Adult Neurogenic Communication Disorders
This program addresses speech-language disorders that results from a stroke or other brain disorders or injury. A change in speech is often the first sign that such an injury has occurred. This change may be so slight as to be barely noticeable, or so severe that the patient is unable to speak.
The inpatient program emphasizes continuity of care, beginning in Tisch Hospital, where the acute medical needs of a patient with stroke or other brain injury are cared for. Once the patient is ready, he or she is transferred to the Inpatient Stroke Rehabilitation Unit or the Inpatient Brain Injury Program at Rusk, where a minimum of three hours of combined therapies-physical therapy, occupational therapy and, where indicated, speech-language pathology-are provided. Upon discharge from Rusk, patients will often continue speech-language therapy through an outpatient program. This series of seamless transitions is one of our program’s strengths.
Many different types of communication problems can result from a stroke or other brain injury. Each patient’s treatment is geared to their particular condition. Following are the most common communication disorders:
- Aphasia is the impaired ability to use or understand language. People with this disorder not only have difficulty speaking, but also have trouble understanding spoken language, reading, and writing. Treatment may involve working on one or more of those areas.
- Dysarthria is an impaired ability to perform the physical movements required for speech. The major difficulty typically involves a lack of strength or control in the muscles of the lips, tongue, or larynx (voice box). Dysarthria treatment targets these muscles in order to strengthen them and improve control of their movements during speech.
- Cognitive-communicative impairment (CCI) arises from problems in the underlying thought processes involved in communication. For example, difficulties in concentrating, remembering or reasoning can affect a person’s ability to communicate effectively. The treatment of CCI involves identifying the impact of these tasks on everyday activities, and finding ways either to circumvent these deficits or to restore or maximize cognitive function.
Education about the communication problems associated with stroke is also a critical part of the program. Speech-language disorders are frequently the most devastating aspect of a stroke. To help deal with this challenge, patients and family members receive individual instruction on how to maximize communication, and are also provided with information about community services and resources for patients with communication disorders.
The outpatient program, now housed in our new Ambulatory Care Center, services persons with neurological problems including (but not limited to):
- Brain tumor
- Traumatic brain injury
- Primary progressive aphasia
- Parkinson’s disease
- Multiple sclerosis
- Muscular dystrophy
- Cerebellar degeneration
- Other neurological diseases or conditions
The outpatient program, now housed in the brand new Ambulatory Care Center, provides diagnostic assessment, individual treatment, group therapy, and computer assisted treatment and counseling as needed. Our comprehensive assessments may include:
- Language abilities: Examination of naming, description, speech fluency, speech repetition, comprehension of spoken and written language, (i.e., reading) and writing skills.
- Speech production: Articulation (i.e. pronunciation), voicing, rate, rhythm and melody of speech; strength, coordination and agility of lip, tongue, and jaw movement
- Functional communication: Assessment of participation in everyday tasks such as using the telephone, conversing in a 1:1 or group setting, understanding and following directions, reading instructions, managing personal business, writing letters, and using a computer.
- Impact of communication impairment: Impact on ones’ identity as a worker, family member, and member of the community.