Have Questions? Ask our Professional Of The Month: Audrey Holland, Ph.D., CCC-SLP BC-NCD .

Question:

I am looking for therapist for my father who is suffering from Aphasia. He has not had a stroke or a head injury, it seems to be simply a result of aging. He would like to try Melodic Intonation Therapy but his current therapist is not familiar with it. He lives in Seattle. Mentally and physically he is very sharp, still skiing and cycling at 82, but slowly his ability to speak continues to deteriorate. Does anyone know of a therapist in the Seattle area who does melodic intonation therapy for aphasia? Is there a software program or DVD he could use.

Any advice would be helpful. He his still mentally and physically vibrant but his speech problems cause much frustration and hinder his social interactions.

Thank you

Our Professional Answers:

It’s wonderful that you are reaching out and getting more information about therapy methods for aphasia for your father. He sounds like a great man! Melodic Intonation Therapy is a excellent method and is appropriate to use in combination with other techniques for a speech therapist working with someone with aphasia. You can locate other speech pathologists in the area several ways: http://www.asha.org is our national certification site and they have listings of therapists; local rehabilitation centers and hospital outpatient programs likely have therapists more familiar with traditional adult neurogenic techniques. Any SLP should consider the communication needs of the individual and, with deterioration of skills, look to set up systems that will compensate for the changes that are occuring. Evaluating for perserved skill areas is essential in making sure that other reliable communication systems are available to him when and if he needs them.
I would say, however, that the issue is not the technique but that without a stroke or brain injury, your father is experiencing aphasia and with that a continual deterioration of speech. Has he seen a neurologist or been tested by a neuropsychologist? There are many causes for aphasia and a physician should be presented with a timeline and history of the onset. For example, people can experience aphasia from a medication or other medical reason and there is a subset of progressive frontotemporal dementias that include aphasia, called PPA or Primary Progressive Aphasia. Neurological testing and imaging studies should be conducted to rule out a specific pathology or reason for the aphasia. There are excellent resources available and I’m happy to help however I can. Please write back with any further questions.
Maura English Silverman, MS, CCC/SLP

MORE QUESTIONS:

Question:

my husband is 55 he had stroke on sep 9 2011, he is aphasia diagnosis he said aaaa,ooooo, and that but i don’t know if he going back to speak i don’t know about aphasia, he is in a rehab center, he want to go back home, he is reciving only 3 days a week therapy , but i try talk to him everyday he answer but in not understand so is good idea if he came back home??????????? but i dont have resours to get information here im live in san jose california please help me!!!!!!
Jacqueline

Answer From our Professional of the Month,
Dr. Leonard LePointe:

Dear Jacqueline:

It is not easy to face all the decisions necessary to get help with a family member who has aphasia. The decision on discharge may have been made already at this time and is usually made based on medical stability and health issues. If your husband is now at home, it would be beneficial to get continued speech and language therapy for his aphasia. We can expect some recovery as time goes on, but therapy can certainly help. Here is some contact information for support groups and places for aphasia support in the San Jose area.

Good luck to you and I hope you find some help for your husband.

A Time To Talk
O’Connor Hospital, DePaul Room, 2105 Forest Ave, San Jose, CA, 95128

*Meets 2nd Wednesday of month, 3:00-5pm. Refreshments provided.

Contacts: Marianne Heidtmann, SLP; Craig Maloney, OT; and Gary Standridge, OT
Phone: (408) 947-2709 or (408) 947-2873
Website: http://www.psastroke.org (click on ”Support Groups”)

Stroke Classes at Santa Clara Medical Center
Santa Clara Valley Medical Center, Rehabilitation Center, Second Floor Rehab Day Room, 751 S Bascom Ave, San Jose, CA 95128

*Mondays 6-7pm

Call (408) 885-5604 for more information.
Website: http://www.psastroke.org (click on ”Support Groups”)

Stroke Support Group at The Regional Medical Center
Regional Medical Center, Peppertree Auditorium, 225 N Jackson Ave, San Jose, CA 95116

*Meets 1st Monday of the month at 11am. 2008 Dates: March 3rd, April 7th, May 5th, June 2nd

Contacts: PT, OT, SLP staff and social workers.
Phone(s): (888) 762-8881 – Eng/Spanish Speakers; (888) 762-8811 (Vietnamese Speakers)

MORE QUESTIONS AND ANSWERS:

Question:

My grandmother had a stroke six weeks ago. She was diagnosed with Apahsia and Dysphasia so it is very difficult to communicate with her. She lives alone in the UK, unfortunately all of her family is in the USA.
I wanted to know if you have any ideas of entertainment for someone with these communication problems. She has no TV or computer access. She used to like crosswords, but obviously she can no longer do those. She does recognize some visual cues, like our names and faces from photos.
Any advice you have on this matter would be greatly appreciated.

