Dysautonomia in Neurorehabilitation | Julie A. Fechter

Full video interview with Julie A. Fechter, MS, CCC-SLP, for "The Autonomic Wildcard: Dysautonomia in Neuro Rehab," an episode of the Brainstorm(s) podcast.

Hosted by: Renee Garrett, MSED, CCC-SLP, CBIS

Earn 0.1 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/cours...

In this episode, Renee Garrett, MSEd, CCC-SLP, CBIS, is joined by Julie A. Fechter, MS, CCC-SLP, to explore dysautonomia, an often overlooked but highly impactful factor in neurorehabilitation. Autonomic dysfunction can quietly influence attention, fatigue, communication tolerance, swallowing safety, and overall engagement, showing up in therapy sessions in ways that are easy to miss or misinterpret.

This conversation is especially relevant for clinicians working with adults following stroke, TBI, long COVID, and other neurologic conditions. Renee and Julie walk through common red flags, practical assessment considerations, and therapy modifications that help protect energy and support carryover. If you have ever wondered why a patient’s alertness, vital signs, or cognitive endurance seem inconsistent from session to session, this episode offers a clearer framework for understanding what may be happening and how to adapt your clinical approach with greater confidence.

About the Guest: Julie A. Fechter, MS, CCC-SLP, is an adult medical SLP with 15 years of experience across nearly every setting imaginable. Specializing in Parkinson’s in her home health clinical practice, Julie was recently diagnosed with Sjogren's disease. She participated in a clinical trial, which significantly deepened her understanding of the patient experience. Julie has spoken at state speech conventions in California and Louisiana, as well as for the APDA NW. Julie spends time outside of work traveling (60+ countries), baking, arguing about politics, and moderating speech Facebook groups.

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