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Monday, August 31, 2009


living room, garage, back yard

by Dorothy E Ross PhD CCC-SLP
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Ischemic Stroke

S Andrew Josephson

S Andrew Josephson

San Francisco, CA


A stroke is defined as the sudden onset of a neurologic deficit attributable to a vascular cause. A stroke results from lack of blood flow to an area of the brain. Without adequate blood flow, neurons (nerve cells) in the brain will begin to die. Symptoms of a stroke are variable based on the area of the brain involved; sudden weakness and numbness on one side of the body is one common symptom of stroke. If the symptoms completely resolve within 24 hours, the condition is instead termed a transient ischemic attack (TIA)(TIA knol).

Nearly 500,000 people in the United States survive a stroke yearly, but it is the third leading cause of death in the U.S. and a major cause of disability worldwide. The risk of stroke increases with age, but can affect younger individuals including children and neonates. A stroke is classified as either (1) ischemic (also termed “cerebrovascular accident” [CVA]), where an occluded blood vessel deprives an area of the brain of blood flow, or (2) hemorrhagic, where there is bleeding into the brain parenchyma itself – that is, the brain tissue(intracerebral hemorrhage knol); approximately 80 percent of strokes are ischemic in nature and these are the focus of this review.

When an area of the brain is deprived of blood flow during an ischemic stroke, a cascade of events is triggered in neurons and other cells of the brain that eventually leads to cell death. Immediately after a vascular occlusion causes a stroke, much of the brain territory deprived of blood is not irreversibly damaged and may be spared permanent injury if blood flow is restored quickly over minutes to a few hours; this strategy of urgent revascularization is the basis of most acute stroke therapies currently in use.


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Sunday, August 30, 2009

Inside Aphasia

Inside Aphasia from Alin Bijan on Vimeo.

This is a clip from a documentary about Aphasia.

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Thursday, August 27, 2009

Hitchhiking mystery man's identity solved

Aug 27, 2009 04:30 AM

Staff Reporter

The 80-year-old was wandering in a ditch beside the I-90 in Montana, bleeding in his brain and incoherent to the young police officer who had pulled over to ask where he was going.

It turned out Bob Lance was not a vagrant, nor a drunk, nor on the run, but seemed to be hitchhiking across America with some determination, on his way back to his family in Brampton.

Lance, who suffered a bad fall in the spring, thought he was dying.

But he happened to be suffering from global aphasia, which obliterates the ability to speak or comprehend language and was, in this case, accompanied by memory loss.

When he was found in May, Lance was unable to recognize, or consistently say, his first name, answer simple questions or understand his environment.

It took two weeks before Jonalyn Brown, a speech pathologist at a rehab clinic in Laurel, Mont., found out why a man who grew up in Toronto had state identification from Washington – he started his voyage in Seattle – and was in a ditch in Montana.

"He was on his way to Toronto," Brown said, noting a bad fall in the spring may have induced stroke-like symptoms and convinced him he did not have much longer to live.

"He was worried that after the fall, he was going to die," she added. "He didn't know what was going to happen. He was 80, he didn't know how much time he had left, and he wanted to get to his family."

And so he fled Seattle, where he lived with someone who Brown said was "using" him, and took to the open road, as in his youth.

He ended up in that ditch and then in Brown's rehab centre, muttering about a tourist attraction, which she later discovered was Niagara Falls, and pointing to Canada.

"Once he was able to speak more, just little pieces, every session a little bit more information would come out about something to do with his past," Brown continued.

"It was almost like a puzzle. He was a big, huge puzzle that I wanted to help him put back together, because I knew he was so determined to tell me and I knew something important was in there."

Eventually, Brown – who worked with the cheery patient for 90 minutes each day, five days a week, from June 4 until his return to the GTA this week – began to click Lance's life together, piece by piece, until a portrait of his former self began to emerge from the man's disjointed memories.

The life that emerged was one of an adventurer, travelling America working as a labourer, wooing a woman and watching her pass away, living in Seattle and spending every day in the library, apparently working on seven separate books. After his fall, it was a Seattle librarian who reminded him of his name.

He had to be likewise prompted about other information, such as the city he grew up in and where his family still lived (Toronto) and the names of his siblings.

Lance flew to Toronto on Tuesday.

"Hitchhiking on the I-90, it's pretty wild," Lance's nephew, Michael, told the Star. "It's hard to wrap my head around that, an 80-year-old, a guy that old, thumbin', hitchhiking, you know? He was always a character, for sure."

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The role of the arcuate fasciculus in conduction aphasia

Brain, Vol. 132, No. 9. (1 September 2009), pp. 2309-2316.

In aphasia literature, it has been considered that a speech repetition defect represents the main constituent of conduction aphasia. Conduction aphasia has frequently been interpreted as a language impairment due to lesions of the arcuate fasciculus (AF) that disconnect receptive language areas from expressive ones. Modern neuroradiological studies suggest that the AF connects posterior receptive areas with premotor/motor areas, and not with Broca's area. Some clinical and neurophysiological findings challenge the role of the AF in language transferring. Unusual cases of inter-hemispheric dissociation of language lateralization (e.g. Broca's area in the left, and Wernicke's area in the right hemisphere) have been reported without evident repetition defects; electrocortical studies have found that the AF not only transmits information from temporal to frontal areas, but also in the opposite direction; transferring of speech information from the temporal to the frontal lobe utilizes two different streams and conduction aphasia can be found in cases of cortical damage without subcortical extension. Taken altogether, these findings may suggest that the AF is not required for repetition although could have a subsidiary role in it. A new language network model is proposed, emphasizing that the AF connects posterior brain areas with Broca's area via a relay station in the premotor/motor areas. 10.1093/brain/awp206

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Aphasia from Dan Warner on Vimeo .

Short Motion Design.

Nano-machines silently going about their work deep inside the inner realms of the human body.