Answer:

Dear Seslyn,
I am sure you and your family are very frustrated with the inability to communicate with your grandmother. I have a couple of suggestions. Most importantly is her attendance in some type of speech therapy so that she will continue to progress and improve on her current level of functioning. Also getting involved in a stroke support group would be very beneficial for your grandmother. You can access the stoke association in England using the address: stroke.org.uk. On this website you will find stroke support groups according to your location. If your grandmother has a neighbor, friend or church member that could take her to one of these groups she would find it extremely beneficial. Since you had mentioned that your grandmother liked to do crossword puzzles I thought you might find this information helpful. Another resource that this site lists is a shopping tab. This tab connects to the Amazon Company in the UK. If you look up puzzle books for stroke survivors you will find a variety of puzzle books that have been adapted for individuals with aphasia. I had purchased one in the past that I felt was interesting and adaptable for my patients with aphasia. It is still available through the Amazon site listed on the Stroke Association website but here is the order information if you like: The Puzzle Book Published by the Stroke Association CHSA House, Whitecross Street, London EC1Y 8JJ Tel# 0171 490 7999. The authors are: Valerie Eaton Griffith, Elizabeth Pepys and Sue Miller. I have personally met Ms. Griffith in the past, she was the caregiver of a stroke patient for many years so any information she publishes would be highly recommended. And although I realize that your grandmother does not have a computer if one of her friends could allow her access to their computer, she could use SKYPE to communicate or at least see all of her family in the US. Just seeing her family might brighten her spirits even though she might not be able to verbally communicate with them. Good Luck and I hope this helps!
Carole Pomilio M.S., CCC-SLP

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Questioin:

Dad’s Aphasia Hope Foundation < .b>
My dad is 58, and a neurologist recently diagnosed him with expressive aphasia. Without an MRI….We went ahead and paid for an MRI anyway. They say that there is nothing unusual about his results. I thought that aphasia is directly cause by some sort of brain damage….is this true? I’m not wanting to accept this diagnosis. I understand that ultimately….this is what he has…but I wonder if I should get a 3rd opinion. I also want to know about some therapy options for him. He lives near Great Bend, Kansas.
Thank you
Shannon

Our Professional of the Month answers:

Dear Shannon, it sounds like you have received some partial information, which just adds to the confusion and frustration you and your family may already be experiencing with a change in your father’s language skills. It is possible that an MRI would not ”pick up” the type of neurological insult your father experienced. There are multiple types of neurological changes that may result in expressive aphasia, as well. While having that type of diagnostic information would be helpful, the speech-language diagnosis of expressive aphasia is probably more useful because that is the issue with which you are dealing. A qualified speech-language pathologist would do a thorough speech-language-cognitive evaluation and assist your family in developing a rehabilitation plan (usually in conjunction with a neurologist or other health care provider). To find a qualified speech-language pathologist, you might start with recommendations from the neurologist’s office or contact local hospitals for outpatient clinics or therapists. Good luck and I hope your father has a speedy and thorough recovery. Anne

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Another forum highlight:
Questioin:

RIC Intensive aphasia therapy progam

My wife who is 47 suffered a major stroke 3 months ago amd was discharged from an acute rehab faculity a fews ago. Currently she going to a 5 day a week outpatient program. As a result of the stroke she has aphasia which makes it almost impossible to communicate.
I’ve been doing research and am considering try to get her into the intensive program at RIC in Chicago. I was wondering if you heard reviews regarding this program.
Paul

Our Professional of the Month answers:

