Services Rendered

  • Hearing-Aid Acoustics
  • Occupational Therapy
  • Physiotherapy
  • Speech Therapy

Hearing-Aid Acoustics

Hearing is an essential part of effective verbal communication. Loss of hearing can hinder normal speech and language development in children, cause communication breakdown, and over the long term, lead to social isolation.

It is our desire to assist you with sensitivity to better understand your own hearing, the impact it has on your daily functioning, and what can be done to get access to optimal communication function again. At the end of the day it is our hope that we can assist you to achieve a better quality of life.

Core Services & Products

A full diagnostic hearing test takes about 45 minutes to complete (+15 minutes feedback). The results obtained from the test gives us an accurate idea of

  • whether hearing loss is indeed present
  • where (in your hearing system) the damage is
  • how big the damage is.

Your hearing test results (also called an audiogram), guides the clinician in recommending appropriate intervention to you. It also helps determine whether your hearing loss is temporary or permanent.

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Depending on the type and degree of your hearing loss, intervention will be recommended. This might include

  • Referral to a general practitioner (GP)
  • Referral to a Ear- Nose- and Throat Specialist (ENT)
  • Hearing aid fitting

If you have a permanent hearing loss, hearing aids can assist you in achieving functional communication (and hopefully a more harmonious relationship with your spouse or significant other). The only way to find out if hearing aids are going to really benefit you in your daily life is to take it for a test drive.

This is why we recommend a trial-fitting with hearing aids after a hearing test (if you present with a permanent hearing loss) so you can get a practical experience of the devices and decide for yourself whether it is helpful to you or not.

We work with Widex, Oticon and Unitron hearing aids.

Fine tuning and minor repairs of hearing aids are done at the practice. Hearing Aid Batteries and other hearing aid accessories are also available at the Stepmed office. Please give us a ring before you come to make sure we have stock available of the desired accessories.

If you are exposed to high noise levels in your workplace or during social events (hunting, clubbing, woodwork, etc.) your hearing is at risk of damage. One way of safeguarding your hearing is to make use of appropriate hearing protection. Contact us to for more information about available product options suitable for your specific needs.

Prevention is after all better than cure.

When do I come for a hearing test?

  • When you have difficulty hearing speech clearly when there is background noise.
  • When it feels like people are mumbling when they don’t look at you when they speak.
  • When you frequently experience ringing in your ears (e.g. sunbeetle noise).
  • When you have to put the radio or TV volume very loud to hear it.
  • When you have to frequently ask people to repeat what they have said.
  • 10 Cool Facts about Hearing

    How you hear naturally is fascinating.

    Think about it. All of the components of this intricately designed process must work at peak function to carry waves in the air around you to your brain, where they are understood as distinct sounds. Hearing allows you to communicate, learn, experience, and enjoy the world around you.

    • The smallest bones are the ossicles in the middle ear: the incus, themalleus, and the stapes (also called the anvil, hammer, and stirrup).
    • The inner ear is no larger than a pencil eraser in circumference.
    • Your sense of hearing is dependent upon tiny hairs deep inside your ear. If you lose these hairs, you lose your hearing.
    • You do not need to clean wax out of your ears unless you have an abnormal condition. Ears push excess wax out as needed.
    • The majority of individuals suffering from hearing loss are under the age of 65.
    • The number one cause of hearing loss is exposure to excessively loud sounds (85 decibels or higher).
    • Your hearing can be damaged permanently even after a single incident of exposure to extremely loud noise (shotgun blast, explosion, etc.).
    • Your ears never stop hearing, even when you sleep. Your brain just ignores incoming sounds.
    • Your ears are more than just necessary for hearing; they also help you keep your balance.
    • Not all living creatures hear with ears. Snakes use jawbones, fish respond to pressure changes, and male mosquitoes use antennae.

    Occupational Therapy

    Occupational Therapy joined the STEPMED team in 2010. This growing practice works in the clinical areas of neurology and physical rehabilitation in the adult as well as the paediatric fields. Services are rendered in the following areas:

    • In hospital (acute)
    • Out of hospital (sub-acute
    • Home visits (chronic)
    • School visits (for children when necessary)

    Our main aim is to treat our patients holistically and have a team approach. It is our goal to render an affordable and accessible service with practical outcomes for our patients. Our role in issuing assistive devices is essential.

