When most stroke survivors go home, that's not the end of recovery or therapy. They often get to go to an outpatient facility a few times a week to continue making progress with PT, OT, and speech therapy. It's great when that's feasible.
Unfortunately, it can mean spending several hours to attend a 45 minute session. An it may require that not only from the survivor but also from a care partner. Transportation logistics, scheduling challenges, etc. can take energy that would better spent on recovery and rehab.
But do we really need to travel?
The pandemic radically sped up the adoption of telemedicine and remote healthcare. Facilities added infrastructure and patients learned to use Zoom and Teams. A lot of therapy -- especially speech therapy can be done online with a remote therapist.
Lenora Edwards is a Speech Language Pathologist with Better Speech. Better Speech has more than 150 therapists around the US offering remote Speech Therapy.
In this episode, Lenora tells us how this works, how it helps, and when remote therapy doesn't make sense.
If you don't see the audio player below, visit http://Strokecast.com/MSN/BetterSpeech to listen to the conversation.
Who is Lenora Edwards?
Lenora Edwards is an ASHA board certified Speech-Language Pathologist.
Throughout her career as a speech therapist, she has enjoyed treating and evaluating a wide variety of speech and language issues across the lifespan.
Aphasia, Apraxia, and Dysarthria
These are three common speech challenges after a stroke.
Aphasia is trouble finding words. A person has all their thoughts, feelings, and smarts, but they just can't access the vocabulary to express themselves. They're not dumb, and they still have all their intellectual capability and processes. They just can't use words.
In some cases, they can understand things fine; in others, they lose the ability to understand words, too. Sometimes they can read and write. Sometimes those functions break.
Apraxia is a challenge of getting the words in the right order. Once you can access your words, and pull them off a metaphorical shelf, you still need to chain them together into sentences and paragraphs to communicate with other people.
Dysarthria isn't a language issue itself; it's a speech issue. Dysarthria happens when we have trouble with the mechanics of speech -- tongue, larynx, jaw, and lip movements for example. This is what had for a little while. My hemiparesis wasn't just my arm and leg, but also the muscles on the left side of my face and mouth. It resulted is some slurring and mild pronunciation challenges. Overall, it was one of my milder deficits at the time. Most folks thought it cleared up in a couple weeks; I continued to notice it for 6 months.
One fascinating aspect of all this is just how much goes into language and communication. There are so many different ways it can go wrong, it's a wonder anyone can speak at all.
Adjective Sequence
We learn our first language intuitively We pick it up as a child from those around us, cultural tools, our environment, and later school. We don't learn the rules first. We learn them after we've already been using them for much of our lives.
In English, adjective sequence is one of those rules. Many of us heard or read the children's books about Clifford, the big, red dog. Just saying that phrase will trigger a memory for many folks. Even if this is the first time you've heard about Clifford, you understand what I mean. You may not be aware that by big, I mean house-sized, but you get the point.
If I mention Clifford, the red, big dog, it seems wrong. And it is because in English (in the US, at least), size adjectives come before color adjectives. That's the rule. When did I learn this?
Last year. Seriously.
I never knew this was a rule before, but I "knew" it was a rule. I knew it intuitively from hearing and speaking the language for 50+ years. I think that's the experience most people have.
It's one of the reasons language is so fascinating. Two sentences adhering to the core rules of grammar with all the same words come into our awareness, and one of them is simply wrong. And we may not know why. But we know it.
Adjective sequencing is an interesting topic. You can read more about it at Grammarly.
Emojis!
English is a phonetic language. We build our words with letters and letter combinations that make sounds that align with the sound of the words when we speak. We can create any written word with just 26 symbols.
Other languages are symbolic. Characters may not represent a sound, by a symbol. Combining symbols and impressions of images and concepts is how to create words. Many languages from Asia are primarily symbolic languages. Learning to "spell" words is more complex, if you can even call it spelling.
Language is continuing to evolve, though. Over the past 30 years, we've seen the definite increase in symbolic elements coming into our written communication. For example : )
Using the keyboard to create symbols from letters grew rapidly in the online communities of the late 80s and early 90s. Gradually, we started to see Emojis, or dedicated symbolic characters come into the mainstream of communication, to the point where we now have hundreds of them. 😊
Abbreviations and acronyms have become words. We know what lol, WTF, AFK, and more mean at a glance even though we might never say them out loud. They exist mainly in our typed language.
One thing I like about emojis is that they can add nuance to our text-based communication. The add a flair to the conversation that might have been a tone in the voice in a vocal conversation. They help add emotion back into text that got stripped out when we started typing.
And since they're visual, everyone can understand, right? I mean a smiley face transcends borders and language, right?
Well, all languages evolve, even emojis. At one point, the eggplant and peach emojis just represented a vegetable and fruit. Over time, they've come to be stand-ins for sexual activity. If you don't know that, it can make for some awkward situations.
With abbreviations, it matters, too. For some, LOL means "laughing out loud." For others, it means, "Lots of Love." Knowing who your typing with and that you both have the same interpretation matters.
There was an interesting thread on the Ask A Manager site about this recently. It discussed the face with steam coming from the nose. 😤 This may even look different on different devices. But if someone sends that to you, does that mean they are working hard or does it mean they are angry. You can read the thread here.
And this is one more reason why language is such a fascinating area and why aphasia really sucks.
Hack of the Week
We've heard it before because it is so important -- be patient, and allow those around you to be patient with you.
Our own recovery takes time. It's a marathon, not a sprint. Reacquiring abilities can take years.
It's equally important for others in a survivor's life to be patient. There is an instinct to help as much as possible -- to rush and open a door, to take things from a survivor to carry them, or to finish their sentences for them. But don't. sure, help if asked. Or if you want to offer help, that's okay. But when a survivor declines help, respect that decision.
The way to learn to do things again is to do them. We have to be patient with ourselves and others to make that possible.
Links
Where do we go from here?
- Check out the links above to learn more about Lenora and Better Speech.
- Share this episode with someone you know by giving them the link http://Strokecast.com/BetterSpeech
- Share your Win of the Week by calling 321-5Stroke and sharing it in a voicemail.
- Don't get best…get better.
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