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Speech and language therapy after a stroke

A stroke is a life-changing experience. People often experience real challenges in their ability to understand, to speak and to swallow following a stroke.

Roughly one third of stroke patients experience communication difficulties (dysphasia) and 40% of stroke patients experience difficulty when swallowing (dysphagia). Without the right support during stroke recovery, these issues can remain for the long-term.

At Circle Rehabilitation, we’re here to help accelerate your post-stroke recovery. Our multidisciplinary care team will build a rehabilitation programme around your personal needs and aims. 

Circle Rehabilitation, Birmingham is ideally placed in the West Midlands for people in Birmingham, Coventry, Wolverhampton, Dudley, Stoke, Shrewsbury, Worcester and beyond. We also see people who travel from across the UK. You don’t need to be local to benefit from our state-of-the-art recovery centres. We offer residential facilities, so we are poised to help patients from across the UK.

Our rehabilitation programmes are medically-led - your care and rehabilitation is overseen by one of our specialist rehabilitation consultants and physicians.

A stroke causes damage to the brain, and which parts of your brain are affected will determine what symptoms you have after the stroke. Problems with speech, language and the ability to swallow are all common effects of a stroke, caused by damage to the related areas of the brain.

Language

When we talk about issues with language, we mean the both words that we understand (input of language) and the words that we use to communicate (output of language). Both can be affected by a stroke.

‘Input’ is used to describe what is understood by a person. A speech and language therapist will seek to examine how much you understand of the spoken word, and/or your ability to understand what they read.

‘Output’ describes the ability of a person to speak, write and gesture in order to communicate. Depending on the severity of a stroke, any or all of these outputs can be affected to different degrees. We’ll assess them all in order to determine the level at which therapeutic intervention should commence.

Speech

Dysarthria is the term we use to describe dysfunction in speech. The common symptoms are reduced speech or reduced ability to articulate, and a difficulty pronouncing words.

Following a stroke, your tongue, lips and voice may not work correctly. Your speech might be difficult to understand. This will often be very frustrating for the person recovering from a stroke as well as their family members and friends, as they find they are unable to communicate as effectively as they would like.

The severity of the stroke will determine the extent of the loss of speech function, which can range from mild to severe.

Swallowing

Swallowing is a complex process. In strokes where the brain stem is affected, a loss in swallowing function is common. Cerebral strokes can also result in swallowing difficulties. The medical term for swallowing difficulties is dysphagia, and as with all problems following a stroke, it can vary in its severity.

Some people find that following a stroke they have great difficulty swallowing certain foods or liquids. Others may not be able to swallow safely at all and a feeding tube to maintain adequate hydration and nutrition may be needed as a temporary or permanent measure. 

Swallowing assessment may be an informal clinical bedside assessment or an objective assessment, namely FEES (a nasendoscopy to look at swallow function) and/or videofluoroscopy (radiographic examination of swallowing). Therapy aims to return swallow function to the optimum level achievable for each person.

A speech and language therapist will need to assess the extent of any loss of function of speech, language and swallowing. At Circle Rehabilitation this is done by both informal (observation) and formal assessment.

Informal assessment is carried out from the time you arrive at Circle Rehabilitation until the time you are discharged, while formal assessment is carried out at regular intervals using specific formal assessments.

For formal assessment, our speech and language therapists use a battery of assessments such as the Comprehensive Aphasia Test (CAT) and the Mount Wilga high level language test, amongst many others. These tests help to assess the extent of any functional loss and to determine the level of support you will need to optimise function.

A speech and language therapist can be a great help in restoring function in language, speech and swallowing following a stroke. Regaining the ability to communicate effectively can be a huge practical and emotional relief to people, and the work the speech and language therapists carry out at Circle Rehabilitation is absolutely vital in pots-stroke rehabilitation.

The priority for a speech and language therapist is to optimise the ability of a patient to communicate. Regaining as much function as possible for language, speech and swallowing is key. For some patients, this may be a relatively simple process, while for others who have experienced a significant stroke; the process may be much longer and more involved.

The aim is to start work at the level a person is at and then give them the tools, the techniques, the practice and the support they need to progress and improve.

Generally, our speech and language therapist will see patients for a 45-minute session, which is the national guideline. Some patients may require shorter sessions and so we always make sure that each session is an appropriate length for them.

Everything we do – whether with our state-of-the-art equipment and technology or through focused individual time with one of our physiotherapists – is directed to giving you back your independence as fully and as quickly as possible.

If you are struggling to regain your independence or confidence after a stroke, why not seek help from the very best specialists, in the very finest purpose-built rehabilitation centre and with the very best possible care?

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