Time since stroke: 1.5 years
ProblemsProblem: Tim, a retired government employee, had been a romantic and friendly person his whole life. His wife described him as a 'slow-thinker' who liked to listen first and then respond. She was devastated by his severe aphasia and mobility issues as “he took care of everything for me” and sorely missed ‘the old Tim’. She was also very frustrated and angry about his stereotypies and inability to communicate.
With global aphasia, Tim’s speech was stereotypic “I don’t know” or “it’s better than that”. Occasionally he perseverated on the word “Cadillac”. When he didn’t understand something, he just stared off into the distance and didn’t react. He wasn’t aware of his utterances at the beginning of treatment. As treatment progressed, he became more aware of his errors and more frustrated when he got stuck. Comprehension in context improved significantly.
Using WAB-R testing protocols
- Severe word-finding issues
- Some repetition of words and short phrases
- Very slow processing during conversation
- Poor single word reading
- Poor writing — copied some uppercase letters with effort
He completed a 6-week program
and My Aphasia Coach software homework daily.
Auditory Word Recognition
Written Word Recognition
- Spontaneous speech improved, such as "I'm going to the bathroom" independently
- Requested clarification when he didn't understand
- Used written words to select items for meals and activities
- Wrote his name independently
- His wife learned strategies and expectations to better communicate with him
- Counseling with his wife to help her with her frustrations, introducing her to other caregivers for support