    Core Services & Products

    We have achieved additional qualifications in the treatment of neurologically-based injuries. Conditions most commonly treated by us are:

    • Stroke
    • Traumatic Brain injuries
    • Guillian Barré Syndrome
    • Encephalopathy
    • Brain Cancer
    • Spinal cord injuries

    As OT’s we help people regain their functional independence following any condition that may render a patient impaired in any way. The OT plays an important role in the rehabilitation process. We work to address difficulties caused by the condition that impact the patient’s ability to perform activities of daily life such as dressing, bathing, and managing a household or a job. The therapist assesses and, if necessary, treats a range of skill areas, including:

    • Physical skills, e.g strength, coordination, and balance
    • Cognitive skills, e.g memory, problem solving, sequencing, and ability to focus on an activity
    • Visual skills, e.g scanning and depth perception
    • Psychological skills, e.g ability to cope and manage frustration, and
    • Sensory skills, e.g being able to identify different textures or temperatures and having a sense of space.

    Together, the patient, the family, and the Rehab team will identify and prioritize the main areas that need to be improved in order to increase the patient’s functional independence. If necessary, the occupational therapist can recommend and help provide tools to make activities of daily living easier, such as adaptive equipment and home modifications.

    When to call your OT?

    • Are you concerned about memory loss or any other difficulties with concentration, problem solving?
    • Any difficulty coping at home with a loved one, who had a stroke, back operation, or any other disease impairing their function?
    • Do you need a wheelchair, assistive devices for the shower or other special equipment to make life easier for you or a loved one? Did you know I can order these through your medical aid?

    Paediatric occupational therapy deals with the unique daily living challenges of children with disabilities. Our most commonly treated conditions are:

    • Cerebral Palsy
    • Spina Bifida
    • Hydrocephaly
    • Microcephaly
    • Traumatic Brain injuries

    We analyse how the neurological condition affects the child’s everyday skills, including:

    • Performing activities of daily living, e.g washing, dressing and eating.
    • Fine motor skills, e.g feeding, drawing, playing with beads or fasten zippers or buttons.
    • Visual motor integration, e.g any pen and paper tasks
    • Cognition, e.g number, shape and colour concept.
    • Communication, e.g effective speech or devices to assist where speech is not possible.
    • Sensory integration, e.g playing with different textures and hot or cold elements.

    Since children learn through play, therapeutic activities are chosen specifically for individual children in order to help them meet their goals and ultimately improve their quality of life. Our occupational therapists assist children in adapting to their environment by developing strategies and techniques to help them successfully perform different tasks. As part of this effort, we will often recommend assistive equipment that can help the child in developing age appropriate independence.

    When to call your OT?

    • Do you need a wheelchair, special seating, splints or standing devices?
    • Is your child late to develop certain developmental milestones?

    Infants being born prematurely have an immature nervous system and tend to have difficulty processing every day stimuli. We have knowledge about typical development and implications of prematurity on development. We can provide information on these areas. Although a child does not have a neurological condition, it is important to ensure optimal development and stimulation.

    We are specifically trained ‎to work with babies to assist with typical development. The crucial age for babies to be assessed by an OT is from 5 months, and not 12 months as a lot of people would think. Delayes in development can be detected very early, and not only once walking has not been reached at one year of age. It is beneficial to assess your baby if there was any trauma at birth, any illness after birth, hospitilazation or brain insult.

    Stimulation for your baby:

    • Motor skills to strengthen the body and ensure optimal movement patterns.
    • Sensory stimulation to optimize processing of information‎.
    • Visual stimulation (Assymetry in eyes, squinting, lack of following of objects)

    When to call your OT?

    • Was your child born prematurely and is showing signs of having difficulty coping with his direct environment or disliking handling and touch?
    • Is your child currently in the NICU?


    Physiotherapy is an evolving occupation, which aims to improve the physical function of patients. This is achieved by decreasing pain, increasing strength and mobility and re-teaching movements that a patient’s body cannot perform.

    At StepMed we have a special interest in assisting those with neurological problems (problems with the brain, spine or peripheral nerves).

    Core Services & Products

    • Developmental problems
    • Delayed milestones
    • Cerebral palsy
    • Microcephaly
    • Hypotonic patients
    • Metabolic disorders
    • Neonatal / prematurely born childre
    • Children admitted to the Neonatal ICU
    • Erb’s palsy
    • Spina bifida
    • Other Neural tube abnormalities

    • Stroke
    • Traumatic brain injury
    • Spinal cord injury
    • Parkinson’s disease
    • Ataxia
    • Apraxia
    • Patients with balance problems
    • Pusher syndrome
    • Cerebral meningitis / encephalitis
    • Intracranial abscess
    • Cancer affecting the brain or spinal cord
    • Multiple sclerosis
    • Hemibalism
    • Myasthenia Gravis
    • Arnold Chiari syndrome

    • Peripheral neuropathies
    • Bell’s Palsy
    • GuillianBarre
    • Myopathies
    • Syringomyelia
    • Poliomyelitis
    • Transverse myelitis
    • Motor neuron disease
    • Muscle dystrophies

    • Multiple injuries
    • Amputees
    • Chronic pain
    • Lymphoedema

    Our aim at StepMed is to enable all patients to achieve their maximal physical potential. We aim to assist the patient to obtain

    • Medical stability
    • Maximal function
    • Maximal re-integration in society.

