by Vincent M. DelGiudice, MSCCC-SLP
Speech-Language Pathologist

Speech Therapy Talks About Strokes

When someone in our family has a stroke, it can be a very difficult event. Of course, we want to make sure our family member is going to be okay, but sometimes it can be difficult to communicate with medical professionals. Listening to doctors, nurses, & other members of the medical team can be like listening to a different language.

In speech therapy, patient education is usually the first step, because by the time you get to us, you probably have plenty of questions. We are going to break down some of the terms you may hear discussed when you or a loved one has a stroke. Let’s start with a simple one.

CVA: A CVA or Cerebrovascular Accident is another word for a stroke. You can either have an Ischemic Stroke or Hemorrhagic Stroke. Ischemic means blockage and Hemorrhagic means a brain bleed.

In speech therapy, we work with the following impairments:

Dysphagia: Difficulty or inability to swallow. This can result in aspiration (food or liquid going down the wrong pipe) which can cause pneumonia.

Dysarthria: This is when speech sounds slurred due to muscle weakness or muscle incoordination.

Apraxia: This is a neurological disorder that results in a person’s inability to perform physical movements, whether it is speaking or moving one’s arms and legs. The person wants to perform the task but motor planning is impaired. In other words, the brain knows what it wants done, it just doesn’t know how to do it.

Aphasia: The loss of one’s language resulting in difficulty communicating. A person can have difficulty with speaking or understanding others. This usually results from damage to the left side of the brain.

Some other terms that you may run into outside of speech therapy are the following:

Hemiplegia: Total or partial paralysis of the body

Hemiparesis: Weakness on one side of the body

Quadriplegia: Total or partial paralysis of all of the limbs.

TPA: Tissue Plasminogen Activator, or TPA, is a drug used to break up clots in an artery. The drug will dissolve the clot to restore blood flow to the brain. This drug is only used if there is a clot, not if there is a hemorrhage.

TIA: Transient Ischemic Attack, or TIA, is when blood flow to a certain part of the brain is cut off for a short period of time, usually less than 15 minutes. A TIA is a warning sign that something is wrong, and it should be taken as seriously as a stroke.

Thrombus: This a blood clot that forms in a blood vessel in the brain.

Lability: When a person has emotional responses that do not coincide with the current situation.

Hyperlipidemia:  High Cholesterol

Hypertension: High blood pressure.

Endarterectomy: Surgical removal of plaque from an artery.

Stenting: Placing a small mesh tube in an artery during an angioplasty.

LTAC: Long term acute care.

Skilled Nursing Facility:  A facility that offers long-term care and rehabilitation with therapy such as physical, occupational and speech therapy.

The most important thing to know is what to do if we think a loved one or anyone is having a stroke. We use the acronym act FAST. FAST is an easy way to recognize the most common symptoms of a stroke.

Face: Ask the person to smile. Does one side of the face droop?

Arms: Ask the person to raise both arms. Does one arm drift downward?

Speech: Ask the person to repeat a simple phrase. Does their speech sound slurred or strange?

Time: If you observe any of these symptoms call 9-1-1 immediately. Acting quickly is important. Note the time when you began observing these symptoms.

If you or a loved one had a stroke, and communication or speech is a problem. Contact Vegas Voice Institute for speech therapy at 702-558-9900 so we may assist.

We provide speech therapy for patients having difficulty communicating or understanding others. Let us help you regain your communication.

by Vincent M. DelGiudice, MSCCC-SLP
Speech-Language Pathologist

Does someone you know have Aphasia? This isn’t a word we hear often. People usually only learn about Aphasia when it directly affects them or a family member. You may have met someone with aphasia and didn’t really understand what was wrong, but knew something wasn’t quite right. Here is a breakdown of what aphasia is and how we deal with it in speech therapy.

Aphasia most often occurs when someone suffers from a stroke, but it can occur when there is any type of brain damage such as a brain injury. A person with aphasia may have trouble understanding, speaking, reading, or writing. Aphasia DOES NOT cause a loss of intelligence or ability to think.
People with aphasia may describe it as knowing what they want to say but unable to form the words. It is similar to when you have a word on the tip of your tongue but can’t quite think of it. When someone is newly diagnosed with aphasia, it is important that they go to speech therapy to try and regain as much language as they can. The longer someone waits to go to therapy it decreases the chances of making progress.
If we break apart language into a couple different parts we can look at different symptoms of aphasia. Here are some of the symptoms we may look for in speech therapy.

Expressive Language (or talking)

• They can’t think of words.
• They use made up words.
• They have difficulty forming sentences; maybe using single words is easier.
• They may use the wrong word in a sentence. It may be a related word, like mixing up “river” and “ocean” or it could be unrelated such as replacing “chair” with “milk”

Receptive Language (or understanding)

• This is when there is difficulty understanding what others may say whether it be because they are talking to fast or because it is too noisy.
• A person who has difficulty understanding may have difficulty correcting their own sentences because they don’t hear or feel like what they are saying is wrong.

Reading and Writing

• Any difficulty reading whether it is with books, a form to fill out at the doctor’s office, or a grocery list.
• Difficulty with spelling or writing words in the correct order.
• Difficulty with using math for basic activities such as paying a bills or adding and subtracting.

In speech therapy, we treat all these impairments. We use communication-based and impairment-based strategies. Communication-based therapy focuses on the “now.” We look at ways to help communication now, so that our patient can communicate basic needs. Impairment-based therapy focuses on repairing the impairments that a patient may be suffering from. This include programs such as melodic intonation therapy.

There are certain strategies you should employ when conversing with someone with aphasia. It isn’t always easy to communicate with someone suffering from aphasia but there are ways that it can improve just by using some simple strategies.

Tips for communicating when someone suffers from Aphasia

1. Get the person’s attention before you start speaking.
2. Give them context or tell them the topic of what you will be discussing.
3. Speak slowly and be direct. Don’t speak loudly or yell, they can hear you just fine.
4. Maintain the topic that you are discussing. If you change topics, be sure to let your communication partner know.
5. Use visuals if necessary to help explain.
6. It may help to write things down if they are not having difficulty reading.
7. Try to ask questions that have “yes” or “no” answers.
8. Don’t finish their sentences, allow the person time so that they can express what they want to tell you.
9. Let the person make mistakes and let them try to fix them on his/her own. Wait until they ask for help before jumping in.

Aphasia is frustrating for everyone involved! Although humans are able to communicate, we all know that we aren’t always the best communicators. Work hard at being patient with someone who is having difficulty with communicating. It takes hard work to make sure that everyone’s wants and needs are being addressed. Look up a speech therapy office like ours at Vegas Voice Institute, to help you and your spouse, family member, or friend improve their ability to communicate with others!