Browsing Posts in Tips

Hope is Alive

Author: Bill Connors

Here is the Tip of The Month from Bill Connors of the Aphasia Solutions Network (ASN) .

Hope for the patient with aphasia is critical to the rehabilitation process. Hope is what drives the patient to persevere both when the patient is making progress and when the effectiveness of the aphasia treatment has reached a plateau. As caregiver or speech therapist how do you know when the patient has hope or when hope is flagging? One obvious sign is the patient’s response to treatment. If the patient has a focused look in their eyes and is gesturing or using other body language in a positive way, hope is alive and well. If the patient isn’t making good eye contact, appears unfocused or distracted, and is gesturing or using other body language in a negative way, hope may be the missing emotional ingredient.

Simply Smart Aphasia Therapy works to keep hope alive within the patient, caregiver, and therapist at all times in a number of ways. The SSAT protocols are designed to fit each unique therapy situation. This allows the treatment to be focused on the patient’s needs of the moment. The protocols all allow the patient to begin practice at a relatively simple level and progress to more complex therapy tasks within the same protocol. This is what Vertical Stepping and Horizontal Tweaking is all about. The suggested materials all match the protocols, diminishing any gap between expectation and execution.

If the aphasia patient’s hope can be kept alive, progress will be made. To learn more, or to sign up for the monthly newsletter, contact Bill Connors by clicking on his name or [email protected].

Recognizing a STRoke

Author: Sandy Caudell

A neurologist says that if a Stroke victim can get to the hospital within 3 hours generally the effects of a stroke can totally be reversed. The trick is to get a stroke recognized, diagnosed and then getting the patient medically cared for within 3 hours, which is tough.

REMEMBER: Recognize a STR*oke:

*S = Ask the individual to SMILE (check to see if their smile droops to one side)
*T = Ask the person to TALK (speak a simple sentence such as “It is sunny out today”)
*R = Ask him or her to RAISE both arms (check to see if one arm drops down)

If he or she has trouble with ANY ONE of these tasks, call emergency services immediately and describe the symptoms. This is URGENT!

Author: American Stroke Foundation

1. I needed you to treat me like I was going to recover completely. It might take two years or five years or a lifetime, but I needed to be treated like I was going to recover completely.

2. I needed you to honor the healing power of sleep. The brain is a brilliant machine that processes trillions of bits of data every moment. The brain uses sleep to shut down incoming stimulation and create order out of the day’s events. In the beginning, my brain wanted to sleep a lot. I believe that it was partially because we honored the healing power of sleep that my brain recovered so well.

3. I needed to challenge my brain systems immediately. I understood that connections in my brain had been broken, and it was critically important that I challenged the system before more cells had a chance to die. When awake, I was always given choices - did I want this or that to eat, did I want to do this or that. I was forced to answer questions that made me think, instead of yes/no questions that required nothing from me.

4. I needed you to love me - not for the person I was before, but for who I might become. The woman I had been died that morning. With my left hemisphere no longer functioning, I needed people to love me for who I had become. I might have looked the same and sounded the same, but I was different - and that had to be OK.

5. I needed to define my priorities for what I wanted to get back the most. I lost my ability to speak and understand language, to walk and drive, as well as all my science and math abilities. Because I had very limited energy, I had to focus my time. I realized that I night never be a scientist again, but I had a message to communicate about the beauty and resiliency of the brain. I chose to focus my energy on public speaking. Because speaking on the telephone was an obvious energy drain for me, my family protected me by not letting me speak on the phone. That was a lot of help.

6. I needed you to focus on my ability, not my disability. I needed to celebrate everything. If all I was doing was breathing, then we could celebrate that I was alive - and breathe deeper together. If I stumbled, then we could celebrate when I was upright! If I was drooling, we could celebrate my swallowing! It was way too easy to focus on my disabilities because they were vast, I needed you to celebrate my triumphs every day! My successes, no matter how small, inspired me.

7. I needed to allow myself to receive support, love, help. It would be at least two years before we really knew how extensive my recovery would be. I needed to get out of my own way. I needed to stop beating on myself for being less. I needed time to let my brain heal. I needed you to cut me some slack and not be so heavy all the time! I was not less, I was different, and it’s OK to be different.

8. I needed to divide every task into smaller and simpler stages or steps of action. Instead of rolling over, I might rock. Instead of standing up, I might sit and rock. Just because you could not see that I was trying, it did not mean that I was not trying. Sometimes when I was tired, I just needed to sleep, and I needed you to just accept that.

9. I needed you to assume that I knew nothing, I had, after all, lost my mind. Pieces of information did not fit together anymore in my brain; for instance, I might not know what a fork was. I might not know what a shoe was -much less that my socks went on first and why. As my caregiver, you were my teacher. It helped when you talked to me, repeated yourself and didn’t act like I was stupid if I didn’t get it the first 20 times! Raising your voice did not help you communicate with me. I was not deaf, I was wounded.

