Do you want to see improvements in communication or swallowing, to increase independence and quality of life?
Although a stroke will leave many people with some level of communication or swallowing difficulty, in the days and weeks after the stroke there is usually some spontaneous recovery, although the amount varies from patient to patient as no two strokes are identical.
Speech and Language Therapy can help to speed the process of recovery up and try to keep improvements being made for longer; this is done by working on specific goals and areas of treatment identified with the patient. Because of the “plastic” nature of the brain, meaning that it is sometimes able to find or make new connections, it is possible for the brain to create new paths and so avoid the damaged areas caused by the stroke. Although early treatment is very important in helping to recover abilities lost through impairment, there is increasing evidence that gains can be made many years post stroke.
Aphasia (sometimes called dysphasia): This is an impairment in the ability to process language; it can affect language coming in (receptive language) or language going out (expressive language). There could be problems with;
- Receptive language (understanding) – affecting reading or the ability to understand speech
- Expressive language (creating a message) – word finding problems where the person can’t access the word or says the wrong word, sentence construction, speaking, or writing difficulties
How speech therapy helps aphasia:
- Therapy is provided at a level that is right for you
- Practical advice is given on coping with the communication difficulty
- A tailored programme of exercises works on both impairment and functional goals
- Treatment is based on your priorities
- A realistic prognosis is provided as soon as possible
Apraxia (sometimes called dyspraxia): Is a motor programming difficulty that affects speech; the signals from the brain to the muscles involved in speaking are interrupted or blocked. This can result in inaccurate production of speech sounds and words, making it harder for other people to understand what is being said. Speech can also be slow due to the time taken to produce individual sounds. Patients with apraxia often also have aphasia.
How speech therapy helps apraxia:
- Exercises to facial muscles
- Practising saying automatic speech e.g. name, days of the week, months of the year
- Everyday words and phrases are identified and worked on intensively to improve speech
- Drills of specific sounds, clusters or words can help to increase word length
- We aim to improve your self-monitoring of speech
- Use of visual aids and computer packages so that you can practice independently
- Working toward reading aloud and conversational speech
Dysarthria: Dysarthia is where the physical movements of speech are impaired. This can make the speech sound different (eg slurred, or too nasal), it can also make it hard for other people to understand what is being said. Treatment for this often consists of various physical exercises of the speech muscles, and development of strategies to improve the quality of speech.
How speech therapy helps dysarthria:
- Assessment of breathing for those who have reduced or disordered breath support for speech
- Voice exercises targeting quality or volume of voice
- Strategies to improve articulation of specific sounds and clarity of your speech
- Exercises to facial muscles to build up the strength, speed and range of movement
- Working on pacing, stress, intonation and pausing can help
- Exercises to put strategies into practice
- Speech recording of your speech can help identify progress and support self monitoring
- Natural and intelligible speech is the aim of treatment
Dysphagia: Dysphagia is a disorder of swallowing affecting the mouth, throat and oesophagus. Many patients have dysphagia in the early stages following a stroke, and this needs to be managed so that food and drink do not enter the airway and cause chest infections.
Please see the swallowing page for further information.
I am an experienced speech and language therapist, with my own private practice in central London who has helped many people to improve their communication after a stroke. Please contact me if you have any questions, or if you would like to discuss any issues.