To continue our series, I'd like to introduce aphasia myth #4, which has to do with progression or regression in aphasia. I hope that when you receive speech or other therapies that you have experienced some progress in your skills. This is, after all, the whole point of attending therapy. I want to address a misconception about a patient's skills after he has completed therapy. People will often say to me that they don't want their loved one to "get worse" by not attending therapy.
The idea of "use it or lose it" is generally true in most of life, and can apply to aphasia as well. What this adage means is that if you don't continue to work on and use the skills you've learned, you will see a decrease in those skills over time. In this scenario, you could conceivably "get worse" because you have fallen backwards from the improvement you were making while in therapy. If you imagine a typical line graph, you start at some low number and then the line goes upwards as it travels over time to the right of the graph. There may be some zigzagging and up-and-down movement in which some days are better than others in this progression. No matter what you do, however, you will never return to zero. Zero represents you the day of your stroke or immediately afterwards. If you receive therapy and start to heal the brain injury from your stroke, you will not remain at the baseline of when you had your stroke. Therefore, you will not ever "get worse" in the sense that you will be the same as you were that day or week.
The idea of aphasia recovery would be to continue to make progress, moving that imaginary line upwards and outwards over time. Rest assured that every bit of effort that you put in to your recovery will count over time. Keep working!!