Recovery and progress in aphasia therapy

Recovery and progress in aphasia therapy

Introduction

Aphasia is a language disorder. In other words, parts of the brain for language have a deficit. Further, there is trouble speaking, understanding, reading, and writing. This is caused due to a stroke most often. Other neuro disorders can also cause a stroke.

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Furthermore, there are types of aphasias. Broca’s, Wernicke’s, Transcortical and Anomic. Rare aphasias are conduction and subcortical aphasia.  Hence, the person is referred to an SLP for therapy. Speech Therapy is crucial in aphasia rehab. Aphasia treatment is a part of life after a stroke. Additionally, therapy works on communication skills.

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Now, are you wondering what is the progress like? Further, many factors affect this. Progress and recovery depend on each person. So, let’s talk about it. Read on to know more!

Recovery and Language

In India, people speak two languages. Hence, there are two questions. In which language, therapy is done? Which language will recover faster? Therapy is done in the language that is dominant post aphasia. The language, used by the person often. Usually, it is the native language. Nevertheless, therapy will improve communication.

Recovery Patterns Based on the Language

1. Both languages are affected. Recovering at the same rate.
2. One language is recovering at a different rate.
3. One language is not progressing. The other is getting better.
4. In blended recovery. The person mixes their languages.
5. Sometimes one language recovers but then regresses.
6. There are different rate and recovery patterns. All persons show different patterns of recovery.

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Factors affecting recovery and progress in Aphasia

• Person’s age: Younger people improve more than older. Further, our brain can learn fast at an early age. As we grow older, learning speed reduces. Additionally, the effect of aging is in older people.
• Better language & literacy skills: The better the literacy pre aphasia. The better is the progress. Literacy surely improves our mental skills. Hence, people with academic skills show good progress. However, this is not true always.
• Education & Occupation: High levels of education. Those with greater demand for speaking. They improve better. The more mentally active the person was before, the better it is. This is not the case always.
• The lesion, location, and severity of the damage: The location of the injury. The type of injury and severity is critical. This greatly affects the recovery. A diffuse lesion results in more loss of skill. So, recovery may take longer. The location also plays a vital role. The more severe the deficit. The recovery is slow. Mild or moderate aphasia recovers faster. A small area of damage is easy to treat. If a larger brain area is affected. Many skills need to be worked on. This affects the speed of progress.
• Associated issues: Any co-existing issues. Such as paralysis of limbs, vision, and swallowing skills. These affect the progress. Progress takes longer. Pure aphasias are easy to treat. Dementia makes the recovery slow. Regression of learned skills can be seen. This is due to memory loss.
• Type of aphasia: Some aphasia types show faster recovery. Other aphasia types have slower recovery. When a small skill is affected. As in anomic aphasia. The recovery is quick. In global aphasia, recovery may be slower. This is because many skill sets are deficient. Type of aphasia can affect the speed of recovery.

Treatment-Related Factors

• Timing of starting treatment:
• Early treatment will show better progress. Delayed treatment has slow progress. The earlier, we start therapy the better it is. Stimulation during the early stages of aphasia is vital. This helps the brain to recover faster. The more the delay, the brain is left untrained. So, recovery will be slow if therapy is given later. Begin therapy as soon as you can. Once the person is medically stable. You can start the rehab. Be it speech or physical therapy. Always initiate therapy soon.

• Treatment technique:

• Effective techniques produce positive results. The right strategy will result in desired progress. This is decided by your therapist. Choosing the therapy technique is crucial. Techniques are based on the person’s needs. One or more strategies may be used. This depends on the skills being trained.
• There are many techniques. The right one will give good results. So, discuss and stay informed. Ask your therapist for information. They will help and guide you.

• Accuracy of treatment:

• Effective treatment is not enough. Its application should be accurate. Only then, it will show good progress. Carrying out the daily home training is essential.
• Therapy does not end in the session. You have to include it in daily life.
• Daily practice will give fast progress. So, home training is vital and crucial.

• The length of therapy:

• Longer treatments have a greater impact. Brief treatments will not show good results. Therapy can last anywhere between few months to years. So, be patient and look forward to positive results. Progress expected wait time is usually a few months to years. Some people stay in therapy for years together. It finally depends on the person and the above conditions.

• The intensity of treatment:

• More intensive treatment. Produce better results. Therapy sessions that are longer and intensive have better outcomes. If you go to rehab only once a week and expect greater progress, it’s tough. So, be regular for therapy. Intensive rehab is always advised in the early stages. Therapy of 8 hours a week for 12 weeks. This will give a better outcome. Lesser duration will impact progress.
• However, take therapy as directed by your therapist. Every person had different needs. Your therapist will advise.

• Family involvement:

• Family involvement is crucial. The better the family support, the best it is. Persons with aphasia need moral and physical support. So, always make sure you’re involved in sessions. The person will feel happy.
• The decline in general health during therapy. This will impact the progress. Good health is vital during the rehab process.
• Hence, make sure your loved one is in good health. Consult your doctor regularly. Keep his/her health in check.

• Spontaneous recovery:

• Spontaneous recovery is when our brain cures itself. Our brain is working to help us. So, start therapy to support spontaneous recovery. Especially during the first 6 months. During this time recovery is fast. So, start therapy early.
• However, spontaneous recovery does not happen in every case. Young people recover better. As we grow this goes down.

What should caregivers do when they start therapy?

• Some show faster progress. For some, it takes longer.
• Consult an SLP upon discharge or in hospital.
• Begin rehab early.
• Early intervention in aphasia gives better results.
• Support you’re loved one.
• Be regular in sessions. Be consistent.
• Follow home training at home.
• Take intensive therapy in the early days.
• Make sure to discuss concerns in the sessions.
• Trust your therapist and have a healthy bond.
• The therapist is there to help you. So, have faith in the process.
• Do not overburden your loved one. Be mindful.
• Teach functional vocabulary.
• Talk about things relevant to them.
• Stay connected with the therapist for guidance.
• Monitor the health of your loved one.

Some tips for caregivers: 

• Be regular and persistent: Progress takes longer often. Hence, be patient and wait for results. DO not rush your loved one. So, cheer them up and support them. Further, consult with a counselor if needed. A counselor will help you deal with stress and low feelings.
• Empathizing with the patient: People with aphasia have depression often. Therapy can be frustrating also. Further, this is due to the fact that they are unable to communicate. So, be empathetic. Support them and help them.
• Do not treat the person with aphasia as a child. In other words, they are the same person. Except that now they are unable to communicate. So, treat them as per their age.
• Give them time to speak. Ask fewer questions.
• Do not interrupt them while speaking. Give them time to respond. Do not bombard them with questions.
• Do some physical activity such as walking. Take them outside and meet people.
• Keep talk simple but adult-like. Do not complete sentences for them.
• Keep your volume at a normal level. Reduce background noise.
• Engage in normal activities. Further, play cognitive games with them. Furthermore, involve them in decision-making. Keep them engaged. Talk to them often. Discuss family priorities with them.
• Make your loved one feel wanted.
• Encourage independence. Further, avoid being overprotective. Similarly, give them the freedom like an adult.
• Furthermore, let them be a part of social circles. Socialization will help them. This boosts speech and keeps them active.
• Further, social meetings will keep them in a good mental state. It will keep them happy. They can also vent their feelings to their friends and feel at ease.

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