Paul, I believe your wife is very fortunate to have you as her advocate. I genuinely believe that individuals with aphasia benefit greatly when their spouse/family are hopeful and motivated to provide the best care/treatment possible. With that said, research has indicated that individuals with aphasia have benefited from high dose intensive service programs. Rehab Institute of Chicago is recognized as a highly reputable program known for providing a comprehensive service for individuals with aphasia. The mission and vision of RIC has the best interest of the individual at the center. I think it’s critical that you contact a speech pathologist from RIC regarding the program content. You may learn more about the program by viewing their website. The contact information for RIC is: 312-238-6163. I also recommend talking with the neurologist and physiatrist. The neurologist and physiatrist will have recommendations with respect to your wife’s ability to tolerate the intensity at this time in her recovery. It’s important to know that if your wife is not up to the intensity at this time she may benefit in a few months or even a year or more down the road. The speech pathologist at RIC will be a great resource for you.
Paul, I’m sure you have been provided with more information than you can currently read; however I’d strongly recommend reading Jon Lyon’s book, Coping with Aphasia and Martha Taylor Sarno’s book, Understanding Aphasia for Family and friends. I have talked with family members that have found great strength in looking at this website and in looking at the resources of the National Aphasia Association.
Again, I believe your wife is very fortunate to have you caring for her. Take care,
Mary Beth Clark, MS/CCC

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Another forum highlight:

Question: My wife who is 47 suffered a major stroke 3 months ago amd was discharged from an acute rehab faculity a fews ago. Currently she going to a 5 day a week outpatient program. As a result of the stroke she has aphasia which makes it almost impossible to communicate.

Answer: Your wife is very fortunate to have you as an advocate during this challenging time. Without knowing your wife, and testing her language and cognitive skills, it would be difficult for me to recommend a specific speech and language intervention or program for her. What I can tell you is that intensive therapy has been shown to be quite beneficial for some individuals with aphasia and RIC has an excellent reputation. If you are considering this option, I’d highly recommend that you contact a speech-language pathologist at the facility and discuss the details (RIC’s Intensive Aphasia Therapy Program, 312-238-6163). Again, this program is not appropriate for everyone with aphasia. Gather information about many programs, including the program that your wife is currently attending. Her current facility may provide intensive treatment as well. Once you have gathered the information about the various programs, talk you’re your wife’s neurologist/physiatrist/primary care physician about the best treatment options. Wishing you and your wife the best. Read more.

Every. Second. Counts. When stroke hits, acting FAST means recognizing and responding at the first sign by calling 9-1-1 and getting to a hospital where lifesaving treatment can be given if a person arrives in time.
Everyone must know the warning signs to save lives.

That’s why the National Stroke Association is asking you to take the Five Faces Pledge right this second. It’s simple—just tell five people you care about exactly what to look for and the importance of acting FAST.

The National Stroke Association is shooting for 2,500 pledges in the next week to help launch National Stroke Awareness Month with more support than ever. Raising awareness now could mean your parent or neighbor gets the critical care they need during a stroke.

Making good on the pledge is easy. They have tools available to share with your network through email, Facebook and Twitter.

Now is our chance to break through the noise and champion this lifesaving cause.

Click here to take the Five Faces Pledge. When you tell five friends about stroke, you’ll be saving lives.

Millions of families are affected by stroke annually, and more than 100,000 people are at risk of dying this year. But if warning signs are recognized and responded to quickly, medical intervention can make for thousands of promising futures.

By teaming up with National Stroke Association, you’ll be aligned with an organization that helps give people the tools to keep our families healthy and happy. There’s no better way to spread the word than through this amazing grassroots movement.

Can we count you in on the Five Faces Pledge?

Frontotemporal Degeneration and Primary Progressive Aphasia

Family Caregiver and Professional Education and Support Conference

Saturday, March 24, 2012

Northwestern University
Thorne Auditorium, Rubloff Building
375 E Chicago Ave, Chicago, IL 60611

The purpose of the conference is to educate professionals and families about FTD and PPA and provide information on caring for those diagnosed with FTD and PPA and their families.

Register Now

Agenda
The day will open with an update on FTD and PPA research and treatment by Dr. Diana Kerwin. This year’s keynote speaker is Dr. Geri Hall, advance practice nurse from Banner Alzheimer’s Institute – Phoenix, who has lectured and published widely on behavioral interventions and communication strategies in dementia, specifically FTD and PPA. A panel of clinicians and caregivers will follow the keynote lecture. Afternoon breakout sessions and a closing plenary on stress and caregiving by Dr. Jennifer Medina will conclude the day.

