Speech Therapy After a Stroke – Aphasia

Can Aphasia Therapy Help?

The days following a stroke are often challenging as the brain heals and physical, cognitive, and communication abilities may improve on their own. Speech therapy can enhance this spontaneous recovery to make life more manageable for those who have experienced an injury or illness.

The Speech-Language Pathologist (SLP) is there not only help with improvement of everyday communication abilities but also provide support through rehabilitation which will last long after speech therapy for expressive aphasia has ended.

Aphasia therapy can focus on teaching people after a stroke with strategies to overcome communication issues such as problems understanding or producing speech correctly (aphasia), slurred speech due to weak muscles (dysarthria), and/or difficulty in programming the muscles of the mouth for speech production (apraxia). Some people might also have issues with social communication,  like taking conversational turns or problems maintaining a topic of conversation.

Many stroke patients have difficulty speaking or understanding words. To improve their ability, speech therapists will work on specific strategies to help them with word retrieval skills as well as conversational abilities such a role playing which is very effective at teaching social cues required for speech production.

If dysphagia occurs due the injury from stroke, there are many therapeutic interventions available that can be used including exercises designed just for this situation.

Can Speech Therapy Online Help with Aphasia?

Speech therapy for aphasia is very helpful and can target the following communication goals:

• Improving finding words or getting the words out
• Understanding others better
• Problems reading, writing or math
• Process long or unfamiliar words

As a caregiver or spouse to someone who is struggling with aphasia it can be disheartening and frustrating when your loved one cannot communicate. They might struggle for words in social situations where others may think they know what’s going on because of their lack of functional speech production abilities.

However, there are effective treatments available, as well as many ways to get involved and help someone overcome their communication obstacles.

As a person living with aphasia, you deserve to be informed. The best way for everyone in your life – from friends and family members, to friends visiting to nurses helping you heal, is that they have all the information necessary before working together as a team to lead the person with aphasia towards successful treatment outcomes.

Included below are some common questions about Aphasia paired up with detailed answers so there’s no need go searching elsewhere.

What is Aphasia?

Aphasia is a language disorder that impacts one’s ability to communicate. Often it happens due to a stroke that occurs in the part of the brain that controls speech and language (about 25-40% of stroke survivors acquire aphasia). And it can also be caused by any type of brain damage like brain tumors, head injuries, brain disorders, or other neurological disorders like Alzheimer’s disease.

Aphasia can occur suddenly, such as after a stroke, or it can develop more gradually as a result of a brain tumor or neurological disorder.

The severity of aphasia can vary dramatically. Some individuals are unable to communicate effectively, while others may only notice minor effects on their speech and reading abilities.

Aphasia can make it difficult for a person to speak, understand, read, and write, and the severity fluctuates dramatically.

Aphasia can affect one’s ability to string words together in sentences or recall the names of people and objects. It may also become hard navigating daily activities like mealtime because they cannot recall the name of the foods they want to eat, or if a person works they may have difficulty with the specific technical language they used to use.

People with aphasia are not any less intelligent than they were before – the difficulty lies in remembering information. It may be difficult for them to communicate, which is why some people find themselves struggling when trying to convey their thoughts and ideas effectively or contributing meaningfully during conversations; what was disrupted wasn’t necessarily that person’s intelligence itself but rather their ability to say what they are thinking.

What are the Different Types of Aphasia?

Here are a few types of aphasia and common symptoms for each type:

• Wernicke’s Aphasia: Results from damage to the temporal lobe of the brain; difficulty grasping the meaning of spoken words; can usually produce speech but sentences may not make sense; people may create made-up words. People with this type of Aphasia are often unaware of their mistakes. So listeners may have a hard time understanding what an individual is trying to say.
• Broca’s Aphasia: Results when the frontal lobe of the brain is injured; impact on how someone puts words together to make complete and understandable sentences. People with this aphasia may have decreased speech output, speak in short sentences that require effort to produce, vocabulary can be limited, and they can have a hard time forming intelligible sentences; sometimes they leave out small words like “is,” “the,” or “and.”
• Global Aphasia: The most severe form of aphasia; due to extensive damage to portions of the brain; people with this aphasia can have severe communication issues: they may say only a  few meaningful words, understand hardly any spoken language, and are not capable of reading or writing. They may also repeat a few words or phrases over and over.

Diagnosis of aphasia is needed by a physician or speech-language pathologist who can help identify what type of aphasia someone is presenting with. There are several other forms of aphasia and each has treatment options that are best for that type.

Is Aphasia different from Dysarthria and Apraxia of Speech?

Yes it is different, and a correct diagnosis will impact how therapy proceeds.

• Apraxia of Speech: This can also occur due to brain injury like a stroke and it can happen along with aphasia but it is different. Apraxia of speech impacts a person’s ability to coordinate the muscle motion needed for speech production like the lips and tongue. Apraxia decreases a person’s intelligibility and it is hard for people to communicate and form coherent sounds, phrases, and sentences. We have additional information on apraxia here.
• Dysarthria: This disorder can also occur after a stripe and also impacts the muscles needed for speech. People with dysarthria can have slow or slurred speech or have a hard time controlling voice pitch and volume. It creates a weakness or paralysis of muscles people with dysarthria can drool or have problems taking in enough air to speak properly.

