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User profile for Nan Musson
Name: Nan Musson
Alias: Nan Musson
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Re: aphasia in children
Posted at: 2022-03-12 07:53:00
Aphasia is an aquired language disorder and may occur in children after any trauma to the brain including stroke. It would be important to rule out a prior learning or language disability. I will do a bit of searching and let you know if there are any research programs specific to children.
Re: aphasia connected to pregnancy
Posted at: 2022-01-18 13:01:10
Sounds as if there was some type of transient or short term problem with communication or language during your mother’s pregnancies. Aphasia refers to changes in all areas of language including speaking, listening, reading, and writing.

And you are correct, aphasia is usually diagnosed after a stroke (typically left side of the brain) or secondary to a trauma to the head or tumor. Strokes can occur during pregnancy or during the delivery and language problems may be persistent. Without knowing any prior medical history or physical status - she may have had a “small stroke” (transient ischemic attack) or another type of event that reduced blood flow to the brain.

Hope this helps let us know if you have additional questions.

Re: treatment for aphasia
Posted at: 2022-01-18 12:47:24
I believe this question was addressed by previous professionals and suggestions were given to see a Speech Language Pathologist or Therapist.

Medications will not cure aphasia. There are some medications that are being studied in the US and are administered as soon as the stroke symptoms are observed and it would not benefit your father or his type of stroke. There are some medications that are being studied when they are given with rehabilitation. The evidence for use of medication paired with rehabilitation is yet to be reported for large patient populations. And I am not sure what medications may be approved and distributed in your part of the world - so again would recommend you talk with a Neurologists and Speech Language Pathologist to review all potential options.

Let us know if we can answer additional questions or assist you.

Re: mom’s speech
Posted at: 2022-01-18 10:55:06
It is not uncomon that individuals either become frustrated or do not want to “practice” language or speaking with family members. Some individuals may also withdraw from communication or become depressed if “tested” or forced to talk when they may not be successful. So again - may want to consider a variety of non-verbal communication activities and not force verbal.
You may want to try very simple but interactive activities such as a card game, checkers or dominoes…..something she may have enjoyed in the past where you can interact with gestures, showing cards or pointing and yet not demand speech to have a successful exchange. Another possible activity - setting up a scrap book with pictures of family members or favorite places and friends. You could write down names, places and dates to add to the scrapbooks. She can then share this with others. Her friends or family members can then add pages with important, people, events or activities to share.
I agree with you - do not stop any interactions or communication with her friends. Friends are very precious and may provide a variety of communication interactions for her. Also you do not want to discourage friends from calling or contacting her. (Sometimes friends or family members will stop interactions if they cannot communicate so it is important to retain as many friends as possible).
Hope this provides some additional suggestions - and feel free to send more questions.
Re: Temporary Aphasia
Posted at: 2022-01-11 06:48:01
I spoke with two neurology colleagues and they confirm that a migrane may cause transient aphasia (few hours). However, his history of two strokes and symptoms of severe aphasia and dysphagia once a month that last for an average of three days may also suggest another etiology for strokes or mini-strokes often refered to as transient ischemic attacks (TIA). Heprin may not always be the treatment of choice for migrane or TIAs. So we would suggest you and your husband consider reviewing your sequence of medical events and symptoms with his physician or neurologist to rule out any additional reasons for possible TIAs that may be treated by a variety of medications or interventions.
You may also want to talk to your physician about a referral to a speech-language pathologist or neuropsychologist to document changes in memory and language skills.
Thank you for your question and let us know if you have additional questions.
Re: mom’s speech
Posted at: 2022-01-10 13:02:48
Thanks for writing -
Without a differential diagnosis and evaluation it would be very difficult for me to give you a specific recommendation for speaking or to provide you with a prognosis…

But, there is a positive comment in your note…She can read. You and your mother should use that to your advantage. Use this as an alternate or supplement to communication - for example: write down a list of 5 - 10 words that you would commonly use and encourage her to point to the words in response to simple questions. If that works you may consider a iist of short phrases, a longer list of words or specific lists of words for certain topics/events. When she points to a word say the word aloud to confirm. Sometimes hearing a word or seeing a word can provide enough “cues” to help with sound or syllables. I would caution that sometimes there may be a coexisting problem called Apraxia that will interfere with speech production and may be the reason for difficulty with speech. Too much emphasis on speaking can sometimes be frustrating for the person and any communication partners.
Remember - speaking is only one way to communicate. Non-verbal options for communication such as pointing, gesturing, facial expressions, and head nods/shake can convey up to 70% of the message. So I would encourage her to use all of these options during communication. Also - if she is able to hold a pencil or pen encourage her to draw as another form of communication.
I would encourage you to seek additional Speech Language Pathology Services at a university or community group setting. And don’t forget Stroke Support groups can also provide additional information for you and your mother. Let us know if you have additional questions.

Re: help!
Posted at: 2022-01-24 12:28:26
I am assuming that you are asking for a communications class or clinic (not sure about the initials you listed in your e-mail)?

There are numerous questions that you could ask on an initial intake but here are some common issues that you may want include in your questions focused toward adults with potential aphasia….

When did the stroke or change in communication occur?

If the individual has had a medical work-up it is helpful to obtain additional information regarding the site of the brain damage, etiology, prognosis and any medical intervention provided. (You will also want to know what the individual and caregiver understands about their brain damage and communication problems - you may start intervention by teaching about the diagnosis or etiology).

