Picture of Dr. Jorri HendersonAuthor: Jorri Henderson, SLPD, CCC-SLP

I dedicate this article to my uncle, Lawrence Smith, who, after multiple strokes and loss of speech and language, passed in 2018.

Speech therapist caseloads may include communication disorder caused by a stroke – aphasia. There may often be a lack of knowledge, attentiveness, and training across staff and administration regarding people with aphasia (PWA) in the medical field..

People with Aphasia (PWA)

PWA experience a significant loss when the language function is disrupted, yet may retain non-linguistic cognitive skills, such as executive and memory function (however, these skills and others might concurrently be affected by language loss).

Difficulties that these patients encounter may include problems with speaking, listening, reading, and writing, while basic intelligence and awareness remain unaffected. Quality of life is also reduced when individuals are unable to engage with others, understand what is being said, navigate the environment, or express emotions.

Picture of man with a stroke.

© 2018 Rector and Visitors of the University of Virginia

Augmentative Alternative Communication & Recovery Support

Whether a full or partial recovery is predicted, augmentative alternative communication (AAC) devices have been useful to support language recovery or to serve as a primary means of communication. AAC strategies may include drawing or gesturing instead of talking and writing and may include low-level or high-level technology. Low-level technology might incorporate such things as a wallet containing key phrase cards or a small bulletin board displaying multiple words. Both options allow the PWA to point to a word or group of words to communicate.  Hi-level technology might incorporate a laptop or tablet as external communication aids, such as the Proloquo2 app that uses symbols to allow patients to communicate.

PWA Recovery Essentials

PWA can range from mild to severe in having a receptive and/or expressive language deficit that may result in communication challenges regarding basic medical needs and wants. To help these individuals, it is imperative to educate and remind all medical staff and families of patients to make sure they speak clearly to them, take things slowly, write things down, and give extra time. It is also important to teach medical staff and families about the benefits of AAC technologies to restore communication and increase participation in routines of daily life – medical staff and families are influential in promoting acceptance of such devices by post-stroke patients.

PWA Research at RMUoHP

During my time at Rocky Mountain University of Health Professions (RMUoHP), I conducted research on AAC strategies, which has been accepted as a poster presentation at the American Speech-Language-Hearing Association Connect Conference 2019 in Chicago. The purpose of the study was to examine the effectiveness of a low-tech device compared to a high-tech device for adults over the age of 50 years with expressive aphasia in communicating functional information. The findings were that an increase in communication occurred using both low and high-tech devices. The study found that younger participants favored the high-tech tablet, whereas the older participants preferred the low-tech communication board. Both patients demonstrated improvement. Based on my findings, I use both a low- and high-tech devices when conducting therapy sessions, depending on the individual cognitive function.

The Future

As healthcare professionals, we need to continue to educate and help medical staff, administration, and families regarding functional communication – the successful communication through non-verbal, spoken, and/or written modalities within their daily interactions. Through attentive, supportive care and improved communication, the PWA may sooner express needs and exert some independence in communication, decreasing the likelihood of negative consequences of language loss.

If you are interested in contacting Dr. Henderson for more information on her research you can email her at [email protected]. Learn more about our Doctor of Speech-Language Pathology program visit our website at https://rm.edu/academics/doctor-speech-language-pathology/

Bio: Dr. Henderson is a native of Chicago and she graduated with her master’s from Southern University A&M and doctor of speech-language pathology from Rocky Mountain University of Health Professions.