Colleen Kempf, MS, is a speech-language pathologist who treats patients with speech disorders caused by brain trauma. She also manages the advanced clinical therapy program for the MossRehab Aphasia Center, which cares for people with chronic and progressive aphasia.
Why did you decide to become a speech-language pathologist?
My older sister, who is an occupational therapist, introduced me to the world of medical rehabilitation. I've always been interested in language, English, singing, science, and the arts. Becoming a speech-language pathologist combined many of my interests perfectly.
Can you discuss your education and clinical work?
I completed a five-year program at La Salle University, which combined a bachelor's degree in Communication Sciences and Disorders and a master's in Speech-Language Pathology. While attending college, I completed several medical practicums and fell in love with the profession. I completed one practicum at Fox Chase Cancer Center, working in both the inpatient and outpatient departments, one in the outpatient clinics at La Salle's private practice with pediatrics and adults, and another at the Camden City School District. After graduation, I completed a nine-month clinical fellowship at Genesis Rehab Services (a provider of short-term post-acute care services) in Holland, Pa.
Where did you work before MossRehab?
I worked in several different healthcare settings to find the adult populations and areas of speech pathology that interested me most. After finishing my clinical fellowship, I began my career at Fox Chase Cancer Center and Jeanes Hospital on temporary assignments. Then, I got a full-time position at Kessler Institute for Rehabilitation in Marlton, N.J. where I practiced in outpatient and inpatient acute rehab settings. It was there that I realized I wanted to work with outpatients with neurological disorders.
Why did you decide to work at MossRehab?
I was raised in Bucks County, Pa., so I grew up hearing about MossRehab. To me, it is the pinnacle of rehab. In addition to having a clinic close to my home, Moss has a fabulous reputation. During my interview, I was told I would work with the neuro population and patients with aphasia. It's a perfect fit for me. I'm so honored to work here.
Where do you work in the MossRehab network?
I started working at the Elkins Park campus in the outpatient department mid-pandemic in December 2020, so I haven't seen the lower halves of a lot of my co-workers yet! I also manage the Advanced Clinical Therapy program in conjunction with the MossRehab Aphasia Center, which offers different services and programs for people living with aphasia.
Who are your patients?
Most commonly, my patients are people who have suffered strokes or traumatic brain injuries that affect their language and/or cognitive skills. I also occasionally work with people with Parkinson's Disease and those with head and neck cancer.
What is the advanced clinical therapy program?
The Advanced Clinical Therapy Program (ACT) treats patients with chronic or persisting aphasia for greater than six months and individuals diagnosed with primary progressive aphasia. Many patients are told that they’ve reached their highest recovery level after therapy. However, research shows that people with aphasia can continue to make progress over time. The ACT program provides specialized outpatient therapy using new research treatments, evidence-based assessment and treatment protocols developed by the Moss Rehabilitation Research Institute (MRRI). What makes the program different is that speech-language pathologists work closely with the researchers and clinicians at the Aphasia Center to guide treatment protocols. Read more about the Advanced Clinical Therapy Program.
What is aphasia?
Aphasia is a language disorder often but not always caused by a stroke or traumatic brain injury (TBI). Sometimes, it results from a tumor or an infection of the brain. Primary progressive aphasia is different. It develops gradually as cells located in the language networks of the brain degenerate. It’s important to note that aphasia does not denote a change in intellect. Rather, it is characterized by difficulty accessing language, whether that be reading, writing, speaking, or understanding language.
Do you treat other language disorders in addition to aphasia?
In addition to aphasia, I treat apraxia of speech, which isn't a language disorder, but a motor speech disorder. Apraxia is caused by the brain having trouble communicating the right sequence of muscle movements to make a certain sound for speech. I also work with patients who have voice disorders such as dysphonia and speech disorders such as dysarthria, which affects speech clarity due to weak or uncoordinated muscles caused by some form of brain damage.
What is your approach to therapy?
