Time Since Stroke:18 months
- His depression interfered with his motivation and cooperation in therapy.
- Had been largely watching tv for months.
- He wanted to go back to his old life and didn't believe he could make any progress
- Only independent speech was "no".
- Didn't want to try speaking if it wasn't perfect
Assessment: Russell may not seem to be a good candidate for treatment. His depression had not been disclosed prior to his acceptance, but typically depression lessens while at the program. Once a client begins to see that he can make progress in his speech, he tends to have more hope about the future. He stopped taking his medication during the program, but began taking it again by the 4th week. He maintained strong support from loved ones. His cognitive skills were relatively good, but his speech was severely apraxic.
Treatment: 6 week program. After extensive counseling during his treatment, he agreed to participate fully in the program. Daily goals helped him see his progress more frequently and easily. His treatment focused largely on speech production and compensatory strategies to help him feel more success.
Results: Amazingly, he made rapid progress once he chose to fully participate.
- By the middle of the program, Russell said 2-3 word phrases 75% accurately and communicated verbally 50% of the day.
- He ordered his own lunch verbally with some help.
- He also read short sentences aloud with 60% accuracy.
- His testing showed that he his overall aphasia rating went up 47% at the end of the program. Reading scores increased by 15.5% without being directly treated.
- Writing scores increased by 30% without being directly targeted.