STROKE THERAPY AND APHASIASpeech Therapy for Adults
During a stroke, an artery in the brain becomes blocked or bursts. This change in blood flow means that the brain does not get the oxygen it needs which affects the brain cells. A stroke can cause physical, emotional and communication impairments.
Following a stroke, you and your family members will have many questions, both during and after the hospital period, about the assessment and treatments that are available to promote recovery.
Aphasia is the communication disorder that occurs following a stroke. This is as a result of damage to the parts of the brain that controls language. Aphasia can also occur following a traumatic brain injury e.g. from a fall, sports injury, anoxia to the brain, motor vehicle accident, brain tumor and other neurological disorders.
Aphasia can affect any or all of the ways we communicate. It can affect:
Every person is affected differently. Some people have difficulty speaking or expressing themselves, some have challenges understanding, and others have difficulty with both. Some people have mild aphasia where they may only have difficulty finding words (this is like having words “on the tip of your tongue”).
Other people may have severe aphasia where they understand very little of what is said to them and may say very little or nothing at all. People with aphasia may also have difficulty saying the sounds that make up words. This could be caused by apraxia (difficulty planning motor movements to form sounds and words) or dysarthria (slurred speech). It’s common for people with aphasia to know what to say but at the same time having trouble formulating the right words.
Difficulties with understanding may include:
- Difficulty understanding the names of people and objects
- Difficulty understanding instructions and directions
- Difficulty following group conversation
- Difficulty understanding one-on-one conversation
- Difficulty understanding conversation that is fast e.g. group conversation, TV
- Difficulty understanding “yes” and “no”
Difficulties with expression may include:
- Difficulty finding the right words
- Difficulty speaking in single words, short sentences
- Leaving out small words like “and” “the” and “a”
- Putting words in the wrong order
- Mixing up words e.g. calling a chair a table
- Mixing up sounds e.g. calling a table a fable
- Using a combination of real and nonsense words that make no sense
- Mixing up “yes” and “no”
- Difficulty gesturing “yes” “no” and “more”
Aphasia affects the whole family and a speech-language pathologist will include the client and family in treatment. An initial assessment is very important to determine a baseline and treatment goals so that we know how to help the person with aphasia.
> Treating the Person with Aphasia:
The speech-language pathologist (S-LP) will create an individualized treatment plan for each client following the assessment. There isn’t one type of treatment for everyone. There are many types of treatment for people with aphasia. Some examples may include teaching the person how to learn the sounds and use more complete sentences. The speech language pathologist may also work on strategies to reduce frustration and help the person get the message across by using supported communication e.g. writing down key words, using gesture and act as a facilitator to help the person communicate his wants and needs, opinions and ideas. A combination of approaches is often used in treatment.
> Teaching the Family to use Communication Strategies:
It is extremely important to include the family and teach them communication strategies so that they can help their family member express their wants, needs, opinions and ideas. Communication Partner Training is a very important aspect of the after-stroke therapy process.
The speech-language pathologist will be involved in providing education to the person with aphasia, the family, and other rehabilitation members about the type of aphasia and the communication strategies to help them express themselves.
How You Can Help
- Give the person time to get the message out
- Keep your message simple
- Write down key words as the person with aphasia is talking
- If stuck on a word, provide a first sound cue, draw the word (if possible), describe the word
- Provide verbal and written choices e.g. ”is it a chair or a table?”
- Encourage any method of communication e.g. thumbs up (yes) and down (no), pointing, drawing to reduce frustration
- Simplify questions
- Ask yes/no questions
- Use “life-history books” and/or memory books that can be made together with the S-LP to assist with communication
- Always have a notepad and pen available (black marker is preferable)
It can be very difficult and stressful for family members or caregivers when a loved one has a stroke. At the Speech Therapy Centres of Canada, our ‘Whole Family Approach’ to care means we are here to support you through this time.
Our aphasia therapy services for stroke and other neurological conditions are available in our clinics.
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