Time Since Stroke: 14 months
Problems: The father of three young children, Kory’s lack of progress in therapy had affected the entire family. He would become angry and his children were afraid because they didn’t understand him. His spouse had been told that he couldn’t get better.
Assessment: Standardized testing placed Kory in the Very Severe Global Aphasia range. However, he did have relatively good comprehension and some single word reading. He could also write his full name independently. He had very severe apraxia and decreased awareness of his speech production, but he was also extremely motivated. He had a great sense of humor, however, and was always playing jokes on everyone at the office.
Treatment: He began with a 6-week treatment session, but added two weeks. He received OT three times per week. He worked on speech production and other ways to communicate.
At the beginning, Kory’s speech was limited to “guhbuh” and “buhbuh”. Very severe apraxia meant that he could not form sounds purposefully or sequence mouth movements.
- In the first week, he learned 8 phonemes (sounds) and 2 words with minimum to maximum help
- During the first three weeks, he added 25 new words and 9 new phonemes with max cues
- He began to say some sounds or words after seeing the word or picture of the sound. Over the next five weeks, Kory added approximately 30 new words and more than 6 phonemes (total of 55+). He said simple words independently during the day (“hi”, “bye”, “no”, “coke”)
- He also began to use two-word sequences with maximum cueing, such as “go home” and “my coke”. To his family’s delight, he also learned to say his son’s name