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Hi Line Park

Hello Everyone,
If you haven't yet been to the wonderful Hi Line Park in West Chelsea, you should definitely make it a weekend or evening priority.
A few of us from the West Side Aphasia Group met there last evening and thoroughly enjoyed ourselves, walking along the tracks of the old HiLine rail line and then sitting and having a light dinner together. The soft breeze, the crowd, the beautiful wild grasses and the views across the Hudson all added to our pleasure. All that was missing were the cocktails! And we did pretty well without them.
Happy Labor Day Everyone! And please RSVP for our first September meeting, which is:
Wednesday, September 2
6:45 PM
155 W. 68th Street
Apt. 34B
Helen & Lewis

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Wednesday, August 26, 2009

Research Study

Hi Ms. Rubinstein,

I got your email from the National Aphasia Association website; I'm writing to tell you about a research study at the University of Pennsylvania, in the Department of Neurology. This study explores the effectiveness of TMS (transcranial magnetic stimulation) in improving symptoms of aphasia after stroke. In case you have group members potentially interested in enrolling, I have attached a letter that our lab sends out to patients who have expressed interest in participating. You can also read about the study on our website:

If it would be helpful, the principal investigators, Drs. H. Branch Coslett and Roy Hamilton, would be happy to come speak with your group and describe the study to any interested parties.

I hope to hear from you if and when it is convenient.
-Jen Benson

Jennifer Benson
Research Assistant
University of Pennsylvania

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Tuesday, August 25, 2009

Speech pathologist in Laurel helps man find family

David Grubbs
Bob Lance, 80, of Seattle, and his sisters Pat Lance, 69, center, and Doris Dixon, 79, both of Toronto, joke around like kids in the parking lot of the Billings Logan International Airport on Monday. The three were united after a 40-year separation.

  • Family reunion
  • Family reunion
  • Family reunion

Nobody can say how Bob Lance made his way from Seattle to Billings earlier this year, not even Lance.

When police found him wandering in a borrow pit along Interstate 90 in May, the 80-year-old retired laborer could say hardly anything at all.

"He could say his first name but not consistently," said Jonalyn Brown, a speech language pathologist at Evergreen Laurel Health and Rehabilitation Center. "He couldn't tell me where he was from. He couldn't label objects."

If not for Brown, Lance's story might have ended differently and, chances are, less happily.

But Brown, who has worked as a speech pathologist for seven years, took it upon herself to help Lance figure out who he was and where he belonged.

A little bit of detective work and a lot of disjointed conversation later, Brown watched Monday as Lance was reunited with family members who hadn't heard from him in 20 years or seen him in 40.

"Hiya, sweet cheeks, how are you?" said his younger sister, Pat Lance, as she strode toward him at the Billings airport.

Pat hadn't talked to her brother since their mother died in 1989.

But she and another sister, Doris Dixon, knew Lance as soon as they saw him waiting at the bottom of the stairs near baggage claim. The sisters said he looks just like their father and another brother, Arthur.

It was Arthur who first learned that Lance had been found disoriented and coatless on a Montana highway in the middle of the night.

Brown called Arthur, 87, at home in Toronto as part of her quest to help Lance find his family. That was after she taught Lance how to talk.

Lance suffers from global aphasia, a condition that impacts his ability to speak and to understand spoken words.

Aphasia often occurs after a stroke but can also result from a head injury or a brain tumor. An MRI at a Billings hospital, where authorities took Lance after picking him up on I-90, revealed bleeding in his brain.

Lance thinks he fell and hit his head in Seattle. He says he remembers going to a medical center after the fall, but Brown could find no records to confirm that memory.

She did learn that he was hospitalized in Seattle in 2006 after exhibiting stroke-like symptoms. Tests performed then showed that Lance had a small growth on the left side of his brain. It wasn't cancer, and his symptoms resolved, so he was sent home.

It was probably earlier this year that he fell and lost his ability to communicate, although Brown hasn't been able to piece together exactly what happened or when.

At some point, Lance decided to head home to Toronto.

He walked and hitchhiked east on I-90, using the few words he could reliably say and simple gestures to communicate with people who stopped to give him rides.

Aphasia essentially disconnects or scrambles the part of the brain that processes language, so even if Lance knew the answer to a question, his brain couldn't tell his mouth to say it.

Likewise, his ear often couldn't translate what was being said to him.

"I just, 'Uh-huh, uh-huh, uh-huh,' " Lance said of how he responded when drivers wanted to talk. "I don't know what they're saying."

For the most part, it didn't seem to matter. Drivers apparently thought they had found a good listener in Lance.

"Those people seemed to like what they were saying," he said.

Lance said he doesn't remember being cold or hungry on the road, although he had only $99 and no jacket when he got to Billings.

"I was having one pop and a hamburger," he said. "That was my eat for the day."

Although aphasia is not necessarily accompanied by memory loss, it was in Lance's case. He didn't know who he was.

A Washington state ID card in his pocket provided few clues beyond his name and an address in the Seattle-Tacoma area.

He hadn't been reported missing in Seattle, where Brown later learned he lived for more than 25 years, and police who visited the address on the ID card learned only that he used to live there.

As Brown worked with Lance to restore his speech, she also asked him questions about his life. He began to answer one of them - where are you from? - consistently.

"The lakes," he said. "The lakes."

Brown showed him a map of the United States, and Lance pointed to the Great Lakes.

Actually, he pointed above the lakes, which led Brown to show him a map of Canada. When he pointed to Toronto, she typed his last name into an Internet database of Toronto telephone listings and started making phone calls.

Lance's brother Arthur was the second person she reached.

After listening to Brown for a few moments, he said, "I used to have a brother named Bob."

"He was our wanderer out of the eight of us," Lance's sister Pat said. "We figured eventually we would hear from him or something about him, but we didn't."

Lance was born in Michigan but was raised in Canada. He left for the United States at age 40 because he wanted adventure.

He traveled around working as a laborer until he fell in love with a woman in Seattle and settled down.

