Stroke and aphasia speech therapy in Cherry Hill, NJ

After a stroke, many people can walk out of hospital and still be unable to tell their family what they need. Speech and language are how we connect to other people. When they change, everything changes.

What happens to communication after a stroke

A stroke damages part of the brain. Which abilities change depends on which part. Four things come up most often, and many people have more than one.

Aphasia

Aphasia is a language disorder. It affects the ability to speak, understand, read and write. You may struggle to find the right word, or speak in incomplete sentences, or lose track of what someone has said to you.

There are different patterns:

• Expressive aphasia (Broca’s): difficulty getting thoughts into words and forming sentences. Speech is halting and effortful.
• Receptive aphasia (Wernicke’s): difficulty understanding language, both spoken and written.
• Global aphasia: severe difficulty with both expression and understanding.

Aphasia is not a loss of intelligence. The thoughts are intact. The route to the words is damaged.

Apraxia of speech

Apraxia is a motor speech disorder. The brain has trouble planning and coordinating the movements needed for speech, even though the muscles themselves are not weak.

Signs include difficulty repeating sounds or words, inconsistent errors (a word said correctly once and incorrectly the next time), visible groping as the lips, tongue and jaw search for the right position, and slower speech. Automatic phrases such as “hello” or “how are you” often stay intact when everything else is difficult.

Dysarthria

Dysarthria is slurred or slow speech caused by genuine weakness in the muscles that control speech. Communication is difficult even when the person knows exactly what they want to say.

Cognitive-communication changes

A stroke can affect attention, memory, problem-solving and the executive functions you need for everyday conversation. Sometimes this is the part that makes going back to work hard, even when speech itself sounds fine.

What therapy actually involves

Therapy is tailored to what the stroke affected and what you want to get back to. In practice it usually includes some combination of:

• word retrieval — getting to the word you want, faster and more reliably
• building sentences and structured conversation practice
• understanding spoken and written language
• reading and writing
• speech clarity and articulation work
• memory and attention exercises inside real conversation, not in isolation
• strategies you and your family can use immediately, while the rest is still being rebuilt
• communication devices and AAC where they help

We deliberately work on things you actually do. Ordering in a restaurant. Making a phone call. Reading to a grandchild. Getting through a family dinner without dropping out of the conversation.

The protocols and tools we are certified in

• CBIS — Certified Brain Injury Specialist, for the cognitive-communication side of recovery.
• Lingraphica certified technology specialist — for adult AAC devices, including assessment, funding and training.
• Aphasia intensive program — our own concentrated program, three hours a day, four days a week, for people who want to make a concentrated push. See intensive programs.
• NMES and Ampcare ESP™ — for the swallowing problems that often accompany a stroke. See dysphagia therapy.

We are also listed in the National Aphasia Association provider directory.

Who this is for

• Adults and teenagers — we do not treat young children
• Anyone recovering from a stroke, whether it was last month or six years ago
• People with aphasia, apraxia of speech, dysarthria or a mix
• People living with primary progressive aphasia and their families
• People discharged from hospital or outpatient therapy who do not feel finished
• Families who want to learn how to support communication at home

What the first appointment looks like

The evaluation usually takes about an hour. Here is the shape of it.

1. We talk

   You tell us what has changed and what you want to get back to. We go through your medical history. Bring your family or your caregiver if you can — they notice things you cannot.

2. We assess

   A mix of standardized tests and real, everyday tasks. For stroke and aphasia we look at expressive and receptive language, speech clarity, reading, writing, and the cognitive-communication skills that hold a conversation together. If swallowing is a concern we assess that too.

3. We tell you what we found, the same day

   We discuss the results with you at the end of the session and build a plan together, using your goals and your real situations. You do not go away and wait for a letter.