Have Questions? Ask our Professional Of The Month: Anne Ver Hoef, MA, CCC-SLP .

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.