Although he remembers how he wooed her, how they lived together and how she got sick and died, Lance cannot remember the woman's name.

He lost contact with his family after his mother died in 1989, and Brown thinks he became depressed after his love died about 10 years later.

Still, he was eager to work with her when he got to Laurel.

"I know somehow this is the right thing for me because I know I need help," Lance said. "I'm here because I should be."

Arthur, the eldest of the Lance children, connected Brown with his sister, Betty, 85.

After she realized that Brown wasn't a telemarketer, Betty told her to call Pat, the baby of the family at 69.

Pat and her sons, Kenneth and John, helped Brown piece together what she could about Lance's life and helped Lance apply for a passport so he could go to Toronto.

It wasn't easy. Lance couldn't answer many of the required questions on his own, and the passport agent didn't seem willing to work with him, Brown said. A call to the governor's office in Washington state finally did the trick.

Meanwhile, Lance worked on his communication skills. He spent so much time talking to other residents and staff at Evergreen that he was chronically hoarse.

After three months of speech therapy, Lance understands most of what is said to him and can often say what he means.

He tends to get off on tangents while talking, but a careful listener can usually follow his gist. He is a gregarious speaker and doesn't seem to get frustrated when he can't get his point across.

His communication skills should continue to improve, especially if he works with a speech therapist in Toronto as planned, Brown said.

The brain can rewire itself around an injury, continuing to heal for years.

Lance will live with Pat and Doris in Toronto. The siblings were flying back to Canada today.

On Monday, they joked around like school kids in the airport parking lot. Words tumbled out of Lance's mouth as he walked his sisters to Brown's vehicle.

"If I put your hands behind your back, will you stop talking?" Doris asked him, giggling.

A few minutes later, Pat grabbed her brother by the arm and dragged him toward the car.

"As Mum would say, 'Motormouth, get in the car,' " she said.

Earlier, Lance said he wasn't nervous about going home.

"It doesn't matter what I say or do," he said. "I'm always Bobby to them."

Contact Diane Cochran at or 657-1287.

By Carly Conway
Speech pathologist in Laurel helps man find familySocialTwist Tell-a-Friend

Monday, August 24, 2009

Aphasia and Migraine

Written by Lileya

Sunday, 23 August 2009 at 18:08

The rarer forms of migraines and the rarer symptoms are often neglected and goes unmentioned just because it’s rare and there seems to be this whole concept around ‘rare’ being so unlikely that it can just be done away with. Aphasia (a partial or complete loss of the ability to articulate or comprehend written or spoken language) is a rare symptom mainly associated with the aura-phase of a basilar type migraine, but may also be experienced as a symptom of either the aura or headache phase of any type. It’s temporary and completely reversable, but I have headaches on most days. During the aura and headache phase, language becomes difficult and it doesn’t feel so temporary.

Difficulty understanding language: I occasionally have difficulty understanding either spoken or written language. Having APD (Auditory Processing Disorder), I’m rather familiar with the weirdest things coming out of people’s mouths, but my love for books makes it very difficult to look at a text and not be able to read it. I know the effect is temporary, but being able to read some days but not every day, is a difficult adjustment to make, even though I can’t tolerate enough light in a room anyway to be able to read with a headache. Things that help me to understand spoken language better:

  • Start topic specific conversations by stating the obvious – start with a summary then follow with details.
  • Use shorter sentences, slow down and be patient.
  • I don’t mind talking about various topics simultaneously, but be clear about switching topics by either stating which topic you’re talking about when you switch or retaining the same order.
  • Type particulars out, such as a particular name and use visual clips. I adore links thrown into verbal conversations to either text, screenshots or video.
  • Accompany names with descriptions. I may not recall a film, book or game by its title, but give me the tagline or a clip or a screenshot and it all comes flooding back.
  • Minimize background noise.
  • If I say I don’t understand, rephrase rather than repeat.
  • Summarize and rephrase when summarizing. I sometimes think I understand but misheard something or missed something and unless the gist of the conversation is repeated at some point, I don’t necessarily realize that I’m not quite getting what you’re saying.

Inability to understand the emotional content of written or spoken language (Receptive dysprosody): I rely heavily on the emotional content of language for understanding as a result of APD. I can’t always process words, but I can infer meaning and formulate an appropriate response based on the emotive tone. If the emotional tone is suddenly absent, I’m lost. Communication that happens via the internet means language is all there is and it’s challenging to maintain meaningful conversations and relationships when words are often incomprehensible and emotion is entirely absent. Things that help me:

  • Emotes. The more the better. However, don’t expect me to get sarcasm, humour, irony or inferred meaning. Be literal with the use of emotes and try to actually type what you mean to say.
  • Tell me how you feel if you want me to know, don’t assume that I’ll know otherwise.
  • Be explicit and blunt. Yell, swear, type in capitals etc. I’m much happier being yelled at than I am worrying about whether someone is angry with me or not.

Difficulty with speech: I often have issues related to talking. Some headache days, talking is extremely difficult and limited to single words, very short sentences or even just made-up words. We’ve created our own pretty concise vocabulary of made-up words, gestures and inflection and so the frustration of not being able to communicate is not as prevalent as it used to be. That said, I have a tendency to grab whichever word I can find and speaking more languages than Chris does, the word isn’t always part of the English vocabulary. I find talking on most days pretty difficult and rather frustrating. Practised phrases are easiest and it makes using recognition software easier to use. New subjects are the most difficult. Some days pronunciation is difficult, other days speech are slurred a little or a lot. Sentences aren’t always completed and I may have issues either naming things or recalling particular words. The jumbled up days are hardest, when speech is there but unreliable and incomplete. When it’s absent, there’s just a vast emptiness in the complete chaos headaches create in my head and it’s almost comforting. I stop talking, sometimes for days at a time and it’s one less thing to worry about. Things that help me:

  • Contrary to popular guidelines that advocate space and independence, I’d much rather focus on understanding than the process of communicating. If I’m struggling, don’t just sit there and wait patiently, help. Complete my sentences for me, suggest the word I may be looking for and if you know me well enough to know what I’m about to try and say, feel free to talk for me.
  • Don’t correct unnecessarily. I’m aware that I got the grammar wrong, and sometimes I may even deliberately do so. I’m aware that my pronunciation is off, that I just used the wrong word or phrase or said yes when I meant to say no. If I’m talking to you and you get what I meant to say, then leave it be. If you don’t, by all means, ask for clarification.
  • Don’t ask me to verbally answer long or complicated questions, I’ll just say no. If I can talk, I will without being prompted. Accept that when I say “I know” or “I get it” that I do even though I can’t necessarily explain it back.
  • I don’t always say what I mean. Don’t assume I’m not paying attention just because I said something was funny when I meant to say sad or because I come across as confused or seem to get the details wrong. I usually know what I’m talking about, I just don’t have the right words at hand to say what I really mean to say.
  • Shape conversation when I have issues so that you can do the talking and I can respond in a monosyllabic fashion.

Difficulty with writing: Writing is much easier than talking, but still problematic at times. Common issues that crop up are words left out, words used inappropriately, grammatical errors and sometimes formulating longer sentences are just not viable. Emotes and fixed expressions make it easier. On most days I can get away with typing as long as I keep it short and to the point and concentrate very hard on what is being said and how to respond. Talking to more than one person isn’t an option, it just gets too complicated, but talking to a single person for a little while on a well-known topic is doable. Things that help me:

  • Replies take longer. If I can type but not talk very well, I can’t use speech recognition software and typing is often a slow process. When language is difficult, I may also need to think more before I type and so replies may be rather slow even when they’re short.
  • Read over errors in grammar, syntax and vocabulary if possible. As when talking, I know I’m making mistakes, but can’t always help it. Pointing it out doesn’t help me. Only refer to errors if it affects your understanding of what I’m saying. By all means, ask for clarification when needed.
  • Don’t be offended if I don’t talk. Mostly I can only do one conversation at a time and so if I’m talking to someone else already, I may say just that and not talk to you until I’m done talking to them. Sometimes I’m happy to listen/read, but typing is difficult and so the conversation will rest entirely on your shoulders.

Communication is an integral part of life. Over the years I’ve become quite skilled in both the art of subterfuge and avoidance. I’m not a very social or talkative person. I have few friends and mostly keep to myself. Finding communication a hurdle hasn’t helped. It’s easier to talk about and explain things like dislocating joints, breathing problems or even headaches. Trying to explain transient yet persistent and variable problems with language is very difficult. Today you can read and tomorrow you can’t? Now you can type but five minutes later you can’t? Yesterday you spent hours listening to me talk on vent and today you don’t understand a word I’m saying? A Chris favourite “You have a degree in psychology and yet you can’t tell that I’m angry with you?”

Yesterday I wanted a neck massage and the request was done mostly by gestures accompanied by something that may have sounded like “neck – hurt – fix – there”. Today I can say “Could you massage the sternocleidomastoid muscle? Particularly at the insertion points, you know, on the lateral surface of the mastoid process and where the aponeurosis insert into the lateral half of the the superior nuchal line of the occipital bone?” Most days, I don’t get it myself. It’s frustrating when words are just there to be taken for granted and then, suddenly, inexplicably, they’re gone or turn chaotic and I sound like the village idiot. Or maybe that’s just the way it makes me feel. Language is important. Some days, I sit in silence and touch the empty white screen waiting for words, unable to acquiesce.

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Winter Clothes

Vocabulary - coat, hat, glove

by Dorothy E Ross PhD CCC-SLP
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Coping With Aphasia: Paul's 7 Quick Tips

By Paul Berger, Stroke Survival Expert

I have aphasia from a stroke, caused by a ruptured aneurysm when I was 36. Aphasia is a medical word that means I have problems with reading, writing, and speaking. Aphasia is very hard because people think that you are not smart if your speech is bad. Here are my seven quick tips on how to live with aphasia.

1. You need a positive attitude.

2. There is no pill to cure aphasia. You have to do it with willpower. Therapists, doctors, professionals, government agencies, and others are tools to help you.

3. You are a person, a survivor. Think of yourself as a stroke survivor or a person with aphasia. You are not a stroke or a brain injury.

4. You should become a good listener. Other people will see that you are interested in them if you listen to what they say about work, family, and interests.

5. You should use a pocket notebook and pen. With aphasia, it is hard to understand names, addresses, dates, and other numbers. Ask the person to write it down in your notebook.

6. Speech can improve with aphasia therapy, and also, with other activities that make you think and see other people: volunteering, classes, hobbies, travel, and a job.

7. If I can do it, you can do it, too!!

Copyright (c) Paul E. Berger & Stephanie Mensh
Permission is granted to reprint this article
in your newsletter or magazine only with the following byline:
"Paul Berger is a speaker and author.
To find out more about his programs and services,
or call (703) 241-2375."
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WSAG Meeting Wednesday, August

We will be getting together this Wednesday, August 26 at Hi Line Park. There are several entrances. We will meet UPSTAIRS at:

10th Avenue and 16th Street -- 6:30 pm

Take the elevator -- you will see it below the tracks on the North Side of 16th Street. We will meet on the Park Level right outside the elevator exit.

Please meet at 6:30 & bring dinner with you. The park is really wonderful and hopefully, we will find a couple of chairs & tables or lounges to gather round and eat dinner together.


In case of rain we will meet as usual, 6:45pm at 155 West 68th St., Apt. 34B.

VERY IMPORTANT -- Please RSVP - so we know that we should wait for you at the Park.
Please send me a contact phone # when you rsvp, so I can reach you in case of rain or other problems.

