Speech therapy after a stroke
Posted on 27 June 2017
After a stroke, it’s very common to experience communication problems. Known as aphasia, the condition can affect the ability to speak, read and write. A Mediclinic audiologist and speech therapist explains how it is treated.
Mark Perronet* suffered a stroke that affected his speech. He presented with Broca’s, or expressive aphasia, which means the person knows what he wants to say but can’t find the words.
‘Mark was able to understand instructions and follow conversations, but couldn’t express himself,’ says Shamima Seedat, an audiologist and speech therapist at Mediclinic Newcastle.
Aphasia can affect the expression and understanding of language, as well as reading and writing – but a full recovery is possible.
How does a stroke cause aphasia?
A stroke occurs either when the blood supply to the brain is blocked or when a blood vessel in the brain ruptures. Both can cause brain tissue to die.
‘Aphasia is caused by damage to one or more of the language areas of the brain,’ explains Shamima. ‘For most people this is part of the left side of the brain.’
Shamima notes that aphasia may co-occur with speech disorders such as dysarthria (slow or slurred speech) or apraxia of speech (a motor speech disorder in which messages from the brain to the mouth are disrupted, and the person can’t move their lips or tongue to the correct place to say sounds correctly, even though the muscles aren’t weak).
How does speech therapy work for aphasia?
Speech therapy is the most common treatment for aphasia, employing a variety of exercises and techniques.
‘Aphasia therapy conducted by a speech-language therapist strives to improve the person’s ability to communicate. It helps them to use their remaining abilities to restore language abilities as much as possible, to compensate for language problems, and to learn other methods of communicating,’ Shamima explains.
She adds that family involvement is a crucial component of aphasia treatment, so that family members can learn the best way to communicate with their loved ones.
What is the duration and success rate of speech therapy?
These are difficult to measure, says Shamima, and are influenced by a number of factors, including the area of the brain that was damaged and the extent of the injury, as well as the age and health of the affected person. ‘To a large extent, recovery time is patient dependent, but it usually continues over a two-year period,’ she says. ‘A multidisciplinary team facilitates faster recovery.’
‘Speech therapists work closely with physiotherapists, occupational therapists, physicians and nurses,’ Shamima adds.
These and other professionals may use treatments including melodic intonation therapy (in which the patient sings words they can’t speak), art therapy, visual speech perception therapy (associating pictures with words), and some prescription medication.
What can you do at home to help a patient?
‘Maintain a natural conversational style, but try to simplify it somewhat by using short, uncomplicated sentences,’ Shamima suggests. ‘Include the person in conversations, giving them plenty of time to talk, and avoid correcting their speech.’
Following six months of intensive aphasia therapy and good family support, Mark is now able to express himself quite well.
*Name has been changed