We have talked about speech and language disorders that affect primarily children; but adults can have communication problems, as well, and it can be frustrating for the patient and for the family. There are a few things that can cause communication problems in adults, including stroke, head injury, head-neck cancers, dementias, and various progress neurological diseases such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease). These are generally patients who once had an intact speech and language system, and now are faced with an inability to speak or communicate effectively.
Damage to the brain can be from a blockage of the blood to regions of the brain or bleeding in the brain. Depending upon where these issues happened in the brain, the results can be very different. Broadly speaking, damage in the left hemisphere often causes a loss or partial loss of communication – either loss of speech, loss of specific words, and/or loss of the language. The loss or impairment of communication is called aphasia. Aphasia can range from fairly fluent speech with a few errors, to fluent speech that is meaningless, to little or no attempt to speak at all. The patient may or may not be aware of his deficits.
Often speech improves as the blood recedes, swelling is reduced, and/or blood supply is returned to the area; but spontaneous recovery is seldom complete. A speech pathologist may be called in at the hospital, rehabilitation center, and referred to one when he leaves facilities. There are many evidence-based, therapy techniques for treating aphasia, each designed to address the specific deficits exhibited by the patient. Progress can be slow, requiring repetition and work, and may not restore speech to “normal”. If speech does not return to a functional level, and depending upon the damage done to the language system, a voice-output augmentative communication device may be recommended. These are computerized devices and apps that produce speech when the words, letters or icons are activated. More about these devices in the next article.
ALS and other progressive diseases can cause gradual loss of speech, the ability to swallow, and other motor problems. It is important to get with a speech pathologist early in the diagnosis to evaluate and recommend an appropriate voice-output augmentative communication device with multiple access options. The device can provide communication with doctors and family, ensuring proper treatment as the disease progresses and continued connection with family and friends.
Verbal communication is a distinctly human activity. We inform each other, confide in each other, encourage each other and maintain closeness with each other through communication. Loss of the ability to communicate is devastating. This is just a reminder to get important information, papers, passwords, accounts, etc. together in one place. Make sure someone knows where things are and ideally that someone can legally act on your behalf in case of disability. Watch your blood pressure, quit smoking, and know the name of a good speech-language pathologist!