Something I have not been able to do as much as I had before I had children is reading. I love being transported to new worlds but more so, I love learning new things. I have always preferred non-fiction. My favorite author is Malcolm Gladwell, teaching us social issues and tiny minutia of life that actually has huge impacts. Because of my love for learning new things and tiny things that actually have a huge impact, I love learning about the brain. Perhaps it is part of why I became a speech therapist.
This weekend, my husband and I actually went on a date and we chose to just chill out at the library. I was able to relax with a book on the brain called The Man Who Mistook His Wife For A Hat. This book reminds me a lot of my favorite book on neurology, Phantoms In The Brain. These books talk about how important certain areas of our brain are in everyday functions that we don’t even realize are important until they are damaged in some way.
One of the first stories in The Man Who Mistook His Wife For A Hat is about how the study of the mind as it relates to the brain didn’t even start until 1861 when Pierre Paul Broca, a physician in France, found that his patients who displayed problems with speech production consistently had damage to a certain area in the brain, an area in the left side of the brain that we call Broca’s Area today.
In our modern culture, we know now that these difficulties with language are called Aphasia. This is an acquired disorder that is caused by some kind of damage to certain language centers of the brain, mostly from stroke or head trauma. Again, in today’s culture, we also know that there several areas of the left side of the brain responsible for language functioning, including Broca’s area (responsible for grammar and structure of sentences) and Wernicke’s area (responsible for vocabulary and meaning). Lastly, we know that there are many different kinds of aphasia that can range from mild to severe and can affect one or many of the four domains of communication: receptive language (what we understand), expressive language (what we can say), reading, and writing.
Someone with aphasia may present with only being able to get out a few words with meaning (example: “Mom. Sock. Morning” meaning, “Mom put on my socks this morning”) or they may fluently speak but with little to no meaning (example: an incoherent string of words or “jibberish”). They may not be able to read, write, use sign language, understand what is being said to them, or communicate their thoughts clearly. Motor functioning of speech and hearing are not affected by damage to the areas of the brain that cause aphasia; this means that a person with aphasia will still be able to functionally move their mouth for speech and hear speech (unless of course those areas of the brain were damaged too, but these would be separate diagnoses). It must be understood, too, that intelligence is not affected by having aphasia. I am sure you can imagine how frustrating, lonely, and confusing it must be to be for a person who can very easily understand and use language at will to lose their functioning in any of these domains.
So, now that I have explained a little of what aphasia is, I am sure you may be wondering, “Well, how do you help these people?” First, we assess an individual who is identified with having some kind of damage to their brain and/or is having problems with language that they did not have before. We determine if that individual has symptoms of one of the eight types of aphasia. Typically, this is done in the hospital after an incident but may happen in other settings, particularly if the individual is gradually losing functioning. Then, we would assess what domains of communication with which the person is having difficulty and create a plan to address those areas in terms of creating a way to communicate, which may include alternative and augmented communication (AAC) such as a device or a picture book, and we address ways in which to create new neural pathways by implementing therapy techniques specific to the type of aphasia (including but certainly not limited to Melodic Intonation Therapy, Semantic Feature Analysis, Visual Action Therapy). It is important to remember that the brain is an amazing organ and has the capacity to heal and create new pathways if we are utilizing both hemispheres and allowing a person to use their strengths to aid the weaknesses.
Intensive therapy is important within the first 1-2 years of brain damage, more specifically within the first 6 months when spontaneous recovery happens, as research has shown this to be the time of most improvement for an individual (Smania, et al., 2010). There is no consensus on what “intensive” qualifies as, so this is something a team of professionals, including doctors and SLPs, should agree upon. However, a person’s fatigue levels, stamina, and motivation need to be taken into account for intensity as well.
I have given the “Cliff Notes” version of aphasia and aphasia therapy. There are so many more nuances and so much more information if you need it. Please feel free to leave a comment, send me an email (Kathleen.rehabspecialists@gmail.com), or call us here at the office (412-761-6062) if you have any other questions about aphasia or speech therapy. Until next time!
Kathleen
Journal Article Mentioned:
Smania, N., Gandolfi, M., Aglioti, S.M., et. al., How Long Is the Recovery of Global Aphasia? Twenty-Five Years of Follow-up in a Patient With Left Hemisphere Stroke. Neurorehabilitation and Neural Repair, Vol 24, Issue 9, pp. 871 – 875; First Published September 9, 2010; Retrieved from https://doi.org/10.1177/1545968310368962
Books mentioned:
The Man Who Mistook His Wife For A Hat and Other Clinical Tales by Oliver Sacks
Phantoms In The Brain: Probing The Histories Of The Human Mind by V.S. Ramachandran
This weekend, my husband and I actually went on a date and we chose to just chill out at the library. I was able to relax with a book on the brain called The Man Who Mistook His Wife For A Hat. This book reminds me a lot of my favorite book on neurology, Phantoms In The Brain. These books talk about how important certain areas of our brain are in everyday functions that we don’t even realize are important until they are damaged in some way.
One of the first stories in The Man Who Mistook His Wife For A Hat is about how the study of the mind as it relates to the brain didn’t even start until 1861 when Pierre Paul Broca, a physician in France, found that his patients who displayed problems with speech production consistently had damage to a certain area in the brain, an area in the left side of the brain that we call Broca’s Area today.