Save the Date

National Aphasia Association’s

25th Anniversary Benefit

June 13, 2012
6:00 to 9:00 pm

HONOREES
Barbara Kessler

Aphasia Center of California

The NAA Founders Group
Martha Taylor Sarno, M.A., M.D. (honorary)
Martin L. Albert, M.D.
Thomas Anderson, M.D.
Alan Bandler, Esq.
Antonia Buonaguro, Ed.D.
Don A. Olson, Ph.D.

Helen Mills Event Space and Theater
137-139 West 26th Street
New York City

Details to Follow.

The Rehabilitation Institute of Chicago would like to ask your assistance with a survey research project being conducted by the Rehabilitation Institute of Chicago in partnership with the National Aphasia Association. This project concerns return to work after stroke. If you are a stroke survivor who is thinking about or has returned to work, we would be very interested to know your opinions about this issue. The survey will take 20-30 minutes of your time to complete and the responses will be anonymous.

If you have not had a stroke yourself, but if you know a stroke survivor who might be interested in offering their opinion on returning to work, please feel free to pass this email along to them.

We value your opinions to help find ways for stroke survivors to return to a productive work life.

Thank you for your time

Click on the link below to go directly to the survey. Survey

If you have difficulty connecting to the survey, please contact Dr. Robert Hartke, the Principal Investigator of this study, at rhartke@ric.org.

Telling your stroke story helps us save lives.

We call them Faces of Stroke… these stories of real people surviving and thriving and the stories of those who help them through it. Dozens of personal stories were shared last year on our website through our Faces of Stroke campaign, and we’re looking to do even more this year. These stories are enormously powerful tools to educate people about the warning signs and risk factors of stroke. And they’re a great way to prove that no one has to face the aftermath of stroke alone.

With National Stroke Awareness Month fast approaching in May, we want to hear from you! We want to share Faces of Stroke stories far and wide—during May and all year long.

We’re looking to get submissions—text, photos, or videos—in by next Friday, February 24, so please share your story today!

Click here to tell us your Faces of Stroke story. Hearing from survivors, caregivers, family members and healthcare professionals helps us put a human face on stroke to raise awareness and save lives.

We know that for this campaign to be successful we need the courage and inspiration of so many willing to share their stroke story. This is a real opportunity for our community to come together, and we are so grateful for all the stroke champions who make it possible.

With your continued support and participation, we can do more and more every day to prevent stroke. Hope to hear from you soon!

Contact the National Stroke Association to tell your Faces of Stroke story. Hearing from survivors, caregivers, family members and healthcare professionals helps us put a human face on stroke to raise awareness and save lives. Or email: nsa@stroke.org.

Jim Baranski
Chief Executive Officer

National Stroke Association

P.S.: You can already read Faces of Stroke stories from members of the stroke community on the website: Stories

Congress has less than two months to act before some stroke survivors are, once again, at risk of losing access to critical speech, physical and occupational therapy services. Contact Congress today and ask them to preserve access to therapy services above the annual cap for Medicare beneficiaries.

Under current Medicare rules, beneficiaries can receive up to $1,880 per year of speech and physical therapy (combined) and another $1,880 for occupational therapy provided in non-hospital, outpatient settings (in 2012). Beneficiaries who require more services can use an exceptions process to obtain them before the start of the next year. However, this exceptions process is set to expire on February 29, 2012.

Congress extended this deadline for two months (from December 31, 2011 to the end of February 2012) through legislation passed at the eleventh hour just before the end of last year. However, this only ensures that stroke survivors covered by Medicare have access to additional therapy services until February 29. Congress must extend, or reauthorize, the exceptions process in order for beneficiaries to take advantage of it beyond this date. If Congress fails to act and the exceptions process expires, Medicare will only pay for rehabilitation services up to this capped amount—even if additional rehabilitation services are considered medically necessary by a healthcare professional.

