Post-Stroke Rehabilitation

Post-Stroke Rehabilitation

Therapeutic services designed to improve cognitive and oral-motor swallowing function after a stroke. When an individual has a stroke, they may experience difficulty with their ability to use language and use normal oral-motor and swallowing function.  A person who has experienced a stroke may have a diagnosis of Dysphagia (swallowing disorder) and/or Aphasia (language impairment).

Aphasia

Language impairment that diminishes the ability to both speak and understand language, while also reducing ability to read and write. It can affect all or parts of language but does not affect thinking and intelligence. People who have Aphasia may not understand what is being said to them, misplace words and grammar within a sentence, demonstrate difficulty finding a word immediately and/or have trouble following directions.  Depending on the patient’s difficulties, the SLP will evaluate and set goals that will focus on improving the understanding of words, sentences, and understanding what people say, use compensatory strategies like gestures or pointing,  and/or use augmentative and alternative communication (AAC) strategies to help with expression.

Signs of Aphasia:

  • May not understand what is being said to them
  • Misplaces words and grammar within a sentence
  • Inability to find or say a word immediately
  • Having trouble understand either conversations or something that was read
  • May be able to understand simple questions, but unable to follow directions
  • Carry on short conversations but leaves words out in a sentence

How can an SLP help with Aphasia: Depending on the patient’s difficulties, the SLP will:

  • Evaluate and set goals that will focus on important communication needs and abilities for everyday life activities.
  • Improve understanding of words, sentences, and understanding what people say
  • Use compensatory strategies like gestures or pointing
  • Use augmentative and alternative communication (AAC) strategies to help with expression.
  • 84% of people with a speech disorder (dysarthria/apraxia) following a stroke made progress with SLP services in an acute care or rehabilitation hospital (ASHA).

Dysarthria

People who are experiencing muscle weakness or problems with muscle movements making speech hard to understand for others may have dysarthria. Other signs of this disorder are difficulty with pronunciation of sounds, trouble maintaining rate and rhythm of speech causing either slurred, flat, or irregular speech, diminished quality of voice (i.e. weak or hoarse voice), and a nasally sound to their voice.

Signs of Dysarthria:

  • Difficultly with pronunciation of sounds
  • Trouble maintaining rate and rhythm of speech causing either slurred, flat, or irregular speech.
  • Diminished quality of voice (i.e. weak or hoarse voice)
  • A nasally sound to their voice

Apraxia

Those who have apraxia typically cannot “plan” the movement of the muscles in their mouth (i.e. tongue, lips, mouth) to produce speech.  These muscles are not paralyzed, people with apraxia now have difficulty moving their mouth to find and make the right sound.  Some signs of apraxia include mixing up words and sounds, saying things differently each time they say them, and for the most severe cases, cannot produce sounds at all.

Signs of Apraxia:

  • Mix up words and sounds
  • Say things differently each time they say them
  • For the most severe cases, cannot produce sounds at all

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