You will want to know if the communication problems have improved, declined or been stable.

You will want to know about any pre-existing or co-existing medical or psychiatric problems. (Example: Respiratory problems may interfere with voice/speech production or depression may interfere with test results and treatments).

Current medications may be helpful.

Information about abuses may also guide treatment approaches - drinking or drug use.

Include questions about education, occupation and social history. (This will also guide your approaches to communication strategies/interventions - example: an individual with 5th grade education with learning disabilities may not be able to complete tasks required on traditional adult tests).

Known, acquired or suspected hearing and visual problems are important.

You may want to know about past and current rehabilitation and their perception of the progress they made.

You will likely want the individual’s perception of any problems and also ask the spouse, family or caregivers - try to obtain information about their frustrations or concerns and strengths during interactions with others. (For this you may want to have a list of activities of daily living and independent activities or you could use one of any numerous functional scales that have been published). You sould probably include specific questions about reading, writing, speaking, listening and gestural skills.

You will want to know if they have received any counseling or educational materials and if so from what resources.

This should get you started ….
Let us know if you would like additional information.

Re: stem cell implants
Posted at: 2021-06-03 06:15:38
This is a forwarded e-mail response from a Neurologist and Researcher following stem cell protocols at the University of Florida:

“This is years away and anyone doing it now is doing it without an adequate basis in scientific knowledge. The potential benefit is
completely unknown and the risks could be great (e.g., subsequent development of malignant brain tumors). This is certainly a worthy line of scientific study but extensive animal studies will need to be done and a far greater understanding achieved of the underlying neurobiology before we can proceed with brain stem cell implants in
humans.”

Re: stem cell implants
Posted at: 2021-05-27 11:55:46
I agree with your neurologist - there are several facilities reviewing research protocols and outcomes with animals cells but I do not recall anything with humans -
But I will check around - and get back to you.
Re: expressive aphasia
Posted at: 2021-05-27 11:50:41
Your oservations regarding preserved ability to sing are quite common. One reason - songs have a set rhythm, melodies and words that are rehearsed over and over, memorized and eventually becomes an “automatic” activity. In general, the term “automatic” implies that we know something so well that we do not need to concentrate or process the words and we say it or the words come out “automatically”- other examples include saying a prayer, a pledge, counting,or saying the alphabet. Some patients may use profanity automatically. Another reason - different parts of the brain facilitate different activities. Many people that study the brain feel that the right side (hemisphere) of the brain processes music and the beat of the music - while the left side of the brain processes the words we hear and say. In turn, when we sing we are tapping into the right hemisphere and facilitating the production of the words that are memorized. Thus, when we speak we are primarily using the left side (hemisphere) and each time we produce a unique combination of sounds. Speaking is more difficult than singing (automatic/ memorized or melodic patterns).

There are a couple of rehabilitation approaches that include melodies and intonational patterns into treatment for aphasia. One of the most common treatments is called Melodic Intonation Therapy (MIT) and Nancy Helm-Estabrooks has published articles describing this structured program and the types of aphasia that may benefit from this technique. You may want to check with the rehabilitation staff to see if MIT may be an option to consider for this individual or not. In the meantime, it never hurt anyone to sing and enjoy the music!

Although very common, am going to mention that I am not a fan of the word “expressive” to describe aphasia….. Why?
Well when we here the word “expressive” it implies that only speech output is involved while in reality aphasia impacts all language skills - listening/understanding, reading, talking, writing and gestures. I prefer the words “non-fluent” aphasia or there are types of aphasias that are defined by the the location in the brain - example: Broca’s Aphasia.

Good thought to consider alternate ways to communicate rather relying on speaking alone. Other options may include drawing, writing or pointing to pictures. In addition, did you know that our intonational patterns and facial expressions also play a significant role in communication with others?
To answer your question about would she be able to learn sign language? I will not be able to give you a definate answer without observing - but here are some of my thoughts -
Finger spelling (alphabet) - this may be difficult for an individual with aphasia because often there are problems with spelling. Problems spelling may also be seen when attempting to write or pointing to letters on an alphabet board.
Traditional Sign Language used by hearing impaired/deaf communities - incorporates standard upper extremity movements and would be like learning a new language with different rules and grammar. This would also be difficult for an adult to learn after a stroke and if there are any weaknesses of the arms or hands this would increase difficulty in signing.
Amerind - has been used with some success and incudes movements that imitate functional use of objects or easy to interpret gestures. And if I am not mistaken was originally used by American Indians.
As a clinician - I incorporate gestures that imitate common movement patterns to augment communication - example: drinking a glass of water, eating with a fork or cutting with a knife, brushing teeth, etc.
But sometimes there are motor planning problems that will limit these gestures and interrupt a smooth or complete movement. The differential diagnosis would be apraxia, specifically limb apraxia. The rehab specialists should be able to help you sort the potential differential diagnosis.
And - if the individual has had extensive, diffuse brain damage or more than one stroke - “learning skills” may be diminished. Someone on the rehab team should be able to evaluate the individual’s ability to learn new information and ability generalize the new information.
Most patients can also point with at least one hand - so I also encourage pointing when they are having difficulty saying the correct word.

All good questions - Thanks for writing.

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