Speech Therapy

Speech therapy helps stroke patients relearn language and speaking skills, or learn other forms of communication. It is appropriate for patients who have problems understanding speech or written words, or problems forming speech.

A speech therapist helps stroke patients help themselves by working to improve language skills, develop alternative ways of communicating, and develop coping skills to deal with the frustration of not being able to communicate fully. With time and patience, a stroke survivor should be able to regain some, and sometimes all, language and speaking abilities.

Speech therapy also can help with dysphagia, which refers to difficulty swallowing due to dysfunction of the muscles of the mouth and throat.

Aphasia Speech Therapy

After a stroke, you may have problems speaking, listening, writing or comprehending speech or other forms of communication — a disorder known as aphasia.

Aphasia is a common stroke complication, affecting about 40 percent of stroke survivors. Many recover within a few months after the stroke, but up to 60% still have language impairments more than six months after a stroke, a condition known as chronic aphasia. It would be good to practice basic skills, such as naming objects or explaining the purpose of an object.

Below are some of the popular aphasia treatments used during speech therapy:

• Cognitive linguistic therapy - This form of therapy emphasizes the emotional components of language. For example, some exercises require patients to interpret the characteristics of different emotional tones of voice. Others require them to describe the meaning of highly descriptive words or terms such as the word "happy." These speech therapy exercises help patients practice comprehension skills while focusing on understanding the emotional components of language.
  
• Programmed simulation - This type of speech therapy uses multiple sensory modalities, including pictures and music, introduced in a gradual progression from easy to difficult.
  
• Stimulation-facilitation therapy - This form of aphasia therapy focuses mostly on the semantic and syntactic parts of language. The main stimulus used during therapy sessions is auditory stimulation. One of the main assumptions of this type of therapy is that improvements in language skills are best accomplished with repetition.
  
• Group therapy - This type of therapy provides a social context for patients to practice the communication skills they have learned during individual therapy sessions, while getting important feedback from therapists and other aphasics. Family treatment strategies have a similar effect, while also involves facilitation of the communications of aphasics with their loved ones.
  
• PACE (Promoting Aphasic's Communicative Effectiveness) - This form of aphasia therapy promotes improvements in communication by using conversation as a tool for learning. PACE therapy sessions typically involve an enacted conversation between the therapist and the patient. In order to stimulate spontaneous communication, this type of therapy uses drawings, pictures, and other visually-stimulating items which are used by the patient to generate ideas to be communicated during the conversation. The therapist and the patient take turns to convey their ideas.
  
• Pharmacotherapy - Many medications have been tried so far including piracetam, bifenalade, piribedil, bromocriptine, idebenone and dextran 40, donezepil, amphetamines and several antidepressants. There is little evidence that suggests some degree of efficacy of donezepil, piribedil and amphetamines in aphasia treatment
  
• Transcranial Magnetic Stimulation (TMS) - Although this modality of treatment is seldom used, its efficacy is under intense investigation. TMS consists of aiming a magnet directly at a part of the brain which is thought to inhibit language recovery after stroke. By suppressing the function of that part of the brain, recovery is enhanced. The type of magnetic therapy that has been tried in aphasia rehabilitation is the "slow and repeated" version of TMS.
  

Dysphagia Speech Therapy

Difficulties in swallowing occur in up to half of people experiencing a non-fatal stroke. Although some spontaneously recover this function in the first two weeks, many continue to have problems that interfere with physical function, nutrition, recovery and quality of life.

Speech therapy also includes tongue exercises for dysphagia caused by stroke. These can induce significant improvements in swallowing and quality of life.

The exercises described below are meant to serve as a standard way of strengthening tongue function. For some people, these exercises will be fairly easy to do. As each exercise becomes easier to do, higher strength and repetition goals should be set.

Speech therapy tongue exercises:

1. Open your mouth as wide as you can, and touch the tip of your tongue to you upper teeth or to the front of the palate. Do this for 3 to 5 seconds, and repeat 5 to 10 times.
2. OPen your mouth and touch the tip of your tongue to the back of the roof of your mouth. Keep your tongue back for 3 to 5 seconds, and repeat 5-10 times.
3. Stick your tongue out as far as you can, and leave it there for approx 10 seconds. Do this 5 to 10 times.
4. Bring the tip of the tongue to the very back of the roof of your mouth, and keep it there for about 10 seconds. Repeat this exercise 5 to 10 times.
5. Move the tip of your tongue across the roof of your mouth from the very front (just behind your upper teeth) to the very back (to where the soft palate is located). Do this 10 times, bringing it as far back as possible each time. Repeat the exercise 5 to 10 times.
6. Press the inside of each cheek with the tip of your tongue. Repeat the exercise 5 to 10 times.
7. Stick your tongue out as far as you can. Using its tip, press up against a spoon or some other clean object. Do this for 5 seconds. Repeat this exercise 10 times.

Depending on the specific degree of dysfunction, a stroke patient might or might not be able to do perform one or more of the exercises. Keep on trying. Push yourself each day.