Where Should I Go
Speech Therapy for Aphasia?
I must confess that during the last 3 months I have been out of circulation with a herniated disc that caused me to be confined to a wheel chair and unable to walk. I was finally able to get it properly evaluated and learned what my options were in order to get our “real” lives back.
It was then that I had to start finding out why I was unable to walk, whether it could be treated by conservative physical therapy or whether mine was causing a disabling condition that would likely affect the quality of my life, for the rest of my life. I learned all about the surgeries, how they were done, and whether minimally invasive surgery would work, or whether I had to have open back surgery with months of recovery time and significant risks. Asking where do I go for a procedure that the literature said might be one third successful, one third not, or one third worse off than before was daunting.
I knew it was time to do homework to find the best option and spinal specialist in the country and go there. After a month of full time 8-10 hour a day research, calling on surgeons in New York City, Los Angeles, Chicago, Tampa, Florida and elsewhere, I found a doctor in Sugarland, Texas, who came very highly recommended by people who had back injuries that required surgical intervention. They said the spinal surgeon and procedures had worked for them and described their surgeon as a “true expert who was reportedly one of the best at his specialty.” And not only that, but he was described as a “nice, personable guy, with great bedside manners, a very supportive staff and exceptional skill.” He had been providing surgical procedures to people with spinal injuries for over 12 years.
For the life of me I just don’t understand why people are so fast to get treated, whether it’s speech pathology or spine surgery by the first Tom, Dick or Trudy. By the time I researched what my problem was, explored all the options, checked out myriads of doctors, read patient reviews, and called on people who had the procedure done it was time to make the call to the doctor of choice. End of story? I DID FIND THE BEST ONE, went to his office, was impressed by his candor and sincerity and scheduled surgery two days later. (He even initiated a prayer for my wife and I once we were in the operating suite.) The procedure was a success and we will return the wheelchair tomorrow. Today I racked 1.2 miles walking on my pedometer. (6 days after the surgical procedure.) I was totally unable to walk since mid July, 2014.
So what’s the message? Here it is plain and simple:
There are many wonderful groups that aid people with aphasia and they are truly a blessing. Many people with aphasia today require very specialized care, especially by a therapist who has not only been trained in the many approaches to aphasia, but also has years of expertise. Now what is expertise? It is what every practitioner goes through during the first 5 or so years where they make plenty of mistakes, find out what works and does not, and figures out the best way to approach those with speaking difficulties as people or individuals. Our courtesy, bedside manner and personality as a therapist can have a profound influence on the response of each patient. Please find the best therapist you can who not only has good training, but expertise. An experienced speech language pathologist can devise a plan of care based on those symptoms and can implement therapy that will be specifically targeted to the presenting speaking difficulties whether they be speed, rhythm, voice, articulation, fluency, language formulation, language comprehension, swallowing and clarity of speaking. Please don’t leave your loved ones care to someone who is not a true expert or to a “device.”
People with aphasia have a problem of communication which is essential for living and surviving; like walking is essential for many who want an adventuresome life. Speech therapy for those with aphasia should not be left up to non-experts who have not had specific training and years of experience providing diagnosis and treatment for aphasia. Most speech pathologists, myself included, needed years of practice working with the extreme variability of symptoms which present with aphasia, head injury, etc. before true skill and competence were obtained.
The ability to talk is what most people with aphasia or head injury want; many can significantly improve the ability to communicate, and there will be others who don’t. Most people I have seen through the years improved talking and communicating. For many severe cases the need for intensive speech and language stimulation often took a year and more for functional improvement. The days of carte blanche “as long as it is needed therapy” is unfortunately over. That is why it is critical to find the best speech language pathologist early in the game, before it is time to be discharged due to insurance limitations.
The point I wish to make here is to look at the speech language pathologist and the ability to speak and talk very much like looking for a surgeon who can help repair the heart, lungs, or spine, or a cancer specialist who can develop a plan to get you well. There are gifted and experienced surgeons, physicians, and therapists who excel at what they do! They can truly do a lot more for you in less time and personal expense than going somewhere that is “adequate, or second best.”
Your job, if possible is to find out who and where the true experts really are and not to settle for anything less. If you find a truly gifted expert the chances of speaking and communication improvement should be significantly better.
Mark A. Ittleman has spent 43 years of his career providing one on one and small group therapy with adults and children with speaking difficulties. He authored the Teaching of Talking, Learn to do Expert Speech and Language Stimulation at Home with Children and Adults. He is available by email, and provides mentoring, and learning lectures to students, SLP’s, family members, loved ones and parents.
Mark A. Ittleman, M.S., CCC/SLP
Teaching of Talking book: Amazon
Teaching of Talking: (Kindle Edition) Amazon