Helen Rubinstein
West Side Aphasia Group

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Sunday, August 23, 2009


Vocabulary - shirt, pants, shoes

by Dorothy E Ross PhD CCC-SLP
ClothingSocialTwist Tell-a-Friend

Friday, August 21, 2009

Inside the Body

by Dorothy E Ross PhD CCC-SLP
Inside the BodySocialTwist Tell-a-Friend

Easter Seals and Autism Services

August 21st, 2009 by 1 in 150 newborns Will Have Autism Today

I found this on the Easter Seals site and suggest visiting their site for more in depth information on Autism and Services needed for children on the spectrum.

Easter Seals — helping people with disabilities gain greater independence

Easter Seals provides exceptional services, education, outreach, and advocacy so that people living with autism and other disabilities can live, learn, work and play in our communities.
Understanding Speech and Hearing Therapy

Speech and hearing therapy (also known as speech-language pathology and audiology) are important health-related specialties concerned with normal development of human communication and treatment of its disorders. Speech therapy focuses on voice and speech-language skills, while hearing therapy deals with hearing and hearing impairment.

Speech or language disorders may be present at birth or acquired later in life by disease, illness, head injury, substance abuse or allergy.

Hearing loss may be acquired before or during birth if a pregnant woman takes certain drugs or contracts a viral disease such as rubella (German Measles). Children sometimes acquire hearing loss from infection and inflammation of the middle ear or from communicable diseases. Adult hearing may be affected by prolonged exposure to loud noise and the process of aging.

Who Needs Speech-Language Pathology and Audiological Services?

Speech-Language Pathology is used to help:

* Individuals with voice disorders to develop proper control of their vocal and respiratory systems
* Individuals who stutter to learn to cope with the disorder and increase fluency
* Individuals with aphasia (a condition in which an individual has difficulty expressing thoughts and understanding others) as a result of a stroke or head injury. Speech-language pathology helps individuals relearn language and speech skills.
* Children and young adults with language disorders

Audiological services are used to:

* Determine existence and type of hearing impairments
* Provide rehabilitative services
* Assess amplification devices, such as hearing aids
* Teach individuals ways in which they can make the best use of their remaining hearing

Speech and hearing therapists, recognized as speech-language pathologists and audiologists, who provide treatment are professionally trained specialists holding master’s degrees or the equivalent from programs accredited by an Educational Standards Board of the American Speech-Language-Hearing Association (ASHA).

Some speech-language pathologists and audiologists hold doctoral degrees and work as teachers, advisors, researchers and consultants. Some specialize in certain areas, such as aphasia or hearing disorders in children, or participate in prevention and early identification programs.

Speech-language pathologists who use the initials “CCC-SLP” after their name have passed a national examination administered by the Clinical Certification Board of ASHA. Audiologists who pass a different national test, administered by the board, receive a Certificate of Clinical Competence in Audiology and qualify to use the initials “CCC-A” after their name. A person who meets requirements in both professional areas may be awarded both certificates.

Individualized Treatment Plans

A speech-language pathologist evaluates a person’s speech-language skills, determines the probable cause and extent of any existing disorder and develops appropriate treatment to correct or lessen the communication problem. Clinical methods used depend on the nature and severity of the problem, the age of the client and the client’s awareness of the problem.

An audiologist, after evaluating a person’s hearing and determining the type of hearing loss, establishes a treatment plan. This may involve therapy, prescription of special equipment such as hearing aids and electronic communication devices and referral for possible surgery or medication.

Easter Seals and Autism ServicesSocialTwist Tell-a-Friend

Thursday, August 20, 2009

Wednesday, August 19, 2009

The Face

Parts of the body - eyes, nose, mouth

by Dorothy E Ross PhD CCC-SLP
The FaceSocialTwist Tell-a-Friend

Newsman Bob Woodruff's Biggest Story Is the Environment

An exclusive interview with the host of Planet Green's Focus Earth series.

bob woodruff journalist of planet green focus earth

In January of 2006, Americans were horrified to learn ABC's World News Tonight anchorman Bob Woodruff suffered grave injuries from a roadside Iraqi bomb. His severe brain trauma forced doctors to put the award-winning journalist into a medically induced coma for a month; shrapnel was lodged in his face, neck and back, and his skull was shattered. No one could say whether the 44-year-old father of four would walk or talk again.

Three years earlier, another high-profile media personality (and Woodruff's close pal), 39-year-old NBC news correspondent David Bloom, died from a pulmonary embolism during the initial Iraq invasion. Of course Bloom's death was mourned, but by the time Woodruff was injured, Americans were decidedly mixed about being in Iraq and distressed over the thousands of wounded and dead soldiers. For many, Woodruff's plight became personal. "He put a face on the injured," Paul Rieckhoff, executive director of the Iraq and Afghanistan Veterans of America, told the New York Times, calling Woodruff "the most visible wounded person in this war."

For months Woodruff defied expectations and fought his way back from extensive neuro-damage. A little over a year later, he was back on ABC News, reporting about his recovery and profiling soldiers with traumatic brain injuries. The only remnant of Woodruff's multiple injuries is mild aphasia, occasional difficulty finding the appropriate word. But that hasn't stopped the intrepid newsman from tackling the global climate change battle.

Besides continuing as an anchor for ABC News, last year Woodruff launched "Focus Earth," a weekly series on the 24/7 eco network Planet Green. "I tried for so many years to do more stories on climate change," Woodruff tells The Daily Green. "It hasn't been an easy topic to get on the news, but now you're seeing a huge outpouring of these stories." The eco-warrior continues: "I covered wars for so many years, but what happened to me means I'm still doing the international reporting, which I'm addicted to, but just not in war zones. Now it's environmental reporting."

And this new beat hasn't cramped Woodruff's travel itinerary. When we talked, he'd just returned from Indonesia, where he covered a story about garbage dumping in the oceans and deforestation. Just this past year, he trekked to Kenya, the Galapagos Islands, the Arctic and all across the United States, including West Virginia's coal country and his hometown Detroit. "Because of the Internet and media, we are now connected more closely than ever before," Woodruff says.

