Georgia: 33 years old, 6 months after stroke, Broca’s aphasia and apraxia, 6 week session
- At the beginning , she said a few single words and short automatic phrases (“I don’t know”) due to severe apraxia.
- She had an Ipad and Iphone that she could use almost independently to answer questions
- She rarely tried to speak, wanting to use her phone instead
- She wanted to return to work soon and speak in sentences
This client was a good candidate for intensive therapy because of age, relatively good understanding, able to easily use technology, supportive family and friends, and the most important part of all—motivation to improve.
Goal: Say 15+ different 1-3 words/phrases
- We started with key functional words/phrases such as “diet coke”, “water”, “bathroom”, “hungry”, “please”, etc.
- Halfway through, she was consistently saying more than 15 unique, single words in a session
- She said several 2-4 word utterances with assistance (e.g., “help me, please”)
- By the end of the program, she spoke spontaneously 50-80% of the time
- In social conversations, she said 1-3 words independently, allowing quicker responses and a natural conversational rhythm.
Goal 2: Sequence (pronounce) 1-3 syllables words/phrases clearly and accurately
- At the beginning , she repeated simple one and two-syllable words accurately (nose, snowball),
- Speech was difficult to understand for longer words/phrases due to her apraxia of speech.
- By the second week , Georgia said 2-3 syllable words with 94% accuracy
- At the final week, she said 1-3 words at a time independently or with little assistance.
Her aphasia test score for speaking, understanding and repeating went from 32 to 45.7, a gain of 13.7 points. Her reading comprehension score went up 55%, and her caregiver rated improvements from 19%-46% in the areas of getting attention, recalling and saying names of people, and in participating in a group discussion about herself.
Summary of Treatment
- To increase speaking independence, we worked directly on her apraxia.
- This client did a fairly good job of writing down the word that she couldn’t say during conversation, but needed help to then say it.
- With apraxia, the first sound of a word is usually the most difficult to do without looking at someone else saying it first.
Georgia returned to The Aphasia Center for another 4 weeks 2 weeks later to continue her treatment.