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Neurologic Rehabilitation

SPEAKOUT!® and The LOUD Crowd®

 My Services

Addresses changes one might have in thinking or communication related to changes in brain function. Changes can be caused by: Stroke Concussion or Traumatic Brain Injury Long COVID  Brain tumor or changes due to chemo toxicity ​ Individualized therapy plan includes: Comprehensive evaluation of speech, language, cognition Engaging, personally relevant exercises and activities to address  Speaking​ Listening Attention Problem Solving Memory Reading/Writing ​​ Connection to community resources

Clinically-proven speech therapy approach for individuals with Parkinson's. The program helps patients REGAIN and MAINTAIN their speaking abilities with a combination of education, individual speech therapy, daily home practice, group sessions, and regular re-assessments. SPEAK OUT! is based on principles of motor learning and teachings of the late Daniel R. Boone, Ph.D., CCC-SLP. In the 1950s, Boone recognized individuals with Parkinson’s could improve their communication by "speaking with intent."


Augmentative Alternative Communication

Development of tools and systems to allow those whose natural speech doesn't meet all of their communication needs and that facilitates their independent participation in social exchanges. ​​ Individualized therapy plan includes: Comprehensive evaluation of a person's nature communication abilities and needs Identification of assistive technologies, including speech generating devices, that can facilitate communication and participation​ Community based therapy activities to promote use of AAC Communication partner training for supporting a person's use of AAC Attainment of insurance coverage for speech generating devices ​

Gender Affirming Voice

Addresses aspects of voice and communication related to gender identity ​​ Individualized therapy plan includes: Comprehensive evaluation of voice and social communication Engaging, personally relevant exercises and activities to address  Pitch Resonance Gender presentation including postures, gestures Connection to community resources​ ​



Ashley Couture, M.S., CCC-SLP

Certified Speech Language Pathologist

I have been working in the field of medical Speech Language Pathology nearly 25 years. I am passionate about helping each individual find their true voice and helping to remove barriers to people’s participation in life that may be created by differences in communication. 


  • Brain injury such as stroke, concussion, long COVID 

  • SPEAKOUT! ® and LOUDCROWD ®  for Parkinson’s Disease. 

  • Augmentative alternative communication 

  • Gender affirming voice

Ashley was astute to listen and understand me and my deficits. Also she was and still is compassionate, empathetic and a knowledgeable guide for me and other patients.

- TOM PICHLER, person with aphasia


Ashley's extraordinary expertise, guidance, advocacy and overall care is one of the primary reasons my daughter is the thriving and capable teenager she is today.  It is impossible to overstate how critical Ashley is to her recovery, and how much she has meant to my daughter and to me as a therapist, an ally, and a friend.

-JESSE NATHA VENDITUOLI, mother of a young stroke survivor

During one of the most terrifying times of my life, Ashley provided hope and the skills to realize those hopes for my husband. She is an outstanding speech language therapist and an extremely good human being.




VT Medicaid 


Phone (802) 373-5312    |    Fax (888) 531-3959 

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