Articles we have written that have been printed elsewhere.

Tips for Expression

MS Focus Magazine Vol. 12, Issue 1, Winter 2010

If your loved one can’t find the right words to say,resist the urge to do it for them. Instead, ask them to show you, gesture it, describe it, write it, or even wait a few moments for them to collect their thoughts. You can tell them, “Let’s try again in a few minutes.” Ask them if they want your help.

Depending upon how writing has been affected, you can ask them to write down one or two words to help you understand. For example, if you want to know what they want for breakfast, and they have difficulty telling you, you could ask them to point to the item or to write down its name. Always have a small pad of paper and pen nearby so that you can use this in any setting. Even if your family member can only write the “e” for eggs, you can narrow down the choices with just this information. You can then clarify the choice by asking, “Do you mean eggs?” while finishing the word for them.

When dining out, allow the person with aphasia to do as much of their own ordering as possible. Try to get the restaurant menu before your outing so that you can slowly go over it together. This strategy gives you and your loved one time to explore the different options – “The entrée comes with two side dishes, which ones would you like?”

Restaurants are often busy, and the person with aphasia may feel pressure to communicate with an unfamiliar person in a hurry. Another strategy is to ask your family member to point out the items he or she wants to order to the wait staff, or they could write out their order and hand it to the wait staff. People with aphasia can become just as frustrated as you are when they cannot  effectively get their message across.

Remember that they may not be able to think of the most efficient way to communicate.They are struggling to express themselves in the only way that they can. You may play “20 questions” to get to the right response, but  they may need you to guide them through the process to find the right concept. If you find that you are both frequently frustrated, you may want to consult a speech pathologist.

Survivors Take Charge of Their Own Recovery

Rehabilitation & Recovery, Fall 2010

Aphasia is an impairment of language. Stroke survivors with aphasia might be unable to  use and comprehend words, but aphasia does not affect intelligence. It is a common

problem for many stroke survivors and might make it hard to:

  • Talk
  • Understand what other people say
  • Read
  • Write
  • Use numbers and do calculations

No two people experience aphasia the same way. Some people have different symptoms than others. Some have mild problems, while others experience more severe  issues.

I am often asked to recommend a center or colleague to provide speech therapy  services. Before I recommend where to go or who to see, I like to introduce the idea that  a survivor can continue to make progress even years after a stroke. Research shows  that patients make more lasting and quicker progress when their goals are relevant to  them.

Personalized, functional activities could include:

  • Learning how to order at a restaurant.
  • Writing personal information.
  • Using a variety of ways to communicate with family — speech, writing, reading,  gestures, etc.
  • Using new strategies and technology to read the newspaper.

Frequently the person living with aphasia receives various therapies immediately  following the stroke. At some point insurance reimbursement decreases or ceases and  therapy stops. The patient might be told that he or she has reached a plateau. Many  patients and families might not have been educated about recovery from aphasia and  do not realize that they can continue rehabilitation on their own. Studies in neuroimaging have shown that the “spontaneous recovery period” can last up  to two years after a stroke. This means that the most gains are made within the first two  years. However, research also shows that patients can continue to make gains after two years, as long as they keep working on it.Gains might not be as fast or as large as the initial improvements, but they can definitely  add up. At The Aphasia Center at Steps Forward, we have seen improvements in  people who have been living with aphasia for as long as 20 years.  The key is to keep going to therapy and to keep teaching oneself. After all, if brains  could not change, no one would ever learn anything. Humans continue to learn  throughout life because of  neuroplasticity. Loosely translated, this means the brain has  the ability to change and form new connections — the ability to adapt and learn.  Because people are able to learn new things after brain damage, stroke survivors can  continue to improve speech, language, memory, arm strength and walking, among other  activities.

So, regardless of what patients are told when discharged from therapy, they can  continue to improve. And they are in charge of how aggressively they pursue change.  Stroke survivors should become familiar with their insurance coverage benefits for speech therapy. Some companies might renew the number of sessions each calendar year. Do not let anyone claim that stroke survivors cannot get better. Become empowered. Be insistent. It might take more time and effort, but it can be done. Get started now.

Aphasia Resources

  • National Aphasia Association at or 800-922-4622.
  • Local colleges might have a speech-language training program with a clinic.
  • Students learning to become speech pathologists perform the services under the supervision of licensed speech pathologists. Services are often free or low cost per semester.
  • Some rehabilitation centers or hospitals have a sliding-fee scale for treatment.