Last week it was announced by Bruce Willis’s family that he would be retiring from his Hollywood acting career following a diagnosis of aphasia, which is affecting his cognitive abilities.
News item can be viewed here.

Following the announcement, ‘The Bill’ star Chris Ellison’s wife also shared that he has lost the ability to speak since surviving a stroke 18 months ago.
News item can be viewed here.

Our Lead Speech and Language Therapist, Jo Holder explains what aphasia is and how it can be treated.

What is Aphasia?

Aphasia is a condition that affects a person’s ability to use and understand language, which can impact significantly on communication. Aphasia can cause mild through to profound difficulties. Mild difficulties can present as difficulties finding and using the right word and problems with spelling. More profound difficulties can mean the person may not be able to use or understand language and communication in all forms. Aphasia does not affect intelligence. People with aphasia can maintain other cognitive abilities and may be able to compensate for their difficulties by using different means of communication.

350,000 people in the UK have Aphasia (Stroke Association, 2022).

Causes of Aphasia

The condition is most commonly caused by damage to the left-hand side of the brain following a stroke or a brain injury.

Aphasia can also develop gradually from a slow-growing brain tumour or a progressive neurological disorder such as dementia.

Treatment for Aphasia

In some cases, a person may recover their language and communication skills without the need for treatment. However, it is more common for a person with aphasia to undertake a period of speech and language therapy to restore their ability to communicate. Speech and language therapy can also help a person develop new or alternative methods of communication where and if necessary.

Speech and Language Therapy

Speech and language therapy can be hugely beneficial to anyone living with aphasia, it can help a person reach their full potential by improving communication and reducing stress and anxiety associated with having a communication impairment. It’s important not only to work with the individual, but also their families, friends, carers and other people of significance in their lives.

There are a broad range of therapy treatment approaches. Some work at the level of the impairment e.g., single word level and others work at a more functional level e.g., within conversation.

An example of a therapy approach is semantic feature analysis which is aimed at improving word retrieval. The aims of the approach are to improve the connection of words in the brain and to reinforce the process of using the features of a words so the person can self-cue to aid word retrieval. The speech therapist will work with the client to identify the features of a specific word (usually shown as a picture) for example features (shape, colour, size), category, use and association.

An example of a therapy approach which works with both the person with aphasia and their communication partners is Supported conversation for Adults with Aphasia (SCA™). SCA teaches the conversation partner valuable bespoke strategies to help the person with aphasia to get and give information. It is a multi-modal approach which encourages speaking, writing and drawing as a means to communicate. People with aphasia remain competent but may need support from a conversation partner to reveal their competence.

Alternative and augmentative communication (AAC)

Some people with aphasia may need to use AAC to help them communicate. These can be low tech aids, for example using a picture book or photos to aid communication or a high-tech aid e.g., an iPad.

There are a broad range of therapy apps which people with aphasia can use on both iPad and Android devices to use in speech therapy sessions or to supplement their therapy sessions. These apps can be very motivating and helpful in tracking the client’s progress.

The STEPS speech and language therapy team have extensive experience of working with people with aphasia, both newly diagnosed and those who have been living with the condition over a number of years.

Case study

STEPS SLT team have worked with a range of clients with aphasia. One of our clients had a chronic aphasia which limited their expressive abilities. They had good comprehension of the words they heard and were able to understand simple written information. They had significant word finding difficulties which presented as a ‘tip of the tongue’ phenomenon, that is the word was in their head, but they could not access the sounds to then say the word. This caused a great deal of frustration and distress with the client abandoning their attempts to communicate. The client remained motivated to work at single word level to improve their abilities and was also supported to consider alternative means to support communication.

A tablet with an AAC app was introduced and personalised to enable to client to communicate basic information about themselves and to be able to respond to contextual questions. The client was involved in identifying the information they wished to have on the app and encouraged to try using it in different contexts.

STEPS was the starting point of their journey in learning how to use technology to augment communication.

Speech and Language Team at STEPS

The Speech and Language Team at STEPS is made up of 3 speech and language therapists; Jo Holder, Annabelle John, and Susanne Herbst and a speech and language therapy assistant; Jess Reynard.

As a team we meet with each client on their admission to STEPS and develop individual programmes tailored to their condition and their personal goals. Where appropriate the teamwork with the client’s partners, carers and loved ones as well.

STEPS Rehabilitation

STEPS have a unique rehabilitation environment that enables clients to access a wide range of therapies and medical specialists all under one roof.

Our expert team comprises of physiotherapists, neuropsychologists, neurologic music therapists, prosthetic and orthotics specialists, nurses experienced in complex care, occupational therapists and speech and language therapists.

For more information, please contact: 0114 258 7769.

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