10. I needed you to come close and not be afraid of me. I needed you to touch me, stroke my arm, my hair, and wipe my face if I was drooling - to be kind to me. What you said was not as important as how you said it. What you did was not as important as how you did it. It helped when you came close and enunciated clearly. If you brought your best self forward, my spirit would greet you - only when I trusted you as a caring giver would we heal my brain together.

Dr. Jill Bolte Taylor, a trained and published neuroanatomist, specializes in the postmortem investigation of the human brain. But as irony would have it, on December 10, 1996, Dr. Taylor woke up to discover that she was experiencing a rare form of stroke, an arterio-venous malformation (AVM). Jill now sings about the brain in an effort to educate the public about strokes and aphasia. Note: Many survivors that cannot speak words, can sing them!

This articles was taken from the American Stroke Foundation. Click Here to learn more about the American Stroke Foundation.

Author: Stroke Connection May/June 2004

Tips for Socializing with Aphasia

Excerpted from the article “Talking Tough?”, Stroke Connection May/June 2004

For most, a stroke has a startling and life-altering effect on both the survivor and family members. All involved find themselves trying to come to terms with changes that range from physical and sensory loss to loss of speech and language.

For many survivors, it is this loss or change in speech (dysarthria, apraxia) and language (aphasia) that profoundly alters their social life. Ironically, research has shown that despite the difficulty of socializing, it is one of the best ways to maximize stroke recovery. Many experts contend that socializing should begin right away in the recovery process.

The question then becomes, for many living with aphasia, dysarthria or apraxia, how can they socialize if they cannot communicate how they used to.

Here are some tips you can use to begin your recovery “Talking Tough”.

Word Finding Strategies

1. use a gesture or a sign.
2. Draw the item.
3. Attempt to write the word.
4. Attempt to put the word in a sentence.
5. Search the alphabet for the initial letter of the word.
6. Describe the concept/item. Talk about its properties, category, membership, location, use, etc.

Build Up Your Brain

Author: The following review is by Tara Parker-Pope. Tara Parker-Pope is the creator and writer of “Well,” a daily health blog and weekly column for The New York Times. Well features and stories focus primarily on the small everyday decisions we make about food, family and fun that ultimately influence our long-term health and happiness. Prior to joining the Times in August 2007, Tara was the long-time health columnist for The Wall Street Journal, and also worked as a correspondent in the paper’s London bureau.

Is mental decline an inevitable part of getting old?

For years the conventional wisdom has been that people are at the mercy of genetics and fate when it comes to their aging brains. But a new understanding of how the brain works has turned that theory on its head.

Now scientists know that the brain, like other organs, is affected-dramatically-by how it is treated. Just as people can do their part with diet and exercise to prevent physical ailments such as heart disease and diabetes, they can take steps to protect their brains and stave of mental decline.

The theory is that by being proactive now, anyone can create a “reserve” of brain cells and pathways to fall back on as the brain ages.

“As you build your brain reserve throughout your life you’re going to be protected from decline in late life,” says Howard Fillit, executive director for the Institute for the Study of Aging in New York City. “There has be a real paradigm shift in the way we think.”

Most experience some mild memory loss or other cognitive changes as they age. They may forget words or be slower to learn new things, but the problems generally don’t result in any marked impairment. However, about 25 percent of people older than 75 and 40 percent of people older than 80 have more serious cognitive decline.

A growing body of research shows that many cognitive problems can be delayed or prevented-and some even reversed-with a little physical and mental effort by the patient.

Doctors now know that physical exercise improves brain function by improving blood flow to the brain. But it also is believed to trigger the production of neurons-the nerve cells that enable a person to think. Exercise also stimulates the production of a chemical-brain-derived neurotrophic factor-that helps repair cells and prevent further damage.

The brain isn’t hard-wired at birth. And because it’s an ever-changing organ, an individual’s activities can influence how it develops. Studies of concert violinists, for example, show that the part of the brain that controls the functions of the left hand is far more developed than in the average person.

Doctors say new mental challenges-learning a second language, taking piano lessons, attending lectures, tackling a crossword puzzle, reading a difficult book-help to map out new pathways in the brain. The effect is likened to a driver who knows only one route to work. If that road is damaged or filled with traffic, he’s stuck. But if the driver learns several routes, he can still get where he wants to go even if certain paths become blocked.

“Every time you learn something new it builds new connections to the brain cells,” says Margery Silver, assistant professor of psychology at Harvard Medical School and associate director of the New England Centenarian Study. “That way, if you do have a few changes-a few plaques and tangles associated with Alzheimer’s-and a few brain cells become damaged, you still have a reserve because of all these additional connections you built up.”

