Speech and Language Therapy Niamh Ruddle Speech and Language Therapist
Aims Role of Speech & Language Therapist Swallowing disorders Signs of swallowing difficulties Communication disorders Practical communication tips
Swallowing
Dysphagia Swallowing difficulties are common after a stroke. (25% to 50% of patients will present with oropharyngeal dysphagia) SLT s role to assess and manage swallowing difficulties Compensatory techniques Rehabilitation techniques Alternative feeding may be needed e.g.peg tube
Signs of dysphagia Food or liquid spilling from the mouth or oral residue Coughing / choking / eye tearing during or soon after eating or drinking Wet or gurgly sounding voice during or after eating or drinking Shortness of breath during and after eating or drinking Extra effort or time needed to chew or swallow Chest infection / aspiration pneumonia Weight loss or dehydration from not being able to eat enough
Communication
Communication Difficulties Aphasia / Dysphasia Dysarthria Dyspraxia
Aphasia / Dysphasia Language difficulty Understanding Talking Reading Writing
Aphasia / Dysphasia Aphasia is an acquired long-term, lifechanging communication disability, which affects both the individual and others around them. Aphasia can impair a persons ability to understand and use oral and written language Living with aphasia involves individuals and those in their environment in a process of adaptation to change in terms of communication style, lifestyle and sense of self.
Prevalence 14, 500 people with aphasia in Ireland 220, 000 people with aphasia in the UK Aphasia is more common than such conditions as Parkinson s Disease, Multiple Sclerosis and Muscular Dystrophy (Elman, Ogar and Elman, 2000)
Challenges of Aphasia After a stroke the communication difficulties will improve with spontaneous recovery and rehabilitation (impairment based therapy) But also rehabilitation is about learning to live with a communication disability / aphasia This is a big challenge both for the person with aphasia and those around them
People with aphasia may find it difficult to.. Take part in conversation Talk in a group or noisy environment Read a book or magazine or road sign Understand or tell jokes Follow the TV or radio Use the telephone Use numbers/money Say their own names or names of their family Express their immediate needs or ideas or words Stop themselves swearing
Family and friends living with Aphasia may find it hard to.. Slow down Resist finishing sentences Adapt the way they communicate Keep the conversation going Understand what a person is saying Know what to do
Dysarthria Motor Speech disorder Difficulty with speech production due to weakness, in-coordination, and/or paralysis of the muscles necessary for speech. Speech is slow, weak, imprecise or uncoordinated. The type and severity of dysarthria depend on which area of the nervous system is affected.
Apraxia of speech Motor speech planning / programming disorder Characterised by loss of the ability to execute or carry out skilled movements, despite having the desire and the physical ability to perform them. One of the most notable symptoms is difficulty putting sounds and syllables together in the correct order to form words. In the most severe cases, a person may not be able to communicate effectively with speech, and may need the help of alternative or additional communication methods.
Tips for helping to get your message across No distractions Glasses / hearing aids on Face each other Take your time Present one idea at a time Repeat / rephrase Plain, clear English
Tips for helping to get your message across Illustrate the idea using writing key words, drawing, facial expression, intonation, gesture, pointing Check things out before moving on Establish a consistent yes/no Props
Tips for the Communication Partner Take your time Watch and listen Summarise and check Give written choices Use and encourage alternative means of communicating drawing, writing, gesture, facial expression, pointing Establish clear yes/no Types of questions
Conversational partner scheme People with Aphasia are trained as trainers Recruitment of Volunteers Training of Volunteers People with Aphasia are matched with a conversational partner (6 month period) DVD Anyone interested?
Useful websites http://www.asha.org www.ukconnect.org http://www.aphasia.org http://www.stroke.org.uk/