Improving Communication

"I want him/her to talk!"
I was explaining our philosophy and our program to a prospective client the other day, and I heard these familiar words. Of course, it seems everyone's goal is to speak better--that's the hallmark problem of aphasia. However, we want to explain why using gesture and other multimodal forms of communication are so important. Speaking better and being able to use gesture, written words, or writing are all part of the same goal!

Communication is important, we all know that. But communication doesn't consist entirely of speech. If you've been having issues or frustrations because your loved one plays "20 questions" with you, then wouldn't it be nice for both of you to have alternative and augmentative systems of communication. Our goal is to reduce the amount of frustration for all parties involved, as well as to improve the communication pathways. If your loved one cannot say at the time "I want to get the boat cleaned" but can point to the boat or give you the number for the boat-cleaner, isn't this a good place to start?

What most people don't know is that by using these alternatives, or multimodal, forms of communication, comprehension and expression of language are improved for both the listener and the speaker. The person with aphasia may produce speech more quickly and easily when the gesture and verbal attempts are paired. For example, unable to say "toothbrush", the person with aphasia may make the gesture, then spontaneously produce the word while gesturing. Additionally, seeing the word "toothbrush" may cue the verbal production. This happens ALL THE TIME!

So please remember, your goals are our goals, we may just go about them differently. The end result, however, should be improved overall communication. This is what we're striving for!

Isolation in aphasia

Statistics show that persons with aphasia tend to be isolated from other persons with aphasia. This is the result of several factors, such as lack of area resources, lack of knowledge in the medical community about aphasia, and lack of direction from medical professionals before you are discharged from therapy. If you use Google or other search engines, you'll realize that there really aren't alot of information or resources out there. It's even rarer to find something near to your location. Family and friends may have slowly dropped out the social scene because they feel uncomfortable about interaction. So many times I hear that the person with aphasia is just sitting at home watching TV. This "activity" isn't helping anyone recover unless they are actively engaging in the process, which is hard to do with a TV.

If there aren't any aphasia support groups or aphasia centers in your area (check at www.aphasia.org), one solution could be to find support or treatment online. I have recently become acquainted with Bill Connors at the Aphasia Solutions Network (www.aphasiatoolbox.com), whose therapists have both group and individual sessions online. I tried it out myself today and found that there really isn't too much technological knowledge needed on my end. I speak with people all over the country who don't have the financial resources or perhaps the physical capabilities to attend our intensive program, and I think this may be an option. Especially for younger persons with aphasia, social isolation is devastating. The online groups would provide socialization while helping to improve the aphasia. Like our aphasia center, the ASN will work with your financial situation to provide affordable therapy. With all of the technology available today, there's no reason not to try it! Let me know what YOU think!
Lori

Testing and aphasia

When you are receiving speech therapy or other therapy services, your therapist will typically do a standardized test (a test that tells how well someone in doing in relation to other people who have the same problem) at the beginning to decide how severe the aphasia is and your strengths and weaknesses with language. Depending upon what kind of test is given, and there are only a few out there, your therapist may set goals based upon your performance on these tests. Typical goals produced in this manner will deal with auditory comprehension or verbal expression. Using the test to target weak areas is one school of thought, whereas the other school of thought is to use the test to show me your strengths. I prefer this approach because, through your strengths, I can help you target your weaknesses in one area while providing success in other areas. I already know that you have aphasia, and that you probably have difficulty with some test items. What I don't know is, what are you good at? For example, if you're good at writing single words, then we may use that in therapy to help you communicate your ideas.

A recent survey by the American Speech-Language and Hearing Association showed that not all outpatient therapists give discharge tests to show your progress. This is most likely to do with insurance reimbursement and lack of available time for the therapist. If you have received post-testing, it's important to keep the scores in perspective. I would caution that put too much emphasis on scores, whether good or bad, is confusing the issue. You could have great final scores and only be able to do the tasks that are on the test, such as being able to point to alphabet letters. You could get poor scores (let's face it, no one likes tests), but now be able to say "hi" to your friends and better follow a conversation. Most aphasia tests only give credit for verbal responses, meaning that if you drew, wrote, or gestured the answers, you don't get credit for it.
As always, demand that your therapist work on things that are important to you! Even I fall asleep doing those silly reading questions about aardvarks and such!