Many people who have suffered a brain injury lose a large part of their ability to communicate: control speech movements, remember words, express thoughts, understand what is said to them, etc. The loss of such an essential ability as communication has a strong impact on the affected person and his or her family. On the occasion of World Voice Day, which is celebrated this Sunday, April 16, we gather the contributions of Dr. Montserrat Martinell, specialist in Speech Therapy and Phoniatrics and member of Top Doctors, on such a sensitive pathology as aphasia.
Rehabilitating aphasia
The intervention of the speech therapist is part of a global rehabilitation that includes medical, neuropsychological and social aspects. It begins with an evaluation to establish the diagnosis and determine which language components are affected and which are preserved. Rehabilitation then begins with two parallel objectives: to provide the means to communicate more effectively and to achieve the maximum possible recovery of language skills. At the same time, work is done on the new relationship that should help the patient and his family to encourage themselves, to find new goals and to adapt to their new situation.
Providing means to communicate
In severe aphasia, alternative communication systems based on writing are not valid because it is the written and oral language itself that is affected. The person with severe aphasia can use a picture-plus-word notebook with essential information: significant people, basic needs, calendar, schedule of activities, places frequented and topics of interest. However, a person with severe aphasia will hardly take the initiative to express himself by this means. The use of a notebook requires motivation, learning and collaboration from the environment. Many people with aphasia do not become accustomed to these systems for various reasons: for example, because they have few opportunities to communicate, because of difficulties in their use, because their relatives already understand them by facial expression, intonation and some gestures in daily routines, or because it is a means of expression that is foreign to them. Thus, it is paramount in all cases to provide the person who has suffered from aphasia and their family members with communication strategies: stimulating understanding, helping them to express themselves, creating opportunities to develop communication, taking advantage of their preserved skills, etc.
Restoring language
Language assessment is not only intended to collect errors, but also to identify the underlying altered processes and, consequently, to establish a personalized rehabilitation plan, which should be updated as evolutionary changes occur. It is necessary, on the one hand, to improve basic cognitive abilities, such as attention, and on the other hand, the components of language altered at the phonological and articulatory, grammatical, lexical and semantic levels, in the modalities of oral comprehension, oral expression, reading and writing. These actions are carried out in sessions that can be individual, group or computerized. Recovery requires a lot of effort and is usually partial, although it varies greatly from case to case. The participation of the family can significantly increase the results of rehabilitation. Guidelines are given to the family to provide environmental language stimulation and to collaborate in the daily work necessary to optimize recovery.