Newsman Bob Woodruff's Biggest Story Is the EnvironmentSocialTwist Tell-a-Friend

Used~Workbook For Aphasia ~ Book ~ Speech Therapy

Used~Workbook For Aphasia ~ Book ~ Speech TherapySocialTwist Tell-a-Friend

Aphasia NYC Blogger: Bear Mountain Trip Cancelled


Unfortunately, we had to cancel the trip because of some logistical issues that could not be solved. We apologize for the disappointment and inconvenience and hope you are having a good summer.

Avi Golden
Helen Rubinstein
Aphasia NYC Blogger: Bear Mountain Trip CancelledSocialTwist Tell-a-Friend

Tuesday, August 18, 2009


Names of parts of the body

by Dorothy E Ross PhD CCC-SLP
BodySocialTwist Tell-a-Friend

Actions General

Action words - fix, drive, carry

by Dorothy E Ross PhD CCC-SLP
Actions GeneralSocialTwist Tell-a-Friend

Monday, August 17, 2009

Actions body noises

Action words - cough, burp, sneeze

by Dorothy E Ross PhD CCC-SLP
Actions body noisesSocialTwist Tell-a-Friend

Sunday, August 16, 2009

Who Do You Want To Hire At A Record Store. An Aphasic Person Or Someone Who’s Not?

Saturday, August 15, 2009
By FindAJob

I had applied for a job at a record store, but I was rejected because of my disability in speech and communication(aphasia). After leaving the store, I heard them called me crazy, retarded, and dumb. Months later, few people got arrested for theft at the store. The ones arrested were the assistant manager and the one person who applied an application at the same time I applied one. In addiction, he had drugs in his system. I kind of laughed about it because it was something that goes around comes around. Sometimes it’s was for the best because something more had waited where I can do more with my art work and an occupation of working at an office as one of the Dean’s assistant where I can go places.
Who Do You Want To Hire At A Record Store. An Aphasic Person Or Someone Who’s Not?SocialTwist Tell-a-Friend

Friday, August 14, 2009

Actions of the eye and hand

by Dorothy E Ross PhD CCC-SLP
Actions of the eye and handSocialTwist Tell-a-Friend

Knowing risk factors, warning signs of stroke

Knowing the risk factors and recognizing warning signs are important if people want to prevent strokes or minimize the damage it can cause.

By: Ruth Nerhaugen, The Republican Eagle

Knowing the risk factors and recognizing warning signs are important if people want to prevent strokes or minimize the damage it can cause.

A stroke is a brain injury that occurs when the blood flow in the brain is interrupted. Strokes are the nation’s No. 3 killer and a leading cause of disability.

“We know what the risk factors are,” said Dr. Jack Alexander, chief medical officer at Fairview Red Wing Medical Center. If symptoms are noted, testing is available to assess an individual’s situation.

For example, he said, a patient may be worried about symptoms such as TIA — transient ischemic attacks or “mini strokes” which produce symptoms of a stroke but have no lasting effects.

“We can do a carotid artery analysis” to determine if the person is at high risk of a stroke, he said. Surgery is an option if the warning signs indicate it is needed.

The medical community has a good handle on identifying people who are at high risk of stroke, Dr. Alexander said — such as people who are diabetic, have hypertension, smoke, or experience atrial fibrillation.

Atrial fibrillation is an irregular contraction of the heart rather than a steady beat, he said. “The small blood vessels in the heart can break off,” making the patient at higher risk. Physicians often prescribe blood thinners to lower that risk, he said. “It’s quite effective with relatively little impact on your life.”

People should know those risk factors and what they can do about them, such as work to reduce high cholesterol or lower blood pressure, he said.

“We’re much more aggressive in treating strokes when they occur,” he added. The first three-hour period is critical. Clot-dissolving medication can be administered during that time period which can reverse any damage, Alexander said — even if there are severe symptoms such as paralysis or aphasia.

“The critical thing is the countdown. Know the signs” that a stroke is occurring and act quickly, he stressed.

Stroke survivors

Fairview provides rehabilitation services to people who have had strokes, including physical, occupational and speech therapy.

In addition, a stroke support group is available locally. It is sponsored by the Red Wing Area Seniors and Fairview Red Wing Medical Center.

Monthly meetings of the support group are open to all stroke survivors, their friends, family and caregivers. People talk about their difficulties and their recoveries as they share stories about living after a stroke.

“Understanding is one of the biggest difficulties stroke survivors face,” Fairview officials said. Other difficulties may include personality change, impaired communication or some paralysis. Many difficulties can be overcome with therapy, but some changes are permanent and the stroke survivors and their families must adapt.

“Our brains don’t work the same way they used to,” said one survivor. Another said, “What you used to be able to do; now you can only dream about.” Yet another, “Our friends don’t understand, they treat us differently.”

Sharing coupled with encouragement and problem-solving is common at the support meetings.

Deb Howard, speech language pathologist at Fairview Red Wing Health Services, facilitates the group. “My mom had strokes and I know how it affected our family. Having a group that understands what you are going through makes a big difference,” Howard said.

Knowing risk factors, warning signs of strokeSocialTwist Tell-a-Friend

Thursday, August 13, 2009

How has traditional aphasia treatment failed the 1.25 million residents of the US and Canada who have aphasia?

Happy Father's Day to all of our clients, subscribers, caregivers and professionals who are fathers.

Self-Help Aphasia Group Meetings:

6/30/09 Cleveland, OH

7/9/09 Monroeville, PA

7/8/09 Conway, PA

8/13/09 Northern VA

Planned Presentations:

2/10 The Kentucky Speech, Language and Hearing Convention

Groups are being planned for OH, MD, WV and VA. For information contactinformation@aphasiatoolbox.comor call 724.494.2534


Visit to read about the success that Paul Berger of VA has achieved with our program. Paul has been working with us on his speech and language for 6 months. He has been chronicling his progress and amazing story in his newsletters. Paul practices 2-3 hours each day taking advantage the Aphasia Sight Reader program , for online sessions and email for ongoing feedback and practice monitoring. Despite being 22 years post stroke, Paul and Bill have been able to accomplish remarkable improvements in Paul's communication skills noticed by many of his friends and family. Let Paul tell you his story at . The book that he published tells his personal pathway of recovery in poignant detail. Be sure to register for his free newsletter which every month presents interesting and useful information.

