doctor referral is required to schedule a vestibular rehabilitation appointment. Call 262-641-4280. Our team will communicate with your primary care doctor, neurologist, ENT and audiologist to help manage your symptoms and support your care plan.

Parkinson disease (PD) is a degenerative disorder of the central nervous system that impacts a person's motor skills, speech, and cognitive function. Often characterized by having tremors PD can result in many challenges including: 

• Difficulty walking (shuffling and or freezing)
• Slowed or small movements
• Rigidity or stiffness in arms, legs, or trunk
• Poor posture
• Difficulty completing daily activities (ie getting dressed, bathing, toileting, laundry, cleaning, lack of participation in hobbies)
• Fine motor skills (tying shoes, handwriting, buttoning or zipping)
• Quiet speech (others have difficulty hearing or understanding you)
• Difficulty chewing and/or swallowing
• Cognitive or memory impairments
• Difficulty getting out of a chair or bed
• Recent falls or concern about balance

At the Elmbrook Neuro Rehab clinic, our specially certified Occupational, Physical, and Speech therapists offer a comprehensive rehabilitation program to enhance the well-being of those with Parkinson’s Disease and other Parkinsonism disorders. No matter the stage of PD, we work as a team to develop well coordinated and individualized treatment programs. Our goals are to minimize deficits, improve and or maintain current function and maximize health and quality of life. We also provide diagnosis specific education and offer community resources. 

What does this program mean to you?

We offer LSVT BIG, and LSVT LOUD, and the PWR! (Parkinson's Wellness Recovery) Program. These are evidenced based programs specific to Parkinson’s disease.

LSVT BIG is a program developed with the goal of restoring normal movement patterns in everyday activities.

LSVT LOUD is a highly effective, evidence-based speech therapy that improves communication and quality of life for individuals with Parkinson’s Disease.

PWR!MovesⓇ Certified Therapists are physical and occupational therapists who implement comprehensive PD-specific functional skill training that is research - informed.

A full array of cognitive, communicative, and swallowing therapies and services. 

Continuum of care 

Cognitive, communicative and swallow therapy 

Voice disorders 

Speech Therapy services are located in the Neuro Outpatient Clinic on the Elmbrook Hospital Campus rehabilitation services speech-language pathologists are trained in perceptual and instrumental evaluation and treatment of voice disorders, including vocal cord paralysis, laryngeal dyskinesia, voicing problems following laryngeal surgery, voice problems related to Parkinson’s disease, and functional voice disorders including vocal fold nodules. 

Language disorders 

Our expert clinicians are skilled in the comprehensive individualized assessment and treatment of language disorders, including expression, comprehension, visual recognition, writing, and non-verbal expression (including various technological assistive devices). 

Cognitive disorders 

Experienced therapists provide direction, compensatory strategies, and memory techniques that can make the difference between independent living and dependence on others. Examples of cognitive deficits that can be treated include changes in memory, problem-solving and reasoning abilities; orientation, attention and concentration skills; or a lack of insight or awareness of physical/cognitive deficits.

Vestibular Rehab can be helpful for treating: 

• Vertigo
• Dizziness
• Unsteadiness

Using infrared goggles, along with clinical testing, can determine if an individual’s dizziness and/or imbalance are coming from the vestibular system or from the brain that may necessitate further testing.

Our Clinic also provides evaluation of deficits related to a concussion and provides treatments using exercises, manual therapy for the neck/head as indicated and specialized equipment to train balance and facilitate a return to busy environments.

We work with your primary care doctor, neurologist, ENT and audiologist to manage your symptoms and help you meet your recovery goals.

If you answer YES to any of these questions, then physical therapy (PT) may be an option as part of your recovery. 

• Are you having problems rolling over or getting in and out of bed?
• Have you had any falls while standing? For example, have you fallen during an activity that you could do safely prior, such as putting on pants or moving around your home?
• Has walking become more unsteady?
• Do you avoid walking outside or avoid walking alone? Do you feel less confident with your mobility?
• Are you having much more difficulty getting up and down stairs?

Neurological physical therapy (PT) provides a specialized evaluation and treatment plan for individuals with a movement problem from a brain, spine or nervous system disorder. Your therapist starts by listening to understand you and your needs. Our PTs have advanced training to help restore, improve or adapt functions you may have lost. They focus on areas affected by the neurological disorder, including balance, coordination and strength.

Lauren Doyle, PT, DPT, ATC, CMTPT

Lauren Doyle has her doctorate in physical therapy and a certificate in vestibular therapy from Duke University. She is a board-certified athletic trainer and is certified in myofascial trigger-point dry needling. She has a special interest in treating vestibular disorders, functional movement disorders, neurological diseases, and fall prevention.

Michelle Prudlow, PT

Michelle Prudlow is a board-certified physical therapist. She has completed special training in neurodevelopmental treatments. She has a special interest in comprehensive evaluation and treatment of individuals with movement problems due to disease or injury of the nervous system, cancer or falls. She focuses on whole-person care using the latest therapeutic interventions.

Occupational therapy (OT) helps support you and your care plan to improve or maintain your participation in activities of daily living. Your OT uses neurorehabilitation strategies, evaluations and treatments to help manage your symptoms and support your neurological recovery goals. 

Jenny Stuber, MS, OTR/L

Jenny Stuber is a board-certified occupational therapist and is certified in the LSVT BIG Parkinson’s disease treatment approach. She has a special interest in working with upper extremity recovery after neurological injury, cognition deficits affecting daily functions, lifestyle management of chronic conditions, and driver’s readiness evaluations. She enjoys working with patients to help increase independence and incorporate safety into their daily routines.

Your speech-language pathologist (SLP), also referred to as a speech therapist, evaluates a patient after the stroke and provides communication and swallowing therapies based on your health needs. They use aphasia-friendly materials to help improve voice and swallowing problems. A SLP also delivers specialized speech and language therapy for conditions that affect your cognitive and neuromuscular abilities.   

Larissa Harrison, MS, CCC-SLP
Larissa Harrison is a licensed and certified speech-language pathologist (speech therapist) who treats patients with speech, language, cognitive, voice, and swallowing disorders using strategies that address the needs and goals of each patient and their support system. Her experience in the field at multiple levels of care with adults helps her provide patient-centered treatment and maximize patient benefits from skilled treatment in the field of speech-language pathology.

Alyssa Stallons, MS, CCC-SLP
Ali Stallons is a licensed and certified speech-language pathologist (speech therapist) who treats patients with speech, language, cognitive, voice, and swallowing disorders. She has experience working with a variety of neurological disorders and also has specialized training with head and neck cancer patients. In her practice, Ali uses evidence-based techniques to address the needs and goals of each patient while incorporating education and counseling for the overall well being of the patient and their support system.