Speech therapy is a form of therapy aimed at improving the ability to understand and express language, including speech and non-verbal forms of communication. It is applied by speech and language therapists. In addition to many language and speech disorders, speech therapy provides positive results for patients with paralysis.
For whom is it done?
20-30% of patients with stroke due to stroke have some speech and communication difficulties.
Speech difficulties affect the person negatively in terms of self-confidence, morale, social relations and social independence.
When should speech therapy be started for paralyzed patients?
In stroke patients with aphasia , speech therapy should be initiated as soon as the patient’s clinical condition is favourable, after the life-threatening situation has passed.
In the first periods, short-term but frequent sessions are applied as the patient is more tired and it is difficult to concentrate. The duration of the session can be extended as the patient recovers.
Patients whose aphasia persists for more than two weeks should be placed on a more intensive schedule lasting 2-8 hours per week.
What kind of evaluation is made before speech therapy?
First of all, a general evaluation of the patient’s comprehension and speaking skills is made by the physician or therapist. Detailed evaluation is then made for aphasic patients using structured tests. With this evaluation, disorders that were not noticed in the first place can be detected. In addition, the tests provide a baseline against which changes over the course of therapy can be compared.
The aphasia test includes parts such as being able to understand yes/no questions, improvising speaking, repeating simple syllables or words.
Vision, hearing, memory problems and mouth/teeth structure that may affect the person’s communication are also examined.
How is speech therapy applied?
According to the test results, the language areas that the patient has the most trouble with are determined and therapy is started by focusing on these parts.
For example, if there is a problem in understanding words, exercises such as matching words with pictures, dividing words into groups according to their meanings, and finding synonyms are done.
If the patient cannot find the word he wants to say, exercises such as naming the pictures, finding out whether the words rhyme and repeating the words that the therapist has said are performed. Depending on the severity of the patient’s condition, the therapist may say the first letter or syllable of the word or use other clues.
If the patient has weakness in the mouth muscles, the first step of therapy may be to strengthen the mouth muscles. If there are difficulties in forming syllables and sounds, the therapist describes the position and movement that the tongue, lips and chin should take for each syllable. Sitting in the correct posture is also important.
Breath control is another pillar of speech therapy. Techniques such as breathing exercises and how to pause and breathe while speaking are taught to improve breath control.
In some speech difficulties (eg, dyspraxia), saying words and sentences in accordance with a certain melody or rhythm can improve speech.
Sometimes the person may not be able to make the sounds in the correct order to form words. In this case, the differences between the words are distinguished by listening, and repetition studies are made for the words that get longer and longer.
Some patients can name objects but have difficulty forming sentences. In this case, therapy focuses on sentence structure.
One aspect of speech therapy is finding alternative and empowering ways to communicate. Ways such as gestures, writing, drawing, letter board can be preferred.
Many patients with speech problems also have writing and reading difficulties. Speech therapy also strengthens reading and writing skills.
Speech therapy for paralyzed patients includes much more than the methods briefly mentioned here to give an example.
For better results, the patient needs to practice a lot between therapy sessions with their relatives.
Comprehension, speaking, proper pronunciation of syllables and words, reading and writing skills are improved. Swallowing problems in paralyzed patients also benefit from this therapy.
The more concentrated speech therapy is, the better the results. A treatment lasting 2 hours a week for 6 months provides good results.