I use the principles of "Life Participation Approach for Aphasia", which ensures that the patient is in charge of deciding their goals. Research shows that working towards a patient's goals provides greater beneficial outcomes. Some individuals may want to read a bedtime story to their grandchildren, while others want to go out with friends. The patient's goals direct my treatment. For example, someone returning to work might need to work on a work-specific vocabulary. For a patient who wants to go to Starbucks and order a drink, I will create a script and practice it with them. On discharge day, patients may not necessarily be 100% at where they want to be, but they can independently utilize the tools and strategies needed to continue to progress on their own.
Can you give me an example of how you worked with a patient?
I had a 53-year-old patient who experienced a stroke and had problems communicating. I started therapy with him three months after hospital discharge when he could only answer questions with "okay", "yes," or "no," which were not always reliable answers. The inpatient therapist started him with a speech-generating device so he could choose icons to provide verbal output to express himself.
During the outpatient evaluation, I built a rapport with him and his family. To communicate, the patient pointed to a green checkmark or red X to answer "yes" or "no" to questions. From my evaluation, I diagnosed him with severe progressive non-fluent aphasia. He had severe receptive and expressive language deficits meaning that he had difficulty understanding and speaking. He had trouble following two-step instructions, answering complex questions and understanding a spoken short paragraph. He would make up words and get stuck repeating the same phrase even if not intending to say it. His family said he wasn't much of a talker but loved being around his huge family. He had a soft spot for his young son and wanted to spend time with him fishing, playing tennis, and going to the beach.
We considered all these facts when mutually developing his goals. Over four to five months of therapy, his competence with language skills increased and he no longer depended on a speech-generating device. He could say his son's name as well as beach and medical terms that related to his life. He successfully ordered food over the phone and could hold a conversation with background noise, such as at family gatherings. He met many of his communication goals.
What kind of practices do you use with your patients?
I use several evidence-based approaches including verb network strengthening where I give a patient a verb and they provide the subject and the object to create a sentence. I use picture descriptions, synonym generation, and description tasks. The last technique has a person describe the word they are trying to say so it eventually pops out or the person to whom they are speaking gets enough information to fill in the blank.
What are your clinical interests?
Aphasia is my number one interest. It's amazing how the neuroplasticity of the brain allows for the recovery of language. I am also a Lee Silverman Voice Treatment (LSVT) LOUD certified clinician, so I work with the Parkinson's community. LSVT LOUD is a program to improve volume, quality and articulation of the voice for those with neurological disorders including Parkinson's Disease. I also enjoy working with patients who had traumatic brain injuries and concussions.
What inspires you on the job?
Patient stories inspire me. I'm amazed by their motivation, resilience and success. I had one patient who was working on trying to say her name - Grace. We taught her to sing the chorus of Amazing Grace as her singing voice was intact. So, she sings the chorus when asked her name.
Who has had a strong influence on your life?
My sister, Gretchen, is my role model. She's a homecare occupational therapist (OT) and one of the few pelvic floor certified OTs in the world. Her patients absolutely love her. She's very motivated, knowledgeable, caring, and charismatic, embodying all of the characteristics that make a wonderful therapist and human - in my opinion. One of my favorite examples of her determination and selflessness was when she was nine months pregnant and championed care for my dad who was diagnosed with stomach cancer during the pandemic. Since having surgery, he is now in remission and healthy.
What are your interests outside of work?
I am a big reader and do the New York Times crossword puzzle every day. I play field hockey, take art lessons, ski, camp, and spend lots of time with my dog, Junie.
Where's your favorite place to vacation?
I like going anywhere where I can have a mini adventure. My fiancée and I went backpacking across Europe with his family in 2015. Right now, we're planning our honeymoon to Iceland.
What's the last book that you read?
I recently finished The Fruit of the Drunken Tree by Ingrid Rojas Contreras, which provides a fictional account of two young girls growing up in Bogota, Columbia during Pablo Escobar’s drug empire. It’s my highest-rated book of the year.
What's your favorite food?
What's your life motto?
It's good to pause in our pursuit of happiness and just be happy.
Read about the different programs offered by the MossRehab Aphasia Center.