10/21/2013 1:02:00 PM Language exercises help stroke patients regain speech
EAR DOCTOR K: My mother recently had a stroke, and it's severely impacted her ability to speak. What can be done to help her regain her speech?
DEAR READER: Losing the ability to speak, or to understand speech, takes away an important part of ourselves -- the ability to communicate easily with others. I would rather be blind or deaf than unable to speak or to understand others. But there is hope that your mother can improve.
A stroke occurs when a blood vessel supplying the brain bursts or becomes blocked. In both cases, the injury deprives the brain of a constant supply of oxygen- and nutrient-rich blood. Brain cells can die, possibly affecting a person's ability to move, feel, think or even recognize people. In your mother's case, it has taken her ability to speak.
Your mother should begin a rehabilitation program with a speech-language pathologist as soon as she is able. This therapist will help your mother improve her capacity to speak and understand speech.
The two most common stroke-related speech impairments are aphasia and dysarthria.
Aphasia is the loss of the power to use or understand words. In most people, it occurs when a stroke damages the left side of the brain, which is where language is processed. Some people with aphasia have trouble talking but can easily understand speech. Others talk easily but can't understand what people are saying.
Rehab for someone with aphasia involves speech and language exercises that help the patient regain the ability to understand, speak, read and write. Exercises include repeating words a therapist says, practicing following directions, and practicing reading and writing. Group therapy sessions provide opportunities to practice talking with others who are recovering from strokes. A therapist may also recommend a voice-output, or speech-generating, device to aid communication in daily life.
Dysarthria is the inability to speak because the stroke has weakened the muscles of the tongue, palate and lips -- the parts of the mouth that utter words. With dysarthria, a person can understand speech and form proper words in his mind, but just cannot get the words out of his mouth. Persons with dysarthria often can write their thoughts down perfectly well even though they cannot speak them out loud.
A person with dysarthria can do exercises to help increase strength and endurance in the muscles used for speech. The therapist also helps to improve enunciation. He or she might recommend speaking more slowly or taking deeper breaths before speaking.
A patient of mine in his early 70s ran a small Italian restaurant. During the holidays, 40 to 50 of his closest family members would congregate at his house. He and his wife cooked. He loved these family reunions even though they required lots of work. "That's what makes our family so close: food and conversation." He suffered a stroke that caused dysarthria. At the family gatherings, he installed a blackboard on an easel and "spoke" by writing comments on the blackboard. Despite his stroke, he kept the family conversation going.
(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)