In our modern culture, we know now that these difficulties with language are called Aphasia. This is an acquired disorder that is caused by some kind of damage to certain language centers of the brain, mostly from stroke or head trauma. Again, in today’s culture, we also know that there several areas of the left side of the brain responsible for language functioning, including Broca’s area (responsible for grammar and structure of sentences) and Wernicke’s area (responsible for vocabulary and meaning). Lastly, we know that there are many different kinds of aphasia that can range from mild to severe and can affect one or many of the four domains of communication: receptive language (what we understand), expressive language (what we can say), reading, and writing.
Someone with aphasia may present with only being able to get out a few words with meaning (example: “Mom. Sock. Morning” meaning, “Mom put on my socks this morning”) or they may fluently speak but with little to no meaning (example: an incoherent string of words or “jibberish”). They may not be able to read, write, use sign language, understand what is being said to them, or communicate their thoughts clearly. Motor functioning of speech and hearing are not affected by damage to the areas of the brain that cause aphasia; this means that a person with aphasia will still be able to functionally move their mouth for speech and hear speech (unless of course those areas of the brain were damaged too, but these would be separate diagnoses). It must be understood, too, that intelligence is not affected by having aphasia. I am sure you can imagine how frustrating, lonely, and confusing it must be to be for a person who can very easily understand and use language at will to lose their functioning in any of these domains.
So, now that I have explained a little of what aphasia is, I am sure you may be wondering, “Well, how do you help these people?” First, we assess an individual who is identified with having some kind of damage to their brain and/or is having problems with language that they did not have before. We determine if that individual has symptoms of one of the eight types of aphasia. Typically, this is done in the hospital after an incident but may happen in other settings, particularly if the individual is gradually losing functioning. Then, we would assess what domains of communication with which the person is having difficulty and create a plan to address those areas in terms of creating a way to communicate, which may include alternative and augmented communication (AAC) such as a device or a picture book, and we address ways in which to create new neural pathways by implementing therapy techniques specific to the type of aphasia (including but certainly not limited to Melodic Intonation Therapy, Semantic Feature Analysis, Visual Action Therapy). It is important to remember that the brain is an amazing organ and has the capacity to heal and create new pathways if we are utilizing both hemispheres and allowing a person to use their strengths to aid the weaknesses.
Intensive therapy is important within the first 1-2 years of brain damage, more specifically within the first 6 months when spontaneous recovery happens, as research has shown this to be the time of most improvement for an individual (Smania, et al., 2010). There is no consensus on what “intensive” qualifies as, so this is something a team of professionals, including doctors and SLPs, should agree upon. However, a person’s fatigue levels, stamina, and motivation need to be taken into account for intensity as well.
Here in Pittsburgh, Duquesne University (my alma mater) has an aphasia clinic at the university where individuals and their families can receive intensive individual therapy and group therapy which also serves as a support group for these individuals and their families. Duquesne doesn’t even know I am giving them a plug in this blog post, I just saw so many good things studying in the aphasia clinic and I often refer individuals for their services. Contact information can be found below and new and interesting happens can be found at the Communication and Cognition Lab Facebook page found at https://www.facebook.com/CommunicationAndCognitionLab/ and run by the very knowledgeable Dr. Sarah Wallace.
In addition, there is a program specifically for veterans (https://www.pittsburgh.va.gov/pirate/), and a whole list of providers approved by the National Aphasia Association in Western PA (https://www.aphasia.org/aphasia-support-pennsylvania/). The most important aspects in choosing where to seek therapy services, besides who is in network with your insurance provider, would be where the individual feels comfortable and has a good rapport with the therapist(s). One aspect about our private practice here at Rehabilitation Specialists is that our wonderful boss and director, Kathy Helfrich-Miller, wanted her practice to feel like home. That is why we operate out of an old house right in the heart of Bellevue. Right across from scenic Bayne Park and in one of our treatment rooms that feels like you are visiting a friend, we may be a good fit for people looking to feel comfortable in therapy.
In addition, there is a program specifically for veterans (https://www.pittsburgh.va.gov/pirate/), and a whole list of providers approved by the National Aphasia Association in Western PA (https://www.aphasia.org/aphasia-support-pennsylvania/). The most important aspects in choosing where to seek therapy services, besides who is in network with your insurance provider, would be where the individual feels comfortable and has a good rapport with the therapist(s). One aspect about our private practice here at Rehabilitation Specialists is that our wonderful boss and director, Kathy Helfrich-Miller, wanted her practice to feel like home. That is why we operate out of an old house right in the heart of Bellevue. Right across from scenic Bayne Park and in one of our treatment rooms that feels like you are visiting a friend, we may be a good fit for people looking to feel comfortable in therapy.
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| Our home away from home |
Kathleen
Other Resources:
ASHA’s Overview: https://www.asha.org/Practice-Portal/Clinical-Topics/Aphasia/
Duquesne University's Speech-Language-Hearing Clinic: Call 412.396.4200 or email slhclinic@duq.edu; webpage at https://www.duq.edu/academics/
Journal Article Mentioned:
Smania, N., Gandolfi, M., Aglioti, S.M., et. al., How Long Is the Recovery of Global Aphasia? Twenty-Five Years of Follow-up in a Patient With Left Hemisphere Stroke. Neurorehabilitation and Neural Repair, Vol 24, Issue 9, pp. 871 – 875; First Published September 9, 2010; Retrieved from https://doi.org/10.1177/1545968310368962
Books mentioned:
The Man Who Mistook His Wife For A Hat and Other Clinical Tales by Oliver Sacks
Phantoms In The Brain: Probing The Histories Of The Human Mind by V.S. Ramachandran
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