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Tuesday, August 11, 2009

How Speech-Language Therapeutic Intervention Can Help After a Stroke

by Mona Greenfield, PhD, LCSW, CCC-SLP
Published: aphasianyc.org 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.

MG:AM

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