Age: 54
Time Since Stroke: 8 months
Betty was very unhappy with her discharge from speech therapy. She wanted to return to work, but lacked the high-level skills needed to feel confident in her role. She felt that her patients wouldn't want to work with her if she wasn't 100%. She was the mother to 4 children and had many pets.
Problems:
- She had owned her own business
- She needed to read patient charts, use complex medical terms
- Impulsively answered yes/no questions incorrectly
- Highly intelligent and motivated but discouraged
- Could start a conversation but then experienced severe word-finding issues
- Felt very isolated from her family and friends.
Assessment: She spoke in 2+ word sentences, but word-finding problems made her speak haltingly and more slowly. She retained her knowledge about her work and life, but usually needed help in putting the words together. She was largely fluent with shorter words, but needed help with longer, more complex work-related words and sentences. She could read short paragraphs but could no longer read books or magazines. She lacked confidence in her speech and ability to interact with anyone. She often cried during therapy.
Treatment: The family chose a 4 week program. Treatment focused on functional speech to help her gain confidence to participate in the community
Results: She worked to increase her speech to 7-10 words at a time, which she did over 90% of opportunities independently. Her multi-syllabic word production increased from 75% to over 90% accuracy. Betty became faster at responding to questions and could better maintain the conversational flow. She visited with family that she hadn't seen since her stroke and reported that everyone could understand her much better. She felt that she could interact rather than watch everyone else talk. On an outing to a grocery store, she ran into one of her former patients, who was thrilled to see her.