our services

Accent Modification


“Accent modification,” “accent reduction,” “second accent addition” — different ways of thinking about the process of changing your sound. The hard work of becoming bilingual can hit a speed-bump on accent. Fortunately, our structured and customized plans will allow you to work very efficiently on a standard Canadian accent. This efficiency can be hard to achieve on your own. Working together with a coach can pay dividends in noticeable improvement in clarity and confidence within weeks and months. There are many kinds of accent coaches — choosing an SLP (speech-language pathologist) provides the advantage of a more in-depth knowledge of the mechanics of speech and voice and the increased customization of your plan that that can allow. Our structured 13-week course aligned with the internationally recognized Compton P-ESL method includes a full pre-assessment of your accent, a customized path to your new accent, and weekly hour-long coaching sessions to keep your progress moving swiftly. Though we strongly recommend the full course, less intense schedules are available. We meet you wherever you like, and video-conferencing is an option. Click below to complete a free screening and free follow-up video chat to determine if this is right for you. Contact us if you have any questions.

Hourly rate $150 for one-to-one coaching time.

Accent Modification Coaching

Complete basic swallowing exam



A speech-language pathologist will meet you at your location to provide a complete basic exam including taking a detailed history of the problem, testing the nerves and muscles that control eating/drinking, and testing swallowing directly using a variety of fluid consistencies and solids textures.

A full report will be provided including safer swallowing strategies, food and drink texture recommendations, and a plan for any needed swallowing exercises or other followup. The cost of $295 includes the SLP visit, food and other test materials, and a full report.

Scroll down for information on more advanced mobile endoscopic swallow exams.

Complete basic swallowing exam

Mobile endoscopic swallow exam



Also known as FEEVS (flexible endoscopic evaluation of voice and swallowing), this is a more advanced hospital-level swallowing test that provides a higher degree of certainty about swallowing function, larynx (voicebox) function, and any risk of aspiration (food or drink going the wrong way). This service is mobile, meaning that it will be brought to your location. In addition to the testing included in the complete basic exam, a thin flexible camera is passed through the nose to gain a view of the top of the throat, the larynx (voicebox), and the entrance to the esophagus while actual swallowing is occurring. This provides a high degree of certainty about the swallowing function and the degree of airway protection while eating and drinking.

A full report is provided including safer swallowing strategies, food and drink texture recommendations, and a plan for any needed swallowing exercises or other follow up.

The cost of $495 includes a single-use Ambu endoscope, the foods materials involved in testing, the SLP visit, and a written report.

Mobile endoscopic swallowing exam

Post-laryngectomy care


Learning to take care of a stoma, voice prosthesis, laryngectomy tube, electrolarynx — learning to manage all of this after a total laryngectomy surgery can be overwhelming. Even if a person’s vision and hand-eye coordination are good the learning curve is steep and some help is often needed.

We have worked for years with people who have undergone laryngectomy surgeries, helping them both while they are in hospital and afterwards as outpatients. We are now able to offer in-home assistance in maintenance, cleaning, training, and practice with voicing whether that be via voice prosthesis or electrolarynx.

The hourly rate is $150, with half-hour visits also available as needed.

Post-laryngectomy care

Photo by Charles Deluvio on Unsplash

Communication therapy



Regaining confidence is a key to better communication after it has been affected by an illness or injury. We design therapy sessions with your interests and communication style at the center, working to expand your ability and confidence step by step.

We offer one-to-one therapy for dysarthria (slurred speech), apraxia of speech (difficulty coordinating the movements of speech) and aphasia (difficulty with finding and combining words, or difficulty comprehending them).

Speech-language pathologist hourly rate $150, with half-hour increments available.

Communication therapy

Why Carter Speech Pathology?

Because one-to-one in-person service is the best way to see progress. Many aspects of communication, swallowing mechanics, and post-laryngectomy life seem very technical, but with an experienced commitment to one-to-one help, progress can be made.

This is the meaning behind our logo, the rising sun gear image, reminiscent of the familiar ‘settings’ icon — it reflects not only our shared place on the Pacific Rim, but also the aspects of communication and swallowing that can be changed internally with a little thoughtful work. The designer of the logo is local graphic artist Francis Cheung.

Advanced FEES course:
SA Swallowing Services (Dr. J. Ashford)

Registered SLP

ILP certified

12+ years experience



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