Announcing the Satellite Offices - Ohio and Virginia

We are pleased to announce that we are working with patients at our Northern VA and Northern OH offices now in addition to our home base in PA. To schedule a first consultation with Bill Connors contact him at 724.494.2534 or .

We have also expanded our online treatment program to residents of Alberta, Canada and Greece.

The fact that 1.25 million residents of Canada and the USA continue to suffer the independence-robbing, socially isolating effects of aphasia and apraxia gives rise to the question, "How has traditional aphasia treatment failed?" Despite the millions of dollars spent on awareness, research, and treatment, the data shows too often that only nominal and limited movement toward real progress for these people and the millions of caregivers and loved ones.

We have identified twelve reasons why traditional aphasia therapy has failed so many:

1. The treatment program has invested in approaches that either don't work or are too slow in achieving results.

2. The treatment program lacks faith and give up too quickly on the patient.

3. The treatment program blames the patient with comments like, "You have reached a plateau."

4. The treatment program focuses treatment on data not mental processes. The question should be, "Who's doing the thinking and who's doing the talking during therapy?". It must be the patient who is doing the thinking and talking for meaningful progress toward return of conversational skills..

5. The treatment program fails to collaborate causing the patient to lack resources at discharge.

6. The treatment program fails to go beyond the clinical evidence and research.

7. The treatment program fails to recognize that "Aphasia is different for everybody." and therefore applies cookie-cutter activities.

8. The treatment program fails to provide for ongoing, self-help practice after discharge using innovative tools with caregiver training.

9. The treatment program fails to use innovative tools and materials.

10. The treatment program relies on imitation and external cuing [ for example: "Read this."; "Finish this sentence."; "Name this picture"; "Watch me and do what I do." "Look in the mirror." ] instead of having the patient work from his/her own memory and thoughts building from the normal, propositional brain pathways.

11. The treatment program fails to revolve everything around speaking.

12. The treatment program fails to address the cognitive underpinnings of speech such as verbal working memory; focused, selective, sustained and alternating attention; and effective mental resource allocation.

If you want to know what truly does work, stay tuned for our next newsletter. Discover how so many of our patients and clients have made such real progress toward conversing, reading, writing and talking again. Find out why years since the stroke and a patient's age are not critical factors in aphasia recovery. We will be sharing details on how to make every therapy activity truly therapeutic and how to get the patient practicing hours each day.

Too eager to wait? Contact us at or call 724.494.2534

How has traditional aphasia treatment failed the 1.25 million residents of the US and Canada who have aphasia?SocialTwist Tell-a-Friend

Wednesday, August 12, 2009

DynaVox Xpress Handheld Communication Device

August 12, 2009

dyna xpress 300x191 DynaVox Xpress Handheld Communication DeviceThe Xpress is the worlds most powerful augmentative communication device according to DynaVox, it’s creators. The unit is a handheld device that allows people to communicate more efficiently. It is designed for mobility and works well for those with, Stroke/Aphasia, Autism, Down Syndrome, Traumatic Brain Injury, Amyotrophic Lateral Sclerosis (ALS) or Motor Neuron Disease (MND), Apraxia of Speech.

On the technical side of things it has 2 battery options which can provide either 3.5 hours with swappable batteries or a single 8 hour battery for longer periods of use. Power management features are also included to help extend the battery life more. The case is made of Magnesium to prevent cracks and breaks if dropped for example. To further the dropping thing an 8GB flash memory module is included to prevent damage if dropped unlike a harddrive which potentially could be damaged. The front panel is made of glass to be resistant to scratches and water damage.

For full details of what the device can do and what it can be used for, check out the product page over at DynaVox. No details on pricing or availability are known just yet.

DynaVox Xpress Handheld Communication DeviceSocialTwist Tell-a-Friend

FREE memory workshop

NYC aphasia community a FREE memory workshop being held at my facility next Monday, August 17, 2009.

Attached please find the flyer. MemoryWorkshop.pdf

Marissa A. Barrera, MS, CCC-SLP

Chief, Speech-Language Pathologist

Raymond Naftali Center for Rehabilitation

508 West 26th Street, 10th Floor

New York, NY 10001

Phone: 646.230.9292

FREE memory workshopSocialTwist Tell-a-Friend

Tuesday, August 11, 2009

How Speech-Language Therapeutic Intervention Can Help After a Stroke

by Mona Greenfield, PhD, LCSW, CCC-SLP
Published: at August 10, 2009

After a stroke, there may be areas of speech-language-cognition and/or swallowing affected. Difficulties can be experienced with

processing information, producing fluent speech, word finding (anomia), use of complete sentence structure (agrammatism), reading, writing, memory, organizing information, performing motor aspects of speech production (dysarthria) and volitional production of oral tasks and/or volitional sequencing of speech sounds, words and ideas (apraxia) and a range of feeding/swallowing concerns. A complete speech-language evaluation is recommended to identify areas of strengths and weaknesses. This is the beginning of the road to recovery. This process can be a lengthy and frustrating path. Therapy with continued stimulation and support are crucial to the improvement of communication skills.

There are many ways in which speech-language therapy can be helpful. When you are able to realize where you are at right after your stroke and the gradual improvements (although oftentimes not feeling as if this is enough), you will become aware of how this rehabilitation process is working. Individual and group therapy is beneficial. Individual therapy can help with specific difficulties and include drill work, conversational work, and memory work. Group therapy can also address these areas of difficulty as well as the opportunity to practice these skills in a real life context. When interacting with a group, the benefits of support from therapists and other group members, use of strategies learned in individual therapy sessions and new learning or relearning through group activities can help the therapeutic process.