You can help ensure that stroke survivors covered by Medicare have access to an adequate level of rehabilitation services. Send a message to your members of Congress urging them to preserve the exceptions process. Take action today! Even if you’ve already contacted your members of Congress about this issue, they need to hear from you again to ensure they take action on this issue by February 29.

Once you’ve sent your messages, follow up with your members of Congress to ensure they take action on your request. The Stroke Advocacy Network can help you identify your members of Congress and find phone numbers for their offices (local or in Washington, D.C.). Following up with a phone call will ensure that your request is not only heard but acted on as well.

Visit their website: www.stroke.org .

In response to the flood of calls, texts, postings and emails we have received from people in the aphasia community in the US and around the world, the National Aphasia Association would like to offer information about this condition to the general public in an effort to correct an error of omission in ABC’s coverage of Congresswoman Gabrielle Giffords’ recovery.

First, we would like to express our heartfelt congratulations to Gabby for her recovery so far and offer her, Mark Kelly and their family any ongoing support they might need as they face the challenge of aphasia.
While ABC did an accurate and comprehensive job of explaining aphasia, the program inexplicably never mentioned Gabby’s condition by name. It is aphasia – the inability to read, write, speak or communicate after a stroke or other sudden traumatic brain injury, such as the one Gabby tragically experienced.

Many people with aphasia, their families, friends and caregivers, were very disappointed and frustrated by this omission. Eagerly, they watched that special Monday night edition of 20/20, hoping that finally, a greater awareness and understanding for aphasia would be realized. The general public would finally hear the word aphasia and begin to understand the condition. Unfortunately, the hour-long program never used the word aphasia once, which added to the pain and frustration of the over 1 million people estimated to have aphasia.

It was only during the subsequent Nightline program hours later that night, when Bob Woodruff used the word aphasia when he talked about his struggle with the condition and his understanding and compassion for Gabby’s difficult, but hopeful journey.

We urge ABC and other news media to use the word APHASIA when reporting on Gabby Giffords and other people with the condition. This will help raise awareness and understanding.

Too often, people with aphasia are mistaken for being mentally incapacitated or being under the influence. This is not true. People with aphasia maintain their intellect completely. They have a communication disorder that makes it difficult for them to express themselves and understand language. It is estimated that there are over 200,000 new cases of aphasia every year.

At the National Aphasia Association (a nonprofit organization), we offer free and low-cost support for people with aphasia and their families including:

NAA Hotline (800-922-4622) helps over 4,000 families a year.

www.aphasia.org receives over 12,000 hits per month, helping an estimated 300,000 families a year.

NAA National Registry links to over 440 aphasia US support groups and 210 state representatives.

Emergency Responders Training Program educates first responders how to recognize aphasia and communicate with people who have the condition

Aphasia Friendly Business Program trains businesses and their employees how to interact with customers who have aphasia.

The Aphasia Handbook: A Guide for Stroke and Brain Injury Survivors and Their Families

Aphasia can occur in people of all ages, nationalities, socio-economic backgrounds and equally among men and women. Understanding, patience and a few commonsense strategies will help family, friends, caregivers and the public communicate with people with aphasia:

1) Have the person’s attention before you speak.
2) Minimize or eliminate background noise (TV, radio, other people).
3) Keep your own voice at a normal level.
4) Keep communication simple, but adult.
5) Give them time to speak, resist the urge to finish sentences or
offer words.
6) Communicate with drawings, gestures, writing and facial
expressions.
7) Confirm that you are communicating successfully with “yes” and
“no” questions.
Praise all attempts to speak and downplay any errors.
9) Engage in normal activities whenever possible.
10) Encourage independence, avoid being overprotective.

For more information, media outlets and the public can contact the National Aphasia Association at (800) 922-4622 or (212) 267-2814.

Best wishes to everyone in the aphasia community,

Ellayne S. Ganzfried, M.S., CCC-SLP
ASHA Fellow
Executive Director

Barbara C. Martin
President- Board of Directors

The National Stroke Association is excited to announce their 2011 Raising Awareness in Stroke Excellence (RAISE) Awards winners in the coming days and they wanted to thank everyone who sent in nominations to be considered for the inaugural year. The winners are excited to have their activities highlighted and they are honored to showcase them.

They had a tremendous response to the call for nominations and thank you for sharing these truly amazing efforts being made across the country. It is clear that those of you invested in raising awareness—no matter your reach or resources—are inspirations that deserve support and recognition.