    • At StepMed we provide good quality treatments.
    • We do not believe in treating the symptoms alone. Instead we look for the problem in the body and work to correct it.
    • Patients with neurological problems need specialised treatment to prevent their conditions from becoming worse.
    • We intend to give hope where there is no hope and to inspire our patients to be the best they can. As physiotherapists we are but one of the facilitators of the rehabilitation process. It is Important that the team, family and patient all take each other’s hands and work together. In such a way we can achieve the best results.

    Speech Therapy

    Although Speech-Language Therapy encompasses a wide field of treatment, LOURENS Speech Therapy has a specific (although not exclusive) focus on the evaluation and treatment of speech, language and swallowing disorders related to neurological impairments. We work in both the paediatric and the adult populations.

    As Speech Therapists we are well aware of how incredibly important communication is to a person and his independent functioning. But as therapists working in the field of rehabilitation we have also come to appreciate the need for a Speech Therapist to have a degree of understanding of the functioning of the rest of the body, as well as to be able to work within a team context where our therapy goals are often dependent and/or intertwined with those of the physiotherapist, occupational therapist and psychologist. With this in mind, our speech therapists are all trained in the BOBATH concept with a holistic team approach to patient treatment.

    Core Services & Products

    Speech & Communication difficulties due to

    • Neurological involvement
    • Stuttering
    • Language developmental delays
    • Augmentative & Alternative Communication

    Feeding difficulties due to

    • Premature Birth
      • When a baby is born prematurely, several function areas are often under-developed. Some of these underdeveloped areas include breathing capacity and coordination of muscle movements.

        On a sensory level (the taking in of information received from the senses: visual, auditory, tactile, smelling, taste) the baby’s system isn’t quite ready for the overload of information that the world around them throws at them. They are easily over-stimulated with resulting anxiety to their little systems.

        Any of the above-named factors could contribute to the premature baby not being able to suck and/or feed effectively.

        The Speech Therapist works together with the nursing staff to establish functional sucking and feeding, while also assisting the mother and father to understand, support and enjoy their little baby during this unexpected season.

    • Neurological involvement
      • When a baby has suffered neurological damage, especially during the birthing process, there is a possibility that their ability to coordinate their muscles to achieve successful and functional sucking, swallowing and breathing actions may be affected. A Speech Therapist can assist you and your baby to achieve safe and sufficient feeding routines.

    • Behavioral & Sensory Difficulties
      • Oral hypersensitivity to certain tastes, temperatures and textures can cause babies or children to resist specific foods and/or liquids. We evaluate and help you determine what the root of the problem is and how it can be addressed.

    Speech & Communication difficulties due to

    • Voice disorders
      • Voice disorders refers to any changes in your vocal quality or volume that you don’t consider normal and that persists. It could involve hoarseness, limited vocal pitch range, or complete loss of voice. A speech therapist can evaluate your vocal function and assist with the determination and management of the source of the difficulty.

    • Stuttering
    • Stroke & Traumatic Brain Injuries
      • Dysarthria
        • Refers to weakness and/or in-coordination of speech muscles.

      • Apraxia
        • Difficulty saying sounds, syllables and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g. lips, jaw, tongue) needed for speech. The person knows what he wants to say, but his brain has difficulty coordinating the muscle movements needed to say the words. (Source: ASHA, Apraxia of Speech)

      • Aphasia
        • Refers to a disturbance in the comprehension and/or expression of language caused by dysfunction in the brain. Various forms of aphasia exists ranging from having difficulty remembering words to losing the ability to speak, read, or write.

      • Dysgraphia
        • Spelling and reading difficulties.

    • Augmentative & Alternative Communication

    Feeding difficulties due to

    • Stroke & Traumatic Brain Injuries
      • The Speech Therapist is involved in the administration of swallow evaluations while the patient is still in the ICU, in the hospital ward or have been discharged home. We assist in determining when it is safe for the patient to start eating and drinking Speech Therapists work with dieticians to make sure the patient receives the correct consistency food and sufficient nutritional intake according to their awareness levels and motor/muscle strength and coordination abilities. This way the risk for complications like pneumonia and malnutrition is dramatically decreased after neural damage, and the recovery process is less likely to be interrupted.

    • Cancer treatment / surgery