In therapy, a range of strategies can be used to facilitate optimal communication. Music and singing, prompting and cueing using alphabet letters and/or sounds, associative description of items/people/places and scripts (written conversations) may all help with retrieving words and expressing feelings, thoughts and ideas. Alternative and augmentative communication may also be indicated as a support when verbal communication is extremely difficult. This includes communication books/boards and devices which can help with communication using picture/symbols, words and phrases to communicate needs and express ideas and feeling. It is important to be an active participant in conversation.

The recovery process takes times and patience. Changes in both processing information and expressing needs, wants and thoughts can continue to improve even years post stroke. Continued stimulation through speech-language therapy and groups are important both for working on skills (word finding, reading, writing, expressive language, comprehending and organizing information, memory and new learning) as well as for continued support. It is important to “hang in there” as skills are slowly regained and progress is made.


Posted via web from Aphasia NYC's posterous

How Speech-Language Therapeutic Intervention Can Help After a StrokeSocialTwist Tell-a-Friend

Thursday, August 6, 2009









TRIP TO BEAR MOUNTAINSocialTwist Tell-a-Friend

MedicAlert Member News

MedicAlert Member News Header
MedicAlert® Member News | August 2009
Feature Story

August is National Immunization Awareness Month Sunscreen

August is the perfect time to remind family and friends to catch up on their vaccinations. Parents are enrolling their children in school, students are entering college, and healthcare workers are preparing for the upcoming flu season.

Why are immunizations important?
Vaccines offer safe and effective protection from infectious diseases. Vaccines have eradicated smallpox, eliminated wild poliovirus in the United States and significantly reduced the number of cases of measles, diphtheria, rubella, pertussis (whooping cough), and other diseases. By staying up-to-date on the recommended vaccines, individuals can protect themselves, their families and friends from serious, life-threatening infections.

Who should be immunized?
Getting immunized is a lifelong effort regardless of age, gender, race, ethnic background, or country of origin. Recommended vaccinations begin soon after birth and may continue throug adulthood. Being aware of the vaccines that are recommended for people of all ages, and making sure that we receive these immunizations, is critical to protecting ourselves and our communities from disease.

When are immunizations given?
Because children are particularly vulnerable to infection, most vaccines are given during the first five to six years of life. Other immunizations are recommended during adolescent or adult years. For certain vaccines, booster immunizations are recommended throughout life. Vaccines against certain diseases that may be encountered outside of the U.S. are recommended for specific regions of the world.*

Check the Centers for Disease Control and Prevention website for more information about immunizations, including an Adult immunization schedule and the Childhood and adolescent immunization schedule.


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Offer ends August 31, 2009. Discount cannot be combined with any other offer.

MedicAlert News

Increase the Impact of Your Gift to MedicAlert Today!

Do you want your charitable gift to MedicAlert Foundation to go even further? Check with your Human Resources department to see if your employer matches donations to nonprofit organizations like MedicAlert Foundation. While most employers match gifts dollar for dollar, some even double the donation. For example, your gift of $50.00 could be turned into a $100.00 donation to fund MedicAlert's lifesaving mission!

Contact your Human Resources department today and ask for a matching gift form. The specific guidelines for the matching gift amount vary with each company. Fill out your portion and return it along with your contribution to:

MedicAlert Foundation
P.O. Box 819012
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Monday, August 3, 2009

OpenID - All emails

All emails are available when:

Follower or Comment with OpenID
OpenID - All emailsSocialTwist Tell-a-Friend

Know the Symptoms of a Stroke

by Dorothy E Ross PhD CCC-SLP
Published: at August 2, 2009

Why is it important to know the symptoms of a stroke?
Twenty years ago, if you had a stroke, there was no treatment available. Doctors could only help you with the after effects. They could not help the stroke itself. At that time, if you had a stroke, there was usually no rush to go to the hospital. You might call your doctor, and he would make an appointment to see you in two or three days.

What can help a stroke?
Now there is a drug that will help lessen the effects of a stroke. This drug is called t-PA. This drug can be very effective in making strokes less severe.

However, in order to work, t-PA has to be given within 3 hours of the beginning of the stroke. Before t-PA can be given, you have to have tests to make sure that the treatment will be effective. In order to allow time for the whole process, you need to arrive in the hospital within one hour of the beginning of the stroke. Currently, only 3-5% of people who have strokes arrive at the hospital in time to receive t-PA.

What are the symptoms of a stroke?
Everyone should know the symptoms of a stroke. There is an easy to remember acronym to remember the main symptoms – FAST
F – Facial weakness, especially on one side
A – Arm weakness
S – Speech is slurred, or the person is unable to speak
T – Time is critical, go to the hospital!

Besides the symptoms just mentioned, there are many more symptoms that can indicate a stroke. Since the brain controls all the body functions, a stroke can affect almost any body function. Any sudden change in your abilities could be a stroke.

Some of the most common other symptoms are "HaVe BeeF"
H - Headache
V- Visual problems
B- Balance problems
F- Falling

If you think you having a stroke, tell the 911 operator and emergency workers so that they can get you help faster.

This is my own original article, that I wrote myself. Feel free to use it in any way you like. Let me know if you think it needs any changes for your purposes.


Posted via email from Aphasia NYC's posterous

Know the Symptoms of a StrokeSocialTwist Tell-a-Friend

Saturday, August 1, 2009

Aphasia NYC Blogger: Research Project Aphasia Therapy

Aphasia NYC Blogger: Research Project Aphasia Therapy

The aphasia therapy project will take place at the NYU Speech Pathology Dept at 665 Broadway, 9th floor. It is near W3rd St in the Washington Square Park area of NYC. I hope to begin ASAP, as soon as 4 participants can be found.
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