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Why speech therapists are important to stroke victims

Sticking your nose up, holding your body erect and repeating with precision, “The rain in Spain falls mainly on the plain” is how many of us picture a speech therapist would work with us.

But the field of speech and language pathology is much broader than the elocution work ‘Pygmalion's' Professor Henry Higgins did with Eliza Doolittle in getting her to speak the Queen's English. Speech and language pathologists at King Edward VII Memorial Hospital (KEMH) for example, are an integral part of rehabilitation for stroke victims.

Elwood Fox, chief of rehabilitation at KEMH, said stroke victims commonly experience problems understanding, communicating and/or swallowing. Speech and language pathologists can assess the extent to which stroke victims are affected in each of these areas, and can help them regain or improve their functionality.

Commonly stroke patients lose some muscle control in both chewing and swallowing. This loss of control can result in food not being properly manipulated and moved around the mouth. The tongue may push food down the trachea, which leads to the lungs, instead of down the esophagus, which leads to the stomach. In this way food can get stuck and interfere with breathing. In healthy people the coughing reflex automatically expels bits or food or debris that might accidentally get into the trachea. In stroke victims this reflex is typically too weak to do the work. The end result is that the stroke patient is at increased risk of having his or her air supply completely blocked.

The impairment in chewing and swallowing can also cause something called aspiration pneumonia. Dr Fox said this potentially life-threatening pneumonia develops when material from the mouth, complete with mouth bacteria, ends up in the lungs. It is the bacteria that cause infection in the lung that can lead to pneumonia.

Stroke patients often have their ability to communicate and understand impaired in a condition called aphasia. Most commonly, this manifests as either: 1) the patient's physical inability to speak despite knowing what they want to say, or 2) the patient loses understanding of what is said.

“In aphasia, patients become virtually trapped in their bodies,” said Melissa Moniz, a local speech pathologist in private practice. “This is often devastating for patients who were fully functional before having a stroke.

“It can be as simple as them wanting to have their hair combed and not being able to say it, or telling you that they don't want to eat chicken, that they want a hamburger. It's frustrating for them not be understood.”

Dr Fox said things like attention and memory in a stroke victim, can indicate to a speech pathologist that the patient has lost some cognition.

‘Someone who was fully independent before, might have trouble remembering things,” he said. “Balancing their cherub book might suddenly become something they cannot do.

“Speech therapists can help them to regain that understanding.”

Thursday is Speech and Hearing Day. A display outlining the many services offered by speech therapists locally will be on display in the KEMH lobby all week.

Dr Elwood Fox, KEMH Chief of Rehabilitation

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Published March 01, 2011 at 1:00 am (Updated March 01, 2011 at 7:57 am)

Why speech therapists are important to stroke victims

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