Is Aphasia Common?

The National Aphasia Association, reports that as many as two million Americans have aphasia, and almost 180,000 Americans are diagnosed with the disorder every year. Therefore it is more common that Parkinson’s disease, cerebral palsy, and muscular dystrophy.

Are there Common Symptoms of Aphasia?

American Speech-Language-Hearing Association (ASHA) lists some of the most common symptoms of Aphasia.

Speaking:

• A hard time thinking of the right words
• Not including words or using the wrong word
• Using a related but incorrect word (e.g. saying “fork” when you mean “knife”)
• Substituting sounds in words (e.g., saying “bat” when you mean “cat”)
• Making up words
• Having a hard time using full sentences
• Saying sentences that combine real and made up words

Comprehension:

• Difficulty understanding what others are saying especially when listening to fast, long, complex sentences

Reading/Writing:

• Difficulty reading anything written (books, signs, text messages)
• Hard time spelling and writing sentences
• Using numbers or doing math

What does Aphasia Therapy Look Like?

Our speech therapists work with the person with aphasia and their family and caregivers, to create an individualized treatment plan. The strategies and techniques your assigned speech therapist will use and the goals for treatment will depend on the client and their specific life circumstances.

Some speech therapy sessions may include:

• Name pictures, repeat sounds or words to improve vocabulary skills
• Sorting words into categories to increase comprehension
• Practicing conversational skills like phone calls to improve the ability to use communication during social situations
• Using alternative strategies like simple hand gestures, writing, pointing to letters and pictures, or using a computer or electronic devices to help communicate until the symptoms of aphasia decrease or as compensatory strategies if aphasia is severe. This also temporarily helps caregivers communicate with their loved one. This is referred to as augmentative and alternative communication, or AAC. 

Tips for Speaking to Someone with Aphasia

Caregivers, spouses, or family members of someone with aphasia need help too.

Here are some tips to help communicate:

• Use short, simple sentences that are easy to follow with minimal processing
• Speak slowly (not too slowly) and clearly
• Decrease background noise when speaking (TV, music)
• SPeak at a normal and consistent volume
• Give the person plenty of time to respond; pause often to let your loved one process what you said
• Pointing and gesturing to what you are referring to
• Ask simple, yes-or-no questions (e.g., “do you want pasta or chicken?”)
• Decrease complex, open-ended questions (e.g. “what do you want for dinner?”)
• Try to give clues for a word someone might want to say; you can write the word and see if they can read or give a sound cue like “t-t-t” for “tea”)

Benefits of Online Speech Therapy for Aphasia after a Stroke

Online speech therapy for aphasia is an effective alternative to more traditional, in-person settings. Instead of meeting with your speech therapist in person, you connect with them virtually through video chat. While you’ll continue to receive the same quality of care, online speech therapy is often much more affordable.

Many people with aphasia may have other co-occurring physical difficulties as a result of the stroke and cannot travel to a separate setting for treatment. So speech therapy online offers them the opportunity to get treatment from the comfort of their home.

This is one of the greatest advantages of speech therapy online with Therapy Works Together. Not only can you meet with a qualified certified speech therapist at the click of a button, and from the comfort of your home, but you can schedule sessions around your busy life – mornings, evenings, or weekends.

You are no longer limited by location or scheduling issues, and you can get access to the expert speech therapist you need.

How Can Therapy Works Together Evaluate and Treat All Ages Online?

Therapy Works  Together helps families connect online with a licensed and certified speech therapist that is a trained expert in diagnosing and treating a variety of speech, language and communication issues. Speech therapy is delivered online at home with video conferencing applications.

The age of our clients as well as their diagnosis and goals is important in determining how speech therapy online will be delivered.

Speech therapy for babies and toddlers: For kids age 0-3, we usually work on early communication skills like joint attention, social communication, or increasing language skills in late talking toddlers.

Parents work with their assigned speech language pathologist, usually in a parent coaching model, to learn tips and strategies that speech therapists use so they can be adept at practicing teaching their child after the session is over and at home. You can read more here about how important it is for parents to be involved in their child’s speech therapy at home.

Speech therapy for preschoolers: For kids age 3-6, speech therapists target age appropriate articulation, language delays, reading readiness and more. Parents join in for online video sessions with the child so that both learn the speech strategies and skills from the speech therapist. Learning how to use these skills after the session helps kids improve.

Speech therapy for school age kids: for children age 7 and up, speech therapists might work on academic skills, increasing vocabulary, social skills for kids with autism, stuttering and more. Children this age can come to online video sessions on their own. Our speech therapists keep parents informed by sharing tips and homework.

Speech therapy for adults: Adults attend speech therapy sessions online after becoming stroke patients, for stuttering, for accent modification and more. They come to sessions on their own from the comfort of their home or office. Often, they bring a caregiver or family members to learn strategies if they will need help communicating with others.