While they are only able to honor a few winners this year, they hope you will join them as they work to establish a devoted and organized community engaged for the long term to raise awareness. You are the reasons why people everywhere are becoming better armed to recognize and respond to stroke.

Watch in the coming days as the 2011 RAISE Awards winners are revealed. The National Stroke Association hopes you share their successes—and your own—with loved ones and others who might be inspired to become a stroke champion

A student from University of Cincinnati is working on a project designing rehabilitation devices for people suffering from aphasia. Adrienne is currently seeking more information, and has created a survey with questions for caretaker of people with aphasia. If you would like to participate, and/or pass it along to those that would be willing to help, it would deeply appreciate it.

Click Here for survey .

Adrienne Pearson’s information:

(248) 225-7416
pearsoar@mail.uc.edu

.An article in Medical News Today, 18 Feb 2009

When ABC journalist Bob Woodruff was injured while reporting in Iraq in 2006, he suffered severe head injuries that caused him to lose his ability to recall and produce common words – a condition called aphasia. Today, Woodruff has recovered most of his language skills thanks to intensive behavioral therapy – reading and repeating words and sounds.

“The standard of care for patients with aphasia has always been and will always be speech/language therapy, but a new area is opening up that looks at what drugs can be used in combination with therapy to enhance recovery from brain damage and help the brain repair itself,” said Gerry Stefanatos, D.Phil., an associate professor of communication sciences and disorders in the College of Health Professions. “We’re looking at the mechanism of how this combination works – it’s underlying effect on patients with aphasia.”

In research presented at the International Neurological Society this month, Stefanatos found that dextroamphetamine (D-AMPH), a drug commonly used to treat attention deficit hyperactivity disorder, improved the processing of speech among those suffering from Broca’s aphasia and the similar Anomic aphasia.

“Improving a patient’s attention and working memory may allow them to better focus and process information during therapy sessions,” said Stefanatos. “Attention is critically important for learning and relearning skills, and could be helpful in forging new neural pathways in the brain.”

The National Aphasia Association estimates some one million people in the United States live with aphasia, which is caused by lesions to the language centers of the brain. These lesions are often due to stroke or brain injury, but can also be the result of a brain tumor or progressive disease such as Parkinson’s or Alzheimer’s. Types of aphasia can range from a patient having difficulty finding and producing a word to a patient having no ability at all to speak or understand language.

Stefanatos’ study looked at the use of D-AMPH in ten aphasia patients. All were also given a placebo for comparison purposes. In each condition, participants were asked to make decisions about different types of speech sounds (vowels, consonant-vowels) and complex tones. Their brain’s electrical response to each was recorded via an electroencephalogram (EEG).

Those who took the D-AMPH had a strong reaction to the sounds – even to consonant-vowel sounds, which are more often difficult for individuals with aphasia to process.

“This tells us that D-AMPH may help the left hemisphere of the brain regain the ability to perform its functions,” said Stefanatos. “Understanding why the drug is having this effect allows us to start to think about how to tailor treatments to make them more effective or explore alternative drugs or drug combinations.”

Stefanatos said he and his team chose to look at this particular drug because in patients with ADHD it has been shown to stimulate the release of dopamine and epinephrine, which help in attention and learning. But he notes that some people aren’t good candidates for this particular drug.

“Now that we have a rudimentary understanding of why the drug may work to enhance the results of therapy, our next step is to look at dose effects and perhaps other drugs with more favorable side effect profiles,” said Stefanatos.

With collaborators from the departments of Radiology and Physical Medicine and Rehabilitation, Stefanatos will next study functional magnetic resonance imaging to explore the effects of D-AMPH on cerebral metabolism and where in the brain of individuals with aphasia it has the greatest effect.

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Article adapted by Medical News Today from original press release.
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Other authors on this study are Andrew DeMarco at Temple University, Robert Segal at McGill University in Quebec, and Arthur Gershoff, M.D. and Y. Ieuji of the Moss Rehab Stroke and Neurological Diseases Program, part of the Albert Einstein Healthcare Network in Philadelphia. This work was funded by grants from the National Institute of Health and the Pennsylvania Department of Health.