You may think as the owner of an intensive aphasia program that I would advocate for aphasia therapy for more than five hours a day every day. While our clients participate in scheduled therapy for 25-29 hour a week, many clients want more therapy every day. They are very motivated to improve and many feel that they have to work 16 hours a day to do this. Motivation and discipline are key to improving anything you want to do.
However, one of the first things we talk about in orientation is that you need to pace yourself. The example that I give is to think about a time in which you crammed for a test. You studied hours and hours for a period of time. At some point, your brain was too tired to process any more information. You could study more, but no new information would stick around. You’d need to rest before trying to learn more. If you tried to cram in too much too quickly, you may remember some of the material for the test, but you didn’t it learn it. You may have just memorized it for a short time.
The same concept applies to aphasia therapy. I’ve been told that some clients stay up late practicing by themselves or make every moment here about practicing. After a week or so of that type of schedule, these clients are exhausted. Then all of their efforts during the day are less successful. Since they are already practicing at least 5.5 hours daily at the office, adding another 3 hours every night doesn’t help them get any further ahead. The most important thing you will ever learn about aphasia may be:
There is not a linear relationship between effort and progress in aphasia after a certain point.
I understand that clients or their families may feel a lot of pressure to “recover” during our program. They’re specifically here to do a lot of work! We do everything that we can to help clients by discovering the fastest way to gain a skill, but this process isn’t a sprint. Good aphasia therapy requires pinpointing the exact “broken piece” of a skill, thinking of the best/fastest way to make it better, and repetition of that process.
Pacing the client’s repetition is very important. The best way we’ve found to keep gaining skills is to cycle intensive therapy incrementally with specific home practice. Spreading out the client’s intensive therapy and home practice in a scheduled manner is going to produce better results than trying to do 8 hours of therapy a day for 6 weeks. There’s a reason we only schedule 5.5 hours of therapy a day–rest is very important to make progress. Thinking about something other than aphasia 24/7 is important to their progress. Recovery = hard work over time.
Many clients were workaholics before their stroke, so the idea of pacing is very difficult for them to believe. Definitely keep working, set smaller goals, pace yourselves and believe that your loved one can keep getting better.