In the past, it was thought, and taught, that recovery from aphasia post stroke would likely occur in the first 6 months following a stroke, and expectation for language recovery beyond a year very limited. This prognosis for poor recovery of language once the first year had passed also influenced whether insurance would pay for speech services when it was months or even years following an initial stroke. This left many patients in the position of receiving LOTS of therapy in the first 2-3 months ( when spontaneous recovery is already taking place) , and with little or no speech therapy treatment in the months or years following a stroke. Early or late depression ( unrecognized or unmanaged) might also influence how willing or motivated an individual is to participate in speech therapy treatment.
With advances in neuroimaging techniques, such as MRI, theories are evolving about neuroplasticity ( the brain’s capacity to create new pathways over a lifetime), and in the case of a brain damage from stroke, for undamaged areas to take over for damaged areas. From aphasia research we are learning that the patterns of aphasia recovery varies significantly among patients and many patients experience some spontaneous recovery well after what is traditionally defined as the chronic phase of stroke. For patients with chronic aphasia, neuroimaging has revealed that successful aphasia treatment, along with improving communication ability, does influence both brain function and brain structure, and further research will hopefully guide speech-language pathologists in selection of the best treatment approaches based on the location of stroke and an individual persons learning styles.
Recently, I discovered a great resource for persons with aphasia, motivated to practice on their own and within a community of other persons with aphasia. Aphasia Toolbox, developed by Bill Connors, allows anyone with a computer to continue to improve communication skills from home. Learn more:http://www.aphasiaapps.com/
Up Close and Personal:
Anthony is a patient of mine. He came to me 10 months post stroke with severe, persistent aphasia and apraxia. He had been discharged from treatment elsewhere, being told there was "nothing more that could be offered." Anthony's wife called me in tears, requesting further help, and a speech generating device ( Lingraphica(R) ) designed especially for persons with aphasia seemed approriate. Anthony is seen below just being introduced to the device, but he has recently obtained his own, and is "thrilled" to be able to continue to practice communicating at home, and wherever he goes!