Managing other diseases and health problems also can play a significant role. Depression is a major cause of dementia in elderly people, but once treated, the dementia symptoms can be reversed. Untreated hypertension and vascular disease can trigger vascular dementia, the second most common form of age-related dementia.

High cholesterol also is a risk factor for Alzheimer’s. Recent studies show that cholesterol-lowering statin drugs may help protect against the disease. It’s not yet clear whether the benefit comes from the lowered cholesterol or if the drug have an effect that staves off the disease.

“What we need to be saying to patients is that if you have hypertension you should take your medicine ever day, not just to prevent a heart attack 10 years from now but to prevent your mind getting demented in old age,” Fillit says.

Someone who appears to be suffering memory loss or other problems should see a doctor. “It’s very important to get a dementia evaluation,” Silver says. “Many things are curable, or at least the progress can be slowed down.”

A study in the New England Journal of Medicine found that nonsteroidal, anti-inflammatory drugs such as ibuprofen may greatly reduce Alzheimer’s risk. Some research also has shown that daily low-dose aspirin therapy, often recommended for people at risk for heart attack and stroke, may also help prevent cognitive decline, but the data are conflicting.

Antioxidants such as vitamin E also may help stave of mental decline and work, in essence, “like keeping rust from forming on a pipe,” says Guy M. McKhann, professor of neurology and neuroscience at John Hopkins School of Medicine, Baltimore.

But the most important factor in preventing mental decline is to stay physically, mentally, and socially active, experts say.

“You don’t want to just retire and sit around and do nothing and say ‘Isn’t this great, I don’t have to think anymore,’ ” says Marilyn Albert, Harvard professor of psychiatry and neurology. “That’s actually going to hurt your brain.”

Printed in the Kansas City Star on Monday, December 31, 2001. Read more from www.taraparkerpope

Be a Proactive Patient

Rather than taking a passive role in your or a loved-ones recovery, here are some tips for becoming a more proactive patient. These lists have been compiled from two sources: the Imaginis website and an article in USA Today by Kim Painter about the website and book “The Best Doctors In America” produced by Gregory White Smith and Steven Naifeh. To view the complete list on becoming a Proactive Patient, please go to the Imaginis website By Clicking Here. For further information on “The Best Doctors in America”, please Click here.

1. Take control of your illness and recovery
2. Find a good doctor and medical facility. Do a background check on the doctor and/or facility from the American Medical Association by clicking here .
3. Ask your doctor for a recommendation for a 2nd opinion
4. Get a recommendation from a friend, family member, neighbor, or
healthcare professional
5. Question the doctor’s office for patient load, waiting time and insurance
6. Recognize that all medical decisions are tradeoffs. There are no right
answers, only different costs and benefits.
7. Find an advocate. If you don’t have the energy or skills to research your
illness, find a doctor or a friend, family member or professional to do it
for you.
8. Be prepared to ask questions. Write your questions down before you
see the doctor.
9. Sustain a claim to life. A will to live, optimism, a fighting spirit - whatever
you call it - is important but must be accommpanied by action: join a
support group, make plans, set goals.
10. Research health issues online and through non-profits & government
11. ASK questions, questions and more questions!


Sometimes symptoms of a stroke are difficult to identify. Unfortunately,
the lack of awareness spells disaster. The stroke victim may suffer brain
damage when people nearby fail to recognize the symptoms of a stroke.
Now doctors say a bystander can recognize a stroke by asking three
simple questions:

*Ask the individual to SMILE.

*Ask him or her to RAISE BOTH ARMS.

*Ask the person to SPEAK A SIMPLE SENTENCE.

If he or she has trouble with any of these tasks, call 9-1-1 immediately and describe the symptoms to the dispatcher.

After discovering that a group of nonmedical volunteers could identify
facial weakness, arm weakness and speech problems, researchers urged
the general public to learn the three questions. They presented their
conclusions at the American Stroke Association’s annual meeting last February. Widespread use of this test could result in prompt diagnosis
and treatment of the stroke and prevent brain damage.

Talking Tough?

Author: Angela Hein Ciccia, Ph.D., CCC-SLP, and Jamie Harding, M.A., CCC-SLP

For most, a stroke has a startling and life-altering effect on both the survivor and family members. All involved find themselves trying to come to terms with changes that range from physical and sensory loss to loss of speech and language.

For many survivors, it is this loss or change in speech (dysarthria, apraxia) and language (aphasia) that profoundly alters their social life. Ironically, research has shown that despite the difficulty of socializing, it is one of the best ways to maximize stroke recovery. Many experts contend that socializing should begin right away in the recovery process.

The question then becomes how can they socialize if they cannot communicate how they used to? There are things you can do. Here are some tips you can use from the beginning of recovery.

