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Helping Aphasia patients better communicate

Approximately 800,000 people have a stroke each year; about one every 40 seconds. Only heart disease, cancer, chronic lower respiratory diseases and accidents are more deadly. Strokes occur due to problems with the blood supply to the brain: either the blood supply is blocked or a blood vessel within the brain ruptures, causing brain tissue to die.

The lasting effects of a stroke can run a very broad spectrum, from the patient returning to a regular lifestyle to major complications including varying degrees of paralysis, neurological difficulties and communication problems. Stroke is the leading cause of aphasia, a communication disorder that results from damage or injury to language parts of the brain. Aphasia may also be caused by a brain tumor, brain infection or dementia such as Alzheimer’s Disease. After a patient suffers a stroke, a team of medical professionals usually get involved with the assessment to determine the specific areas of the brain involved and what follow-up treatment and therapies are necessary.

According to Marla Kovatch, M.A., a member of the Clinical Faculty in Marywood University’s Department of Communications Sciences and Disorders, a stroke or other injury to the language centers in the brain can lead to aphasia. While we take our communication skills for granted, there are numerous components to the communication process that give us the ability to understand others and communicate with them through forming words, putting sentences together, writing as well as understanding time and numbers including money.

The specific impairments can be so different and are approached in different manners. The major types of aphasia include:

• Expressive or non-fluent aphasia is when the individual knows what they want to say, yet has difficulty communicating to others either in writing or speech.

• Receptive or fluent aphasia occurs when the patient hears a voice or reads print but may not understand the meaning of the message. They may not even understand their own language.

• Anomic aphasia is when the patient has word-finding difficulties for both speech and writing.

• Global aphasia is the most severe form, and it is often seen right after someone has had a stroke. The patient has trouble speaking and understanding words and can also not read or write. This can improve if the damage from the stroke is not too severe.

A speech pathologist has a wide assortment of assessments and evaluations he or she will use as they meet with an aphasia patient to determine their strengths and weaknesses within the communications area. Do aphasia patients understand the words being spoken to them? Do they know the words they want to speak and can’t form them or perhaps the words are not coming to them. Perhaps words come out but might not make any sense.

Kovatch stressed that no two patients with aphasia are the same. Each is assessed and treated accordingly. The speech-language pathologist will meet regularly with a patient to increase his or her ability to speak and communicate. The therapist can also help develop alternative methods of communication that do not involve speech, which can help compensate for language difficulties. Unaided communication systems include gestures, body language and sign language. Aided communications can be as simple as word cards or pictures to electronics like hand held devices or computer that combines the use of icons on the screen and a generated voice.

Marywood University’s Department of Communications Science and Disorders offers a free weekly community support group for individuals who are at any stage in the recovery process. Mrs. Kovatch states, “our aphasia group encourages all affected by a stroke to come together in a warm and accepting environment. Through group discussion, organized language and literacy activities, we aim to encourage independence and to maximize speech, language and reading skills. Each member is paired with a graduate student clinician for individual appropriate support.

Kovatch believes that the support group offers a comfortable environment to both share frustrations and celebrate successes. It provides weekly practice of oral reading, reading comprehension, receptive and expressive language, and pragmatic skills. The emotional support the group provides can lead to uncovering hidden strengths and successful coping strategies in addition to maintaining current skill levels. The members are inspiring and encouraging role models for one another. The Aphasia Group has received national recognition; receiving the National Stroke Association Voter’s Choice Award in 2015 and in 2014 for the Most Outstanding Aphasia Group.

The meetings are held Mondays from 1 – 1:45 p.m. in the McGowan Building room 1066. The meetings are held throughout the year except for school breaks and holidays.

“The more quickly that a stroke patient is treated, the better the chances for recovery of speech and language problems as well as other physical concerns,” added the instructor. For those who have never had a stroke there is much that can be done to lower the risk. New guidelines from the American Heart Association and the American Stroke Association reinforce the fact that a healthy lifestyle is crucial.

The guidelines recommend that people:

Eat a Mediterranean of DASH-style (Dietary Approach to Stop Hypertension) diet with nuts added.

Monitor blood pressure.

Limit the levels of sodium in the diet.

Don’t smoke and avoid secondhand smoke.

The speech and language specialist also suggests that everyone become familiar with the acronym F.A.S.T. It’s a way to remember the signs of stroke, and can help identify the onset of stroke quickly:

Face drooping: if the person tries to smile does one side of the face droop?

Arm weakness: if the person tries to raise both their arms does one arm drift downward?

Speech difficulty: if the person tries to repeat a simple phrase is their speech slurred or strange?

Time to call 911: if any of these signs are observed, immediately contact emergency personnel.