During the first week or so of stroke recovery, become educated about aphasia. This is important for learning how to communicate in a new way. Learn the definitions and distinctions of aphasia, dysarthria and apraxia. Specifically identify how these conditions affect your communication abilities. Survivors often can learn this from a speech- language pathologist. It is accompanied by a speech and language evaluation that serves as an outline of individual strengths and challenges.

Not only is it important for survivors to become educated, close family members need to be involved so they can understand their loved one’s communication needs and begin to learn ways to facilitate speech and language. Early education of family members supports socialization because they become communication partners with whom the survivor begins to have success and establish confidence.

As the survivor moves out of the initial stage of recovery, rehabilitation begins. This is where people start to experiment with strategies that facilitate social interaction. This stage includes strategies for both survivors and family members as well as changes in the environment that support communication.

For example, many stroke survivors with communication challenges compensate by writing or drawing to supplement verbal expression. They may also use gestures or a picture communication book, or even a computer communication system. Using these strategies gives the survivor the tools to interact with others while continuing rehabilitation of speech and language skills.

Family members can facilitate communication with some simple techniques such as asking yes/no questions, paraphrase periodically during conversation, modify the length and complexity of conversations, use gestures to emphasize important points, and establish a topic before beginning conversation.

The environment also can help support successful socialization. Survivors have told us that it is easiest to begin practicing conversation in a one-on-one situation with someone they are comfortable with and who understands communication disorders. It always helps to practice conversation in a quiet, distraction-free environment. As you become more confident, slowly add more conversational partners but continue to limit distractions such as background noise (music, other talking, TV).

As you become more comfortable in one-to-one or small group interactions, explore less-controlled social situations with your speech-language pathologist, close friends and family, or other stroke survivors. Before you attend these gatherings, practice common things discussed in a variety of situations. For example, before going to a family function, rehearse phrases that are common in that situation (“how are you?” “It’s been a long time”). Practice a few statements about current events (“did you see the basketball game?” or “Boy, we are having beautiful weather!”) The more you practice the script, the greater your chances for success. For people with more severe communication challenges, family members can prepare written cues, or organize pictures to promote interactions.

Once you achieve a level of comfort with close family and friends, you can start getting involved in the community. This can be as simple as going to familiar large group activities such as church events or weekly social gatherings. Or they can be as new and challenging as volunteering, returning to work or joining a new interest group. And, remember, there is no rush. You should step into this stage at a comfortable pace.

An effective tool for expanding socialization opportunities is attending a stroke support group, especially if there are other members with speech and language challenges. In Cleveland, Ohio, Speakeasy is a conversational practice group that meets weekly for two hours. Its members have a chance to practice their communication skills and gain confidence in their ability to communicate. We asked them to share tips for communicating with speech and language limitations in social settings. They said:
1- Try, try, try to get your point across no matter what anybody says or thinks.
2- Waiters are impatient when I go out to dinner. I ask them to slow down when they are talking too quickly.
3- I prefer one-on-one conversations.
4- I gained confidence talking to others when my voice grew stronger and I could say three words at a time.
5- When talking on the phone with a new person, I repeat, “I’m a stroke survivor…can you understand me?”
6- I’m home a lot during the day since my stroke. I make a point to go out.
7- A group like Speakeasy gives me a place where I can talk and know that everybody will listen.
8- No matter who tells you that you can’t, it’s always possible to keep recovering!

Remember that the speech and language changes stroke survivors experience can last a lifetime in some form or another. As life circumstances change, and your speech and language needs evolve, reevaluate what works and what has not worked in social situations. And continue to expand your horizons. Socializing is an important part of the recovery process.

For more information on aphasia or to find an ASHA-certified speech-language pathologist in your area, call ASHA’s Action Center at 800-638-8255 or e-mail ASHA at [email protected] or visit ASHA on the Web at

This article was taken from Stroke Connection’s May/June 2004 Issue. Click on Stroke Connection to sign up for this free publication.

Author: Cheryl Paul

The members of the U.S.F. Aphasia Reading and Writing Group offer these tips to people with aphasia:

Fred M.- Help each other.

Bob- Work everyday on your speech.

Tom- Help others. Learn to be patient.

June- Practice speech everyday. Find an aphasia group. Read “My Stroke of
Luck” by Kirk Douglas

John- Learn to speak one word for one hour everyday. Exercise at least a half
hour daily.

Harry- Do not give up hope! Exercise your voice every day.

Mike- You should read outloud everyday.

Curt- Never give up hope! I work out 3 days a week. I used to powerlift 800 lbs-
that’s a record!

Henry- Never give up hope. Life is short, too short. Exercise speech over and
over again.

Ann- Work on your speech after a stroke.

Fred M- Find an aphasia group. It helps 100%